Leases - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Lessee, Lease, Description [Line Items]
Straight line rent adjustment	$ 112,398		$ 146,508
Rental and other revenues related to operating lease payments	$ 275,046	$ 412,147	1,061,311	$ 1,178,817
Rental and other revenues related to operating lease payments, variable leases			153,217	$ 147,815
Genesis Health Care
Lessee, Lease, Description [Line Items]
Straight line rent adjustment			$ 91,025
Minimum
Lessee, Lease, Description [Line Items]
Lease term extension period			1 year
Maximum
Lessee, Lease, Description [Line Items]
Lease term extension period			25 years