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CONSOLIDATED STATEMENTS OF CASH FLOWS - Supplemental (Parenthetical) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
SUPPLEMENTAL CASH FLOW INFORMATION:      
Interest paid $ 235,994 $ 195,599 $ 177,308
Income taxes paid 2,798 399 452
Decrease in assets and liabilities resulting from the deconsolidation of an investment that was previously consolidated:      
Real estate, net (686,320) 0 0
Mortgage notes, net 618,452 0 0
Real estate improvements accrued, not paid 20,031 18,097 14,111
Capitalized interest 1,297 1,833 1,124
Joint venture | ALR      
Decrease in assets and liabilities resulting from the deconsolidation of an investment that was previously consolidated:      
Restructuring transaction additional consideration 0 (75,000) 0
ALR      
Decrease in assets and liabilities resulting from the deconsolidation of an investment that was previously consolidated:      
AlerisLife Inc. common stock 0 97,896 0
NON-CASH FINANCING ACTIVITIES:      
Distribution to common shareholders of the right to receive AlerisLife Inc. common stock $ 0 $ (59,801) $ 0