Supplemental Disclosure of Cash Flow Information

12 Months Ended

Dec. 31, 2023

Supplemental Cash Flow Elements [Abstract]

Supplemental Disclosure of Cash Flow Information

18. Supplemental Disclosure of Cash Flow Information

(in thousands)	For the Years Ended December 31,
Supplemental Disclosure of Cash Flow Information:	2023		2022		2021
Interest paid	$	231,786	$	200,308	$	188,791
Income taxes paid, net of (refunds)	$	(1,429)	$	(330)	$	5,923
Capital expenditures, net of related payables:
Capital expenditures - non-development, net	$	216,511	$	168,166	$	137,410
Capital expenditures - development, net	1,762		6,193		3,208
Capital expenditures - non-development - reimbursable from lessor	10,319		25,650		42,100
Trade accounts payable	4,613		(3,085)		(6,061)
Net cash paid	$	233,205	$	196,924	$	176,657

	For the Years Ended December 31,
(in thousands)	2023		2022		2021
Acquisition of assets, net of cash acquired:
Prepaid expenses and other assets, net	$	23	$	—	$	—
Property, plant and equipment and leasehold intangibles, net	6,872		4		—
Investment in unconsolidated ventures	(3,395)		—		—
Financing lease obligations	—		6,000		—
Other liabilities	(384)		—		—
Other non-operating loss (income)	(2,542)		—		—
Net cash paid	$	574	$	6,004	$	—
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 other assets, net:
Prepaid expenses and other assets, net	$	(1,889)	$	(1,308)	$	(1,983)
Assets held for sale	—		(3,668)		(16,166)
Property, plant and equipment and leasehold intangibles, net	(36,545)		(107)		(878)
Investment in unconsolidated ventures	(27,392)		—		—
Refundable fees and deferred revenue	9,347		—		—
Other liabilities	10,690		1,025		(75)
Non-operating loss (gain) on sale of assets, net	(1,441)		(595)		(2,346)
Loss (gain) on sale of communities, net	(36,296)		—		—
Net cash received	$	(83,526)	$	(4,653)	$	(21,448)

Supplemental Schedule of Non-cash Operating, Investing and Financing Activities:
	For the Years Ended December 31,
(in thousands)	2023		2022		2021
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	$	(51,518)	$	11,098	$	4,056
Operating lease right-of-use assets	223,309		11,419		17,197
Operating lease obligations	(260,611)		(16,179)		(17,197)
Financing lease obligations	88,820		(6,338)		(4,056)
Net	$	—	$	—	$	—

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

	December 31,
(in thousands)	2023		2022
Current:
Interest rate cap escrows	$	17,843	$	3,797
Real estate tax and property insurance escrows	16,061		15,722
Replacement reserve escrows	7,194		7,999
Other	243		217
Subtotal	41,341		27,735
Long term:
Insurance deposits	15,961		18,230
CCRCs escrows	10,813		15,847
Debt service reserve	3,472		13,779
Letters of credit collateral	110		107
Subtotal	30,356		47,963
Total	$	71,697	$	75,698

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)	2023		2022
Reconciliation of cash, cash equivalents, and restricted cash:
Cash and cash equivalents	$	277,971	$	398,850
Restricted cash	41,341		27,735
Long-term restricted cash	30,356		47,963
Total cash, cash equivalents, and restricted cash	$	349,668	$	474,548