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Indebtedness - Narrative (Details)
1 Months Ended 12 Months Ended
Jun. 30, 2018
USD ($)
property
Mar. 31, 2018
USD ($)
building
property
Feb. 28, 2018
USD ($)
property
Dec. 31, 2018
USD ($)
property
building
note
Dec. 31, 2017
USD ($)
property
Dec. 31, 2016
USD ($)
property
Feb. 27, 2019
USD ($)
Sep. 30, 2018
USD ($)
property
Jul. 31, 2018
USD ($)
property
Jan. 31, 2018
USD ($)
property
Jun. 30, 2017
USD ($)
property
May 31, 2017
USD ($)
property
Apr. 30, 2017
USD ($)
property
Mar. 31, 2017
Oct. 31, 2016
USD ($)
property
Sep. 30, 2016
USD ($)
property
Jul. 31, 2016
USD ($)
building
property
Apr. 30, 2016
USD ($)
property
Feb. 29, 2016
USD ($)
Jan. 31, 2016
USD ($)
property
Dec. 31, 2015
USD ($)
Dec. 31, 2014
USD ($)
Debt Instrument [Line Items]                                            
Principal amount of debt       $ 2,250,000,000 $ 1,750,000,000                                  
Mortgage debt assumed       44,386,000 0 $ 0                                
Real estate property, gross       7,876,300,000 7,824,763,000                                  
Capital leases       9,800,000                                    
Unsecured revolving credit facility       139,000,000 596,000,000                                  
Loss on early extinguishment of debt       (22,000) $ (7,627,000) $ (526,000)                                
Unsecured revolving credit facility                                            
Debt Instrument [Line Items]                                            
Unsecured revolving credit facility, maximum borrowing capacity       $ 1,000,000,000                                    
Number of public issues of unsecured senior notes | note       7                                    
Maximum borrowing capacity that may be increased       $ 2,000,000,000                                    
Revolving credit facility, interest rate payable (as a percent)       3.60%                                    
Weighted average interest rate on debt (as a percent)       3.00% 2.40% 1.80%                                
Unsecured revolving credit facility       $ 139,000,000                                    
Revolving credit facility, available amount       $ 861,000,000                                    
Senior unsecured notes due 2019                                            
Debt Instrument [Line Items]                                            
Interest rate (as a percent)       3.25%                                    
Maximum borrowing capacity that may be increased       $ 400,000,000                                    
Senior Unsecured Notes 6.75 Percent Due 2020                                            
Debt Instrument [Line Items]                                            
Principal amount of debt       $ 200,000,000                                    
Interest rate (as a percent)       6.75%                                    
Unsecured senior notes due 2021                                            
Debt Instrument [Line Items]                                            
Principal amount of debt       $ 300,000,000 $ 300,000,000                                  
Interest rate (as a percent)       6.75%                                    
Senior unsecured notes due 2024                                            
Debt Instrument [Line Items]                                            
Principal amount of debt       $ 250,000,000 250,000,000                                  
Interest rate (as a percent)       4.75%                                    
Senior Unsecured Notes Due 2028                                            
Debt Instrument [Line Items]                                            
Principal amount of debt     $ 500,000,000 $ 500,000,000 0                                  
Interest rate (as a percent)     4.75% 4.75%                                    
Senior unsecured notes 5.625% due in 2042                                            
Debt Instrument [Line Items]                                            
Principal amount of debt       $ 350,000,000 350,000,000                                  
Interest rate (as a percent)       5.625%                                    
Senior unsecured notes due in 2046                                            
Debt Instrument [Line Items]                                            
Principal amount of debt       $ 250,000,000 $ 250,000,000                           $ 250,000,000      
Interest rate (as a percent)       6.25%                             6.25%      
Unsecured Notes Due June 2023                                            
Debt Instrument [Line Items]                                            
Interest rate (as a percent)     6.64%                                      
Mortgage debt assumed     $ 16,748,000                                      
Unsecured Notes Due June 2023 | Senior Living Communities                                            
Debt Instrument [Line Items]                                            
Number of properties mortgaged | property     1                                      
Unsecured Notes Due July 2043                                            
Debt Instrument [Line Items]                                            
Interest rate (as a percent)   4.44%                                        
Mortgage debt assumed   $ 11,050,000                                        
Unsecured Notes Due July 2043 | MOBs                                            
Debt Instrument [Line Items]                                            
Number of properties mortgaged | property   1                                        
Number of buildings mortgaged | building   1                                        
Senior Notes Due October 2022                                            
Debt Instrument [Line Items]                                            
Interest rate (as a percent) 5.75%                                          
Mortgage debt assumed $ 16,588,000                                          
Senior Notes Due October 2022 | Senior Living Communities                                            
Debt Instrument [Line Items]                                            
Number of properties mortgaged | property 2                                          
Term loan due 2020                                            
Debt Instrument [Line Items]                                            
Principal amount of debt                                           $ 350,000,000
Interest rate (as a percent)       3.70%                                    
Maximum borrowing capacity that may be increased       $ 700,000,000                                    
Weighted average interest rate on debt (as a percent)       3.40% 2.50% 1.90%                                
Interest expense and other associated costs incurred       $ 12,555,000 $ 9,338,000 $ 7,231,000                                
Term loan due 2020 | LIBOR                                            
Debt Instrument [Line Items]                                            
Basis points per annum (as a percent)       1.40%                                    
Term loan due 2022                                            
Debt Instrument [Line Items]                                            
Principal amount of debt                                         $ 200,000,000  
Interest rate (as a percent)       3.90%                                    
Weighted average interest rate on debt (as a percent)       3.40% 2.70% 2.30%                                
Interest expense and other associated costs incurred       $ 7,095,000 $ 5,756,000 $ 4,889,000                                
Term loan due 2022 | LIBOR                                            
Debt Instrument [Line Items]                                            
Basis points per annum (as a percent)       1.35%                                    
Mortgages                                            
Debt Instrument [Line Items]                                            
Secured debt       $ 734,748,000                                    
Number of properties mortgaged | property       13                                    
Number of buildings mortgaged | building       14                                    
Real estate property, gross       $ 1,034,799,000                                    
Capital leases                                            
Debt Instrument [Line Items]                                            
Real estate property, gross       $ 34,568,000                                    
Number of properties recorded under capital lease | property       2                                    
Capital leases       $ 9,832,000                                    
Secured debt financing due 2026 | MOBs                                            
Debt Instrument [Line Items]                                            
Secured debt                                 $ 620,000,000          
Number of properties mortgaged | property                                 1          
Number of buildings mortgaged | building                                 2          
Weighted average interest rate on debt (as a percent)                                 3.53%          
Mortgage maturing in September 2043                                            
Debt Instrument [Line Items]                                            
Interest rate (as a percent)                   4.40%                        
Secured debt                   $ 4,338,000                        
Number of properties mortgaged | property                   1                        
Senior Unsecured Notes Due October 2018                                            
Debt Instrument [Line Items]                                            
Principal amount of debt                 $ 90,602,000                          
Number of properties mortgaged | property                 12                          
Weighted average interest rate on debt (as a percent)                 5.00%                          
Senior Unsecured Notes Due January 2019                                            
Debt Instrument [Line Items]                                            
Principal amount of debt               $ 6,325,000                            
Interest rate (as a percent)               4.70%                            
Number of properties mortgaged | property               1                            
Senior Unsecured Notes Due September 2019                                            
Debt Instrument [Line Items]                                            
Principal amount of debt                         $ 5,449,000                  
Interest rate (as a percent)                         6.71%                  
Secured debt                         $ 277,837,000                  
Number of properties mortgaged | property                         17                  
Senior Unsecured Notes Due August 2017                                            
Debt Instrument [Line Items]                                            
Interest rate (as a percent)                       6.15%                    
Secured debt                       $ 10,579,000                    
Number of properties mortgaged | property                       1                    
Senior Unsecured Notes Due August 2037                                            
Debt Instrument [Line Items]                                            
Interest rate (as a percent)                     5.95%                      
Secured debt                     $ 8,807,000                      
Number of properties mortgaged | property                     1                      
Senior Unsecured Notes Due April 2018                                            
Debt Instrument [Line Items]                                            
Interest rate (as a percent)         6.73%                                  
Secured debt         $ 8,403,000                                  
Number of properties mortgaged | property         1                                  
Senior Unsecured Notes Due April 2016                                            
Debt Instrument [Line Items]                                            
Interest rate (as a percent)                                       5.97%    
Secured debt                                       $ 6,115,000    
Number of properties mortgaged | property                                       1    
Senior Unsecured Notes Due July 2016                                            
Debt Instrument [Line Items]                                            
Interest rate (as a percent)                                   4.65%        
Secured debt                                   $ 18,000,000        
Number of properties mortgaged | property                                   1        
Senior Unsecured Notes Due November 2016                                            
Debt Instrument [Line Items]                                            
Interest rate (as a percent)                                 6.25%          
Secured debt                               $ 79,957,000 $ 11,871,000          
Number of properties mortgaged | property                               2 1          
Weighted average interest rate on debt (as a percent)                               5.92%            
Senior Unsecured Notes Due May 2017                                            
Debt Instrument [Line Items]                                            
Principal amount of debt                             $ 42,542,000              
Number of properties mortgaged | property                             8              
Weighted average interest rate on debt (as a percent)                             6.54%              
Senior Unsecured Notes Due March 2017                                            
Debt Instrument [Line Items]                                            
Interest rate (as a percent)           5.86%                                
Secured debt           $ 5,428,000                                
Number of properties mortgaged | property           1                                
Revolving Credit Facility | Unsecured revolving credit facility                                            
Debt Instrument [Line Items]                                            
Interest expense and other associated costs incurred       $ 10,348,000 $ 14,346,000 $ 13,100,000                                
Revolving Credit Facility | Unsecured revolving credit facility | LIBOR                                            
Debt Instrument [Line Items]                                            
Basis points per annum (as a percent)       1.20%                                    
Loan commitment fee percentage       0.25%                                    
Joint Venture                                            
Debt Instrument [Line Items]                                            
Ownership interest by parent                           55.00%                
Joint Venture | Secured debt financing due 2026 | MOBs                                            
Debt Instrument [Line Items]                                            
Ownership interest by parent                                 55.00%          
Subsequent Event | Unsecured revolving credit facility                                            
Debt Instrument [Line Items]                                            
Unsecured revolving credit facility             $ 238,000,000                              
Revolving credit facility, available amount             $ 762,000,000