Significant Accounting Policies Schedule of Variable Interest Entities (Details) $ in Thousands	Dec. 31, 2018 USD ($)
Bickford Senior Living [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	$ 53,649
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	77,878
Senior Living Management [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	26,584
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	26,584
Evolve Senior Living [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	9,928
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	9,928
Senior Living Communities [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	44,376
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	57,475
LCS Timber Ridge [Member] | Life Care Services [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	57,939
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	59,781
LCS Sagewood [Member] | Life Care Services [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	85,017
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	$ 178,200