Diversified Healthcare Trust (DHC) 10-Q 5 May 21 2021 Q1 Quarterly report Financial data

Cover

Cover - shares	3 Months Ended
	Mar. 31, 2021	May 03, 2021
Entity Information
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2021
Document Transition Report	false
Entity File Number	1-15319
Entity Registrant Name	DIVERSIFIED HEALTHCARE TRUST
Entity Incorporation, State or Country Code	MD
Entity Tax Identification Number	04-3445278
Entity Address, Address Line One	Two Newton Place, 255 Washington Street, Suite 300,
Entity Address, City or Town	Newton
Entity Address, State or Province	MA
Entity Address, Postal Zip Code	02458-1634
City Area Code	617
Local Phone Number	796 - 8350
Title Of Each Class	Common Shares of Beneficial Interest
Trading Symbol(s)	DHC
Name Of Each Exchange On Which Registered	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Smaller Reporting Company	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding (in shares)		238,268,478
Entity Central Index Key	0001075415
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q1
Senior Notes Due 2042
Entity Information
Title Of Each Class	5.625% Senior Notes due 2042
Trading Symbol(s)	DHCNI
Name Of Each Exchange On Which Registered	NASDAQ
Senior Notes Due 2046
Entity Information
Title Of Each Class	6.25% Senior Notes due 2046
Trading Symbol(s)	DHCNL
Name Of Each Exchange On Which Registered	NASDAQ

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2021		Dec. 31, 2020
Real estate properties:
Land	$ 792,923		$ 789,125
Buildings and improvements	6,695,854		6,621,605
Total real estate properties, gross	7,488,777		7,410,730
Accumulated depreciation	(1,742,606)		(1,694,901)
Total real estate properties, net	5,746,171		5,715,829
Assets of properties held for sale	63,563		112,437
Cash and cash equivalents	843,237		74,417
Restricted cash	326,768	[1]	16,432
Acquired real estate leases and other intangible assets, net	274,987		286,513
Other assets, net	287,980		270,796
Total assets	7,542,706		6,476,424
Liabilities and Equity
Revolving credit facility	800,000		0
Term loan, net	0		199,049
Senior unsecured notes, net	3,101,318		2,608,189
Secured debt and finance leases, net	690,733		691,573
Liabilities of properties held for sale	393		3,525
Accrued interest	52,807		23,772
Assumed real estate lease obligations, net	65,642		67,830
Other liabilities	286,623		263,264
Total liabilities	4,997,516		3,857,202
Commitments and contingencies
Equity attributable to common shareholders:
Common shares of beneficial interest, $.01 par value: 300,000,000 shares authorized, 238,268,478 shares issued and outstanding for both periods presented	2,383		2,383
Additional paid in capital	4,614,132		4,613,904
Cumulative net income	1,845,604		1,913,109
Cumulative distributions	(4,035,942)		(4,033,559)
Total equity attributable to common shareholders	2,426,177		2,495,837
Noncontrolling interest:
Total equity attributable to noncontrolling interest	119,013		123,385
Total equity	2,545,190		2,619,222
Total liabilities and equity	$ 7,542,706		$ 6,476,424
Common shares of beneficial interest, shares issued (in shares)	238,268,478		238,268,478
[1]	As of March 31, 2021, restricted cash includes amounts we will use to redeem all $300,000 of our outstanding 6.75% senior notes due 2021 in June 2021, when these notes become redeemable with no prepayment premium. In April 2021, we delivered a notice of redemption with respect to these senior notes for a redemption price equal to the principal amount plus accrued and unpaid interest. Restricted cash also consists of amounts escrowed for real estate taxes, insurance and capital expenditures at certain of our mortgaged properties and cash held for the operations of the life science property that is owned in a joint venture arrangement in which we own a 55% equity interest.

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Mar. 31, 2021	Dec. 31, 2020
Statement of Financial Position [Abstract]
Common shares of beneficial interest, par value (in dollars per share)	$ 0.01	$ 0.01
Common shares of beneficial interest, shares authorized (in shares)	300,000,000	300,000,000
Common shares of beneficial interest, shares issued (in shares)	238,268,478	238,268,478
Common shares of beneficial interest, shares outstanding (in shares)	238,268,478	238,268,478

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Revenues:
Revenues	$ 362,724	$ 442,467
Expenses:
Property operating expenses	287,391	316,585
Depreciation and amortization	66,153	68,430
General and administrative	7,542	8,832
Acquisition and certain other transaction related costs	0	663
Impairment of assets	(174)	11,234
Costs and Expenses, Total	360,912	405,744
(Loss) gain on sale of properties	(122)	2,782
Losses on equity securities, net	(8,339)	(9,943)
Interest and other income	2,835	138
Interest expense (including net amortization of debt premiums, discounts and issuance costs of $2,812 and $1,509, respectively)	(60,091)	(41,650)
Gain on lease termination	0	22,896
Loss on early extinguishment of debt	(2,040)	(246)
(Loss) income from continuing operations before income tax (expense) benefit	(65,945)	10,700
Income tax (expense) benefit	(238)	443
Net (loss) income	(66,183)	11,143
Net income attributable to noncontrolling interest	(1,322)	(1,408)
Net (loss) income attributable to common shareholders	$ (67,505)	$ 9,735
Weighted average common shares outstanding (basic) (in shares)	237,834	237,669
Weighted average common shares outstanding (diluted) (in shares)	237,834	237,669
Per common share amounts (basic and diluted):
Net (loss) income attributable to common shareholders (in dollars per share)	$ (0.28)	$ 0.04
Rental income
Revenues:
Revenues	$ 102,758	$ 110,498
Residents fees and services
Revenues:
Revenues	$ 259,966	$ 331,969

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (Parenthetical) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Income Statement [Abstract]
Net amortization of debt premiums, discounts and issuance costs	$ 2,812	$ 1,509

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF SHAREHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Five Star	Five StarShareholders	Common Shares	Additional Paid In Capital	Cumulative Net Income	Cumulative Distributions	Cumulative DistributionsFive StarShareholders	Total Equity Attributable to Common Shareholders	Total Equity Attributable to Common ShareholdersFive StarShareholders	Total Equity Attributable to Noncontrolling Interest
Beginning balance at Dec. 31, 2019	$ 2,877,050			$ 2,379	$ 4,612,511	$ 2,052,562	$ (3,930,933)		$ 2,736,519		$ 140,531
Beginning balance (in shares) at Dec. 31, 2019		10,268,158		237,897,163
Increase (Decrease) in Stockholders' Equity
Net (loss) income	11,143					9,735			9,735		1,408
Distributions	(35,684)		$ (59,801)				(35,684)	$ (59,801)	(35,684)	$ (59,801)
Share grants	249				249				249
Share repurchases	(21)				(21)				(21)
Share repurchases (in shares)				(3,438)
Distributions to noncontrolling interest	(5,767)										(5,767)
Ending balance at Mar. 31, 2020	2,787,169			$ 2,379	4,612,739	2,062,297	(4,026,418)		2,650,997		136,172
Ending balance (in shares) at Mar. 31, 2020				237,893,725
Beginning balance at Dec. 31, 2020	$ 2,619,222			$ 2,383	4,613,904	1,913,109	(4,033,559)		2,495,837		123,385
Beginning balance (in shares) at Dec. 31, 2020	238,268,478			238,268,478
Increase (Decrease) in Stockholders' Equity
Net (loss) income	$ (66,183)					(67,505)			(67,505)		1,322
Distributions	(2,383)						(2,383)		(2,383)
Share grants	228				228				228
Distributions to noncontrolling interest	(5,694)										(5,694)
Ending balance at Mar. 31, 2021	$ 2,545,190			$ 2,383	$ 4,614,132	$ 1,845,604	$ (4,035,942)		$ 2,426,177		$ 119,013
Ending balance (in shares) at Mar. 31, 2021	238,268,478			238,268,478

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Cash flows from operating activities:
Net (loss) income	$ (66,183)	$ 11,143
Adjustments to reconcile net (loss) income to cash provided by operating activities:
Depreciation and amortization	66,153	68,430
Net amortization of debt premiums, discounts and issuance costs	2,812	1,509
Straight line rental income	(804)	(1,153)
Amortization of acquired real estate leases	(1,866)	(1,873)
Loss on early extinguishment of debt	2,040	25
Gain on lease termination	0	(22,896)
Impairment of assets	(174)	11,234
Loss (gain) on sale of properties	122	(2,782)
Losses on equity securities, net	8,339	9,943
Other non-cash adjustments, net	(715)	(943)
Change in assets and liabilities:
Other assets	(24,552)	(39,433)
Accrued interest	29,035	5,167
Other liabilities	20,615	17,941
Net cash provided by operating activities	34,822	56,312
Cash flows from investing activities:
Real estate acquisitions and deposits	0	(2,526)
Real estate improvements	(44,005)	(41,045)
Proceeds from sale of properties, net	8,702	16,930
Net cash used in investing activities	(35,303)	(26,641)
Cash flows from financing activities:
Proceeds from issuance of senior unsecured notes, net	492,500	0
Proceeds from borrowings on revolving credit facility	800,000	130,500
Repayments of borrowings on revolving credit facility	0	(83,000)
Repayment of term loan	(200,000)	0
Repayment of other debt	(779)	(2,466)
Loss on early extinguishment of debt settled in cash	0	(221)
Payment of debt issuance costs	(4,007)	0
Repurchase of common shares	0	(21)
Distributions to noncontrolling interest	(5,694)	(5,767)
Distributions to shareholders	(2,383)	(35,684)
Net cash provided by financing activities	1,079,637	3,341
Increase in cash and cash equivalents and restricted cash	1,079,156	33,012
Cash and cash equivalents and restricted cash at beginning of period	90,849	52,224
Cash and cash equivalents and restricted cash at end of period	$ 1,170,005	$ 85,236

CONDENSED CONSOLIDATED STATEM_5

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - Supplemental (Parenthetical) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Supplemental cash flow information:
Interest paid	$ 29,071	$ 35,280
Non-cash investing activities:
Capitalized interest	827	306
Five Star
Non-cash investing activities:
Restructuring Transaction additional consideration	0	(75,000)
Five Star
Non-cash investing activities:
Five Star Senior Living Inc. common stock	0	97,896
Non-cash financing activities:
Distribution to common shareholders of the right to receive Five Star Senior Living Inc. common stock	$ 0	$ (59,801)

CONDENSED CONSOLIDATED STATEM_6

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - Cash and Restricted Cash (Parenthetical)	Mar. 31, 2021USD ($)property		Feb. 28, 2021	Dec. 31, 2020USD ($)	Mar. 31, 2020USD ($)		Dec. 31, 2019USD ($)
Cash and cash equivalents	$ 843,237,000			$ 74,417,000	$ 69,545,000
Restricted cash	326,768,000	[1]		16,432,000	15,691,000	[1]
Total cash and cash equivalents and restricted cash shown in our condensed consolidated statements of cash flows	$ 1,170,005,000			$ 90,849,000	$ 85,236,000		$ 52,224,000
Number of properties (property) | property	396
Senior Unsecured Notes Due June 2021 | Senior Unsecured Notes
Debt face amount	$ 300,000,000
Interest rate (as a percent)			6.75%
Life Science Property | Joint Venture
Ownership percentage	55.00%
[1]	As of March 31, 2021, restricted cash includes amounts we will use to redeem all $300,000 of our outstanding 6.75% senior notes due 2021 in June 2021, when these notes become redeemable with no prepayment premium. In April 2021, we delivered a notice of redemption with respect to these senior notes for a redemption price equal to the principal amount plus accrued and unpaid interest. Restricted cash also consists of amounts escrowed for real estate taxes, insurance and capital expenditures at certain of our mortgaged properties and cash held for the operations of the life science property that is owned in a joint venture arrangement in which we own a 55% equity interest.

Basis of Presentation

Basis of Presentation	3 Months Ended
	Mar. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation	Basis of Presentation The accompanying condensed consolidated financial statements of Diversified Healthcare Trust and its subsidiaries, or we, us, or our, are unaudited. Certain information and disclosures required by U.S. generally accepted accounting principles, or GAAP, for complete financial statements have been condensed or omitted. We believe the disclosures made are adequate to make the information presented not misleading. However, the accompanying condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and notes contained in our Annual Report on Form 10-K for the year ended December 31, 2020, or our Annual Report. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair statement of results for the interim period have been included. All intercompany transactions and balances with or among our consolidated subsidiaries have been eliminated. Operating results for interim periods are not necessarily indicative of the results that may be expected for the full year. The preparation of financial statements in conformity with GAAP requires us to make estimates and assumptions that affect reported amounts. Actual results could differ from those estimates. Significant estimates in our condensed consolidated financial statements include purchase price allocations, useful lives of fixed assets and impairments of real estate and intangible assets. We have been, are currently, and expect in the future to be involved in claims, lawsuits, and regulatory and other governmental audits, investigations and proceedings arising in the ordinary course of our business, some of which may involve material amounts. Also, the defense and resolution of these claims, lawsuits, and regulatory and other governmental audits, investigations and proceedings may require us to incur significant expense. We account for claims and litigation losses in accordance with FASB ASC Topic 450, Contingencies , or ASC 450. Under ASC 450, loss contingency provisions are recorded for probable and estimable losses at our best estimate of a loss or, when a best estimate cannot be made, at our estimate of the minimum loss. These estimates are often developed prior to knowing the amount of the ultimate loss, require the application of considerable judgment, and are refined as additional information becomes known. Accordingly, we are often initially unable to develop a best estimate of loss and therefore the estimated minimum loss amount, which could be zero, is recorded; and then, as information becomes known, the minimum loss amount is updated, as appropriate. A minimum or best estimate amount may be increased or decreased when events result in a changed expectation. We are party to a joint venture arrangement with an institutional investor. This joint venture arrangement owns a life science property located in Boston, Massachusetts. The investor owns a 45% equity interest in the joint venture, and we own the remaining 55% equity interest in the joint venture. We have determined that this joint venture is a variable interest entity, or VIE, as defined under the Consolidation Topic of the Financial Accounting Standards Board, or FASB, Accounting Standards Codification. We concluded that we must consolidate this VIE because we are the entity with the power to direct the activities that most significantly impact the VIE's economic performance and we have the obligation to absorb losses of, and the right to receive benefits from, the VIE that could be significant to the VIE, and therefore are the primary beneficiary of the VIE. The assets of this VIE were $958,013 and $970,142 as of March 31, 2021 and December 31, 2020, respectively, and consist primarily of the net real estate owned by the joint venture. The liabilities of this VIE were $694,847 and $697,129 as of March 31, 2021 and December 31, 2020, respectively, and consist primarily of mortgage debts secured by the property. The investor's interest in this consolidated entity is reflected as a noncontrolling interest in our condensed consolidated financial statements. See Note 6 for further information about this joint venture.

Real Estate Properties

Real Estate Properties	3 Months Ended
	Mar. 31, 2021
Real Estate [Abstract]
Real Estate Properties	Real Estate Properties As of March 31, 2021, we owned 396 properties located in 36 states and Washington, D.C., including four properties classified as held for sale and one life science property owned in a joint venture arrangement in which we own a 55% equity interest. We regularly evaluate our assets for indicators of impairment. Impairment indicators may include declining tenant or resident occupancy, weak or declining profitability from the property, decreasing tenant cash flows or liquidity, our decision to dispose of an asset before the end of its estimated useful life, and legislative, market or industry changes that could permanently reduce the value of an asset. If indicators of impairment are present, we evaluate the carrying value of the affected assets by comparing it to the expected future cash flows to be generated from those assets. The future cash flows are subjective and are based in part on assumptions regarding hold periods, market rents and terminal capitalization rates. If the sum of these expected future cash flows is less than the carrying value, we reduce the net carrying value of the asset to its estimated fair value. During the three months ended March 31, 2021, we recorded a reversal of impairment charges of $174 related to the estimated costs to sell 10 senior living communities that were classified as held for sale as of December 31, 2020 and changed the status of those communities from held for sale to held and used as of March 31, 2021. Acquisitions and Dispositions: During the three months ended March 31, 2021, we sold one property for a sale price of $9,000, excluding closing costs, as presented in the table below. The sale of this property does not represent a significant disposition, nor do we believe it represents a strategic shift in our business. As a result, the results of the operation for this property is included in continuing operations through the date of sale of such property in our condensed consolidated statements of comprehensive income (loss). Date of Sale Location Type of Property Number of Properties Square Feet Sale Price (1) Loss on Sale February 2021 Pennsylvania Medical Office 1 92,000 $ 9,000 $ (122) 1 $ 9,000 $ (122) (1) Sale price excludes closing costs. As of March 31, 2021, we had four properties classified as held for sale in our condensed consolidated balance sheet as follows: Type of Property Number of Properties Gross Book Value Life Science and Medical Office 4 $ 66,113 4 $ 66,113 In April 2021, we sold these four life science and medical office properties for a sales price of $95,500, excluding closing costs. In April 2021, we entered into an agreement to acquire a property which is adjacent to one of our existing properties located in Silver Springs, Maryland for a purchase price of $19,600, excluding acquisition related costs. This acquisition is expected to close during the third quarter of 2021. However, this acquisition is subject to conditions; accordingly, we cannot be sure that we will complete this acquisition, that this acquisition will not be delayed or that the terms will not change.

Leases

Leases	3 Months Ended
	Mar. 31, 2021
Leases [Abstract]
Leases	Leases We are a lessor of medical office and life science properties, senior living communities and other healthcare related properties. Our leases provide our tenants with the contractual right to use and economically benefit from all of the premises demised under the leases; therefore, we have determined to evaluate our leases as lease arrangements. Certain of our leases provide for base rent payments and in addition may include variable payments. Rental income from operating leases, including any payments derived by index or market based indices, is recognized on a straight line basis over the lease term when we have determined that the collectability of substantially all of the lease payments is probable. Some of our leases have options to extend or terminate the lease exercisable at the option of our tenants, which are considered when determining the lease term. We increased rental income to record revenue on a straight line basis by $804 and $1,153 for the three months ended March 31, 2021 and 2020, respectively. Rents receivable, excluding receivables related to our properties classified as held for sale, include $105,279 and $104,803 of straight line rent receivables at March 31, 2021 and December 31, 2020, respectively, and are included in other assets, net in our condensed consolidated balance sheets. We do not include in our measurement of our lease receivables certain variable payments, including changes in the index or market based indices after the inception of the lease, certain tenant reimbursements and other income until the specific events that trigger the variable payments have occurred. Such payments totaled $18,228 and $20,028 for the three months ended March 31, 2021 and 2020, respectively, of which tenant reimbursements totaled $18,180 and $19,983, respectively. Certain of our tenants requested relief from their obligations to pay rent due to us in response to the current economic conditions resulting from the COVID-19 pandemic. In most cases, these tenants granted deferrals were obligated to pay the deferred rents in 12 equal monthly installments beginning in September 2020. As of March 31, 2021 and December 31, 2020, deferred payments totaling $878 and $1,486, respectively, are included in other assets, net in our condensed consolidated balance sheets. These deferred amounts did not negatively impact our operating results for the three months ended March 31, 2021 or 2020. Right of Use Asset and Lease Liability . For leases where we are the lessee, we recognized a right of use asset and a lease liability equal to the present value of the minimum lease payments with rental payments being applied to the lease liability and the right of use asset being amortized over the term of the lease. The values of the right of use asset and related liability representing our future obligation under the lease arrangement for which we are the lessee were $4,216 and $4,395, respectively, as of March 31, 2021, and $4,237 and $4,410, respectively, as of December 31, 2020. The right of use asset and related lease liability are included within other assets, net other liabilities

Indebtedness

Indebtedness	3 Months Ended
	Mar. 31, 2021
Debt Disclosure [Abstract]
Indebtedness	Indebtedness Our principal debt obligations at March 31, 2021 were: (1) outstanding borrowings under our $800,000 revolving credit facility; (2) $3,150,000 outstanding principal amount of senior unsecured notes; and (3) $683,990 aggregate principal amount of mortgage notes (excluding premiums, discounts and net debt issuance costs) secured by seven properties, of which $620,000 is related to the life science property owned by a joint venture arrangement in which we own a 55% equity interest. These seven mortgaged properties had a gross book value of $947,085 at March 31, 2021. We also had two properties subject to finance leases with lease obligations totaling $7,525 at March 31, 2021; these two properties had gross book value and accumulated depreciation of $35,893 and $17,685, respectively, at March 31, 2021, and $35,676 and $17,579, respectively, at December 31, 2020, and the finance leases expire in 2026. We have a $800,000 revolving credit facility that is available for general business purposes. The maturity date of our revolving credit facility is January 2022, and, subject to the payment of an extension fee and meeting other conditions, we have two, one year options to extend the maturity date of the facility to January 2024. Our revolving credit facility provides that we can borrow, repay and re-borrow funds available under our revolving credit facility until maturity, and no principal repayment is due until maturity. As of March 31, 2021, our revolving credit facility required interest to be paid on borrowings at the annual rate of 2.9%, plus a facility fee of 30 basis points per annum on the total amount of lending commitments under the facility. The weighted average annual interest rates for borrowings under our revolving credit facility were 2.9% and 2.6% for the three months ended March 31, 2021 and 2020, respectively. The interest rate premium and facility fee are each subject to adjustment based upon changes to our credit ratings. On March 31, 2021, we borrowed $800,000 under our revolving credit facility as a precautionary measure to increase our cash position and preserve financial flexibility in light of continued uncertainty resulting from the COVID-19 pandemic. As of March 31, 2021 and May 3, 2021, we were fully drawn under our revolving credit facility. In February 2021, we issued $500,000 aggregate principal amount of our 4.375% senior notes due 2031 in an underwritten public offering raising net proceeds of $491,365, after deducting estimated offering expenses and underwriters' discounts. These notes are guaranteed by all of our subsidiaries, except for certain excluded subsidiaries, including pledged subsidiaries under the agreement governing our revolving credit facility, or our credit agreement, and require semi-annual interest payments through maturity. We used the net proceeds from this offering to prepay in full our $200,000 term loan which was scheduled to mature in September 2022. The weighted average interest rate under our $200,000 term loan was 2.9% for the period from January 1, 2021 to February 7, 2021. As a result of the prepayment of our $200,000 term loan, we recorded a loss on early extinguishment of debt of $1,477 for the three months ended March 31, 2021. We will use the remaining net proceeds from this offering and cash on hand to redeem all $300,000 of our outstanding 6.75% senior notes due 2021 in June 2021, when these notes become redeemable with no prepayment premium. In April 2021, we delivered a notice of redemption to U.S. Bank National Association, as trustee, with respect to these senior notes for a redemption price equal to the principal amount plus accrued and unpaid interest. In January 2021, we amended the agreements governing our revolving credit facility and our $200,000 term loan, or collectively, our credit and term loan agreements, in order to provide us with certain flexibility in light of the uncertainties related to the COVID-19 pandemic. Pursuant to the amendments: • certain of the financial covenants under our credit and term loan agreements, including covenants that require us to maintain certain financial ratios, have been waived through June 2022, or the Amendment Period; • the revolving credit facility commitments have been reduced from $1,000,000 to $800,000, and as a result of the reduction in commitments, we recorded a loss on early extinguishment of debt of $563 for the three months ended March 31, 2021; • we pledged certain equity interests of subsidiaries owning properties to secure our obligations under our credit and term loan agreements and agreed to provide first mortgage liens on 62 medical office and life science properties with an aggregate gross book value of real estate assets of $1,035,255 as of March 31, 2021 to secure our obligations, which pledges and/or mortgage liens may be removed or new ones may be added during the Amendment Period based on outstanding debt amounts, among other things; • we have the ability to fund $250,000 of capital expenditures per year, which increased to $350,000 per year following the repayment of our term loan in February 2021, and are restricted in our ability to acquire real property as defined in our credit agreement; • the interest rate premium over LIBOR under our revolving credit facility and term loan increased by 30 basis points; • certain covenants and restrictions on distributions to common shareholders, share repurchases, capital expenditures, acquiring additional properties and incurring additional indebtedness (in each case subject to various exceptions), and the minimum liquidity requirement of $200,000 will remain in place during the Amendment Period; and • we are generally required to apply the net cash proceeds from the disposition of assets, capital markets transactions, and debt financings to the repayment of our $300,000 senior notes due in 2021, or maintain sufficient cash for such payment of these senior notes until they can be paid at par, our $200,000 term loan and any amounts outstanding under our revolving credit facility. In February 2021, we prepaid our $200,000 term loan using proceeds from our February 2021 issuance of $500,000 aggregate principal amount of 4.375% senior notes due 2031. We will use the remaining net proceeds from this offering and cash on hand to redeem all of our outstanding 6.75% senior notes due 2021 in June 2021, when these notes become redeemable with no prepayment premium. In April 2021, we delivered a notice of redemption to U.S. Bank National Association, as trustee, with respect to these senior notes for a redemption price equal to the principal amount plus accrued and unpaid interest. Our credit agreement and our senior unsecured notes indentures and their supplements provide for acceleration of payment of all amounts due thereunder upon the occurrence and continuation of certain events of default, such as, in the case of our credit agreement, a change of control of us, as defined, which includes The RMR Group LLC, or RMR LLC, ceasing to act as our business and property manager. Our credit agreement and our senior unsecured notes indentures and their supplements also contain covenants, including covenants that restrict our ability to incur debts, and generally require us to maintain certain financial ratios, and our credit agreement restricts our ability to make distributions under certain circumstances. We believe we were in compliance with the terms and conditions of the respective covenants under our credit agreement and our senior unsecured notes indentures and their supplements at March 31, 2021. Although we have taken steps to enhance our ability to maintain sufficient liquidity, as noted elsewhere in this Quarterly Report on Form 10-Q, a protracted negative economic impact resulting from the COVID-19 pandemic may cause increased pressure on our ability to satisfy financial and other covenants. We may fail to satisfy covenants and conditions under our credit agreement or fail to satisfy our public debt covenants. We expect the ratio of consolidated income available for debt service to debt service could fall below the 1.5x requirement under our revolving credit facility and our public debt covenants in 2021 as the continued effects of the COVID-19 pandemic adversely impact our operations. We will not be allowed to incur additional debt while this ratio is below 1.5x.

Fair Value of Assets and Liabil

Fair Value of Assets and Liabilities	3 Months Ended
	Mar. 31, 2021
Fair Value Disclosures [Abstract]
Fair Value of Assets and Liabilities	Fair Value of Assets and Liabilities The following table presents certain of our assets that are measured at fair value at March 31, 2021, categorized by the level of inputs as defined in the fair value hierarchy under GAAP, used in the valuation of each asset. Fair Value at Reporting Date Using Quoted Prices in Significant Other Observable Inputs Significant Unobservable Inputs Description Total (Level 1) (Level 2) (Level 3) Recurring Fair Value Measurements Assets: Investment in Five Star (1) $ 65,433 $ 65,433 $ — $ — (1) Our 10,691,658 shares of common stock of Five Star Senior Living Inc., or Five Star, are included in other assets, net in our condensed consolidated balance sheets, and are reported at fair value, which is based upon quoted market prices on The Nasdaq Stock Market LLC, or Nasdaq, (Level 1 inputs). Our adjusted cost basis for these shares was $44,448 as of March 31, 2021. During the three months ended March 31, 2021 and 2020, we recorded unrealized losses of $8,339 and $9,943, respectively, which are included in losses on equity securities, net in our condensed consolidated statements of comprehensive income (loss), to adjust the carrying value of our investment in Five Star common shares to their fair value. See Note 11 for further information about our investment in Five Star. In addition to the assets described in the table above, our financial instruments at March 31, 2021 and December 31, 2020 included cash and cash equivalents, restricted cash, other assets, our revolving credit facility, term loan, senior unsecured notes, secured debt and finance leases and other unsecured obligations and liabilities. The fair values of these financial instruments approximated their carrying values in our condensed consolidated financial statements as of such dates, except as follows: As of March 31, 2021 As of December 31, 2020 Description Carrying Amount (1) Estimated Fair Value Carrying Amount (1) Estimated Fair Value Senior unsecured notes, 6.750% coupon rate, due in 2021 (2) $ 299,470 $ 302,631 $ 299,273 $ 303,891 Senior unsecured notes, 4.750% coupon rate, due in 2024 249,138 258,289 249,068 256,258 Senior unsecured notes, 9.750% coupon rate, due in 2025 985,245 1,130,760 984,359 1,135,800 Senior unsecured notes, 4.750% coupon rate, due in 2028 491,244 493,445 490,925 502,648 Senior unsecured notes, 4.375% coupon rate, due in 2031 491,490 487,870 — — Senior unsecured notes, 5.625% coupon rate, due in 2042 341,897 323,400 341,802 330,120 Senior unsecured notes, 6.250% coupon rate, due in 2046 242,834 243,600 242,762 245,000 Secured debts (3) (4) 690,733 704,289 691,573 716,185 $ 3,792,051 $ 3,944,284 $ 3,299,762 $ 3,489,902 (1) Includes unamortized net debt issuance costs, premiums and discounts. (2) In April 2021, we delivered a notice of redemption to redeem all $300,000 of our outstanding 6.75% senior notes due 2021 in June 2021, when these notes become redeemable with no prepayment premium. (3) We assumed certain of these secured debts in connection with our acquisition of certain properties. We recorded the assumed mortgage notes at estimated fair value on the date of acquisition and we are amortizing the fair value adjustments, if any, to interest expense over the respective terms of the mortgage notes to adjust interest expense to the estimated market interest rates as of the date of acquisition. (4) Includes secured debts for the life science property owned by a joint venture arrangement in which we own a 55% equity interest. The amounts listed in the table for these debts have not been adjusted to reflect the equity interests in the joint venture that we do not own. We estimated the fair value of our two issuances of senior unsecured notes due 2042 and 2046 based on the closing price on Nasdaq (Level 1 input) as of March 31, 2021. We estimated the fair values of our five issuances of senior unsecured notes due 2021, 2024, 2025, 2028 and 2031 using an average of the bid and ask price on Nasdaq on or about March 31, 2021 (Level 2 inputs as defined in the fair value hierarchy under GAAP). We estimated the fair values of our secured debts by using

Noncontrolling Interest

Noncontrolling Interest	3 Months Ended
	Mar. 31, 2021
Noncontrolling Interest [Abstract]
Noncontrolling Interest	Noncontrolling Interest We are party to a joint venture arrangement with an institutional investor for one of our life science properties located in Boston, Massachusetts. The investor owns a 45% equity interest in the joint venture, and we own the remaining 55% equity interest in the joint venture. We continue to control this property and therefore continue to account for this property on a consolidated basis in our condensed consolidated financial statements under the VIE model. The portion of the joint venture's net income and comprehensive income not attributable to us, or $1,322 and $1,408 for the three months ended March 31, 2021 and 2020, respectively, is reported as a noncontrolling interest in our condensed consolidated statements of comprehensive income (loss). The joint venture made aggregate cash distributions to the other joint venture investor of $5,694 and $5,767 for the three months ended March 31, 2021 and 2020, respectively, which are reflected as a decrease in total equity attributable to noncontrolling interest in our condensed consolidated balance sheets. As of March 31, 2021, this joint venture held real estate assets with an aggregate net book value of $700,192, subject to mortgage notes of $620,000. In assessing whether we have a controlling interest in this joint venture arrangement and are required to consolidate the accounts of the joint venture entity, we considered the members' rights to residual gains and obligations to absorb losses, which activities most significantly impact the economic performance of the entity and which member has the power to direct those activities.

Shareholders' Equity

Shareholders' Equity	3 Months Ended
	Mar. 31, 2021
Stockholders' Equity Note [Abstract]
Shareholders' Equity	Shareholders' Equity Distributions: During the three months ended March 31, 2021, we declared and paid a quarterly distribution to common shareholders as follows: Record Date Payment Date Distribution Per Share Total Distributions January 25, 2021 February 18, 2021 $ 0.01 $ 2,383 On April 15, 2021, we declared a quarterly distribution payable to our common shareholders of record on April 26, 2021 in the amount of $0.01 per share, or approximately $2,383. We expect to pay this distribution on or about May 20, 2021.

Segment Reporting

Segment Reporting	3 Months Ended
	Mar. 31, 2021
Segment Reporting [Abstract]
Segment Reporting	Segment Reporting We operate in, and report financial information for, the following two segments: Office Portfolio and senior housing operating portfolio, or SHOP. We aggregate each of these two reporting segments based on their similar operating and economic characteristics. Our Office Portfolio segment consists of medical office properties leased to medical providers and other medical related businesses, as well as life science properties leased to biotech laboratories and other similar tenants. Our SHOP segment consists of managed senior living communities that provide short term and long term residential living and in some instances care and other services for residents where we pay fees to the operator to manage the communities for our account. We also report “non-segment” operations, which consists of triple net leased senior living communities that are leased to operators from which we receive rents, and wellness centers, which we do not consider to be sufficiently material to constitute a separate reporting segment, and any other income or expenses that are not attributable to a specific reporting segment. For the Three Months Ended March 31, 2021 Office Portfolio SHOP Non-Segment Consolidated Revenues: Rental income $ 93,323 $ — $ 9,435 $ 102,758 Residents fees and services — 259,966 — 259,966 Total revenues 93,323 259,966 9,435 362,724 Expenses: Property operating expenses 31,293 256,098 — 287,391 Depreciation and amortization 31,938 31,361 2,854 66,153 General and administrative — — 7,542 7,542 Impairment of assets — (174) — (174) Total expenses 63,231 287,285 10,396 360,912 Loss on sale of properties (122) — — (122) Losses on equity securities, net — — (8,339) (8,339) Interest and other income — 2,433 402 2,835 Interest expense (5,939) (528) (53,624) (60,091) Loss on early extinguishment of debt — — (2,040) (2,040) Income (loss) from continuing operations before income tax expense 24,031 (25,414) (64,562) (65,945) Income tax expense — — (238) (238) Net income (loss) 24,031 (25,414) (64,800) (66,183) Net income attributable to noncontrolling interest (1,322) — — (1,322) Net income (loss) attributable to common shareholders $ 22,709 $ (25,414) $ (64,800) $ (67,505) As of March 31, 2021 Office Portfolio SHOP Non-Segment Consolidated Total assets $ 3,072,160 $ 2,908,334 $ 1,562,212 $ 7,542,706 For the Three Months Ended March 31, 2020 Office Portfolio SHOP Non-Segment Consolidated Revenues: Rental income $ 98,770 $ — $ 11,728 $ 110,498 Residents fees and services — 331,969 — 331,969 Total revenues 98,770 331,969 11,728 442,467 Expenses: Property operating expenses 32,706 283,879 — 316,585 Depreciation and amortization 32,163 33,042 3,225 68,430 General and administrative — — 8,832 8,832 Acquisition and certain other transaction related costs — — 663 663 Impairment of assets 6,218 5,016 — 11,234 Total expenses 71,087 321,937 12,720 405,744 Gain on sale of properties 2,782 — — 2,782 Losses on equity securities, net — — (9,943) (9,943) Interest and other income — — 138 138 Interest expense (6,052) (564) (35,034) (41,650) Gain on lease termination — — 22,896 22,896 Loss on early extinguishment of debt (246) — — (246) Income (loss) from continuing operations before income tax benefit 24,167 9,468 (22,935) 10,700 Income tax benefit — — 443 443 Net income (loss) 24,167 9,468 (22,492) 11,143 Net income attributable to noncontrolling interest (1,408) — — (1,408) Net income (loss) attributable to common shareholders $ 22,759 $ 9,468 $ (22,492) $ 9,735 As of December 31, 2020 Office Portfolio SHOP Non-Segment Consolidated Total assets $ 3,092,289 $ 2,912,570 $ 471,565 $ 6,476,424

Leases and Management Agreement

Leases and Management Agreements with Five Star	3 Months Ended
	Mar. 31, 2021
Risks and Uncertainties [Abstract]
Leases and Management Agreements with Five Star	Leases and Management Agreements with Five Star 2020 Restructuring of our Business Arrangements with Five Star. Effective as of January 1, 2020: • our previously existing master leases with Five Star for all of our senior living communities that Five Star leased, as well as our previously existing management agreements and pooling agreements with Five Star for our senior living communities that Five Star managed, were terminated and replaced with new management agreements and a related omnibus agreement, or collectively, the Five Star management agreements; • Five Star issued to us 10,268,158 Five Star common shares and an aggregate of 16,118,849 Five Star common shares to our shareholders of record as of December 13, 2019; • as consideration for these share issuances, we provided Five Star with $75,000 of additional consideration by assuming certain of Five Star's working capital liabilities and through cash payments, resulting in a gain on lease termination of $22,896 for the three months ended March 31, 2020 in our condensed consolidated statements of comprehensive income (loss); and • pursuant to a guaranty agreement dated as of January 1, 2020 made by Five Star in favor of our applicable subsidiaries, Five Star has guaranteed the payment and performance of each of its applicable subsidiary's obligations under the applicable Five Star management agreements. Effective January 1, 2020, we determined that Five Star is not a VIE and we will account for our 33.8% investment in Five Star using the equity method of accounting because we are deemed to exert significant influence, but not control, over Five Star's most significant activities. We have elected to use the fair value option to account for our investment in Five Star. 2021 Amendments to our Management Arrangements with Five Star. On April 9, 2021, we announced that we have agreed to amend our management arrangements with Five Star. The principal changes to the management arrangements will include: • that Five Star will cooperate with us in transitioning 108 of our senior living communities with approximately 7,500 living units to other third party operators without our payment of any termination fee to Five Star, and that we will no longer have the right to sell up to an additional $682,000 of senior living communities currently managed by Five Star and terminate Five Star's management of those communities without our payment of a fee to Five Star upon sale; • that Five Star will continue to manage 120 of our senior living communities with approximately 18,000 living units for our account, and that the skilled nursing units in all of our continuing care retirement communities that Five Star will continue to manage for our account, which currently includes approximately 1,500 living units, will be closed and repositioned; • that our performance termination rights pursuant to our existing management agreements with Five Star will be amended for the senior living communities that Five Star will continue to manage for our account, such that, commencing in 2025, we can terminate up to 10% of the senior living communities managed by Five Star for our account, based on total revenues, per year without our payment of any termination fee to Five Star for failure to meet 80% of a target EBITDA in prior years; • that the incentive fee calculation included in our existing management agreements with Five Star will be amended for the senior living communities that Five Star will continue to manage for our account such that there will no longer be a cap placed on any incentive fee earned by Five Star in any calendar year and that any senior living communities that are undergoing a major renovation or repositioning will be excluded from the calculation; • that RMR LLC will assume control of any major renovation or repositioning activities at the senior living communities that Five Star will continue to manage for our account; and • that the term of our existing management agreements with Five Star will be extended by two years to December 31, 2036. We expect that the transition of the management of the 108 senior living communities to other third party operators will be completed before year end 2021. We also expect to incur costs related to retention, temporary labor and other transition costs for these communities, which costs may be significant. Our Senior Living Communities Managed by Five Star . Five Star managed 235, including seven closed senior living communities, and 244 senior living communities for our account as of March 31, 2021 and 2020, respectively. We lease our senior living communities that are managed by Five Star to our taxable REIT subsidiaries, or TRSs. We incurred management fees payable to Five Star of $13,850 and $17,050 for the three months ended March 31, 2021 and 2020, respectively. For the three months ended March 31, 2021 and 2020, $13,016 and $16,588, respectively, of the total management fees were expensed to property operating expenses in our condensed consolidated statements of comprehensive income (loss) and $834 and $462, respectively, were capitalized in our condensed consolidated balance sheets. The following table presents residents fees and services revenue disaggregated by type of contract and payer: Three Months Ended March 31, Revenue from contracts with customers: 2021 2020 Basic housing and support services $ 188,029 $ 231,516 Medicare and Medicaid programs 35,948 49,668 Private pay and other third party payer SNF services 35,989 50,785 Total residents fees and services $ 259,966 $ 331,969 We incurred fees of $5,441 and $8,057 for the three months ended March 31, 2021 and 2020, respectively, with respect to rehabilitation services Five Star provided at senior living communities it manages for our account that are payable by us. These amounts are included in property operating expenses in our condensed consolidated statements of comprehensive income (loss). As a result of routine monitoring protocols that are a part of Five Star's compliance program activities related to Medicare billing, Five Star discovered potentially inadequate documentation at one of our senior living communities that Five Star manages. This monitoring was not initiated in response to any specific complaint or allegation but rather was of the type that Five Star periodically undertakes to test its compliance with applicable Medicare billing rules. We and Five Star voluntarily disclosed this matter to the United States Department of Health and Human Services, Office of the Inspector General, or the OIG, pursuant to the OIG’s Provider Self-Disclosure Protocol. In January 2021, we and Five Star settled this matter with the OIG and we agreed to pay approximately $5,763 in exchange for a customary release, but we and Five Star did not admit any liability. We recognized that amount in our consolidated statement of comprehensive income (loss) during the year ended December 31, 2020 and paid that amount to the OIG in January 2021. Five Star refunded to us approximately $115 of management fees it previously received relating to the Medicare payments we refunded to the OIG. Since January 1, 2020, we sold certain senior living communities that were then managed by Five Star. We and Five Star terminated our management agreements for these senior living communities in connection with these sales. See Note 3 to the consolidated financial statements contained in our Annual Report for further information regarding these sales. We lease to Five Star space at certain of our senior living communities that Five Star manages. Five Star uses this space for outpatient rehabilitation clinics. We recognized a reduction in property operating expenses of $397 and $294 for the three months ended March 31, 2021 and 2020, respectively, with respect to these leases.

Business and Property Managemen

Business and Property Management Agreements with RMR LLC	3 Months Ended
	Mar. 31, 2021
Related Party Transactions [Abstract]
Business and Property Management Agreements with RMR LLC	Business and Property Management Agreements with RMR LLC We have no employees. The personnel and various services we require to operate our business are provided to us by RMR LLC. We have two agreements with RMR LLC to provide management services to us: (1) a business management agreement, which relates to our business generally; and (2) a property management agreement, which relates to the property level operations of our medical office and life science properties. RMR LLC will also provide certain construction supervision services at our senior living communities managed by Five Star. We also have a subsidiary level management agreement with RMR LLC related to the life science property located in Boston, Massachusetts, which we entered in connection with the joint venture arrangement for that life science property. Under that agreement, our subsidiary pays RMR LLC certain business management fees directly, which fees are credited against the business management fees payable by us to RMR LLC. See Note 11 for further information regarding our relationship, agreements and transactions with RMR LLC. We recognized net business management fees payable to RMR LLC of $5,317 and $5,769 for the three months ended March 31, 2021 and 2020, respectively. The net business management fees we recognized include $725 of management fees related to our subsidiary level management agreement with RMR LLC entered in connection with our joint venture arrangement for both the three months ended March 31, 2021 and 2020. Based on our common share total return, as defined in our business management agreement, as of each of March 31, 2021 and 2020, no estimated incentive fees are included in the net business management fees we recognized for the three months ended March 31, 2021 or 2020. The actual amount of annual incentive fees for 2021, if any, will be based on our common share total return as defined in our business management agreement, for the three-year period ending December 31, 2021, and will be payable in 2022. We did not incur any incentive fee payable for the year ended December 31, 2020. We recognize business management and incentive fees in general and administrative expenses in our condensed consolidated statements of comprehensive income (loss). We recognized aggregate net property management and construction supervision fees payable to RMR LLC of $3,154 and $3,192 for the three months ended March 31, 2021 and 2020, respectively. Of those amounts, for the three months ended March 31, 2021 and 2020, $2,485 and $2,596, respectively, were expensed to property operating expenses in our condensed consolidated statements of comprehensive income (loss) and $669 and $596, respectively, were capitalized as building improvements in our condensed consolidated balance sheets. We are generally responsible for all our operating expenses, including certain expenses incurred or arranged by RMR LLC on our behalf. We are generally not responsible for payment of RMR LLC's employment, office or administrative expenses incurred to provide management services to us, except for the employment and related expenses of RMR LLC's employees assigned to work exclusively or partly at our medical office and life science properties, our share of the wages, benefits and other related costs of RMR LLC's centralized accounting personnel, our share of RMR LLC's costs for providing our internal audit function, or as otherwise agreed. Our property level operating expenses are generally incorporated into the rents charged to our tenants, including certain payroll and related costs incurred by RMR LLC. We reimbursed RMR LLC $3,297 and $3,443 for these expenses and costs for the three months ended March 31, 2021 and 2020, respectively. These amounts are included in property operating expenses and general and administrative expenses, as applicable, in our condensed consolidated statements of comprehensive income (loss).

Related Person Transactions

Related Person Transactions	3 Months Ended
	Mar. 31, 2021
Related Party Transactions [Abstract]
Related Person Transactions	Related Person Transactions We have relationships and historical and continuing transactions with RMR LLC, The RMR Group Inc., or RMR Inc., Five Star and others related to them, including other companies to which RMR LLC or its subsidiaries provide management services and some of which have trustees, directors or officers who are also our Trustees or officers. RMR Inc. is the managing member of RMR LLC. The Chair of our Board and one of our Managing Trustees, Adam D. Portnoy, is the sole trustee, an officer and the controlling shareholder of ABP Trust, which is the controlling shareholder of RMR Inc., a managing director and the president and chief executive officer of RMR Inc., an officer and employee of RMR LLC and the chair of the board of directors and a managing director of Five Star. Jennifer B. Clark, our other Managing Trustee and our Secretary, also serves as a managing director and the executive vice president, general counsel and secretary of RMR Inc., an officer and employee of RMR LLC, an officer of ABP Trust and a managing director and the secretary of Five Star. Jennifer F. Francis, our President and Chief Operating Officer is an executive vice president of RMR Inc. and she and our Chief Financial Officer and Treasurer are also employees and officers of RMR LLC. Certain of Five Star's officers are officers and employees of RMR LLC. Some of our Independent Trustees also serve as independent trustees or independent directors of other public companies to which RMR LLC or its subsidiaries provide management services. Adam Portnoy serves as the chair of the boards of trustees or boards of directors of several of these public companies and as a managing director or managing trustee of these companies. Other officers of RMR LLC, including Ms. Clark and certain of our officers, serve as managing trustees, managing directors or officers of certain of these companies. In addition, officers of RMR LLC and RMR Inc. serve as our officers and officers of other companies to which RMR LLC or its subsidiaries provide management services. Five Star. We are currently Five Star's largest stockholder. As of March 31, 2021, we owned 10,691,658 Five Star common shares, or approximately 33.8% of Five Star's outstanding common shares. Five Star currently manages for our account most of the senior living communities we own. RMR LLC provides management services to both us and Five Star. See Note 9 for further information regarding our relationships, agreements and transactions with Five Star and Note 5 for further information regarding our investment in Five Star. As of March 31, 2021, ABP Acquisition LLC, a subsidiary of ABP Trust, the controlling shareholder of RMR Inc., together with ABP Trust, owned approximately 6.3% of Five Star's outstanding common shares. Our Manager, RMR LLC. We have two agreements with RMR LLC to provide management services to us. See Note 10 for further information regarding our management agreements with RMR LLC. For further information about these and other such relationships and certain other related person transactions, see our Annual Report.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2021
Income Tax Disclosure [Abstract]
Income Taxes	Income TaxesWe have elected to be taxed as a real estate investment trust, or REIT, under the Internal Revenue Code of 1986, as amended, and, as such, are generally not subject to federal and most state income taxation on our operating income provided we distribute our taxable income to our shareholders and meet certain organization and operating requirements. We do, however, lease our managed senior living communities to our wholly owned TRSs that, unlike most of our subsidiaries, file a separate consolidated federal corporate income tax return and are subject to federal and state income taxes. Our consolidated income tax provision includes the income tax provision related to the operations of our TRSs and certain state income taxes we incur despite our taxation as a REIT. During the three months ended March 31, 2021 and 2020, we recognized income tax expense of $238 and benefit of $443, respectively.

Weighted Average Common Shares

Weighted Average Common Shares	3 Months Ended
	Mar. 31, 2021
Earnings Per Share [Abstract]
Weighted Average Common Shares	Weighted Average Common Shares (share amounts in thousands) We calculate basic earnings per common share by dividing net income (loss) by the weighted average number of our common shares outstanding during the period. We calculate diluted earnings per share using the more dilutive of the two class method or the treasury stock method. Unvested share awards and other potentially dilutive common shares, and the related impact on earnings, are considered when calculating diluted earnings per share. For the three months ended March 31, 2021 and 2020, 20 and 123 unvested common shares, respectively, were not included in the calculation of diluted earnings per share because to do so would have been antidilutive.

Real Estate Properties (Tables)

Real Estate Properties (Tables)	3 Months Ended
	Mar. 31, 2021
Real Estate [Abstract]
Schedule of Real Estate Properties	Date of Sale Location Type of Property Number of Properties Square Feet Sale Price (1) Loss on Sale February 2021 Pennsylvania Medical Office 1 92,000 $ 9,000 $ (122) 1 $ 9,000 $ (122) (1) Sale price excludes closing costs. As of March 31, 2021, we had four properties classified as held for sale in our condensed consolidated balance sheet as follows: Type of Property Number of Properties Gross Book Value Life Science and Medical Office 4 $ 66,113 4 $ 66,113

Fair Value of Assets and Liab_2

Fair Value of Assets and Liabilities (Tables)	3 Months Ended
	Mar. 31, 2021
Fair Value Disclosures [Abstract]
Assets and Liabilities Recurring and Nonrecurring Measured at Fair Value	The following table presents certain of our assets that are measured at fair value at March 31, 2021, categorized by the level of inputs as defined in the fair value hierarchy under GAAP, used in the valuation of each asset. Fair Value at Reporting Date Using Quoted Prices in Significant Other Observable Inputs Significant Unobservable Inputs Description Total (Level 1) (Level 2) (Level 3) Recurring Fair Value Measurements Assets: Investment in Five Star (1) $ 65,433 $ 65,433 $ — $ — (1) Our 10,691,658 shares of common stock of Five Star Senior Living Inc., or Five Star, are included in other assets, net in our condensed consolidated balance sheets, and are reported at fair value, which is based upon quoted market prices on The Nasdaq Stock Market LLC, or Nasdaq, (Level 1 inputs). Our adjusted cost basis for these shares was $44,448 as of March 31, 2021. During the three months ended March 31, 2021 and 2020, we recorded unrealized losses of $8,339 and $9,943, respectively, which are included in losses on equity securities, net in our condensed consolidated statements of comprehensive income (loss), to adjust the carrying value of our investment in Five Star common shares to their fair value. See Note 11 for further information about our investment in Five Star.
Schedule of Carrying Value and Fair Value of the Financial Instruments	The fair values of these financial instruments approximated their carrying values in our condensed consolidated financial statements as of such dates, except as follows: As of March 31, 2021 As of December 31, 2020 Description Carrying Amount (1) Estimated Fair Value Carrying Amount (1) Estimated Fair Value Senior unsecured notes, 6.750% coupon rate, due in 2021 (2) $ 299,470 $ 302,631 $ 299,273 $ 303,891 Senior unsecured notes, 4.750% coupon rate, due in 2024 249,138 258,289 249,068 256,258 Senior unsecured notes, 9.750% coupon rate, due in 2025 985,245 1,130,760 984,359 1,135,800 Senior unsecured notes, 4.750% coupon rate, due in 2028 491,244 493,445 490,925 502,648 Senior unsecured notes, 4.375% coupon rate, due in 2031 491,490 487,870 — — Senior unsecured notes, 5.625% coupon rate, due in 2042 341,897 323,400 341,802 330,120 Senior unsecured notes, 6.250% coupon rate, due in 2046 242,834 243,600 242,762 245,000 Secured debts (3) (4) 690,733 704,289 691,573 716,185 $ 3,792,051 $ 3,944,284 $ 3,299,762 $ 3,489,902 (1) Includes unamortized net debt issuance costs, premiums and discounts. (2) In April 2021, we delivered a notice of redemption to redeem all $300,000 of our outstanding 6.75% senior notes due 2021 in June 2021, when these notes become redeemable with no prepayment premium. (3) We assumed certain of these secured debts in connection with our acquisition of certain properties. We recorded the assumed mortgage notes at estimated fair value on the date of acquisition and we are amortizing the fair value adjustments, if any, to interest expense over the respective terms of the mortgage notes to adjust interest expense to the estimated market interest rates as of the date of acquisition. (4) Includes secured debts for the life science property owned by a joint venture arrangement in which we own a 55% equity interest. The amounts listed in the table for these debts have not been adjusted to reflect the equity interests in the joint venture that we do not own.

Shareholders' Equity (Tables)

Shareholders' Equity (Tables)	3 Months Ended
	Mar. 31, 2021
Stockholders' Equity Note [Abstract]
Schedule of Dividends Declared and Paid	During the three months ended March 31, 2021, we declared and paid a quarterly distribution to common shareholders as follows: Record Date Payment Date Distribution Per Share Total Distributions January 25, 2021 February 18, 2021 $ 0.01 $ 2,383

Segment Reporting (Tables)

Segment Reporting (Tables)	3 Months Ended
	Mar. 31, 2021
Segment Reporting [Abstract]
Schedule of segment reporting information	For the Three Months Ended March 31, 2021 Office Portfolio SHOP Non-Segment Consolidated Revenues: Rental income $ 93,323 $ — $ 9,435 $ 102,758 Residents fees and services — 259,966 — 259,966 Total revenues 93,323 259,966 9,435 362,724 Expenses: Property operating expenses 31,293 256,098 — 287,391 Depreciation and amortization 31,938 31,361 2,854 66,153 General and administrative — — 7,542 7,542 Impairment of assets — (174) — (174) Total expenses 63,231 287,285 10,396 360,912 Loss on sale of properties (122) — — (122) Losses on equity securities, net — — (8,339) (8,339) Interest and other income — 2,433 402 2,835 Interest expense (5,939) (528) (53,624) (60,091) Loss on early extinguishment of debt — — (2,040) (2,040) Income (loss) from continuing operations before income tax expense 24,031 (25,414) (64,562) (65,945) Income tax expense — — (238) (238) Net income (loss) 24,031 (25,414) (64,800) (66,183) Net income attributable to noncontrolling interest (1,322) — — (1,322) Net income (loss) attributable to common shareholders $ 22,709 $ (25,414) $ (64,800) $ (67,505) As of March 31, 2021 Office Portfolio SHOP Non-Segment Consolidated Total assets $ 3,072,160 $ 2,908,334 $ 1,562,212 $ 7,542,706 For the Three Months Ended March 31, 2020 Office Portfolio SHOP Non-Segment Consolidated Revenues: Rental income $ 98,770 $ — $ 11,728 $ 110,498 Residents fees and services — 331,969 — 331,969 Total revenues 98,770 331,969 11,728 442,467 Expenses: Property operating expenses 32,706 283,879 — 316,585 Depreciation and amortization 32,163 33,042 3,225 68,430 General and administrative — — 8,832 8,832 Acquisition and certain other transaction related costs — — 663 663 Impairment of assets 6,218 5,016 — 11,234 Total expenses 71,087 321,937 12,720 405,744 Gain on sale of properties 2,782 — — 2,782 Losses on equity securities, net — — (9,943) (9,943) Interest and other income — — 138 138 Interest expense (6,052) (564) (35,034) (41,650) Gain on lease termination — — 22,896 22,896 Loss on early extinguishment of debt (246) — — (246) Income (loss) from continuing operations before income tax benefit 24,167 9,468 (22,935) 10,700 Income tax benefit — — 443 443 Net income (loss) 24,167 9,468 (22,492) 11,143 Net income attributable to noncontrolling interest (1,408) — — (1,408) Net income (loss) attributable to common shareholders $ 22,759 $ 9,468 $ (22,492) $ 9,735 As of December 31, 2020 Office Portfolio SHOP Non-Segment Consolidated Total assets $ 3,092,289 $ 2,912,570 $ 471,565 $ 6,476,424

Leases and Management Agreeme_2

Leases and Management Agreements with Five Star (Tables)	3 Months Ended
	Mar. 31, 2021
Risks and Uncertainties [Abstract]
Disaggregation of Revenue	The following table presents residents fees and services revenue disaggregated by type of contract and payer: Three Months Ended March 31, Revenue from contracts with customers: 2021 2020 Basic housing and support services $ 188,029 $ 231,516 Medicare and Medicaid programs 35,948 49,668 Private pay and other third party payer SNF services 35,989 50,785 Total residents fees and services $ 259,966 $ 331,969

Basis of Presentation (Details)

Basis of Presentation (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Basis Of Presentation
Assets	$ 7,542,706	$ 6,476,424
Liabilities	4,997,516	3,857,202
VIE, Primary Beneficiary
Basis Of Presentation
Assets	958,013	970,142
Liabilities	$ 694,847	$ 697,129
Joint Venture
Basis Of Presentation
Noncontrolling interest, ownership percentage by parent	45.00%
Ownership percentage	55.00%
Joint Venture | Lire Science Building Located In Boston Massachusetts
Basis Of Presentation
Ownership percentage	55.00%
Joint Venture | Lire Science Building Located In Boston Massachusetts | Investor
Basis Of Presentation
Noncontrolling interest, ownership percentage by parent	45.00%

Real Estate Properties - Narrat

Real Estate Properties - Narrative (Details) $ in Thousands	1 Months Ended	3 Months Ended
	Apr. 30, 2021USD ($)property	Mar. 31, 2021USD ($)propertystatecommunity	Mar. 31, 2020USD ($)
Real Estate Properties
Number of real estate properties		396
Number of states in which properties are located | state		36
Impairment of assets | $		$ (174)	$ 11,234
Life Science Building
Real Estate Properties
Number of real estate properties		1
Senior Living Communities | Scenario, Adjustment
Real Estate Properties
Number of real estate properties | community		10
Impairment of assets | $		$ (174)
Held-for-sale
Real Estate Properties
Number of real estate properties		4
Held-for-sale | Life Science and Medical Office
Real Estate Properties
Number of real estate properties		4
Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate Properties
Number of real estate properties		1
Aggregate sale price | $		$ 9,000
Joint Venture
Real Estate Properties
Ownership percentage		55.00%
Subsequent Event | Silver Springs, Maryland
Real Estate Properties
Purchase price | $	$ 19,600
Subsequent Event | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate Properties
Aggregate sale price | $	$ 95,500
Subsequent Event | Disposal Group, Disposed of by Sale, Not Discontinued Operations | Life Science and Medical Office
Real Estate Properties
Number of real estate properties	4

Real Estate Properties - Schedu

Real Estate Properties - Schedule of Real Estate Properties (Details) ft² in Thousands, $ in Thousands	1 Months Ended	3 Months Ended
	Feb. 28, 2021USD ($)ft²property	Mar. 31, 2021USD ($)property	Mar. 31, 2020USD ($)
Real Estate
Number of properties (property) | property		396
Impairment of Assets		$ (174)	$ 11,234
Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate
Number of properties (property) | property		1
Sales Price		$ 9,000
Loss on Sale		$ (122)
Disposal Group, Disposed of by Sale, Not Discontinued Operations | Medical Office Buildings | Pennsylvania
Real Estate
Number of properties (property) | property	1
Square Feet | ft²	92
Sales Price	$ 9,000
Loss on Sale	$ (122)
Held-for-sale
Real Estate
Number of properties (property) | property		4
Gross Book Value		$ 66,113
Held-for-sale | Life Science and Medical Office
Real Estate
Number of properties (property) | property		4
Gross Book Value		$ 66,113

Leases (Details)

Leases (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020
Leases [Abstract]
Straight line rental income	$ 804	$ 1,153
Straight line rental income, excluding properties held-for-sale	105,279		$ 104,803
Variable lease, payment	18,228	20,028
Reimbursement revenue lease	18,180	$ 19,983
Deferred rents	878		1,486
Operating lease, right-of-use asset	$ 4,216		$ 4,237
Operating Lease, Right-of-Use Asset, Statement of Financial Position	Other assets, net		Other assets, net
Operating lease, liability	$ 4,395		$ 4,410
Operating Lease, Liability, Statement of Financial Position	Other liabilities		Other liabilities

Indebtedness (Details)

Indebtedness (Details)	1 Months Ended		3 Months Ended
	Feb. 28, 2021USD ($)	Jan. 31, 2021USD ($)	Mar. 31, 2021USD ($)property	Mar. 31, 2020USD ($)	Jun. 30, 2021	Jan. 30, 2021USD ($)	Dec. 31, 2020USD ($)	Jun. 30, 2020USD ($)
Indebtedness
Number of properties (property) | property			396
Total real estate properties, gross			$ 7,488,777,000				$ 7,410,730,000
Revolving credit facility			800,000,000				0
Loss on early extinguishment of debt			$ 2,040,000	$ 246,000
Number of real estate properties | property			396
Forecast
Indebtedness
Debt ratio					150.00%
Finance Leased Properties
Indebtedness
Number of properties (property) | property			2
Finance lease obligations			$ 7,525,000
Finance leased asset, gross			35,893,000				35,676,000
Finance leased asset, accumulated depreciation			$ 17,685,000				$ 17,579,000
Number of real estate properties | property			2
Joint Venture
Indebtedness
Ownership percentage			55.00%
Unsecured revolving credit facility
Indebtedness
Unsecured revolving credit facility, maximum borrowing capacity		$ 800,000,000	$ 800,000,000			$ 1,000,000,000
Revolving credit facility, interest rate payable (as a percent)			2.90%
Debt instrument, facility fee (as a percent)			0.30%
Weighted average interest rate on debt (as a percent)			2.90%	2.60%
Revolving credit facility			$ 800,000,000
Loss on early extinguishment of debt			$ 563,000
Capital expenditure	$ 350,000,000	250,000,000
Minimum liquidity requirement		$ 200,000,000
Unsecured revolving credit facility | Medical Office And Life Science
Indebtedness
Number of properties (property) | property			62
Total real estate properties, gross			$ 1,035,255,000
Number of real estate properties | property			62
Unsecured revolving credit facility | LIBOR | Revolving Credit Facility
Indebtedness
Basis points per annum (as a percent)		0.30%
Mortgages
Indebtedness
Aggregate principal amount of mortgage debt			$ 683,990,000
Number of properties (property) | property			7
Total real estate properties, gross			$ 947,085,000
Number of real estate properties | property			7
Mortgages | Joint Venture
Indebtedness
Aggregate principal amount of mortgage debt			$ 620,000,000
Ownership percentage			55.00%
Senior Unsecured Notes Due Feb 2021
Indebtedness
Debt face amount	200,000,000	$ 200,000,000
Senior Unsecured Notes Due 2021
Indebtedness
Debt face amount		$ 300,000,000
Unsecured Debt
Indebtedness
Debt face amount			$ 3,150,000,000
Senior Unsecured Notes | Senior Note 4.375 Due 2031
Indebtedness
Debt face amount	$ 500,000,000
Interest rate (as a percent)	4.375%
Proceeds from debt	$ 491,365,000
Senior Unsecured Notes | Term loan due 2022
Indebtedness
Debt face amount	$ 200,000,000		$ 300,000,000
Weighted average interest rate on debt (as a percent)	2.90%
Revolving credit facility								$ 200,000,000
Interest rate (as a percent)			6.75%
Loss on early extinguishment of debt			$ 1,477,000
Senior Unsecured Notes | Senior Unsecured 4.375 Percent Notes Due 2031
Indebtedness
Debt face amount	$ 500,000,000
Interest rate (as a percent)	4.375%
Senior Unsecured Notes | Senior Unsecured Notes Due June 2021
Indebtedness
Debt face amount			$ 300,000,000
Interest rate (as a percent)	6.75%

Fair Value of Assets and Liab_3

Fair Value of Assets and Liabilities - Assets and Liabilities (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Gains (losses) on equity securities, net	$ (8,339)	$ (9,943)
Five Star
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Equity securities investment (in shares)	10,691,658
Recurring | Five Star
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Investments in affiliates, fair value	$ 65,433
Recurring | Five Star | Carrying Amount
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Investments in affiliates, fair value	44,448
Recurring | Quoted Prices in Active Markets for Identical Assets (Level 1) | Five Star
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Investments in affiliates, fair value	65,433
Recurring | Significant Other Observable Inputs (Level 2) | Five Star
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Investments in affiliates, fair value	0
Recurring | Significant Unobservable Inputs (Level 3) | Five Star
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Investments in affiliates, fair value	$ 0
Common Shares | Five Star
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Equity securities investment (in shares)	10,691,658

Fair Value of Assets and Liab_4

Fair Value of Assets and Liabilities - Liabilities (Details) - USD ($)	Mar. 31, 2021	Dec. 31, 2020
Life Science Property | Joint Venture
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Ownership percentage	55.00%
Senior Unsecured Notes | Senior unsecured notes, 6.750% coupon rate, due in 2021
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Coupon rate (percent)	6.75%
Debt face amount	$ 300,000,000
Carrying Amount
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Fair value disclosure	$ 3,792,051,000	$ 3,299,762,000
Carrying Amount | Senior Unsecured Notes | Senior unsecured notes, 6.750% coupon rate, due in 2021
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Coupon rate (percent)	6.75%
Fair value disclosure	$ 299,470,000	299,273,000
Carrying Amount | Senior Unsecured Notes | Senior unsecured notes, 4.750% coupon rate, due in 2024
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Coupon rate (percent)	4.75%
Fair value disclosure	$ 249,138,000	249,068,000
Carrying Amount | Senior Unsecured Notes | Senior unsecured notes, 9.750% coupon rate, due in 2025
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Coupon rate (percent)	9.75%
Fair value disclosure	$ 985,245,000	984,359,000
Carrying Amount | Senior Unsecured Notes | Senior unsecured notes, 4.750% coupon rate, due in 2028
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Coupon rate (percent)	4.75%
Fair value disclosure	$ 491,244,000	490,925,000
Carrying Amount | Senior Unsecured Notes | Senior unsecured notes, 4.375% coupon rate, due in 2031
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Coupon rate (percent)	4.375%
Fair value disclosure	$ 491,490,000	0
Carrying Amount | Senior Unsecured Notes | Senior unsecured notes, 5.625% coupon rate, due in 2042
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Coupon rate (percent)	5.625%
Fair value disclosure	$ 341,897,000	341,802,000
Carrying Amount | Senior Unsecured Notes | Senior unsecured notes, 6.250% coupon rate, due in 2046
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Coupon rate (percent)	6.25%
Fair value disclosure	$ 242,834,000	242,762,000
Carrying Amount | Secured debts
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Fair value disclosure	690,733,000	691,573,000
Estimated Fair Value
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Fair value disclosure	3,944,284,000	3,489,902,000
Estimated Fair Value | Senior Unsecured Notes | Senior unsecured notes, 6.750% coupon rate, due in 2021
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Fair value disclosure	302,631,000	303,891,000
Estimated Fair Value | Senior Unsecured Notes | Senior unsecured notes, 4.750% coupon rate, due in 2024
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Fair value disclosure	258,289,000	256,258,000
Estimated Fair Value | Senior Unsecured Notes | Senior unsecured notes, 9.750% coupon rate, due in 2025
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Fair value disclosure	1,130,760,000	1,135,800,000
Estimated Fair Value | Senior Unsecured Notes | Senior unsecured notes, 4.750% coupon rate, due in 2028
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Fair value disclosure	493,445,000	502,648,000
Estimated Fair Value | Senior Unsecured Notes | Senior unsecured notes, 4.375% coupon rate, due in 2031
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Fair value disclosure	487,870,000	0
Estimated Fair Value | Senior Unsecured Notes | Senior unsecured notes, 5.625% coupon rate, due in 2042
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Fair value disclosure	323,400,000	330,120,000
Estimated Fair Value | Senior Unsecured Notes | Senior unsecured notes, 6.250% coupon rate, due in 2046
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Fair value disclosure	243,600,000	245,000,000
Estimated Fair Value | Secured debts
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Fair value disclosure	$ 704,289,000	$ 716,185,000

Fair Value of Assets and Liab_5

Fair Value of Assets and Liabilities - Narrative (Details)	Mar. 31, 2021security
Fair Value, Inputs, Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Fair value measurement, number of debt securities	2
Fair Value, Inputs, Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Fair value measurement, number of debt securities	5

Noncontrolling Interest (Detail

Noncontrolling Interest (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2021USD ($)property	Mar. 31, 2020USD ($)
Noncontrolling Interest
Net income attributable to noncontrolling interest	$ (1,322)	$ (1,408)
Cash distribution for joint venture partners	5,694	$ 5,767
Variable interest entity, consolidated, carrying amount, real estate assets	700,192
Variable interest entity, consolidated, carrying amount, mortgage debt	$ 620,000
Joint Venture
Noncontrolling Interest
Ownership percentage by noncontrolling owners	45.00%
Ownership percentage	55.00%
Boston, MA | Life Science Building | Joint Venture
Noncontrolling Interest
Number of properties included in joint venture agreement | property	1

Shareholders' Equity - Schedule

Shareholders' Equity - Schedule of Dividends Declared and Paid (Details) - USD ($) $ / shares in Units, $ in Thousands	Feb. 18, 2021	Mar. 31, 2021	Mar. 31, 2020
Stockholders' Equity Note [Abstract]
Distribution Per Share (in dollars per share)	$ 0.01
Total Distributions	$ 2,383	$ 2,383	$ 35,684

Shareholders' Equity - Narrativ

Shareholders' Equity - Narrative (Details) - USD ($) $ / shares in Units, $ in Thousands	Apr. 15, 2021	Feb. 18, 2021	Mar. 31, 2021	Mar. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Distributions to shareholders		$ 2,383	$ 2,383	$ 35,684
Subsequent Event
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Distributions to common shareholders declared (in dollars per share)	$ 0.01
Distributions to shareholders	$ 2,383

Segment Reporting - Narrative (

Segment Reporting - Narrative (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2021USD ($)segment	Mar. 31, 2020USD ($)
Segment reporting
Number of operating segments | segment	2
Interest and other income	$ 2,835	$ 138
Operating Segments | SHOP
Segment reporting
Interest and other income	$ 2,433	$ 0

Segment Reporting - Income Stat

Segment Reporting - Income Statements (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Revenues:
Total revenues	$ 362,724	$ 442,467
Expenses:
Property operating expenses	287,391	316,585
Depreciation and amortization	66,153	68,430
General and administrative	7,542	8,832
Impairment of assets	(174)	11,234
Total expenses	360,912	405,744
Acquisition and certain other transaction related costs	0	663
Gain (loss) on sale of properties	(122)	2,782
Gains (losses) on equity securities, net	(8,339)	(9,943)
Interest and other income	2,835	138
Interest expense	(60,091)	(41,650)
Gain on lease termination	0	22,896
Loss on early extinguishment of debt	(2,040)	(246)
Income (loss) from continuing operations before income tax expense	(65,945)	10,700
Income tax (expense) benefit	(238)	443
Net income (loss)	(66,183)	11,143
Net income attributable to noncontrolling interest	(1,322)	(1,408)
Net income (loss) attributable to common shareholders	(67,505)	9,735
Operating Segments | Office Portfolio
Revenues:
Total revenues	93,323	98,770
Expenses:
Property operating expenses	31,293	32,706
Depreciation and amortization	31,938	32,163
General and administrative	0	0
Impairment of assets	0	6,218
Total expenses	63,231	71,087
Acquisition and certain other transaction related costs		0
Gain (loss) on sale of properties	(122)	2,782
Gains (losses) on equity securities, net	0	0
Interest and other income	0	0
Interest expense	(5,939)	(6,052)
Gain on lease termination		0
Loss on early extinguishment of debt	0	(246)
Income (loss) from continuing operations before income tax expense	24,031	24,167
Income tax (expense) benefit	0	0
Net income (loss)	24,031	24,167
Net income attributable to noncontrolling interest	(1,322)	(1,408)
Net income (loss) attributable to common shareholders	22,709	22,759
Operating Segments | SHOP
Revenues:
Total revenues	259,966	331,969
Expenses:
Property operating expenses	256,098	283,879
Depreciation and amortization	31,361	33,042
General and administrative	0	0
Impairment of assets	(174)	5,016
Total expenses	287,285	321,937
Acquisition and certain other transaction related costs		0
Gain (loss) on sale of properties	0	0
Gains (losses) on equity securities, net	0	0
Interest and other income	2,433	0
Interest expense	(528)	(564)
Gain on lease termination		0
Loss on early extinguishment of debt	0	0
Income (loss) from continuing operations before income tax expense	(25,414)	9,468
Income tax (expense) benefit	0	0
Net income (loss)	(25,414)	9,468
Net income attributable to noncontrolling interest	0	0
Net income (loss) attributable to common shareholders	(25,414)	9,468
Non-Segment
Revenues:
Total revenues	9,435	11,728
Expenses:
Property operating expenses	0	0
Depreciation and amortization	2,854	3,225
General and administrative	7,542	8,832
Impairment of assets	0	0
Total expenses	10,396	12,720
Acquisition and certain other transaction related costs		663
Gain (loss) on sale of properties	0	0
Gains (losses) on equity securities, net	(8,339)	(9,943)
Interest and other income	402	138
Interest expense	(53,624)	(35,034)
Gain on lease termination		22,896
Loss on early extinguishment of debt	(2,040)	0
Income (loss) from continuing operations before income tax expense	(64,562)	(22,935)
Income tax (expense) benefit	(238)	443
Net income (loss)	(64,800)	(22,492)
Net income attributable to noncontrolling interest	0	0
Net income (loss) attributable to common shareholders	(64,800)	(22,492)
Rental income
Revenues:
Total revenues	102,758	110,498
Rental income | Operating Segments | Office Portfolio
Revenues:
Total revenues	93,323	98,770
Rental income | Operating Segments | SHOP
Revenues:
Total revenues	0	0
Rental income | Non-Segment
Revenues:
Total revenues	9,435	11,728
Residents fees and services
Revenues:
Total revenues	259,966	331,969
Residents fees and services | Operating Segments | Office Portfolio
Revenues:
Total revenues	0	0
Residents fees and services | Operating Segments | SHOP
Revenues:
Total revenues	259,966	331,969
Residents fees and services | Non-Segment
Revenues:
Total revenues	$ 0	$ 0

Segment Reporting - Assets (Det

Segment Reporting - Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Segment reporting
Total assets	$ 7,542,706	$ 6,476,424
Operating Segments | Office Portfolio
Segment reporting
Total assets	3,072,160	3,092,289
Operating Segments | SHOP
Segment reporting
Total assets	2,908,334	2,912,570
Non-Segment
Segment reporting
Total assets	$ 1,562,212	$ 471,565

Leases and Management Agreeme_3

Leases and Management Agreements with Five Star - Narrative (Details) $ in Thousands	Apr. 09, 2021USD ($)unitcommunity	Jan. 31, 2021USD ($)	Mar. 31, 2021USD ($)communitypropertytrusteeshares	Mar. 31, 2020USD ($)community	Dec. 31, 2020shares	Dec. 31, 2019shares
Common shares of beneficial interest, shares issued (in shares) | shares			238,268,478		238,268,478
Gain on lease termination			$ 0	$ 22,896
Number of properties (property) | property			396
Rental income			$ 397	294
Five Star
Total rental income recognized				75,000
Gain on lease termination				$ 22,896
Five Star
Payments made in exchange for customary release		$ 5,763
Five Star | Senior Living Communities
Number of properties (property) | community			235	244
Number of real estate properties inadequate documentation | trustee			1
Revenue reserve, management fees payable reduction			$ 115
Five Star | Senior Living Communities | Closed
Number of properties (property) | community			7
Five Star
Common shares of beneficial interest, shares issued (in shares) | shares						10,268,158
Aggregate Shares Issued | shares					16,118,849
Five Star
Investment owned, percentage of total shares outstanding			33.80%
Property management agreement expense			$ 13,850	$ 17,050
Related party transaction capitalized amount			834	462
Five Star | Operating Expense
Property management agreement expense			13,016	16,588
Five Star | Senior Living Communities | Subsequent Event
Number of properties (property) | community	120
Number of property units (units) | unit	18,000
Related party transactions, termination percentage	10.00%
Percentage target EBITDA of new management agreement not earned	80.00%
Five Star | Senior Living Communities | Subsequent Event | Disposal Group, Disposed of by Means Other than Sale, Not Discontinued Operations
Total rental income recognized	$ 682,000
Number of properties (property) | community	108
Number of property units (units) | unit	7,500
Five Star | Senior Living Communities | Subsequent Event | Closed
Number of property units (units) | unit	1,500
Five Star | Rehabilitation Services
Expenses from transactions with related party			$ 5,441	$ 8,057

Leases and Management Agreeme_4

Leases and Management Agreements with Five Star - Schedule of Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Disaggregation of Revenue
Revenues	$ 362,724	$ 442,467
Residents fees and services
Disaggregation of Revenue
Revenues	259,966	331,969
Residents fees and services | Basic housing and support services
Disaggregation of Revenue
Revenues	188,029	231,516
Residents fees and services | Medicare and Medicaid programs
Disaggregation of Revenue
Revenues	35,948	49,668
Residents fees and services | Private pay and other third party payer SNF services
Disaggregation of Revenue
Revenues	$ 35,989	$ 50,785

Business and Property Managem_2

Business and Property Management Agreements with RMR LLC (Details)	3 Months Ended		12 Months Ended
	Mar. 31, 2021USD ($)agreementemployee	Mar. 31, 2020USD ($)	Dec. 31, 2020
Related person transactions
Number of employees | employee	0
Property management and construction supervision fees	$ 3,154,000	$ 3,192,000
Property management and construction supervision fees paid	3,297,000	3,443,000
RMR LLC
Related person transactions
Business management fees incurred	5,317,000	5,769,000
Related party transaction business management fees related to subsidiary level management	725,000
Related party transaction business management agreement, annual incentive fee estimate included in management fees	0	0
Period of actual amount of incentive fees			3 years
Property management and construction supervision fees	2,485,000	2,596,000
Party transaction property management and construction supervision fees capitalized	$ 669,000	$ 596,000
Senior Living Communities | Five Star
Related person transactions
Number of consecutive renewal terms of agreement | agreement	2

Related Person Transactions (De

Related Person Transactions (Details)	Mar. 31, 2021agreementshares
Five Star
Related person transactions
Equity securities investment (in shares) | shares	10,691,658
Investment owned, percentage of total shares outstanding	33.80%
RMR LLC
Related person transactions
Number of management agreements | agreement	2
RMR LLC | Five Star
Related person transactions
Investment owned, percentage of total shares outstanding	6.30%

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Income Tax Disclosure [Abstract]
Income tax expense (benefit)	$ 238	$ (443)

Weighted Average Common Shares

Weighted Average Common Shares (Details) - shares shares in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Earnings Per Share [Abstract]
Antidilutive securities excluded from computation of earnings per share (in shares)	20	123