Real Estate Investments - Types of property Development and Improvement (Details) - USD ($)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Real estate investments
Invested in projects	$ 8,977,000
Developments | Development and Improvement Commitments
Real estate investments
Invested in projects	6,957,000	$ 8,591,000
Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects	259,000	534,000
ALF | Developments | Development and Improvement Commitments
Real estate investments
Invested in projects	4,507,000	6,803,000
ALF | Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects	256,000	122,000
SNF | Developments | Development and Improvement Commitments
Real estate investments
Invested in projects	2,450,000	1,788,000
SNF | Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects		279,000
Other | Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects	$ 3,000	$ 133,000