AlerisLife (ALR) 10-Q 3 Nov 21 2021 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2021	Nov. 01, 2021
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2021
Document Transition Report	false
Entity File Number	1-16817
Entity Registrant Name	FIVE STAR SENIOR LIVING INC.
Entity Incorporation, State or Country Code	MD
Entity Tax Identification Number	04-3516029
Entity Address, Address Line One	400 Centre Street
Entity Address, City or Town	Newton
Entity Address, State or Province	MA
Entity Address, Postal Zip Code	02458
City Area Code	617
Local Phone Number	796-8387
Title of 12(b) Security	Common Stock
Trading Symbol	FVE
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		31,750,204
Entity Central Index Key	0001159281
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q3
Amendment Flag	false
Current Fiscal Year End Date	--12-31

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 80,188	$ 84,351
Restricted cash and cash equivalents	23,615	23,877
Accounts receivable, net of allowance of $3,709 and $3,149, respectively	8,647	9,104
Due from related person	33,215	96,357
Debt and equity investments, of which $8,689 and $11,125 are restricted, respectively	19,498	19,961
Prepaid expenses and other current assets	19,990	28,658
Total current assets	185,153	262,308
Property and equipment, net	157,028	159,251
Operating lease right-of-use assets	9,452	18,030
Finance lease right-of-use assets	3,698	4,493
Restricted cash and cash equivalents	1,137	1,369
Restricted debt and equity investments	3,841	4,788
Equity investment of an investee, net	11	11
Other long-term assets	10,119	3,956
Total assets	370,439	454,206
Current liabilities:
Accounts payable	16,440	23,454
Accrued expenses and other current liabilities	32,000	41,843
Accrued compensation and benefits	38,072	70,543
Accrued self-insurance obligations	30,461	31,355
Operating lease liabilities	417	2,567
Finance lease liabilities	856	808
Due to related persons	3,413	6,585
Mortgage note payable	409	388
Security deposits and current portion of continuing care contracts	303	365
Total current liabilities	122,371	177,908
Long-term liabilities:
Accrued self-insurance obligations	36,664	37,420
Operating lease liabilities	9,552	17,104
Finance lease liabilities	3,274	3,921
Mortgage note payable	6,473	6,783
Other long-term liabilities	338	538
Total long-term liabilities	56,301	65,766
Commitments and contingencies
Shareholders’ equity:
Common stock, par value $0.01: 75,000,000 shares authorized, 31,753,484 and 31,679,207 shares issued and outstanding, respectively	318	317
Additional paid-in-capital	460,798	460,038
Accumulated deficit	(270,330)	(251,139)
Accumulated other comprehensive income	981	1,316
Total shareholders’ equity	191,767	210,532
Total liabilities and shareholders' equity	$ 370,439	$ 454,206

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Statement of Financial Position [Abstract]
Accounts receivable, net of allowance	$ 3,709	$ 3,149
Debt and equity investments, restricted	$ 8,689	$ 11,125
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	75,000,000	75,000,000
Common stock, shares issued (in shares)	31,753,484	31,679,207
Common stock, shares outstanding (in shares)	31,753,484	31,679,207

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
REVENUES
Total revenues	$ 225,831,000	$ 295,323,000	$ 753,552,000	$ 877,852,000
Other operating income	0	0	7,795,000	1,499,000
OPERATING EXPENSES
General and administrative	21,817,000	19,774,000	66,956,000	65,051,000
Restructuring expenses	1,220,000	142,000	16,859,000	1,412,000
Depreciation and amortization	2,983,000	2,680,000	8,912,000	8,084,000
Total operating expenses	232,518,000	291,630,000	776,677,000	865,690,000
Operating (loss) income	(6,687,000)	3,693,000	(15,330,000)	13,661,000
Interest, dividend and other income	84,000	104,000	244,000	625,000
Interest and other expense	(507,000)	(379,000)	(1,379,000)	(1,170,000)
Unrealized gain (loss) on equity investments	22,000	435,000	555,000	(160,000)
Realized gain on sale of debt and equity investments	0	327,000	193,000	422,000
Loss on termination of leases	(3,277,000)	0	(3,277,000)	(22,899,000)
Income (loss) before income taxes	(10,365,000)	4,180,000	(18,994,000)	(9,521,000)
(Provision) benefit for income taxes	164,000	(465,000)	(194,000)	(971,000)
Net (loss) income	$ (10,201,000)	$ 3,715,000	$ (19,188,000)	$ (10,492,000)
Weighted average shares outstanding—basic (in shares)	31,618	31,486	31,567	31,465
Weighted average shares outstanding—diluted (in shares)	31,618	31,563	31,567	31,465
Net (loss) income per share—basic (in dollars per share)	$ (0.32)	$ 0.12	$ (0.61)	$ (0.33)
Net (loss) income per share—diluted (in dollars per share)	$ (0.32)	$ 0.12	$ (0.61)	$ (0.33)
Total management and operating revenues
REVENUES
Total revenues	$ 42,922,000	$ 54,951,000	$ 140,140,000	$ 168,946,000
Rehabilitation and wellness services
REVENUES
Total revenues	15,382,000	21,124,000	52,388,000	61,776,000
OPERATING EXPENSES
Cost of revenues	13,536,000	16,716,000	45,414,000	50,361,000
Senior living
REVENUES
Total revenues	16,320,000	18,525,000	49,755,000	59,112,000
Management fees
REVENUES
Total revenues	11,220,000	15,302,000	37,997,000	48,058,000
Reimbursed community-level costs incurred on behalf of managed communities
REVENUES
Total revenues	177,231,000	233,783,000	585,662,000	689,903,000
OPERATING EXPENSES
Cost of revenues	177,231,000	233,783,000	585,662,000	689,903,000
Other reimbursed expenses
REVENUES
Total revenues	5,678,000	6,589,000	27,750,000	19,003,000
Senior living wages and benefits
OPERATING EXPENSES
Cost of revenues	8,547,000	11,128,000	30,456,000	30,633,000
Other senior living operating expenses
OPERATING EXPENSES
Cost of revenues	$ 7,184,000	$ 7,407,000	$ 22,418,000	$ 20,246,000

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Statement of Comprehensive Income [Abstract]
Net (loss) income	$ (10,201)	$ 3,715	$ (19,188)	$ (10,492)
Other comprehensive (loss) income:
Unrealized (loss) gain on debt investments, net of tax of $0	(67)	(20)	(317)	710
Realized gain on debt investments reclassified and included in net (loss) income, net of tax of $0	0	(290)	(18)	(303)
Other comprehensive (loss) income	(67)	(310)	(335)	407
Comprehensive (loss) income	$ (10,268)	$ 3,405	$ (19,523)	$ (10,085)

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Statement of Comprehensive Income [Abstract]
Tax on unrealized gain (loss) on debt investments	$ 0	$ 0	$ 0	$ 0
Tax on realized (gain) loss on debt investments	$ 0	$ 0	$ 0	$ 0

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF SHAREHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Cumulative Effect, Period of Adoption, Adjustment	Common Stock	Additional Paid-in Capital	Accumulated Deficit	Accumulated DeficitCumulative Effect, Period of Adoption, Adjustment	Accumulated Other Comprehensive Income	Accumulated Other Comprehensive IncomeCumulative Effect, Period of Adoption, Adjustment
Beginning balance (in shares) at Dec. 31, 2019			5,154,892
Beginning balance at Dec. 31, 2019	$ 119,981	$ 0	$ 52	$ 362,450	$ (245,184)	$ 1,694	$ 2,663	$ (1,694)
Comprehensive income (loss):
Net (loss) income	(17,209)				(17,209)
Unrealized gain (loss) on debt investments, net of tax	427						427
Realized gain on debt investments reclassified and included in net loss, net of tax	(10)						(10)
Comprehensive (loss) income	(16,792)				(17,209)		417
Issuance of common shares (in shares)			26,387,007
Issuance of common shares	97,340		$ 264	97,076
Grants under share award plan and share based compensation (in shares)			4,000
Grants under share award plan and share-based compensation	81			81
Repurchases and forfeitures under share award plan (in shares)			(3,564)
Repurchases and forfeitures under share award plan	(1)			(1)
Ending balance (in shares) at Mar. 31, 2020			31,542,335
Ending balance at Mar. 31, 2020	200,609		$ 316	459,606	(260,699)		1,386
Beginning balance (in shares) at Dec. 31, 2019			5,154,892
Beginning balance at Dec. 31, 2019	119,981	$ 0	$ 52	362,450	(245,184)	$ 1,694	2,663	$ (1,694)
Comprehensive income (loss):
Net (loss) income	(10,492)
Comprehensive (loss) income	(10,085)
Ending balance (in shares) at Sep. 30, 2020			31,573,289
Ending balance at Sep. 30, 2020	207,561		$ 316	459,851	(253,982)		1,376
Beginning balance (in shares) at Mar. 31, 2020			31,542,335
Beginning balance at Mar. 31, 2020	200,609		$ 316	459,606	(260,699)		1,386
Comprehensive income (loss):
Net (loss) income	3,002				3,002
Unrealized gain (loss) on debt investments, net of tax	303						303
Realized gain on debt investments reclassified and included in net loss, net of tax	(3)						(3)
Comprehensive (loss) income	3,302				3,002		300
Grants under share award plan and share based compensation (in shares)			35,000
Grants under share award plan and share-based compensation	199			199
Repurchases and forfeitures under share award plan (in shares)			(2,836)
Repurchases and forfeitures under share award plan	(4)			(4)
Ending balance (in shares) at Jun. 30, 2020			31,574,499
Ending balance at Jun. 30, 2020	204,106		$ 316	459,801	(257,697)		1,686
Comprehensive income (loss):
Net (loss) income	3,715				3,715
Unrealized gain (loss) on debt investments, net of tax	(20)						(20)
Realized gain on debt investments reclassified and included in net loss, net of tax	(290)						(290)
Comprehensive (loss) income	3,405				3,715		(310)
Grants under share award plan and share-based compensation	53			53
Repurchases and forfeitures under share award plan (in shares)			(1,210)
Repurchases and forfeitures under share award plan	(3)			(3)
Ending balance (in shares) at Sep. 30, 2020			31,573,289
Ending balance at Sep. 30, 2020	$ 207,561		$ 316	459,851	(253,982)		1,376
Beginning balance (in shares) at Dec. 31, 2020	31,679,207		31,679,207
Beginning balance at Dec. 31, 2020	$ 210,532		$ 317	460,038	(251,139)		1,316
Comprehensive income (loss):
Net (loss) income	3,315				3,315
Unrealized gain (loss) on debt investments, net of tax	(294)						(294)
Comprehensive (loss) income	3,021				3,315		(294)
Grants under share award plan and share-based compensation	76			76
Repurchases and forfeitures under share award plan (in shares)			(2,778)
Repurchases and forfeitures under share award plan	(1)			(1)
Ending balance (in shares) at Mar. 31, 2021			31,676,429
Ending balance at Mar. 31, 2021	$ 213,628		$ 317	460,113	(247,824)		1,022
Beginning balance (in shares) at Dec. 31, 2020	31,679,207		31,679,207
Beginning balance at Dec. 31, 2020	$ 210,532		$ 317	460,038	(251,139)		1,316
Comprehensive income (loss):
Net (loss) income	(19,188)
Comprehensive (loss) income	$ (19,523)
Ending balance (in shares) at Sep. 30, 2021	31,753,484		31,753,484
Ending balance at Sep. 30, 2021	$ 191,767		$ 318	460,798	(270,330)		981
Beginning balance (in shares) at Mar. 31, 2021			31,676,429
Beginning balance at Mar. 31, 2021	213,628		$ 317	460,113	(247,824)		1,022
Comprehensive income (loss):
Net (loss) income	(12,302)				(12,302)
Unrealized gain (loss) on debt investments, net of tax	44						44
Realized gain on debt investments reclassified and included in net loss, net of tax	(18)						(18)
Comprehensive (loss) income	(12,276)				(12,302)		26
Grants under share award plan and share based compensation (in shares)			87,500
Grants under share award plan and share-based compensation	638		$ 1	637
Repurchases and forfeitures under share award plan (in shares)			(2,801)
Repurchases and forfeitures under share award plan	(16)			(13)	(3)
Ending balance (in shares) at Jun. 30, 2021			31,761,128
Ending balance at Jun. 30, 2021	201,974		$ 318	460,737	(260,129)		1,048
Comprehensive income (loss):
Net (loss) income	(10,201)				(10,201)
Unrealized gain (loss) on debt investments, net of tax	(67)						(67)
Comprehensive (loss) income	(10,268)				(10,201)		(67)
Grants under share award plan and share-based compensation	76			76
Repurchases and forfeitures under share award plan (in shares)			(7,644)
Repurchases and forfeitures under share award plan	$ (15)			(15)
Ending balance (in shares) at Sep. 30, 2021	31,753,484		31,753,484
Ending balance at Sep. 30, 2021	$ 191,767		$ 318	$ 460,798	$ (270,330)		$ 981

CONDENSED CONSOLIDATED STATEM_5

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
CASH FLOW FROM OPERATING ACTIVITIES:
Net loss	$ (19,188)	$ (10,492)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation and amortization	8,912	8,084
Unrealized (gain) loss on equity investments	(555)	160
Realized gain on sale of debt and equity investments	(193)	(422)
Lease terminations	(408)	22,899
Long-lived asset impairment	890	0
Share-based compensation	761	325
Provision for losses on accounts receivables	1,432	1,315
Other non-cash expense (income) adjustments, net	652	175
Changes in assets and liabilities:
Accounts receivable	(975)	23,120
Due from related person	63,142	(54,249)
Prepaid expenses and other current assets	2,175	(2,393)
Accounts payable	(7,014)	(8,897)
Accrued expenses and other current liabilities	(10,387)	46,126
Accrued compensation and benefits	(32,471)	32,096
Due to related persons	(3,172)	(2,048)
Other current and long term liabilities	(1,801)	6,241
Net cash provided by operating activities	1,800	62,040
CASH FLOW FROM INVESTING ACTIVITIES:
Acquisition of property and equipment	(7,350)	(4,132)
Purchases of debt and equity investments	(231)	(5,688)
Proceeds from sale of property and equipment	0	2,725
Distributions in excess of earnings from Affiliates Insurance Company	0	287
Proceeds from sale of debt and equity investments	2,035	9,078
Net cash (used in) provided by investing activities	(5,546)	2,270
CASH FLOW FROM FINANCING ACTIVITIES:
Costs related to issuance of common stock	0	(559)
Repayments of mortgage notes payable	(308)	(288)
Repayments of finance lease principal	(600)	0
Payment of employee tax obligations on withheld shares	(3)	0
Net cash used in financing activities	(911)	(847)
(Decrease) increase in cash and cash equivalents and restricted cash and cash equivalents	(4,657)	63,463
Cash and cash equivalents and restricted cash and cash equivalents at beginning of period	109,597	56,979
Cash and cash equivalents and restricted cash and cash equivalents at end of period	104,940	120,442
Reconciliation of cash and cash equivalents and restricted cash and cash equivalents:
Cash and cash equivalents	80,188	95,779
Current restricted cash and cash equivalents	23,615	23,842
Other restricted cash and cash equivalents	1,137	821
Cash and cash equivalents and restricted cash and cash equivalents at end of period	104,940	120,442
Supplemental cash flow information:
Interest paid	597	363
Income taxes paid, net	436	40
Operating lease payments, including lease termination payment	6,388	2,620
Financing lease interest payments	255	0
Non-cash investing and financing activities:
Liabilities assumed related to issuance of our common stock	0	51,547
Real estate improvements in accrued, not paid	558	2,554
Right-of-use assets obtained in exchange for finance lease liabilities	0	4,515
Right-of-use assets obtained in exchange for operating lease liabilities	$ 9,746	$ 0

Basis of Presentation and Organ

Basis of Presentation and Organization	9 Months Ended
	Sep. 30, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation and Organization	Basis of Presentation and Organization General. The accompanying condensed consolidated financial statements of Five Star Senior Living Inc. and its subsidiaries are unaudited. Certain information and disclosures required by the rules and regulations of the Securities and Exchange Commission, or SEC, and U.S. generally accepted accounting principles, or GAAP, for complete financial statements have been condensed or omitted pursuant to SEC rules and regulations related to interim financial statements. We believe the disclosures made are adequate to make the information presented not misleading. As of September 30, 2021, we managed or operated 179 senior living communities (primarily independent and assisted living communities) located in 29 states with 22,768 living units, which include four continuing care retirement communities, or CCRCs, with 625 living units which will be transitioned to new operators. As of September 30, 2021, we managed 159 of these senior living communities (20,669 living units) and we owned and operated 20 of these senior living communities (2,099 living units). Our 179 senior living communities, as of September 30, 2021, included 10,628 independent living apartments, 11,856 assisted living suites (which includes 2,454 of our Bridge to Rediscovery memory care units) and 284 skilled nursing facilities, or SNF, units. During the three months ended September 30, 2021 we transitioned the management of 69 senior living communities with approximately 4,800 living units to new operators pursuant to our April 9, 2021 Strategic Plan described below. No units were transitioned prior to June 30, 2021. On September 30, 2021, we terminated our lease on all four communities (with approximately 200 living units) previously leased from Healthpeak Properties Inc., or PEAK. The foregoing numbers exclude living units categorized as out of service. Our rehabilitation and wellness services segment, which is primarily comprised of Five Star Rehabilitation and Wellness Services doing business as Ageility Physical Therapy Solutions, or Ageility, provides a comprehensive suite of rehabilitation, personal fitness, and wellness services at our senior living communities as well as at unaffiliated senior living communities. As of September 30, 2021, we operated ten inpatient rehabilitation and wellness services clinics in senior living communities owned by Diversified Healthcare Trust, or DHC, of which two of the communities are managed by us and eight of the communities were transitioned to new operators during the three months ended September 30, 2021. As of September 30, 2021, we operated 223 outpatient rehabilitation and wellness services clinics, of which 122 were located at our managed and owned senior living communities and 101 were located within senior living communities not owned by us or managed on behalf of DHC. Strategic Plan . On April 9, 2021, we announced a new strategic plan, or the Strategic Plan, including to: • Reposition our senior living management service offering to focus on larger independent living and assisted living as well as active adult communities and exit skilled nursing by transitioning 108 communities to new operators and closing approximately 1,500 SNF living units in retained CCRCs; • Evolve through investment in an enhanced scalable corporate shared services center to support operations to deliver differentiated, customer focused resident experiences across segmented senior living service offerings, as well as through home health and concierge offerings. We are expanding our Ageility service line by introducing innovative fitness and personal training offerings to complement outpatient therapy, and home health services, including strength training, orthopedic rehabilitation, fall prevention, cognitive or memory enhancement, aquatic therapy, and general personal fitness and wellness programs; and • Diversify with a focus on revenue diversification opportunities, including growing Ageility rehabilitation services and expanding ancillary services to provide choice based, financially flexible resident experience and reach customers outside of our senior living communities. During the nine months ended September 30, 2021, we made the following progress with respect to the Reposition phase of the Strategic Plan: • We and DHC amended our management arrangements on June 9, 2021; see Note 11 for additional information on the amendments to the management arrangements with DHC, • Transitioned the management of 69 senior living communities with approximately 4,800 living units to new operators, all of which occurred during the three months ended September 30, 2021, • DHC has entered into agreements for us to transition the management of an additional 35 senior living communities, with approximately 2,100 living units, to new operators in the fourth quarter of 2021, • Plan to close one community with approximately 100 living units, • Closed all 1,532 SNF living units in 27 managed CCRCs, and began collaborating with DHC to reposition these SNF units, • Closed 27 of the 37 Ageility inpatient rehabilitation clinics we planned to close, and • For six Ageility inpatient rehabilitation clinics, we entered into agreements with the new operators to continue to operate those clinics for 12 months. During the nine months ended September 30, 2021, we made the following progress with respect to the Evolve phase of the Strategic Plan: • Implemented enhancements to our corporate technology infrastructure, • Invested in critical areas of residential experience, including community wireless connectivity, resident transportation services, re-designed community common areas and resident units, • Made enhancements to digital marketing infrastructure and implemented a labor management tool, and • Standardized certain administrative functions through centralization efforts to enhance operating efficiency. During the nine months ended September 30, 2021, we made the following progress with respect to the Diversify phase of the Strategic Plan: • Opened 16 net new Ageility outpatient rehabilitation clinics, bringing our Ageility outpatient rehabilitation clinic total to 223, and • Grew Ageility fitness revenues to $2,413 or a 41.1% increase over the same period in 2020. In connection with the repositioning of our senior living management services, we expect to incur restructuring expenses of up to $19,000, approximately $13,000 of which we expect DHC will reimburse. These expenses are expected to include up to $7,500 of retention bonus payments, up to $8,700 of severance, benefits and transition expenses, and up to $2,800 of transaction expenses, of which we expect DHC to reimburse approximately $5,100, $7,200 and $700, respectively. For the three and nine months ended September 30, 2021, respectively, we recognized restructuring expenses of $1,220 and $16,859 related to the Strategic Plan which was partially offset by $813 and $12,344 of other reimbursed expenses related to the amounts to be reimbursed by DHC, respectively, for the three and nine months ended September 30, 2021. See Note 16 for summary of restructuring expenses and the corresponding liability. See Notes 11, 16 and 17 for more information on the Strategic Plan, the amendments to our management arrangements and our business arrangements with DHC. See Note 17 for summary of further progress made on the repositioning of our senior living management services during October 2021. Reclassifications . 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 (loss) or shareholders’ equity. The accompanying financial statements should be read in conjunction with the financial statements and notes contained in our Annual Report on Form 10-K for the year ended December 31, 2020, or our Annual Report. In the opinion of our management, all adjustments, which include only normal recurring adjustments considered necessary for a fair presentation, have been included. All intercompany transactions and balances with or among our consolidated subsidiaries have been eliminated. Our operating results for interim periods are not necessarily indicative of the results that may be expected for the full year.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2021
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies Estimates and Assumptions. The preparation of these condensed consolidated financial statements in conformity with GAAP requires us to make estimates and assumptions that may affect the amounts reported in these condensed consolidated financial statements and related notes. Significant estimates in our condensed consolidated financial statements relate to revenue recognition, including contractual allowances, the allowance for doubtful accounts, self-insurance reserves and estimates concerning our provision for income taxes or valuation allowance related to deferred tax assets. Our actual results could differ from our estimates. We periodically review estimates and assumptions, and we reflect the effects of changes, if any, in the condensed consolidated financial statements in the period that they are determined. There have been no changes to our significant accounting policies disclosed in our Annual Report, except for the additional disclosure noted below. See summary of significant accounting policies in our Annual Report. Accounting for Costs Associated with Exit or Disposal Activities. A liability for costs associated with exit or disposal activities other than in a business combination, is recognized when the liability is incurred. The liability, recognized under Accounting Standards Codification, or ASC, 420, Exit or Disposal Cost Obligations and ASC 712, Compensation — Nonretirement Postemployment - special termination benefits , is measured at fair value, with adjustments for changes in estimated cash flows recognized in earnings. During the three and nine months ended September 30, 2021, costs were incurred related to the Strategic Plan. See Note 16 for summary of restructuring expenses and the corresponding liability. Recently Issued Accounting Pronouncements Not Yet Adopted. In June 2016, the Financial Accounting Standards Board, or FASB, issued Accounting Standards Update, or ASU, No. 2016-13, Financial Instruments-Credit Losses (Topic 326) , which requires a financial asset or a group of financial assets measured at amortized cost basis to be presented at the net amount expected to be collected. This ASU eliminates the probable initial recognition threshold and instead requires reflection of an entity’s current estimate of all expected credit losses. In addition, this ASU amends the current other-than-temporary impairment model for available for sale debt securities. The length of time that the fair value of an available for sale debt security has been below the amortized cost will no longer impact the determination of whether a credit loss exists and credit losses will now be limited to the difference between a security’s amortized cost basis and its fair value. In November 2018, the FASB issued ASU No. 2018-19, Codification Improvements to Topic 326, Financial Instruments-Credit Losses , which amends the transition and effective date for nonpublic entities and smaller reporting companies, such as us, and clarifies that receivables arising from operating leases are not in the scope of this ASU. In November 2019, the FASB issued ASU No. 2019-11, Codification Improvements to Topic 326 , Financial Instruments-Credit Losses , which clarifies guidance around how to report expected recoveries. Entities will apply the provisions of the ASU as a cumulative-effect adjustment to retained earnings as of the beginning of the first reporting period in which the guidance is effective. This ASU is effective for smaller reporting companies for reporting periods beginning after December 15, 2022. We are assessing the potential impact that the adoption of this ASU (and the related clarifying guidance issued by the FASB) will have on our condensed consolidated financial statements. In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting , which provides temporary optional expedients and exceptions on contract modifications meeting certain criteria to ease the financial reporting burdens of the expected market transition from the London Inter-bank Offered Rate, or LIBOR, and other interbank offered rates to the alternative reference rates. For a contract that meets the criteria, this ASU generally allows an entity to account for and present modifications as an event that does not require remeasurement at the modification date or reassessment of a previous accounting determination. This ASU was effective upon issuance and can be applied through December 31, 2022. We expect this ASU will not have a material impact on our condensed consolidated financial statements.

Revenue and Other Operating Inc

Revenue and Other Operating Income	9 Months Ended
	Sep. 30, 2021
Revenue from Contract with Customer [Abstract]
Revenue and Other Operating Income	Revenue and Other Operating Income The following tables present revenue from contracts by segment with customers disaggregated by type of payer, as we believe it best depicts how the nature, amount, timing and uncertainty of our revenue and cash flows are affected by economic factors: Three Months Ended September 30, 2021 Senior Living Rehabilitation and Wellness Services (3) Total Private payer $ 16,032 $ 293 $ 16,325 Medicare and Medicaid programs 288 10,073 10,361 Other third-party payer programs — 5,016 5,016 Management fees 11,220 (1) (2) — 11,220 Reimbursed community-level costs incurred on behalf of managed communities 177,231 (1) (2) — 177,231 Other reimbursed expenses 5,678 (1) (4) — 5,678 Total revenues $ 210,449 $ 15,382 $ 225,831 _______________________________________ (1) Represents separate revenue sources earned from DHC; see Note 4 for discussion of Segment Information. (2) (i) We intend to transition 108 senior living communities managed on behalf of DHC, with approximately 7,500 living units to new operators in 2021; of which 69 senior living communities with approximately 4,800 living units were transitioned to new operators during the three months ended September 30, 2021 and (ii) we closed 59 SNF units in one CCRC during the three months ended September 30, 2021 and closed an additional 1,473 SNF units in 26 CCRCs during the three months ended June 30, 2021 and are in the process of repositioning these units that we will continue to manage for DHC. The management fees we recognized related to these communities and units for the three months ended September 30, 2021 were $2,710. See Notes 1, 11, 16 and 17 for more information. (3) We expect to close an additional ten Ageility inpatient rehabilitation clinics. Revenue related to these clinics for the three months ended September 30, 2021 was $1,508. See Notes 1, 16 and 17 for more information. (4) Includes $813 of restructuring expenses to be reimbursed by DHC for the three months ended September 30, 2021. Three Months Ended September 30, 2020 Senior Living Rehabilitation and Wellness Services Total Private payer $ 18,347 $ 1,296 $ 19,643 Medicare and Medicaid programs 178 10,747 10,925 Other third-party payer programs — 9,081 9,081 Management fees 15,302 (1) — 15,302 Reimbursed community-level costs incurred on behalf of managed communities 233,783 (1) — 233,783 Other reimbursed expenses 6,589 (1) — 6,589 Total revenues $ 274,199 $ 21,124 $ 295,323 _______________________________________ (1) Represents separate revenue sources earned from DHC. Nine Months Ended September 30, 2021 Senior Living Rehabilitation and Wellness Services (3) Total Private payer $ 48,935 $ 805 $ 49,740 Medicare and Medicaid programs 820 31,433 32,253 Other third-party payer programs — 20,150 20,150 Management fees 37,997 (1) (2) — 37,997 Reimbursed community-level costs incurred on behalf of managed communities 585,662 (1) (2) — 585,662 Other reimbursed expenses 27,750 (1) (4) — 27,750 Total revenues $ 701,164 $ 52,388 $ 753,552 _______________________________________ (1) Represents separate revenue sources earned from DHC; see Note 4 for discussion of Segment Information. (2) (i) We intend to transition 108 senior living communities managed on behalf of DHC, with approximately 7,500 living units to new operators in 2021; of which 69 senior living communities with approximately 4,800 living units were transitioned to new operators during the three months ended September 30, 2021 and (ii) we closed 1,532 SNF units in 27 CCRCs during the nine months ended September 30, 2021 and are in the process of repositioning these units that we will continue to manage for DHC. The management fees we recognized related to these communities and units for the nine months ended September 30, 2021 were $12,329. See Notes 1, 11, 16 and 17 for more information. (3) 27 Ageility inpatient rehabilitation clinics were closed during the nine months ended September 30, 2021 and we expect to close an additional ten Ageility inpatient rehabilitation clinics. Revenue related to these clinics for the nine months ended September 30, 2021 was $9,579. See Notes 1, 16 and 17 for more information. (4) Includes $12,344 of restructuring expenses to be reimbursed by DHC for the nine months ended September 30, 2021. Nine Months Ended September 30, 2020 Senior Living Rehabilitation and Wellness Services Total Private payer $ 57,921 $ 3,407 $ 61,328 Medicare and Medicaid programs 1,191 29,881 31,072 Other third-party payer programs — 28,488 28,488 Management fees 48,058 (1) — 48,058 Reimbursed community-level costs incurred on behalf of managed communities 689,903 (1) — 689,903 Other reimbursed expenses 19,003 (1) — 19,003 Total revenues $ 816,076 $ 61,776 $ 877,852 _______________________________________ (1) Represents separate revenue sources earned from DHC. Other operating income. On March 27, 2020, the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, was signed into law. Under the CARES Act, the U.S. Department of Health and Human Services, or HHS, established the Provider Relief Fund. The Provider Relief Fund was further supplemented on December 27, 2020 by the Consolidated Appropriations Act, 2021. Retention and use of the funds received under the CARES Act are subject to certain terms and conditions, including certain reporting requirements. Other operating income includes income recognized for funds we have received pursuant to the Provider Relief Fund of the CARES Act for which we have determined that we were in compliance with the terms and conditions of the Provider Relief Fund of the CARES Act. We recognize other operating income in our condensed consolidated statements of operations to the extent we estimate we have COVID-19 incurred losses or related costs for which provisions of the CARES Act is intended to compensate. The amount of income we recognize for these estimated losses and costs is limited to the amount of funds we received during the period in which the estimated losses and costs were recognized or incurred or, if funds were received subsequently, the period in which the funds were received. We recognized other operating income of $7,795 and $1,499 for the nine months ended September 30, 2021 and 2020, respectively, and none in the three months ended September 30, 2021 and 2020. See Note 15 for more information.

Segment Information

Segment Information	9 Months Ended
	Sep. 30, 2021
Segment Reporting [Abstract]
Segment Information	Segment Information We do not allocate assets to operating segments and, therefore, no asset information is provided for reportable segments. Certain of our general and administrative expenses incurred at our corporate office are deemed centralized services and allocated amongst operating segments. Centralized services are largely determined by job function and allocated by percentage of total revenue. Results of operations and selected financial information by reportable segment and the reconciliation to the condensed consolidated financial statements are as follows: Three Months Ended September 30, 2021 Senior Living (1) Rehabilitation and Wellness Services (2) Corporate and Other (3) Total Revenues $ 210,449 $ 15,382 $ — $ 225,831 Operating expenses 200,570 13,349 18,599 232,518 Operating income (loss) 9,879 2,033 (18,599) (6,687) Allocated corporate and other costs (10,388) (770) 11,158 — Other (loss) income, net (3,202) — (476) (3,678) (Loss) income before income taxes (3,711) 1,263 (7,917) (10,365) Benefit for income taxes — — 164 164 Net (loss) income $ (3,711) $ 1,263 $ (7,753) $ (10,201) _______________________________________ (1) (i) We intend to transition 108 senior living communities managed on behalf of DHC, with approximately 7,500 living units to new operators in 2021; of which 69 senior living communities with approximately 4,800 living units were transitioned to new operators during the three months ended September 30, 2021 and (ii) we closed 59 SNF units in one CCRC during the three months ended September 30, 2021 and closed an additional 1,473 SNF units in 26 CCRCs during the three months ended June 30, 2021 and are in the process of repositioning these units that we will continue to manage for DHC. See Notes 1, 11, 16 and 17 for more information. As more fully described in Note 16, the senior living segment recognized $813 of restructuring expenses related to the Strategic Plan and $813 of other reimbursed expenses in the three months ended September 30, 2021. (2) We expect to close an additional ten Ageility inpatient rehabilitation clinics. See Notes 1, 16 and 17 for more information. As more fully described in Note 16, the rehabilitation and wellness services segment recognized $(310) of restructuring expenses related to the Strategic Plan in the three months ended September 30, 2021. (3) As more fully described in Note 16, Corporate and Other recognized $717 of restructuring expenses related to the Strategic Plan in the three months ended September 30, 2021. Three Months Ended September 30, 2020 Senior Living Rehabilitation and Wellness Services Corporate and Other Total Revenues $ 274,199 $ 21,124 $ — $ 295,323 Other operating income — — — — Operating expenses 260,077 16,833 14,720 291,630 Operating income (loss) 14,122 4,291 (14,720) 3,693 Allocated corporate and other costs (13,657) (1,052) 14,709 — Other income (loss), net (122) — 609 487 Income before income taxes 343 3,239 598 4,180 Provision for income taxes — — (465) (465) Net income $ 343 $ 3,239 $ 133 $ 3,715 Nine Months Ended September 30, 2021 Senior Living (1) Rehabilitation and Wellness Services (2) Corporate and Other (3) Total Revenues $ 701,164 $ 52,388 $ — $ 753,552 Other operating income 7,776 19 — 7,795 Operating expenses 671,991 47,204 57,482 776,677 Operating income (loss) 36,949 5,203 (57,482) (15,330) Allocated corporate and other costs (34,811) (2,621) 37,432 — Other (loss) income, net (2,557) — (1,107) (3,664) (Loss) income before income taxes (419) 2,582 (21,157) (18,994) Provision for income taxes — — (194) (194) Net (loss) income $ (419) $ 2,582 $ (21,351) $ (19,188) _______________________________________ (1) (i) We intend to transition 108 senior living communities managed on behalf of DHC, with approximately 7,500 living units to new operators in 2021; of which 69 senior living communities with approximately 4,800 living units were transitioned to new operators during the three months ended September 30, 2021 and (ii) we closed 1,532 SNF units in 27 CCRCs during the nine months ended September 30, 2021 and are in the process of repositioning these units that we will continue to manage for DHC. See Notes 1, 11, 16 and 17 for more information. As more fully described in Note 16, the senior living segment recognized $12,344 of restructuring expenses related to the Strategic Plan and $12,344 of other reimbursed expenses in the nine months ended September 30, 2021. (2) 27 Ageility inpatient rehabilitation clinics were closed during the nine months ended September 30, 2021 and we expect to close an additional ten Ageility inpatient rehabilitation clinics. See Notes 1, 16 and 17 for more information. As more fully described in Note 16, the rehabilitation and wellness services segment recognized $1,410 of restructuring expenses related to the Strategic Plan in the nine months ended September 30, 2021. (3) As more fully described in Note 16, Corporate and Other recognized $3,105 of restructuring expenses related to the Strategic Plan in the nine months ended September 30, 2021. Nine Months Ended September 30, 2020 Senior Living Rehabilitation and Wellness Services Corporate and Other Total Revenues $ 816,076 $ 61,776 $ — $ 877,852 Other operating income — 1,499 — 1,499 Operating expenses 766,415 50,708 48,567 865,690 Operating income (loss) 49,661 12,567 (48,567) 13,661 Allocated corporate and other costs (43,448) (3,094) 46,542 — Other income (loss), net (163) — (23,019) (23,182) (Loss) income before income taxes 6,050 9,473 (25,044) (9,521) Provision for income taxes — — (971) (971) Net (loss) income $ 6,050 $ 9,473 $ (26,015) $ (10,492)

Property and Equipment, net

Property and Equipment, net	9 Months Ended
	Sep. 30, 2021
Property, Plant and Equipment [Abstract]
Property and Equipment, net	Property and Equipment, net Property and equipment, net consist of the following: September 30, 2021 December 31, 2020 Land $ 12,155 $ 12,155 Buildings, construction in process and improvements 202,897 202,679 Furniture, fixtures and equipment 61,551 60,713 Property and equipment, at cost 276,603 275,547 Less: accumulated depreciation (119,575) (116,296) Property and equipment, net $ 157,028 $ 159,251 On September 30, 2021, we terminated our lease on the four communities that we leased from PEAK. Under the terms of the termination agreements, we recorded a loss on lease termination of $3,277. Included in the calculation of the loss on lease termination was the derecognition of $1,173 of all property and equipment at the four previously leased communities. The loss was the aggregate of the lease termination fee of $3,100, other obligations of $548, legal transaction costs of $37, and the net derecogniton carrying amounts of our right of use asset of $16,055, leasehold improvements and other fixed assets of $1,173, and the remaining lease obligations of $17,636. See Note 11 for further information on our determination of the loss on termination of the four leased communities. On April 4, 2021, one of the four previously leased communities had a fire that caused extensive damage to the community. As a result, we recorded an impairment on certain furniture, fixtures and equipment and building improvements for the nine months ended September 30, 2021 of $890, which is recorded in other senior living expenses in the statement of operations. Insurance proceeds received for property damages to the previously leased community caused by the fire of $1,500 were subsequently transferred to PEAK. We recorded depreciation expense relating to our property and equipment of $2,692 and $2,680 for the three months ended September 30, 2021 and 2020, respectively, and $8,082 and $8,084 for the nine months ended September 30, 2021 and 2020, respectively. In relation to the communities previously leased from PEAK, the disposal of fixed assets resulted in a decrease in accumulated depreciation of $4,803.

Accumulated Other Comprehensive

Accumulated Other Comprehensive Income	9 Months Ended
	Sep. 30, 2021
Equity [Abstract]
Accumulated Other Comprehensive Income	Accumulated Other Comprehensive Income The following tables detail the changes in accumulated other comprehensive income (loss), net of tax, for the nine months ended September 30, 2021 and 2020: Nine Months Ended September 30, 2021 Equity Investments Accumulated Balance at January 1, 2021 $ (175) $ 1,491 $ 1,316 Unrealized loss on debt investments, net of tax — (317) (317) Realized gain on debt investments reclassified and included in net loss, net of tax — (18) (18) Balance at September 30, 2021 $ (175) $ 1,156 $ 981 Nine Months Ended September 30, 2020 Equity Investments Accumulated Balance at January 1, 2020 $ (175) $ 2,838 $ 2,663 Cumulative effect adjustment to beginning accumulated deficit and accumulated other comprehensive income in connection with a reclassification of equity investments previously classified as debt investments — (1,694) (1,694) Unrealized gain on debt investments, net of tax — 710 710 Realized gain on debt investments reclassified and included in net income, net of tax — (303) (303) Balance at September 30, 2020 $ (175) $ 1,551 $ 1,376 Accumulated other comprehensive income represents the unrealized gains and losses of our debt investments, net of tax, and our share of other comprehensive income (loss) relating to our former investment in Affiliates Insurance Company which dissolved on February 13, 2020. The cost of debt investments sold and for which realized gains and losses are reclassified and included in net income are determined on a specific identification basis.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2021
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes We recognized a benefit for income taxes of $164 and provision for income taxes of $194 for the three and nine months ended September 30, 2021, respectively. We recognized a provision for income taxes of $465 and $971 for the three and nine months ended September 30, 2020, respectively. The benefit for income taxes for the three months ended September 30, 2021 and the provision for income taxes for the nine months ended September 30, 2021 are related to state income taxes. The provision for income taxes for the three months ended September 30, 2020 is related to state income taxes. The provision for income taxes for the nine months ended September 30, 2020 is related to federal income taxes, partially offset by a federal alternative minimum tax, or AMT, credit refund benefit and a federal benefit related to lease termination expense, plus state income taxes, including state valuation allowance. See Note 15 for more information regarding the impact of certain provisions of the CARES Act relating to income and other taxes. We previously determined it was more likely than not that a majority of our net deferred tax assets would not be realized and concluded that a valuation allowance was required, which eliminated the majority of our net deferred tax assets recorded in our condensed consolidated balance sheets. In the future, if we believe that we will more likely than not realize the benefit of these deferred tax assets, we will adjust our valuation allowance and recognize an income tax benefit, which may affect our results of operations.

Net (Loss) Income Per Share

Net (Loss) Income Per Share	9 Months Ended
	Sep. 30, 2021
Earnings Per Share [Abstract]
Net (Loss) Income Per Share	Net (Loss) Income Per Share Basic net (loss) income per share is calculated by dividing net (loss) income by the weighted average number of outstanding common shares outstanding during the period. When applicable, net (loss) income per share—diluted reflects the more dilutive earnings per share using the weighted average number of our common shares calculated using the two-class method, or the treasury stock method. The following table provides a reconciliation of the weighted average number of common shares used in the calculation of basic and diluted net (loss) income per share (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 Weighted average shares outstanding—basic 31,618 31,486 31,567 31,465 Effect of dilutive securities: unvested share awards — 77 — — Weighted average shares outstanding—diluted (1) 31,618 31,563 31,567 31,465 _______________________________________ (1) For the three months ended September 30, 2021, 157 of our unvested common shares were not included in the calculation of net loss per share—diluted because to do so would have been anti-dilutive. For the nine months ended September 30, 2021 and 2020, 146 and 108, respectively, of our unvested common shares were not included in the calculation of the net loss per share—diluted because to do so would have been antidilutive.

Fair Values of Assets and Liabi

Fair Values of Assets and Liabilities	9 Months Ended
	Sep. 30, 2021
Fair Value Disclosures [Abstract]
Fair Values of Assets and Liabilities	Fair Values of Assets and Liabilities Recurring Fair Value Measures The tables below present certain of our assets measured at fair value at September 30, 2021 and December 31, 2020, categorized by the level of input used in the valuation of each asset. As of September 30, 2021 Description Total Quoted Prices in Significant Significant Cash equivalents (1) $ 26,378 $ 26,378 $ — $ — Investments: Total equity investments (2) 12,858 6,800 6,058 — Total debt investments (3) 10,481 5,789 4,692 — Total investments 23,339 12,589 10,750 — Total $ 49,717 $ 38,967 $ 10,750 $ — As of December 31, 2020 Description Total Quoted Prices in Significant Significant Cash equivalents (1) $ 26,291 $ 26,291 $ — $ — Investments: Total equity investments (2) 12,439 6,465 5,974 — Total debt investments (3) 12,310 7,301 5,009 — Total investments 24,749 13,766 10,983 — Total $ 51,040 $ 40,057 $ 10,983 $ — _______________________________________ (1) Cash equivalents consist of short-term, highly liquid investments and money market funds held primarily for obligations arising from our self-insurance programs. Cash equivalents are reported in our condensed consolidated balance sheets as cash and cash equivalents and current and long-term restricted cash and cash equivalents. Cash equivalents include $22,278 and $22,837 of balances that were restricted at September 30, 2021 and December 31, 2020, respectively. In addition to the cash equivalents of $26,378 and $26,291 at September 30, 2021 and December 31, 2020, respectively, reflected above, there were cash balances of $76,088 and $80,897 and restricted cash balances of $2,474 and $2,409 at September 30, 2021 and December 31, 2020, respectively. (2) The fair value of our equity investments is readily determinable. During the nine months ended September 30, 2021 and 2020, we received gross proceeds of $741 and $3,141, respectively, in connection with the sales of equity investments and recorded gross realized gains totaling $175 and $339, respectively, and gross realized losses totaling $0 and $219, respectively. (3) As of September 30, 2021, our debt investments, which are classified as available for sale, had a fair value of $10,481 with an amortized cost of $10,060; the difference between the fair value and amortized cost amounts resulted from unrealized gains of $421, net of unrealized losses of $23. As of December 31, 2020, our debt investments had a fair value of $12,310 with an amortized cost of $11,554; the difference between the fair value and amortized cost amounts resulted from unrealized gains of $756, net of unrealized losses of $4. Debt investments include $6,874 and $8,395 of balances that were restricted as of September 30, 2021 and December 31, 2020, respectively. At September 30, 2021, four debt investments we held, with a fair value of $788, had been in a loss position for less than 12 months and we did not hold any debt investments with a fair value in a loss position for greater than 12 months. We do not believe these investments are impaired primarily because they have not been in a loss position for an extended period of time, the financial conditions of the issuers of these investments remain strong with solid fundamentals as of September 30, 2021, we do not intend to sell the investments and it is not more likely than not that we will be required to sell the investments before recovery, and other factors that support our conclusion that the loss is temporary. During the nine months ended September 30, 2021 and 2020, we received gross proceeds of $1,294 and $5,938, respectively, in connection with the sales of debt investments and recorded gross realized gains totaling $18 and $302, respectively. There were no gross realized losses for the nine months ended September 30, 2021 and 2020, respectively. We record gains and losses on the sales of these investments using the specific identification method. The amortized cost basis and fair value of available for sale debt securities at September 30, 2021, by contractual maturity, are shown below. Amortized Cost Fair Value Due in one year or less $ 2,142 $ 2,173 Due after one year through five years 4,019 4,219 Due after five years through ten years 3,899 4,089 Total $ 10,060 $ 10,481 Our financial assets (which include cash equivalents and investments) have been valued at the transaction price and subsequently valued, at the end of each reporting period, utilizing third-party pricing services or other market observable data. During the nine months ended September 30, 2021, we did not change the type of inputs used to determine the fair value of any of our assets and liabilities that we measure at fair value. The carrying value of accounts receivable and accounts payable approximates fair value as of September 30, 2021 and December 31, 2020. The carrying value and fair value of our mortgage notes payable were $6,882 and $7,772, respectively, as of September 30, 2021 and $7,171 and $8,177, respectively, as of December 31, 2020, and are categorized in Level 3 of the fair value hierarchy. We estimate the fair value of our mortgage note payable by using discounted cash flow analyses and currently prevailing market terms as of the measurement date. Non-Recurring Fair Value Measures We review the carrying value of our long-lived assets, including our right-of-use assets, property and equipment and other intangible assets, for impairment whenever events or changes in circumstances indicate that the carrying value of an asset or asset group may not be recoverable. On April 4, 2021, one of the four previously leased communities had a fire that caused extensive damage to the community. As a result, we deemed the recorded furniture, fixtures and equipment and building improvements at the community had no net recoverable value. We recorded an impairment equal to their carrying value in the nine months ended September 30, 2021 of $890, which is recorded in other senior living expenses in the statement of operations.

Indebtedness

Indebtedness	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
Indebtedness	Indebtedness Our $65,000 secured revolving credit facility, or Credit Facility, is governed by a credit agreement with a syndicate of lenders. The maturity date of our Credit Facility is June 12, 2022. Our Credit Facility is available for general business purposes, including acquisitions, and provides for the issuance of letters of credit. We are required to pay interest at a rate of LIBOR plus a premium of 250 basis points per annum, or at a base rate, as defined in our Credit Agreement, plus 150 basis points per annum, on borrowings under our Credit Facility; the effective annual interest rate options, as of September 30, 2021, were 2.58% and 4.75%, respectively. We are also required to pay a quarterly commitment fee of 0.35% per annum on the unused portion of the available capacity under our Credit Facility. As of September 30, 2021 and 2020, we had no borrowings outstanding under our Credit Facility. As of September 30, 2021, we had letters of credit issued under the Credit Facility in an aggregate amount of $792 and we had $26,513 available for borrowings under our Credit Facility. We incurred aggregate interest expense related to our Credit Facility of $108 and $253 for the three months ended September 30, 2021 and 2020, respectively, and $566 and $792 for the nine months ended September 30, 2021 and 2020, respectively. Our Credit Facility is secured by 11 senior living communities we own with a combined 1,236 living units owned by certain of our subsidiaries that guarantee our obligations under our Credit Facility. Our Credit Facility is also secured by these senior living communities' accounts receivable and related collateral. The amount of available borrowings under our Credit Facility is subject to our having sufficient qualified collateral, which is primarily based on the value and operating performance of the communities securing our obligations under our Credit Facility. Our Credit Facility provides for the acceleration of payment of all amounts outstanding under our Credit Facility upon the occurrence and continuation of certain events of default, including a change of control of us, as defined in our Credit Agreement. Our Credit Agreement contains financial and other covenants, including those that restrict our ability to pay dividends or make other distributions to our shareholders in certain circumstances. At September 30, 2021, we had six irrevocable standby letters of credit outstanding, totaling $27,642. One of these letters of credit in the amount of $26,850, which secures our workers' compensation insurance program, is collateralized by approximately $21,481 of cash equivalents and $5,656 of debt and equity investments. This letter of credit expires in June 2022 and is automatically extended for one-year terms unless notice of nonrenewal is provided prior to the end of the applicable term. At September 30, 2021, the cash equivalents collateralizing this letter of credit are classified as short-term restricted cash and cash equivalents in our condensed consolidated balance sheets, and the debt and equity investments collateralizing this letter of credit are classified as short-term restricted debt and equity investments in our condensed consolidated balance sheets. The remaining five irrevocable standby letters of credit outstanding at September 30, 2021, totaling $792, which are issued under the Credit Facility, secure certain of our other obligations. The termination of leases on our four leased communities resulted in our outstanding letters of credit being reduced by $728 in October 2021. The remaining letter of credit is scheduled to mature in June 2022 and is required to be renewed annually. At September 30, 2021, one of our senior living communities was encumbered by a mortgage note. This mortgage note contains standard mortgage covenants. We recorded a discount in connection with the assumption of this mortgage note as part of our acquisition of the senior living community secured by this mortgage in order to record this mortgage note at its then estimated fair value. We amortize this discount as an increase in interest expense until the maturity of this mortgage note. This mortgage note requires payments of principal and interest monthly until maturity. The following table is a summary of this mortgage note as of September 30, 2021: Balance as of Contractual Stated Effective Maturity Date Monthly Lender $ 7,092 (1) 6.20 % 6.70 % September 2032 $ 72 Federal Home Loan Mortgage Corporation _______________________________________ (1) Contractual principal payments excluding unamortized discount $210. We incurred interest expense, net of discount amortization, of $119 and $125 with respect to the mortgage note for the three months ended September 30, 2021 and 2020, respectively, and $359 and $378 for the nine months ended September 30, 2021 and 2020, respectively. We believe we were in compliance with all applicable covenants under our Credit Facility and mortgage note as of September 30, 2021.

Leases with DHC and Healthpeak

Leases with DHC and Healthpeak Properties Inc. and Management Agreements with DHC	9 Months Ended
	Sep. 30, 2021
Leases [Abstract]
Leases with DHC and Healthpeak Properties Inc. and Management Agreements with DHC	Leases with DHC and Healthpeak Properties Inc. and Management Agreements with DHC 2020 Restructuring of our Business Arrangements with DHC . Effective as of January 1, 2020: • our five then existing master leases with DHC as well as our then existing management and pooling agreements with DHC were terminated and replaced with new management agreements and a related omnibus agreement; • we issued 10,268,158 of our common shares to DHC and an aggregate of 16,118,849 of our common shares to DHC’s shareholders of record as of December 13, 2019; • as consideration for the share issuances, DHC provided to us $75,000 by assuming certain of our working capital liabilities and through cash payments; we recognized $22,899 in loss on termination of leases, representing the excess of the fair value of the share issuances of $97,899 compared to the consideration of $75,000 paid by DHC. As of September 30, 2020, DHC assumed $51,547 of our working capital liabilities. We received cash of $23,453 from DHC during the nine months ended September 30, 2020; and • pursuant to a guaranty agreement dated as of January 1, 2020, made by us in favor of DHC’s applicable subsidiaries, we have guaranteed the payment and performance of each of our applicable subsidiary’s obligations under our applicable management agreements with DHC. We recognized transaction costs of $142 and $1,412 related to the 2020 restructuring of our business arrangements with DHC for the three and nine months ended September 30, 2020, respectively. 2021 Amendments to our Management Arrangements with DHC. As part of the implementation of the Strategic Plan, on June 9, 2021, we amended our management arrangements with DHC. See Notes 1, 16 and 17 for additional information on the Strategic Plan. The principal changes to the management arrangements include: • we will cooperate with DHC in transitioning the management of 108 senior living communities with approximately 7,500 living units that we then managed, to other third party managers without payment of any termination fee to us; • DHC will no longer have the right to sell up to an additional $682,000 of senior living communities managed by us and terminate our management of those communities without payment of a termination fee to us upon sale; • DHC's ability to terminate the management agreement was revised: (i) to not commence until 2025; (ii) the maximum amount of communities that may be terminated was reduced to 10% (from 20%) of the total managed portfolio by revenue per year; and (iii) to provide that achieving less than 80% (from 90%) of budgeted earnings before interest, taxes, and depreciation and amortization, or EBITDA, will be required to qualify as a “Non-Performing Asset” DHC will not be obligated to pay any termination fee to us if it exercises these termination rights; • we will continue to manage for DHC 120 senior living communities we then managed for it; • we will close and reposition the 27 skilled nursing units in CCRC communities that we will continue to manage with approximately 1,500 living units; • the incentive fee that we may earn in any calendar year for the senior living communities that we will continue to manage for DHC will no longer be subject to a cap and that any senior living communities that are undergoing a major renovation or repositioning will be excluded from the calculation of the incentive fee and the incentive fee calculation will be reset pursuant to the terms of the management agreements as a result of expected capital projects DHC is planning in the next five years; • The RMR Group LLC, or RMR LLC, assumed oversight of major community renovation or repositioning activities at the senior living communities that we will continue to manage for DHC; and • the term of our existing management agreements with DHC was extended by two years to December 31, 2036. We and DHC entered into a n amended and restated master management agreement for the senior living communities that we will continue to manage for DHC and interim management agreements for the senior living communities that we and DHC agreed to transition to new operators. These agreements replaced our prior management and omnibus agreements with DHC. In addition, we delivered to DHC a related amended and restated guaranty agreement pursuant to which we will continue to guarantee the payment and performance of each of our applicable subsidiary's obligations under the applicable management agreements. During the three months ended September 30, 2021, we transitioned the management of 69 senior living communities with approximately 4,800 living units to new operators. As of September 30, 2021, DHC had entered into agreements for us to transition an additional 35 senior living communities with approximately 2,100 living units to new operators in 2021; of which 27 senior living communities with approximately 1,700 living units were transitioned to new operators in October 2021. In October 2021, DHC entered into agreements for us to transition three senior living communities with approximately 500 living units to new operators. During the nine months ended September 30, 2021, we closed all 1,532 SNF units within the 27 CCRC communities that we will continue to manage for DHC. We expect the transition of management of the 11 senior living communities and the repositioning of the 1,532 closed SNF units to be completed during the remainder of 2021. For the three and nine months ended September 30, 2021, we recognized $2,710 and $12,329, respectively, of management fees related to the management of these communities and units. See Note 17 for summary of progress made on the repositioning phase of the Strategic Plan in October 2021. Senior Living Communities Leased from Healthpeak Properties, Inc. As of June 30, 2021, we leased four senior living communities under one lease with PEAK. On March 8, 2021, we entered into a second amendment to our master lease with PEAK, pursuant to which we agreed to pay a lease termination fee upon the sale by PEAK of any of the four communities we leased in an amount equal to the difference between: (i) the net present value of the allocated minimum rate payments that would otherwise have been payable with respect to that community for the period beginning on the sale date and ending on April 30, 2023 (discounted at 9%) and (ii) the net present value of the reinvestment returns of the net proceeds from the sale of the community (discounted at 9%), and assuming such net proceeds are reinvested for the period commencing on the sale date and ending on April 30, 2023 at a rate of 5.5%. On June 3, 2021, we entered into an operations transfer agreement to assist with the transfer of three of four communities that we leased from PEAK to new operators, subject to regulatory and other approvals. These three communities had 152 living units and had senior living revenues of $1,458 and $4,467 for the three and nine months ended September 30, 2021, respectively and lease expense of $538 and $1,622 for the three and nine months ended September 30, 2021, respectively. On September 30, 2021, we terminated our lease on all four communities that we leased from PEAK. We recognized a $3,277 loss on lease termination for these communities during the three and nine months ended September 30, 2021. The loss was the aggregate of the lease termination fee of $3,100, other obligations of $548, legal transaction costs of $37, and the net derecognition carrying amounts of the Company's right of use asset of $16,055, leasehold improvements and other fixed assets of $1,173, and the remaining lease obligations of $17,636. On April 4, 2021, one of the communities that we leased from PEAK had a fire that caused extensive damage and the community has been out of service since that date. Insurance proceeds received for damage to the community of $1,500 were remitted to PEAK as of September 30, 2021. As of October 1, 2021 the PEAK communities are no longer part of our senior living operations. Senior Living Communities Managed for the Account of DHC and its Related Entities . As of September 30, 2021 and 2020, we managed 159 and 239 senior living communities, respectively, for the account of DHC. We earned management fees of $10,418 and $14,609 from the senior living communities we managed for the account of DHC for the three months ended September 30, 2021 and 2020, respectively, and $35,437 and $46,206 for the nine months ended September 30, 2021 and 2020, respectively. In addition, we earned fees for our management of capital expenditure projects at the communities we managed for the account of DHC of $702 and $573 for the three months ended September 30, 2021 and 2020, respectively, and $2,251 and $1,479 for the nine months ended September 30, 2021 and 2020, respectively. These amounts are included in management fee revenue in our condensed consolidated statements of operations. We also provide ancillary services to residents at some of the senior living communities we manage for the account of DHC, such as rehabilitation and wellness services. At senior living communities we manage for the account of DHC where we provide rehabilitation and wellness services on an outpatient basis, the residents, third party payers or government programs pay us for those rehabilitation and wellness services. At senior living communities we manage for the account of DHC where we provide inpatient rehabilitation and wellness services, DHC generally pays us for these services and charges for such services are included in amounts charged to residents, third party payers or government programs. We earned revenues of $960 and $5,972 for the three months ended September 30, 2021 and 2020, respectively, and $9,031 and $19,843 for the nine months ended September 30, 2021 and 2020, respectively, for rehabilitation and wellness services we provided at senior living communities we manage for the account of DHC and that are payable by DHC. These amounts are included in rehabilitation and wellness services in our condensed consolidated statements of operations. We earned management fees of $100 and $120 for the three months ended September 30, 2021 and 2020, respectively, $309 and $372 for the nine months ended September 30, 2021 and 2020, respectively, for management services at a part of a senior living community DHC subleases to an affiliate, which amounts are included in management fee revenues in our condensed consolidated statements of operations. In 2020, DHC sold nine senior living communities that we previously managed. Upon completion of these sales, our management agreements with DHC with respect to those communities were terminated. In addition, in 2020, DHC also closed seven additional senior living communities and closed one building in one senior living community. For the three and nine months ended September 30, 2020, we recognized $622 and $2,338 of management fees related to these communities. During the nine months ended September 30, 2021, we closed 1,532 SNF units and are in the process of repositioning them. We will continue to manage the repositioned units for DHC. For the three months ended September 30, 2021 and 2020, we recognized $29 and $1,306 of management fee revenue related to these closed SNF units, respectively. For the nine months ended September 30, 2021 and 2020, we recognized $1,863 and $4,503 of management fee revenue related to these closed SNF units, respectively. In the three months ended September 30, 2021 we transitioned the management of 69 senior living communities that we managed for DHC with approximately 4,800 living units to new operators. For the three months ended September 30, 2021 and 2020, we recognized $1,306 and $2,820 of management fee revenue related to these transitioned communities, respectively. For the nine months ended September 30, 2021 and 2020, we recognized $6,354 and $8,629 of management fee revenue related to these transitioned communities, respectively. Ageility Clinics Leased from DHC. We lease space from DHC at certain of the senior living communities that we manage for DHC. We use this leased space for outpatient rehabilitation and wellness services clinics. We recognized rent expense of $370 and $392 for the three months ended September 30, 2021 and 2020, respectively, and $1,165 and $1,175 for the nine months ended September 30, 2021 and 2020, respectively, with respect to these leases.

Business Management Agreement w

Business Management Agreement with RMR LLC	9 Months Ended
	Sep. 30, 2021
Management Agreement [Abstract]
Business Management Agreement with RMR LLC	Business Management Agreement with RMR LLC RMR LLC, provides business management services to us pursuant to our business management and shared services agreement. We incurred aggregate fees and certain cost reimbursements payable to RMR LLC of $1,550 and $2,061 for the three months ended September 30, 2021 and 2020, respectively, and $5,149 and $6,535 for the nine months ended September 30, 2021 and 2020, respectively. These amounts are included in general and administrative expenses in our condensed consolidated statements of operations. For further information about our relationship with RMR LLC, see our Annual Report.

Related Person Transactions

Related Person Transactions	9 Months Ended
	Sep. 30, 2021
Related Party Transactions [Abstract]
Related Person Transactions	Related Person TransactionsWe have relationships and historical and continuing transactions with DHC, RMR LLC and others related to them, including other companies to which RMR LLC or its subsidiaries provide management services and some of which have trustees, directors and officers who are also our Directors or officers. The RMR Group Inc., or RMR Inc., is the managing member of RMR LLC. The Chair of our Board and one of our Managing Directors, Adam D. Portnoy, is the sole trustee, an officer and the controlling shareholder of ABP Trust, which is the controlling shareholder of RMR Inc. Mr. Portnoy is also a managing director and the president and chief executive officer of RMR Inc. and an officer and employee of RMR LLC. Jennifer B. Clark, our other Managing Director and our Secretary, also serves as a managing director and the executive vice president, general counsel and secretary of RMR Inc., an officer and employee of RMR LLC and an officer of ABP Trust. Certain of our officers, and DHC’s officers, are also officers and employees of RMR LLC. Some of our Independent Directors also serve as independent trustees or independent directors of other public companies to which RMR LLC or its subsidiaries provide management services. Mr. Portnoy serves as the chair of the boards of trustees or boards of directors and as a managing director or managing trustee of those companies. Other officers of RMR LLC, including Ms. Clark, serve as managing trustees or managing directors of certain of these companies. DHC . DHC is currently our largest shareholder, owning, as of September 30, 2021, 10,691,658 of our common shares, or 33.7% of our outstanding common shares. We manage for the account of DHC a substantial majority of the senior living communities we operate. Mr. Portnoy is chair of the board of trustees and a managing trustee of DHC. Ms. Clark is a former managing trustee and the secretary of DHC. Included in accrued expenses and other current liabilities on our condensed consolidated balance sheets at September 30, 2021 and December 31, 2020 are $18,384 and $30,090, respectively, of expenses we incurred in connection with the senior living communities we manage for DHC. DHC will reimburse us those amounts, and we have included those amounts in due from related person. See Note 11 for more information regarding our relationships, agreements and transactions with DHC and certain parties related to it and us. RMR LLC. We have an agreement with RMR LLC for RMR LLC to provide business management services to us. See Note 12 for more information regarding our relationship with RMR LLC. ABP Trust. ABP Trust and its subsidiaries owned 1,972,783 of our common shares, representing 6.2% of our outstanding common shares, as of September 30, 2021. We lease our headquarters from a subsidiary of ABP Trust. On February 24, 2021, we and the ABP Trust subsidiary renewed the lease through December 31, 2031. The annual lease payment will range from $1,026 to $1,395 over the period of the lease. The lease also provides us with an improvements allowance from ABP Trust not to exceed $2,667. Our rent expense for our headquarters, including utilities and real estate taxes that we pay as additional rent, was $518 and $442 for the three months ended September 30, 2021 and 2020, respectively, and $1,554 and $1,302 for the nine months ended September 30, 2021 and 2020, which amounts are included in general and administrative expenses. As a result of renewing this lease, we increased each of our right-of-use asset and lease liability noted below on our condensed consolidated balance sheets by $9,746 to reflect the terms of the amendment. We recognized a right-of-use asset and lease liability, which amounts were $9,968 and $496 for the lease liability and $9,452 and $452 for the right-of-use asset as of September 30, 2021 and December 31, 2020, respectively, with respect to our headquarters lease, using an incremental borrowing rate of 3.9%. The right-of-use asset has been reduced by the amount of accrued lease payments, which amounts are not material to our condensed consolidated financial statements. For further information about these and other such relationships and certain other related person transactions, see our Annual Report.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2021
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies We have been, are currently, and expect in the future to be involved in claims, lawsuits, and regulatory and other government audits, investigations and proceedings arising in the ordinary course of our business, some of which may involve material amounts. Also, the defense and resolution of these claims, lawsuits, and regulatory and other government audits, investigations and proceedings may require us to incur significant expense. Loss contingency provisions are recorded for probable and estimable losses at our best estimate of a loss or, when a best estimate cannot be made, at our estimate of the minimum loss. These estimates are often developed prior to knowing the amount of the ultimate loss, require the application of considerable judgment and are refined as additional information becomes known. Accordingly, we are often initially unable to develop a best estimate of loss and therefore the estimated minimum loss amount, which could be zero, is recorded; then, as information becomes known, the minimum loss amount is updated, as appropriate. We were defendants in two lawsuits filed by former employees in California. The first lawsuit, Lefevre v. Five Star Quality Care, Inc. was filed in San Bernardino County Superior Court in May 2015 and the second lawsuit, Mandviwala v. Five Star Quality Care, Inc. d/b/a Five Star Quality Care - CA, Inc. and FVE Managers, Inc., our wholly owned subsidiary, was filed in Orange County Superior Court in July 2015. The claims asserted against us in the similar, though not identical, complaints included: (i) failure to pay all wages due, (ii) failure to pay overtime, (iii) failure to provide meal and rest breaks, (iv) failure to provide itemized, printed wage statements, (v) failure to keep accurate payroll records and (vi) failure to reimburse business expenses. Both plaintiffs asserted causes of action on behalf of themselves and on behalf of other similarly situated employees, including causes of action pursuant to the California Labor Code Private Attorney General Act, or PAGA. On July 10, 2020, the parties in Lefevre v. Five Star Quality Care, Inc., agreed, without admitting fault, to settle Ms. Lefevre's individual and PAGA claims. The settlement was approved by the court and final judgement on the settlement has been entered. The settlement amount was $3,062, of which $2,400 was allocated to us and $662 was allocated to DHC. The total settlement amount was paid on May 12, 2021. The settlement extinguished the Mandviwala v. Five Star Quality Care, Inc.

COVID-19 Pandemic

COVID-19 Pandemic	9 Months Ended
	Sep. 30, 2021
Unusual or Infrequent Items, or Both [Abstract]
COVID-19 Pandemic	COVID-19 Pandemic On March 11, 2020, the World Health Organization declared the disease caused by the novel coronavirus SARS-CoV-2, or COVID-19, a pandemic, or the Pandemic. The global spread of COVID-19 caused economic disruption worldwide, and although conditions have significantly improved in the United States since the low points experienced, significant uncertainty regarding the Pandemic's ultimate duration, severity and near and long term impacts remain. Governments in affected regions have implemented and may continue to implement, safety precautions, including quarantines, travel restrictions, business closures and other public safety measures. During the Pandemic, we have experienced occupancy declines, increased labor costs and increased costs related to COVID-19 testing, medical and sanitation supplies and certain other costs. Additionally, we have purchased Personal Protective Equipment, or PPE, to be used at our senior living communities and rehabilitation and wellness clinics. At September 30, 2021, $6,159 of PPE for future use was included in prepaid expenses and other current assets in our condensed consolidated balance sheets. PPE that is deployed to senior living communities that we manage on behalf of DHC is reimbursable to us by DHC. For the three and nine months ended September 30, 2021, we deployed $152 and $3,209, respectively, of PPE to senior living communities that we manage on behalf of DHC. In response to the Pandemic, the United States enacted the CARES Act on March 27, 2020. The CARES Act, among other things, provides billions of dollars of relief to certain individuals and businesses suffering from the impact of the Pandemic. We record any funds we receive pursuant to the CARES Act as other operating income. We did not recognize any other operating income for the three months ended September 30, 2021 or 2020, and we recognized other operating income of $7,795 and $1,499 for the nine months ended September 30, 2021 and 2020, respectively, related to funds we received pursuant to the CARES Act, primarily for our senior living communities for which we believe we have met the required terms and conditions The CARES Act delayed the payment of certain required federal tax deposits for payroll taxes, including the employer's share of Old-Age, Survivors, and Disability Insurance Tax, or Social Security, employment taxes, incurred between March 27, 2020 and December 31, 2020. Amounts were to be considered timely paid if 50% of the deferred amount was paid by December 31, 2021, and the remainder by December 31, 2022. As of December 31, 2020, we deferred $27,593 of employer payroll taxes, which are included in accrued compensation and benefits in our condensed consolidated balance sheets as of December 31, 2020, of which $22,194 will be reimbursable to us by DHC pursuant to the management agreements and are included in due from related persons in our condensed consolidated balance sheet at December 31, 2020. In September 2021, we paid the deferred amounts and received the amounts due from DHC. The Sequestration Transparency Act of 2012 subjected all Medicare fee-for-service payments to a 2% sequestration reduction, or the 2% Medicare Sequestration. The CARES Act temporarily suspended the 2% Medicare Sequestration for the period from May 1, 2020 to March 31, 2021, which benefited our rehabilitation and wellness services segment and the senior living communities we manage in the form of increased rates for services provided and the management fees we earn from these communities as a result. Increases in rates are recognized in revenue in the period services are provided. On April 14, 2021, President Biden signed into law legislation that further extended the temporary suspension of the 2% Medicare Sequestration until December 31, 2021. The Tax Cuts and Jobs Act of 2017 repealed the AMT and allowed corporations to fully offset regular tax liability with AMT credits. Any remaining AMT credit amount became refundable incrementally from tax years 2018 through 2021. The CARES Act accelerates the refund schedule, permitting corporate taxpayers to claim the refund in full in either tax year 2018 or 2019. We expect to apply an AMT credit refund of $554 for tax year 2019 to our 2021 tax return, as we do not have a federal tax liability to utilize the refund against our 2020 tax return. In lieu of requesting a 2019 AMT credit refund of $554, we applied the entire overpayment to 2020 and requested a refund of $454, with the balance of $100 applied to 2021.

Restructuring Expense

Restructuring Expense	9 Months Ended
	Sep. 30, 2021
Restructuring and Related Activities [Abstract]
Restructuring Expense	Restructuring Expense On April 9, 2021, we announced, as part of the Strategic Plan, the repositioning of the Company's senior living management business to focus on larger independent living, assisted living and memory care communities as well as stand- alone independent living and active adult communities. We expect these transition activities to be substantially completed prior to December 31, 2021. See Notes 1, 11 and 17 for more information on the Strategic Plan and our business arrangements with DHC. During the nine months ended September 30, 2021, the following actions were taken pursuant to the repositioning phase of the Strategic Plan, we: • And DHC amended our management arrangements on June 9, 2021. See Note 11 for additional information regarding the amendments to the management arrangements with DHC, • Closed all 1,532 SNF living units in 27 managed CCRCs, and began collaborating with DHC to reposition these SNF units, • Closed 27 of the 37 planned Ageility inpatient rehabilitation clinics, • Transitioned the management of 69 senior living communities with approximately 4,800 living units to new operators, all of which occurred during the three months ended September 30, 2021, • Recognized severance and retention costs of $14,609, and • Incurred other costs in connection with the closure of communities and units of $2,250. A summary of the liabilities incurred combined with a reconciliation of the related components of the Strategic Plan restructuring expense recognized in the three and nine months ended September 30, 2021, follows, first by cost component and then by segment, the expenses are aggregated and reported in the line item Restructuring expenses in our condensed consolidated statements of operations: Summary of Liabilities and Expenses as of and for the Three Months Ended September 30, 2021 (1) Type of Expense: Beginning Balance Expenses Incurred Payments Ending Balance Retention bonuses $ 2,495 $ 875 $ 1,793 $ 1,577 Severance, benefits and transition expenses 3,494 (810) 1,475 1,209 Transaction expenses 738 1,155 1,441 452 Total $ 6,727 $ 1,220 $ 4,709 $ 3,238 _______________________________________ (1) No obligations related to the Strategic Plan were incurred in 2020. Accrued bonuses and other compensation are reported in the condensed consolidated balance sheet as part of Accrued compensation and benefits and accrued transaction expenses are reported as part of Accrued expenses and other current liabilities in the condensed consolidated balance sheet. Summary of Liabilities and Expenses as of and for the Nine Months Ended September 30, 2021 (1) Type of Expense: Beginning Balance Expenses Incurred Payments Ending Balance Retention bonuses $ — $ 6,480 $ 4,903 $ 1,577 Severance, benefits and transition expenses — 8,129 6,920 1,209 Transaction expenses — 2,250 1,798 452 Total $ — $ 16,859 $ 13,621 $ 3,238 _______________________________________ (1) No obligations related to the Strategic Plan were incurred in 2020. Accrued bonuses and other compensation are reported in the condensed consolidated balance sheet as part of Accrued compensation and benefits and accrued transaction expenses are reported as part of Accrued expenses and other current liabilities in the condensed consolidated balance sheet. Summary of Liabilities and Expenses as of and for the Three Months Ended September 30, 2021 (1) By Segment: Beginning Balance Expenses Incurred Payments Ending Balance Senior Living $ 4,144 $ 813 $ 2,752 $ 2,205 Rehabilitation and Wellness Services 576 (310) 266 — Corporate and Other 2,007 717 1,691 1,033 Total $ 6,727 $ 1,220 $ 4,709 $ 3,238 _______________________________________ (1) No obligations related to the Strategic Plan were incurred in 2020. Accrued bonuses and other compensation are reported in the condensed consolidated balance sheet as part of Accrued compensation and benefits and accrued transaction expenses are reported as part of Accrued expenses and other current liabilities in the condensed consolidated balance sheet. Summary of Liabilities and Expenses as of and for the Nine Months Ended September 30, 2021 (1) By Segment: Beginning Balance Expenses Incurred Payments Ending Balance Senior Living $ — $ 12,344 $ 10,139 $ 2,205 Rehabilitation and Wellness Services — 1,410 1,410 — Corporate and Other — 3,105 2,072 1,033 Total $ — $ 16,859 $ 13,621 $ 3,238 _______________________________________ (1) No obligations related to the Strategic Plan were incurred in 2020. Accrued bonuses and other compensation are reported in the condensed consolidated balance sheet as part of Accrued compensation and benefits and accrued transaction expenses are reported as part of Accrued expenses and other current liabilities in the condensed consolidated balance sheet. In connection with the repositioning of our senior living management services, we expect to incur restructuring obligations, recognized under ASC 420, Exit or Disposal Cost Obligations and ASC 712, Compensation-Nonretirement Postemployment Benefits-special termination benefits of up to $19,000, approximately $13,000 of which we expect DHC will reimburse. These expenses are expected to include up to $7,500 of retention bonus payments, up to $8,700 of severance, benefits and transition expenses, and up to $2,800 of transaction expenses, of which we expect DHC to reimburse approximately $5,100, $7,200 and $700, respectively. For the three and nine months ended September 30, 2021, respectively, we recognized restructuring expenses of $1,220 and $16,859 related to the Strategic Plan which was partially offset by $813 and $12,344 of other reimbursed expenses related to the amounts to be reimbursed by DHC, respectively, for the three and nine months ended September 30, 2021. See Notes 1, 11 and 17 for more information on the Strategic Plan and our business arrangements with DHC.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2021
Subsequent Events [Abstract]
Subsequent Events	Subsequent EventsIn October 2021 we continued to make progress on the Strategic Plan as we transitioned 27 senior living communities (with approximately 1,700 living units) to new operators. In addition, in October 2021 DHC entered into agreements to transition the management of an additional three senior living communities (approximately 500 living units) to new operators.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2021
Accounting Policies [Abstract]
Estimates and Assumptions	Estimates and Assumptions. The preparation of these condensed consolidated financial statements in conformity with GAAP requires us to make estimates and assumptions that may affect the amounts reported in these condensed consolidated financial statements and related notes. Significant estimates in our condensed consolidated financial statements relate to revenue recognition, including contractual allowances, the allowance for doubtful accounts, self-insurance reserves and estimates concerning our provision for income taxes or valuation allowance related to deferred tax assets. Our actual results could differ from our estimates. We periodically review estimates and assumptions, and we reflect the effects of changes, if any, in the condensed consolidated financial statements in the period that they are determined.
Accounting for Costs Associated with Exit or Disposal Activities	Accounting for Costs Associated with Exit or Disposal Activities. A liability for costs associated with exit or disposal activities other than in a business combination, is recognized when the liability is incurred. The liability, recognized under Accounting Standards Codification, or ASC, 420, Exit or Disposal Cost Obligations and ASC 712, Compensation — Nonretirement Postemployment - special termination benefits
Recently Issued Accounting Pronouncements Not Yet Adopted	Recently Issued Accounting Pronouncements Not Yet Adopted. In June 2016, the Financial Accounting Standards Board, or FASB, issued Accounting Standards Update, or ASU, No. 2016-13, Financial Instruments-Credit Losses (Topic 326) , which requires a financial asset or a group of financial assets measured at amortized cost basis to be presented at the net amount expected to be collected. This ASU eliminates the probable initial recognition threshold and instead requires reflection of an entity’s current estimate of all expected credit losses. In addition, this ASU amends the current other-than-temporary impairment model for available for sale debt securities. The length of time that the fair value of an available for sale debt security has been below the amortized cost will no longer impact the determination of whether a credit loss exists and credit losses will now be limited to the difference between a security’s amortized cost basis and its fair value. In November 2018, the FASB issued ASU No. 2018-19, Codification Improvements to Topic 326, Financial Instruments-Credit Losses , which amends the transition and effective date for nonpublic entities and smaller reporting companies, such as us, and clarifies that receivables arising from operating leases are not in the scope of this ASU. In November 2019, the FASB issued ASU No. 2019-11, Codification Improvements to Topic 326 , Financial Instruments-Credit Losses , which clarifies guidance around how to report expected recoveries. Entities will apply the provisions of the ASU as a cumulative-effect adjustment to retained earnings as of the beginning of the first reporting period in which the guidance is effective. This ASU is effective for smaller reporting companies for reporting periods beginning after December 15, 2022. We are assessing the potential impact that the adoption of this ASU (and the related clarifying guidance issued by the FASB) will have on our condensed consolidated financial statements. In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting , which provides temporary optional expedients and exceptions on contract modifications meeting certain criteria to ease the financial reporting burdens of the expected market transition from the London Inter-bank Offered Rate, or LIBOR, and other interbank offered rates to the alternative reference rates. For a contract that meets the criteria, this ASU generally allows an entity to account for and present modifications as an event that does not require remeasurement at the modification date or reassessment of a previous accounting determination. This ASU was effective upon issuance and can be applied through December 31, 2022. We expect this ASU will not have a material impact on our condensed consolidated financial statements.

Revenue and Other Operating I_2

Revenue and Other Operating Income (Tables)	9 Months Ended
	Sep. 30, 2021
Revenue from Contract with Customer [Abstract]
Schedule of Disaggregation of Revenue	The following tables present revenue from contracts by segment with customers disaggregated by type of payer, as we believe it best depicts how the nature, amount, timing and uncertainty of our revenue and cash flows are affected by economic factors: Three Months Ended September 30, 2021 Senior Living Rehabilitation and Wellness Services (3) Total Private payer $ 16,032 $ 293 $ 16,325 Medicare and Medicaid programs 288 10,073 10,361 Other third-party payer programs — 5,016 5,016 Management fees 11,220 (1) (2) — 11,220 Reimbursed community-level costs incurred on behalf of managed communities 177,231 (1) (2) — 177,231 Other reimbursed expenses 5,678 (1) (4) — 5,678 Total revenues $ 210,449 $ 15,382 $ 225,831 _______________________________________ (1) Represents separate revenue sources earned from DHC; see Note 4 for discussion of Segment Information. (2) (i) We intend to transition 108 senior living communities managed on behalf of DHC, with approximately 7,500 living units to new operators in 2021; of which 69 senior living communities with approximately 4,800 living units were transitioned to new operators during the three months ended September 30, 2021 and (ii) we closed 59 SNF units in one CCRC during the three months ended September 30, 2021 and closed an additional 1,473 SNF units in 26 CCRCs during the three months ended June 30, 2021 and are in the process of repositioning these units that we will continue to manage for DHC. The management fees we recognized related to these communities and units for the three months ended September 30, 2021 were $2,710. See Notes 1, 11, 16 and 17 for more information. (3) We expect to close an additional ten Ageility inpatient rehabilitation clinics. Revenue related to these clinics for the three months ended September 30, 2021 was $1,508. See Notes 1, 16 and 17 for more information. (4) Includes $813 of restructuring expenses to be reimbursed by DHC for the three months ended September 30, 2021. Three Months Ended September 30, 2020 Senior Living Rehabilitation and Wellness Services Total Private payer $ 18,347 $ 1,296 $ 19,643 Medicare and Medicaid programs 178 10,747 10,925 Other third-party payer programs — 9,081 9,081 Management fees 15,302 (1) — 15,302 Reimbursed community-level costs incurred on behalf of managed communities 233,783 (1) — 233,783 Other reimbursed expenses 6,589 (1) — 6,589 Total revenues $ 274,199 $ 21,124 $ 295,323 _______________________________________ (1) Represents separate revenue sources earned from DHC. Nine Months Ended September 30, 2021 Senior Living Rehabilitation and Wellness Services (3) Total Private payer $ 48,935 $ 805 $ 49,740 Medicare and Medicaid programs 820 31,433 32,253 Other third-party payer programs — 20,150 20,150 Management fees 37,997 (1) (2) — 37,997 Reimbursed community-level costs incurred on behalf of managed communities 585,662 (1) (2) — 585,662 Other reimbursed expenses 27,750 (1) (4) — 27,750 Total revenues $ 701,164 $ 52,388 $ 753,552 _______________________________________ (1) Represents separate revenue sources earned from DHC; see Note 4 for discussion of Segment Information. (2) (i) We intend to transition 108 senior living communities managed on behalf of DHC, with approximately 7,500 living units to new operators in 2021; of which 69 senior living communities with approximately 4,800 living units were transitioned to new operators during the three months ended September 30, 2021 and (ii) we closed 1,532 SNF units in 27 CCRCs during the nine months ended September 30, 2021 and are in the process of repositioning these units that we will continue to manage for DHC. The management fees we recognized related to these communities and units for the nine months ended September 30, 2021 were $12,329. See Notes 1, 11, 16 and 17 for more information. (3) 27 Ageility inpatient rehabilitation clinics were closed during the nine months ended September 30, 2021 and we expect to close an additional ten Ageility inpatient rehabilitation clinics. Revenue related to these clinics for the nine months ended September 30, 2021 was $9,579. See Notes 1, 16 and 17 for more information. (4) Includes $12,344 of restructuring expenses to be reimbursed by DHC for the nine months ended September 30, 2021. Nine Months Ended September 30, 2020 Senior Living Rehabilitation and Wellness Services Total Private payer $ 57,921 $ 3,407 $ 61,328 Medicare and Medicaid programs 1,191 29,881 31,072 Other third-party payer programs — 28,488 28,488 Management fees 48,058 (1) — 48,058 Reimbursed community-level costs incurred on behalf of managed communities 689,903 (1) — 689,903 Other reimbursed expenses 19,003 (1) — 19,003 Total revenues $ 816,076 $ 61,776 $ 877,852 _______________________________________ (1) Represents separate revenue sources earned from DHC.

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 2021
Segment Reporting [Abstract]
Schedule of Segment Information	Results of operations and selected financial information by reportable segment and the reconciliation to the condensed consolidated financial statements are as follows: Three Months Ended September 30, 2021 Senior Living (1) Rehabilitation and Wellness Services (2) Corporate and Other (3) Total Revenues $ 210,449 $ 15,382 $ — $ 225,831 Operating expenses 200,570 13,349 18,599 232,518 Operating income (loss) 9,879 2,033 (18,599) (6,687) Allocated corporate and other costs (10,388) (770) 11,158 — Other (loss) income, net (3,202) — (476) (3,678) (Loss) income before income taxes (3,711) 1,263 (7,917) (10,365) Benefit for income taxes — — 164 164 Net (loss) income $ (3,711) $ 1,263 $ (7,753) $ (10,201) _______________________________________ (1) (i) We intend to transition 108 senior living communities managed on behalf of DHC, with approximately 7,500 living units to new operators in 2021; of which 69 senior living communities with approximately 4,800 living units were transitioned to new operators during the three months ended September 30, 2021 and (ii) we closed 59 SNF units in one CCRC during the three months ended September 30, 2021 and closed an additional 1,473 SNF units in 26 CCRCs during the three months ended June 30, 2021 and are in the process of repositioning these units that we will continue to manage for DHC. See Notes 1, 11, 16 and 17 for more information. As more fully described in Note 16, the senior living segment recognized $813 of restructuring expenses related to the Strategic Plan and $813 of other reimbursed expenses in the three months ended September 30, 2021. (2) We expect to close an additional ten Ageility inpatient rehabilitation clinics. See Notes 1, 16 and 17 for more information. As more fully described in Note 16, the rehabilitation and wellness services segment recognized $(310) of restructuring expenses related to the Strategic Plan in the three months ended September 30, 2021. (3) As more fully described in Note 16, Corporate and Other recognized $717 of restructuring expenses related to the Strategic Plan in the three months ended September 30, 2021. Three Months Ended September 30, 2020 Senior Living Rehabilitation and Wellness Services Corporate and Other Total Revenues $ 274,199 $ 21,124 $ — $ 295,323 Other operating income — — — — Operating expenses 260,077 16,833 14,720 291,630 Operating income (loss) 14,122 4,291 (14,720) 3,693 Allocated corporate and other costs (13,657) (1,052) 14,709 — Other income (loss), net (122) — 609 487 Income before income taxes 343 3,239 598 4,180 Provision for income taxes — — (465) (465) Net income $ 343 $ 3,239 $ 133 $ 3,715 Nine Months Ended September 30, 2021 Senior Living (1) Rehabilitation and Wellness Services (2) Corporate and Other (3) Total Revenues $ 701,164 $ 52,388 $ — $ 753,552 Other operating income 7,776 19 — 7,795 Operating expenses 671,991 47,204 57,482 776,677 Operating income (loss) 36,949 5,203 (57,482) (15,330) Allocated corporate and other costs (34,811) (2,621) 37,432 — Other (loss) income, net (2,557) — (1,107) (3,664) (Loss) income before income taxes (419) 2,582 (21,157) (18,994) Provision for income taxes — — (194) (194) Net (loss) income $ (419) $ 2,582 $ (21,351) $ (19,188) _______________________________________ (1) (i) We intend to transition 108 senior living communities managed on behalf of DHC, with approximately 7,500 living units to new operators in 2021; of which 69 senior living communities with approximately 4,800 living units were transitioned to new operators during the three months ended September 30, 2021 and (ii) we closed 1,532 SNF units in 27 CCRCs during the nine months ended September 30, 2021 and are in the process of repositioning these units that we will continue to manage for DHC. See Notes 1, 11, 16 and 17 for more information. As more fully described in Note 16, the senior living segment recognized $12,344 of restructuring expenses related to the Strategic Plan and $12,344 of other reimbursed expenses in the nine months ended September 30, 2021. (2) 27 Ageility inpatient rehabilitation clinics were closed during the nine months ended September 30, 2021 and we expect to close an additional ten Ageility inpatient rehabilitation clinics. See Notes 1, 16 and 17 for more information. As more fully described in Note 16, the rehabilitation and wellness services segment recognized $1,410 of restructuring expenses related to the Strategic Plan in the nine months ended September 30, 2021. (3) As more fully described in Note 16, Corporate and Other recognized $3,105 of restructuring expenses related to the Strategic Plan in the nine months ended September 30, 2021. Nine Months Ended September 30, 2020 Senior Living Rehabilitation and Wellness Services Corporate and Other Total Revenues $ 816,076 $ 61,776 $ — $ 877,852 Other operating income — 1,499 — 1,499 Operating expenses 766,415 50,708 48,567 865,690 Operating income (loss) 49,661 12,567 (48,567) 13,661 Allocated corporate and other costs (43,448) (3,094) 46,542 — Other income (loss), net (163) — (23,019) (23,182) (Loss) income before income taxes 6,050 9,473 (25,044) (9,521) Provision for income taxes — — (971) (971) Net (loss) income $ 6,050 $ 9,473 $ (26,015) $ (10,492)

Property and Equipment, net (Ta

Property and Equipment, net (Tables)	9 Months Ended
	Sep. 30, 2021
Property, Plant and Equipment [Abstract]
Schedule of Property and Equipment, Net	Property and equipment, net consist of the following: September 30, 2021 December 31, 2020 Land $ 12,155 $ 12,155 Buildings, construction in process and improvements 202,897 202,679 Furniture, fixtures and equipment 61,551 60,713 Property and equipment, at cost 276,603 275,547 Less: accumulated depreciation (119,575) (116,296) Property and equipment, net $ 157,028 $ 159,251

Accumulated Other Comprehensi_2

Accumulated Other Comprehensive Income (Tables)	9 Months Ended
	Sep. 30, 2021
Equity [Abstract]
Schedule of Changes in Accumulated Other Comprehensive Income, Net of Tax	The following tables detail the changes in accumulated other comprehensive income (loss), net of tax, for the nine months ended September 30, 2021 and 2020: Nine Months Ended September 30, 2021 Equity Investments Accumulated Balance at January 1, 2021 $ (175) $ 1,491 $ 1,316 Unrealized loss on debt investments, net of tax — (317) (317) Realized gain on debt investments reclassified and included in net loss, net of tax — (18) (18) Balance at September 30, 2021 $ (175) $ 1,156 $ 981 Nine Months Ended September 30, 2020 Equity Investments Accumulated Balance at January 1, 2020 $ (175) $ 2,838 $ 2,663 Cumulative effect adjustment to beginning accumulated deficit and accumulated other comprehensive income in connection with a reclassification of equity investments previously classified as debt investments — (1,694) (1,694) Unrealized gain on debt investments, net of tax — 710 710 Realized gain on debt investments reclassified and included in net income, net of tax — (303) (303) Balance at September 30, 2020 $ (175) $ 1,551 $ 1,376

Net (Loss) Income Per Share (Ta

Net (Loss) Income Per Share (Tables)	9 Months Ended
	Sep. 30, 2021
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 net (loss) income per share (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 Weighted average shares outstanding—basic 31,618 31,486 31,567 31,465 Effect of dilutive securities: unvested share awards — 77 — — Weighted average shares outstanding—diluted (1) 31,618 31,563 31,567 31,465 _______________________________________ (1) For the three months ended September 30, 2021, 157 of our unvested common shares were not included in the calculation of net loss per share—diluted because to do so would have been anti-dilutive. For the nine months ended September 30, 2021 and 2020, 146 and 108, respectively, of our unvested common shares were not included in the calculation of the net loss per share—diluted because to do so would have been antidilutive.

Fair Values of Assets and Lia_2

Fair Values of Assets and Liabilities (Tables)	9 Months Ended
	Sep. 30, 2021
Fair Value Disclosures [Abstract]
Schedule of Assets and Liabilities Measured at Fair Value on a Recurring and Non Recurring Basis, Categorized by the Level of Inputs Used in the Valuation of Each Asset	The tables below present certain of our assets measured at fair value at September 30, 2021 and December 31, 2020, categorized by the level of input used in the valuation of each asset. As of September 30, 2021 Description Total Quoted Prices in Significant Significant Cash equivalents (1) $ 26,378 $ 26,378 $ — $ — Investments: Total equity investments (2) 12,858 6,800 6,058 — Total debt investments (3) 10,481 5,789 4,692 — Total investments 23,339 12,589 10,750 — Total $ 49,717 $ 38,967 $ 10,750 $ — As of December 31, 2020 Description Total Quoted Prices in Significant Significant Cash equivalents (1) $ 26,291 $ 26,291 $ — $ — Investments: Total equity investments (2) 12,439 6,465 5,974 — Total debt investments (3) 12,310 7,301 5,009 — Total investments 24,749 13,766 10,983 — Total $ 51,040 $ 40,057 $ 10,983 $ — _______________________________________ (1) Cash equivalents consist of short-term, highly liquid investments and money market funds held primarily for obligations arising from our self-insurance programs. Cash equivalents are reported in our condensed consolidated balance sheets as cash and cash equivalents and current and long-term restricted cash and cash equivalents. Cash equivalents include $22,278 and $22,837 of balances that were restricted at September 30, 2021 and December 31, 2020, respectively. In addition to the cash equivalents of $26,378 and $26,291 at September 30, 2021 and December 31, 2020, respectively, reflected above, there were cash balances of $76,088 and $80,897 and restricted cash balances of $2,474 and $2,409 at September 30, 2021 and December 31, 2020, respectively. (2) The fair value of our equity investments is readily determinable. During the nine months ended September 30, 2021 and 2020, we received gross proceeds of $741 and $3,141, respectively, in connection with the sales of equity investments and recorded gross realized gains totaling $175 and $339, respectively, and gross realized losses totaling $0 and $219, respectively. (3) As of September 30, 2021, our debt investments, which are classified as available for sale, had a fair value of $10,481 with an amortized cost of $10,060; the difference between the fair value and amortized cost amounts resulted from unrealized gains of $421, net of unrealized losses of $23. As of December 31, 2020, our debt investments had a fair value of $12,310 with an amortized cost of $11,554; the difference between the fair value and amortized cost amounts resulted from unrealized gains of $756, net of unrealized losses of $4. Debt investments include $6,874 and $8,395 of balances that were restricted as of September 30, 2021 and December 31, 2020, respectively. At September 30, 2021, four debt investments we held, with a fair value of $788, had been in a loss position for less than 12 months and we did not hold any debt investments with a fair value in a loss position for greater than 12 months. We do not believe these investments are impaired primarily because they have not been in a loss position for an extended period of time, the financial conditions of the issuers of these investments remain strong with solid fundamentals as of September 30, 2021, we do not intend to sell the investments and it is not more likely than not that we will be required to sell the investments before recovery, and other factors that support our conclusion that the loss is temporary. During the nine months ended September 30, 2021 and 2020, we received gross proceeds of $1,294 and $5,938, respectively, in connection with the sales of debt investments and recorded gross realized gains totaling $18 and $302, respectively. There were no gross realized losses for the nine months ended September 30, 2021 and 2020, respectively. We record gains and losses on the sales of these investments using the specific identification method.
Schedule of Debt Securities	The amortized cost basis and fair value of available for sale debt securities at September 30, 2021, by contractual maturity, are shown below. Amortized Cost Fair Value Due in one year or less $ 2,142 $ 2,173 Due after one year through five years 4,019 4,219 Due after five years through ten years 3,899 4,089 Total $ 10,060 $ 10,481

Indebtedness (Tables)

Indebtedness (Tables)	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
Schedule of Mortgages	The following table is a summary of this mortgage note as of September 30, 2021: Balance as of Contractual Stated Effective Maturity Date Monthly Lender $ 7,092 (1) 6.20 % 6.70 % September 2032 $ 72 Federal Home Loan Mortgage Corporation _______________________________________ (1) Contractual principal payments excluding unamortized discount $210.

Restructuring Expense (Tables)

Restructuring Expense (Tables)	9 Months Ended
	Sep. 30, 2021
Restructuring and Related Activities [Abstract]
Schedule of Liabilities and Expenses Related to Strategic Plan	A summary of the liabilities incurred combined with a reconciliation of the related components of the Strategic Plan restructuring expense recognized in the three and nine months ended September 30, 2021, follows, first by cost component and then by segment, the expenses are aggregated and reported in the line item Restructuring expenses in our condensed consolidated statements of operations: Summary of Liabilities and Expenses as of and for the Three Months Ended September 30, 2021 (1) Type of Expense: Beginning Balance Expenses Incurred Payments Ending Balance Retention bonuses $ 2,495 $ 875 $ 1,793 $ 1,577 Severance, benefits and transition expenses 3,494 (810) 1,475 1,209 Transaction expenses 738 1,155 1,441 452 Total $ 6,727 $ 1,220 $ 4,709 $ 3,238 _______________________________________ (1) No obligations related to the Strategic Plan were incurred in 2020. Accrued bonuses and other compensation are reported in the condensed consolidated balance sheet as part of Accrued compensation and benefits and accrued transaction expenses are reported as part of Accrued expenses and other current liabilities in the condensed consolidated balance sheet. Summary of Liabilities and Expenses as of and for the Nine Months Ended September 30, 2021 (1) Type of Expense: Beginning Balance Expenses Incurred Payments Ending Balance Retention bonuses $ — $ 6,480 $ 4,903 $ 1,577 Severance, benefits and transition expenses — 8,129 6,920 1,209 Transaction expenses — 2,250 1,798 452 Total $ — $ 16,859 $ 13,621 $ 3,238 _______________________________________ (1) No obligations related to the Strategic Plan were incurred in 2020. Accrued bonuses and other compensation are reported in the condensed consolidated balance sheet as part of Accrued compensation and benefits and accrued transaction expenses are reported as part of Accrued expenses and other current liabilities in the condensed consolidated balance sheet. Summary of Liabilities and Expenses as of and for the Three Months Ended September 30, 2021 (1) By Segment: Beginning Balance Expenses Incurred Payments Ending Balance Senior Living $ 4,144 $ 813 $ 2,752 $ 2,205 Rehabilitation and Wellness Services 576 (310) 266 — Corporate and Other 2,007 717 1,691 1,033 Total $ 6,727 $ 1,220 $ 4,709 $ 3,238 _______________________________________ (1) No obligations related to the Strategic Plan were incurred in 2020. Accrued bonuses and other compensation are reported in the condensed consolidated balance sheet as part of Accrued compensation and benefits and accrued transaction expenses are reported as part of Accrued expenses and other current liabilities in the condensed consolidated balance sheet. Summary of Liabilities and Expenses as of and for the Nine Months Ended September 30, 2021 (1) By Segment: Beginning Balance Expenses Incurred Payments Ending Balance Senior Living $ — $ 12,344 $ 10,139 $ 2,205 Rehabilitation and Wellness Services — 1,410 1,410 — Corporate and Other — 3,105 2,072 1,033 Total $ — $ 16,859 $ 13,621 $ 3,238 _______________________________________ (1) No obligations related to the Strategic Plan were incurred in 2020. Accrued bonuses and other compensation are reported in the condensed consolidated balance sheet as part of Accrued compensation and benefits and accrued transaction expenses are reported as part of Accrued expenses and other current liabilities in the condensed consolidated balance sheet.

Basis of Presentation and Org_2

Basis of Presentation and Organization (Details) $ in Thousands

3 Months Ended

9 Months Ended

Sep. 30, 2021USD ($)

Sep. 30, 2020USD ($)

Sep. 30, 2021USD ($)

Sep. 30, 2020USD ($)

Sep. 30, 2021USD ($)

Sep. 30, 2021state

Sep. 30, 2021living_unit

Sep. 30, 2021community

Sep. 30, 2021property

Sep. 30, 2021apartment

Sep. 30, 2021suite

Sep. 30, 2021bed

Sep. 30, 2021facility

Jun. 30, 2021living_unitcommunity

Jun. 03, 2021community

Apr. 09, 2021living_unit

Real Estate Properties [Line Items]

Restructuring expenses

$ 1,220

$ 142

$ 16,859

$ 1,412

Revenues

225,831

295,323

753,552

877,852

Other reimbursed expenses

Real Estate Properties [Line Items]

Revenues

5,678

6,589

27,750

19,003

Strategic Plan

Real Estate Properties [Line Items]

Number of units in real estate properties transitioned | living_unit

0

Restructuring and related cost, expected costs

$ 19,000

Restructuring expenses

1,220

16,859

Strategic Plan | Severance, benefits and transition expenses

Real Estate Properties [Line Items]

Restructuring and related cost, expected costs

8,700

Restructuring expenses

14,609

Strategic Plan | Retention bonuses

Real Estate Properties [Line Items]

Restructuring and related cost, expected costs

7,500

Restructuring expenses

875

6,480

Strategic Plan | Transaction expenses

Real Estate Properties [Line Items]

Restructuring and related cost, expected costs

2,800

Restructuring expenses

1,155

2,250

Diversified Healthcare Trust | Other reimbursed expenses

Real Estate Properties [Line Items]

Revenues

12,344

Diversified Healthcare Trust | Strategic Plan

Real Estate Properties [Line Items]

Costs expected to be reimbursed

13,000

Diversified Healthcare Trust | Strategic Plan | Other reimbursed expenses

Real Estate Properties [Line Items]

Revenues

813

Diversified Healthcare Trust | Strategic Plan | Severance, benefits and transition expenses

Real Estate Properties [Line Items]

Costs expected to be reimbursed

7,200

Diversified Healthcare Trust | Strategic Plan | Retention bonuses

Real Estate Properties [Line Items]

Costs expected to be reimbursed

5,100

Diversified Healthcare Trust | Strategic Plan | Transaction expenses

Real Estate Properties [Line Items]

Costs expected to be reimbursed

$ 700

DHC | Strategic Plan

Real Estate Properties [Line Items]

Number of units in real estate property closed | living_unit

100

Number of real estate properties closed | community

1

Transaction Agreement | Affiliated Entity

Real Estate Properties [Line Items]

Number of properties managed | community

159

Rehabilitation And Wellness | Other reimbursed expenses

Real Estate Properties [Line Items]

Revenues

$ 0

$ 0

$ 0

$ 0

Senior Living Communities

Real Estate Properties [Line Items]

Number of properties operated | property

179

Number of states in which real estate properties are located | state

29

Number of living units in properties operated | living_unit

22,768

120

Number of units in properties managed | living_unit

20,669

Number of properties owned and operated | property

20

Number of living units in properties owned and operated | living_unit

2,099

Number of communities operating | community

11

Senior Living Communities | Strategic Plan

Real Estate Properties [Line Items]

Number of real estate properties transitioned | community

69

Number of units in real estate properties transitioned | living_unit

4,800

Senior Living Communities | Healthpeak Properties Inc

Real Estate Properties [Line Items]

Number of communities operating | community

4

3

Number of units in properties leased and operated | living_unit

200

Senior Living Communities | Diversified Healthcare Trust | Strategic Plan

Real Estate Properties [Line Items]

Number of living units in properties operated | living_unit

7,500

Senior Living Communities | DHC | Diversified Healthcare Trust | Strategic Plan

Real Estate Properties [Line Items]

Number of real estate properties transitioned | community

35

Number of units in real estate properties transitioned | living_unit

2,100

Continuing Care Retirement Communities

Real Estate Properties [Line Items]

Number of properties operated | community

4

Number of living units in properties operated | living_unit

1

Number of units in properties managed | living_unit

625

Number of units in real estate property closed | living_unit

27

Number of real estate properties closed | community

26

Continuing Care Retirement Communities | Strategic Plan

Real Estate Properties [Line Items]

Number of living units in properties operated | living_unit

1,500

Continuing Care Retirement Communities | DHC | Strategic Plan

Real Estate Properties [Line Items]

Number of properties operated | community

27

SNF

Real Estate Properties [Line Items]

Number of units in real estate property closed

59

1,532

1,473

SNF | Strategic Plan

Real Estate Properties [Line Items]

Number of units in real estate property closed | living_unit

1,532

SNF | Diversified Healthcare Trust | Strategic Plan

Real Estate Properties [Line Items]

Number of properties operated | community

108

Independent Living Apartment

Real Estate Properties [Line Items]

Number of living units in properties operated | apartment

10,628

Assisted Living Suites

Real Estate Properties [Line Items]

Number of living units in properties operated | suite

11,856

Rediscovery Memory Care Units

Real Estate Properties [Line Items]

Number of living units in properties operated | bed

2,454

Skilled Nursing Units

Real Estate Properties [Line Items]

Number of living units in properties operated | bed

284

Ageility Inpatient Rehabilitation

Real Estate Properties [Line Items]

Service period

12 months

12 months

Revenue

$ 2,413

Percentage increase in revenue

41.10%

Ageility Inpatient Rehabilitation | Strategic Plan

Real Estate Properties [Line Items]

Number of properties operated | community

37

Number of real estate properties closed | community

27

Ageility Inpatient Rehabilitation | Diversified Healthcare Trust

Real Estate Properties [Line Items]

Number of properties operated | living_unit

16

Ageility Inpatient Rehabilitation | Rehabilitation And Wellness

Real Estate Properties [Line Items]

Number of properties operated | property

6

Ageility Inpatient Rehabilitation | Rehabilitation And Wellness | Diversified Healthcare Trust

Real Estate Properties [Line Items]

Number of properties operated | property

10

Number of properties managed | property

2

Ageility Inpatient Rehabilitation | Rehabilitation And Wellness | DHC

Real Estate Properties [Line Items]

Number of real estate properties transitioned | property

8

Outpatient Rehabilitation Clinics | Diversified Healthcare Trust

Real Estate Properties [Line Items]

Number of properties operated | property

223

Number of properties managed | property

122

Number of real estate properties transitioned | property

101

Revenue and Other Operating I_3

Revenue and Other Operating Income (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2021USD ($)living_unit	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)living_unit	Sep. 30, 2020USD ($)	Sep. 30, 2021community	Sep. 30, 2021property	Sep. 30, 2021facility	Jun. 30, 2021living_unitcommunity	Apr. 09, 2021living_unit
Disaggregation of Revenue [Line Items]
Revenues	$ 225,831,000	$ 295,323,000	$ 753,552,000	$ 877,852,000
Other operating income	$ 0	0	$ 7,795,000	1,499,000
Strategic Plan
Disaggregation of Revenue [Line Items]
Number of units in real estate properties transitioned | living_unit									0
Strategic Plan | DHC
Disaggregation of Revenue [Line Items]
Number of units in real estate property closed | living_unit	100		100
Number of real estate properties closed | community					1
Senior Living Communities
Disaggregation of Revenue [Line Items]
Number of properties operated | property						179
Number of living units in properties operated | living_unit	22,768		22,768						120
Senior Living Communities | Strategic Plan
Disaggregation of Revenue [Line Items]
Number of real estate properties transitioned | community					69
Number of units in real estate properties transitioned | living_unit	4,800		4,800
SNF
Disaggregation of Revenue [Line Items]
Number of units in real estate property closed	59		59				1,532	1,473
SNF | Strategic Plan
Disaggregation of Revenue [Line Items]
Number of units in real estate property closed | living_unit	1,532		1,532
Continuing Care Retirement Communities
Disaggregation of Revenue [Line Items]
Number of properties operated | community					4
Number of living units in properties operated | living_unit	1		1
Number of units in real estate property closed | living_unit	27		27
Number of real estate properties closed | community								26
Continuing Care Retirement Communities | Strategic Plan
Disaggregation of Revenue [Line Items]
Number of living units in properties operated | living_unit									1,500
Continuing Care Retirement Communities | Strategic Plan | DHC
Disaggregation of Revenue [Line Items]
Number of properties operated | community					27
Ageility Inpatient Rehabilitation | Strategic Plan
Disaggregation of Revenue [Line Items]
Number of properties operated | community					37
Number of real estate properties closed | community					27
Inpatient Rehabilitation Clinics
Disaggregation of Revenue [Line Items]
Revenues	$ 1,508,000		$ 9,579,000
Diversified Healthcare Trust | Senior Living Communities | Strategic Plan
Disaggregation of Revenue [Line Items]
Number of living units in properties operated | living_unit	7,500		7,500
Diversified Healthcare Trust | Senior Living Communities | Strategic Plan | DHC
Disaggregation of Revenue [Line Items]
Number of real estate properties transitioned | community					35
Number of units in real estate properties transitioned | living_unit	2,100		2,100
Diversified Healthcare Trust | SNF | Strategic Plan
Disaggregation of Revenue [Line Items]
Number of properties operated | community					108
Diversified Healthcare Trust | Ageility Inpatient Rehabilitation
Disaggregation of Revenue [Line Items]
Number of properties operated | living_unit	16		16
Private payer
Disaggregation of Revenue [Line Items]
Revenues	$ 16,325,000	19,643,000	$ 49,740,000	61,328,000
Medicare and Medicaid programs
Disaggregation of Revenue [Line Items]
Revenues	10,361,000	10,925,000	32,253,000	31,072,000
Other third-party payer programs
Disaggregation of Revenue [Line Items]
Revenues	5,016,000	9,081,000	20,150,000	28,488,000
Management fees
Disaggregation of Revenue [Line Items]
Revenues	11,220,000	15,302,000	37,997,000	48,058,000
Management fees | DHC
Disaggregation of Revenue [Line Items]
Revenues	1,306,000	2,820,000	6,354,000	8,629,000
Management fees | Senior Living Communities | DHC
Disaggregation of Revenue [Line Items]
Revenues	2,710,000	622,000	12,329,000	2,338,000
Management fees | SNF
Disaggregation of Revenue [Line Items]
Revenues	29,000	1,306,000	1,863,000	4,503,000
Reimbursed community-level costs incurred on behalf of managed communities
Disaggregation of Revenue [Line Items]
Revenues	177,231,000	233,783,000	585,662,000	689,903,000
Other reimbursed expenses
Disaggregation of Revenue [Line Items]
Revenues	5,678,000	6,589,000	27,750,000	19,003,000
Other reimbursed expenses | Diversified Healthcare Trust
Disaggregation of Revenue [Line Items]
Revenues			12,344,000
Other reimbursed expenses | Diversified Healthcare Trust | Strategic Plan
Disaggregation of Revenue [Line Items]
Revenues	813,000
Total revenues
Disaggregation of Revenue [Line Items]
Revenues	225,831,000	295,323,000	753,552,000	877,852,000
Senior Living | Private payer
Disaggregation of Revenue [Line Items]
Revenues	16,032,000	18,347,000	48,935,000	57,921,000
Senior Living | Medicare and Medicaid programs
Disaggregation of Revenue [Line Items]
Revenues	288,000	178,000	820,000	1,191,000
Senior Living | Other third-party payer programs
Disaggregation of Revenue [Line Items]
Revenues	0	0	0	0
Senior Living | Management fees
Disaggregation of Revenue [Line Items]
Revenues	11,220,000	15,302,000	37,997,000	48,058,000
Senior Living | Reimbursed community-level costs incurred on behalf of managed communities
Disaggregation of Revenue [Line Items]
Revenues	177,231,000	233,783,000	585,662,000	689,903,000
Senior Living | Other reimbursed expenses
Disaggregation of Revenue [Line Items]
Revenues	5,678,000	6,589,000	27,750,000	19,003,000
Senior Living | Total revenues
Disaggregation of Revenue [Line Items]
Revenues	210,449,000	274,199,000	701,164,000	816,076,000
Rehabilitation and Wellness Services | Ageility Inpatient Rehabilitation
Disaggregation of Revenue [Line Items]
Number of properties operated | property						6
Rehabilitation and Wellness Services | Ageility Inpatient Rehabilitation | DHC
Disaggregation of Revenue [Line Items]
Number of real estate properties transitioned | property						8
Rehabilitation and Wellness Services | Diversified Healthcare Trust | Ageility Inpatient Rehabilitation
Disaggregation of Revenue [Line Items]
Number of properties operated | property						10
Rehabilitation and Wellness Services | Private payer
Disaggregation of Revenue [Line Items]
Revenues	293,000	1,296,000	805,000	3,407,000
Rehabilitation and Wellness Services | Medicare and Medicaid programs
Disaggregation of Revenue [Line Items]
Revenues	10,073,000	10,747,000	31,433,000	29,881,000
Rehabilitation and Wellness Services | Other third-party payer programs
Disaggregation of Revenue [Line Items]
Revenues	5,016,000	9,081,000	20,150,000	28,488,000
Rehabilitation and Wellness Services | Management fees
Disaggregation of Revenue [Line Items]
Revenues	0	0	0	0
Rehabilitation and Wellness Services | Reimbursed community-level costs incurred on behalf of managed communities
Disaggregation of Revenue [Line Items]
Revenues	0	0	0	0
Rehabilitation and Wellness Services | Other reimbursed expenses
Disaggregation of Revenue [Line Items]
Revenues	0	0	0	0
Rehabilitation and Wellness Services | Total revenues
Disaggregation of Revenue [Line Items]
Revenues	$ 15,382,000	$ 21,124,000	$ 52,388,000	$ 61,776,000

Segment Information (Details)

Segment Information (Details)	3 Months Ended						9 Months Ended
	Sep. 30, 2021USD ($)living_unit	Jun. 30, 2021USD ($)communityliving_unit	Mar. 31, 2021USD ($)	Sep. 30, 2020USD ($)	Jun. 30, 2020USD ($)	Mar. 31, 2020USD ($)	Sep. 30, 2021USD ($)living_unit	Sep. 30, 2020USD ($)	Sep. 30, 2021community	Sep. 30, 2021property	Sep. 30, 2021facility	Apr. 09, 2021living_unit
Segment Reporting Information [Line Items]
Revenues	$ 225,831,000			$ 295,323,000			$ 753,552,000	$ 877,852,000
Other operating income	0			0			7,795,000	1,499,000
Operating expenses	232,518,000			291,630,000			776,677,000	865,690,000
Operating (loss) income	(6,687,000)			3,693,000			(15,330,000)	13,661,000
Allocated corporate and other costs	0			0			0	0
Other (loss) income, net	(3,678,000)			487,000			(3,664,000)	(23,182,000)
(Loss) income before income taxes	(10,365,000)			4,180,000			(18,994,000)	(9,521,000)
(Provision) benefit for income taxes	164,000			(465,000)			(194,000)	(971,000)
Net (loss) income	(10,201,000)	$ (12,302,000)	$ 3,315,000	3,715,000	$ 3,002,000	$ (17,209,000)	(19,188,000)	(10,492,000)
Restructuring expenses	1,220,000			142,000			16,859,000	1,412,000
Other reimbursed expenses
Segment Reporting Information [Line Items]
Revenues	$ 5,678,000			6,589,000			$ 27,750,000	19,003,000
Senior Living Communities
Segment Reporting Information [Line Items]
Number of properties operated | property										179
Number of living units in properties operated | living_unit	22,768						22,768					120
SNF
Segment Reporting Information [Line Items]
Number of units in real estate property closed	59	1,473					59				1,532
Continuing Care Retirement Communities
Segment Reporting Information [Line Items]
Number of properties operated | community									4
Number of living units in properties operated | living_unit	1						1
Number of units in real estate property closed | living_unit	27						27
Number of real estate properties closed | community		26
Strategic Plan
Segment Reporting Information [Line Items]
Number of units in real estate properties transitioned | living_unit												0
Restructuring expenses	$ 1,220,000						$ 16,859,000
Strategic Plan | Senior Living Communities
Segment Reporting Information [Line Items]
Number of real estate properties transitioned | community									69
Number of units in real estate properties transitioned | living_unit	4,800						4,800
Strategic Plan | SNF
Segment Reporting Information [Line Items]
Number of units in real estate property closed | living_unit	1,532						1,532
Strategic Plan | Continuing Care Retirement Communities
Segment Reporting Information [Line Items]
Number of living units in properties operated | living_unit												1,500
Strategic Plan | Ageility Inpatient Rehabilitation
Segment Reporting Information [Line Items]
Number of properties operated | community									37
Number of real estate properties closed | community									27
Diversified Healthcare Trust | Other reimbursed expenses
Segment Reporting Information [Line Items]
Revenues							$ 12,344,000
Diversified Healthcare Trust | Ageility Inpatient Rehabilitation
Segment Reporting Information [Line Items]
Number of properties operated | living_unit	16						16
Diversified Healthcare Trust | Strategic Plan | Other reimbursed expenses
Segment Reporting Information [Line Items]
Revenues	$ 813,000
Diversified Healthcare Trust | Strategic Plan | Senior Living Communities
Segment Reporting Information [Line Items]
Number of living units in properties operated | living_unit	7,500						7,500
Diversified Healthcare Trust | Strategic Plan | SNF
Segment Reporting Information [Line Items]
Number of properties operated | community									108
Senior Living | Other reimbursed expenses
Segment Reporting Information [Line Items]
Revenues	$ 5,678,000			6,589,000			$ 27,750,000	19,003,000
Rehabilitation And Wellness | Other reimbursed expenses
Segment Reporting Information [Line Items]
Revenues	0			0			0	0
Rehabilitation And Wellness | Ageility Inpatient Rehabilitation
Segment Reporting Information [Line Items]
Number of properties operated | property										6
Rehabilitation And Wellness | Diversified Healthcare Trust | Ageility Inpatient Rehabilitation
Segment Reporting Information [Line Items]
Number of properties operated | property										10
Operating Segments | Senior Living
Segment Reporting Information [Line Items]
Revenues	210,449,000			274,199,000			701,164,000	816,076,000
Other operating income				0			7,776,000	0
Operating expenses	200,570,000			260,077,000			671,991,000	766,415,000
Operating (loss) income	9,879,000			14,122,000			36,949,000	49,661,000
Allocated corporate and other costs	(10,388,000)			(13,657,000)			(34,811,000)	(43,448,000)
Other (loss) income, net	(3,202,000)			(122,000)			(2,557,000)	(163,000)
(Loss) income before income taxes	(3,711,000)			343,000			(419,000)	6,050,000
(Provision) benefit for income taxes	0			0			0	0
Net (loss) income	(3,711,000)			343,000			(419,000)	6,050,000
Operating Segments | Senior Living | Strategic Plan
Segment Reporting Information [Line Items]
Restructuring expenses	813,000						12,344,000
Operating Segments | Rehabilitation And Wellness
Segment Reporting Information [Line Items]
Revenues	15,382,000			21,124,000			52,388,000	61,776,000
Other operating income				0			19,000	1,499,000
Operating expenses	13,349,000			16,833,000			47,204,000	50,708,000
Operating (loss) income	2,033,000			4,291,000			5,203,000	12,567,000
Allocated corporate and other costs	(770,000)			(1,052,000)			(2,621,000)	(3,094,000)
Other (loss) income, net	0			0			0	0
(Loss) income before income taxes	1,263,000			3,239,000			2,582,000	9,473,000
(Provision) benefit for income taxes	0			0			0	0
Net (loss) income	1,263,000			3,239,000			2,582,000	9,473,000
Operating Segments | Rehabilitation And Wellness | Strategic Plan
Segment Reporting Information [Line Items]
Restructuring expenses	(310,000)						1,410,000
Corporate and Other
Segment Reporting Information [Line Items]
Revenues	0			0			0	0
Other operating income				0			0	0
Operating expenses	18,599,000			14,720,000			57,482,000	48,567,000
Operating (loss) income	(18,599,000)			(14,720,000)			(57,482,000)	(48,567,000)
Allocated corporate and other costs	11,158,000			14,709,000			37,432,000	46,542,000
Other (loss) income, net	(476,000)			609,000			(1,107,000)	(23,019,000)
(Loss) income before income taxes	(7,917,000)			598,000			(21,157,000)	(25,044,000)
(Provision) benefit for income taxes	164,000			(465,000)			(194,000)	(971,000)
Net (loss) income	(7,753,000)			$ 133,000			(21,351,000)	$ (26,015,000)
Corporate and Other | Strategic Plan
Segment Reporting Information [Line Items]
Restructuring expenses	$ 717,000						$ 3,105,000

Property and Equipment, net (De

Property and Equipment, net (Details) $ in Thousands	Sep. 30, 2021USD ($)community	Sep. 30, 2021USD ($)community	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)community	Sep. 30, 2020USD ($)	Jun. 03, 2021community	Dec. 31, 2020USD ($)
Property, Plant and Equipment [Line Items]
Property and equipment, at cost	$ 276,603	$ 276,603		$ 276,603			$ 275,547
Less: accumulated depreciation	(119,575)	(119,575)		(119,575)			(116,296)
Property and equipment, net	157,028	157,028		157,028			159,251
Gain (loss) on termination of lease		(3,277)	$ 0	(3,277)	$ (22,899)
Operating lease right-of-use assets	$ 9,452	9,452		9,452			18,030
Depreciation expenses		$ 2,692	$ 2,680	$ 8,082	$ 8,084
Senior Living Communities
Property, Plant and Equipment [Line Items]
Number of communities operating | community	11	11		11
Healthpeak Properties Inc
Property, Plant and Equipment [Line Items]
Gain (loss) on termination of lease	$ (3,277)
Termination fee				$ 3,100
Other obligation fee				548
Legal transaction cost				37
Operating lease right-of-use assets	16,055	$ 16,055		16,055
Operating lease liability	$ 17,636	$ 17,636		17,636
Proceeds from insurance				1,500
Accumulated depreciation increase (decrease)				$ (4,803)
Healthpeak Properties Inc | Senior Living Communities
Property, Plant and Equipment [Line Items]
Number of communities operating | community	4	4		4		3
Land
Property, Plant and Equipment [Line Items]
Property and equipment, at cost	$ 12,155	$ 12,155		$ 12,155			12,155
Buildings, construction in process and improvements
Property, Plant and Equipment [Line Items]
Property and equipment, at cost	202,897	202,897		202,897			202,679
Furniture, fixtures and equipment
Property, Plant and Equipment [Line Items]
Property and equipment, at cost	61,551	61,551		61,551			$ 60,713
Leasehold Improvements and Other Fixed Assets | Healthpeak Properties Inc
Property, Plant and Equipment [Line Items]
Property and equipment, net	$ 1,173	$ 1,173		$ 1,173

Accumulated Other Comprehensi_3

Accumulated Other Comprehensive Income (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Changes in accumulated other comprehensive income
Beginning balance	$ 210,532	$ 119,981
Unrealized loss on debt investments, net of tax	(317)	710
Realized gain on debt investments reclassified and included in net income (loss), net of tax	(18)	(303)
Ending balance	191,767	207,561
Cumulative Effect, Period of Adoption, Adjustment
Changes in accumulated other comprehensive income
Beginning balance		0
Equity Investment of an Investee
Changes in accumulated other comprehensive income
Beginning balance	(175)	(175)
Unrealized loss on debt investments, net of tax	0	0
Realized gain on debt investments reclassified and included in net income (loss), net of tax	0	0
Ending balance	(175)	(175)
Equity Investment of an Investee | Cumulative Effect, Period of Adoption, Adjustment
Changes in accumulated other comprehensive income
Beginning balance		0
Investments
Changes in accumulated other comprehensive income
Beginning balance	1,491	2,838
Unrealized loss on debt investments, net of tax	(317)	710
Realized gain on debt investments reclassified and included in net income (loss), net of tax	(18)	(303)
Ending balance	1,156	1,551
Investments | Cumulative Effect, Period of Adoption, Adjustment
Changes in accumulated other comprehensive income
Beginning balance		(1,694)
Accumulated Other Comprehensive Income
Changes in accumulated other comprehensive income
Beginning balance	1,316	2,663
Ending balance	$ 981	1,376
Accumulated Other Comprehensive Income | Cumulative Effect, Period of Adoption, Adjustment
Changes in accumulated other comprehensive income
Beginning balance		$ (1,694)

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Income Tax Disclosure [Abstract]
Provision (benefit) for income taxes	$ (164)	$ 465	$ 194	$ 971

Net (Loss) Income Per Share (De

Net (Loss) Income Per Share (Details) - shares shares in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Earnings Per Share [Abstract]
Weighted average shares outstanding—basic (in shares)	31,618	31,486	31,567	31,465
Effect of dilutive securities: unvested share awards (in shares)	0	77	0	0
Weighted average shares outstanding—diluted (in shares)	31,618	31,563	31,567	31,465
Potentially dilutive restricted unvested common shares, not included in diluted EPS calculation (in shares)	157		146	108

Fair Values of Assets and Lia_3

Fair Values of Assets and Liabilities - Recurring Measurements (Details)	9 Months Ended
	Sep. 30, 2021USD ($)communitysecurity	Sep. 30, 2020USD ($)	Jun. 30, 2021community	Jun. 03, 2021community	Apr. 04, 2021community	Dec. 31, 2020USD ($)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents	$ 26,378,000					$ 26,291,000
Total equity investments	12,858,000					12,439,000
Total debt investments	10,481,000					12,310,000
Total investments	23,339,000					24,749,000
Total	49,717,000					51,040,000
Restricted cash equivalents	22,278,000					22,837,000
Cash	76,088,000					80,897,000
Restricted cash	2,474,000					2,409,000
Gross proceeds from sale of equity securities	741,000	$ 3,141,000
Gross realized gains recorded on sale of equity securities	175,000	339,000
Gross realized losses recorded on sale of equity securities	0	219,000
Amortized cost of available for sale debt securities	10,060,000					11,554,000
Unrealized gains on available for sale debt securities	421,000					756,000
Unrealized losses on available for sale debt securities	$ 23,000					4,000
Debt investments fair value | security	4,000
Debt Securities unrealized loss position, less than 12 months	$ 788,000
Gross proceeds from sale of available for sale debt securities	1,294,000	5,938,000
Gross realized gains recorded on sale of debt securities	18,000	302,000
Gross realized losses recorded on sale of debt securities	0	$ 0
Mortgage note payable	$ 6,473,000					6,783,000
Senior Living Communities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Number of communities operating | community	11
Healthpeak Properties Inc | Senior Living Communities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Number of communities operating | community	4			3
Fair Value, Nonrecurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Long lived asset impairment charges	$ 890,000
Fair Value, Nonrecurring | Healthpeak Properties Inc
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Number of communities operating | community					1
Fair Value, Nonrecurring | Healthpeak Properties Inc | Senior Living Communities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Number of communities operating | community			4
Carrying Value
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Mortgage note payable	6,882,000					7,171,000
Estimated Fair Value
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Mortgage note payable	7,772,000					8,177,000
Restricted debt securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total debt investments	6,874,000					8,395,000
Quoted Prices in Active Markets for Identical Assets (Level 1)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents	26,378,000					26,291,000
Total equity investments	6,800,000					6,465,000
Total debt investments	5,789,000					7,301,000
Total investments	12,589,000					13,766,000
Total	38,967,000					40,057,000
Significant  Other Observable  Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents	0					0
Total equity investments	6,058,000					5,974,000
Total debt investments	4,692,000					5,009,000
Total investments	10,750,000					10,983,000
Total	10,750,000					10,983,000
Significant Unobservable  Inputs (Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents	0					0
Total equity investments	0					0
Total debt investments	0					0
Total investments	0					0
Total	$ 0					$ 0

Fair Values of Assets and Lia_4

Fair Values of Assets and Liabilities - Debt Securities, Contractual Maturities (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Amortized Cost
Due in one year or less	$ 2,142
Due after one year through five years	4,019
Due after five years through ten years	3,899
Total	10,060	$ 11,554
Fair Value
Due in one year or less	2,173
Due after one year through five years	4,219
Due after five years through ten years	4,089
Total	$ 10,481	$ 12,310

Indebtedness - Debt Instruments

Indebtedness - Debt Instruments Summary (Details)	1 Months Ended	3 Months Ended		9 Months Ended
	Oct. 31, 2021USD ($)	Sep. 30, 2021USD ($)communityliving_unitagreement	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)communityliving_unitagreement	Sep. 30, 2020USD ($)	Jun. 03, 2021community
Debt Instrument [Line Items]
Letters of credit outstanding		$ 27,642,000		$ 27,642,000
Senior Living Communities
Debt Instrument [Line Items]
Number of communities operating | community		11		11
Senior Living Communities | Healthpeak Properties Inc
Debt Instrument [Line Items]
Number of communities operating | community		4		4		3
Mortgage Notes
Debt Instrument [Line Items]
Interest expense and other associated costs incurred		$ 119,000	$ 125,000	$ 359,000	$ 378,000
Mortgage Notes | Senior Living Communities
Debt Instrument [Line Items]
Number of real estate properties mortgaged | community		1		1
Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Interest expense and other associated costs incurred		$ 108,000	253,000	$ 566,000	792,000
Revolving Credit Facility | Secured Revolving Credit Facility Maturing June 2022 | Senior Living Communities
Debt Instrument [Line Items]
Number of real estate properties securing borrowings on the new credit facility | community				11
Number of units in real estate properties securing borrowings on the new credit facility | living_unit				1,236
Revolving Credit Facility | Secured Revolving Credit Facility Maturing June 2022 | Line of Credit
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 65,000,000		$ 65,000,000
Interest rate at period end		0.35%		0.35%
Debt outstanding		$ 0	$ 0	$ 0	$ 0
Letters of credit outstanding		792,000		792,000
Available for borrowings		$ 26,513,000		$ 26,513,000
Revolving Credit Facility | Secured Revolving Credit Facility Maturing June 2022 | Line of Credit | LIBOR
Debt Instrument [Line Items]
Variable rate				2.50%
Interest rate at period end		2.58%		2.58%
Revolving Credit Facility | Secured Revolving Credit Facility Maturing June 2022 | Line of Credit | Base Rate
Debt Instrument [Line Items]
Variable rate				1.50%
Interest rate at period end		4.75%		4.75%
Standby Letters of Credit
Debt Instrument [Line Items]
Number of irrevocable standby letters of credit agreements | agreement		6		6
Standby Letters of Credit | Workers' Compensation Insurance Program
Debt Instrument [Line Items]
Letter of credit amount securing workers' compensation insurance program		$ 26,850,000		$ 26,850,000
Extension term				1 year
Standby Letters of Credit | Workers' Compensation Insurance Program | Cash Equivalents
Debt Instrument [Line Items]
Collateral securing workers' compensation insurance program		21,481,000		$ 21,481,000
Standby Letters of Credit | Workers' Compensation Insurance Program | Debt and Equity Investments
Debt Instrument [Line Items]
Collateral securing workers' compensation insurance program		$ 5,656,000		$ 5,656,000
Letter of Credit | Subsequent Event
Debt Instrument [Line Items]
Increase (decrease) in line of credit facility	$ (728,000)
Letter of Credit | Other Than Workers Compensation Insurance Program Collateral
Debt Instrument [Line Items]
Number of irrevocable standby letters of credit agreements | living_unit		5		5

Indebtedness - Payments of Prin

Indebtedness - Payments of Principal and Interest (Details) - September 2032 $ in Thousands	9 Months Ended
	Sep. 30, 2021USD ($)
Debt Instrument [Line Items]
Unamortized discount and debt issuance costs	$ 210
Mortgage Notes
Debt Instrument [Line Items]
Debt outstanding	$ 7,092
Contractual Stated Interest Rate	6.20%
Effective Interest Rate	6.70%
Monthly Payment	$ 72

Leases with DHC and Healthpea_2

Leases with DHC and Healthpeak Properties Inc. and Management Agreements with DHC - Narrative (Details) $ in Thousands	Sep. 30, 2021USD ($)	Apr. 07, 2021	Sep. 30, 2021USD ($)	Sep. 30, 2020USD ($)community	Jun. 30, 2021communityliving_unit	Sep. 30, 2021USD ($)	Sep. 30, 2020USD ($)community	Dec. 31, 2020USD ($)communityliving_unitbuilding	Dec. 31, 2019USD ($)leaseshares	Oct. 31, 2021living_unitcommunity	Sep. 30, 2021living_unit	Sep. 30, 2021community	Sep. 30, 2021property	Sep. 30, 2021facility	Jul. 31, 2021living_unit	Jun. 03, 2021community	Apr. 09, 2021living_unit	Apr. 04, 2021community
Operating Leased Assets [Line Items]
Additional consideration from share issuances							$ 23,453
Lease terminations							22,899
Decrease in working capital liabilities							51,547
Revenues			$ 225,831	$ 295,323		$ 753,552	877,852
Net present value of the allocated minimum rate percentage					9.00%
Net proceeds sale of the community discount percentage					9.00%
Net proceeds of reinvested sale rate percentage					5.50%
Gain (loss) on termination of lease			(3,277)	0		(3,277)	(22,899)
Operating lease right-of-use assets	$ 9,452		9,452			9,452		$ 18,030
Property and equipment, net	157,028		157,028			157,028		$ 159,251
Management Fee Revenue
Operating Leased Assets [Line Items]
Revenues			11,220	15,302		37,997	48,058
Strategic Plan
Operating Leased Assets [Line Items]
Number of units in real estate properties transitioned | living_unit																	0
Healthpeak Properties Inc
Operating Leased Assets [Line Items]
Gain (loss) on termination of lease	(3,277)
Termination fee						3,100
Other obligation fee						548
Legal transaction cost						37
Operating lease right-of-use assets	16,055		16,055			16,055
Operating lease liability	17,636		17,636			17,636
Proceeds from insurance						1,500
Healthpeak Properties Inc | Fair Value, Nonrecurring
Operating Leased Assets [Line Items]
Number of communities operating | community																		1
Healthpeak Properties Inc | Leasehold Improvements and Other Fixed Assets
Operating Leased Assets [Line Items]
Property and equipment, net	1,173		1,173			1,173
PEAK
Operating Leased Assets [Line Items]
Number of master leases | community					1
SNH | Management Fee Revenue
Operating Leased Assets [Line Items]
Revenues form senior living communities			10,418	14,609		35,437	46,206
DHC
Operating Leased Assets [Line Items]
Termination fees	682,000		682,000			682,000
Number of buildings to be sold | building								1
DHC | Management Fee Revenue
Operating Leased Assets [Line Items]
Revenues			1,306	2,820		6,354	8,629
DHC | Strategic Plan
Operating Leased Assets [Line Items]
Number of units in real estate property closed | living_unit											100
Transaction Agreement | Diversified Healthcare Trust | Strategic Plan
Operating Leased Assets [Line Items]
Management agreement, term of agreement, extension		2 years
Transaction Agreement | SNH
Operating Leased Assets [Line Items]
Number of properties managed | community												159
Transaction Agreement | SNH | Shares Issued
Operating Leased Assets [Line Items]
Additional consideration from share issuances									$ 75,000
Excess fair value of shares issued	$ 97,899		97,899			97,899
Transaction Agreement | SNH | Diversified Healthcare Trust | Shares Issued
Operating Leased Assets [Line Items]
Number of shares sold (in shares) | shares									10,268,158
Transaction Agreement | SNH | Diversified Healthcare Trust Shareholders | Shares Issued
Operating Leased Assets [Line Items]
Number of shares sold (in shares) | shares									16,118,849
Other Services Provided to Residents at Managed Communities | SNH
Operating Leased Assets [Line Items]
Rehabilitation service revenue			960	$ 5,972		9,031	$ 19,843
Senior Living Communities | SNH
Operating Leased Assets [Line Items]
Number of properties managed | community				239			239
Senior Living Communities
Operating Leased Assets [Line Items]
Number of properties operated | property													179
Number of living units in properties operated | living_unit											22,768						120
Number of communities operating | community												11
Number of buildings to be sold | building								1
Senior Living Communities | Strategic Plan
Operating Leased Assets [Line Items]
Number of real estate properties transitioned | community												69
Number of units in real estate properties transitioned | living_unit											4,800
Senior Living Communities | Strategic Plan | Subsequent Event
Operating Leased Assets [Line Items]
Number of real estate properties transitioned | community										27
Number of units in real estate property transitioned | living_unit										1,700
Senior Living Communities | Diversified Healthcare Trust | Strategic Plan
Operating Leased Assets [Line Items]
Number of living units in properties operated | living_unit											7,500
Management agreement, percentage of communities allowed for termination								20.00%									10.00%
Management agreement, percentage of EBITDA								90.00%									80.00%
Senior Living Communities | Healthpeak Properties Inc
Operating Leased Assets [Line Items]
Number of communities operating | community												4				3
Senior Living Communities | Healthpeak Properties Inc | Fair Value, Nonrecurring
Operating Leased Assets [Line Items]
Number of communities operating | community					4
Senior Living Communities | PEAK
Operating Leased Assets [Line Items]
Number of living units in properties operated | living_unit															152
Revenues			1,458			4,467
Lease expense			538			1,622
Senior Living Communities | SNH | Management Fee Revenue
Operating Leased Assets [Line Items]
Revenues form senior living communities			702	$ 573		2,251	$ 1,479
Senior Living Communities | SNH | Management Fee Revenue | D&R Yonkers LLC
Operating Leased Assets [Line Items]
Revenues form senior living communities			100	120		309	372
Senior Living Communities | DHC
Operating Leased Assets [Line Items]
Lease expense			370	392		1,165	1,175
Number of communities sold | community								9
Additional number of communities managed | living_unit								7
Senior Living Communities | DHC | Management Fee Revenue
Operating Leased Assets [Line Items]
Revenues			2,710	622		12,329	2,338
Senior Living Communities | DHC | Diversified Healthcare Trust | Strategic Plan
Operating Leased Assets [Line Items]
Number of real estate properties transitioned | community												35
Number of units in real estate properties transitioned | living_unit											2,100
Senior Living Communities | DHC | Diversified Healthcare Trust | Strategic Plan | Subsequent Event
Operating Leased Assets [Line Items]
Number of real estate properties transitioned | community										3
Number of units in real estate property transitioned | living_unit										500
Senior Living Communities | Transaction Agreement | SNH
Operating Leased Assets [Line Items]
Number of master leases | lease									5
Related party transaction costs				142			1,412
SNF
Operating Leased Assets [Line Items]
Number of units in real estate property closed					1,473						59			1,532
SNF | Management Fee Revenue
Operating Leased Assets [Line Items]
Revenues			$ 29	$ 1,306		$ 1,863	$ 4,503
SNF | Strategic Plan
Operating Leased Assets [Line Items]
Number of units in real estate property closed | living_unit											1,532
SNF | Diversified Healthcare Trust | Strategic Plan
Operating Leased Assets [Line Items]
Number of properties operated | community												108
Continuing Care Retirement Communities
Operating Leased Assets [Line Items]
Number of properties operated | community												4
Number of living units in properties operated | living_unit											1
Number of units in real estate property closed | living_unit											27
Continuing Care Retirement Communities | Strategic Plan
Operating Leased Assets [Line Items]
Number of living units in properties operated | living_unit																	1,500
Continuing Care Retirement Communities | DHC | Strategic Plan
Operating Leased Assets [Line Items]
Number of properties operated | community												27

Business Management Agreement_2

Business Management Agreement with RMR LLC - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Reit Management And Research LLC
Business Management Agreement [Line Items]
Business management fees and costs	$ 1,550	$ 2,061	$ 5,149	$ 6,535

Related Person Transactions (De

Related Person Transactions (Details) - USD ($) $ in Thousands	Feb. 24, 2021	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Related Party Transaction [Line Items]
Accrued expenses and other current liabilities		$ 32,000		$ 32,000		$ 41,843
Operating lease right-of-use assets		9,452		9,452		18,030
COVID-19
Related Party Transaction [Line Items]
Accrued expenses and other current liabilities		$ 18,384		$ 18,384		30,090
DHC | Affiliated Entity
Related Party Transaction [Line Items]
Number of shares owned (in shares)		10,691,658		10,691,658
Percentage of outstanding common shares owned		33.70%		33.70%
ABP Trust | Affiliated Entity
Related Party Transaction [Line Items]
Number of shares owned (in shares)		1,972,783		1,972,783
Percentage of outstanding common shares owned		6.20%		6.20%
Rent expense		$ 518	$ 442	$ 1,554	$ 1,302
Leasehold improvements, gross	$ 2,667
Incremental borrowing rate		3.90%		3.90%
ABP Trust | Affiliated Entity | Headquarters
Related Party Transaction [Line Items]
Operating lease, cost				$ 9,746
Lease liability		$ 9,968		9,968		496
Operating lease right-of-use assets		$ 9,452		$ 9,452		$ 452
ABP Trust | Affiliated Entity | Minimum
Related Party Transaction [Line Items]
Rent expense	1,026
ABP Trust | Affiliated Entity | Maximum
Related Party Transaction [Line Items]
Rent expense	$ 1,395

Commitments and Contingencies (

Commitments and Contingencies (Details)	May 12, 2021USD ($)	Sep. 30, 2021USD ($)lawsuit
Loss Contingencies [Line Items]
Litigation settlement expense	$ 3,062,000
Office of the Inspector General
Loss Contingencies [Line Items]
Estimated minimum loss		$ 0
Lefevre v. Five Star Quality Care, Inc.
Loss Contingencies [Line Items]
Number of lawsuits | lawsuit		2
Litigation settlement expense	2,400,000
DHC | Lefevre v. Five Star Quality Care, Inc.
Loss Contingencies [Line Items]
Litigation settlement expense	$ 662,000

COVID-19 Pandemic - Narrative (

COVID-19 Pandemic - Narrative (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Unusual or Infrequent Item, or Both [Line Items]
Other operating income	$ 0	$ 0	$ 7,795,000	$ 1,499,000
Tax Year 2020
Unusual or Infrequent Item, or Both [Line Items]
AMT amount	454,000		454,000
Latest Tax Year
Unusual or Infrequent Item, or Both [Line Items]
AMT amount	100,000		100,000
COVID-19
Unusual or Infrequent Item, or Both [Line Items]
Payments for protective equipment			6,159,000
Deferred payroll taxes					$ 27,593,000
Payment of deferred taxes			22,194,000
AMT amount	554,000		554,000
COVID-19 | Senior living
Unusual or Infrequent Item, or Both [Line Items]
Payments for protective equipment	$ 152,000		$ 3,209,000

Restructuring Expense - Narrati

Restructuring Expense - Narrative (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2021community	Sep. 30, 2021property	Sep. 30, 2021living_unit	Sep. 30, 2021facility	Jun. 30, 2021living_unitcommunity	Apr. 09, 2021living_unit
Restructuring Cost and Reserve [Line Items]
Restructuring expenses	$ 1,220	$ 142	$ 16,859	$ 1,412
Revenues	225,831	295,323	753,552	877,852
Other reimbursed expenses
Restructuring Cost and Reserve [Line Items]
Revenues	5,678	$ 6,589	27,750	$ 19,003
Diversified Healthcare Trust | Other reimbursed expenses
Restructuring Cost and Reserve [Line Items]
Revenues			12,344
Strategic Plan
Restructuring Cost and Reserve [Line Items]
Number of units in real estate properties transitioned | living_unit										0
Restructuring expenses	1,220		16,859
Restructuring and related cost, expected costs	19,000		19,000
Strategic Plan | DHC
Restructuring Cost and Reserve [Line Items]
Number of units in real estate property closed | living_unit							100
Number of real estate properties closed | community					1
Strategic Plan | Retention bonuses
Restructuring Cost and Reserve [Line Items]
Restructuring expenses	875		6,480
Restructuring and related cost, expected costs	7,500		7,500
Strategic Plan | Severance, benefits and transition expenses
Restructuring Cost and Reserve [Line Items]
Restructuring expenses			14,609
Restructuring and related cost, expected costs	8,700		8,700
Strategic Plan | Transaction expenses
Restructuring Cost and Reserve [Line Items]
Restructuring expenses	1,155		2,250
Restructuring and related cost, expected costs	2,800		2,800
Strategic Plan | Diversified Healthcare Trust
Restructuring Cost and Reserve [Line Items]
Costs expected to be reimbursed	13,000		13,000
Strategic Plan | Diversified Healthcare Trust | Other reimbursed expenses
Restructuring Cost and Reserve [Line Items]
Revenues	813
Strategic Plan | Diversified Healthcare Trust | Retention bonuses
Restructuring Cost and Reserve [Line Items]
Costs expected to be reimbursed	5,100		5,100
Strategic Plan | Diversified Healthcare Trust | Severance, benefits and transition expenses
Restructuring Cost and Reserve [Line Items]
Costs expected to be reimbursed	7,200		7,200
Strategic Plan | Diversified Healthcare Trust | Transaction expenses
Restructuring Cost and Reserve [Line Items]
Costs expected to be reimbursed	$ 700		$ 700
SNF
Restructuring Cost and Reserve [Line Items]
Number of units in real estate property closed							59	1,532	1,473
SNF | Strategic Plan
Restructuring Cost and Reserve [Line Items]
Number of units in real estate property closed | living_unit							1,532
SNF | Strategic Plan | Diversified Healthcare Trust
Restructuring Cost and Reserve [Line Items]
Number of properties operated | community					108
Continuing Care Retirement Communities
Restructuring Cost and Reserve [Line Items]
Number of units in real estate property closed | living_unit							27
Number of properties operated | community					4
Number of real estate properties closed | community									26
Continuing Care Retirement Communities | Strategic Plan | DHC
Restructuring Cost and Reserve [Line Items]
Number of properties operated | community					27
Ageility Inpatient Rehabilitation | Diversified Healthcare Trust
Restructuring Cost and Reserve [Line Items]
Number of properties operated | living_unit							16
Ageility Inpatient Rehabilitation | Strategic Plan
Restructuring Cost and Reserve [Line Items]
Number of properties operated | community					37
Number of real estate properties closed | community					27
Senior Living Communities
Restructuring Cost and Reserve [Line Items]
Number of properties operated | property						179
Senior Living Communities | Strategic Plan
Restructuring Cost and Reserve [Line Items]
Number of real estate properties transitioned | community					69
Number of units in real estate properties transitioned | living_unit							4,800
Senior Living Communities | Strategic Plan | Diversified Healthcare Trust | DHC
Restructuring Cost and Reserve [Line Items]
Number of real estate properties transitioned | community					35
Number of units in real estate properties transitioned | living_unit							2,100

Restructuring Expense - Summary

Restructuring Expense - Summary of Liabilities and Expenses (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Restructuring Reserve [Roll Forward]
Expenses Incurred	$ 1,220	$ 142	$ 16,859	$ 1,412
Strategic Plan
Restructuring Reserve [Roll Forward]
Beginning Balance	6,727		0
Expenses Incurred	1,220		16,859
Payments	4,709		13,621
Ending Balance	3,238		3,238
Strategic Plan | Corporate and Other
Restructuring Reserve [Roll Forward]
Beginning Balance	2,007		0
Expenses Incurred	717		3,105
Payments	1,691		2,072
Ending Balance	1,033		1,033
Strategic Plan | Senior living | Operating Segments
Restructuring Reserve [Roll Forward]
Beginning Balance	4,144		0
Expenses Incurred	813		12,344
Payments	2,752		10,139
Ending Balance	2,205		2,205
Strategic Plan | Rehabilitation And Wellness | Operating Segments
Restructuring Reserve [Roll Forward]
Beginning Balance	576		0
Expenses Incurred	(310)		1,410
Payments	266		1,410
Ending Balance	0		0
Strategic Plan | Retention bonuses
Restructuring Reserve [Roll Forward]
Beginning Balance	2,495		0
Expenses Incurred	875		6,480
Payments	1,793		4,903
Ending Balance	1,577		1,577
Strategic Plan | Severance, benefits and transition expenses
Restructuring Reserve [Roll Forward]
Beginning Balance	3,494		0
Expenses Incurred	(810)		8,129
Payments	1,475		6,920
Ending Balance	1,209		1,209
Strategic Plan | Transaction expenses
Restructuring Reserve [Roll Forward]
Beginning Balance	738		0
Expenses Incurred	1,155		2,250
Payments	1,441		1,798
Ending Balance	$ 452		$ 452

Subsequent Events (Details)

Subsequent Events (Details) - Senior Living Communities - Strategic Plan	Oct. 31, 2021communityliving_unit	Sep. 30, 2021community
Subsequent Event [Line Items]
Number of real estate properties transitioned		69
Diversified Healthcare Trust | DHC
Subsequent Event [Line Items]
Number of real estate properties transitioned		35
Subsequent Event
Subsequent Event [Line Items]
Number of real estate properties transitioned	27
Number of units in real estate property transitioned | living_unit	1,700
Subsequent Event | Diversified Healthcare Trust | DHC
Subsequent Event [Line Items]
Number of real estate properties transitioned	3
Number of units in real estate property transitioned | living_unit	500