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Segment Reporting (Tables)
6 Months Ended
Jun. 30, 2019
Segment Reporting [Abstract]  
Summary Information for Reportable Segments Summary information for the reportable segments (which excludes unconsolidated entities) is as follows (in thousands): 
Three Months Ended June 30, 2019:

Seniors Housing Operating

Triple-net
 
Outpatient Medical

Non-segment / Corporate

Total
Resident fees and services

$
914,085


$

 
$


$


$
914,085

Rental income



222,362

 
163,224




385,586

Interest income



17,118

 
238




17,356

Other income

1,444


1,278

 
(97
)

454


3,079

Total revenues

915,529

 
240,758

 
163,365

 
454


1,320,106

 
 
 
 
 
 
 
 
 
 


Property operating expenses

637,317


12,823

 
50,987




701,127

Consolidated net operating income

278,212

 
227,935

 
112,378

 
454


618,979

 
 
 
 
 
 
 
 
 
 


Depreciation and amortization

136,551


56,056

 
55,445




248,052

Interest expense

17,572


3,225

 
3,386


117,153


141,336

General and administrative expenses




 


33,741


33,741

Loss (gain) on derivatives and financial instruments, net



1,913

 




1,913

Impairment of assets



(940
)
 
10,879




9,939

Other expenses

11,857


5,560

 
(4
)

4,215


21,628

Income (loss) from continuing operations before income taxes and other items

112,232

 
162,121

 
42,672

 
(154,655
)

162,370

Income tax (expense) benefit

375


(1,361
)
 
(586
)

(27
)

(1,599
)
(Loss) income from unconsolidated entities

(17,453
)

6,578

 
1,826




(9,049
)
Gain (loss) on real estate dispositions, net

(550
)

(1,130
)
 
(2
)



(1,682
)
Income (loss) from continuing operations

94,604

 
166,208

 
43,910

 
(154,682
)

150,040

Net income (loss)

$
94,604

 
$
166,208

 
$
43,910

 
$
(154,682
)

$
150,040

 
 
 
 
 
 
 
 
 
 


Total assets

$
16,440,104


$
9,494,388

 
$
7,004,561


$
209,644


$
33,148,697

Three Months Ended June 30, 2018:
 
Seniors Housing Operating
 
Triple-net
 
Outpatient Medical
 
Non-segment / Corporate
 
Total
Resident fees and services
 
$
763,345

 
$

 
$

 
$

 
$
763,345

Rental income
 

 
197,961

 
135,640

 

 
333,601

Interest income
 
172

 
13,247

 
43

 

 
13,462

Other income
 
1,650

 
13,212

 
144

 
498

 
15,504

Total revenues
 
765,167

 
224,420

 
135,827

 
498

 
1,125,912

 
 
 
 
 
 
 
 
 
 


Property operating expenses
 
525,662

 
136

 
42,953

 

 
568,751

Consolidated net operating income
 
239,505

 
224,284

 
92,874

 
498

 
557,161

 
 
 
 
 
 
 
 
 
 


Depreciation and amortization
 
134,779

 
55,309

 
46,187

 

 
236,275

Interest expense
 
16,971

 
3,800

 
1,656

 
98,989

 
121,416

General and administrative expenses
 

 

 

 
32,831

 
32,831

Loss (gain) on derivatives and financial instruments, net
 

 
(7,460
)
 

 

 
(7,460
)
Loss (gain) on extinguishment of debt, net
 
299

 

 

 

 
299

Impairment of assets
 
2,212

 
2,420

 

 

 
4,632

Other expenses
 
6,167

 
957


2,095

 
839

 
10,058

Income (loss) from continuing operations before income taxes and other items
 
79,077

 
169,258

 
42,936

 
(132,161
)
 
159,110

Income tax (expense) benefit
 
(2,617
)
 
(688
)
 
(378
)
 
(158
)
 
(3,841
)
(Loss) income from unconsolidated entities
 
(5,204
)
 
5,062

 
1,391

 

 
1,249

Gain (loss) on real estate dispositions, net
 
(1
)
 
10,759

 
(3
)
 

 
10,755

Income (loss) from continuing operations
 
71,255

 
184,391

 
43,946

 
(132,319
)
 
167,273

Net income (loss)
 
$
71,255

 
$
184,391

 
$
43,946

 
$
(132,319
)
 
$
167,273

 
 
 
 
 
 
 
 
 
 
 

Six Months Ended June 30, 2019
 
Seniors Housing Operating
 
Triple-net
 
Outpatient Medical
 
Non-segment / Corporate
 
Total
Resident fees and services
 
$
1,782,370

 
$

 
$

 
$

 
$
1,782,370

Rental income
 

 
454,394

 
312,276

 

 
766,670

Interest income
 

 
32,064

 
411

 

 
32,475

Other income
 
5,545

 
2,541

 
139

 
2,611

 
10,836

Total revenues
 
1,787,915

 
488,999

 
312,826

 
2,611

 
2,592,351

 
 
 
 
 
 
 
 
 
 

Property operating expenses
 
1,245,003

 
27,778

 
99,153

 

 
1,371,934

Consolidated net operating income
 
542,912

 
461,221

 
213,673

 
2,611

 
1,220,417

 
 
 
 
 
 
 
 
 
 

Depreciation and amortization
 
268,126

 
117,404

 
106,454

 

 
491,984

Interest expense
 
35,823

 
6,665

 
6,734

 
237,346

 
286,568

General and administrative expenses
 

 

 

 
69,023

 
69,023

Loss (gain) on derivatives and financial instruments, net
 

 
(574
)
 

 

 
(574
)
Loss (gain) on extinguishment of debt, net
 

 

 

 
15,719

 
15,719

Provision for loan losses
 

 
18,690

 

 

 
18,690

Impairment of assets
 

 
(940
)
 
10,879

 

 
9,939

Other expenses
 
14,803

 
8,589

 
750

 
6,242

 
30,384

Income (loss) from continuing operations before income taxes and other items
 
224,160

 
311,387

 
88,856

 
(325,719
)
 
298,684

Income tax (expense) benefit
 
(244
)
 
(2,312
)
 
(951
)
 
(314
)
 
(3,821
)
(Loss) income from unconsolidated entities
 
(34,033
)
 
12,236

 
3,549

 

 
(18,248
)
Gain (loss) on real estate dispositions, net
 
(710
)
 
166,444

 
(7
)
 

 
165,727

Income (loss) from continuing operations
 
189,173

 
487,755

 
91,447

 
(326,033
)
 
442,342

Net income (loss)
 
$
189,173

 
$
487,755

 
$
91,447

 
$
(326,033
)
 
$
442,342


Six Months Ended June 30, 2018
 
Seniors Housing Operating
 
Triple-net
 
Outpatient Medical
 
Non-segment / Corporate
 
Total
Resident fees and services
 
$
1,499,279

 
$

 
$

 
$

 
$
1,499,279

Rental income
 

 
404,792

 
272,178

 

 
676,970

Interest income
 
257

 
27,798

 
55

 

 
28,110

Other income
 
2,798

 
14,589

 
265

 
866

 
18,518

Total revenues
 
1,502,334

 
447,179

 
272,498

 
866

 
2,222,877

 
 
 
 
 
 
 
 
 
 
 
Property operating expenses
 
1,037,603

 
157

 
87,456

 

 
1,125,216

Consolidated net operating income
 
464,731

 
447,022

 
185,042

 
866

 
1,097,661

 
 
 
 
 
 
 
 
 
 
 
Depreciation and amortization
 
260,548

 
111,341

 
92,587

 

 
464,476

Interest expense
 
33,906

 
7,242

 
3,332

 
199,711

 
244,191

General and administrative expenses
 

 

 

 
66,536

 
66,536

Loss (gain) on derivatives and financial
instruments, net
 

 
(14,633
)
 

 

 
(14,633
)
Loss (gain) on extinguishment of debt, net
 
110

 
(32
)
 
11,928

 

 
12,006

Impairment of assets
 
4,513

 
28,304

 

 

 
32,817

Other expenses
 
5,979

 
2,077

 
2,693

 
3,021

 
13,770

Income (loss) from continuing operations before income taxes and other items
 
159,675

 
312,723

 
74,502

 
(268,402
)
 
278,498

Income tax (expense) benefit
 
(2,455
)
 
(1,824
)
 
(806
)
 
(344
)
 
(5,429
)
(Loss) income from unconsolidated entities
 
(14,684
)
 
10,883

 
2,621

 

 
(1,180
)
Gain (loss) on real estate dispositions, net
 
4

 
134,156

 
214,779

 

 
348,939

Income (loss) from continuing operations
 
142,540

 
455,938

 
291,096

 
(268,746
)
 
620,828

Net income (loss)
 
$
142,540

 
$
455,938

 
$
291,096

 
$
(268,746
)
 
$
620,828


Summary of Geographic Information The following is a summary of geographic information for the periods presented (dollars in thousands): 
 
 
Three Months Ended
 
Six Months Ended
 
 
June 30, 2019
 
June 30, 2018
 
June 30, 2019
 
June 30, 2018
Revenues:
 
Amount
 
%
 
Amount
 
%
 
Amount
 
%
 
Amount
 
%
United States
 
$
1,092,376

 
82.8
%
 
$
895,734

 
79.5
%
 
$
2,136,042

 
82.4
%
 
$
1,759,523

 
79.1
%
United Kingdom
 
112,647

 
8.5
%
 
112,031

 
10.0
%
 
225,065

 
8.7
%
 
228,556

 
10.3
%
Canada
 
115,083

 
8.7
%
 
118,147

 
10.5
%
 
231,244

 
8.9
%
 
234,798

 
10.6
%
Total
 
$
1,320,106

 
100.0
%
 
$
1,125,912

 
100.0
%
 
$
2,592,351

 
100.0
%
 
$
2,222,877

 
100.0
%
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
As of
 
 
 
 
June 30, 2019
 
December 31, 2018
 
 
 
 
Assets:
 
Amount
 
%
 
Amount
 
%
 
 
 
 
 
 
 
 
United States
 
$
27,496,270

 
82.9
%
 
$
24,884,292

 
82.0
%
 
 
 
 
 
 
 
 
United Kingdom
 
3,173,654

 
9.6
%
 
3,078,994

 
10.1
%
 
 
 
 
 
 
 
 
Canada
 
2,478,773

 
7.5
%
 
2,378,786

 
7.9
%
 
 
 
 
 
 
 
 
Total
 
$
33,148,697

 
100.0
%
 
$
30,342,072

 
100.0
%