Real Estate Investments - Property Sales (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021 USD ($)	Sep. 30, 2020 USD ($)	Sep. 30, 2021 USD ($) item property	Sep. 30, 2020 USD ($) item property	Dec. 31, 2020 USD ($)
Disposals and other
Carrying value	$ 1,041,916		$ 1,041,916		$ 1,102,358
Net Gain (loss)	2,702	$ 30	$ 7,392	$ 44,073
Impairment charges		941		$ 941
Properties sold
Disposals and other
Number of properties sold | property			6	21
Number of beds or units in property sold | item			426	2,411
Sales price			$ 45,600	$ 74,800
Carrying value	36,528	29,084	36,528	29,084
Net Gain (loss)			7,392	44,073
Net Gain (loss)			$ 292	108
Holdback amount		838		$ 838
Properties sold | SNF | Arizona
Disposals and other
Number of properties sold | property				1
Number of beds or units in property sold | item				194
Sales price				$ 12,550
Carrying value		2,229		2,229
Net Gain (loss)				$ 10,292
Properties sold | SNF | Colorado
Disposals and other
Number of properties sold | property				3
Number of beds or units in property sold | item				275
Sales price				$ 15,000
Carrying value		4,271		4,271
Net Gain (loss)				$ 10,364
Properties sold | SNF | Iowa
Disposals and other
Number of properties sold | property				7
Number of beds or units in property sold | item				544
Sales price				$ 14,500
Carrying value		4,886		4,886
Net Gain (loss)				9,029
Holdback amount					$ 150
Realizable holdback amount				$ 471
Properties sold | SNF | Kansas
Disposals and other
Number of properties sold | property				3
Number of beds or units in property sold | item				250
Sales price				$ 9,750
Carrying value		7,438		7,438
Net Gain (loss)				$ 1,993
Properties sold | SNF | Texas
Disposals and other
Number of properties sold | property				7
Number of beds or units in property sold | item				1,148
Sales price				$ 23,000
Carrying value		$ 10,260		10,260
Net Gain (loss)				$ 12,287
Properties sold | SNF | Washington
Disposals and other
Number of properties sold | property			1
Number of beds or units in property sold | item			123
Sales price			$ 7,700
Carrying value	4,528		4,528
Net Gain (loss)			$ 2,562
Properties sold | ALF | Florida
Disposals and other
Number of properties sold | property			1
Sales price			$ 2,000
Carrying value	2,626		2,626
Net Gain (loss)			$ (858)
Properties sold | ALF | Nebraska
Disposals and other
Number of properties sold | property			1
Number of beds or units in property sold | item			40
Sales price			$ 900
Carrying value	1,079		1,079
Net Gain (loss)			$ (198)
Properties sold | ALF | Wisconsin
Disposals and other
Number of properties sold | property			3
Number of beds or units in property sold | item			263
Sales price			$ 35,000
Carrying value	$ 28,295		28,295
Net Gain (loss)			$ 5,594