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Segment Reporting - Income Statements (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Revenues:      
Total revenues $ 1,495,427 $ 1,410,308 $ 1,283,566
Less:      
Interest expense 235,239 191,775 209,383
Depreciation and amortization 284,957 284,083 239,280
Net loss (370,255) (293,572) (15,774)
Reconciliation of segment loss:      
General and administrative (26,518) (26,131) (26,435)
Acquisition and certain other transaction related costs (2,510) (10,853) (2,605)
Gains and losses on equity securities, net 0 8,126 (25,660)
Interest and other income 8,950 15,536 15,929
Interest expense (235,239) (191,775) (209,383)
Loss on modification or early extinguishment of debt 324 2,468 30,043
Income tax expense (467) (445) (710)
Equity in net earnings (losses) of investees 1,597 (20,461) 6,055
Net loss (370,255) (293,572) (15,774)
Rental income      
Revenues:      
Total revenues 251,038 258,400 260,740
Residents fees and services      
Revenues:      
Total revenues 1,244,389 1,151,908 1,022,826
Operating Segments      
Revenues:      
Total revenues 1,457,709 1,372,438 1,245,216
Less:      
Senior living labor and benefits 630,998 603,711 566,384
Dietary 85,620 78,508 69,455
Utilities 84,303 83,198 80,025
Real estate taxes 72,107 73,921 73,473
Insurance 44,066 42,426 39,232
Other operating expenses 318,872 291,291 279,830
Interest expense 5,972 1,000 2,447
Depreciation and amortization 275,024 274,131 227,937
Other segment items 97,222 36,055 (332,260)
Net loss (156,475) (111,803) 238,693
Reconciliation of segment loss:      
Interest expense (5,972) (1,000) (2,447)
Net loss (156,475) (111,803) 238,693
Operating Segments | Medical Office and Life Science Portfolio      
Revenues:      
Total revenues 213,320 220,530 222,390
Less:      
Senior living labor and benefits 0 0 0
Dietary 0 0 0
Utilities 13,687 13,918 13,555
Real estate taxes 28,483 29,445 29,037
Insurance 3,000 2,854 2,514
Other operating expenses 52,467 51,747 49,193
Interest expense 5,743 449 913
Depreciation and amortization 79,386 98,205 76,007
Other segment items 97,222 36,095 (327,111)
Net loss (66,668) (12,183) 378,282
Reconciliation of segment loss:      
Interest expense (5,743) (449) (913)
Net loss (66,668) (12,183) 378,282
Operating Segments | SHOP      
Revenues:      
Total revenues 1,244,389 1,151,908 1,022,826
Less:      
Senior living labor and benefits 630,998 603,711 566,384
Dietary 85,620 78,508 69,455
Utilities 70,616 69,280 66,470
Real estate taxes 43,624 44,476 44,436
Insurance 41,066 39,572 36,718
Other operating expenses 266,405 239,544 230,637
Interest expense 229 551 1,534
Depreciation and amortization 195,638 175,926 151,930
Other segment items 0 (40) (5,149)
Net loss (89,807) (99,620) (139,589)
Reconciliation of segment loss:      
Interest and other income 0 1,581 4,327
Interest expense (229) (551) (1,534)
Net loss (89,807) (99,620) (139,589)
Operating Segments | Rental income      
Revenues:      
Total revenues 213,320 220,530 222,390
Operating Segments | Rental income | Medical Office and Life Science Portfolio      
Revenues:      
Total revenues 213,320 220,530 222,390
Operating Segments | Rental income | SHOP      
Revenues:      
Total revenues 0 0 0
Operating Segments | Residents fees and services      
Revenues:      
Total revenues 1,244,389 1,151,908 1,022,826
Operating Segments | Residents fees and services | Medical Office and Life Science Portfolio      
Revenues:      
Total revenues 0 0 0
Operating Segments | Residents fees and services | SHOP      
Revenues:      
Total revenues 1,244,389 1,151,908 1,022,826
All Other      
Revenues:      
Total revenues 37,718 37,870 38,350
Less:      
Interest expense 229,267 190,775 206,936
Reconciliation of segment loss:      
Other Income 27,209 26,822 26,336
General and administrative (26,518) (26,131) (26,435)
Acquisition and certain other transaction related costs (2,510) (10,853) (2,605)
Gains and losses on equity securities, net   8,126 (25,660)
Interest and other income 8,950 13,955 11,602
Interest expense (229,267) (190,775) (206,936)
Loss on modification or early extinguishment of debt 324 2,468 30,059
Income tax expense (467) $ (445) $ (710)
Equity in net earnings (losses) of investees $ 9,147