Segment Reporting

3 Months Ended

Mar. 31, 2026

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 wellness housing, 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. Prior to the Outpatient Medical Portfolio Disposition discussed in Note 5, our Outpatient Medical properties were typically leased to multiple tenants and generally required a certain level of property management. Our remaining Outpatient Medical portfolio, exclusive of held for sale properties, primarily consists of properties triple-net leased to healthcare providers.

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.

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, 2025). 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 three months ended March 31, 2026 (in thousands): 

Three Months Ended March 31, 2026	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment/Corporate		Total
Resident fees and services	$	2,780,931	$	—	$	—	$	—	$	2,780,931
Rental income	—		383,803		70,039		—		453,842
Interest income	—		8,077		—		62,852		70,929
Other income	9,443		232		1,093		35,456		46,224
Total revenues	2,790,374		392,112		71,132		98,308		3,351,926
Property operating expenses	2,015,361		7,806		17,833		14,420		2,055,420
Consolidated net operating income (loss)	$	775,013	$	384,306	$	53,299	$	83,888	1,296,506
Depreciation and amortization									622,752
Interest expense									192,715
General and administrative expenses									67,474
Loss (gain) on extinguishment of debt, net									727
Provision for loan losses, net									1,632
Impairment of assets									4,826
Other expenses									61,137
Income (loss) from continuing operations before income taxes and other items									345,243
Income tax (expense) benefit									(11,633)
Income (loss) from unconsolidated entities									(1,686)
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net									420,400
Income (loss) from continuing operations									752,324
Net income (loss)									$	752,324

The following table summarizes significant expense categories by segment for the three months ended March 31, 2026 (in thousands):

	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment/Corporate		Total
Compensation	$	1,248,229	$	28	$	3,277	$	—	$	1,251,534
Utilities	121,594		83		3,325		—		125,002
Food	102,531		—		—		—		102,531
Repairs and maintenance	79,672		129		2,800		—		82,601
Property taxes	72,697		5,803		5,231		—		83,731
Other segment expenses(1)	390,638		1,763		3,200		14,420		410,021
Total property operating expenses	$	2,015,361	$	7,806	$	17,833	$	14,420	$	2,055,420
(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 March 31, 2025 (in thousands):

Three Months Ended March 31, 2025	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment/Corporate		Total
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 income	3,341		231		2,137		28,791		34,500
Total revenues	1,867,871		255,030		211,016		89,170		2,423,087
Property operating expenses	1,384,684		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 amortization									485,869
Interest expense									144,962
General and administrative expenses									63,758
Loss (gain) on derivatives and financial instruments, net									(3,210)
Loss (gain) on extinguishment of debt, net									6,156
Provision for loan losses, net									(2,007)
Impairment of assets									52,402
Other expenses									14,060
Income (loss) from continuing operations before income taxes and other items									198,707
Income tax (expense) benefit									5,519
Income (loss) from unconsolidated entities									1,263
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net									51,777
Income (loss) from continuing operations									257,266
Net income (loss)									$	257,266

The following table summarizes significant expense categories by segment for the three months ended March 31, 2025 (in thousands):

	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment/Corporate		Total
Compensation	$	818,164	$	12	$	13,695	$	—	$	831,871
Utilities	89,927		94		13,881		—		103,902
Food	71,805		—		—		—		71,805
Repairs and maintenance	52,983		29		11,543		—		64,555
Property taxes	61,933		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 our total assets by segment for the periods presented (in thousands):

	As of
	March 31, 2026				December 31, 2025
Assets:	Amount		%		Amount		%
Seniors Housing Operating	$	42,769,806	63.6	%	$	42,014,932	62.4	%
Triple-net	12,871,092		19.1	%	13,448,058		20.0	%
Outpatient Medical	2,404,025		3.6	%	3,322,225		4.9	%
Non-segment/Corporate	9,175,633		13.7	%	8,517,832		12.7	%
Total	$	67,220,556	100.0	%	$	67,303,047	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, 2026				March 31, 2025
Revenues:	Amount		%		Amount		%
United States	$	2,067,124	61.7	%	$	1,889,335	78.0	%
United Kingdom	1,083,186		32.3	%	375,507		15.5	%
Canada	201,616		6.0	%	158,245		6.5	%
Total	$	3,351,926	100.0	%	$	2,423,087	100.0	%
	Three Months Ended
	March 31, 2026				March 31, 2025
Resident Fees and Services:	Amount		%		Amount		%
United States	$	1,634,557	58.8	%	$	1,394,008	74.7	%
United Kingdom	961,814		34.6	%	321,829		17.3	%
Canada	184,560		6.6	%	148,693		8.0	%
Total	$	2,780,931	100.0	%	$	1,864,530	100.0	%
	As of
	March 31, 2026				December 31, 2025
Assets:	Amount		%		Amount		%
United States	$	43,212,714	64.3	%	$	43,536,068	64.7	%
United Kingdom	17,803,264		26.5	%	18,056,095		26.8	%
Canada	6,204,578		9.2	%	5,710,884		8.5	%
Total	$	67,220,556	100.0	%	$	67,303,047	100.0	%