Real Property Acquisitions and Development (Details 1) - USD ($) $ in Thousands		6 Months Ended
		Jun. 30, 2017	Jun. 30, 2016
Triple Net [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		$ 30,440	$ 18,901
Buildings and improvements		188,569	160,209
Acquired lease intangibles		0	2,876
Total assets acquired		219,009	181,986
Accrued expenses and other liabilities		(20,855)	(1,459)
Total liabilities assumed		(20,855)	(1,459)
Noncontrolling interests		(7,284)	0
Non-cash acquisition related activity	[1]	(54,989)	(37,703)
Cash disbursed for acquisitions		135,881	142,824
Construction in progress additions		76,245	85,687
Less: Capitalized Interest		(3,215)	(3,771)
Less: Foreign currency translation		(3,044)	(2,712)
Cash disbursed for construction in progress		69,986	79,204
Capital improvements to existing properties		15,269	14,877
Total cash invested in real property		221,136	236,905
Non Cash Acquisition Financed As Real Estate Loan Receivable		54,989	31,014
Non cash acquisition financed as equity investments			6,630
Senior housing - operating [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		10,590	5,617
Buildings and improvements		69,056	128,200
Acquired lease intangibles		3,596	6,334
Receivables and other assets		296	894
Total assets acquired	[2]	83,538	141,045
Accrued expenses and other liabilities		(8,606)	(4,853)
Total liabilities assumed		(8,606)	(4,853)
Noncontrolling interests		(647)	(549)
Non-cash acquisition related activity	[3]	(31,546)	(7,659)
Cash disbursed for acquisitions		42,739	127,984
Construction in progress additions		42,787	134,019
Less: Capitalized Interest		(3,804)	(2,011)
Less: Foreign currency translation		3,060	(5,344)
Cash disbursed for construction in progress		42,043	126,664
Capital improvements to existing properties		60,129	47,553
Total cash invested in real property		144,911	302,201
Cash Acquired from Acquisition		400	134
Non Cash Acquisition Financed As Real Estate Loan Receivable		6,349
Non cash acquisition financed as equity investments		25,197	7,659
Outpatient Medical [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		25,060	0
Buildings and improvements		62,038	32,650
Acquired lease intangibles		8,397	0
Receivables and other assets		118	0
Total assets acquired		95,613	32,650
Secured debt		(25,824)	0
Accrued expenses and other liabilities		(2,210)	(990)
Total liabilities assumed		(28,034)	(990)
Noncontrolling interests		(9,080)	0
Non-cash acquisition related activity	[4]	0	(15,013)
Cash disbursed for acquisitions		58,499	16,647
Construction in progress additions		31,830	50,896
Less: Capitalized Interest		(1,343)	(1,561)
Less: Accruals	[5]	6,530	(5,336)
Cash disbursed for construction in progress		37,017	43,999
Capital improvements to existing properties		17,409	25,099
Total cash invested in real property		$ 112,925	$ 85,745

[1] For the six months ended June 30, 2017, $54,989,000 is related to the acquisition of assets previously financed as real estate loans receivable. For the six months ended June 30, 2016, $31,014,000 is related to the acquisition of assets previously financed as real estate loans receivable and $6,630,000 is related to the acquisition of assets previously financed as an investment in an unconsolidated entity.

[2] Excludes $400,000 and $134,000 of cash acquired during the six months ended June 30, 2017 and 2016, respectively.

[3] Includes $6,349,000 related to the acquisition of assets previously financed as real estate loans receivable during the six months ended June 30, 2017. Includes $25,197,000 and $7,659,000 for the six months ended June 30, 2017 and 2016 related to the acquisition of assets previously financed as an investments in an unconsolidated entity.

[4] Represents the acquisition of assets previously financed as real estate loans receivable. Please refer to Note 6 for additional information.

[5] Represents the change in non-cash consideration accruals for amounts to be paid in periods other than the period in which the construction projects converted to operations.