Segment Reporting (Tables)

6 Months Ended

Jun. 30, 2023

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, 2023	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment / Corporate		Total
Resident fees and services	$	1,159,449	$	—	$	—	$	—	$	1,159,449
Rental income	—		198,916		184,523		—		383,439
Interest income	2,095		36,520		95		—		38,710
Other income	2,895		66,692		1,574		12,719		83,880
Total revenues	1,164,439		302,128		186,192		12,719		1,665,478
Property operating expenses	885,187		10,598		58,697		4,190		958,672
Consolidated net operating income (loss)	279,252		291,530		127,495		8,529		706,806
Depreciation and amortization	220,428		55,234		66,283		—		341,945
Interest expense	16,136		(795)		3,152		133,844		152,337
General and administrative expenses	—		—		—		44,287		44,287
Loss (gain) on derivatives and financial instruments, net	—		1,280		—		—		1,280
Loss (gain) on extinguishment of debt, net	—		—		1		—		1
Provision for loan losses, net	1,867		591		(2)		—		2,456
Impairment of assets	—		1,086		—		—		1,086
Other expenses	8,060		818		647		1,544		11,069
Income (loss) from continuing operations before income taxes and other items	32,761		233,316		57,414		(171,146)		152,345
Income tax (expense) benefit	—		—		—		(3,503)		(3,503)
Income (loss) from unconsolidated entities	(39,445)		(630)		(257)		—		(40,332)
Gain (loss) on real estate dispositions, net	(2,096)		(72)		—		—		(2,168)
Income (loss) from continuing operations	(8,780)		232,614		57,157		(174,649)		106,342
Net income (loss)	$	(8,780)	$	232,614	$	57,157	$	(174,649)	$	106,342
Total assets	$	22,074,247	$	8,754,820	$	7,049,214	$	2,185,854	$	40,064,135

Three Months Ended June 30, 2022	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment / Corporate		Total
Resident fees and services	$	1,009,999	$	—	$	—	$	—	$	1,009,999
Rental income	—		197,182		164,229		—		361,411
Interest income	1,683		35,392		65		—		37,140
Other income	59,528		1,786		2,028		644		63,986
Total revenues	1,071,210		234,360		166,322		644		1,472,536
Property operating expenses	789,299		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 amortization	201,178		49,561		59,556		—		310,295
Interest expense	7,481		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, net	400		—		4		199		603
Provision for loan losses, net	342		(176)		(1)		—		165
Other expenses	29,249		463		207		5,247		35,166
Income (loss) from continuing operations before income taxes and other items	43,261		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 operations	29,368		177,853		50,935		(162,484)		95,672
Net income (loss)	$	29,368	$	177,853	$	50,935	$	(162,484)	$	95,672

Six Months Ended June 30, 2023	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment / Corporate		Total
Resident fees and services	$	2,291,134	$	—	$	—	$	—	$	2,291,134
Rental income	—		401,335		366,163		—		767,498
Interest income	4,646		70,283		186		—		75,115
Other income	5,340		68,575		4,674		13,871		92,460
Total revenues	2,301,120		540,193		371,023		13,871		3,226,207
Property operating expenses	1,768,971		22,321		117,062		8,071		1,916,425
Consolidated net operating income (loss)	532,149		517,872		253,961		5,800		1,309,782
Depreciation and amortization	440,835		109,762		130,460		—		681,057
Interest expense	27,623		(810)		7,256		262,671		296,740
General and administrative expenses	—		—		—		88,658		88,658
Loss (gain) on derivatives and financial instruments, net	—		2,210		—		—		2,210
Loss (gain) on extinguishment of debt, net	—		—		6		—		6
Provision for loan losses, net	1,794		1,441		(2)		—		3,233
Impairment of assets	12,629		1,086		—		—		13,715
Other expenses	25,639		3,285		1,194		3,696		33,814
Income (loss) from continuing operations before income taxes and other items	23,629		400,898		115,047		(349,225)		190,349
Income tax (expense) benefit	—		—		—		(6,548)		(6,548)
Income (loss) from unconsolidated entities	(55,034)		7,802		(171)		—		(47,403)
Gain (loss) on real estate dispositions, net	(1,263)		448		(606)		—		(1,421)
Income (loss) from continuing operations	(32,668)		409,148		114,270		(355,773)		134,977
Net income (loss)	$	(32,668)	$	409,148	$	114,270	$	(355,773)	$	134,977

Six Months Ended June 30, 2022	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment / Corporate		Total
Resident fees and services	$	2,004,334	$	—	$	—	$	—	$	2,004,334
Rental income	—		393,183		324,618		—		717,801
Interest income	3,100		72,898		136		—		76,134
Other income	60,388		3,442		4,891		1,250		69,971
Total revenues	2,067,822		469,523		329,645		1,250		2,868,240
Property operating expenses	1,579,227		22,702		100,563		5,260		1,707,752
Consolidated net operating income (loss)	488,595		446,821		229,082		(4,010)		1,160,488
Depreciation and amortization	393,971		103,065		117,347		—		614,383
Interest expense	15,131		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, net	385		—		7		199		591
Provision for loan losses, net	609		(1,241)		(7)		—		(639)
Other expenses	37,440		11,507		996		11,292		61,235
Income (loss) from continuing operations before income taxes and other items	41,059		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, net	1,477		18,320		(395)		—		19,402
Income (loss) from continuing operations	12,085		371,422		100,338		(322,422)		161,423
Net income (loss)	$	12,085	$	371,422	$	100,338	$	(322,422)	$	161,423

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, 2023				June 30, 2022				June 30, 2023				June 30, 2022
Revenues:	Amount		%		Amount		%		Amount(1)		%		Amount		%
United States	$	1,392,512	83.7	%	$	1,218,879	82.7	%	$	2,688,534	83.3	%	$	2,357,895	82.2	%
United Kingdom	154,028		9.2	%	139,352		9.5	%	301,904		9.4	%	283,843		9.9	%
Canada	118,938		7.1	%	114,305		7.8	%	235,769		7.3	%	226,502		7.9	%
Total	$	1,665,478	100.0	%	$	1,472,536	100.0	%	$	3,226,207	100.0	%	$	2,868,240	100.0	%
	Three Months Ended								Six Months Ended
	June 30, 2023				June 30, 2022				June 30, 2023				June 30, 2022
Resident Fees and Services:	Amount		%		Amount		%		Amount(1)		%		Amount		%
United States	$	929,997	80.2	%	$	798,825	79.1	%	$	1,838,941	80.3	%	$	1,582,922	79.0	%
United Kingdom	113,585		9.8	%	99,626		9.9	%	222,597		9.7	%	200,716		10.0	%
Canada	115,867		10.0	%	111,548		11.0	%	229,596		10.0	%	220,696		11.0	%
Total	$	1,159,449	100.0	%	$	1,009,999	100.0	%	$	2,291,134	100.0	%	$	2,004,334	100.0	%
	As of
	June 30, 2023				December 31, 2022
Assets:	Amount		%		Amount		%
United States	$	33,868,263	84.5	%	$	31,740,907	83.8	%
United Kingdom	3,468,475		8.7	%	3,476,793		9.2	%
Canada	2,727,397		6.8	%	2,675,533		7.0	%
Total	$	40,064,135	100.0	%	$	37,893,233	100.0	%