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Real Estate Loans Receivable (Tables)
9 Months Ended
Sep. 30, 2017
Real Estate Loans Receivable (Tables) [Abstract]  
Summary of real estate loan activity
Nine Months Ended
September 30, 2017September 30, 2016
OutpatientOutpatient
Triple-netMedicalTotalsTriple-netMedicalTotals
Advances on real estate loans receivable:
Investments in new loans$11,315$-$11,315$8,223$-$8,223
Draws on existing loans58,736-58,73694,6222,65197,273
Net cash advances on real estate loans70,051-70,051102,8452,651105,496
Receipts on real estate loans receivable:
Loan payoffs142,39260,500202,892251,29327,303278,596
Principal payments on loans1,121-1,1216,553-6,553
Sub-total143,51360,500204,013257,84627,303285,149
Less: Non-cash activity(1)(2)(61,250)(60,500)(121,750)(45,044)(15,013)(60,057)
Net cash receipts on real estate loans82,263-82,263212,80212,290225,092
Net cash advances (receipts) on real estate loans(12,212)-(12,212)(109,957)(9,639)(119,596)
Change in balance due to foreign currency translation8,183-8,183(9,819)-(9,819)
Net change in real estate loans receivable$(65,279)$(60,500)$(125,779)$(164,820)$(24,652)$(189,472)
(1) Triple-net and prior year outpatient medical represents acquisitions of assets previously financed as real estate loans.
(2) Current year outpatient medical represents a deed in lieu of foreclosure on a previously financed first mortgage property.

Nine Months Ended
September 30, 2017September 30, 2016
Balance of impaired loans at end of period$282,929$-
Allowance for loan losses5,406-
Balance of impaired loans not reserved$277,523$-
Average impaired loans for the period$324,255$-
Interest recognized on impaired loans23,957-