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2017 Dispositions Activity (Details) $ in Thousands	1 Months Ended	12 Months Ended
2017 Dispositions Activity (Details) $ in Thousands	Aug. 31, 2017 property	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($) property	Dec. 31, 2016 USD ($)	Nov. 30, 2016 USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain on real estate dispositions		$ 46,247	$ 717,273	$ 98,203
Dispositions 2017
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from sale of real estate			870,800
Gain on the sale of real estate			$ 717,300
Medical Office Buildings \| Dispositions 2017
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties sold \| property			5
Skilled Nursing Facilities
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties sold \| property	22
Skilled Nursing Facilities \| Kindred
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Potential Revenue from Sale of Real Estate					$ 700,000
Proceeds from sale of real estate			$ 700,000
Gain on real estate dispositions			$ 657,600
Skilled Nursing Facilities \| Dispositions 2017 \| Kindred
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties sold \| property			36
Triple Net Leased Properties \| Dispositions 2017
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties sold \| property			53