Segment Reporting (Tables)

6 Months Ended

Jun. 30, 2025

Segment Reporting [Abstract]

Summary Information for Reportable Segments

The following table summarizes information for the reportable segments for the three months ended June 30, 2025 (in thousands): 

Three Months Ended June 30, 2025	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment/Corporate		Total
Resident fees and services	$	1,971,044	$	—	$	—	$	—	$	1,971,044
Rental income	—		273,394		209,646		—		483,040
Interest income	—		—		—		62,057		62,057
Other income	4,688		360		2,165		24,890		32,103
Total revenues	1,975,732		273,754		211,811		86,947		2,548,244
Property operating expenses	1,438,277		8,652		62,834		4,948		1,514,711
Consolidated net operating income (loss)	$	537,455	$	265,102	$	148,977	$	81,999	1,033,533
Depreciation and amortization									495,036
Interest expense									141,157
General and administrative expenses									64,175
Loss (gain) on derivatives and financial instruments, net									(409)
Provision for loan losses, net									(1,113)
Impairment of assets									19,876
Other expenses									16,598
Income (loss) from continuing operations before income taxes and other items									298,213
Income tax (expense) benefit									(1,053)
Income (loss) from unconsolidated entities									(7,392)
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net									14,850
Income (loss) from continuing operations									304,618
Net income (loss)									$	304,618

The following table summarizes significant expense categories by segment for the three months ended June 30, 2025 (in thousands):

	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment/Corporate		Total
Compensation	$	858,972	$	20	$	14,845	$	—	$	873,837
Utilities	78,287		115		12,613		—		91,015
Food	77,387		—		—		—		77,387
Repairs and maintenance	54,807		17		10,835		—		65,659
Property taxes	64,612		5,999		17,980		—		88,591
Other segment expenses(1)	304,212		2,501		6,561		4,948		318,222
Total property operating expenses	$	1,438,277	$	8,652	$	62,834	$	4,948	$	1,514,711
(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 three months ended June 30, 2024 (in thousands):

Three Months Ended June 30, 2024	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment/Corporate		Total
Resident fees and services	$	1,393,473	$	—	$	—	$	—	$	1,393,473
Rental income	—		141,151		194,660		—		335,811
Interest income	—		—		—		63,453		63,453
Other income	1,900		931		2,577		26,739		32,147
Total revenues	1,395,373		142,082		197,237		90,192		1,824,884
Property operating expenses	1,034,906		10,495		61,185		4,711		1,111,297
Consolidated net operating income (loss)	$	360,467	$	131,587	$	136,052	$	85,481	713,587
Depreciation and amortization									382,045
Interest expense									133,424
General and administrative expenses									55,565
Loss (gain) on derivatives and financial instruments, net									(5,825)
Loss (gain) on extinguishment of debt, net									1,705
Provision for loan losses, net									5,163
Impairment of assets									2,394
Other expenses									48,684
Income (loss) from continuing operations before income taxes and other items									90,432
Income tax (expense) benefit									(1,101)
Income (loss) from unconsolidated entities									4,896
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net									166,443
Income (loss) from continuing operations									260,670
Net income (loss)									$	260,670

The following table summarizes significant expense categories by segment for the three months ended June 30, 2024 (in thousands):

	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment/Corporate		Total
Compensation	$	606,115	$	21	$	14,059	$	—	$	620,195
Utilities	59,890		98		12,690		—		72,678
Food	56,132		—		—		—		56,132
Repairs and maintenance	40,158		18		10,063		—		50,239
Property taxes	52,434		7,820		18,099		—		78,353
Other segment expenses(1)	220,177		2,538		6,274		4,711		233,700
Total property operating expenses	$	1,034,906	$	10,495	$	61,185	$	4,711	$	1,111,297
(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
	June 30, 2025				December 31, 2024
Assets:	Amount		%		Amount		%
Seniors Housing Operating	$	33,037,597	59.2	%	$	30,094,016	59.0	%
Triple-net	8,880,142		15.9	%	7,934,415		15.5	%
Outpatient Medical	7,495,922		13.4	%	7,530,815		14.8	%
Non-segment/Corporate	6,419,834		11.5	%	5,485,062		10.7	%
Total	$	55,833,495	100.0	%	$	51,044,308	100.0	%

The following table summarizes information for the reportable segments for the six months ended June 30, 2025 (in thousands): 

Six Months Ended June 30, 2025	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment / Corporate		Total
Resident fees and services	$	3,835,574	$	—	$	—	$	—	$	3,835,574
Rental income	—		526,082		418,525		—		944,607
Interest income	—		2,111		—		122,436		124,547
Other income	8,029		591		4,302		53,681		66,603
Total revenues	3,843,603		528,784		422,827		176,117		4,971,331
Property operating expenses	2,822,961		17,470		127,440		9,230		2,977,101
Consolidated net operating income (loss)	$	1,020,642	$	511,314	$	295,387	$	166,887	1,994,230
Depreciation and amortization									980,905
Interest expense									286,119
General and administrative expenses									127,933
Loss (gain) on derivatives and financial instruments, net									(3,619)
Loss (gain) on extinguishment of debt, net									6,156
Provision for loan losses, net									(3,120)
Impairment of assets									72,278
Other expenses									30,658
Income (loss) from continuing operations before income taxes and other items									496,920
Income tax (expense) benefit									4,466
Income (loss) from unconsolidated entities									(6,129)
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net									66,627
Income (loss) from continuing operations									561,884
Net income (loss)									$	561,884

The following table summarizes significant expense categories by segment for the six months ended June 30, 2025 (in thousands):

	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment/Corporate		Total
Compensation	$	1,677,136	$	32	$	28,540	$	—	$	1,705,708
Utilities	168,214		209		26,494		—		194,917
Food	149,192		—		—		—		149,192
Repairs and maintenance	107,790		46		22,378		—		130,214
Property taxes	126,545		11,966		36,224		—		174,735
Other segment expenses(1)	594,084		5,217		13,804		9,230		622,335
Total property operating expenses	$	2,822,961	$	17,470	$	127,440	$	9,230	$	2,977,101
(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.

Six Months Ended June 30, 2024	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment / Corporate		Total
Resident fees and services	$	2,753,747	$	—	$	—	$	—	$	2,753,747
Rental income	—		362,895		390,568		—		753,463
Interest income	—		—		—		116,117		116,117
Other income	3,363		2,130		4,979		50,826		61,298
Total revenues	2,757,110		365,025		395,547		166,943		3,684,625
Property operating expenses	2,054,253		21,312		123,648		8,997		2,208,210
Consolidated net operating income (loss)	$	702,857	$	343,713	$	271,899	$	157,946	1,476,415
Depreciation and amortization									747,908
Interest expense									280,742
General and administrative expenses									108,883
Loss (gain) on derivatives and financial instruments, net									(8,879)
Loss (gain) on extinguishment of debt, net									1,711
Provision for loan losses, net									6,177
Impairment of assets									45,725
Other expenses									62,815
Income (loss) from continuing operations before income taxes and other items									231,333
Income tax (expense) benefit									(7,292)
Income (loss) from unconsolidated entities									(2,887)
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net									171,150
Income (loss) from continuing operations									392,304
Net income (loss)									$	392,304

The following table summarizes significant expense categories by segment for the six months ended June 30, 2024 (in thousands):

	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment/Corporate		Total
Compensation	$	1,204,733	$	41	$	28,063	$	—	$	1,232,837
Utilities	127,530		187		24,652		—		152,369
Food	111,757		—		—		—		111,757
Repairs and maintenance	78,968		48		20,488		—		99,504
Property taxes	102,941		15,970		36,912		—		155,823
Other segment expenses(1)	428,324		5,066		13,533		8,997		455,920
Total property operating expenses	$	2,054,253	$	21,312	$	123,648	$	8,997	$	2,208,210
(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.

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, 2025				June 30, 2024				June 30, 2025				June 30, 2024
Revenues:	Amount		%		Amount		%		Amount		%		Amount		%
United States	$	1,944,405	76.3	%	$	1,530,174	83.9	%	$	3,833,740	77.2	%	$	3,077,070	83.5	%
United Kingdom	416,809		16.4	%	163,264		8.9	%	792,316		15.9	%	324,772		8.8	%
Canada	187,030		7.3	%	131,446		7.2	%	345,275		6.9	%	282,783		7.7	%
Total	$	2,548,244	100.0	%	$	1,824,884	100.0	%	$	4,971,331	100.0	%	$	3,684,625	100.0	%
	Three Months Ended								Six Months Ended
	June 30, 2025				June 30, 2024				June 30, 2025				June 30, 2024
Resident Fees and Services:	Amount		%		Amount		%		Amount		%		Amount		%
United States	$	1,446,648	73.4	%	$	1,148,809	82.4	%	$	2,840,656	74.1	%	$	2,246,148	81.6	%
United Kingdom	356,939		18.1	%	117,794		8.5	%	678,768		17.7	%	234,673		8.5	%
Canada	167,457		8.5	%	126,870		9.1	%	316,150		8.2	%	272,926		9.9	%
Total	$	1,971,044	100.0	%	$	1,393,473	100.0	%	$	3,835,574	100.0	%	$	2,753,747	100.0	%
	As of
	June 30, 2025				December 31, 2024
Assets:	Amount		%		Amount		%
United States	$	43,370,689	77.7	%	$	41,966,871	82.2	%
United Kingdom	6,826,892		12.2	%	5,892,598		11.5	%
Canada	5,635,914		10.1	%	3,184,839		6.3	%
Total	$	55,833,495	100.0	%	$	51,044,308	100.0	%