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Segment Reporting (Tables)
6 Months Ended
Jun. 30, 2022
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, 2022:Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment / CorporateTotal
Resident fees and services$1,009,999 $— $— $— $1,009,999 
Rental income— 197,182 164,229 — 361,411 
Interest income1,683 35,392 65 — 37,140 
Other income59,528 1,786 2,028 644 63,986 
Total revenues1,071,210 234,360 166,322 644 1,472,536 
Property operating expenses789,299 11,491 50,648 2,645 854,083 
Consolidated net operating income (loss)281,911 222,869 115,674 (2,001)618,453 
Depreciation and amortization201,178 49,561 59,556 — 310,295 
Interest expense7,481 320 4,531 115,418 127,750 
General and administrative expenses— — — 36,554 36,554 
Loss (gain) on derivatives and financial instruments, net— (1,407)— — (1,407)
Loss (gain) on extinguishment of debt, net400 — 199 603 
Provision for loan losses, net342 (176)(1)— 165 
Other expenses29,249 463 207 5,247 35,166 
Income (loss) from continuing operations before income taxes and other items43,261 174,108 51,377 (159,419)109,327 
Income tax (expense) benefit— — — (3,065)(3,065)
Income (loss) from unconsolidated entities(12,669)5,874 (263)— (7,058)
Gain (loss) on real estate dispositions, net(1,224)(2,129)(179)— (3,532)
Income (loss) from continuing operations29,368 177,853 50,935 (162,484)95,672 
Net income (loss)$29,368 $177,853 $50,935 $(162,484)$95,672 
Total assets$20,972,302 $8,851,738 $6,451,415 $298,216 $36,573,671 
Three Months Ended June 30, 2021:Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment / CorporateTotal
Resident fees and services$740,891 $— $— $— $740,891 
Rental income— 204,725 149,998 — 354,723 
Interest income856 32,861 4,731 — 38,448 
Other income802 1,355 4,343 430 6,930 
Total revenues742,549 238,941 159,072 430 1,140,992 
Property operating expenses582,361 12,627 45,495 2,174 642,657 
Consolidated net operating income (loss)160,188 226,314 113,577 (1,744)498,335 
Depreciation and amortization131,035 54,406 55,444 — 240,885 
Interest expense10,553 1,704 3,907 106,177 122,341 
General and administrative expenses— — — 31,436 31,436 
Loss (gain) on derivatives and financial instruments, net— (359)— — (359)
Loss (gain) on extinguishment of debt, net3,106 — — 52,506 55,612 
Provision for loan losses, net(181)10,019 (3,641)— 6,197 
Impairment of assets17,713 3,768 2,211 — 23,692 
Other expenses3,709 4,110 

1,098 2,770 11,687 
Income (loss) from continuing operations before income taxes and other items(5,747)152,666 54,558 (194,633)6,844 
Income tax (expense) benefit— — — 2,221 2,221 
Income (loss) from unconsolidated entities(12,938)4,877 85 — (7,976)
Gain (loss) on real estate dispositions, net(28)42,709 1,987 — 44,668 
Income (loss) from continuing operations(18,713)200,252 56,630 (192,412)45,757 
Net income (loss)$(18,713)$200,252 $56,630 $(192,412)$45,757 
Six Months Ended June 30, 2022Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment / CorporateTotal
Resident fees and services$2,004,334 $— $— $— $2,004,334 
Rental income— 393,183 324,618 — 717,801 
Interest income3,100 72,898 136 — 76,134 
Other income60,388 3,442 4,891 1,250 69,971 
Total revenues2,067,822 469,523 329,645 1,250 2,868,240 
Property operating expenses1,579,227 22,702 100,563 5,260 1,707,752 
Consolidated net operating income488,595 446,821 229,082 (4,010)1,160,488 
Depreciation and amortization393,971 103,065 117,347 — 614,383 
Interest expense15,131 634 9,098 224,583 249,446 
General and administrative expenses— — — 74,260 74,260 
Loss (gain) on derivatives and financial instruments, net— 1,171 — — 1,171 
Loss (gain) on extinguishment of debt, net385 — 199 591 
Provision for loan losses, net609 (1,241)(7)— (639)
Other expenses37,440 11,507 996 11,292 61,235 
Income (loss) from continuing operations before income taxes and other items41,059 331,685 101,641 (314,344)160,041 
Income tax (expense) benefit— — — (8,078)(8,078)
Income (loss) from unconsolidated entities(30,451)21,417 (908)— (9,942)
Gain (loss) on real estate dispositions, net1,477 18,320 (395)— 19,402 
Income (loss) from continuing operations12,085 371,422 100,338 (322,422)161,423 
Net income (loss)$12,085 $371,422 $100,338 $(322,422)$161,423 

Six Months Ended June 30, 2021Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment / CorporateTotal
Resident fees and services$1,464,355 $— $— $— $1,464,355 
Rental income— 357,188 300,378 — 657,566 
Interest income1,975 47,783 8,269 — 58,027 
Other income2,621 2,452 6,648 1,385 13,106 
Total revenues1,468,951 407,423 315,295 1,385 2,193,054 
Property operating expenses1,138,329 25,468 92,358 3,828 1,259,983 
Consolidated net operating income330,622 381,955 222,937 (2,443)933,071 
Depreciation and amortization263,621 111,073 110,617 — 485,311 
Interest expense21,971 3,586 7,922 212,004 245,483 
General and administrative expenses— — — 61,362 61,362 
Loss (gain) on derivatives and financial
instruments, net
— 1,575 — — 1,575 
Loss (gain) on extinguishment of debt, net(1,537)— — 52,506 50,969 
Provision for loan losses, net70 18.69 10,872 — (3,362)18.69 — 7,580 
Impairment of assets22,317 22,732 2,211 — 47,260 
Other expenses7,168 9,093 1,810 4,610 22,681 
Income (loss) from continuing operations before income taxes and other items17,012 223,024 103,739 (332,925)10,850 
Income tax (expense) benefit— — — (1,722)(1,722)
Income (loss) from unconsolidated entities(7,704)9,784 2,993 — 5,073 
Gain (loss) on real estate dispositions, net5,167 44,751 53,830 — 103,748 
Income (loss) from continuing operations14,475 277,559 160,562 (334,647)117,949 
Net income (loss)$14,475 $277,559 $160,562 $(334,647)$117,949 
Summary of Geographic Information The following is a summary of geographic information for the periods presented (dollars in thousands): 
 Three Months EndedSix Months Ended
 June 30, 2022June 30, 2021June 30, 2022June 30, 2021
Revenues:
Amount(1)
%Amount%
Amount(1)
%Amount%
United States$1,218,879 82.7 %$893,672 78.4 %$2,357,895 82.2 %$1,719,320 78.4 %
United Kingdom139,352 9.5 %140,756 12.3 %283,843 9.9 %259,630 11.8 %
Canada114,305 7.8 %106,564 9.3 %226,502 7.9 %214,104 9.8 %
Total$1,472,536 100.0 %$1,140,992 100.0 %$2,868,240 100.0 %$2,193,054 100.0 %
 As of
 June 30, 2022December 31, 2021
Assets:Amount%Amount%
United States$30,181,095 82.5 %$28,595,703 81.9 %
United Kingdom3,519,917 9.6 %3,938,258 11.3 %
Canada2,872,659 7.9 %2,376,364 6.8 %
Total$36,573,671 100.0 %$34,910,325 100.0 %
(1) The United States, United Kingdom and Canada represent 79%, 10% and 11% of our resident fees and services revenue for the three and six month periods ended June 30, 2022, respectively.