CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Cash flows from operating activities:
Net income (loss)	$ 493,354	$ 278,008
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Depreciation and amortization of real estate, in-place lease, and other intangibles	506,172	541,394
Amortization of stock-based compensation	13,895	13,392
Amortization of deferred financing costs	6,677	7,670
Straight-line rents	(23,627)	(24,086)
Amortization of nonrefundable entrance fees and above/below market lease intangibles	(68,854)	(58,849)
Equity loss (income) from unconsolidated joint ventures	(9,508)	48,545
Distributions of earnings from unconsolidated joint ventures	4,731	11,928
Loss (gain) on sale of real estate under direct financing leases	0	(41,670)
Deferred income tax expense (benefit)	(3,999)	(8,245)
Impairments and loan loss reserves (recoveries), net	37,194	97,723
Loss (gain) on debt extinguishments	225,824	42,912
Loss (gain) on sales of real estate, net	(598,531)	(247,881)
Loss (gain) upon change of control, net	(1,042)	(173,222)
Casualty-related loss (recoveries), net	1,632	469
Other non-cash items	(8,640)	653
Changes in:
Decrease (increase) in accounts receivable and other assets, net	27,576	22,503
Increase (decrease) in accounts payable, accrued liabilities, and deferred revenue	(31,519)	28,480
Net cash provided by (used in) operating activities	571,335	539,724
Cash flows from investing activities:
Acquisitions of real estate	(978,473)	(340,405)
Development, redevelopment, and other major improvements of real estate	(430,510)	(577,524)
Leasing costs, tenant improvements, and recurring capital expenditures	(72,112)	(61,329)
Proceeds from sales of real estate, net	2,383,017	568,828
Acquisition of CCRC Portfolio	0	(394,177)
Contributions to unconsolidated joint ventures	(12,828)	(9,792)
Distributions in excess of earnings from unconsolidated joint ventures	37,139	6,200
Proceeds from sales/principal repayments on loans receivable and direct financing leases	291,223	125,372
Investments in loans receivable and other	(13,781)	(83,651)
Net cash provided by (used in) investing activities	1,203,675	(766,478)
Cash flows from financing activities:
Borrowings under bank line of credit and commercial paper	12,931,450	2,025,600
Repayments under bank line of credit and commercial paper	(12,037,040)	(2,118,600)
Issuance and borrowings of debt, excluding bank line of credit and commercial paper	591,546	594,750
Repayments and repurchase of debt, excluding bank line of credit and commercial paper	(2,421,598)	(559,725)
Payments for debt extinguishment and deferred financing costs	(232,306)	(47,149)
Issuance of common stock and exercise of options	4,713	1,067,706
Repurchase of common stock	(12,553)	(10,273)
Dividends paid on common stock	(488,084)	(587,596)
Distributions to and purchase of noncontrolling interests	(24,443)	(22,925)
Contributions from and issuance of noncontrolling interests	426	0
Net cash provided by (used in) financing activities	(1,687,889)	341,788
Effect of foreign exchanges on cash, cash equivalents and restricted cash	0	(153)
Net increase (decrease) in cash, cash equivalents and restricted cash	87,121	114,881
Cash, cash equivalents and restricted cash, beginning of period	181,685	184,657
Cash, cash equivalents and restricted cash, end of period	$ 268,806	$ 299,538