Real Property Acquisitions and Development (Details 3) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
Development projects:
Total development projects	$ 188,344	$ 350,142
Expansion Projects	8,879	10,336
Total construction in progress conversions	197,223	360,478
Triple Net
Development projects:
Total development projects	90,055	283,472
Seniors housing operating [Member]
Development projects:
Total development projects	86,931	3,634
Outpatient Medical
Development projects:
Total development projects	$ 11,358	$ 63,036