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Leases and Management Agreements with Five Star - Schedule of Disaggregation of Revenue (Details) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended
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Dec. 31, 2019 | Sep. 30, 2019 | Jun. 30, 2019 | Mar. 31, 2019 | Dec. 31, 2018 | Sep. 30, 2018 | Jun. 30, 2018 | Mar. 31, 2018 | Dec. 31, 2019 | Dec. 31, 2018 | Dec. 31, 2017
Disaggregation of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |
Total revenues | $ 256,039 | $ 255,827 | $ 262,003 | $ 266,286 | $ 285,222 | $ 278,969 | $ 277,202 | $ 275,770 | $ 1,040,155 | $ 1,117,164 | $ 1,074,729
Basic housing and support services |  |  |  |  |  |  |  |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |
Total revenues |  |  |  |  |  |  |  |  | 353,699 |  |
Medicare and Medicaid programs |  |  |  |  |  |  |  |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |
Total revenues |  |  |  |  |  |  |  |  | 31,324 |  |
Private pay and other third party payer SNF services |  |  |  |  |  |  |  |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |
Total revenues |  |  |  |  |  |  |  |  | 48,574 |  |
Residents fees and services |  |  |  |  |  |  |  |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |
Total revenues |  |  |  |  |  |  |  |  | $ 433,597 | $ 416,523 | $ 393,707

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