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Leases and Management Agreements with Five Star (Details) - Five Star $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018 USD ($) living_unit community	Sep. 30, 2017 USD ($) community	Sep. 30, 2018 USD ($) living_unit community lease_agreement	Sep. 30, 2017 USD ($) community	Nov. 30, 2018 living_unit	Dec. 31, 2017 USD ($)
Number of communities leased by the Company | community	184	185	184	185
Number of leases with related party | lease_agreement			5
Total rental income recognized	$ 51,757	$ 51,333	$ 155,207	$ 153,441
Related party transaction, annual rents due	1,386	1,353	4,050	4,190
Rents receivable	$ 17,256		17,256			$ 18,539
Real estate improvements purchased			14,749	30,698
Increase or decrease in annual lease rent payable			$ 1,177	2,464
Number of communities owned and managed by related party | living_unit	98		98
Property management agreement expense	$ 3,666	3,414	$ 10,694	$ 10,531
Rents from significant lessee | Revenues
Percentage of rental income	18.60%		18.70%
Rents from significant lessee | Investment
Percentage of rental income			27.00%
Senior Living Communities
Number of communities managed by related party | community			75	68
Rehabilitation Services
Expenses from transactions with related party	$ 1,584	$ 1,841	$ 4,944	$ 5,709
Subsequent Event
Number of communities owned and managed by related party | living_unit					238

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