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Concentration of Risk - Narrative (Details)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2018
USD ($)
facility
Sep. 30, 2017
USD ($)
Sep. 30, 2018
USD ($)
state
facility
bed
Sep. 30, 2017
USD ($)
Concentration Risk [Line Items]        
Number of living facilities 193   193  
Description of highest concentration of properties     The four states in which Ensign leases the highest concentration of properties are California, Texas, Utah and Arizona.  
Rental income | $ $ 35,332 $ 29,404 $ 103,856 $ 85,254
Skilled Nursing, Assisted Living and Independent Living Facilities | Assets Leased to Ensign        
Concentration Risk [Line Items]        
Number of living facilities 190   190  
Number of units available in living facilities | bed     18,693  
Ensign        
Concentration Risk [Line Items]        
Number of states where Ensign leases the highest concentration of properties | state     4  
Ensign | Skilled Nursing, Assisted Living and Independent Living Facilities | Assets Leased to Ensign        
Concentration Risk [Line Items]        
Number of living facilities 92   92  
Number of units available in living facilities | bed     9,805  
Customer Concentration Risk | Rental Income        
Concentration Risk [Line Items]        
Rental income | $     $ 59,100  
Concentration risk (percent)     42.00%