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Segment Reporting
3 Months Ended
Mar. 31, 2021
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, 2020). 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. All inter-segment transactions are eliminated.
Summary information for the reportable segments (which excludes unconsolidated entities) is as follows (in thousands): 
Three Months Ended March 31, 2021:Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment / CorporateTotal
Resident fees and services$723,464 $— $— $— $723,464 
Rental income— 152,463 150,380 — 302,843 
Interest income1,119 14,922 3,538 — 19,579 
Other income1,819 1,097 2,305 955 6,176 
Total revenues726,402 168,482 156,223 955 1,052,062 
Property operating expenses555,968 12,841 46,863 1,654 617,326 
Consolidated net operating income170,434 155,641 109,360 (699)434,736 
Depreciation and amortization132,586 56,667 55,173 — 244,426 
Interest expense11,418 1,882 4,015 105,827 123,142 
General and administrative expenses— — — 29,926 29,926 
Loss (gain) on derivatives and financial instruments, net— 1,934 — — 1,934 
Loss (gain) on extinguishment of debt, net(4,643)— — — (4,643)
Provision for loan losses251 853 279 — 1,383 
Impairment of assets4,604 18,964 — — 23,568 
Other expenses3,459 4,983 712 1,840 10,994 
Income (loss) from continuing operations before income taxes and other items22,759 70,358 49,181 (138,292)4,006 
Income tax (expense) benefit— — — (3,943)(3,943)
Income (loss) from unconsolidated entities5,234 4,907 2,908 — 13,049 
Gain (loss) on real estate dispositions, net5,195 2,042 51,843 — 59,080 
Income (loss) from continuing operations33,188 77,307 103,932 (142,235)72,192 
Net income (loss)$33,188 $77,307 $103,932 $(142,235)$72,192 
Total assets$16,032,225 $8,660,043 $6,380,835 $1,919,148 $32,992,251 
Three Months Ended March 31, 2020:Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment / CorporateTotal
Resident fees and services$849,972 $— $— $— $849,972 
Rental income— 191,385 198,575 — 389,960 
Interest income104 14,671 466 — 15,241 
Other income1,052 1,673 288 416 3,429 
Total revenues851,128 207,729 199,329 416 1,258,602 
Property operating expenses607,871 13,302 60,608 — 681,781 
Consolidated net operating income243,257 194,427 138,721 416 576,821 
Depreciation and amortization146,774 57,694 70,333 — 274,801 
Interest expense16,434 2,852 4,808 117,913 142,007 
General and administrative expenses— — — 35,481 35,481 
Loss (gain) on derivatives and financial instruments, net— 7,651 — — 7,651 
Provision for loan losses— 7,072 — — 7,072 
Impairment of assets3,495 24,332 — — 27,827 
Other expenses2,989 513 

1,007 1,783 6,292 
Income (loss) from continuing operations before income taxes and other items73,565 94,313 62,573 (154,761)75,690 
Income tax (expense) benefit— — — (5,442)(5,442)
Income (loss) from unconsolidated entities(11,024)5,796 1,536 — (3,692)
Gain (loss) on real estate dispositions, net(149)49,637 213,336 — 262,824 
Income (loss) from continuing operations62,392 149,746 277,445 (160,203)329,380 
Net income (loss)$62,392 $149,746 $277,445 $(160,203)$329,380 
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 Ended
 March 31, 2021March 31, 2020
Revenues:
Amount(1)
%Amount%
United States$825,648 78.5 %$1,027,781 81.6 %
United Kingdom118,874 11.3 %117,882 9.4 %
Canada107,540 10.2 %112,939 9.0 %
Total$1,052,062 100.0 %$1,258,602 100.0 %
 As of
 March 31, 2021December 31, 2020
Assets:Amount%Amount%
United States$27,112,760 82.1 %$26,658,659 82.1 %
United Kingdom3,415,851 10.4 %3,352,549 10.3 %
Canada2,463,640 7.5 %2,472,434 7.6 %
Total$32,992,251 100.0 %$32,483,642 100.0 %
(1) The United States, United Kingdom and Canada represent 72%, 14% and 14%, respectively, of our resident fees and services revenue stream for the three months ended March 31, 2021.