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Supplemental Disclosure of Cash Flow Information (Tables)
 12 Months Ended
Dec. 31, 2024
Supplemental Cash Flow Elements [Abstract]  
Schedule of Supplemental Disclosure of Cash Flow Information
(in thousands)For the Years Ended December 31,
Supplemental Disclosure of Cash Flow Information:202420232022
Interest paid$243,071 $231,786 $200,308 
Income taxes paid, net of (refunds)$1,051 $(1,429)$(330)
Capital expenditures, net of related payables:
Capital expenditures - non-development, net$186,755 $216,511 $168,166 
Capital expenditures - development, net637 1,762 6,193 
Capital expenditures - non-development - reimbursable from lessor16,958 10,319 25,650 
Trade accounts payable(3,100)4,613 (3,085)
Net cash paid$201,250 $233,205 $196,924 
Acquisition of assets, net of cash acquired:
Prepaid expenses and other assets, net$— $23 $— 
Property, plant and equipment and leasehold intangibles, net277,997 6,872 4 
Investment in unconsolidated ventures— (3,395)— 
Operating lease right-of-use assets(51,968)— — 
Long-term debt(188,634)— — 
Financing lease obligations— — 6,000 
Operating lease obligations71,016 — — 
Other liabilities— (384)— 
Other non-operating loss (income)— (2,542)— 
Net cash paid$108,411 $574 $6,004 
Proceeds from sale of assets, net:
Prepaid expenses and other assets, net$(362)$(1,889)$(1,308)
Assets held for sale— — (3,668)
Property, plant and equipment and leasehold intangibles, net(6,291)(36,545)(107)
Investment in unconsolidated ventures— (27,392)— 
Refundable fees and deferred revenue— 9,347 — 
Other liabilities559 10,690 1,025 
Non-operating loss (gain) on sale of assets, net(923)(1,441)(595)
Loss (gain) on sale of communities, net— (36,296)— 
Net cash received$(7,017)$(83,526)$(4,653)

Supplemental Schedule of Non-cash Operating, Investing and Financing Activities:
For the Years Ended December 31,
(in thousands)202420232022
Non-cash lease transactions, net:
Property, plant and equipment and leasehold intangibles, net$146,571 $(51,518)$(209,379)
Operating lease right-of-use assets660,756 223,309 103,060 
Operating lease obligations(654,352)(260,611)(107,820)
Financing lease obligations(152,975)88,820 287,989 
Loss (gain) on sale of assets, net— — (73,850)
Net$— $— $— 
Schedule of Cash and Restricted Cash
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 general and professional liability programs, property insurance programs and workers' compensation programs, and regulatory reserves for certain CCRCs. The components of restricted cash are as follows.

 December 31,
(in thousands)20242023
Current:  
Interest rate cap escrows$16,861 $17,843 
Real estate tax and property insurance escrows16,307 16,061 
Replacement reserve escrows6,452 7,194 
Other251 243 
Subtotal39,871 41,341 
Non-current:
Insurance deposits17,508 15,961 
CCRCs escrows11,277 10,813 
Debt service reserve2,147 3,472 
Letters of credit collateral112 110 
Subtotal31,044 30,356 
      Total$70,915 $71,697 

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)20242023
Reconciliation of cash, cash equivalents, and restricted cash:
Cash and cash equivalents$308,925 $277,971 
Restricted cash - current39,871 41,341 
Restricted cash - non-current31,044 30,356 
Total cash, cash equivalents, and restricted cash$379,840 $349,668