Segment Reporting (Tables)

12 Months Ended

Dec. 31, 2024

Segment Reporting [Abstract]

Summary of Information for Reportable Segments

The following table summarizes information for the reportable segments during the years ended December 31, 2024 (in thousands):

	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment/Corporate		Total
Resident fees and services	$	6,027,149	$	—	$	—	$	—	$	6,027,149
Rental income	—		777,297		792,981		—		1,570,278
Interest income	—		8,167		—		248,024		256,191
Other income	8,312		3,307		9,132		116,749		137,500
Total revenues	6,035,461		788,771		802,113		364,773		7,991,118
Total property operating expenses	4,523,780		40,722		245,636		20,073		4,830,211
Consolidated net operating income (loss)	$	1,511,681	$	748,049	$	556,477	$	344,700	3,160,907
Depreciation and amortization									1,632,093
Interest expense									574,261
General and administrative expenses									235,491
Loss (gain) on derivatives and financial instruments, net									(27,887)
Loss (gain) on extinguishment of debt, net									2,130
Provision for loan losses, net									10,125
Impairment of assets									92,793
Other expenses									117,459
Income (loss) from continuing operations before income taxes and other items									524,442
Income tax (expense) benefit									(2,700)
Income (loss) from unconsolidated entities									(496)
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net									451,611
Income (loss) from continuing operations									972,857
Net income (loss)									$	972,857

The following table summarizes significant expense categories by segment for the year ended December 31, 2024 (in thousands):

	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment/Corporate		Total
Compensation	$	2,659,251	$	77	$	55,817	$	—	$	2,715,145
Utilities	275,885		266		52,141		—		328,292
Food	246,893		—		—		—		246,893
Repairs and maintenance	171,155		73		40,977		—		212,205
Property taxes	210,028		29,918		70,626		—		310,572
Other segment expenses(1)	960,568		10,388		26,075		20,073		1,017,104
Total property operating expenses	$	4,523,780	$	40,722	$	245,636	$	20,073	$	4,830,211
(1) Other segment expenses for Seniors Housing Operating include management fees, insurance expense, marketing, supplies, other miscellaneous expenses and right of use asset amortization for properties subject to lease. Triple-net other segment expenses include right of use asset amortization for properties subject to ground leases and other miscellaneous expenses. Outpatient Medical other segment expenses include insurance expense, right of use asset amortization for properties subject to ground leases and other miscellaneous expenses. Non-segment/Corporate other segment expenses primarily represent insurance costs related to our captive insurance program.

The following table summarizes information for the reportable segments for the year ended December 31, 2023 (in thousands):

	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment/Corporate		Total
Resident fees and services	$	4,753,804	$	—	$	—	$	—	$	4,753,804
Rental income	—		814,751		741,322		—		1,556,073
Interest income	—		1,369		—		166,985		168,354
Other income	9,743		70,986		9,167		69,868		159,764
Total revenues	4,763,547		887,106		750,489		236,853		6,637,995
Total property operating expenses	3,655,508		42,194		231,956		18,118		3,947,776
Consolidated net operating income (loss)	$	1,108,039	$	844,912	$	518,533	$	218,735	2,690,219
Depreciation and amortization									1,401,101
Interest expense									607,846
General and administrative expenses									179,091
Loss (gain) on derivatives and financial instruments, net									(2,120)
Loss (gain) on extinguishment of debt, net									7
Provision for loan losses, net									9,809
Impairment of assets									36,097
Other expenses									108,341
Income (loss) from continuing operations before income taxes and other items									350,047
Income tax (expense) benefit									(6,364)
Income (loss) from unconsolidated entities									(53,442)
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net									67,898
Income (loss) from continuing operations									358,139
Net income (loss)									$	358,139

The following table summarizes significant expense categories by segment for the year ended December 31, 2023 (in thousands):

	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment/Corporate		Total
Compensation	$	2,179,578	$	61	$	50,900	$	—	$	2,230,539
Utilities	237,438		380		48,248		—		286,066
Food	195,410		—		—		—		195,410
Repairs and maintenance	141,566		138		36,991		—		178,695
Property taxes	172,567		32,957		71,448		—		276,972
Other segment expenses(1)	728,949		8,658		24,369		18,118		780,094
Total property operating expenses	$	3,655,508	$	42,194	$	231,956	$	18,118	$	3,947,776
(1) Other segment expenses for Seniors Housing Operating include management fees, insurance expense, marketing, supplies, other miscellaneous expenses and right of use asset amortization for properties subject to lease. Triple-net other segment expenses include right of use asset amortization for properties subject to ground leases and other miscellaneous expenses. Outpatient Medical other segment expenses include insurance expense, right of use asset amortization for properties subject to ground leases and other miscellaneous expenses. Non-segment/Corporate other segment expenses primarily represent insurance costs related to our captive insurance program.

The following table summarizes information for the reportable segments for the year ended December 31, 2022 (in thousands):

	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment/Corporate		Total
Resident fees and services	$	4,173,711	$	—	$	—	$	—	$	4,173,711
Rental income	—		782,329		669,457		—		1,451,786
Interest income	—		1,606		—		148,965		150,571
Other income	63,839		6,776		8,998		4,934		84,547
Total revenues	4,237,550		790,711		678,455		153,899		5,860,615
Total property operating expenses	3,292,045		44,483		205,997		16,245		3,558,770
Consolidated net operating income (loss)	$	945,505	$	746,228	$	472,458	$	137,654	2,301,845
Depreciation and amortization									1,310,368
Interest expense									529,519
General and administrative expenses									150,390
Loss (gain) on derivatives and financial instruments, net									8,334
Loss (gain) on extinguishment of debt, net									680
Provision for loan losses, net									10,320
Impairment of assets									17,502
Other expenses									101,670
Income (loss) from continuing operations before income taxes and other items									173,062
Income tax (expense) benefit									(7,247)
Income (loss) from unconsolidated entities									(21,290)
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net									16,043
Income (loss) from continuing operations									160,568
Net income (loss)									$	160,568

The following table summarizes significant expense categories by segment for the year ended December 31, 2022 (in thousands):

	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment/Corporate		Total
Compensation	$	1,973,307	$	109	$	46,190	$	—	$	2,019,606
Utilities	213,067		440		42,125		—		255,632
Food	173,639		—		—		—		173,639
Repairs and maintenance	130,828		211		32,595		—		163,634
Property taxes	156,585		33,128		64,205		—		253,918
Other segment expenses(1)	644,619		10,595		20,882		16,245		692,341
Total property operating expenses	$	3,292,045	$	44,483	$	205,997	$	16,245	$	3,558,770
(1) Other segment expenses for Seniors Housing Operating include management fees, insurance expense, marketing, supplies, other miscellaneous expenses and right of use asset amortization for properties subject to lease. Triple-net other segment expenses include right of use asset amortization for properties subject to ground leases and other miscellaneous expenses. Outpatient Medical other segment expenses include insurance expense, right of use asset amortization for properties subject to ground leases and other miscellaneous expenses. Non-segment/Corporate other segment expenses primarily represent insurance costs related to our captive insurance program.

The following table summarizes our total assets by segment for the periods presented (in thousands):

	As of
	December 31, 2024				December 31, 2023
Assets:	Amount		%		Amount		%
Seniors Housing Operating	$	30,094,016	59.0	%	$	24,622,107	55.9	%
Triple-Net	7,934,415		15.5	%	8,394,073		19.1	%
Outpatient Medical	7,530,815		14.8	%	7,327,102		16.6	%
Non-segment/Corporate	5,485,062		10.7	%	3,668,884		8.4	%
Total	$	51,044,308	100.0	%	$	44,012,166	100.0	%

Summary of Geographic Information

The following is a summary of geographic information for the periods presented (dollars in thousands):

	Year Ended
	December 31, 2024				December 31, 2023				December 31, 2022
Revenues:	Amount		%		Amount		%		Amount		%
United States	$	6,564,077	82.1	%	$	5,521,933	83.2	%	$	4,843,417	82.6	%
United Kingdom	872,479		10.9	%	606,750		9.1	%	558,308		9.5	%
Canada	554,562		7.0	%	509,312		7.7	%	458,890		7.9	%
Total	$	7,991,118	100.0	%	$	6,637,995	100.0	%	$	5,860,615	100.0	%
	Year Ended
	December 31, 2024				December 31, 2023				December 31, 2022
Resident fees and services:	Amount		%		Amount		%		Amount		%
United States	$	4,808,221	79.8	%	$	3,811,915	80.2	%	$	3,325,466	79.7	%
United Kingdom	683,803		11.3	%	447,219		9.4	%	401,195		9.6	%
Canada	535,125		8.9	%	494,670		10.4	%	447,050		10.7	%
Total	$	6,027,149	100.0	%	$	4,753,804	100.0	%	$	4,173,711	100.0	%
	As of
	December 31, 2024				December 31, 2023
Assets:	Amount		%		Amount		%
United States	$	41,966,871	82.2	%	$	36,929,186	83.9	%
United Kingdom	5,892,598		11.5	%	3,587,230		8.2	%
Canada	3,184,839		6.3	%	3,495,750		7.9	%
Total	$	51,044,308	100.0	%	$	44,012,166	100.0	%