Real Estate Investments - Development and Improvement Projects (Details) - USD ($)	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Real estate investments
Invested in projects	$ 25,144,000
Developments | Development and Improvement Commitments
Real estate investments
Invested in projects	18,623,000	$ 9,155,000
Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects	1,763,000	2,195,000
ALF | Developments | Development and Improvement Commitments
Real estate investments
Invested in projects	14,653,000	7,198,000
ALF | Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects	1,048,000	839,000
SNF | Developments | Development and Improvement Commitments
Real estate investments
Invested in projects	3,970,000	1,957,000
SNF | Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects	500,000	$ 1,356,000
Other | Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects	$ 215,000