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Segment Reporting (Tables)
 12 Months Ended
Dec. 31, 2023
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, 2023, 2022 and 2021 is as follows (in thousands):
Year Ended December 31, 2023:Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment/CorporateTotal
Resident fees and services$4,753,804 $— $— $— $4,753,804 
Rental income— 814,751 741,322 — 1,556,073 
Interest income10,096 157,592 666 — 168,354 
Other income9,743 70,986 9,167 69,868 159,764 
Total revenues4,773,643 1,043,329 751,155 69,868 6,637,995 
Property operating expenses3,655,508 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 amortization906,771 231,028 263,302 — 1,401,101 
Interest expense56,509 (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, net3,197 6,348 264 — 9,809 
Impairment of assets24,999 11,098 — — 36,097 
Other expenses96,972 5,060 2,289 4,020 108,341 
Income (loss) from continuing operations before income taxes and other items29,687 749,786 242,794 (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, net68,290 259 (651)— 67,898 
Income (loss) from continuing operations28,142 766,745 241,836 (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 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 
Summary of Geographic Information The following is a summary of geographic information for the periods presented (dollars in thousands):
 Year Ended
 December 31, 2023December 31, 2022December 31, 2021
Revenues:Amount%Amount%Amount%
United States$5,521,933 83.2 %$4,843,417 82.6 %$3,766,707 79.4 %
United Kingdom606,750 9.1 %558,308 9.5 %552,650 11.7 %
Canada509,312 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, 2023December 31, 2022December 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 Kingdom447,219 9.4 %401,195 9.6 %396,610 12.4 %
Canada494,670 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, 2023December 31, 2022  
Assets:Amount%Amount%  
United States$36,929,186 83.9 %$31,740,907 83.8 % 
United Kingdom3,587,230 8.2 %3,476,793 9.2 % 
Canada3,495,750 7.9 %2,675,533 7.0 %  
Total$44,012,166 100.0 %$37,893,233 100.0 %