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Segment Reporting (Details)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2016
USD ($)
Sep. 30, 2015
USD ($)
Sep. 30, 2016
USD ($)
Sep. 30, 2015
USD ($)
Dec. 31, 2015
USD ($)
Summary of information for reportable segments          
Rental income $ 421,152 $ 409,290 $ 1,259,442 $ 1,185,502  
Resident fees and services 630,017 545,255 1,847,386 1,573,318  
Interest income 25,080 22,380 74,275 59,950  
Other income 2,884 2,072 21,735 11,572  
Total revenues 1,079,133 978,997 3,202,838 2,830,342  
Property operating expenses 473,680 408,703 1,382,148 1,183,519  
Net Operating Income from Continuing Operations 605,453 [1] 570,294 1,820,690 [1] 1,646,823  
Interest expense 129,699 121,130 394,985 361,071  
Loss (gain) on derivatives, net (2,516) 0 (2,516) (58,427)  
Depreciation and amortization 218,061 205,799 673,326 603,431  
General and administrative 36,828 36,950 122,434 110,562  
Transaction costs 19,842 9,333 33,207 70,379  
Loss (gain) on extinguishment of debt, net 0 584 9 34,872  
Impairment of Asset 9,705 0 24,019 2,220  
Other expenses 0 0 3,161 10,583  
Income (loss) from continuing operations before income taxes and income from unconsolidated entities 193,834 196,498 572,065 512,132  
Income tax (expense) benefit 305 3,344 2,543 (3,769)  
(Loss) income from unconsolidated entities (1,749) (2,631) (7,528) (18,231)  
Income (loss) from continuing operations 192,390 197,211 567,080 490,132  
Gain (loss) on real estate dispositions, net 162,351 2,046 163,881 249,002  
Net income 354,741 $ 199,257 730,961 $ 739,134  
Total assets $ 29,856,339   $ 29,856,339   $ 29,023,845
Percent Of Assets 1   1   1
Percent Of Revenues 1 1 1 1  
United States          
Summary of information for reportable segments          
Total revenues $ 874,050 $ 793,429 $ 2,581,533 $ 2,309,596  
Total assets $ 24,600,436   $ 24,600,436   $ 25,995,793
Percent Of Assets 0.824   0.824   0.896
Percent Of Revenues 0.81 0.81 0.807 0.816  
United Kingdom          
Summary of information for reportable segments          
Total revenues $ 95,068 $ 106,372 $ 295,203 $ 301,718  
Total assets $ 2,715,817   $ 2,715,817   $ 1,741,973
Percent Of Assets 0.091   0.091   0.06
Percent Of Revenues 0.088 0.109 0.091 0.107  
Canada          
Summary of information for reportable segments          
Total revenues $ 110,015 $ 79,196 $ 326,102 $ 219,028  
Total assets $ 2,540,086   $ 2,540,086   $ 1,286,079
Percent Of Assets 0.085   0.085   0.044
Percent Of Revenues 0.102 0.081 0.102 0.077  
Triple Net [Member]          
Summary of information for reportable segments          
Rental income $ 286,226 $ 277,614 $ 857,184 $ 812,179  
Resident fees and services 0 0 0 0  
Interest income 23,017 19,454 67,842 52,343  
Other income 1,621 969 4,317 5,823  
Total revenues 310,864 298,037 929,343 870,345  
Property operating expenses 0 0 0 0  
Net Operating Income from Continuing Operations 310,864 298,037 929,343 870,345  
Interest expense 985 11,347 8,608 21,083  
Loss (gain) on derivatives, net 0   0 (58,427)  
Depreciation and amortization 74,296 72,589 229,906 212,537  
General and administrative 0 0 0 0  
Transaction costs 1,613 1,865 5,760 45,615  
Loss (gain) on extinguishment of debt, net   (139) 97 10,096  
Impairment of Asset 5,070   19,384 2,220  
Other expenses     0 0  
Income (loss) from continuing operations before income taxes and income from unconsolidated entities 228,900 212,375 665,588 637,221  
Income tax (expense) benefit (896) 87 (1,425) (2,617)  
(Loss) income from unconsolidated entities 1,998 2,851 8,097 5,697  
Income (loss) from continuing operations 230,002 215,313 672,260 640,301  
Gain (loss) on real estate dispositions, net 163,579 2,155 165,109 56,251  
Net income 393,581 217,468 837,369 696,552  
Total assets 11,988,519   11,988,519    
Senior housing - operating [Member]          
Summary of information for reportable segments          
Rental income 0 0 0 0  
Resident fees and services 630,017 545,255 1,847,386 1,573,318  
Interest income 1,054 1,054 3,126 3,126  
Other income 716 772 11,889 5,001  
Total revenues 631,787 547,081 1,862,401 1,581,445  
Property operating expenses 432,292 368,050 1,259,182 1,067,127  
Net Operating Income from Continuing Operations 199,495 179,031 603,219 514,318  
Interest expense 39,927 30,990 123,445 104,283  
Loss (gain) on derivatives, net 0   0 0  
Depreciation and amortization 97,210 87,306 301,354 252,785  
General and administrative 0 0 0 0  
Transaction costs 18,083 7,630 25,259 23,610  
Loss (gain) on extinguishment of debt, net   0 (88) 0  
Impairment of Asset 0   0 0  
Other expenses     0 0  
Income (loss) from continuing operations before income taxes and income from unconsolidated entities 44,275 53,105 153,249 133,640  
Income tax (expense) benefit 515 3,237 5,304 (745)  
(Loss) income from unconsolidated entities (3,891) (5,629) (15,713) (26,785)  
Income (loss) from continuing operations 40,899 50,713 142,840 106,110  
Gain (loss) on real estate dispositions, net 0 0 0 0  
Net income 40,899 50,713 142,840 106,110  
Total assets 12,580,092   12,580,092    
Outpatient Medical [Member]          
Summary of information for reportable segments          
Rental income 134,926 131,676 402,258 373,323  
Resident fees and services 0 0 0 0  
Interest income 1,009 1,872 3,307 4,481  
Other income 358 309 4,824 665  
Total revenues 136,293 133,857 410,389 378,469  
Property operating expenses 41,388 40,653 122,966 116,392  
Net Operating Income from Continuing Operations 94,905 93,204 287,423 262,077  
Interest expense 3,986 6,811 15,132 21,192  
Loss (gain) on derivatives, net 0   0 0  
Depreciation and amortization 46,555 45,904 142,066 138,109  
General and administrative 0 0 0 0  
Transaction costs 146 (162) 2,188 1,154  
Loss (gain) on extinguishment of debt, net   0 0 0  
Impairment of Asset 4,635   4,635 0  
Other expenses     0 0  
Income (loss) from continuing operations before income taxes and income from unconsolidated entities 39,583 40,651 123,402 101,622  
Income tax (expense) benefit 417 154 (59) 460  
(Loss) income from unconsolidated entities 144 147 88 2,857  
Income (loss) from continuing operations 40,144 40,952 123,431 104,939  
Gain (loss) on real estate dispositions, net (1,228) (109) (1,228) 192,751  
Net income 38,916 40,843 122,203 297,690  
Total assets 4,899,012   4,899,012    
Corporate, Non-Segment [Member]          
Summary of information for reportable segments          
Rental income 0 0 0 0  
Resident fees and services 0 0 0 0  
Interest income 0 0 0 0  
Other income 189 22 705 83  
Total revenues 189 22 705 83  
Property operating expenses 0 0 0 0  
Net Operating Income from Continuing Operations 189 22 705 83  
Interest expense 84,801 71,982 247,800 214,513  
Loss (gain) on derivatives, net (2,516)   (2,516) 0  
Depreciation and amortization 0 0 0 0  
General and administrative 36,828 36,950 122,434 110,562  
Transaction costs 0 0 0 0  
Loss (gain) on extinguishment of debt, net   723 0 24,776  
Impairment of Asset 0   0 0  
Other expenses     3,161 10,583  
Income (loss) from continuing operations before income taxes and income from unconsolidated entities (118,924) (109,633) (370,174) (360,351)  
Income tax (expense) benefit 269 (134) (1,277) (867)  
(Loss) income from unconsolidated entities 0 0 0 0  
Income (loss) from continuing operations (118,655) (109,767) (371,451) (361,218)  
Gain (loss) on real estate dispositions, net 0 0 0 0  
Net income (118,655) $ (109,767) (371,451) $ (361,218)  
Total assets $ 388,716   $ 388,716    
[1] (1) Genesis Healthcare is in our triple-net segment. Sunrise Senior Living and Revera are in our seniors housing operating segment. Benchmark Senior Living and Brookdale Senior Living are in both our triple-net and seniors housing operating segments.