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Segment Reporting
12 Months Ended
Dec. 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 cash investments recorded in 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). 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) during the years ended December 31, 2021, 2020 and 2019 is as follows (in thousands):
Year Ended December 31, 2021:Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment / CorporateTotal
Resident fees and services$3,197,223 $— $— $— $3,197,223 
Rental income— 761,441 613,254 — 1,374,695 
Interest income4,231 124,540 8,792 — 137,563 
Other income11,796 4,603 13,243 2,992 32,634 
Total revenues3,213,250 890,584 635,289 2,992 4,742,115 
Property operating expenses2,529,344 49,462 186,939 8,817 2,774,562 
Consolidated net operating income (loss)683,906 841,122 448,350 (5,825)1,967,553 
Depreciation and amortization593,565 220,699 223,302 — 1,037,566 
Interest expense39,327 6,376 17,506 426,644 489,853 
General and administrative expenses— — — 126,727 126,727 
Loss (gain) on derivatives and financial instruments, net— (7,333)— — (7,333)
Loss (gain) on extinguishment of debt, net(2,628)— (4)52,506 49,874 
Provision for loan losses, net394 10,339 (3,463)— 7,270 
Impairment of assets22,317 26,579 2,211 — 51,107 
Other expenses27,132 4,189 2,523 7,895 41,739 
Income (loss) from continuing operations before income taxes and other items3,799 580,273 206,275 (619,597)170,750 
Income tax (expense) benefit— — — (8,713)(8,713)
Income (loss) from unconsolidated entities(39,225)20,687 (4,395)— (22,933)
Gain (loss) on real estate dispositions, net6,146 135,881 93,348 — 235,375 
Income (loss) from continuing operations(29,280)736,841 295,228 (628,310)374,479 
Net income (loss)$(29,280)$736,841 $295,228 $(628,310)$374,479 
Total assets$18,851,999 $9,710,194 $6,204,064 $144,068 $34,910,325 
Year Ended December 31, 2020:Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment / CorporateTotal
Resident fees and services$3,074,022 $— $— $— $3,074,022 
Rental income— 733,776 709,584 — 1,443,360 
Interest income618 62,625 5,913 — 69,156 
Other income7,223 4,903 4,522 2,781 19,429 
Total revenues3,081,863 801,304 720,019 2,781 4,605,967 
Property operating expenses2,326,311 53,183 214,948 3,381 2,597,823 
Consolidated net operating income (loss)755,552 748,121 505,071 (600)2,008,144 
Depreciation and amortization544,462 232,604 261,371 — 1,038,437 
Interest expense54,901 9,477 17,579 432,431 514,388 
General and administrative expenses— — — 128,394 128,394 
Loss (gain) on derivatives and financial instruments, net— 11,049 — — 11,049 
Loss (gain) on extinguishment of debt, net12,659 — 1,046 33,344 47,049 
Provision for loan losses, net671 90,563 3,202 — 94,436 
Impairment of assets100,741 34,867 — — 135,608 
Other expenses14,265 22,923 8,218 24,929 70,335 
Income (loss) from continuing operations before income taxes and other items27,853 346,638 213,655 (619,698)(31,552)
Income tax (expense) benefit— — — (9,968)(9,968)
Income (loss) from unconsolidated entities(33,857)18,462 7,312 — (8,083)
Gain (loss) on real estate dispositions, net328,249 64,288 695,918 — 1,088,455 
Income (loss) from continuing operations322,245 429,388 916,885 (629,666)1,038,852 
Net income (loss)$322,245 $429,388 $916,885 $(629,666)$1,038,852 
Total assets$16,044,153 $8,547,482 $6,522,880 $1,369,127 $32,483,642 
Year Ended December 31, 2019:Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment / CorporateTotal
Resident fees and services$3,448,175 $— $— $— $3,448,175 
Rental income— 903,798 684,602 — 1,588,400 
Interest income36 62,599 1,195 — 63,830 
Other income8,658 6,246 2,031 3,966 20,901 
Total revenues3,456,869 972,643 687,828 3,966 5,121,306 
Property operating expenses2,417,349 53,900 218,793 — 2,690,042 
Consolidated net operating income (loss)1,039,520 918,743 469,035 3,966 2,431,264 
Depreciation and amortization553,189 232,626 241,258 — 1,027,073 
Interest expense67,983 12,892 13,411 461,273 555,559 
General and administrative expenses— — — 126,549 126,549 
Loss (gain) on derivatives and financial instruments, net— (4,399)— — (4,399)
Loss (gain) on extinguishment of debt, net1,614 — — 82,541 84,155 
Provision for loan losses, net— 18,690 — — 18,690 
Impairment of assets2,145 11,926 14,062 — 28,133 
Other expenses26,348 13,771 1,788 10,705 52,612 
Income (loss) from continuing operations before income taxes and other items388,241 633,237 198,516 (677,102)542,892 
Income tax (expense) benefit— — — (2,957)(2,957)
Income (loss) from unconsolidated entities12,388 22,985 7,061 — 42,434 
Gain (loss) on real estate dispositions, net528,747 218,322 972 — 748,041 
Income (loss) from continuing operations929,376 874,544 206,549 (680,059)1,330,410 
Net income (loss)$929,376 $874,544 $206,549 $(680,059)$1,330,410 

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):
 Year Ended
 December 31, 2021December 31, 2020December 31, 2019
Revenues:
Amount(1)
%Amount%Amount%
United States$3,766,707 79.4 %$3,720,155 80.8 %$4,205,492 82.1 %
United Kingdom552,650 11.7 %451,399 9.8 %452,698 8.8 %
Canada422,758 8.9 %434,413 9.4 %463,116 9.1 %
Total$4,742,115 100.0 %$4,605,967 100.0 %$5,121,306 100.0 %
 As of  
 December 31, 2021December 31, 2020  
Assets:Amount%Amount%  
United States$28,595,703 81.9 %$26,658,659 82.1 %  
United Kingdom3,938,258 11.3 %3,352,549 10.3 %  
Canada2,376,364 6.8 %2,472,434 7.6 %  
Total$34,910,325 100.0 %$32,483,642 100.0 %  
(1) The United States, United Kingdom and Canada represent 75%, 12% and 13%, respectively, of our resident fees and services revenue for the year ended December 31, 2021.