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Leases and Management Agreements with Five Star - Schedule of Disaggregation of Revenue (Details) - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2019
Sep. 30, 2018
Sep. 30, 2019
Sep. 30, 2018
Disaggregation of Revenue [Line Items]        
Total revenues $ 255,827 $ 278,969 $ 784,116 $ 831,942
Basic housing and support services        
Disaggregation of Revenue [Line Items]        
Total revenues 88,623   265,117  
Medicare and Medicaid programs        
Disaggregation of Revenue [Line Items]        
Total revenues 6,902   23,333  
Private pay and other third party payer SNF services        
Disaggregation of Revenue [Line Items]        
Total revenues 12,291   36,317  
Residents fees and services        
Disaggregation of Revenue [Line Items]        
Total revenues $ 107,816 $ 105,321 $ 324,767 $ 309,981