Griffin-American Healthcare REIT III (GRAH) 10-Q 14 Aug 19 2019 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2019	Aug. 09, 2019
Document and Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Jun. 30, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q2
Entity Registrant Name	Griffin-American Healthcare REIT III, Inc.
Entity Central Index Key	0001566912
Current Fiscal Year End Date	--12-31
Entity Filer Category	Non-accelerated Filer
Entity Emerging Growth Company	false
Entity Current Reporting Status	Yes
Entity Small Business	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		195,730,548

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands		Jun. 30, 2019	Dec. 31, 2018
ASSETS
Real estate investments, net		$ 2,230,950	$ 2,222,681
Real estate notes receivable and debt security investment, net		71,272	98,655
Cash and cash equivalents		34,026	35,132
Accounts and other receivables, net		131,120	122,918
Restricted cash		39,697	37,573
Real estate deposits		281	3,077
Identified intangible assets, net		168,187	179,521
Goodwill		75,309	75,309
Operating lease right-of-use assets		204,527	0
Other assets, net		130,784	114,226
Total assets		3,086,153	2,889,092
Liabilities:
Mortgage loans payable, net	[1]	743,564	688,262
Lines of credit and term loans	[1]	757,567	738,048
Accounts payable and accrued liabilities	[1]	143,567	139,383
Accounts payable due to affiliates	[1]	2,582	2,103
Identified intangible liabilities, net		842	1,051
Financing obligations	[1]	28,951	25,947
Operating lease liabilities	[1]	193,390	0
Security deposits, prepaid rent and other liabilities	[1]	38,600	37,418
Total liabilities		1,909,063	1,632,212
Commitments and contingencies (Note 11)
Redeemable noncontrolling interests (Note 12)		38,115	38,245
Stockholders’ equity:
Preferred stock, $0.01 par value per share; 200,000,000 shares authorized; none issued and outstanding		0	0
Common stock, $0.01 par value per share; 1,000,000,000 shares authorized; 194,736,018 and 197,557,377 shares issued and outstanding as of June 30, 2019 and December 31, 2018, respectively		1,946	1,975
Additional paid-in capital		1,739,119	1,765,840
Accumulated deficit		(759,520)	(704,748)
Accumulated other comprehensive loss		(2,580)	(2,560)
Total stockholders’ equity		978,965	1,060,507
Noncontrolling interests (Note 13)		160,010	158,128
Total equity		1,138,975	1,218,635
Total liabilities, redeemable noncontrolling interests and equity		$ 3,086,153	$ 2,889,092
[1]	Such liabilities of Griffin-American Healthcare REIT III, Inc. as of June 30, 2019 and December 31, 2018 represented liabilities of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries. Griffin-American Healthcare REIT III Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of Griffin-American Healthcare REIT III, Inc. The creditors of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries do not have recourse against Griffin-American Healthcare REIT III, Inc., except for six and five mortgage loans in the aggregate amount of $100,061,000 and $50,316,000 as of June 30, 2019 and December 31, 2018, respectively, and the 2019 Corporate Line of Credit and 2016 Corporate Line of Credit, as defined in Note 8, held by Griffin-American Healthcare REIT III Holdings, LP in the amount of $557,000,000 and $548,500,000 as of June 30, 2019 and December 31, 2018, respectively, which is guaranteed by Griffin-American Healthcare REIT III, Inc.

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical)		Jun. 30, 2019USD ($)loan$ / sharesshares	Dec. 31, 2018USD ($)loan$ / sharesshares
Preferred stock, par value (usd per share) | $ / shares		$ 0.01	$ 0.01
Preferred stock, shares authorized		200,000,000	200,000,000
Preferred stock, shares issued		0	0
Preferred stock, shares outstanding		0	0
Common stock, par value (usd per share) | $ / shares		$ 0.01	$ 0.01
Common stock, shares authorized		1,000,000,000	1,000,000,000
Common stock, shares, issued		194,736,018	197,557,377
Common stock, shares outstanding		194,736,018	197,557,377
Number of mortgage loans (in loans) | loan		6	5
Lines of credit and term loans | $	[1]	$ 757,567,000	$ 738,048,000
2019 Corporate Line of Credit [Member] | Line of Credit [Member]
Lines of credit and term loans | $		557,000,000
2016 Corporate Line Of Credit [Member] | Line of Credit [Member]
Lines of credit and term loans | $			548,500,000
Recourse Loan [Member]
Long-term debt | $		$ 100,061,000	$ 50,316,000
[1]	Such liabilities of Griffin-American Healthcare REIT III, Inc. as of June 30, 2019 and December 31, 2018 represented liabilities of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries. Griffin-American Healthcare REIT III Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of Griffin-American Healthcare REIT III, Inc. The creditors of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries do not have recourse against Griffin-American Healthcare REIT III, Inc., except for six and five mortgage loans in the aggregate amount of $100,061,000 and $50,316,000 as of June 30, 2019 and December 31, 2018, respectively, and the 2019 Corporate Line of Credit and 2016 Corporate Line of Credit, as defined in Note 8, held by Griffin-American Healthcare REIT III Holdings, LP in the amount of $557,000,000 and $548,500,000 as of June 30, 2019 and December 31, 2018, respectively, which is guaranteed by Griffin-American Healthcare REIT III, Inc.

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Revenues:
Resident fees and services	$ 272,472,000	$ 247,582,000	$ 540,754,000	$ 492,975,000
Real estate revenue	32,459,000	32,681,000	65,235,000	65,180,000
Total revenues	304,931,000	280,263,000	605,989,000	558,155,000
Expenses:
Property operating expenses	239,890,000	218,271,000	474,842,000	435,630,000
Rental expenses	8,226,000	8,747,000	16,651,000	17,687,000
General and administrative	6,512,000	6,622,000	13,429,000	13,010,000
Acquisition related expenses	400,000	214,000	(296,000)	(555,000)
Depreciation and amortization	24,743,000	22,682,000	50,371,000	46,374,000
Total expenses	279,771,000	256,536,000	554,997,000	512,146,000
Other income (expense):
Interest expense (including amortization of deferred financing costs and debt discount/premium)	(19,560,000)	(16,479,000)	(38,619,000)	(31,831,000)
Loss in fair value of derivative financial instruments	(4,117,000)	(487,000)	(4,677,000)	(377,000)
Impairment of real estate investments	0	(2,542,000)	0	(2,542,000)
Loss from unconsolidated entities	(493,000)	(1,458,000)	(947,000)	(2,535,000)
Foreign currency loss	(1,232,000)	(2,829,000)	(190,000)	(1,033,000)
Other income	246,000	224,000	454,000	519,000
Income before income taxes	4,000	156,000	7,013,000	8,210,000
Income tax (expense) benefit	(159,000)	526,000	(310,000)	897,000
Net (loss) income	(155,000)	682,000	6,703,000	9,107,000
Less: net income attributable to noncontrolling interests	(1,430,000)	(740,000)	(2,778,000)	(1,012,000)
Net (loss) income attributable to controlling interest	$ (1,585,000)	$ (58,000)	$ 3,925,000	$ 8,095,000
Net (loss) income per common share attributable to controlling interest — basic and diluted	$ (0.01)	$ 0	$ 0.02	$ 0.04
Weighted average number of common shares outstanding — basic and diluted	196,075,614	200,202,193	197,231,713	200,274,238
Other comprehensive loss:
Foreign currency translation adjustments	$ (239,000)	$ (684,000)	$ (20,000)	$ (238,000)
Total other comprehensive loss	(239,000)	(684,000)	(20,000)	(238,000)
Comprehensive (loss) income	(394,000)	(2,000)	6,683,000	8,869,000
Less: comprehensive income attributable to noncontrolling interests	(1,430,000)	(740,000)	(2,778,000)	(1,012,000)
Comprehensive (loss) income attributable to controlling interest	$ (1,824,000)	$ (742,000)	$ 3,905,000	$ 7,857,000

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF EQUITY - USD ($) $ in Thousands	Total	Total Stockholders' Equity	Common Stock	Additional Paid-In Capital	Accumulated Deficit	Accumulated Other Comprehensive Loss	Noncontrolling Interests
Beginning balance, Shares at Dec. 31, 2017			199,343,234
Beginning balance Stockholders' Equity at Dec. 31, 2017	$ 1,346,575	$ 1,187,850	$ 1,993	$ 1,785,872	$ (598,044)	$ (1,971)	$ 158,725
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Offering costs — common stock	(6)	(6)		(6)
Issuance of vested and nonvested restricted common stock, Shares			7,500
Issuance of vested and nonvested restricted common stock	14	14		14
Issuance of common stock under the DRIP, shares			3,284,653
Issuance of common stock under the DRIP	30,449	30,449	$ 33	30,416
Amortization of nonvested common stock compensation	85	85		85
Stock based compensation	390						390
Repurchase of common stock, shares			(3,770,572)
Repurchase of common stock	(34,700)	(34,700)	$ (38)	(34,662)
Contributions from noncontrolling interests	4,470						4,470
Distributions to noncontrolling interests	(3,373)						(3,373)
Reclassification of noncontrolling interests to mezzanine equity	(390)						(390)
Fair value adjustment to redeemable noncontrolling interests	(293)	(205)		(205)			(88)
Distributions declared	(59,602)	(59,602)			(59,602)
Net income (loss)	9,000	8,095			8,095		905	[1]
Other comprehensive income (loss)	(238)	(238)				(238)
Ending balance, Shares at Jun. 30, 2018			198,864,815
Ending balance Stockholders' Equity at Jun. 30, 2018	1,292,381	1,131,742	$ 1,988	1,781,514	(649,551)	(2,209)	160,639
Beginning balance, Shares at Mar. 31, 2018			199,193,544
Beginning balance Stockholders' Equity at Mar. 31, 2018	1,326,834	1,165,389	$ 1,991	1,784,461	(619,538)	(1,525)	161,445
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of vested and nonvested restricted common stock, Shares			7,500
Issuance of vested and nonvested restricted common stock	14	14		14
Issuance of common stock under the DRIP, shares			1,641,819
Issuance of common stock under the DRIP	15,220	15,220	$ 17	15,203
Amortization of nonvested common stock compensation	42	42		42
Stock based compensation	195						195
Repurchase of common stock, shares			(1,978,048)
Repurchase of common stock	(18,194)	(18,194)	$ (20)	(18,174)
Distributions to noncontrolling interests	(1,454)						(1,454)
Reclassification of noncontrolling interests to mezzanine equity	(195)						(195)
Fair value adjustment to redeemable noncontrolling interests	(46)	(32)		(32)			(14)
Distributions declared	(29,955)	(29,955)			(29,955)
Net income (loss)	604	(58)			(58)		662	[1]
Other comprehensive income (loss)	(684)	(684)				(684)
Ending balance, Shares at Jun. 30, 2018			198,864,815
Ending balance Stockholders' Equity at Jun. 30, 2018	1,292,381	1,131,742	$ 1,988	1,781,514	(649,551)	(2,209)	160,639
Beginning balance, Shares at Dec. 31, 2018			197,557,377
Beginning balance Stockholders' Equity at Dec. 31, 2018	1,218,635	1,060,507	$ 1,975	1,765,840	(704,748)	(2,560)	158,128
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Offering costs — common stock	(84)	(84)		(84)
Issuance of vested and nonvested restricted common stock, Shares			7,500
Issuance of vested and nonvested restricted common stock	14	14		14
Issuance of common stock under the DRIP, shares			3,021,493
Issuance of common stock under the DRIP	28,311	28,311	$ 30	28,281
Amortization of nonvested common stock compensation	86	86		86
Stock based compensation	390						390
Repurchase of common stock, shares			(5,850,352)
Repurchase of common stock	(55,135)	(55,135)	$ (59)	(55,076)
Contributions from noncontrolling interests	3,000						3,000
Distributions to noncontrolling interests	(3,635)						(3,635)
Reclassification of noncontrolling interests to mezzanine equity	(390)						(390)
Fair value adjustment to redeemable noncontrolling interests	84	58		58			26
Distributions declared	(58,697)	(58,697)			(58,697)
Net income (loss)	6,416	3,925			3,925		2,491	[1]
Other comprehensive income (loss)	(20)	(20)				(20)
Ending balance, Shares at Jun. 30, 2019			194,736,018
Ending balance Stockholders' Equity at Jun. 30, 2019	1,138,975	978,965	$ 1,946	1,739,119	(759,520)	(2,580)	160,010
Beginning balance, Shares at Mar. 31, 2019			195,188,759
Beginning balance Stockholders' Equity at Mar. 31, 2019	1,175,318	1,014,723	$ 1,951	1,743,711	(728,598)	(2,341)	160,595
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Offering costs — common stock	(1)	(1)		(1)
Issuance of vested and nonvested restricted common stock, Shares			7,500
Issuance of vested and nonvested restricted common stock	14	14		14
Issuance of common stock under the DRIP, shares			1,506,395
Issuance of common stock under the DRIP	14,115	14,115	$ 15	14,100
Amortization of nonvested common stock compensation	43	43		43
Stock based compensation	195						195
Repurchase of common stock, shares			(1,966,636)
Repurchase of common stock	(18,649)	(18,649)	$ (20)	(18,629)
Distributions to noncontrolling interests	(1,818)						(1,818)
Reclassification of noncontrolling interests to mezzanine equity	(195)						(195)
Fair value adjustment to redeemable noncontrolling interests	(169)	(119)		(119)			(50)
Distributions declared	(29,337)	(29,337)			(29,337)
Net income (loss)	(302)	(1,585)			(1,585)		1,283	[1]
Other comprehensive income (loss)	(239)	(239)				(239)
Ending balance, Shares at Jun. 30, 2019			194,736,018
Ending balance Stockholders' Equity at Jun. 30, 2019	$ 1,138,975	$ 978,965	$ 1,946	$ 1,739,119	$ (759,520)	$ (2,580)	$ 160,010
[1]	For the three months ended June 30, 2019 and 2018, amounts exclude $147,000 and $78,000, respectively, of the net income attributable to redeemable noncontrolling interests. For the six months ended June 30, 2019 and 2018, amounts exclude $287,000 and $107,000, respectively, of net income attributable to redeemable noncontrolling interests. See Note 12, Redeemable Noncontrolling Interests, for a further discussion

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF EQUITY (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Statement of Stockholders' Equity [Abstract]
Distribution per share (in usd per share)	$ 0.15	$ 0.15	$ 0.30	$ 0.30
Net income attributable to redeemable noncontrolling interests	$ 147	$ 78	$ 287	$ 107

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018
CASH FLOWS FROM OPERATING ACTIVITIES
Net income	$ 6,703,000	$ 9,107,000
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	50,371,000	46,374,000
Other amortization	15,211,000	2,846,000
Deferred rent	(3,403,000)	(2,754,000)
Stock based compensation	390,000	390,000
Stock based compensation — nonvested restricted common stock	100,000	99,000
Loss from unconsolidated entities	947,000	2,535,000
Bad debt expense	272,000	283,000
Foreign currency loss	189,000	1,000,000
Change in fair value of contingent consideration	(681,000)	(489,000)
Change in fair value of derivative financial instruments	4,677,000	377,000
Impairment of real estate investments	0	2,542,000
Changes in operating assets and liabilities:
Accounts and other receivables	(8,475,000)	(2,200,000)
Other assets	(1,322,000)	(11,668,000)
Accounts payable and accrued liabilities	2,474,000	(3,014,000)
Accounts payable due to affiliates	429,000	(13,000)
Security deposits, prepaid rent, operating lease and other liabilities	(14,051,000)	1,275,000
Net cash provided by operating activities	53,831,000	46,690,000
CASH FLOWS FROM INVESTING ACTIVITIES
Acquisitions of real estate investments	(17,457,000)	(444,000)
Proceeds from real estate dispositions	0	1,000,000
Principal repayments on real estate notes receivable	28,650,000	0
Investments in unconsolidated entities	(1,520,000)	0
Capital expenditures	(38,510,000)	(24,545,000)
Real estate and other deposits	(613,000)	(2,878,000)
Net cash used in investing activities	(29,450,000)	(26,867,000)
CASH FLOWS FROM FINANCING ACTIVITIES
Borrowings under mortgage loans payable	61,472,000	1,364,000
Payments on mortgage loans payable	(6,331,000)	(5,045,000)
Borrowings under the lines of credit and term loans	692,519,000	122,596,000
Payments on the lines of credit and term loans	(673,000,000)	(72,444,000)
Payments under financing obligations	(3,731,000)	(3,555,000)
Deferred financing costs	(6,807,000)	(187,000)
Repurchase of common stock	(55,088,000)	(34,700,000)
Repurchase of stock warrants and redeemable noncontrolling interest	(78,000)	(77,000)
Contributions from noncontrolling interests	3,000,000	4,470,000
Distributions to noncontrolling interests	(3,635,000)	(3,373,000)
Contributions from redeemable noncontrolling interests	0	535,000
Distributions to redeemable noncontrolling interests	(720,000)	(332,000)
Security deposits and other	(55,000)	43,000
Distributions paid	(30,886,000)	(29,447,000)
Net cash used in financing activities	(23,340,000)	(20,152,000)
NET CHANGE IN CASH, CASH EQUIVALENTS AND RESTRICTED CASH	1,041,000	(329,000)
EFFECT OF FOREIGN CURRENCY TRANSLATION ON CASH, CASH EQUIVALENTS AND RESTRICTED CASH	(23,000)	(24,000)
CASH, CASH EQUIVALENTS AND RESTRICTED CASH — Beginning of period	72,705,000	64,143,000
CASH, CASH EQUIVALENTS AND RESTRICTED CASH — End of period	73,723,000	63,790,000
Cash and cash equivalents at beginning of period	35,132,000	33,656,000
Restricted cash at beginning of period	37,573,000	30,487,000
Cash and cash equivalents at end of period	34,026,000	33,805,000
Restricted cash at end of period	39,697,000	29,985,000
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION
Cash paid for: Interest	34,783,000	28,103,000
Cash paid for: Income taxes	544,000	572,000
Investing Activities:
Accrued capital expenditures	14,332,000	10,062,000
Capital expenditures from financing obligations	6,735,000	4,194,000
Tenant improvement overage	645,000	355,000
Equity method investments noncash	5,276,000	0
The following represents the increase in certain liabilities in connection with our acquisitions of real estate investments:
Accounts payable and accrued liabilities	37,000	1,000
Prepaid rent	105,000	0
Financing Activities:
Issuance of common stock under the DRIP	28,311,000	30,449,000
Distributions declared but not paid	9,689,000	9,898,000
Payable to transfer agent	47,000	0
Reclassification of noncontrolling interests to mezzanine equity	390,000	390,000
Accrued deferred financing costs	$ 51,000	$ 10,000

Organization and Description of

Organization and Description of Business	6 Months Ended
	Jun. 30, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Description of Business	1. Organization and Description of Business Griffin-American Healthcare REIT III, Inc., a Maryland corporation, was incorporated on January 11, 2013 and therefore, we consider that our date of inception. We were initially capitalized on January 15, 2013 . We invest in a diversified portfolio of real estate properties, focusing primarily on medical office buildings, hospitals, skilled nursing facilities, senior housing and other healthcare-related facilities. We also operate healthcare-related facilities utilizing the structure permitted by the REIT Investment Diversification and Empowerment Act of 2007, which is commonly referred to as a “RIDEA” structure (the provisions of the Internal Revenue Code of 1986, as amended, or the Code, authorizing the RIDEA structure were enacted as part of the Housing and Economic Recovery Act of 2008). We also originate and acquire secured loans and may also originate and acquire other real estate-related investments on an infrequent and opportunistic basis. We generally seek investments that produce current income. We qualified to be taxed as a real estate investment trust, or REIT, under the Code for federal income tax purposes beginning with our taxable year ended December 31, 2014 , and we intend to continue to qualify to be taxed as a REIT. On February 26, 2014, we commenced a best efforts initial public offering, or our initial offering, in which we offered to the public up to $1,900,000,000 in shares of our common stock. As of April 22, 2015, the deregistration date of our initial offering, we had received and accepted subscriptions in our initial offering for 184,930,598 shares of our common stock, or $1,842,618,000 , excluding shares of our common stock issued pursuant to our initial distribution reinvestment plan, or the Initial DRIP. As of April 22, 2015, a total of $18,511,000 in distributions were reinvested that resulted in 1,948,563 shares of our common stock being issued pursuant to the Initial DRIP. See Note 13, Equity — Common Stock, for a further discussion. On March 25, 2015, we filed a Registration Statement on Form S-3 under the Securities Act of 1933, as amended, or the Securities Act, to register a maximum of $250,000,000 of additional shares of our common stock to be issued pursuant to the Initial DRIP, or the 2015 DRIP Offering. We commenced offering shares pursuant to the 2015 DRIP Offering following the deregistration of our initial offering. Effective October 5, 2016, we amended and restated the Initial DRIP, or the Amended and Restated DRIP, to amend the price at which shares of our common stock are issued pursuant to the 2015 DRIP Offering. We continued to offer shares of our common stock pursuant to the 2015 DRIP Offering until the termination and deregistration of such offering on March 29, 2019. As of March 29, 2019, a total of $245,396,000 in distributions were reinvested that resulted in 26,386,545 shares of common stock being issued pursuant to the 2015 DRIP Offering. On January 30, 2019, we filed a Registration Statement on Form S-3 under the Securities Act to register a maximum of $200,000,000 of additional shares of our common stock to be issued pursuant to the Amended and Restated DRIP, or the 2019 DRIP Offering; however, we did not commence offering shares pursuant to the 2019 DRIP Offering until April 1, 2019, following the deregistration of the 2015 DRIP Offering. As of June 30, 2019 , a total of $14,115,000 in distributions were reinvested that resulted in 1,506,395 shares of common stock being issued pursuant to the 2019 DRIP Offering. We collectively refer to the Initial DRIP portion of our initial offering, the 2015 DRIP Offering and the 2019 DRIP Offering as our DRIP Offerings. See Note 13, Equity — Distribution Reinvestment Plan, for a further discussion. We conduct substantially all of our operations through Griffin-American Healthcare REIT III Holdings, LP, or our operating partnership. We are externally advised by Griffin-American Healthcare REIT III Advisor, LLC, or Griffin-American Advisor, or our advisor, pursuant to an advisory agreement, or the Advisory Agreement, between us and our advisor. The Advisory Agreement was effective as of February 26, 2014 and had a one -year term, subject to successive one -year renewals upon the mutual consent of the parties. The Advisory Agreement was last renewed pursuant to the mutual consent of the parties on February 13, 2019 and expires on February 26, 2020. Our advisor uses its best efforts, subject to the oversight, review and approval of our board of directors, or our board, to, am ong other things, research, identify, review and make investments in and dispositions of properties and securities on our behalf consistent with our investment policies and objectives. Our advisor performs its duties and responsibilities under the Advisory Agreement as our fiduciary. Our a dvisor is 75.0% owned and managed by American Healthcare Investors, LLC, or American Healthcare Investors, and 25.0% owned by a wholly owned subsidiary of Griffin Capital Company, LLC, or Griffin Capital, or collectively, our co-sponsors. American Healthcare Investors is 47.1% owned by AHI Group Holdings, LLC, or AHI Group Holdings, 45.1% indirectly owned by Colony Capital, Inc. (NYSE: CLNY), or Colony Capital, and 7.8% owned by James F. Flaherty III, a former partner of Colony Capital. We are not affiliated with Griffin Capital, Griffin Capital Securities, LLC, the dealer manager for our initial offering, or our dealer manager, Colony Capital or Mr. Flaherty; however, we are affiliated with Griffin-American Advisor, American Healthcare Investors and AHI Group Holdings. We currently operate through six reportable business segments: medical office buildings, hospitals, skilled nursing facilities, senior housing, senior housing — RIDEA and integrated senior health campuses. As of June 30, 2019 , we owned and/or operated 98 properties, comprising 102 buildings, and 113 integrated senior health campuses including completed development projects, or approximately 13,412,000 square feet of gross leasable area, or GLA, for an aggregate contract purchase price of $2,968,740,000 . In addition, as of June 30, 2019 , we had invested $60,429,000 in real estate-related investments, net of principal repayments.

Summary of Significant Accounti

Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2019
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies The summary of significant accounting policies presented below is designed to assist in understanding our accompanying condensed consolidated financial statements. Such condensed consolidated financial statements and the accompanying notes thereto are the representations of our management, who are responsible for their integrity and objectivity. These accounting policies conform to accounting principles generally accepted in the United States, or GAAP, in all material respects, and have been consistently applied in preparing our accompanying condensed consolidated financial statements. Basis of Presentation Our accompanying condensed consolidated financial statements include our accounts and those of our operating partnership, the wholly owned subsidiaries of our operating partnership and all non-wholly owned subsidiaries in which we have control, as well as any VIEs in which we are the primary beneficiary. We evaluate our ability to control an entity, and whether the entity is a VIE and we are the primary beneficiary, by considering substantive terms of the arrangement and identifying which enterprise has the power to direct the activities of the entity that most significantly impacts the entity’s economic performance. We operate and intend to co ntinue to operate in an umbrella partnership REIT structure in which our operating partnership, or wholly owned subsidiaries of our operating partnership and all non-wholly owned subsidiaries of which we have control, will own substantially all of the interests in properties acquired on our behalf. We ar e the sole general partner of our operating partnership, and as of June 30, 2019 and December 31, 2018 , we owned greater than a 99.99% general partnership interest therein. As of June 30, 2019 and December 31, 2018 , our advisor owned less than a 0.01% limited partnership interest in our operating partnership. Because we are the sole general partner of our operating partnership and have unilateral control over its management and major operating decisions (even if additional limited partners are admitted to our operating partnership), the accounts of our operating partnership are consolidated in our accompanying condensed consolidated financial statements. All intercompany accounts and transactions are eliminated in consolidation. Interim Unaudited Financial Data Our accompanying condensed consolidated financial statements have been prepared by us in accordance with GAAP in conjunction with the rules and regulations of the United States Securities and Exchange Commission, or SEC. Certain information and footnote disclosures required for annual financial statements have been condensed or excluded pursuant to SEC rules and regulations. Accordingly, our accompanying condensed consolidated financial statements do not include all of the information and footnotes required by GAAP for complete financial statements. Our accompanying condensed consolidated financial statements reflect all adjustments which are, in our view, of a normal recurring nature and necessary for a fair presentation of our financial position, results of operations and cash flows for the interim period. Interim results of operations are not necessarily indicative of the results to be expected for the full year; such full year results may be less favorable. In preparing our accompanying condensed consolidated financial statements, management has evaluated subsequent events through the financial statement issuance date. We believe that although the disclosures contained herein are adequate to prevent the information presented from being misleading, our accompanying condensed consolidated financial statements should be read in conjunction with our audited consolidated financial statements and the notes thereto included in our 2018 Annual Report on Form 10-K, as filed with the SEC on March 21, 2019. Use of Estimates The preparation of our accompanying condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, as well as the disclosure of contingent assets and liabilities, at the date of our condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. These estimates are made and evaluated on an on-going basis using information that is currently available as well as various other assumptions believed to be reasonable under the circumstances. Actual results could differ from those estimates, perhaps in material adverse ways, and those estimates could be different under different assumptions or conditions. Leases On January 1, 2019, we adopted Financial Accounting Standards Board, or FASB, Accounting Standards Codification, or ASC, Topic 842, or ASC Topic 842. ASC Topic 842 supersedes ASC Topic 840, Leases , or ASC Topic 840. We adopted ASC Topic 842 using the modified retrospective approach whereby the cumulative effect of adoption was recognized on the adoption date and prior periods were not restated. There was no net cumulative effect adjustment to retained earnings as of January 1, 2019 as a result of this adoption. Therefore, with respect to our leases as both lessees and lessors, information is presented under ASC Topic 842 as of and for the three and six months ended June 30, 2019 and under ASC Topic 840 as of December 31, 2018 and for the three and six months ended June 30, 2018 . In addition, ASC Topic 842 provides a practical expedient package that allows an entity to not reassess the following upon adoption (must be elected as a group): (i) whether an expired or existing contract contains a lease arrangement; (ii) the lease classification related to expired or existing lease arrangements; or (iii) whether costs incurred on expired or existing leases qualify as initial direct costs. We elected such practical expedient package upon our adoption of ASC Topic 842 on January 1, 2019. We determine if a contract is a lease upon inception of the lease. We maintain a distinction between finance leases and operating leases, which is substantially similar to the classification criteria for distinguishing between capital leases and operating leases in the previous lease guidance. Lessee : Pursuant to ASC Topic 842, lessees are required to recognize the following for all leases with terms greater of 12 months at the commencement date: (i) a lease liability, which is a lessee’s obligation to make lease payments arising from a lease; and (ii) a right-of-use asset, which is an asset that represents the lessee’s right to use, or control the use of, a specified asset for the lease term. The lease liability is calculated by using either the implicit rate of the lease or the incremental borrowing rate. As a result of the adoption of ASC Topic 842 on January 1, 2019, we recognized an initial amount of lease liability of $198,453,000 in our condensed consolidated balance sheet for all of our operating leases for which we are the lessee, including facilities leases and ground leases. In addition, we recorded a corresponding right-of-use asset of $211,679,000 , which is the lease liability, net of the existing prepaid rent asset and accrued straight-line rent liability balance and adjusted for unamortized above/below market ground lease intangibles. The accretion of lease liability and amortization expense on right-of-use assets for our operating leases are included in property operating expenses and rental expenses in our accompanying condensed consolidated statements of operations and comprehensive income (loss). The operating lease liability was calculated using our incremental borrowing rate based on the information available as of our adoption date. The accounting for our existing capital (finance) leases upon adoption of ASC Topic 842 remains substantially unchanged. For our finance leases, the accretion of lease liability is included in interest expense and the amortization expense on right-of-use assets is included in depreciation and amortization in our accompanying condensed consolidated statements of operations and comprehensive income (loss). Further, finance lease assets are included within real estate investments, net and finance lease liabilities are included within financing obligations in our accompanying condensed consolidated balance sheets. Lessor : Pursuant to ASC Topic 842, lessors bifurcate lease revenues into lease components and non-lease components and separately recognize and disclose non-lease components that are executory in nature. Lease components continue to be recognized on a straight-line basis over the lease term and certain non-lease components may be accounted for under the new revenue recognition guidance in ASC Topic 606, Revenue from Contracts with Customers, or ASC Topic 606. See “Revenue Recognition” section below. ASC Topic 842 also provides for a practical expedient package that permits lessors to not separate non-lease components from the associated lease component if certain conditions are met. Such practical expedient is limited to circumstances in which (i) the timing and pattern of transfer are the same for the non-lease component and the related lease component; and (ii) the lease component, if accounted for separately, would be classified as an operating lease. In addition, such practical expedient causes an entity to assess whether a contract is predominately lease or service based, and recognize the revenue from the entire contract under the relevant accounting guidance. Effective upon our adoption of ASC Topic 842 on January 1, 2019, we recognize revenue for our medical office buildings, senior housing, skilled nursing facilities and hospitals segments under ASC Topic 842 as real estate revenue. Minimum annual rental revenue is recognized on a straight-line basis over the term of the related lease (including rent holidays). Differences between real estate revenue recognized and cash amounts contractually due from tenants under the lease agreements are recorded to deferred rent receivable. Tenant reimbursement revenue, which comprises additional amounts recoverable from tenants for common area maintenance expenses and certain other recoverable expenses, are considered non-lease components. We qualified for and elected the practical expedient as outlined above to combine the non-lease component with the lease component, which is the predominant component, and therefore is recognized as part of real estate revenue. In addition as lessors, we exclude certain lessor costs (i.e., property taxes and insurance) paid directly by a lessee to third parties on our behalf from our measurement of variable lease revenue and associated expense (i.e., no gross up of revenue and expense for these costs); and (ii) include lessor costs that we paid and are reimbursed by the lessee in our measurement of variable lease revenue and associated expense (i.e., gross up revenue and expense for these costs). Therefore, we no longer record revenue or expense when the lessee pays the property taxes and insurance directly to a third party. Our senior housing — RIDEA facilities offer residents room and board (lease component), standard meals and monthly healthcare services (non-lease component), and certain ancillary services that are not contemplated in the lease with each resident (i.e., laundry, guest meals, etc.). For our senior housing — RIDEA facilities, we recognize revenue under ASC Topic 606 as resident fees and services, based on our predominance assessment from electing the practical expedient outlined above. See “Revenue Recognition” below. See Note 17, Leases , for a further discussion. Revenue Recognition On January 1, 2018, we adopted ASC Topic 606, applying the modified retrospective method. Results for reporting periods beginning after January 1, 2018 are presented under ASC Topic 606, while prior period amounts are not adjusted and continue to be reported under the accounting standards in effect for the prior period. The adoption of ASC Topic 606 did not have a material impact on the measurement nor on the recognition of revenue as of January 1, 2018; therefore, no cumulative adjustment has been made to the opening balance of retained earnings at the beginning of 2018. Real estate revenue Prior to January 1, 2019, minimum annual rental revenue was recognized on a straight-line basis over the term of the related lease (including rent holidays) in accordance with ASC Topic 840. Differences between real estate revenue recognized and cash amounts contractually due from tenants under the lease agreements were recorded to deferred rent receivable or deferred rent liability, as applicable. Tenant reimbursement revenue, which comprises additional amounts recoverable from tenants for common area maintenance expenses and certain other recoverable expenses, was recognized as revenue in the period in which the related expenses were incurred. Tenant reimbursements were recognized and presented in accordance with ASC Subtopic 606-10-55-36, Revenue Recognition — Principal Versus Agent Consideration, or ASC Subtopic 606. ASC Subtopic 606 requires that these reimbursements be recorded on a gross basis as we are generally primarily responsible to fulfill the promise to provide specified goods and services. We recognized lease termination fees at such time when there was a signed termination letter agreement, all of the conditions of such agreement have been met and the tenant is no longer occupying the property. Effective January 1, 2019, we recognize real estate revenue in accordance with ASC Topic 842. See “Leases” section above. Resident fees and services revenue Disaggregation of Resident Fees and Services Revenue The following table disaggregates our resident fees and services revenue by line of business, according to whether such revenue is recognized at a point in time or over time: Three Months Ended June 30, 2019 2018 Point in Time Over Time Total Point in Time Over Time Total Integrated senior health campuses $ 53,390,000 $ 202,651,000 $ 256,041,000 $ 44,657,000 $ 186,864,000 $ 231,521,000 Senior housing — RIDEA(1) 735,000 15,696,000 16,431,000 729,000 15,332,000 16,061,000 Total resident fees and services $ 54,125,000 $ 218,347,000 $ 272,472,000 $ 45,386,000 $ 202,196,000 $ 247,582,000 Six Months Ended June 30, 2019 2018 Point in Time Over Time Total Point in Time Over Time Total Integrated senior health campuses $ 105,733,000 $ 402,022,000 $ 507,755,000 $ 89,822,000 $ 370,760,000 $ 460,582,000 Senior housing — RIDEA(1) 1,446,000 31,553,000 32,999,000 1,497,000 30,896,000 32,393,000 Total resident fees and services $ 107,179,000 $ 433,575,000 $ 540,754,000 $ 91,319,000 $ 401,656,000 $ 492,975,000 The following table disaggregates our resident fees and services revenue by payor class: Three Months Ended June 30, 2019 2018 Integrated Senior Health Campuses Senior Housing — RIDEA(1) Total Integrated Senior Health Campuses(2) Senior Housing — RIDEA(1) Total Medicare $ 84,481,000 $ — $ 84,481,000 $ 76,838,000 $ — $ 76,838,000 Medicaid 46,643,000 21,000 46,664,000 40,815,000 — 40,815,000 Private and other payors 124,917,000 16,410,000 141,327,000 113,868,000 16,061,000 129,929,000 Total resident fees and services $ 256,041,000 $ 16,431,000 $ 272,472,000 $ 231,521,000 $ 16,061,000 $ 247,582,000 Six Months Ended June 30, 2019 2018 Integrated Senior Health Campuses Senior Housing — RIDEA(1) Total Integrated Senior Health Campuses(2) Senior Housing — RIDEA(1) Total Medicare $ 168,958,000 $ — $ 168,958,000 $ 154,875,000 $ — $ 154,875,000 Medicaid 91,679,000 34,000 91,713,000 81,219,000 3,000 81,222,000 Private and other payors 247,118,000 32,965,000 280,083,000 224,488,000 32,390,000 256,878,000 Total resident fees and services $ 507,755,000 $ 32,999,000 $ 540,754,000 $ 460,582,000 $ 32,393,000 $ 492,975,000 ___________ (1) This includes fees for basic housing and assisted living care. We record revenue when services are rendered at amounts billable to individual residents. Residency agreements are generally for a term of 30 days, with resident fees billed monthly in advance. For patients under reimbursement arrangements with Medicaid, revenue is recorded based on contractually agreed-upon amounts or rates on a per resident, daily basis or as services are rendered. (2) For the three and six months ended June 30, 2018 , Medicare includes $0 and $21,881,000 , respectively, of revenue that was previously disclosed as Private and other payors. There was no net change in previously disclosed total resident fees and services. Accounts Receivable, Net — Resident Fees and Services Revenue The beginning and ending balances of accounts receivable, net — resident fees and services are as follows: Medicare Medicaid Private and Other Payors Total Beginning balance — January 1, 2019 $ 29,160,000 $ 18,676,000 $ 39,112,000 $ 86,948,000 Ending balance — June 30, 2019 30,618,000 19,478,000 46,278,000 96,374,000 Increase $ 1,458,000 $ 802,000 $ 7,166,000 $ 9,426,000 Deferred Revenue — Resident Fees and Services Revenue The beginning and ending balances of deferred revenue — resident fees and services, all of which relates to private and other payors, are as follows: Total Beginning balance — January 1, 2019 $ 12,569,000 Ending balance — June 30, 2019 10,954,000 Decrease $ (1,615,000 ) Tenant and Resident Receivables and Allowance for Uncollectible Accounts Resident receivables are carried net of an allowance for uncollectible amounts. An allowance is maintained for estimated losses resulting from the inability of residents and payors to meet the contractual obligations under their lease or service agreements. Upon our adoption of ASC Topic 606, substantially all of such allowances are recorded as direct reductions of resident fees and services revenue as contractual adjustments provided to third-party payors or implicit price concessions in our accompanying condensed consolidated statements of operations and comprehensive income (loss). Our determination of the adequacy of these allowances is based primarily upon evaluations of historical loss experience, the residents’ financial condition, security deposits, cash collection patterns by payor and by state, current economic conditions and other relevant factors. Prior to our adoption of ASC Topic 842, tenant receivables and unbilled deferred rent receivables were reduced for uncollectible amounts. Such amounts were charged to bad debt expense, which was included in general and administrative in our accompanying condensed consolidated statements of operations and comprehensive income (loss). Effective upon our adoption of ASC Topic 842 on January 1, 2019, such amounts are recognized as direct reductions of real estate revenue in our accompanying condensed consolidated statements of operations and comprehensive income (loss). Accounts Payable and Accrued Liabilities As of June 30, 2019 and December 31, 2018 , accounts payable and accrued liabilities primarily includes insurance payables of $33,497,000 and $32,123,000 , respectively, reimbursement of payroll related costs to the managers of our senior housing — RIDEA facilities and integrated senior health campuses of $27,607,000 and $26,428,000 , respectively, accrued property taxes of $15,468,000 and $15,121,000 , respectively, accrued distributions of $9,689,000 and $10,189,000 , respectively, and accrued capital expenditures to unaffiliated third parties of $14,135,000 and $12,490,000 , respectively. Recently Issued Accounting Pronouncements In June 2016, the FASB issued Accounting Standards Update, or ASU, 2016-13, Measurement of Credit Losses on Financial Instruments, or ASU 2016-13, which introduces a new approach to estimate credit losses on certain types of financial instruments based on expected losses. It also modifies the impairment model for available-for-sale debt securities and provides for a simplified accounting model for purchased financial assets with credit deterioration since their origination. Subsequently, in November 2018, the FASB issued ASU 2018-19, Codification Improvements to Topic 326, Financial Instruments — Credit Losses, or ASU 2018-19 , which amended the scope of ASU 2016-13 to clarify that operating lease receivables should be accounted for under the new leasing standard ASC Topic 842. In April 2019, the FASB issued ASU 2019-04, Codification Improvements to Topic 326, Financial Instruments — Credit Losses, Topic 815, Derivatives and Hedging, and Topic 825, Financial Instruments, or ASU 2019-04 , to increase stakeholders’ awareness of the amendments and to expedite improvements to the Accounting Standards Codification. In May 2019, the FASB issued ASU 2019-05, Targeted Transition Relief, or ASU 2019-05, to address certain stakeholders’ concerns by providing an option to irrevocably elect the fair value option for certain financial assets previously measured at amortized cost basis. ASU 2016-13, ASU 2018-19, ASU 2019-04 and ASU 2019-05 are effective for fiscal years and interim periods beginning after December 15, 2019. Early adoption is permitted. We are evaluating the impact of the adoption of ASU 2016-13, ASU 2018-19, ASU 2019-04 and ASU 2019-05 on January 1, 2020 to our consolidated financial position and results of operations. In August 2018, the FASB issued ASU 2018-13, Changes to the Disclosure Requirements for Fair Value Measurement, or ASU 2018-13, which modifies the disclosure requirements in ASC Topic 820, Fair Value Measurements and Disclosures , by removing certain disclosure requirements related to the fair value hierarchy, modifying existing disclosure requirements related to measurement uncertainty and adding new disclosure requirements, such as disclosing the changes in unrealized gains and losses for the period included in other comprehensive income for recurring Level 3 fair value measurements held at the end of the reporting period and disclosing the range and weighted average of significant unobservable inputs used to develop Level 3 measurements. ASU 2018-13 is effective for fiscal years and interim periods beginning after December 15, 2019. Early adoption is permitted for any removed or modified disclosures. We are evaluating the complete impact of the adoption of ASU 2018-13 on January 1, 2020 to our consolidated financial statement disclosures.

Real Estate Investments, Net

Real Estate Investments, Net	6 Months Ended
	Jun. 30, 2019
Real Estate [Abstract]
Real Estate Investments, Net	3. Real Estate Investments, Net Our real estate investments, net consisted of the following as of June 30, 2019 and December 31, 2018 : June 30, 2019 December 31, Building, improvements and construction in process $ 2,199,377,000 $ 2,160,944,000 Land and improvements 189,855,000 189,446,000 Furniture, fixtures and equipment 137,958,000 126,985,000 2,527,190,000 2,477,375,000 Less: accumulated depreciation (296,240,000 ) (254,694,000 ) $ 2,230,950,000 $ 2,222,681,000 Depreciation expense for the three months ended June 30, 2019 and 2018 was $21,530,000 and $20,287,000 , respectively. Depreciation expense for the six months ended June 30, 2019 and 2018 was $43,734,000 and $40,687,000 , respectively. No impairment charges were recognized for the three and six months ended June 30, 2019 . For both the three and six months ended June 30, 2018 , we determined that one of our medical office buildings was impaired and recognized an impairment charge of $2,542,000 , which reduced the total carrying value of such investment to $7,387,000 . The fair value of such medical office building was based upon a discounted cash flow analysis where the most significant inputs were considered Level 3 measurements within the fair value hierarchy. See Note 15, Fair Value Measurements — Assets and Liabilities Reported at Fair Value — Real Estate Investment, for a further discussion. For the three months ended June 30, 2019 , we incurred capital expenditures of $23,106,000 for our integrated senior health campuses, $4,684,000 for our medical office buildings, $473,000 for our senior housing — RIDEA facilities, $126,000 for our skilled nursing facilities and $50,000 for our hospitals. We did not incur any capital expenditures for our senior housing facilities for the three months ended June 30, 2019 . For the six months ended June 30, 2019 , we incurred capital expenditures of $36,734,000 for our integrated senior health campuses, $6,718,000 for our medical office buildings, $778,000 for our senior housing — RIDEA facilities, $160,000 for our skilled nursing facilities and $50,000 for our hospitals. We did not incur any capital expenditures for our senior housing facilities for the six months ended June 30, 2019 . Acquisitions of Real Estate Investments For the six months ended June 30, 2019 , using cash on hand and debt financing, we completed the acquisition of one building from an unaffiliated third party, which we added to our existing North Carolina ALF Portfolio. The other six buildings in North Carolina ALF Portfolio were acquired between January 2015 and August 2018. The following is a summary of our property acquisition for the six months ended June 30, 2019 : Acquisition(1) Location Type Date Acquired Contract Purchase Price Lines of Credit and Term Loans(2) Acquisition Fee(3) North Carolina ALF Portfolio Garner, NC Senior Housing 03/27/19 $ 15,000,000 $ 15,000,000 $ 338,000 ___________ (1) We own 100% of our property acquired in 2019 . (2) Represents a borrowing under the 2019 Corporate Line of Credit, as defined in Note 8, Lines of Credit and Term Loans , at the time of acquisition. (3) Our advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our property, an acquisition fee of 2.25% of the contract purchase price of such property. In addition to the property acquisition discussed above, for the six months ended June 30, 2019 , we, through a majority-owned subsidiary of Trilogy Investors, LLC, or Trilogy, of which we own 67.7% , acquired land in Michigan and Ohio for an aggregate contract purchase price of $2,067,000 plus closing costs and paid to our advisor an acquisition fee of 2.25% of the portion of the contract purchase price of each land parcel attributed to our ownership interest. For the six months ended June 30, 2019 , we accounted for our real estate acquisitions as asset acquisitions. We incurred and capitalized closing costs and direct acquisition related expenses of $489,000 for such acquisitions. The following table summarizes the purchase price of the assets acquired and liabilities assumed at the time of acquisition from our acquisitions in 2019 based on their relative fair values: 2019 Real Estate Acquisitions Building and improvements $ 11,700,000 Land 3,878,000 In-place leases 1,978,000 Total assets acquired $ 17,556,000 Completed Development For the six months ended June 30, 2019 , we completed the development of one integrated senior health campus for $10,558,000 , which is included in real estate investments, net, in our accompanying condensed consolidated balance sheets.

Real Estate Notes Receivable an

Real Estate Notes Receivable and Debt Security Investment, Net	6 Months Ended
	Jun. 30, 2019
Real Estate Notes Receivable [Abstract]
Real Estate Notes Receivable and Investment, Net	4. Real Estate Notes Receivable and Debt Security Investment, Net The following is a summary of our notes receivable and debt security investment, including unamortized loan and closing costs, net as of June 30, 2019 and December 31, 2018 : Balance Origination Date Maturity Date Contractual Interest Rate Maximum Advances Available June 30, 2019 December 31, 2018 Mezzanine Fixed Rate Notes(1) 02/04/15 12/09/19 6.75% $ — $ — $ 28,650,000 Debt security investment(2) 10/15/15 08/25/25 4.24% N/A 69,822,000 68,355,000 69,822,000 97,005,000 Unamortized loan and closing costs, net 1,450,000 1,650,000 $ 71,272,000 $ 98,655,000 ___________ (1) The Mezzanine Fixed Rate Notes evidence interests in a portion of a mezzanine loan that is secured by pledges of equity interests in the owners of a portfolio of domestic healthcare properties, which such owners are themselves owned indirectly by a non-wholly owned subsidiary of Colony Capital. In June 2019, the Mezzanine Fixed Rate Notes were paid in full by the borrower. (2) The commercial mortgage-backed debt security, or the debt security, bears an interest rate on the stated principal amount thereof equal to 4.24% per annum, the terms of which security provide for monthly interest-only payments. The debt security matures on August 25, 2025 at a stated amount of $93,433,000 , resulting in an anticipated yield-to-maturity of 10.0% per annum. The debt security was issued by an unaffiliated mortgage trust and represents a 10.0% beneficial ownership interest in such mortgage trust. The debt security is subordinate to all other interests in the mortgage trust and is not guaranteed by a government-sponsored entity. As of June 30, 2019 and December 31, 2018 , the net carrying amount with accretion was $71,272,000 and $69,873,000 , respectively. We classify our debt security investment as held-to-maturity and we have not recorded any unrealized holding gains or losses on such investment. The following table reflects the changes in the carrying amount of our real estate notes receivable and debt security investment for the six months ended June 30, 2019 and 2018 : Six Months Ended June 30, 2019 2018 Beginning balance $ 98,655,000 $ 97,988,000 Additions: Accretion on debt security 1,467,000 1,331,000 Deductions: Principal repayments on real estate notes receivable (28,650,000 ) — Amortization of loan and closing costs (200,000 ) (121,000 ) Ending balance $ 71,272,000 $ 99,198,000 For the three and six months ended June 30, 2019 and 2018 , we did no t record any impairment losses on our real estate notes receivable or debt security investment. Amortization expense on loan and closing costs for the three months ended June 30, 2019 and 2018 was $132,000 and $62,000 , respectively, and for the six months ended June 30, 2019 and 2018 , was $200,000 and $121,000 , respectively, which was recorded against real estate revenue in our accompanying condensed consolidated statements of operations and comprehensive income (loss).

Identified Intangible Assets, N

Identified Intangible Assets, Net	6 Months Ended
	Jun. 30, 2019
Finite-Lived Intangible Assets, Net [Abstract]
Identified Intangible Assets, Net	5. Identified Intangible Assets, Net Identified intangible assets, net consisted of the following as of June 30, 2019 and December 31, 2018 : June 30, 2019 December 31, 2018 Amortized intangible assets: In-place leases, net of accumulated amortization of $27,499,000 and $23,497,000 as of June 30, 2019 and December 31, 2018, respectively (with a weighted average remaining life of 10.3 years and 9.8 years as of June 30, 2019 and December 31, 2018, respectively) $ 41,810,000 $ 45,815,000 Leasehold interests, net of accumulated amortization of $548,000 as of December 31, 2018 (with a weighted average remaining life of 53.6 years as of December 31, 2018)(1) — 7,346,000 Customer relationships, net of accumulated amortization of $262,000 and $187,000 as of June 30, 2019 and December 31, 2018, respectively (with a weighted average remaining life of 17.3 years and 18.8 years as of June 30, 2019 and December 31, 2018, respectively) 2,578,000 2,653,000 Above-market leases, net of accumulated amortization of $2,049,000 and $2,851,000 as of June 30, 2019 and December 31, 2018, respectively (with a weighted average remaining life of 5.1 years and 5.2 years as of June 30, 2019 and December 31, 2018, respectively) 1,715,000 2,059,000 Internally developed technology and software, net of accumulated amortization of $164,000 and $117,000 as of June 30, 2019 and December 31, 2018, respectively (with a weighted average remaining life of 3.3 years and 3.8 years as of June 30, 2019 and December 31, 2018, respectively) 306,000 353,000 Unamortized intangible assets: Certificates of need 90,991,000 88,590,000 Trade names 30,787,000 30,787,000 Purchase option asset(2) — 1,918,000 $ 168,187,000 $ 179,521,000 ___________ (1) Such amount related to our ownership of fee simple interests in the building and improvements of 11 of our buildings that are subject to respective ground leases. Upon our adoption of ASC Topic 842 on January 1, 2019, such amount was reclassed to operating lease right-of-use assets in our accompanying condensed consolidated balance sheet. See Note 2, Summary of Significant Accounting Policies — Leases, and Note 17, Leases , for a further discussion. (2) For the six months ended June 30, 2019 , we exercised our right to acquire a property through our unconsolidated investment in RHS Partners, LLC, or RHS. The value of the purchase option asset utilized was $1,918,000 . See Note 6, Other Assets, Net for a further discussion. Amortization expense for the three months ended June 30, 2019 and 2018 was $3,094,000 and $2,465,000 , respectively, which included $132,000 and $217,000 , respectively, of amortization recorded against real estate revenue for above-market leases and $0 and $35,000 , respectively, of amortization recorded to rental expenses for leasehold interests in our accompanying condensed consolidated statements of operations and comprehensive income (loss). Amortization expense for the six months ended June 30, 2019 and 2018 was $6,439,000 and $5,977,000 , respectively, which included $344,000 and $556,000 , respectively, of amortization recorded against real estate revenue for above-market leases and $0 and $71,000 , respectively, of amortization recorded to rental expenses for leasehold interests in our accompanying condensed consolidated statements of operations and comprehensive income (loss). The aggregate weighted average remaining life of the identified intangible assets was 10.5 years and 15.5 years as of June 30, 2019 and December 31, 2018 , respectively. As of June 30, 2019 , estimated amortization expense on the identified intangible assets for the six months ending December 31, 2019 and for each of the next four years ending December 31 and thereafter was as follows: Year Amount 2019 $ 3,897,000 2020 6,075,000 2021 5,503,000 2022 4,785,000 2023 4,010,000 Thereafter 22,139,000 $ 46,409,000

Other Assets, Net

Other Assets, Net	6 Months Ended
	Jun. 30, 2019
Other Assets [Abstract]
Other Assets, Net	6. Other Assets, Net Other assets, net consisted of the following as of June 30, 2019 and December 31, 2018 : June 30, 2019 December 31, 2018 Deferred rent receivables $ 33,251,000 $ 23,334,000 Prepaid expenses, deposits and other assets 28,425,000 29,803,000 Investment in unconsolidated entities 21,281,000 15,432,000 Inventory 19,247,000 21,151,000 Deferred tax assets, net(1) 9,022,000 9,461,000 Lease commissions, net of accumulated amortization of $1,700,000 and $1,274,000 as of June 30, 2019 and December 31, 2018, respectively 9,446,000 8,523,000 Deferred financing costs, net of accumulated amortization of $8,721,000 and $12,487,000 as of June 30, 2019 and December 31, 2018, respectively(2) 6,077,000 2,311,000 Lease inducement, net of accumulated amortization of $965,000 and $789,000 as of June 30, 2019 and December 31, 2018, respectively (with a weighted average remaining life of 11.5 years and 12.0 years as of June 30, 2019 and December 31, 2018, respectively) 4,035,000 4,211,000 $ 130,784,000 $ 114,226,000 ___________ (1) See Note 16, Income Taxes , for a further discussion. (2) Deferred financing costs only include costs related to our lines of credit and term loans. Amortization expense on deferred financing costs of our lines of credit and term loans for the three months ended June 30, 2019 and 2018 was $970,000 and $1,612,000 , respectively, and for the six months ended June 30, 2019 and 2018 was $2,000,000 and $2,597,000 , respectively. Amortization expense on deferred financing costs of our lines of credit and term loans is recorded to interest expense in our accompanying condensed consolidated statements of operations and comprehensive income (loss). Amortization expense on lease commissions for the three months ended June 30, 2019 and 2018 was $251,000 and $182,000 , respectively, and for the six months ended June 30, 2019 and 2018 was $542,000 and $337,000 , respectively. Amortization expense on lease inducement for the three months ended June 30, 2019 and 2018 was $88,000 and $87,000 , respectively, and for the six months ended June 30, 2019 and 2018 was $176,000 and $175,000 , respectively. Amortization expense on lease inducement is recorded against real estate revenue in our accompanying condensed consolidated statements of operations and comprehensive income (loss). Investments in unconsolidated entities primarily represents our investment in RHS, a privately-held company that owns three integrated senior health campuses and operates 13 integrated senior health campuses. Our effective ownership of RHS was 33.9% and 33.8% as of June 30, 2019 and December 31, 2018 , respectively. As of June 30, 2019 and December 31, 2018 , we had a receivable of $3,826,000 and $2,507,000 , respectively, due from RHS, which is included in accounts and other receivables, net, in our accompanying condensed consolidated balance sheets. The following is summarized financial information of our investments in unconsolidated entities: June 30, 2019 December 31, 2018 RHS Other Total RHS Other Total Balance Sheet Data: Total assets $ 283,387,000 $ 17,542,000 $ 300,929,000 $ 48,291,000 $ 100,000 $ 48,391,000 Total liabilities $ 255,176,000 $ 16,743,000 $ 271,919,000 $ 25,263,000 $ — $ 25,263,000 Three Months Ended June 30, 2019 2018 RHS Other Total RHS Other Total Statement of Operations Data: Revenues $ 35,062,000 $ 1,076,000 $ 36,138,000 $ 31,695,000 $ — $ 31,695,000 Expenses 35,743,000 1,431,000 37,174,000 34,611,000 — 34,611,000 Net loss $ (681,000 ) $ (355,000 ) $ (1,036,000 ) $ (2,916,000 ) $ — $ (2,916,000 ) Six Months Ended June 30, 2019 2018 RHS Other Total RHS Other Total Statement of Operations Data: Revenues $ 70,430,000 $ 1,076,000 $ 71,506,000 $ 64,170,000 $ — $ 64,170,000 Expenses 71,974,000 1,477,000 73,451,000 69,239,000 — 69,239,000 Net loss $ (1,544,000 ) $ (401,000 ) $ (1,945,000 ) $ (5,069,000 ) $ — $ (5,069,000 )

Mortgage Loans Payable, Net

Mortgage Loans Payable, Net	6 Months Ended
	Jun. 30, 2019
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Abstract]
Mortgage Loans Payable, Net	7. Mortgage Loans Payable, Net Mortgage loans payable were $768,171,000 ( $743,564,000 , including discount/premium and deferred financing costs, net) and $713,030,000 ( $688,262,000 , including discount/premium and deferred financing costs, net) as of June 30, 2019 and December 31, 2018 , respectively. As of June 30, 2019 , we had 58 fixed-rate mortgage loans payable and eight variable-rate mortgage loans payable with effective interest rates ranging from 2.45% to 6.94% per annum based on interest rates in effect as of June 30, 2019 and a weighted average effective interest rate of 4.00% . As of December 31, 2018 , we had 57 fixed-rate mortgage loans payable and six variable-rate mortgage loans payable with effective interest rates ranging from 2.45% to 8.46% per annum based on interest rates in effect as of December 31, 2018 and a weighted average effective interest rate of 3.98% . We are required by the terms of certain loan documents to meet certain covenants, such as net worth ratios, fixed charge coverage ratio, leverage ratio and reporting requirements. Mortgage loans payable, net consisted of the following as of June 30, 2019 and December 31, 2018 : June 30, 2019 December 31, 2018 Total fixed-rate debt $ 631,575,000 $ 624,616,000 Total variable-rate debt 136,596,000 88,414,000 Total fixed- and variable-rate debt 768,171,000 713,030,000 Less: deferred financing costs, net (9,001,000 ) (8,824,000 ) Add: premium 484,000 663,000 Less: discount (16,090,000 ) (16,607,000 ) Mortgage loans payable, net $ 743,564,000 $ 688,262,000 The following table reflects the changes in the carrying amount of mortgage loans payable for the six months ended June 30, 2019 and 2018 : Six Months Ended June 30, 2019 2018 Beginning balance $ 688,262,000 $ 613,558,000 Additions: Borrowings on mortgage loans payable 61,472,000 1,364,000 Amortization of deferred financing costs 660,000 649,000 Amortization of discount/premium on mortgage loans payable 338,000 277,000 Deductions: Scheduled principal payments on mortgage loans payable (6,331,000 ) (5,045,000 ) Deferred financing costs (837,000 ) (14,000 ) Ending balance $ 743,564,000 $ 610,789,000 As of June 30, 2019 , the principal payments due on our mortgage loans payable for the six months ending December 31, 2019 and for each of the next four years ending December 31 and thereafter were as follows: Year Amount 2019 $ 71,635,000 2020 82,209,000 2021 34,775,000 2022 61,186,000 2023 28,973,000 Thereafter 489,393,000 $ 768,171,000

Lines of Credit and Term Loans

Lines of Credit and Term Loans	6 Months Ended
	Jun. 30, 2019
Line of Credit Facility [Abstract]
Lines Of Credit	8. Lines of Credit and Term Loans 2016 Corporate Line of Credit On February 3, 2016, we, through certain of our subsidiaries, entered into a credit agreement, or the 2016 Corporate Credit Agreement, with Bank of America, N.A., or Bank of America, as administrative agent, a swing line lender and a letter of credit issuer; KeyBank, National Association, or KeyBank, as syndication agent, a swing line lender and a letter of credit issuer; and a syndicate of other banks, as lenders, to obtain a revolving line of credit with an aggregate maximum principal amount of $300,000,000 , or the 2016 Corporate Revolving Credit Facility, and a term loan credit facility in the amount of $200,000,000 , or the 2016 Corporate Term Loan Facility, and together with the 2016 Corporate Revolving Credit Facility, the 2016 Corporate Line of Credit. On February 3, 2016, we also entered into separate revolving notes, or the 2016 Corporate Revolving Notes, and separate term notes with each of Bank of America, KeyBank and a syndicate of other banks. The 2016 Corporate Line of Credit would have matured on February 3, 2019 . On August 3, 2017, we entered into a First Amendment, Waiver and Commitment Increase Agreement, or the Amendment, with Bank of America, KeyBank, and the lenders named therein, to amend the 2016 Corporate Credit Agreement. The material terms of the Amendment included: (i) an increase in the 2016 Corporate Term Loan Facility in an amount equal to $50,000,000 ; (ii) a revision to the definition of Term Loan Commitment, as defined in the 2016 Corporate Credit Agreement, to reflect the increase in the 2016 Corporate Term Loan Facility and specify that the aggregate principal amount of the Term Loan Commitments of all of the Term Loan Lenders, as defined in the 2016 Corporate Credit Agreement, as in effect on the effective date of the Amendment is $250,000,000 ; and (iii) the addition of Bank of the West, or New Lender, as a party to the 2016 Corporate Credit Agreement and a Term Loan Lender and Lender, as defined in the 2016 Corporate Credit Agreement, and New Lender’s agreement to be bound by all terms, provisions and conditions applicable to Lenders contained in the 2016 Corporate Credit Agreement. As a result of the Amendment, our aggregate borrowing capacity under the 2016 Corporate Line of Credit was increased to $550,000,000 . On December 20, 2018, we entered into a Commitment Increase Agreement with Bank of America. The material terms of the Commitment Increase Agreement provided for an increase in the 2016 Corporate Revolving Credit Facility by an aggregate amount equal to $25,000,000 . On December 20, 2018, we also entered into an Amended and Restated Revolving Note with Bank of America, whereby we promised to pay the principal amount and accrued interest of each loan to the respective lender or its registered assigns, in accordance with the terms and conditions of the 2016 Corporate Credit Agreement, as amended. As a result of the Commitment Increase Agreement, our aggregate borrowing capacity under the 2016 Corporate Line Credit was increased to $575,000,000 . As of December 31, 2018 , our aggregate borrowing capacity under the 2016 Corporate Line of Credit was $575,000,000 . As of December 31, 2018 , borrowings outstanding under the 2016 Corporate Line of Credit totaled $548,500,000 and the weighted average interest rate on such borrowings outstanding was 4.60% per annum. On January 25, 2019, we terminated the 2016 Corporate Credit Agreement, as amended, and the 2016 Corporate Revolving Notes and entered into the 2019 Corporate Line of Credit as described below. We currently do not have any obligations under the 2016 Corporate Credit Agreement, as amended, or the 2016 Corporate Revolving Notes. 2019 Corporate Line of Credit On January 25, 2019, we, through our operating partnership and certain of our subsidiaries entered into a credit agreement, or the 2019 Corporate Credit Agreement, with Bank of America as administrative agent, a swing line lender and a letter of credit issuer; KeyBank, as syndication agent, a swing line lender and a letter of credit issuer; Citizens Bank, National Association, as a syndication agent, a swing line lender, a letter of credit issuer, a joint lead arranger and joint bookrunner; and a syndicate of other banks, as lenders, to obtain a credit facility with an aggregate maximum principal amount of $630,000,000 , or the 2019 Corporate Line of Credit. The 2019 Corporate Line of Credit consists of a senior unsecured revolving credit facility in the initial aggregate amount of $150,000,000 and a senior unsecured term loan facility in the initial aggregate amount of $480,000,000 . We may obtain up to $25,000,000 in the form of standby letters of credit and up to $25,000,000 in the form of swing line loans. The maximum principal amount of the 2019 Corporate Line of Credit may be increased by up to $370,000,000 , for a total principal amount of $1,000,000,000 , subject to: (i) the terms of the 2019 Corporate Credit Agreement; and (ii) at least five business days’ prior written notice to Bank of America. At our option, the 2019 Corporate Line of Credit bears interest at per annum rates equal to (a) (i) the Eurodollar Rate, as defined in the 2019 Corporate Credit Agreement, plus (ii) a margin ranging from 1.50% to 2.20% based on our Consolidated Leverage Ratio, as defined in the 2019 Corporate Credit Agreement, or (b) (i) the greater of: (1) the prime rate publicly announced by Bank of America, (2) the Federal Funds Rate, as defined in the 2019 Corporate Credit Agreement, plus 0.50% , (3) the one-month Eurodollar Rate plus 1.00% , and (4) 0.00% , plus (ii) a margin ranging from 0.50% to 1.20% based on our Consolidated Leverage Ratio. Accrued interest on the 2019 Corporate Line of Credit is payable monthly. The loans may be repaid in whole or in part without prepayment premium or penalty, subject to certain conditions. We are required to pay a fee on the unused portion of the lenders’ commitments under the 2019 Corporate Credit Agreement at a per annum rate equal to 0.20% if the average daily used amount is greater than 50% of the commitments and 0.25% if the average daily used amount is less than or equal to 50% of the commitments, which fee shall be measured and payable on a quarterly basis. The 2019 Corporate Line of Credit matures on January 25, 2022 , and may be extended for one 12 -month period during the term of the 2019 Credit Agreement, subject to satisfaction of certain conditions, including payment of an extension fee. The 2019 Corporate Credit Agreement contains various affirmative and negative covenants that are customary for credit facilities and transactions of this type, including limitations on the incurrence of debt by our operating partnership and its subsidiaries and limitations on secured recourse indebtedness. As of June 30, 2019 , our aggregate borrowing capacity under the 2019 Corporate Line of Credit was $630,000,000 . As of June 30, 2019 , borrowings outstanding under the 2019 Corporate Line of Credit totaled $557,000,000 and the weighted average interest rate on such borrowings outstanding was 4.28% per annum. Trilogy PropCo Line of Credit In connection with our acquisition of Trilogy, on December 1, 2015, we, through Trilogy PropCo Finance, LLC, a Delaware limited liability company and an indirect subsidiary of Trilogy, or Trilogy PropCo Parent, and certain of its subsidiaries, or the Trilogy PropCo Co-Borrowers, and, together with Trilogy PropCo Parent, the Trilogy PropCo Borrowers, entered into a loan agreement, or the Trilogy PropCo Credit Agreement, with KeyBank, as administrative agent; Regions Bank, as syndication agent; and a syndicate of other banks, as lenders, to obtain a line of credit with an aggregate maximum principal amount of $300,000,000 , or the Trilogy PropCo Line of Credit. We also entered into separate revolving notes with each of KeyBank and Regions Bank, whereby we promised to pay the principal amount of each revolving loan and accrued interest to the respective lender or its registered assigns, in accordance with the terms and conditions of the Trilogy PropCo Credit Agreement. The proceeds of the loans made under the Trilogy PropCo Line of Credit may be used for working capital, capital expenditures, acquisition of properties and fee interests in leasehold properties and general corporate purposes. The Trilogy PropCo Line of Credit matures on December 1, 2019 , unless extended for a one -year period subject to satisfaction of certain conditions, including payment of an extension fee, or otherwise terminated in accordance with the terms thereunder. Availability of the total commitment under the Trilogy PropCo Line of Credit is subject to a borrowing base based on, among other things, the appraised value of certain real estate and villa units constructed on such real estate. In addition to paying interest on the outstanding principal under the Trilogy PropCo Line of Credit, the Trilogy PropCo Borrowers are required to pay an unused fee to the lenders in respect of the unutilized commitments at a rate equal to an initial rate of 0.25% per annum, subject to adjustment depending on usage. Outstanding amounts under the Trilogy PropCo Line of Credit may be prepaid, in whole or in part, at any time, without penalty or premium, subject to customary breakage costs. The Trilogy PropCo Credit Agreement contains various affirmative and negative covenants that are customary for credit facilities and transactions of this type, including incurrence of debt and limitations on secured recourse indebtedness. On October 27, 2017, we entered into an amendment to the Trilogy PropCo Credit Agreement, or the Trilogy PropCo Amendment, with KeyBank, as administrative agent, and a syndicate of other banks, as lenders, to amend the terms of the Trilogy PropCo Credit Agreement. The material terms of the Trilogy PropCo Amendment included: (i) a reduction of the total commitment under the Trilogy PropCo Line of Credit from $300,000,000 to $250,000,000 ; and (ii) a revision to the definition of applicable margin, pursuant to which the Trilogy PropCo Line of Credit bears interest at a floating rate based on an adjusted London Interbank Offered Rate, or LIBOR, plus an applicable margin of 4.00% per annum or an alternate base rate plus an applicable margin of 3.00% per annum, at the Trilogy PropCo Borrowers’ option. Our aggregate borrowing capacity under the Trilogy PropCo Line of Credit was $250,000,000 as of both June 30, 2019 and December 31, 2018 . As of June 30, 2019 and December 31, 2018 , borrowings outstanding under the Trilogy PropCo Line of Credit totaled $181,517,000 and $170,518,000 , respectively, and the weighted average interest rate on such borrowings outstanding was 6.40% and 6.45% per annum, respectively. Trilogy OpCo Line of Credit On March 21, 2016, we, through Trilogy Healthcare Holdings, Inc., a Delaware corporation and a direct subsidiary of Trilogy, and certain of its subsidiaries, or the Trilogy OpCo Borrowers, entered into a credit agreement, or the Trilogy OpCo Credit Agreement, with Wells Fargo Bank, National Association, or Wells Fargo, N.A., as administrative agent and lender; and a syndicate of other banks, as lenders, to obtain a $42,000,000 secured revolving credit facility, or the Trilogy OpCo Line of Credit. The Trilogy OpCo Line of Credit is secured primarily by residents’ receivables of the Trilogy OpCo Borrowers. On April 1, 2016, we entered into an amendment to the Trilogy OpCo Credit Agreement to increase the aggregate maximum principal amount of the Trilogy OpCo Line of Credit to $60,000,000 . In April 2018, we further amended the Trilogy OpCo Credit Agreement, or the Trilogy OpCo Amendment. The material terms of the Trilogy OpCo Amendment provided for: (i) a reduction in the aggregate maximum principal amount from $60,000,000 to $25,000,000 ; (ii) a reduced floating interest rate based on LIBOR, plus an applicable margin of 2.75% per annum, for LIBOR Rate Loans, as defined in the Trilogy OpCo Credit Agreement, or an alternate base rate plus an applicable margin of 1.75% per annum, for Base Rate Loans, as defined in the Trilogy OpCo Credit Agreement, at the Trilogy OpCo Borrowers’ option; (iii) a reduced letter of credit fee of 2.75% per annum times the undrawn amount of outstanding letters of credit; and (iv) an updated maturity date of April 27, 2021 . Accrued interest under the Trilogy OpCo Line of Credit is payable monthly. In addition to paying interest on the outstanding principal under the Trilogy OpCo Line of Credit, the Trilogy OpCo Borrowers are required to pay an unused fee in an amount equal to 0.50% per annum times the average monthly unutilized commitment. The unused fee is payable monthly in arrears, commencing on the first day of each month from and after the closing date up to the first day of the month prior to the date on which the obligations are paid in full. The Trilogy OpCo Credit Agreement, as amended, contains customary events of default, covenants and other terms, including, among other things, restrictions on the payment of dividends and other distributions, incurrence of indebtedness, creation of liens and transactions with affiliates. Availability of the total commitment under the Trilogy OpCo Line of Credit is subject to a borrowing base based on, among other things, the eligible accounts receivable outstanding of the Trilogy OpCo Borrowers. Our aggregate borrowing capacity under the Trilogy OpCo Line of Credit was $25,000,000 as of both June 30, 2019 and December 31, 2018 , subject to certain terms and conditions. As of June 30, 2019 and December 31, 2018 , borrowings outstanding under the Trilogy OpCo Line of Credit totaled $19,050,000 and $19,030,000 , respectively, and the weighted average interest rate on such borrowings outstanding was 5.16% and 5.17% per annum, respectively.

Derivative Financial Instrument

Derivative Financial Instruments	6 Months Ended
	Jun. 30, 2019
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative Instruments and Hedging Activities Disclosure	9. Derivative Financial Instruments We record derivative financial instruments in our accompanying condensed consolidated balance sheets as either an asset or a liability measured at fair value. The following table lists the derivative financial instruments held by us as of June 30, 2019 and December 31, 2018 : Fair Value Instrument Notional Amount Index Interest Rate Maturity Date June 30, 2019 December 31, 2018 Swap $ 140,000,000 one month LIBOR 0.82% 02/03/19 $ — $ 221,000 Swap 60,000,000 one month LIBOR 0.78% 02/03/19 — 97,000 Swap 50,000,000 one month LIBOR 1.39% 02/03/19 — 51,000 Cap 20,000,000 one month LIBOR 3.00% 09/23/21 4,000 48,000 Swap 250,000,000 one month LIBOR 2.10% 01/25/22 (2,962,000 ) — Swap 130,000,000 one month LIBOR 1.98% 01/25/22 (1,149,000 ) — $ (4,107,000 ) $ 417,000 ASC Topic 815, Derivatives and Hedging , or ASC Topic 815, permits special hedge accounting if certain requirements are met. Hedge accounting allows for gains and losses on derivatives designated as hedges to be offset by the change in value of the hedged item or items or to be deferred in other comprehensive income (loss). As of June 30, 2019 and December 31, 2018 , none of our derivative financial instruments were designated as hedges. Derivative financial instruments not designated as hedges are not speculative and are used to manage our exposure to interest rate movements, but do not meet the strict hedge accounting requirements of ASC Topic 815. Changes in the fair value of derivative financial instruments are recorded as a component of interest expense in our accompanying condensed consolidated statements of operations and comprehensive income (loss). For the three months ended June 30, 2019 and 2018 , we recorded $(4,117,000) and $(487,000) , respectively, and for the six months ended June 30, 2019 and 2018 , we recorded $(4,677,000) and $(377,000) , respectively, as an increase to interest expense in our accompanying condensed consolidated statements of operations and comprehensive income (loss) related to the change in the fair value of our derivative financial instruments. See Note 15, Fair Value Measurements , for a further discussion of the fair value of our derivative financial instruments.

Identified Intangible Liabiliti

Identified Intangible Liabilities, Net	6 Months Ended
	Jun. 30, 2019
Identified Intangible Liabilities [Abstract]
Identified Intangible Liabilities, Net	10. Identified Intangible Liabilities, Net As of June 30, 2019 and December 31, 2018 , identified intangible liabilities consisted of below-market leases of $842,000 and $1,051,000 , respectively, net of accumulated amortization of $1,244,000 and $1,229,000 , respectively. Amortization expense on below-market leases for the three months ended June 30, 2019 and 2018 was $104,000 and $129,000 , respectively, and for the six months ended June 30, 2019 and 2018 was $209,000 and $269,000 , respectively, which is recorded to real estate revenue in our accompanying condensed consolidated statements of operations and comprehensive income (loss). The weighted average remaining life of below-market leases was 4.3 years as of both June 30, 2019 and December 31, 2018 , respectively. As of June 30, 2019 , estimated amortization expense on below-market leases for the six months ending December 31, 2019 and for each of the next four years ending December 31 and thereafter was as follows: Year Amount 2019 $ 179,000 2020 260,000 2021 143,000 2022 93,000 2023 78,000 Thereafter 89,000 $ 842,000

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2019
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	11. Commitments and Contingencies Litigation We are not presently subject to any material litigation nor, to our knowledge, is any material litigation threatened against us, which if determined unfavorably to us, would have a material adverse effect on our consolidated financial position, results of operations or cash flows. Environmental Matters We follow a policy of monitoring our properties for the presence of hazardous or toxic substances. While there can be no assurance that a material environmental liability does not exist at our properties, we are not currently aware of any environmental liability with respect to our properties that would have a material effect on our consolidated financial position, results of operations or cash flows. Further, we are not aware of any material environmental liability or any unasserted claim or assessment with respect to an environmental liability that we believe would require additional disclosure or the recording of a loss contingency. Other Our other commitments and contingencies include the usual obligations of real estate owners and operators in the normal course of business, which include calls/puts to sell/acquire properties. In our view, these matters are not expected to have a material adverse effect on our consolidated financial position, results of operations or cash flows.

Redeemable Noncontrolling Inter

Redeemable Noncontrolling Interest	6 Months Ended
	Jun. 30, 2019
Temporary Equity [Abstract]
Redeemable Noncontrolling Interest	12. Redeemable Noncontrolling Interests On January 15, 2013, our advisor made an initial capital contribution of $2,000 to our operating partnership in exchange for 222 limited partnership units. Upon the effectiveness of the Advisory Agreeme nt on February 26, 2014, Griffin-American Advisor became our advisor. As of June 30, 2019 and December 31, 2018 , we owned greater than a 99.99% general partnership interest in our operating partnership, and our advisor owned less than a 0.01% limited partnership interest in our operating partnership. As our advisor, Griffin-American Advisor is entitled to special redemption rights of its limited partnership units. The noncontrolling interest of our advisor in our operating partnership that has redemption features outside of our control is accounted for as a redeemable noncontrolling interest and is presented outside of permanent equity in our accompanying condensed consolidated balance sheets. See Note 14, Related Party Transactions — Liquidity Stage — Subordinated Participation Interest — Subordinated Distribution Upon Listing and Note 14, Related Party Transactions — Subordinated Distribution Upon Termination, for a further discussion of the redemption features of the limited partnership units. On December 1, 2015, we, through Trilogy REIT Holdings, LLC, or Trilogy REIT Holdings, in which we indirectly hold a 70.0% ownership interest, pursuant to an equity purchase agreement with Trilogy and other seller parties thereto, completed the acquisition of approximately 96.7% of the outstanding equity interests of Trilogy. Pursuant to the equity purchase agreement, at the closing of the acquisition, certain members of Trilogy’s pre-closing management retained a portion of the outstanding equity interests of Trilogy held by such members of Trilogy’s pre-closing management, representing in the aggregate approximately 3.3% of the outstanding equity interests of Trilogy. The noncontrolling interests held by Trilogy’s pre-closing management have redemption features outside of our control and are accounted for as redeemable noncontrolling interests in our accompanying condensed consolidated balance sheets. As of both June 30, 2019 and December 31, 2018 , Trilogy REIT Holdings and certain members of Trilogy’s pre-closing management owned approximately 96.7% and 3.3% of Trilogy, respectively. We record the carrying amount of redeemable noncontrolling interests at the greater of: (i) the initial carrying amount, increased or decreased for the noncontrolling interests’ share of net income or loss and distributions or (ii) the redemption value. The changes in the carrying amount of redeemable noncontrolling interests consisted of the following for the six months ended June 30, 2019 and 2018 : Six Months Ended June 30, 2019 2018 Beginning balance $ 38,245,000 $ 32,435,000 Additions — 535,000 Reclassification from equity 390,000 390,000 Distributions (720,000 ) (332,000 ) Repurchase of redeemable noncontrolling interest (3,000 ) (229,000 ) Fair value adjustment to redemption value (84,000 ) 293,000 Net income attributable to redeemable noncontrolling interests 287,000 107,000 Ending balance $ 38,115,000 $ 33,199,000

Equity

Equity	6 Months Ended
	Jun. 30, 2019
Equity [Abstract]
Equity	13. Equity Preferred Stock Our charter authorizes us to issue 200,000,000 shares of our preferred stock, par value $0.01 per share. As of June 30, 2019 and December 31, 2018 , no shares of preferred stock were issued and outstanding. Common Stock Our charter authorizes us to issue 1,000,000,000 shares of our common stock, par value $0.01 per share. On January 15, 2013, our advisor acquired 22,222 shares of our common stock for total cash consideration of $200,000 and was admitted as our initial stockholder. We used the proceeds from the sale of shares of our common stock to our advisor to make an initial capital contribution to our operating partnership. On March 12, 2015, we terminated the primary portion of our initial public offering. We continued to offer shares of our common stock in our initial offering pursuant to the Initial DRIP, until the termination of the DRIP portion of our initial offering and deregistration of our initial offering on April 22, 2015. On March 25, 2015, we filed a Registration Statement on Form S-3 under the Securities Act to register a maximum of $250,000,000 of additional shares of our common stock pursuant to the 2015 DRIP Offering. We did not commence offering shares to the 2015 DRIP Offering until April 22, 2015 following the deregistration of our initial offering. We continued to offer shares of our common stock pursuant to the 2015 DRIP Offering until the termination and deregistration of our offering on March 29, 2019. On January 30, 2019, we filed a Registration Statement on Form S-3 under the Securities Act to register a maximum of $200,000,000 of additional shares of our common stock to be issued pursuant to the 2019 DRIP Offering. The Registration Statement on Form S-3 was automatically effective with the SEC upon its filing; however, we did not commence offering shares pursuant to the 2019 DRIP Offering until April 1, 2019, following the deregistration of the 2015 DRIP Offering. Through June 30, 2019 , we had issued 184,930,598 shares of our common stock in connection with the primary portion of our initial public offering and 29,841,503 shares of our common stock pursuant to our DRIP Offerings. We also repurchased 20,170,805 shares of our common stock under our share repurchase plan and granted an aggregate of 112,500 shares of our restricted common stock to our independent directors through June 30, 2019 . As of June 30, 2019 and December 31, 2018 , we had 194,736,018 and 197,557,377 shares of our common stock issued and outstanding, respectively. Accumulated Other Comprehensive Loss The changes in accumulated other comprehensive loss, net of noncontrolling interests, by component consisted of the following for the six months ended June 30, 2019 and 2018 : Six Months Ended June 30, 2019 2018 Beginning balance — foreign currency translation adjustments $ (2,560,000 ) $ (1,971,000 ) Net change in current period (20,000 ) (238,000 ) Ending balance — foreign currency translation adjustments $ (2,580,000 ) $ (2,209,000 ) Noncontrolling Interests As of June 30, 2019 and December 31, 2018 , Trilogy REIT Holdings owned approximately 96.7% of Trilogy. We are the indirect owner of a 70.0% interest in Trilogy REIT Holdings pursuant to a joint venture agreement, or the Trilogy JV Agreement, with an indirect, wholly-owned subsidiary of NorthStar Healthcare Income, Inc., or NHI. We serve as the sole manager of Trilogy REIT Holdings. Prior to October 1, 2018, NHI was the indirect owner of the remaining 30.0% interest in Trilogy REIT Holdings. On October 1, 2018, we amended the Trilogy JV Agreement as a result of the purchase by an indirect, wholly-owned subsidiary of the operating partnership of Griffin-American Healthcare REIT IV, Inc., or GAHR IV JV Member, of 6.0% of the total membership interests in Trilogy REIT Holdings from a wholly-owned subsidiary of NHI. Both Griffin-American Healthcare REIT IV, Inc. and us are sponsored by American Healthcare Investors. Effective October 1, 2018, NHI and GAHR IV JV Member indirectly own a 24.0% and 6.0% membership interest, respectively, in Trilogy REIT Holdings. As of June 30, 2019 and December 31, 2018 , 30.0% of the net earnings of Trilogy REIT Holdings were allocated to noncontrolling interests. In connection with our acquisition and operation of Trilogy, profit interest units in Trilogy, or the Profit Interests, were issued to Trilogy Management Services, LLC and an independent director of Trilogy, both unaffiliated third parties that manage or direct the day-to-day operations of Trilogy. The Profit Interests consist of time-based or performance-based commitments. The time-based Profit Interests were measured at their grant date fair value and vest in increments of 20.0% on each anniversary of the respective grant date over a five -year period. We amortize the time-based Profit Interests on a straight-line basis over the vesting periods, which are recorded to general and administrative in our accompanying condensed consolidated statements of operations and comprehensive income (loss). The performance-based Profit Interests are subject to a performance commitment and vest upon liquidity events as defined in the Profit Interests agreements. The performance-based Profit Interests were measured at their grant date fair value and immediately expensed. The performance-based Profit Interests are subject to fair value measurements until vesting occurs with changes to fair value recorded to general and administrative in our accompanying condensed consolidated statements of operations and comprehensive income (loss). For both the three months ended June 30, 2019 and 2018 , we recognized stock compensation expense related to Profit Interests of $195,000 and for both the six months ended June 30, 2019 and 2018 , we recognized stock compensation expense related to the Profit Interests of $390,000 . There were no canceled, expired or exercised Profit Interests during the six months ended June 30, 2019 and 2018 . The nonvested awards are presented as noncontrolling interests and are re-classified to redeemable noncontrolling interests upon vesting as they have redemption features outside of our control similar to the common stock units held by Trilogy’s pre-closing management. See Note 12, Redeemable Noncontrolling Interests , for a further discussion. On January 6, 2016, one of our consolidated subsidiaries issued non-voting preferred shares of beneficial interests to qualified investors for total proceeds of $125,000 . These preferred shares of beneficial interests are entitled to receive cumulative preferential cash dividends at the rate of 12.5% per annum. We classify the value of the subsidiary’s preferred shares of beneficial interests as noncontrolling interests in our accompanying condensed consolidated balance sheets and the dividends of the preferred shares of beneficial interests as net income attributable to noncontrolling interests in our accompanying condensed consolidated statements of operations and comprehensive income (loss). In addition, as of June 30, 2019 and December 31, 2018 , we owned an 86.0% interest in a consolidated limited liability company that owns Lakeview IN Medical Plaza, which we acquired on January 21, 2016. As such, 14.0% of the net earnings of Lakeview IN Medical Plaza were allocated to noncontrolling interests for the three and six months ended June 30, 2019 and 2018 . Distribution Reinvestment Plan We adopted the Initial DRIP that allowed stockholders to purchase additional shares of our common stock through the reinvestment of distributions at an offering price equal to 95.0% of the primary offering price of our initial offering, subject to certain conditions. We had registered and reserved $35,000,000 in shares of our common stock for sale pursuant to the Initial DRIP in our initial offering, which we deregistered on April 22, 2015. On March 25, 2015, we filed a Registration Statement on Form S-3 under the Securities Act to register a maximum of $250,000,000 of additional shares of our common stock pursuant to the 2015 DRIP Offering. We commenced offering shares pursuant to the 2015 DRIP Offering, following the deregistration of our initial offering on April 22, 2015. We continued to offer shares of our common stock pursuant to the 2015 DRIP Offering until the deregistration of such offering on March 29, 2019. On January 30, 2019, we filed a Registration Statement on Form S-3 under the Securities Act to register a maximum of $200,000,000 of additional shares of our common stock to be issued pursuant to the 2019 DRIP Offering. We commenced offering shares pursuant to the 2019 DRIP Offering on April 1, 2019, following the deregistration of the 2015 DRIP Offering. Effective October 5, 2016, we amended and restated the Initial DRIP to amend the price at which shares of our common stock are issued pursuant to such distribution reinvestment plan. Pursuant to the Amended and Restated DRIP, shares are issued at a price equal to the most recently estimated value of one share of our common stock, as approved and established by our board. The Amended and Restated DRIP became effective with the distribution payment to stockholders paid in the month of November 2016. In all other material respects, the terms of the 2015 DRIP Offering remain unchanged by the Amended and Restated DRIP. Since October 5, 2016, our board has approved and established an estimated per share net asset value, or NAV, on at least an annual basis. Commencing with the distribution payment to stockholders paid in the month following such board approval, shares of our common stock issued pursuant to the Amended and Restated DRIP were or will be issued at the current estimated per share NAV until such time as our board determines an updated estimated per share NAV. The following is a summary of our historical and current estimated per share NAV: Approval Date by our Board Estimated Per Share NAV (Unaudited) 10/05/16 $ 9.01 10/04/17 $ 9.27 10/03/18 $ 9.37 For the three and six months ended June 30, 2019 , $14,115,000 and $28,311,000 , respectively, in distributions were reinvested and 1,506,395 and 3,021,493 shares of our common stock, respectively, were issued pursuant to the 2015 DRIP Offering and 2019 DRIP Offering. For the three and six months ended June 30, 2018 , $15,220,000 and $30,449,000 , respectively, in distributions were reinvested and 1,641,819 and 3,284,653 shares of our common stock, respectively, were issued pursuant to the 2015 DRIP Offering. As of June 30, 2019 and December 31, 2018 , a total of $278,022,000 and $249,711,000 , respectively, in distributions were reinvested that resulted in 29,841,503 and 26,820,010 shares of our common stock, respectively, being issued pursuant to our DRIP Offerings. Share Repurchase Plan Our board has approved a share repurchase plan, which allows for repurchases of shares of our common stock by us when certain criteria are met. Share repurchases will be made at the sole discretion of our board. Subject to the availability of the funds for share repurchases, we will generally limit the number of shares of our common stock repurchased during any calendar year to 5.0% of the weighted average number of shares of our common stock outstanding during the prior calendar year. Additionally, effective with respect to share repurchase requests submitted for repurchase during the second quarter 2019, the number of shares that we will repurchase during any fiscal quarter will be limited to an amount equal to the net proceeds that we received from the sale of shares issued pursuant to the DRIP Offerings during the immediately preceding completed fiscal quarter; provided however, that shares subject to a repurchase requested upon the death or “qualifying disability,” as defined in our share repurchase plan, of a stockholder will not be subject to this quarterly cap or to our existing cap on repurchases to 5.0% of the weighted average number of shares outstanding during the calendar year prior to the repurchase date. Funds for the repurchase of shares of our common stock will come from the cumulative proceeds we receive from the sale of shares of our common stock pursuant to our DRIP Offerings. Furthermore, our share repurchase plan, as amended, provides that if there are insufficient funds to honor all repurchase requests, pending requests may be honored among all requests for repurchase in any given repurchase period as follows: first, repurchases in full as to repurchases that would result in a stockholder owning less than $2,500 of shares; and, next, pro rata as to other repurchase requests. All repurchases will be subject to a one -year holding period, except for repurchases made in connection with a stockholder’s death or qualifying disability. Further, all share repurchases will be repurchased following a one -year holding period at a price between 92.5% and 100% of each stockholder’s repurchase amount, depending on the period of time their shares have been held. Until October 4, 2016, the repurchase amount for shares repurchased under our share repurchase plan was equal to the lesser of the amount a stockholder paid for their shares of our common stock or the most recent per share offering price. However, if shares of our common stock were repurchased in connection with a stockholder’s death or qualifying disability, the repurchase price was no less than 100% of the price paid to acquire the shares of our common stock from us. Effective with respect to share repurchase requests submitted during the fourth quarter 2016, the Repurchase Amount, as such term is defined in our share repurchase plan, is equal to the lesser of (i) the amount per share that a stockholder paid for their shares of our common stock, or (ii) the most recent estimated value of one share of our common stock, as determined by our board. Accordingly, commencing with the share repurchase requests submitted during the fourth quarter 2016, we repurchase shares as follows: (a) for stockholders who have continuously held their shares of our common stock for at least one year, the price will be 92.5% of the Repurchase Amount; (b) for stockholders who have continuously held their shares of our common stock for at least two years, the price will be 95.0% of the Repurchase Amount; (c) for stockholders who have continuously held their shares of our common stock for at least three years, the price will be 97.5% of the Repurchase Amount; (d) for stockholders who have held their shares of our common stock for at least four years, the price will be 100% of the Repurchase Amount; and (e) for requests submitted pursuant to a death or a qualifying disability, the price will be 100% of the amount per share the stockholder paid for their shares of common stock (in each case, as adjusted for any stock dividends, combinations, splits, recapitalizations and the like with respect to our common stock). Since October 5, 2016, our board has approved and established an estimated per share NAV on at least an annual basis. See summary of our historical and current estimated per share NAV in the “Distribution Reinvestment Plan” section above. Accordingly, commencing with share repurchase requests submitted during the quarter that our board has approved and established an estimated per share NAV, such NAV per share served or will serve as the Repurchase Amount for stockholders who purchased their shares at a price equal to or greater than such NAV per share in our initial offering, until such time as our board determines an updated estimated per share NAV. For the three months ended June 30, 2019 and 2018 , we received share repurchase requests of 5,252,062 and 1,978,048 shares of our common stock, respectively, and repurchased 1,966,636 and 1,978,048 shares of our common stock, respectively, for an aggregate of $18,649,000 and $18,194,000 , respectively, at an average repurchase price of $9.48 and $9.20 per share, respectively. For the six months ended June 30, 2019 and 2018 , we received share repurchase requests of 9,135,778 and 3,770,572 shares of our common stock, respectively, and repurchased 5,850,352 and 3,770,572 shares of our common stock, respectively, for an aggregate of $55,135,000 and $34,700,000 , respectively, at an average repurchase price of $9.42 and $9.20 per share, respectively. As of June 30, 2019 and December 31, 2018 , we received cumulative share repurchase requests 23,456,231 and 14,320,453 shares of our common stock, respectively, and repurchased 20,170,805 and 14,320,453 shares of our common stock, respectively, for an aggregate of $187,070,000 and $131,935,000 , respectively, at an average repurchase price of $9.27 and $9.21 per share, respectively. Shares were repurchased using proceeds we received from the cumulative sale of shares of our common stock pursuant to our DRIP Offerings. 2013 Incentive Plan We adopted the 2013 Incentive Plan, or our incentive plan, pursuant to which our board or a committee of our independent directors may make grants of options, shares of our common stock, stock purchase rights, stock appreciation rights or other awards to our independent directors, employees and consultants. The maximum number of shares of our common stock that may be issued pursuant to our incentive plan is 2,000,000 shares. For both the three and six months ended June 30, 2019 , we granted an aggregate of 7,500 shares of our restricted common stock, at a weighted average grant date fair value of $9.37 per share, to our independent directors in connection with their re-election to our board. Such shares vest as to 20.0% of the shares on the date of grant on each of the first four anniversaries of the grant date. For the three months ended June 30, 2019 and 2018 , we recognized stock compensation expense related to the independent director grants of $57,000 and $56,000 , respectively, and for the six months ended June 30, 2019 and 2018 , we recognized stock compensation expense related to the director grants of $100,000 and $99,000 , respectively. Such stock compensation expense is included in general and administrative in our accompanying condensed consolidated statements of operations and comprehensive income (loss).

Related Party Transactions

Related Party Transactions	6 Months Ended
	Jun. 30, 2019
Related Party Transactions [Abstract]
Related Party Transactions	14. Related Party Transactions Fees and Expenses Paid to Affiliates All of our executive officers and our non-independent directors are also executive officers and employees and/or holders of a direct or indirect interest in our advisor, one of our co-sponsors or other affiliated entities. We are affiliated with our advisor, American Healthcare Investors and AHI Group Holdings; however, we are not affiliated with Griffin Capital, our dealer manager, Colony Capital or Mr. Flaherty. We entered into the Advisory Agreement, which entitles our advisor and its affiliates to specified compensation for certain services, as well as reimbursement of certain expenses. Our board, including a majority of our independent directors, has reviewed the material transactions between our affiliates and us during the three and six months ended June 30, 2019 . Set forth below is a description of the transactions with affiliates. We believe that we have executed all of the transactions set forth below on terms that are fair and reasonable to us and on terms no less favorable to us than those available from unaffiliated third parties. In the aggregate, for the three months ended June 30, 2019 and 2018 , we incurred $6,477,000 and $6,133,000 , respectively, and for the six months ended June 30, 2019 and 2018 , we incurred $12,718,000 and $11,652,000 , respectively, in fees and expenses to our affiliates as detailed below. Acquisition and Development Stage Acquisition Fee We pay our advisor or its affiliates an acquisition fee of up to 2.25% of the contract purchase price, including any contingent or earn-out payments that may be paid, for each property we acquire or 2.00% of the origination or acquisition price, including any contingent or earn-out payments that may be paid, for any real estate-related investment we originate or acquire. Since January 31, 2015, acquisition fees are and have been paid in cash. Our advisor or its affiliates are entitled to receive these acquisition fees for properties and real estate-related investments we acquire with funds raised in our initial offering including acquisitions completed after the termination of the Advisory Agreement, or funded with net proceeds from the sale of a property or real estate-related investment, subject to certain conditions. For the three months ended June 30, 2019 and 2018 , we incurred $440,000 and $7,000 , respectively, and for the six months ended June 30, 2019 and 2018 , we incurred $798,000 and $7,000 , respectively, in acquisition fees to our advisor. Acquisition fees in connection with the acquisition of properties accounted for as asset acquisitions or the acquisition of real estate-related investments are capitalized as part of the associated investments in our accompanying condensed consolidated balance sheets. Development Fee In the event our advisor or its affiliates provide development-related services, our advisor or its affiliates receive a development fee in an amount that is usual and customary for comparable services rendered for similar projects in the geographic market where the services are provided; however, we will not pay a development fee to our advisor or its affiliates if our advisor or its affiliates elect to receive an acquisition fee based on the cost of such development. For the three months ended June 30, 2019 and 2018 , we incurred $13,000 and $45,000 , respectively, and for the six months ended June 30, 2019 and 2018 , we incurred $163,000 and $45,000 , respectively, in development fees to our advisor or its affiliates, which was capitalized as part of the associated investments in our accompanying condensed consolidated balance sheets. Reimbursement of Acquisition Expenses We reimburse our advisor or its affiliates for acquisition expenses related to selecting, evaluating and acquiring assets, which are reimbursed regardless of whether an asset is acquired. The reimbursement of acquisition expenses, acquisition fees, total development costs, real estate commissions or other fees paid to unaffiliated third parties will not exceed, in the aggregate, 6.0% of the contract purchase price or real estate-related investments, unless fees in excess of such limits are approved by a majority of our directors, including a majority of our independent directors, not otherwise interested in the transaction. For the three and six months ended June 30, 2019 and 2018 , such fees and expenses noted above did not exceed 6.0% of the contract purchase price of our acquisitions of real estate or real estate-related investments. For the three and six months ended June 30, 2019 and 2018 , we did not incur any acquisition expenses to our advisor or its affiliates. Reimbursements of acquisition expenses in connection with the acquisition of properties accounted for as asset acquisitions or the acquisition of real estate-related investments are capitalized as part of the associated investments in our accompanying condensed consolidated balance sheets. Operational Stage Asset Management Fee We pay our advisor or its affiliates a monthly fee for services rendered in connection with the management of our assets equal to one-twelfth of 0.75% of average invested assets, subject to our stockholders receiving distributions in an amount equal to 5.0% per annum, cumulative, non-compounded, of invested capital. For such purposes, average invested assets means the average of the aggregate book value of our assets invested in real estate and real estate-related investments, before deducting depreciation, amortization, bad debt and other similar non-cash reserves, computed by taking the average of such values at the end of each month during the period of calculation; and invested capital means, for a specified period, the aggregate issue price of shares of our common stock purchased by our stockholders, reduced by distributions of net sales proceeds by us to our stockholders and by any amounts paid by us to repurchase shares of our common stock pursuant to our share repurchase plan. For the three months ended June 30, 2019 and 2018 , we incurred $5,020,000 and $4,784,000 , respectively, and for the six months ended June 30, 2019 and 2018 , we incurred $9,997,000 and $9,565,000 , respectively, in asset management fees to our advisor or its affiliates. Asset management fees are included in general and administrative in our accompanying condensed consolidated statements of operations and comprehensive income (loss). Property Management Fee Our advisor or its affiliates may directly serve as property manager of our properties or may sub-contract their property management duties to any third party and provide oversight of such third-party property manager. We pay our advisor or its affiliates a monthly management fee equal to a percentage of the gross monthly cash receipts of such property as follows: (i) a property management oversight fee of 1.0% of the gross monthly cash receipts of any stand-alone, single-tenant, net leased property; (ii) a property management oversight fee of 1.5% of the gross monthly cash receipts of any property that is not a stand-alone, single-tenant, net leased property and for which our advisor or its affiliates provide oversight of a third party that performs the duties of a property manager with respect to such property; or (iii) a fair and reasonable property management fee that is approved by a majority of our directors, including a majority of our independent directors, that is not less favorable to us than terms available from unaffiliated third parties for any property that is not a stand-alone, single-tenant, net leased property and for which our advisor or its affiliates will directly serve as the property manager without sub-contracting such duties to a third party. For the three months ended June 30, 2019 and 2018 , we incurred $660,000 and $583,000 , respectively, and for the six months ended June 30, 2019 and 2018 , we incurred $1,279,000 and $1,194,000 , respectively, in property management fees to our advisor or its affiliates. Property management fees are included in property operating expenses and rental expenses in our accompanying condensed consolidated statements of operations and comprehensive income (loss). Lease Fees We pay our advisor or its affiliates a separate fee for any leasing activities in an amount not to exceed the fee customarily charged in arm’s-length transactions by others rendering similar services in the same geographic area for similar properties as determined by a survey of brokers and agents in such area. Such fee is generally expected to range from 3.0% to 6.0% of the gross revenues generated during the initial term of the lease. For the three months ended June 30, 2019 and 2018 , we incurred $145,000 and $659,000 , respectively, and for the six months ended June 30, 2019 and 2018 , we incurred $169,000 and $728,000 , respectively, in lease fees to our advisor or its affiliates. Lease fees are capitalized as lease commissions and included in other assets, net in our accompanying condensed consolidated balance sheets. Construction Management Fee In the event that our advisor or its affiliates assist with planning and coordinating the construction of any capital or tenant improvements, our advisor or its affiliates are paid a construction management fee of up to 5.0% of the cost of such improvements. For the three months ended June 30, 2019 and 2018 , we incurred $162,000 and $8,000 , respectively, and for the six months ended June 30, 2019 and 2018 , we incurred $199,000 and $14,000 , respectively, in construction management fees to our advisor or its affiliates. Construction management fees are capitalized as part of the associated asset and included in real estate investments, net in our accompanying condensed consolidated balance sheets or are expensed and included in our accompanying condensed consolidated statements of operations and comprehensive income (loss), as applicable. Operating Expenses We reimburse our advisor or its affiliates for operating expenses incurred in rendering services to us, subject to certain limitations. However, we cannot reimburse our advisor or its affiliates at the end of any fiscal quarter for total operating expenses that, in the four consecutive fiscal quarters then ended, exceed the greater of: (i) 2.0% of our average invested assets, as defined in the Advisory Agreement; or (ii) 25.0% of our net income, as defined in the Advisory Agreement, unless our independent directors determined that such excess expenses were justified based on unusual and nonrecurring factors which they deem sufficient. For the 12 months ended June 30, 2019 and 2018 , our operating expenses did not exceed the aforementioned limitations. The following table reflects our operating expenses as a percentage of average invested assets and as a percentage of net income for the 12 month periods then ended: 12 months ended June 30, 2019 2018 Operating expenses as a percentage of average invested assets 0.9 % 0.9 % Operating expenses as a percentage of net income 19.2 % 17.6 % For the three months ended June 30, 2019 and 2018 , our advisor or its affiliates incurred operating expenses on our behalf of $37,000 and $47,000 , respectively, and for the six months ended June 30, 2019 and 2018 , incurred $113,000 and $99,000 , respectively. Operating expenses are generally included in general and administrative in our accompanying condensed consolidated statements of operations and comprehensive income (loss). Compensation for Additional Services We pay our advisor and its affiliates for services performed for us other than those required to be rendered by our advisor or its affiliates under the Advisory Agreement. The rate of compensation for these services has to be approved by a majority of our board, including a majority of our independent directors, and cannot exceed an amount that would be paid to unaffiliated third parties for similar services. For the three and six months ended June 30, 2019 and 2018 , our advisor and its affiliates were not compensated for any additional services. Liquidity Stage Disposition Fees For services relating to the sale of one or more properties, we pay our advisor or its affiliates a disposition fee of up to the lesser of 2.0% of the contract sales price or 50.0% of a customary competitive real estate commission given the circumstances surrounding the sale, in each case as determined by our board, including a majority of our independent directors, upon the provision of a substantial amount of the services in the sales effort. The amount of disposition fees paid, when added to the real estate commissions paid to unaffiliated third parties, will not exceed the lesser of the customary competitive real estate commission or an amount equal to 6.0% of the contract sales price. For the three and six months ended June 30, 2019 and 2018 , we did not incur any disposition fees to our advisor or its affiliates. Subordinated Participation Interest Subordinated Distribution of Net Sales Proceeds In the event of liquidation, we will pay our advisor a subordinated distribution of net sales proceeds. The distribution will be equal to 15.0% of the remaining net proceeds from the sales of properties, after distributions to our stockholders, in the aggregate, of: (i) a full return of capital raised from stockholders (less amounts paid to repurchase shares of our common stock pursuant to our share repurchase plan); plus (ii) an annual 7.0% cumulative, non-compounded return on the gross proceeds from the sale of shares of our common stock, as adjusted for distributions of net sales proceeds. Actual amounts to be received depend on the sale prices of properties upon liquidation. For the three and six months ended June 30, 2019 and 2018 , we did not pay any such distributions to our advisor. Subordinated Distribution Upon Listing Upon the listing of shares of our common stock on a national securities exchange, in redemption of our advisor’s limited partnership units, we will pay our advisor a distribution equal to 15.0% of the amount by which: (i) the market value of our outstanding common stock at listing plus distributions paid prior to listing exceeds (ii) the sum of the total amount of capital raised from stockholders (less amounts paid to repurchase shares of our common stock pursuant to our share repurchase plan) and the amount of cash that, if distributed to stockholders as of the date of listing, would have provided them an annual 7.0% cumulative, non-compounded return on the gross proceeds from the sale of shares of our common stock through the date of listing. Actual amounts to be paid depend upon the market value of our outstanding stock at the time of listing, among other factors. For the three and six months ended June 30, 2019 and 2018 , we did not pay any such distributions to our advisor. Subordinated Distribution Upon Termination Pursuant to the Agreement of Limited Partnership, as amended, of our operating partnership, upon termination or non-renewal of the Advisory Agreement, our advisor will also be entitled to a subordinated distribution in redemption of its limited partnership units from our operating partnership equal to 15.0% of the amount, if any, by which: (i) the appraised value of our assets on the termination date, less any indebtedness secured by such assets, plus total distributions paid through the termination date, exceeds (ii) the sum of the total amount of capital raised from stockholders (less amounts paid to repurchase shares of our common stock pursuant to our share repurchase plan) and the total amount of cash equal to an annual 7.0% cumulative, non-compounded return on the gross proceeds from the sale of shares of our common stock through the termination date. In addition, our advisor may elect to defer its right to receive a subordinated distribution upon termination until either a listing or other liquidity event, including a liquidation, sale of substantially all of our assets or merger in which our stockholders receive in exchange for their shares of our common stock, shares of a company that are traded on a national securities exchange. As of June 30, 2019 and December 31, 2018 , we did not have any liability related to the subordinated distribution upon termination. Accounts Payable Due to Affiliates The following amounts were outstanding to our affiliates as of June 30, 2019 and December 31, 2018 : Fee June 30, 2019 December 31, 2018 Asset and property management fees $ 1,898,000 $ 1,856,000 Acquisition fees 411,000 15,000 Construction management fees 186,000 58,000 Lease commissions 73,000 94,000 Operating expenses 14,000 12,000 Development fees — 68,000 $ 2,582,000 $ 2,103,000

Fair Value Measurements

Fair Value Measurements	6 Months Ended
	Jun. 30, 2019
Fair Value Disclosures [Abstract]
Fair Value Measurements	15. Fair Value Measurements Assets and Liabilities Reported at Fair Value The table below presents our assets and liabilities measured at fair value on a recurring basis as of June 30, 2019 , aggregated by the level in the fair value hierarchy within which those measurements fall: Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Total Assets: Derivative financial instrument $ — $ 4,000 $ — $ 4,000 Total assets at fair value $ — $ 4,000 $ — $ 4,000 Liabilities: Derivative financial instruments $ — $ 4,111,000 $ — $ 4,111,000 Warrants — — 1,132,000 1,132,000 Total liabilities at fair value $ — $ 4,111,000 $ 1,132,000 $ 5,243,000 The table below presents our assets and liabilities measured at fair value on a recurring basis as of December 31, 2018 , aggregated by the level in the fair value hierarchy within which those measurements fall: Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Total Assets: Derivative financial instruments $ — $ 417,000 $ — $ 417,000 Total assets at fair value $ — $ 417,000 $ — $ 417,000 Liabilities: Contingent consideration obligation $ — $ — $ 681,000 $ 681,000 Warrants — — 1,207,000 1,207,000 Total liabilities at fair value $ — $ — $ 1,888,000 $ 1,888,000 There were no transfers into and out of fair value measurement levels during the six months ended June 30, 2019 and 2018 . Derivative Financial Instruments We use interest rate swaps and interest rate caps to manage interest rate risk associated with variable-rate debt. The valuation of these instruments is determined using widely accepted valuation techniques including a discounted cash flow analysis on the expected cash flows of each derivative. This analysis reflects the contractual terms of the derivatives, including the period to maturity, and uses observable market-based inputs, including interest rate curves, as well as option volatility. The fair values of interest rate swaps are determined by netting the discounted future fixed cash payments and the discounted expected variable cash receipts. The variable cash receipts are based on an expectation of future interest rates derived from observable market interest rate curves. We incorporate credit valuation adjustments to appropriately reflect both our own nonperformance risk and the respective counterparty’s nonperformance risk in the fair value measurements. In adjusting the fair value of our derivative contracts for the effect of nonperformance risk, we have considered the impact of netting and any applicable credit enhancements, such as collateral postings, thresholds, mutual puts and guarantees. Although we have determined that the majority of the inputs used to value our derivative financial instruments fall within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with these instruments utilize Level 3 inputs, such as estimates of current credit spreads, to evaluate the likelihood of default by us and our counterparty. However, as of June 30, 2019 , we have assessed the significance of the impact of the credit valuation adjustments on the overall valuation of our derivative positions and have determined that the credit valuation adjustments are not significant to the overall valuation of our derivatives. As a result, we have determined that our derivative valuations in their entirety are classified in Level 2 of the fair value hierarchy. Contingent Consideration Liability As of June 30, 2019 and December 31, 2018 , we have accrued $0 and $681,000 , respectively, of a contingent consideration obligation in connection with our Clemmons facility within North Carolina ALF Portfolio. Such obligation was included in security deposits, prepaid rent and other liabilities in our accompanying condensed consolidated balance sheets and may be paid upon various conditions being met, including our tenants achieving certain operating performance metrics. In particular, the amounts may have been paid based upon the computation in the lease agreement, as amended, and receipt of notification within four years after the applicable acquisition date that the tenant has increased its earnings before interest, taxes, depreciation and rent cost, or EBITDAR, as defined in the lease agreement, for the preceding three months. There was no minimum required payment but the total maximum was capped at $11,000,000 and also limited by the tenant’s ability to increase its EBITDAR. Any payment made would have resulted in an increase in the monthly rent charged to the tenant and additional rental revenue to us. The contingent consideration obligation was not exercised and expired as of June 30, 2019 , and as such, no contingent consideration amounts were due for the Clemmons facility within North Carolina ALF Portfolio. Warrants As of June 30, 2019 and December 31, 2018 , we have recorded $1,132,000 and $1,207,000 , respectively, related to warrants in Trilogy common units held by certain members of Trilogy’s pre-closing management, which is included in security deposits, prepaid rent and other liabilities in our accompanying condensed consolidated balance sheets. Once exercised, these warrants have redemption features similar to the common units held by members of Trilogy’s pre-closing management. See Note 12, Redeemable Noncontrolling Interests , for a further discussion. As of June 30, 2019 and December 31, 2018 , the carrying value is a reasonable estimate of fair value. Real Estate Investment No impairment charges were recognized for the three and six months ended June 30, 2019 . For both the three and six months ended June 30, 2018 , we determined that one of our medical office buildings was impaired based upon discounted cash flow analyses where the most significant inputs were market rent, capitalization rate and discount rate. We considered these inputs as Level 3 measurements within the fair value hierarchy. The following table is a summary of the quantitative information related to the non-recurring fair value measurement for the impairment of our real estate investment as of June 30, 2018: Range of Inputs or Inputs June 30, 2018 Unobservable Inputs Market rent per square foot $13.75 to $25.00 Capitalization rate 7.50 % Discount rate 8.00 % Financial Instruments Disclosed at Fair Value Our accompanying condensed consolidated balance sheets include the following financial instruments: real estate notes receivable, debt security investment, cash and cash equivalents, accounts and other receivables, restricted cash, real estate deposits, accounts payable and accrued liabilities, accounts payable due to affiliates, mortgage loans payable and borrowings under our lines of credit and term loans. We consider the carrying values of real estate notes receivable, cash and cash equivalents, accounts and other receivables, restricted cash, real estate deposits and accounts payable and accrued liabilities to approximate the fair value for these financial instruments based upon an evaluation of the underlying characteristics, market data and because of the short period of time between origination of the instruments and their expected realization. The fair value of cash and cash equivalents is classified in Level 1 of the fair value hierarchy. The fair value of accounts payable due to affiliates is not determinable due to the related party nature of the accounts payable. The fair values of the other financial instruments are classified in Level 2 of the fair value hierarchy. The fair value of our debt security investment is estimated using a discounted cash flow analysis using interest rates available to us for investments with similar terms and maturities. The fair value of our mortgage loans payable and our lines of credit and term loans are estimated using a discounted cash flow analysis using borrowing rates available to us for debt instruments with similar terms and maturities. We have determined that the valuations of our debt security investment, mortgage loans payable and lines of credit and term loans are classified in Level 2 within the fair value hierarchy. The carrying amounts and estimated fair values of such financial instruments as of June 30, 2019 and December 31, 2018 were as follows: June 30, 2019 December 31, 2018 Carrying Amount Fair Value Carrying Amount Fair Value Financial Assets: Debt security investment $ 71,272,000 $ 93,349,000 $ 69,873,000 $ 94,116,000 Financial Liabilities: Mortgage loans payable $ 743,564,000 $ 701,027,000 $ 688,262,000 $ 618,886,000 Lines of credit and term loans $ 751,490,000 $ 757,914,000 $ 735,737,000 $ 737,982,000

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2019
Income Tax Disclosure [Abstract]
Income Taxes	16. Income Taxes As a REIT, we generally will not be subject to federal income tax on taxable income that we distribute to our stockholders. We have elected to treat certain of our consolidated subsidiaries as taxable REIT subsidiaries, or TRSs, pursuant to the Code. TRSs may participate in services that would otherwise be considered impermissible for REITs and are subject to federal and state income tax at regular corporate tax rates. On December 22, 2017, the U.S. government enacted comprehensive tax legislation pursuant to the Tax Cuts and Jobs Act of 2017, or the Tax Act. The Tax Act makes broad and complex changes to the U.S. tax code, including, but not limited to, reducing the U.S. federal corporate tax rate from 35.0% to 21.0%, eliminating the corporate alternative minimum tax and changing rules related to uses and limitations of net operating loss carryforwards created in tax years beginning after December 31, 2017. The Tax Act is still unclear in some respects and could be subject to potential amendments and technical corrections. The federal income tax rules dealing with U.S. federal income taxation and REITs are constantly under review by persons involved in the legislative process, the IRS and the U.S. Treasury Department, which results in statutory changes as well as frequent revisions to regulations and interpretations. As a result, the long-term impact of the Tax Act on the overall economy, government revenues, our tenants, us, and the real estate industry cannot be reliably predicted at this time. We continue to work with our tax advisors to determine the full impact that the recent tax legislation as a whole will have on us. The components of income before taxes for the three and six months ended June 30, 2019 and 2018 were as follows: Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Domestic $ 109,000 $ 213,000 $ 7,315,000 $ 8,322,000 Foreign (105,000 ) (57,000 ) (302,000 ) (112,000 ) Income before income taxes $ 4,000 $ 156,000 $ 7,013,000 $ 8,210,000 The components of income tax expense (benefit) for the three and six months ended June 30, 2019 and 2018 were as follows: Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Federal deferred $ (543,000 ) $ (1,146,000 ) $ (1,091,000 ) $ (2,478,000 ) State deferred (70,000 ) (236,000 ) (140,000 ) (503,000 ) Foreign current 275,000 102,000 420,000 181,000 Valuation allowances 497,000 754,000 1,121,000 1,903,000 Total income tax expense (benefit) $ 159,000 $ (526,000 ) $ 310,000 $ (897,000 ) Current Income Tax Federal and state income taxes are generally a function of the level of income recognized by our TRSs. Foreign income taxes are generally a function of our income on our real estate and real estate-related investments located in the United Kingdom, or UK, and Isle of Man. Deferred Taxes Deferred income tax is generally a function of the period’s temporary differences (primarily basis differences between tax and financial reporting for real estate assets and equity investments) and generation of tax net operating losses that may be realized in future periods depending on sufficient taxable income. We recognize the financial statement effects of an uncertain tax position when it is more likely than not, based on the technical merits of the tax position, that such a position will be sustained upon examination by the relevant tax authorities. If the tax benefit meets the “more likely than not” threshold, the measurement of the tax benefit will be based on our estimate of the ultimate tax benefit to be sustained if audited by the taxing authority. As of June 30, 2019 and December 31, 2018 , we did not have any tax benefits or liabilities for uncertain tax positions that we believe should be recognized in our accompanying condensed consolidated financial statements. We assess the available evidence to estimate if sufficient future taxable income will be generated to use the existing deferred tax assets. A valuation allowance is established if we believe it is more likely than not that all or a portion of the deferred tax assets are not realizable. As of June 30, 2019 and December 31, 2018 , our valuation allowance substantially reserves the net deferred tax assets due to inherent uncertainty of future income. We will continue to monitor industry and economic conditions, and our ability to generate taxable income based on our business plan and available tax planning strategies, which would allow us to utilize the tax benefits of the net deferred tax assets and thereby allow us to reverse all, or a portion of, our valuation allowance in the future.

Leases

Leases	6 Months Ended
	Jun. 30, 2019
Leases [Abstract]
Leases	17. Leases Lessor We have operating leases with tenants that expire at various dates through 2059 . For the three and six months ended June 30, 2019 , we recognized $30,898,000 and $61,951,000 , respectively, of revenues related to operating lease payments, of which $4,349,000 and $9,090,000 , respectively, was for variable lease payments. The following table sets forth the undiscounted cash flows for future minimum base rents due under operating leases for leases in effect for properties we wholly own for the six months ending December 31, 2019 and for each of the next four years ending December 31 and thereafter: Year Amount 2019 $ 48,032,000 2020 93,555,000 2021 91,476,000 2022 84,811,000 2023 77,433,000 Thereafter 578,689,000 Total $ 973,996,000 Future minimum base rent contractually due under operating leases, excluding tenant reimbursements of certain costs, as of December 31, 2018 for each of the next five years ending December 31 and thereafter was as follows: Year Amount 2019 $ 92,888,000 2020 88,536,000 2021 86,362,000 2022 80,233,000 2023 72,535,000 Thereafter 559,649,000 Total $ 980,203,000 Lessee We lease certain land, buildings, furniture, fixtures, campus equipment, office equipment and automobiles. We have lease agreements with lease and non-lease components, which are generally accounted for separately. Most leases include one or more options to renew, with renewal terms that generally can extend at various dates through 2112, excluding extension options. The exercise of lease renewal options is at our sole discretion. Certain leases also include options to purchase the leased property. As of June 30, 2019 , we have additional operating leases that have not yet commenced of $56,945,000 . These operating leases will commence between fiscal year 2019 and fiscal year 2020 with lease terms of up to 15 years . The depreciable life of assets and leasehold improvements are limited by the expected lease term, unless there is a transfer of title or purchase option reasonably certain of exercise. Certain of our lease agreements include rental payments that are adjusted periodically based on Consumer Price Index, and may also include other variable lease costs (i.e., common area maintenance, property taxes and insurance). Our lease agreements do not contain any material residual value guarantees or material restrictive covenants. The components of lease costs were as follows: Lease Cost Classification Three Months Ended June 30, 2019 Six Months Ended June 30, 2019 Operating lease cost(1) Property operating expenses and rental expenses $ 7,664,000 $ 15,120,000 Finance lease cost Amortization of leased assets Depreciation and amortization 79,000 1,053,000 Accretion of lease liabilities Interest expense 53,000 132,000 Total lease cost $ 7,796,000 $ 16,305,000 ___________ (1) Includes short-term leases and variable lease costs, which are immaterial. Other information related to leases was as follows: Supplemental Disclosure of Cash Flows Information Six Months Ended June 30, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 11,087,000 Operating cash flows from finance leases $ 131,000 Financing cash flows from finance leases $ 1,772,000 Right-of-use assets obtained in exchange for operating lease liabilities $ 114,000 Lease Term and Discount Rate As of June 30, 2019 Weighted average remaining lease term (in years) Operating leases 13.5 Finance leases 1.4 Weighted average discount rate Operating leases 6.13 % Finance leases 7.66 % Operating Leases The following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for the six months ending December 31, 2019 and for each of the next four years ending December 31 and thereafter, as well as the reconciliation of those cash flows to operating lease liabilities: Year Amount 2019 $ 11,780,000 2020 23,103,000 2021 23,571,000 2022 23,950,000 2023 23,257,000 Thereafter 189,416,000 Total operating lease payments 295,077,000 Less: interest 101,687,000 Present value of operating lease liabilities $ 193,390,000 Future minimum lease obligations under non-cancelable ground and other lease obligations as of December 31, 2018 for each of the next five years ending December 31 and thereafter was as follows: Year Amount 2019 $ 22,194,000 2020 22,564,000 2021 23,166,000 2022 23,702,000 2023 23,154,000 Thereafter 177,927,000 Total $ 292,707,000 Finance Leases The following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for the six months ending December 31, 2019 and for each of the next four years ending December 31 and thereafter, as well as a reconciliation of those cash flows to finance lease liabilities: Year Amount 2019 $ 1,395,000 2020 1,265,000 2021 130,000 2022 — 2023 — Total finance lease payments 2,790,000 Less: interest 124,000 Present value of finance lease liabilities $ 2,666,000 Future minimum lease payments under finance leases as of December 31, 2018 and for each of the next five years ending December 31 and thereafter was as follows: Year Amount(1) 2019 $ 3,307,000 2020 1,266,000 2021 130,000 2022 — 2023 — $ 4,703,000 ___________ (1) Amounts above represent principal of $4,438,000 and interest obligations of $265,000 under finance lease.
Leases	17. Leases Lessor We have operating leases with tenants that expire at various dates through 2059 . For the three and six months ended June 30, 2019 , we recognized $30,898,000 and $61,951,000 , respectively, of revenues related to operating lease payments, of which $4,349,000 and $9,090,000 , respectively, was for variable lease payments. The following table sets forth the undiscounted cash flows for future minimum base rents due under operating leases for leases in effect for properties we wholly own for the six months ending December 31, 2019 and for each of the next four years ending December 31 and thereafter: Year Amount 2019 $ 48,032,000 2020 93,555,000 2021 91,476,000 2022 84,811,000 2023 77,433,000 Thereafter 578,689,000 Total $ 973,996,000 Future minimum base rent contractually due under operating leases, excluding tenant reimbursements of certain costs, as of December 31, 2018 for each of the next five years ending December 31 and thereafter was as follows: Year Amount 2019 $ 92,888,000 2020 88,536,000 2021 86,362,000 2022 80,233,000 2023 72,535,000 Thereafter 559,649,000 Total $ 980,203,000 Lessee We lease certain land, buildings, furniture, fixtures, campus equipment, office equipment and automobiles. We have lease agreements with lease and non-lease components, which are generally accounted for separately. Most leases include one or more options to renew, with renewal terms that generally can extend at various dates through 2112, excluding extension options. The exercise of lease renewal options is at our sole discretion. Certain leases also include options to purchase the leased property. As of June 30, 2019 , we have additional operating leases that have not yet commenced of $56,945,000 . These operating leases will commence between fiscal year 2019 and fiscal year 2020 with lease terms of up to 15 years . The depreciable life of assets and leasehold improvements are limited by the expected lease term, unless there is a transfer of title or purchase option reasonably certain of exercise. Certain of our lease agreements include rental payments that are adjusted periodically based on Consumer Price Index, and may also include other variable lease costs (i.e., common area maintenance, property taxes and insurance). Our lease agreements do not contain any material residual value guarantees or material restrictive covenants. The components of lease costs were as follows: Lease Cost Classification Three Months Ended June 30, 2019 Six Months Ended June 30, 2019 Operating lease cost(1) Property operating expenses and rental expenses $ 7,664,000 $ 15,120,000 Finance lease cost Amortization of leased assets Depreciation and amortization 79,000 1,053,000 Accretion of lease liabilities Interest expense 53,000 132,000 Total lease cost $ 7,796,000 $ 16,305,000 ___________ (1) Includes short-term leases and variable lease costs, which are immaterial. Other information related to leases was as follows: Supplemental Disclosure of Cash Flows Information Six Months Ended June 30, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 11,087,000 Operating cash flows from finance leases $ 131,000 Financing cash flows from finance leases $ 1,772,000 Right-of-use assets obtained in exchange for operating lease liabilities $ 114,000 Lease Term and Discount Rate As of June 30, 2019 Weighted average remaining lease term (in years) Operating leases 13.5 Finance leases 1.4 Weighted average discount rate Operating leases 6.13 % Finance leases 7.66 % Operating Leases The following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for the six months ending December 31, 2019 and for each of the next four years ending December 31 and thereafter, as well as the reconciliation of those cash flows to operating lease liabilities: Year Amount 2019 $ 11,780,000 2020 23,103,000 2021 23,571,000 2022 23,950,000 2023 23,257,000 Thereafter 189,416,000 Total operating lease payments 295,077,000 Less: interest 101,687,000 Present value of operating lease liabilities $ 193,390,000 Future minimum lease obligations under non-cancelable ground and other lease obligations as of December 31, 2018 for each of the next five years ending December 31 and thereafter was as follows: Year Amount 2019 $ 22,194,000 2020 22,564,000 2021 23,166,000 2022 23,702,000 2023 23,154,000 Thereafter 177,927,000 Total $ 292,707,000 Finance Leases The following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for the six months ending December 31, 2019 and for each of the next four years ending December 31 and thereafter, as well as a reconciliation of those cash flows to finance lease liabilities: Year Amount 2019 $ 1,395,000 2020 1,265,000 2021 130,000 2022 — 2023 — Total finance lease payments 2,790,000 Less: interest 124,000 Present value of finance lease liabilities $ 2,666,000 Future minimum lease payments under finance leases as of December 31, 2018 and for each of the next five years ending December 31 and thereafter was as follows: Year Amount(1) 2019 $ 3,307,000 2020 1,266,000 2021 130,000 2022 — 2023 — $ 4,703,000 ___________ (1) Amounts above represent principal of $4,438,000 and interest obligations of $265,000 under finance lease.
Leases	17. Leases Lessor We have operating leases with tenants that expire at various dates through 2059 . For the three and six months ended June 30, 2019 , we recognized $30,898,000 and $61,951,000 , respectively, of revenues related to operating lease payments, of which $4,349,000 and $9,090,000 , respectively, was for variable lease payments. The following table sets forth the undiscounted cash flows for future minimum base rents due under operating leases for leases in effect for properties we wholly own for the six months ending December 31, 2019 and for each of the next four years ending December 31 and thereafter: Year Amount 2019 $ 48,032,000 2020 93,555,000 2021 91,476,000 2022 84,811,000 2023 77,433,000 Thereafter 578,689,000 Total $ 973,996,000 Future minimum base rent contractually due under operating leases, excluding tenant reimbursements of certain costs, as of December 31, 2018 for each of the next five years ending December 31 and thereafter was as follows: Year Amount 2019 $ 92,888,000 2020 88,536,000 2021 86,362,000 2022 80,233,000 2023 72,535,000 Thereafter 559,649,000 Total $ 980,203,000 Lessee We lease certain land, buildings, furniture, fixtures, campus equipment, office equipment and automobiles. We have lease agreements with lease and non-lease components, which are generally accounted for separately. Most leases include one or more options to renew, with renewal terms that generally can extend at various dates through 2112, excluding extension options. The exercise of lease renewal options is at our sole discretion. Certain leases also include options to purchase the leased property. As of June 30, 2019 , we have additional operating leases that have not yet commenced of $56,945,000 . These operating leases will commence between fiscal year 2019 and fiscal year 2020 with lease terms of up to 15 years . The depreciable life of assets and leasehold improvements are limited by the expected lease term, unless there is a transfer of title or purchase option reasonably certain of exercise. Certain of our lease agreements include rental payments that are adjusted periodically based on Consumer Price Index, and may also include other variable lease costs (i.e., common area maintenance, property taxes and insurance). Our lease agreements do not contain any material residual value guarantees or material restrictive covenants. The components of lease costs were as follows: Lease Cost Classification Three Months Ended June 30, 2019 Six Months Ended June 30, 2019 Operating lease cost(1) Property operating expenses and rental expenses $ 7,664,000 $ 15,120,000 Finance lease cost Amortization of leased assets Depreciation and amortization 79,000 1,053,000 Accretion of lease liabilities Interest expense 53,000 132,000 Total lease cost $ 7,796,000 $ 16,305,000 ___________ (1) Includes short-term leases and variable lease costs, which are immaterial. Other information related to leases was as follows: Supplemental Disclosure of Cash Flows Information Six Months Ended June 30, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 11,087,000 Operating cash flows from finance leases $ 131,000 Financing cash flows from finance leases $ 1,772,000 Right-of-use assets obtained in exchange for operating lease liabilities $ 114,000 Lease Term and Discount Rate As of June 30, 2019 Weighted average remaining lease term (in years) Operating leases 13.5 Finance leases 1.4 Weighted average discount rate Operating leases 6.13 % Finance leases 7.66 % Operating Leases The following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for the six months ending December 31, 2019 and for each of the next four years ending December 31 and thereafter, as well as the reconciliation of those cash flows to operating lease liabilities: Year Amount 2019 $ 11,780,000 2020 23,103,000 2021 23,571,000 2022 23,950,000 2023 23,257,000 Thereafter 189,416,000 Total operating lease payments 295,077,000 Less: interest 101,687,000 Present value of operating lease liabilities $ 193,390,000 Future minimum lease obligations under non-cancelable ground and other lease obligations as of December 31, 2018 for each of the next five years ending December 31 and thereafter was as follows: Year Amount 2019 $ 22,194,000 2020 22,564,000 2021 23,166,000 2022 23,702,000 2023 23,154,000 Thereafter 177,927,000 Total $ 292,707,000 Finance Leases The following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for the six months ending December 31, 2019 and for each of the next four years ending December 31 and thereafter, as well as a reconciliation of those cash flows to finance lease liabilities: Year Amount 2019 $ 1,395,000 2020 1,265,000 2021 130,000 2022 — 2023 — Total finance lease payments 2,790,000 Less: interest 124,000 Present value of finance lease liabilities $ 2,666,000 Future minimum lease payments under finance leases as of December 31, 2018 and for each of the next five years ending December 31 and thereafter was as follows: Year Amount(1) 2019 $ 3,307,000 2020 1,266,000 2021 130,000 2022 — 2023 — $ 4,703,000 ___________ (1) Amounts above represent principal of $4,438,000 and interest obligations of $265,000 under finance lease.

Segment Reporting

Segment Reporting	6 Months Ended
	Jun. 30, 2019
Segment Reporting [Abstract]
Segment Reporting Disclosure	18. Segment Reporting As of June 30, 2019 , we evaluated our business and made resource allocations based on six reportable business segments: medical office buildings, hospitals, skilled nursing facilities, senior housing, senior housing — RIDEA and integrated senior health campuses. Our medical office buildings are typically leased to multiple tenants under separate leases, thus requiring active management and responsibility for many of the associated operating expenses (much of which are, or can effectively be, passed through to the tenants). Our hospital investments are primarily single-tenant properties that lease the facilities to unaffiliated tenants under triple-net and generally master leases that transfer the obligation for all facility operating costs (including maintenance, repairs, taxes, insurance and capital expenditures) to the tenant. Our skilled nursing facilities and senior housing facilities are similarly structured as our hospital investments. In addition, our senior housing segment includes our debt security investment. Our senior housing — RIDEA properties include senior housing facilities that are owned and operated utilizing a RIDEA structure. Our integrated senior health campuses include a range of assisted living, memory care, independent living, skilled nursing services and certain ancillary businesses that are owned and operated utilizing a RIDEA structure. We evaluate performance based upon segment net operating income. We define segment net operating income as total revenues, less property operating expenses and rental expenses, which excludes depreciation and amortization, general and administrative expenses, acquisition related expenses, interest expense, foreign currency gain (loss), other income (expense), loss from unconsolidated entities and income tax benefit (expense) for each segment. We believe that net income (loss), as defined by GAAP, is the most appropriate earnings measurement. However, we believe that segment net operating income serves as an appropriate supplemental performance measure to net income (loss) because it allows investors and our management to measure unlevered property-level operating results and to compare our operating results to the operating results of other real estate companies and between periods on a consistent basis. Interest expense, depreciation and amortization and other expenses not attributable to individual properties are not allocated to individual segments for purposes of assessing segment performance. Non-segment assets primarily consist of corporate assets including cash and cash equivalents, other receivables, deferred financing costs and other assets not attributable to individual properties. Summary information for the reportable segments during the three and six months ended June 30, 2019 and 2018 was as follows: Integrated Senior Health Campuses Senior Housing — RIDEA Medical Office Buildings Senior Housing Skilled Nursing Facilities Hospitals Three Months Ended June 30, 2019 Revenues: Resident fees and services $ 256,041,000 $ 16,431,000 $ — $ — $ — $ — $ 272,472,000 Real estate revenue — — 20,104,000 5,931,000 3,667,000 2,757,000 32,459,000 Total revenues 256,041,000 16,431,000 20,104,000 5,931,000 3,667,000 2,757,000 304,931,000 Expenses: Property operating expenses 228,319,000 11,571,000 — — — — 239,890,000 Rental expenses — — 7,597,000 127,000 368,000 134,000 8,226,000 Segment net operating income $ 27,722,000 $ 4,860,000 $ 12,507,000 $ 5,804,000 $ 3,299,000 $ 2,623,000 $ 56,815,000 Expenses: General and administrative $ 6,512,000 Acquisition related expenses 400,000 Depreciation and amortization 24,743,000 Other income (expense): Interest expense: Interest expense (including amortization of deferred financing costs and debt discount/premium) (19,560,000 ) Loss in fair value of derivative financial instruments (4,117,000 ) Loss from unconsolidated entities (493,000 ) Foreign currency loss (1,232,000 ) Other income 246,000 Income before income taxes 4,000 Income tax expense (159,000 ) Net loss $ (155,000 ) Integrated Senior Health Campuses Senior Housing — RIDEA Medical Office Buildings Senior Housing Skilled Nursing Facilities Hospitals Three Months Ended June 30, 2018 Revenues: Resident fees and services $ 231,521,000 $ 16,061,000 $ — $ — $ — $ — $ 247,582,000 Real estate revenue — — 20,206,000 5,393,000 3,728,000 3,354,000 32,681,000 Total revenues 231,521,000 16,061,000 20,206,000 5,393,000 3,728,000 3,354,000 280,263,000 Expenses: Property operating expenses 207,277,000 10,994,000 — — — — 218,271,000 Rental expenses — — 7,748,000 185,000 395,000 419,000 8,747,000 Segment net operating income $ 24,244,000 $ 5,067,000 $ 12,458,000 $ 5,208,000 $ 3,333,000 $ 2,935,000 $ 53,245,000 Expenses: General and administrative $ 6,622,000 Acquisition related expenses 214,000 Depreciation and amortization 22,682,000 Other income (expense): Interest expense: Interest expense (including amortization of deferred financing costs and debt discount/premium) (16,479,000 ) Loss in fair value of derivative financial instruments (487,000 ) Impairment of real estate investments (2,542,000 ) Loss from unconsolidated entities (1,458,000 ) Foreign currency loss (2,829,000 ) Other income 224,000 Income before income taxes 156,000 Income tax benefit 526,000 Net income $ 682,000 Integrated Senior Health Campuses Senior Housing — RIDEA Medical Office Buildings Senior Housing Skilled Nursing Facilities Hospitals Six Months Ended June 30, 2019 Revenues: Resident fees and services $ 507,755,000 $ 32,999,000 $ — $ — $ — $ — $ 540,754,000 Real estate revenue — — 40,658,000 11,583,000 7,326,000 5,668,000 65,235,000 Total revenues 507,755,000 32,999,000 40,658,000 11,583,000 7,326,000 5,668,000 605,989,000 Expenses: Property operating expenses 451,647,000 23,195,000 — — — — 474,842,000 Rental expenses — — 15,413,000 223,000 730,000 285,000 16,651,000 Segment net operating income $ 56,108,000 $ 9,804,000 $ 25,245,000 $ 11,360,000 $ 6,596,000 $ 5,383,000 $ 114,496,000 Expenses: General and administrative $ 13,429,000 Acquisition related expenses (296,000 ) Depreciation and amortization 50,371,000 Other income (expense): Interest expense: Interest expense (including amortization of deferred financing costs and debt discount/premium) (38,619,000 ) Loss in fair value of derivative financial instruments (4,677,000 ) Loss from unconsolidated entities (947,000 ) Foreign currency loss (190,000 ) Other income 454,000 Income before income taxes 7,013,000 Income tax expense (310,000 ) Net income $ 6,703,000 Integrated Senior Health Campuses Senior Housing — RIDEA Medical Office Buildings Senior Housing Skilled Nursing Facilities Hospitals Six Months Ended June 30, 2018 Revenues: Resident fees and services $ 460,582,000 $ 32,393,000 $ — $ — $ — $ — $ 492,975,000 Real estate revenue — — 40,287,000 10,793,000 7,467,000 6,633,000 65,180,000 Total revenues 460,582,000 32,393,000 40,287,000 10,793,000 7,467,000 6,633,000 558,155,000 Expenses: Property operating expenses 413,572,000 22,058,000 — — — — 435,630,000 Rental expenses — — 15,678,000 372,000 816,000 821,000 17,687,000 Segment net operating income $ 47,010,000 $ 10,335,000 $ 24,609,000 $ 10,421,000 $ 6,651,000 $ 5,812,000 $ 104,838,000 Expenses: General and administrative $ 13,010,000 Acquisition related expenses (555,000 ) Depreciation and amortization 46,374,000 Other income (expense): Interest expense: Interest expense (including amortization of deferred financing costs and debt discount/premium) (31,831,000 ) Loss in fair value of derivative financial instruments (377,000 ) Impairment of real estate investments (2,542,000 ) Loss from unconsolidated entities (2,535,000 ) Foreign currency loss (1,033,000 ) Other income 519,000 Income before income taxes 8,210,000 Income tax benefit 897,000 Net income $ 9,107,000 Total assets by reportable segment as of June 30, 2019 and December 31, 2018 were as follows: June 30, 2019 December 31, 2018 Integrated senior health campuses $ 1,691,133,000 $ 1,478,147,000 Medical office buildings 621,700,000 646,784,000 Senior housing — RIDEA 265,119,000 271,381,000 Senior housing 258,424,000 242,686,000 Skilled nursing facilities 126,155,000 127,809,000 Hospitals 115,623,000 118,685,000 Other 7,999,000 3,600,000 Total assets $ 3,086,153,000 $ 2,889,092,000 As of both June 30, 2019 and December 31, 2018 , goodwill of $75,309,000 was allocated to integrated senior health campuses, and no other segments had goodwill. Our portfolio of properties and other investments are located in the United States, Isle of Man and the UK. Revenues and assets are attributed to the country in which the property is physically located. The following is a summary of geographic information for our operations for the periods presented: Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Revenues: United States $ 303,721,000 $ 279,015,000 $ 603,543,000 $ 555,626,000 International 1,210,000 1,248,000 2,446,000 2,529,000 $ 304,931,000 $ 280,263,000 $ 605,989,000 $ 558,155,000 The following is a summary of real estate investments, net by geographic regions as of June 30, 2019 and December 31, 2018 : June 30, 2019 December 31, 2018 Real estate investments, net: United States $ 2,181,809,000 $ 2,173,395,000 International 49,141,000 49,286,000 $ 2,230,950,000 $ 2,222,681,000

Concentration of Credit Risk

Concentration of Credit Risk	6 Months Ended
	Jun. 30, 2019
Concentration of Credit Risk [Abstract]
Concentration of Credit Risk	19. Concentration of Credit Risk Financial instruments that potentially subject us to a concentration of credit risk are primarily debt security investment, cash and cash equivalents, accounts and other receivables, restricted cash and real estate deposits. We are exposed to credit risk with respect to the debt security investment, but we believe collection of the outstanding amount is probable. Cash and cash equivalents are generally invested in investment-grade, short-term instruments with a maturity of three months or less when purchased. We have cash and cash equivalents in financial institutions that are insured by the Federal Deposit Insurance Corporation, or FDIC. As of June 30, 2019 and December 31, 2018 , we had cash and cash equivalents in excess of FDIC insured limits. We believe this risk is not significant. Concentration of credit risk with respect to accounts receivable from tenants is limited. We perform credit evaluations of prospective tenants and security deposits are obtained at the time of property acquisition and upon lease execution. Based on leases in effect as of June 30, 2019 , properties in two states in the United States accounted for 10.0% or more of our total property portfolio’s annualized base rent or annualized net operating income. Properties located in Indiana and Ohio accounted for 33.8% and 10.3% , respectively, of our total property portfolio’s annualized base rent or annualized net operating income. Accordingly, there is a geographic concentration of risk subject to fluctuations in each such state’s economy. Based on leases in effect as of June 30, 2019 , our six reportable business segments, integrated senior health campuses, medical office buildings, senior housing — RIDEA, senior housing, skilled nursing facilities and hospitals accounted for 48.5% , 26.8% , 8.8% , 6.8% , 5.3% and 3.8% , respectively, of our total property portfolio’s annualized base rent or annualized net operating income. As of June 30, 2019 , none of our tenants at our properties accounted for 10.0% or more of our total property portfolio’s annualized base rent or annualized net operating income, which is based on contractual base rent from leases in effect inclusive of our senior housing — RIDEA facilities and integrated senior health campuses operations as of June 30, 2019 .

Per Share Data

Per Share Data	6 Months Ended
	Jun. 30, 2019
Earnings Per Share [Abstract]
Per Share Data	20. Per Share Data Basic earnings (loss) per share for all periods presented are computed by dividing net income (loss) applicable to common stock by the weighted average number of shares of our common stock outstanding during the period. Net income (loss) applicable to common stock is calculated as net income (loss) attributable to controlling interest less distributions allocated to participating securities of $7,000 and $6,000 for the three months ended June 30, 2019 and 2018 , respectively, and $14,000 and $13,000 , respectively, for the six months ended June 30, 2019 and 2018 . Diluted earnings (loss) per share are computed based on the weighted average number of shares of our common stock and all potentially dilutive securities, if any. Nonvested shares of our restricted common stock and redeemable limited partnership units of our operating partnership are participating securities and give rise to potentially dilutive shares of our common stock. As of June 30, 2019 and 2018 , there were 46,500 and 44,500 nonvested shares, respectively, of our restricted common stock outstanding, but such shares were excluded from the computation of diluted earnings per share because such shares were anti-dilutive during these periods. As of both June 30, 2019 and 2018 , there were 222 units of redeemable limited partnership units of our operating partnership outstanding, but such units were also excluded from the computation of diluted earnings per share because such units were anti-dilutive during these periods.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2019
Accounting Policies [Abstract]
Basis of Presentation	Our accompanying condensed consolidated financial statements include our accounts and those of our operating partnership, the wholly owned subsidiaries of our operating partnership and all non-wholly owned subsidiaries in which we have control, as well as any VIEs in which we are the primary beneficiary. We evaluate our ability to control an entity, and whether the entity is a VIE and we are the primary beneficiary, by considering substantive terms of the arrangement and identifying which enterprise has the power to direct the activities of the entity that most significantly impacts the entity’s economic performance. We operate and intend to co ntinue to operate in an umbrella partnership REIT structure in which our operating partnership, or wholly owned subsidiaries of our operating partnership and all non-wholly owned subsidiaries of which we have control, will own substantially all of the interests in properties acquired on our behalf. Because we are the sole general partner of our operating partnership and have unilateral control over its management and major operating decisions (even if additional limited partners are admitted to our operating partnership), the accounts of our operating partnership are consolidated in our accompanying condensed consolidated financial statements. All intercompany accounts and transactions are eliminated in consolidation.
Interim Unaudited Financial Data	Interim Unaudited Financial Data Our accompanying condensed consolidated financial statements have been prepared by us in accordance with GAAP in conjunction with the rules and regulations of the United States Securities and Exchange Commission, or SEC. Certain information and footnote disclosures required for annual financial statements have been condensed or excluded pursuant to SEC rules and regulations. Accordingly, our accompanying condensed consolidated financial statements do not include all of the information and footnotes required by GAAP for complete financial statements. Our accompanying condensed consolidated financial statements reflect all adjustments which are, in our view, of a normal recurring nature and necessary for a fair presentation of our financial position, results of operations and cash flows for the interim period. Interim results of operations are not necessarily indicative of the results to be expected for the full year; such full year results may be less favorable. In preparing our accompanying condensed consolidated financial statements, management has evaluated subsequent events through the financial statement issuance date. We believe that although the disclosures contained herein are adequate to prevent the information presented from being misleading, our accompanying condensed consolidated financial statements should be read in conjunction with our audited consolidated financial statements and the notes thereto included in our 2018 Annual Report on Form 10-K, as filed with the SEC on March 21, 2019.
Use of Estimates	Use of Estimates The preparation of our accompanying condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, as well as the disclosure of contingent assets and liabilities, at the date of our condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. These estimates are made and evaluated on an on-going basis using information that is currently available as well as various other assumptions believed to be reasonable under the circumstances. Actual results could differ from those estimates, perhaps in material adverse ways, and those estimates could be different under different assumptions or conditions.
Leases - Lessee	Leases On January 1, 2019, we adopted Financial Accounting Standards Board, or FASB, Accounting Standards Codification, or ASC, Topic 842, or ASC Topic 842. ASC Topic 842 supersedes ASC Topic 840, Leases , or ASC Topic 840. We adopted ASC Topic 842 using the modified retrospective approach whereby the cumulative effect of adoption was recognized on the adoption date and prior periods were not restated. There was no net cumulative effect adjustment to retained earnings as of January 1, 2019 as a result of this adoption. Therefore, with respect to our leases as both lessees and lessors, information is presented under ASC Topic 842 as of and for the three and six months ended June 30, 2019 and under ASC Topic 840 as of December 31, 2018 and for the three and six months ended June 30, 2018 . In addition, ASC Topic 842 provides a practical expedient package that allows an entity to not reassess the following upon adoption (must be elected as a group): (i) whether an expired or existing contract contains a lease arrangement; (ii) the lease classification related to expired or existing lease arrangements; or (iii) whether costs incurred on expired or existing leases qualify as initial direct costs. We elected such practical expedient package upon our adoption of ASC Topic 842 on January 1, 2019. We determine if a contract is a lease upon inception of the lease. We maintain a distinction between finance leases and operating leases, which is substantially similar to the classification criteria for distinguishing between capital leases and operating leases in the previous lease guidance. Lessee : Pursuant to ASC Topic 842, lessees are required to recognize the following for all leases with terms greater of 12 months at the commencement date: (i) a lease liability, which is a lessee’s obligation to make lease payments arising from a lease; and (ii) a right-of-use asset, which is an asset that represents the lessee’s right to use, or control the use of, a specified asset for the lease term. The lease liability is calculated by using either the implicit rate of the lease or the incremental borrowing rate. As a result of the adoption of ASC Topic 842 on January 1, 2019, we recognized an initial amount of lease liability of $198,453,000 in our condensed consolidated balance sheet for all of our operating leases for which we are the lessee, including facilities leases and ground leases. In addition, we recorded a corresponding right-of-use asset of $211,679,000 , which is the lease liability, net of the existing prepaid rent asset and accrued straight-line rent liability balance and adjusted for unamortized above/below market ground lease intangibles. The accretion of lease liability and amortization expense on right-of-use assets for our operating leases are included in property operating expenses and rental expenses in our accompanying condensed consolidated statements of operations and comprehensive income (loss). The operating lease liability was calculated using our incremental borrowing rate based on the information available as of our adoption date. The accounting for our existing capital (finance) leases upon adoption of ASC Topic 842 remains substantially unchanged. For our finance leases, the accretion of lease liability is included in interest expense and the amortization expense on right-of-use assets is included in depreciation and amortization in our accompanying condensed consolidated statements of operations and comprehensive income (loss). Further, finance lease assets are included within real estate investments, net and finance lease liabilities are included within financing obligations in our accompanying condensed consolidated balance sheets.
Leases - Lessor	Lessor : Pursuant to ASC Topic 842, lessors bifurcate lease revenues into lease components and non-lease components and separately recognize and disclose non-lease components that are executory in nature. Lease components continue to be recognized on a straight-line basis over the lease term and certain non-lease components may be accounted for under the new revenue recognition guidance in ASC Topic 606, Revenue from Contracts with Customers, or ASC Topic 606. See “Revenue Recognition” section below. ASC Topic 842 also provides for a practical expedient package that permits lessors to not separate non-lease components from the associated lease component if certain conditions are met. Such practical expedient is limited to circumstances in which (i) the timing and pattern of transfer are the same for the non-lease component and the related lease component; and (ii) the lease component, if accounted for separately, would be classified as an operating lease. In addition, such practical expedient causes an entity to assess whether a contract is predominately lease or service based, and recognize the revenue from the entire contract under the relevant accounting guidance. Effective upon our adoption of ASC Topic 842 on January 1, 2019, we recognize revenue for our medical office buildings, senior housing, skilled nursing facilities and hospitals segments under ASC Topic 842 as real estate revenue. Minimum annual rental revenue is recognized on a straight-line basis over the term of the related lease (including rent holidays). Differences between real estate revenue recognized and cash amounts contractually due from tenants under the lease agreements are recorded to deferred rent receivable. Tenant reimbursement revenue, which comprises additional amounts recoverable from tenants for common area maintenance expenses and certain other recoverable expenses, are considered non-lease components. We qualified for and elected the practical expedient as outlined above to combine the non-lease component with the lease component, which is the predominant component, and therefore is recognized as part of real estate revenue. In addition as lessors, we exclude certain lessor costs (i.e., property taxes and insurance) paid directly by a lessee to third parties on our behalf from our measurement of variable lease revenue and associated expense (i.e., no gross up of revenue and expense for these costs); and (ii) include lessor costs that we paid and are reimbursed by the lessee in our measurement of variable lease revenue and associated expense (i.e., gross up revenue and expense for these costs). Therefore, we no longer record revenue or expense when the lessee pays the property taxes and insurance directly to a third party. Our senior housing — RIDEA facilities offer residents room and board (lease component), standard meals and monthly healthcare services (non-lease component), and certain ancillary services that are not contemplated in the lease with each resident (i.e., laundry, guest meals, etc.). For our senior housing — RIDEA facilities, we recognize revenue under ASC Topic 606 as resident fees and services, based on our predominance assessment from electing the practical expedient outlined above. See “Revenue Recognition” below. See Note 17, Leases , for a further discussion. Leases On January 1, 2019, we adopted Financial Accounting Standards Board, or FASB, Accounting Standards Codification, or ASC, Topic 842, or ASC Topic 842. ASC Topic 842 supersedes ASC Topic 840, Leases , or ASC Topic 840. We adopted ASC Topic 842 using the modified retrospective approach whereby the cumulative effect of adoption was recognized on the adoption date and prior periods were not restated. There was no net cumulative effect adjustment to retained earnings as of January 1, 2019 as a result of this adoption. Therefore, with respect to our leases as both lessees and lessors, information is presented under ASC Topic 842 as of and for the three and six months ended June 30, 2019 and under ASC Topic 840 as of December 31, 2018 and for the three and six months ended June 30, 2018 . In addition, ASC Topic 842 provides a practical expedient package that allows an entity to not reassess the following upon adoption (must be elected as a group): (i) whether an expired or existing contract contains a lease arrangement; (ii) the lease classification related to expired or existing lease arrangements; or (iii) whether costs incurred on expired or existing leases qualify as initial direct costs. We elected such practical expedient package upon our adoption of ASC Topic 842 on January 1, 2019. We determine if a contract is a lease upon inception of the lease. We maintain a distinction between finance leases and operating leases, which is substantially similar to the classification criteria for distinguishing between capital leases and operating leases in the previous lease guidance.
Revenue Recognition	Revenue Recognition On January 1, 2018, we adopted ASC Topic 606, applying the modified retrospective method. Results for reporting periods beginning after January 1, 2018 are presented under ASC Topic 606, while prior period amounts are not adjusted and continue to be reported under the accounting standards in effect for the prior period. The adoption of ASC Topic 606 did not have a material impact on the measurement nor on the recognition of revenue as of January 1, 2018; therefore, no cumulative adjustment has been made to the opening balance of retained earnings at the beginning of 2018. Real estate revenue Prior to January 1, 2019, minimum annual rental revenue was recognized on a straight-line basis over the term of the related lease (including rent holidays) in accordance with ASC Topic 840. Differences between real estate revenue recognized and cash amounts contractually due from tenants under the lease agreements were recorded to deferred rent receivable or deferred rent liability, as applicable. Tenant reimbursement revenue, which comprises additional amounts recoverable from tenants for common area maintenance expenses and certain other recoverable expenses, was recognized as revenue in the period in which the related expenses were incurred. Tenant reimbursements were recognized and presented in accordance with ASC Subtopic 606-10-55-36, Revenue Recognition — Principal Versus Agent Consideration, or ASC Subtopic 606. ASC Subtopic 606 requires that these reimbursements be recorded on a gross basis as we are generally primarily responsible to fulfill the promise to provide specified goods and services. We recognized lease termination fees at such time when there was a signed termination letter agreement, all of the conditions of such agreement have been met and the tenant is no longer occupying the property. Effective January 1, 2019, we recognize real estate revenue in accordance with ASC Topic 842. See “Leases” section above.
Tenant and Resident Receivables and Allowance for Uncollectible Accounts	Tenant and Resident Receivables and Allowance for Uncollectible Accounts Resident receivables are carried net of an allowance for uncollectible amounts. An allowance is maintained for estimated losses resulting from the inability of residents and payors to meet the contractual obligations under their lease or service agreements. Upon our adoption of ASC Topic 606, substantially all of such allowances are recorded as direct reductions of resident fees and services revenue as contractual adjustments provided to third-party payors or implicit price concessions in our accompanying condensed consolidated statements of operations and comprehensive income (loss). Our determination of the adequacy of these allowances is based primarily upon evaluations of historical loss experience, the residents’ financial condition, security deposits, cash collection patterns by payor and by state, current economic conditions and other relevant factors. Prior to our adoption of ASC Topic 842, tenant receivables and unbilled deferred rent receivables were reduced for uncollectible amounts. Such amounts were charged to bad debt expense, which was included in general and administrative in our accompanying condensed consolidated statements of operations and comprehensive income (loss). Effective upon our adoption of ASC Topic 842 on January 1, 2019, such amounts are recognized as direct reductions of real estate revenue in our accompanying condensed consolidated statements of operations and comprehensive income (loss).
Accounts Payable and Accrued Liabilities	Accounts Payable and Accrued Liabilities As of June 30, 2019 and December 31, 2018 , accounts payable and accrued liabilities primarily includes insurance payables of $33,497,000 and $32,123,000 , respectively, reimbursement of payroll related costs to the managers of our senior housing — RIDEA facilities and integrated senior health campuses of $27,607,000 and $26,428,000 , respectively, accrued property taxes of $15,468,000 and $15,121,000 , respectively, accrued distributions of $9,689,000 and $10,189,000 , respectively, and accrued capital expenditures to unaffiliated third parties of $14,135,000 and $12,490,000 , respectively.
Recently Issued Accounting Pronouncements	Recently Issued Accounting Pronouncements In June 2016, the FASB issued Accounting Standards Update, or ASU, 2016-13, Measurement of Credit Losses on Financial Instruments, or ASU 2016-13, which introduces a new approach to estimate credit losses on certain types of financial instruments based on expected losses. It also modifies the impairment model for available-for-sale debt securities and provides for a simplified accounting model for purchased financial assets with credit deterioration since their origination. Subsequently, in November 2018, the FASB issued ASU 2018-19, Codification Improvements to Topic 326, Financial Instruments — Credit Losses, or ASU 2018-19 , which amended the scope of ASU 2016-13 to clarify that operating lease receivables should be accounted for under the new leasing standard ASC Topic 842. In April 2019, the FASB issued ASU 2019-04, Codification Improvements to Topic 326, Financial Instruments — Credit Losses, Topic 815, Derivatives and Hedging, and Topic 825, Financial Instruments, or ASU 2019-04 , to increase stakeholders’ awareness of the amendments and to expedite improvements to the Accounting Standards Codification. In May 2019, the FASB issued ASU 2019-05, Targeted Transition Relief, or ASU 2019-05, to address certain stakeholders’ concerns by providing an option to irrevocably elect the fair value option for certain financial assets previously measured at amortized cost basis. ASU 2016-13, ASU 2018-19, ASU 2019-04 and ASU 2019-05 are effective for fiscal years and interim periods beginning after December 15, 2019. Early adoption is permitted. We are evaluating the impact of the adoption of ASU 2016-13, ASU 2018-19, ASU 2019-04 and ASU 2019-05 on January 1, 2020 to our consolidated financial position and results of operations. In August 2018, the FASB issued ASU 2018-13, Changes to the Disclosure Requirements for Fair Value Measurement, or ASU 2018-13, which modifies the disclosure requirements in ASC Topic 820, Fair Value Measurements and Disclosures , by removing certain disclosure requirements related to the fair value hierarchy, modifying existing disclosure requirements related to measurement uncertainty and adding new disclosure requirements, such as disclosing the changes in unrealized gains and losses for the period included in other comprehensive income for recurring Level 3 fair value measurements held at the end of the reporting period and disclosing the range and weighted average of significant unobservable inputs used to develop Level 3 measurements. ASU 2018-13 is effective for fiscal years and interim periods beginning after December 15, 2019. Early adoption is permitted for any removed or modified disclosures. We are evaluating the complete impact of the adoption of ASU 2018-13 on January 1, 2020 to our consolidated financial statement disclosures.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	6 Months Ended
	Jun. 30, 2019
Accounting Policies [Abstract]
Schedule of Disaggregation of Revenue	The following table disaggregates our resident fees and services revenue by line of business, according to whether such revenue is recognized at a point in time or over time: Three Months Ended June 30, 2019 2018 Point in Time Over Time Total Point in Time Over Time Total Integrated senior health campuses $ 53,390,000 $ 202,651,000 $ 256,041,000 $ 44,657,000 $ 186,864,000 $ 231,521,000 Senior housing — RIDEA(1) 735,000 15,696,000 16,431,000 729,000 15,332,000 16,061,000 Total resident fees and services $ 54,125,000 $ 218,347,000 $ 272,472,000 $ 45,386,000 $ 202,196,000 $ 247,582,000 Six Months Ended June 30, 2019 2018 Point in Time Over Time Total Point in Time Over Time Total Integrated senior health campuses $ 105,733,000 $ 402,022,000 $ 507,755,000 $ 89,822,000 $ 370,760,000 $ 460,582,000 Senior housing — RIDEA(1) 1,446,000 31,553,000 32,999,000 1,497,000 30,896,000 32,393,000 Total resident fees and services $ 107,179,000 $ 433,575,000 $ 540,754,000 $ 91,319,000 $ 401,656,000 $ 492,975,000 The following table disaggregates our resident fees and services revenue by payor class: Three Months Ended June 30, 2019 2018 Integrated Senior Health Campuses Senior Housing — RIDEA(1) Total Integrated Senior Health Campuses(2) Senior Housing — RIDEA(1) Total Medicare $ 84,481,000 $ — $ 84,481,000 $ 76,838,000 $ — $ 76,838,000 Medicaid 46,643,000 21,000 46,664,000 40,815,000 — 40,815,000 Private and other payors 124,917,000 16,410,000 141,327,000 113,868,000 16,061,000 129,929,000 Total resident fees and services $ 256,041,000 $ 16,431,000 $ 272,472,000 $ 231,521,000 $ 16,061,000 $ 247,582,000 Six Months Ended June 30, 2019 2018 Integrated Senior Health Campuses Senior Housing — RIDEA(1) Total Integrated Senior Health Campuses(2) Senior Housing — RIDEA(1) Total Medicare $ 168,958,000 $ — $ 168,958,000 $ 154,875,000 $ — $ 154,875,000 Medicaid 91,679,000 34,000 91,713,000 81,219,000 3,000 81,222,000 Private and other payors 247,118,000 32,965,000 280,083,000 224,488,000 32,390,000 256,878,000 Total resident fees and services $ 507,755,000 $ 32,999,000 $ 540,754,000 $ 460,582,000 $ 32,393,000 $ 492,975,000 ___________ (1) This includes fees for basic housing and assisted living care. We record revenue when services are rendered at amounts billable to individual residents. Residency agreements are generally for a term of 30 days, with resident fees billed monthly in advance. For patients under reimbursement arrangements with Medicaid, revenue is recorded based on contractually agreed-upon amounts or rates on a per resident, daily basis or as services are rendered. (2) For the three and six months ended June 30, 2018 , Medicare includes $0 and $21,881,000 , respectively, of revenue that was previously disclosed as Private and other payors. There was no net change in previously disclosed total resident fees and services.
Schedule of Receivables and Deferred Revenue - Resident Fees and Services	Accounts Receivable, Net — Resident Fees and Services Revenue The beginning and ending balances of accounts receivable, net — resident fees and services are as follows: Medicare Medicaid Private and Other Payors Total Beginning balance — January 1, 2019 $ 29,160,000 $ 18,676,000 $ 39,112,000 $ 86,948,000 Ending balance — June 30, 2019 30,618,000 19,478,000 46,278,000 96,374,000 Increase $ 1,458,000 $ 802,000 $ 7,166,000 $ 9,426,000 Deferred Revenue — Resident Fees and Services Revenue The beginning and ending balances of deferred revenue — resident fees and services, all of which relates to private and other payors, are as follows: Total Beginning balance — January 1, 2019 $ 12,569,000 Ending balance — June 30, 2019 10,954,000 Decrease $ (1,615,000 )

Real Estate Investments, Net (T

Real Estate Investments, Net (Tables)	6 Months Ended
	Jun. 30, 2019
Real Estate [Abstract]
Real Estate Investments, Net	Our real estate investments, net consisted of the following as of June 30, 2019 and December 31, 2018 : June 30, 2019 December 31, Building, improvements and construction in process $ 2,199,377,000 $ 2,160,944,000 Land and improvements 189,855,000 189,446,000 Furniture, fixtures and equipment 137,958,000 126,985,000 2,527,190,000 2,477,375,000 Less: accumulated depreciation (296,240,000 ) (254,694,000 ) $ 2,230,950,000 $ 2,222,681,000
Summary Of Acquisitions	The following is a summary of our property acquisition for the six months ended June 30, 2019 : Acquisition(1) Location Type Date Acquired Contract Purchase Price Lines of Credit and Term Loans(2) Acquisition Fee(3) North Carolina ALF Portfolio Garner, NC Senior Housing 03/27/19 $ 15,000,000 $ 15,000,000 $ 338,000 ___________ (1) We own 100% of our property acquired in 2019 . (2) Represents a borrowing under the 2019 Corporate Line of Credit, as defined in Note 8, Lines of Credit and Term Loans , at the time of acquisition. (3) Our advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our property, an acquisition fee of 2.25% of the contract purchase price of such property.
Schedule of Asset Acquisitions, by Acquisition	The following table summarizes the purchase price of the assets acquired and liabilities assumed at the time of acquisition from our acquisitions in 2019 based on their relative fair values: 2019 Real Estate Acquisitions Building and improvements $ 11,700,000 Land 3,878,000 In-place leases 1,978,000 Total assets acquired $ 17,556,000

Real Estate Notes Receivable _2

Real Estate Notes Receivable and Debt Security Investment, Net (Tables)	6 Months Ended
	Jun. 30, 2019
Real Estate Notes Receivable [Abstract]
Real Estate Notes Receivable, Net	The following is a summary of our notes receivable and debt security investment, including unamortized loan and closing costs, net as of June 30, 2019 and December 31, 2018 : Balance Origination Date Maturity Date Contractual Interest Rate Maximum Advances Available June 30, 2019 December 31, 2018 Mezzanine Fixed Rate Notes(1) 02/04/15 12/09/19 6.75% $ — $ — $ 28,650,000 Debt security investment(2) 10/15/15 08/25/25 4.24% N/A 69,822,000 68,355,000 69,822,000 97,005,000 Unamortized loan and closing costs, net 1,450,000 1,650,000 $ 71,272,000 $ 98,655,000 ___________ (1) The Mezzanine Fixed Rate Notes evidence interests in a portion of a mezzanine loan that is secured by pledges of equity interests in the owners of a portfolio of domestic healthcare properties, which such owners are themselves owned indirectly by a non-wholly owned subsidiary of Colony Capital. In June 2019, the Mezzanine Fixed Rate Notes were paid in full by the borrower. (2) The commercial mortgage-backed debt security, or the debt security, bears an interest rate on the stated principal amount thereof equal to 4.24% per annum, the terms of which security provide for monthly interest-only payments. The debt security matures on August 25, 2025 at a stated amount of $93,433,000 , resulting in an anticipated yield-to-maturity of 10.0% per annum. The debt security was issued by an unaffiliated mortgage trust and represents a 10.0% beneficial ownership interest in such mortgage trust. The debt security is subordinate to all other interests in the mortgage trust and is not guaranteed by a government-sponsored entity. As of June 30, 2019 and December 31, 2018 , the net carrying amount with accretion was $71,272,000 and $69,873,000 , respectively. We classify our debt security investment as held-to-maturity and we have not recorded any unrealized holding gains or losses on such investment.
Changes in Carrying Amount of Real Estate Notes Receivable	The following table reflects the changes in the carrying amount of our real estate notes receivable and debt security investment for the six months ended June 30, 2019 and 2018 : Six Months Ended June 30, 2019 2018 Beginning balance $ 98,655,000 $ 97,988,000 Additions: Accretion on debt security 1,467,000 1,331,000 Deductions: Principal repayments on real estate notes receivable (28,650,000 ) — Amortization of loan and closing costs (200,000 ) (121,000 ) Ending balance $ 71,272,000 $ 99,198,000

Identified Intangible Assets,_2

Identified Intangible Assets, Net (Tables)	6 Months Ended
	Jun. 30, 2019
Finite-Lived Intangible Assets, Net [Abstract]
Identified intangible assets, net	Identified intangible assets, net consisted of the following as of June 30, 2019 and December 31, 2018 : June 30, 2019 December 31, 2018 Amortized intangible assets: In-place leases, net of accumulated amortization of $27,499,000 and $23,497,000 as of June 30, 2019 and December 31, 2018, respectively (with a weighted average remaining life of 10.3 years and 9.8 years as of June 30, 2019 and December 31, 2018, respectively) $ 41,810,000 $ 45,815,000 Leasehold interests, net of accumulated amortization of $548,000 as of December 31, 2018 (with a weighted average remaining life of 53.6 years as of December 31, 2018)(1) — 7,346,000 Customer relationships, net of accumulated amortization of $262,000 and $187,000 as of June 30, 2019 and December 31, 2018, respectively (with a weighted average remaining life of 17.3 years and 18.8 years as of June 30, 2019 and December 31, 2018, respectively) 2,578,000 2,653,000 Above-market leases, net of accumulated amortization of $2,049,000 and $2,851,000 as of June 30, 2019 and December 31, 2018, respectively (with a weighted average remaining life of 5.1 years and 5.2 years as of June 30, 2019 and December 31, 2018, respectively) 1,715,000 2,059,000 Internally developed technology and software, net of accumulated amortization of $164,000 and $117,000 as of June 30, 2019 and December 31, 2018, respectively (with a weighted average remaining life of 3.3 years and 3.8 years as of June 30, 2019 and December 31, 2018, respectively) 306,000 353,000 Unamortized intangible assets: Certificates of need 90,991,000 88,590,000 Trade names 30,787,000 30,787,000 Purchase option asset(2) — 1,918,000 $ 168,187,000 $ 179,521,000 ___________ (1) Such amount related to our ownership of fee simple interests in the building and improvements of 11 of our buildings that are subject to respective ground leases. Upon our adoption of ASC Topic 842 on January 1, 2019, such amount was reclassed to operating lease right-of-use assets in our accompanying condensed consolidated balance sheet. See Note 2, Summary of Significant Accounting Policies — Leases, and Note 17, Leases , for a further discussion. (2) For the six months ended June 30, 2019 , we exercised our right to acquire a property through our unconsolidated investment in RHS Partners, LLC, or RHS. The value of the purchase option asset utilized was $1,918,000 . See Note 6, Other Assets, Net for a further discussion.
Amortization expense on identified intangible assets	As of June 30, 2019 , estimated amortization expense on the identified intangible assets for the six months ending December 31, 2019 and for each of the next four years ending December 31 and thereafter was as follows: Year Amount 2019 $ 3,897,000 2020 6,075,000 2021 5,503,000 2022 4,785,000 2023 4,010,000 Thereafter 22,139,000 $ 46,409,000

Other Assets, Net (Tables)

Other Assets, Net (Tables)	6 Months Ended
	Jun. 30, 2019
Other Assets [Abstract]
Other Assets, Net	Other assets, net consisted of the following as of June 30, 2019 and December 31, 2018 : June 30, 2019 December 31, 2018 Deferred rent receivables $ 33,251,000 $ 23,334,000 Prepaid expenses, deposits and other assets 28,425,000 29,803,000 Investment in unconsolidated entities 21,281,000 15,432,000 Inventory 19,247,000 21,151,000 Deferred tax assets, net(1) 9,022,000 9,461,000 Lease commissions, net of accumulated amortization of $1,700,000 and $1,274,000 as of June 30, 2019 and December 31, 2018, respectively 9,446,000 8,523,000 Deferred financing costs, net of accumulated amortization of $8,721,000 and $12,487,000 as of June 30, 2019 and December 31, 2018, respectively(2) 6,077,000 2,311,000 Lease inducement, net of accumulated amortization of $965,000 and $789,000 as of June 30, 2019 and December 31, 2018, respectively (with a weighted average remaining life of 11.5 years and 12.0 years as of June 30, 2019 and December 31, 2018, respectively) 4,035,000 4,211,000 $ 130,784,000 $ 114,226,000 ___________ (1) See Note 16, Income Taxes , for a further discussion. (2) Deferred financing costs only include costs related to our lines of credit and term loans.
Summarized Financial Information of Unconsolidated Entity	The following is summarized financial information of our investments in unconsolidated entities: June 30, 2019 December 31, 2018 RHS Other Total RHS Other Total Balance Sheet Data: Total assets $ 283,387,000 $ 17,542,000 $ 300,929,000 $ 48,291,000 $ 100,000 $ 48,391,000 Total liabilities $ 255,176,000 $ 16,743,000 $ 271,919,000 $ 25,263,000 $ — $ 25,263,000 Three Months Ended June 30, 2019 2018 RHS Other Total RHS Other Total Statement of Operations Data: Revenues $ 35,062,000 $ 1,076,000 $ 36,138,000 $ 31,695,000 $ — $ 31,695,000 Expenses 35,743,000 1,431,000 37,174,000 34,611,000 — 34,611,000 Net loss $ (681,000 ) $ (355,000 ) $ (1,036,000 ) $ (2,916,000 ) $ — $ (2,916,000 ) Six Months Ended June 30, 2019 2018 RHS Other Total RHS Other Total Statement of Operations Data: Revenues $ 70,430,000 $ 1,076,000 $ 71,506,000 $ 64,170,000 $ — $ 64,170,000 Expenses 71,974,000 1,477,000 73,451,000 69,239,000 — 69,239,000 Net loss $ (1,544,000 ) $ (401,000 ) $ (1,945,000 ) $ (5,069,000 ) $ — $ (5,069,000 )

Mortgage Loans Payable, Net (Ta

Mortgage Loans Payable, Net (Tables)	6 Months Ended
	Jun. 30, 2019
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Abstract]
Mortgage Loans Payable, Net	Mortgage loans payable, net consisted of the following as of June 30, 2019 and December 31, 2018 : June 30, 2019 December 31, 2018 Total fixed-rate debt $ 631,575,000 $ 624,616,000 Total variable-rate debt 136,596,000 88,414,000 Total fixed- and variable-rate debt 768,171,000 713,030,000 Less: deferred financing costs, net (9,001,000 ) (8,824,000 ) Add: premium 484,000 663,000 Less: discount (16,090,000 ) (16,607,000 ) Mortgage loans payable, net $ 743,564,000 $ 688,262,000
Schedule of Activity Related to Mortgage Loans Payable	The following table reflects the changes in the carrying amount of mortgage loans payable for the six months ended June 30, 2019 and 2018 : Six Months Ended June 30, 2019 2018 Beginning balance $ 688,262,000 $ 613,558,000 Additions: Borrowings on mortgage loans payable 61,472,000 1,364,000 Amortization of deferred financing costs 660,000 649,000 Amortization of discount/premium on mortgage loans payable 338,000 277,000 Deductions: Scheduled principal payments on mortgage loans payable (6,331,000 ) (5,045,000 ) Deferred financing costs (837,000 ) (14,000 ) Ending balance $ 743,564,000 $ 610,789,000
Principal Payments Due on Mortgage Loans Payable	As of June 30, 2019 , the principal payments due on our mortgage loans payable for the six months ending December 31, 2019 and for each of the next four years ending December 31 and thereafter were as follows: Year Amount 2019 $ 71,635,000 2020 82,209,000 2021 34,775,000 2022 61,186,000 2023 28,973,000 Thereafter 489,393,000 $ 768,171,000

Derivative Financial Instrume_2

Derivative Financial Instruments (Tables)	6 Months Ended
	Jun. 30, 2019
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Derivative Instruments	The following table lists the derivative financial instruments held by us as of June 30, 2019 and December 31, 2018 : Fair Value Instrument Notional Amount Index Interest Rate Maturity Date June 30, 2019 December 31, 2018 Swap $ 140,000,000 one month LIBOR 0.82% 02/03/19 $ — $ 221,000 Swap 60,000,000 one month LIBOR 0.78% 02/03/19 — 97,000 Swap 50,000,000 one month LIBOR 1.39% 02/03/19 — 51,000 Cap 20,000,000 one month LIBOR 3.00% 09/23/21 4,000 48,000 Swap 250,000,000 one month LIBOR 2.10% 01/25/22 (2,962,000 ) — Swap 130,000,000 one month LIBOR 1.98% 01/25/22 (1,149,000 ) — $ (4,107,000 ) $ 417,000

Identified Intangible Liabili_2

Identified Intangible Liabilities, Net (Tables)	6 Months Ended
	Jun. 30, 2019
Identified Intangible Liabilities [Abstract]
Summary of Amortization Expense on Below Market Leases	As of June 30, 2019 , estimated amortization expense on below-market leases for the six months ending December 31, 2019 and for each of the next four years ending December 31 and thereafter was as follows: Year Amount 2019 $ 179,000 2020 260,000 2021 143,000 2022 93,000 2023 78,000 Thereafter 89,000 $ 842,000

Redeemable Noncontrolling Int_2

Redeemable Noncontrolling Interest (Tables)	6 Months Ended
	Jun. 30, 2019
Temporary Equity [Abstract]
Redeemable Noncontrolling Interest	The changes in the carrying amount of redeemable noncontrolling interests consisted of the following for the six months ended June 30, 2019 and 2018 : Six Months Ended June 30, 2019 2018 Beginning balance $ 38,245,000 $ 32,435,000 Additions — 535,000 Reclassification from equity 390,000 390,000 Distributions (720,000 ) (332,000 ) Repurchase of redeemable noncontrolling interest (3,000 ) (229,000 ) Fair value adjustment to redemption value (84,000 ) 293,000 Net income attributable to redeemable noncontrolling interests 287,000 107,000 Ending balance $ 38,115,000 $ 33,199,000

Equity (Tables)

Equity (Tables)	6 Months Ended
	Jun. 30, 2019
Equity [Abstract]
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Table Text Block]	The following is a summary of our historical and current estimated per share NAV: Approval Date by our Board Estimated Per Share NAV (Unaudited) 10/05/16 $ 9.01 10/04/17 $ 9.27 10/03/18 $ 9.37
Schedule of Accumulated Other Comprehensive Income (Loss)	The changes in accumulated other comprehensive loss, net of noncontrolling interests, by component consisted of the following for the six months ended June 30, 2019 and 2018 : Six Months Ended June 30, 2019 2018 Beginning balance — foreign currency translation adjustments $ (2,560,000 ) $ (1,971,000 ) Net change in current period (20,000 ) (238,000 ) Ending balance — foreign currency translation adjustments $ (2,580,000 ) $ (2,209,000 )

Related Party Transactions (Tab

Related Party Transactions (Tables)	6 Months Ended
	Jun. 30, 2019
Related Party Transactions [Abstract]
Schedule of limitation on affiliate reimbursement [Text Block]	The following table reflects our operating expenses as a percentage of average invested assets and as a percentage of net income for the 12 month periods then ended: 12 months ended June 30, 2019 2018 Operating expenses as a percentage of average invested assets 0.9 % 0.9 % Operating expenses as a percentage of net income 19.2 % 17.6 %
Schedule Of Amounts Outstanding To Affiliates Table	The following amounts were outstanding to our affiliates as of June 30, 2019 and December 31, 2018 : Fee June 30, 2019 December 31, 2018 Asset and property management fees $ 1,898,000 $ 1,856,000 Acquisition fees 411,000 15,000 Construction management fees 186,000 58,000 Lease commissions 73,000 94,000 Operating expenses 14,000 12,000 Development fees — 68,000 $ 2,582,000 $ 2,103,000

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value Measurement Inputs and Valuation Techniques [Table Text Block]		The following table is a summary of the quantitative information related to the non-recurring fair value measurement for the impairment of our real estate investment as of June 30, 2018: Range of Inputs or Inputs June 30, 2018 Unobservable Inputs Market rent per square foot $13.75 to $25.00 Capitalization rate 7.50 % Discount rate 8.00 %
Assets and Liabilities Measured at Fair Value on Recurring Basis	The table below presents our assets and liabilities measured at fair value on a recurring basis as of June 30, 2019 , aggregated by the level in the fair value hierarchy within which those measurements fall: Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Total Assets: Derivative financial instrument $ — $ 4,000 $ — $ 4,000 Total assets at fair value $ — $ 4,000 $ — $ 4,000 Liabilities: Derivative financial instruments $ — $ 4,111,000 $ — $ 4,111,000 Warrants — — 1,132,000 1,132,000 Total liabilities at fair value $ — $ 4,111,000 $ 1,132,000 $ 5,243,000 The table below presents our assets and liabilities measured at fair value on a recurring basis as of December 31, 2018 , aggregated by the level in the fair value hierarchy within which those measurements fall: Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Total Assets: Derivative financial instruments $ — $ 417,000 $ — $ 417,000 Total assets at fair value $ — $ 417,000 $ — $ 417,000 Liabilities: Contingent consideration obligation $ — $ — $ 681,000 $ 681,000 Warrants — — 1,207,000 1,207,000 Total liabilities at fair value $ — $ — $ 1,888,000 $ 1,888,000
Fair Value, by Balance Sheet Grouping	The carrying amounts and estimated fair values of such financial instruments as of June 30, 2019 and December 31, 2018 were as follows: June 30, 2019 December 31, 2018 Carrying Amount Fair Value Carrying Amount Fair Value Financial Assets: Debt security investment $ 71,272,000 $ 93,349,000 $ 69,873,000 $ 94,116,000 Financial Liabilities: Mortgage loans payable $ 743,564,000 $ 701,027,000 $ 688,262,000 $ 618,886,000 Lines of credit and term loans $ 751,490,000 $ 757,914,000 $ 735,737,000 $ 737,982,000

Income Taxes (Tables)

Income Taxes (Tables)	6 Months Ended
	Jun. 30, 2019
Income Tax Disclosure [Abstract]
Schedule of loss before Income Tax, Domestic and Foreign	The components of income before taxes for the three and six months ended June 30, 2019 and 2018 were as follows: Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Domestic $ 109,000 $ 213,000 $ 7,315,000 $ 8,322,000 Foreign (105,000 ) (57,000 ) (302,000 ) (112,000 ) Income before income taxes $ 4,000 $ 156,000 $ 7,013,000 $ 8,210,000
Schedule of Components of Income Tax Expense (Benefit)	The components of income tax expense (benefit) for the three and six months ended June 30, 2019 and 2018 were as follows: Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Federal deferred $ (543,000 ) $ (1,146,000 ) $ (1,091,000 ) $ (2,478,000 ) State deferred (70,000 ) (236,000 ) (140,000 ) (503,000 ) Foreign current 275,000 102,000 420,000 181,000 Valuation allowances 497,000 754,000 1,121,000 1,903,000 Total income tax expense (benefit) $ 159,000 $ (526,000 ) $ 310,000 $ (897,000 )

Leases (Tables)

Leases (Tables)	6 Months Ended
	Jun. 30, 2019
Leases [Abstract]
Schedule of Lease Payments to be Received	The following table sets forth the undiscounted cash flows for future minimum base rents due under operating leases for leases in effect for properties we wholly own for the six months ending December 31, 2019 and for each of the next four years ending December 31 and thereafter: Year Amount 2019 $ 48,032,000 2020 93,555,000 2021 91,476,000 2022 84,811,000 2023 77,433,000 Thereafter 578,689,000 Total $ 973,996,000 Future minimum base rent contractually due under operating leases, excluding tenant reimbursements of certain costs, as of December 31, 2018 for each of the next five years ending December 31 and thereafter was as follows: Year Amount 2019 $ 92,888,000 2020 88,536,000 2021 86,362,000 2022 80,233,000 2023 72,535,000 Thereafter 559,649,000 Total $ 980,203,000
Schedule of Lease Cost	The components of lease costs were as follows: Lease Cost Classification Three Months Ended June 30, 2019 Six Months Ended June 30, 2019 Operating lease cost(1) Property operating expenses and rental expenses $ 7,664,000 $ 15,120,000 Finance lease cost Amortization of leased assets Depreciation and amortization 79,000 1,053,000 Accretion of lease liabilities Interest expense 53,000 132,000 Total lease cost $ 7,796,000 $ 16,305,000 ___________ (1) Includes short-term leases and variable lease costs, which are immaterial. Other information related to leases was as follows: Supplemental Disclosure of Cash Flows Information Six Months Ended June 30, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 11,087,000 Operating cash flows from finance leases $ 131,000 Financing cash flows from finance leases $ 1,772,000 Right-of-use assets obtained in exchange for operating lease liabilities $ 114,000 Lease Term and Discount Rate As of June 30, 2019 Weighted average remaining lease term (in years) Operating leases 13.5 Finance leases 1.4 Weighted average discount rate Operating leases 6.13 % Finance leases 7.66 %
Schedule of Operating Lease Liability	The following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for the six months ending December 31, 2019 and for each of the next four years ending December 31 and thereafter, as well as the reconciliation of those cash flows to operating lease liabilities: Year Amount 2019 $ 11,780,000 2020 23,103,000 2021 23,571,000 2022 23,950,000 2023 23,257,000 Thereafter 189,416,000 Total operating lease payments 295,077,000 Less: interest 101,687,000 Present value of operating lease liabilities $ 193,390,000 Future minimum lease obligations under non-cancelable ground and other lease obligations as of December 31, 2018 for each of the next five years ending December 31 and thereafter was as follows: Year Amount 2019 $ 22,194,000 2020 22,564,000 2021 23,166,000 2022 23,702,000 2023 23,154,000 Thereafter 177,927,000 Total $ 292,707,000
Schedule of Finance Lease Liability	The following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for the six months ending December 31, 2019 and for each of the next four years ending December 31 and thereafter, as well as a reconciliation of those cash flows to finance lease liabilities: Year Amount 2019 $ 1,395,000 2020 1,265,000 2021 130,000 2022 — 2023 — Total finance lease payments 2,790,000 Less: interest 124,000 Present value of finance lease liabilities $ 2,666,000 Future minimum lease payments under finance leases as of December 31, 2018 and for each of the next five years ending December 31 and thereafter was as follows: Year Amount(1) 2019 $ 3,307,000 2020 1,266,000 2021 130,000 2022 — 2023 — $ 4,703,000 ___________ (1) Amounts above represent principal of $4,438,000 and interest obligations of $265,000 under finance lease.

Segment Reporting (Tables)

Segment Reporting (Tables)	6 Months Ended
	Jun. 30, 2019
Segment Reporting [Abstract]
Summary Information by Reportable Segment	Summary information for the reportable segments during the three and six months ended June 30, 2019 and 2018 was as follows: Integrated Senior Health Campuses Senior Housing — RIDEA Medical Office Buildings Senior Housing Skilled Nursing Facilities Hospitals Three Months Ended June 30, 2019 Revenues: Resident fees and services $ 256,041,000 $ 16,431,000 $ — $ — $ — $ — $ 272,472,000 Real estate revenue — — 20,104,000 5,931,000 3,667,000 2,757,000 32,459,000 Total revenues 256,041,000 16,431,000 20,104,000 5,931,000 3,667,000 2,757,000 304,931,000 Expenses: Property operating expenses 228,319,000 11,571,000 — — — — 239,890,000 Rental expenses — — 7,597,000 127,000 368,000 134,000 8,226,000 Segment net operating income $ 27,722,000 $ 4,860,000 $ 12,507,000 $ 5,804,000 $ 3,299,000 $ 2,623,000 $ 56,815,000 Expenses: General and administrative $ 6,512,000 Acquisition related expenses 400,000 Depreciation and amortization 24,743,000 Other income (expense): Interest expense: Interest expense (including amortization of deferred financing costs and debt discount/premium) (19,560,000 ) Loss in fair value of derivative financial instruments (4,117,000 ) Loss from unconsolidated entities (493,000 ) Foreign currency loss (1,232,000 ) Other income 246,000 Income before income taxes 4,000 Income tax expense (159,000 ) Net loss $ (155,000 ) Integrated Senior Health Campuses Senior Housing — RIDEA Medical Office Buildings Senior Housing Skilled Nursing Facilities Hospitals Three Months Ended June 30, 2018 Revenues: Resident fees and services $ 231,521,000 $ 16,061,000 $ — $ — $ — $ — $ 247,582,000 Real estate revenue — — 20,206,000 5,393,000 3,728,000 3,354,000 32,681,000 Total revenues 231,521,000 16,061,000 20,206,000 5,393,000 3,728,000 3,354,000 280,263,000 Expenses: Property operating expenses 207,277,000 10,994,000 — — — — 218,271,000 Rental expenses — — 7,748,000 185,000 395,000 419,000 8,747,000 Segment net operating income $ 24,244,000 $ 5,067,000 $ 12,458,000 $ 5,208,000 $ 3,333,000 $ 2,935,000 $ 53,245,000 Expenses: General and administrative $ 6,622,000 Acquisition related expenses 214,000 Depreciation and amortization 22,682,000 Other income (expense): Interest expense: Interest expense (including amortization of deferred financing costs and debt discount/premium) (16,479,000 ) Loss in fair value of derivative financial instruments (487,000 ) Impairment of real estate investments (2,542,000 ) Loss from unconsolidated entities (1,458,000 ) Foreign currency loss (2,829,000 ) Other income 224,000 Income before income taxes 156,000 Income tax benefit 526,000 Net income $ 682,000 Integrated Senior Health Campuses Senior Housing — RIDEA Medical Office Buildings Senior Housing Skilled Nursing Facilities Hospitals Six Months Ended June 30, 2019 Revenues: Resident fees and services $ 507,755,000 $ 32,999,000 $ — $ — $ — $ — $ 540,754,000 Real estate revenue — — 40,658,000 11,583,000 7,326,000 5,668,000 65,235,000 Total revenues 507,755,000 32,999,000 40,658,000 11,583,000 7,326,000 5,668,000 605,989,000 Expenses: Property operating expenses 451,647,000 23,195,000 — — — — 474,842,000 Rental expenses — — 15,413,000 223,000 730,000 285,000 16,651,000 Segment net operating income $ 56,108,000 $ 9,804,000 $ 25,245,000 $ 11,360,000 $ 6,596,000 $ 5,383,000 $ 114,496,000 Expenses: General and administrative $ 13,429,000 Acquisition related expenses (296,000 ) Depreciation and amortization 50,371,000 Other income (expense): Interest expense: Interest expense (including amortization of deferred financing costs and debt discount/premium) (38,619,000 ) Loss in fair value of derivative financial instruments (4,677,000 ) Loss from unconsolidated entities (947,000 ) Foreign currency loss (190,000 ) Other income 454,000 Income before income taxes 7,013,000 Income tax expense (310,000 ) Net income $ 6,703,000 Integrated Senior Health Campuses Senior Housing — RIDEA Medical Office Buildings Senior Housing Skilled Nursing Facilities Hospitals Six Months Ended June 30, 2018 Revenues: Resident fees and services $ 460,582,000 $ 32,393,000 $ — $ — $ — $ — $ 492,975,000 Real estate revenue — — 40,287,000 10,793,000 7,467,000 6,633,000 65,180,000 Total revenues 460,582,000 32,393,000 40,287,000 10,793,000 7,467,000 6,633,000 558,155,000 Expenses: Property operating expenses 413,572,000 22,058,000 — — — — 435,630,000 Rental expenses — — 15,678,000 372,000 816,000 821,000 17,687,000 Segment net operating income $ 47,010,000 $ 10,335,000 $ 24,609,000 $ 10,421,000 $ 6,651,000 $ 5,812,000 $ 104,838,000 Expenses: General and administrative $ 13,010,000 Acquisition related expenses (555,000 ) Depreciation and amortization 46,374,000 Other income (expense): Interest expense: Interest expense (including amortization of deferred financing costs and debt discount/premium) (31,831,000 ) Loss in fair value of derivative financial instruments (377,000 ) Impairment of real estate investments (2,542,000 ) Loss from unconsolidated entities (2,535,000 ) Foreign currency loss (1,033,000 ) Other income 519,000 Income before income taxes 8,210,000 Income tax benefit 897,000 Net income $ 9,107,000
Assets by Reportable Segment	Total assets by reportable segment as of June 30, 2019 and December 31, 2018 were as follows: June 30, 2019 December 31, 2018 Integrated senior health campuses $ 1,691,133,000 $ 1,478,147,000 Medical office buildings 621,700,000 646,784,000 Senior housing — RIDEA 265,119,000 271,381,000 Senior housing 258,424,000 242,686,000 Skilled nursing facilities 126,155,000 127,809,000 Hospitals 115,623,000 118,685,000 Other 7,999,000 3,600,000 Total assets $ 3,086,153,000 $ 2,889,092,000
Revenue and Real Estate Investments by Geographical Areas	The following is a summary of geographic information for our operations for the periods presented: Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Revenues: United States $ 303,721,000 $ 279,015,000 $ 603,543,000 $ 555,626,000 International 1,210,000 1,248,000 2,446,000 2,529,000 $ 304,931,000 $ 280,263,000 $ 605,989,000 $ 558,155,000 The following is a summary of real estate investments, net by geographic regions as of June 30, 2019 and December 31, 2018 : June 30, 2019 December 31, 2018 Real estate investments, net: United States $ 2,181,809,000 $ 2,173,395,000 International 49,141,000 49,286,000 $ 2,230,950,000 $ 2,222,681,000

Organization and Description _2

Organization and Description of Business (Detail) ft² in Thousands	Jun. 30, 2019ft²segment	Feb. 26, 2014USD ($)	Jun. 30, 2019USD ($)ft²shares	Jun. 30, 2018USD ($)shares	Jun. 30, 2019USD ($)ft²segment	Jun. 30, 2018USD ($)shares	Apr. 21, 2015USD ($)shares	Mar. 29, 2019USD ($)shares	Dec. 31, 2018USD ($)shares	Jun. 30, 2019USD ($)ft²shares	Jun. 30, 2019USD ($)ft²BuildingPropertyCampus	Jun. 30, 2019ft²	Jan. 30, 2019USD ($)	Mar. 25, 2015USD ($)
Schedule of Capitalization, Equity [Line Items]
Date of inception											Jan. 11, 2013
Date of capitalization												Jan. 15, 2013
Maximum dollar amount of common stock issuable under public offering		$ 1,900,000,000
Issuance of common stock under the DRIP			$ 14,115,000	$ 15,220,000	$ 28,311,000	$ 30,449,000			$ 249,711,000	$ 278,022,000
Issuance of common stock under the DRIP, shares | shares									26,820,010	29,841,503
Advisory agreement term		1 year
Advisory agreement renewal term		1 year
Number of reportable segments | segment	6				6
Number of properties acquired from unaffiliated parties | Property											98
Number of buildings acquired from unaffiliated parties | Building											102
Number of integrated senior health campuses acquired from unaffiliated parties | Campus											113
GLA (Sq Ft) | ft²	13,412		13,412		13,412					13,412	13,412	13,412
Acquisition aggregate cost of acquired properties purchase price, net of dispositions											$ 2,968,740,000
Acquisition aggregate cost of acquired real estate related investments purchase price, net of principal repayments											$ 60,429,000
American Healthcare Investors [Member]
Schedule of Capitalization, Equity [Line Items]
Ownership percentage in affiliate	47.10%		47.10%		47.10%					47.10%	47.10%	47.10%
Colony Capital, Inc. [Member]
Schedule of Capitalization, Equity [Line Items]
Ownership percentage in affiliate	45.10%		45.10%		45.10%					45.10%	45.10%	45.10%
James F. Flaherty III [Member]
Schedule of Capitalization, Equity [Line Items]
Ownership percentage in affiliate	7.80%		7.80%		7.80%					7.80%	7.80%	7.80%
American Healthcare Investors [Member]
Schedule of Capitalization, Equity [Line Items]
Ownership percentage in affiliate	75.00%		75.00%		75.00%					75.00%	75.00%	75.00%
Griffin Capital Corporation [Member]
Schedule of Capitalization, Equity [Line Items]
Ownership percentage in affiliate	25.00%		25.00%		25.00%					25.00%	25.00%	25.00%
Common Stock
Schedule of Capitalization, Equity [Line Items]
Subscriptions in offering of common stock received and accepted shares | shares							184,930,598
Subscriptions in offering of common stock received and accepted value							$ 1,842,618,000
DRIP [Member]
Schedule of Capitalization, Equity [Line Items]
Subscriptions in offering of common stock received and accepted shares | shares							1,948,563
Subscriptions in offering of common stock received and accepted value							$ 18,511,000
2015 DRIP Offering [Member]
Schedule of Capitalization, Equity [Line Items]
Maximum dollar amount of common stock issuable under public offering														$ 250,000,000
Issuance of common stock under the DRIP				$ 15,220,000		$ 30,449,000		$ 245,396,000
Issuance of common stock under the DRIP, shares | shares				1,641,819		3,284,653		26,386,545
2019 DRIP Offering [Member]
Schedule of Capitalization, Equity [Line Items]
Maximum dollar amount of common stock issuable under public offering													$ 200,000,000
Issuance of common stock under the DRIP			$ 14,115,000
Issuance of common stock under the DRIP, shares | shares			1,506,395

Summary of Significant Accoun_4

Summary of Significant Accounting Policies (Detail) - USD ($) $ in Thousands	72 Months Ended	78 Months Ended
	Dec. 31, 2018	Jun. 30, 2019	Jun. 30, 2018
Accounting Policies [Abstract]
Percentage of ownership in operating partnership	99.99%	99.99%
Percentage of limited partnership interest	0.01%	0.01%
Insurance payable	$ 32,123	$ 33,497
Payroll related costs	26,428	27,607
Accrued property taxes	15,121	15,468
Accrued capital expenditures	12,490	14,135
Accrued distributions	$ 10,189	$ 9,689	$ 9,898

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Leases (Details) - USD ($)		Jun. 30, 2019	Jan. 01, 2019	Dec. 31, 2018
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Operating lease liabilities	[1]	$ 193,390,000		$ 0
Operating lease right-of-use assets		$ 204,527,000		$ 0
Accounting Standards Update 2016-02
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Operating lease liabilities			$ 198,453,000
Operating lease right-of-use assets			$ 211,679,000
[1]	Such liabilities of Griffin-American Healthcare REIT III, Inc. as of June 30, 2019 and December 31, 2018 represented liabilities of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries. Griffin-American Healthcare REIT III Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of Griffin-American Healthcare REIT III, Inc. The creditors of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries do not have recourse against Griffin-American Healthcare REIT III, Inc., except for six and five mortgage loans in the aggregate amount of $100,061,000 and $50,316,000 as of June 30, 2019 and December 31, 2018, respectively, and the 2019 Corporate Line of Credit and 2016 Corporate Line of Credit, as defined in Note 8, held by Griffin-American Healthcare REIT III Holdings, LP in the amount of $557,000,000 and $548,500,000 as of June 30, 2019 and December 31, 2018, respectively, which is guaranteed by Griffin-American Healthcare REIT III, Inc.

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Impact of Adoption of New Accounting Pronouncement (Details) - USD ($) $ in Thousands		3 Months Ended		6 Months Ended
		Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Accounting Policies [Abstract]
Resident fees and services		$ 272,472	$ 247,582	$ 540,754	$ 492,975
Property operating expenses		239,890	218,271	474,842	435,630
General and administrative		6,512	6,622	13,429	13,010
Net income		(155)	$ 682	6,703	$ 9,107
Assets
Other assets, net		130,784		130,784		$ 114,226
Liabilities
Accounts payable and accrued liabilities	[1]	143,567		143,567		139,383
Equity
Accumulated deficit		$ (759,520)		$ (759,520)		$ (704,748)
[1]	Such liabilities of Griffin-American Healthcare REIT III, Inc. as of June 30, 2019 and December 31, 2018 represented liabilities of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries. Griffin-American Healthcare REIT III Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of Griffin-American Healthcare REIT III, Inc. The creditors of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries do not have recourse against Griffin-American Healthcare REIT III, Inc., except for six and five mortgage loans in the aggregate amount of $100,061,000 and $50,316,000 as of June 30, 2019 and December 31, 2018, respectively, and the 2019 Corporate Line of Credit and 2016 Corporate Line of Credit, as defined in Note 8, held by Griffin-American Healthcare REIT III Holdings, LP in the amount of $557,000,000 and $548,500,000 as of June 30, 2019 and December 31, 2018, respectively, which is guaranteed by Griffin-American Healthcare REIT III, Inc.

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Disaggregation of Revenue [Line Items]
Resident fees and services	$ 272,472	$ 247,582	$ 540,754	$ 492,975
Integrated Senior Health Campuses [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	256,041	231,521	507,755	460,582
Senior Housing-RIDEA [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	16,431	16,061	32,999	32,393
Resident Fees and Services [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	272,472	247,582	540,754	492,975
Resident Fees and Services [Member] | Point in Time [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	54,125	45,386	107,179	91,319
Resident Fees and Services [Member] | Over Time [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	218,347	202,196	433,575	401,656
Resident Fees and Services [Member] | Medicare [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	84,481	76,838	168,958	154,875
Resident Fees and Services [Member] | Medicaid [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	46,664	40,815	91,713	81,222
Resident Fees and Services [Member] | Private and Other Payors [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	141,327	129,929	280,083	256,878
Resident Fees and Services [Member] | Integrated Senior Health Campuses [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	256,041	231,521	507,755	460,582
Resident Fees and Services [Member] | Integrated Senior Health Campuses [Member] | Point in Time [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	53,390	44,657	105,733	89,822
Resident Fees and Services [Member] | Integrated Senior Health Campuses [Member] | Over Time [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	202,651	186,864	402,022	370,760
Resident Fees and Services [Member] | Integrated Senior Health Campuses [Member] | Medicare [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	84,481	76,838	168,958	154,875
Resident Fees and Services [Member] | Integrated Senior Health Campuses [Member] | Medicaid [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	46,643	40,815	91,679	81,219
Resident Fees and Services [Member] | Integrated Senior Health Campuses [Member] | Private and Other Payors [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	124,917	113,868	247,118	224,488
Resident Fees and Services [Member] | Senior Housing-RIDEA [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	16,431	16,061	32,999	32,393
Resident Fees and Services [Member] | Senior Housing-RIDEA [Member] | Point in Time [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	735	729	1,446	1,497
Resident Fees and Services [Member] | Senior Housing-RIDEA [Member] | Over Time [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	15,696	15,332	31,553	30,896
Resident Fees and Services [Member] | Senior Housing-RIDEA [Member] | Medicare [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	0	0	0	0
Resident Fees and Services [Member] | Senior Housing-RIDEA [Member] | Medicaid [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	21	0	34	3
Resident Fees and Services [Member] | Senior Housing-RIDEA [Member] | Private and Other Payors [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services	$ 16,410	16,061	$ 32,965	32,390
Scenario, Adjustment [Member] | Resident Fees and Services [Member] | Integrated Senior Health Campuses [Member]
Disaggregation of Revenue [Line Items]
Resident fees and services		$ 0		$ 21,881

Summary of Significant Accoun_8

Summary of Significant Accounting Policies - Accounts Receivable and Deferred Revenue (Details) - Resident Fees and Services [Member] - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2019	Jan. 01, 2019
Accounts Receivable, Net - Resident Fees and Services
Accounts Receivable, Net - Resident Fees and Services	$ 96,374	$ 86,948
Increase	9,426
Deferred Revenue - Resident fees and Services
Deferred Revenue	10,954	12,569
Decrease	(1,615)
Medicare [Member]
Accounts Receivable, Net - Resident Fees and Services
Accounts Receivable, Net - Resident Fees and Services	30,618	29,160
Increase	1,458
Medicaid [Member]
Accounts Receivable, Net - Resident Fees and Services
Accounts Receivable, Net - Resident Fees and Services	19,478	18,676
Increase	802
Private and Other Payors [Member]
Accounts Receivable, Net - Resident Fees and Services
Accounts Receivable, Net - Resident Fees and Services	46,278	$ 39,112
Increase	$ 7,166

Real Estate Investments, Net -

Real Estate Investments, Net - Investments in Consolidated Properties (Detail) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Real Estate Properties [Line Items]
Real estate investment, at cost	$ 2,527,190	$ 2,477,375
Less: accumulated depreciation	(296,240)	(254,694)
Real estate investments, net	2,230,950	2,222,681
Building, improvements and construction in process [Member]
Real Estate Properties [Line Items]
Real estate investment, at cost	2,199,377	2,160,944
Land and Land Improvements [Member]
Real Estate Properties [Line Items]
Real estate investment, at cost	189,855	189,446
Furniture, fixtures and equipment [Member]
Real Estate Properties [Line Items]
Real estate investment, at cost	$ 137,958	$ 126,985

Real Estate Investments, Net _2

Real Estate Investments, Net - Additional Information (Detail)	3 Months Ended		6 Months Ended		78 Months Ended
	Jun. 30, 2019USD ($)	Jun. 30, 2018USD ($)Building	Jun. 30, 2019USD ($)BuildingCampus	Jun. 30, 2018USD ($)Building	Jun. 30, 2019USD ($)Building
Real Estate Properties [Line Items]
Number of integrated senior health campuses development completed | Campus			1
Depreciation	$ 21,530,000	$ 20,287,000	$ 43,734,000	$ 40,687,000
Number of medical office buildings impaired (in buildings) | Building		1		1
Impairment of real estate investments	0	$ 2,542,000	0	$ 2,542,000
Number of buildings acquired from unaffiliated parties | Building					102
Integrated Senior Health Campuses [Member]
Real Estate Properties [Line Items]
Capital expenditures incurred	23,106,000		36,734,000
Total completed development cost			10,558,000
Medical Office Building [Member]
Real Estate Properties [Line Items]
Capital expenditures incurred	4,684,000		6,718,000
Senior Housing-RIDEA [Member]
Real Estate Properties [Line Items]
Capital expenditures incurred	473,000		778,000
Skilled Nursing Facilities [Member]
Real Estate Properties [Line Items]
Capital expenditures incurred	126,000		160,000
Senior Housing [Member]
Real Estate Properties [Line Items]
Capital expenditures incurred	0		0
Hospitals [Member]
Real Estate Properties [Line Items]
Capital expenditures incurred	50,000		50,000
Medical Office Building [Member]
Real Estate Properties [Line Items]
Impairment of real estate investments		2,542,000		2,542,000
Property, Plant, and Equipment, Fair Value Disclosure		$ 7,387,000		$ 7,387,000
2019 Acquisitions
Real Estate Properties [Line Items]
Asset Acquisition, Transaction Costs	$ 489,000		$ 489,000		$ 489,000
Percentage of contract purchase price paid acquisition fee, in cash			2.25%
Ownership percentage			67.70%
Number of buildings acquired from unaffiliated parties | Building			1
North Carolina ALF Portfolio [Member]
Real Estate Properties [Line Items]
Number of buildings acquired from unaffiliated parties | Building			6

Real Estate Investments, Net _3

Real Estate Investments, Net - Acquisitions (Detail) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018
2019 Acquisitions
Real Estate Properties [Line Items]
Ownership percentage	67.70%
Acquisition contract purchase price of land acquired	$ 2,067
Percentage of contract purchase price paid acquisition fee, in cash	2.25%
2019 Acquisitions | North Carolina ALF Portfolio - Garner [Member]
Real Estate Properties [Line Items]
Type	Senior Housing
Date Acquired	Mar. 27, 2019
Contract Purchase Price	$ 15,000
Lines of Credit and Term Loans	15,000
Acquisition Fees	$ 338
Ownership percentage	100.00%
Percentage of contract purchase price paid acquisition fee, in cash	2.25%
Medical Office Building [Member]
Real Estate Properties [Line Items]
Property, Plant, and Equipment, Fair Value Disclosure		$ 7,387

Real Estate Investments, Net _4

Real Estate Investments, Net - Assets and Liabilities Acquired (Details) - 2019 Acquisitions $ in Thousands	Jun. 30, 2019USD ($)
Real Estate Properties [Line Items]
Building and improvements	$ 11,700
Land	3,878
In-place leases	1,978
Total assets acquired	$ 17,556

Real Estate Notes Receivable _3

Real Estate Notes Receivable and Debt Security Investment, Net - Additional Information (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018	Oct. 15, 2015
Real Estate Notes Receivable and Investment, Net
Investment	$ 71,272,000		$ 71,272,000		$ 69,873,000
Impairment of real estate notes receivable and investment	0	$ 0	0	$ 0
Amortization of Deferred Loan Origination Fees, Net	$ 132,000	$ 62,000	$ 200,000	$ 121,000
Debt security investment [Member]
Real Estate Notes Receivable and Investment, Net
Debt Instrument, Interest Rate, Stated Percentage						4.24%
Debt Securities, Held-to-maturity, Maturity, Allocated and Single Maturity Date, after 10 Years, Fair Value						$ 93,433,000
Yield to Maturity Interest Rate						10.00%
Beneficial ownership interest in Mortgage Trust	10.00%		10.00%

Real Estate Notes Receivable _4

Real Estate Notes Receivable and Debt Security Investment, Net (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Real Estate Notes Receivable and Investment, Net
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate, Collections of Principal			$ 28,650	$ 0
Real Estate Notes Receivable And Investment	$ 69,822		69,822		$ 97,005
Unamortized loan and closing costs, net	1,450		1,450		1,650
Real Estate Loans Receivable [Roll Forward]
Beginning balance			98,655	97,988
Accretion on debt security			1,467	1,331
Amortization of loan and closing costs	(132)	$ (62)	(200)	(121)
Ending balance	71,272	$ 99,198	$ 71,272	$ 99,198
Mezzanine Fixed Rate Notes [Member]
Real Estate Notes Receivable and Investment, Net
Origination Date			Feb. 4, 2015
Maturity date			Dec. 9, 2019
Contractual Interest Rate			6.75%
Maximum Advances Available	0		$ 0
Real Estate Notes Receivable And Investment	0		$ 0		28,650
Debt security investment [Member]
Real Estate Notes Receivable and Investment, Net
Origination Date			Oct. 15, 2015
Maturity date			Aug. 25, 2025
Contractual Interest Rate			4.24%
Real Estate Notes Receivable And Investment	$ 69,822		$ 69,822		$ 68,355

Identified Intangible Assets,_3

Identified Intangible Assets, Net - Summary of Identified Intangibles, Net (Detail)	6 Months Ended	12 Months Ended
	Jun. 30, 2019USD ($)Building	Dec. 31, 2018USD ($)
Finite-Lived Intangible Assets [Line Items]
Number of buildings subject to ground leases (in buildings) | Building	11
Amortized intangible assets	$ 46,409,000
Identified intangible assets, net	$ 168,187,000	$ 179,521,000
Weighted average remaining life	10 years 6 months	15 years 6 months 18 days
Certificates Of Need [Member]
Finite-Lived Intangible Assets [Line Items]
Unamortized intangible assets	$ 90,991,000	$ 88,590,000
Trade Names [Member]
Finite-Lived Intangible Assets [Line Items]
Unamortized intangible assets	30,787,000	30,787,000
Purchase Option Intangibles [Member]
Finite-Lived Intangible Assets [Line Items]
Unamortized intangible assets	0	1,918,000
Purchase option asset utilized	1,918,000
In-Place Leases [Member]
Finite-Lived Intangible Assets [Line Items]
Amortized intangible assets	$ 41,810,000	$ 45,815,000
Weighted average remaining life	10 years 3 months 18 days	9 years 9 months 18 days
Leasehold Interests [Member]
Finite-Lived Intangible Assets [Line Items]
Amortized intangible assets	$ 0	$ 7,346,000
Weighted average remaining life		53 years 7 months 6 days
Customer Relationships [Member]
Finite-Lived Intangible Assets [Line Items]
Amortized intangible assets	$ 2,578,000	$ 2,653,000
Weighted average remaining life	17 years 3 months 18 days	18 years 9 months 18 days
Above Market Leases [Member]
Finite-Lived Intangible Assets [Line Items]
Amortized intangible assets	$ 1,715,000	$ 2,059,000
Weighted average remaining life	5 years 1 month 6 days	5 years 2 months 12 days
Internally Developed Technology and Software [Member]
Finite-Lived Intangible Assets [Line Items]
Amortized intangible assets	$ 306,000	$ 353,000
Weighted average remaining life	3 years 3 months 18 days	3 years 9 months 18 days

Identified Intangible Assets,_4

Identified Intangible Assets, Net - Summary of Identified Intangibles, Net (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Finite-Lived Intangible Assets [Line Items]
Amortization expense	$ 3,094	$ 2,465	$ 6,439	$ 5,977
In-Place Leases [Member]
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Accumulated Amortization	27,499		27,499		$ 23,497
Leasehold Interests [Member]
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Accumulated Amortization					548
Customer Relationships [Member]
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Accumulated Amortization	262		262		187
Above Market Leases [Member]
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Accumulated Amortization	2,049		2,049		2,851
Internally Developed Technology and Software [Member]
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Accumulated Amortization	164		164		$ 117
Leasehold Interests [Member]
Finite-Lived Intangible Assets [Line Items]
Amortization expense	0	35	0	71
Above Market Leases [Member]
Finite-Lived Intangible Assets [Line Items]
Amortization expense	$ 132	$ 217	$ 344	$ 556

Identified Intangible Assets,_5

Identified Intangible Assets, Net - Summary of Amortization Expense on Identified Intangible Assets, Net (Detail) $ in Thousands	Jun. 30, 2019USD ($)
Finite-Lived Intangible Assets [Line Items]
2019	$ 3,897
2020	6,075
2021	5,503
2022	4,785
2023	4,010
Thereafter	22,139
Amortized intangible assets	$ 46,409

Other Assets, Net - Other Asset

Other Assets, Net - Other Assets, Net (Detail) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2019	Dec. 31, 2018
Other Assets [Abstract]
Deferred rent receivables	$ 33,251	$ 23,334
Prepaid expenses, deposits and other assets	28,425	29,803
Investment in unconsolidated entities	21,281	15,432
Inventory	19,247	21,151
Deferred tax asset, net	9,022	9,461
Lease commissions, net of accumulated amortization of $1,700,000 and $1,274,000 as of June 30, 2019 and December 31, 2018, respectively	9,446	8,523
Deferred financing costs, net of accumulated amortization of $8,721,000 and $12,487,000 as of June 30, 2019 and December 31, 2018, respectively(2)	6,077	2,311
Lease inducement, net of accumulated amortization of $965,000 and $789,000 as of June 30, 2019 and December 31, 2018, respectively (with a weighted average remaining life of 11.5 years and 12.0 years as of June 30, 2019 and December 31, 2018, respectively)	4,035	4,211
Other assets, net	130,784	114,226
Accumulated amortization of lease commissions	1,700	1,274
Accumulated amortization of deferred financing costs	8,721	12,487
Accumulated amortization of lease inducements	$ 965	$ 789
Weighted average remaining life of lease inducements	11 years 6 months	12 years

Other Assets, Net - Additional

Other Assets, Net - Additional Information (Detail) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019USD ($)Campus	Jun. 30, 2018USD ($)	Jun. 30, 2019USD ($)Campus	Jun. 30, 2018USD ($)	Dec. 31, 2018USD ($)
Other Assets [Abstract]
Number of senior health campuses | Campus	13		13
Number of Senior Health Campuses Owned by Joint Venture | Campus	3		3
Amortization expense on deferred financing costs	$ 970	$ 1,612	$ 2,000	$ 2,597
Amortization expense on lease commissions	251	182	542	337
Amortization of deferred lease inducements	$ 88	$ 87	$ 176	$ 175
Unconsolidated Entity
Related Party Transaction [Line Items]
Ownership percentage in affiliate	33.90%		33.90%		33.80%
Due from unconsolidated entity	$ 3,826		$ 3,826		$ 2,507

Other Assets, Net - Unconsolida

Other Assets, Net - Unconsolidated Entity Financial Information (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Balance Sheet Data:
Total assets	$ 300,929		$ 300,929		$ 48,391
Total liabilities	271,919		271,919		25,263
Statement of Operations Data:
Revenues	36,138	$ 31,695	71,506	$ 64,170
Expenses	37,174	34,611	73,451	69,239
Net loss	(1,036)	(2,916)	(1,945)	(5,069)
Unconsolidated Entity
Balance Sheet Data:
Total assets	283,387		283,387		48,291
Total liabilities	255,176		255,176		25,263
Statement of Operations Data:
Revenues	35,062	31,695	70,430	64,170
Expenses	35,743	34,611	71,974	69,239
Net loss	(681)	(2,916)	(1,544)	(5,069)
Other Subsidiary, Unconsolidated [Member]
Balance Sheet Data:
Total assets	17,542		17,542		100
Total liabilities	16,743		16,743		$ 0
Statement of Operations Data:
Revenues	1,076	0	1,076	0
Expenses	1,431	0	1,477	0
Net loss	$ (355)	$ 0	$ (401)	$ 0

Mortgage Loans Payable, Net - A

Mortgage Loans Payable, Net - Additional Information (Detail) $ in Thousands	Jun. 30, 2019USD ($)MortgageLoan		Dec. 31, 2018USD ($)MortgageLoan		Jun. 30, 2018USD ($)	Dec. 31, 2017USD ($)
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Mortgage loans payable, gross | $	$ 768,171		$ 713,030
Mortgage loans payable, net | $	$ 743,564	[1]	$ 688,262	[1]	$ 610,789	$ 613,558
Number of fixed rate mortgage loans payable | MortgageLoan	58		57
Number Of Variable Rate Mortgage Loans Payable | MortgageLoan	8		6
Mortgage Loans Payable, Net
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Debt, weighted average interest rate	4.00%		3.98%
Minimum [Member]
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Debt Instrument, Interest Rate, Effective Percentage	2.45%		2.45%
Maximum [Member]
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Debt Instrument, Interest Rate, Effective Percentage	6.94%		8.46%
Revolving Credit Facility [Member] | Trilogy Propco Line Of Credit [Member]
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Debt, weighted average interest rate	6.40%		6.45%
[1]	Such liabilities of Griffin-American Healthcare REIT III, Inc. as of June 30, 2019 and December 31, 2018 represented liabilities of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries. Griffin-American Healthcare REIT III Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of Griffin-American Healthcare REIT III, Inc. The creditors of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries do not have recourse against Griffin-American Healthcare REIT III, Inc., except for six and five mortgage loans in the aggregate amount of $100,061,000 and $50,316,000 as of June 30, 2019 and December 31, 2018, respectively, and the 2019 Corporate Line of Credit and 2016 Corporate Line of Credit, as defined in Note 8, held by Griffin-American Healthcare REIT III Holdings, LP in the amount of $557,000,000 and $548,500,000 as of June 30, 2019 and December 31, 2018, respectively, which is guaranteed by Griffin-American Healthcare REIT III, Inc.

Mortgage Loans Payable, Net - M

Mortgage Loans Payable, Net - Mortgage Loans Payable (Detail) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2019		Jun. 30, 2018	Dec. 31, 2018
Debt Instrument:
Total debt	$ 768,171			$ 713,030
Deferred finance costs, net	(6,077)			(2,311)
Add: premium	484			663
Less: discount	(16,090)			(16,607)
Change in Carrying Amount of Mortgage Loans Payable [Roll Forward]
Beginning balance	688,262	[1]	$ 613,558
Borrowings under mortgage loans payable	61,472		1,364
Amortization of deferred financing costs	660		649
Amortization of discount/premium on mortgage loans payable	338		277
Scheduled principal payments on mortgage loans payable	(6,331)		(5,045)
Deferred financing costs	(837)		(14)
Ending balance	743,564	[1]	$ 610,789
Fixed Rate Debt
Debt Instrument:
Total debt	631,575			624,616
Variable Rate Debt
Debt Instrument:
Total debt	136,596			88,414
Mortgage Loans Payable, Net
Debt Instrument:
Deferred finance costs, net	$ (9,001)			$ (8,824)
[1]	Such liabilities of Griffin-American Healthcare REIT III, Inc. as of June 30, 2019 and December 31, 2018 represented liabilities of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries. Griffin-American Healthcare REIT III Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of Griffin-American Healthcare REIT III, Inc. The creditors of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries do not have recourse against Griffin-American Healthcare REIT III, Inc., except for six and five mortgage loans in the aggregate amount of $100,061,000 and $50,316,000 as of June 30, 2019 and December 31, 2018, respectively, and the 2019 Corporate Line of Credit and 2016 Corporate Line of Credit, as defined in Note 8, held by Griffin-American Healthcare REIT III Holdings, LP in the amount of $557,000,000 and $548,500,000 as of June 30, 2019 and December 31, 2018, respectively, which is guaranteed by Griffin-American Healthcare REIT III, Inc.

Mortgage Loans Payable - Princi

Mortgage Loans Payable - Principal Payments Due on Mortgage Loans Payable (Detail) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Abstract]
2019	$ 71,635
2020	82,209
2021	34,775
2022	61,186
2023	28,973
Thereafter	489,393
Total	$ 768,171	$ 713,030

Lines of Credit and Term Loans

Lines of Credit and Term Loans (Detail)

Jan. 25, 2019USD ($)Extension

Dec. 20, 2018USD ($)

Apr. 27, 2018USD ($)

Oct. 27, 2017USD ($)

Aug. 03, 2017USD ($)

Mar. 21, 2016USD ($)

Feb. 03, 2016USD ($)

Dec. 01, 2015USD ($)

Jun. 30, 2019USD ($)

Dec. 31, 2018USD ($)

Apr. 26, 2018USD ($)

Oct. 26, 2017USD ($)

Apr. 01, 2016USD ($)

Line of Credit Facility [Line Items]

Lines of credit and term loans

[1]

$ 757,567,000

$ 738,048,000

2016 Corporate Term Loan Facility [Member] | Term Loan [Member] | Line of Credit [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

$ 200,000,000

2016 Corporate Revolving Credit Facility [Member] | Revolving Credit Facility [Member] | Line of Credit [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

$ 575,000,000

$ 300,000,000

2016 Corporate Line Of Credit [Member] | Line of Credit [Member]

Line of Credit Facility [Line Items]

Increase in borrowing capacity

$ 25,000,000

$ 50,000,000

Debt Instrument, Maturity Date

Feb. 3, 2019

Line of credit facility, maximum borrowing capacity

550,000,000

2016 Corporate Line Of Credit [Member] | Line of Credit [Member]

Line of Credit Facility [Line Items]

Debt, weighted average interest rate

4.60%

Current borrowing capacity

$ 250,000,000

$ 575,000,000

Lines of credit and term loans

$ 548,500,000

2019 Corporate Line of Credit [Member] | Line of Credit [Member]

Line of Credit Facility [Line Items]

Line Of Credit Facility, Potential Maximum Borrowing Capacity

$ 1,000,000,000

Debt Instrument, Maturity Date

Jan. 25, 2022

Line of credit facility, maximum borrowing capacity

$ 480,000,000

Line Of Credit Facility, Maximum Borrowing Capacity Increase

$ 370,000,000

Line Of Credit Facility, Number Of Potential Extensions | Extension

1

Line Of Credit Facility, Potential Extension Term

12 months

2019 Corporate Line of Credit [Member] | Base Rate [Member] | Line of Credit [Member]

Line of Credit Facility [Line Items]

Debt Instrument, Base Rate, Percent

0.00%

2019 Corporate Line of Credit [Member] | Federal Funds Rate [Member] | Line of Credit [Member]

Line of Credit Facility [Line Items]

Variable rate

0.50%

2019 Corporate Line of Credit [Member] | One-Month Eurodollar [Member] | Line of Credit [Member]

Line of Credit Facility [Line Items]

Variable rate

1.00%

2019 Corporate Line of Credit [Member] | Minimum [Member] | Eurodollar [Member] | Line of Credit [Member]

Line of Credit Facility [Line Items]

Variable rate

1.50%

2019 Corporate Line of Credit [Member] | Minimum [Member] | Base Rate [Member] | Line of Credit [Member]

Line of Credit Facility [Line Items]

Variable rate

0.50%

2019 Corporate Line of Credit [Member] | Maximum [Member] | Eurodollar [Member] | Line of Credit [Member]

Line of Credit Facility [Line Items]

Variable rate

2.20%

2019 Corporate Line of Credit [Member] | Maximum [Member] | Base Rate [Member] | Line of Credit [Member]

Line of Credit Facility [Line Items]

Variable rate

1.20%

2019 Corporate Line of Credit [Member] | Line of Credit [Member]

Line of Credit Facility [Line Items]

Debt, weighted average interest rate

4.28%

Current borrowing capacity

$ 630,000,000

Lines of credit and term loans

$ 557,000,000

2019 Corporate Line of Credit [Member] | Revolving Credit Facility [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

$ 150,000,000

2019 Corporate Line of Credit [Member] | Revolving Credit Facility [Member] | Line of Credit [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

$ 630,000,000

Commitment fee percentage condition one

0.20%

Line Of Credit Facility Average Daily Used Amount Percentage Condition One

50.00%

Commitment fee percentage condition two

0.25%

Line Of Credit Facility Average Daily Used Amount Percentage Condition Two

50.00%

2019 Corporate Line of Credit [Member] | Standby Letters of Credit [Member] | Line of Credit [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

$ 25,000,000

2019 Corporate Line of Credit [Member] | Swing Line Loan [Member] | Line of Credit [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

$ 25,000,000

Trilogy Propco Line Of Credit [Member] | Revolving Credit Facility [Member]

Line of Credit Facility [Line Items]

Debt, weighted average interest rate

6.40%

6.45%

Line of credit extension term

1 year

Debt Instrument, Maturity Date

Dec. 1, 2019

Line of credit facility, maximum borrowing capacity

$ 250,000,000

$ 300,000,000

$ 300,000,000

Current borrowing capacity

$ 250,000,000

$ 250,000,000

Lines of credit and term loans

$ 181,517,000

$ 170,518,000

Trilogy Propco Line Of Credit [Member] | Revolving Credit Facility [Member] | Base Rate [Member]

Line of Credit Facility [Line Items]

Variable rate

3.00%

Trilogy Propco Line Of Credit [Member] | Revolving Credit Facility [Member] | London Interbank Offered Rate (LIBOR) [Member]

Line of Credit Facility [Line Items]

Variable rate

4.00%

Trilogy OpCo Line Of Credit [Member] | Revolving Credit Facility [Member]

Line of Credit Facility [Line Items]

Debt, weighted average interest rate

5.16%

5.17%

Line of Credit Facility, Commitment Fee Percentage

2.75%

Debt Instrument, Maturity Date

Apr. 27, 2021

Line of credit facility, maximum borrowing capacity

$ 25,000,000

$ 60,000,000

Current borrowing capacity

$ 25,000,000

$ 25,000,000

Lines of credit and term loans

$ 19,050,000

$ 19,030,000

Trilogy OpCo Line Of Credit [Member] | Revolving Credit Facility [Member] | Line of Credit [Member]

Line of Credit Facility [Line Items]

Line of Credit Facility, Unused Capacity, Commitment Fee Percentage

0.50%

Line of credit facility, maximum borrowing capacity

$ 42,000,000

Increased line of credit facility maximum borrowing capacity

$ 60,000,000

Trilogy OpCo Line Of Credit [Member] | Revolving Credit Facility [Member] | Base Rate [Member]

Line of Credit Facility [Line Items]

Variable rate

1.75%

Trilogy OpCo Line Of Credit [Member] | Revolving Credit Facility [Member] | London Interbank Offered Rate (LIBOR) [Member]

Line of Credit Facility [Line Items]

Variable rate

2.75%

Trilogy Borrowers [Member] | Trilogy Propco Line Of Credit [Member] | Revolving Credit Facility [Member]

Line of Credit Facility [Line Items]

Line of Credit Facility, Commitment Fee Percentage

0.25%

[1]

Such liabilities of Griffin-American Healthcare REIT III, Inc. as of June 30, 2019 and December 31, 2018 represented liabilities of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries. Griffin-American Healthcare REIT III Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of Griffin-American Healthcare REIT III, Inc. The creditors of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries do not have recourse against Griffin-American Healthcare REIT III, Inc., except for six and five mortgage loans in the aggregate amount of $100,061,000 and $50,316,000 as of June 30, 2019 and December 31, 2018, respectively, and the 2019 Corporate Line of Credit and 2016 Corporate Line of Credit, as defined in Note 8, held by Griffin-American Healthcare REIT III Holdings, LP in the amount of $557,000,000 and $548,500,000 as of June 30, 2019 and December 31, 2018, respectively, which is guaranteed by Griffin-American Healthcare REIT III, Inc.

Derivative Financial Instrume_3

Derivative Financial Instruments - Additional Information (Details) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019USD ($)instrument	Jun. 30, 2018USD ($)	Jun. 30, 2019USD ($)instrument	Jun. 30, 2018USD ($)	Dec. 31, 2018instrument
Derivative [Line Items]
Loss in fair value of derivative financial instruments | $	$ (4,117)	$ (487)	$ (4,677)	$ (377)
Not Designated as Hedging Instrument
Derivative [Line Items]
Number of derivative financial instruments (in instruments) | instrument	0		0		0

Derivative Financial Instrume_4

Derivative Financial Instruments (Detail) - Not Designated as Hedging Instrument - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2019	Dec. 31, 2018
Derivative [Line Items]
Notional Amount
Fair Value	$ (4,107)	$ 417
Swap, .82% Interest Rate [Member]
Derivative [Line Items]
Instrument	Swap
Notional Amount	$ 140,000
Index	one month LIBOR
Interest Rate	0.82%
Maturity Date	Feb. 3, 2019
Fair Value	$ 0	221
Swap, .78% Interest Rate [Member]
Derivative [Line Items]
Instrument	Swap
Notional Amount	$ 60,000
Index	one month LIBOR
Interest Rate	0.78%
Maturity Date	Feb. 3, 2019
Fair Value	$ 0	97
Swap, 1.39% Interest Rate [Member]
Derivative [Line Items]
Instrument	Swap
Notional Amount	$ 50,000
Index	one month LIBOR
Interest Rate	1.39%
Maturity Date	Feb. 3, 2019
Fair Value	$ 0	51
Cap [Member]
Derivative [Line Items]
Instrument	Cap
Notional Amount	$ 20,000
Index	one month LIBOR
Interest Rate	3.00%
Maturity Date	Sep. 23, 2021
Fair Value	$ 4	48
Swap, 2.10% Interest Rate [Member]
Derivative [Line Items]
Instrument	Swap
Notional Amount	$ 250,000
Index	one month LIBOR
Interest Rate	2.10%
Maturity Date	Jan. 25, 2022
Fair Value	$ (2,962)	0
Swap, 1.98% Interest Rate [Member]
Derivative [Line Items]
Instrument	Swap
Notional Amount	$ 130,000
Index	one month LIBOR
Interest Rate	1.98%
Maturity Date	Jan. 25, 2022
Fair Value	$ (1,149)	$ 0

Identified Intangible Liabili_3

Identified Intangible Liabilities, Net - Summary of Identified Intangibles, Net (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Finite Lived Intangible Liabilities [Line Items]
Identified intangible liabilities, net	$ 842		$ 842		$ 1,051
Below Market Lease [Member]
Finite Lived Intangible Liabilities [Line Items]
Identified intangible liabilities, net	842		842		1,051
Net of accumulated amortization	1,244		1,244		$ 1,229
Amortization expense	$ 104	$ 129	$ 209	$ 269
Weighted average remaining life			4 years 3 months 18 days		4 years 3 months 18 days

Identified Intangible Liabili_4

Identified Intangible Liabilities, Net - Summary of Amortization Expense on Below Market Leases (Detail) $ in Thousands	Jun. 30, 2019USD ($)
Intangible Liabilities [Abstract]
2019	$ 179
2020	260
2021	143
2022	93
2023	78
Thereafter	89
Finite Lived Intangible Liabilities Net	$ 842

Redeemable Noncontrolling Int_3

Redeemable Noncontrolling Interest (Details) - USD ($)	Jan. 15, 2013	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018	Jun. 30, 2019	Dec. 31, 2018	Jun. 30, 2019	Dec. 01, 2015
Redeemable Noncontrolling Interest [Line Items]
Issuance of common stock under the DRIP		$ 14,115,000	$ 15,220,000	$ 28,311,000	$ 30,449,000	$ 249,711,000	$ 278,022,000
Contributions from noncontrolling interests	$ 2,000			3,000,000	4,470,000
Number of limited partnership units issued to noncontrolling	222
Percentage of ownership in operating partnership								99.99%	99.99%
Percentage of limited partnership interest								0.01%	0.01%
Changes in the carrying amount of redeemable noncontrolling interest [Roll Forward]
Beginning balance				38,245,000	32,435,000
Additions				0	535,000
Reclassification from equity		195,000	195,000	390,000	390,000
Distributions				(720,000)	(332,000)
Repurchase of redeemable noncontrolling interest				(3,000)	(229,000)
Fair value adjustment to redemption value		169,000	46,000	(84,000)	293,000
Net income attributable to redeemable noncontrolling interests		147,000	78,000	287,000	107,000
Ending balance		$ 38,115,000	33,199,000	$ 38,115,000	33,199,000	$ 38,245,000	$ 38,115,000	$ 38,245,000	$ 38,115,000
Trilogy Joint Venture [Member]
Redeemable Noncontrolling Interest [Line Items]
Joint venture ownership interest		70.00%		70.00%			70.00%		70.00%	70.00%
Trilogy Investors, LLC [Member]
Redeemable Noncontrolling Interest [Line Items]
Ownership percentage equity interest		96.70%		96.70%		96.70%	96.70%	96.70%	96.70%	96.70%
Noncontrolling interest, ownership percentage by noncontrolling owners		3.30%		3.30%		3.30%	3.30%	3.30%	3.30%	3.30%
Parent
Redeemable Noncontrolling Interest [Line Items]
Issuance of common stock under the DRIP		$ 14,115,000	15,220,000	$ 28,311,000	30,449,000
Changes in the carrying amount of redeemable noncontrolling interest [Roll Forward]
Fair value adjustment to redemption value		$ 119,000	$ 32,000	$ (58,000)	$ 205,000

Equity Accumulated Other Compre

Equity Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning balance Stockholders' Equity	$ 1,175,318	$ 1,326,834	$ 1,218,635	$ 1,346,575
Net change in current period	(239)	(684)	(20)	(238)
Ending balance Stockholders' Equity	1,138,975	1,292,381	1,138,975	1,292,381
Accumulated Other Comprehensive Loss
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning balance Stockholders' Equity	(2,341)	(1,525)	(2,560)	(1,971)
Ending balance Stockholders' Equity	$ (2,580)	$ (2,209)	$ (2,580)	$ (2,209)

Equity (Detail)

Equity (Detail)	Oct. 01, 2018	Dec. 01, 2015	Feb. 26, 2014USD ($)	Jan. 15, 2013USD ($)shares	Jun. 30, 2019USD ($)Anniversary$ / sharesshares	Jun. 30, 2018USD ($)$ / sharesshares	Jun. 30, 2019USD ($)Anniversary$ / sharesRateshares	Jun. 30, 2018USD ($)$ / sharesshares	Apr. 21, 2015shares	Dec. 31, 2018USD ($)$ / sharesshares	Jun. 30, 2019USD ($)Anniversary$ / sharesshares	Mar. 29, 2019USD ($)shares	Dec. 31, 2018USD ($)$ / sharesshares	Jun. 30, 2019USD ($)Anniversary$ / sharesshares	Mar. 31, 2019USD ($)shares	Jan. 30, 2019USD ($)	Oct. 03, 2018$ / shares	Sep. 30, 2018	Mar. 31, 2018USD ($)shares	Dec. 31, 2017USD ($)shares	Oct. 04, 2017$ / shares	Oct. 05, 2016$ / shares	Jan. 06, 2016USD ($)	Mar. 25, 2015USD ($)
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest					$ 1,138,975,000	$ 1,292,381,000	$ 1,138,975,000	$ 1,292,381,000		$ 1,218,635,000	$ 1,138,975,000		$ 1,218,635,000	$ 1,138,975,000	$ 1,175,318,000				$ 1,326,834,000	$ 1,346,575,000
Net earning of joint venture allocated to noncontrolling interest										30.00%	30.00%
Number of limited partnership units issued to noncontrolling | shares				222
Contributions from noncontrolling interests				$ 2,000			$ 3,000,000	$ 4,470,000
Share repurchase plan percentage of price per-share condition two			100.00%		95.00%		95.00%				95.00%			95.00%
Issuance of common stock under the DRIP, shares | shares													26,820,010	29,841,503
Granted (in shares) | shares														112,500
Maximum percentage of common stock repurchased during period			5.00%
Cap percentage on repurchases			5.00%
Maximum Number of Repurchase Shares Owned, Value			$ 2,500
Common Stock Repurchase Requests During Period Under Share Repurchase Plan Shares | shares					5,252,062	1,978,048	9,135,778	3,770,572
Common stock repuchased during period under share repurchase plan, shares | shares					1,966,636	1,978,048	5,850,352	3,770,572					14,320,453	20,170,805
Stock repuchased during period value under the share repurchase plan, value					$ 18,649,000	$ 18,194,000	$ 55,135,000	$ 34,700,000					$ 131,935,000	$ 187,070,000
Stock acquired average cost per share | $ / shares					$ 9.48	$ 9.20	$ 9.42	$ 9.20					$ 9.21	$ 9.27
Cumulative common stock repurchase requests (in shares) | shares					23,456,231		23,456,231			14,320,453	23,456,231		14,320,453	23,456,231
Number of shares of preferred stock, authorized to be issued | shares					200,000,000		200,000,000			200,000,000	200,000,000		200,000,000	200,000,000
Par value of preferred stock, authorized to be issued | $ / shares					$ 0.01		$ 0.01			$ 0.01	$ 0.01		$ 0.01	$ 0.01
Par value of common stock to be offered and sold to the public | $ / shares					$ 0.01		$ 0.01			$ 0.01	$ 0.01		$ 0.01	$ 0.01
Issuance of common stock under the DRIP					$ 14,115,000	$ 15,220,000	$ 28,311,000	$ 30,449,000					$ 249,711,000	$ 278,022,000
Number of shares of common stock, authorized to be issued | shares					1,000,000,000		1,000,000,000			1,000,000,000	1,000,000,000		1,000,000,000	1,000,000,000
Maximum dollar amount of common stock issuable under public offering			$ 1,900,000,000
Common stock, shares outstanding | shares					194,736,018		194,736,018			197,557,377	194,736,018		197,557,377	194,736,018
Share repurchase plan holding period			1 year				1 year
Share Repurchase Plan Percentage of Price per-Share Condition One			92.50%		92.50%		92.50%				92.50%			92.50%
Stock based compensation							$ 100,000	99,000
Preferred Stock, Value, Subscriptions																							$ 125,000
Preferred Stock, Dividend Rate, Percentage | Rate							12.50%
Common stock, shares, issued | shares					194,736,018		194,736,018			197,557,377	194,736,018		197,557,377	194,736,018
Share Repurchase Plan Percentage of Price per-Share Condition Three					97.50%		97.50%				97.50%			97.50%
Share Repurchase Plan Percentage of Price per-Share Condition Four					100.00%		100.00%				100.00%			100.00%
Preferred stock, shares issued | shares					0		0			0	0		0	0
Preferred stock, shares outstanding | shares					0		0			0	0		0	0
Two Thousand Thirteen Incentive Plan [Member] | Common Stock
Share-based compensation arrangement by share-based payment award, number of shares authorized | shares					2,000,000		2,000,000				2,000,000			2,000,000
Two Thousand Thirteen Incentive Plan [Member] | Restricted Stock [Member]
Stock based compensation					$ 57,000	$ 56,000	$ 100,000	$ 99,000
2019 DRIP Offering [Member]
Issuance of common stock under the DRIP, shares | shares					1,506,395
Issuance of common stock under the DRIP					$ 14,115,000
Maximum dollar amount of common stock issuable under public offering																$ 200,000,000
2015 DRIP Offering and 2019 DRIP Offering [Member]
Issuance of common stock under the DRIP, shares | shares							3,021,493
Issuance of common stock under the DRIP							$ 28,311,000
DRIP [Member]
Subscriptions in offering of common stock received and accepted shares | shares									1,948,563
Percentage of offering price			95.00%
Maximum amount of common stock issuable under public offering			$ 35,000,000
Share price | $ / shares																	$ 9.37				$ 9.27	$ 9.01
DRIP S-3 Public Offering [Member]
Maximum dollar amount of common stock issuable under public offering																$ 200,000,000
Common Stock
Subscriptions in offering of common stock received and accepted shares | shares									184,930,598
2015 DRIP Offering [Member]
Issuance of common stock under the DRIP, shares | shares						1,641,819		3,284,653				26,386,545
Issuance of common stock under the DRIP						$ 15,220,000		$ 30,449,000				$ 245,396,000
Maximum dollar amount of common stock issuable under public offering																								$ 250,000,000
Accumulated Other Comprehensive Loss
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest					(2,580,000)	(2,209,000)	(2,580,000)	(2,209,000)		$ (2,560,000)	$ (2,580,000)		$ (2,560,000)	$ (2,580,000)	(2,341,000)				(1,525,000)	(1,971,000)
Total Stockholders' Equity
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest					978,965,000	1,131,742,000	978,965,000	1,131,742,000		1,060,507,000	978,965,000		1,060,507,000	978,965,000	1,014,723,000				1,165,389,000	1,187,850,000
Issuance of common stock under the DRIP					14,115,000	15,220,000	28,311,000	30,449,000
Common Stock
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest					$ 1,946,000	$ 1,988,000	$ 1,946,000	$ 1,988,000		$ 1,975,000	$ 1,946,000		$ 1,975,000	$ 1,946,000	$ 1,951,000				$ 1,991,000	$ 1,993,000
Issuance of common stock under the DRIP, shares | shares					1,506,395	1,641,819	3,021,493	3,284,653
Issuance of common stock under the DRIP					$ 15,000	$ 17,000	$ 30,000	$ 33,000
Shares, Issued | shares					194,736,018	198,864,815	194,736,018	198,864,815		197,557,377	194,736,018		197,557,377	194,736,018	195,188,759				199,193,544	199,343,234
Trilogy Investors, LLC [Member]
Ownership percentage equity interest		96.70%			96.70%		96.70%			96.70%	96.70%		96.70%	96.70%
Trilogy Joint Venture [Member]
Joint venture ownership interest		70.00%			70.00%		70.00%				70.00%			70.00%
Lakeview IN Medical Plaza [Member]
Joint venture ownership interest					86.00%		86.00%			86.00%	86.00%		86.00%	86.00%
Joint venture earnings percentage allocation					14.00%	14.00%	14.00%	14.00%			14.00%			14.00%
Trilogy Joint Venture [Member] | Profits Interests [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Rights, Percentage		20.00%
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period		5 years
Stock based compensation					$ 390,000	$ 195,000	$ 195,000	$ 390,000
Griffin American Advisor [Member]
Stock purchased | shares				22,222
Value of stock purchased				$ 200,000
Griffin-American Healthcare REIT IV, Inc. [Member] | Trilogy Joint Venture [Member]
Ownership percentage equity interest	6.00%
Ownership interest acquired	6.00%
NorthStar Healthcare Income, Inc. [Member] | Trilogy Joint Venture [Member]
Ownership percentage equity interest	24.00%																	30.00%
Maximum [Member]
Share repurchase plan percentage of price per-share condition two					100.00%		100.00%				100.00%			100.00%
Independent Director [Member] | Two Thousand Thirteen Incentive Plan [Member] | Restricted Stock [Member]
Granted (in shares) | shares					7,500		7,500
Granted (usd per share) | $ / shares					$ 9.37		$ 9.37				$ 9.37			$ 9.37
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Number Of Vesting Anniversaries | Anniversary					4		4				4			4
Re-elected or Newly Elected Independent Directors [Member] | Two Thousand Thirteen Incentive Plan [Member] | Restricted Stock [Member]
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Vesting Percentage					20.00%		20.00%				20.00%			20.00%

Equity - Status and Changes of

Equity - Status and Changes of Nonvested Shares of Restricted Common Stock (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended		64 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019
Equity - Status and Changes of Nonvested Shares of Restricted Common Stock [Roll Forward]
Granted (in shares)					112,500
Stock based compensation			$ 100	$ 99
Two Thousand Thirteen Incentive Plan [Member] | Restricted Stock [Member]
Equity - Status and Changes of Nonvested Shares of Restricted Common Stock [Roll Forward]
Stock based compensation	$ 57	$ 56	$ 100	$ 99
Common Stock | Two Thousand Thirteen Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement by share-based payment award, number of shares authorized	2,000,000		2,000,000		2,000,000
Independent Director [Member] | Two Thousand Thirteen Incentive Plan [Member] | Restricted Stock [Member]
Equity - Status and Changes of Nonvested Shares of Restricted Common Stock [Roll Forward]
Granted (in shares)	7,500		7,500
Granted (usd per share)	$ 9.37		$ 9.37		$ 9.37

Related Party Transactions - Ad

Related Party Transactions - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended		12 Months Ended		53 Months Ended	64 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2019
Related Party Transaction [Line Items]
Related party transaction, expenses from transactions with related party	$ 6,477	$ 6,133	$ 12,718	$ 11,652
Advisor [Member]
Related Party Transaction [Line Items]
Percentage of contract purchase price paid acquisition fee, in cash							2.25%
Acquisition price for any real estate-related investment we originate or acquire							2.00%
Maximum percentage of fees and expenses associated with the acquisition	6.00%	6.00%	6.00%	6.00%				6.00%
Asset Management Fee Percent								0.75%
Subordinated asset management fee subject to stockholders receiving distributions, percentage	5.00%		5.00%		5.00%		5.00%	5.00%
Percentage Of Property Oversight Fees	1.00%		1.00%		1.00%		1.00%	1.00%
Percentage Of Property Oversight Fees - Multiple Tenants	1.50%		1.50%		1.50%		1.50%	1.50%
Minimum percentage of lease fee	3.00%		3.00%		3.00%		3.00%	3.00%
Maximum percentage of lease fee	6.00%		6.00%		6.00%		6.00%	6.00%
Maximum percentage of construction management fee	5.00%		5.00%		5.00%		5.00%	5.00%
Percentage Of Operating Expenses Of Average Invested Asset	2.00%		2.00%		2.00%		2.00%	2.00%
Percentage Of Operating Expense Of Net Income			25.00%
Disposition fees as percentage of contract sales price	2.00%		2.00%		2.00%		2.00%	2.00%
Disposition fees as percentage of customary competitive real estate commission	50.00%		50.00%		50.00%		50.00%	50.00%
Maximum percentage of disposition fee	6.00%		6.00%		6.00%		6.00%	6.00%
Acquistion Fees [Member]
Related Party Transaction [Line Items]
Related party transaction, expenses from transactions with related party	$ 440	$ 7	$ 798	$ 7
Development Fees [Member]
Related Party Transaction [Line Items]
Related party transaction, expenses from transactions with related party	13	45	163	45
Asset Management [Member]
Related Party Transaction [Line Items]
Related party transaction, expenses from transactions with related party	5,020	4,784	9,997	9,565
Property Management Fee [Member]
Related Party Transaction [Line Items]
Related party transaction, expenses from transactions with related party	660	583	1,279	1,194
Lease Commissions [Member]
Related Party Transaction [Line Items]
Related party transaction, expenses from transactions with related party	145	659	169	728
Construction Management Fee [Member]
Related Party Transaction [Line Items]
Related party transaction, expenses from transactions with related party	162	8	199	14
Operating Expense [Member]
Related Party Transaction [Line Items]
Related party transaction, expenses from transactions with related party	$ 37	$ 47	$ 113	$ 99
Percentage of operating expenses of average invested assets					0.90%	0.90%
Percentage of operating expenses of net income					19.20%	17.60%
Subordinated distribution of net sales proceeds [Member]
Related Party Transaction [Line Items]
Percentage of distribution of net proceeds from sales of properties	15.00%		15.00%		15.00%		15.00%	15.00%
Annual cumulative non compounded return on gross proceeds from sale of shares	7.00%		7.00%		7.00%		7.00%	7.00%
Subordinated Distribution Upon Listing [Member]
Related Party Transaction [Line Items]
Percentage of distribution of net proceeds from sales of properties	15.00%		15.00%		15.00%		15.00%	15.00%
Annual cumulative non compounded return upon listing of shares	7.00%		7.00%		7.00%		7.00%	7.00%
Subordinated Distribution Upon Termination [Member]
Related Party Transaction [Line Items]
Distribution rate of partnership amount to sub advisor	15.00%		15.00%		15.00%		15.00%	15.00%
Annual cumulative non compounded return on gross proceeds from sale of shares	7.00%		7.00%		7.00%		7.00%	7.00%

Related Party Transactions - Sc

Related Party Transactions - Schedule of Amount Outstanding to Affiliates (Detail) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Related Party Transaction [Line Items]
Due to affiliates	$ 2,582	$ 2,103
Asset And Property Management Fees [Member]
Related Party Transaction [Line Items]
Due to affiliates	1,898	1,856
Acquistion Fees [Member]
Related Party Transaction [Line Items]
Due to affiliates	411	15
Construction Management Fee [Member]
Related Party Transaction [Line Items]
Due to affiliates	186	58
Lease Commissions [Member]
Related Party Transaction [Line Items]
Due to affiliates	73	94
Operating Expense [Member]
Related Party Transaction [Line Items]
Due to affiliates	14	12
Development Fees [Member]
Related Party Transaction [Line Items]
Due to affiliates	$ 0	$ 68

Fair Value Measurements - Asset

Fair Value Measurements - Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Liabilities:
Contingent consideration obligations	$ 0	$ 681
Fair Value, Measurements, Recurring [Member]
Assets:
Derivative financial instruments	4	417
Total assets at fair value	4	417
Liabilities:
Fair Value, Concentration of Risk, Derivative Instruments, Liabilities	4,111
Contingent consideration obligations		681
Warrants	1,132	1,207
Total liabilities at fair value	5,243	1,888
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member] | Fair Value, Measurements, Recurring [Member]
Assets:
Derivative financial instruments	0	0
Total assets at fair value	0	0
Liabilities:
Fair Value, Concentration of Risk, Derivative Instruments, Liabilities	0
Contingent consideration obligations		0
Warrants	0	0
Total liabilities at fair value	0	0
Significant Other Observable Inputs (Level 2) [Member] | Fair Value, Measurements, Recurring [Member]
Assets:
Derivative financial instruments	4	417
Total assets at fair value	4	417
Liabilities:
Fair Value, Concentration of Risk, Derivative Instruments, Liabilities	4,111
Contingent consideration obligations		0
Warrants	0	0
Total liabilities at fair value	4,111	0
Significant Unobservable Inputs (Level 3) [Member] | Fair Value, Measurements, Recurring [Member]
Assets:
Derivative financial instruments	0	0
Total assets at fair value	0	0
Liabilities:
Fair Value, Concentration of Risk, Derivative Instruments, Liabilities	0
Contingent consideration obligations		681
Warrants	1,132	1,207
Total liabilities at fair value	$ 1,132	$ 1,888

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Detail) $ in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2018Property	Jun. 30, 2019USD ($)	Jun. 30, 2018Property	Dec. 31, 2018USD ($)
Business Acquisitions [Line Items]
Contingent consideration obligations		$ 0		$ 681
North Carolina ALF Portfolio - Clemmons [Member] | Contingent Consideration Obligation [Member]
Business Acquisitions [Line Items]
Business combination, contingent consideration arrangements, range of outcomes, value, high		$ 11,000
North Carolina ALF Portfolio [Member] | Contingent Consideration Obligation [Member]
Business Acquisitions [Line Items]
Contingent consideration period earnout payment is based on		3 months
Fair Value, Measurements, Recurring [Member]
Business Acquisitions [Line Items]
Derivative financial instruments		$ 4		417
Fair Value, Concentration of Risk, Derivative Instruments, Liabilities		4,111
Contingent consideration obligations				681
Warrants		1,132		1,207
Fair Value, Inputs, Level 2 [Member] | Fair Value, Measurements, Recurring [Member]
Business Acquisitions [Line Items]
Derivative financial instruments		4		417
Fair Value, Concentration of Risk, Derivative Instruments, Liabilities		4,111
Contingent consideration obligations				0
Warrants		0		0
Significant Unobservable Inputs (Level 3) [Member] | Fair Value, Measurements, Recurring [Member]
Business Acquisitions [Line Items]
Derivative financial instruments		0		0
Fair Value, Concentration of Risk, Derivative Instruments, Liabilities		0
Contingent consideration obligations				681
Warrants		$ 1,132		$ 1,207
Medical Office Building [Member]
Business Acquisitions [Line Items]
Number of real estate properties impaired (in properties) | Property	1		1

Fair Value Measurements Fair Va

Fair Value Measurements Fair Value by Balance Sheet Grouping (Details) - USD ($) $ in Thousands	Jun. 30, 2019		Dec. 31, 2018		Jun. 30, 2018	Dec. 31, 2017
Financial Instruments, Financial Assets, Balance Sheet Groupings [Abstract]
Debt security investment	$ 71,272		$ 69,873
Debt security investment, fair value	93,349		94,116
Financial Instruments, Financial Liabilities, Balance Sheet Groupings [Abstract]
Mortgage loans payable, net	743,564	[1]	688,262	[1]	$ 610,789	$ 613,558
Mortgage loans payable, net fair value	701,027		618,886
Lines of credit and term loan, net	751,490		735,737
Line of credit and term loan, net fair value	$ 757,914		$ 737,982
[1]	Such liabilities of Griffin-American Healthcare REIT III, Inc. as of June 30, 2019 and December 31, 2018 represented liabilities of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries. Griffin-American Healthcare REIT III Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of Griffin-American Healthcare REIT III, Inc. The creditors of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries do not have recourse against Griffin-American Healthcare REIT III, Inc., except for six and five mortgage loans in the aggregate amount of $100,061,000 and $50,316,000 as of June 30, 2019 and December 31, 2018, respectively, and the 2019 Corporate Line of Credit and 2016 Corporate Line of Credit, as defined in Note 8, held by Griffin-American Healthcare REIT III Holdings, LP in the amount of $557,000,000 and $548,500,000 as of June 30, 2019 and December 31, 2018, respectively, which is guaranteed by Griffin-American Healthcare REIT III, Inc.

Fair Value Measurements - Real

Fair Value Measurements - Real Estate Investment (Details)	3 Months Ended	6 Months Ended
	Jun. 30, 2018Property	Jun. 30, 2018Property
Measurement Input, Cap Rate [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs	0.0750	0.0750
Measurement Input, Discount Rate [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs	0.0800	0.0800
Minimum [Member] | Measurement Input, Cap Rate [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs	13.75	13.75
Maximum [Member] | Measurement Input, Cap Rate [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs	25	25
Medical Office Building [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Number of real estate properties impaired (in properties)	1	1

Income Taxes -Income (loss) bef

Income Taxes -Income (loss) before income tax (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Income Tax Disclosure [Abstract]
Domestic	$ 109	$ 213	$ 7,315	$ 8,322
Foreign	(105)	(57)	(302)	(112)
Income before income taxes	$ 4	$ 156	$ 7,013	$ 8,210

Income Taxes - Income Tax Expen

Income Taxes - Income Tax Expense (Benefit) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Income Tax Disclosure [Abstract]
Federal deferred	$ (543)	$ (1,146)	$ (1,091)	$ (2,478)
State deferred	(70)	(236)	(140)	(503)
Foreign current	275	102	420	181
Valuation allowances	497	754	1,121	1,903
Total income tax expense (benefit)	$ 159	$ (526)	$ 310	$ (897)

Leases - Additional Information

Leases - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2019	Dec. 31, 2018
Lessee, Lease, Description [Line Items]
Operating lease revenue	$ 30,898	$ 61,951
Variable lease payments	4,349	9,090
Principal obligations			$ 4,438
Interest obligations			$ 265
Lease not yet commenced	$ 56,945	$ 56,945
Maximum [Member]
Lessee, Lease, Description [Line Items]
Lease not yet commenced, term of contract	15 years	15 years

Leases - Lessor, Future Minimum

Leases - Lessor, Future Minimum Rents Due (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Future Minimum Rent [Abstract]
2019	$ 48,032
2020	93,555
2021	91,476
2022	84,811
2023	77,433
Thereafter	578,689
Total	$ 973,996
2019		$ 92,888
2020		88,536
2021		86,362
2022		80,233
2023		72,535
Thereafter		559,649
Total		$ 980,203

Leases - Supplemental Disclosur

Leases - Supplemental Disclosure of Cash Flows Information (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2019USD ($)
Leases [Abstract]
Operating cash flows from operating leases	$ 11,087
Operating cash flows from finance leases	131
Financing cash flows from finance leases	1,772
Right-of-use assets obtained in exchange for operating lease liabilities	$ 114

Leases - Components of Lease Co

Leases - Components of Lease Cost (Details) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2019
Leases [Abstract]
Operating lease cost	$ 7,664	$ 15,120
Amortization of leased assets	79	1,053
Accretion of lease liabilities	53	132
Total lease cost	$ 7,796	$ 16,305

Leases - Lease Term and Discoun

Leases - Lease Term and Discount Rate (Details)	Jun. 30, 2019
Leases [Abstract]
Operating leases, weighted-average remaining lease term	13 years 6 months
Finance leases, weighted-average remaining lease term	1 year 4 months 24 days
Operating leases, weighted-average discount rate	6.13%
Finance leases, weighted-average discount rate	7.66%

Leases - Future Minimum Rent Pa

Leases - Future Minimum Rent Payments, Operating Leases (Details) - USD ($) $ in Thousands		Jun. 30, 2019	Dec. 31, 2018
Lessee, Operating Lease, Description [Abstract]
2019		$ 11,780
2020		23,103
2021		23,571
2022		23,950
2023		23,257
Thereafter		189,416
Total operating lease payments		295,077
Less: interest		101,687
Present value of operating lease liabilities	[1]	$ 193,390	$ 0
2019			22,194
2020			22,564
2021			23,166
2022			23,702
2023			23,154
Thereafter			177,927
Total operating lease payments			$ 292,707
[1]	Such liabilities of Griffin-American Healthcare REIT III, Inc. as of June 30, 2019 and December 31, 2018 represented liabilities of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries. Griffin-American Healthcare REIT III Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of Griffin-American Healthcare REIT III, Inc. The creditors of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries do not have recourse against Griffin-American Healthcare REIT III, Inc., except for six and five mortgage loans in the aggregate amount of $100,061,000 and $50,316,000 as of June 30, 2019 and December 31, 2018, respectively, and the 2019 Corporate Line of Credit and 2016 Corporate Line of Credit, as defined in Note 8, held by Griffin-American Healthcare REIT III Holdings, LP in the amount of $557,000,000 and $548,500,000 as of June 30, 2019 and December 31, 2018, respectively, which is guaranteed by Griffin-American Healthcare REIT III, Inc.

Leases - Future Minimum Rent _2

Leases - Future Minimum Rent Payments, Finance Leases (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Lessee, Finance Lease, Description [Abstract]
2019	$ 1,395
2020	1,265
2021	130
2022	0
2023	0
Total finance lease payments	2,790
Less: interest	124
Present value of finance lease liabilities	$ 2,666
2019		$ 3,307
2020		1,266
2021		130
2022		0
2023		0
Total capital lease payments		$ 4,703

Segment Reporting - Summary Inf

Segment Reporting - Summary Information for Reportable Segments (Detail)	Jun. 30, 2019USD ($)segment	Jun. 30, 2019USD ($)	Jun. 30, 2018USD ($)	Jun. 30, 2019USD ($)segment	Jun. 30, 2018USD ($)	Dec. 31, 2018USD ($)
Segment Reporting [Abstract]
Number of reportable segments | segment	6			6
Revenues:
Resident fees and services		$ 272,472,000	$ 247,582,000	$ 540,754,000	$ 492,975,000
Real estate revenue		32,459,000	32,681,000	65,235,000	65,180,000
Total revenues		304,931,000	280,263,000	605,989,000	558,155,000
Expenses:
Property operating expenses		239,890,000	218,271,000	474,842,000	435,630,000
Rental expenses		8,226,000	8,747,000	16,651,000	17,687,000
Segment net operating income		56,815,000	53,245,000	114,496,000	104,838,000
Operating Expenses
General and administrative		6,512,000	6,622,000	13,429,000	13,010,000
Acquisition related expenses		400,000	214,000	(296,000)	(555,000)
Depreciation and amortization		24,743,000	22,682,000	50,371,000	46,374,000
Other income (expense):
Interest expense (including amortization of deferred financing costs and debt discount/premium)		(19,560,000)	(16,479,000)	(38,619,000)	(31,831,000)
Loss in fair value of derivative financial instruments		(4,117,000)	(487,000)	(4,677,000)	(377,000)
Impairment of real estate investments		0	(2,542,000)	0	(2,542,000)
Loss from unconsolidated entities		(493,000)	(1,458,000)	(947,000)	(2,535,000)
Foreign currency loss		(1,232,000)	(2,829,000)	(190,000)	(1,033,000)
Other income		246,000	224,000	454,000	519,000
Income before income taxes		4,000	156,000	7,013,000	8,210,000
Income tax (expense) benefit		(159,000)	526,000	(310,000)	897,000
Net income		(155,000)	682,000	6,703,000	9,107,000
Assets by Reportable Segment
Total assets	$ 3,086,153,000	3,086,153,000		3,086,153,000		$ 2,889,092,000
Goodwill	75,309,000	75,309,000		75,309,000		75,309,000
Segments, Geographical Areas
Real estate investments, net	2,230,950,000	2,230,950,000		2,230,950,000		2,222,681,000
United States [Member]
Revenues:
Total revenues		303,721,000	279,015,000	603,543,000	555,626,000
Segments, Geographical Areas
Real estate investments, net	2,181,809,000	2,181,809,000		2,181,809,000		2,173,395,000
International [Member]
Revenues:
Total revenues		1,210,000	1,248,000	2,446,000	2,529,000
Segments, Geographical Areas
Real estate investments, net	49,141,000	49,141,000		49,141,000		49,286,000
Integrated Senior Health Campuses [Member]
Revenues:
Resident fees and services		256,041,000	231,521,000	507,755,000	460,582,000
Real estate revenue		0	0	0	0
Total revenues		256,041,000	231,521,000	507,755,000	460,582,000
Expenses:
Property operating expenses		228,319,000	207,277,000	451,647,000	413,572,000
Rental expenses		0	0	0	0
Segment net operating income		27,722,000	24,244,000	56,108,000	47,010,000
Assets by Reportable Segment
Total assets	1,691,133,000	1,691,133,000		1,691,133,000		1,478,147,000
Goodwill	75,309,000	75,309,000		75,309,000		75,309,000
Senior Housing-RIDEA [Member]
Revenues:
Resident fees and services		16,431,000	16,061,000	32,999,000	32,393,000
Real estate revenue		0	0	0	0
Total revenues		16,431,000	16,061,000	32,999,000	32,393,000
Expenses:
Property operating expenses		11,571,000	10,994,000	23,195,000	22,058,000
Rental expenses		0	0	0	0
Segment net operating income		4,860,000	5,067,000	9,804,000	10,335,000
Assets by Reportable Segment
Total assets	265,119,000	265,119,000		265,119,000		271,381,000
Medical Office Building [Member]
Revenues:
Resident fees and services		0	0	0	0
Real estate revenue		20,104,000	20,206,000	40,658,000	40,287,000
Total revenues		20,104,000	20,206,000	40,658,000	40,287,000
Expenses:
Property operating expenses		0	0	0	0
Rental expenses		7,597,000	7,748,000	15,413,000	15,678,000
Segment net operating income		12,507,000	12,458,000	25,245,000	24,609,000
Assets by Reportable Segment
Total assets	621,700,000	621,700,000		621,700,000		646,784,000
Senior Housing [Member]
Revenues:
Resident fees and services		0	0	0	0
Real estate revenue		5,931,000	5,393,000	11,583,000	10,793,000
Total revenues		5,931,000	5,393,000	11,583,000	10,793,000
Expenses:
Property operating expenses		0	0	0	0
Rental expenses		127,000	185,000	223,000	372,000
Segment net operating income		5,804,000	5,208,000	11,360,000	10,421,000
Assets by Reportable Segment
Total assets	258,424,000	258,424,000		258,424,000		242,686,000
Skilled Nursing Facilities [Member]
Revenues:
Resident fees and services		0	0	0	0
Real estate revenue		3,667,000	3,728,000	7,326,000	7,467,000
Total revenues		3,667,000	3,728,000	7,326,000	7,467,000
Expenses:
Property operating expenses		0	0	0	0
Rental expenses		368,000	395,000	730,000	816,000
Segment net operating income		3,299,000	3,333,000	6,596,000	6,651,000
Assets by Reportable Segment
Total assets	126,155,000	126,155,000		126,155,000		127,809,000
Hospitals [Member]
Revenues:
Resident fees and services		0	0	0	0
Real estate revenue		2,757,000	3,354,000	5,668,000	6,633,000
Total revenues		2,757,000	3,354,000	5,668,000	6,633,000
Expenses:
Property operating expenses		0	0	0	0
Rental expenses		134,000	419,000	285,000	821,000
Segment net operating income		2,623,000	$ 2,935,000	5,383,000	$ 5,812,000
Assets by Reportable Segment
Total assets	115,623,000	115,623,000		115,623,000		118,685,000
Other Segments [Member]
Assets by Reportable Segment
Total assets	$ 7,999,000	$ 7,999,000		$ 7,999,000		$ 3,600,000

Concentration of Credit Risk -

Concentration of Credit Risk - Additional Information (Detail)	Jun. 30, 2019segmentState	Jun. 30, 2019segmentState
Concentration of Credit Risk
Number of states accounted for ten percent | State	2	2
Minimum percent share of each state annualized base rent that company owned	10.00%	10.00%
Number of reportable segments | segment	6	6
Minimum percent share of annualized base rent accounted by tenants	10.00%	10.00%
Integrated Senior Health Campuses [Member]
Concentration of Credit Risk
Percentage of annual base rent	48.50%	48.50%
Medical Office Building [Member]
Concentration of Credit Risk
Percentage of annual base rent	26.80%	26.80%
Senior Housing-RIDEA [Member]
Concentration of Credit Risk
Percentage of annual base rent	8.80%	8.80%
Senior Housing [Member]
Concentration of Credit Risk
Percentage of annual base rent	6.80%	6.80%
Skilled Nursing Facilities [Member]
Concentration of Credit Risk
Percentage of annual base rent	5.30%	5.30%
Hospitals [Member]
Concentration of Credit Risk
Percentage of annual base rent	3.80%	3.80%
Indiana [Member]
Concentration of Credit Risk
Percentage of annual base rent	33.80%	33.80%
OHIO [Member]
Concentration of Credit Risk
Percentage of annual base rent	10.30%	10.30%

Per Share Data (Detail)

Per Share Data (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Participating securities, distributed and undistributed earnings (loss), basic	$ 7	$ 6	$ 14	$ 13
Restricted Common Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share			46,500	44,500
Redeemable Limited Partnership Units [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share			222	222