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Acquisitions, Dispositions and Other Significant Transactions - Welltower Lease and RIDEA Venture Restructuring (Details)
$ in Thousands
3 Months Ended 12 Months Ended
Jun. 30, 2018
USD ($)
lease_portfolio
community
Dec. 31, 2018
USD ($)
Sep. 30, 2018
USD ($)
lease
community
Jun. 30, 2018
USD ($)
community
Mar. 31, 2018
USD ($)
Dec. 31, 2018
USD ($)
community
Dec. 31, 2017
USD ($)
Dec. 31, 2016
USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]                
Payments for lease termination           $ 12,548 $ 552 $ 9,250
Loss on facility lease termination and modification, net   $ 13,197 $ 2,337 $ 146,467 $ 0 162,001 14,276 11,113
Base rent           $ 303,294 $ 339,721 $ 373,635
Welltower Lease Transactions                
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]                
Number Of Leases Not Renewed | lease     2          
Master Leases Not Renewed, Number Of Communities | community     11          
Number of communities managed | community           74    
Welltower Lease Transactions | 37 Communities Disposed Of Through Lease Terminations                
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]                
Number of communities disposed of | community 37              
Loss on facility lease termination and modification, net           $ 22,600    
Welltower Inc. | Welltower Lease Transactions                
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]                
Number of lease portfolios | lease_portfolio 2              
Payments for lease termination $ 58,000              
Rent credit, potential future lease terminations 6.25%              
Welltower Inc. | Welltower Lease Transactions, Lease Portfolio Maturing In 2028                
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]                
Number of communities leased | community 27     27        
Welltower Inc. | Welltower Lease Transactions, Lease Portfolio Maturing In 2020                
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]                
Number of communities leased | community 10     10        
Maximum | Welltower Inc. | Welltower Lease Transactions                
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]                
Base rent $ 5,000              
Welltower RIDEA                
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]                
Ownership Percentage 20.00%     20.00%        
Welltower RIDEA | Welltower Inc.                
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]                
Proceeds from sale of equity method investment $ 33,500              
Gain on sale of equity method investment $ 14,700