Business Developments and Other Significant Transactions - Narrative (Details)			12 Months Ended
	Aug. 30, 2019 nursing_center	Oct. 01, 2018 nursing_center lease_extension	Dec. 31, 2020 nursing_center	Sep. 30, 2020 nursing_center	Oct. 01, 2019	Sep. 01, 2019 nursing_center	Aug. 30, 2019 facility	Aug. 30, 2019 lease_extension	May 13, 2019 nursing_center	Apr. 30, 2019 nursing_center	Mar. 31, 2019 nursing_center
Business Acquisition [Line Items]
Number of nursing center facilities leased		34	46
Number of skilled nursing centers under lease		23
Number of skilled nursing centers participating in QIPP		11				11			4	11	1
Operating lease, initial term	12 years	12 years
Operating lease, number of lease extensions allowed | lease_extension		2						2
Lease extension period	10 years	10 years
Annual lease fixed escalators, percent		2.15%			2.15%
Number of nursing center facilities terminated				10
Absent termination cause by either party ,contract term			3 years
Kentucky Properties | Discontinued Operations
Business Acquisition [Line Items]
Number of nursing center facilities terminated	10						10