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Segment Reporting (Tables)
 12 Months Ended
Dec. 31, 2022
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, 2022, 2021 and 2020 is as follows (in thousands):

Year Ended December 31, 2022:Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment / CorporateTotal
Resident fees and services$4,173,711 $— $— $— $4,173,711 
Rental income— 782,329 669,457 — 1,451,786 
Interest income7,867 142,402 302 — 150,571 
Other income63,839 6,776 8,998 4,934 84,547 
Total revenues4,245,417 931,507 678,757 4,934 5,860,615 
Property operating expenses3,292,045 44,483 205,997 16,245 3,558,770 
Consolidated net operating income (loss)953,372 887,024 472,760 (11,311)2,301,845 
Depreciation and amortization854,800 215,887 239,681 — 1,310,368 
Interest expense34,833 963 18,078 475,645 529,519 
General and administrative expenses— — — 150,390 150,390 
Loss (gain) on derivatives and financial instruments, net— 8,334 — — 8,334 
Loss (gain) on extinguishment of debt, net386 80 15 199 680 
Provision for loan losses, net1,039 9,289 (8)— 10,320 
Impairment of assets13,146 3,595 761 — 17,502 
Other expenses66,026 13,043 2,537 20,064 101,670 
Income (loss) from continuing operations before income taxes and other items(16,858)635,833 211,696 (657,609)173,062 
Income tax (expense) benefit— — — (7,247)(7,247)
Income (loss) from unconsolidated entities(53,318)34,495 (2,467)— (21,290)
Gain (loss) on real estate dispositions, net5,794 16,648 (6,399)— 16,043 
Income (loss) from continuing operations(64,382)686,976 202,830 (664,856)160,568 
Net income (loss)$(64,382)$686,976 $202,830 $(664,856)$160,568 
Total assets$22,000,732 $8,619,314 $6,614,887 $658,300 $37,893,233 
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 
Summary of Geographic Information The following is a summary of geographic information for the periods presented (dollars in thousands):
 Year Ended
 December 31, 2022December 31, 2021December 31, 2020
Revenues:Amount%Amount%Amount%
United States$4,843,417 82.6 %$3,766,707 79.4 %$3,720,155 80.8 %
United Kingdom558,308 9.5 %552,650 11.7 %451,399 9.8 %
Canada458,890 7.9 %422,758 8.9 %434,413 9.4 %
Total$5,860,615 100.0 %$4,742,115 100.0 %$4,605,967 100.0 %
Year Ended
December 31, 2022December 31, 2021December 31, 2020
Resident fees and services:Amount%Amount%Amount%
United States$3,325,466 79.7 %$2,389,257 74.7 %$2,321,956 75.5 %
United Kingdom401,195 9.6 %396,610 12.4 %327,687 10.7 %
Canada447,050 10.7 %411,356 12.9 %424,379 13.8 %
Total$4,173,711 100.0 %$3,197,223 100.0 %$3,074,022 100.0 %
 As of  
 December 31, 2022December 31, 2021  
Assets:Amount%Amount%  
United States$31,740,907 83.8 %$28,595,703 81.9 % 
United Kingdom3,476,793 9.2 %3,938,258 11.3 % 
Canada2,675,533 7.0 %2,376,364 6.8 %  
Total$37,893,233 100.0 %$34,910,325 100.0 %