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Segment Reporting - Summary Information for Reportable Segments (Details)
$ in Thousands
12 Months Ended
Dec. 31, 2021
USD ($)
segment
Oct. 01, 2021
Property
ft²
Building
Dec. 31, 2021
USD ($)
segment
Dec. 31, 2020
USD ($)
Dec. 31, 2019
USD ($)
Segment Reporting [Line Items]          
Number of reportable segments | segment 6   6    
Number of properties acquired | Property   87      
Number of square feet of property acquired | ft²   4,799,000      
Number of buildings acquired | Building   92      
Goodwill $ 209,898   $ 209,898 $ 75,309  
Revenues and grant income:          
Resident fees and services     1,123,935 1,069,073 $ 1,099,078
Real estate revenue     141,368 120,047 124,038
Grant income     16,951 55,181 0
Total revenues and grant income     1,282,254 1,244,301 1,223,116
Expenses:          
Property operating expenses     1,030,193 993,727 967,860
Rental expenses     38,725 32,298 33,859
Segment net operating income     213,336 218,276 221,397
Expenses:          
General and administrative     43,199 27,007 29,749
Business acquisition expenses     13,022 290 (161)
Depreciation and amortization     133,191 98,858 111,412
Other income (expense):          
Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments)     (80,937) (71,278) (78,553)
Gain (loss) in fair value of derivative financial instruments     8,200 (3,906) (4,541)
(Loss) gain on dispositions of real estate investments     (100) 1,395 0
Impairment of real estate investments     (3,335) (11,069) 0
Loss from unconsolidated entities     (1,355) (4,517) (2,097)
Foreign currency (loss) gain     (564) 1,469 1,730
Other income     1,854 1,570 3,736
Total net other expense     (76,237) (86,336) (79,725)
Income before income taxes     (52,313) 5,785 672
Income tax (expense) benefit     (956) 3,078 (1,524)
Net (loss) income     (53,269) 8,863 (852)
Integrated Senior Health Campuses          
Revenues and grant income:          
Resident fees and services     1,025,699 983,169 1,030,934
Real estate revenue     0 0 0
Grant income     13,911 53,855 0
Total revenues and grant income     1,039,610 1,037,024 1,030,934
Expenses:          
Property operating expenses     943,743 929,897 919,793
Rental expenses     0 0 0
Segment net operating income     95,867 107,127 111,141
SHOP          
Revenues and grant income:          
Resident fees and services     98,236 85,904 68,144
Real estate revenue     0 0 0
Grant income     3,040 1,326 0
Total revenues and grant income     101,276 87,230 68,144
Expenses:          
Property operating expenses     86,450 63,830 48,067
Rental expenses     0 0 0
Segment net operating income     14,826 23,400 20,077
Medical Office Building          
Revenues and grant income:          
Resident fees and services     0 0 0
Real estate revenue     97,297 78,424 80,805
Grant income     0 0 0
Total revenues and grant income     97,297 78,424 80,805
Expenses:          
Property operating expenses     0 0 0
Rental expenses     36,375 30,216 30,870
Segment net operating income     60,922 48,208 49,935
Senior Housing          
Revenues and grant income:          
Resident fees and services     0 0 0
Real estate revenue     16,530 14,524 18,407
Grant income     0 0 0
Total revenues and grant income     16,530 14,524 18,407
Expenses:          
Property operating expenses     0 0 0
Rental expenses     366 64 1,001
Segment net operating income     16,164 14,460 17,406
Skilled Nursing Facilities          
Revenues and grant income:          
Resident fees and services     0 0 0
Real estate revenue     17,309 16,107 13,345
Grant income     0 0 0
Total revenues and grant income     17,309 16,107 13,345
Expenses:          
Property operating expenses     0 0 0
Rental expenses     1,507 1,572 1,456
Segment net operating income     15,802 14,535 11,889
Hospitals          
Revenues and grant income:          
Resident fees and services     0 0 0
Real estate revenue     10,232 10,992 11,481
Grant income     0 0 0
Total revenues and grant income     10,232 10,992 11,481
Expenses:          
Property operating expenses     0 0 0
Rental expenses     477 446 532
Segment net operating income     $ 9,755 $ 10,546 $ 10,949