Real Estate Investments - Types of property Development and Improvement (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Real estate investments
Invested in projects	$ 15,646
Developments | Development and Improvement Commitments
Real estate investments
Invested in projects	16,699	$ 20,524	$ 35,279
Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects	6,913	2,839	3,249
ALF | Developments | Development and Improvement Commitments
Real estate investments
Invested in projects	4,491	14,088	27,505
ALF | Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects	6,842	2,544	2,292
SNF | Developments | Development and Improvement Commitments
Real estate investments
Invested in projects	12,208	6,436	7,774
SNF | Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects	$ 71		500
Other | Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects		$ 295	$ 457