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Leases and Management Agreements with Five Star - Narrative (Details) $ in Thousands		1 Months Ended	3 Months Ended		9 Months Ended
	Apr. 01, 2019 USD ($)	Sep. 30, 2019 USD ($) community property	Sep. 30, 2019 USD ($) community	Sep. 30, 2018 USD ($) community	Sep. 30, 2019 USD ($) building community property lease_agreement renewal_option	Sep. 30, 2018 USD ($) community	Feb. 01, 2019 USD ($)	Dec. 31, 2018 USD ($)
Line of credit		$ 589,000	$ 589,000		$ 589,000			$ 139,000
Senior Living Communities
Monthly minimum rent payable		$ 10,815	$ 10,815		$ 10,815
Payments to acquire assets	$ 49,155
Five Star
Investment owned, percentage of total shares outstanding		34.00%	34.00%		34.00%
Percentage of total outstanding share issuances		51.00%	51.00%		51.00%
Total rental income recognized					$ 75,000
Monthly minimum rent payable							$ 11,000
Payments to acquire assets					$ 49,155
Management fees as percentage of gross revenues		5.00%	5.00%		5.00%
Percentage of annual incentive fee		15.00%	15.00%		15.00%
Percentage of gross revenues realized at all communities		1.50%	1.50%		1.50%
Property management agreement, initial term					15 years
Number of consecutive renewal terms of agreement | renewal_option					2
Percentage target EBITDA of new management agreement not earned					90.00%
Percentage target EBITDA of new Management agreement not earned for all communities					20.00%
Line of credit		$ 25,000	$ 25,000		$ 25,000
Interest rate (as a percent)		6.00%	6.00%		6.00%
Annual minimum rent payable				$ 1,177		$ 1,177
Amount of improvements to communities					$ 97,480
Property management agreement, renewal term					5 years
SNF
Number of real estate properties sold | property		15
Five Star
Number of communities leased by the Company | community		166	166	184	166	184
Number of leases with related party | lease_agreement					5
Investment owned, percentage of total shares outstanding		8.30%	8.30%		8.30%
Total rental income recognized			$ 32,738	$ 51,757	$ 105,451	$ 155,207
Variable rent payment included in rental income					538
Variable rent payment excluded from rental income				1,386		4,050
Receivables		$ 17,045	17,045		17,045			$ 18,697
Real estate improvements purchased						14,749
Property management agreement expense			$ 3,832	$ 3,666	$ 11,492	$ 10,694
Five Star | Rents from significant lessee | Investment
Percentage of rental income					27.00%
Five Star | Senior Living Communities
Number of communities managed by related party | community		77	77	75	77	75
Rehabilitation Services | Five Star
Expenses from transactions with related party			$ 1,478	$ 1,584	$ 4,666	$ 4,944
Rental income | Five Star | Rents from significant lessee | Investment
Percentage of rental income			12.80%		13.40%
Maximum | Senior Living Communities
Payments to acquire assets	$ 60,000
Disposal Group, Disposed of by Sale, Not Discontinued Operations
Number of real estate properties sold | building					33
Aggregate sale price					$ 53,033
Disposal Group, Disposed of by Sale, Not Discontinued Operations | SNF
Number of real estate properties sold | property					18
Aggregate sale price					$ 29,500

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