Leases (Tables)

12 Months Ended

Dec. 31, 2020

Commitments and Contingencies Disclosure [Abstract]

Lease cost

A summary of operating and financing lease expense (including the respective presentation on the consolidated statements of operations) and net cash paid from leasing transactions is as follows:

	Years Ended December 31,
Operating Leases (in thousands)	2020		2019
Facility operating expense	$	19,241	$	18,677
Facility lease expense	224,033		269,666
Operating lease expense	243,274		288,343
Operating lease expense adjustment (1)	136,276		19,453
Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements	(22,242)		(31,305)
Operating cash flows from operating leases	$	357,308	$	276,491

(1) Represents the difference between the amount of cash operating lease payments and the amount of operating lease expense recognized in accordance with ASC 842. Operating cash flows from operating leases for the year ended December 31, 2020 includes the $119.2 million one-time cash lease payment made to Ventas in connection with the Company's lease restructuring transaction effective July 26, 2020.

	Years Ended December 31,
Financing Leases (in thousands)	2020		2019
Depreciation and amortization	$	32,647	$	46,646
Interest expense: financing lease obligations	48,534		66,353
Financing lease expense	$	81,181	$	112,999
Operating cash flows from financing leases	$	48,534	$	66,353
Financing cash flows from financing leases	18,867		22,242
Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement	(5,603)		(3,504)
Total cash flows from financing leases	$	61,798	$	85,091

Summary of facility operating leases

A summary of facility lease expense and the impact of operating lease expense adjustment, under ASC 840, and deferred gains are as follows:

(in thousands)	Year Ended December 31, 2018
Cash basis payment - operating leases	$	324,870
Operating lease expense adjustment	(17,218)
Amortization of deferred gain	(4,358)
Facility lease expense	$	303,294

Lessee, operating Lease, liability, maturity

The aggregate amounts of future minimum lease payments, including community, office, and equipment leases, recognized on the consolidated balance sheet as of December 31, 2020 are as follows (in thousands):

Year Ending December 31,	Operating Leases		Financing Leases
2021	$	209,787	$	64,914
2022	192,771		65,521
2023	192,381		66,250
2024	191,991		67,460
2025	189,961		57,499
Thereafter	280,233		109,590
Total lease payments	1,257,124		431,234
Purchase option liability and non-cash gain on future sale of property	—		413,426
Imputed interest and variable lease payments	(291,469)		(281,353)
Total lease obligations	$	965,655	$	563,307