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Debt (Details)
$ in Thousands, £ in Millions
12 Months Ended
Dec. 01, 2015
USD ($)
Jun. 08, 2015
USD ($)
May. 20, 2015
USD ($)
Mar. 01, 2015
USD ($)
Jan. 21, 2015
USD ($)
Jan. 12, 2015
GBP (£)
Aug. 14, 2014
USD ($)
Jun. 14, 2014
USD ($)
Feb. 21, 2014
USD ($)
Feb. 01, 2014
USD ($)
Jul. 30, 2012
GBP (£)
Dec. 31, 2015
USD ($)
Dec. 31, 2015
GBP (£)
item
Dec. 31, 2015
USD ($)
item
Jan. 12, 2015
USD ($)
Dec. 31, 2014
USD ($)
Debt Instrument                                
Bank line of credit                           $ 397,432   $ 838,516
Debt instruments, carrying amount                           10,974,558    
Term of the interest rate swap agreement           3 years                    
Repayments of Lines of Credit                       $ 511,521        
Senior unsecured notes                           9,120,107   7,589,960
Total debt before discount, net                           11,056,810    
Discounts, net                           (82,252)    
Other debt                           94,445   $ 97,022
Debt maturing in 2016                                
Debt Instrument                                
2015                           1,381,228    
Debt maturing in 2017                                
Debt Instrument                                
2016                           1,331,891    
Debt maturing in 2018                                
Debt Instrument                                
2017                           1,004,015    
Debt maturing in 2019                                
Debt Instrument                                
2018                           776,506    
Debt maturing in 2020                                
Debt Instrument                                
2019                           802,078    
Thereafter                                
Debt Instrument                                
Thereafter                           $ 5,761,092    
Line of Credit and Term Loan                                
Debt Instrument                                
Debt instrument, covenant debt to assets (as a percent)                         60.00% 60.00%    
Debt instrument, covenant secured debt to assets (as a percent)                         30.00% 30.00%    
Debt instrument, covenant unsecured debt to unencumbered assets (as a percent)                         60.00% 60.00%    
Debt instrument, covenant minimum fixed charge coverage ratio                         1.5 1.5    
Debt instrument, covenant net worth                           $ 9,500,000    
Bank Line of Credit                                
Debt Instrument                                
Line of credit facility, maximum borrowing capacity                           $ 2,000,000    
Extended debt instrument term                       1 year        
Debt instrument, basis spread on variable rate (as a percent)                       0.925%        
Debt instrument, facility fee (as a percent)                       0.15%        
Line of credit facility additional aggregate amount, maximum                       $ 500,000        
Bank line of credit | £                         £ 270      
Weighted-average interest rate (as a percent)                         1.72% 1.72%    
Debt instruments, carrying amount                           $ 397,432    
Repayments of Lines of Credit | £           £ 220                    
Total debt before discount, net                           397,432    
Bank Line of Credit | Debt maturing in 2018                                
Debt Instrument                                
2017                           397,432    
Term loans                                
Debt Instrument                                
Debt instruments, carrying amount                           524,807    
2016 | £                         £ 357      
2019 | £                         £ 357      
Total debt before discount, net                           526,468    
Discounts, net                           (1,661)    
Term loans | Debt maturing in 2016                                
Debt Instrument                                
2015                           202,034    
Term loans | Debt maturing in 2019                                
Debt Instrument                                
2018                           324,434    
2012 Term Loan                                
Debt Instrument                                
Debt instrument, basis spread on variable rate (as a percent)                     1.20%          
Debt instruments, carrying amount                     £ 137     $ 202,000    
Maturity period of debt instruments                     4 years          
Debt instrument, variable rate basis                     GBP LIBOR          
Length of debt instrument extension period                     1 year          
2012 Term Loan | Interest-rate swap contracts                                
Debt Instrument                                
Term of the interest rate swap agreement                     4 years          
Derivative, fixed interest rate (as a percent)                     1.81%          
2015 Term Loan [Member]                                
Debt Instrument                                
Debt instrument, basis spread on variable rate (as a percent)           0.975%                    
Maturity period of debt instruments           4 years                    
Debt instrument, variable rate basis           GBP LIBOR                    
Derivative, fixed interest rate (as a percent)           1.79%                 1.79%  
Length of debt instrument extension period           1 year                    
Senior unsecured notes           £ 220                 $ 323,000  
Senior Unsecured Notes                                
Debt Instrument                                
Weighted-average interest rate (as a percent)                         4.68% 4.68%    
Debt instruments, carrying amount                           $ 9,120,107    
Debt Instrument, Interest Rate, Stated Percentage                         4.68% 4.68%    
Total debt before discount, net                           $ 9,200,000    
Discounts, net                           $ (79,893)    
Weighted-average maturity                       6 years        
Senior Unsecured Notes | Minimum                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage                         2.79% 2.79%    
Senior Unsecured Notes | Maximum                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage                         6.88% 6.88%    
Senior Unsecured Notes | Debt maturing in 2016                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage                         5.09% 5.09%    
2015                           $ 900,000    
Senior Unsecured Notes | Debt maturing in 2017                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage                         6.02% 6.02%    
2016                           $ 750,000    
Senior Unsecured Notes | Debt maturing in 2018                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage                         6.81% 6.81%    
2017                           $ 600,000    
Senior Unsecured Notes | Debt maturing in 2019                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage                         3.97% 3.97%    
2018                           $ 450,000    
Senior Unsecured Notes | Debt maturing in 2020                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage                         2.79% 2.79%    
2019                           $ 800,000    
Senior Unsecured Notes | Thereafter                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage                         4.54% 4.54%    
Thereafter                           $ 5,700,000    
Senior Unsecured, 3.40% notes due 2025                                
Debt Instrument                                
Debt Instrument, Face Amount         $ 600,000                      
Debt Instrument, Interest Rate, Stated Percentage         3.40%                      
Proceeds from Issuance of Long-term Debt         $ 591,000                      
Senior Unsecured 4.0% notes due 2025                                
Debt Instrument                                
Debt Instrument, Face Amount     $ 750,000                          
Debt Instrument, Interest Rate, Stated Percentage     4.00%                          
Proceeds from Issuance of Long-term Debt     $ 739,000                          
Senior Unsecured, 4.0% notes due 2022                                
Debt Instrument                                
Debt Instrument, Face Amount $ 600,000                              
Debt Instrument, Interest Rate, Stated Percentage 4.00%                              
Proceeds from Issuance of Long-term Debt $ 594,000                              
Senior Unsecured, 3.875% notes due 2024                                
Debt Instrument                                
Debt Instrument, Face Amount             $ 800,000                  
Debt Instrument, Interest Rate, Stated Percentage             3.875%                  
Proceeds from Issuance of Long-term Debt             $ 792,000                  
Senior Unsecured, 4.20% notes due 2024                                
Debt Instrument                                
Debt Instrument, Face Amount                 $ 350,000              
Debt Instrument, Interest Rate, Stated Percentage                 4.20%              
Proceeds from Issuance of Long-term Debt                 $ 346,000              
Senior Unsecured Debt 6.0 Percent Incepted March 1, 2015                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage       6.00%                        
Repayments of Senior Debt       $ 200,000                        
Senior Unsecured Debt 7.07 Percent Incepted June 8, 2015 [Member]                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage   7.072%                            
Repayments of Senior Debt   $ 200,000                            
Senior Unsecured Debt 6.0 Percent Incepted June 14, 2014                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage               6.00%                
Repayments of Senior Debt               $ 62,000                
Senior Unsecured, 2.70% notes due 2014                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage                   2.70%            
Repayments of Senior Debt                   $ 400,000            
Mortgage Debt                                
Debt Instrument                                
Weighted-average interest rate (as a percent)                         6.21% 6.21%    
Debt instruments, carrying amount                           $ 932,212    
Debt Instrument, Interest Rate, Stated Percentage                         6.21% 6.21%    
Number of healthcare facilities used to secure debt | item                         62 62    
Debt instrument, collateral, healthcare facilities carrying value                           $ 1,200,000    
Total debt before discount, net                           932,910    
Discounts, net                           $ (698)    
Weighted-average maturity                       2 years        
Mortgage Debt | Minimum                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage                         3.14% 3.14%    
Mortgage Debt | Maximum                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage                         8.35% 8.35%    
Mortgage Debt | Debt maturing in 2016                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage                         6.84% 6.84%    
2015                           $ 279,194    
Mortgage Debt | Debt maturing in 2017                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage                         6.08% 6.08%    
2016                           $ 581,891    
Mortgage Debt | Debt maturing in 2018                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage                         5.90% 5.90%    
2017                           $ 6,583    
Mortgage Debt | Debt maturing in 2019                                
Debt Instrument                                
2018                           $ 2,072    
Mortgage Debt | Debt maturing in 2020                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage                         5.14% 5.14%    
2019                           $ 2,078    
Mortgage Debt | Thereafter                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage                         4.98% 4.98%    
Thereafter                           $ 61,092    
Demand Note                                
Debt Instrument                                
Debt Instrument, Interest Rate, Stated Percentage                         4.50% 4.50%    
Proceeds from Issuance of Long-term Debt                       $ 28,000        
Non-interest Bearing Life Care Bonds                                
Debt Instrument                                
Other debt                           $ 66,000    
Number of CCRC issuing non-interest life care bonds | item                         2 2    
Number of facilities with non-interest bearing occupancy fee deposits | item                         2 2