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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, 2018
Sep. 30, 2018
Jun. 30, 2018
Mar. 31, 2018
Dec. 31, 2017
Sep. 30, 2017
Jun. 30, 2017
Mar. 31, 2017
Dec. 31, 2018
Dec. 31, 2017
Dec. 31, 2016
Concentration Risk [Line Items]                      
Carrying Value of Investment $ 7,876,300       $ 7,824,763       $ 7,876,300 $ 7,824,763  
Total revenues 285,222 $ 278,969 $ 277,202 $ 275,770 278,543 $ 266,673 $ 264,992 $ 264,521 1,117,164 1,074,729 $ 1,058,022
Real Estate Investment Property At Cost | Rents from significant lessee                      
Concentration Risk [Line Items]                      
Carrying Value of Investment 8,428,644       8,474,950       $ 8,428,644 $ 8,474,950  
Concentration of credit risk (as a percent)                 100.00% 100.00%  
Sales Revenue, Services, Net | Rents from significant lessee                      
Concentration Risk [Line Items]                      
Concentration of credit risk (as a percent)                 100.00% 100.00%  
Total revenues                 $ 1,117,164 $ 1,074,819  
Five Star | Real Estate Investment Property At Cost | Rents from significant lessee                      
Concentration Risk [Line Items]                      
Carrying Value of Investment 2,253,853       2,330,630       $ 2,253,853 $ 2,330,630  
Concentration of credit risk (as a percent)                 26.70% 27.50%  
Five Star | Sales Revenue, Services, Net | Rents from significant lessee                      
Concentration Risk [Line Items]                      
Concentration of credit risk (as a percent)                 19.00% 19.60%  
Total revenues                 $ 212,622 $ 210,539  
All others | Real Estate Investment Property At Cost | Rents from significant lessee                      
Concentration Risk [Line Items]                      
Carrying Value of Investment $ 6,174,791       $ 6,144,320       $ 6,174,791 $ 6,144,320  
Concentration of credit risk (as a percent)                 73.30% 72.50%  
All others | Sales Revenue, Services, Net | Rents from significant lessee                      
Concentration Risk [Line Items]                      
Concentration of credit risk (as a percent)                 81.00% 80.40%  
Total revenues                 $ 904,542 $ 864,280