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Real Estate Loans Receivable (Tables)
 12 Months Ended
Dec. 31, 2018
Mortgage Loans on Real Estate, Commercial and Consumer, Net, (Investment Based Operations Presentation) [Abstract]  
Summary of real estate loans receivable The following is a summary of our real estate loans receivable (in thousands):
 
 
December 31,
 
 
2018
 
2017
Mortgage loans
 
$
317,443

 
$
374,492

Other real estate loans
 
81,268

 
121,379

Totals
 
$
398,711

 
$
495,871
Summary of real estate loan activity The following is a summary of our real estate loan activity for the periods presented (in thousands):
 
 
Year Ended
 
 
December 31, 2018
 
December 31, 2017
 
December 31, 2016
 
 
Seniors
Housing
Operating
 
Triple-net
 
Outpatient
Medical
 
Totals
 
Triple-net
 
Outpatient
Medical
 
Totals
 
Triple-net
 
Outpatient
Medical
 
Totals
Advances on real estate loans receivable:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Investments in new loans
 
$
11,806

 
$
13,062

 
$
23,421

 
$
48,289

 
$
12,091

 
$
—

 
$
12,091

 
$
8,445

 
$
—

 
$
8,445

Draws on existing loans
 
—

 
34,759

 
—

 
34,759

 
71,647

 
—

 
71,647

 
118,788

 
2,651

 
121,439

Net cash advances on real estate loans
 
11,806

 
47,822

 
23,421

 
83,048

 
83,738

 
—

 
83,738

 
127,233

 
2,651

 
129,884

Receipts on real estate loans receivable:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Loan payoffs
 
15,000

 
116,161

 
—

 
131,161

 
157,912

 
60,500

 
218,412

 
275,439

 
27,303

 
302,742

Principal payments on loans
 
—

 
49,669

 
—

 
49,669

 
1,219

 
—

 
1,219

 
6,867

 
—

 
6,867

Sub-total
 
15,000

 
165,830

 
—

 
180,830

 
159,131

 
60,500

 
219,631

 
282,306

 
27,303

 
309,609

Less: Non-cash activity(1)
 
—

 
—

 
—

 
—

 
(63,108
)
 
(60,500
)
 
(123,608
)
 
(45,044
)
 
(15,013
)
 
(60,057
)
Net cash receipts on real estate loans
 
15,000

 
165,830

 
—

 
180,830

 
96,023

 
—

 
96,023

 
237,262

 
12,290

 
249,552

Net cash advances (receipts) on real estate loans
 
$
(3,194
)
 
$
(118,008
)
 
$
23,421

 
$
(97,781
)
 
$
(12,285
)
 
$
—

 
$
(12,285
)
 
$
(110,029
)
 
$
(9,639
)
 
$
(119,668
)
(1) Triple-net primarily represents acquisitions of assets previously financed as real estate loans. Please see Note 3 for further information. Outpatient Medical represents a deed in lieu of foreclosure on a previously financed first mortgage property for the year ended December 31, 2017 and acquisition of assets previously financed as real estate loans for the year ended December 31, 2016.
Summary of allowance for losses on loans receivable The following is a summary of the allowance for losses on loans receivable for the periods presented (in thousands):
 
 
Year Ended December 31,
 
 
2018
 
2017
 
2016
Balance at beginning of year
 
$
68,372

 
$
6,563

 
$
—

Provision for loan losses(1)
 
—

 
62,966

 
6,935

Change in present value
 
—

 
(1,157
)
 
(372
)
Balance at end of  year
 
$
68,372

 
$
68,372

 
$
6,563

(1) Excludes direct write down of an impaired loan receivable in 2016. 
Summary of impaired loans The following is a summary of our impaired loans (in thousands):
 
 
Year Ended December 31,
 
 
2018
 
2017
 
2016
Balance of impaired loans at end of  year
 
$
189,272

 
$
282,882

 
$
377,549

Allowance for loan losses
 
68,372

 
68,372

 
6,563

Balance of impaired loans not reserved
 
$
120,900

 
$
214,510

 
$
370,986

Average impaired loans for the year
 
$
236,077

 
$
330,216

 
$
188,775

Interest recognized on impaired loans(1)
 
17,241

 
27,793

 
8,707

 (1) Represents cash interest recognized in the period since loans were identified as impaired.