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Business and Property Management Agreements with RMR LLC (Details)
 12 Months Ended
Jun. 05, 2015
Dec. 31, 2018
USD ($)
day
employee
Dec. 31, 2018
USD ($)
day
employee
Dec. 31, 2018
USD ($)
day
employee
Dec. 31, 2018
USD ($)
day
lease_agreement
employee
Dec. 31, 2018
USD ($)
day
management_agreement
employee
Dec. 31, 2017
USD ($)
Dec. 31, 2016
USD ($)
Related Party Transaction [Line Items]                
Number of employees | employee   0 0 0 0 0    
Professional fees     $ 242,000       $ 275,000 $ 235,000
RMR LLC                
Related Party Transaction [Line Items]                
Management agreement incentive fee payable   $ 40,642,000 $ 40,642,000 $ 40,642,000 $ 40,642,000 $ 40,642,000 55,740,000 0
Percentage of property management fees payable       3.00%        
Construction supervision fees payable under property management agreement as a percentage of construction costs   5.00% 5.00% 5.00% 5.00% 5.00%    
Business management fees incurred     $ 35,874,000       38,638,000 36,763,000
Recognized amortization of the liability     2,974,000       2,974,000 2,974,000
Property management and construction supervision fees     12,214,000       10,919,000 10,585,000
Amortization of liability related to property management and construction supervision fees     798,000       798,000 798,000
Property management and construction supervision fees paid     11,891,000       9,993,000 9,061,000
Payroll and related costs reimbursed          
Period over which transition services will be provided by the related party after termination of the agreement   120 days            
Senior Living Communities | Five Star                
Related Party Transaction [Line Items]                
Number of consecutive renewal terms of agreement         2 2    
Amended Agreement                
Related Party Transaction [Line Items]                
Base management fee payable as a percentage of aggregate book value of real estate assets or transferred assets   0.50% 0.50% 0.50% 0.50% 0.50%    
Amended Agreement | RMR LLC                
Related Party Transaction [Line Items]                
Base management fee payable as a percentage of average historical cost of real estate investments, excluding transferred assets for investments exceeding specified amount   0.50% 0.50% 0.50% 0.50% 0.50%    
Base management fee payable as a percentage of average historical cost of real estate investments, excluding transferred assets for investments up to specified amount   0.70% 0.70% 0.70% 0.70% 0.70%    
Threshold amount of other real estate investments for payment of base management fee   $ 250,000,000 $ 250,000,000 $ 250,000,000 $ 250,000,000 $ 250,000,000    
Base management fee payable as a percentage of average market capitalization exceeding specified amount   0.50% 0.50% 0.50% 0.50% 0.50%    
Threshold amount of average market capitalization for payment of base management fee   $ 250,000,000 $ 250,000,000 $ 250,000,000 $ 250,000,000 $ 250,000,000    
Base management fee payable as a percentage of average closing price per share of common shares on NYSE   0.70% 0.70% 0.70% 0.70% 0.70%    
Incentive management fee payable (as a percent)   12.00% 12.00% 12.00% 12.00% 12.00%    
Period of measurement   3 years            
Top consecutive trading days | day   10 10 10 10 10    
Consecutive trading days | day   30 30 30 30 30    
Management agreement incentive fee payable   $ 0 $ 0 $ 0 $ 0 $ 0    
Incentive management fee cap on common shares   1.50% 1.50% 1.50% 1.50% 1.50%    
Amended Agreement | RMR LLC | Up C Transaction                
Related Party Transaction [Line Items]                
Number of business days notice for termination of property management agreement for convenience by the related party 60 days              
Window for providing notice of termination of property management agreement for performance by the related party 60 days              
Window for providing notice of termination of property management agreement for change of control by the related party 12 months              
Number of terminated management agreements for convenience before termination fee is incurred | lease_agreement         1      
Number of RMR LLC terminated management agreements for good cause before termination fee is incurred | lease_agreement         1      
Number of terminated management agreements for a performance reason before termination fee is incurred | lease_agreement         1      
Termination fee remaining term assumption   10 years            
Maximum | RMR LLC                
Related Party Transaction [Line Items]                
Threshold amount of real estate investments for payment of base management fee   $ 250,000,000 $ 250,000,000 $ 250,000,000 $ 250,000,000 $ 250,000,000    
Base management fee payable, average market capitalization   $ 250,000,000 $ 250,000,000 $ 250,000,000 $ 250,000,000 $ 250,000,000    
Maximum | Amended Agreement | RMR LLC | Up C Transaction                
Related Party Transaction [Line Items]                
Termination fee term   20 years            
Minimum | Amended Agreement | RMR LLC | Up C Transaction                
Related Party Transaction [Line Items]                
Termination fee term   19 years            
SNL US REIT Healthcare Index | Maximum | Amended Agreement | RMR LLC                
Related Party Transaction [Line Items]                
Incentive management fee reduction, basis spread       500.00%        
SNL US REIT Healthcare Index | Minimum | Amended Agreement | RMR LLC                
Related Party Transaction [Line Items]                
Incentive management fee reduction, basis spread       200.00%