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Real Property Acquisitions and Development
3 Months Ended
Mar. 31, 2024
Real Estate [Abstract]  
Real Property Acquisitions and Development Real Property Acquisitions and Development 
The total purchase price for all properties acquired has been allocated to the tangible and identifiable intangible assets and liabilities at cost on a relative fair value basis. Liabilities assumed and any associated noncontrolling interests are reflected at fair value. The results of operations for these acquisitions have been included in our consolidated results of operations since the date of acquisition and are a component of the appropriate segments. Transaction costs primarily represent costs incurred with acquisitions, including due diligence costs, fees for legal and valuation services, termination of pre-existing relationships computed based on the fair value of the assets acquired, lease termination fees and other acquisition-related costs. Transaction costs directly related to asset acquisitions are capitalized as a component of purchase price and all other non-capitalizable costs are reflected in other expenses on our Consolidated Statements of Comprehensive Income. Our acquisition of properties are at times subject to earn out provisions based on the future operating performance of the acquired properties, which could result in incremental payments in the future. Our policy is to recognize such contingent consideration when the contingency is resolved and the consideration becomes payable.
The following is a summary of our real property investment activity by segment for the periods presented (in thousands):
 Three Months Ended
 March 31, 2024March 31, 2023
Seniors Housing OperatingTriple-netOutpatient
Medical
TotalsSeniors Housing OperatingTriple-netOutpatient
Medical
Totals
Land and land improvements$26,691 $710 $— $27,401 $2,517 $7,370 $60,527 $70,414 
Buildings and improvements48,615 253 — 48,868 16,434 74,289 255,706 346,429 
Acquired lease intangibles5,861 — — 5,861 865 — 39,090 39,955 
Right of use assets, net— — — — — — 927 927 
Total net real estate assets81,167 963 — 82,130 19,816 81,659 356,250 457,725 
Receivables and other assets24 — — 24 234 — 358 592 
Total assets acquired81,191 963 — 82,154 20,050 81,659 356,608 458,317 
Secured debt— — — — (5,501)— (40,953)(46,454)
Lease liabilities— — — — — — (953)(953)
Accrued expenses and other liabilities(532)— — (532)(120)— (8,071)(8,191)
Total liabilities acquired(532)— — (532)(5,621)— (49,977)(55,598)
Non-cash acquisition related activity(1)
(18,141)(710)— (18,851)— — — — 
Cash disbursed for acquisitions62,518 253 — 62,771 14,429 81,659 306,631 402,719 
Construction in progress additions165,140 28 83,529 248,697 131,944 4,995 101,609 238,548 
Less: Capitalized interest(11,660)— (2,149)(13,809)(7,950)(1,248)(1,137)(10,335)
Accruals (2)
2,248 72 (5,445)(3,125)2,303 — (4,290)(1,987)
Cash disbursed for construction in progress155,728 100 75,935 231,763 126,297 3,747 96,182 226,226 
Capital improvements to existing properties104,812 6,064 21,633 132,509 69,783 4,427 17,129 91,339 
Total cash invested in real property, net of cash acquired$323,058 $6,417 $97,568 $427,043 $210,509 $89,833 $419,942 $720,284 
(1) Primarily relates to the acquisition of assets previously financed as real estate loans receivable.
(2) Represents non-cash accruals for amounts to be paid in future periods for properties that converted, offset by amounts paid in the current period.
Affinity Living Communities ("Affinity") Acquisition
In February 2024, we entered into a definitive agreement to acquire 25 Seniors Housing Operating properties for a total purchase price of $969 million, which will be managed under the Affinity brand. The transaction is expected to close in the second quarter of 2024 and will be funded through a combination of cash and the assumption of $523 million of secured debt, subject to customary closing conditions and lender consents.
Construction Activity 
The following is a summary of the construction projects that were placed into service and began generating revenues during the periods presented (in thousands):
 Three Months Ended
 March 31, 2024March 31, 2023
Development projects:
Seniors Housing Operating
$88,680 $26,712 
Outpatient Medical
91,248 9,351 
Total development projects
179,928 36,063 
Expansion projects
3,083 17,245 
Total construction in progress conversions$183,011 $53,308