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Real Property Acquisitions and Development (Tables)
9 Months Ended
Sep. 30, 2021
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):
 Nine Months Ended
 September 30, 2021September 30, 2020
Seniors Housing OperatingTriple-netOutpatient
Medical
TotalsSeniors Housing OperatingTriple-netOutpatient
Medical
Totals
Land and land improvements$264,706 $48,099 $45,350 $358,155 $15,758 $— $43,252 $59,010 
Buildings and improvements1,655,067 436,828 227,390 2,319,285 132,481 765 171,630 304,876 
Acquired lease intangibles142,439 — 17,333 159,772 10,810 — 23,823 34,633 
Right of use assets, net77,455 — — 77,455 — — — — 
Total net real estate assets2,139,667 484,927 290,073 2,914,667 159,049 765 238,705 398,519 
Receivables and other assets6,041 — 3,534 9,575 257 — 139 396 
Total assets acquired (1)
2,145,708 484,927 293,607 2,924,242 159,306 765 238,844 398,915 
Lease liabilities(138,126)— — (138,126)— — — — 
Accrued expenses and other liabilities(20,748)(8,703)(266)(29,717)(671)— (2,043)(2,714)
Total liabilities acquired(158,874)(8,703)(266)(167,843)(671)— (2,043)(2,714)
Noncontrolling interests (2)
(2,597)(2,056)(16,540)(21,193)(2,827)— — (2,827)
Cash disbursed for acquisitions1,984,237 474,168 276,801 2,735,206 155,808 765 236,801 393,374 
Construction in progress additions190,672 60,251 29,448 280,371 75,617 33,021 33,593 142,231 
Less: Capitalized interest(9,658)(2,092)(2,277)(14,027)(7,760)(2,569)(2,905)(13,234)
Accruals (3)
38 — (3,057)(3,019)(1,376)— (922)(2,298)
Cash disbursed for construction in progress181,052 58,159 24,114 263,325 66,481 30,452 29,766 126,699 
Capital improvements to existing properties115,115 26,496 24,080 165,691 130,465 5,971 46,888 183,324 
Total cash invested in real property, net of cash acquired$2,280,404 $558,823 $324,995 $3,164,222 $352,754 $37,188 $313,455 $703,397 
(1) Excludes $301,000 and $580,000 of unrestricted and restricted cash acquired during the nine months ended September 30, 2021 and September 30, 2020, respectively.
(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.
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, 2021September 30, 2020
Development projects:
Seniors Housing Operating
$58,844 $93,188 
Triple-net
22,990 59,201 
Outpatient Medical
116,612 43,493 
Total development projects
198,446 195,882 
Expansion projects
— 48,600 
Total construction in progress conversions$198,446 $244,482