Real Estate Investments - Properties Sold (Details) $ in Thousands	3 Months Ended			9 Months Ended
	Sep. 30, 2023 USD ($)	Jun. 30, 2023 USD ($)	Sep. 30, 2022 USD ($)	Sep. 30, 2023 USD ($) item property	Sep. 30, 2022 USD ($) property item	Dec. 31, 2022 USD ($)
Disposals and other
Carrying value	$ 1,007,775			$ 1,007,775		$ 1,019,218
Net gain (loss)	4,870		$ (387)	$ 20,545	$ 37,809
Virginia
Disposals and other
Lease termination fee payable			1,181		$ 1,181
Properties sold
Disposals and other
Number of properties sold | property				10	5
Number of beds or units in property sold | item				651	427
Sales price				$ 53,212	$ 74,345
Carrying value	30,865		35,924	30,865	35,924
Net gain (loss)	4,870		(387)	$ 20,545	37,809
Net Gain (Loss)					$ 186
Properties sold | ALF | Florida
Disposals and other
Number of properties sold | property				1
Number of beds or units in property sold | item				70
Sales price		$ 4,850		$ 4,850
Carrying value	4,082			4,082
Net Gain (Loss)				$ 65
Properties sold | ALF | Kentucky
Disposals and other
Number of properties sold | property				1
Number of beds or units in property sold | item				60
Sales price				$ 11,000
Carrying value	10,720			10,720
Net Gain (Loss)				$ 57
Properties sold | ALF | New Jersey
Disposals and other
Number of properties sold | property				1
Number of beds or units in property sold | item				39
Sales price				$ 2,000
Carrying value	1,552			1,552
Net Gain (Loss)				$ 266
Properties sold | ALF | Nebraska
Disposals and other
Number of properties sold | property				3
Number of beds or units in property sold | item				117
Sales price				$ 2,984
Carrying value	2,934			$ 2,934
Properties sold | ALF | Pennsylvania
Disposals and other
Number of properties sold | property				2
Number of beds or units in property sold | item				130
Sales price				$ 11,128
Carrying value	6,054			6,054
Net Gain (Loss)				$ 4,870
Properties sold | ALF | California
Disposals and other
Number of properties sold | property					2
Number of beds or units in property sold | item					232
Sales price					$ 43,715
Carrying value			17,832		17,832
Net Gain (Loss)					$ 25,867
Properties sold | ALF | Virginia
Disposals and other
Number of properties sold | property					1
Number of beds or units in property sold | item					74
Sales price					$ 16,895
Carrying value			15,549		15,549
Net Gain (Loss)					$ 1,344
Properties sold | SNF | New Mexico
Disposals and other
Number of properties sold | property				2
Number of beds or units in property sold | item				235
Sales price				$ 21,250
Carrying value	$ 5,523			5,523
Net Gain (Loss)				$ 15,287
Properties sold | SNF | California
Disposals and other
Number of properties sold | property					1
Number of beds or units in property sold | item					121
Sales price					$ 13,250
Carrying value			1,846		1,846
Net Gain (Loss)					$ 10,846
Properties sold | SNF | Texas
Disposals and other
Number of properties sold | property					1
Sales price					$ 485
Carrying value			$ 697		697
Net Gain (Loss)					$ (434)