Real Estate Investments - Acquisitions (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2017 USD ($) item property	Dec. 31, 2016 USD ($) item property	Dec. 31, 2015 USD ($) item property
Real estate investments
Investment Commitment	$ 193,708
2017 Acquisitions
Real estate investments
Purchase Price	81,818
Transaction Costs	587
Total Acquisition Costs	$ 82,405
Number of properties acquired | property	5
Number of beds/units acquired | item	400
2017 Acquisitions | ALF
Real estate investments
Purchase Price	$ 81,018
Transaction Costs	569
Total Acquisition Costs	$ 81,587
Number of properties acquired | property	5
Number of beds/units acquired | item	400
2017 Acquisitions | ALF | 107-unit ALF and a 73-unit MC
Real estate investments
Number of beds/units acquired | item	107
2017 Acquisitions | MC | 107-unit ALF and a 73-unit MC
Real estate investments
Number of beds/units acquired | item	73
2017 Acquisitions | MC | Memory Care Property with 60 Units
Real estate investments
Purchase Price	$ 15,650
Number of beds/units acquired | item	60
2017 Acquisitions | Land
Real estate investments
Purchase Price	$ 800
Transaction Costs	18
Total Acquisition Costs	818
2017 Acquisitions | ALF & MC | 107-unit ALF and a 73-unit MC
Real estate investments
Purchase Price	38,813
2017 Acquisitions | ALF & MC | 73-unit ALF/MC
Real estate investments
Purchase Price	$ 16,555
Number of beds/units acquired | item	73
2017 Acquisitions | ALF & MC | 87-unit ALF/MC
Real estate investments
Purchase Price	$ 10,000
Number of beds/units acquired | item	87
2017 Acquisitions | ALF/ILF/MC | Wisconsin
Real estate investments
Investment Commitment	$ 22,471
Number of beds/units under development | item	110
2016 Acquisitions
Real estate investments
Purchase Price		$ 76,441
Transaction Costs		576
Total Acquisition Costs		$ 77,017
Number of properties acquired | property		5
Number of beds/units acquired | item		376
2016 Acquisitions | SNF
Real estate investments
Purchase Price		$ 16,000
Transaction Costs		45
Total Acquisition Costs		$ 16,045
Number of properties acquired | property		1
Number of beds/units acquired | item		126
2016 Acquisitions | SNF | Texas
Real estate investments
Number of beds/units acquired | item		126
2016 Acquisitions | ALF
Real estate investments
Purchase Price		$ 53,550
Transaction Costs		423
Total Acquisition Costs		$ 53,973
Number of properties acquired | property		4
Number of beds/units acquired | item		250
2016 Acquisitions | MC | Kentucky
Real estate investments
Purchase Price		$ 14,250
2016 Acquisitions | MC | Kentucky | Holdback
Real estate investments
Contingent consideration		2,000
2016 Acquisitions | MC | Kansas
Real estate investments
Purchase Price		$ 25,000
Number of properties acquired | property		2
2016 Acquisitions | Land
Real estate investments
Purchase Price		$ 6,891
Transaction Costs		108
Total Acquisition Costs		$ 6,999
2016 Acquisitions | Land | Real Estate Development Commitments | Kentucky
Real estate investments
Number of beds/units under development | item		143
2016 Acquisitions | Land | Real Estate Development Commitments | Illinois
Real estate investments
Investment Commitment		$ 14,500
2016 Acquisitions | Land | Real Estate Development Commitments | Maximum | Kentucky
Real estate investments
Investment Commitment		24,325
2016 Acquisitions | ALF & MC | Georgia
Real estate investments
Purchase Price		$ 14,300
2015 Acquisitions
Real estate investments
Purchase Price			$ 218,626
Transaction Costs			1,071
Total Acquisition Costs			$ 219,697
Number of properties acquired | property			15
Number of beds/units acquired | property			1,429
2015 Acquisitions | SNF
Real estate investments
Purchase Price			$ 36,946
Transaction Costs			87
Total Acquisition Costs			$ 37,033
Number of properties acquired | property			3
Number of beds/units acquired | property			360
2015 Acquisitions | SNF | Real Estate Investment | Texas
Real estate investments
Purchase Price			$ 23,000
Number of properties acquired | property			2
Number of beds/units acquired | item			254
2015 Acquisitions | SNF | Real Estate Investment | Wisconsin
Real estate investments
Loan commitment under which the purchase option was exercised			$ 10,600
Payments to acquire productive assets			3,346
2015 Acquisitions | ALF
Real estate investments
Purchase Price			156,097
Transaction Costs			590
Total Acquisition Costs			$ 156,687
Number of properties acquired | property			11
Number of beds/units acquired | property			951
2015 Acquisitions | ALF | Memory Care Property with 60 Units | Real Estate Investment
Real estate investments
Purchase Price			$ 14,250
Total Acquisition Costs			$ 14,132
Number of beds/units acquired | property			60
2015 Acquisitions | ALF | Memory Care Property with 60 Units | Real Estate Investment | Working capital reserve
Real estate investments
Contingent consideration			$ 2,000
2015 Acquisitions | ALF | Memory Care Property with 60 Units | Real Estate Investment | Working capital reserve | Fair Value
Real estate investments
Contingent consideration			$ 1,847
2015 Acquisitions | MC | Real Estate Development Commitments
Real estate investments
Number of beds/units acquired | item			56
2015 Acquisitions | MC | Real Estate Development Commitments | Land Acquisition
Real estate investments
Number of properties acquired | property			3
Number of beds/units acquired | item			198
Number of land parcels acquired | property			5
2015 Acquisitions | MC | Real Estate Development Commitments | Illinois | Land Acquisition
Real estate investments
Number of beds/units acquired | item			108
2015 Acquisitions | MC | Real Estate Development Commitments, Commitments One | Maximum
Real estate investments
Investment Commitment			$ 70,298
2015 Acquisitions | MC | Real Estate Development Commitments, Commitments Two | Maximum
Real estate investments
Investment Commitment			13,524
2015 Acquisitions | Other Properties
Real estate investments
Purchase Price			9,250
Transaction Costs			42
Total Acquisition Costs			$ 9,292
Number of properties acquired | property			1
Number of beds/units acquired | property			118
2015 Acquisitions | Other Properties | Hospital Beds | Real Estate Investment | Nevada | Acquisition of Behavioral Health Care Hospital
Real estate investments
Purchase Price			$ 9,300
Number of beds/units acquired | item			116
2015 Acquisitions | Other Properties | SNF Beds | Real Estate Investment | Nevada | Acquisition of Behavioral Health Care Hospital
Real estate investments
Number of beds/units acquired | item			2
2015 Acquisitions | Land
Real estate investments
Purchase Price			$ 16,333
Transaction Costs			352
Total Acquisition Costs			$ 16,685
2015 Acquisitions | ALF & MC | Real Estate Development Commitments | Land Acquisition
Real estate investments
Number of beds/units acquired | item			89
2015 Acquisitions | ALF/ILF/MC | Real Estate Investment
Real estate investments
Purchase Price			$ 142,000
Number of properties acquired | property			10