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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 6 Months Ended
Jun. 30, 2020
Jun. 30, 2019
Cash flows from operating activities:    
Net (loss) income $ (13,599) $ (4,312)
Adjustments to reconcile net loss to cash provided by operating activities:    
Depreciation and amortization 137,255 146,154
Amortization of debt issuance costs and debt discounts and premiums 3,126 3,171
Straight line rental income (2,538) (2,364)
Amortization of acquired real estate leases and other intangible assets (3,703) (3,080)
Loss on early extinguishment of debt 51 17
Gain on lease termination (22,896) 0
Impairment of assets 42,409 8,419
Gain on sale of properties (2,614) (17,710)
Gains and losses on equity securities, net (2,031) 41,516
Other non-cash adjustments (1,885) (1,885)
Equity in earnings of an investee 0 (534)
Change in assets and liabilities:    
Other assets (26,836) 9,370
Accrued interest 3,085 (765)
Other liabilities 849 (52,123)
Net cash provided by operating activities 110,673 125,874
Cash flows from investing activities:    
Real estate acquisitions and deposits (2,526) 0
Real estate improvements (71,762) (135,750)
Proceeds from sale of properties, net 66,604 34,116
Distributions in excess of earnings from Affiliates Insurance Company 287 0
Net cash used in investing activities (7,397) (101,634)
Cash flows from financing activities:    
Proceeds from issuance of senior unsecured notes, net 985,000 0
Proceeds from borrowings on revolving credit facility 405,500 730,000
Repayments of borrowings on revolving credit facility (943,000) (179,000)
Repayment of senior unsecured notes (200,000) (400,000)
Repayment of unsecured term loan (250,000) 0
Repayment of other debt (4,455) (44,552)
Loss on early extinguishment of debt settled in cash (376) 0
Payment of debt issuance costs (4,926) 0
Repurchase of common shares (29) (33)
Distributions to noncontrolling interest (11,383) (11,187)
Distributions to shareholders (38,063) (128,373)
Net cash used in financing activities (61,732) (33,145)
Increase (decrease) in cash and cash equivalents and restricted cash 41,544 (8,905)
Cash and cash equivalents and restricted cash at beginning of period 52,224 70,071
Cash and cash equivalents and restricted cash at end of period 93,768 61,166
Supplemental cash flow information:    
Interest paid 80,131 90,061
Income taxes paid 0 431
Non-cash investing activities:    
Capitalized interest 718 $ 444
Five Star    
Non-cash investing activities:    
Transaction Agreement additional consideration (75,000)  
Five Star    
Non-cash investing activities:    
Five Star Senior Living Inc. common stock 97,896  
Shareholders | Five Star    
Noncash Financing Activities [Abstract]    
Distribution to common shareholders of the right to receive Five Star Senior Living Inc. common stock $ (59,801)