Supplemental Disclosure of Cash Flow Information

12 Months Ended

Dec. 31, 2022

Supplemental Cash Flow Elements [Abstract]

Supplemental Disclosure of Cash Flow Information

20. Supplemental Disclosure of Cash Flow Information

(in thousands)	For the Years Ended December 31,
Supplemental Disclosure of Cash Flow Information:	2022		2021		2020
Interest paid	$	200,308	$	188,791	$	204,696
Income taxes paid, net of refunds	$	(330)	$	5,923	$	8,878
Capital expenditures, net of related payables:
Capital expenditures - non-development, net	$	168,166	$	137,410	$	139,592
Capital expenditures - development, net	6,193		3,208		13,667
Capital expenditures - non-development - reimbursable	25,650		42,100		27,846
Trade accounts payable	(3,085)		(6,061)		4,766
Net cash paid	$	196,924	$	176,657	$	185,871
Acquisition of communities from Healthpeak:
Property, plant and equipment and leasehold intangibles, net	$	—	$	—	$	286,734
Operating lease right-of-use assets	—		—		(63,285)
Financing lease obligations	—		—		129,196
Operating lease obligations	—		—		74,335
Loss (gain) on debt modification and extinguishment, net	—		—		(19,731)
Net cash paid	$	—	$	—	$	407,249

	For the Years Ended December 31,
(in thousands)	2022		2021		2020
Acquisition of other assets:
Property, plant and equipment and leasehold intangibles, net	$	4	$	—	$	684
Financing lease obligations	6,000		—		64,260
Net cash paid	$	6,004	$	—	$	64,944
Proceeds from HCS Sale, net:
Accounts receivable, net	$	—	$	(57,582)	$	—
Property, plant and equipment and leasehold intangibles, net	—		(1,806)		—
Operating lease right-of-use assets	—		(8,145)		—
Investment in unconsolidated ventures	—		100,000		—
Goodwill	—		(126,810)		—
Prepaid expenses and other assets, net	—		(32,963)		—
Trade accounts payable	—		1,387		—
Accrued expenses	—		25,226		—
Refundable fees and deferred revenue	—		57,314		—
Operating lease obligations	—		8,145		—
Other liabilities	—		9,165		—
Non-operating loss (gain) on sale of assets, net	—		(286,489)		—
Net cash received	$	—	$	(312,558)	$	—
Proceeds from sale of CCRC Venture, net:
Investment in unconsolidated ventures	$	—	$	—	$	(14,848)
Current portion of long-term debt	—		—		34,706
Other liabilities	—		—		60,748
Non-operating loss (gain) on sale of assets, net	—		—		(369,831)
Net cash received	$	—	$	—	$	(289,225)
Proceeds from sale of other assets, net:
Prepaid expenses and other assets, net	$	(1,308)	$	(1,983)	$	(1,318)
Assets held for sale	(3,668)		(16,166)		(34,348)
Property, plant and equipment and leasehold intangibles, net	(107)		(878)		(938)
Other liabilities	1,025		(75)		(786)
Non-operating loss (gain) on sale of assets, net	(595)		(2,346)		(4,701)
Net cash received	$	(4,653)	$	(21,448)	$	(42,091)
Master Agreement with Ventas:
Property, plant and equipment and leasehold intangibles, net	$	—	$	—	$	(66,444)
Operating lease right-of-use assets	—		—		(153,213)
Other assets, net	—		—		(42,354)
Long-term debt	—		—		34,053
Financing lease obligations	—		—		7,077
Operating lease obligations	—		—		362,944
Additional paid-in-capital	—		—		(22,883)
Net cash paid	$	—	$	—	$	119,180

Supplemental Schedule of Non-cash Operating, Investing and Financing Activities:
	For the Years Ended December 31,
(in thousands)	2022		2021		2020
Assets designated as held for sale:
Assets held for sale	$	—	$	3,612	$	7,935
Property, plant and equipment and leasehold intangibles, net	—		(3,612)		(7,935)
Net	$	—	$	—	$	—
Healthpeak master lease modification:
Property, plant and equipment and leasehold intangibles, net	$	—	$	—	$	(57,462)
Operating lease right-of-use assets	—		—		88,044
Financing lease obligations	—		—		70,874
Operating lease obligations	—		—		(101,456)
Net	$	—	$	—	$	—
Gain on sale for master lease amendment:
Property, plant and equipment and leasehold intangibles, net	$	(220,477)	$	—	$	—
Operating lease right-of-use assets	91,641		—		—
Financing lease obligations	294,327		—		—
Operating lease obligations	(91,641)		—		—
Loss (gain) on sale of communities, net	(73,850)		—		—
Net	$	—	$	—	$	—
Other non-cash lease transactions, net:
Property, plant and equipment and leasehold intangibles, net	11,098		4,056		10,707
Operating lease right-of-use assets	11,419		17,197		(7,941)
Operating lease obligations	(16,179)		(17,197)		15,126
Financing lease obligations	(6,338)		(4,056)		(15,483)
Other liabilities	—		—		(77)
Loss (gain) on facility operating lease termination, net	—		—		(2,332)
Net	$	—	$	—	$	—

Restricted cash consists principally of deposits as security for self-insured retention risk under workers' compensation programs and property insurance programs, escrow deposits for real estate taxes, property insurance, and capital expenditures, regulatory reserves for certain CCRCs, and debt service reserve accounts required by certain lenders under mortgage debt agreements. The components of restricted cash are as follows.

	December 31,
(in thousands)	2022		2021
Current:
Real estate tax and property insurance escrows	$	15,722	$	16,272
Replacement reserve escrows	7,999		9,756
Interest rate cap escrows	3,797		585
Other	217		232
Subtotal	27,735		26,845
Long term:
Insurance deposits	18,230		30,932
CCRCs escrows	15,847		15,346
Debt service reserve	13,779		18,053
Letters of credit collateral	107		107
Subtotal	47,963		64,438
Total	$	75,698	$	91,283

The following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the consolidated balance sheets that sums to the total of the same such amounts shown in the consolidated statements of cash flows.

	December 31,
(in thousands)	2022		2021
Reconciliation of cash, cash equivalents, and restricted cash:
Cash and cash equivalents	$	398,850	$	347,031
Restricted cash	27,735		26,845
Long-term restricted cash	47,963		64,438
Total cash, cash equivalents, and restricted cash	$	474,548	$	438,314