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Real Property Acquisitions and Development (Tables)
 9 Months Ended
Sep. 30, 2018
Real Estate Liabilities Associated with Assets Held for Development and Sale [Abstract]  
Schedule of Acquired Assets and Liabilities
The following table presents the purchase price calculation and the allocation to assets acquired and liabilities assumed based upon their relative fair value:
(In thousands)
 
 
 
Land and land improvements
 
$
417,983

 
Buildings and improvements
 
2,249,803

 
Acquired lease intangibles
 
15,512

 
Real property held for sale
 
418,297

 
Cash and cash equivalents
 
381,913

 
Restricted cash
 
4,981

 
Receivables and other assets
 
1,322

 
 
Total assets acquired
 
3,489,811

 
Accrued expenses and other liabilities  
 
(13,199
)
 
 
Total liabilities assumed
 
(13,199
)
 
Noncontrolling interests
 
(512,741
)
 
 
Net assets acquired
 
$
2,963,871

 
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Triple-net Activity
 
 
 
Nine Months Ended
(In thousands)
 
September 30, 2018
 
September 30, 2017
Land and land improvements
 
$
413,588

 
$
31,948

Buildings and improvements
 
2,239,422

 
206,910

Acquired lease intangibles
 
12,383

 
—

Real property held for sale
 
396,265

 
—

Receivables and other assets
 
1,322

 
—

 
Total assets acquired(1)
 
3,062,980

 
238,858

Accrued expenses and other liabilities  
 
(13,199
)
 
(21,236
)
 
Total liabilities assumed
 
(13,199
)
 
(21,236
)
Noncontrolling interests
 
(512,741
)
 
(7,275
)
Non-cash acquisition related activity(2)
 
—

 
(54,901
)
 
Cash disbursed for acquisitions
 
2,537,040

 
155,446

Construction in progress additions
 
49,619

 
106,186

Less:
Capitalized interest
 
(1,932
)
 
(3,886
)
 
Foreign currency translation
 
180

 
(656
)
Cash disbursed for construction in progress
 
47,867

 
101,644

Capital improvements to existing properties
 
6,766

 
17,873

 
Total cash invested in real property, net of cash acquired
 
$
2,591,673

 
$
274,963

(1) Excludes $386,894,000 of unrestricted and restricted cash acquired during the nine months ended September 30, 2018.
(2) For the nine months ended September 30, 2017, $54,901,000 is related to the acquisition of assets previously financed as a real estate loan receivable.


Seniors Housing Operating Activity
 
 
 
Nine Months Ended
(In thousands)
 
September 30, 2018
 
September 30, 2017
Land and land improvements
 
$
47,865

 
$
31,006

Building and improvements
 
535,436

 
384,522

Acquired lease intangibles
 
68,084

 
48,197

Receivables and other assets
 
1,255

 
3,164

  
Total assets acquired(1)
 
652,640

 
466,889

Secured debt
 
(89,973
)
 
—

Accrued expenses and other liabilities  
 
(14,686
)
 
(43,364
)
 
Total liabilities assumed
 
(104,659
)
 
(43,364
)
Noncontrolling interests
 
(9,818
)
 
(4,701
)
Non-cash acquisition related activity(2)
 
—

 
(59,065
)
 
Cash disbursed for acquisitions
 
538,163

 
359,759

Construction in progress additions
 
28,222

 
65,282

Less:
Capitalized interest
 
(2,608
)
 
(5,996
)
 
Foreign currency translation
 
2,151

 
(6,218
)
Cash disbursed for construction in progress
 
27,765

 
53,068

Capital improvements to existing properties
 
127,274

 
110,372

 
Total cash invested in real property, net of cash acquired
 
$
693,202

 
$
523,199

(1) Excludes $2,442,000 and $6,273,000 of unrestricted and restricted cash acquired during the nine months ended September 30, 2018 and 2017, respectively.
(2) Includes $6,349,000 related to the acquisition of assets previously financed as real estate loans receivable and $51,097,000 previously financed as an investment in an unconsolidated entity during the nine months ended September 30, 2017.

Outpatient Medical Activity
 
 
 
Nine Months Ended
(In thousands)
 
September 30, 2018
 
September 30, 2017
Land and land improvements
 
$
18,496

 
$
25,060

Buildings and improvements
 
79,205

 
62,336

Acquired lease intangibles
 
11,271

 
8,397

Real property held for sale
 
22,032

 
—

Receivables and other assets
 
6

 
3

  
Total assets acquired(1)
 
131,010

 
95,796

Secured debt
 
(14,769
)
 
(25,709
)
Accrued expenses and other liabilities
 
(910
)
 
(2,210
)
 
Total liabilities assumed  
 
(15,679
)
 
(27,919
)
Noncontrolling interests
 
—

 
(9,080
)
 
Cash disbursed for acquisitions
 
115,331

 
58,797

Construction in progress additions
 
16,733

 
33,495

Less:
Capitalized interest
 
(1,817
)
 
(1,847
)
 
Accruals(2)
 
(2,402
)
 
11,708

Cash disbursed for construction in progress
 
12,514

 
43,356

Capital improvements to existing properties
 
39,595

 
30,897

 
Total cash invested in real property
 
$
167,440

 
$
133,050

 
(1) Excludes $2,244,000 and $0 of unrestricted and restricted cash acquired during the nine months ended September 30, 2018 and 2017, respectively.
(2) Represents non-cash accruals for amounts to be paid in future periods for properties that converted, off-set by amounts paid in the current period.

Construction Activity 
The following is a summary of the construction projects that were placed into service and began generating revenues during the periods presented (in thousands):
 
 
Nine Months Ended
 
 
September 30, 2018
 
September 30, 2017
Development projects:
 
 
 
 
Triple-net
 
$
90,055

 
$
283,472

Seniors housing operating
 
86,931

 
3,634

Outpatient medical
 
11,358

 
63,036

Total development projects
 
188,344

 
350,142

Expansion projects
 
8,879

 
10,336

Total construction in progress conversions
 
$
197,223

 
$
360,478