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Leases and Management Agreements with Five Star Leases and Management Agreements with Five Star - Schedule of Disaggregation of Revenue (Details) - USD ($) $ in Thousands | 3 Months Ended
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Mar. 31, 2019 | Mar. 31, 2018
Disaggregation of Revenue [Line Items] |  |
Total revenues | $ 266,286 | $ 275,770
Basic housing and support services |  |
Disaggregation of Revenue [Line Items] |  |
Total revenues | 87,412 |
Medicare and Medicaid programs |  |
Disaggregation of Revenue [Line Items] |  |
Total revenues | 8,745 |
Private pay and other third party payer SNF services |  |
Disaggregation of Revenue [Line Items] |  |
Total revenues | 11,888 |
Residents fees and services |  |
Disaggregation of Revenue [Line Items] |  |
Total revenues | $ 108,045 | $ 102,042

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