Loans Receivable - Credit Loss Roll Forward (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020
Financing Receivable, Allowance for Credit Loss [Roll Forward]
Balance at beginning of period	$ 224,036	$ 68,372
Provision for loan losses	7,580	8,494
Loan write-offs (1)	(64,075)	0
Foreign currency translation	(109)	(93)
Balance at end of period	167,432	$ 81,985
Accounting Standards Update [Extensible List]		Accounting Standards Update 2016-13
Genesis Healthcare
Financing Receivable, Allowance for Credit Loss [Roll Forward]
Loan write-offs (1)	$ (62,753)
Accounting Standards Update 2016-13 | Cumulative effect, period of adoption, adjustment
Financing Receivable, Allowance for Credit Loss [Roll Forward]
Balance at beginning of period		$ 5,212