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Real Property Acquisitions and Development
3 Months Ended
Mar. 31, 2021
Real Estate [Abstract]  
Real Property Acquisitions and Development Real Property Acquisitions and Development 
The total purchase price for all properties acquired has been allocated to the tangible and identifiable intangible assets and liabilities at cost on a relative fair value basis. Liabilities assumed and any associated noncontrolling interests are reflected at fair value. The results of operations for these acquisitions have been included in our consolidated results of operations since the date of acquisition and are a component of the appropriate segments. Transaction costs primarily represent costs incurred with acquisitions, including due diligence costs, fees for legal and valuation services, termination of pre-existing relationships computed based on the fair value of the assets acquired, lease termination fees and other acquisition-related costs. Transaction costs related to asset acquisitions are capitalized as a component of purchase price and all other non-capitalizable costs are reflected in other expenses on our Consolidated Statements of Comprehensive Income.
The following is a summary of our real property investment activity by segment for the periods presented (in thousands):
 Three Months Ended
 March 31, 2021March 31, 2020
Seniors Housing OperatingTriple-netOutpatient
Medical
TotalsSeniors Housing OperatingTriple-netOutpatient
Medical
Totals
Land and land improvements$1,240 $24,154 $2,273 $27,667 $15,758 $— $40,847 $56,605 
Buildings and improvements3,491 170,362 10,570 184,423 132,480 765 171,457 304,702 
Acquired lease intangibles339 — 1,439 1,778 10,810 — 23,823 34,633 
Receivables and other assets34 — — 34 257 — 139 396 
Total assets acquired (1)
5,104 194,516 14,282 213,902 159,305 765 236,266 396,336 
Accrued expenses and other liabilities— (8,703)(36)(8,739)(671)— (2,036)(2,707)
Total liabilities acquired— (8,703)(36)(8,739)(671)— (2,036)(2,707)
Noncontrolling interests (2)
— (2,056)— (2,056)(2,827)— — (2,827)
Cash disbursed for acquisitions5,104 183,757 14,246 203,107 155,807 765 234,230 390,802 
Construction in progress additions38,373 31,809 7,601 77,783 29,841 13,929 13,645 57,415 
Less: Capitalized interest(2,980)(524)(992)(4,496)(2,812)(941)(993)(4,746)
Accruals (3)
— 311 318 (2,600)— (1,294)(3,894)
Cash disbursed for construction in progress35,400 31,285 6,920 73,605 24,429 12,988 11,358 48,775 
Capital improvements to existing properties(3,159)25,295 6,644 28,780 52,503 3,248 13,631 69,382 
Total cash invested in real property, net of cash acquired$37,345 $240,337 $27,810 $305,492 $232,739 $17,001 $259,219 $508,959 
(1) Excludes $580,000 of unrestricted and restricted cash acquired during the three months ended March 31, 2020.
(2) Includes amounts attributable to both redeemable noncontrolling interests and noncontrolling interests.
(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.
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):
 Three Months Ended
 March 31, 2021March 31, 2020
Development projects:
Seniors Housing Operating
$— $93,188 
Triple-net
22,990 — 
Outpatient Medical
— 19,369 
Total construction in progress conversions$22,990 $112,557