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Intangible Assets and Goodwill
 6 Months Ended
Jun. 30, 2025
Goodwill and Intangible Assets Disclosure [Abstract]  
Intangible Assets and Goodwill Intangible Assets and Goodwill
The following is a summary of our real estate intangibles, excluding those related to ground leases or classified as held for sale, as of the dates indicated (in thousands):
 June 30, 2025December 31, 2024
Assets:
Gross acquired lease intangibles$2,775,121 $2,548,766 
Accumulated amortization(2,119,885)(1,882,822)
Net book value$655,236 $665,944 
Liabilities:
Below market tenant leases$78,679 $70,364 
Accumulated amortization(54,387)(52,397)
Net book value$24,292 $17,967 
The following is a summary of real estate intangible amortization income (expense) for the periods presented (in thousands):
Three Months Ended June 30,
Six Months Ended June 30,
2025202420252024
Rental income related to (above)/below market tenant leases, net$(148)$(54)$(310)$(85)
Amortization related to in-place lease intangibles and lease commissions(101,546)(60,876)(210,529)(107,667)
Goodwill
The change in the carrying amount of goodwill by reportable segment is as follows (in thousands):
Seniors Housing OperatingOutpatient MedicalTotal
Balance at December 31, 2024
$80,904 $68,321 $149,225 
Acquisition measurement period adjustment$50,893 $— $50,893 
Effect of foreign currency translation8,365 — 8,365 
Balance at June 30, 2025
$140,162 $68,321 $208,483