Diversified Healthcare Trust (DHC) 10-Q 9 May 19 2019 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2019	May 08, 2019
Document and Entity Information
Entity Registrant Name	SENIOR HOUSING PROPERTIES TRUST
Entity Central Index Key	0001075415
Document Type	10-Q
Document Period End Date	Mar. 31, 2019
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding (in shares)		237,726,371
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q1
Entity Emerging Growth Company	false
Entity Smaller Reporting Company	false

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Real estate properties:
Land	$ 837,575	$ 844,567
Buildings and improvements	7,022,101	7,031,733
Total real estate properties, gross	7,859,676	7,876,300
Accumulated depreciation	(1,560,690)	(1,534,392)
Total real estate properties, net	6,298,986	6,341,908
Cash and cash equivalents	39,875	54,976
Restricted cash	14,877	15,095
Acquired real estate leases and other intangible assets, net	401,209	419,244
Other assets, net	390,953	329,203
Total assets	7,145,900	7,160,426
LIABILITIES AND EQUITY
Unsecured revolving credit facility	225,000	139,000
Unsecured term loans, net	548,493	548,286
Senior unsecured notes, net	2,217,989	2,216,945
Secured debt and capital leases, net	742,883	744,186
Accrued interest	35,241	26,182
Assumed real estate lease obligations, net	83,919	86,304
Other liabilities	178,937	219,653
Total liabilities	4,032,462	3,980,556
Commitments and contingencies
Equity attributable to common shareholders:
Common shares of beneficial interest, $.01 par value: 300,000,000 shares authorized, 237,729,900 shares issued and outstanding at March 31, 2019 and December 31, 2018	2,377	2,377
Additional paid in capital	4,611,634	4,611,419
Cumulative net income	2,170,878	2,140,796
Cumulative other comprehensive income	(200)	(266)
Cumulative distributions	(3,823,928)	(3,731,214)
Total equity attributable to common shareholders	2,960,761	3,023,112
Noncontrolling interest:
Total equity attributable to noncontrolling interest	152,677	156,758
Total equity	3,113,438	3,179,870
Total liabilities and equity	$ 7,145,900	$ 7,160,426

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Mar. 31, 2019	Dec. 31, 2018
Statement of Financial Position [Abstract]
Common shares of beneficial interest, par value (in dollars per share)	$ 0.01	$ 0.01
Common shares of beneficial interest, shares authorized (in shares)	300,000,000	300,000,000
Common shares of beneficial interest, shares issued (in shares)	237,729,900	237,729,900
Common shares of beneficial interest, shares outstanding (in shares)	237,729,900	237,729,900

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Revenues:
Total revenues	$ 266,286	$ 275,770
Expenses:
Property operating expenses	117,222	108,098
Depreciation and amortization	72,230	70,339
General and administrative	9,816	25,118
Acquisition and certain other transaction related costs	7,814	20
Impairment of assets	6,206	0
Total expenses	213,288	203,575
(Loss) gain on sale of properties	(122)	181,154
Dividend income	923	659
Unrealized gains and losses on equity securities, net	22,932	27,241
Interest and other income	114	54
Interest expense (including net amortization of debt premiums, discounts and issuance costs of $1,652 and $1,411, respectively)	(45,611)	(43,552)
Loss on early extinguishment of debt	0	(130)
Income from continuing operations before income tax expense and equity in earnings of an investee	31,234	237,621
Income tax expense	(134)	(260)
Equity in earnings of an investee	404	44
Net income (loss)	31,504	237,405
Net income attributable to noncontrolling interest	(1,422)	(1,383)
Net income (loss) attributable to common shareholders	30,082	236,022
Other comprehensive income:
Equity in unrealized gain (loss) of an investee	66	(93)
Other comprehensive income (loss)	66	(93)
Comprehensive income	31,570	237,312
Comprehensive income attributable to noncontrolling interest	(1,422)	(1,383)
Comprehensive income attributable to common shareholders	$ 30,148	$ 235,929
Weighted average common shares outstanding (basic) (in shares)	237,568	237,478
Weighted average common shares outstanding (diluted) (in shares)	237,600	237,493
Per common share amounts (basic and diluted):
Net income attributable to common shareholders (in dollars per share)	$ 0.13	$ 0.99
Rental income
Revenues:
Total revenues	$ 158,241	$ 173,728
Residents fees and services
Revenues:
Total revenues	$ 108,045	$ 102,042

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (Parenthetical) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Income Statement [Abstract]
Amortization of debt issuance costs and debt discounts and premiums	$ 1,652	$ 1,411

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF SHAREHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Common Shares	Additional Paid-in Capital	Cumulative Net Income	Cumulative Other Comprehensive Income (Loss)	Cumulative Distributions	Total Equity Attributable to Common Shareholders	Total Equity Attributable to Noncontrolling Interest
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Cumulative adjustment upon adoption of ASU No. 2016-01	$ 0			$ 87,429	$ (87,429)
Adjusted balance	3,277,188	$ 2,376	$ 4,609,316	1,853,924	(198)	$ (3,360,468)	$ 3,104,950	$ 172,238
Beginning balance (in shares) at Dec. 31, 2017		237,630,409
Beginning balance at Dec. 31, 2017	3,277,188	$ 2,376	4,609,316	1,766,495	87,231	(3,360,468)	3,104,950	172,238
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Comprehensive income (loss)	237,312			236,022	(93)		235,929	1,383
Distributions	(92,674)					(92,674)	(92,674)
Share grants (in shares)		3,000
Share grants	47		47				47
Share repurchases (in shares)		(4,628)
Share repurchases	(89)		(89)				(89)
Distributions to noncontrolling interest	(5,667)							(5,667)
Ending balance (in shares) at Mar. 31, 2018		237,628,781
Ending balance at Mar. 31, 2018	$ 3,416,117	$ 2,376	4,609,274	2,089,946	(291)	(3,453,142)	3,248,163	167,954
Beginning balance (in shares) at Dec. 31, 2018	237,729,900	237,729,900
Beginning balance at Dec. 31, 2018	$ 3,179,870	$ 2,377	4,611,419	2,140,796	(266)	(3,731,214)	3,023,112	156,758
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Comprehensive income (loss)	31,570			30,082	66		30,148	1,422
Distributions	(92,714)					(92,714)	(92,714)
Share grants	215		215				215
Distributions to noncontrolling interest	$ (5,503)							(5,503)
Ending balance (in shares) at Mar. 31, 2019	237,729,900	237,729,900
Ending balance at Mar. 31, 2019	$ 3,113,438	$ 2,377	$ 4,611,634	$ 2,170,878	$ (200)	$ (3,823,928)	$ 2,960,761	$ 152,677

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Cash flows from operating activities:
Net income	$ 31,504	$ 237,405
Adjustments to reconcile net income to cash provided by operating activities:
Depreciation and amortization	72,230	70,339
Amortization of debt issuance costs and debt discounts and premiums	1,652	1,411
Straight line rental income	(1,934)	(2,993)
Amortization of acquired real estate leases and other intangible assets	(1,525)	(1,381)
Loss on early extinguishment of debt	0	130
Impairment of assets	6,206	0
Loss (gain) on sale of properties	122	(181,154)
Unrealized gains and losses on equity securities, net	22,932	27,241
Other non-cash adjustments	(943)	(943)
Equity in earnings of an investee	(404)	(44)
Change in assets and liabilities:
Other assets	(5,862)	3,097
Accrued interest	9,059	17,088
Other liabilities	(45,658)	(31,680)
Net cash provided by operating activities	41,515	84,034
Cash flows from investing activities:
Real estate acquisitions and deposits	0	(122,221)
Real estate improvements	(46,237)	(13,443)
Proceeds from sale of properties	2,929	216,013
Net cash (used in) provided by investing activities	(43,308)	80,349
Cash flows from financing activities:
Proceeds from issuance of senior unsecured notes, net	0	491,560
Proceeds from borrowings on revolving credit facility	178,000	316,000
Repayments of borrowings on revolving credit facility	(92,000)	(857,000)
Repayment of other debt	(1,309)	(6,166)
Loss on early extinguishment of debt settled in cash	0	(130)
Payment of debt issuance costs	0	(4,296)
Repurchase of common shares	0	(90)
Distributions to noncontrolling interest	(5,503)	(5,667)
Distributions to shareholders	(92,714)	(92,674)
Net cash used in financing activities	(13,526)	(158,463)
(Decrease) increase in cash and cash equivalents and restricted cash	(15,319)	5,920
Cash and cash equivalents and restricted cash at beginning of period	70,071
Cash and cash equivalents and restricted cash at end of period	54,752	53,241
Supplemental cash flows information:
Interest paid	35,034	25,053
Income taxes paid	31	0
Non-cash investing activities:
Acquisitions funded by assumed debt	0	(27,798)
Non-cash financing activities:
Assumption of mortgage notes payable	$ 0	$ 27,798

CONDENSED CONSOLIDATED STATEM_5

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018	Mar. 31, 2018	Mar. 31, 2017
Statement of Cash Flows [Abstract]
Cash and cash equivalents	$ 39,875	$ 54,976	$ 39,161
Restricted cash	14,877	15,095	14,080
Total cash and cash equivalents and restricted cash shown in the statements of cash flows	$ 54,752	$ 70,071	$ 53,241	$ 47,321

Basis of Presentation

Basis of Presentation	3 Months Ended
	Mar. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation	Basis of Presentation The accompanying condensed consolidated financial statements of Senior Housing Properties Trust and its subsidiaries, or we, us, or our, are unaudited. Certain information and disclosures required by U.S. generally accepted accounting principles, or GAAP, for complete financial statements have been condensed or omitted. We believe the disclosures made are adequate to make the information presented not misleading. However, the accompanying condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and notes contained in our Annual Report on Form 10-K for the year ended December 31, 2018 , or our Annual Report. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair statement of results for the interim period have been included. All intercompany transactions and balances with or among our consolidated subsidiaries have been eliminated. Operating results for interim periods are not necessarily indicative of the results that may be expected for the full year. The preparation of financial statements in conformity with GAAP requires us to make estimates and assumptions that affect reported amounts. Actual results could differ from those estimates. Significant estimates in our condensed consolidated financial statements include purchase price allocations, useful lives of fixed assets and impairment of real estate and intangible assets. We have made reclassifications to the financial statements of prior periods to conform to the current period presentation. These reclassifications had no effect on net income or equity. We have a joint venture arrangement with a sovereign investor for one of our properties ( two buildings) leased to medical providers, medical related business, clinics and biotech laboratory tenants, or MOBs, located in Boston, Massachusetts. The investor owns a 45% equity interest in the joint venture, and we own the remaining 55% equity interest in the joint venture. We have determined that this joint venture is a variable interest entity, or VIE, as defined under the Consolidation Topic of the Financial Accounting Standards Board, or FASB, Accounting Standards Codification. We concluded that we must consolidate this VIE because we have the power to direct the activities that most significantly impact the VIE’s economic performance and we have the obligation to absorb losses of, and the right to receive benefits from, the VIE that could be significant to the VIE, and therefore are the primary beneficiary of the VIE. The assets of this VIE were $1,050,254 and $1,061,593 as of March 31, 2019 and December 31, 2018 , respectively, and consist primarily of the net real estate owned by the joint venture. The liabilities of this VIE were $711,792 and $714,226 as of March 31, 2019 and December 31, 2018 , respectively, and consist primarily of the debt securing the property. The sovereign investor's interest in this consolidated entity is reflected as noncontrolling interest in our condensed consolidated financial statements. See Note 6 for further information about this joint venture.

Recent Accounting Pronouncement

Recent Accounting Pronouncements	3 Months Ended
	Mar. 31, 2019
Accounting Changes and Error Corrections [Abstract]
Recent Accounting Pronouncements	Recent Accounting Pronouncements In February 2016, the FASB issued Accounting Standards Update, or ASU, No. 2016-02, Leases . In July 2018, the FASB issued ASU No. 2018-10, Codification Improvements to Topic 842, Leases and ASU No. 2018-11, Leases (Topic 842): Targeted Improvements . In December 2018, the FASB issued ASU No. 2018-20 Leases (Topic 842), Narrow-Scope Improvements for Lessors . Collectively, these standards set out the principles for the recognition, measurement, presentation and disclosure of leases for both parties to a contract (i.e., lessees and lessors). ASU No. 2016-02 requires lessees to apply a dual approach, classifying leases as either finance or operating leases based on the principle of whether or not the lease is effectively a financed purchase of the leased asset by the lessee. This classification will determine whether the lease expense is recognized based on an effective interest method or on a straight line basis over the term of the lease. ASU No. 2016-02 requires lessors to account for leases using an approach that is substantially equivalent to existing guidance for sales type leases, direct financing leases and operating leases. These standards were effective as of January 1, 2019. Upon adoption, we applied the package of practical expedients that has allowed us to not reassess (i) whether any expired or existing contracts are or contain leases, (ii) lease classification for any expired or existing leases and (iii) initial direct costs for any expired or existing leases. Furthermore, we applied the optional transition method in ASU No. 2018-11, which has allowed us to initially apply the new leases standard at the adoption date and recognize a cumulative effect adjustment to the opening balance of retained earnings in the adoption period, although we did not have an adjustment. Additionally, our leases met the criteria in ASU No. 2018-11 to not separate non-lease components from the related lease component; therefore, the accounting for these leases remained largely unchanged from the previous standard. The adoption of ASU No. 2016-02 and the related improvements did not have a material impact in our condensed consolidated financial statements. Upon adoption, (i) allowances for bad debts are now recognized as a direct reduction of rental income, and (ii) legal costs associated with the execution of our leases, which were previously capitalized and amortized over the life of their respective leases, are expensed as incurred. Subsequent to January 1, 2019, provisions for credit losses are now included in rental income in our condensed consolidated financial statements. Provisions for credit losses prior to January 1, 2019 were previously included in property operating expenses in our condensed consolidated financial statements and prior periods are not reclassified to conform to the current presentation. We completed our assessment of predominance as it relates to our contracts with residents for housing services at properties leased to our taxable REIT subsidiaries, or TRSs, and have recognized revenue from these properties under ASC 606, which did not have any impact to the timing or amount of our revenue recognized. For leases in which we are the lessee, we recognized a right of use asset and a lease liability equal to the present value of the minimum lease payments with rental payments being applied to the lease liability and the right of use asset being amortized over the term of the lease. The adoption of this standard resulted in an increase in total assets and liabilities of $4,507 . The right of use asset and related lease liability are included within other assets, net and other liabilities, respectively, within our condensed consolidated balance sheets. In addition, we lease equipment at certain of our managed senior living communities. These leases are short term in nature, are cancelable with no fee or do not result in an annual expense in excess of our capitalization policy and, as a result, will not be recorded on our condensed consolidated balance sheets. The adoption of ASU No. 2016-02 and the related ASU improvements did not have a material impact in our condensed consolidated financial statements. Revenue Recognition. We are a lessor of MOBs, senior living communities and wellness centers. Our leases provide our tenants with the contractual right to use and economically benefit from all of the premises demised under the leases; therefore, we have determined to evaluate our leases as lease arrangements. Certain of our leases provide for base rent payments and in addition may include variable payments. Rental income from operating leases, including any payments derived by index or market based indices, is recognized on a straight line basis over the lease term when we have determined that the collectability of substantially all of the lease payments is probable. Some of our leases have options to extend or terminate the lease exercisable at the option of our tenants, which are considered when determining the lease term. We do not include in our measurement of our lease receivables certain variable payments, including changes in the index or market based indices after the inception of the lease, certain tenant reimbursements and other income until the specific events that trigger the variable payments have occurred. Such payments totaled $18,845 for the three months ended March 31, 2019. Certain of our leases contain non-lease components, such as property level operating expenses and capital expenditures reimbursed by our tenants as well as other required lease payments. We have determined that all of our leases qualify for the practical expedient to not separate the lease and non-lease components because (i) the lease components are operating leases and (ii) the timing and pattern of recognition of the non-lease components are the same as those of the lease components. We apply Accounting Standards Codification Topic 842, Leases, to the combined component. Income derived by our leases is recorded in rental income in our condensed consolidated statements of comprehensive income. Certain tenants are obligated to pay directly their obligations under their leases for insurance, real estate taxes and certain other expenses. These obligations, which have been assumed by the tenants under the terms of their respective leases, are not reflected in our condensed consolidated financial statements. To the extent any tenant responsible for any such obligations under the applicable lease defaults on such lease or if it is deemed probable that the tenant will fail to pay for such obligations, we would record a liability for such obligations. The following table presents our operating lease maturity analysis as of March 31, 2019: Year Amount 2019 $ 373,701 2020 347,718 2021 324,230 2022 302,712 2023 279,407 Thereafter 1,105,830 Total $ 2,733,598 In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments - Credit Losses (Topic 326) : Measurement of Credit Losses on Financial Instruments , which requires that entities use a new forward-looking “expected loss” model that generally will result in the earlier recognition of allowance for credit losses. The measurement of expected credit losses is based upon historical experience, current conditions, and reasonable and supportable forecasts that affect the collectability of the reported amount. ASU No. 2016-13 will be effective for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years. We are currently assessing the potential impact the adoption of ASU No. 2016-13 will have in our condensed consolidated financial statements although lease related receivables are governed by the lease standards referred to above and are not subject to ASU No. 2016-13. We currently expect to adopt this standard using the modified retrospective approach.

Real Estate Properties

Real Estate Properties	3 Months Ended
	Mar. 31, 2019
Real Estate [Abstract]
Real Estate Properties	Real Estate Properties At March 31, 2019 , we owned 467 properties, including 30 properties classified as held for sale, located in 42 states and Washington, D.C., including one MOB ( two buildings) owned by a joint venture in which we own a 55% equity interest. Impairment: We periodically evaluate our assets for impairments. Impairment indicators may include declining tenant or resident occupancy, weak or declining profitability from the property, decreasing tenant cash flows or liquidity, our decision to dispose of an asset before the end of its estimated useful life, and legislative, market or industry changes that could permanently reduce the value of an asset. If indicators of impairment are present, we evaluate the carrying value of the affected assets by comparing it to the expected future undiscounted net cash flows to be generated from those assets. If the sum of these expected future net cash flows is less than the carrying value, we reduce the net carrying value of the asset to its estimated fair value. During the three months ended March 31, 2019, we recorded impairment charges of $6,206 to adjust the carrying values of 15 skilled nursing facilities, or SNFs, located in Kansas, Iowa and Nebraska, to their aggregate estimated fair value. These SNFs are classified as held for sale in our condensed consolidated balance sheet as of March 31, 2019, and the associated impairment charges are included in impairment of assets in our condensed consolidated statements of comprehensive income as of March 31, 2019. Dispositions: During the three months ended March 31, 2019, we sold two MOBs with an aggregate of 64,796 rentable square feet for an aggregate sales price of $2,975 , excluding closing costs, as presented in the following table. We recognized rental income of $123 during the three months ended March 31, 2019 related to these MOBs. Date of Sale Location Type of Property Number of Properties Gross Sales Price (1) February 2019 Florida MOB 1 $ 2,900 March 2019 Massachusetts MOB 1 75 2 $ 2,975 (1) Gross sales price excludes closing costs. As of March 31, 2019, we had 10 MOBs under agreements to sell for an aggregate sales price of approximately $15,609 , excluding closing costs, which have an aggregate undepreciated carrying value of $17,347 . These 10 MOBs are classified as held for sale in our condensed consolidated balance sheet as of March 31, 2019. As of March 31, 2019, we had 20 SNFs under agreements to sell for an aggregate sales price of approximately $40,500 , excluding closing costs, which have an aggregate undepreciated carrying value of $44,342 . These 20 SNFs are classified as held for sale in our condensed consolidated balance sheet as of March 31, 2019. In May 2019, we sold three of these SNFs located in California for an aggregate sales price of $21,500 , excluding closing costs. Subsequent to March 31, 2019, we entered into agreements to sell three MOBs located in Massachusetts for an aggregate sales price of approximately $4,955 , excluding closing costs. These three MOBs are not classified as held for sale in our condensed consolidated balance sheet as of March 31, 2019.

Indebtedness

Indebtedness	3 Months Ended
	Mar. 31, 2019
Debt Disclosure [Abstract]
Indebtedness	Indebtedness Our principal debt obligations at March 31, 2019 were: (1) outstanding borrowings under our $1,000,000 unsecured revolving credit facility; (2) seven public issuances of senior unsecured notes, including: (a) $400,000 principal amount at an annual interest rate of 3.25% due 2019, (b) $200,000 principal amount at an annual interest rate of 6.75% due 2020, (c) $300,000 principal amount at an annual interest rate of 6.75% due 2021, (d) $250,000 principal amount at an annual interest rate of 4.75% due 2024, (e) $500,000 principal amount at an annual interest rate of 4.75% due 2028, (f) $350,000 principal amount at an annual interest rate of 5.625% due 2042 and (g) $250,000 principal amount at an annual interest rate of 6.25% due 2046; (3) our $350,000 principal amount unsecured term loan due 2020; (4) our $200,000 principal amount unsecured term loan due 2022; and (5) $733,672 aggregate principal amount of mortgages (excluding premiums, discounts and net debt issuance costs) secured by 14 properties with maturity dates between 2019 and 2043. These 14 mortgaged properties had a carrying value (before accumulated depreciation) of $1,035,640 at March 31, 2019 . We also had two properties subject to capital leases with lease obligations totaling $9,599 at March 31, 2019 ; these two properties had a carrying value (before accumulated depreciation) of $34,828 at March 31, 2019 , and the capital leases expire in 2026. We have a $1,000,000 revolving credit facility that is available for general business purposes, including acquisitions. The maturity date of our revolving credit facility is January 15, 2022, and, subject to the payment of an extension fee and meeting other conditions, we have the option to extend the maturity date of the facility for an additional year. Our revolving credit facility provides that we can borrow, repay and re-borrow funds available under our revolving credit facility until maturity, and no principal repayment is due until maturity. Our revolving credit facility requires annual interest to be paid on borrowings at the rate of LIBOR plus a premium of 120 basis points, plus a facility fee of 25 basis points per annum on the total amount of lending commitments under the facility. The interest rate premium and facility fee are each subject to adjustment based upon changes to our credit ratings. The facility also includes a feature pursuant to which in certain circumstances maximum borrowings under the facility may be increased to up to $2,000,000 . As of March 31, 2019 , the annual interest rate payable on borrowings under our revolving credit facility was 3.6% . The weighted average annual interest rates for borrowings under our revolving credit facility were 3.6% and 2.7% for the three months ended March 31, 2019 and 2018 , respectively. As of March 31, 2019 , we had $225,000 outstanding and $775,000 available for borrowing, and as of May 8, 2019 , we had $628,000 outstanding and $372,000 available for borrowing under our revolving credit facility. We have a $350,000 term loan that matures in January 2020 and is prepayable without penalty at any time. This term loan requires annual interest to be paid at the rate of LIBOR plus a premium of 140 basis points that is subject to adjustment based upon changes to our credit ratings. At March 31, 2019 , the annual interest rate payable on amounts outstanding under this term loan was 3.9% . The weighted average annual interest rate for amounts outstanding under this term loan was 4.0% and 3.1% for the three months ended March 31, 2019 and 2018 , respectively. This term loan includes an accordion feature under which maximum borrowings may be increased to up to $700,000 in certain circumstances. We have a $200,000 term loan that matures in September 2022 and is prepayable without penalty at any time. This term loan requires annual interest to be paid at the rate of LIBOR plus a premium of 135 basis points that is subject to adjustment based upon changes to our credit ratings. At March 31, 2019 , the annual interest rate payable on amounts outstanding under this term loan was 3.8% . The weighted average annual interest rate for amounts outstanding under this term loan was 3.9% and 3.0% for the three months ended March 31, 2019 and 2018 , respectively. This term loan includes an accordion feature under which maximum borrowings may be increased to up to $400,000 in certain circumstances. In May 2019, we redeemed at par all of our outstanding 3.25% senior notes due 2019 for a redemption price equal to the principal amount of $400,000 , plus accrued and unpaid interest of $6,500 . We funded this redemption with cash on hand and borrowings under our revolving credit facility. In April 2019, we gave notice of our intention to prepay, at par plus accrued interest, a mortgage note secured by four of our senior living communities with an outstanding principal balance of approximately $42,211 , a maturity date in July 2019 and an annual interest rate of 3.79% . We expect to make this prepayment in May 2019 using cash on hand and borrowings under our revolving credit facility. Our revolving credit facility and term loan agreements and our senior unsecured notes indentures and their supplements provide for acceleration of payment of all amounts due thereunder upon the occurrence and continuation of certain events of default, such as, in the case of our revolving credit facility and term loan agreements, a change of control of us, as defined, which includes The RMR Group LLC, or RMR LLC, ceasing to act as our business and property manager. Our revolving credit facility and term loan agreements and our senior unsecured notes indentures and their supplements also contain covenants, including those that restrict our ability to incur debts, and generally require us to maintain certain financial ratios, and our revolving credit facility and term loan agreements restrict our ability to make distributions under certain circumstances. We believe we were in compliance with the terms and conditions of the respective covenants under our revolving credit facility and term loan agreements and our senior unsecured notes indentures and their supplements at March 31, 2019 .

Fair Value of Assets and Liabil

Fair Value of Assets and Liabilities	3 Months Ended
	Mar. 31, 2019
Fair Value Disclosures [Abstract]
Fair Value of Assets and Liabilities	Fair Value of Assets and Liabilities Items Measured at Fair Value on a Recurring Basis: The following table presents certain of our assets that are measured at fair value on a recurring basis at March 31, 2019 , categorized by the level of inputs as defined in the fair value hierarchy under GAAP, used in the valuation of each asset or liability. Fair Value at Reporting Date Using Quoted Prices in Active Markets for Identical Assets Significant Other Observable Inputs Significant Unobservable Inputs Description Total (Level 1) (Level 2) (Level 3) Recurring Fair Value Measurements Assets: Investment in RMR Inc. (1) $ 160,830 $ 160,830 $ — $ — Investment in Five Star (2) $ 4,129 $ 4,129 $ — $ — (1) Our 2,637,408 shares of class A common stock of The RMR Group Inc., or RMR Inc., which are included in other assets in our condensed consolidated balance sheets, are reported at fair value which is based on quoted market prices (Level 1 inputs). Our historical cost basis for these shares is $69,826 as of March 31, 2019 . During the three months ended March 31, 2019 , we recorded an unrealized gain of $20,836 to adjust the carrying value of our investment in RMR Inc. class A common shares to their fair value. (2) Our 4,235,000 common shares of Five Star Senior Living Inc., or Five Star, which are included in other assets in our condensed consolidated balance sheets, are reported at fair value which is based on quoted market prices (Level 1 inputs). Our adjusted cost basis for these shares is $6,353 as of March 31, 2019 . During the three months ended March 31, 2019 , we recorded an unrealized gain of $2,096 to adjust the carrying value of our investment in Five Star common shares to their fair value. Items Measured at Fair Value on a Nonrecurring Basis: In addition to items that are measured at fair value on a recurring basis, we also have assets in our condensed consolidated balance sheets that are measured at fair value on a nonrecurring basis. During the three months ended March 31, 2019, we recorded impairment charges of $6,206 to reduce the carrying value of 15 SNFs that are classified as held for sale to their estimated sales price, based on a letter of intent, less estimated costs to sell of $7,489 . See Note 3 for further information about impairment charges and these and other properties we have classified as held for sale. The estimated fair value of these 15 SNFs as of March 31, 2019 was as follows: Quoted Prices in Active Markets for Identical Assets Significant Other Observable Inputs Significant Unobservable Inputs Description Total (Level 1) (Level 2) (Level 3) Non-Recurring Fair Value Measurements Real estate properties held for sale $ 7,489 $ — $ 7,489 $ — In addition to the assets described in the tables above, our financial instruments at March 31, 2019 and December 31, 2018 included cash and cash equivalents, restricted cash, other assets, our revolving credit facility, term loans, senior unsecured notes, secured debt and capital leases and other unsecured obligations and liabilities. The fair values of these financial instruments approximated their carrying values in our condensed consolidated financial statements as of such dates, except as follows: As of March 31, 2019 As of December 31, 2018 Description Carrying Amount (1) Estimated Fair Value Carrying Amount (1) Estimated Fair Value Senior unsecured notes $ 2,217,989 $ 2,225,390 $ 2,216,945 $ 2,138,202 Secured debts (2) 742,883 720,339 744,186 723,003 $ 2,960,872 $ 2,945,729 $ 2,961,131 $ 2,861,205 (1) Includes unamortized debt issuance costs, premiums and discounts. (2) We assumed certain of these secured debts in connection with our acquisitions of certain properties. We recorded the assumed mortgage notes debts at estimated fair value on the date of acquisition and we are amortizing the fair value adjustments, if any, to interest expense over the respective terms of the mortgage notes to reduce interest expense to the estimated market interest rates as of the date of acquisition. We estimated the fair value of our two issuances of senior unsecured notes due 2042 and 2046 based on the closing price on The Nasdaq Stock Market LLC, or Nasdaq, (a Level 1 input) as of March 31, 2019 . We estimated the fair values of our five issuances of senior unsecured notes due 2019, 2020, 2021, 2024 and 2028 using an average of the bid and ask price on or about March 31, 2019 (Level 2 inputs as defined in the fair value hierarchy under GAAP). We estimated the fair values of our secured debts by using discounted cash flows analyses and currently prevailing market terms as of the measurement date (Level 3 inputs as defined in the fair value hierarchy under GAAP). Because Level 3 inputs are unobservable, our estimated fair value may differ materially from the actual fair value.

Noncontrolling Interest

Noncontrolling Interest	3 Months Ended
	Mar. 31, 2019
Noncontrolling Interest [Abstract]
Noncontrolling Interest	Noncontrolling Interest We have a joint venture arrangement with a sovereign investor for one of our MOBs ( two buildings) located in Boston, Massachusetts. The investor owns a 45% equity interest in the joint venture, and we own the remaining 55% equity interest in the joint venture. We continue to control this property and therefore continue to account for this property on a consolidated basis in our condensed consolidated financial statements under the VIE model. The portion of the joint venture's net income and comprehensive income not attributable to us, or $1,422 and $1,383 for the three months ended March 31, 2019 and 2018 , respectively, is reported as noncontrolling interest in our condensed consolidated statements of comprehensive income. We made aggregate cash distributions to our joint venture partner of $5,503 and $5,667 for the three months ended March 31, 2019 and 2018 , respectively, which are reflected as a decrease in total equity attributable to noncontrolling interest in our condensed consolidated balance sheets. As of March 31, 2019 , this joint venture held real estate assets with an aggregate net book value of $740,105 , subject to mortgage notes of $620,000 . In assessing whether we have a controlling interest in this joint venture arrangement and are required to consolidate the accounts of the joint venture entity, we considered the members' rights to residual gains and obligations to absorb losses, which activities most significantly impact the economic performance of the entity and which member has the power to direct those activities.

Shareholders' Equity

Shareholders' Equity	3 Months Ended
	Mar. 31, 2019
Stockholders' Equity Note [Abstract]
Shareholders' Equity	Shareholders’ Equity Share Purchases: On April 5, 2019, we purchased 3,529 of our common shares, valued at $9.47 per share, the closing price of our common shares on Nasdaq on that day, from a former employee of RMR LLC in satisfaction of tax withholding and payment obligations in connection with the vesting of awards of our common shares. Distributions: On February 21, 2019 , we paid a regular quarterly distribution to common shareholders of $0.39 per share, or approximately $92,714 , that was declared on January 18, 2019 and was payable to shareholders of record on January 28, 2019. On April 18, 2019, we declared a regular quarterly distribution payable to common shareholders of record on April 29, 2019, of $0.15 per share, or approximately $35,659 . We expect to pay this distribution on or about May 16, 2019.

Segment Reporting

Segment Reporting	3 Months Ended
	Mar. 31, 2019
Segment Reporting [Abstract]
Segment Reporting	Segment Reporting As of March 31, 2019 , we have four operating segments, of which three are separate reporting segments. We aggregate the reporting units in each of our MOBs, our triple net leased senior living communities and our managed senior living communities into three reporting segments, based on their similar operating and economic characteristics. The first reporting segment includes MOBs where the tenants pay us rent. The second reporting segment includes triple net leased senior living communities that provide short term and long term residential care and other services for residents and from which we receive rents from the operators. The third reporting segment includes managed senior living communities that provide short term and long term residential care and other services for residents where we pay fees to the operator to manage the communities for our account. Our fourth segment includes all of our other operations, including certain properties that offer wellness, fitness and spa services to members and with respect to which we receive rents from operators, which we do not consider to be sufficiently material to constitute a separate reporting segment. For the Three Months Ended March 31, 2019 MOBs Triple Net Leased Senior Living Communities Managed Senior Living Communities All Other Operations Consolidated Revenues: Rental income $ 103,221 $ 50,320 $ — $ 4,700 $ 158,241 Residents fees and services — — 108,045 — 108,045 Total revenues 103,221 50,320 108,045 4,700 266,286 Expenses: Property operating expenses 32,177 — 85,045 — 117,222 Depreciation and amortization 36,101 19,422 15,760 947 72,230 General and administrative — — — 9,816 9,816 Acquisition and certain other transaction related costs — — — 7,814 7,814 Impairment of assets — 6,206 — — 6,206 Total expenses 68,278 25,628 100,805 18,577 213,288 Loss on sale of properties (122 ) — — — (122 ) Dividend income — — — 923 923 Unrealized gains on equity securities — — — 22,932 22,932 Interest and other income — — — 114 114 Interest expense (6,030 ) (238 ) (820 ) (38,523 ) (45,611 ) Income (loss) from continuing operations before income tax expense and equity in earnings of an investee 28,791 24,454 6,420 (28,431 ) 31,234 Income tax expense — — — (134 ) (134 ) Equity in earnings of an investee — — — 404 404 Net income (loss) 28,791 24,454 6,420 (28,161 ) 31,504 Net income attributable to noncontrolling interest (1,422 ) — — — (1,422 ) Net income (loss) attributable to common shareholders $ 27,369 $ 24,454 $ 6,420 $ (28,161 ) $ 30,082 As of March 31, 2019 MOBs Triple Net Leased Senior Living Communities Managed Senior Living Communities All Other Operations Consolidated Total assets $ 3,325,184 $ 2,030,946 $ 1,388,949 $ 400,821 $ 7,145,900 For the Three Months Ended March 31, 2018 MOBs Triple Net Leased Senior Living Communities Managed Senior Living Communities All Other Operations Consolidated Revenues: Rental income $ 101,151 $ 67,975 $ — $ 4,602 $ 173,728 Residents fees and services — — 102,042 — 102,042 Total revenues 101,151 67,975 102,042 4,602 275,770 Expenses: Property operating expenses 30,938 — 77,160 — 108,098 Depreciation and amortization 34,385 20,195 14,811 948 70,339 General and administrative — — — 25,118 25,118 Acquisition and certain other transaction related costs — — — 20 20 Total expenses 65,323 20,195 91,971 26,086 203,575 Gain on sale of properties — 181,154 — — 181,154 Dividend income — — — 659 659 Unrealized gains and losses on equity securities, net — — — 27,241 27,241 Interest and other income — — — 54 54 Interest expense (5,909 ) (571 ) (1,327 ) (35,745 ) (43,552 ) Loss on early extinguishment of debt — — (130 ) — (130 ) Income (loss) from continuing operations before income tax expense and equity in earnings of an investee 29,919 228,363 8,614 (29,275 ) 237,621 Income tax expense — — — (260 ) (260 ) Equity in earnings of an investee — — — 44 44 Net income (loss) 29,919 228,363 8,614 (29,491 ) 237,405 Net income attributable to noncontrolling interest (1,383 ) — — — (1,383 ) Net income (loss) attributable to common shareholders $ 28,536 $ 228,363 $ 8,614 $ (29,491 ) $ 236,022 As of December 31, 2018 MOBs Triple Net Leased Senior Living Communities Managed Senior Living Communities All Other Operations Consolidated Total assets $ 3,344,581 $ 2,044,939 $ 1,395,657 $ 375,249 $ 7,160,426

Leases and Management Agreement

Leases and Management Agreements with Five Star	3 Months Ended
	Mar. 31, 2019
Risks and Uncertainties [Abstract]
Leases and Management Agreements with Five Star	Leases and Management Agreements with Five Star Our Senior Living Communities Leased by Five Star. We are Five Star’s largest landlord and Five Star is our largest tenant. As of March 31, 2019 and 2018 , we leased 184 and 185 senior living communities to Five Star, respectively. We lease senior living communities to Five Star pursuant to five master leases. Five Star has announced that, due to current senior living industry conditions, its recurring operating losses and the risk that it may not be able to obtain sufficient funding for its operating requirements, a substantial doubt existed regarding Five Star's ability to continue as a going concern. On March 11, 2019, we entered into a letter agreement with Five Star, pursuant to which, with respect to our master leases with Five Star, we agreed to defer, until March 31, 2019, payment of the aggregate minimum rent due and payable by Five Star to us under the lease agreements for February 2019. On April 1, 2019, we entered into a transaction agreement with Five Star, or the Transaction Agreement, pursuant to which we agreed to modify our existing business arrangements with Five Star, subject to certain conditions and the receipt of various approvals, as further described in Note 14. We cannot be sure whether the transactions contemplated by the Transaction Agreement will be completed or whether Five Star will be able to continue as a going concern. We recognized rental income payable by Five Star of $39,313 and $51,759 for the three months ended March 31, 2019 and 2018 , respectively. These amounts exclude variable payments we received from Five Star of $538 and $1,374 for the three months ended March 31, 2019 and 2018 , respectively. We determine actual variable payments due under our Five Star leases annually and recognize any resulting amount as rental income at year end when all contingencies are met. As of March 31, 2019 and December 31, 2018 , we had rents receivable from Five Star of $22,000 and $18,697 , respectively, which amounts are included in other assets in our condensed consolidated balance sheets. Rental income from Five Star represented 14.8% of our total revenues for the three months ended March 31, 2019 , and the properties Five Star leases from us represented 26.5% of our real estate investments, at cost, as of March 31, 2019 . Pursuant to the terms of our leases with Five Star, for the three months ended March 31, 2019 , we funded $22,579 of improvements to communities leased to Five Star. We did not fund any capital improvements at communities leased to Five Star for the three months ended March 31, 2018. Our Senior Living Communities Managed by Five Star . As of March 31, 2019 and 2018 , Five Star managed 76 and 72 senior living communities for our account, respectively. We lease our senior living communities that are managed by Five Star and include assisted living units or SNF units to our TRSs, and Five Star manages these communities pursuant to long term management and pooling agreements. As further described in Note 14, pursuant to the Transaction Agreement we have agreed to replace our long term management and pooling agreements with Five Star with new management agreements, subject to certain conditions and the receipt of various approvals. We incurred management fees payable to Five Star of $3,789 and $3,494 for the three months ended March 31, 2019 and 2018 , respectively. These amounts are included in property operating expenses or have been capitalized, as appropriate, in our condensed consolidated financial statements. The following table presents residents fees and services revenue disaggregated by type of contract and payer: Revenue from contracts with customers: Three Months Ended March 31, 2019 Basic housing and support services $ 87,412 Medicare and Medicaid programs 8,745 Private pay and other third party payer SNF services 11,888 Total residents fees and services $ 108,045 Five Star also provides certain other services directly to residents at some of the senior living communities it manages for our account, such as rehabilitation services. At senior living communities Five Star manages for us where Five Star provides rehabilitation services on an outpatient basis, the residents, third party payers or government programs pay Five Star for those rehabilitation services. At senior living communities Five Star manages for us where Five Star provides both inpatient and outpatient rehabilitation services, we generally pay Five Star for these services and charges for these services are included in amounts charged to residents, third party payers or government programs. We incurred fees payable to Five Star of $1,675 and $1,699 for the three months ended March 31, 2019 and 2018 , respectively, for rehabilitation services Five Star provided at senior living communities it manages for us; we include these amounts in property operating expenses in our condensed consolidated statement of comprehensive income.

Business and Property Managemen

Business and Property Management Agreements with RMR LLC	3 Months Ended
	Mar. 31, 2019
Related Party Transactions [Abstract]
Business and Property Management Agreements with RMR LLC	Business and Property Management Agreements with RMR LLC We have no employees. The personnel and various services we require to operate our business are provided to us by RMR LLC. We have two agreements with RMR LLC to provide management services to us: (1) a business management agreement, which relates to our business generally; and (2) a property management agreement, which relates to the property level operations of our MOBs. We also have a subsidiary level management agreement with RMR LLC related to one of our MOBs located in Boston, Massachusetts, which we entered in connection with the joint venture arrangement for that MOB. Under that agreement, our subsidiary pays RMR LLC certain business management fees directly, which fees are credited against the business management fees payable by us to RMR LLC. Pursuant to our business management agreement with RMR LLC, we recognized net business management fees of $7,719 and $23,323 for the three months ended March 31, 2019 and 2018 , respectively. The net business management fees we recognized for the three months ended March 31, 2019 include $725 of management fees related to our subsidiary level management agreement with RMR LLC entered in connection with our joint venture arrangement. Based on our common share total return, as defined in our business management agreement, as of March 31, 2019 , no estimated 2019 incentive fees are included in the net business management fees we recognized for the three months ended March 31, 2019 . The actual amount of annual incentive fees for 2019, if any, will be based on our common share total return as defined in our business management agreement, for the three-year period ending December 31, 2019, and will be payable in 2020. The net business management fees for the three months ended March 31, 2018 included $725 of management fees related to our subsidiary level management agreement with RMR LLC and $14,347 of estimated 2018 incentive fees based on our common share total return, as defined in our business management agreement, as of March 31, 2018 . In January 2019, we paid RMR LLC an incentive fee of $40,642 for 2018. We include business management fee amounts in general and administrative expenses in our condensed consolidated statements of comprehensive income. Pursuant to our property management agreement with RMR LLC, we recognized aggregate net property management and construction supervision fees of $3,064 and $2,821 for the three months ended March 31, 2019 and 2018 , respectively. These amounts are included in property operating expenses or have been capitalized, as appropriate, in our condensed consolidated financial statements. We are generally responsible for all our operating expenses, including certain expenses incurred or arranged by RMR LLC on our behalf. We are generally not responsible for payment of RMR LLC’s employment, office or administrative expenses incurred to provide management services to us, except for the employment and related expenses of RMR LLC’s employees assigned to work exclusively or partly at our MOBs, our share of the wages, benefits and other related costs of RMR LLC's centralized accounting personnel, our share of RMR LLC’s costs for providing our internal audit function, or as otherwise agreed. Our property level operating expenses are generally incorporated into the rents charged to our tenants, including certain payroll and related costs incurred by RMR LLC. We reimbursed RMR LLC $3,374 and $2,779 for these expenses and costs for the three months ended March 31, 2019 and 2018 , respectively. We included these amounts in other operating expenses and general and administrative expenses, as applicable, in our condensed consolidated statements of comprehensive income.

Related Person Transactions

Related Person Transactions	3 Months Ended
	Mar. 31, 2019
Related Party Transactions [Abstract]
Related Person Transactions	Related Person Transactions We have relationships and historical and continuing transactions with Five Star, RMR LLC, RMR Inc., Affiliates Insurance Company, or AIC, and others related to them, including other companies to which RMR LLC provides management services and which have trustees, directors and officers who are also our Trustees or officers. Five Star. We are currently one of Five Star’s largest stockholders. As of March 31, 2019 , we owned 4,235,000 of Five Star’s common shares, or approximately 8.3% of Five Star’s outstanding common shares. Five Star is our largest tenant and the manager of our managed senior living communities. RMR LLC provides management services to both us and Five Star. As of March 31, 2019 , ABP Acquisition LLC, a subsidiary of ABP Trust, the controlling shareholder of RMR Inc., owned 35.4% of Five Star's outstanding common shares. Adam D. Portnoy, one of our Managing Trustees, is the sole trustee of ABP Trust and a managing director of Five Star. Five Star’s president and chief executive officer and executive vice president, chief financial officer and treasurer are officers and employees of RMR LLC. On April 1, 2019, we entered into the Transaction Agreement, pursuant to which we agreed to modify our existing business arrangements with Five Star, subject to certain conditions and the receipt of various approvals. See Notes 9 and 14 for further information regarding our relationships, agreements and transactions with Five Star and Note 5 for further information regarding our investment in Five Star. Our Manager, RMR LLC. We have two agreements with RMR LLC to provide management services to us. See Note 10 for further information regarding our management agreements with RMR LLC. RMR Inc. RMR LLC is a majority owned subsidiary of RMR Inc. and RMR Inc. is the managing member of RMR LLC. Adam D. Portnoy, one of our Managing Trustees, is the sole trustee, an officer and the controlling shareholder of ABP Trust, which is the controlling shareholder of RMR Inc., a managing director, president and chief executive officer of RMR Inc., and an officer and employee of RMR LLC. Jennifer B. Clark, our other Managing Trustee, also serves as a managing director and as executive vice president, general counsel and secretary of RMR Inc. and an officer of ABP Trust and RMR LLC. Other officers and employees of RMR LLC also serve as our officers. As of March 31, 2019 , we owned 2,637,408 shares of class A common stock of RMR Inc. See Note 5 for further information regarding our investment in RMR Inc. AIC. We, ABP Trust, Five Star and four other companies to which RMR LLC provides management services currently own AIC in equal amounts. We (including our consolidated joint venture) and the other AIC shareholders participate in a combined property insurance program arranged and reinsured in part by AIC. As of March 31, 2019 and December 31, 2018 , our investment in AIC had a carrying value of $9,102 and $8,632 , respectively. These amounts are included in other assets in our condensed consolidated balance sheets. We recognized income related to our investment in AIC, which is presented as equity in earnings of an investee in our condensed consolidated statements of comprehensive income. Our other comprehensive income includes our proportionate part of unrealized gains on securities that are owned by AIC related to our investment in AIC. For further information about these and other such relationships and certain other related person transactions, refer to our Annual Report.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2019
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes We have elected to be taxed as a real estate investment trust, or REIT, under the Internal Revenue Code of 1986, as amended, and as such, are generally not subject to federal and most state income taxation on our operating income provided we distribute our taxable income to our shareholders and meet certain organization and operating requirements. We do, however, lease certain managed senior living communities to our wholly owned TRSs that, unlike most of our subsidiaries, file a separate consolidated federal corporate income tax return and are subject to federal and state income taxes. Our consolidated income tax provision includes the income tax provision related to the operations of our TRSs and certain state income taxes we incur despite our taxation as a REIT. During the three months ended March 31, 2019 and 2018 , we recognized income tax expense of $134 and $260 , respectively.

Weighted Average Common Shares

Weighted Average Common Shares	3 Months Ended
	Mar. 31, 2019
Earnings Per Share [Abstract]
Weighted Average Common Shares	Weighted Average Common Shares The following table provides a reconciliation of the weighted average number of common shares used in the calculation of basic and diluted earnings per share (in thousands): Three Months Ended March 31, 2019 2018 Weighted average common shares for basic earnings per share 237,568 237,478 Effect of dilutive securities: unvested share awards 32 15 Weighted average common shares for diluted earnings per share 237,600 237,493

Subsequent Events

Subsequent Events	3 Months Ended
	Mar. 31, 2019
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events In April 2019, Five Star began managing for our account a senior living community we own located in Oregon with 318 living units, pursuant to a management agreement with Five Star on terms substantially similar to those of existing management agreements between us and Five Star, after the previous tenant defaulted on its lease with us. The April 2019 Transaction Agreement with Five Star. In April 2019, we entered into the Transaction Agreement. Among other things, the Transaction Agreement provides that, subject to approval by Five Star’s stockholders of the Five Star Share Issuances (as defined below) and receipt of other required approvals, effective January 1, 2020 (or January 1, 2021 if extended under the Transaction Agreement), or the Conversion Time: • our five existing master leases with Five Star for all of our senior living communities that are leased by Five Star, as well as our existing management agreements and pooling agreements with Five Star for our senior living communities that are operated by Five Star, will be terminated and replaced, or the Conversion, with new management agreements for all of these senior living communities, or collectively, the New Management Agreements; • Five Star will issue to us such number of Five Star common shares as is necessary to cause us to own, when considered together with our then owned Five Star common shares, approximately 34% of the then outstanding Five Star common shares, and we will declare a pro rata distribution to holders of our common shares of beneficial interest of the right to receive, and Five Star will issue on a pro rata basis to such holders, a number of Five Star common shares which equals approximately 51% of the then outstanding Five Star common shares, or, together, the Five Star Share Issuances; the noted percentage ownership amounts are post-issuance, giving effect to the Five Star Share Issuances; and • as consideration for the Five Star Share Issuances, we will provide to Five Star $75,000 of additional consideration, or, collectively with the Conversion and the Five Star Share Issuances, the Five Star Restructuring Transactions. Also pursuant to the Transaction Agreement: (1) commencing February 1, 2019 through December 31, 2019, the aggregate amount of monthly minimum rent payable to us by Five Star under our master leases with Five Star is $11,000 , subject to adjustment and extension, and no additional rent is payable to us by Five Star from such date to the Conversion Time; and (2) on April 1, 2019, we purchased from Five Star approximately $50,000 of unencumbered Qualifying PP&E (as defined in the Transaction Agreement) related to our senior living communities leased and operated by Five Star, which amount is subject to adjustment but will not exceed $60,000 . The Five Star Restructuring Transactions are subject to conditions, including, among others: (1) approval of the Five Star Share Issuances by at least a majority of the votes cast, in person or by proxy, by the holders of outstanding Five Star common shares at any meeting of Five Star’s stockholders held for that purpose, or the Five Star Stockholder Approval; (2) the receipt of all Required Licenses (as defined in the Transaction Agreement) and any other third party consent or approval required for the consummation of the Five Star Restructuring Transactions; (3) the effectiveness of the registration statement on Form S-1 to be filed by Five Star with the Securities and Exchange Commission, or SEC, to register the Five Star common shares to be issued pursuant to the Five Star Share Issuances; and (4) approval by Nasdaq of the listing of the Five Star common shares to be issued pursuant to the Five Star Share Issuances, subject to official notice of issuance. If any required approval (other than the Five Star Stockholder Approval) is not obtained by December 31, 2019, and the failure to obtain such approval is not the result of a breach or default by Five Star under the Transaction Agreement, we and Five Star have agreed to work in good faith to determine an alternative to allow the Restructuring Transactions to occur on January 1, 2020; provided we are not required to agree to any alternative that would adversely affect our qualification for taxation as a REIT under the Internal Revenue Code of 1986, as amended. If we and Five Star do not agree to any such alternative, and, as of January 1, 2020, the failure to obtain a required approval is the only remaining condition under the Transaction Agreement, the Conversion Time will be automatically extended to January 1, 2021. If the Five Star Stockholder Approval is not obtained by December 31, 2019, and we do not elect to extend the Transaction Agreement, the Transaction Agreement will terminate, our existing master leases and management agreements and pooling agreements with Five Star will remain in effect, and the amount of monthly minimum rent payable to us by Five Star under our existing master leases with Five Star will return to the rate provided for therein and additional rent again will be payable to us by Five Star in accordance therewith. If the Five Star Stockholder Approval is obtained by December 31, 2019, our existing master leases with Five Star will remain at $11,000 per month, subject to adjustment, regardless of whether the Transaction Agreement is extended and/or is terminated. Five Star has agreed to, within six months following the Conversion Time, expand its board of directors to add an independent director (as defined in Five Star’s bylaws) reasonably satisfactory to us. In addition, we and ABP Trust, on behalf of ABP Acquisition LLC, a wholly owned subsidiary of ABP Trust and Five Star’s largest stockholder, have each agreed to vote all the Five Star common shares that we and ABP Trust beneficially own in favor of approval of the Five Star Share Issuances at any meeting of Five Star’s stockholders held for that purpose. Pursuant to the New Management Agreements, Five Star will receive a management fee equal to 5% of the gross revenues realized at the applicable senior living communities plus reimbursement for its direct costs and expenses related to such communities, as well as an annual incentive fee equal to 15% of the amount by which the annual earnings before interest, taxes, depreciation and amortization, or EBITDA, of all communities on a combined basis exceeds the target EBITDA for all communities on a combined basis for such calendar year, provided that in no event shall the incentive fee be greater than 1.5% of the gross revenues realized at all communities on a combined basis for such calendar year. The New Management Agreements provide for 15 year terms, subject to Five Star’s right to extend for two consecutive five year terms if it achieves certain performance targets for the combined managed communities portfolio. The New Management Agreements also provide us with the right to terminate the New Management Agreement for any community that does not earn 90% of the target EBITDA for such community for two consecutive calendar years or in any two of three consecutive calendar years, with the measurement period commencing January 1, 2021 (and the first termination not possible until the beginning of calendar year 2023), provided we may not in any calendar year terminate communities representing more than 20% of the combined revenues for all communities for the calendar year prior to such termination. In connection with the Transaction Agreement, we entered into a credit agreement with Five Star, pursuant to which we extended to Five Star a $25,000 line of credit, or the Five Star credit facility. The Five Star credit facility matures on January 1, 2020, or January 1, 2021 if the Conversion Time is extended pursuant to the Transaction Agreement. The Five Star credit facility provides for interest to be paid on borrowed amounts at a rate of 6% per year and is secured by real estate mortgages on six senior living communities owned by certain of Five Star’s subsidiaries that guarantee Five Star’s obligations under the Five Star credit facility, and certain personal property owned by those and certain other Five Star subsidiaries. The Five Star credit facility provides for acceleration of payment of all amounts outstanding under the Five Star credit facility upon the occurrence and continuation of certain events of default, including a default by Five Star under the Transaction Agreement and certain other agreements. The agreement governing the Five Star credit facility contains covenants, including those that restrict Five Star’s ability to incur debt or to pay dividends or make other distributions to its stockholders in certain circumstances.

Recent Accounting Pronounceme_2

Recent Accounting Pronouncements (Policies)	3 Months Ended
	Mar. 31, 2019
Accounting Changes and Error Corrections [Abstract]
Recent Accounting Pronouncements	Recent Accounting Pronouncements In February 2016, the FASB issued Accounting Standards Update, or ASU, No. 2016-02, Leases . In July 2018, the FASB issued ASU No. 2018-10, Codification Improvements to Topic 842, Leases and ASU No. 2018-11, Leases (Topic 842): Targeted Improvements . In December 2018, the FASB issued ASU No. 2018-20 Leases (Topic 842), Narrow-Scope Improvements for Lessors . Collectively, these standards set out the principles for the recognition, measurement, presentation and disclosure of leases for both parties to a contract (i.e., lessees and lessors). ASU No. 2016-02 requires lessees to apply a dual approach, classifying leases as either finance or operating leases based on the principle of whether or not the lease is effectively a financed purchase of the leased asset by the lessee. This classification will determine whether the lease expense is recognized based on an effective interest method or on a straight line basis over the term of the lease. ASU No. 2016-02 requires lessors to account for leases using an approach that is substantially equivalent to existing guidance for sales type leases, direct financing leases and operating leases. These standards were effective as of January 1, 2019. Upon adoption, we applied the package of practical expedients that has allowed us to not reassess (i) whether any expired or existing contracts are or contain leases, (ii) lease classification for any expired or existing leases and (iii) initial direct costs for any expired or existing leases. Furthermore, we applied the optional transition method in ASU No. 2018-11, which has allowed us to initially apply the new leases standard at the adoption date and recognize a cumulative effect adjustment to the opening balance of retained earnings in the adoption period, although we did not have an adjustment. Additionally, our leases met the criteria in ASU No. 2018-11 to not separate non-lease components from the related lease component; therefore, the accounting for these leases remained largely unchanged from the previous standard. The adoption of ASU No. 2016-02 and the related improvements did not have a material impact in our condensed consolidated financial statements. Upon adoption, (i) allowances for bad debts are now recognized as a direct reduction of rental income, and (ii) legal costs associated with the execution of our leases, which were previously capitalized and amortized over the life of their respective leases, are expensed as incurred. Subsequent to January 1, 2019, provisions for credit losses are now included in rental income in our condensed consolidated financial statements. Provisions for credit losses prior to January 1, 2019 were previously included in property operating expenses in our condensed consolidated financial statements and prior periods are not reclassified to conform to the current presentation. We completed our assessment of predominance as it relates to our contracts with residents for housing services at properties leased to our taxable REIT subsidiaries, or TRSs, and have recognized revenue from these properties under ASC 606, which did not have any impact to the timing or amount of our revenue recognized. For leases in which we are the lessee, we recognized a right of use asset and a lease liability equal to the present value of the minimum lease payments with rental payments being applied to the lease liability and the right of use asset being amortized over the term of the lease. The adoption of this standard resulted in an increase in total assets and liabilities of $4,507 . The right of use asset and related lease liability are included within other assets, net and other liabilities, respectively, within our condensed consolidated balance sheets. In addition, we lease equipment at certain of our managed senior living communities. These leases are short term in nature, are cancelable with no fee or do not result in an annual expense in excess of our capitalization policy and, as a result, will not be recorded on our condensed consolidated balance sheets. The adoption of ASU No. 2016-02 and the related ASU improvements did not have a material impact in our condensed consolidated financial statements. Revenue Recognition. We are a lessor of MOBs, senior living communities and wellness centers. Our leases provide our tenants with the contractual right to use and economically benefit from all of the premises demised under the leases; therefore, we have determined to evaluate our leases as lease arrangements. Certain of our leases provide for base rent payments and in addition may include variable payments. Rental income from operating leases, including any payments derived by index or market based indices, is recognized on a straight line basis over the lease term when we have determined that the collectability of substantially all of the lease payments is probable. Some of our leases have options to extend or terminate the lease exercisable at the option of our tenants, which are considered when determining the lease term. We do not include in our measurement of our lease receivables certain variable payments, including changes in the index or market based indices after the inception of the lease, certain tenant reimbursements and other income until the specific events that trigger the variable payments have occurred. Such payments totaled $18,845 for the three months ended March 31, 2019. Certain of our leases contain non-lease components, such as property level operating expenses and capital expenditures reimbursed by our tenants as well as other required lease payments. We have determined that all of our leases qualify for the practical expedient to not separate the lease and non-lease components because (i) the lease components are operating leases and (ii) the timing and pattern of recognition of the non-lease components are the same as those of the lease components. We apply Accounting Standards Codification Topic 842, Leases, to the combined component. Income derived by our leases is recorded in rental income in our condensed consolidated statements of comprehensive income. Certain tenants are obligated to pay directly their obligations under their leases for insurance, real estate taxes and certain other expenses. These obligations, which have been assumed by the tenants under the terms of their respective leases, are not reflected in our condensed consolidated financial statements. To the extent any tenant responsible for any such obligations under the applicable lease defaults on such lease or if it is deemed probable that the tenant will fail to pay for such obligations, we would record a liability for such obligations. The following table presents our operating lease maturity analysis as of March 31, 2019: Year Amount 2019 $ 373,701 2020 347,718 2021 324,230 2022 302,712 2023 279,407 Thereafter 1,105,830 Total $ 2,733,598 In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments - Credit Losses (Topic 326) : Measurement of Credit Losses on Financial Instruments , which requires that entities use a new forward-looking “expected loss” model that generally will result in the earlier recognition of allowance for credit losses. The measurement of expected credit losses is based upon historical experience, current conditions, and reasonable and supportable forecasts that affect the collectability of the reported amount. ASU No. 2016-13 will be effective for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years. We are currently assessing the potential impact the adoption of ASU No. 2016-13 will have in our condensed consolidated financial statements although lease related receivables are governed by the lease standards referred to above and are not subject to ASU No. 2016-13. We currently expect to adopt this standard using the modified retrospective approach.

Recent Accounting Pronounceme_3

Recent Accounting Pronouncements (Tables)	3 Months Ended
	Mar. 31, 2019
Accounting Changes and Error Corrections [Abstract]
Lessee, Operating Lease, Liability, Maturity	The following table presents our operating lease maturity analysis as of March 31, 2019: Year Amount 2019 $ 373,701 2020 347,718 2021 324,230 2022 302,712 2023 279,407 Thereafter 1,105,830 Total $ 2,733,598

Real Estate Properties Real Est

Real Estate Properties Real Estate Properties (Tables)	3 Months Ended
	Mar. 31, 2019
Real Estate [Abstract]
Schedule of Real Estate Properties	Date of Sale Location Type of Property Number of Properties Gross Sales Price (1) February 2019 Florida MOB 1 $ 2,900 March 2019 Massachusetts MOB 1 75 2 $ 2,975 (1) Gross sales price excludes closing costs.

Fair Value of Assets and Liab_2

Fair Value of Assets and Liabilities (Tables)	3 Months Ended
	Mar. 31, 2019
Fair Value Disclosures [Abstract]
Assets and liabilities recurring and nonrecurring measured at fair value	The estimated fair value of these 15 SNFs as of March 31, 2019 was as follows: Quoted Prices in Active Markets for Identical Assets Significant Other Observable Inputs Significant Unobservable Inputs Description Total (Level 1) (Level 2) (Level 3) Non-Recurring Fair Value Measurements Real estate properties held for sale $ 7,489 $ — $ 7,489 $ — The following table presents certain of our assets that are measured at fair value on a recurring basis at March 31, 2019 , categorized by the level of inputs as defined in the fair value hierarchy under GAAP, used in the valuation of each asset or liability. Fair Value at Reporting Date Using Quoted Prices in Active Markets for Identical Assets Significant Other Observable Inputs Significant Unobservable Inputs Description Total (Level 1) (Level 2) (Level 3) Recurring Fair Value Measurements Assets: Investment in RMR Inc. (1) $ 160,830 $ 160,830 $ — $ — Investment in Five Star (2) $ 4,129 $ 4,129 $ — $ — (1) Our 2,637,408 shares of class A common stock of The RMR Group Inc., or RMR Inc., which are included in other assets in our condensed consolidated balance sheets, are reported at fair value which is based on quoted market prices (Level 1 inputs). Our historical cost basis for these shares is $69,826 as of March 31, 2019 . During the three months ended March 31, 2019 , we recorded an unrealized gain of $20,836 to adjust the carrying value of our investment in RMR Inc. class A common shares to their fair value. (2) Our 4,235,000 common shares of Five Star Senior Living Inc., or Five Star, which are included in other assets in our condensed consolidated balance sheets, are reported at fair value which is based on quoted market prices (Level 1 inputs). Our adjusted cost basis for these shares is $6,353 as of March 31, 2019 . During the three months ended March 31, 2019 , we recorded an unrealized gain of $2,096 to adjust the carrying value of our investment in Five Star common shares to their fair value.
Schedule of carrying value and fair value of the financial instruments	The fair values of these financial instruments approximated their carrying values in our condensed consolidated financial statements as of such dates, except as follows: As of March 31, 2019 As of December 31, 2018 Description Carrying Amount (1) Estimated Fair Value Carrying Amount (1) Estimated Fair Value Senior unsecured notes $ 2,217,989 $ 2,225,390 $ 2,216,945 $ 2,138,202 Secured debts (2) 742,883 720,339 744,186 723,003 $ 2,960,872 $ 2,945,729 $ 2,961,131 $ 2,861,205 (1) Includes unamortized debt issuance costs, premiums and discounts. (2) We assumed certain of these secured debts in connection with our acquisitions of certain properties. We recorded the assumed mortgage notes debts at estimated fair value on the date of acquisition and we are amortizing the fair value adjustments, if any, to interest expense over the respective terms of the mortgage notes to reduce interest expense to the estimated market interest rates as of the date of acquisition.

Segment Reporting (Tables)

Segment Reporting (Tables)	3 Months Ended
	Mar. 31, 2019
Segment Reporting [Abstract]
Schedule of segment reporting information	For the Three Months Ended March 31, 2019 MOBs Triple Net Leased Senior Living Communities Managed Senior Living Communities All Other Operations Consolidated Revenues: Rental income $ 103,221 $ 50,320 $ — $ 4,700 $ 158,241 Residents fees and services — — 108,045 — 108,045 Total revenues 103,221 50,320 108,045 4,700 266,286 Expenses: Property operating expenses 32,177 — 85,045 — 117,222 Depreciation and amortization 36,101 19,422 15,760 947 72,230 General and administrative — — — 9,816 9,816 Acquisition and certain other transaction related costs — — — 7,814 7,814 Impairment of assets — 6,206 — — 6,206 Total expenses 68,278 25,628 100,805 18,577 213,288 Loss on sale of properties (122 ) — — — (122 ) Dividend income — — — 923 923 Unrealized gains on equity securities — — — 22,932 22,932 Interest and other income — — — 114 114 Interest expense (6,030 ) (238 ) (820 ) (38,523 ) (45,611 ) Income (loss) from continuing operations before income tax expense and equity in earnings of an investee 28,791 24,454 6,420 (28,431 ) 31,234 Income tax expense — — — (134 ) (134 ) Equity in earnings of an investee — — — 404 404 Net income (loss) 28,791 24,454 6,420 (28,161 ) 31,504 Net income attributable to noncontrolling interest (1,422 ) — — — (1,422 ) Net income (loss) attributable to common shareholders $ 27,369 $ 24,454 $ 6,420 $ (28,161 ) $ 30,082 As of March 31, 2019 MOBs Triple Net Leased Senior Living Communities Managed Senior Living Communities All Other Operations Consolidated Total assets $ 3,325,184 $ 2,030,946 $ 1,388,949 $ 400,821 $ 7,145,900 For the Three Months Ended March 31, 2018 MOBs Triple Net Leased Senior Living Communities Managed Senior Living Communities All Other Operations Consolidated Revenues: Rental income $ 101,151 $ 67,975 $ — $ 4,602 $ 173,728 Residents fees and services — — 102,042 — 102,042 Total revenues 101,151 67,975 102,042 4,602 275,770 Expenses: Property operating expenses 30,938 — 77,160 — 108,098 Depreciation and amortization 34,385 20,195 14,811 948 70,339 General and administrative — — — 25,118 25,118 Acquisition and certain other transaction related costs — — — 20 20 Total expenses 65,323 20,195 91,971 26,086 203,575 Gain on sale of properties — 181,154 — — 181,154 Dividend income — — — 659 659 Unrealized gains and losses on equity securities, net — — — 27,241 27,241 Interest and other income — — — 54 54 Interest expense (5,909 ) (571 ) (1,327 ) (35,745 ) (43,552 ) Loss on early extinguishment of debt — — (130 ) — (130 ) Income (loss) from continuing operations before income tax expense and equity in earnings of an investee 29,919 228,363 8,614 (29,275 ) 237,621 Income tax expense — — — (260 ) (260 ) Equity in earnings of an investee — — — 44 44 Net income (loss) 29,919 228,363 8,614 (29,491 ) 237,405 Net income attributable to noncontrolling interest (1,383 ) — — — (1,383 ) Net income (loss) attributable to common shareholders $ 28,536 $ 228,363 $ 8,614 $ (29,491 ) $ 236,022 As of December 31, 2018 MOBs Triple Net Leased Senior Living Communities Managed Senior Living Communities All Other Operations Consolidated Total assets $ 3,344,581 $ 2,044,939 $ 1,395,657 $ 375,249 $ 7,160,426

Leases and Management Agreeme_2

Leases and Management Agreements with Five Star Leases and Management Agreements with Five Star (Tables)	3 Months Ended
	Mar. 31, 2019
Risks and Uncertainties [Abstract]
Disaggregation of Revenue	The following table presents residents fees and services revenue disaggregated by type of contract and payer: Revenue from contracts with customers: Three Months Ended March 31, 2019 Basic housing and support services $ 87,412 Medicare and Medicaid programs 8,745 Private pay and other third party payer SNF services 11,888 Total residents fees and services $ 108,045

Weighted Average Common Shares

Weighted Average Common Shares (Tables)	3 Months Ended
	Mar. 31, 2019
Earnings Per Share [Abstract]
Schedule of weighted average number of shares	The following table provides a reconciliation of the weighted average number of common shares used in the calculation of basic and diluted earnings per share (in thousands): Three Months Ended March 31, 2019 2018 Weighted average common shares for basic earnings per share 237,568 237,478 Effect of dilutive securities: unvested share awards 32 15 Weighted average common shares for diluted earnings per share 237,600 237,493

Basis of Presentation (Details)

Basis of Presentation (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)buildingproperty	Dec. 31, 2018USD ($)
Basis Of Presentation [Line Items]
Variable interest entity, consolidated, carrying amount, assets	$ 1,050,254	$ 1,061,593
Variable interest entity, consolidated, carrying amount, liabilities	$ (711,792)	$ (714,226)
Joint Venture
Basis Of Presentation [Line Items]
Noncontrolling interest, ownership percentage by parent	45.00%
Ownership percentage	55.00%
Massachusetts | MOBs | Joint Venture
Basis Of Presentation [Line Items]
Number of properties included in joint venture agreement | property	1
Number of buildings included in joint venture agreement | building	2

Recent Accounting Pronounceme_4

Recent Accounting Pronouncements - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Jan. 01, 2019
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Variable lease, payment	$ 18,845
Accounting Standards Update 2016-02
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Operating lease, right-of-use asset		$ 4,507
Operating lease, liability		$ 4,507

Recent Accounting Pronounceme_5

Recent Accounting Pronouncements Recent Accounting Pronouncements - Schedule of Operating Lease Maturity (Details) $ in Thousands	Mar. 31, 2019USD ($)
Accounting Changes and Error Corrections [Abstract]
2019	$ 373,701
2020	347,718
2021	324,230
2022	302,712
2023	279,407
Thereafter	1,105,830
Total	$ 2,733,598

Real Estate Properties - Narrat

Real Estate Properties - Narrative (Details) $ in Thousands	1 Months Ended		3 Months Ended
	May 09, 2019USD ($)community	Mar. 31, 2019USD ($)statebuildingproperty	Mar. 31, 2019USD ($)ft²statebuildingcommunityproperty	Mar. 31, 2018USD ($)
Real Estate Properties
Impairment of assets			$ 6,206	$ 0
Skilled Nursing Facility
Real Estate Properties
Impairment of assets			$ 6,206
Number of properties acquired | property			15
Discontinued Operations, Held-for-sale
Real Estate Properties
Number of real estate properties | building		467	467
Number of real estate properties held for sale | property		30	30
Number of states in which properties are located | state		42	42
Discontinued Operations, Held-for-sale | MOBs
Real Estate Properties
Number of communities sold | community			10
Aggregate purchase price			$ 15,609
Amount under agreement to sell		$ 17,347	$ 17,347
Discontinued Operations, Held-for-sale | Skilled Nursing Facility
Real Estate Properties
Number of communities sold | community			20
Aggregate purchase price			$ 40,500
Amount under agreement to sell		$ 44,342	$ 44,342
Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate Properties
Number of real estate properties | building		2	2
Aggregate purchase price			$ 2,975
Disposal Group, Disposed of by Sale, Not Discontinued Operations | MOBs
Real Estate Properties
Number of communities sold | community			2
Square footage of real estate property | ft²			64,796
Aggregate purchase price			$ 2,975
Rental income			$ 123
Joint Venture
Real Estate Properties
Number of buildings | building		2	2
Ownership percentage		55.00%	55.00%
Joint Venture | MOBs
Real Estate Properties
Number of real estate properties held for sale | property		1	1
California | Disposal Group, Disposed of by Sale, Not Discontinued Operations | Skilled Nursing Facility
Real Estate Properties
Number of communities sold | community			3
Aggregate purchase price			$ 21,500
Massachusetts | Disposal Group, Disposed of by Sale, Not Discontinued Operations | MOBs
Real Estate Properties
Number of real estate properties | building		1	1
Aggregate purchase price		$ 75
Subsequent Event | Massachusetts | Discontinued Operations, Held-for-sale | MOBs
Real Estate Properties
Number of communities sold | community	3
Aggregate purchase price	$ 4,955

Real Estate Properties - Schedu

Real Estate Properties - Schedule of Real Estate Properties (Details) - Disposal Group, Disposed of by Sale, Not Discontinued Operations $ in Thousands	1 Months Ended		3 Months Ended
	Mar. 31, 2019USD ($)building	Feb. 28, 2019USD ($)building	Mar. 31, 2019USD ($)building
Real Estate [Line Items]
Number of Properties | building	2		2
Gross Sales Price			$ 2,975
MOBs
Real Estate [Line Items]
Gross Sales Price			$ 2,975
MOBs | Florida
Real Estate [Line Items]
Number of Properties | building		1
Gross Sales Price		$ 2,900
MOBs | Massachusetts
Real Estate [Line Items]
Number of Properties | building	1		1
Gross Sales Price	$ 75

Indebtedness (Details)

Indebtedness (Details)	May 09, 2019USD ($)	Mar. 31, 2019USD ($)buildingnoteproperty	Mar. 31, 2018	May 08, 2019USD ($)	Apr. 30, 2019USD ($)	Dec. 31, 2018USD ($)
Indebtedness
Total real estate properties, gross		$ 7,859,676,000				$ 7,876,300,000
Unsecured revolving credit facility		225,000,000				$ 139,000,000
Unsecured revolving credit facility
Indebtedness
Unsecured revolving credit facility, maximum borrowing capacity		$ 1,000,000,000
Number of public issues of unsecured senior notes | note		7
Line of credit facility, periodic payment, principal		$ 0
Revolving credit facility, interest rate payable (as a percent)		3.60%
Weighted average interest rate on debt (as a percent)		3.60%	2.70%
Unsecured revolving credit facility		$ 225,000,000
Revolving credit facility, available amount		775,000,000
Maximum borrowing capacity that may be increased (up to)		$ 2,000,000,000
Unsecured revolving credit facility | LIBOR
Indebtedness
Interest rate added to the base rate (as a percent)		1.20%
Debt instrument, facility fee (as a percent)		0.25%
Unsecured revolving credit facility | Subsequent Event
Indebtedness
Unsecured revolving credit facility				$ 628,000,000
Revolving credit facility, available amount				$ 372,000,000
Senior unsecured notes due 2019
Indebtedness
Debt face amount		$ 400,000,000
Interest rate (as a percent)		3.25%
Maximum borrowing capacity that may be increased (up to)		$ 400,000,000
Senior unsecured notes due 2019 | Subsequent Event
Indebtedness
Debt face amount					$ 42,211,000
Interest rate (as a percent)	3.25%				3.79%
Principal amount plus accrued and unpaid interest	$ 400,000,000
Extinguishment of debt, accrued and interest payable	$ 6,500,000
Senior unsecured notes due 2020
Indebtedness
Debt face amount		$ 200,000,000
Interest rate (as a percent)		6.75%
Senior unsecured notes due 2021
Indebtedness
Debt face amount		$ 300,000,000
Interest rate (as a percent)		6.75%
Senior unsecured notes due 2024
Indebtedness
Debt face amount		$ 250,000,000
Interest rate (as a percent)		4.75%
Senior unsecured notes due 2028
Indebtedness
Debt face amount		$ 500,000,000
Interest rate (as a percent)		4.75%
Senior unsecured notes due 2042
Indebtedness
Debt face amount		$ 350,000,000
Interest rate (as a percent)		5.625%
Senior unsecured notes due 2046
Indebtedness
Debt face amount		$ 250,000,000
Interest rate (as a percent)		6.25%
Term loan due 2020
Indebtedness
Debt face amount		$ 350,000,000
Interest rate (as a percent)		3.90%
Weighted average interest rate on debt (as a percent)		4.00%	3.10%
Maximum borrowing capacity that may be increased (up to)		$ 700,000,000
Term loan due 2020 | LIBOR
Indebtedness
Interest rate added to the base rate (as a percent)		1.40%
Term loan due 2022
Indebtedness
Debt face amount		$ 200,000,000
Interest rate (as a percent)		3.80%
Weighted average interest rate on debt (as a percent)		3.90%	3.00%
Term loan due 2022 | LIBOR
Indebtedness
Interest rate added to the base rate (as a percent)		1.35%
Mortgages
Indebtedness
Aggregate principal amount of mortgage debt		$ 733,672,000
Number of buildings mortgaged | building		14
Total real estate properties, gross		$ 1,035,640,000
Capital leases
Indebtedness
Total real estate properties, gross		$ 34,828,000
Number of real estate properties | property		2
Lease obligations		$ 9,599,000

Fair Value of Assets and Liab_3

Fair Value of Assets and Liabilities - Assets (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Unrealized gain on equity securities	$ 22,932	$ 27,241
Five Star
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Equity securities investment (in shares)	4,235,000
Recurring | RMR Inc
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments in affiliates, fair value	$ 160,830
Recurring | Five Star
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments in affiliates, fair value	4,129
Recurring | Quoted Prices in Active Markets for Identical Assets (Level 1) | RMR Inc
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments in affiliates, fair value	160,830
Recurring | Quoted Prices in Active Markets for Identical Assets (Level 1) | Five Star
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments in affiliates, fair value	4,129
Recurring | Significant Other Observable Inputs (Level 2) | RMR Inc
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments in affiliates, fair value	0
Recurring | Significant Other Observable Inputs (Level 2) | Five Star
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments in affiliates, fair value	0
Recurring | Significant Unobservable Inputs (Level 3) | RMR Inc
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments in affiliates, fair value	0
Recurring | Significant Unobservable Inputs (Level 3) | Five Star
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments in affiliates, fair value	0
Nonrecurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Real estate properties held for sale	7,489
Nonrecurring | Quoted Prices in Active Markets for Identical Assets (Level 1)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Real estate properties held for sale	0
Nonrecurring | Significant Other Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Real estate properties held for sale	7,489
Nonrecurring | Significant Unobservable Inputs (Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Real estate properties held for sale	$ 0
Class A common shares | RMR Inc
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Equity securities investment (in shares)	2,637,408
Historical cost basis for shares owned	$ 69,826
Unrealized gain on equity securities	$ 20,836
Common Shares | Five Star
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Equity securities investment (in shares)	4,235,000
Historical cost basis for shares owned	$ 6,353
Unrealized gain on equity securities	$ 2,096

Fair Value of Assets and Liab_4

Fair Value of Assets and Liabilities - Narrative (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)debt_securityproperty	Mar. 31, 2018USD ($)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment of assets	$ 6,206	$ 0
Fair Value, Inputs, Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value measurement, number of debt securities | debt_security	2
Fair Value, Inputs, Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value measurement, number of debt securities | debt_security	5
Nonrecurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Sale price less estimated cost to sell	$ 7,489
Nonrecurring | Fair Value, Inputs, Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Sale price less estimated cost to sell	0
Nonrecurring | Fair Value, Inputs, Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Sale price less estimated cost to sell	$ 7,489
Discontinued Operations, Held-for-sale | Nonrecurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Number of properties acquired | property	15
Sale price less estimated cost to sell	$ 7,489
Impairment of assets	$ 6,206

Fair Value of Assets and Liab_5

Fair Value of Assets and Liabilities - Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Carrying Amount
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt instrument	$ 2,960,872	$ 2,961,131
Estimated Fair Value
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt instrument	2,945,729	2,861,205
Senior unsecured notes | Carrying Amount
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt instrument	2,217,989	2,216,945
Senior unsecured notes | Estimated Fair Value
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt instrument	2,225,390	2,138,202
Secured debts | Carrying Amount
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt instrument	742,883	744,186
Secured debts | Estimated Fair Value
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt instrument	$ 720,339	$ 723,003

Noncontrolling Interest (Detail

Noncontrolling Interest (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)buildingproperty	Mar. 31, 2018USD ($)
Noncontrolling Interest [Line Items]
Comprehensive income attributable to noncontrolling interest	$ (1,422)	$ (1,383)
Cash distribution for joint venture partners	5,503	$ 5,667
Variable interest entity, consolidated, carrying amount, real estate assets	740,105
Variable interest entity, consolidated, carrying amount, mortgage debt	$ 620,000
Joint Venture
Noncontrolling Interest [Line Items]
Ownership percentage by noncontrolling owners	45.00%
Ownership percentage	55.00%
Massachusetts | MOBs | Joint Venture
Noncontrolling Interest [Line Items]
Number of properties included in joint venture agreement | property	1
Number of buildings included in joint venture agreement | building	2

Shareholders' Equity (Details)

Shareholders' Equity (Details) - USD ($) $ / shares in Units, $ in Thousands	Apr. 18, 2019	Apr. 05, 2019	Feb. 21, 2019	Mar. 31, 2019	Mar. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Dividends paid (in dollars per share)			$ 0.39
Distributions to shareholders			$ 92,714	$ 92,714	$ 92,674
Subsequent Event
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Distributions to common shareholders declared (in dollars per share)	$ 0.15
Distributions to shareholders	$ 35,659
Subsequent Event | Former Employees Of RMR LLC
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares purchased to satisfy tax withholding and payment obligations (in shares)		3,529
Distributions to common shareholders declared (in dollars per share)		$ 9.47

Segment Reporting (Details)

Segment Reporting (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)segment	Mar. 31, 2018USD ($)	Dec. 31, 2018USD ($)
Segment Reporting [Abstract]
Number of operating segments | segment	4
Number of reportable segments | segment	3
Revenues:
Total revenues	$ 266,286	$ 275,770
Expenses:
Property operating expenses	117,222	108,098
Depreciation and amortization	72,230	70,339
General and administrative	9,816	25,118
Acquisition and certain other transaction related costs	7,814	20
Impairment of assets	6,206	0
Total expenses	213,288	203,575
(Loss) gain on sale of properties	(122)	181,154
Dividend income	923	659
Unrealized gains on equity securities	22,932	27,241
Interest and other income	114	54
Interest expense	(45,611)	(43,552)
Gain on early extinguishment of debt	0	(130)
Income from continuing operations before income tax expense and equity in earnings of an investee	31,234	237,621
Income tax expense	(134)	(260)
Equity in earnings of an investee	404	44
Net income (loss)	31,504	237,405
Net income attributable to noncontrolling interest	(1,422)	(1,383)
Net income (loss) attributable to common shareholders	30,082	236,022
Assets	7,145,900		$ 7,160,426
MOBs
Revenues:
Total revenues	103,221	101,151
Expenses:
Property operating expenses	32,177	30,938
Depreciation and amortization	36,101	34,385
General and administrative	0	0
Acquisition and certain other transaction related costs	0	0
Impairment of assets	0
Total expenses	68,278	65,323
(Loss) gain on sale of properties	(122)	0
Dividend income	0	0
Unrealized gains on equity securities	0	0
Interest and other income	0	0
Interest expense	(6,030)	(5,909)
Gain on early extinguishment of debt		0
Income from continuing operations before income tax expense and equity in earnings of an investee	28,791	29,919
Income tax expense	0	0
Equity in earnings of an investee	0	0
Net income (loss)	28,791	29,919
Net income attributable to noncontrolling interest	(1,422)	(1,383)
Net income (loss) attributable to common shareholders	27,369	28,536
Assets	3,325,184		3,344,581
Triple Net Leased Senior Living Communities
Revenues:
Total revenues	50,320	67,975
Expenses:
Property operating expenses	0	0
Depreciation and amortization	19,422	20,195
General and administrative	0	0
Acquisition and certain other transaction related costs	0	0
Impairment of assets	6,206
Total expenses	25,628	20,195
(Loss) gain on sale of properties	0	181,154
Dividend income	0	0
Unrealized gains on equity securities	0	0
Interest and other income	0	0
Interest expense	(238)	(571)
Gain on early extinguishment of debt		0
Income from continuing operations before income tax expense and equity in earnings of an investee	24,454	228,363
Income tax expense	0	0
Equity in earnings of an investee	0	0
Net income (loss)	24,454	228,363
Net income attributable to noncontrolling interest	0	0
Net income (loss) attributable to common shareholders	24,454	228,363
Assets	2,030,946		2,044,939
Managed Senior Living Communities
Revenues:
Total revenues	108,045	102,042
Expenses:
Property operating expenses	85,045	77,160
Depreciation and amortization	15,760	14,811
General and administrative	0	0
Acquisition and certain other transaction related costs	0	0
Impairment of assets	0
Total expenses	100,805	91,971
(Loss) gain on sale of properties	0	0
Dividend income	0	0
Unrealized gains on equity securities	0	0
Interest and other income	0	0
Interest expense	(820)	(1,327)
Gain on early extinguishment of debt		(130)
Income from continuing operations before income tax expense and equity in earnings of an investee	6,420	8,614
Income tax expense	0	0
Equity in earnings of an investee	0	0
Net income (loss)	6,420	8,614
Net income attributable to noncontrolling interest	0	0
Net income (loss) attributable to common shareholders	6,420	8,614
Assets	1,388,949		1,395,657
All Other Operations
Revenues:
Total revenues	4,700	4,602
Expenses:
Property operating expenses	0	0
Depreciation and amortization	947	948
General and administrative	9,816	25,118
Acquisition and certain other transaction related costs	7,814	20
Impairment of assets	0
Total expenses	18,577	26,086
(Loss) gain on sale of properties	0	0
Dividend income	923	659
Unrealized gains on equity securities	22,932	27,241
Interest and other income	114	54
Interest expense	(38,523)	(35,745)
Gain on early extinguishment of debt		0
Income from continuing operations before income tax expense and equity in earnings of an investee	(28,431)	(29,275)
Income tax expense	(134)	(260)
Equity in earnings of an investee	404	44
Net income (loss)	(28,161)	(29,491)
Net income attributable to noncontrolling interest	0	0
Net income (loss) attributable to common shareholders	(28,161)	(29,491)
Assets	400,821		$ 375,249
Rental income
Revenues:
Total revenues	158,241	173,728
Rental income | MOBs
Revenues:
Total revenues	103,221	101,151
Rental income | Triple Net Leased Senior Living Communities
Revenues:
Total revenues	50,320	67,975
Rental income | Managed Senior Living Communities
Revenues:
Total revenues	0	0
Rental income | All Other Operations
Revenues:
Total revenues	4,700	4,602
Residents fees and services
Revenues:
Total revenues	108,045	102,042
Residents fees and services | MOBs
Revenues:
Total revenues	0	0
Residents fees and services | Triple Net Leased Senior Living Communities
Revenues:
Total revenues	0	0
Residents fees and services | Managed Senior Living Communities
Revenues:
Total revenues	108,045	102,042
Residents fees and services | All Other Operations
Revenues:
Total revenues	$ 0	$ 0

Leases and Management Agreeme_3

Leases and Management Agreements with Five Star - Narrative (Details) - Five Star $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)lease_agreementcommunity	Mar. 31, 2018USD ($)community	Dec. 31, 2018USD ($)
Number of communities leased by the Company | community	184	185
Number of leases with related party | lease_agreement	5
Total rental income recognized	$ 39,313	$ 51,759
Related party transaction, annual rents due	538	1,374
Rents receivable	22,000		$ 18,697
Real estate improvements purchased	22,579
Property management agreement expense	$ 3,789	$ 3,494
Rents from significant lessee | Investment
Percentage of rental income	26.50%
Senior Living Communities
Number of communities managed by related party | community	76	72
Rehabilitation Services
Expenses from transactions with related party	$ 1,675	$ 1,699
Rental income | Rents from significant lessee | Investment
Percentage of rental income	14.80%

Leases and Management Agreeme_4

Leases and Management Agreements with Five Star Leases and Management Agreements with Five Star - Schedule of Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Disaggregation of Revenue [Line Items]
Total revenues	$ 266,286	$ 275,770
Basic housing and support services
Disaggregation of Revenue [Line Items]
Total revenues	87,412
Medicare and Medicaid programs
Disaggregation of Revenue [Line Items]
Total revenues	8,745
Private pay and other third party payer SNF services
Disaggregation of Revenue [Line Items]
Total revenues	11,888
Residents fees and services
Disaggregation of Revenue [Line Items]
Total revenues	$ 108,045	$ 102,042

Business and Property Managem_2

Business and Property Management Agreements with RMR LLC (Details)	1 Months Ended	3 Months Ended
	Jan. 31, 2019USD ($)	Mar. 31, 2019USD ($)employeemanagement_agreementproperty	Mar. 31, 2018USD ($)
Related person transactions
Number of employees | employee		0
Related party transaction business management agreement incentive fee paid	$ 40,642,000
Property management and construction supervision fees		$ 3,064,000	$ 2,821,000
Property management and construction supervision fees paid		3,374,000	2,779,000
RMR LLC
Related person transactions
Business management fees incurred		7,719,000	23,323,000
Related party transaction business management fees related to subsidiary level management		725,000	725,000
Related party transaction business management agreement, annual incentive fee estimate included in management fees		$ 0	$ 14,347,000
Senior Living Communities | RMR Inc
Related person transactions
Number of consecutive renewal terms of agreement | management_agreement		2
Number of communities managed by related party | property		1

Related Person Transactions (De

Related Person Transactions (Details) $ in Thousands	Mar. 31, 2019USD ($)agreementshares	Dec. 31, 2018USD ($)
RMR Inc | Class A common shares
Related person transactions
Equity securities investment (in shares)	2,637,408
Number of management agreements | agreement	2
Five Star
Related person transactions
Equity securities investment (in shares)	4,235,000
Investment owned, percentage of total shares outstanding	8.30%
AIC
Related person transactions
Equity method investments | $	$ 9,102	$ 8,632
RMR LLC | Five Star
Related person transactions
Investment owned, percentage of total shares outstanding	35.40%

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Income Tax Disclosure [Abstract]
Income tax expense	$ 134	$ 260

Weighted Average Common Share_2

Weighted Average Common Shares (Details) - shares shares in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Earnings Per Share [Abstract]
Weighted average common shares for basic earnings per share (in shares)	237,568	237,478
Effect of dilutive securities: unvested share awards (in shares)	32	15
Weighted average common shares for diluted earnings per share (in shares)	237,600	237,493

Subsequent Events (Details)

Subsequent Events (Details) - Five Star	Apr. 01, 2019USD ($)	Apr. 30, 2019USD ($)living_unitlease_agreementrenewal_optioncommunity	May 09, 2019USD ($)	Apr. 30, 2019USD ($)living_unitcommunity	Mar. 31, 2019USD ($)	Mar. 31, 2018USD ($)
Subsequent Event [Line Items]
Amounts of transaction					$ 39,313,000	$ 51,759,000
Subsequent Event
Subsequent Event [Line Items]
Percentage of common shares to be issued		34.00%		34.00%
Percent of shares issued and outstanding		51.00%		51.00%
Amounts of transaction		$ 75,000,000
Monthly minimum rent payable			$ 11,000,000	$ 0
Period within conversion time		6 months
Annual incentive fee estimate included in management fees		$ 0.15
Percentage of gross revenues realized at all communities		1.50%		1.50%
Aggregate period of new management fee term		15 years
Number of consecutive renewal terms of agreement | renewal_option		2
Period of new management fee term		5 years
Percentage target EBITDA of new management agreement not earned		90.00%
Period of consecutive calender year of target EBITDA		2 years
Aggregate period of consecutive calender year of target EBITDA		3 years
Percentage of combined revenues in new management agreement		20.00%
Senior Living Communities | Subsequent Event
Subsequent Event [Line Items]
Number of existing master leases | lease_agreement		5
Amounts of transaction	$ 50,000,000
Management fees as percentage of gross revenues		5.00%		5.00%
Oregon | Senior Living Communities | Subsequent Event
Subsequent Event [Line Items]
Number of units | living_unit		318		318
Maximum | Senior Living Communities | Subsequent Event
Subsequent Event [Line Items]
Adjustment amount not to be exceeded	$ 60,000,000
Line of Credit | Senior Living Communities | Subsequent Event
Subsequent Event [Line Items]
Line of credit		$ 25,000,000		$ 25,000,000
Number of real estate properties | community		6		6
Interest rate (as a percent)		6.00%		6.00%