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Segment Reporting (Tables)
6 Months Ended
Jun. 30, 2018
Segment Reporting [Abstract]  
Summary of information for reportable segments
The following is a summary of geographic information for the periods presented (dollars in thousands): 
 
 
Three Months Ended
 
Six Months Ended
 
 
June 30, 2018
 
June 30, 2017
 
June 30, 2018
 
June 30, 2017
Revenues:
 
Amount
 
%
 
Amount
 
%
 
Amount
 
%
 
Amount
 
%
United States
 
$
895,734

 
79.5
%
 
$
851,943

 
80.5
%
 
$
1,759,523

 
79.1
%
 
$
1,710,611

 
80.7
%
United Kingdom
 
112,031

 
10.0
%
 
99,747

 
9.4
%
 
228,556

 
10.3
%
 
193,590

 
9.1
%
Canada
 
118,147

 
10.5
%
 
106,912

 
10.1
%
 
234,798

 
10.6
%
 
216,699

 
10.2
%
Total
 
$
1,125,912

 
100.0
%
 
$
1,058,602

 
100.0
%
 
$
2,222,877

 
100.0
%
 
$
2,120,900

 
100.0
%
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
As of
 
 
 
 
June 30, 2018
 
December 31, 2017
 
 
 
 
Assets:
 
Amount
 
%
 
Amount
 
%
 
 
 
 
 
 
 
 
United States
 
$
21,959,262

 
79.5
%
 
$
22,274,443

 
79.7
%
 
 
 
 
 
 
 
 
United Kingdom
 
3,208,929

 
11.6
%
 
3,239,039

 
11.6
%
 
 
 
 
 
 
 
 
Canada
 
2,450,791

 
8.9
%
 
2,430,963

 
8.7
%
 
 
 
 
 
 
 
 
Total
 
$
27,618,982

 
100.0
%
 
$
27,944,445

 
100.0
%
 
 
 
 
 
 
 
 
Summary information for the reportable segments (which excludes unconsolidated entities) is as follows (in thousands): 
Three Months Ended June 30, 2018:

Triple-net

Seniors Housing Operating

Outpatient Medical

Non-segment / Corporate

Total
Rental income

$
197,961


$


$
135,640


$


$
333,601

Resident fees and services



763,345






763,345

Interest income

13,247


172


43




13,462

Other income(1)

13,212


1,650


144


498


15,504

Total revenues

224,420

 
765,167

 
135,827

 
498


1,125,912

Property operating expenses

136


525,662


42,953




568,751

Consolidated net operating income

224,284

 
239,505

 
92,874

 
498


557,161

Interest expense

3,800


16,971


1,656


98,989


121,416

Loss (gain) on derivatives and financial instruments, net

(7,460
)







(7,460
)
Depreciation and amortization

55,309


134,779


46,187




236,275

General and administrative







32,831


32,831

Loss (gain) on extinguishment of debt, net



299






299

Impairment of assets

2,420


2,212






4,632

Other expenses

957


6,167


2,095


839


10,058

Income (loss) from continuing operations before income taxes and income from unconsolidated entities

169,258

 
79,077

 
42,936

 
(132,161
)

159,110

Income tax (expense) benefit

(688
)

(2,617
)

(378
)

(158
)

(3,841
)
Income (loss) from unconsolidated entities

5,062


(5,204
)

1,391




1,249

Income (loss) from continuing operations

173,632

 
71,256

 
43,949

 
(132,319
)

156,518

Gain (loss) on real estate dispositions, net

10,759


(1
)

(3
)



10,755

Net income (loss)

$
184,391

 
$
71,255

 
$
43,946

 
$
(132,319
)

$
167,273

Total assets

$
8,735,524


$
13,785,165


$
4,886,011


$
212,282


$
27,618,982

 
 
 
 
 
 
 
 
 
 
 
(1) Includes $10,805,000 of lease termination fee income recognized in the triple-net segment.
Three Months Ended June 30, 2017:
 
Triple-net
 
Seniors Housing Operating
 
Outpatient Medical
 
Non-segment / Corporate
 
Total
Rental income
 
$
217,889

 
$

 
$
137,710

 
$

 
$
355,599

Resident fees and services
 

 
677,040

 

 

 
677,040

Interest income
 
20,901

 

 

 

 
20,901

Other income
 
2,557

 
1,049

 
1,217

 
239

 
5,062

Total revenues
 
241,347

 
678,089

 
138,927

 
239

 
1,058,602

Property operating expenses
 

 
459,111

 
42,744

 

 
501,855

Consolidated net operating income
 
241,347

 
218,978

 
96,183

 
239

 
556,747

Interest expense
 
2,515

 
15,403

 
2,122

 
96,191

 
116,231

Loss (gain) on derivatives and financial instruments, net
 
736

 

 

 

 
736

Depreciation and amortization
 
60,171

 
117,198

 
47,478

 

 
224,847

General and administrative
 

 

 

 
32,632

 
32,632

Loss (gain) on extinguishment of debt, net
 

 
2,524

 
2,991

 

 
5,515

Impairment of assets
 
4,846

 
8,785

 

 

 
13,631

Other expenses
 
2,181

 
1,165

 
1,310

 
1,683

 
6,339

Income (loss) from continuing operations before income taxes and income from unconsolidated entities
 
170,898

 
73,903

 
42,282

 
(130,267
)
 
156,816

Income tax (expense) benefit
 
(1,471
)
 
10,247

 
(351
)
 
23

 
8,448

Income (loss) from unconsolidated entities
 
3,867

 
(8,449
)
 
604

 

 
(3,978
)
Income (loss) from continuing operations
 
173,294

 
75,701

 
42,535

 
(130,244
)
 
161,286

Gain (loss) on real estate dispositions, net
 
42,155

 

 

 

 
42,155

Net income (loss)
 
$
215,449

 
$
75,701

 
$
42,535

 
$
(130,244
)
 
$
203,441


Six Months Ended June 30, 2018
 
Triple-net
 
Seniors Housing Operating
 
Outpatient Medical
 
Non-segment / Corporate
 
Total
Rental income
 
$
404,792

 
$

 
$
272,178

 
$

 
$
676,970

Resident fees and services
 

 
1,499,279

 

 

 
1,499,279

Interest income
 
27,798

 
257

 
55

 

 
28,110

Other income
 
14,589

 
2,798

 
265

 
866

 
18,518

Total revenues
 
447,179

 
1,502,334

 
272,498

 
866

 
2,222,877

Property operating expenses
 
157

 
1,037,603

 
87,456

 

 
1,125,216

Consolidated net operating income
 
447,022

 
464,731

 
185,042

 
866

 
1,097,661

Interest expense
 
7,242

 
33,906

 
3,332

 
199,711

 
244,191

Loss (gain) on derivatives and financial instruments, net
 
(14,633
)
 

 

 

 
(14,633
)
Depreciation and amortization
 
111,341

 
260,548

 
92,587

 

 
464,476

General and administrative
 

 

 

 
66,536

 
66,536

Loss (gain) on extinguishment of debt, net
 
(32
)
 
110

 
11,928

 

 
12,006

Impairment of assets
 
28,304

 
4,513

 

 

 
32,817

Other expenses
 
2,077

 
5,979

 
2,693

 
3,021

 
13,770

Income (loss) from continuing operations before income taxes and income from unconsolidated entities
 
312,723

 
159,675

 
74,502

 
(268,402
)
 
278,498

Income tax (expense) benefit
 
(1,824
)
 
(2,455
)
 
(806
)
 
(344
)
 
(5,429
)
Income (loss) from unconsolidated entities
 
10,883

 
(14,684
)
 
2,621

 

 
(1,180
)
Income (loss) from continuing operations
 
321,782

 
142,536

 
76,317

 
(268,746
)
 
271,889

Gain (loss) on real estate dispositions, net
 
134,156

 
4

 
214,779

 

 
348,939

Net income (loss)
 
$
455,938

 
$
142,540

 
$
291,096

 
$
(268,746
)
 
$
620,828



Six Months Ended June 30, 2017
 
Triple-net
 
Seniors Housing Operating
 
Outpatient Medical
 
Non-segment / Corporate
 
Total
Rental income
 
$
445,180

 
$

 
$
277,561

 
$

 
$
722,741

Resident fees and services
 

 
1,347,377

 

 

 
1,347,377

Interest income
 
41,580

 
69

 

 

 
41,649

Other income
 
4,321

 
2,510

 
1,830

 
472

 
9,133

Total revenues
 
491,081

 
1,349,956

 
279,391

 
472

 
2,120,900

Property operating expenses
 

 
921,536

 
90,488

 

 
1,012,024

Consolidated net operating income
 
491,081

 
428,420

 
188,903

 
472

 
1,108,876

Interest expense
 
8,025

 
31,219

 
4,413

 
191,170

 
234,827

Loss (gain) on derivatives and financial instruments, net
 
1,960

 

 

 

 
1,960

Depreciation and amortization
 
119,781

 
236,935

 
96,408

 

 
453,124

General and administrative
 

 

 

 
63,733

 
63,733

Loss (gain) on extinguishment of debt, net
 
29,083

 
3,414

 
4,373

 

 
36,870

Impairment of assets
 
4,846

 
14,191

 
5,625

 

 
24,662

Other expenses
 
7,190

 
2,943

 
1,671

 
6,210

 
18,014

Income (loss) from continuing operations before income taxes and income from unconsolidated entities
 
320,196

 
139,718

 
76,413

 
(260,641
)
 
275,686

Income tax (expense) benefit
 
(2,271
)
 
9,160

 
(686
)
 

 
6,203

Income (loss) from unconsolidated entities
 
9,505

 
(37,640
)
 
1,051

 

 
(27,084
)
Income (loss) from continuing operations
 
327,430

 
111,238

 
76,778

 
(260,641
)
 
254,805

Gain (loss) on real estate dispositions, net
 
273,236

 
13,011

 

 

 
286,247

Net income (loss)
 
$
600,666

 
$
124,249

 
$
76,778

 
$
(260,641
)
 
$
541,052