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Fair Value of Assets and Liabilities - Assets and Liabilities (Details) $ in Thousands | 3 Months Ended | 9 Months Ended |  |
--- | --- | --- | --- | ---
Sep. 30, 2020 USD ($) property shares | Sep. 30, 2019 USD ($) | Sep. 30, 2020 USD ($) property shares | Sep. 30, 2019 USD ($) | Jan. 01, 2020 USD ($) shares | Dec. 31, 2019 shares
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] |  |  |  |  |  |
Common shares of beneficial interest, shares issued (in shares) | shares | 238,268,478 |  | 238,268,478 |  |  | 237,897,163
Common shares of beneficial interest, shares outstanding (in shares) | shares | 238,268,478 |  | 238,268,478 |  |  | 237,897,163
Unrealized gains and losses on equity securities held | $ 12,510 | $ 40 | $ 14,541 | $ (40) |  |
Impairment of assets | $ 64,202 | $ 33,099 | $ 106,611 | $ 41,518 |  |
Number of real estate properties | property | 407 |  | 407 |  |  |
Five Star |  |  |  |  |  |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] |  |  |  |  |  |
Common shares of beneficial interest, shares issued (in shares) | shares |  |  |  |  | 10,268,158 | 10,268,158
Five Star |  |  |  |  |  |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] |  |  |  |  |  |
Equity securities investment (in shares) | shares | 10,691,658 |  | 10,691,658 |  |  |
Initial cost basis | $ 44,448 |  | $ 44,448 |  | $ 38,095 |
Common shares of beneficial interest, shares outstanding (in shares) | shares |  |  |  |  |  | 423,500
Unrealized gains and losses on equity securities held | 12,510 |  | 14,541 |  |  |
Recurring | Five Star |  |  |  |  |  |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] |  |  |  |  |  |
Investments in affiliates, fair value | 54,207 |  | 54,207 |  |  |
Recurring | Quoted Prices in Active Markets for Identical Assets (Level 1) | Five Star |  |  |  |  |  |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] |  |  |  |  |  |
Investments in affiliates, fair value | 54,207 |  | 54,207 |  |  |
Recurring | Significant Other Observable Inputs (Level 2) | Five Star |  |  |  |  |  |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] |  |  |  |  |  |
Investments in affiliates, fair value | 0 |  | 0 |  |  |
Recurring | Significant Unobservable Inputs (Level 3) | Five Star |  |  |  |  |  |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] |  |  |  |  |  |
Investments in affiliates, fair value | 0 |  | 0 |  |  |
Nonrecurring |  |  |  |  |  |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] |  |  |  |  |  |
Real estate properties held for sale | 56,673 |  | 56,673 |  |  |
Real estate properties at fair value | 31,010 |  | 31,010 |  |  |
Nonrecurring | Quoted Prices in Active Markets for Identical Assets (Level 1) |  |  |  |  |  |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] |  |  |  |  |  |
Real estate properties held for sale | 0 |  | 0 |  |  |
Real estate properties at fair value | 0 |  | 0 |  |  |
Nonrecurring | Significant Other Observable Inputs (Level 2) |  |  |  |  |  |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] |  |  |  |  |  |
Real estate properties held for sale | 56,673 |  | 56,673 |  |  |
Real estate properties at fair value | 0 |  | 0 |  |  |
Nonrecurring | Significant Unobservable Inputs (Level 3) |  |  |  |  |  |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] |  |  |  |  |  |
Real estate properties held for sale | 0 |  | 0 |  |  |
Real estate properties at fair value | $ 31,010 |  | $ 31,010 |  |  |
Common Shares | Five Star |  |  |  |  |  |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] |  |  |  |  |  |
Equity securities investment (in shares) | shares | 10,691,658 |  | 10,691,658 |  |  |
Medical Office Buildings | Nonrecurring |  |  |  |  |  |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] |  |  |  |  |  |
Sale price less estimated cost to sell | $ 3,875 |  | $ 3,875 |  |  |
Medical Office Buildings | Held-for-sale, Not Discontinued Operations | Nonrecurring |  |  |  |  |  |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] |  |  |  |  |  |
Impairment of assets |  |  | $ 1,524 |  |  |
Number of real estate properties held for sale | property | 1 |  | 1 |  |  |
Sale price less estimated cost to sell | $ 160 |  | $ 160 |  |  |
Senior Living Communities | Nonrecurring |  |  |  |  |  |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] |  |  |  |  |  |
Real estate properties at fair value | 31,010 |  | 31,010 |  |  |
Impairment of assets |  |  | 59,847 |  |  |
Sale price less estimated cost to sell | $ 54,100 |  | $ 54,100 |  |  |
Number of real estate properties | property | 9 |  | 9 |  |  |
Senior Living Communities | Held-for-sale, Not Discontinued Operations | Nonrecurring |  |  |  |  |  |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] |  |  |  |  |  |
Impairment of assets |  |  | $ 33,356 |  |  |
Number of real estate properties held for sale | property | 14 |  | 14 |  |  |
Sale price less estimated cost to sell | $ 1,142 |  | $ 1,142 |  |  |

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