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Segment Reporting (Tables)
9 Months Ended
Sep. 30, 2019
Segment Reporting [Abstract]  
Summary Information for Reportable Segments Summary information for the reportable segments (which excludes unconsolidated entities) is as follows (in thousands): 
Three Months Ended September 30, 2019:

Seniors Housing Operating

Triple-net
 
Outpatient Medical

Non-segment / Corporate

Total
Resident fees and services

$
834,121


$

 
$


$


$
834,121

Rental income



227,499

 
184,648




412,147

Interest income



15,279

 
358




15,637

Other income

1,375


1,829

 
183


841


4,228

Total revenues

835,496

 
244,607

 
185,189

 
841


1,266,133

 
 
 
 
 
 
 
 
 
 


Property operating expenses

581,341


13,922

 
60,325




655,588

Consolidated net operating income

254,155

 
230,685

 
124,864

 
841


610,545

 
 
 
 
 
 
 
 
 
 


Depreciation and amortization

148,126


57,147

 
67,172




272,445

Interest expense

16,356


3,076

 
3,363


114,548


137,343

General and administrative expenses




 


31,019


31,019

Loss (gain) on derivatives and financial instruments, net



1,244

 




1,244

Loss (gain) on extinguishment of debt, net

1,450



 


64,374


65,824

Impairment of assets

2,599


12,314

 
3,183




18,096

Other expenses

4,274


(2,496
)
 
524


3,884


6,186

Income (loss) from continuing operations before income taxes and other items

81,350

 
159,400

 
50,622

 
(212,984
)

78,388

Income tax (expense) benefit

(2,554
)

12

 
(302
)

(1,124
)

(3,968
)
(Loss) income from unconsolidated entities

(3,859
)

5,276

 
1,845




3,262

Gain (loss) on real estate dispositions, net

519,203


51,529

 
(482
)



570,250

Income (loss) from continuing operations

594,140

 
216,217

 
51,683

 
(214,108
)

647,932

Net income (loss)

$
594,140

 
$
216,217

 
$
51,683

 
$
(214,108
)

$
647,932

 
 
 
 
 
 
 
 
 
 


Total assets

$
15,095,737


$
9,350,606

 
$
7,173,763


$
243,849


$
31,863,955

Three Months Ended September 30, 2018:
 
Seniors Housing Operating
 
Triple-net
 
Outpatient Medical
 
Non-segment / Corporate
 
Total
Resident fees and services
 
$
875,171

 
$

 
$

 
$

 
$
875,171

Rental income
 

 
203,039

 
139,848

 

 
342,887

Interest income
 
159

 
14,378

 
85

 

 
14,622

Other income
 
1,175

 
1,693

 
136

 
695

 
3,699

Total revenues
 
876,505

 
219,110

 
140,069

 
695

 
1,236,379

 
 
 
 
 
 
 
 
 
 


Property operating expenses
 
610,659

 
426

 
46,072

 

 
657,157

Consolidated net operating income
 
265,846

 
218,684

 
93,997

 
695

 
579,222

 
 
 
 
 
 
 
 
 
 


Depreciation and amortization
 
136,532

 
60,383

 
46,234

 

 
243,149

Interest expense
 
17,319

 
3,500

 
1,643

 
115,570

 
138,032

General and administrative expenses
 

 

 

 
28,746

 
28,746

Loss (gain) on derivatives and financial instruments, net
 

 
8,991

 

 

 
8,991

Loss (gain) on extinguishment of debt, net
 

 

 

 
4,038

 
4,038

Impairment of assets
 
562

 
6,178

 

 

 
6,740

Other expenses
 
(811
)
 
87,076


1,055

 
1,306

 
88,626

Income (loss) from continuing operations before income taxes and other items
 
112,244

 
52,556

 
45,065

 
(148,965
)
 
60,900

Income tax (expense) benefit
 
211

 
1,116

 
239

 
(3,307
)
 
(1,741
)
(Loss) income from unconsolidated entities
 
(6,705
)
 
5,377

 
1,672

 

 
344

Gain (loss) on real estate dispositions, net
 
(1
)
 
24,782

 
(58
)
 

 
24,723

Income (loss) from continuing operations
 
105,749

 
83,831

 
46,918

 
(152,272
)
 
84,226

Net income (loss)
 
$
105,749

 
$
83,831

 
$
46,918

 
$
(152,272
)
 
$
84,226


Nine Months Ended September 30, 2019
 
Seniors Housing Operating
 
Triple-net
 
Outpatient Medical
 
Non-segment / Corporate
 
Total
Resident fees and services
 
$
2,616,491

 
$

 
$

 
$

 
$
2,616,491

Rental income
 

 
681,893

 
496,924

 

 
1,178,817

Interest income
 

 
47,343

 
769

 

 
48,112

Other income
 
6,920

 
4,370

 
322

 
3,452

 
15,064

Total revenues
 
2,623,411

 
733,606

 
498,015

 
3,452

 
3,858,484

 
 
 
 
 
 
 
 
 
 

Property operating expenses
 
1,826,344

 
41,700

 
159,478

 

 
2,027,522

Consolidated net operating income
 
797,067

 
691,906

 
338,537

 
3,452

 
1,830,962

 
 
 
 
 
 
 
 
 
 

Depreciation and amortization
 
416,252

 
174,551

 
173,626

 

 
764,429

Interest expense
 
52,179

 
9,741

 
10,097

 
351,894

 
423,911

General and administrative expenses
 

 

 

 
100,042

 
100,042

Loss (gain) on derivatives and financial instruments, net
 

 
670

 

 

 
670

Loss (gain) on extinguishment of debt, net
 
1,450

 

 

 
80,093

 
81,543

Provision for loan losses
 

 
18,690

 

 

 
18,690

Impairment of assets
 
2,599

 
11,374

 
14,062

 

 
28,035

Other expenses
 
19,077

 
6,093

 
1,274

 
10,126

 
36,570

Income (loss) from continuing operations before income taxes and other items
 
305,510

 
470,787

 
139,478

 
(538,703
)
 
377,072

Income tax (expense) benefit
 
(2,798
)
 
(2,300
)
 
(1,253
)
 
(1,438
)
 
(7,789
)
(Loss) income from unconsolidated entities
 
(37,892
)
 
17,512

 
5,394

 

 
(14,986
)
Gain (loss) on real estate dispositions, net
 
518,493

 
217,973

 
(489
)
 

 
735,977

Income (loss) from continuing operations
 
783,313

 
703,972

 
143,130

 
(540,141
)
 
1,090,274

Net income (loss)
 
$
783,313

 
$
703,972

 
$
143,130

 
$
(540,141
)
 
$
1,090,274


Nine Months Ended September 30, 2018
 
Seniors Housing Operating
 
Triple-net
 
Outpatient Medical
 
Non-segment / Corporate
 
Total
Resident fees and services
 
$
2,374,450

 
$

 
$

 
$

 
$
2,374,450

Rental income
 

 
607,831

 
412,026

 

 
1,019,857

Interest income
 
416

 
42,176

 
140

 

 
42,732

Other income
 
3,973

 
16,282

 
401

 
1,561

 
22,217

Total revenues
 
2,378,839

 
666,289

 
412,567

 
1,561

 
3,459,256

 
 
 
 
 
 
 
 
 
 
 
Property operating expenses
 
1,648,262

 
583

 
133,528

 

 
1,782,373

Consolidated net operating income
 
730,577

 
665,706

 
279,039

 
1,561

 
1,676,883

 
 
 
 
 
 
 
 
 
 
 
Depreciation and amortization
 
397,080

 
171,724

 
138,821

 

 
707,625

Interest expense
 
51,225

 
10,742

 
4,975

 
315,281

 
382,223

General and administrative expenses
 

 

 

 
95,282

 
95,282

Loss (gain) on derivatives and financial
instruments, net
 

 
(5,642
)
 

 

 
(5,642
)
Loss (gain) on extinguishment of debt, net
 
110

 
(32
)
 
11,928

 
4,038

 
16,044

Impairment of assets
 
5,075

 
34,482

 

 

 
39,557

Other expenses
 
5,168

 
89,153

 
3,748

 
4,327

 
102,396

Income (loss) from continuing operations before income taxes and other items
 
271,919

 
365,279

 
119,567

 
(417,367
)
 
339,398

Income tax (expense) benefit
 
(2,244
)
 
(708
)
 
(567
)
 
(3,651
)
 
(7,170
)
(Loss) income from unconsolidated entities
 
(21,389
)
 
16,260

 
4,293

 

 
(836
)
Gain (loss) on real estate dispositions, net
 
3

 
158,938

 
214,721

 

 
373,662

Income (loss) from continuing operations
 
248,289

 
539,769

 
338,014

 
(421,018
)
 
705,054

Net income (loss)
 
$
248,289

 
$
539,769

 
$
338,014

 
$
(421,018
)
 
$
705,054


Summary of Geographic Information The following is a summary of geographic information for the periods presented (dollars in thousands): 
 
 
Three Months Ended
 
Nine Months Ended
 
 
September 30, 2019
 
September 30, 2018
 
September 30, 2019
 
September 30, 2018
Revenues:
 
Amount
 
%
 
Amount
 
%
 
Amount
 
%
 
Amount
 
%
United States
 
$
1,039,016

 
82.1
%
 
$
1,007,203

 
81.5
%
 
$
3,175,059

 
82.3
%
 
$
2,766,726

 
80.0
%
United Kingdom
 
110,303

 
8.7
%
 
111,503

 
9.0
%
 
335,368

 
8.7
%
 
340,059

 
9.8
%
Canada
 
116,814

 
9.2
%
 
117,673

 
9.5
%
 
348,057

 
9.0
%
 
352,471

 
10.2
%
Total
 
$
1,266,133

 
100.0
%
 
$
1,236,379

 
100.0
%
 
$
3,858,484

 
100.0
%
 
$
3,459,256

 
100.0
%
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
As of
 
 
 
 
September 30, 2019
 
December 31, 2018
 
 
 
 
Assets:
 
Amount
 
%
 
Amount
 
%
 
 
 
 
 
 
 
 
United States
 
$
26,302,481

 
82.5
%
 
$
24,884,292

 
82.0
%
 
 
 
 
 
 
 
 
United Kingdom
 
3,109,553

 
9.8
%
 
3,078,994

 
10.1
%
 
 
 
 
 
 
 
 
Canada
 
2,451,921

 
7.7
%
 
2,378,786

 
7.9
%
 
 
 
 
 
 
 
 
Total
 
$
31,863,955

 
100.0
%
 
$
30,342,072

 
100.0
%