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Real Property Acquisitions and Development
3 Months Ended
Mar. 31, 2023
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, 2023March 31, 2022
Seniors Housing OperatingTriple-netOutpatient
Medical
TotalsSeniors Housing OperatingTriple-netOutpatient
Medical
Totals
Land and land improvements$2,517 $7,370 $60,527 $70,414 $43,897 $— $240 $44,137 
Buildings and improvements16,434 74,289 255,706 346,429 402,342 171 131,412 533,925 
Acquired lease intangibles865 — 39,090 39,955 31,366 — 16,978 48,344 
Right of use assets, net— — 927 927 — — 3,852 3,852 
Total net real estate assets19,816 81,659 356,250 457,725 477,605 171 152,482 630,258 
Receivables and other assets234 — 358 592 1,630 — — 1,630 
Total assets acquired20,050 81,659 356,608 458,317 479,235 171 152,482 631,888 
Secured debt(5,501)— (40,953)(46,454)— — — — 
Lease liabilities— — (953)(953)— — (3,852)(3,852)
Accrued expenses and other liabilities(120)— (8,071)(8,191)(4,154)— — (4,154)
Total liabilities acquired(5,621)— (49,977)(55,598)(4,154)— (3,852)(8,006)
Noncontrolling interests (1)
— — — — (20,348)(4)— (20,352)
Non-cash acquisition related activity(2)
— — — — (2,120)— — (2,120)
Cash disbursed for acquisitions14,429 81,659 306,631 402,719 452,613 167 148,630 601,410 
Construction in progress additions131,944 4,995 101,609 238,548 113,407 20,756 9,642 143,805 
Less: Capitalized interest(7,950)(1,248)(1,137)(10,335)(4,179)(1,089)(211)(5,479)
Accruals (3)
2,303 — (4,290)(1,987)(1,963)— 1,778 (185)
Cash disbursed for construction in progress126,297 3,747 96,182 226,226 107,265 19,667 11,209 138,141 
Capital improvements to existing properties69,783 4,427 17,129 91,339 68,612 8,294 13,323 90,229 
Total cash invested in real property, net of cash acquired$210,509 $89,833 $419,942 $720,284 $628,490 $28,128 $173,162 $829,780 
(1) Includes amounts attributable to both redeemable noncontrolling interests and noncontrolling interests.
(2) Relates to the acquisition of assets recognized as investments in unconsolidated entities.
(3) Represents non-cash accruals for amounts to be paid in future periods for properties that converted, offset by amounts paid in the current period.
Effective on April 1, 2022, our leasehold interest relating to the master lease with National Health Investors, Inc. ("NHI") for 17 properties assumed in conjunction with the Holiday Retirement acquisition was terminated as a result of the transition or sale of the properties by NHI. The lease termination was part of an agreement to resolve outstanding litigation with NHI. In conjunction with the agreement, a wholly owned subsidiary and the lessee on the master lease agreed to release $6,883,000 of cash to the landlord, which represents the net cash flow generated from the properties since we assumed the leasehold interest. Additionally, in connection with the lease termination, during the three months ended June 30, 2022, we recognized $58,621,000 in other income on our Consolidated Statements of Comprehensive Income from the derecognition of the right of use asset and related lease liability.
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, 2023March 31, 2022
Development projects:
Seniors Housing Operating
$26,712 $73,458 
Outpatient Medical
9,351 — 
Total development projects
36,063 73,458 
Expansion projects
17,245 — 
Total construction in progress conversions$53,308 $73,458