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Segment Reporting (Details)
$ in Thousands
 3 Months Ended 12 Months Ended
Dec. 31, 2015
USD ($)
Sep. 30, 2015
USD ($)
Jun. 30, 2015
USD ($)
Mar. 31, 2015
USD ($)
Dec. 31, 2014
USD ($)
Sep. 30, 2014
USD ($)
Jun. 30, 2014
USD ($)
Mar. 31, 2014
USD ($)
Dec. 31, 2015
USD ($)
segment
Dec. 31, 2015
USD ($)
item
Dec. 31, 2015
USD ($)
Dec. 31, 2014
USD ($)
Dec. 31, 2013
USD ($)
Segment reporting                          
Number of operating segments | segment                 4        
Number of reportable segments                 3 3      
Revenues:                          
Rental income                     $ 630,899 $ 526,703 $ 459,380
Residents fees and services                     367,874 318,184 302,058
Total revenues $ 267,519 $ 255,275 $ 247,402 $ 228,577 $ 229,809 $ 216,873 $ 206,708 $ 191,497     998,773 844,887 761,438
Expenses:                          
Property operating expenses                     377,579 324,564 299,878
Depreciation                     257,783 185,391 153,026
General and administrative                     42,830 38,946 32,657
Acquisition related costs                     6,853 4,607 3,378
Impairment of assets                     194 (10) 7,989
Total expenses                     685,239 553,498 496,928
Operating income                     313,534 291,389 264,510
Dividend income                     2,773 63 250
Interest and other income                     379 362 461
Interest expense                     (150,881) (135,114) (117,819)
Non Cash Loss On Special Distribution Of Equity                     (38,437)    
Loss on early extinguishment of debt       1,409             (1,894) (12) (797)
Income (loss) before income tax expense and equity in earnings of an investee                     125,474 156,688 146,605
Income tax expense                     (574) (576) (600)
Equity in (losses) earnings of an investee                     20 87 334
Income from continuing operations                     124,920 156,199 146,339
Discontinued Operations:                          
(Loss) income from discontinued operations                     (350) 1,362 5,043
Impairment of assets from discontinued operations                     (602) (4,377) (37,610)
Income before gain on sale of properties                     123,968 153,184 113,772
Gain on sale of properties                       5,453 37,392
Net income 9,544 $ 38,249 $ 36,387 $ 39,789 45,288 $ 37,112 $ 37,659 $ 38,580     123,968 158,637 151,164
Total assets 7,183,978       5,968,269       $ 7,183,978 $ 7,183,978 7,183,978 5,968,269 4,764,666
Triple Net Leased Senior Living Communities                          
Revenues:                          
Rental income                     256,035 230,718 237,209
Total revenues                     256,035 230,718 237,209
Expenses:                          
Depreciation                     70,417 61,825 66,854
Impairment of assets                     194 (10) 6,685
Total expenses                     70,611 61,815 73,539
Operating income                     185,424 168,903 163,670
Interest expense                     (25,015) (25,473) (26,501)
Loss on early extinguishment of debt                     (6) 128  
Income (loss) before income tax expense and equity in earnings of an investee                     160,403 143,558 137,169
Income from continuing operations                     160,403 143,558 137,169
Discontinued Operations:                          
Income before gain on sale of properties                     160,403 143,558 137,169
Gain on sale of properties                       5,453 37,392
Net income                     160,403 149,011 174,561
Total assets 2,251,302       1,777,684       2,251,302 2,251,302 2,251,302 1,777,684 1,778,591
Managed Senior Living Communities                          
Revenues:                          
Residents fees and services                     367,874 318,184 302,058
Total revenues                     367,874 318,184 302,058
Expenses:                          
Property operating expenses                     278,242 245,093 233,711
Depreciation                     60,600 32,462 28,972
Total expenses                     338,842 277,555 262,683
Operating income                     29,032 40,629 39,375
Interest expense                     (9,973) (10,599) (12,217)
Loss on early extinguishment of debt                     (34) (140)  
Income (loss) before income tax expense and equity in earnings of an investee                     19,025 29,890 27,158
Income from continuing operations                     19,025 29,890 27,158
Discontinued Operations:                          
Income before gain on sale of properties                     19,025 29,890 27,158
Net income                     19,025 29,890 27,158
Total assets 1,260,653       961,618       1,260,653 1,260,653 1,260,653 961,618 979,152
MOBs                          
Revenues:                          
Rental income                     356,586 278,041 204,594
Total revenues                     356,586 278,041 204,594
Expenses:                          
Property operating expenses                     99,337 79,471 66,167
Depreciation                     122,974 87,312 53,408
Total expenses                     222,311 166,783 119,575
Operating income                     134,275 111,258 85,019
Interest expense                     (6,214) (5,844) (5,466)
Loss on early extinguishment of debt                     (250)    
Income (loss) before income tax expense and equity in earnings of an investee                     127,811 105,414 79,553
Income from continuing operations                     127,811 105,414 79,553
Discontinued Operations:                          
(Loss) income from discontinued operations                     (350) 1,362 5,043
Impairment of assets from discontinued operations                     (602) (4,377) (37,610)
Income before gain on sale of properties                     126,859 102,399 46,986
Net income                     126,859 102,399 46,986
Total assets 3,362,636       2,922,623       3,362,636 3,362,636 3,362,636 2,922,623 1,727,497
All Other Operations                          
Revenues:                          
Rental income                     18,278 17,944 17,577
Total revenues                     18,278 17,944 17,577
Expenses:                          
Depreciation                     3,792 3,792 3,792
General and administrative                     42,830 38,946 32,657
Acquisition related costs                     6,853 4,607 3,378
Impairment of assets                         1,304
Total expenses                     53,475 47,345 41,131
Operating income                     (35,197) (29,401) (23,554)
Dividend income                     2,773 63 250
Interest and other income                     379 362 461
Interest expense                     (109,679) (93,198) (73,635)
Non Cash Loss On Special Distribution Of Equity                     (38,437)    
Loss on early extinguishment of debt                     (1,604)   (797)
Income (loss) before income tax expense and equity in earnings of an investee                     (181,765) (122,174) (97,275)
Income tax expense                     (574) (576) (600)
Equity in (losses) earnings of an investee                     20 87 334
Income from continuing operations                     (182,319) (122,663) (97,541)
Discontinued Operations:                          
Income before gain on sale of properties                     (182,319) (122,663) (97,541)
Net income                     (182,319) (122,663) (97,541)
Total assets $ 309,387       $ 306,344       $ 309,387 $ 309,387 $ 309,387 $ 306,344 $ 279,426