Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands		6 Months Ended
		Jun. 30, 2016		Jun. 30, 2015
Operating activities
Net income (loss)		$ 376,223		$ 539,880
Adjustments to reconcile net income to net cash provided from (used in) operating activities:
Depreciation and amortization		455,265		397,631
Other amortization expenses		3,141		2,458
Asset Impairment Charges		14,314		2,220
Stock-based compensation expense		15,217		20,178
Loss (gain) on derivatives, net		0	[1]	(58,427)
Loss (gain) on extinguishment of debt, net		9		34,288
Income from unconsolidated entities		5,778		15,600
Rental income in excess of cash received		(54,055)		(57,047)
Amortization related to above (below) market leases, net		332		870
Net loss (gain) on sales of properties		(1,530)		(246,956)
Distributions by unconsolidated entities		351		282
Increase (decrease) in accrued expenses and other liabilities		36,705		10,417
Decrease (increase) in receivables and other assets		(3,009)		(42,048)
Net cash provided from (used in) operating activities		848,741		619,346
Investing activities
Cash disbursed for acquisitions		(287,455)		(2,153,970)
Cash disbursed for capital improvements to existing properties		(87,529)		(67,086)
Cash disbursed for construction in progress		(249,867)		(114,478)
Capitalized interest		(7,343)		(4,446)
Investment in real estate loans receivable		(51,059)		(416,588)
Other investments, net of payments		(16,664)		(110,531)
Principal collected on real estate loans receivable		168,343		37,342
Contributions to unconsolidated entities		(39,644)		(117,047)
Distributions by unconsolidated entities		19,301		116,288
Proceeds from (payments on) derivatives investing		56,842		72,477
Decrease (increase) in restricted cash		3,342		12,422
Proceeds from sales of real property		130,298		523,175
Net cash provided from (used in) investing activities		(361,435)		(2,222,442)
Financing activities
Net increase (decrease) under unsecured lines of credit arrangements		(90,000)		350,000
Proceeds from issuance of senior unsecured notes		693,560		743,407
Payments to extinguish senior unsecured notes		(400,000)		(477,550)
Secured debt issued		161,992		136,801
Payments on secured debt		(281,051)		(323,950)
Net proceeds from the issuance of common stock		159,032		1,562,350
Decrease (increase) in deferred loan costs		(17,439)		(5,285)
Contributions by noncontrolling interests	[2]	138,458		4,926
Distributions to noncontrolling interests	[2]	(91,133)		(19,371)
Acquisitions of noncontrolling interests		0		(4,741)
Cash distributions to stockholders		(645,866)		(594,617)
Other financing activities		(730)		(27,253)
Net cash provided from (used in) financing activities		(373,177)		1,344,717
Effect of foreign currency translation on cash and cash equivalents		(8,452)		2,595
Increase (decrease) in cash and cash equivalents		105,677		(255,784)
Cash and cash equivalents at beginning of period		360,908		473,726
Cash and cash equivalents at end of period		466,585		217,942
Supplemental cash flow information:
Interest paid		236,861		208,885
Income taxes paid		$ 3,889		$ 10,140

[1] (1) In April 2011, we completed the acquisition of substantially all of the real estate assets of privately-owned Genesis Healthcare Corporation. In conjunction with this transaction, we received the option to acquire an ownership interest in Genesis Healthcare. In February 2015, Genesis Healthcare closed on a transaction to merge with Skilled Healthcare Group to become a publicly traded company which required us to record the value of the derivative asset due to the net settlement feature.

[2] (1) Includes amounts attributable to redeemable noncontrolling interests.