Loans Receivable - Credit Loss Roll Forward (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($) loan	Dec. 31, 2019 USD ($)
Financing Receivable, Allowance for Credit Loss [Roll Forward]
Balance at beginning of period	$ 224,036	$ 68,372	$ 68,372
Provision for loan losses	7,270	94,436	18,690
Loan write-offs	(64,075)	(7,000)	(18,690)
Foreign currency translation	(446)	197	0
Reclassification of deferred gain as credit loss	0	62,819	0
Balance at end of period	166,785	224,036	68,372
Loan writeoff	64,075	$ 7,000	18,690
Avery Healthcare
Financing Receivable, Allowance for Credit Loss [Roll Forward]
Loan write-offs	(64,075)
Loan writeoff	64,075
Genesis healthcare receivable
Financing Receivable, Allowance for Credit Loss [Roll Forward]
Number of loans | loan		2
Loan Carrying Value		$ 62,753
Accounting Standards Update 2016-13
Financing Receivable, Allowance for Credit Loss [Roll Forward]
Accounting standards update [Extensible List]		Accounting Standards Update 2016-13
Accounting Standards Update 2016-13 | Cumulative Effect, Period of Adoption, Adjustment
Financing Receivable, Allowance for Credit Loss [Roll Forward]
Balance at beginning of period	$ 0	$ 5,212	0
Balance at end of period		$ 0	$ 5,212