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Segment Reporting - Summary Information for Reportable Segments (Details)
$ in Thousands
 1 Months Ended 3 Months Ended
Mar. 31, 2019
USD ($)
Mar. 31, 2019
USD ($)
segment
Mar. 31, 2018
USD ($)
Dec. 31, 2018
USD ($)
 [1]
Segment Reporting [Abstract]        
Number of operating segments | segment   3    
Segment Reporting Information [Line Items]        
Rental income   $ 381,084 $ 343,369  
Total revenues   1,272,245 1,096,965  
Property operating expenses   670,807 556,465  
Consolidated net operating income   601,438 540,500  
Depreciation and amortization   243,932 228,201  
Interest expense   145,232 122,775  
General and administrative expenses   35,282 33,705  
Loss (gain) on derivatives and financial instruments, net   (2,487) (7,173)  
Loss (gain) on extinguishment of debt, net   15,719 11,707  
Provision for loan losses $ 18,690 18,690 0  
Impairment of assets   0 28,185  
Other expenses   8,756 3,712  
Income (loss) from continuing operations before income taxes and other items   136,314 119,388  
Income tax (expense) benefit   (2,222) (1,588)  
(Loss) income from unconsolidated entities   (9,199) (2,429)  
Gain (loss) on real estate dispositions, net   167,409 338,184  
Income (loss) from continuing operations   292,302 453,555  
Net income (loss)   292,302 453,555  
Total assets 30,637,336 30,637,336   $ 30,342,072
Resident fees and services        
Segment Reporting Information [Line Items]        
Revenue from contract with customer   868,285 735,934  
Interest income        
Segment Reporting Information [Line Items]        
Revenue from contract with customer   15,119 14,648  
Other income        
Segment Reporting Information [Line Items]        
Revenue from contract with customer   7,757 3,014  
Operating Segments | Seniors Housing Operating        
Segment Reporting Information [Line Items]        
Rental income   0 0  
Total revenues   872,386 737,167  
Property operating expenses   607,686 511,941  
Consolidated net operating income   264,700 225,226  
Depreciation and amortization   131,575 125,769  
Interest expense   18,251 16,935  
General and administrative expenses   0 0  
Loss (gain) on derivatives and financial instruments, net   0 0  
Loss (gain) on extinguishment of debt, net   0 (189)  
Provision for loan losses   0    
Impairment of assets     2,301  
Other expenses   2,946 (188)  
Income (loss) from continuing operations before income taxes and other items   111,928 80,598  
Income tax (expense) benefit   (619) 162  
(Loss) income from unconsolidated entities   (16,580) (9,480)  
Gain (loss) on real estate dispositions, net   (160) 5  
Income (loss) from continuing operations   94,569 71,285  
Net income (loss)   94,569 71,285  
Total assets 15,237,260 15,237,260    
Operating Segments | Seniors Housing Operating | Resident fees and services        
Segment Reporting Information [Line Items]        
Revenue from contract with customer   868,285 735,934  
Operating Segments | Seniors Housing Operating | Interest income        
Segment Reporting Information [Line Items]        
Revenue from contract with customer   0 85  
Operating Segments | Seniors Housing Operating | Other income        
Segment Reporting Information [Line Items]        
Revenue from contract with customer   4,101 1,148  
Operating Segments | Triple-net        
Segment Reporting Information [Line Items]        
Rental income   232,032 206,831  
Total revenues   248,241 222,759  
Property operating expenses   14,955 21  
Consolidated net operating income   233,286 222,738  
Depreciation and amortization   61,348 56,032  
Interest expense   3,440 3,442  
General and administrative expenses   0 0  
Loss (gain) on derivatives and financial instruments, net   (2,487) (7,173)  
Loss (gain) on extinguishment of debt, net   0 (32)  
Provision for loan losses   18,690    
Impairment of assets     25,884  
Other expenses   3,029 1,120  
Income (loss) from continuing operations before income taxes and other items   149,266 143,465  
Income tax (expense) benefit   (951) (1,136)  
(Loss) income from unconsolidated entities   5,658 5,821  
Gain (loss) on real estate dispositions, net   167,574 123,397  
Income (loss) from continuing operations   321,547 271,547  
Net income (loss)   321,547 271,547  
Total assets 9,494,799 9,494,799    
Operating Segments | Triple-net | Resident fees and services        
Segment Reporting Information [Line Items]        
Revenue from contract with customer   0 0  
Operating Segments | Triple-net | Interest income        
Segment Reporting Information [Line Items]        
Revenue from contract with customer   14,946 14,551  
Operating Segments | Triple-net | Other income        
Segment Reporting Information [Line Items]        
Revenue from contract with customer   1,263 1,377  
Operating Segments | Outpatient Medical        
Segment Reporting Information [Line Items]        
Rental income   149,052 136,538  
Total revenues   149,461 136,671  
Property operating expenses   48,166 44,503  
Consolidated net operating income   101,295 92,168  
Depreciation and amortization   51,009 46,400  
Interest expense   3,348 1,676  
General and administrative expenses   0 0  
Loss (gain) on derivatives and financial instruments, net   0 0  
Loss (gain) on extinguishment of debt, net   0 11,928  
Provision for loan losses   0    
Impairment of assets     0  
Other expenses   754 598  
Income (loss) from continuing operations before income taxes and other items   46,184 31,566  
Income tax (expense) benefit   (365) (428)  
(Loss) income from unconsolidated entities   1,723 1,230  
Gain (loss) on real estate dispositions, net   (5) 214,782  
Income (loss) from continuing operations   47,537 247,150  
Net income (loss)   47,537 247,150  
Total assets 5,729,959 5,729,959    
Operating Segments | Outpatient Medical | Resident fees and services        
Segment Reporting Information [Line Items]        
Revenue from contract with customer   0 0  
Operating Segments | Outpatient Medical | Interest income        
Segment Reporting Information [Line Items]        
Revenue from contract with customer   173 12  
Operating Segments | Outpatient Medical | Other income        
Segment Reporting Information [Line Items]        
Revenue from contract with customer   236 121  
Non-segment / Corporate        
Segment Reporting Information [Line Items]        
Rental income   0 0  
Total revenues   2,157 368  
Property operating expenses   0 0  
Consolidated net operating income   2,157 368  
Depreciation and amortization   0 0  
Interest expense   120,193 100,722  
General and administrative expenses   35,282 33,705  
Loss (gain) on derivatives and financial instruments, net   0 0  
Loss (gain) on extinguishment of debt, net   15,719 0  
Provision for loan losses   0    
Impairment of assets     0  
Other expenses   2,027 2,182  
Income (loss) from continuing operations before income taxes and other items   (171,064) (136,241)  
Income tax (expense) benefit   (287) (186)  
(Loss) income from unconsolidated entities   0 0  
Gain (loss) on real estate dispositions, net   0 0  
Income (loss) from continuing operations   (171,351) (136,427)  
Net income (loss)   (171,351) (136,427)  
Total assets $ 175,318 175,318    
Non-segment / Corporate | Resident fees and services        
Segment Reporting Information [Line Items]        
Revenue from contract with customer   0 0  
Non-segment / Corporate | Interest income        
Segment Reporting Information [Line Items]        
Revenue from contract with customer   0 0  
Non-segment / Corporate | Other income        
Segment Reporting Information [Line Items]        
Revenue from contract with customer   $ 2,157 $ 368  
[1] The consolidated balance sheet at December 31, 2018 has been derived from the audited financial statements at that date but does not include all of the information and footnotes required by U.S. generally accepted accounting principles for complete financial statements.