Property and Equipment (Details) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Property and Equipment
Property and equipment, gross	$ 423,446	$ 402,751
Accumulated depreciation	(83,170)	(65,257)
Property and equipment, net	340,276	337,494
Depreciation expense	25,871	22,882	19,097
SNH
Property and Equipment
Assets held for sale for increased rent pursuant to the terms of leases with SNH	9,342	9,625
Land
Property and Equipment
Property and equipment, gross	22,214	21,714
Building and Improvements
Property and Equipment
Property and equipment, gross	286,467	277,330
Furniture, fixtures and equipment
Property and Equipment
Property and equipment, gross	$ 114,765	$ 103,707