Real Estate Investments - Development and Improvement Projects (Details) - USD ($)	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
Real estate investments
Invested in projects	$ 24,608,000
Developments | Development and Improvement Commitments
Real estate investments
Invested in projects	25,717,000	$ 13,939,000
Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects	2,063,000	2,308,000
ALF | Developments | Development and Improvement Commitments
Real estate investments
Invested in projects	19,251,000	10,366,000
ALF | Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects	1,131,000	951,000
SNF | Developments | Development and Improvement Commitments
Real estate investments
Invested in projects	6,466,000	3,573,000
SNF | Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects	500,000	$ 1,357,000
Other | Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects	$ 432,000