Leases and Management Agreements with Five Star Leases and Management Agreements with Five Star - Schedule of Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Disaggregation of Revenue [Line Items]
Total revenues	$ 266,286	$ 275,770
Basic housing and support services
Disaggregation of Revenue [Line Items]
Total revenues	87,412
Medicare and Medicaid programs
Disaggregation of Revenue [Line Items]
Total revenues	8,745
Private pay and other third party payer SNF services
Disaggregation of Revenue [Line Items]
Total revenues	11,888
Residents fees and services
Disaggregation of Revenue [Line Items]
Total revenues	$ 108,045	$ 102,042