Real Estate Investments - Property Sales (Details)	3 Months Ended	12 Months Ended
	Jun. 30, 2018 facility	Dec. 31, 2019 USD ($) item property	Dec. 31, 2018 USD ($) item property	Dec. 31, 2017 USD ($) item property
Disposals and other
Carrying value		$ 1,136,816,000	$ 1,106,581,000
Net Gain (Loss)		2,106,000	70,682,000	$ 3,814,000
Impairment charges		$ 0	$ 0	$ 1,880,000
Properties sold
Disposals and other
Number of properties sold | property		4	10	6
Number of beds or units in property sold | item		618	774	296
Sales price		$ 15,311,000	$ 95,825,000	$ 15,650,000
Carrying value		12,825,000	22,393,000	11,277,000
Net Gain (Loss)		2,106,000	$ 70,682,000	$ 3,814,000
Properties sold | SNF
Disposals and other
Holdback amount		1,091,000
Realizable holdback amount		$ 613,000
Properties sold | SNF | Arizona, Georgia and Texas
Disposals and other
Number of properties sold | property		3
Number of beds or units in property sold | item		478
Sales price		$ 15,310,000
Carrying value		8,995,000
Net Gain (Loss)		5,556,000
Properties sold | SNF | Georgia
Disposals and other
Carrying value		1,639,000
Proceeds from sale of properties		7,920,000
Properties sold | SNF | Alabama
Disposals and other
Number of properties sold | property			4
Number of beds or units in property sold | item			454
Sales price			$ 27,975,000
Carrying value			5,695,000
Net Gain (Loss)			21,987,000
Properties sold | SNF | Texas
Disposals and other
Number of properties sold | property				1
Number of beds or units in property sold | item				85
Carrying value				$ 1,170,000
Net Gain (Loss)				(1,171,000)
Donation of property				$ 1,170,000
Properties sold | ALF
Disposals and other
Net Gain (Loss)		$ 500,000
Number of facilities sold | facility	6
Properties sold | ALF | Kansas
Disposals and other
Sales price			350,000
Carrying value			$ 346,000
Properties sold | ALF | Ohio and Pennsylvania
Disposals and other
Number of properties sold | property			6
Number of beds or units in property sold | item			320
Sales price			$ 67,500,000
Carrying value			16,352,000
Net Gain (Loss)			$ 48,695,000
Properties sold | ALF | Indiana, Iowa and Oregon
Disposals and other
Number of properties sold | property				5
Number of beds or units in property sold | item				211
Sales price				$ 15,650,000
Carrying value				10,107,000
Net Gain (Loss)				$ 4,985,000
Properties sold | ALF | Texas
Disposals and other
Number of properties sold | property		1
Number of beds or units in property sold | item		140
Sales price		$ 1,000
Carrying value		3,830,000
Net Gain (Loss)		(3,950,000)
Preferred Care, Inc. | Properties sold | Texas
Disposals and other
Carrying value		871,000
Proceeds from sale of properties		140,000
Preferred Care, Inc. | Properties sold | SNF | Arizona
Disposals and other
Carrying value		6,485,000
Proceeds from sale of properties		$ 7,250,000