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Segment Information
 9 Months Ended
Sep. 30, 2020
Segment Reporting [Abstract]  
Segment Information Segment Information
The Company has five reportable segments: Independent Living; Assisted Living and Memory Care; CCRCs; Health Care Services; and Management Services. Operating segments are defined as components of an enterprise that engage in business activities from which it may earn revenues and incur expenses; for which separate financial information is available; and whose operating results are regularly reviewed by the chief operating decision maker to assess the performance of the individual segment and make decisions about resources to be allocated to the segment.

Independent Living. The Company's Independent Living segment includes owned or leased communities that are primarily designed for middle to upper income seniors who desire an upscale residential environment providing the highest quality of service. The majority of the Company's independent living communities consist of both independent and assisted living units in a single community, which allows residents to age-in-place by providing them with a continuum of senior independent and assisted living services.

Assisted Living and Memory Care. The Company's Assisted Living and Memory Care segment includes owned or leased communities that offer housing and 24-hour assistance with activities of daily life to mid-acuity frail and elderly residents. Assisted living and memory care communities include both freestanding, multi-story communities and freestanding, single story communities. The Company also provides memory care services at freestanding memory care communities that are specially designed for residents with Alzheimer's disease and other dementias.

CCRCs. The Company's CCRCs segment includes large owned or leased communities that offer a variety of living arrangements and services to accommodate all levels of physical ability and health. Most of the Company's CCRCs have independent living, assisted living, and skilled nursing available on one campus or within the immediate market, and some also include memory care services.
Health Care Services. The Company's Health Care Services segment includes the home health, hospice, and outpatient therapy services, as well as education and wellness programs, provided to residents of many of the Company's communities and to seniors living outside of the Company's communities. The Health Care Services segment does not include the skilled nursing and inpatient healthcare services provided in the Company's skilled nursing units, which are included in the Company's CCRCs segment.

Management Services. The Company's Management Services segment includes communities operated by the Company pursuant to management agreements. In some of the cases, the controlling financial interest in the community is held by third parties and, in other cases, the community is owned in a venture structure in which the Company has an ownership interest. Under the management agreements for these communities, the Company receives management fees as well as reimbursed expenses, which represent the reimbursement of expenses it incurs on behalf of the owners.

The following table sets forth selected segment financial and operating data:
Three Months Ended
September 30,		Nine Months Ended
September 30,
(in thousands)2020201920202019
Revenue and other operating income:
Independent Living(1)(2)
$125,858 $136,874 $391,998 $408,519 
Assisted Living and Memory Care(1)(2)
410,631 452,474 1,300,418 1,361,225 
CCRCs(1)(2)
79,252 100,104 262,370 305,084 
Health Care Services(1)(2)
95,795 111,785 297,779 337,751 
Management Services(3)
96,444 207,712 435,463 657,871 
Total revenue and other operating income$807,980 $1,008,949 $2,688,028 $3,070,450 
Segment operating income:(4)
Independent Living$42,438 $49,414 $134,890 $153,749 
Assisted Living and Memory Care87,152 116,856 306,861 390,699 
CCRCs9,954 14,472 43,735 53,956 
Health Care Services1,462 4,778 2,033 22,118 
Management Services5,669 13,564 120,460 44,756 
Total segment operating income146,675 199,084 607,979 665,278 
General and administrative expense (including non-cash stock-based compensation expense)
54,138 56,409 161,251 170,296 
Facility operating lease expense51,620 67,253 178,480 203,610 
Depreciation and amortization87,821 93,550 271,713 284,462 
Asset impairment:
Independent Living— — 31,317 — 
Assisted Living and Memory Care8,213 802 51,301 2,340 
CCRCs— 1,252 12,173 1,252 
Corporate and Management Services— 40 1,938 2,662 
Total asset impairment8,213 2,094 96,729 6,254 
Loss (gain) on facility lease termination and modification, net— — — 2,006 
Income (loss) from operations$(55,117)$(20,222)$(100,194)$(1,350)
As of
(in thousands)September 30, 2020December 31, 2019
Total assets:
Independent Living$1,434,312 $1,441,652 
Assisted Living and Memory Care3,853,458 4,157,610 
CCRCs759,743 742,809 
Health Care Services238,621 256,715 
Corporate and Management Services721,793 595,647 
Total assets$7,007,927 $7,194,433 

(1)All revenue and other operating income is earned from external third parties in the United States.

(2)The Independent Living, Assisted Living and Memory Care, CCRCs, and Health Care Services segments include $0.1 million, $1.9 million, $2.8 million, and $5.9 million respectively, for the three months ended September 30, 2020 and $0.1 million, $2.1 million, $12.4 million, and $22.9 million respectively, for the nine months ended September 30, 2020, of other operating income recognized for grants pursuant to the Provider Relief Fund described in Note 3 and other government sources. Allocations to the applicable segment reflect the segment's receipt and acceptance of the amounts and the Company's estimates of its satisfaction of the conditions of grant during the period.

(3)Management services segment revenue includes management fees and reimbursements of costs incurred on behalf of managed communities.
(4)Segment operating income is defined as segment revenues and other operating income less segment facility operating expense (excluding depreciation and amortization) and costs incurred on behalf of managed communities.