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Segment Reporting
 3 Months Ended
Mar. 31, 2025
Segment Reporting [Abstract]  
Segment Reporting Segment Reporting
We invest in seniors housing and healthcare real estate. We evaluate our business and make resource allocations for our three operating segments: Seniors Housing Operating, Triple-net and Outpatient Medical. Our Seniors Housing Operating properties include seniors apartments, assisted living communities, independent living/continuing care retirement communities, independent supportive living communities (Canada), care homes with and without nursing (U.K.) and combinations thereof. Seniors Housing Operating properties that are deemed qualified healthcare properties are owned and operated through RIDEA structures (see Note 19). Our Triple-net properties include the property types described above as well as long-term/post-acute care facilities. Under the Triple-net segment, we invest in seniors housing and healthcare real estate through acquisition of single tenant properties. Properties acquired are generally leased under triple-net leases and we are not involved in the management of the property. Our Outpatient Medical properties are typically leased to multiple tenants and generally require a certain level of property management by us.
We evaluate performance based on consolidated NOI of each segment. We define NOI as total revenues, including tenant reimbursements, less property operating expenses. We believe NOI provides investors relevant and useful information as it measures the operating performance of our properties at the property level on an unleveraged basis. The Chief Operating Decision Maker ("CODM"), who is our Vice Chairman & Chief Operating Officer, uses NOI to make decisions about resource allocations and to assess the property-level performance of our properties.
During the year ended December 31, 2024, we adopted ASU 2023-07 (see Note 2 in our Annual Report on Form 10-K for the year ended December 31, 2024 for further details). Additionally, we reclassified loans receivable balances and equity warrants received through lending activities (see Note 12 for further details), the related interest income, provision for loan losses and
change in the fair value of the equity warrants from our three operating segments to Non-segment/Corporate to better align with the manner in which the CODM reviews results. Accordingly, the segment information provided in this Note has been updated to conform to the current presentation for all periods presented.
Non-segment revenue consists mainly of interest income on loans receivable balances. Additionally, it includes interest income earned on cash investments recorded in other income. Non-segment assets consist of corporate assets including loans receivable, cash, deferred loan expenses and corporate offices and equipment among others. Non-property specific revenues and expenses are not allocated to individual segments in determining NOI.
The accounting policies of the segments are the same as those described in the summary of significant accounting policies (see Note 2 to the financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2024). The results of operations for all acquisitions described in Note 3 are included in our consolidated results of operations from the acquisition dates and are components of the appropriate segments. All inter-segment transactions are eliminated.
The following table summarizes information for the reportable segments for the quarter ended March 31, 2025 (in thousands): 
Three Months Ended March 31, 2025
Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment/CorporateTotal
Resident fees and services$1,864,530 $— $— $— $1,864,530 
Rental income— 252,688 208,879 — 461,567 
Interest income— 2,111 — 60,379 62,490 
Other income3,341 231 2,137 28,791 34,500 
Total revenues1,867,871 255,030 211,016 89,170 2,423,087 
Property operating expenses1,384,684 8,818 64,606 4,282 1,462,390 
Consolidated net operating income (loss)$483,187 $246,212 $146,410 $84,888 960,697 
Depreciation and amortization485,869 
Interest expense144,962 
General and administrative expenses63,758 
Loss (gain) on derivatives and financial instruments, net(3,210)
Loss (gain) on extinguishment of debt, net6,156 
Provision for loan losses, net(2,007)
Impairment of assets52,402 
Other expenses14,060 
Income (loss) from continuing operations before income taxes and other items198,707 
Income tax (expense) benefit5,519 
Income (loss) from unconsolidated entities1,263 
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net51,777 
Income (loss) from continuing operations257,266 
Net income (loss)$257,266 
The following table summarizes significant expense categories by segment for the quarter ended March 31, 2025 (in thousands):
Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment/CorporateTotal
Compensation$818,164 $12 $13,695 $— $831,871 
Utilities89,927 94 13,881 — 103,902 
Food71,805 — — — 71,805 
Repairs and maintenance52,983 29 11,543 — 64,555 
Property taxes61,933 5,967 18,244 — 86,144 
Other segment expenses(1)
289,872 2,716 7,243 4,282 304,113 
Total property operating expenses$1,384,684 8,818 $64,606 4,282 $1,462,390 
(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 quarter ended March 31, 2024 (in thousands):
Three Months Ended March 31, 2024
Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment/CorporateTotal
Resident fees and services$1,360,274 $— $— $— $1,360,274 
Rental income— 221,744 195,908 — 417,652 
Interest income— — — 52,664 52,664 
Other income1,463 1,199 2,402 24,087 29,151 
Total revenues1,361,737 222,943 198,310 76,751 1,859,741 
Property operating expenses1,019,347 10,817 62,463 4,286 1,096,913 
Consolidated net operating income (loss)$342,390 $212,126 $135,847 $72,465 762,828 
Depreciation and amortization365,863 
Interest expense147,318 
General and administrative expenses53,318 
Loss (gain) on derivatives and financial instruments, net(3,054)
Loss (gain) on extinguishment of debt, net6 
Provision for loan losses, net1,014 
Impairment of assets43,331 
Other expenses14,131 
Income (loss) from continuing operations before income taxes and other items140,901 
Income tax (expense) benefit(6,191)
Income (loss) from unconsolidated entities(7,783)
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net4,707 
Income (loss) from continuing operations131,634 
Net income (loss)$131,634 
The following table summarizes significant expense categories by segment for the quarter ended March 31, 2024 (in thousands):
Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment/CorporateTotal
Compensation$598,618 $20 $14,004 $— $612,642 
Utilities67,640 89 11,962 — 79,691 
Food55,625 — — — 55,625 
Repairs and maintenance38,810 30 10,425 — 49,265 
Property taxes50,507 8,150 18,813 — 77,470 
Other segment expenses(1)
208,147 2,528 7,259 4,286 222,220 
Total property operating expenses$1,019,347 $10,817 $62,463 $4,286 $1,096,913 
(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
March 31, 2025December 31, 2024
Assets:Amount%Amount%
Seniors Housing Operating$31,598,061 59.3 %$30,094,016 59.0 %
Triple-net8,757,037 16.4 %7,934,415 15.5 %
Outpatient Medical7,538,246 14.1 %7,530,815 14.8 %
Non-segment/Corporate5,400,270 10.1 %5,485,062 10.7 %
Total$53,293,614 100.0 %$51,044,308 100.0 %
Our portfolio of properties and other investments are located in the United States, the United Kingdom and Canada. Revenues and assets are attributed to the country in which the property is physically located. The following is a summary of geographic information for the periods presented (dollars in thousands): 
 Three Months Ended
 March 31, 2025March 31, 2024
Revenues:Amount%Amount%
United States$1,889,335 78.0 %$1,546,896 83.2 %
United Kingdom375,507 15.5 %161,508 8.7 %
Canada158,245 6.5 %151,337 8.1 %
Total$2,423,087 100.0 %$1,859,741 100.0 %
Three Months Ended
March 31, 2025March 31, 2024
Resident Fees and Services:Amount%Amount%
United States$1,394,008 74.7 %$1,097,339 80.7 %
United Kingdom321,829 17.3 %116,879 8.6 %
Canada148,693 8.0 %146,056 10.7 %
Total$1,864,530 100.0 %$1,360,274 100.0 %
 As of
 March 31, 2025December 31, 2024
Assets:Amount%Amount%
United States$41,525,349 77.9 %$41,966,871 82.2 %
United Kingdom6,412,025 12.0 %5,892,598 11.5 %
Canada5,356,240 10.1 %3,184,839 6.3 %
Total$53,293,614 100.0 %$51,044,308 100.0 %