Sonida Senior Living (SNDA) 10-K 31 Mar 20 2019 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2019	Mar. 25, 2020	Jun. 28, 2019
Cover [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	FY
Trading Symbol	CSU
Title of 12(b) Security	Common Stock, $.01 par value per share
Security Exchange Name	NYSE
Entity Registrant Name	CAPITAL SENIOR LIVING CORP
Entity Central Index Key	0001043000
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Shell Company	false
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		31,956,439
Entity Public Float			$ 127
Entity File Number	1-13445
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	75-2678809
Entity Address, Address Line One	14160 Dallas Parkway
Entity Address, Address Line Two	Suite 300
Entity Address, City or Town	Dallas
Entity Address, State or Province	TX
Entity Address, Postal Zip Code	75254
City Area Code	972
Local Phone Number	770-5600
Document Annual Report	true
Document Transition Report	false
Documents Incorporated by Reference	DOCUMENTS INCORPORATED BY REFERENCE Portions of the Registrant’s definitive proxy statement pertaining to its 2020 Annual Meeting of Stockholders and filed or to be filed not later than 120 days after the end of the fiscal year pursuant to Regulation 14A are incorporated herein by reference into Part III of this report.

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Current assets:
Cash and cash equivalents	$ 23,975	$ 31,309
Restricted cash	13,088	13,011
Accounts receivable, net	8,143	10,581
Federal and state income taxes receivable	72	152
Property tax and insurance deposits	12,627	13,173
Prepaid expenses and other	5,308	5,232
Total current assets	63,213	73,458
Property and equipment, net	969,211	1,059,049
Operating lease right-of-use assets, net	224,523
Deferred taxes, net	76	152
Other assets, net	10,673	16,485
Total assets	1,267,696	1,149,144
Current liabilities:
Accounts payable	10,382	9,095
Accrued expenses	46,227	41,880
Current portion of notes payable, net of deferred loan costs	15,819	14,342
Current portion of deferred income	7,201	14,892
Current portion of financing obligations	1,741	3,113
Current portion of lease liabilities	45,988
Federal and state income taxes payable	420	406
Customer deposits	1,247	1,302
Total current liabilities	129,025	85,030
Deferred income, net of current portion		8,151
Financing obligations, net of current portion	9,688	45,647
Lease liabilities, net of current portion	208,967
Other long-term liabilities		15,643
Notes payable, net of deferred loan costs and current portion	905,637	959,408
Commitments and contingencies
Shareholders’ equity:
Preferred stock, $.01 par value: Authorized shares - 15,000; no shares issued or outstanding
Common stock, $.01 par value: Authorized shares - 65,000; issued and outstanding shares 31,441 and 31,273 in 2019 and 2018, respectively	319	318
Additional paid-in capital	190,386	187,879
Retained deficit	(172,896)	(149,502)
Treasury stock, at cost — 494 shares in 2019 and 2018	(3,430)	(3,430)
Total shareholders’ equity	14,379	35,265
Total liabilities and shareholders’ equity	$ 1,267,696	$ 1,149,144

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 2019	Dec. 31, 2018
Statement Of Financial Position [Abstract]
Preferred stock, par value	$ 0.01	$ 0.01
Preferred stock, shares authorized	15,000,000	15,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	65,000,000	65,000,000
Common stock, shares issued	31,441,000	31,273,000
Common stock, shares outstanding	31,441,000	31,273,000
Treasury stock, shares	494,000	494,000

Consolidated Statements of Oper

Consolidated Statements of Operations and Comprehensive Loss - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Revenues:
Resident revenue	$ 447,100	$ 460,018	$ 466,997
Type Of Revenue [Extensible List]	us-gaap:HealthCareResidentServiceMember	us-gaap:HealthCareResidentServiceMember	us-gaap:HealthCareResidentServiceMember
Expenses:
Operating expenses (exclusive of facility lease expense and depreciation and amortization expense shown below)	$ 306,786	$ 294,661	$ 290,662
General and administrative expenses	27,518	26,961	23,574
Facility lease expense	57,021	56,551	56,432
Loss on facility lease termination			12,858
Provision for bad debts	3,765	2,990	1,748
Stock-based compensation expense	2,509	8,428	7,682
Depreciation and amortization expense	64,190	62,824	66,199
Total expenses	461,789	452,415	459,155
Income (Loss) from operations	(14,689)	7,603	7,842
Other income (expense):
Interest income	221	165	73
Interest expense	(49,802)	(50,543)	(49,471)
Write-off of deferred loan costs and prepayment premiums	(4,843)	(12,623)
Long-lived asset impairment	(3,004)
Gain (Loss) on disposition of assets, net	36,528	28	(123)
Other income	7	3	7
Loss before benefit (provision) for income taxes	(35,582)	(55,367)	(41,672)
Benefit (Provision) for income taxes	(448)	1,771	(2,496)
Net loss	$ (36,030)	$ (53,596)	$ (44,168)
Per share data:
Basic net loss per share	$ (1.19)	$ (1.80)	$ (1.50)
Diluted net loss per share	$ (1.19)	$ (1.80)	$ (1.50)
Weighted average shares outstanding — basic	30,263	29,812	29,453
Weighted average shares outstanding — diluted	30,263	29,812	29,453
Comprehensive loss	$ (36,030)	$ (53,596)	$ (44,168)

Consolidated Statements of Shar

Consolidated Statements of Shareholders' Equity - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock [Member]	Additional Paid-In Capital [Member]	Retained Deficit [Member]	Treasury Stock [Member]
Beginning Balance at Dec. 31, 2016	$ 116,918	$ 305	$ 171,599	$ (51,556)	$ (3,430)
Beginning Balance, Shares at Dec. 31, 2016		30,012
Restricted stock unit conversions	0		0
Restricted stock unit conversions, Shares		3
Restricted stock awards	1	$ 5	(4)
Restricted stock awards, Shares		490
Stock-based compensation	7,682		7,864	(182)
Net loss	(44,168)			(44,168)
Ending Balance at Dec. 31, 2017	80,433	$ 310	179,459	(95,906)	(3,430)
Ending Balance, Shares at Dec. 31, 2017		30,505
Restricted stock awards		$ 8	(8)
Restricted stock awards, Shares		768
Stock-based compensation	8,428		8,428
Net loss	(53,596)			(53,596)
Ending Balance at Dec. 31, 2018	35,265	$ 318	187,879	(149,502)	(3,430)
Ending Balance, Shares at Dec. 31, 2018		31,273
Adoption of ASC 842	12,636			12,636
Restricted stock awards	(1)	$ 1	(2)
Restricted stock awards, Shares		168
Stock-based compensation	2,509		2,509
Net loss	(36,030)			(36,030)
Ending Balance at Dec. 31, 2019	$ 14,379	$ 319	$ 190,386	$ (172,896)	$ (3,430)
Ending Balance, Shares at Dec. 31, 2019		31,441

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Operating Activities
Net loss	$ (36,030)	$ (53,596)	$ (44,168)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation and amortization	64,190	62,824	66,199
Amortization of deferred financing charges	1,612	1,709	1,626
Amortization of deferred lease costs and lease intangibles, net		849	859
Amortization of lease incentives		(2,074)	(1,336)
Deferred income	1,078	(1,391)	(1,397)
Deferred taxes	157	(2,245)	1,941
Operating lease expense adjustment	(5,243)
Lease incentives		3,376	5,673
Loss on facility lease termination			12,858
Write-off of deferred loan costs and prepayment premiums	4,843	12,623
(Gain) Loss on disposition of assets, net	(36,528)	(28)	123
Long-lived asset impairment	3,004
Provision for bad debts	3,765	2,990	1,748
Stock-based compensation expense	2,509	8,428	7,682
Changes in operating assets and liabilities:
Accounts receivable	(1,326)	(3,173)	(8,159)
Property tax and insurance deposits	545	1,213	279
Prepaid expenses and other	(1,013)	1,100	33
Other assets	(500)	1,350	4,061
Accounts payable	(715)	1,294	2,750
Accrued expenses	4,343	1,129	1,689
Other liabilities			5,017
Federal and state income taxes receivable/payable	14	23	165
Deferred resident revenue	579	561	(1,898)
Customer deposits	(55)	(92)	(151)
Net cash provided by operating activities	5,229	36,870	55,594
Investing Activities
Capital expenditures	(20,306)	(21,965)	(39,959)
Cash paid for acquisitions			(85,000)
Proceeds from disposition of assets	68,084	57	19
Net cash provided by (used in) investing activities	47,778	(21,908)	(124,940)
Financing Activities
Proceeds from notes payable	37,499	208,841	77,197
Repayments of notes payable	(95,077)	(204,093)	(20,099)
Cash payments for financing lease and financing obligations	(1,516)	(3,151)	(2,869)
Deferred financing charges paid	(1,170)	(3,263)	(1,182)
Net cash provided by (used in) financing activities	(60,264)	(1,666)	53,047
Increase (Decrease) in cash and cash equivalents	(7,257)	13,296	(16,299)
Cash and cash equivalents and restricted cash at beginning of year	44,320	31,024	47,323
Cash and cash equivalents and restricted cash at end of year	37,063	44,320	31,024
Cash paid during the year for:
Interest	47,448	49,225	47,022
Income taxes	$ 505	$ 555	$ 543

Organization

Organization	12 Months Ended
	Dec. 31, 2019
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Organization	1. Organization Capital Senior Living Corporation, a Delaware corporation (together with its subsidiaries, the “Company”), is one of the largest operators of senior housing communities in the United States in terms of resident capacity. The Company owns, operates, develops and manages senior housing communities throughout the United States. As of December 31, 2019, the Company operated 126 senior housing communities in 23 states with an aggregate capacity of approximately 16,000 residents, including 80 senior housing communities which the Company owned and 46 senior housing communities that the Company leased. The accompanying consolidated financial statements include the financial statements of Capital Senior Living Corporation and its wholly owned subsidiaries. All material intercompany balances and transactions have been eliminated in consolidation.

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2019
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Cash and Cash Equivalents and Restricted Cash The Company considers all highly liquid investments with original maturities of three months or less at the date of acquisition to be cash equivalents. The Company has deposits in banks that exceed Federal Deposit Insurance Corporation insurance limits. Management believes that credit risk related to these deposits is minimal. Restricted cash consists of deposits required by certain lenders as collateral pursuant to letters of credit. The deposit must remain so long as the letter of credit is outstanding which is subject to renewal annually. The following table sets forth our cash and cash equivalents and restricted cash (in thousands): Year Ended December 31, 2019 2018 Cash and cash equivalents $ 23,975 $ 31,309 Restricted cash 13,088 13,011 $ 37,063 $ 44,320 Long-Lived Assets and Impairment Property and equipment are stated at cost and depreciated on a straight-line basis over the estimated useful lives of the assets. At each balance sheet date, the Company reviews the carrying value of its property and equipment to determine if facts and circumstances suggest that they may be impaired or that the depreciation period may need to be changed. The Company considers internal factors such as net operating losses along with external factors relating to each asset, including contract changes, local market developments, and other publicly available information to determine whether impairment indicators exist. If an indicator of impairment is identified, the carrying value of a long-lived asset is considered impaired when the anticipated undiscounted cash flows from such asset is separately identifiable and is less than its carrying value. Recoverability of an asset group is assessed by comparing its carrying amount to the estimated future undiscounted net cash flows expected to be generated by the asset group through operation or disposition, calculated utilizing the lowest level of identifiable cash flows. If this comparison indicates that the carrying amount of an asset group is not recoverable, we are required to recognize an impairment loss. The Company determines the fair value of operating lease ROU assets by comparing the contractual rent payments to estimated market rental rates. Long-lived ROU and fixed assets are valued at fair value using inputs classified as Level 3 in the fair value hierarchy, which are unobservable inputs based on the Company’s assumptions. Impairment, if any, is recorded in the period in which the impairment occurred. Assets Held for Sale Assets are classified as held for sale when the Company has determined all of the held-for-sale criteria have been met. The Company determines the fair value, net of costs of disposal, of an asset on the date the asset is categorized as held for sale, and the asset is recorded at the lower of its fair value, net of cost of disposal, or carrying value on that date. The Company periodically reevaluates assets held for sale to determine if the assets are still recorded at the lower of fair value, net of cost of disposal, or carrying value. The fair values are generally determined based on market rates, industry trends and recent comparable sales transactions. During the year ended December 31, 2019, the Company determined a remeasurement write down of approximately $2.3 million was required to adjust the carrying value of a community classified as held for sale to its fair value, net of cost of disposal, which is included in gain (loss) on disposition of assets, net on the Company’s Consolidated Statements of Operations and Comprehensive Loss. The community was sold prior to December 31, 2019. The Company did not recognize any expense related to assets held for sale during the year ended December 31, 2018. The fair values are generally determined based on market rates, industry trends, and recent comparable sales transactions. The actual sales price of these assets could differ significantly from the Company’s estimates. There were no senior housing communities classified as held for sale by the Company at December 31, 2019 or 2018. Advertising Costs The Company expenses advertising costs as incurred. Advertising expense was approximately $3.9 million $3.3 million $2.8 million for the years ended December 31, 2019 2018 2017 Off-Balance Sheet Arrangements The Company had no material off-balance sheet arrangements at December 31, 2019 or 2018. Income Taxes Income taxes are computed using the asset and liability method and current income taxes are recorded based on amounts refundable or payable. Deferred income taxes are recorded based on the estimated future tax effects of loss carryforwards and temporary differences between financial statement carrying amounts of existing assets and liabilities and their respective tax basis. Deferred tax assets and liabilities are measured using enacted tax rates that are expected to apply to taxable income in the years in which we expect those carryforwards and temporary differences to be recovered or settled. Management regularly evaluates the future realization of deferred tax assets and provides a valuation allowance, if considered necessary, based on such evaluation. As part of the evaluation, management has evaluated taxable income in carryback years, future reversals of taxable temporary differences, feasible tax planning strategies, and future expectations of income. The Company evaluates uncertain tax positions through consideration of accounting and reporting guidance on criteria, measurement, derecognition, classification, interest and penalties, accounting in interim periods, disclosure, and transition that is intended to provide better financial-statement comparability among different companies. The Company is required to recognize a tax benefit in its financial statements for an uncertain tax position only if management’s assessment is that its position is “more likely than not” (i.e., a greater than 50 percent likelihood) to be upheld on audit based only on the technical merits of the tax position. The Company’s policy is to recognize interest related to unrecognized tax benefits as interest expense and penalties as income tax expense. Revenue Recognition Resident revenue consists of fees for basic housing and certain support services and fees associated with additional housing and expanded support requirements such as assisted living care, memory care, and ancillary services. Basic housing and certain support services revenue is recorded when services are rendered and amounts billed are Residency agreements are generally short term in nature with durations of one year or less and are typically terminable by either party, under certain circumstances, upon providing 30 days’ notice, unless state law provides otherwise, with resident fees billed monthly in advance. and were recognized as a component of resident revenue within the Company’s Consolidated Statements of Operations and Comprehensive Loss. Revenue for certain ancillary services is recognized as services are provided, and includes fees for services such as medication management, daily living activities, beautician/barber, laundry, television, guest meals, pets, and parking which are generally billed monthly in arrears. The Company's senior housing communities have residency agreements which generally require the resident to pay a community fee prior to moving into the community and are recorded initially by the Company as deferred revenue. At each of December 31, 2019 and 2018, the Company had contract liabilities for deferred community fees totaling approximately $2.2 million and $1.1 million, respectively, which are included as a component of deferred income within current liabilities of the Company’s Consolidated Balance Sheets. The Company recognized community fees as a component of resident revenue within the Company’s Consolidated Statements of Operations and Comprehensive Loss of approximately $2.9 million and $2.8 million, respectively, during the fiscal years ended December 31, 2019 and 2018. Revenues from the Medicaid program accounted for approximately 5.9% of the Company’s revenue in fiscal 2019, 5.4% of the Company’s revenue in fiscal 2018, and 5.6% of the Company’s revenue in fiscal 2017. During fiscal 2019, 2018, and 2017, 41, 40, and 41, respectively, of the Company’s communities were providers of services under the Medicaid program. Accordingly, these communities were entitled to reimbursement under the foregoing program at established rates that were lower than private pay rates. Patient service revenue for Medicaid patients was recorded at the reimbursement rates as the rates were set prospectively by the applicable state upon the filing of an annual cost report. None of the Company’s communities were providers of services under the Medicare program during fiscal 2019, 2018, or 2017. Laws and regulations governing the Medicaid program are complex and subject to interpretation. The Company believes that it is in compliance with all applicable laws and regulations and is not aware of any pending or threatened investigations involving allegations of potential wrongdoing. While no such regulatory inquiries have been made, compliance with such laws and regulations can be subject to future government review and interpretation as well as significant regulatory action including fines, penalties, and exclusion from the Medicaid program. Purchase Accounting In determining the allocation of the purchase price of senior housing communities acquired to net tangible and identified intangible assets acquired and liabilities assumed, if any, the Company makes estimates of fair value using information obtained as a result of pre-acquisition due diligence, leasing activities and/or independent appraisals. The Company assigns the purchase price for senior living communities to assets acquired and liabilities assumed based on their estimated fair values. The determination of fair value involves the use of significant judgments and estimates which is generally assessed as follows: The Company allocates the fair values of buildings acquired on an as-if-vacant basis and depreciates the building values over the estimated remaining lives of the buildings, not to exceed 40 years. The Company The fair value of acquired lease-related intangibles reflects the estimated fair value of existing resident in-place leases as represented by the cost to obtain residents and an estimated absorption period to reflect the value of the rent and recovery costs foregone during a reasonable lease-up period as if the property acquired was vacant. The Company amortizes any acquired resident in-place lease intangibles to depreciation and amortization expense over the estimated remaining useful life of the respective resident operating leases. Credit Risk and Allowance for Doubtful Accounts The Company’s resident receivables are generally due within 30 days from the date billed. Accounts receivable are reported net of an allowance for doubtful accounts of $8.6 million and $6.8 million at December 31, 2019 and 2018, respectively, and represent the Company’s estimate of the amount that ultimately will be collected. The adequacy of the Company’s allowance for doubtful accounts is reviewed on an ongoing basis, using historical payment trends, write-off experience, analyses of receivable portfolios by payor source and aging of receivables, as well as a review of specific accounts, and adjustments are made to the allowance as necessary. Credit losses on resident receivables have historically been within management’s estimates, and management believes that the allowance for doubtful accounts adequately provides for expected losses. Lease Accounting Effective January 1, 2019, the Company adopted the new lease standard provisions of ASC 842. Due to the adoption of ASC 842, the unamortized balances of lease acquisition costs and lease incentives were reclassified as a component of the respective operating lease right-of-use asset. Additionally, the unamortized balance of deferred gains associated with sale leaseback transactions totaling approximately $10.0 million was written-off to retained deficit. Management determines if a contract is or contains a lease at inception or modification of a contract. A contract is or contains a lease if the contract conveys the right to control the use of an identified asset for a period of time in exchange for consideration. Control over the use of the identified asset means the lessee has both the right to obtain substantially all of the economic benefits from the use of the asset and the right to direct the use of the asset. Operating lease right-of-use assets and liabilities are recognized based on the present value of future minimum lease payments over the expected lease term on the lease commencement date. When the implicit lease rate is not determinable, management uses the Company’s incremental borrowing rate based on the information available at the lease commencement date in determining the present value of future minimum lease payments. The expected lease terms include options to extend or terminate the lease when it is reasonably certain the Company will exercise such options. Lease expense for minimum lease payments is recognized on a straight-line basis over the expected lease terms. Certain of the Company’s lease arrangements have lease and non-lease components. The Company accounts for the lease components and non-lease components as a single lease component for all classes of underlying assets. Leases with an expected lease term of 12 months or less are not recorded on the balance sheet and the related lease expense is recognized on a straight-line basis over the expected lease term. Self-Insurance Liability Accruals The Company offers full-time employees an option to participate in its health and dental plans. The Company is self-insured up to certain limits and is insured if claims in excess of these limits are incurred. The cost of employee health and dental benefits, net of employee contributions, is shared between the corporate office and the senior housing communities based on the respective number of plan participants. Funds collected are used to pay the actual program costs, including estimated annual claims, third-party administrative fees, network provider fees, communication costs, and other related administrative costs incurred by the plans. Claims are paid as they are submitted to the Company’s third-party administrator. The Company records a liability for outstanding claims and claims that have been incurred but not yet reported. This liability is based on the historical claim reporting lag and payment trends of health insurance claims. Management believes that the liability for outstanding losses and expenses is adequate to cover the ultimate cost of losses and expenses incurred at December 31, 2019; however, actual claims and expenses may differ. Any subsequent changes in estimates are recorded in the period in which they are determined. The Company uses a combination of insurance and self-insurance for workers’ compensation. Determining the reserve for workers’ compensation losses and costs that the Company has incurred as of the end of a reporting period involves significant judgments based on projected future events, including potential settlements for pending claims, known incidents which may result in claims, estimates of incurred but not yet reported claims, changes in insurance premiums, estimated litigation costs and other factors. The Company regularly adjusts these estimates to reflect changes in the foregoing factors. However, since this reserve is based on estimates, the actual expenses incurred may differ from the amounts reserved. Any subsequent changes in estimates are recorded in the period in which they are determined. Net Loss Per Share Basic net loss per common share is computed by dividing net loss by the weighted average number of common shares outstanding for the period. Potentially dilutive securities consist of unvested restricted shares and shares that could be issued under outstanding stock options. Potentially dilutive securities are excluded from the computation of net loss per common share if their effect is antidilutive. The following table sets forth the computation of basic and diluted net loss per share (in thousands, except for per share amounts): Year Ended December 31, 2019 2018 2017 Net loss $ (36,030 ) $ (53,596 ) $ (44,168 ) Net loss allocated to unvested restricted shares — — — Undistributed net loss allocated to common shares $ (36,030 ) $ (53,596 ) $ (44,168 ) Weighted average shares outstanding — basic 30,263 29,812 29,453 Effects of dilutive securities: Employee equity compensation plans — — — Weighted average shares outstanding — diluted 30,263 29,812 29,453 Basic net loss per share $ (1.19 ) $ (1.80 ) $ (1.50 ) Diluted net loss per share $ (1.19 ) $ (1.80 ) $ (1.50 ) Awards of unvested restricted stock representing approximately 1.1 million, 1.3 million, and 0.9 million shares were outstanding for the fiscal years ended December 31, 2019, 2018, and 2017, respectively, and are antidilutive. Treasury Stock The Company accounts for treasury stock under the cost method and includes treasury stock as a component of shareholders’ equity until it is canceled. There were no repurchases of the Company’s common stock during fiscal 2019 or 2018. Stock-Based Compensation The Company recognizes compensation expense for share-based payment awards to certain employees and directors, including grants of stock options and awards of restricted stock, in the Consolidated Statements of Operations and Comprehensive Loss based on their fair values. On May 8, 2007, the Company’s stockholders approved the 2007 Omnibus Stock and Incentive Plan for Capital Senior Living Corporation (as amended, the “2007 Plan”) which provided for, among other things, the grant of restricted stock awards and stock options to purchase shares of the Company’s common stock. The 2007 Plan authorized the Company to issue up to 4.6 million shares of common stock, and the Company had reserved shares of common stock for future issuance pursuant to awards under the 2007 Plan. On May 14, 2019, the Company’s stockholders approved the 2019 Omnibus Stock and Incentive Plan for Capital Senior Living Corporation (the “2019 Plan”), which replaced the 2007 Plan. The 2019 Plan provides for, among other things, the grant of restricted stock awards, restricted stock units and stock options to purchase shares of the Company’s common stock. The 2019 Plan authorizes the Company to issue up to 2,250,000 shares of common stock plus reserved shares not issued or subject to outstanding awards under the 2007 Plan, and the Company has reserved shares of common stock for future issuance pursuant to awards under the 2019 Plan. Effective March 26, 2019, the 2007 Plan was terminated and no additional awards will be granted under the 2007 Plan. Segment Information The Company evaluates the performance and allocates resources of its senior living facilities based on current operations and market assessments on a property-by-property basis. The Company does not have a concentration of operations geographically or by product or service as its management functions are integrated at the property level. The Company has determined that all of its operating units meet the criteria in Accounting Standards Codification (“ASC”) Topic 280, Segment Reporting Recently Issued Accounting Guidance In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820) , which modifies certain disclosure requirements in Topic 820, such as the removal of the need to disclose the amount of and reason for transfers between Level 1 and Level 2 of the fair value hierarchy, and several changes related to Level 3 fair value measurements. ASU 2018-13 is effective for fiscal years and interim periods within those fiscal years beginning after December 15, 2019. The Company does not expect the adoption of ASU 2018-13 to have a material impact on its consolidated financial statements. In June 2016, the FASB issued ASU 2016-13, Financial Instruments - Credit Losses: Measurement of Credit Losses on Financial Instruments In February 2016, the FASB issued ASU 2016-02, Leases Leases, Targeted Improvements The fair value of the right-of-use assets was estimated, utilizing a discounted cash flow approach based upon historical and projected cash flows and market data, including management fees and a market supported lease coverage ratio. The estimated future cash flows were discounted at a rate that is consistent with a weighted average cost of capital from a market participant perspective. The adoption of ASC 842 resulted in the following adjustments to the Company’s Consolidated Balance Sheet at January 1, 2019: Assets Prepaid expenses and other $ (2,050) Property and equipment, net (15,569) Operating lease right-of-use assets, net 255,386 Other assets, net (4,715) Total assets $ 233,052 Liabilities and Shareholder’s Equity Deferred income $ (17,498) Financing obligations (35,956) Operating lease liabilities 289,513 Other long-term liabilities (15,643) Total liabilities $ 220,416 Total shareholder’s equity $ 12,636 Use of Estimates and Critical Accounting Policies The preparation of financial statements in conformity with U.S. generally accepted accounting principles requires management to make estimates and assumptions that affect the amounts reported in the accompanying financial statements and related footnotes. Management bases its estimates and assumptions on historical experience, observance of industry trends and various other sources of information and factors, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Actual results could differ from these estimates. Critical accounting policies are defined as those that are reflective of significant judgments and uncertainties, and potentially could result in materially different results under different assumptions and conditions. The Company believes revenue recognition, long-lived asset impairment, and self-insurance liability accruals are its most critical accounting policies and/or require management’s most subjective judgments.

Impairment of Long-Lived Assets

Impairment of Long-Lived Assets	12 Months Ended
	Dec. 31, 2019
Asset Impairment Charges [Abstract]
Impairment of Long-Lived Assets	3. Impairment of Long-Lived Assets During the year ended December 31, 2019. the Company recorded impairment charges of $1.6 million and $1.4 million related to fixed assets and lease ROU assets, respectively, due to a change in the useful life of its community located in Boca Raton, Florida, which transferred to a new operator subsequent to year-end (see Note 18, Subsequent Events,

Dispositions and Other Signific

Dispositions and Other Significant Transactions	12 Months Ended
	Dec. 31, 2019
Dispositions And Other Significant Transactions [Abstract]
Dispositions and Other Significant Transactions	4. On October 22, 2019, the Company entered into a lease amendment with Healthpeak, as lessors of certain of the Company’s leased properties, which was later amended, to transition one Healthpeak property to new operators on or around January 15, 2020, and to sell the remaining eight as soon as possible, with expected sale dates in or around the second quarter of 2020, to a buyer or buyers. Under the terms of the agreement, the Company will make a one-time payment of $250,000 for the transitioned property as a prepayment against the remaining lease payments. For the eight properties to be sold, Healthpeak is required to arrange, negotiate, and close the sale of these properties. The Company is entitled to 50% of the proceeds in excess of a specified selling price for one of the properties, up to $350,000. At December 31, 2019, none of the properties had been transitioned to a new operator or sold. Subsequent to year-end, the Company entered into an agreement with Healthpeak, providing for the early termination of its other Master Lease Agreement between it and Healthpeak. See discussion at Note 18- Subsequent Events Effective October 1, 2019, the Company sold two communities located in Springfield, Missouri and Peoria, Illinois, for $64.8 million. The properties were sold in order to monetize assets deemed at peak performance and resulted in net proceeds to the Company of approximately $14.8 million. The Company recognized a gain of $38.8 million on the disposition of the two communities, which is included in gain (loss) on disposition of assets, net on the Company’s Consolidated Statements of Operations and Comprehensive Loss. At September 30, 2019, these properties were deemed as assets held for sale resulting in $24.4 million being reclassified to assets held for sale and $44.4 million of corresponding mortgage debt being reclassified to the current portion of notes payable within the Company’s Consolidated Balance Sheets. These communities comprised of 156 and 158 independent living units, respectively. Effective May 1, 2019, the Company closed on the sale of one senior housing community located in Kokomo, Indiana, for a total purchase price of $5.0 million and received approximately $1.4 million in net proceeds after retiring outstanding mortgage debt of $3.5 million and paying customary transaction and closing costs (the “Kokomo Sale Transaction”). The community was comprised of 96 assisted living units. The Company had reported these assets as held for sale at March 31, 2019 and recorded a remeasurement write-down of approximately $2.3 million to adjust the carrying values of these assets to the sales price, less costs to sell, which was included in Gain (loss) on disposition of assets, net, on the Company’s Consolidated Statements of Operations and Comprehensive Loss

Property and Equipment

Property and Equipment	12 Months Ended
	Dec. 31, 2019
Property Plant And Equipment [Abstract]
Property and Equipment	5 . Property and Equipment As of December 31, 2019 and 2018, net property and equipment and leasehold improvements, which include assets under financing leases, consists of the following (in thousands): December 31, Asset Lives 2019 2018 Land $ 66,764 $ 69,842 Land improvements 5 to 20 years 25,718 25,373 Buildings and building improvements 10 to 40 years 1,096,386 1,158,577 Furniture and equipment 5 to 10 years 65,828 66,202 Automobiles 5 to 7 years 5,947 6,344 Assets under financing leases and leasehold improvements (1) 95,281 98,396 Construction in progress NA 1,491 421 1,357,415 1,425,155 Less accumulated depreciation and amortization (388,204 ) (366,106 ) Property and equipment, net $ 969,211 $ 1,059,049 (1) Leasehold improvements are amortized over the shorter of the useful life of the asset or the remaining lease term. Assets under financing leases and leasehold improvements include $0.6million of financing lease right-of-use assets, net of accumulated amortization, as of December 31, 2019. Refer to Note 16, Leases , for further information on the Company’s financing leases At December 31, 2019 and 2018, furniture and equipment included $4.1 million and $3.8 million of capitalized computer software development costs of which $3.3 million and $3.1 million, respectively, has been amortized and is included as a component of accumulated depreciation and amortization. At December 31, 2019 and 2018, property and equipment, net included $2.0 million and $0.8 million, respectively, of capital expenditures which had been incurred but not yet paid.

Other Assets

Other Assets	12 Months Ended
	Dec. 31, 2019
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract]
Other Assets	6 . Other Assets Other assets consist of the following (in thousands): December 31, 2019 2018 Deferred lease costs, net $ - $ 4,715 Security and other deposits 9,915 9,889 Other 758 1,881 $ 10,673 $ 16,485 Prior to the adoption of ASC 842, lease acquisition and modification costs were classified as other assets and amortized over their respective lease terms. The unamortized portion of lease acquisition and modification costs were reclassified into operating right-of-use assets in conjunction with the Company’s adoption of ASC 842 on January 1, 2019. See Note 2, Summary of Significant Accounting Policies,

Accrued Expenses

Accrued Expenses	12 Months Ended
	Dec. 31, 2019
Text Block [Abstract]
Accrued Expenses	7 . Accrued expenses consist of the following (in thousands): December 31, 2019 2018 Accrued salaries, bonuses and related expenses $ 14,733 $ 11,996 Accrued property taxes 15,186 14,079 Accrued interest 3,617 3,066 Accrued health claims and workers compensation 5,281 4,845 Accrued professional fees 1,265 1,012 Other 6,145 6,882 $ 46,227 $ 41,880

Notes Payable

Notes Payable	12 Months Ended
	Dec. 31, 2019
Debt Disclosure [Abstract]
Notes Payable	8 . Notes Payable Notes payable consists of the following (in thousands): Average Monthly Net Book Value Notes Payable December 31, Lender Payment Of Collateral (1) Interest Rate Maturity Date 2019 2018 Fannie Mae $ 135 $ 24,980 4.69 April 2022 $ 22,592 $ 23,127 Fannie Mae 11 3,992 4.97 April 2022 1,958 1,991 Fannie Mae 60 14,170 4.48 May 2022 10,214 10,462 Fannie Mae 20 14,170 4.85 May 2022 3,579 3,640 Fannie Mae — — 4.32 January 2023 — 15,194 Fannie Mae — — 5.39 January 2023 — 8,327 Fannie Mae 39 7,756 4.58 January 2023 6,656 6,808 Fannie Mae 17 7,756 5.49 January 2023 2,950 2,990 Fannie Mae 45 7,810 5.93 October 2023 6,972 7,092 Fannie Mae 67 12,408 5.50 November 2023 10,792 10,992 Fannie Mae 67 11,598 5.38 November 2023 10,837 11,042 Fannie Mae 282 49,090 5.56 January 2024 45,077 45,892 Fannie Mae 632 103,848 4.24 July 2024 116,183 118,715 Fannie Mae 120 24,074 4.48 July 2024 21,513 21,963 Fannie Mae 81 19,081 4.30 July 2024 14,836 15,156 Fannie Mae 91 61,630 4.98 July 2024 16,053 16,322 Fannie Mae 11 8,817 6.30 July 2024 1,777 1,796 Fannie Mae 134 25,548 4.59 September 2024 23,856 24,342 Fannie Mae 22 12,916 5.72 September 2024 3,584 3,634 Fannie Mae 54 9,810 4.70 September 2024 9,494 9,683 Fannie Mae 53 11,293 4.50 January 2025 9,538 9,731 Fannie Mae 95 6,552 4.46 January 2025 17,333 17,686 Fannie Mae 70 14,605 4.35 February 2025 12,912 13,179 Fannie Mae — — 3.85 March 2025 — 21,633 Fannie Mae 102 22,879 3.84 April 2025 19,883 20,324 Fannie Mae 31 22,879 5.53 April 2025 5,223 5,300 Fannie Mae 81 14,732 5.30 June 2025 13,077 13,335 Fannie Mae 58 12,021 4.69 October 2025 10,402 10,595 Fannie Mae 44 8,878 4.70 October 2025 7,862 8,008 Fannie Mae 273 37,074 4.68 December 2025 49,385 50,295 Fannie Mae 9 8,787 5.81 December 2025 1,407 1,426 Fannie Mae 98 22,990 4.10 October 2026 19,127 19,498 Fannie Mae 108 23,515 4.24 December 2026 20,853 21,243 Fannie Mae 655 148,134 5.13 January 2029 150,782 150,782 Fannie Mae 163 148,134 (3 ) January 2029 50,261 50,261 Protective Life 96 23,558 3.55 April 2025 19,325 19,787 Protective Life 49 10,566 4.25 August 2025 9,157 9,350 Protective Life 78 16,938 4.25 September 2025 14,565 14,871 Protective Life 138 30,917 4.25 November 2025 25,940 26,478 Protective Life 57 12,901 4.50 February 2026 10,554 10,761 Protective Life 187 39,862 4.38 March 2026 32,099 32,920 Protective Life 70 14,620 4.13 October 2031 11,995 12,326 Berkadia 230 60,462 (4 ) December 2021 (4) 40,500 65,000 Berkadia — — — July 2020 — 3,500 Berkadia 96 16,953 (5 ) October 2021 10,992 11,255 Fifth Third 125 33,852 (6 ) December 2021 31,500 — HUD 16 4,572 4.48 September 2045 2,875 2,933 Insurance Financing — — 3.64 May 2019 — 799 Insurance Financing — — 4.40 November 2019 — 763 Insurance Financing 240 — 4.40 May 2020 1,187 — Insurance Financing 74 — 4.04 November 2020 730 — Insurance Financing 173 — 4.40 October 2020 1,698 — $ 5,357 4.65% (2) $ 930,085 $ 983,207 Less deferred loan costs, net 8,629 9,457 $ 921,456 $ 973,750 Less current portion 15,819 14,342 $ 905,637 $ 959,408 (1) 78 (2) Weighted average interest rate on current fixed interest rate debt outstanding. (3) Variable interest rate of LIBOR plus 2.14%, which was 3.87% at December 31, 2019. (4) Variable interest rate of LIBOR plus 4.50%, which was 6.23% at December 31, 2019. Effective December 23, 2019, the Company repaid $24.5 million of the loan and extended the maturity date with Berkadia to December 10, 2021. ( 5 ) Variable interest rate of LIBOR plus 5.00%, which was 6.73% at December 31, 2019. ( 6 ) Variable interest rate of LIBOR plus 3.25%, which was 4.98% at December 31, 2019. The aggregate scheduled maturities of notes payable at December 31, 2019 are as follows (in thousands): 2020 $ 17,793 2021 97,144 2022 53,293 2023 52,741 2024 240,493 Thereafter 468,621 $ 930,085 On December 23, 2019, the Company obtained $31.5 million of mortgage debt from Fifth Third Bank on its Autumn Glen and Cottonwood Village senior housing communities. The new mortgage loan is interest only and has a two-year term and an initial variable interest rate of LIBOR plus 3.25%. The Company incurred approximately $0.6 million in deferred financing costs related to this loan, which are being amortized over the term of the loan. On the same date, the Company amended and repaid $24.5 million in principal of the interest-only mortgage loan with BBVA USA on its Cottonwood Village, Georgetowne Place, Harrison at Eagle Valley, and Rose Arbor. As a result of the amendment, BBVA released the Cottonwood Village assets from collateral of the mortgage and extended the maturity date from July 11, 2020 to December 10, 2021. The amended mortgage has an interest-only variable rate of LIBOR plus 4.5%. On October 1, 2019, in conjunction with the sale of two of its senior housing communities, the Company repaid $44.4 million of associated mortgage debt and $4.4 million of prepayment penalties. Effective June 28, 2019, the Company exercised its option to extend its interest-only variable interest rate mortgage loan with BBVA USA (formerly Compass Bank) on four of its senior housing communities (Cottonwood Village, Georgetowne Place, Harrison at Eagle Valley, and Rose Arbor). The maturity date was extended from May 11, 2020 to July 11, 2020. On May 31, 2019, the Company renewed certain insurance policies and entered into two finance agreements totaling approximately $2.6 million and $2.7 million. The finance agreements each have a fixed interest rate of 4.4%, with the principal being repaid over an 11-month and 18-month term, respectively. The Company issued standby letters of credit with Wells Fargo Bank (“Wells Fargo”), totaling approximately $3.4 million, for the benefit of Hartford Financial Services (“Hartford”) associated with the administration of workers compensation which remain outstanding as of December 31, 2019. The Company issued standby letters of credit with JPMorgan Chase Bank (“Chase”), totaling approximately $6.5 million, for the benefit of Welltower, Inc. (“Welltower”), formerly Healthcare REIT, Inc. on certain leases between Welltower and the Company which remain outstanding as of December 31, 2019. The Company issued standby letters of credit with Chase, totaling approximately $2.9 million, for the benefit of Healthpeak Properties, Inc. (“Healthpeak”) on certain leases between Healthpeak and the Company which remain outstanding as of December 31, 2019. On December 18, 2018, the Company repaid certain mortgage loans associated with 21 of its senior living communities totaling approximately $170.6 million from Fannie Mae which were scheduled to mature on various dates beginning August 2021 through April 2026. The repayment of these mortgage loans facilitated the establishment of a Master Credit Facility (“MCF”) with Berkadia whereby the Company obtained approximately $201.0 million of new mortgage financing. The MCF will allow the Company to make future advances, should the Company decide to do so, assuming certain borrowing conditions are satisfied. The MCF consists of two separate loans which are cross-defaulted and cross-collateralized. Approximately $150.8 million of the new financing is long-term fixed interest rate debt at a fixed interest rate of 5.13% with a 10-year term and interest only for the first 36 months and the principal amortized over a 30-year term thereafter. Approximately $50.3 million of the new financing is long-term variable interest rate debt at a variable interest rate of LIBOR plus 2.14% with a 10-year term and interest only for the first 36 months and a fixed monthly principal component of $67,000 thereafter. The Company incurred approximately $3.0 million in deferred financing costs related to the MCF, which are being amortized over 10 years. As a result of the early repayment of the Fannie Mae mortgage debt, the Company accelerated the amortization of approximately $1.5 million in unamortized deferred financing costs and incurred prepayment premiums of approximately $11.1 million. The MCF was subsequently assigned to Fannie Mae on December 28, 2018, and is reported as such in preceding notes payable summary table. On December 18, 2018, the Company completed mortgage financing of $3.5 million from Berkadia at a variable interest rate of LIBOR plus 3.75% on one community located in Kokomo, Indiana. The mortgage loan is interest-only and has an 18-month term maturing in July 2020. The Company incurred approximately $91,000 in deferred financing costs related to this loan, which are being amortized over 18 months. On December 1, 2018, the Company renewed certain insurance policies and entered into a finance agreement totaling approximately $0.8 million. The finance agreement has a fixed interest rate of 4.40% with the principal being repaid over an 11-month term. On November 30, 2018, the Company completed supplemental mortgage financing of approximately $1.8 million from Fannie Mae at a fixed interest rate of 6.30% on one community located in Mesquite, Texas. The supplemental mortgage loan is coterminous, cross-collateralized and cross-defaulted with the original existing mortgage debt maturing in July 2024. The Company incurred approximately $0.1 million in deferred financing costs related to this loan, which are being amortized over the remaining initial loan term. Effective June 29, 2018, the Company extended its mortgage loan with Berkadia on one of its senior living communities located in Canton, Ohio. The maturity date was extended to October 10, 2021 with an initial variable interest rate of LIBOR plus 5.0% with principal amortized over 25 years. Effective May 31, 2018, the Company renewed certain insurance policies and entered into a finance agreement totaling approximately $1.7 million. The finance agreement has a fixed interest rate of 3.64% with the principal being repaid over an 11-month term. In connection with the Company’s loan commitments described above, the Company incurred financing charges that were deferred and amortized over the life of the notes. At December 31, 2019 and 2018, the Company had gross deferred loan costs of $14.3 million and $14.1 million, respectively. Accumulated amortization was $5.7 million and $4.7 million at December 31, 2019 and 2018, respectively. Amortization expense is expected to be approximately $1.6 million in each of the next five fiscal years. The Company was in compliance with all aspects of its outstanding indebtedness at December 31, 2019 and 2018.

Equity

Equity	12 Months Ended
	Dec. 31, 2019
Equity [Abstract]
Equity	9 . Equity Preferred Stock The Company is authorized to issue preferred stock in series and to fix and state the voting powers and such designations, preferences and relative participating, optional or other special rights of the shares of each such series and the qualifications, limitations and restrictions thereof. Such action may be taken by the Board without stockholder approval. The rights, preferences and privileges of holders of common stock are subject to the rights of the holders of preferred stock. No preferred stock was outstanding as of December 31, 2019 and 2018. Share Repurchases On January 22, 2009, the Company’s board of directors approved a share repurchase program that authorized the Company to purchase up to $10.0 million of the Company’s common stock. Purchases may be made from time to time using a variety of methods, which may include open market purchases, privately negotiated transactions or block trades, or by any combination of such methods, in accordance with applicable insider trading and other securities laws and regulations. The size, scope and timing of any purchases will be based on business, market and other conditions and factors, including price, regulatory and contractual requirements or consents, and capital availability. The repurchase program does not obligate the Company to acquire any particular amount of common stock and the share repurchase authorization has no stated expiration date. Shares of stock repurchased under the program will be held as treasury shares. Pursuant to this authorization, during fiscal 2009, the Company purchased 349,800 shares at an average cost of $2.67 per share for a total cost to the Company of approximately $0.9 million. On January 14, 2016, the Company announced that its board of directors approved a continuation of the share repurchase program. Pursuant to this authorization, during fiscal 2016, the Company purchased 144,315 shares of its common stock at an average cost of $17.29 per share for a total cost to the Company of approximately $2.5 million. All such purchases were made in open market transactions. There were no repurchases of the Company’s common stock during fiscal 2019 or 2018.

Stock-Based Compensation

Stock-Based Compensation	12 Months Ended
	Dec. 31, 2019
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock-Based Compensation	10 . Stock-Based Compensation The Company recognizes compensation expense for share-based stock awards to certain employees and directors, including grants of employee stock options and awards of restricted stock, in the Company’s Consolidated Statements of Operations and Comprehensive Loss based on their fair values. The Company’s Amended 2007 Omnibus Stock and Incentive Plan (the “2007 Plan”) provided for, among other things, the grant of restricted stock awards, restricted stock units and stock options to purchase shares of the Company’s common stock. The 2007 Plan authorized the Company to issue up to 4,600,000 million shares of common stock and the Company had reserved shares of common stock for future issuance pursuant to awards under the 2007 Plan. On May 14, 2019, the Company’s stockholders approved the 2019 Omnibus Stock and Incentive Plan for Capital Senior Living Corporation (the “2019 Plan”), which replaced the 2007 Plan. The 2019 Plan provides for, among other things, the grant of restricted stock awards, restricted stock units and stock options to purchase shares of the Company’s common stock. The 2019 Plan authorizes the Company to issue up to 2,250,000 shares of common stock plus reserved shares not issued or subject to outstanding awards under the 2007 Plan, and the Company has reserved shares of common stock for future issuance pursuant to awards under the 2019 Plan. Effective March 26, 2019, the 2007 Plan was terminated and no additional awards will be granted under the 2007 Plan. Stock Options The Company’s stock option program is a long-term retention program that is intended to attract, retain and provide incentives for employees, officers and directors and to more closely align stockholder and employee interests. The Company’s stock options generally vest over one to five years and the related expense is amortized on a straight-line basis over the vesting period. The fair value of stock options was estimated using the Black-Scholes option pricing model. The Black-Scholes model requires the input of certain assumptions including expected volatility, expected dividend yield, expected life of the option and the risk-free interest rate. The expected volatility used by the Company is based primarily on an analysis of historical prices of the Company’s common stock. The expected term of options granted is based primarily on historical exercise patterns on the Company’s outstanding stock options. The risk-free rate is based on zero-coupon U.S. Treasury yields in effect at the date of grant with the same period as the expected option life. The Company does not expect to pay dividends on its common stock and therefore has used a dividend yield of zero in determining the fair value of its awards. The option forfeiture rate assumption used by the Company is based primarily on the Company’s historical option forfeiture patterns. The fair value of stock options was estimated using a Black-Scholes option pricing model with the following weighted-average assumptions: Year ended December 31, 2019 Expected volatility 37.0% Expected dividend yield 0.0% Expected term in years 6.0 Risk free rate 2.55% Expected forfeiture rate 0.0% The options outstanding at December 31, 2019 had no intrinsic value, a weighted-average remaining contractual life of 9.0 years, and a weighted-average exercise price of $7.46. None of the options outstanding at December 31, 2019 were exercisable. No stock options were outstanding at December 31, 2018 and 2017, as all outstanding options had fully vested and have been exercised or forfeited. A summary of the Company’s stock option transactions for the years ended December 31, 2019, 2018, and 2017 is as follows: Outstanding Beginning of Year Granted Exercised Forfeited Outstanding End of Year Options Exercisable December 31, 2019 Shares — 147,239 — — 147,239 — Weighted average price $ — $ 7.46 $ — — $ 7.46 $ — December 31, 2018 Shares — — — — — — Weighted average price $ — — $ — — $ — $ — December 31, 2017 Shares — — — — — — Weighted average price $ — — $ — — $ — $ — At December 31, 2019, there was approximately $0.3 million of total unrecognized compensation expense related to unvested stock option awards, which is expected to be recognized over a weighted average period of 2.0 years. The fair value of the stock options is amortized as compensation expense over the vesting periods of the options. The Company recorded stock-based compensation expense related to stock options of approximately $0.1 million in 2019. No expense was recorded related to stock options in 2018 or 2017. Restricted Stock The Company may grant restricted stock awards and units to employees, officers, and directors in order to attract, retain, and provide incentives for such individuals and to more closely align stockholder and employee interests. For restricted stock awards and units without performance and market-based vesting conditions, the Company records compensation expense for the entire award on a straight-line basis over the requisite service period, which is generally a period of one to four years, unless the award is subject to certain accelerated vesting requirements. Restricted stock awards are considered outstanding at the time of grant since the holders thereof are entitled to dividends, upon vesting, and voting rights. For restricted stock awards with performance and market-based vesting conditions, total compensation expense is recognized over the requisite service period once the performance target is deemed probable of achievement. Performance goals are evaluated periodically and if such goals are not ultimately met or it is not probable the goals will be achieved, no compensation expense is recognized and any previously recognized compensation expense is reversed. If the achievement of a market condition varies from initial estimates on the date of grant, compensation expense will not be adjusted to reflect the difference since the grant date fair value of the performance award gave consideration to the probability of market condition achievement. The Company recognizes compensation expense of a restricted stock award over its respective vesting or performance period based on the fair value of the award on the grant date, net of actual forfeitures. A summary of the Company’s restricted common stock awards activity and related information for the years ended December 31, 2019, 2018, and 2017 is presented below: Outstanding Beginning of Year Issued Vested Forfeited Outstanding End of Year December 31, 2019 Shares 1,345,159 662,154 (424,556 ) (493,411 ) 1,089,346 December 31, 2018 Shares 964,484 830,794 (386,900 ) (63,219 ) 1,345,159 December 31, 2017 Shares 829,766 565,745 (355,400 ) (75,627 ) 964,484 The restricted stock outstanding at December 31, 2019, 2018, and 2017, had an aggregate intrinsic value of $3.4 million, $9.1 million, and $13.0 million, respectively. During fiscal 2019, the Company awarded 662,154 shares of restricted common stock to certain employees and directors of the Company, of which 325,415 shares were subject to performance and market-based vesting conditions. The average market value of the common stock on the date of grant was $4.50. These awards of restricted shares vest over a one to four-year period, unless the award is subject to certain accelerated vesting requirements, and had an intrinsic value of $3.0 million on the date of grant. Additionally, during fiscal 2019, the Company awarded 59,841 restricted stock units to certain directors of the Company with average market value of $3.76 on the date of grant. These awards of restricted units vest over a one-year period and had an intrinsic value of approximately $0.2 million on the date of grant. Stock Based Compensation The Company uses the Monte-Carlo simulation model to determine the fair value of performance awards which include market-based vesting conditions. The Monte-Carlo simulation model uses the same input assumptions as the Black-Scholes model; however, it also further incorporates into the fair-value determination the possibility that the market condition may not be satisfied. Compensation costs related to awards with a market-based condition are recognized regardless of whether the market condition is satisfied, provided that the requisite service has been provided. During fiscal 2019, in accordance with the Company’s long-term incentive compensation plan, the Company granted 325,415 shares of restricted common stock with performance and market-based vesting conditions to certain employees of the Company. These performance awards are subject to a market-based condition that may increase or decrease the number of shares vested if the Company’s 2021 Total Stockholder Return (“TSR”) exceeds or falls below certain achievement level parameters when ranked against the Company’s designated Peer Group. These restricted performance shares vest over a three-year period based on the Company’s Earnings before Interest, Taxes, Depreciation, Amortization, and Rent (“EBITDAR”) financial performance target set by the Company’s compensation committee for the fiscal year ending December 31, 2021. The number of shares of restricted common stock ultimately issued will be prorated between performance level targets achieved. The Company recognized $2.5 million, $8.4 million, and $7.7 million in stock-based compensation expense during fiscal 2019, 2018, and 2017, respectively, which primarily is associated with employees whose corresponding salaries and wages are included in general and administrative expenses within the Company’s Consolidated Statements of Operations and Comprehensive Loss. Unrecognized stock-based compensation expense is $3.7 million at December 31, 2019. The Company expects stock-based compensation expense to be recognized over a one to three-year period for performance restricted stock awards and a one to four-year period for nonperformance-based restricted stock awards and units.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Income Taxes	1 1 . The (benefit) provision for income taxes consists of the following (in thousands): Year Ended December 31, 2019 2018 2017 Current: Federal $ (71 ) $ (152 ) $ 6 State 443 474 550 Deferred: Federal 76 (2,093 ) 1,940 State — — — (Benefit) Provision for income taxes $ 448 $ (1,771 ) $ 2,496 The (benefit) provision for income taxes differed from the amounts of income tax (benefit) provision determined by applying the U.S. federal statutory income tax rate to income before (benefit) provision for income taxes as a result of the following (in thousands): Year Ended December 31, 2019 2018 2017 Tax benefit at federal statutory rates $ (7,472 ) $ (11,627 ) $ (14,168 ) State income tax benefit, net of federal effects (548 ) (665 ) (648 ) Change in deferred tax asset valuation allowance 7,478 9,543 7,857 Tax reform impact on deferred income taxes — — 13,959 Share based compensation ASU 2016-09 adoption — — (5,326 ) Other 990 978 822 (Benefit) Provision for income taxes $ 448 $ (1,771 ) $ 2,496 The effective tax rate for fiscal 2019 differs from the statutory tax rate primarily due to state income taxes, changes in the deferred tax asset valuation allowance, and other permanent tax differences. The Company is impacted by the Texas Margin Tax (“TMT”), which effectively imposes tax on modified gross revenues for communities within the State of Texas and accounts for the majority of the Company’s current state tax expense. The valuation allowance recorded as of Fiscal 2019 was $50.7 million, which had increased from the prior year by $4.4 million. Of the $4.4 million adjustment to the valuation allowance during fiscal 2019, a $3.0 million decrease in the valuation allowance was the result of retained earnings impact related to the adoption of ASC 842 and a $7.4 million increase to the valuation allowance was current year activity. The fiscal 2019 other permanent tax differences include $0.7 million of stock compensation shortfalls and $0.4 million of Section 162(m) compensation limitation. The effective tax rate for fiscal 2018 differs from the statutory tax rate primarily due to state income taxes, changes in the deferred tax asset valuation allowance, and other permanent tax differences. The fiscal 2018 other permanent tax differences include $0.5 million of stock compensation shortfalls and $0.3 million of Section 162(m) compensation limitation. The effective tax rate for fiscal 2017 differs from the statutory tax rate primarily due to state income taxes, changes in the deferred tax asset valuation allowance, tax reform impact on deferred income taxes, adoption of ASU 2016-09, and other permanent tax differences. The fiscal 2017 other permanent tax differences include $0.7 million of stock compensation shortfalls and $0.2 million of Section 162(m) compensation limitation. A summary of the Company’s deferred tax assets and liabilities, are as follows (in thousands): December 31, 2019 2018 Deferred tax assets: Deferred gains on sale/leaseback transactions $ — $ 2,440 Lease liabilities 62,166 — Net operating loss carryforward 34,284 33,252 Compensation costs 2,134 3,087 Depreciation and amortization 3,525 5,323 Other 2,991 2,330 Total deferred tax assets 105,100 46,432 Deferred tax asset valuation allowance (50,699 ) (46,280 ) Total deferred tax assets, net 54,401 152 Deferred tax liabilities: Depreciation and amortization — — Operating lease right-of-use assets (54,325 ) — Total deferred tax liabilities $ (54,325 ) $ — Deferred taxes, net $ 76 $ 152 Income taxes are computed using the asset and liability method and current income taxes are recorded based on amounts refundable or payable. Deferred income taxes are recorded based on the estimated future tax effects of loss carryforwards and temporary differences between financial statement carrying amounts of existing assets and liabilities and their respective tax basis. Deferred tax assets and liabilities are measured using enacted tax rates that are expected to apply to taxable income in the years in which we expect those carryforwards and temporary differences to be recovered or settled. Management regularly evaluates the future realization of deferred tax assets and provides a valuation allowance, if considered necessary, based on such evaluation. As part of the evaluation, management has evaluated taxable income in carryback years, future reversals of taxable temporary differences, feasible tax planning strategies, and future expectations of income. Based upon this evaluation, a valuation allowance has been recorded to reduce the Company’s net deferred tax assets to the amount that is more likely than not to be realized. A significant component of objective evidence evaluated was the cumulative losses before income taxes incurred by the Company over the past several fiscal years. Such objective evidence severely limits the ability to consider other subjective evidence such as the Company’s ability to generate sufficient taxable income in future periods to fully recover the deferred tax assets. However, in the event that we were to determine that it would be more likely than not that the Company would realize the benefit of deferred tax assets in the future in excess of their net recorded amounts, adjustments to deferred tax assets would increase net income in the period we made such a determination . At December 31, 2017, the Company completed an analysis determining its best estimate for provisional tax adjustments based on the revised tax legislation associated with the Tax Cuts and Jobs Act (“TCJA”), which was enacted on December 22, 2017. Additionally, the Securities and Exchange Commission issued Staff Accounting Bulletin 118 (“SAB 118”), to address the accounting and reporting of the Act. SAB 118 allowed companies to take a reasonable period, which should not extent beyond one year from enactment of the TCJA, to measure and recognize the effects of the new tax law. Based upon the Company’s analysis of the TCJA and consideration of SAB 118, the Company remeasured its deferred income taxes on a provisional basis as of December 31, 2017, which resulted in a net $14.0 million reduction in the Company’s deferred tax assets and liabilities. The remeasurement consisted of a $15.9 million reduction to the Company’s deferred tax assets for the change in the corporate statutory tax rate from 34% to 21% and a $0.3 million reduction to the Company’s deferred tax asset valuation allowance for the repeal of the corporate Alternative Minimum Tax (“AMT”), partially offset by a $2.2 million increase to the Company’s deferred tax asset valuation allowance for maximum deduction limits for future net operating loss (“NOL”) carryforwards to 80% of taxable income for losses arising in tax years beginning after December 31, 2017. The Company completed its assessment of the TCJA under SAB 118 as of December 31, 2018, resulting in a net $2.2 million reduction to the Company’s deferred tax asset valuation allowance. The $2.2 million reduction was primarily related to guidance released in December 2018 for companies electing real property trade or business under Section 163(j)(7)(B) of the Internal Revenue Code to opt out of the interest expense limitation. This guidance requires residential rental property to be depreciated under the Alternative Depreciation System (“ADS”), including assets placed in service prior to 2018. As of December 31, 2019, the Company has federal and state NOL carryforwards of $160.5 million and $135.0 million and related deferred tax assets of $33.7 million and $7.2 million, respectively, and a federal AMT credit carryforward of $0.1 million. The federal and state NOL carryforwards in the income tax returns filed included unrecognized tax benefits. The deferred tax assets recognized for those NOLs are presented net of the unrecognized benefits. If not used, the federal NOL generated prior to fiscal 2018 will expire during fiscal 2033 to 2037 and non-conforming state NOL’s will expire during fiscal 2020 to 2039. Federal NOL’s generated in fiscal 2018 and beyond currently have no expiration due to changes to tax laws enacted with the TCJA. Some state jurisdictions conform to the unlimited net operating loss carryforward provisions as modified by the TCJA. However, some jurisdictions do not conform to the above-mentioned provisions. Utilization of the net operating loss carryforwards might be subject to a substantial annual limitation due to ownership change limitations that may have occurred or that could occur in the future, as required by Section 382 of the Internal Revenue Code of 1986, as amended (the “Code”). These ownership changes may limit the amount of NOL carryforwards that can be utilized annually to offset future taxable income and tax, respectively. In general, an “ownership change” as defined by Section 382 of the Code results from a transaction or series of transactions over a three-year period resulting in an ownership change of more than 50 percentage points of the outstanding stock of a company by certain stockholders or public groups. Since the Company’s formation, the Company has raised capital through the issuance of capital stock on several occasions which, combined with the purchasing stockholders’ subsequent disposition of those shares, may have resulted in such an ownership change, or could result in an ownership change in the future upon subsequent disposition. As no utilization of the NOL carryforwards are being or are projected to be utilized in the near future, the Company has not currently completed a study to assess whether an ownership change has occurred. As the Company maintains a valuation allowance in all jurisdictions where the NOL carryovers are present, any potential Section 382 limitation would also be impacted by the valuation allowance. Any carryforwards that will expire prior to utilization as a result of a Section 382 limitations will be removed from deferred tax assets with a corresponding reduction of the valuation allowance A summary of the Company’s unrecognized tax benefits activity and related information for the years ended December 31, 2019, 2018, and 2017 is presented below (in thousands): 2019 2018 2017 Beginning balance, January 1 $ 4,644 $ 3,416 $ 3,786 Gross increases – tax positions in prior period 2,468 1,228 — Gross decreases – tax positions in prior period — — (370 ) Gross increases – tax positions in current period — — — Settlements — — — Lapse of statute of limitations (323 ) — — Ending balance, December 31 $ 6,789 $ 4,644 $ 3,416 The Company evaluates uncertain tax positions through consideration of accounting and reporting guidance on criteria, measurement, derecognition, classification, interest and penalties, accounting in interim periods, disclosure, and transition that is intended to provide better financial-statement comparability among different companies. The Company is required to recognize a tax benefit in its financial statements for an uncertain tax position only if management’s assessment is that its position is “more likely than not” (i.e., a greater than 50 percent likelihood) to be upheld on audit based only on the technical merits of the tax position. The Company’s policy is to recognize interest related to unrecognized tax benefits as interest expense and penalties as income tax expense. As of December 31, 2019, the Company has unrecognized tax benefits of $6.8 million for an uncertain tax position associated with a change in accounting method. The unrecognized tax benefits as of December 31, 2019 are timing-related uncertainties that if recognized would not impact the effective tax rate of the Company. Unrecognized tax benefit changes in the next 12 months will be a reduction of $1.7 million. The Company files income tax returns in the U.S. federal jurisdiction and U.S. state jurisdictions. As of December 31, 2019, the Company is generally no longer subject to U.S. federal and state income tax examinations for tax years prior to 2016.

Employee Benefit Plans

Employee Benefit Plans	12 Months Ended
	Dec. 31, 2019
Compensation And Retirement Disclosure [Abstract]
Employee Benefit Plans	1 2 . Employee Benefit Plans The Company has a 401(k) salary deferral plan (the “Plan”) in which certain employees of the Company meeting minimum service and age requirements are eligible to participate. Contributions to the Plan are in the form of employee salary deferrals, which are subject to employer matching contributions of 50% of up to 4% of the employee’s annual salary. The Company’s contributions are funded semi-monthly to the Plan administrator. Matching contributions of $0.5 million were contributed to the Plan in each of fiscal 2019, 2018 and 2017. The Company incurred administrative expenses related to the Plan of $24,000, $25,000, and $21,300 in fiscal 2019, 2018, and 2017, respectively.

Contingencies

Contingencies	12 Months Ended
	Dec. 31, 2019
Commitments And Contingencies Disclosure [Abstract]
Contingencies	1 3 . Contingencies The Company has claims incurred in the normal course of its business. Most of these claims are believed by management to be covered by insurance, subject to normal reservations of rights by the insurance companies and possibly subject to certain exclusions in the applicable insurance policies. Whether or not covered by insurance, these claims, in the opinion of management, based on advice of legal counsel, should not have a material effect on the consolidated financial statements of the Company if determined adversely to the Company. The Company had two of its senior housing communities located in southeast Texas impacted by Hurricane Harvey during the third quarter of fiscal 2017. We maintain insurance coverage on these communities which includes damage caused by flooding. The insurance claim for this incident required a deductible of $100,000 that was expensed as a component of operating expenses in the Company’s Consolidated Statement of Operations and Comprehensive Loss in the third quarter of fiscal 2017. Physical repairs have been completed to restore the communities to their condition prior to the incident and these communities reopened and began accepting residents in July 2018. We have incurred approximately $6.2 million in clean-up and physical repair costs, almost all of which have been recovered through insurance proceeds. At December 31, 2019 and 2018, the Company expected to receive an additional $0.3 million and $2.4 million, respectively, in insurance proceeds from our respective carrier, which was included in prepaid expenses and other on the Company’s Consolidated Balance Sheets. In addition to the repairs of physical damage to the buildings, the Company’s insurance coverage includes loss of business income (“Business Interruption”). Business Interruption includes reimbursement for lost revenue as well as incremental expenses incurred as a result of the hurricane. The Company received payments from our insurance underwriters during fiscal 2019 and 2018 totaling approximately $2.5 million and $5.1 million related to Business Interruption, respectively, which have been included as a reduction to operating expenses in the Company’s Consolidated Statement of Operations and Comprehensive Loss for each respective year. Business interruption payments ceased in accordance with our insurance policy in July 2019. In July 2018, the Company received notifications from the Internal Revenue Service (“IRS”) pursuant to the Affordable Care Act (“ACA”) that the Company may be liable for an Employer Shared Responsibility Payment (“ESRP”) in the amount of approximately $2.1 million for the year ended December 31, 2015. The ESRP is applicable to employers that had 50 or more full-time equivalent employees, did not offer minimum essential coverage (“MEC”) to at least 70% of full-time employees and their dependents, or did offer MEC to at least 70% of full-time employees and their dependents which did not meet the affordable or minimum value criteria and had one or more full-time employees certified as being allowed the premium tax credit (“PTC”). The IRS determines the amount of the proposed ESRP from information returns completed by employers and from income tax returns completed by employees. Based upon the Company’s review of the notifications provided by the IRS, the Company initially concluded it would be liable for approximately $0.2 million of the ESRP assessments which was accrued within certain employee benefit reserves. The Company formally responded to the notifications from the IRS and received favorable decisions revising the ESRP to $83,200 during the fourth quarter of fiscal 2018. The Company believes it has appropriate reserves as of December 31, 2019 and 2018.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	12 Months Ended
	Dec. 31, 2019
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	14. The carrying amounts and fair values of financial instruments at December 31, 2019 and 2018 are as follows (in thousands): 2019 2018 Carrying Amount Fair Value Carrying Amount Fair Value Cash and cash equivalents $ 23,975 $ 23,975 $ 31,309 $ 31,309 Restricted cash 13,088 13,088 13,011 13,011 Notes payable, excluding deferred loan costs 930,085 899,326 983,207 945,318 The following methods and assumptions were used in estimating its fair value disclosures for financial instruments: Cash and cash equivalents and Restricted cash: The carrying amounts reported in the balance sheet for cash and cash equivalents and restricted cash equal fair value, which represent Level 1 inputs as defined in the accounting standards codification. Notes payable: The fair value of notes payable is estimated using discounted cash flow analysis, based on current incremental borrowing rates for similar types of borrowing arrangements, which represent Level 2 inputs as defined in the accounting standards codification. Assets Held for Sale During the first quarter of fiscal 2019, the Company classified one senior living community as held for sale and determined a remeasurement write-down of approximately $2.3 million was required to adjust the carrying value to its fair value, net of cost of disposal. The senior living community was sold during the second quarter of fiscal 2019 for its carrying value. During the third quarter of fiscal 2019, the Company classified two senior living communities as held for sale which required no remeasurement to adjust the carrying value to its fair value. The Company determines, using Level 2 inputs as defined in the accounting standards codification, the fair value, net of costs of disposal, of an asset on the date the asset is categorized as held for sale, and the asset is recorded at the lower of its fair value, net of cost of disposal, or carrying value on that date. The Company periodically reevaluates assets held for sale to determine if the assets are still recorded at the lower of fair value, net of cost of disposal, or carrying value. The fair values are generally determined based on market rates, industry trends and recent comparable sales transactions. Operating Lease Right-Of-Use Assets The Company’s adoption of ASC 842 on January 1, 2019, resulted in the recognition of operating lease right-of-use assets which were determined not fully recoverable and required impairment write-down adjustments of approximately $17.8 million recorded directly to retained deficit. The fair value of the right-of-use assets was estimated, using level 3 inputs as defined in the accounting standards codification, utilizing a discounted cash flow approach based upon historical and projected cash flows and market data, including management fees and a market supported lease coverage ratio. The estimated future cash flows were discounted at a rate that is consistent with a weighted average cost of capital from a market participant perspective. The estimated fair value of these assets and liabilities could be affected by market changes and this effect could be material.

Allowance for Doubtful Accounts

Allowance for Doubtful Accounts	12 Months Ended
	Dec. 31, 2019
Text Block [Abstract]
Allowance for Doubtful Accounts	1 5 . Allowance for Doubtful Accounts The components of the allowance for doubtful accounts are as follows (in thousands): December 31, 2019 2018 2017 Balance at beginning of year $ 6,793 $ 4,881 $ 4,253 Provision for bad debts, net of recoveries 3,765 2,990 1,748 Write-offs and other (1,915 ) (1,078 ) (1,120 ) Balance at end of year $ 8,643 $ 6,793 $ 4,881 Accounts receivable are reported net of an allowance for doubtful accounts to represent the Company’s estimate of inherent losses at the balance sheet date. The increase in the allowance for doubtful accounts is primarily due to an increase in Medicaid receivables, which is due to an increase in the number of residents for which Medicaid is the payor. The Company’s bad debt expense for Medicaid is higher than that for private pay residents.

Leases

Leases	12 Months Ended
	Dec. 31, 2019
Leases [Abstract]
Leases	1 6 . Leases The Company has operating leases for various real estate (primarily senior housing communities) and equipment as well as financing leases for certain vehicles. As of December 31, 2019, the Company leased 46 senior housing communities from certain real estate investment trusts (“REITs”). Under these facility lease agreements, the Company is responsible for all operating costs, maintenance and repairs, insurance and property taxes. Additionally, facility leases may include contingent rent increases when certain operational performance thresholds are surpassed, at which time the right-of-use assets and lease liability will be remeasured. Ventas As of December 31, 2019, the Company leased seven senior housing communities (collectively the “Ventas Lease Agreements”) from Ventas. Effective January 31, 2017, the Company acquired from Ventas the underlying real estate associated with four of its operating leases (the “Four Property Lease Transaction”) Prior to the Four Property Lease Transaction, the Company previously leased 11 senior housing communities from Ventas. During the second quarter of fiscal 2015, the Company executed amendments to the master lease agreements with Ventas to facilitate up to $24.5 million of leasehold improvements for 10 communities within the Ventas lease portfolio and extend the lease terms until September 30, 2025, with two five-year renewal extensions available at the Company’s option. During the second quarter of fiscal 2016, the Company executed amendments to the master lease agreements with Ventas to increase the funds budgeted for leasehold improvements (the “Special Project Funds”) from $24.5 million to $28.5 million and extend the date for completion of the leasehold improvements to June 30, 2017. During the second quarter of fiscal 2017, the Company executed amendments to the master lease agreements with Ventas to decrease the Special Project Funds for leasehold improvements from $28.5 million to approximately $17.0 million due to the Four Property Lease Transaction and extend the date for completion of the leasehold improvements to June 30, 2018. During the second quarter of fiscal 2019, the Company executed amendments to the master lease agreements with Ventas to increase the Special Project Funds for leasehold improvements from approximately $17.0 million to approximately $20.0 million and extend the date for completion of the leasehold improvements to June 30, 2021. The initial lease rates under each of the Ventas Lease Agreements ranged from 6.75% to 8% and are subject to contingent rent escalation clauses. When a contingency is resolved and an escalation occurs, the amount is included within lease payments and reflected in the ROU asset and lease liability Subsequent Events Healthpeak As of December 31, 2019, the Company leased 15 senior housing communities (collectively the “Healthpeak Lease Agreements”) from Healthpeak Properties, Inc., formerly HCP, Inc. (“Healthpeak”). During the fourth quarter of fiscal 2013, the Company executed an amendment to the master lease agreement with Healthpeak to facilitate up to $3.3 million of leasehold improvements for one community within the Healthpeak lease portfolio and extend the initial lease terms for nine communities until October 31, 2020. During the second quarter of fiscal 2015, the Company exercised its right to extend the lease term with Healthpeak for the remaining six communities in the Healthpeak lease portfolio until April 30, 2026. The initial lease rates under the Healthpeak Lease Agreements ranged from 7.25% to 8% and are subject to certain conditional escalation clauses. When a contingency is resolved and an escalation occurs, the amount is included within lease payments and reflected in the ROU asset and lease liability Subsequent Events Welltower As of December 31, 2019, the Company leased 24 senior housing communities (collectively the “Welltower Lease Agreements”) from Welltower. The Welltower Lease Agreements each have an initial term of 15 years. The initial lease rates under the Welltower Lease Agreements ranged from 7.25% to 8.5% and are subject to certain conditional escalation clauses. When a contingency is resolved and an escalation occurs, the amount is included within lease payments and reflected in the ROU asset and lease liability Subsequent Events The Company determines if a contract is or contains a lease at inception or modification of a contract. A contract is or contains a lease if the contract conveys the right to control the use of an identified asset for a period of time in exchange for consideration. Control over the use of the identified asset means the lessee has both the right to obtain substantially all of the economic benefits from the use of the asset and the right to direct the use of the asset. The Company, as lessee, makes a determination with respect to each of its community and equipment leases as to whether each should be accounted for as an operating lease or financing lease. The classification criteria is based on estimates regarding the fair value of the leased asset, minimum lease payments, effective cost of funds, economic life of the asset, and certain other terms in each lease agreement. Operating lease right-of-use assets and liabilities are recognized based on the present value of future minimum lease payments over the expected lease term on the lease commencement date. When the implicit lease rate is not determinable, the Company’s incremental borrowing rate based on the information available at the lease commencement date is used in determining the present value of future minimum lease payments. As of December 31, 2019, the weighted average discount rate and average remaining lease terms of the Company's operating leases was 7.8% and 5.6 years, respectively. The expected lease terms include options to extend or terminate the lease when it is reasonably certain the Company will exercise such options. Lease expense for minimum lease payments is recognized on a straight-line basis over the expected lease terms. Financing lease right-of-use assets are recognized within property, plant and equipment and leasehold improvements, net on the Company's consolidated balance sheets. The Company recognizes interest expense on the financing lease liabilities utilizing the effective interest method. As of December 31, 2019, the weighted average discount rate and average remaining lease term of the Company's financing leases was 7.1% and 3.9 years, respectively. The right-of-use asset is generally amortized to depreciation and amortization expense on a straight-line basis over the lease term. Certain of the Company’s lease arrangements have lease and non-lease components. The Company accounts for the lease components and non-lease components as a single lease component for all classes of underlying assets. Leases with an expected lease term of 12 months or less are not recorded on the balance sheet and the related lease expense is recognized on a straight-line basis over the expected lease term. Most of the Company’s lease agreements include one or more options to renew, with renewal terms that can extend the lease term for an additional one to 20 years at the Company’s option. The recoverability of assets and depreciable life of leasehold improvements are limited by expected lease terms. There are various financial covenants and other restrictions in the Company’s lease agreements. The Company’s lease agreements do not contain any material residual value guarantees. The Company was in compliance with all of its lease covenants at December 31, 2018 and lease covenants with regard to its Healthpeak leases at December 31, 2019. A summary of operating and financing lease expense (including the respective presentation on the consolidated statement of operations) and cash flows from leasing transactions for the year ended December 31, 2019 is as follows: Operating Leases (in thousands) Year Ended December 31, 2019 Facility lease expense $ 57,022 General and administrative expenses 812 Operating expenses, including variable lease expense of $6,142 6,466 Total operating lease costs $ 64,300 Operating lease expense adjustment 5,243 Operating cash flows from operating leases $ 69,543 Financing Leases (in thousands) Year Ended December 31, 2019 Depreciation and amortization $ 11 Interest expense: financing lease obligations 3 Total financing lease costs $ 14 Operating cash flows from financing leases 11 Financing cash flows from financing leases 3 Total cash flows from financing leases $ 14 The aggregate amounts of future minimum lease payments recognized on the consolidated balance sheet as of December 31, 2019 are as follows (in thousands): Year Ending December 31, Operating Leases Financing Leases 2020 $ 63,549 $ 148 2021 51,401 148 2022 51,321 148 2023 51,274 138 2024 51,245 — Thereafter 44,762 — Total $ 313,552 $ 582 Less: Amount representing interest (present value discount) (59,107 ) (72 ) Present value of lease liabilities $ 254,445 $ 510 Less: Current portion of lease liabilities (45,871 ) (117 ) Lease liabilities, net of current portion $ 208,574 $ 393 The aggregate amounts of future minimum operating lease payments not recognized on the consolidated balance sheet under ASC 840 as of December 31, 2018 are as follows (in thousands): Year Ending December 31, Operating Leases 2019 $ 66,455 2020 63,929 2021 52,093 2022 52,062 2023 52,026 Thereafter 97,165 Total lease payments $ 383,730

Quarterly Financial Information

Quarterly Financial Information (Unaudited)	12 Months Ended
	Dec. 31, 2019
Quarterly Financial Information Disclosure [Abstract]
Quarterly Financial Information (Unaudited)	1 7 . Quarterly Financial Information (Unaudited) The following table presents certain unaudited quarterly financial information for each of the four quarters ended December 31, 2019 and 2018. This information has been prepared on the same basis as the audited consolidated financial statements of the Company and include, in the opinion of the Company’s management, all adjustments (consisting of normal recurring adjustments) necessary to present fairly the quarterly results when read in conjunction with the audited consolidated financial statements of the Company. 2019 Calendar Quarters First Second Third Fourth (1) (In thousands, except per share amounts) Total revenues $ 114,176 $ 113,126 $ 111,110 108,688 Income (Loss) from operations 1,970 203 (8,105 ) (8,757 ) Net income (loss) and comprehensive income (loss) (12,984 ) (12,534 ) (20,731 ) 10,219 Net income (loss) per share, basic $ (0.43 ) $ (0.41 ) $ (0.68 ) $ 0.34 Net income (loss) per share, diluted $ (0.43 ) $ (0.41 ) $ (0.68 ) $ 0.34 Weighted average shares outstanding, basic 30,102 30,279 30,324 30,342 Weighted average shares outstanding, fully diluted 30,102 30,279 30,324 30,412 (1) The fourth quarter of calendar 2019 was impacted by a $38.8 million gain the Company recognized due to the sale of two communities located in Springfield, Missouri and Peoria, Illinois on October 1, 2019. 2018 Calendar Quarters First Second Third Fourth (1) (In thousands, except per share amounts) Total revenues $ 114,643 $ 114,627 $ 115,650 $ 115,098 Income (Loss) from operations 5,386 3,643 1,696 (3,122 ) Net loss and comprehensive loss (7,156 ) (9,060 ) (11,089 ) (26,291 ) Net loss per share, basic $ (0.24 ) $ (0.30 ) $ (0.37 ) $ (0.88 ) Net loss per share, diluted $ (0.24 ) $ (0.30 ) $ (0.37 ) $ (0.88 ) Weighted average shares outstanding, basic 29,627 29,831 29,877 29,908 Weighted average shares outstanding, fully diluted 29,627 29,831 29,877 29,908 (1) The fourth quarter of calendar 2018 was impacted by $4.2 million of additional general and administrative expenses for separation and placement costs primarily associated with the retirement and replacement of the Company’s CEO and $12.6 million for write-off of deferred loan costs and prepayment premiums from the early repayment of certain mortgage debt on the Company’s owned properties due to the opportunity to establish an MCF with Berkadia and extend scheduled maturities.

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2019
Subsequent Events [Abstract]
Subsequent Events	18. Disposition of Boca Raton, Florida Community Effective January 15, 2020, the Company’s leased senior living community located in Boca Raton, Florida transitioned to a new operator. In conjunction with the transition, the Company paid Healthpeak a one-time $0.3 million payment as a prepayment against the remaining lease payments and was relieved of any additional obligation to Healthpeak with regard to that property. The transition was the first transaction under the Company’s October 22, 2019 agreement with Healthpeak. Early Termination of Master Lease Agreements Welltower On March 15, 2020, the Company entered into an agreement with Welltower, providing for the early termination of three Master Lease Agreements between it and Welltower covering 24 communities. Pursuant to such agreement, among other things, from February 1, 2020 through December 31, 2020, the Company agreed to pay Welltower rent of approximately $2.2 million per month for such communities as compared to approximately $2.8 million per month that would otherwise have been due and payable under the Master Lease Agreements. The Company will not be required to comply with certain financial covenants of the Master Lease Agreements during the forbearance period. In conjunction with the agreement, the Company agreed to release $6.5 million in security deposits held by Welltower. In addition, the agreement with Welltower provides for the conversion of the lease agreements covering the communities into property management agreements with the Company on December 31, 2020, if such communities have not been transitioned to a successor operator. Ventas On March 10, 2020, the Company entered into an agreement with Ventas, providing for the early termination of a Master Lease Agreement between it and Ventas covering seven communities. Pursuant to such agreement, among other things, from February 1, 2020 through December 31, 2020, the Company agreed to pay Ventas rent of approximately $1.0 million per month for such communities as compared to approximately $1.3 million per month that would otherwise have been due and payable under the Master Lease Agreements. The Company will not be required to comply with certain financial covenants of the Master Lease Agreements during the forbearance period. In conjunction with the agreement, the Company agreed to release $3.9 million in security deposits held by Ventas. In addition, the agreement with Ventas provides for the conversion of the lease agreements covering the communities into property management agreements with the Company on December 31, 2020 if Ventas has not transitioned such communities to a successor operator. Healthpeak On March 1, 2020, the Company entered into an agreement with Healthpeak, effective February 1, 2020, providing for the early termination of a Master Lease Agreement between it and Healthpeak, previously scheduled to mature in April 2026. The Master Lease Agreement was converted into a management agreement under a RIDEA structure pursuant to which the Company agreed to manage the six communities that were subject to such lease agreement until such communities are sold by Healthpeak. In conjunction with the agreement, the Company agreed to release approximately $1.9 million of security deposits held by Healthpeak. The Company expects that these agreements will result in lease modifications under ASC 842, which will significantly reduce the Company’s operating lease right-of-use assets, net and its operating lease liabilities. Additionally, the Company expects the lease modifications to advance the timing of recognition within the Company’s Consolidated Statements of Operations and Comprehensive Loss for certain assets and liabilities including $43.7 million of leasehold improvements and $11.4 million of lease related financing obligations as of December 31, 2019 as the modified leases are now expected to terminate by December 31, 2020. Coronavirus Since its discovery in December 2019, a new strain of coronavirus, which causes the viral disease known as COVID-19, has spread from China to many other countries, including the United States. The outbreak has been declared to be a pandemic by the World Health Organization, and the Health and Human Services Secretary has declared a public health emergency in the United States in response to the outbreak. Additionally, the Centers for Disease Control and Prevention has stated that older adults are at a higher risk for serious illness from the coronavirus. As a result of the outbreak, which effectively began impacting the United States in early March, the Company has taken necessary precautions to prevent and/or minimize spread of the virus at its communities. The Company is monitoring the potential impact on its revenues and expenses. The extent to which the coronavirus impacts our operations will depend on future developments, which are highly uncertain and cannot be predicted with confidence, including the duration of the outbreak, new information that may emerge concerning the severity of the coronavirus and the actions taken to contain the coronavirus or treat its impact, among others. Disposition of Merrillville, Indiana Community Effective March 31, 2020, the Company sold one community located in Merrillville, Indiana for a total purchase price of $7.0 million and received approximately $6.9 million in net proceeds after paying customary closing costs. The community was unencumbered. The community was comprised of 171 assisted living units and 42 memory care units.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2019
Accounting Policies [Abstract]
Cash and Cash Equivalents and Restricted Cash	Cash and Cash Equivalents and Restricted Cash The Company considers all highly liquid investments with original maturities of three months or less at the date of acquisition to be cash equivalents. The Company has deposits in banks that exceed Federal Deposit Insurance Corporation insurance limits. Management believes that credit risk related to these deposits is minimal. Restricted cash consists of deposits required by certain lenders as collateral pursuant to letters of credit. The deposit must remain so long as the letter of credit is outstanding which is subject to renewal annually. The following table sets forth our cash and cash equivalents and restricted cash (in thousands): Year Ended December 31, 2019 2018 Cash and cash equivalents $ 23,975 $ 31,309 Restricted cash 13,088 13,011 $ 37,063 $ 44,320
Long-Lived Assets and Impairment	Long-Lived Assets and Impairment Property and equipment are stated at cost and depreciated on a straight-line basis over the estimated useful lives of the assets. At each balance sheet date, the Company reviews the carrying value of its property and equipment to determine if facts and circumstances suggest that they may be impaired or that the depreciation period may need to be changed. The Company considers internal factors such as net operating losses along with external factors relating to each asset, including contract changes, local market developments, and other publicly available information to determine whether impairment indicators exist. If an indicator of impairment is identified, the carrying value of a long-lived asset is considered impaired when the anticipated undiscounted cash flows from such asset is separately identifiable and is less than its carrying value. Recoverability of an asset group is assessed by comparing its carrying amount to the estimated future undiscounted net cash flows expected to be generated by the asset group through operation or disposition, calculated utilizing the lowest level of identifiable cash flows. If this comparison indicates that the carrying amount of an asset group is not recoverable, we are required to recognize an impairment loss. The Company determines the fair value of operating lease ROU assets by comparing the contractual rent payments to estimated market rental rates. Long-lived ROU and fixed assets are valued at fair value using inputs classified as Level 3 in the fair value hierarchy, which are unobservable inputs based on the Company’s assumptions. Impairment, if any, is recorded in the period in which the impairment occurred.
Assets Held for Sale	Assets Held for Sale Assets are classified as held for sale when the Company has determined all of the held-for-sale criteria have been met. The Company determines the fair value, net of costs of disposal, of an asset on the date the asset is categorized as held for sale, and the asset is recorded at the lower of its fair value, net of cost of disposal, or carrying value on that date. The Company periodically reevaluates assets held for sale to determine if the assets are still recorded at the lower of fair value, net of cost of disposal, or carrying value. The fair values are generally determined based on market rates, industry trends and recent comparable sales transactions. During the year ended December 31, 2019, the Company determined a remeasurement write down of approximately $2.3 million was required to adjust the carrying value of a community classified as held for sale to its fair value, net of cost of disposal, which is included in gain (loss) on disposition of assets, net on the Company’s Consolidated Statements of Operations and Comprehensive Loss. The community was sold prior to December 31, 2019. The Company did not recognize any expense related to assets held for sale during the year ended December 31, 2018. The fair values are generally determined based on market rates, industry trends, and recent comparable sales transactions. The actual sales price of these assets could differ significantly from the Company’s estimates. There were no senior housing communities classified as held for sale by the Company at December 31, 2019 or 2018.
Advertising Costs	Advertising Costs The Company expenses advertising costs as incurred. Advertising expense was approximately $3.9 million $3.3 million $2.8 million for the years ended December 31, 2019 2018 2017
Off-Balance Sheet Arrangements	Off-Balance Sheet Arrangements The Company had no material off-balance sheet arrangements at December 31, 2019 or 2018.
Income Taxes	Income Taxes Income taxes are computed using the asset and liability method and current income taxes are recorded based on amounts refundable or payable. Deferred income taxes are recorded based on the estimated future tax effects of loss carryforwards and temporary differences between financial statement carrying amounts of existing assets and liabilities and their respective tax basis. Deferred tax assets and liabilities are measured using enacted tax rates that are expected to apply to taxable income in the years in which we expect those carryforwards and temporary differences to be recovered or settled. Management regularly evaluates the future realization of deferred tax assets and provides a valuation allowance, if considered necessary, based on such evaluation. As part of the evaluation, management has evaluated taxable income in carryback years, future reversals of taxable temporary differences, feasible tax planning strategies, and future expectations of income. The Company evaluates uncertain tax positions through consideration of accounting and reporting guidance on criteria, measurement, derecognition, classification, interest and penalties, accounting in interim periods, disclosure, and transition that is intended to provide better financial-statement comparability among different companies. The Company is required to recognize a tax benefit in its financial statements for an uncertain tax position only if management’s assessment is that its position is “more likely than not” (i.e., a greater than 50 percent likelihood) to be upheld on audit based only on the technical merits of the tax position. The Company’s policy is to recognize interest related to unrecognized tax benefits as interest expense and penalties as income tax expense.
Revenue Recognition	Revenue Recognition Resident revenue consists of fees for basic housing and certain support services and fees associated with additional housing and expanded support requirements such as assisted living care, memory care, and ancillary services. Basic housing and certain support services revenue is recorded when services are rendered and amounts billed are Residency agreements are generally short term in nature with durations of one year or less and are typically terminable by either party, under certain circumstances, upon providing 30 days’ notice, unless state law provides otherwise, with resident fees billed monthly in advance. and were recognized as a component of resident revenue within the Company’s Consolidated Statements of Operations and Comprehensive Loss. Revenue for certain ancillary services is recognized as services are provided, and includes fees for services such as medication management, daily living activities, beautician/barber, laundry, television, guest meals, pets, and parking which are generally billed monthly in arrears. The Company's senior housing communities have residency agreements which generally require the resident to pay a community fee prior to moving into the community and are recorded initially by the Company as deferred revenue. At each of December 31, 2019 and 2018, the Company had contract liabilities for deferred community fees totaling approximately $2.2 million and $1.1 million, respectively, which are included as a component of deferred income within current liabilities of the Company’s Consolidated Balance Sheets. The Company recognized community fees as a component of resident revenue within the Company’s Consolidated Statements of Operations and Comprehensive Loss of approximately $2.9 million and $2.8 million, respectively, during the fiscal years ended December 31, 2019 and 2018. Revenues from the Medicaid program accounted for approximately 5.9% of the Company’s revenue in fiscal 2019, 5.4% of the Company’s revenue in fiscal 2018, and 5.6% of the Company’s revenue in fiscal 2017. During fiscal 2019, 2018, and 2017, 41, 40, and 41, respectively, of the Company’s communities were providers of services under the Medicaid program. Accordingly, these communities were entitled to reimbursement under the foregoing program at established rates that were lower than private pay rates. Patient service revenue for Medicaid patients was recorded at the reimbursement rates as the rates were set prospectively by the applicable state upon the filing of an annual cost report. None of the Company’s communities were providers of services under the Medicare program during fiscal 2019, 2018, or 2017. Laws and regulations governing the Medicaid program are complex and subject to interpretation. The Company believes that it is in compliance with all applicable laws and regulations and is not aware of any pending or threatened investigations involving allegations of potential wrongdoing. While no such regulatory inquiries have been made, compliance with such laws and regulations can be subject to future government review and interpretation as well as significant regulatory action including fines, penalties, and exclusion from the Medicaid program.
Purchase Accounting	Purchase Accounting In determining the allocation of the purchase price of senior housing communities acquired to net tangible and identified intangible assets acquired and liabilities assumed, if any, the Company makes estimates of fair value using information obtained as a result of pre-acquisition due diligence, leasing activities and/or independent appraisals. The Company assigns the purchase price for senior living communities to assets acquired and liabilities assumed based on their estimated fair values. The determination of fair value involves the use of significant judgments and estimates which is generally assessed as follows: The Company allocates the fair values of buildings acquired on an as-if-vacant basis and depreciates the building values over the estimated remaining lives of the buildings, not to exceed 40 years. The Company The fair value of acquired lease-related intangibles reflects the estimated fair value of existing resident in-place leases as represented by the cost to obtain residents and an estimated absorption period to reflect the value of the rent and recovery costs foregone during a reasonable lease-up period as if the property acquired was vacant. The Company amortizes any acquired resident in-place lease intangibles to depreciation and amortization expense over the estimated remaining useful life of the respective resident operating leases.
Credit Risk and Allowance for Doubtful Accounts	Credit Risk and Allowance for Doubtful Accounts The Company’s resident receivables are generally due within 30 days from the date billed. Accounts receivable are reported net of an allowance for doubtful accounts of $8.6 million and $6.8 million at December 31, 2019 and 2018, respectively, and represent the Company’s estimate of the amount that ultimately will be collected. The adequacy of the Company’s allowance for doubtful accounts is reviewed on an ongoing basis, using historical payment trends, write-off experience, analyses of receivable portfolios by payor source and aging of receivables, as well as a review of specific accounts, and adjustments are made to the allowance as necessary. Credit losses on resident receivables have historically been within management’s estimates, and management believes that the allowance for doubtful accounts adequately provides for expected losses.
Lease Accounting	Lease Accounting Effective January 1, 2019, the Company adopted the new lease standard provisions of ASC 842. Due to the adoption of ASC 842, the unamortized balances of lease acquisition costs and lease incentives were reclassified as a component of the respective operating lease right-of-use asset. Additionally, the unamortized balance of deferred gains associated with sale leaseback transactions totaling approximately $10.0 million was written-off to retained deficit. Management determines if a contract is or contains a lease at inception or modification of a contract. A contract is or contains a lease if the contract conveys the right to control the use of an identified asset for a period of time in exchange for consideration. Control over the use of the identified asset means the lessee has both the right to obtain substantially all of the economic benefits from the use of the asset and the right to direct the use of the asset. Operating lease right-of-use assets and liabilities are recognized based on the present value of future minimum lease payments over the expected lease term on the lease commencement date. When the implicit lease rate is not determinable, management uses the Company’s incremental borrowing rate based on the information available at the lease commencement date in determining the present value of future minimum lease payments. The expected lease terms include options to extend or terminate the lease when it is reasonably certain the Company will exercise such options. Lease expense for minimum lease payments is recognized on a straight-line basis over the expected lease terms. Certain of the Company’s lease arrangements have lease and non-lease components. The Company accounts for the lease components and non-lease components as a single lease component for all classes of underlying assets. Leases with an expected lease term of 12 months or less are not recorded on the balance sheet and the related lease expense is recognized on a straight-line basis over the expected lease term.
Self-Insurance Liability Accruals	Self-Insurance Liability Accruals The Company offers full-time employees an option to participate in its health and dental plans. The Company is self-insured up to certain limits and is insured if claims in excess of these limits are incurred. The cost of employee health and dental benefits, net of employee contributions, is shared between the corporate office and the senior housing communities based on the respective number of plan participants. Funds collected are used to pay the actual program costs, including estimated annual claims, third-party administrative fees, network provider fees, communication costs, and other related administrative costs incurred by the plans. Claims are paid as they are submitted to the Company’s third-party administrator. The Company records a liability for outstanding claims and claims that have been incurred but not yet reported. This liability is based on the historical claim reporting lag and payment trends of health insurance claims. Management believes that the liability for outstanding losses and expenses is adequate to cover the ultimate cost of losses and expenses incurred at December 31, 2019; however, actual claims and expenses may differ. Any subsequent changes in estimates are recorded in the period in which they are determined. The Company uses a combination of insurance and self-insurance for workers’ compensation. Determining the reserve for workers’ compensation losses and costs that the Company has incurred as of the end of a reporting period involves significant judgments based on projected future events, including potential settlements for pending claims, known incidents which may result in claims, estimates of incurred but not yet reported claims, changes in insurance premiums, estimated litigation costs and other factors. The Company regularly adjusts these estimates to reflect changes in the foregoing factors. However, since this reserve is based on estimates, the actual expenses incurred may differ from the amounts reserved. Any subsequent changes in estimates are recorded in the period in which they are determined.
Net Loss Per Share	Net Loss Per Share Basic net loss per common share is computed by dividing net loss by the weighted average number of common shares outstanding for the period. Potentially dilutive securities consist of unvested restricted shares and shares that could be issued under outstanding stock options. Potentially dilutive securities are excluded from the computation of net loss per common share if their effect is antidilutive. The following table sets forth the computation of basic and diluted net loss per share (in thousands, except for per share amounts): Year Ended December 31, 2019 2018 2017 Net loss $ (36,030 ) $ (53,596 ) $ (44,168 ) Net loss allocated to unvested restricted shares — — — Undistributed net loss allocated to common shares $ (36,030 ) $ (53,596 ) $ (44,168 ) Weighted average shares outstanding — basic 30,263 29,812 29,453 Effects of dilutive securities: Employee equity compensation plans — — — Weighted average shares outstanding — diluted 30,263 29,812 29,453 Basic net loss per share $ (1.19 ) $ (1.80 ) $ (1.50 ) Diluted net loss per share $ (1.19 ) $ (1.80 ) $ (1.50 ) Awards of unvested restricted stock representing approximately 1.1 million, 1.3 million, and 0.9 million shares were outstanding for the fiscal years ended December 31, 2019, 2018, and 2017, respectively, and are antidilutive.
Treasury Stock	Treasury Stock The Company accounts for treasury stock under the cost method and includes treasury stock as a component of shareholders’ equity until it is canceled. There were no repurchases of the Company’s common stock during fiscal 2019 or 2018.
Stock-Based Compensation	Stock-Based Compensation The Company recognizes compensation expense for share-based payment awards to certain employees and directors, including grants of stock options and awards of restricted stock, in the Consolidated Statements of Operations and Comprehensive Loss based on their fair values. On May 8, 2007, the Company’s stockholders approved the 2007 Omnibus Stock and Incentive Plan for Capital Senior Living Corporation (as amended, the “2007 Plan”) which provided for, among other things, the grant of restricted stock awards and stock options to purchase shares of the Company’s common stock. The 2007 Plan authorized the Company to issue up to 4.6 million shares of common stock, and the Company had reserved shares of common stock for future issuance pursuant to awards under the 2007 Plan. On May 14, 2019, the Company’s stockholders approved the 2019 Omnibus Stock and Incentive Plan for Capital Senior Living Corporation (the “2019 Plan”), which replaced the 2007 Plan. The 2019 Plan provides for, among other things, the grant of restricted stock awards, restricted stock units and stock options to purchase shares of the Company’s common stock. The 2019 Plan authorizes the Company to issue up to 2,250,000 shares of common stock plus reserved shares not issued or subject to outstanding awards under the 2007 Plan, and the Company has reserved shares of common stock for future issuance pursuant to awards under the 2019 Plan. Effective March 26, 2019, the 2007 Plan was terminated and no additional awards will be granted under the 2007 Plan.
Segment Information	Segment Information The Company evaluates the performance and allocates resources of its senior living facilities based on current operations and market assessments on a property-by-property basis. The Company does not have a concentration of operations geographically or by product or service as its management functions are integrated at the property level. The Company has determined that all of its operating units meet the criteria in Accounting Standards Codification (“ASC”) Topic 280, Segment Reporting
Recently Issued Accounting Guidance	Recently Issued Accounting Guidance In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820) , which modifies certain disclosure requirements in Topic 820, such as the removal of the need to disclose the amount of and reason for transfers between Level 1 and Level 2 of the fair value hierarchy, and several changes related to Level 3 fair value measurements. ASU 2018-13 is effective for fiscal years and interim periods within those fiscal years beginning after December 15, 2019. The Company does not expect the adoption of ASU 2018-13 to have a material impact on its consolidated financial statements. In June 2016, the FASB issued ASU 2016-13, Financial Instruments - Credit Losses: Measurement of Credit Losses on Financial Instruments In February 2016, the FASB issued ASU 2016-02, Leases Leases, Targeted Improvements The fair value of the right-of-use assets was estimated, utilizing a discounted cash flow approach based upon historical and projected cash flows and market data, including management fees and a market supported lease coverage ratio. The estimated future cash flows were discounted at a rate that is consistent with a weighted average cost of capital from a market participant perspective. The adoption of ASC 842 resulted in the following adjustments to the Company’s Consolidated Balance Sheet at January 1, 2019: Assets Prepaid expenses and other $ (2,050) Property and equipment, net (15,569) Operating lease right-of-use assets, net 255,386 Other assets, net (4,715) Total assets $ 233,052 Liabilities and Shareholder’s Equity Deferred income $ (17,498) Financing obligations (35,956) Operating lease liabilities 289,513 Other long-term liabilities (15,643) Total liabilities $ 220,416 Total shareholder’s equity $ 12,636
Use of Estimates and Critical Accounting Policies	Use of Estimates and Critical Accounting Policies The preparation of financial statements in conformity with U.S. generally accepted accounting principles requires management to make estimates and assumptions that affect the amounts reported in the accompanying financial statements and related footnotes. Management bases its estimates and assumptions on historical experience, observance of industry trends and various other sources of information and factors, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Actual results could differ from these estimates. Critical accounting policies are defined as those that are reflective of significant judgments and uncertainties, and potentially could result in materially different results under different assumptions and conditions. The Company believes revenue recognition, long-lived asset impairment, and self-insurance liability accruals are its most critical accounting policies and/or require management’s most subjective judgments.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2019
Accounting Policies [Abstract]
Schedule of Cash and Cash Equivalents and Restricted Cash	The following table sets forth our cash and cash equivalents and restricted cash (in thousands): Year Ended December 31, 2019 2018 Cash and cash equivalents $ 23,975 $ 31,309 Restricted cash 13,088 13,011 $ 37,063 $ 44,320
Computation of Basic and Diluted Net Loss Per Share	The following table sets forth the computation of basic and diluted net loss per share (in thousands, except for per share amounts): Year Ended December 31, 2019 2018 2017 Net loss $ (36,030 ) $ (53,596 ) $ (44,168 ) Net loss allocated to unvested restricted shares — — — Undistributed net loss allocated to common shares $ (36,030 ) $ (53,596 ) $ (44,168 ) Weighted average shares outstanding — basic 30,263 29,812 29,453 Effects of dilutive securities: Employee equity compensation plans — — — Weighted average shares outstanding — diluted 30,263 29,812 29,453 Basic net loss per share $ (1.19 ) $ (1.80 ) $ (1.50 ) Diluted net loss per share $ (1.19 ) $ (1.80 ) $ (1.50 )
Adjustments to Company's Consolidated Balance upon Adoption of ASC 842	The adoption of ASC 842 resulted in the following adjustments to the Company’s Consolidated Balance Sheet at January 1, 2019: Assets Prepaid expenses and other $ (2,050) Property and equipment, net (15,569) Operating lease right-of-use assets, net 255,386 Other assets, net (4,715) Total assets $ 233,052 Liabilities and Shareholder’s Equity Deferred income $ (17,498) Financing obligations (35,956) Operating lease liabilities 289,513 Other long-term liabilities (15,643) Total liabilities $ 220,416 Total shareholder’s equity $ 12,636

Property and Equipment (Tables)

Property and Equipment (Tables)	12 Months Ended
	Dec. 31, 2019
Property Plant And Equipment [Abstract]
Schedule of Net Property and Equipment and Leasehold Improvements, include Assets Under Financing Leases	As of December 31, 2019 and 2018, net property and equipment and leasehold improvements, which include assets under financing leases, consists of the following (in thousands): December 31, Asset Lives 2019 2018 Land $ 66,764 $ 69,842 Land improvements 5 to 20 years 25,718 25,373 Buildings and building improvements 10 to 40 years 1,096,386 1,158,577 Furniture and equipment 5 to 10 years 65,828 66,202 Automobiles 5 to 7 years 5,947 6,344 Assets under financing leases and leasehold improvements (1) 95,281 98,396 Construction in progress NA 1,491 421 1,357,415 1,425,155 Less accumulated depreciation and amortization (388,204 ) (366,106 ) Property and equipment, net $ 969,211 $ 1,059,049 (1) Leasehold improvements are amortized over the shorter of the useful life of the asset or the remaining lease term. Assets under financing leases and leasehold improvements include $0.6million of financing lease right-of-use assets, net of accumulated amortization, as of December 31, 2019. Refer to Note 16, Leases , for further information on the Company’s financing leases

Other Assets (Tables)

Other Assets (Tables)	12 Months Ended
	Dec. 31, 2019
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract]
Schedule of Other Assets	Other assets consist of the following (in thousands): December 31, 2019 2018 Deferred lease costs, net $ - $ 4,715 Security and other deposits 9,915 9,889 Other 758 1,881 $ 10,673 $ 16,485

Accrued Expenses (Tables)

Accrued Expenses (Tables)	12 Months Ended
	Dec. 31, 2019
Text Block [Abstract]
Schedule of Accrued Expenses	Accrued expenses consist of the following (in thousands): December 31, 2019 2018 Accrued salaries, bonuses and related expenses $ 14,733 $ 11,996 Accrued property taxes 15,186 14,079 Accrued interest 3,617 3,066 Accrued health claims and workers compensation 5,281 4,845 Accrued professional fees 1,265 1,012 Other 6,145 6,882 $ 46,227 $ 41,880

Notes Payable (Tables)

Notes Payable (Tables)	12 Months Ended
	Dec. 31, 2019
Debt Disclosure [Abstract]
Schedule of Notes Payable	Notes payable consists of the following (in thousands): Average Monthly Net Book Value Notes Payable December 31, Lender Payment Of Collateral (1) Interest Rate Maturity Date 2019 2018 Fannie Mae $ 135 $ 24,980 4.69 April 2022 $ 22,592 $ 23,127 Fannie Mae 11 3,992 4.97 April 2022 1,958 1,991 Fannie Mae 60 14,170 4.48 May 2022 10,214 10,462 Fannie Mae 20 14,170 4.85 May 2022 3,579 3,640 Fannie Mae — — 4.32 January 2023 — 15,194 Fannie Mae — — 5.39 January 2023 — 8,327 Fannie Mae 39 7,756 4.58 January 2023 6,656 6,808 Fannie Mae 17 7,756 5.49 January 2023 2,950 2,990 Fannie Mae 45 7,810 5.93 October 2023 6,972 7,092 Fannie Mae 67 12,408 5.50 November 2023 10,792 10,992 Fannie Mae 67 11,598 5.38 November 2023 10,837 11,042 Fannie Mae 282 49,090 5.56 January 2024 45,077 45,892 Fannie Mae 632 103,848 4.24 July 2024 116,183 118,715 Fannie Mae 120 24,074 4.48 July 2024 21,513 21,963 Fannie Mae 81 19,081 4.30 July 2024 14,836 15,156 Fannie Mae 91 61,630 4.98 July 2024 16,053 16,322 Fannie Mae 11 8,817 6.30 July 2024 1,777 1,796 Fannie Mae 134 25,548 4.59 September 2024 23,856 24,342 Fannie Mae 22 12,916 5.72 September 2024 3,584 3,634 Fannie Mae 54 9,810 4.70 September 2024 9,494 9,683 Fannie Mae 53 11,293 4.50 January 2025 9,538 9,731 Fannie Mae 95 6,552 4.46 January 2025 17,333 17,686 Fannie Mae 70 14,605 4.35 February 2025 12,912 13,179 Fannie Mae — — 3.85 March 2025 — 21,633 Fannie Mae 102 22,879 3.84 April 2025 19,883 20,324 Fannie Mae 31 22,879 5.53 April 2025 5,223 5,300 Fannie Mae 81 14,732 5.30 June 2025 13,077 13,335 Fannie Mae 58 12,021 4.69 October 2025 10,402 10,595 Fannie Mae 44 8,878 4.70 October 2025 7,862 8,008 Fannie Mae 273 37,074 4.68 December 2025 49,385 50,295 Fannie Mae 9 8,787 5.81 December 2025 1,407 1,426 Fannie Mae 98 22,990 4.10 October 2026 19,127 19,498 Fannie Mae 108 23,515 4.24 December 2026 20,853 21,243 Fannie Mae 655 148,134 5.13 January 2029 150,782 150,782 Fannie Mae 163 148,134 (3 ) January 2029 50,261 50,261 Protective Life 96 23,558 3.55 April 2025 19,325 19,787 Protective Life 49 10,566 4.25 August 2025 9,157 9,350 Protective Life 78 16,938 4.25 September 2025 14,565 14,871 Protective Life 138 30,917 4.25 November 2025 25,940 26,478 Protective Life 57 12,901 4.50 February 2026 10,554 10,761 Protective Life 187 39,862 4.38 March 2026 32,099 32,920 Protective Life 70 14,620 4.13 October 2031 11,995 12,326 Berkadia 230 60,462 (4 ) December 2021 (4) 40,500 65,000 Berkadia — — — July 2020 — 3,500 Berkadia 96 16,953 (5 ) October 2021 10,992 11,255 Fifth Third 125 33,852 (6 ) December 2021 31,500 — HUD 16 4,572 4.48 September 2045 2,875 2,933 Insurance Financing — — 3.64 May 2019 — 799 Insurance Financing — — 4.40 November 2019 — 763 Insurance Financing 240 — 4.40 May 2020 1,187 — Insurance Financing 74 — 4.04 November 2020 730 — Insurance Financing 173 — 4.40 October 2020 1,698 — $ 5,357 4.65% (2) $ 930,085 $ 983,207 Less deferred loan costs, net 8,629 9,457 $ 921,456 $ 973,750 Less current portion 15,819 14,342 $ 905,637 $ 959,408 (1) 78 (2) Weighted average interest rate on current fixed interest rate debt outstanding. (3) Variable interest rate of LIBOR plus 2.14%, which was 3.87% at December 31, 2019. (4) Variable interest rate of LIBOR plus 4.50%, which was 6.23% at December 31, 2019. Effective December 23, 2019, the Company repaid $24.5 million of the loan and extended the maturity date with Berkadia to December 10, 2021. ( 5 ) Variable interest rate of LIBOR plus 5.00%, which was 6.73% at December 31, 2019. ( 6 ) Variable interest rate of LIBOR plus 3.25%, which was 4.98% at December 31, 2019.
Summary of Aggregate Scheduled Maturities of Notes Payable	The aggregate scheduled maturities of notes payable at December 31, 2019 are as follows (in thousands): 2020 $ 17,793 2021 97,144 2022 53,293 2023 52,741 2024 240,493 Thereafter 468,621 $ 930,085

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	12 Months Ended
	Dec. 31, 2019
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Summary of Weighted-Average Assumptions Utilized to Estimate Fair Value of Stock Options	The fair value of stock options was estimated using a Black-Scholes option pricing model with the following weighted-average assumptions: Year ended December 31, 2019 Expected volatility 37.0% Expected dividend yield 0.0% Expected term in years 6.0 Risk free rate 2.55% Expected forfeiture rate 0.0%
Summary of Stock Option Transactions	A summary of the Company’s stock option transactions for the years ended December 31, 2019, 2018, and 2017 is as follows: Outstanding Beginning of Year Granted Exercised Forfeited Outstanding End of Year Options Exercisable December 31, 2019 Shares — 147,239 — — 147,239 — Weighted average price $ — $ 7.46 $ — — $ 7.46 $ — December 31, 2018 Shares — — — — — — Weighted average price $ — — $ — — $ — $ — December 31, 2017 Shares — — — — — — Weighted average price $ — — $ — — $ — $ —
Restricted Common Stock Awards Activity and Related Information	A summary of the Company’s restricted common stock awards activity and related information for the years ended December 31, 2019, 2018, and 2017 is presented below: Outstanding Beginning of Year Issued Vested Forfeited Outstanding End of Year December 31, 2019 Shares 1,345,159 662,154 (424,556 ) (493,411 ) 1,089,346 December 31, 2018 Shares 964,484 830,794 (386,900 ) (63,219 ) 1,345,159 December 31, 2017 Shares 829,766 565,745 (355,400 ) (75,627 ) 964,484

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Schedule of (Benefit) Provision for Income Taxes	The (benefit) provision for income taxes consists of the following (in thousands): Year Ended December 31, 2019 2018 2017 Current: Federal $ (71 ) $ (152 ) $ 6 State 443 474 550 Deferred: Federal 76 (2,093 ) 1,940 State — — — (Benefit) Provision for income taxes $ 448 $ (1,771 ) $ 2,496
(Benefit) Provision for Income Taxes Differed from Amounts of Income Tax (Benefit) Provision Determined by Applying Federal Statutory Income Tax Rate to Income Before (Benefit) Provision for Income Taxes	The (benefit) provision for income taxes differed from the amounts of income tax (benefit) provision determined by applying the U.S. federal statutory income tax rate to income before (benefit) provision for income taxes as a result of the following (in thousands): Year Ended December 31, 2019 2018 2017 Tax benefit at federal statutory rates $ (7,472 ) $ (11,627 ) $ (14,168 ) State income tax benefit, net of federal effects (548 ) (665 ) (648 ) Change in deferred tax asset valuation allowance 7,478 9,543 7,857 Tax reform impact on deferred income taxes — — 13,959 Share based compensation ASU 2016-09 adoption — — (5,326 ) Other 990 978 822 (Benefit) Provision for income taxes $ 448 $ (1,771 ) $ 2,496
Summary of Deferred Tax Assets and Liabilities	A summary of the Company’s deferred tax assets and liabilities, are as follows (in thousands): December 31, 2019 2018 Deferred tax assets: Deferred gains on sale/leaseback transactions $ — $ 2,440 Lease liabilities 62,166 — Net operating loss carryforward 34,284 33,252 Compensation costs 2,134 3,087 Depreciation and amortization 3,525 5,323 Other 2,991 2,330 Total deferred tax assets 105,100 46,432 Deferred tax asset valuation allowance (50,699 ) (46,280 ) Total deferred tax assets, net 54,401 152 Deferred tax liabilities: Depreciation and amortization — — Operating lease right-of-use assets (54,325 ) — Total deferred tax liabilities $ (54,325 ) $ — Deferred taxes, net $ 76 $ 152
Schedule of Unrecognized Tax Benefits Activity and Related Information	A summary of the Company’s unrecognized tax benefits activity and related information for the years ended December 31, 2019, 2018, and 2017 is presented below (in thousands): 2019 2018 2017 Beginning balance, January 1 $ 4,644 $ 3,416 $ 3,786 Gross increases – tax positions in prior period 2,468 1,228 — Gross decreases – tax positions in prior period — — (370 ) Gross increases – tax positions in current period — — — Settlements — — — Lapse of statute of limitations (323 ) — — Ending balance, December 31 $ 6,789 $ 4,644 $ 3,416

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2019
Fair Value Disclosures [Abstract]
Carrying Amounts and Fair Values of Financial Instruments	The carrying amounts and fair values of financial instruments at December 31, 2019 and 2018 are as follows (in thousands): 2019 2018 Carrying Amount Fair Value Carrying Amount Fair Value Cash and cash equivalents $ 23,975 $ 23,975 $ 31,309 $ 31,309 Restricted cash 13,088 13,088 13,011 13,011 Notes payable, excluding deferred loan costs 930,085 899,326 983,207 945,318

Allowance for Doubtful Accoun_2

Allowance for Doubtful Accounts (Tables)	12 Months Ended
	Dec. 31, 2019
Text Block [Abstract]
Schedule of Allowance for Doubtful Accounts	The components of the allowance for doubtful accounts are as follows (in thousands): December 31, 2019 2018 2017 Balance at beginning of year $ 6,793 $ 4,881 $ 4,253 Provision for bad debts, net of recoveries 3,765 2,990 1,748 Write-offs and other (1,915 ) (1,078 ) (1,120 ) Balance at end of year $ 8,643 $ 6,793 $ 4,881

Leases (Tables)

Leases (Tables)	12 Months Ended
	Dec. 31, 2019
Leases [Abstract]
Summary of Operating and Financing Lease Expense and Cash Flows from Leasing Transactions	A summary of operating and financing lease expense (including the respective presentation on the consolidated statement of operations) and cash flows from leasing transactions for the year ended December 31, 2019 is as follows: Operating Leases (in thousands) Year Ended December 31, 2019 Facility lease expense $ 57,022 General and administrative expenses 812 Operating expenses, including variable lease expense of $6,142 6,466 Total operating lease costs $ 64,300 Operating lease expense adjustment 5,243 Operating cash flows from operating leases $ 69,543 Financing Leases (in thousands) Year Ended December 31, 2019 Depreciation and amortization $ 11 Interest expense: financing lease obligations 3 Total financing lease costs $ 14 Operating cash flows from financing leases 11 Financing cash flows from financing leases 3 Total cash flows from financing leases $ 14
Schedule of Aggregate Amounts of Future Minimum Lease Payments	The aggregate amounts of future minimum lease payments recognized on the consolidated balance sheet as of December 31, 2019 are as follows (in thousands): Year Ending December 31, Operating Leases Financing Leases 2020 $ 63,549 $ 148 2021 51,401 148 2022 51,321 148 2023 51,274 138 2024 51,245 — Thereafter 44,762 — Total $ 313,552 $ 582 Less: Amount representing interest (present value discount) (59,107 ) (72 ) Present value of lease liabilities $ 254,445 $ 510 Less: Current portion of lease liabilities (45,871 ) (117 ) Lease liabilities, net of current portion $ 208,574 $ 393
Summary of Future Minimum Operating Lease Payments Under ASC 840	The aggregate amounts of future minimum operating lease payments not recognized on the consolidated balance sheet under ASC 840 as of December 31, 2018 are as follows (in thousands): Year Ending December 31, Operating Leases 2019 $ 66,455 2020 63,929 2021 52,093 2022 52,062 2023 52,026 Thereafter 97,165 Total lease payments $ 383,730

Quarterly Financial Informati_2

Quarterly Financial Information (Unaudited) (Tables)	12 Months Ended
	Dec. 31, 2019
Quarterly Financial Information Disclosure [Abstract]
Schedule of Quarterly Financial Information	The following table presents certain unaudited quarterly financial information for each of the four quarters ended December 31, 2019 and 2018. This information has been prepared on the same basis as the audited consolidated financial statements of the Company and include, in the opinion of the Company’s management, all adjustments (consisting of normal recurring adjustments) necessary to present fairly the quarterly results when read in conjunction with the audited consolidated financial statements of the Company. 2019 Calendar Quarters First Second Third Fourth (1) (In thousands, except per share amounts) Total revenues $ 114,176 $ 113,126 $ 111,110 108,688 Income (Loss) from operations 1,970 203 (8,105 ) (8,757 ) Net income (loss) and comprehensive income (loss) (12,984 ) (12,534 ) (20,731 ) 10,219 Net income (loss) per share, basic $ (0.43 ) $ (0.41 ) $ (0.68 ) $ 0.34 Net income (loss) per share, diluted $ (0.43 ) $ (0.41 ) $ (0.68 ) $ 0.34 Weighted average shares outstanding, basic 30,102 30,279 30,324 30,342 Weighted average shares outstanding, fully diluted 30,102 30,279 30,324 30,412 (1) The fourth quarter of calendar 2019 was impacted by a $38.8 million gain the Company recognized due to the sale of two communities located in Springfield, Missouri and Peoria, Illinois on October 1, 2019. 2018 Calendar Quarters First Second Third Fourth (1) (In thousands, except per share amounts) Total revenues $ 114,643 $ 114,627 $ 115,650 $ 115,098 Income (Loss) from operations 5,386 3,643 1,696 (3,122 ) Net loss and comprehensive loss (7,156 ) (9,060 ) (11,089 ) (26,291 ) Net loss per share, basic $ (0.24 ) $ (0.30 ) $ (0.37 ) $ (0.88 ) Net loss per share, diluted $ (0.24 ) $ (0.30 ) $ (0.37 ) $ (0.88 ) Weighted average shares outstanding, basic 29,627 29,831 29,877 29,908 Weighted average shares outstanding, fully diluted 29,627 29,831 29,877 29,908

Organization - Additional Infor

Organization - Additional Information (Detail)	Dec. 31, 2019CommunityStateResident	Dec. 18, 2018Community
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Senior housing communities operated by company	126	21
Number of states in which senior housing communities operated | State	23
Aggregate capacity of residents in company operated senior housing communities | Resident	16,000
Senior housing communities owned by company	80
Senior housing communities on lease by company	46

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Schedule of Cash and Cash Equivalents and Restricted Cash (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Accounting Policies [Abstract]
Cash and cash equivalents	$ 23,975	$ 31,309
Restricted cash	13,088	13,011
Total Cash and cash equivalents and Restricted cash	$ 37,063	$ 44,320	$ 31,024	$ 47,323

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Additional Information (Detail)	May 14, 2019shares	Mar. 31, 2019USD ($)	Jan. 01, 2019USD ($)	Dec. 31, 2019USD ($)shares	Sep. 30, 2019USD ($)	Jun. 30, 2019USD ($)	Mar. 31, 2019USD ($)	Dec. 31, 2018USD ($)	Sep. 30, 2018USD ($)	Jun. 30, 2018USD ($)	Mar. 31, 2018USD ($)	Dec. 31, 2019USD ($)CommunitySegmentshares	Dec. 31, 2018USD ($)Communityshares	Dec. 31, 2017USD ($)Communityshares	Dec. 31, 2016USD ($)shares	Dec. 31, 2009shares	May 08, 2007shares
Accounting Policies [Line Items]
Number of assets held for sale | Community												0	0
Expense recognized related to assets held for sale													$ 0
Advertising expense												$ 3,900,000	3,300,000	$ 2,800,000
Uncertain tax position maximum percentage												50.00%
Resident revenue				$ 108,688,000	$ 111,110,000	$ 113,126,000	$ 114,176,000	$ 115,098,000	$ 115,650,000	$ 114,627,000	$ 114,643,000	$ 447,100,000	460,018,000	$ 466,997,000
Contract liabilities for deferred fees recognized into revenue												4,300,000	4,500,000
Contract liabilities for deferred fees included as deferred income				4,500,000				3,900,000				4,500,000	3,900,000
Contract liabilities for deferred community fees included in current liabilities				1,247,000				1,302,000				$ 1,247,000	$ 1,302,000
Percentage of revenue from Medicare and Medicaid programs												5.90%	5.40%	5.60%
Provider of services under Medicaid program, number of communities | Community												41	40	41
Provider of services under Medicare program, number of communities | Community												0	0	0
Resident receivables due period												30 days
Allowance for doubtful accounts				8,643,000				6,793,000				$ 8,643,000	$ 6,793,000	$ 4,881,000	$ 4,253,000
Outstanding unvested restricted stock | shares												1,100,000	1,300,000	900,000
Repurchase of common stock | shares												0	0		144,315	349,800
Number of reporting segment | Segment												1
Number of operating segment | Segment												1
Operating lease right-of-use assets, net				224,523,000								$ 224,523,000
Operating lease liabilities				$ 254,445,000								$ 254,445,000
2007 Omnibus Stock and Incentive Plan [Member]
Accounting Policies [Line Items]
Authorized shares of common stock | shares				4,600,000								4,600,000					4,600,000
Number of additional shares granted under the plan | shares	0
2019 Omnibus Stock and Incentive Plan [Member]
Accounting Policies [Line Items]
Authorized shares of common stock | shares	2,250,000
ASC 842 [Member]
Accounting Policies [Line Items]
Deferred gains associated with sale leaseback transactions			$ 10,000,000
Operating lease right-of-use assets, net			255,386,000
Operating lease liabilities			289,513,000
Adoption of lease standards, description												The Company elected to utilize certain practical expedients permitted under the transition guidance within the new standard, which allowed the Company to carryforward the historical lease classification, not separate the lease and non-lease components for all classes of underlying assets in which it is the lessee, not reassess initial direct costs for existing leases, and make an accounting policy election not to account for leases with an initial term of 12 months or less on the balance sheet.
ASC 842 [Member] | Deferred Lease Costs and Lease Incentives [Member]
Accounting Policies [Line Items]
Change in accounting principle, effect of change on retained deficit			(16,300,000)
ASC 842 [Member] | Impairment Write-down Adjustments [Member]
Accounting Policies [Line Items]
Change in accounting principle, effect of change on retained deficit			$ (17,800,000)
Rental and Other Services [Member]
Accounting Policies [Line Items]
Resident revenue												$ 440,100,000	$ 452,500,000
Community Fees [Member]
Accounting Policies [Line Items]
Resident revenue												2,900,000	2,800,000
Contract liabilities for deferred community fees included in current liabilities				$ 2,200,000				$ 1,100,000				$ 2,200,000	$ 1,100,000
Maximum [Member]
Accounting Policies [Line Items]
Residency agreements duration period												1 year
Senior Housing Community [Member]
Accounting Policies [Line Items]
Remeasurement write-down of assets held for sale		$ 2,300,000										$ 2,300,000

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Computation of Basic and Diluted Net Loss Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Accounting Policies [Abstract]
Net loss	$ 10,219	$ (20,731)	$ (12,534)	$ (12,984)	$ (26,291)	$ (11,089)	$ (9,060)	$ (7,156)	$ (36,030)	$ (53,596)	$ (44,168)
Net loss allocated to unvested restricted shares									0	0	0
Undistributed net loss allocated to common shares									$ (36,030)	$ (53,596)	$ (44,168)
Weighted average shares outstanding — basic	30,342	30,324	30,279	30,102	29,908	29,877	29,831	29,627	30,263	29,812	29,453
Effects of dilutive securities:
Employee equity compensation plans									0	0	0
Weighted average shares outstanding — diluted	30,412	30,324	30,279	30,102	29,908	29,877	29,831	29,627	30,263	29,812	29,453
Basic net loss per share	$ 0.34	$ (0.68)	$ (0.41)	$ (0.43)	$ (0.88)	$ (0.37)	$ (0.30)	$ (0.24)	$ (1.19)	$ (1.80)	$ (1.50)
Diluted net loss per share	$ 0.34	$ (0.68)	$ (0.41)	$ (0.43)	$ (0.88)	$ (0.37)	$ (0.30)	$ (0.24)	$ (1.19)	$ (1.80)	$ (1.50)

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Adjustments to Company's Consolidated Balance upon Adoption of ASC 842 (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Jan. 01, 2019	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
ASSETS
Prepaid expenses and other	$ 5,308		$ 5,232
Property and equipment, net	969,211		1,059,049
Operating lease right-of-use assets, net	224,523
Other assets, net	10,673		16,485
Total assets	1,267,696		1,149,144
LIABILITIES AND SHAREHOLDERS’ EQUITY
Deferred income			8,151
Financing obligations	510
Operating lease liabilities	254,445
Other long-term liabilities			15,643
Total shareholder’s equity	$ 14,379		$ 35,265	$ 80,433	$ 116,918
ASC 842 [Member]
ASSETS
Prepaid expenses and other		$ (2,050)
Property and equipment, net		(15,569)
Operating lease right-of-use assets, net		255,386
Other assets, net		(4,715)
Total assets		233,052
LIABILITIES AND SHAREHOLDERS’ EQUITY
Deferred income		(17,498)
Financing obligations		(35,956)
Operating lease liabilities		289,513
Other long-term liabilities		(15,643)
Total liabilities		220,416
Total shareholder’s equity		$ 12,636

Impairment of Long-Lived Asse_2

Impairment of Long-Lived Assets - Additional Information (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2019USD ($)
Impaired Long Lived Assets Held And Used [Line Items]
Impairment charges	$ 3,004
Change in Useful Life [Member]
Impaired Long Lived Assets Held And Used [Line Items]
Impairment charges	1,600
Asset impairment, lease ROU assets	$ 1,400

Dispositions and Other Signif_2

Dispositions and Other Significant Transactions - Additional Information (Details)	Jan. 15, 2020USD ($)Property	Oct. 22, 2019USD ($)	Oct. 01, 2019USD ($)Community	May 01, 2019USD ($)Property	Mar. 31, 2019USD ($)	Jun. 30, 2020Property	Dec. 31, 2019USD ($)Property	Dec. 31, 2019USD ($)Property	Dec. 31, 2018USD ($)	Dec. 31, 2017USD ($)	Sep. 30, 2019USD ($)
Dispositions And Other Significant Transactions [Line Items]
Number of communities sold | Community			2
Assets held for sale			$ 64,800,000								$ 24,400,000
Net proceeds from sale of assets			14,800,000
Gain (Loss) on disposition of assets, net			$ 38,800,000				$ 38,800,000	$ 36,528,000	$ 28,000	$ (123,000)
Current portion of notes payable							$ 15,819,000	15,819,000	$ 14,342,000
Senior Housing Community [Member]
Dispositions And Other Significant Transactions [Line Items]
Net proceeds from sale of assets				$ 1,400,000
Number of living units in a housing community sold | Property				96
Purchase price for the sale of asset				$ 5,000,000
Remeasurement write-down of assets held for sale					$ 2,300,000			$ 2,300,000
Senior Housing Community One [Member]
Dispositions And Other Significant Transactions [Line Items]
Number of living units in a housing community sold | Property							156	156
Senior Housing Community Two [Member]
Dispositions And Other Significant Transactions [Line Items]
Number of living units in a housing community sold | Property							158	158
Mortgage Debt [Member]
Dispositions And Other Significant Transactions [Line Items]
Current portion of notes payable											$ 44,400,000
Mortgage Debt [Member] | Senior Housing Community [Member]
Dispositions And Other Significant Transactions [Line Items]
Outstanding mortgage debt retired				$ 3,500,000
Healthpeak Properties Inc [Member]
Dispositions And Other Significant Transactions [Line Items]
Lease amendment period								Oct. 22, 2019
Number of leased properties transition to new operators | Property								0
Transitioned property amount as a prepayment against the remaining lease payments		$ 250,000
Percentage of proceeds in excess of a specified selling price of lease property		50.00%
Number of leased properties sold | Property								0
Healthpeak Properties Inc [Member] | Maximum [Member]
Dispositions And Other Significant Transactions [Line Items]
Proceeds in excess of specified selling price of lease property		$ 350,000
Healthpeak Properties Inc [Member] | Subsequent Event [Member]
Dispositions And Other Significant Transactions [Line Items]
Number of leased properties transition to new operators | Property	1
Transitioned property amount as a prepayment against the remaining lease payments	$ 300,000
Scenario Forecast [Member] | Healthpeak Properties Inc [Member]
Dispositions And Other Significant Transactions [Line Items]
Number of leased properties to be sold | Property						8

Property and Equipment - Schedu

Property and Equipment - Schedule of Net Property and Equipment and Leasehold Improvements, Include Assets Under Financing Leases (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 1,357,415	$ 1,425,155
Less accumulated depreciation and amortization	(388,204)	(366,106)
Property and equipment, net	969,211	1,059,049
Land [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	66,764	69,842
Land Improvements [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 25,718	25,373
Land Improvements [Member] | Minimum [Member]
Property, Plant and Equipment [Line Items]
Asset Lives	5 years
Land Improvements [Member] | Maximum [Member]
Property, Plant and Equipment [Line Items]
Asset Lives	20 years
Building and Building Improvements [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 1,096,386	1,158,577
Building and Building Improvements [Member] | Minimum [Member]
Property, Plant and Equipment [Line Items]
Asset Lives	10 years
Building and Building Improvements [Member] | Maximum [Member]
Property, Plant and Equipment [Line Items]
Asset Lives	40 years
Furniture and Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 65,828	66,202
Furniture and Equipment [Member] | Minimum [Member]
Property, Plant and Equipment [Line Items]
Asset Lives	5 years
Furniture and Equipment [Member] | Maximum [Member]
Property, Plant and Equipment [Line Items]
Asset Lives	10 years
Automobiles [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 5,947	6,344
Automobiles [Member] | Minimum [Member]
Property, Plant and Equipment [Line Items]
Asset Lives	5 years
Automobiles [Member] | Maximum [Member]
Property, Plant and Equipment [Line Items]
Asset Lives	7 years
Assets Under Financing Leases and Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 95,281	98,396
Construction in Progress [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 1,491	$ 421

Property and Equipment - Sche_2

Property and Equipment - Schedule of Net Property and Equipment and Leasehold Improvements, Include Assets Under Financing Leases (Parenthetical) (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2019USD ($)
Property, Plant and Equipment [Line Items]
Financing lease right-of-use assets, net of accumulated amortization	$ 11
Assets Under Financing Leases and Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Financing lease right-of-use assets, net of accumulated amortization	$ 600

Property and Equipment - Additi

Property and Equipment - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Property Plant And Equipment Capitalized Interest Costs [Abstract]
Capitalized computer software development costs	$ 4.1	$ 3.8
Capitalized computer software development costs, accumulated depreciation and amortization	3.3	3.1
Capital expenditure incurred but not yet paid	$ 2	$ 0.8

Other Assets - Schedule of Othe

Other Assets - Schedule of Other Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract]
Deferred lease costs, net		$ 4,715
Security and other deposits	$ 9,915	9,889
Other	758	1,881
Other assets, net	$ 10,673	$ 16,485

Accrued Expenses - Schedule of

Accrued Expenses - Schedule of Accrued Expenses (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Other Income And Expenses [Abstract]
Accrued salaries, bonuses and related expenses	$ 14,733	$ 11,996
Accrued property taxes	15,186	14,079
Accrued interest	3,617	3,066
Accrued health claims and workers compensation	5,281	4,845
Accrued professional fees	1,265	1,012
Other	6,145	6,882
Accrued Expenses, Current, Total	$ 46,227	$ 41,880

Notes Payable - Schedule of Not

Notes Payable - Schedule of Notes Payable (Detail) - Notes Payable [Member] - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Average Monthly Payment	$ 5,357
Interest rate	4.65%
Notes Payable	$ 930,085	$ 983,207
Less deferred loan costs, net	8,629	9,457
Deferred loan costs, Total	921,456	973,750
Less current portion	15,819	14,342
Notes payable, Noncurrent, Total	905,637	959,408
Fannie Mae Maturing on April 2022 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	135
Net Book Value Of Collateral	$ 24,980
Interest rate	4.69%
Maturity Date	2022-04
Notes Payable	$ 22,592	23,127
Fannie Mae Two Maturing on April 2022 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	11
Net Book Value Of Collateral	$ 3,992
Interest rate	4.97%
Maturity Date	2022-04
Notes Payable	$ 1,958	1,991
Fannie Mae Maturing on May 2022 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	60
Net Book Value Of Collateral	$ 14,170
Interest rate	4.48%
Maturity Date	2022-05
Notes Payable	$ 10,214	10,462
Fannie Mae Two Maturing on May 2022 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	20
Net Book Value Of Collateral	$ 14,170
Interest rate	4.85%
Maturity Date	2022-05
Notes Payable	$ 3,579	3,640
Fannie Mae Maturing on January 2023 [Member]
Debt Instrument [Line Items]
Interest rate	4.32%
Maturity Date	2023-01
Notes Payable		15,194
Fannie Mae Two Maturing on January 2023 [Member]
Debt Instrument [Line Items]
Interest rate	5.39%
Maturity Date	2023-01
Notes Payable		8,327
Fannie Mae Three Maturing on January 2023 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	$ 39
Net Book Value Of Collateral	$ 7,756
Interest rate	4.58%
Maturity Date	2023-01
Notes Payable	$ 6,656	6,808
Fannie Mae Four Maturing on January 2023 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	17
Net Book Value Of Collateral	$ 7,756
Interest rate	5.49%
Maturity Date	2023-01
Notes Payable	$ 2,950	2,990
Fannie Mae Maturing on October 2023 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	45
Net Book Value Of Collateral	$ 7,810
Interest rate	5.93%
Maturity Date	2023-10
Notes Payable	$ 6,972	7,092
Fannie Mae Maturing on November 2023 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	67
Net Book Value Of Collateral	$ 12,408
Interest rate	5.50%
Maturity Date	2023-11
Notes Payable	$ 10,792	10,992
Fannie Mae Two Maturing on November 2023 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	67
Net Book Value Of Collateral	$ 11,598
Interest rate	5.38%
Maturity Date	2023-11
Notes Payable	$ 10,837	11,042
Fannie Mae Maturing on January 2024 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	282
Net Book Value Of Collateral	$ 49,090
Interest rate	5.56%
Maturity Date	2024-01
Notes Payable	$ 45,077	45,892
Fannie Mae Maturing on July 2024 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	632
Net Book Value Of Collateral	$ 103,848
Interest rate	4.24%
Maturity Date	2024-07
Notes Payable	$ 116,183	118,715
Fannie Mae Two Maturing on July 2024 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	120
Net Book Value Of Collateral	$ 24,074
Interest rate	4.48%
Maturity Date	2024-07
Notes Payable	$ 21,513	21,963
Fannie Mae Three Maturing on July 2024 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	81
Net Book Value Of Collateral	$ 19,081
Interest rate	4.30%
Maturity Date	2024-07
Notes Payable	$ 14,836	15,156
Fannie Mae Four Maturing on July 2024 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	91
Net Book Value Of Collateral	$ 61,630
Interest rate	4.98%
Maturity Date	2024-07
Notes Payable	$ 16,053	16,322
Fannie Mae Five Maturing on July 2024 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	11
Net Book Value Of Collateral	$ 8,817
Interest rate	6.30%
Maturity Date	2024-07
Notes Payable	$ 1,777	1,796
Fannie Mae Maturing on September 2024 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	134
Net Book Value Of Collateral	$ 25,548
Interest rate	4.59%
Maturity Date	2024-09
Notes Payable	$ 23,856	24,342
Fannie Mae Two Maturing on September 2024 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	22
Net Book Value Of Collateral	$ 12,916
Interest rate	5.72%
Maturity Date	2024-09
Notes Payable	$ 3,584	3,634
Fannie Mae Three Maturing on September 2024 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	54
Net Book Value Of Collateral	$ 9,810
Interest rate	4.70%
Maturity Date	2024-09
Notes Payable	$ 9,494	9,683
Fannie Mae Maturing on January 2025 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	53
Net Book Value Of Collateral	$ 11,293
Interest rate	4.50%
Maturity Date	2025-01
Notes Payable	$ 9,538	9,731
Fannie Mae Two Maturing on January 2025 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	95
Net Book Value Of Collateral	$ 6,552
Interest rate	4.46%
Maturity Date	2025-01
Notes Payable	$ 17,333	17,686
Fannie Mae Maturing on February 2025 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	70
Net Book Value Of Collateral	$ 14,605
Interest rate	4.35%
Maturity Date	2025-02
Notes Payable	$ 12,912	13,179
Fannie Mae Maturing on March 2025 [Member]
Debt Instrument [Line Items]
Interest rate	3.85%
Maturity Date	2025-03
Notes Payable		21,633
Fannie Mae Maturing on April 2025 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	$ 102
Net Book Value Of Collateral	$ 22,879
Interest rate	3.84%
Maturity Date	2025-04
Notes Payable	$ 19,883	20,324
Fannie Mae Two Maturing on April 2025 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	31
Net Book Value Of Collateral	$ 22,879
Interest rate	5.53%
Maturity Date	2025-04
Notes Payable	$ 5,223	5,300
Fannie Mae Maturing on June 2025 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	81
Net Book Value Of Collateral	$ 14,732
Interest rate	5.30%
Maturity Date	2025-06
Notes Payable	$ 13,077	13,335
Fannie Mae Maturing on October 2025 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	58
Net Book Value Of Collateral	$ 12,021
Interest rate	4.69%
Maturity Date	2025-10
Notes Payable	$ 10,402	10,595
Fannie Mae Two Maturing on October 2025 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	44
Net Book Value Of Collateral	$ 8,878
Interest rate	4.70%
Maturity Date	2025-10
Notes Payable	$ 7,862	8,008
Fannie Mae Maturing on December 2025 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	273
Net Book Value Of Collateral	$ 37,074
Interest rate	4.68%
Maturity Date	2025-12
Notes Payable	$ 49,385	50,295
Fannie Mae Two Maturing on December 2025 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	9
Net Book Value Of Collateral	$ 8,787
Interest rate	5.81%
Maturity Date	2025-12
Notes Payable	$ 1,407	1,426
Fannie Mae Maturing on October 2026 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	98
Net Book Value Of Collateral	$ 22,990
Interest rate	4.10%
Maturity Date	2026-10
Notes Payable	$ 19,127	19,498
Fannie Mae Maturing on December 2026 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	108
Net Book Value Of Collateral	$ 23,515
Interest rate	4.24%
Maturity Date	2026-12
Notes Payable	$ 20,853	21,243
Fannie Mae Maturing on January 2029 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	655
Net Book Value Of Collateral	$ 148,134
Interest rate	5.13%
Maturity Date	2029-01
Notes Payable	$ 150,782	150,782
Fannie Mae Two Maturing on January 2029 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	163
Net Book Value Of Collateral	$ 148,134
Maturity Date	2029-01
Notes Payable	$ 50,261	50,261
Protective Life Maturing on April 2025 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	96
Net Book Value Of Collateral	$ 23,558
Interest rate	3.55%
Maturity Date	2025-04
Notes Payable	$ 19,325	19,787
Protective Life Maturing on August 2025 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	49
Net Book Value Of Collateral	$ 10,566
Interest rate	4.25%
Maturity Date	2025-08
Notes Payable	$ 9,157	9,350
Protective Life Maturing on September 2025 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	78
Net Book Value Of Collateral	$ 16,938
Interest rate	4.25%
Maturity Date	2025-09
Notes Payable	$ 14,565	14,871
Protective Life Maturing on March 2026 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	187
Net Book Value Of Collateral	$ 39,862
Interest rate	4.38%
Maturity Date	2026-03
Notes Payable	$ 32,099	32,920
Protective Life Maturing on November 2025 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	138
Net Book Value Of Collateral	$ 30,917
Interest rate	4.25%
Maturity Date	2025-11
Notes Payable	$ 25,940	26,478
Protective Life Maturing on February 2026 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	57
Net Book Value Of Collateral	$ 12,901
Interest rate	4.50%
Maturity Date	2026-02
Notes Payable	$ 10,554	10,761
Protective Life Maturing on October 2031 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	70
Net Book Value Of Collateral	$ 14,620
Interest rate	4.13%
Maturity Date	2031-10
Notes Payable	$ 11,995	12,326
Berkadia Maturing on December 2021 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	230
Net Book Value Of Collateral	$ 60,462
Maturity Date	2021-12
Notes Payable	$ 40,500	65,000
Berkadia Maturing on July 2020 [Member]
Debt Instrument [Line Items]
Maturity Date	2020-07
Notes Payable		3,500
Berkadia Maturing on October 2021 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	$ 96
Net Book Value Of Collateral	$ 16,953
Maturity Date	2021-10
Notes Payable	$ 10,992	11,255
Fifth Third Maturing on December 2021 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	125
Net Book Value Of Collateral	$ 33,852
Maturity Date	2021-12
Notes Payable	$ 31,500
HUD Maturing on September 2045 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	16
Net Book Value Of Collateral	$ 4,572
Interest rate	4.48%
Maturity Date	2045-09
Notes Payable	$ 2,875	2,933
Insurance Financing Maturing on May 2019 [Member]
Debt Instrument [Line Items]
Interest rate	3.64%
Maturity Date	2019-05
Notes Payable		799
Insurance Financing Maturing on November 2019 [Member]
Debt Instrument [Line Items]
Interest rate	4.40%
Maturity Date	2019-11
Notes Payable		$ 763
Insurance Financing Maturing on May 2020 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	$ 240
Interest rate	4.40%
Maturity Date	2020-05
Notes Payable	$ 1,187
Insurance Financing Maturing on November 2020 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	$ 74
Interest rate	4.04%
Maturity Date	2020-11
Notes Payable	$ 730
Insurance Financing Maturing on October 2020 [Member]
Debt Instrument [Line Items]
Average Monthly Payment	$ 173
Interest rate	4.40%
Maturity Date	2020-10
Notes Payable	$ 1,698

Notes Payable - Schedule of N_2

Notes Payable - Schedule of Notes Payable (Parenthetical) (Detail) $ in Millions	Dec. 23, 2019USD ($)	Dec. 31, 2019Facility
Debt Instrument [Line Items]
Number of facilities owned | Facility		78
Notes Payable [Member] | Fannie Mae Two Maturing on January 2029 [Member]
Debt Instrument [Line Items]
Basis on variable rate		2.14%
Interest Rate		3.87%
Notes Payable [Member] | Berkadia Maturing on December 2021 [Member]
Debt Instrument [Line Items]
Basis on variable rate		4.50%
Interest Rate		6.23%
Repayment of mortgage loans | $	$ 24.5
Notes Payable [Member] | Berkadia Maturing on October 2021 [Member]
Debt Instrument [Line Items]
Basis on variable rate		5.00%
Interest Rate		6.73%
Notes Payable [Member] | Fifth Third Maturing on December 2021 [Member]
Debt Instrument [Line Items]
Basis on variable rate		3.25%
Interest Rate		4.98%

Notes Payable - Summary of Aggr

Notes Payable - Summary of Aggregate Scheduled Maturities of Notes (Detail) - Notes Payable [Member] $ in Thousands	Dec. 31, 2019USD ($)
Debt Instrument [Line Items]
2020	$ 17,793
2021	97,144
2022	53,293
2023	52,741
2024	240,493
Thereafter	468,621
Total	$ 930,085

Notes Payable - Additional Info

Notes Payable - Additional Information (Detail)

Dec. 23, 2019USD ($)

Dec. 22, 2019

Oct. 01, 2019USD ($)Community

Jun. 28, 2019Community

Jun. 27, 2019

Dec. 18, 2018USD ($)CommunityLoan

Dec. 01, 2018USD ($)

Nov. 30, 2018USD ($)Community

Jun. 29, 2018Community

May 31, 2019USD ($)

May 31, 2018USD ($)

Dec. 31, 2019USD ($)Community

Dec. 31, 2018USD ($)

Debt Instrument [Line Items]

Deferred financing cost

$ 14,300,000

$ 14,100,000

Number of communities sold | Community

2

Repayment of mortgage debt

$ 44,400,000

Prepayment penalties

$ 4,400,000

Senior housing communities operated by company | Community

21

126

Accumulated amortization

$ 5,700,000

$ 4,700,000

Amortization expense

1,600,000

Hartford Financial Services [Member]

Debt Instrument [Line Items]

Letters of credit remain outstanding

3,400,000

Welltower, Inc. [Member]

Debt Instrument [Line Items]

Letters of credit remain outstanding

6,500,000

Healthpeak Properties Inc [Member]

Debt Instrument [Line Items]

Letters of credit remain outstanding

$ 2,900,000

Mortgage Loans [Member]

Debt Instrument [Line Items]

Mortgage debt

$ 201,000,000

Number of mortgage loans | Loan

2

Deferred financing costs amortization period

10 years

Deferred financing costs

$ 3,000,000

Unamortized deferred financing cost

1,500,000

Prepayment premiums

11,100,000

4.4% Insurance Financing Agreement One [Member]

Debt Instrument [Line Items]

Debt instrument, repayment term

11 months

Notes Payable

$ 2,600,000

Debt instrument, fixed interest rate

4.40%

Insurance finance agreement, outstanding amount

$ 2,600,000

4.4% Insurance Financing Agreement Two [Member]

Debt Instrument [Line Items]

Debt instrument, repayment term

18 months

Notes Payable

$ 2,700,000

Debt instrument, fixed interest rate

4.40%

Insurance finance agreement, outstanding amount

$ 2,700,000

Fannie Mae [Member]

Debt Instrument [Line Items]

Debt repaid

170,600,000

Repayment of mortgage loans

170,600,000

Fannie Mae [Member] | 6.30% [Member] | Texas [Member]

Debt Instrument [Line Items]

Mortgage debt

$ 1,800,000

Deferred financing cost

$ 100,000

Senior housing communities operated by company | Community

1

Fixed interest rate

6.30%

Mortgage debt maturity

2024-07

4.40%,11-Month Term Financing Agreement [Member]

Debt Instrument [Line Items]

Debt instrument, repayment term

11 months

Notes Payable

$ 800,000

Debt instrument, fixed interest rate

4.40%

Insurance finance agreement, outstanding amount

$ 800,000

3.64%,11-Month Term Financing Agreement [Member]

Debt Instrument [Line Items]

Debt instrument, repayment term

11 months

Notes Payable

$ 1,700,000

Debt instrument, fixed interest rate

3.64%

Insurance finance agreement, outstanding amount

$ 1,700,000

Long-term Variable Interest Rate [Member] | Mortgage Loans [Member]

Debt Instrument [Line Items]

Mortgage debt

$ 50,300,000

Debt instrument, repayment term

10 years

Acquisition price at a variable rate

LIBOR plus 2.14%

Debt instrument variable interest rate

2.14%

Fixed monthly principal component

$ 67,000,000

Long-term Variable Interest Rate [Member] | Interest Only Period [Member] | Mortgage Loans [Member]

Debt Instrument [Line Items]

Debt instrument, repayment term

36 months

Long-term Fixed Interest Rate Debt [Member] | Mortgage Loans [Member]

Debt Instrument [Line Items]

Mortgage debt

$ 150,800,000

Debt instrument, repayment term

10 years

Debt instrument, fixed interest rate

5.13%

Deferred financing costs amortization period

30 years

Long-term Fixed Interest Rate Debt [Member] | Interest Only Period [Member] | Mortgage Loans [Member]

Debt Instrument [Line Items]

Debt instrument, repayment term

36 months

Fifth Third Bank [Member] | Long-term Variable Interest Rate [Member] | Mortgage Loans [Member]

Debt Instrument [Line Items]

Deferred financing cost

$ 600,000

Fifth Third Bank [Member] | Long-term Variable Interest Rate [Member] | Interest Only Period [Member] | Mortgage Loans [Member]

Debt Instrument [Line Items]

Mortgage debt

$ 31,500,000

Debt instrument, repayment term

2 years

Acquisition price at a variable rate

LIBOR plus 3.25%

Debt instrument variable interest rate

3.25%

BBVA USA [Member] | Long-term Variable Interest Rate [Member] | Mortgage Loans [Member]

Debt Instrument [Line Items]

Debt instrument maturity date

Dec. 10, 2021

Jul. 11, 2020

BBVA USA [Member] | Long-term Variable Interest Rate [Member] | Interest Only Period [Member] | Mortgage Loans [Member]

Debt Instrument [Line Items]

Acquisition price at a variable rate

LIBOR plus 4.5%.

Debt instrument variable interest rate

4.50%

Debt repaid

$ 24,500,000

Repayment of mortgage loans

$ 24,500,000

Compass Bank [Member]

Debt Instrument [Line Items]

Debt instrument maturity date

Jul. 11, 2020

May 11, 2020

Senior housing communities operated by company | Community

4

Berkadia Commercial Mortgage LLC [Member] | Variable Interest Rate LIBOR Plus 3.75% Loan [Member]

Debt Instrument [Line Items]

Mortgage debt

$ 3,500,000

Debt instrument, repayment term

18 months

Acquisition price at a variable rate

LIBOR plus 3.75%

Debt instrument variable interest rate

3.75%

Senior housing communities operated by company | Community

1

Deferred financing costs amortization period

18 months

Deferred financing costs

$ 91,000

Berkadia Commercial Mortgage LLC [Member] | Variable Interest Rate LIBOR Plus 5.0% Loan [Member]

Debt Instrument [Line Items]

Acquisition price at a variable rate

LIBOR plus 5.0%

Debt instrument variable interest rate

5.00%

Debt instrument maturity date

Oct. 10, 2021

Senior housing communities operated by company | Community

1

Deferred financing costs amortization period

25 years

Equity - Additional Information

Equity - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2016	Dec. 31, 2009	Jan. 22, 2009
Equity [Abstract]
Preferred stock, shares outstanding	0	0
Authorization for purchase of company's common stock					$ 10,000,000
Purchase common stock shares	0	0	144,315	349,800
Average cost of per share			$ 17.29	$ 2.67
Purchase common stock value			$ 2,500,000	$ 900,000

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Detail) - USD ($)	May 14, 2019	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	May 08, 2007
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options vesting period, Minimum		1 year
Stock options vesting period, Maximum		5 years
Stock options outstanding, intrinsic value		$ 0
Stock options outstanding, weighted-average remaining contractual life		9 years
Stock options outstanding, weighted average exercise price		$ 7.46	$ 0	$ 0	$ 0
Stock options outstanding, exercisable		0	0	0
Number of stock options outstanding			0	0
Total unrecognized compensation expense		$ 300,000
Compensation expense recognized		$ 2,500,000	$ 8,400,000	$ 7,700,000
Period of recognition for compensation expense, Minimum		1 year
Period of recognition for compensation expense, Maximum		4 years
Unrecognized stock based compensation expense, net of estimated forfeitures		$ 3,700,000
Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected period of expenses		2 years
Compensation expense recognized		$ 100,000	0	0
Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Compensation expense recognized		0
Restricted stock outstanding, intrinsic value		$ 3,400,000	$ 9,100,000	$ 13,000,000
Restricted common stock, Granted		662,154	830,794	565,745
Performance and market based restricted stock, Granted		325,415
Average market value of common stock awarded to certain employees and directors of company		$ 4.50
Restricted stock award vesting period, Minimum		1 year
Restricted stock award vesting period, Maximum		4 years
Restricted stock outstanding		$ 3,000,000
Restricted Stock Units [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted common stock, Granted		59,841
Average market value of common stock awarded to certain employees and directors of company		$ 3.76
Restricted stock award vesting period, Minimum		1 year
Restricted stock outstanding		$ 200,000
Performance and Market Based Stock Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted stock award vesting period		3 years
Performance and Market Based Stock Awards [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected period of expenses		1 year
Performance and Market Based Stock Awards [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected period of expenses		3 years
Nonperformance Based Stock Awards [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected period of expenses		1 year
Nonperformance Based Stock Awards [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected period of expenses		4 years
2007 Omnibus Stock and Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Authorized shares of common stock		4,600,000				4,600,000
Number of additional shares granted under the plan	0
2019 Omnibus Stock and Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Authorized shares of common stock	2,250,000

Stock-Based Compensation - Summ

Stock-Based Compensation - Summary of Weighted-Average Assumptions Utilized to Estimate Fair Value of Stock Options (Detail)	12 Months Ended
	Dec. 31, 2019
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Expected volatility	37.00%
Expected dividend yield	0.00%
Expected term in years	6 years
Risk free rate	2.55%
Expected forfeiture rate	0.00%

Stock-Based Compensation - Su_2

Stock-Based Compensation - Summary of Stock Option Transactions (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Shares, Outstanding Beginning of Year	0	0	0
Shares, Granted	147,239	0	0
Shares, Exercised	0	0	0
Shares, Forfeited	0	0	0
Shares, Outstanding End of Year	147,239	0	0
Shares, Options Exercisable	0	0	0
Weighted average price, Outstanding Beginning of Year	$ 0	$ 0	$ 0
Weighted average price, Granted	7.46	0	0
Weighted average price, Exercised	0	0	0
Weighted average price, Forfeited	0	0	0
Weighted average price, Outstanding End of Year	$ 7.46	$ 0	$ 0

Stock-Based Compensation - Rest

Stock-Based Compensation - Restricted Stock Awards Activity and Related Information (Detail) - Restricted Stock [Member] - shares	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares, Outstanding Beginning of Year	1,345,159	964,484	829,766
Shares, Issued	662,154	830,794	565,745
Shares, Vested	(424,556)	(386,900)	(355,400)
Shares, Forfeited	(493,411)	(63,219)	(75,627)
Shares, Outstanding End of Year	1,089,346	1,345,159	964,484

Income Taxes - Schedule of (Ben

Income Taxes - Schedule of (Benefit) Provision for Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Current:
Federal	$ (71)	$ (152)	$ 6
State	443	474	550
Deferred:
Federal	76	(2,093)	1,940
State	0	0	0
(Benefit) Provision for income taxes	$ 448	$ (1,771)	$ 2,496

Income Taxes - (Benefit) Provis

Income Taxes - (Benefit) Provision for Income Taxes Differed from Amounts of Income Tax (Benefit) Provision Determined by Applying Federal Statutory Income Tax Rate to Income Before (Benefit) Provision for Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Tax benefit at federal statutory rates	$ (7,472)	$ (11,627)	$ (14,168)
State income tax benefit, net of federal effects	(548)	(665)	(648)
Change in deferred tax asset valuation allowance	7,478	9,543	7,857
Tax reform impact on deferred income taxes			13,959
Share based compensation ASU 2016-09 adoption			(5,326)
Other	990	978	822
(Benefit) Provision for income taxes	$ 448	$ (1,771)	$ 2,496

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Taxes [Line Items]
Valuation allowance recorded	$ 50,699,000	$ 46,280,000
Adjustments to valuation allowance	4,400,000	(2,200,000)	$ 2,200,000
Increase to valuation allowance	7,400,000
Permanent tax differences shortfall from stock compensation	700,000	500,000	700,000
Permanent tax differences, Section 162(m) compensation limitation	$ 400,000	$ 300,000	$ 200,000
Corporate statutory tax rate		21.00%	34.00%
TCJA, provisional remeasurement, net reduction in value of deferred tax assets and liabilities			$ 14,000,000
TCJA, remeasurement, net reduction in value of deferred tax assets			15,900,000
TCJA, Alternative Minimum Tax, provisional income tax benefit			$ 300,000
TCJA, reduction of maximum deduction for net operating loss carryforwards, percentage of taxable income for losses arising in future tax years			80.00%
Deferred tax assets related to federal Net operating loss carry forwards		$ 33,700,000
Deferred tax assets related to state Net operating loss carry forwards		7,200,000
Uncertain tax position maximum percentage	50.00%
Unrecognized tax benefits	$ 6,789,000	4,644,000	$ 3,416,000	$ 3,786,000
Unrecognized tax benefit changes	$ 1,700,000
Domestic Tax Authority [Member]
Income Taxes [Line Items]
Net operating loss carry forwards		160,500,000
AMT credit carryforward		100,000
Domestic Tax Authority [Member] | Earliest Tax Year [Member] | Prior Fiscal Year
Income Taxes [Line Items]
NOL expiration year	2033
Domestic Tax Authority [Member] | Latest Tax Year [Member] | Prior Fiscal Year
Income Taxes [Line Items]
NOL expiration year	2037
State and Local Jurisdiction [Member]
Income Taxes [Line Items]
Net operating loss carry forwards		$ 135,000,000
State and Local Jurisdiction [Member] | Earliest Tax Year [Member] | Prior Fiscal Year
Income Taxes [Line Items]
NOL expiration year	2020
State and Local Jurisdiction [Member] | Latest Tax Year [Member] | Prior Fiscal Year
Income Taxes [Line Items]
NOL expiration year	2039
ASC 842 [Member] | Retained Deficit [Member]
Income Taxes [Line Items]
Adjustments to valuation allowance	$ (3,000,000)

Income Taxes - Summary of Defer

Income Taxes - Summary of Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Deferred tax assets:
Deferred gains on sale/leaseback transactions		$ 2,440
Lease liabilities	$ 62,166
Net operating loss carryforward	34,284	33,252
Compensation costs	2,134	3,087
Depreciation and amortization	3,525	5,323
Other	2,991	2,330
Total deferred tax assets	105,100	46,432
Deferred tax asset valuation allowance	(50,699)	(46,280)
Total deferred tax assets, net	54,401	152
Deferred tax liabilities:
Operating lease right-of-use assets	(54,325)
Total deferred tax liabilities	(54,325)
Deferred taxes, net	$ 76	$ 152

Income Taxes - Schedule of Unre

Income Taxes - Schedule of Unrecognized Tax Benefits Activity and Related Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Beginning balance, January 1	$ 4,644	$ 3,416	$ 3,786
Gross increases – tax positions in prior period	2,468	1,228
Gross decreases – tax positions in prior period			(370)
Settlements			0
Lapse of statute of limitations	(323)		0
Ending balance, December 31	$ 6,789	$ 4,644	$ 3,416

Employee Benefit Plans - Additi

Employee Benefit Plans - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Compensation Related Costs [Abstract]
Employer matching contributions from annual salary	4.00%
Percentage of employer match	50.00%
Contributed to the Plan annually	$ 500,000	$ 500,000	$ 500,000
Administrative expenses	$ 24,000	$ 25,000	$ 21,300

Contingencies - Additional Info

Contingencies - Additional Information (Detail)	3 Months Ended	12 Months Ended		18 Months Ended
	Sep. 30, 2017USD ($)Community	Dec. 31, 2019USD ($)Community	Dec. 31, 2018USD ($)	Dec. 31, 2019USD ($)Community	Dec. 31, 2015USD ($)
Loss Contingencies [Line Items]
Senior housing communities owned by company | Community		80		80
Hurricane related expenses deductible for insurance claim	$ 100,000
Clean-up and physical repair costs				$ 6,200,000
Payments expected to receive from respective carrier		$ 300,000	$ 2,400,000	300,000
Payments received from insurance underwriters		$ 2,500,000	5,100,000
Condition for employer shared responsibility payment		The ESRP is applicable to employers that had 50 or more full-time equivalent employees, did not offer minimum essential coverage (“MEC”) to at least 70% of full-time employees and their dependents, or did offer MEC to at least 70% of full-time employees and their dependents which did not meet the affordable or minimum value criteria and had one or more full-time employees certified as being allowed the premium tax credit (“PTC”).
Employer Shared Responsibility Payment accrued in employee benefit reserves		$ 14,733,000	11,996,000	14,733,000
Internal Revenue Service [Member]
Loss Contingencies [Line Items]
Employer shared responsibility payment contingent liability			$ 83,200,000		$ 2,100,000
Internal Revenue Service [Member] | ESRP Penalties [Member]
Loss Contingencies [Line Items]
Employer Shared Responsibility Payment accrued in employee benefit reserves		$ 200,000		$ 200,000
Texas [Member]
Loss Contingencies [Line Items]
Senior housing communities owned by company | Community	2

Fair Value of Financial Instr_3

Fair Value of Financial Instruments - Carrying Amounts and Fair Values of Financial Instruments (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Restricted cash	$ 13,088	$ 13,011
Carrying Amount [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Cash and cash equivalents	23,975	31,309
Restricted cash	13,088	13,011
Notes payable, excluding deferred loan costs	930,085	983,207
Fair Value [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Cash and cash equivalents	23,975	31,309
Restricted cash	13,088	13,011
Notes payable, excluding deferred loan costs	$ 899,326	$ 945,318

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Detail) $ in Millions	3 Months Ended		12 Months Ended
	Sep. 30, 2019Community	Mar. 31, 2019USD ($)Community	Dec. 31, 2019Community	Dec. 31, 2018Community	Jan. 01, 2019USD ($)
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Number of assets held for sale | Community			0	0
ASC 842 [Member] | Impairment Write-down Adjustments [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Change in accounting principle, effect of change on retained deficit | $					$ (17.8)
Senior Living Community [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Number of assets held for sale | Community	2	1
Remeasurement write-down of assets held for sale | $		$ 2.3

Allowance for Doubtful Accoun_3

Allowance for Doubtful Accounts - Schedule of Allowance for Doubtful Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Receivables [Abstract]
Balance at beginning of year	$ 6,793	$ 4,881	$ 4,253
Provision for bad debts, net of recoveries	3,765	2,990	1,748
Write-offs and other	(1,915)	(1,078)	(1,120)
Balance at end of year	$ 8,643	$ 6,793	$ 4,881

Leases - Additional Information

Leases - Additional Information (Detail) $ in Thousands

Oct. 22, 2019Community

Jan. 31, 2017USD ($)Community

Jun. 30, 2019USD ($)

Jun. 30, 2017USD ($)

Jun. 30, 2016USD ($)

Jun. 30, 2015USD ($)

Dec. 31, 2013USD ($)

Dec. 31, 2019USD ($)CommunityProperty

Mar. 15, 2020Community

Oct. 01, 2019Community

Dec. 31, 2018USD ($)

Dec. 31, 2016Community

Lessee Lease Description [Line Items]

Number of leased senior housing communities

46

Number of remaining lease communities

7

Number of communities sold

2

Lease termination fee | $

$ 6,466

Weighted-average discount rate, operating leases

7.80%

Average remaining lease terms, operating leases

5 years 7 months 6 days

Weighted-average discount rate, financing leases

7.10%

Average remaining lease terms, financing leases

3 years 10 months 24 days

Operating lease, existence of option to extend

true

Operating lease, options to extend

Most of the Company’s lease agreements include one or more options to renew, with renewal terms that can extend the lease term for an additional one to 20 years at the Company’s option.

Minimum [Member]

Lessee Lease Description [Line Items]

Operating lease, renewal term

1 year

Maximum [Member]

Lessee Lease Description [Line Items]

Operating lease, renewal term

20 years

Ventas [Member]

Lessee Lease Description [Line Items]

Number of leased senior housing communities

7

11

Acquisition of senior housing community

4

Acquisition cost | $

$ 85,000

Number of senior housing communities closed

4

Payments for rent | $

$ 2,300

Lease termination obligation | $

$ 11,400

$ 12,900

Capital improvement project | $

$ 17,000

$ 28,500

$ 24,500

$ 24,500

Lease expiration date

Sep. 30, 2025

Number of Lease Extension Available | Property

2

Lease agreements initial terms

5 years

Available renewal extension period

5 years

Capital improvement project, amended amount | $

$ 20,000

$ 28,500

Capital improvement project, decrease in amount | $

$ 17,000

Lease expiration extended date

Jun. 30, 2021

Jun. 30, 2018

Number of senior housing communities under early termination

7

Ventas [Member] | Minimum [Member]

Lessee Lease Description [Line Items]

Lease agreements range

6.75%

Ventas [Member] | Maximum [Member]

Lessee Lease Description [Line Items]

Lease agreements range

8.00%

Ventas [Member] | Bridge Loan [Member]

Lessee Lease Description [Line Items]

Acquisition cost | $

$ 65,000

Bridge loan period

36 months

Bridge loan extend period

6 months

Ventas [Member] | Bridge Loan [Member] | London Interbank Offered Rate (LIBOR)

Lessee Lease Description [Line Items]

Initial variable interest rate

4.00%

Interim financing variable rate description

LIBOR plus 4.0%

Healthpeak Properties Inc [Member]

Lessee Lease Description [Line Items]

Number of leased senior housing communities

15

Capital improvement project | $

$ 3,300

Lease expiration date

Apr. 30, 2026

Oct. 31, 2020

Number of senior housing communities available for sale

8

Lease termination fee | $

$ 300

Healthpeak Properties Inc [Member] | Subsequent Event [Member]

Lessee Lease Description [Line Items]

Number of communities sold

1

Healthpeak Properties Inc [Member] | Minimum [Member]

Lessee Lease Description [Line Items]

Lease agreements range

7.25%

Healthpeak Properties Inc [Member] | Maximum [Member]

Lessee Lease Description [Line Items]

Lease agreements range

8.00%

Welltower [Member]

Lessee Lease Description [Line Items]

Number of leased senior housing communities

24

Lease agreements initial terms

15 years

Number of senior housing communities under early termination

24

Welltower [Member] | Minimum [Member]

Lessee Lease Description [Line Items]

Interim financing variable rate

7.25%

Lease expiration year and month

2025-04

Welltower [Member] | Maximum [Member]

Lessee Lease Description [Line Items]

Interim financing variable rate

8.50%

Lease expiration year and month

2026-04

Leases - Summary of Operating a

Leases - Summary of Operating and Financing Lease Expense and Cash Flows from Leasing Transactions (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2019USD ($)
Lease Cost [Abstract]
Facility lease expense	$ 57,022
General and administrative expenses	812
Operating expenses, including variable lease expense of $6,142	6,466
Total operating lease costs	64,300
Operating lease expense adjustment	5,243
Operating cash flows from operating leases	69,543
Depreciation and amortization	11
Interest expense: financing lease obligations	3
Total financing lease costs	14
Operating cash flows from financing leases	11
Financing cash flows from financing leases	3
Total cash flows from financing leases	$ 14

Leases - Summary of Operating_2

Leases - Summary of Operating and Financing Lease Expense and Cash Flows from Leasing Transactions (Parenthetical) (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2019USD ($)
Lease Cost [Abstract]
Variable lease expense	$ 6,142

Leases - Schedule of Aggregate

Leases - Schedule of Aggregate Amounts of Future Minimum Lease Payments (Detail) $ in Thousands	Dec. 31, 2019USD ($)
Operating Lease Liabilities Payments Due [Abstract]
2020	$ 63,549
2021	51,401
2022	51,321
2023	51,274
2024	51,245
Thereafter	44,762
Total	313,552
Less: Amount representing interest (present value discount)	(59,107)
Present value of lease liabilities	254,445
Less: Current portion of lease liabilities	(45,871)
Lease liabilities, net of current portion	208,574
Finance Lease Liabilities Payments Due [Abstract]
2020	148
2021	148
2022	148
2023	138
Total	582
Less: Amount representing interest (present value discount)	(72)
Present value of lease liabilities	510
Less: Current portion of lease liabilities	(117)
Lease liabilities, net of current portion	$ 393

Leases - Summary of Future Mini

Leases - Summary of Future Minimum Operating Lease Payments Under ASC 840 (Detail) $ in Thousands	Dec. 31, 2018USD ($)
Leases [Abstract]
2019	$ 66,455
2020	63,929
2021	52,093
2022	52,062
2023	52,026
Thereafter	97,165
Total lease payments	$ 383,730

Quarterly Financial Informati_3

Quarterly Financial Information (Unaudited) - Schedule of Quarterly Financial Information (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Quarterly Financial Information Disclosure [Abstract]
Total revenues	$ 108,688	$ 111,110	$ 113,126	$ 114,176	$ 115,098	$ 115,650	$ 114,627	$ 114,643	$ 447,100	$ 460,018	$ 466,997
Income (Loss) from operations	(8,757)	(8,105)	203	1,970	(3,122)	1,696	3,643	5,386
Net income (loss) and comprehensive income (loss)	$ 10,219	$ (20,731)	$ (12,534)	$ (12,984)	$ (26,291)	$ (11,089)	$ (9,060)	$ (7,156)	$ (36,030)	$ (53,596)	$ (44,168)
Net income (loss) per share, basic	$ 0.34	$ (0.68)	$ (0.41)	$ (0.43)	$ (0.88)	$ (0.37)	$ (0.30)	$ (0.24)	$ (1.19)	$ (1.80)	$ (1.50)
Net income (loss) per share, diluted	$ 0.34	$ (0.68)	$ (0.41)	$ (0.43)	$ (0.88)	$ (0.37)	$ (0.30)	$ (0.24)	$ (1.19)	$ (1.80)	$ (1.50)
Weighted average shares outstanding, basic	30,342	30,324	30,279	30,102	29,908	29,877	29,831	29,627	30,263	29,812	29,453
Weighted average shares outstanding, fully diluted	30,412	30,324	30,279	30,102	29,908	29,877	29,831	29,627	30,263	29,812	29,453

Quarterly Financial Informati_4

Quarterly Financial Information (Unaudited) - Schedule of Quarterly Financial Information (Parenthetical) (Detail) $ in Thousands	Oct. 01, 2019USD ($)Community	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)	Dec. 31, 2017USD ($)
Quarterly Financial Information [Line Items]
Gain (Loss) on disposition of assets, net	$ 38,800	$ 38,800		$ 36,528	$ 28	$ (123)
Number of communities sold | Community	2
General and administrative expenses related to retirement and replacement				27,518	26,961	$ 23,574
Write-off of deferred loan costs and prepayment premiums			$ 12,600	$ 4,843	$ 12,623
CEO
Quarterly Financial Information [Line Items]
General and administrative expenses related to retirement and replacement			$ 4,200

Subsequent Events - Additional

Subsequent Events - Additional Information (Details)	Mar. 31, 2020USD ($)CommunityProperty	Mar. 15, 2020USD ($)Community	Mar. 10, 2020USD ($)Community	Mar. 01, 2020USD ($)Community	Jan. 15, 2020USD ($)	Oct. 22, 2019USD ($)	Oct. 01, 2019USD ($)Community	Dec. 31, 2019USD ($)Community
Subsequent Event [Line Items]
Number of leased senior housing communities | Community								46
Rent expense								$ 6,466,000
Financing obligations								510,000
Number of communities sold | Community							2
Net proceeds from sale of assets							$ 14,800,000
Healthpeak Properties Inc [Member]
Subsequent Event [Line Items]
Transitioned property amount as a prepayment against the remaining lease payments						$ 250,000
Healthpeak Properties Inc [Member] | ASC 842 [Member]
Subsequent Event [Line Items]
Leasehold improvements								43,700,000
Financing obligations								$ 11,400,000
Subsequent Event [Member] | Senior Housing Community Merrillville, Indiana Community [Member]
Subsequent Event [Line Items]
Number of communities sold | Community	1
Purchase price for the sale of asset	$ 7,000,000
Net proceeds from sale of assets	$ 6,900,000
Subsequent Event [Member] | Senior Housing Community Merrillville, Indiana Community [Member] | Assisted Living Unit [Member]
Subsequent Event [Line Items]
Number of living units in a housing community sold | Property	171
Subsequent Event [Member] | Senior Housing Community Merrillville, Indiana Community [Member] | Memory Care Units [Member]
Subsequent Event [Line Items]
Number of living units in a housing community sold | Property	42
Subsequent Event [Member] | Healthpeak Properties Inc [Member]
Subsequent Event [Line Items]
Transitioned property amount as a prepayment against the remaining lease payments					$ 300,000
Subsequent Event [Member] | Healthpeak Properties Inc [Member] | Early Termination Agreement [Member]
Subsequent Event [Line Items]
Security deposits yet to be released				$ 1,900,000
Previously scheduled, lease maturity month year				2026-04
Number of communities to be managed | Community				6
Subsequent Event [Member] | Welltower, Inc. [Member] | Early Termination Agreement [Member]
Subsequent Event [Line Items]
Number of leased senior housing communities | Community		24
Rent expense due to early termination of lease		$ 2,200,000
Rent expense		2,800,000
Security deposits yet to be released		$ 6,500,000
Subsequent Event [Member] | Ventas [Member] | Early Termination Agreement [Member]
Subsequent Event [Line Items]
Number of leased senior housing communities | Community			7
Rent expense due to early termination of lease			$ 1,000,000
Rent expense			1,300,000
Security deposits yet to be released			$ 3,900,000