Segment Reporting

12 Months Ended

Dec. 31, 2023

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 generally 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, 2023, 2022 and 2021 is as follows (in thousands):

Year Ended December 31, 2023:	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment/Corporate		Total
Resident fees and services	$	4,753,804	$	—	$	—	$	—	$	4,753,804
Rental income	—		814,751		741,322		—		1,556,073
Interest income	10,096		157,592		666		—		168,354
Other income	9,743		70,986		9,167		69,868		159,764
Total revenues	4,773,643		1,043,329		751,155		69,868		6,637,995
Property operating expenses	3,655,508		42,194		231,956		18,118		3,947,776
Consolidated net operating income (loss)	1,118,135		1,001,135		519,199		51,750		2,690,219
Depreciation and amortization	906,771		231,028		263,302		—		1,401,101
Interest expense	56,509		(65)		10,543		540,859		607,846
General and administrative expenses	—		—		—		179,091		179,091
Loss (gain) on derivatives and financial instruments, net	—		(2,120)		—		—		(2,120)
Loss (gain) on extinguishment of debt, net	—		—		7		—		7
Provision for loan losses, net	3,197		6,348		264		—		9,809
Impairment of assets	24,999		11,098		—		—		36,097
Other expenses	96,972		5,060		2,289		4,020		108,341
Income (loss) from continuing operations before income taxes and other items	29,687		749,786		242,794		(672,220)		350,047
Income tax (expense) benefit	—		—		—		(6,364)		(6,364)
Income (loss) from unconsolidated entities	(69,835)		16,700		(307)		—		(53,442)
Gain (loss) on real estate dispositions, net	68,290		259		(651)		—		67,898
Income (loss) from continuing operations	28,142		766,745		241,836		(678,584)		358,139
Net income (loss)	$	28,142	$	766,745	$	241,836	$	(678,584)	$	358,139
Total assets	$	24,857,722	$	9,985,952	$	7,353,819	$	1,814,673	$	44,012,166

Year Ended December 31, 2022:	Seniors Housing Operating		Triple-net		Outpatient Medical		Non-segment/Corporate		Total
Resident fees and services	$	4,173,711	$	—	$	—	$	—	$	4,173,711
Rental income	—		782,329		669,457		—		1,451,786
Interest income	7,867		142,402		302		—		150,571
Other income	63,839		6,776		8,998		4,934		84,547
Total revenues	4,245,417		931,507		678,757		4,934		5,860,615
Property operating expenses	3,292,045		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 amortization	854,800		215,887		239,681		—		1,310,368
Interest expense	34,833		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, net	386		80		15		199		680
Provision for loan losses, net	1,039		9,289		(8)		—		10,320
Impairment of assets	13,146		3,595		761		—		17,502
Other expenses	66,026		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, net	5,794		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 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

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, 2023				December 31, 2022				December 31, 2021
Revenues:	Amount		%		Amount		%		Amount		%
United States	$	5,521,933	83.2	%	$	4,843,417	82.6	%	$	3,766,707	79.4	%
United Kingdom	606,750		9.1	%	558,308		9.5	%	552,650		11.7	%
Canada	509,312		7.7	%	458,890		7.9	%	422,758		8.9	%
Total	$	6,637,995	100.0	%	$	5,860,615	100.0	%	$	4,742,115	100.0	%
	Year Ended
	December 31, 2023				December 31, 2022				December 31, 2021
Resident fees and services:	Amount		%		Amount		%		Amount		%
United States	$	3,811,915	80.2	%	$	3,325,466	79.7	%	$	2,389,257	74.7	%
United Kingdom	447,219		9.4	%	401,195		9.6	%	396,610		12.4	%
Canada	494,670		10.4	%	447,050		10.7	%	411,356		12.9	%
Total	$	4,753,804	100.0	%	$	4,173,711	100.0	%	$	3,197,223	100.0	%
	As of
	December 31, 2023				December 31, 2022
Assets:	Amount		%		Amount		%
United States	$	36,929,186	83.9	%	$	31,740,907	83.8	%
United Kingdom	3,587,230		8.2	%	3,476,793		9.2	%
Canada	3,495,750		7.9	%	2,675,533		7.0	%
Total	$	44,012,166	100.0	%	$	37,893,233	100.0	%