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Segment Reporting
6 Months Ended
Jun. 30, 2020
Segment Reporting [Abstract]  
Segment Reporting Segment Reporting
We invest in seniors housing and health care real estate. We evaluate our business and make resource allocations on our three operating segments: Seniors Housing Operating, Triple-net and Outpatient Medical. Our Seniors Housing Operating properties include seniors apartments, assisted living, independent living/continuing care retirement communities, independent supportive living communities (Canada), care homes with and without nursing (U.K.) and combinations thereof that are owned and/or 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 health care real estate through acquisition and financing of primarily single tenant properties. Properties acquired are primarily leased under triple-net leases and we are not involved in the management of the property. Our Outpatient Medical properties are typically leased to multiple tenants and generally require a certain level of property management by us.
We evaluate performance based upon 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. We use 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 certain non-real estate investments and other income. Non-segment assets consist of corporate assets including 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, 2019). 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. There are no intersegment sales or transfers.
Summary information for the reportable segments (which excludes unconsolidated entities) is as follows (in thousands): 
Three Months Ended June 30, 2020:Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment / CorporateTotal
Resident fees and services$769,560  $—  $—  $—  $769,560  
Rental income—  217,492  178,813  —  396,305  
Interest income88  15,520  461  —  16,069  
Other income4,002  607  1,557  375  6,541  
Total revenues773,650  233,619  180,831  375  1,188,475  
Property operating expenses595,513  13,563  51,688  —  660,764  
Consolidated net operating income178,137  220,056  129,143  375  527,711  
Depreciation and amortization139,163  58,138  68,070  —  265,371  
Interest expense14,029  2,746  4,326  105,256  126,357  
General and administrative expenses—  —  —  34,062  34,062  
Loss (gain) on derivatives and financial instruments, net—  1,434  —  —  1,434  
Loss (gain) on extinguishment of debt, net(492) —  741  —  249  
Provision for loan losses—  1,451  (29) —  1,422  
Impairment of assets75,151  —  —  —  75,151  
Other expenses5,251  3,500  6,456  4,204  19,411  
Income (loss) from continuing operations before income taxes and other items(54,965) 152,787  49,579  (143,147) 4,254  
Income tax (expense) benefit—  —  —  (2,233) (2,233) 
Income (loss) from unconsolidated entities(6,787) 6,403  1,716  —  1,332  
Gain (loss) on real estate dispositions, net14,465  2,148  139,250  —  155,863  
Income (loss) from continuing operations(47,287) 161,338  190,545  (145,380) 159,216  
Net income (loss)$(47,287) $161,338  $190,545  $(145,380) $159,216  
Total assets$14,915,588  $9,189,707  $7,434,364  $1,622,993  $33,162,652  
Three Months Ended June 30, 2019:Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment / CorporateTotal
Resident fees and services$914,085  $—  $—  $—  $914,085  
Rental income—  222,362  163,224  —  385,586  
Interest income—  17,118  238  —  17,356  
Other income1,444  1,278  (97) 454  3,079  
Total revenues915,529  240,758  163,365  454  1,320,106  
Property operating expenses637,317  12,823  50,987  —  701,127  
Consolidated net operating income278,212  227,935  112,378  454  618,979  
Depreciation and amortization136,551  56,056  55,445  —  248,052  
Interest expense17,572  3,225  3,386  117,153  141,336  
General and administrative expenses—  —  —  33,741  33,741  
Loss (gain) on derivatives and financial instruments, net—  1,913  —  —  1,913  
Impairment of assets—  (940) 10,879  —  9,939  
Other expenses11,857  5,560  

(4) 4,215  21,628  
Income (loss) from continuing operations before income taxes and other items112,232  162,121  42,672  (154,655) 162,370  
Income tax (expense) benefit—  —  —  (1,599) (1,599) 
Income (loss) from unconsolidated entities(17,453) 6,578  1,826  —  (9,049) 
Gain (loss) on real estate dispositions, net(550) (1,130) (2) —  (1,682) 
Income (loss) from continuing operations94,229  167,569  44,496  (156,254) 150,040  
Net income (loss)$94,229  $167,569  $44,496  $(156,254) $150,040  
Six Months Ended June 30, 2020Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment / CorporateTotal
Resident fees and services$1,619,532  $—  $—  $—  $1,619,532  
Rental income—  408,877  377,388  —  786,265  
Interest income192  30,191  927  —  31,310  
Other income5,054  2,280  1,845  791  9,970  
Total revenues1,624,778  441,348  380,160  791  2,447,077  
Property operating expenses1,203,384  26,865  112,296  —  1,342,545  
Consolidated net operating income421,394  414,483  267,864  791  1,104,532  
Depreciation and amortization285,937  115,832  138,403  —  540,172  
Interest expense30,463  5,598  9,134  223,169  268,364  
General and administrative expenses—  —  —  69,543  69,543  
Loss (gain) on derivatives and financial instruments, net—  9,085  —  —  9,085  
Loss (gain) on extinguishment of debt, net(492) —  741  —  249  
Provision for loan losses—  8,523  (29) —  8,494  
Impairment of assets78,646  24,332  —  —  102,978  
Other expenses8,240  4,013  7,463  5,987  25,703  
Income (loss) from continuing operations before income taxes and other items18,600  247,100  112,152  (297,908) 79,944  
Income tax (expense) benefit—  —  —  (7,675) (7,675) 
Income (loss) from unconsolidated entities(17,811) 12,199  3,252  —  (2,360) 
Gain (loss) on real estate dispositions, net14,316  51,785  352,586  —  418,687  
Income (loss) from continuing operations15,105  311,084  467,990  (305,583) 488,596  
Net income (loss)$15,105  $311,084  $467,990  $(305,583) $488,596  

Six Months Ended June 30, 2019Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment / CorporateTotal
Resident fees and services$1,782,370  $—  $—  $—  $1,782,370  
Rental income—  454,394  312,276  —  766,670  
Interest income—  32,064  411  —  32,475  
Other income5,545  2,541  139  2,611  10,836  
Total revenues1,787,915  488,999  312,826  2,611  2,592,351  
Property operating expenses1,245,003  27,778  99,153  —  1,371,934  
Consolidated net operating income542,912  461,221  213,673  2,611  1,220,417  
Depreciation and amortization268,126  117,404  106,454  —  491,984  
Interest expense35,823  6,665  6,734  237,346  286,568  
General and administrative expenses—  —  —  69,023  69,023  
Loss (gain) on derivatives and financial
instruments, net
—  (574) —  —  (574) 
Loss (gain) on extinguishment of debt, net—  —  —  15,719  15,719  
Provision for loan losses—  18.69  18,690  —  —  18.69  —  18,690  
Impairment of assets—  (940) 10,879  —  9,939  
Other expenses14,803  8,589  750  6,242  30,384  
Income (loss) from continuing operations before income taxes and other items224,160  311,387  88,856  (325,719) 298,684  
Income tax (expense) benefit—  —  —  (3,821) (3,821) 
Income (loss) from unconsolidated entities(34,033) 12,236  3,549  —  (18,248) 
Gain (loss) on real estate dispositions, net(710) 166,444  (7) —  165,727  
Income (loss) from continuing operations189,417  490,067  92,398  (329,540) 442,342  
Net income (loss)$189,417  $490,067  $92,398  $(329,540) $442,342  
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 EndedSix Months Ended
 June 30, 2020June 30, 2019June 30, 2020June 30, 2019
Revenues:
Amount(1)
%Amount%
Amount(1)
%Amount%
United States$973,772  81.9 %$1,092,376  82.8 %$2,001,553  81.8 %$2,136,042  82.4 %
United Kingdom109,437  9.2 %112,647  8.5 %227,319  9.3 %225,065  8.7 %
Canada105,266  8.9 %115,083  8.7 %218,205  8.9 %231,244  8.9 %
Total$1,188,475  100.0 %$1,320,106  100.0 %$2,447,077  100.0 %$2,592,351  100.0 %
 As of
 June 30, 2020December 31, 2019
Assets:Amount%Amount%
United States$27,655,745  83.4 %$27,513,911  82.4 %
United Kingdom3,175,033  9.6 %3,405,388  10.2 %
Canada2,331,874  7.0 %2,461,452  7.4 %
Total$33,162,652  100.0 %$33,380,751  100.0 %
(1) The United States, United Kingdom and Canada represent 77%, 10% and 13%, respectively, of our resident fees and services revenue stream for the three and six months ended June 30, 2020.