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Real Property Acquisitions and Development (Tables)
 6 Months Ended
Jun. 30, 2019
Real Estate [Abstract]  
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
The following is a summary of our real property investment activity by segment for the periods presented (in thousands):
 
Six Months Ended
 
June 30, 2019
 
June 30, 2018
 
Seniors Housing Operating
 
Triple-net
 
Outpatient
Medical
 
Totals
 
Seniors Housing Operating
 
Triple-net
 
Outpatient
Medical
 
Totals
Land and land improvements
$
103,743

 
$
8,099

 
$
132,154

 
$
243,996

 
$
47,865

 
$
1,691

 
$
7,369

 
$
56,925

Buildings and improvements
1,109,966

 
96,244

 
1,198,608

 
2,404,818

 
535,921

 
—

 
42,673

 
578,594

Acquired lease intangibles
58,773

 
—

 
85,492

 
144,265

 
68,084

 
—

 
5,852

 
73,936

Construction in progress
36,174

 
—

 
—

 
36,174

 
—

 
—

 
—

 
—

Right of use assets, net
—

 
—

 
56,073

 
56,073

 
—

 
—

 
—

 
—

Receivables and other assets
4,560

 
—

 
376

 
4,936

 
1,255

 
—

 
1

 
1,256

Total assets acquired(1)
1,313,216

 
104,343

 
1,472,703

 
2,890,262

 
653,125

 
1,691

 
55,895

 
710,711

Secured debt
(43,209
)
 
—

 
—

 
(43,209
)
 
(89,973
)
 
—

 
—

 
(89,973
)
Lease liabilities
—

 
—

 
(45,287
)
 
(45,287
)
 
—

 
—

 
—

 
—

Accrued expenses and other liabilities  
(8,677
)
 
—

 
(22,506
)
 
(31,183
)
 
(14,686
)
 
(6
)
 
(632
)
 
(15,324
)
Total liabilities acquired
(51,886
)
 
—

 
(67,793
)
 
(119,679
)
 
(104,659
)
 
(6
)
 
(632
)
 
(105,297
)
Noncontrolling interests
(38,830
)
 
(1,056
)
 
—

 
(39,886
)
 
(9,818
)
 
—

 
—

 
(9,818
)
Non-cash acquisition related activity(2)
(11,889
)
 
—

 
—

 
(11,889
)
 
—

 
—

 
—

 
—

Cash disbursed for acquisitions
1,210,611

 
103,287

 
1,404,910

 
2,718,808

 
538,648

 
1,685

 
55,263

 
595,596

Construction in progress additions
110,761

 
24,066

 
26,587

 
161,414

 
20,704

 
38,238

 
11,319

 
70,261

Less: Capitalized interest
(3,560
)
 
(908
)
 
(1,788
)
 
(6,256
)
 
(1,783
)
 
(1,432
)
 
(1,221
)
 
(4,436
)
Foreign currency translation
141

 
65

 
—

 
206

 
1,176

 
132

 
—

 
1,308

Accruals(3)
—

 
—

 
45

 
45

 
—

 
—

 
(4,155
)
 
(4,155
)
Cash disbursed for construction in progress
107,342

 
23,223

 
24,844

 
155,409

 
20,097

 
36,938

 
5,943

 
62,978

Capital improvements to existing properties
97,867

 
7,423

 
18,886

 
124,176

 
76,237

 
8,569

 
26,526

 
111,332

Total cash invested in real property, net of cash acquired
$
1,415,820

 
$
133,933

 
$
1,448,640

 
$
2,998,393

 
$
634,982

 
$
47,192

 
$
87,732

 
$
769,906

(1) Excludes $ 1,910,000 and $4,392,000 of unrestricted and restricted cash acquired during the six months ended June 30, 2019 and 2018, respectively.
(2) Relates to the acquisition of assets previously recognized as investments in unconsolidated entities.
(3) 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.

The following is a summary of the construction projects that were placed into service and began generating revenues during the periods presented (in thousands):
 
 
Six Months Ended
 
 
June 30, 2019
 
June 30, 2018
Development projects:
 
 
 
 
Seniors Housing Operating
 
$
28,117

 
$
37,215

Triple-net
 
—

 
59,188

Outpatient Medical
 
—

 
11,358

Total construction in progress conversions
 
$
28,117

 
$
107,761