Real Property Acquisitions and Development (Details 1) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Triple Net
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements	$ 1,691	$ 30,440
Buildings and improvements	0	188,569
Total assets acquired	1,691	219,009
Accrued expenses and other liabilities	(6)	(20,855)
Total liabilities assumed	(6)	(20,855)
Noncontrolling interests	0	(7,284)
Non-cash acquisition related activity	0	(54,989)
Cash disbursed for acquisitions	1,685	135,881
Construction in progress additions	38,238	76,245
Less: Capitalized Interest	(1,432)	(3,215)
Less: Foreign currency translation	132	(3,044)
Cash disbursed for construction in progress	36,938	69,986
Capital improvements to existing properties	8,569	15,269
Total cash invested in real property	47,192	221,136
Non Cash Acquisition Financed As Real Estate Loan Receivable		54,989
Senior housing - operating
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements	47,865	10,590
Buildings and improvements	535,921	69,056
Acquired lease intangibles	68,084	3,596
Receivables and other assets	1,255	296
Total assets acquired	653,125	83,538
Secured debt	(89,973)	0
Accrued expenses and other liabilities	(14,686)	(8,606)
Total liabilities assumed	(104,659)	(8,606)
Noncontrolling interests	(9,818)	(647)
Non-cash acquisition related activity	0	(31,546)
Cash disbursed for acquisitions	538,648	42,739
Construction in progress additions	20,704	42,787
Less: Capitalized Interest	(1,783)	(3,804)
Less: Foreign currency translation	1,176	3,060
Cash disbursed for construction in progress	20,097	42,043
Capital improvements to existing properties	76,237	60,129
Total cash invested in real property	634,982	144,911
Cash acquired from acquisition	2,442	400
Non Cash Acquisition Financed As Real Estate Loan Receivable		6,349
Non cash acquisition financed as equity investments		25,197
Outpatient Medical
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements	7,369	25,060
Buildings and improvements	42,673	62,038
Acquired lease intangibles	5,852	8,397
Receivables and other assets	1	118
Total assets acquired	55,895	95,613
Secured debt	0	(25,824)
Accrued expenses and other liabilities	(632)	(2,210)
Total liabilities assumed	(632)	(28,034)
Noncontrolling interests	0	(9,080)
Cash disbursed for acquisitions	55,263	58,499
Construction in progress additions	11,319	31,830
Less: Capitalized Interest	(1,221)	(1,343)
Less: Accruals	(4,155)	6,530
Cash disbursed for construction in progress	5,943	37,017
Capital improvements to existing properties	26,526	17,409
Total cash invested in real property	87,732	112,925
Cash acquired from acquisition	$ 1,950	$ 0