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Segment Reporting (Tables)
3 Months Ended
Mar. 31, 2021
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 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 
Summary of Geographic Information 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.