Equity - Noncontrolling Interest (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2022 USD ($) Center item	Sep. 30, 2023 USD ($) item	Jun. 30, 2023 item	Mar. 31, 2023 item	Sep. 30, 2022 item
Noncontrolling interest
Gross Consolidated Assets	$ 1,656,103	$ 1,867,863
Non-controlling interests	$ 21,940	$ 34,974
Number of units | item					217
ALF & MC
Noncontrolling interest
Number of Assisted Living and Memory Care Communities | item		11
SNF
Noncontrolling interest
Skilled nursing center purchased | Center	3
Partnership
Noncontrolling interest
Gross Consolidated Assets		$ 319,536
Non-controlling interests		34,973
Ohio | ILF/ALF/MC
Noncontrolling interest
Number of units | item			242
Ohio | 2023 Acquisitions | Partnership | ILF/ALF/MC
Noncontrolling interest
Gross Consolidated Assets		54,714
Non-controlling interests		9,134
North Carolina | ALF & MC
Noncontrolling interest
Number of Assisted Living and Memory Care Communities | item				11
Number of units | item				523
North Carolina | 2023 Acquisitions | Partnership | ALF & MC
Noncontrolling interest
Gross Consolidated Assets		121,321
Non-controlling interests		3,831
Florida | SNF
Noncontrolling interest
Skilled nursing center purchased | item	3
Number of units | item	299
Florida | 2022 Acquisitions | Partnership | SNF
Noncontrolling interest
Gross Consolidated Assets		76,712
Non-controlling interests		14,325
Oregon | 2018 Acquisitions | Partnership | ALF & MC
Noncontrolling interest
Gross Consolidated Assets		18,452
Non-controlling interests		1,231
Oregon | 2018 Acquisitions | Partnership | ILF
Noncontrolling interest
Gross Consolidated Assets		14,650
Non-controlling interests		2,907
Wisconsin | 2017 Acquisitions | Partnership | ILF/ALF/MC
Noncontrolling interest
Gross Consolidated Assets		22,007
Non-controlling interests		2,305
South Carolina | 2017 Acquisitions | Partnership | ALF & MC
Noncontrolling interest
Gross Consolidated Assets		11,680
Non-controlling interests		$ 1,240