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Intangible Assets and Goodwill
 9 Months Ended
Sep. 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):
 September 30, 2025December 31, 2024
Assets:
Gross acquired lease intangibles$2,189,639 $2,548,766 
Accumulated amortization(1,805,768)(1,882,822)
Net book value$383,871 $665,944 
Liabilities:
Below market tenant leases$71,914 $70,364 
Accumulated amortization(55,174)(52,397)
Net book value$16,740 $17,967 
The following is a summary of real estate intangible amortization income (expense) for the periods presented (in thousands):
Three Months Ended September 30,
Nine Months Ended September 30,
2025202420252024
Rental income related to (above)/below market tenant leases, net$(156)$(189)$(466)$(274)
Amortization related to in-place lease intangibles and lease commissions(95,694)(61,872)(306,223)(169,539)
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 adjustments$50,625 $— $50,625 
Effect of foreign currency translation5,749 — 5,749 
Balance at September 30, 2025
$137,278 $68,321 $205,599