Brookdale Senior Living (BKD) 10-Q 7 May 21 2021 Q1 Quarterly report Financial data

Cover Page

Cover Page - shares	3 Months Ended
	Mar. 31, 2021	May 05, 2021
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2021
Document Transition Report	false
Entity File Number	001-32641
Entity Registrant Name	BROOKDALE SENIOR LIVING INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	20-3068069
Entity Address, Address Line One	111 Westwood Place,
Entity Address, Address Line Two	Suite 400,
Entity Address, City or Town	Brentwood,
Entity Address, State or Province	TN
Entity Address, Postal Zip Code	37027
City Area Code	615
Local Phone Number	221-2250
Title of 12(b) Security	Common Stock, $0.01 Par Value Per Share
Entity Trading Symbol	BKD
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		185,166,149
Entity Central Index Key	0001332349
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q1
Amendment Flag	false

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Current assets
Cash and cash equivalents	$ 303,952	$ 380,420
Marketable securities	134,933	172,905
Restricted cash	26,503	28,059
Accounts receivable, net	52,588	109,221
Liabilities held for sale	247,627	16,061
Prepaid expenses and other current assets, net	90,949	66,937
Total current assets	856,552	773,603
Property, plant and equipment and leasehold intangibles, net	5,018,409	5,068,060
Operating lease right-of-use assets	743,346	788,138
Restricted cash	71,468	56,669
Investment in unconsolidated ventures	4,972	4,898
Goodwill	27,321	154,131
Other assets, net	24,085	56,259
Total assets	6,746,153	6,901,758
Current liabilities
Current portion of long-term debt	224,890	68,885
Current portion of financing lease obligations	20,083	19,543
Current portion of operating lease obligations	140,339	146,226
Trade accounts payable	65,278	71,233
Liabilities held for sale	116,142	0
Accrued expenses	264,117	287,851
Refundable fees and deferred revenue	68,113	96,995
Total current liabilities	898,962	690,733
Long-term debt, less current portion	3,664,901	3,847,103
Financing lease obligations, less current portion	539,071	543,764
Operating lease obligations, less current portion	797,311	819,429
Deferred tax liability	9,876	9,557
Other liabilities	140,925	188,443
Total liabilities	6,051,046	6,099,029
Preferred stock, $0.01 par value, 50,000,000 shares authorized at March 31, 2021 and December 31, 2020; no shares issued and outstanding	0	0
Common stock, $0.01 par value, 400,000,000 shares authorized at March 31, 2021 and December 31, 2020; 197,757,065 and 198,331,663 shares issued and 187,229,540 and 187,804,138 shares outstanding (including 2,063,391 and 4,349,421 unvested restricted shares), respectively	1,978	1,983
Additional paid-in-capital	4,213,095	4,212,409
Treasury stock, at cost; 10,527,525 shares at March 31, 2021 and December 31, 2020	(102,774)	(102,774)
Accumulated deficit	(3,419,469)	(3,311,184)
Total Brookdale Senior Living Inc. stockholders' equity	692,830	800,434
Noncontrolling interest	2,277	2,295
Total equity	695,107	802,729
Total liabilities and equity	$ 6,746,153	$ 6,901,758

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Mar. 31, 2021	Dec. 31, 2020
Equity, Number of Shares, Par Value and Other Disclosures [Abstract]
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	50,000,000	50,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	400,000,000	400,000,000
Common stock, shares issued (in shares)	197,757,065	198,331,663
Common stock, shares outstanding (in shares)	187,229,540	187,804,138
Treasury stock, shares (in shares)	10,527,525	10,527,525
Unvested Restricted Stock
Equity, Number of Shares, Par Value and Other Disclosures [Abstract]
Common stock, shares outstanding (in shares)	2,063,391	4,349,421

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Revenue
Revenue	$ 749,445	$ 1,014,139
Expense
General and administrative expense (including non-cash stock-based compensation expense of $4,783 and $5,957, respectively)	49,943	54,595
Facility operating lease expense	44,418	64,481
Depreciation and amortization	83,891	90,738
Asset impairment	10,677	78,226
Total operating expense	811,035	999,239
Income (loss) from operations	(61,590)	14,900
Interest income	421	1,455
Interest expense:
Debt	(35,351)	(41,763)
Financing lease obligations	(11,383)	(13,282)
Amortization of deferred financing costs and debt discount	(1,873)	(1,315)
Gain (loss) on debt modification and extinguishment, net	0	19,181
Equity in earnings (loss) of unconsolidated ventures	(531)	(1,008)
Gain (loss) on sale of assets, net	1,112	372,839
Other non-operating income (loss)	1,644	2,662
Income (loss) before income taxes	(107,551)	353,669
Benefit (provision) for income taxes	(752)	15,828
Net income (loss)	(108,303)	369,497
Net (income) loss attributable to noncontrolling interest	18	18
Net income (loss) attributable to Brookdale Senior Living Inc. common stockholders	$ (108,285)	$ 369,515
Net income (loss) per share attributable to Brookdale Senior Living Inc. common stockholders:
Basic (in dollars per share)	$ (0.59)	$ 2.01
Diluted (in dollars per share)	$ (0.59)	$ 2
Weighted average common shares outstanding:
Weighted average shares outstanding - basic	184,011	184,186
Diluted (in shares)	184,011	184,522
Resident fees
Revenue
Revenue	$ 664,350	$ 782,707
Management fees
Revenue
Revenue	8,566	108,715
Reimbursed costs incurred on behalf of managed communities
Revenue
Revenue	65,794	122,717
Expense
Costs of services	65,794	122,717
Other operating income
Revenue
Revenue	10,735	0
Facility operating expense
Expense
Costs of services	$ 556,312	$ 588,482

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (Parenthetical) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Income Statement [Abstract]
Depreciation and amortization	$ 77,274	$ 84,301
Non-cash stock-based compensation expense	$ 4,783	$ 5,957

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF EQUITY - USD ($) $ in Thousands	Total	Common stock:	Additional paid-in-capital:	Treasury stock:	Accumulated deficit:	Noncontrolling interest:	Cumulative Effect Period Of Adoption AdjustmentAccumulated deficit:
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Cumulative effect of change in accounting principle	$ 698,725	$ 1,996	$ 4,172,099	$ (84,651)	$ (3,393,088)	$ 2,369	$ (115)
Balance at beginning of period at Dec. 31, 2019	698,725	1,996	4,172,099	(84,651)	(3,393,088)	2,369	(115)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under Associate Stock Purchase Plan		1	168
Restricted stock and restricted stock units, net		(6)	6
Shares withheld for employee taxes		(6)	(3,892)
Non-cash stock-based compensation expense			5,957
Other, net			18
Purchase of treasury stock				(18,123)
Cumulative effect of change in accounting principle	1,052,230	1,985	4,174,356	(102,774)	(3,023,688)	2,351	$ (115)
Net income (loss)	369,497				369,515	(18)
Balance at end of period at Mar. 31, 2020	1,052,230	$ 1,985	4,174,356	(102,774)	(3,023,688)	2,351
Balance at beginning of period (in shares) at Dec. 31, 2019		192,129,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under Associate Stock Purchase Plan (in shares)		61,000
Restricted stock and restricted stock units, net (in shares)		(504,000)
Shares withheld for employee taxes (in shares)		(611,000)
Purchase of treasury stock (in shares)		(3,063,000)
Balances at end of period (in shares) at Mar. 31, 2020		188,012,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Cumulative effect of change in accounting principle	1,052,230	$ 1,985	4,174,356	(102,774)	(3,023,688)	2,351
Cumulative effect of change in accounting principle	802,729	1,983	4,212,409	(102,774)	(3,311,184)	2,295
Balance at beginning of period at Dec. 31, 2020	802,729	1,983	4,212,409	(102,774)	(3,311,184)	2,295
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under Associate Stock Purchase Plan			224
Restricted stock and restricted stock units, net		2	(2)
Shares withheld for employee taxes		(7)	(4,322)
Non-cash stock-based compensation expense			4,783
Other, net			3
Cumulative effect of change in accounting principle	802,729	1,978	4,213,095	(102,774)	(3,419,469)	2,277
Net income (loss)	(108,303)				(108,285)	(18)
Balance at end of period at Mar. 31, 2021	$ 695,107	$ 1,978	4,213,095	(102,774)	(3,419,469)	2,277
Balance at beginning of period (in shares) at Dec. 31, 2020	187,804,138	187,804,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under Associate Stock Purchase Plan (in shares)		43,000
Restricted stock and restricted stock units, net (in shares)		127,000
Shares withheld for employee taxes (in shares)		(744,000)
Balances at end of period (in shares) at Mar. 31, 2021	187,229,540	187,230,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Cumulative effect of change in accounting principle	$ 695,107	$ 1,978	$ 4,213,095	$ (102,774)	$ (3,419,469)	$ 2,277

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 income (loss)	$ (108,303)	$ 369,497
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Loss (gain) on debt modification and extinguishment, net	0	(19,181)
Depreciation and amortization, net	85,764	92,053
Asset impairment	10,677	78,226
Equity in (earnings) loss of unconsolidated ventures	531	1,008
Amortization of entrance fees	(364)	(377)
Proceeds from deferred entrance fee revenue	670	343
Deferred income tax (benefit) provision	319	(21,767)
Operating lease expense adjustment	(4,664)	(6,733)
Loss (gain) on sale of assets, net	(1,112)	(372,839)
Non-cash stock-based compensation expense	4,783	5,957
Other	(1,416)	(1,460)
Changes in operating assets and liabilities:
Accounts receivable, net	(5,768)	(2,033)
Prepaid expenses and other assets, net	(6,769)	(1,696)
Prepaid insurance premiums financed with notes payable	(12,985)	(17,434)
Trade accounts payable and accrued expenses	(500)	(47,919)
Refundable fees and deferred revenue	7,717	(2,254)
Operating lease assets and liabilities for lessor capital expenditure reimbursements	7,563	4,088
Net cash provided by (used in) operating activities	(23,857)	57,479
Cash Flows from Investing Activities
Change in lease security deposits and lease acquisition deposits, net	(62)	3,211
Purchase of marketable securities	(79,932)	(89,414)
Sale and maturities of marketable securities	117,995	50,000
Capital expenditures, net of related payables	(40,361)	(69,385)
Acquisition of assets, net of related payables and cash received	0	(446,688)
Investment in unconsolidated ventures	(5,206)	(268)
Proceeds from sale of assets, net	3,760	304,617
Net cash provided by (used in) investing activities	(3,806)	(247,927)
Cash Flows from Financing Activities
Proceeds from debt	18,575	471,785
Repayment of debt and financing lease obligations	(49,924)	(263,226)
Proceeds from line of credit	0	166,381
Purchase of treasury stock, net of related payables	0	(18,123)
Payment of financing costs, net of related payables	(87)	(5,815)
Payments of employee taxes for withheld shares	(4,329)	(3,898)
Other	203	146
Net cash provided by (used in) financing activities	(35,562)	347,250
Net increase (decrease) in cash, cash equivalents, and restricted cash	(63,225)	156,802
Cash, cash equivalents, and restricted cash at beginning of period	465,148	301,697
Cash, cash equivalents, and restricted cash at end of period	$ 401,923	$ 458,499

Description of Business

Description of Business	3 Months Ended
	Mar. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Description of Business	Description of BusinessBrookdale Senior Living Inc. ("Brookdale" or the "Company") is an operator of senior living communities throughout the United States. The Company is committed to providing senior living solutions primarily within properties that are designed, purpose-built, and operated to provide quality service, care, and living accommodations for residents. The Company operates and manages independent living, assisted living, memory care, and continuing care retirement communities ("CCRCs"). The Company also offers a range of home health, hospice, and outpatient therapy services to residents of many of its communities and to seniors living outside of its communities. The Company has five reportable segments: Independent Living; Assisted Living and Memory Care; CCRCs; Health Care Services; and Management Services. The Company expects to sell 80% of its equity in its Health Care Services segment, as described in Note 4.

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2021
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies Basis of Presentation The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States ("GAAP") and pursuant to the rules and regulations of the Securities and Exchange Commission ("SEC") for quarterly reports on Form 10-Q. In the opinion of management, these financial statements include all adjustments, which are of a normal and recurring nature, necessary to present fairly the financial position, results of operations, and cash flows of the Company for all periods presented. Certain information and footnote disclosures included in annual financial statements have been condensed or omitted. The Company believes that the disclosures included are adequate and provide a fair presentation of interim period results. Interim financial statements are not necessarily indicative of the financial position or operating results for an entire year. These interim financial statements should be read in conjunction with the audited financial statements and the notes thereto included in the Company's Annual Report on Form 10-K for the year ended December 31, 2020 filed with the SEC on February 25, 2021. Principles of Consolidation The condensed consolidated financial statements include the accounts of Brookdale and its consolidated subsidiaries. The ownership interest of consolidated entities not wholly-owned by the Company are presented as noncontrolling interests in the accompanying condensed consolidated financial statements. Intercompany balances and transactions have been eliminated in consolidation, and net income (loss) is reduced by the portion of net income (loss) attributable to noncontrolling interests. The Company reports investments in unconsolidated entities over whose operating and financial policies it has the ability to exercise significant influence under the equity method of accounting. Use of Estimates The preparation of the condensed consolidated financial statements and related disclosures in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes. Estimates are used for, but not limited to, revenue, other operating income, asset impairments, self-insurance reserves, performance-based compensation, the allowance for credit losses, depreciation and amortization, leasing transactions, income taxes, and other contingencies. Although these estimates are based on management's best knowledge of current events and actions that the Company may undertake in the future, actual results may differ from the original estimates. Lease Accounting The Company, as lessee, recognizes a right-of-use asset and a lease liability on the Company's condensed consolidated balance sheet for its community, office, and equipment leases. As of the commencement date of a lease, a lease liability and corresponding right-of-use asset is established on the Company's condensed consolidated balance sheet at the present value of future minimum lease payments. The Company's community leases generally contain fixed annual rent escalators or annual rent escalators based on an index, such as the consumer price index. The future minimum lease payments recognized on the condensed consolidated balance sheet include fixed payments (including in-substance fixed payments) and variable payments estimated utilizing the index or rate on the lease commencement date. The Company recognizes lease expense as incurred for additional variable payments. For the Company's leases that do not contain an implicit rate, the Company utilizes its estimated incremental borrowing rate to determine the present value of lease payments based on information available at commencement of the lease. The Company's estimated incremental borrowing rate reflects the fixed rate at which the Company could borrow a similar amount for the same term on a collateralized basis. The Company elected the short-term lease exception policy which permits leases with an initial term of 12 months or less to not be recorded on the Company's condensed consolidated balance sheet and instead to be recognized as lease expense as incurred. The Company, as lessee, makes a determination with respect to each of its community, office, and equipment leases as to whether each should be accounted for as an operating lease or financing lease. The classification criteria is based on estimates regarding the fair value of the leased asset, minimum lease payments, effective cost of funds, economic life of the asset, and certain other terms in the lease agreements. Lease right-of-use assets are reviewed for impairment whenever changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of right-of-use assets are assessed by a comparison of the carrying amount of the asset to the estimated future undiscounted net cash flows expected to be generated by the asset, calculated utilizing the lowest level of identifiable cash flows. If estimated future undiscounted net cash flows are less than the carrying amount of the asset then the fair value of the asset is estimated. The impairment expense is determined by comparing the estimated fair value of the asset to its carrying amount, with any amount in excess of fair value recognized as an expense in the current period. Undiscounted cash flow projections and estimates of fair value amounts are based on a number of assumptions such as revenue and expense growth rates and estimated lease coverage ratios (Level 3). Operating Leases The Company recognizes operating lease expense for actual rent paid, generally plus or minus a straight-line adjustment for estimated minimum lease escalators if applicable. The right-of-use asset is generally reduced each period by an amount equal to the difference between the operating lease expense and the amount of expense on the lease liability utilizing the effective interest method. Subsequent to the impairment of an operating lease right-of-use asset, the Company recognizes operating lease expense consisting of the reduction of the right-of-use asset on a straight-line basis over the remaining lease term and the amount of expense on the lease liability utilizing the effective interest method. Financing Leases Financing lease right-of-use assets are recognized within property, plant and equipment and leasehold intangibles, net on the Company's condensed consolidated balance sheets. The Company recognizes interest expense on the financing lease liabilities utilizing the effective interest method. The right-of-use asset is generally amortized to depreciation and amortization expense on a straight-line basis over the lease term unless the lease contains an option to purchase the underlying asset that the Company is reasonably certain to exercise. If the Company is reasonably certain to exercise the purchase option, the asset is amortized over the useful life. Sale-Leaseback Transactions For transactions in which an owned community is sold and leased back from the buyer (sale-leaseback transactions), the Company recognizes an asset sale and lease accounting is applied if the Company has transferred control of the community. For such transactions, the Company removes the transferred assets from the condensed consolidated balance sheet and a gain or loss on the sale is recognized for the difference between the carrying amount of the asset and the transaction price for the sale transaction. For sale‑leaseback transactions in which the Company has not transferred control of the underlying asset, the Company does not recognize an asset sale or derecognize the underlying asset until control is transferred. For such transactions, the Company recognizes the underlying assets within assets under financing leases as a component of property, plant and equipment and leasehold intangibles, net on the condensed consolidated balance sheets and continues to depreciate the assets over their useful lives. Additionally, the Company accounts for any amounts received as a financing lease liability and the Company recognizes interest expense on the financing lease liability utilizing the effective interest method with the interest expense limited to an amount that is not greater than the cash payments on the financing lease liability over the term of the lease. Property, Plant and Equipment and Leasehold Intangibles, Net Long-lived assets are reviewed for impairment whenever events or changes in circumstances indicate the carrying amount of an asset group may not be recoverable. Recoverability of an asset group is assessed by comparing its carrying amount to the estimated future undiscounted net cash flows expected to be generated by the asset group through operation or disposition, calculated utilizing the lowest level of identifiable cash flows. If this comparison indicates that the carrying amount of an asset group is not recoverable, the Company is required to recognize an impairment loss. The impairment loss is measured by the amount by which the carrying amount of the asset exceeds its estimated fair value, with any amount in excess of fair value recognized as an expense in the current period. Undiscounted cash flow projections and estimates of fair value amounts are based on a number of assumptions such as revenue and expense growth rates, estimated holding periods, and estimated capitalization rates (Level 3). Goodwill

COVID-19 Pandemic

COVID-19 Pandemic	3 Months Ended
	Mar. 31, 2021
Unusual or Infrequent Items, or Both [Abstract]
COVID-19 Pandemic	3. COVID-19 Pandemic The United States broadly continues to experience the COVID-19 pandemic, which has significantly disrupted, and likely will continue to significantly disrupt for some period, the senior living industry and the Company's business. Due to the average age and prevalence of chronic medical conditions among the Company's residents and patients, they generally are at disproportionately higher risk of hospitalization and adverse outcomes if they contract COVID-19. The health and wellbeing of the Company's residents, patients, and associates is and has been its highest priority as it continues to serve and care for seniors through the pandemic. Community Restrictions . To help protect the Company's residents, patients, and associates from contracting COVID-19, the Company imposed significant restrictions at its communities beginning in March 2020, including closing its communities to visitors and prospective residents, and in some cases restricting new resident move-ins, suspending group outings, modifying communal dining and programming to comply with social distancing and other regulatory guidelines and, in most cases, implementing in-room only dining and activities programming, requesting that residents refrain from leaving the community unless medically necessary, and requiring new residents and residents returning from a hospital or nursing home to isolate in their apartment for fourteen days. The Company has adopted a framework for determining when to ease restrictions at each of its communities based on several criteria, including regulatory requirements and guidance, completion of baseline testing at the community, and the presence of current confirmed COVID-19 positive cases. The Company may revert to more restrictive measures if the pandemic worsens, as necessary to comply with regulatory requirements, or at the direction of state or local health authorities. As of April 30, 2021, 100% of the Company's communities have opened for visitors and new prospects. Pandemic-Related Expenses . The Company incurred $27.3 million of facility operating expense during the first quarter of 2021 for incremental direct costs to respond to the pandemic. Such costs include those for: acquisition of additional PPE, medical equipment, and cleaning and disposable food service supplies; enhanced cleaning and environmental sanitation; increased employee-related costs, including labor, workers compensation, and health plan expense; increased expense for general liability claims; and COVID-19 testing of residents and associates where not otherwise covered by government payor or third-party insurance sources. On a cumulative basis, the Company has incurred $152.9 million of pandemic related facility operating expense since the beginning of fiscal 2020. The Company recorded non-cash impairment charges in its operating results of $9.0 million for the three months ended March 31, 2021, for its operating lease right-of-use assets, primarily due to the COVID-19 pandemic and lower than expected operating performance at communities with impaired assets. Liquidity . As of March 31, 2021, the Company's total liquidity was $438.9 million, consisting of $304.0 million of unrestricted cash and cash equivalents and $134.9 million of marketable securities. The Company's cash flows from operations, excluding management agreement termination fees and the impact of the Coronavirus Aid, Relief, and Economic Security Act of 2020 ("CARES Act") funding, have been insufficient to cover its operating expenses, capital expenditures, and required interest and lease payments during the pandemic. However, the Company was able to satisfy its liquidity needs over such period utilizing a portion of its preexisting liquidity, together with CARES Act funding. The Company currently estimates that its cash flows from operations, together with cash balances on hand, cash equivalents, marketable securities, and proceeds from the pending sale of 80% of the equity in its Health Care Services segment will be sufficient to fund its liquidity needs for at least the next 12 months. The Company continues to seek opportunities to enhance and preserve its liquidity, including through maintaining expense discipline and increasing occupancy, continuing to evaluate its financing structure and the state of debt markets, and seeking further government-sponsored financial relief related to the pandemic. There is no assurance that debt financing will continue to be available on terms consistent with the Company's expectations or at all, that its efforts will be successful in seeking further government-sponsored financial relief or regarding the amount of, or conditions required to qualify for, any such relief, or that the closing of the pending transaction will be completed in accordance with the Company's expectations, or at all, or generate cash proceeds to the Company in the amount it anticipates. Financial Relief . The CARES Act, signed into law on March 27, 2020, and Paycheck Protection Program and Health Care Enhancement Act, signed into law on April 24, 2020, provide liquidity and financial relief to certain businesses, among other things. Certain impacts of such programs are provided below. • During the first quarter of 2021, the Company accepted $0.8 million of cash from grants from the Public Health and Social Services Emergency Fund ("Provider Relief Fund") administered by the U.S. Department of Health and Human Services ("HHS"), under which grants have been made available to eligible healthcare providers for healthcare related expenses or lost revenues attributable to COVID-19. The grants represented incentive payments made pursuant to the Nursing Home Infection Control Distribution, which related to the Company's skilled nursing care provided through its CCRCs. HHS continues to evaluate future allocations under the Provider Relief Fund and the regulation and guidance regarding grants made under the Provider Relief Fund. The Company intends to pursue additional funding that may become available. There can be no assurance that the Company will qualify for, or receive, such future grants in the amount it expects, that additional restrictions on the permissible uses or terms and conditions of the grants will not be imposed by HHS, or that future funding programs will be made available for which it qualifies. • During the year ended December 31, 2020, the Company received $87.5 million under the Accelerated and Advance Payment Program administered by CMS, $75.2 million of which related to its Health Care Services segment and $12.3 million related to its CCRCs segment. Recoupment of advanced payments will begin one year after payments were issued at a rate of 25% of Medicare payments for the first eleven months following the anniversary of issuance and at a rate of 50% of Medicare payments for the next six months. Any outstanding balance of advanced payments will be due following such recoupment period. Pursuant to the Purchase Agreement providing for the sale of 80% of the Company's equity in its Health Care Services segment (as described below), its net cash proceeds at closing will include a reduction for the then outstanding balance of such advanced payments related to its Health Care Services segment. • During fiscal 2020, the Company deferred payment of $72.7 million of the employer portion of social security payroll taxes incurred from March 27, 2020 through December 31, 2020 pursuant to the CARES Act. One-half of such deferral amount will become due on each of December 31, 2021 and December 31, 2022. Pursuant to the Purchase Agreement providing for the sale of 80% of the Company's equity in its Health Care Services segment, its net cash proceeds at closing will include a reduction for the $8.9 million of deferred payroll tax payments related to its Health Care Services segment. The Company expects to pay approximately $32 million of the deferred payments in both December 2021 and 2022. • The Company is eligible to claim the employee retention credit for certain of its associates under the CARES Act. The credit for 2020 is available to employers that fully or partially suspended operations during any calendar quarter in 2020 due to orders from an appropriate governmental authority limiting commerce, travel, or group meetings due to COVID-19, and is equal to 50% of qualified wages paid after March 12, 2020 through December 31, 2020 to qualified employees, with a maximum credit of $5,000 per employee. During the first quarter of 2021, the Company recognized $9.0 million of employee retention credits on wages paid from March 12, 2020 through September 30, 2020 within other operating income. The credit was modified and extended by subsequent legislation for wages paid from January 1, 2021 through December 31, 2021, and the Company is assessing its eligibility to claim such credit. There can be no assurance that the Company will qualify for, or receive, credits in the amount or on the timing it expects. In addition to the grants described above, during the three months ended March 31, 2021, the Company has received and recognized $0.9 million of other operating income from grants from other government sources. The Company cannot predict with reasonable certainty the impacts that COVID-19 ultimately will have on its business, results of operations, cash flow, and liquidity, and its response efforts may continue to delay or negatively impact its strategic initiatives, including plans for future growth. The ultimate impacts of COVID-19 will depend on many factors, some of which cannot be foreseen, including the duration, severity, and breadth of the pandemic and any resurgence of the disease; the impact of COVID-19 on the nation’s economy and debt and equity markets and the local economies in the Company's markets; the development, availability, utilization, and efficacy of COVID-19 testing, therapeutic agents, and vaccines and the prioritization of such resources among businesses and demographic groups; government financial and regulatory relief efforts that may become available to business and individuals, including the Company's ability to qualify for and satisfy the terms and conditions of financial relief; perceptions regarding the safety of senior living communities during and after the pandemic; changes in demand for senior living communities and the Company's ability to adapt its sales and marketing efforts to meet that demand; the impact of COVID-19 on the Company's residents’ and their families’ ability to afford its resident fees, including due to changes in unemployment rates, consumer confidence, housing markets, and equity markets caused by COVID-19; changes in the acuity levels of the Company's new residents; the disproportionate impact of COVID-19 on seniors generally and those residing in the Company's communities; the duration and costs of the Company's response efforts, including increased equipment, supplies, labor, litigation, testing, vaccination clinic, and other expenses; the impact of COVID-19 on the Company's ability to complete financings and refinancings of various assets, or other transactions (including dispositions and the pending sale of 80% of the equity in the Company's Health Care Services segment) or to generate sufficient cash flow to cover required debt, interest, and lease payments and to satisfy financial and other covenants in its debt and lease documents; increased regulatory requirements, including unfunded, mandatory testing; increased enforcement actions resulting from COVID-19; government action that may limit the Company's collection or discharge efforts for delinquent accounts; and the frequency and magnitude of legal actions and liability claims that may arise due to COVID-19 or the Company's response efforts.

Acquisitions, Dispositions and

Acquisitions, Dispositions and Other Transactions	3 Months Ended
	Mar. 31, 2021
Business Combinations [Abstract]
Acquisitions, Dispositions and Other Transactions	Acquisitions, Dispositions and Other Transactions During the period from January 1, 2020 through March 31, 2021, the Company acquired 27 communities that the Company formerly leased, disposed of eight owned communities (including the conveyance of five communities to Ventas, Inc. ("Ventas")), and sold its ownership interest in its unconsolidated entry fee CCRC Venture (the "CCRC Venture") with Healthpeak Properties, Inc. ("Healthpeak"), and the Company's triple-net lease obligations on five communities were terminated. The Company expects to sell 80% of its equity in its Health Care Services segment, as described below. Additionally, one unencumbered community in the Assisted Living and Memory Care segment and one unencumbered community in the CCRCs segment were classified as held for sale, resulting in $14.0 million being recorded as assets held for sale within the condensed consolidated balance sheet for senior housing communities as of March 31, 2021. The closings of the various pending and expected transactions described within this note are, or will be, subject to the satisfaction of various closing conditions, including (where applicable) the receipt of regulatory approvals. There can be no assurance that the transactions will close or, if they do, when the actual closings will occur. Completed Dispositions of Owned Communities During the three months ended March 31, 2021, the Company completed the sale of one owned community for cash proceeds of $2.7 million, net of transaction costs, and recognized a net gain on sale of assets of $0.5 million. In addition to the conveyance of five communities to Ventas, during the year ended December 31, 2020, the Company completed the sale of two owned communities for cash proceeds of $38.1 million, net of transaction costs, and recognized a net gain on sale of assets of $2.7 million. These dispositions included the sale of one owned community during the three months ended March 31, 2020 for which the Company received cash proceeds of $5.5 million, net of transaction costs, and recognized a net gain on sale of assets of $0.2 million. Pending Sale of Health Care Services On February 24, 2021, the Company entered into a Securities Purchase Agreement (the "Purchase Agreement") with affiliates of HCA Healthcare, Inc., providing for the sale of 80% of the Company’s equity in its Health Care Services segment for a purchase price of $400 million in cash, subject to certain adjustments set forth in the Purchase Agreement, including a reduction for the remaining outstanding balance as of the closing of Medicare advance payments and deferred payroll tax payments related to the Health Care Services segment, which were $75.2 million and $8.9 million respectively, as of March 31, 2021. The Purchase Agreement also contains certain agreed upon indemnities for the benefit of the purchaser. The closing of the sale transaction is anticipated to occur in the early second half of 2021, subject to receipt of applicable regulatory approvals and satisfaction of other customary closing conditions set forth in the Purchase Agreement. Pursuant to the Purchase Agreement, at closing of the transaction, the Company will retain a 20% equity interest in the business. The assets and liabilities of the Health Care Services segment are included within assets held for sale and liabilities held for sale, respectively, within the Company’s condensed consolidated balance sheet as of March 31, 2021. As of March 31, 2021, assets held for sale and liabilities held for sale of the Health Care Services segment consisted of the following: (in thousands) Accounts receivable, net $ 62,401 Property, plant and equipment and leasehold intangibles, net 1,964 Operating lease right-of-use assets 9,688 Goodwill 126,810 Prepaid expenses and other assets, net 32,722 Assets held for sale $ 233,585 Trade accounts payable $ 1,201 Accrued expenses 30,030 Refundable fees and deferred revenue 75,223 Operating lease obligations 9,688 Liabilities held for sale $ 116,142 Refer to Note 16 for selected financial data for the Health Care Services segment.

Fair Value Measurements

Fair Value Measurements	3 Months Ended
	Mar. 31, 2021
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements Marketable Securities As of March 31, 2021, marketable securities of $134.9 million are stated at fair value based on valuations provided by third-party pricing services and are classified within Level 2 of the valuation hierarchy. Debt The Company estimates the fair value of its debt using a discounted cash flow analysis based upon the Company's current borrowing rate for debt with similar maturities and collateral securing the indebtedness. The Company had outstanding long-term debt with a carrying amount of approximately $3.9 billion as of both March 31, 2021 and December 31, 2020. Fair value of the long-term debt approximates carrying amount in all periods presented. The Company's fair value of long-term debt disclosure is classified within Level 2 of the valuation hierarchy. Asset Impairment Expense The following is a summary of asset impairment expense. Three Months Ended (in millions) 2021 2020 Operating lease right-of-use assets $ 9.0 $ 65.7 Property, plant and equipment and leasehold intangibles, net 1.7 11.0 Investment in unconsolidated ventures — 1.5 Asset impairment $ 10.7 $ 78.2

Revenue

Revenue	3 Months Ended
	Mar. 31, 2021
Revenue from Contract with Customer [Abstract]
Revenue	Revenue Disaggregation of Revenue The Company disaggregates its revenue from contracts with customers by payor source as the Company believes it best depicts how the nature, amount, timing, and uncertainty of its revenue and cash flows are affected by economic factors. Resident fee revenue by payor source and reportable segment is as follows: Three Months Ended March 31, 2021 (in thousands) Independent Living Assisted Living and Memory Care CCRCs Health Care Services Total Private pay $ 118,322 $ 370,494 $ 52,213 $ 337 $ 541,366 Government reimbursement 460 16,444 12,487 67,465 96,856 Other third-party payor programs — — 7,079 19,049 26,128 Total resident fee revenue $ 118,782 $ 386,938 $ 71,779 $ 86,851 $ 664,350 Three Months Ended March 31, 2020 (in thousands) Independent Living Assisted Living and Memory Care CCRCs Health Care Services Total Private pay $ 135,290 $ 440,613 $ 64,703 $ 170 $ 640,776 Government reimbursement 572 16,866 19,405 73,689 110,532 Other third-party payor programs — — 10,439 20,960 31,399 Total resident fee revenue $ 135,862 $ 457,479 $ 94,547 $ 94,819 $ 782,707 Contract Balances The payment terms and conditions within the Company's revenue-generating contracts vary by contract type and payor source, although terms generally include payment to be made within 30 days. Resident fee revenue for recurring and routine monthly services is generally billed monthly in advance under the Company's independent living, assisted living, and memory care residency agreements. Resident fee revenue for standalone or certain healthcare services is generally billed monthly in arrears. A portion of the Company's reimbursement from Medicare for certain healthcare services is billed near the start of each period of care, and cash is generally received before all services are rendered. The amount of revenue recognized for periods of care which are incomplete at period end is based on the Company's historical average percentage of days complete on each period of care and any unearned amounts are deferred and recognized when the service is performed. Additionally, non-refundable community fees are generally billed and collected in advance or upon move-in of a resident under the Company's independent living, assisted living, and memory care residency agreements. Amounts of revenue that are collected from residents in advance are recognized as deferred revenue until the performance obligations are satisfied. The Company had total deferred revenue (included within refundable fees and deferred revenue, liabilities held for sale, and other liabilities within the condensed consolidated balance sheets) of $146.0 million and $138.3 million, including $30.1

Property, Plant and Equipment a

Property, Plant and Equipment and Leasehold Intangibles, Net	3 Months Ended
	Mar. 31, 2021
Property, Plant and Equipment [Abstract]
Property, Plant and Equipment and Leasehold Intangibles, Net	Property, Plant and Equipment and Leasehold Intangibles, Net As of March 31, 2021 and December 31, 2020, net property, plant and equipment and leasehold intangibles, which include assets under financing leases, consisted of the following: (in thousands) March 31, 2021 December 31, 2020 Land $ 504,698 $ 505,298 Buildings and improvements 5,222,741 5,215,460 Furniture and equipment 953,773 945,783 Resident and leasehold operating intangibles 305,960 307,071 Construction in progress 64,003 61,491 Assets under financing leases and leasehold improvements 1,534,468 1,523,055 Property, plant and equipment and leasehold intangibles 8,585,643 8,558,158 Accumulated depreciation and amortization (3,567,234) (3,490,098) Property, plant and equipment and leasehold intangibles, net $ 5,018,409 $ 5,068,060 Assets under financing leases and leasehold improvements includes $0.4 billion of financing lease right-of-use assets, net of accumulated amortization, as of both March 31, 2021 and December 31, 2020. Refer to Note 10 for further information on the Company's financing leases.

Goodwill

Goodwill	3 Months Ended
	Mar. 31, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	GoodwillThe Company's Independent Living and Health Care Services segments had a carrying value of goodwill of $27.3 million and $126.8 million, respectively, as of both March 31, 2021 and December 31, 2020. The goodwill of the Health Care Services segment is included within assets held for sale within the Company’s condensed consolidated balance sheet as of March 31, 2021.

Debt

Debt	3 Months Ended
	Mar. 31, 2021
Debt Disclosure [Abstract]
Debt	Debt Long-term debt consists of the following: (in thousands) March 31, 2021 December 31, 2020 Fixed mortgage notes payable due 2022 through 2047; weighted average interest rate of 4.17% and 4.18% as of March 31, 2021 and December 31, 2020, respectively $ 2,334,151 $ 2,366,996 Variable mortgage notes payable due 2022 through 2030, weighted average interest rate of 2.46% and 2.49% as of March 31, 2021 and December 31, 2020, respectively 1,524,496 1,529,935 Other notes payable due 2021 to 2025; weighted average interest rate of 7.79% and 8.98% as of March 31, 2021 and December 31, 2020, respectively 57,468 46,557 Debt discount and deferred financing costs, net (26,324) (27,500) Total long-term debt 3,889,791 3,915,988 Current portion 224,890 68,885 Total long-term debt, less current portion $ 3,664,901 $ 3,847,103 As of March 31, 2021, 97.9%, or $3.8 billion of the Company's total debt obligations represented non-recourse property-level mortgage financings. As of March 31, 2021, $69.9 million of letters of credit and no cash borrowings were outstanding under the Company's $80.0 million secured credit facility. The Company also had a separate secured letter of credit facility providing up to $15.0 million of letters of credit as of March 31, 2021 under which $13.6 million had been issued as of that date. Financial Covenants Certain of the Company's debt documents contain restrictions and financial covenants, such as those requiring the Company to maintain prescribed minimum liquidity, net worth, and stockholders' equity levels and debt service ratios, in each case on a consolidated, portfolio-wide, multi-community, single-community, and/or entity basis. In addition, the Company's debt documents generally contain non-financial covenants, such as those requiring the Company to comply with Medicare or Medicaid provider requirements and maintain insurance coverage. The Company's failure to comply with applicable covenants could constitute an event of default under the applicable debt documents. Many of the Company's debt documents contain cross-default provisions so that a default under one of these instruments could cause a default under other debt and lease documents (including documents with other lenders and lessors). Furthermore, the Company's debt is secured by its communities and, in certain cases, a guaranty by the Company and/or one or more of its subsidiaries. As of March 31, 2021, the Company is in compliance with the financial covenants of its debt agreements.

Leases

Leases	3 Months Ended
	Mar. 31, 2021
Leases [Abstract]
Leases	Leases As of March 31, 2021, the Company operated 301 communities under long-term leases (235 operating leases and 66 financing leases). The substantial majority of the Company's lease arrangements are structured as master leases. Under a master lease, numerous communities are leased through an indivisible lease. The Company typically guarantees the performance and lease payment obligations of its subsidiary lessees under the master leases. An event of default related to an individual property or limited number of properties within a master lease portfolio may result in a default on the entire master lease portfolio. The leases relating to these communities are generally fixed rate leases with annual escalators that are either fixed or based upon changes in the consumer price index or the leased property revenue. The Company is responsible for all operating costs, including repairs, property taxes, and insurance. The leases generally provide for renewal or extension options from 5 to 20 years and in some instances, purchase options. The community leases contain other customary terms, which may include assignment and change of control restrictions, maintenance and capital expenditure obligations, termination provisions and financial covenants, such as those requiring the Company to maintain prescribed minimum liquidity, net worth, and stockholders' equity levels and lease coverage ratios, in each case on a consolidated, portfolio-wide, multi-community, single-community and/or entity basis. In addition, the Company's lease documents generally contain non-financial covenants, such as those requiring the Company to comply with Medicare or Medicaid provider requirements and maintain insurance coverage. The Company's failure to comply with applicable covenants could constitute an event of default under the applicable lease documents. Many of the Company's debt and lease documents contain cross-default provisions so that a default under one of these instruments could cause a default under other debt and lease documents (including documents with other lenders and lessors). Certain leases contain cure provisions, which generally allow the Company to post an additional lease security deposit if the required covenant is not met. Furthermore, the Company's leases are secured by its communities and, in certain cases, a guaranty by the Company and/or one or more of its subsidiaries. As of March 31, 2021, the Company is in compliance with the financial covenants of its long-term leases. A summary of operating and financing lease expense (including the respective presentation on the condensed consolidated statements of operations) and net cash outflows from leases is as follows: Three Months Ended Operating Leases (in thousands) 2021 2020 Facility operating expense $ 4,842 $ 4,850 Facility lease expense 44,418 64,481 Operating lease expense 49,260 69,331 Operating lease expense adjustment (1) 4,664 6,733 Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements (7,563) (4,088) Operating net cash outflows from operating leases $ 46,361 $ 71,976 (1) Represents the difference between the amount of cash operating lease payments and the amount of operating lease expense recognized in accordance with Accounting Standards Codification 842, Leases ("ASC 842"). Three Months Ended Financing Leases (in thousands) 2021 2020 Depreciation and amortization $ 7,630 $ 9,144 Interest expense: financing lease obligations 11,383 13,282 Financing lease expense $ 19,013 $ 22,426 Operating cash flows from financing leases $ 11,383 $ 13,282 Financing cash flows from financing leases 4,789 5,087 Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement (1,389) (1,739) Total net cash outflows from financing leases $ 14,783 $ 16,630 The aggregate amounts of future minimum lease payments, including community, office, and equipment leases (excluding minimum lease payments related to $9.7 million of operating lease obligations included within liabilities held for sale) recognized on the condensed consolidated balance sheet as of March 31, 2021 are as follows (in thousands): Year Ending December 31, Operating Leases Financing Leases 2021 (nine months) $ 151,681 $ 48,807 2022 203,946 65,609 2023 192,625 66,341 2024 193,377 67,553 2025 191,131 57,595 Thereafter 280,960 109,684 Total lease payments 1,213,720 415,589 Purchase option liability and non-cash gain on future sale of property — 413,617 Imputed interest and variable lease payments (276,070) (270,052) Total lease obligations $ 937,650 $ 559,154
Leases	Leases As of March 31, 2021, the Company operated 301 communities under long-term leases (235 operating leases and 66 financing leases). The substantial majority of the Company's lease arrangements are structured as master leases. Under a master lease, numerous communities are leased through an indivisible lease. The Company typically guarantees the performance and lease payment obligations of its subsidiary lessees under the master leases. An event of default related to an individual property or limited number of properties within a master lease portfolio may result in a default on the entire master lease portfolio. The leases relating to these communities are generally fixed rate leases with annual escalators that are either fixed or based upon changes in the consumer price index or the leased property revenue. The Company is responsible for all operating costs, including repairs, property taxes, and insurance. The leases generally provide for renewal or extension options from 5 to 20 years and in some instances, purchase options. The community leases contain other customary terms, which may include assignment and change of control restrictions, maintenance and capital expenditure obligations, termination provisions and financial covenants, such as those requiring the Company to maintain prescribed minimum liquidity, net worth, and stockholders' equity levels and lease coverage ratios, in each case on a consolidated, portfolio-wide, multi-community, single-community and/or entity basis. In addition, the Company's lease documents generally contain non-financial covenants, such as those requiring the Company to comply with Medicare or Medicaid provider requirements and maintain insurance coverage. The Company's failure to comply with applicable covenants could constitute an event of default under the applicable lease documents. Many of the Company's debt and lease documents contain cross-default provisions so that a default under one of these instruments could cause a default under other debt and lease documents (including documents with other lenders and lessors). Certain leases contain cure provisions, which generally allow the Company to post an additional lease security deposit if the required covenant is not met. Furthermore, the Company's leases are secured by its communities and, in certain cases, a guaranty by the Company and/or one or more of its subsidiaries. As of March 31, 2021, the Company is in compliance with the financial covenants of its long-term leases. A summary of operating and financing lease expense (including the respective presentation on the condensed consolidated statements of operations) and net cash outflows from leases is as follows: Three Months Ended Operating Leases (in thousands) 2021 2020 Facility operating expense $ 4,842 $ 4,850 Facility lease expense 44,418 64,481 Operating lease expense 49,260 69,331 Operating lease expense adjustment (1) 4,664 6,733 Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements (7,563) (4,088) Operating net cash outflows from operating leases $ 46,361 $ 71,976 (1) Represents the difference between the amount of cash operating lease payments and the amount of operating lease expense recognized in accordance with Accounting Standards Codification 842, Leases ("ASC 842"). Three Months Ended Financing Leases (in thousands) 2021 2020 Depreciation and amortization $ 7,630 $ 9,144 Interest expense: financing lease obligations 11,383 13,282 Financing lease expense $ 19,013 $ 22,426 Operating cash flows from financing leases $ 11,383 $ 13,282 Financing cash flows from financing leases 4,789 5,087 Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement (1,389) (1,739) Total net cash outflows from financing leases $ 14,783 $ 16,630 The aggregate amounts of future minimum lease payments, including community, office, and equipment leases (excluding minimum lease payments related to $9.7 million of operating lease obligations included within liabilities held for sale) recognized on the condensed consolidated balance sheet as of March 31, 2021 are as follows (in thousands): Year Ending December 31, Operating Leases Financing Leases 2021 (nine months) $ 151,681 $ 48,807 2022 203,946 65,609 2023 192,625 66,341 2024 193,377 67,553 2025 191,131 57,595 Thereafter 280,960 109,684 Total lease payments 1,213,720 415,589 Purchase option liability and non-cash gain on future sale of property — 413,617 Imputed interest and variable lease payments (276,070) (270,052) Total lease obligations $ 937,650 $ 559,154

Litigation

Litigation	3 Months Ended
	Mar. 31, 2021
Litigation [Abstract]
Litigation	Litigation The Company has been and is currently involved in litigation and claims incidental to the conduct of its business, which it believes are generally comparable to other companies in the senior living and healthcare industries, including, but not limited to, putative class action claims from time to time regarding staffing at the Company’s communities and compliance with consumer protection laws and the Americans with Disabilities Act. Certain claims and lawsuits allege large damage amounts and may require significant costs to defend and resolve. As a result, the Company maintains general liability, professional liability, and other insurance policies in amounts and with coverage and deductibles the Company believes are appropriate, based on the nature and risks of its business, historical experience, availability, and industry standards. The Company's current policies provide for deductibles for each claim and contain various exclusions from coverage. Accordingly, the Company is, in effect, self-insured for claims that are less than the deductible amounts and for claims or portions of claims that are not covered by such policies and/or exceed the policy limits. Similarly, the senior living and healthcare industries are continuously subject to scrutiny by governmental regulators, which could result in reviews, audits, investigations, enforcement activities or litigation related to regulatory compliance matters. In addition, as a result of the Company's participation in the Medicare and Medicaid programs, the Company is subject to various governmental reviews, audits and investigations, including but not limited to audits under various government programs, such as the Recovery Audit Contractors (RAC), Zone Program Integrity Contractors (ZPIC), and Unified Program Integrity Contractors (UPIC) programs. The costs to respond to and defend such reviews, audits, and investigations may be significant, and an adverse determination could result in citations, sanctions and other criminal or civil fines and penalties, the refund of overpayments, payment suspensions, termination of participation in Medicare and Medicaid programs, and/or damage to the Company's business reputation. In June 2020, the Company and several current and former executive officers were named as defendants in a putative class action lawsuit alleging violations of the federal securities laws filed in the federal court for the Middle District of Tennessee. The lawsuit asserts that the defendants made material misstatements and omissions concerning the Company's business, operational and compliance policies that caused the Company's stock price to be artificially inflated between August 2016 and April 2020. While the Company cannot predict with certainty the result of this or any other legal proceedings, the Company believes the allegations in the suit are without merit and does not expect this matter to have a material adverse effect on the Company's financial condition, results of operations, or cash flows. In October 2020 and April 2021, alleged stockholders of the Company filed separate stockholder derivative lawsuits in the federal court for the Middle District of Tennessee, asserting claims on behalf of the Company against certain current and former officers and directors for alleged breaches of duties owed to the Company. The complaints refer to the securities lawsuit described above and incorporate substantively similar allegations.

Stock-Based Compensation

Stock-Based Compensation	3 Months Ended
	Mar. 31, 2021
Share-based Payment Arrangement [Abstract]
Stock-Based Compensation	Stock-Based Compensation Grants of restricted stock and restricted stock units under the Company's 2014 Omnibus Incentive Plan were as follows: (in thousands, except for per share and unit amounts) Restricted Stock and Restricted Stock Unit Grants Weighted Average Grant Date Fair Value Total Grant Date Fair Value Three months ended March 31, 2021 1,961 $ 5.09 $ 9,988

Earnings Per Share

Earnings Per Share	3 Months Ended
	Mar. 31, 2021
Earnings Per Share [Abstract]
Earnings Per Share	Earnings Per Share Basic earnings per share ("EPS") is calculated by dividing net income (loss) by the weighted average number of shares of common stock outstanding. Diluted EPS includes the components of basic EPS and also gives effect to dilutive common stock equivalents. Under the treasury stock method, diluted EPS reflects the potential dilution that could occur if securities or other instruments that are convertible into common stock were exercised or could result in the issuance of common stock. Potentially dilutive common stock equivalents include unvested restricted stock, restricted stock units, and warrants. The following table summarizes the computation of basic and diluted earnings (loss) per share amounts presented in the condensed consolidated statement of operations: Three Months Ended (in thousands, except for per share amounts) 2021 2020 Income attributable to common stockholders: Net income (loss) $ (108,285) $ 369,515 Weighted average shares outstanding - basic 184,011 184,186 Effect of dilutive securities - Unvested restricted stock, restricted stock units, and warrants — 336 Weighted average shares outstanding - diluted 184,011 184,522 Basic earnings (loss) per common share: Net income (loss) per share attributable to common stockholders $ (0.59) $ 2.01 Diluted earnings (loss) per common share: Net income (loss) per share attributable to common stockholders $ (0.59) $ 2.00 For the purposes of computing diluted EPS, weighted average shares outstanding do not include potentially dilutive securities that are anti-dilutive under the treasury stock method, and performance-based equity awards are included based on the attainment of the applicable performance metrics as of the end of the reporting period. The following potentially dilutive securities were excluded from the computation of diluted EPS: Three Months Ended (in millions) 2021 (1) 2020 Non-performance-based restricted stock and restricted stock units 6.2 6.9 Performance-based restricted stock and restricted stock units 0.4 1.8 Warrants 16.3 —

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2021
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The difference between the Company's effective tax rate for the three months ended March 31, 2021 and 2020 was primarily due to the tax impact of the multi-part transaction with Healthpeak that occurred in the three months ended March 31, 2020. The impact represented the tax expense recorded on the gain of the sale of the Company's interest in the CCRC Venture offset by a decrease in the valuation allowance that was a direct result of the multi-part transaction with Healthpeak. The Company recorded an aggregate deferred federal, state, and local tax benefit of $25.2 million as a result of the operating loss for the three months ended March 31, 2021, which was offset by a proportionate increase in the valuation allowance of $25.5 million. The Company recorded an aggregate deferred federal, state, and local tax expense of $90.9 million for the three months ended March 31, 2020. The expense included $93.1 million as a result of the gain on the sale of the Company's interest in the CCRC Venture offset by a benefit of $2.2 million as a result of the operating losses (exclusive of the CCRC Venture sale) for the three months ended March 31, 2020. The expense for the three months ended March 31, 2020 was offset by a reduction in the valuation allowance of $112.6 million. The Company evaluates its deferred tax assets each quarter to determine if a valuation allowance is required based on whether it is more likely than not that some portion of the deferred tax asset would not be realized. The Company's valuation allowance as of March 31, 2021 and December 31, 2020 was $406.5 million and $381.0 million, respectively. The increase in the valuation allowance for the three months ended March 31, 2021 is the result of current operating losses during the three months ended March 31, 2021. The change in the valuation allowance for the three months ended March 31, 2020 was primarily the result of a reduction in the Company’s valuation allowance of $117.6 million as a result of the Healthpeak transaction offset by the anticipated reversal of future tax liabilities offset by future tax deductions.

Supplemental Disclosure of Cash

Supplemental Disclosure of Cash Flow Information	3 Months Ended
	Mar. 31, 2021
Supplemental Cash Flow Elements [Abstract]
Supplemental Disclosure of Cash Flow Information	Supplemental Disclosure of Cash Flow Information Three Months Ended (in thousands) 2021 2020 Supplemental Disclosure of Cash Flow Information: Interest paid $ 47,129 $ 59,479 Income taxes paid, net of refunds 904 957 Capital expenditures, net of related payables: Capital expenditures - non-development, net $ 27,450 $ 60,556 Capital expenditures - development, net 1,521 3,900 Capital expenditures - non-development - reimbursable 8,951 5,827 Trade accounts payable 2,439 (898) Net cash paid $ 40,361 $ 69,385 Acquisition of communities from Healthpeak: Property, plant and equipment and leasehold intangibles, net $ — $ 286,734 Operating lease right-of-use assets — (63,285) Financing lease obligations — 129,196 Operating lease obligations — 74,335 Loss (gain) on debt modification and extinguishment, net — (19,731) Net cash paid $ — $ 407,249 Acquisition of other assets, net of related payables and cash received: Property, plant and equipment and leasehold intangibles, net $ — $ 179 Financing lease obligations — 39,260 Net cash paid $ — $ 39,439 Proceeds from sale of CCRC Venture, net: Investments in unconsolidated ventures $ — $ (14,848) Current portion of long-term debt — 34,706 Accrued expenses — (5,025) Other liabilities — 60,748 Loss (gain) on sale of assets, net — (370,745) Net cash received $ — $ (295,164) Proceeds from sale of other assets, net: Prepaid expenses and other assets, net $ — $ (1,261) Assets held for sale (2,125) (5,274) Property, plant and equipment and leasehold intangibles, net (597) — Other liabilities 74 (824) Loss (gain) on sale of assets, net (1,112) (2,094) Net cash received $ (3,760) $ (9,453) Supplemental Schedule of Non-cash Operating, Investing, and Financing Activities: Healthpeak master lease modification: Property, plant and equipment and leasehold intangibles, net $ — $ (57,462) Operating lease right-of-use assets — 88,044 Financing lease obligations — 70,874 Operating lease obligations — (101,456) Net $ — $ — Other non-cash lease transactions, net: Property, plant and equipment and leasehold intangibles, net $ — $ (9,441) Operating lease right-of-use assets 16,721 — Financing lease obligations — 9,516 Operating lease obligations (16,721) — Other liabilities — (75) Net $ — $ — Restricted cash consists principally of deposits for letters of credit, escrow deposits for real estate taxes, property insurance, and capital expenditures, debt service reserve accounts required by certain lenders under mortgage debt agreements, and deposits as security for self-insured retention risk under workers' compensation programs and property insurance programs. The following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the condensed consolidated balance sheets that sums to the total of the same such amounts shown in the condensed consolidated statements of cash flows. (in thousands) March 31, 2021 December 31, 2020 Reconciliation of cash, cash equivalents, and restricted cash: Cash and cash equivalents $ 303,952 $ 380,420 Restricted cash 26,503 28,059 Long-term restricted cash 71,468 56,669 Total cash, cash equivalents, and restricted cash $ 401,923 $ 465,148

Segment Information

Segment Information	3 Months Ended
	Mar. 31, 2021
Segment Reporting [Abstract]
Segment Information	Segment InformationThe Company has five reportable segments: Independent Living; Assisted Living and Memory Care; CCRCs; Health Care Services; and Management Services. Operating segments are defined as components of an enterprise that engage in business activities from which it may earn revenues and incur expenses; for which separate financial information is available; and whose operating results are regularly reviewed by the chief operating decision maker to assess the performance of the individual segment and make decisions about resources to be allocated to the segment. Independent Living . The Company's Independent Living segment includes owned or leased communities that are primarily designed for middle to upper income seniors who desire to live in a residential setting that feels like home, without the efforts of ownership. The majority of the Company's independent living communities consist of both independent and assisted living units in a single community, which allows residents to age-in-place by providing them with a broad continuum of senior independent and assisted living services to accommodate their changing needs. Assisted Living and Memory Care. The Company's Assisted Living and Memory Care segment includes owned or leased communities that offer housing and 24-hour assistance with activities of daily living for mid-acuity and frail elderly residents. The Company's assisted living and memory care communities include both freestanding, multi-story communities, as well as smaller freestanding, single story communities. The Company also provides memory care services at freestanding memory care communities that are specially designed for residents with Alzheimer's disease and other dementias. CCRCs. The Company's CCRCs segment includes large owned or leased communities that offer a variety of living arrangements and services to accommodate a broad spectrum of physical ability and healthcare needs. Most of the Company's CCRCs have independent living, assisted living, memory care, and skilled nursing available on one campus or within the immediate area. Health Care Services . The Company's Health Care Services segment includes the home health, hospice, and outpatient therapy services provided to residents of many of its communities and to seniors living outside its communities. The Health Care Services segment does not include the skilled nursing and inpatient healthcare services provided in the Company's skilled nursing units, which are included in the Company's CCRCs segment. Management Services. The Company's Management Services segment includes communities operated by the Company pursuant to management agreements. In some of the cases, the controlling financial interest in the community is held by third parties and, in other cases, the community is owned in a venture structure in which the Company has an ownership interest. Under the management agreements for these communities, the Company receives management fees as well as reimbursed expenses, which represent the reimbursement of expenses it incurs on behalf of the owners. The following table sets forth selected segment financial data: Three Months Ended (in thousands) 2021 2020 Revenue and other operating income: Independent Living (1)(2) $ 120,146 $ 135,862 Assisted Living and Memory Care (1)(2) 392,042 457,479 CCRCs (1)(2) 73,463 94,547 Health Care Services (1)(2) 89,434 94,819 Management Services (3) 74,360 231,432 Total revenue and other operating income $ 749,445 $ 1,014,139 Segment operating income: (4) Independent Living $ 37,329 $ 51,414 Assisted Living and Memory Care 71,433 132,001 CCRCs 7,608 19,931 Health Care Services 2,403 (9,121) Management Services 8,566 108,715 Total segment operating income 127,339 302,940 General and administrative expense (including non-cash stock-based compensation expense) 49,943 54,595 Facility operating lease expense 44,418 64,481 Depreciation and amortization 83,891 90,738 Asset impairment: Independent Living 520 31,317 Assisted Living and Memory Care 9,642 32,798 CCRCs 515 12,173 Corporate and Management Services — 1,938 Income (loss) from operations $ (61,590) $ 14,900 As of (in thousands) March 31, 2021 December 31, 2020 Total assets: Independent Living $ 1,399,489 $ 1,419,838 Assisted Living and Memory Care 3,740,476 3,787,611 CCRCs 728,621 738,121 Health Care Services 233,585 233,178 Corporate and Management Services 643,982 723,010 Total assets $ 6,746,153 $ 6,901,758 (1) All revenue is earned from external third parties in the United States. (2) The Independent Living, Assisted Living and Memory Care, CCRCs, and Health Care Services segments include $1.4 million, $5.1 million, $1.7 million, and $2.6 million respectively, for the three months ended March 31, 2021 of other operating income recognized for the credits or grants pursuant to the Employee Retention Credit, Provider Relief Fund, and other government sources, as described in Note 3. Allocations to the applicable segment generally reflect the credits earned by the segment, the segment’s receipt and acceptance of the grant, or the segment’s proportional utilization of the grant. (3) Management services segment revenue includes management fees and reimbursements of costs incurred on behalf of managed communities.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2021
Accounting Policies [Abstract]
Basis of Presentation	Basis of PresentationThe accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States ("GAAP") and pursuant to the rules and regulations of the Securities and Exchange Commission ("SEC") for quarterly reports on Form 10-Q. In the opinion of management, these financial statements include all adjustments, which are of a normal and recurring nature, necessary to present fairly the financial position, results of operations, and cash flows of the Company for all periods presented. Certain information and footnote disclosures included in annual financial statements have been condensed or omitted. The Company believes that the disclosures included are adequate and provide a fair presentation of interim period results. Interim financial statements are not necessarily indicative of the financial position or operating results for an entire year. These interim financial statements should be read in conjunction with the audited financial statements and the notes thereto included in the Company's Annual Report on Form 10-K for the year ended December 31, 2020 filed with the SEC on February 25, 2021.
Principles of Consolidation	Principles of ConsolidationThe condensed consolidated financial statements include the accounts of Brookdale and its consolidated subsidiaries. The ownership interest of consolidated entities not wholly-owned by the Company are presented as noncontrolling interests in the accompanying condensed consolidated financial statements. Intercompany balances and transactions have been eliminated in consolidation, and net income (loss) is reduced by the portion of net income (loss) attributable to noncontrolling interests. The Company reports investments in unconsolidated entities over whose operating and financial policies it has the ability to exercise significant influence under the equity method of accounting.
Use of Estimates	Use of EstimatesThe preparation of the condensed consolidated financial statements and related disclosures in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes. Estimates are used for, but not limited to, revenue, other operating income, asset impairments, self-insurance reserves, performance-based compensation, the allowance for credit losses, depreciation and amortization, leasing transactions, income taxes, and other contingencies. Although these estimates are based on management's best knowledge of current events and actions that the Company may undertake in the future, actual results may differ from the original estimates.
Lease Accounting	Lease Accounting The Company, as lessee, recognizes a right-of-use asset and a lease liability on the Company's condensed consolidated balance sheet for its community, office, and equipment leases. As of the commencement date of a lease, a lease liability and corresponding right-of-use asset is established on the Company's condensed consolidated balance sheet at the present value of future minimum lease payments. The Company's community leases generally contain fixed annual rent escalators or annual rent escalators based on an index, such as the consumer price index. The future minimum lease payments recognized on the condensed consolidated balance sheet include fixed payments (including in-substance fixed payments) and variable payments estimated utilizing the index or rate on the lease commencement date. The Company recognizes lease expense as incurred for additional variable payments. For the Company's leases that do not contain an implicit rate, the Company utilizes its estimated incremental borrowing rate to determine the present value of lease payments based on information available at commencement of the lease. The Company's estimated incremental borrowing rate reflects the fixed rate at which the Company could borrow a similar amount for the same term on a collateralized basis. The Company elected the short-term lease exception policy which permits leases with an initial term of 12 months or less to not be recorded on the Company's condensed consolidated balance sheet and instead to be recognized as lease expense as incurred. The Company, as lessee, makes a determination with respect to each of its community, office, and equipment leases as to whether each should be accounted for as an operating lease or financing lease. The classification criteria is based on estimates regarding the fair value of the leased asset, minimum lease payments, effective cost of funds, economic life of the asset, and certain other terms in the lease agreements. Lease right-of-use assets are reviewed for impairment whenever changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of right-of-use assets are assessed by a comparison of the carrying amount of the asset to the estimated future undiscounted net cash flows expected to be generated by the asset, calculated utilizing the lowest level of identifiable cash flows. If estimated future undiscounted net cash flows are less than the carrying amount of the asset then the fair value of the asset is estimated. The impairment expense is determined by comparing the estimated fair value of the asset to its carrying amount, with any amount in excess of fair value recognized as an expense in the current period. Undiscounted cash flow projections and estimates of fair value amounts are based on a number of assumptions such as revenue and expense growth rates and estimated lease coverage ratios (Level 3). Operating Leases The Company recognizes operating lease expense for actual rent paid, generally plus or minus a straight-line adjustment for estimated minimum lease escalators if applicable. The right-of-use asset is generally reduced each period by an amount equal to the difference between the operating lease expense and the amount of expense on the lease liability utilizing the effective interest method. Subsequent to the impairment of an operating lease right-of-use asset, the Company recognizes operating lease expense consisting of the reduction of the right-of-use asset on a straight-line basis over the remaining lease term and the amount of expense on the lease liability utilizing the effective interest method. Financing Leases Financing lease right-of-use assets are recognized within property, plant and equipment and leasehold intangibles, net on the Company's condensed consolidated balance sheets. The Company recognizes interest expense on the financing lease liabilities utilizing the effective interest method. The right-of-use asset is generally amortized to depreciation and amortization expense on a straight-line basis over the lease term unless the lease contains an option to purchase the underlying asset that the Company is reasonably certain to exercise. If the Company is reasonably certain to exercise the purchase option, the asset is amortized over the useful life. Sale-Leaseback Transactions For transactions in which an owned community is sold and leased back from the buyer (sale-leaseback transactions), the Company recognizes an asset sale and lease accounting is applied if the Company has transferred control of the community. For such transactions, the Company removes the transferred assets from the condensed consolidated balance sheet and a gain or loss on the sale is recognized for the difference between the carrying amount of the asset and the transaction price for the sale transaction. For sale‑leaseback transactions in which the Company has not transferred control of the underlying asset, the Company does not recognize an asset sale or derecognize the underlying asset until control is transferred. For such transactions, the Company recognizes the underlying assets within assets under financing leases as a component of property, plant and equipment and leasehold intangibles, net on the condensed consolidated balance sheets and continues to depreciate the assets over their useful lives.
Property, Plant and Equipment and Leasehold Intangibles, Net	Property, Plant and Equipment and Leasehold Intangibles, NetLong-lived assets are reviewed for impairment whenever events or changes in circumstances indicate the carrying amount of an asset group may not be recoverable. Recoverability of an asset group is assessed by comparing its carrying amount to the estimated future undiscounted net cash flows expected to be generated by the asset group through operation or disposition, calculated utilizing the lowest level of identifiable cash flows. If this comparison indicates that the carrying amount of an asset group is not recoverable, the Company is required to recognize an impairment loss. The impairment loss is measured by the amount by which the carrying amount of the asset exceeds its estimated fair value, with any amount in excess of fair value recognized as an expense in the current period. Undiscounted cash flow projections and estimates of fair value amounts are based on a number of assumptions such as revenue and expense growth rates, estimated holding periods, and estimated capitalization rates (Level 3).
Goodwill	GoodwillThe Company tests goodwill for impairment annually during the fourth quarter or more frequently if indicators of impairment arise. Factors the Company considers important in its analysis of whether an indicator of impairment exists include a significant decline in the Company's stock price or market capitalization for a sustained period since the last testing date, significant underperformance relative to historical or projected future operating results, and significant negative industry or economic trends. The Company first assesses qualitative factors to determine if it is more likely than not that the fair value of a reporting unit is less than its carrying amount. If so, the Company performs a quantitative goodwill impairment test based upon a comparison of the estimated fair value of the reporting unit to which the goodwill has been assigned with the reporting unit's carrying amount. The fair values used in the quantitative goodwill impairment test are estimated using Level 3 inputs based upon discounted future cash flow projections for the reporting unit. These cash flow projections are based upon a number of estimates and assumptions such as revenue and expense growth rates, capitalization rates, and discount rates. The Company also considers market-based measures such as earnings multiples in its analysis of estimated fair values of its reporting units. If the quantitative goodwill impairment test results in a reporting unit's carrying amount exceeding its estimated fair value, an impairment charge will be recorded based on the difference, with the impairment charge limited to the amount of goodwill allocated to the reporting unit.

Acquisitions, Dispositions an_2

Acquisitions, Dispositions and Other Transactions (Tables)	3 Months Ended
	Mar. 31, 2021
Business Combinations [Abstract]
Disclosure of Assets and Liabilities Held-for-sale	As of March 31, 2021, assets held for sale and liabilities held for sale of the Health Care Services segment consisted of the following: (in thousands) Accounts receivable, net $ 62,401 Property, plant and equipment and leasehold intangibles, net 1,964 Operating lease right-of-use assets 9,688 Goodwill 126,810 Prepaid expenses and other assets, net 32,722 Assets held for sale $ 233,585 Trade accounts payable $ 1,201 Accrued expenses 30,030 Refundable fees and deferred revenue 75,223 Operating lease obligations 9,688 Liabilities held for sale $ 116,142

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2021
Fair Value Disclosures [Abstract]
Summary of Asset Impairment Expense	The following is a summary of asset impairment expense. Three Months Ended (in millions) 2021 2020 Operating lease right-of-use assets $ 9.0 $ 65.7 Property, plant and equipment and leasehold intangibles, net 1.7 11.0 Investment in unconsolidated ventures — 1.5 Asset impairment $ 10.7 $ 78.2

Revenue (Tables)

Revenue (Tables)	3 Months Ended
	Mar. 31, 2021
Revenue from Contract with Customer [Abstract]
Disaggregation of Revenue	The Company disaggregates its revenue from contracts with customers by payor source as the Company believes it best depicts how the nature, amount, timing, and uncertainty of its revenue and cash flows are affected by economic factors. Resident fee revenue by payor source and reportable segment is as follows: Three Months Ended March 31, 2021 (in thousands) Independent Living Assisted Living and Memory Care CCRCs Health Care Services Total Private pay $ 118,322 $ 370,494 $ 52,213 $ 337 $ 541,366 Government reimbursement 460 16,444 12,487 67,465 96,856 Other third-party payor programs — — 7,079 19,049 26,128 Total resident fee revenue $ 118,782 $ 386,938 $ 71,779 $ 86,851 $ 664,350 Three Months Ended March 31, 2020 (in thousands) Independent Living Assisted Living and Memory Care CCRCs Health Care Services Total Private pay $ 135,290 $ 440,613 $ 64,703 $ 170 $ 640,776 Government reimbursement 572 16,866 19,405 73,689 110,532 Other third-party payor programs — — 10,439 20,960 31,399 Total resident fee revenue $ 135,862 $ 457,479 $ 94,547 $ 94,819 $ 782,707

Property, Plant and Equipment_2

Property, Plant and Equipment and Leasehold Intangibles, Net (Tables)	3 Months Ended
	Mar. 31, 2021
Property, Plant and Equipment [Abstract]
Property, Plant and Equipment and Leasehold Intangibles, Net	As of March 31, 2021 and December 31, 2020, net property, plant and equipment and leasehold intangibles, which include assets under financing leases, consisted of the following: (in thousands) March 31, 2021 December 31, 2020 Land $ 504,698 $ 505,298 Buildings and improvements 5,222,741 5,215,460 Furniture and equipment 953,773 945,783 Resident and leasehold operating intangibles 305,960 307,071 Construction in progress 64,003 61,491 Assets under financing leases and leasehold improvements 1,534,468 1,523,055 Property, plant and equipment and leasehold intangibles 8,585,643 8,558,158 Accumulated depreciation and amortization (3,567,234) (3,490,098) Property, plant and equipment and leasehold intangibles, net $ 5,018,409 $ 5,068,060

Debt (Tables)

Debt (Tables)	3 Months Ended
	Mar. 31, 2021
Debt Disclosure [Abstract]
Schedule of Debt	Long-term debt consists of the following: (in thousands) March 31, 2021 December 31, 2020 Fixed mortgage notes payable due 2022 through 2047; weighted average interest rate of 4.17% and 4.18% as of March 31, 2021 and December 31, 2020, respectively $ 2,334,151 $ 2,366,996 Variable mortgage notes payable due 2022 through 2030, weighted average interest rate of 2.46% and 2.49% as of March 31, 2021 and December 31, 2020, respectively 1,524,496 1,529,935 Other notes payable due 2021 to 2025; weighted average interest rate of 7.79% and 8.98% as of March 31, 2021 and December 31, 2020, respectively 57,468 46,557 Debt discount and deferred financing costs, net (26,324) (27,500) Total long-term debt 3,889,791 3,915,988 Current portion 224,890 68,885 Total long-term debt, less current portion $ 3,664,901 $ 3,847,103

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2021
Leases [Abstract]
Lease Costs	A summary of operating and financing lease expense (including the respective presentation on the condensed consolidated statements of operations) and net cash outflows from leases is as follows: Three Months Ended Operating Leases (in thousands) 2021 2020 Facility operating expense $ 4,842 $ 4,850 Facility lease expense 44,418 64,481 Operating lease expense 49,260 69,331 Operating lease expense adjustment (1) 4,664 6,733 Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements (7,563) (4,088) Operating net cash outflows from operating leases $ 46,361 $ 71,976 (1) Represents the difference between the amount of cash operating lease payments and the amount of operating lease expense recognized in accordance with Accounting Standards Codification 842, Leases ("ASC 842"). Three Months Ended Financing Leases (in thousands) 2021 2020 Depreciation and amortization $ 7,630 $ 9,144 Interest expense: financing lease obligations 11,383 13,282 Financing lease expense $ 19,013 $ 22,426 Operating cash flows from financing leases $ 11,383 $ 13,282 Financing cash flows from financing leases 4,789 5,087 Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement (1,389) (1,739) Total net cash outflows from financing leases $ 14,783 $ 16,630
Finance Lease, Liability, Maturity	The aggregate amounts of future minimum lease payments, including community, office, and equipment leases (excluding minimum lease payments related to $9.7 million of operating lease obligations included within liabilities held for sale) recognized on the condensed consolidated balance sheet as of March 31, 2021 are as follows (in thousands): Year Ending December 31, Operating Leases Financing Leases 2021 (nine months) $ 151,681 $ 48,807 2022 203,946 65,609 2023 192,625 66,341 2024 193,377 67,553 2025 191,131 57,595 Thereafter 280,960 109,684 Total lease payments 1,213,720 415,589 Purchase option liability and non-cash gain on future sale of property — 413,617 Imputed interest and variable lease payments (276,070) (270,052) Total lease obligations $ 937,650 $ 559,154
Lessee, Operating Lease, Liability, Maturity	The aggregate amounts of future minimum lease payments, including community, office, and equipment leases (excluding minimum lease payments related to $9.7 million of operating lease obligations included within liabilities held for sale) recognized on the condensed consolidated balance sheet as of March 31, 2021 are as follows (in thousands): Year Ending December 31, Operating Leases Financing Leases 2021 (nine months) $ 151,681 $ 48,807 2022 203,946 65,609 2023 192,625 66,341 2024 193,377 67,553 2025 191,131 57,595 Thereafter 280,960 109,684 Total lease payments 1,213,720 415,589 Purchase option liability and non-cash gain on future sale of property — 413,617 Imputed interest and variable lease payments (276,070) (270,052) Total lease obligations $ 937,650 $ 559,154

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2021
Share-based Payment Arrangement [Abstract]
Grants of Restricted Stock and Stock Units	Grants of restricted stock and restricted stock units under the Company's 2014 Omnibus Incentive Plan were as follows: (in thousands, except for per share and unit amounts) Restricted Stock and Restricted Stock Unit Grants Weighted Average Grant Date Fair Value Total Grant Date Fair Value Three months ended March 31, 2021 1,961 $ 5.09 $ 9,988

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2021
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	The following table summarizes the computation of basic and diluted earnings (loss) per share amounts presented in the condensed consolidated statement of operations: Three Months Ended (in thousands, except for per share amounts) 2021 2020 Income attributable to common stockholders: Net income (loss) $ (108,285) $ 369,515 Weighted average shares outstanding - basic 184,011 184,186 Effect of dilutive securities - Unvested restricted stock, restricted stock units, and warrants — 336 Weighted average shares outstanding - diluted 184,011 184,522 Basic earnings (loss) per common share: Net income (loss) per share attributable to common stockholders $ (0.59) $ 2.01 Diluted earnings (loss) per common share: Net income (loss) per share attributable to common stockholders $ (0.59) $ 2.00
Schedule of Potentially Dilutive Securities	The following potentially dilutive securities were excluded from the computation of diluted EPS: Three Months Ended (in millions) 2021 (1) 2020 Non-performance-based restricted stock and restricted stock units 6.2 6.9 Performance-based restricted stock and restricted stock units 0.4 1.8 Warrants 16.3 —

Supplemental Disclosure of Ca_2

Supplemental Disclosure of Cash Flow Information (Tables)	3 Months Ended
	Mar. 31, 2021
Supplemental Cash Flow Elements [Abstract]
Supplemental Cash Flow Information	Three Months Ended (in thousands) 2021 2020 Supplemental Disclosure of Cash Flow Information: Interest paid $ 47,129 $ 59,479 Income taxes paid, net of refunds 904 957 Capital expenditures, net of related payables: Capital expenditures - non-development, net $ 27,450 $ 60,556 Capital expenditures - development, net 1,521 3,900 Capital expenditures - non-development - reimbursable 8,951 5,827 Trade accounts payable 2,439 (898) Net cash paid $ 40,361 $ 69,385 Acquisition of communities from Healthpeak: Property, plant and equipment and leasehold intangibles, net $ — $ 286,734 Operating lease right-of-use assets — (63,285) Financing lease obligations — 129,196 Operating lease obligations — 74,335 Loss (gain) on debt modification and extinguishment, net — (19,731) Net cash paid $ — $ 407,249 Acquisition of other assets, net of related payables and cash received: Property, plant and equipment and leasehold intangibles, net $ — $ 179 Financing lease obligations — 39,260 Net cash paid $ — $ 39,439 Proceeds from sale of CCRC Venture, net: Investments in unconsolidated ventures $ — $ (14,848) Current portion of long-term debt — 34,706 Accrued expenses — (5,025) Other liabilities — 60,748 Loss (gain) on sale of assets, net — (370,745) Net cash received $ — $ (295,164) Proceeds from sale of other assets, net: Prepaid expenses and other assets, net $ — $ (1,261) Assets held for sale (2,125) (5,274) Property, plant and equipment and leasehold intangibles, net (597) — Other liabilities 74 (824) Loss (gain) on sale of assets, net (1,112) (2,094) Net cash received $ (3,760) $ (9,453) Supplemental Schedule of Non-cash Operating, Investing, and Financing Activities: Healthpeak master lease modification: Property, plant and equipment and leasehold intangibles, net $ — $ (57,462) Operating lease right-of-use assets — 88,044 Financing lease obligations — 70,874 Operating lease obligations — (101,456) Net $ — $ — Other non-cash lease transactions, net: Property, plant and equipment and leasehold intangibles, net $ — $ (9,441) Operating lease right-of-use assets 16,721 — Financing lease obligations — 9,516 Operating lease obligations (16,721) — Other liabilities — (75) Net $ — $ —
Schedule of Cash, Cash Equivalents, and Restricted Cash	The following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the condensed consolidated balance sheets that sums to the total of the same such amounts shown in the condensed consolidated statements of cash flows. (in thousands) March 31, 2021 December 31, 2020 Reconciliation of cash, cash equivalents, and restricted cash: Cash and cash equivalents $ 303,952 $ 380,420 Restricted cash 26,503 28,059 Long-term restricted cash 71,468 56,669 Total cash, cash equivalents, and restricted cash $ 401,923 $ 465,148

Segment Information (Tables)

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2021
Segment Reporting [Abstract]
Schedule of segment reporting information	The following table sets forth selected segment financial data: Three Months Ended (in thousands) 2021 2020 Revenue and other operating income: Independent Living (1)(2) $ 120,146 $ 135,862 Assisted Living and Memory Care (1)(2) 392,042 457,479 CCRCs (1)(2) 73,463 94,547 Health Care Services (1)(2) 89,434 94,819 Management Services (3) 74,360 231,432 Total revenue and other operating income $ 749,445 $ 1,014,139 Segment operating income: (4) Independent Living $ 37,329 $ 51,414 Assisted Living and Memory Care 71,433 132,001 CCRCs 7,608 19,931 Health Care Services 2,403 (9,121) Management Services 8,566 108,715 Total segment operating income 127,339 302,940 General and administrative expense (including non-cash stock-based compensation expense) 49,943 54,595 Facility operating lease expense 44,418 64,481 Depreciation and amortization 83,891 90,738 Asset impairment: Independent Living 520 31,317 Assisted Living and Memory Care 9,642 32,798 CCRCs 515 12,173 Corporate and Management Services — 1,938 Income (loss) from operations $ (61,590) $ 14,900 As of (in thousands) March 31, 2021 December 31, 2020 Total assets: Independent Living $ 1,399,489 $ 1,419,838 Assisted Living and Memory Care 3,740,476 3,787,611 CCRCs 728,621 738,121 Health Care Services 233,585 233,178 Corporate and Management Services 643,982 723,010 Total assets $ 6,746,153 $ 6,901,758 (1) All revenue is earned from external third parties in the United States. (2) The Independent Living, Assisted Living and Memory Care, CCRCs, and Health Care Services segments include $1.4 million, $5.1 million, $1.7 million, and $2.6 million respectively, for the three months ended March 31, 2021 of other operating income recognized for the credits or grants pursuant to the Employee Retention Credit, Provider Relief Fund, and other government sources, as described in Note 3. Allocations to the applicable segment generally reflect the credits earned by the segment, the segment’s receipt and acceptance of the grant, or the segment’s proportional utilization of the grant. (3) Management services segment revenue includes management fees and reimbursements of costs incurred on behalf of managed communities.

Description of Business Descrip

Description of Business Description of Business (Details) - segment	Feb. 24, 2021	Mar. 31, 2021
Segment Reporting Information [Line Items]
Number of reportable segments		5
Securities Purchase Agreement | HCA Healthcare, Inc. | Health Care Services
Segment Reporting Information [Line Items]
Sale of stock, percentage of ownership sold in transaction	80.00%

COVID-19 Pandemic - Narrative (

COVID-19 Pandemic - Narrative (Details) - USD ($) $ in Thousands	Feb. 24, 2021	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020	Mar. 31, 2021	Dec. 31, 2022	Dec. 31, 2021
Unusual or Infrequent Item, or Both [Line Items]
Percentage of communities accepting new visitors and move-ins		100.00%			100.00%
Total liquidity		$ 438,900			$ 438,900
Cash and cash equivalents		303,952		$ 380,420	303,952
Marketable securities		134,933		172,905	134,933
Revenue from government grants		900
Nonrecurring
Unusual or Infrequent Item, or Both [Line Items]
Operating lease right-of-use assets		9,000	$ 65,700
CARES Act
Unusual or Infrequent Item, or Both [Line Items]
Facility operating expense		$ 27,300			$ 152,900
Employer portion of payroll taxes delayed				72,700
Employee retention credit, percent of wages		50.00%			50.00%
Maximum credit amount per employee		$ 5
Employee retention credit, amount recognized		$ 9,000
CARES Act | Forecast
Unusual or Infrequent Item, or Both [Line Items]
Employer portion of payroll taxes delayed						$ 32,000	$ 32,000
CARES Act | Accelerated and Advance Payment Program
Unusual or Infrequent Item, or Both [Line Items]
Amount received from Accelerated and Advance Payment Program				87,500
CARES Act | The Continuing Appropriations Act, 2021 and Other Extensions Act
Unusual or Infrequent Item, or Both [Line Items]
Recoupment of accelerated/advanced payments start		1 year
CARES Act | The Continuing Appropriations Act, 2021 and Other Extensions Act | Period One
Unusual or Infrequent Item, or Both [Line Items]
Payments for recoupment of accelerated/advanced payments rate		25.00%
Recoupment of accelerated/advanced payments period		11 months
CARES Act | The Continuing Appropriations Act, 2021 and Other Extensions Act | Period Two
Unusual or Infrequent Item, or Both [Line Items]
Payments for recoupment of accelerated/advanced payments rate		50.00%
Recoupment of accelerated/advanced payments period		6 months
Loans Insured or Guaranteed by US Government Authorities | CARES Act
Unusual or Infrequent Item, or Both [Line Items]
Relief received from Provider Relief Fund		$ 800
Health Care Services | CARES Act | Accelerated and Advance Payment Program
Unusual or Infrequent Item, or Both [Line Items]
Amount received from Accelerated and Advance Payment Program				75,200
CCRC Ventures, LLC | CARES Act | Accelerated and Advance Payment Program
Unusual or Infrequent Item, or Both [Line Items]
Amount received from Accelerated and Advance Payment Program				$ 12,300
Securities Purchase Agreement | HCA Healthcare, Inc. | Health Care Services
Unusual or Infrequent Item, or Both [Line Items]
Sale of stock, percentage of ownership sold in transaction	80.00%
Employer portion of payroll taxes delayed		$ 8,900			$ 8,900
Decrease in accrued payroll taxes	$ 8,900

Acquisitions, Dispositions an_3

Acquisitions, Dispositions and Other Transactions - Additional Information (Details) $ in Thousands	Feb. 24, 2021USD ($)	Mar. 31, 2021USD ($)community	Mar. 31, 2020USD ($)community	Dec. 31, 2020USD ($)community	Mar. 31, 2021USD ($)community	Jul. 26, 2020community
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of communities disposed of | community			1
Gain on sale of assets		$ 1,112	$ 372,839
Securities Purchase Agreement | HCA Healthcare, Inc. | Health Care Services
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Sale of stock, percentage of ownership sold in transaction	80.00%
Sale of stock, consideration received on transaction	$ 400,000
Medicare advance payments		75,200			$ 75,200
Employer portion of payroll taxes delayed		$ 8,900			$ 8,900
Sale of stock, percentage of ownership after transaction	20.00%
Communities Disposed of Through Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of communities disposed of | community					8
Sale of 1 community
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Net cash proceeds			5,500
Gain on sale of assets			$ 200
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations | Communities Disposed of Through Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of communities disposed of | community		1		2
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations | Communities Disposed of Through Lease Terminations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of communities disposed of | community					5
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations | One Community Held For Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Assets held for sale		$ 14,000			$ 14,000
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations | One Community Held For Sale | Assisted Living and Memory Care
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of communities classified as held for sale | community		1
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations | One Community Held For Sale | CCRC Ventures, LLC
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of communities classified as held for sale | community		1
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations | Sale of 1 community
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Net cash proceeds		$ 2,700
Gain on sale of assets		$ 500
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations | Sale of 2 communities
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Net cash proceeds				$ 38,100
Gain on sale of assets				$ 2,700
Communities Acquired Previously Leased Or Managed
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of communities acquired | community					27
Ventas, Inc
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of owned communities transferred | community				5		5

Acquisitions, Dispositions an_4

Acquisitions, Dispositions and Other Transactions - Disclosure of Assets and Liabilities Held-for-sale (Details) - Health Care Services $ in Thousands	Mar. 31, 2021USD ($)
Disposal Group, Including Discontinued Operation, Assets [Abstract]
Accounts receivable, net	$ 62,401
Property, plant and equipment and leasehold intangibles, net	1,964
Operating lease right-of-use assets	9,688
Goodwill	126,810
Prepaid expenses and other assets, net	32,722
Assets held for sale	233,585
Disposal Group, Including Discontinued Operation, Liabilities [Abstract]
Trade accounts payable	1,201
Accrued expenses	30,030
Refundable fees and deferred revenue	75,223
Operating lease obligations	9,688
Liabilities held for sale	$ 116,142

Fair Value Measurements -Narrat

Fair Value Measurements -Narrative (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities	$ 134,933	$ 172,905
Total long-term debt	3,889,791	3,915,988
Long-term debt and lines of credit
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total long-term debt	3,900,000	$ 3,900,000
Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities	$ 134,900

Fair Value Measurements - Asset

Fair Value Measurements - Asset Impairment (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Asset impairment	$ 10,677	$ 78,226
Nonrecurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Operating lease right-of-use assets	9,000	65,700
Property, plant and equipment and leasehold intangibles, net	1,700	11,000
Investment in unconsolidated ventures	0	1,500
Asset impairment	$ 10,700	$ 78,200

Revenue - Disaggregation of Rev

Revenue - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Disaggregation of Revenue [Line Items]
Revenue	$ 749,445	$ 1,014,139
Private pay
Disaggregation of Revenue [Line Items]
Revenue	541,366	640,776
Government reimbursement
Disaggregation of Revenue [Line Items]
Revenue	96,856	110,532
Other third-party payor programs
Disaggregation of Revenue [Line Items]
Revenue	26,128	31,399
Total resident fee revenue
Disaggregation of Revenue [Line Items]
Revenue	664,350	782,707
Independent Living | Private pay
Disaggregation of Revenue [Line Items]
Revenue	118,322	135,290
Independent Living | Government reimbursement
Disaggregation of Revenue [Line Items]
Revenue	460	572
Independent Living | Other third-party payor programs
Disaggregation of Revenue [Line Items]
Revenue	0	0
Independent Living | Total resident fee revenue
Disaggregation of Revenue [Line Items]
Revenue	118,782	135,862
Assisted Living and Memory Care | Private pay
Disaggregation of Revenue [Line Items]
Revenue	370,494	440,613
Assisted Living and Memory Care | Government reimbursement
Disaggregation of Revenue [Line Items]
Revenue	16,444	16,866
Assisted Living and Memory Care | Other third-party payor programs
Disaggregation of Revenue [Line Items]
Revenue	0	0
Assisted Living and Memory Care | Total resident fee revenue
Disaggregation of Revenue [Line Items]
Revenue	386,938	457,479
CCRCs | Private pay
Disaggregation of Revenue [Line Items]
Revenue	52,213	64,703
CCRCs | Government reimbursement
Disaggregation of Revenue [Line Items]
Revenue	12,487	19,405
CCRCs | Other third-party payor programs
Disaggregation of Revenue [Line Items]
Revenue	7,079	10,439
CCRCs | Total resident fee revenue
Disaggregation of Revenue [Line Items]
Revenue	71,779	94,547
Health Care Services | Private pay
Disaggregation of Revenue [Line Items]
Revenue	337	170
Health Care Services | Government reimbursement
Disaggregation of Revenue [Line Items]
Revenue	67,465	73,689
Health Care Services | Other third-party payor programs
Disaggregation of Revenue [Line Items]
Revenue	19,049	20,960
Health Care Services | Total resident fee revenue
Disaggregation of Revenue [Line Items]
Revenue	$ 86,851	$ 94,819

Revenue - Additional Informatio

Revenue - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		12 Months Ended
	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020
Disaggregation of Revenue [Line Items]
Monthly resident fees	$ 30.1		$ 21.1
Revenue recognized	30.8	$ 48.3
Deferred Revenue and Credits
Disaggregation of Revenue [Line Items]
Contract with customer, liability	$ 146		138.3
CARES Act | Accelerated and Advance Payment Program
Disaggregation of Revenue [Line Items]
Amount received from Accelerated and Advance Payment Program			$ 87.5

Property, Plant and Equipment_3

Property, Plant and Equipment and Leasehold Intangibles, Net (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	$ 8,585,643		$ 8,558,158
Accumulated depreciation and amortization	(3,567,234)		(3,490,098)
Property, plant and equipment and leasehold intangibles, net	5,018,409		5,068,060
Finance lease, right-of-use asset	400,000		400,000
Depreciation and amortization expense	83,900	$ 90,700
Land
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	504,698		505,298
Buildings and improvements
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	5,222,741		5,215,460
Furniture and equipment
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	953,773		945,783
Resident and leasehold operating intangibles
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	305,960		307,071
Construction in progress
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	64,003		61,491
Assets under financing leases and leasehold improvements
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	$ 1,534,468		$ 1,523,055

Goodwill - Additional Informati

Goodwill - Additional Information (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Goodwill [Line Items]
Goodwill	$ 27,321	$ 154,131
Independent Living
Goodwill [Line Items]
Goodwill	27,300	27,300
Health Care Services
Goodwill [Line Items]
Goodwill	$ 126,800	$ 126,800

Debt - Schedule of Debt (Detail

Debt - Schedule of Debt (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Long-Term Debt, Capital and Financing Leases and Financing Obligations [Line Items]
Debt discount and deferred financing costs, net	$ (26,324)	$ (27,500)
Total long-term debt	3,889,791	3,915,988
Current portion	224,890	68,885
Long-term debt, less current portion	3,664,901	3,847,103
Mortgage notes payable
Long-Term Debt, Capital and Financing Leases and Financing Obligations [Line Items]
Total long-term debt	$ 2,334,151	$ 2,366,996
Weighted average interest rate	4.17%	4.18%
Variable Mortgages
Long-Term Debt, Capital and Financing Leases and Financing Obligations [Line Items]
Total long-term debt	$ 1,524,496	$ 1,529,935
Weighted average interest rate	2.46%	2.49%
Other notes payable
Long-Term Debt, Capital and Financing Leases and Financing Obligations [Line Items]
Total long-term debt	$ 57,468	$ 46,557
Weighted average interest rate	7.79%	8.98%

Debt - Narrative (Details)

Debt - Narrative (Details) - USD ($)	Mar. 31, 2021	Dec. 11, 2020
Credit Facilities [Line Items]
Percentage of total debt	97.90%
Mortgages
Credit Facilities [Line Items]
Mortgage debt	$ 3,800,000,000
Fifth Amended and Restated Credit Agreement | Line of Credit | Letter of Credit Sublimit
Credit Facilities [Line Items]
Letters of credit issued	69,900,000
Fifth Amended and Restated Credit Agreement | Line of Credit | Letter of Credit
Credit Facilities [Line Items]
Letters of credit issued	13,600,000
Credit facility, maximum borrowing capacity	$ 15,000,000
Credit Agreement With Capital One, National Association | Line of Credit | Revolving Credit Facility
Credit Facilities [Line Items]
Credit facility, maximum borrowing capacity		$ 80,000,000

Leases (Details)

Leases (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2021USD ($)leasecommunity
Lessee, Lease, Description [Line Items]
Operating and financing leases, number of communities | community	301
Operating lease, number of communities	235
Financing leases, number of communities	66
Health Care Services
Lessee, Lease, Description [Line Items]
Operating lease obligations | $	$ 9,688
Minimum
Lessee, Lease, Description [Line Items]
Finance and operating lease, renewal term	5 years
Maximum
Lessee, Lease, Description [Line Items]
Finance and operating lease, renewal term	20 years

Leases - Lease Costs (Details)

Leases - Lease Costs (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Leases [Abstract]
Facility operating expense	$ 4,842	$ 4,850
Facility lease expense	44,418	64,481
Operating lease expense	49,260	69,331
Operating lease expense adjustment	4,664	6,733
Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements	(7,563)	(4,088)
Operating net cash outflows from operating leases	46,361	71,976
Depreciation and amortization	7,630	9,144
Interest expense: financing lease obligations	11,383	13,282
Financing lease expense	19,013	22,426
Operating cash flows from financing leases	11,383	13,282
Financing cash flows from financing leases	4,789	5,087
Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement	(1,389)	(1,739)
Total net cash outflows from financing leases	$ 14,783	$ 16,630

Leases - Maturity ASC 842 (Deta

Leases - Maturity ASC 842 (Details) $ in Thousands	Mar. 31, 2021USD ($)
Operating Leases
2021 (nine months)	$ 151,681
2022	203,946
2023	192,625
2024	193,377
2025	191,131
Thereafter	280,960
Total lease payments	1,213,720
Purchase option liability and non-cash gain on future sale of property	0
Imputed interest and variable lease payments	(276,070)
Total lease obligations	937,650
Financing Leases
2021 (nine months)	48,807
2022	65,609
2023	66,341
2024	67,553
2025	57,595
Thereafter	109,684
Total lease payments	415,589
Purchase option liability and non-cash gain on future sale of property	413,617
Imputed interest and variable lease payments	(270,052)
Total lease obligations	$ 559,154

Stock-Based Compensation (Detai

Stock-Based Compensation (Details) - Unvested Restricted Stock $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2021USD ($)$ / sharesshares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted Stock and Restricted Stock Unit Grants (in shares) | shares	1,961
Weighted Average Grant Date Fair Value (in dollars per share) | $ / shares	$ 5.09
Total Grant Date Fair Value | $	$ 9,988

Earnings Per Share - Schedule o

Earnings Per Share - Schedule of Earnings Per Share, Basic and Diluted (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Earnings Per Share [Abstract]
Net income (loss)	$ (108,285)	$ 369,515
Weighted average common shares outstanding:
Weighted average shares outstanding - basic	184,011	184,186
Effect of dilutive securities - Unvested restricted stock, restricted stock units, and warrants (in shares)	0	336
Weighted average shares outstanding - diluted	184,011	184,522
Earnings Per Share, Basic and Diluted [Abstract]
Basic (in dollars per share)	$ (0.59)	$ 2.01
Diluted (in dollars per share)	$ (0.59)	$ 2

Earnings Per Share - Schedule_2

Earnings Per Share - Schedule of Potentially Dilutive Securities (Details) - shares shares in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Diluted (in shares)	184,011	184,522
Number of warrants (in shares)	16,300	0
Non-performance-based restricted stock and restricted stock units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Diluted (in shares)	6,200	6,900
Performance-based restricted stock and restricted stock units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Diluted (in shares)	400	1,800

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020
Valuation Allowance [Line Items]
Gross deferred federal, state and local tax benefit	$ 25,200
Increase (decrease) in valuation allowance	25,500	$ (112,600)
Deferred federal, state and local tax expense (benefit)		(2,200)
Gain on sale of assets	1,112	372,839
Valuation allowance	406,500		$ 381,000
Federal, State, and Local
Valuation Allowance [Line Items]
Deferred federal, state and local tax expense (benefit)		90,900
CCRC Ventures, LLC
Valuation Allowance [Line Items]
Gain on sale of assets		$ 93,100
Healthpeak
Valuation Allowance [Line Items]
Increase (decrease) in valuation allowance	$ (117,600)

Supplemental Disclosure of Ca_3

Supplemental Disclosure of Cash Flow Information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Supplemental Cash Flow Information [Abstract]
Interest paid	$ 47,129	$ 59,479
Income taxes paid, net of refunds	904	957
Net cash paid	40,361	69,385
Loss (gain) on debt modification and extinguishment, net	0	19,181
Investments in unconsolidated ventures	(5,206)	(268)
Loss (gain) on sale of assets, net	1,112	372,839
Prepaid expenses and other assets, net	(6,769)	(1,696)
Additions to property, plant and equipment and leasehold improvements
Supplemental Cash Flow Information [Abstract]
Net cash paid	40,361	69,385
Trade accounts payable	2,439	(898)
Acquisition of communities from Healthpeak
Supplemental Cash Flow Information [Abstract]
Property, plant and equipment and leasehold intangibles, net	0	286,734
Operating lease right-of-use assets	0	(63,285)
Financing lease obligations	0	129,196
Operating lease obligations	0	74,335
Loss (gain) on debt modification and extinguishment, net	0	(19,731)
Net cash paid	0	407,249
Acquisition of assets, net of related payables and cash received
Supplemental Cash Flow Information [Abstract]
Property, plant and equipment and leasehold intangibles, net	0	179
Financing lease obligations	0	39,260
Net cash paid	0	39,439
Proceeds from sale of CCRC Venture, net:
Supplemental Cash Flow Information [Abstract]
Investments in unconsolidated ventures	0	(14,848)
Current portion of long-term debt	0	34,706
Accrued expenses	0	(5,025)
Other liabilities	0	60,748
Loss (gain) on sale of assets, net	0	(370,745)
Net cash received	0	(295,164)
Proceeds from sale of assets, net
Supplemental Cash Flow Information [Abstract]
Property, plant and equipment and leasehold intangibles, net	597	0
Other liabilities	74	(824)
Loss (gain) on sale of assets, net	(1,112)	(2,094)
Prepaid expenses and other assets, net	0	(1,261)
Assets held for sale	(2,125)	(5,274)
Net cash received	(3,760)	(9,453)
Healthpeak master lease modification:
Supplemental Cash Flow Information [Abstract]
Property, plant and equipment and leasehold intangibles, net	0	(57,462)
Operating lease right-of-use assets	0	88,044
Financing lease obligations	0	70,874
Operating lease obligations	0	(101,456)
Net	0	0
Noncash lease termination and modification, net
Supplemental Cash Flow Information [Abstract]
Property, plant and equipment and leasehold intangibles, net	0	(9,441)
Operating lease right-of-use assets	16,721	0
Financing lease obligations	0	9,516
Operating lease obligations	(16,721)	0
Other liabilities	0	(75)
Net	0	0
Non-development | Additions to property, plant and equipment and leasehold improvements
Supplemental Cash Flow Information [Abstract]
Net cash paid	27,450	60,556
Development | Additions to property, plant and equipment and leasehold improvements
Supplemental Cash Flow Information [Abstract]
Net cash paid	1,521	3,900
Non-development - reimbursable | Additions to property, plant and equipment and leasehold improvements
Supplemental Cash Flow Information [Abstract]
Net cash paid	$ 8,951	$ 5,827

Supplemental Disclosure of Ca_4

Supplemental Disclosure of Cash Flow Information - Schedule of cash, cash equivalents, and restricted cash (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020	Mar. 31, 2020	Dec. 31, 2019
Supplemental Cash Flow Elements [Abstract]
Cash and cash equivalents	$ 303,952	$ 380,420
Restricted cash	26,503	28,059
Long-term restricted cash	71,468	56,669
Total cash, cash equivalents, and restricted cash	$ 401,923	$ 465,148	$ 458,499	$ 301,697

Segment Information (Details)

Segment Information (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2021USD ($)segment	Mar. 31, 2020USD ($)	Dec. 31, 2020USD ($)
Segment Reporting Information [Line Items]
Number of reportable segments | segment	5
Revenue	$ 749,445	$ 1,014,139
Segment operating income	127,339	302,940
General and administrative expense (including non-cash stock-based compensation expense)	49,943	54,595
Facility lease expense	44,418	64,481
Depreciation and amortization	83,891	90,738
Asset impairment	10,677	78,226
Income (loss) from operations	(61,590)	14,900
Total assets	6,746,153		$ 6,901,758
Operating Segments | Independent Living
Segment Reporting Information [Line Items]
Revenue	120,146	135,862
Segment operating income	37,329	51,414
Asset impairment	520	31,317
Total assets	1,399,489		1,419,838
Operating Segments | Assisted Living and Memory Care
Segment Reporting Information [Line Items]
Revenue	392,042	457,479
Segment operating income	71,433	132,001
Asset impairment	9,642	32,798
Total assets	3,740,476		3,787,611
Operating Segments | CCRCs
Segment Reporting Information [Line Items]
Revenue	73,463	94,547
Segment operating income	7,608	19,931
Asset impairment	515	12,173
Total assets	728,621		738,121
Operating Segments | Health Care Services
Segment Reporting Information [Line Items]
Revenue	89,434	94,819
Segment operating income	2,403	(9,121)
Total assets	233,585		233,178
Operating Segments | Management Services
Segment Reporting Information [Line Items]
Revenue	74,360	231,432
Segment operating income	8,566	108,715
Asset impairment	0	$ 1,938
Total assets	643,982		$ 723,010
CARES Act | Independent Living
Segment Reporting Information [Line Items]
Cash made available for Provider Relief Fund	1,400
CARES Act | Assisted Living and Memory Care
Segment Reporting Information [Line Items]
Cash made available for Provider Relief Fund	5,100
CARES Act | CCRCs
Segment Reporting Information [Line Items]
Cash made available for Provider Relief Fund	1,700
CARES Act | Health Care Services
Segment Reporting Information [Line Items]
Cash made available for Provider Relief Fund	$ 2,600