Leases and Management Agreements with Five Star - Schedule of Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Disaggregation of Revenue [Line Items]
Total revenues	$ 262,003	$ 277,202	$ 528,289	$ 552,972
Basic housing and support services
Disaggregation of Revenue [Line Items]
Total revenues	89,082		176,494
Medicare and Medicaid programs
Disaggregation of Revenue [Line Items]
Total revenues	7,686		16,431
Private pay and other third party payer SNF services
Disaggregation of Revenue [Line Items]
Total revenues	12,138		24,026
Residents fees and services
Disaggregation of Revenue [Line Items]
Total revenues	$ 108,906	$ 102,617	$ 216,951	$ 204,659