Real Property Acquisitions and Development (Details 1) - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2018	Mar. 31, 2017
Triple Net [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		$ 1,691	$ 4,017
Buildings and improvements		235	37,241
Total assets acquired		1,926	41,258
Accrued expenses and other liabilities		(6)	0
Total liabilities assumed		(6)	0
Cash disbursed for acquisitions	[1]	1,920	41,258
Construction in progress additions		15,850	46,754
Less: Capitalized Interest		(847)	(2,028)
Less: Foreign currency translation		0	(164)
Cash disbursed for construction in progress		15,003	44,562
Capital improvements to existing properties		2,351	10,495
Total cash invested in real property		19,274	96,315
Senior housing - operating [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		35,193	4,304
Buildings and improvements		372,562	44,075
Acquired lease intangibles		48,805	1,741
Receivables and other assets		265	74
Total assets acquired	[2]	456,825	50,194
Secured debt		(89,973)	0
Accrued expenses and other liabilities		(12,808)	(2,755)
Total liabilities assumed		(102,781)	(2,755)
Noncontrolling interests		(5,618)	(647)
Non-cash acquisition related activity	[3]	0	(14,148)
Cash disbursed for acquisitions		348,426	32,644
Construction in progress additions		10,562	8,062
Less: Capitalized Interest		(891)	(1,707)
Less: Foreign currency translation		(5,032)	691
Cash disbursed for construction in progress		4,639	7,046
Capital improvements to existing properties		31,325	24,254
Total cash invested in real property		384,390	63,944
Cash Acquired from Acquisition		2,155	400
Non Cash Acquisition Financed As Real Estate Loan Receivable			6,349
Non cash acquisition financed as equity investments			7,799
Outpatient Medical [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		7,369	2,895
Buildings and improvements		42,673	23,310
Acquired lease intangibles		5,852	3,496
Receivables and other assets		1	3
Total assets acquired	[4]	55,895	29,704
Accrued expenses and other liabilities		(632)	(1,250)
Total liabilities assumed		(632)	(1,250)
Cash disbursed for acquisitions		55,263	28,454
Construction in progress additions		2,803	14,921
Less: Capitalized Interest		(598)	(717)
Less: Accruals	[5]	888	3,522
Cash disbursed for construction in progress		3,093	17,726
Capital improvements to existing properties		12,871	7,366
Total cash invested in real property		71,227	53,546
Cash Acquired from Acquisition		$ 1,950	$ 0

[1] Primarily reprsents land acquired on an existing property during the three months ended March 31, 2018.

[2] Excludes $2,155,000 and $400,000 of unrestricted and restricted cash acquired during the three months ended March 31, 2018 and 2017, respectively.

[3] Includes $6,349,000 related to the acquisition of assets previously financed as real estate loans receivable and $7,799,000 previously financed as an investment in an unconsolidated entity during the three months ended March 31, 2017.

[4] Excludes $1,950,000 of unrestricted and restricted cash acquired during the three months ended March 31, 2018.

[5] Represents non-cash accruals for amounts to be paid in future periods for properties that converted, off-set by amounts paid in the current period.