Segment Reporting (Tables)

12 Months Ended

Dec. 31, 2021

Segment Reporting [Abstract]

Summary of Information for Reportable Segments

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 Operating		Triple-net		Outpatient Medical		Non-segment / Corporate		Total
Resident fees and services	$	3,197,223	$	—	$	—	$	—	$	3,197,223
Rental income	—		761,441		613,254		—		1,374,695
Interest income	4,231		124,540		8,792		—		137,563
Other income	11,796		4,603		13,243		2,992		32,634
Total revenues	3,213,250		890,584		635,289		2,992		4,742,115
Property operating expenses	2,529,344		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 amortization	593,565		220,699		223,302		—		1,037,566
Interest expense	39,327		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, net	394		10,339		(3,463)		—		7,270
Impairment of assets	22,317		26,579		2,211		—		51,107
Other expenses	27,132		4,189		2,523		7,895		41,739
Income (loss) from continuing operations before income taxes and other items	3,799		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, net	6,146		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 Operating		Triple-net		Outpatient Medical		Non-segment / Corporate		Total
Resident fees and services	$	3,074,022	$	—	$	—	$	—	$	3,074,022
Rental income	—		733,776		709,584		—		1,443,360
Interest income	618		62,625		5,913		—		69,156
Other income	7,223		4,903		4,522		2,781		19,429
Total revenues	3,081,863		801,304		720,019		2,781		4,605,967
Property operating expenses	2,326,311		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 amortization	544,462		232,604		261,371		—		1,038,437
Interest expense	54,901		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, net	12,659		—		1,046		33,344		47,049
Provision for loan losses, net	671		90,563		3,202		—		94,436
Impairment of assets	100,741		34,867		—		—		135,608
Other expenses	14,265		22,923		8,218		24,929		70,335
Income (loss) from continuing operations before income taxes and other items	27,853		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, net	328,249		64,288		695,918		—		1,088,455
Income (loss) from continuing operations	322,245		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 Operating		Triple-net		Outpatient Medical		Non-segment / Corporate		Total
Resident fees and services	$	3,448,175	$	—	$	—	$	—	$	3,448,175
Rental income	—		903,798		684,602		—		1,588,400
Interest income	36		62,599		1,195		—		63,830
Other income	8,658		6,246		2,031		3,966		20,901
Total revenues	3,456,869		972,643		687,828		3,966		5,121,306
Property operating expenses	2,417,349		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 amortization	553,189		232,626		241,258		—		1,027,073
Interest expense	67,983		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, net	1,614		—		—		82,541		84,155
Provision for loan losses, net	—		18,690		—		—		18,690
Impairment of assets	2,145		11,926		14,062		—		28,133
Other expenses	26,348		13,771		1,788		10,705		52,612
Income (loss) from continuing operations before income taxes and other items	388,241		633,237		198,516		(677,102)		542,892
Income tax (expense) benefit	—		—		—		(2,957)		(2,957)
Income (loss) from unconsolidated entities	12,388		22,985		7,061		—		42,434
Gain (loss) on real estate dispositions, net	528,747		218,322		972		—		748,041
Income (loss) from continuing operations	929,376		874,544		206,549		(680,059)		1,330,410
Net income (loss)	$	929,376	$	874,544	$	206,549	$	(680,059)	$	1,330,410

The following is a summary of geographic information for the periods presented (dollars in thousands):

	Year Ended
	December 31, 2021				December 31, 2020				December 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 Kingdom	552,650		11.7	%	451,399		9.8	%	452,698		8.8	%
Canada	422,758		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, 2021				December 31, 2020
Assets:	Amount		%		Amount		%
United States	$	28,595,703	81.9	%	$	26,658,659	82.1	%
United Kingdom	3,938,258		11.3	%	3,352,549		10.3	%
Canada	2,376,364		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.