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Segment Reporting (Tables)
6 Months Ended
Jun. 30, 2020
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 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  
Summary of Geographic Information 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.