Commitments and Contingencies - Narrative (Details)					1 Months Ended	12 Months Ended			114 Months Ended
	Feb. 14, 2020 USD ($)	Aug. 30, 2019 facility	Oct. 01, 2018 extension center	Nov. 01, 2016 USD ($)	Feb. 29, 2020 USD ($)	Dec. 31, 2019 USD ($) center bed lawsuit Multiple	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)	Dec. 31, 2017 USD ($)	Oct. 01, 2019	Sep. 30, 2019 center	Aug. 30, 2019 extension	Aug. 30, 2019 center	May 22, 2019	Oct. 01, 2016 center
Commitments and Contingencies [Line Items]
Operating lease cost						$ 52,990,000
Lease and rent expense							$ 49,231,000	$ 48,248,000
Accrued liability related to straightline rent						$ 9,325,000	6,877,000
Number of nursing center facilities leased | center			34			47
Number of skilled nursing centers under lease | center			23
Operating lease, initial term		12 years	12 years
Operating lease, number of lease extensions allowed | extension			2									2
Operating lease, extension period		10 years	10 years
Operating lease, annual lease fixed escalators, percent			2.15%							2.15%
Number of nursing center facilities terminated											10			10
Number of licensed nursing beds | bed						7,329
Estimated insurance recoveries						$ 1,011	5,478
Cash expenditures for self-insured professional liability costs						4,578,000	6,540,000	6,593,000
Liability for workers compensation claims						921,000	618,000
Workers compensation insurance, non current receivable for excess premiums paid						1,575,000	1,258,000
Health insurance, maximum self-insured annual amount per individual						$ 200,000
Salary multiple | Multiple						2
Renewal period for employee agreements						1 year
Number of professional liability lawsuits | lawsuit						95
Number of Professional Liability Lawsuits, Nonoperating Facilities | center						46
Litigation contingency expense						$ 3,100,000	6,400,000	$ 0
Duration of alleged breaches of statutory and contractual obligations to patents						5 years
Leases, acquired-in-place
Commitments and Contingencies [Line Items]
Number of nursing center facilities leased | center						7
Scheduled for trial or arbitration over next 12 months
Commitments and Contingencies [Line Items]
Number of professional liability lawsuits | lawsuit						23
Professional malpractice liability insurance
Commitments and Contingencies [Line Items]
Insurance policy coverage limits per claim						$ 1,000,000
Workers compensation insurance, maximum annual aggregate self-insured amount						3,000,000
Maximum claim amount on insurance						5,000,000
Liability for reported and estimated future claims						27,390,000	27,201,000
Prefunded deductible policy
Commitments and Contingencies [Line Items]
Insurance policy coverage limits per claim									$ 500,000
Professional liability insurance, annual coverage limit per facility									$ 3,000,000
Liability for reported claims and estimates for incurred but unreported claims						$ 1,810,000	$ 1,396,000
Minimum
Commitments and Contingencies [Line Items]
Employee termination agreement term						1 year
Maximum
Commitments and Contingencies [Line Items]
Maximum contingent liability						$ 1,692,000
Employee termination agreement term						3 years
Omega Healthcare Investors, Inc
Commitments and Contingencies [Line Items]
Annual capital expenditure per licensed bed						$ 400
Total required capital expenditures during remaining lease term						12,294,000
Letters of credit security deposit for a lease						5,332,000
Golden Living master lease
Commitments and Contingencies [Line Items]
Annual capital expenditure per licensed bed						520
Total required capital expenditures during remaining lease term						6,404,000
Golden Living | Mississippi
Commitments and Contingencies [Line Items]
Number of nursing center facilities leased | center															8
Golden Living | Alabama
Commitments and Contingencies [Line Items]
Number of nursing center facilities leased | center															12
Golden Living | Amended lease
Commitments and Contingencies [Line Items]
First year rent				$ 24,675,000
Annual rent increase, as a percent				2.00%
Term of lease				10 years
Letter of credit | Golden Living master lease
Commitments and Contingencies [Line Items]
Letters of credit security deposit for a lease						$ 6,481,000
Golden Living
Commitments and Contingencies [Line Items]
Operating lease, number of lease extensions allowed | extension												2
Operating lease, extension period				5 years
Number of nursing center facilities owned | center						20
Omega Healthcare Investors, Inc
Commitments and Contingencies [Line Items]
Number of nursing center facilities leased | center			11
Kentucky Properties | Discontinued Operations
Commitments and Contingencies [Line Items]
Number of nursing center facilities terminated		10											10
Subsequent event | Violations of False Claims Act
Commitments and Contingencies [Line Items]
Litigation contingency expense	$ 9,500,000				$ 9,500,000
Loss Contingency, Initial Payment Requirement, Amount	$ 500,000
Settlement, payment period	5 years				5 years
Settlement agreement, term					5 years