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Leases and Management Agreements with Five Star - Narrative (Details)
$ in Thousands
1 Months Ended 12 Months Ended
Jun. 29, 2016
community
pooling_agreement
agreement
Jun. 30, 2018
living_unit
Nov. 30, 2017
community
property
pooling_agreement
renewal_option
Dec. 31, 2016
USD ($)
community
living_unit
Dec. 31, 2016
USD ($)
community
living_unit
Jun. 30, 2016
pooling_agreement
lease_agreement
Dec. 31, 2018
USD ($)
community
living_unit
Dec. 31, 2018
USD ($)
community
living_unit
Dec. 31, 2018
USD ($)
community
living_unit
Dec. 31, 2018
USD ($)
community
living_unit
lease_agreement
Dec. 31, 2018
USD ($)
community
living_unit
management_agreement
Dec. 31, 2017
USD ($)
community
Dec. 31, 2016
USD ($)
community
living_unit
Nov. 30, 2018
living_unit
Nov. 09, 2017
Jun. 30, 2017
community
Dec. 31, 2015
Five Star                                  
Concentration Risk [Line Items]                                  
Number of real estate properties leased       185 185   184 184 184 184 184 185 185        
Total rental income recognized | $               $ 212,622       $ 210,539 $ 203,581        
Rents receivable | $       $ 18,320 $ 18,320   $ 18,697 $ 18,697 $ 18,697 $ 18,697 $ 18,697 18,539 18,320        
Number of units | living_unit                           238      
Number of units that may be re-assigned to an existing or to a new long term lease             1 1 1 1 1            
Real estate improvements by lessee purchased | $               $ 17,956       39,800 21,438        
Increase in annual lease rent payable | $               1,433       3,193 1,719        
Number of communities included in expansion and development project                               2  
Percentage in addition to rate applicable on outstanding borrowings                               2.00%  
Expenses from property management agreement transactions with related party | $               14,426       $ 14,080 $ 11,918        
Five Star | Senior Living Communities                                  
Concentration Risk [Line Items]                                  
Number of consecutive renewal terms of agreement                   2 2            
Property management agreement renewal period     3 years       15 years                    
Number of communities managed                 76     70 68        
Number of pre-existing management agreements terminated | pooling_agreement 3         3                      
Number of pre-existing management agreements 4         4                      
Number of management agreements 10                                
Property management agreement, number of communities subject to reset of annual minimum return | agreement 10                                
Number of agreements with related party to provide management services to entity | lease_agreement                   2              
Expenses from property management agreement transactions with related party | $               $ 6,442       $ 7,525 $ 7,707        
A L Pooling Agreements | Five Star                                  
Concentration Risk [Line Items]                                  
Number of consecutive renewal terms of agreement | renewal_option     2                            
Property management agreement renewal period     15 years                            
Number of units | living_unit   98                              
Percentage of borrowings per annum   2.00%                              
Percentage in addition to rate applicable on outstanding borrowings     2.00%                         2.00%  
Management fees as a percentage of gross revenues     5.00%                            
Incentive fee as a percentage of annual net operating income after realization of specified percentage of annual return     20.00%                            
Property management agreement, annual return as a percentage of invested capital 7.00% 7.00% 7.00%                            
Property management agreement, payment of capital expenditure as percentage of the funded amount     3.00%                       3.00%   7.00%
Number of communities owned and managed by related party acquired during the period | property     1                            
Minimum | Five Star | Senior Living Communities                                  
Concentration Risk [Line Items]                                  
Property management agreement renewal period             10 years                    
Minimum | A L Pooling Agreements | Five Star                                  
Concentration Risk [Line Items]                                  
Management fees as a percentage of gross revenues 3.00%           3.00% 3.00% 3.00% 3.00% 3.00%            
Incentive fee as a percentage of annual net operating income after realization of specified percentage of annual return 20.00%           20.00% 20.00% 20.00% 20.00% 20.00%            
Property management agreement, annual return as a percentage of invested capital             7.00% 7.00% 7.00% 7.00% 7.00%            
Maximum | Five Star | Senior Living Communities                                  
Concentration Risk [Line Items]                                  
Property management agreement renewal period             15 years                    
Maximum | A L Pooling Agreements | Five Star                                  
Concentration Risk [Line Items]                                  
Management fees as a percentage of gross revenues 5.00%           5.00% 5.00% 5.00% 5.00% 5.00%            
Incentive fee as a percentage of annual net operating income after realization of specified percentage of annual return 35.00%           35.00% 35.00% 35.00% 35.00% 35.00%            
Property management agreement, annual return as a percentage of invested capital             8.00% 8.00% 8.00% 8.00% 8.00%            
California                                  
Concentration Risk [Line Items]                                  
Number of communities not included in pooling agreement                 1                
Georgia | Senior Living Communities                                  
Concentration Risk [Line Items]                                  
Number of communities         5                        
Georgia | Five Star | Senior Living Communities                                  
Concentration Risk [Line Items]                                  
Number of communities associated with leases in default       395 5                        
New York                                  
Concentration Risk [Line Items]                                  
Management fees as a percentage of gross revenues             5.00% 5.00% 5.00% 5.00% 5.00%            
Number of communities owned and managed by related party | living_unit             310 310 310 310 310            
Incentive fee payable | $             $ 0 $ 0 $ 0 $ 0 $ 0            
Five Star                                  
Concentration Risk [Line Items]                                  
Number of communities leased by the company       185 185             185 185        
Number of leases with related party | lease_agreement                   5              
Annual rent as a percentage of gross revenues, percent             4.00% 4.00% 4.00% 4.00% 4.00%            
Annual rent as a percentage of gross revenues, amount | $               $ 5,525       $ 5,533 $ 5,686        
Related party transaction, annual rents due | $               $ 207,664                  
Five Star | Lease No. 1                                  
Concentration Risk [Line Items]                                  
Number of communities                 82                
Five Star | Lease No. 2                                  
Concentration Risk [Line Items]                                  
Number of communities                 47                
Five Star | Lease No. 3                                  
Concentration Risk [Line Items]                                  
Number of communities                 17                
Five Star | Lease No. 4                                  
Concentration Risk [Line Items]                                  
Number of communities                 29                
Five Star | Lease No. 5                                  
Concentration Risk [Line Items]                                  
Number of communities                 9                
Acquisitions | Senior Living Communities                                  
Concentration Risk [Line Items]                                  
Number of units | living_unit       709 709   366 366 366 366 366   709        
Acquisitions | Five Star | Senior Living Communities                                  
Concentration Risk [Line Items]                                  
Number of communities managed     5                            
Number of management agreements | pooling_agreement     2                            
Number of communities owned and managed by related party acquired during the period | property     6                            
Acquisitions | Alabama and Indiana | Five Star | Senior Living Communities                                  
Concentration Risk [Line Items]                                  
Number of communities owned and managed by related party acquired during the period | property     2                            
Acquisitions | Tennessee | Five Star | Senior Living Communities                                  
Concentration Risk [Line Items]                                  
Number of communities owned and managed by related party acquired during the period | property     1                            
Acquisitions | Arizona | Five Star | Senior Living Communities                                  
Concentration Risk [Line Items]                                  
Number of communities owned and managed by related party acquired during the period | property     1                            
Five Star                                  
Concentration Risk [Line Items]                                  
Minimum percentage of ownership of lessee's voting stock above which the entity has the option to cancel all its rights             9.80% 9.80% 9.80% 9.80% 9.80%