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Leases and Management Agreements with Five Star - Schedule of Assets Leased and Revenues Earned (Details) - USD ($)
$ in Thousands
3 Months Ended 12 Months Ended
Dec. 31, 2017
Sep. 30, 2017
Jun. 30, 2017
Mar. 31, 2017
Dec. 31, 2016
Sep. 30, 2016
Jun. 30, 2016
Mar. 31, 2016
Dec. 31, 2017
Dec. 31, 2016
Dec. 31, 2015
Concentration Risk [Line Items]                      
Carrying Value of Investment $ 7,824,763       $ 7,617,547       $ 7,824,763 $ 7,617,547  
Revenues 278,566 $ 266,679 $ 265,013 $ 264,561 274,296 $ 263,983 $ 261,367 $ 258,375 1,074,819 1,058,022 $ 998,773
Real Estate Investment Property At Cost | Rents from significant lessee                      
Concentration Risk [Line Items]                      
Carrying Value of Investment 8,474,950       8,251,964       $ 8,474,950 $ 8,251,964  
Concentration of credit risk (as a percent)                 100.00% 100.00%  
Sales Revenue, Services, Net | Rents from significant lessee                      
Concentration Risk [Line Items]                      
Revenues                 $ 1,074,819 $ 1,058,022  
Concentration of credit risk (as a percent)                 100.00% 100.00%  
Five Star | Real Estate Investment Property At Cost | Rents from significant lessee                      
Concentration Risk [Line Items]                      
Carrying Value of Investment 2,330,630       2,290,029       $ 2,330,630 $ 2,290,029  
Concentration of credit risk (as a percent)                 27.50% 27.80%  
Five Star | Sales Revenue, Services, Net | Rents from significant lessee                      
Concentration Risk [Line Items]                      
Revenues                 $ 210,539 $ 203,581  
Concentration of credit risk (as a percent)                 19.60% 19.20%  
All others | Real Estate Investment Property At Cost | Rents from significant lessee                      
Concentration Risk [Line Items]                      
Carrying Value of Investment $ 6,144,320       $ 5,961,935       $ 6,144,320 $ 5,961,935  
Concentration of credit risk (as a percent)                 72.50% 72.20%  
All others | Sales Revenue, Services, Net | Rents from significant lessee                      
Concentration Risk [Line Items]                      
Revenues                 $ 864,280 $ 854,441  
Concentration of credit risk (as a percent)                 80.40% 80.80%