Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2016	Mar. 31, 2015
Operating activities
Net income (loss)		$ 165,474	$ 209,422
Adjustments to reconcile net income to net cash provided from (used in) operating activities:
Depreciation and amortization		228,696	188,829
Other amortization expenses		1,118	1,320
Asset Impairment Charges		14,314	2,220
Stock-based compensation expense		8,186	9,054
Loss (gain) on derivatives, net		0	(58,427)	[1]
Loss (gain) on extinguishment of debt, net		(24)	15,401
Income from unconsolidated entities		3,820	12,648
Rental income in excess of cash received		(29,669)	(27,244)
Amortization related to above (below) market leases, net		230	113
Net loss (gain) on sales of properties		0	(56,845)
Distributions by unconsolidated entities		174	172
Increase (decrease) in accrued expenses and other liabilities		(20,423)	(47,489)
Decrease (increase) in receivables and other assets		1,816	(22,992)
Net cash provided from (used in) operating activities		373,712	226,182
Investing activities
Cash disbursed for acquisitions		(171,482)	(1,500,994)
Cash disbursed for capital improvements to existing properties		(35,025)	(29,828)
Cash disbursed for construction in progress		(66,739)	(59,552)
Capitalized interest		(3,037)	(2,387)
Investment in real estate loans receivable		(27,251)	(384,695)
Other investments, net of payments		(30,773)	(102,126)
Principal collected on real estate loans receivable		93,774	16,501
Contributions to unconsolidated entities		(12,784)	(83,964)
Distributions by unconsolidated entities		11,747	89,195
Proceeds from (payments on) derivatives investing		0	72,477
Decrease (increase) in restricted cash		(394)	(1,660)
Proceeds from sales of real property		0	177,265
Net cash provided from (used in) investing activities		(241,964)	(1,809,768)
Financing activities
Net increase (decrease) under unsecured lines of credit arrangements		(190,000)	410,000
Proceeds from issuance of senior unsecured notes		688,560	0
Payments to extinguish senior unsecured notes		(400,000)	(154,654)
Secured debt issued		75,136	82,724
Payments on secured debt		(130,343)	(208,057)
Net proceeds from the issuance of common stock		93,433	1,489,547
Decrease (increase) in deferred loan expenses		(1,217)	(4,485)
Contributions by noncontrolling interests	[2]	126,142	2,514
Distributions to noncontrolling interests	[2]	(76,222)	(7,417)
Cash distributions to stockholders		(322,122)	(288,921)
Other financing activities		(397)	(8,428)
Net cash provided from (used in) financing activities		(137,030)	1,312,823
Effect of foreign currency translation on cash and cash equivalents		323	(690)
Increase (decrease) in cash and cash equivalents		(4,959)	(271,453)
Cash and cash equivalents at beginning of period		360,908	473,726
Cash and cash equivalents at end of period		355,949	202,273
Supplemental cash flow information:
Interest paid		134,872	134,737
Income taxes paid		$ 2,431	$ 2,942

[1] (1) In April 2011, we completed the acquisition of substantially all of the real estate assets of privately-owned Genesis Healthcare Corporation. In conjunction with this transaction, we received the option to acquire an ownership interest in Genesis Healthcare. In February 2015, Genesis Healthcare closed on a transaction to merge with Skilled Healthcare Group to become a publicly traded company which required us to record the value of the derivative asset due to the net settlement feature.

[2] (1) Includes amounts attributable to redeemable noncontrolling interests.