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Concentration of Risk - Narrative (Details)
$ in Thousands
12 Months Ended
Dec. 31, 2018
USD ($)
state
facility
bed
Dec. 31, 2017
USD ($)
Dec. 31, 2016
USD ($)
Concentration Risk [Line Items]      
Number of living facilities 197    
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 | $ $ 140,073 $ 117,633 $ 93,126
Skilled Nursing, Assisted Living and Independent Living Facilities | Assets Leased to Ensign      
Concentration Risk [Line Items]      
Number of living facilities 194    
Number of units available in living facilities | bed 19,086    
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    
Number of units available in living facilities | bed 9,801    
Customer Concentration Risk | Revenue, exclusive of tenant reimbursements      
Concentration Risk [Line Items]      
Rental income | $ $ 59,100    
Concentration risk (percent) 41.00%