Brookdale Senior Living (BKD) 10-Q 8 Nov 22 2022 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2022	Nov. 04, 2022
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2022
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	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		186,805,515
Entity Central Index Key	0001332349
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q3
Amendment Flag	false

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Current assets
Cash and cash equivalents	$ 299,201	$ 347,031
Marketable securities	89,504	182,393
Restricted cash	37,258	26,845
Accounts receivable, net	51,548	51,137
Assets held for sale	0	3,642
Prepaid expenses and other current assets, net	103,923	87,946
Total current assets	581,434	698,994
Property, plant and equipment and leasehold intangibles, net	4,801,988	4,904,292
Operating lease right-of-use assets	539,166	630,423
Restricted cash	58,358	64,438
Investment in unconsolidated ventures	57,701	67,424
Goodwill	27,321	27,321
Deferred tax asset	2,348	279
Other assets, net	25,637	17,296
Total assets	6,093,953	6,410,467
Current liabilities
Current portion of long-term debt	61,000	63,125
Current portion of financing lease obligations	23,620	22,151
Current portion of operating lease obligations	158,645	148,642
Trade accounts payable	77,706	76,125
Accrued expenses	261,662	254,831
Refundable fees and deferred revenue	74,370	67,080
Total current liabilities	657,003	631,954
Long-term debt, less current portion	3,758,929	3,778,087
Financing lease obligations, less current portion	522,924	532,136
Operating lease obligations, less current portion	580,213	681,876
Other liabilities	82,085	86,791
Total liabilities	5,601,154	5,710,844
Preferred stock, $0.01 par value, 50,000,000 shares authorized at September 30, 2022 and December 31, 2021; no shares issued and outstanding	0	0
Common stock, $0.01 par value, 400,000,000 shares authorized at September 30, 2022 and December 31, 2021; 197,783,056 and 197,485,318 shares issued and 187,255,531 and 186,957,793 shares outstanding (including 450,016 and 1,549,059 unvested restricted shares), respectively	1,978	1,975
Additional paid-in-capital	4,215,297	4,208,675
Treasury stock, at cost; 10,527,525 shares at September 30, 2022 and December 31, 2021	(102,774)	(102,774)
Accumulated deficit	(3,623,264)	(3,410,474)
Total Brookdale Senior Living Inc. stockholders' equity	491,237	697,402
Noncontrolling interest	1,562	2,221
Total equity	492,799	699,623
Total liabilities and equity	$ 6,093,953	$ 6,410,467

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Sep. 30, 2022	Dec. 31, 2021
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)	197,783,056	197,485,318
Common stock, shares outstanding (in shares)	187,255,531	186,957,793
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)	450,016	1,549,059

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Revenue
Revenue	$ 757,458	$ 641,654	$ 2,124,794	$ 2,114,391
Expense
General and administrative expense (including non-cash stock-based compensation expense of $3,403, $3,568, $10,907, and $12,878, respectively)	41,331	43,812	128,209	146,155
Facility operating lease expense	41,317	43,226	124,419	131,508
Depreciation and amortization	86,922	84,560	259,229	252,042
Asset impairment	5,688	639	17,362	13,394
Total operating expense	738,252	690,509	2,193,170	2,277,331
Income (loss) from operations	19,206	(48,855)	(68,376)	(162,940)
Interest income	2,192	286	3,065	1,048
Interest expense:
Debt	(41,330)	(35,708)	(110,180)	(106,484)
Financing lease obligations	(11,916)	(11,674)	(35,968)	(34,549)
Amortization of deferred financing costs	(1,528)	(1,884)	(4,590)	(5,706)
Change in fair value of derivatives	4,901	(95)	9,277	(286)
Equity in earnings (loss) of unconsolidated ventures	(2,020)	(1,474)	(9,353)	11,941
Gain (loss) on sale of assets, net	(56)	288,375	611	289,408
Other non-operating income (loss)	1,877	571	1,739	5,163
Income (loss) before income taxes	(28,674)	189,542	(213,775)	(2,405)
Benefit (provision) for income taxes	300	(15,279)	1,086	(15,239)
Net income (loss)	(28,374)	174,263	(212,689)	(17,644)
Net (income) loss attributable to noncontrolling interest	15	19	(101)	56
Net income (loss) attributable to Brookdale Senior Living Inc. common stockholders	$ (28,359)	$ 174,282	$ (212,790)	$ (17,588)
Net income (loss) per share attributable to Brookdale Senior Living Inc. common stockholders:
Basic (in dollars per share)	$ (0.15)	$ 0.94	$ (1.14)	$ (0.10)
Diluted (in dollars per share)	$ (0.15)	$ 0.89	$ (1.14)	$ (0.10)
Weighted average common shares outstanding:
Basic (in shares)	186,790	185,317	186,493	184,841
Diluted (in shares)	186,790	196,230	186,493	184,841
Resident fees
Revenue
Revenue	$ 650,248	$ 600,095	$ 1,927,610	$ 1,938,423
Management fees
Revenue
Revenue	2,967	3,621	9,625	17,185
Reimbursed costs incurred on behalf of managed communities
Revenue
Revenue	37,484	37,849	112,013	146,651
Expense
Costs of services	37,484	37,849	112,013	146,651
Other operating income
Revenue
Revenue	66,759	89	75,546	12,132
Facility operating expense (excluding facility depreciation and amortization)
Expense
Costs of services	$ 525,510	$ 480,423	$ 1,551,938	$ 1,587,581

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Income Statement [Abstract]
Depreciation and amortization	$ 81,405	$ 78,756	$ 242,281	$ 233,951
Non-cash stock-based compensation expense	$ 3,403	$ 3,568	$ 10,907	$ 12,878

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:
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]
Restricted stock and restricted stock units, net		(1)	1
Shares withheld for employee taxes		(7)	(4,765)
Non-cash stock-based compensation expense			12,878
Issuance of common stock under Associate Stock Purchase Plan			571
Other, net			18
Net income (loss)	(17,644)				(17,588)	(56)
Balance at end of period at Sep. 30, 2021	793,780	$ 1,975	4,221,112	(102,774)	(3,328,772)	2,239
Balance at beginning of period (in shares) at Dec. 31, 2020		187,804,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under Associate Stock Purchase Plan (in shares)		97,000
Restricted stock and restricted stock units, net (in shares)		(138,000)
Shares withheld for employee taxes (in shares)		(804,000)
Balances at end of period (in shares) at Sep. 30, 2021		186,959,000
Balance at beginning of period at Jun. 30, 2021	616,135	$ 1,977	4,217,728	(102,774)	(3,503,054)	2,258
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Restricted stock and restricted stock units, net		(2)	2
Shares withheld for employee taxes			(328)
Non-cash stock-based compensation expense			3,568
Issuance of common stock under Associate Stock Purchase Plan			134
Other, net			8
Net income (loss)	174,263				174,282	(19)
Balance at end of period at Sep. 30, 2021	793,780	$ 1,975	4,221,112	(102,774)	(3,328,772)	2,239
Balance at beginning of period (in shares) at Jun. 30, 2021		187,139,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under Associate Stock Purchase Plan (in shares)		24,000
Restricted stock and restricted stock units, net (in shares)		(161,000)
Shares withheld for employee taxes (in shares)		(43,000)
Balances at end of period (in shares) at Sep. 30, 2021		186,959,000
Balance at beginning of period at Dec. 31, 2021	699,623	$ 1,975	4,208,675	(102,774)	(3,410,474)	2,221
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Restricted stock and restricted stock units, net		9	(9)
Shares withheld for employee taxes		(6)	(4,276)
Non-cash stock-based compensation expense			10,907
Net income (loss)	(212,689)				(212,790)	101
Noncontrolling interest distribution						(760)
Balance at end of period at Sep. 30, 2022	$ 492,799	$ 1,978	4,215,297	(102,774)	(3,623,264)	1,562
Balance at beginning of period (in shares) at Dec. 31, 2021	186,957,793	186,958,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Restricted stock and restricted stock units, net (in shares)		915,000
Shares withheld for employee taxes (in shares)		(617,000)
Balances at end of period (in shares) at Sep. 30, 2022	187,255,531	187,256,000
Balance at beginning of period at Jun. 30, 2022	$ 518,567	$ 1,978	4,211,931	(102,774)	(3,594,905)	2,337
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Shares withheld for employee taxes			(37)
Non-cash stock-based compensation expense			3,403
Net income (loss)	(28,374)				(28,359)	(15)
Noncontrolling interest distribution						(760)
Balance at end of period at Sep. 30, 2022	$ 492,799	$ 1,978	$ 4,215,297	$ (102,774)	$ (3,623,264)	$ 1,562
Balance at beginning of period (in shares) at Jun. 30, 2022		187,256,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Restricted stock and restricted stock units, net (in shares)		8,000
Shares withheld for employee taxes (in shares)		(8,000)
Balances at end of period (in shares) at Sep. 30, 2022	187,255,531	187,256,000

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Cash Flows from Operating Activities
Net income (loss)	$ (212,689)	$ (17,644)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Depreciation and amortization, net	263,819	257,748
Asset impairment	17,362	13,394
Equity in (earnings) loss of unconsolidated ventures	9,353	(11,941)
Distributions from unconsolidated ventures from cumulative share of net earnings	561	6,191
Amortization of entrance fees	(1,816)	(1,320)
Proceeds from deferred entrance fee revenue	2,360	2,981
Deferred income tax (benefit) provision	(2,068)	8,512
Operating lease expense adjustment	(25,329)	(16,263)
Change in fair value of derivatives	(9,277)	286
Loss (gain) on sale of assets, net	(611)	(289,408)
Non-cash stock-based compensation expense	10,907	12,878
Other	(996)	(4,399)
Changes in operating assets and liabilities:
Accounts receivable, net	(411)	(584)
Prepaid expenses and other assets, net	(11,807)	(7,487)
Prepaid insurance premiums financed with notes payable	(5,552)	(4,634)
Trade accounts payable and accrued expenses	1,548	21,878
Refundable fees and deferred revenue	7,265	(10,492)
Operating lease assets and liabilities for lessor capital expenditure reimbursements	9,224	27,057
Net cash provided by (used in) operating activities	51,843	(13,247)
Cash Flows from Investing Activities
Change in lease security deposits and lease acquisition deposits, net	317	19
Purchase of marketable securities	(230,106)	(247,847)
Sale and maturities of marketable securities	323,765	262,995
Capital expenditures, net of related payables	(150,572)	(125,817)
Acquisition of assets	(6,004)	0
Investment in unconsolidated ventures	(192)	(5,359)
Distributions received from unconsolidated ventures	0	2,155
Proceeds from sale of assets, net	5,844	315,583
Other	(545)	0
Net cash provided by (used in) investing activities	(57,493)	201,729
Cash Flows from Financing Activities
Proceeds from debt	32,031	25,158
Repayment of debt and financing lease obligations	(64,190)	(96,065)
Payment of financing costs, net of related payables	(646)	(196)
Payments of employee taxes for withheld shares	(4,282)	(4,772)
Other	(760)	144
Net cash provided by (used in) financing activities	(37,847)	(75,731)
Net increase (decrease) in cash, cash equivalents, and restricted cash	(43,497)	112,751
Cash, cash equivalents, and restricted cash at beginning of period	438,314	465,148
Cash, cash equivalents, and restricted cash at end of period	$ 394,817	$ 577,899

Description of Business

Description of Business	9 Months Ended
	Sep. 30, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Description of Business	1. Description of Business Brookdale Senior Living Inc. together with its consolidated subsidiaries ("Brookdale" or the "Company") is an operator of 672 senior living communities throughout the United States. The Company is committed to its mission of enriching the lives of the people it serves with compassion, respect, excellence, and integrity. The Company operates and manages independent living, assisted living, memory care, and continuing care retirement communities ("CCRCs"). The Company's senior living communities and its comprehensive network help to provide seniors with care and services in an environment that feels like home. As of September 30, 2022, the Company owned 346 communities, representing a majority of the Company's consolidated community portfolio, leased 295 communities, and managed 31 communities.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2022
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. 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, 2021 filed with the SEC on February 15, 2022. 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 unaudited 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. The Company continually evaluates its potential variable interest entity ("VIE") relationships under certain criteria as provided for in Financial Accounting Standards Board Accounting Standards Codification 810, Consolidation ("ASC 810"). ASC 810 broadly defines a VIE as an entity with one or more of the following characteristics: (a) the total equity investment at risk is insufficient to finance the entity's activities without additional subordinated financial support; (b) as a group, the holders of the equity investment at risk lack (i) the ability to make decisions about the entity's activities through voting or similar rights, (ii) the obligation to absorb the expected losses of the entity, or (iii) the right to receive the expected residual returns of the entity; or (c) the equity investors have voting rights that are not proportional to their economic interests, and substantially all of the entity's activities either involve, or are conducted on behalf of, an investor that has disproportionately few voting rights. The Company performs this analysis on an ongoing basis and consolidates any VIEs for which the Company is determined to be the primary beneficiary, as determined by the Company's power to direct the VIE's activities and the obligation to absorb its losses or the right to receive its benefits, which are potentially significant to the VIE. 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. Reclassifications Certain prior period amounts have been reclassified to conform to the current financial statement presentation, with no effect on the Company's condensed consolidated financial position or results of operations.

COVID-19 Pandemic

COVID-19 Pandemic	9 Months Ended
	Sep. 30, 2022
Unusual or Infrequent Items, or Both [Abstract]
COVID-19 Pandemic	3. COVID-19 Pandemic The COVID-19 pandemic has adversely impacted the Company's occupancy and resident fee revenue beginning in March 2020 and resulted in incremental direct costs to respond to the pandemic. 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 or variants 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, health plan, and other expenses; greater use of contract labor and overtime due to COVID-19 and general labor market conditions; the impact of COVID-19 on the Company's ability to complete financings and refinancings of various assets or other transactions 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 the costs of unfunded, mandatory testing of residents and associates and provision of test kits to the Company's health plan participants; 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. Phase 4 Provider Relief Fund Grants . During the three months ended September 30, 2022, the Company accepted and recognized as other operating income $61.1 million from the Phase 4 general distribution of the Public Health and Social Services Emergency Fund ("Provider Relief Fund") administered by the U.S. Department of Health and Human Services. The grant has been made available to eligible healthcare providers for healthcare related expenses or lost revenues attributable to COVID-19. Employee Retention Credit. The Company was eligible to claim the employee retention credit for certain of its associates under the Coronavirus Aid, Relief, and Economic Security Act of 2020 ("CARES Act"). The Company recognized $9.9 million for the nine months ended September 30, 2021 of employee retention credits on wages paid from March 12, 2020 to December 31, 2020 within other operating income, for which the Company has received $4.6 million in cash as of September 30, 2022. The credit was modified and extended by subsequent legislation for wages paid from January 1, 2021 through December 31, 2021. During the three and nine months ended September 30, 2022, the Company recognized $4.7 million and $9.4 million, respectively, of employee retention credits on wages paid in 2021 within other operating income. The Company has a receivable for the remaining $14.7 million included within prepaid expenses and other current assets, net on the condensed consolidated balance sheet as of September 30, 2022.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2022
Fair Value Disclosures [Abstract]
Fair Value Measurements	4. Fair Value Measurements Marketable Securities As of September 30, 2022 and December 31, 2021, marketable securities of $89.5 million and $182.4 million, respectively, 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 $3.8 billion as of both September 30, 2022 and December 31, 2021. Fair value of the long-term debt is approximately $3.3 billion as of September 30, 2022 and approximates the carrying amount as of December 31, 2021. The Company's fair value of long-term debt disclosure is classified within Level 2 of the valuation hierarchy.

Revenue

Revenue	9 Months Ended
	Sep. 30, 2022
Revenue from Contract with Customer [Abstract]
Revenue	5. 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 is as follows. Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Private pay 93.6 % 93.0 % 93.5 % 84.9 % Government reimbursement 5.1 % 5.5 % 5.1 % 11.8 % Other third-party payor programs 1.3 % 1.5 % 1.4 % 3.3 % The sale of 80% of the Company's equity in its Health Care Services segment on July 1, 2021 reduced its revenue from government reimbursement programs. Refer to Note 15 for disaggregation of revenue by reportable segment.

Property, Plant and Equipment a

Property, Plant and Equipment and Leasehold Intangibles, Net	9 Months Ended
	Sep. 30, 2022
Property, Plant and Equipment [Abstract]
Property, Plant and Equipment and Leasehold Intangibles, Net	6. Property, Plant and Equipment and Leasehold Intangibles, Net As of September 30, 2022 and December 31, 2021, net property, plant and equipment and leasehold intangibles, which include assets under financing leases, consisted of the following. (in thousands) September 30, 2022 December 31, 2021 Land $ 508,110 $ 502,610 Buildings and improvements 5,311,077 5,262,136 Furniture and equipment 1,036,181 990,006 Resident and leasehold operating intangibles 301,732 303,737 Construction in progress 51,665 51,037 Assets under financing leases and leasehold improvements 1,655,718 1,609,217 Property, plant and equipment and leasehold intangibles 8,864,483 8,718,743 Accumulated depreciation and amortization (4,062,495) (3,814,451) Property, plant and equipment and leasehold intangibles, net $ 4,801,988 $ 4,904,292 Assets under financing leases and leasehold improvements includes $307.8 million and $332.3 million of financing lease right-of-use assets, net of accumulated amortization, as of September 30, 2022 and December 31, 2021, respectively. Refer to Note 8 for further information on the Company's financing leases.

Debt

Debt	9 Months Ended
	Sep. 30, 2022
Debt Disclosure [Abstract]
Debt	7. Debt Long-term debt consists of the following. (in thousands) September 30, 2022 December 31, 2021 Fixed rate mortgage notes payable due 2023 through 2047; weighted average interest rate of 4.14% as of both September 30, 2022 and December 31, 2021 $ 2,148,850 $ 2,164,115 Variable rate mortgage notes payable due 2023 through 2030; weighted average interest rate of 5.40% and 2.44% as of September 30, 2022 and December 31, 2021, respectively 1,463,868 1,476,943 Convertible notes payable due October 2026; interest rate of 2.00% as of both September 30, 2022 and December 31, 2021 230,000 230,000 Other notes payable due 2022, interest rate of 2.10% as of September 30, 2022 3,083 — Deferred financing costs, net (25,872) (29,846) Total long-term debt 3,819,929 3,841,212 Current portion 61,000 63,125 Total long-term debt, less current portion $ 3,758,929 $ 3,778,087 As of September 30, 2022, 93.9%, or $3.6 billion, of the Company's total debt obligations represented non-recourse property-level mortgage financings. As of September 30, 2022, $72.6 million of letters of credit and no cash borrowings were outstanding under the Company's $80.0 million secured credit facility maturing January 2024. The Company also had a separate secured letter of credit facility providing up to $15.0 million of letters of credit as of September 30, 2022 under which $13.9 million had been issued as of that date. 2022 Financing On October 13, 2022, the Company obtained $220.0 million of debt secured by first priority mortgages on 24 communities. The loan bears interest at a variable rate equal to the one-month Secured Overnight Financing Rate ("SOFR") plus a margin of 245 basis points, and is interest only for the first three years. The debt matures in October 2025 with two one-year renewal options, exercisable subject to certain performance criteria. The debt documents contain a requirement for the Company to maintain liquidity of at least $130.0 million and 25% of the loan amount is subject to a guaranty by the Company. The proceeds from the financing were primarily utilized to repay $199.6 million of outstanding mortgage debt maturing in 2023 (which is included within long-term debt, less current portion on the condensed consolidated balance sheet as of September 30, 2022) and to purchase a SOFR interest rate swap instrument for $6.1 million. The interest rate swap instrument has a $220.0 million notional amount, a fixed interest rate of 3.0%, and a term of eighteen months. 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, and requiring the Company not to exceed prescribed leverage 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 September 30, 2022, the Company is in compliance with the financial covenants of its debt agreements.

Leases

Leases	9 Months Ended
	Sep. 30, 2022
Leases [Abstract]
Leases	8. Leases As of September 30, 2022, the Company operated 295 communities under long-term leases (230 operating leases and 65 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 September 30, 2022, the Company is in compliance with the financial covenants of its long-term leases. 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. The Company recognized $1.9 million and $11.5 million for the three and nine months ended September 30, 2022, respectively, of non-cash impairment charges in its operating results for its operating lease right-of-use assets, primarily due to decreased occupancy and future cash flow estimates at certain communities as a result of the continuing impacts of the COVID-19 pandemic and property damage sustained at certain communities. The Company recognized $10.5 million for the nine months ended September 30, 2021, of non-cash impairment charges in its operating results for its operating lease right-of-use assets, of which none were recognized for the three months ended September 30, 2021, primarily due to decreased occupancy and future cash flow estimates at certain communities as a result of the continuing impacts of the COVID-19 pandemic. 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 Nine Months Ended Operating Leases (in thousands) 2022 2021 2022 2021 Facility operating expense $ 1,621 $ 1,634 $ 4,705 $ 10,996 Facility lease expense 41,317 43,226 124,419 131,508 Operating lease expense 42,938 44,860 129,124 142,504 Operating lease expense adjustment (1) 8,714 6,273 25,329 16,263 Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements (4,367) (11,551) (9,224) (27,057) Operating net cash outflows from operating leases $ 47,285 $ 39,582 $ 145,229 $ 131,710 (1) Represents the difference between the amount of cash operating lease payments and the amount of operating lease expense. Three Months Ended Nine Months Ended Financing Leases (in thousands) 2022 2021 2022 2021 Depreciation and amortization $ 7,405 $ 7,677 $ 22,678 $ 22,901 Interest expense: financing lease obligations 11,916 11,674 35,968 34,549 Financing lease expense $ 19,321 $ 19,351 $ 58,646 $ 57,450 Operating cash outflows from financing leases $ 11,916 $ 11,674 $ 35,968 $ 34,549 Financing cash outflows from financing leases 5,506 5,039 16,606 14,692 Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement (2,727) (4,136) (9,704) (7,583) Total net cash outflows from financing leases $ 14,695 $ 12,577 $ 42,870 $ 41,658 The aggregate amounts of future minimum lease payments, including community, office, and equipment leases recognized on the condensed consolidated balance sheet as of September 30, 2022 are as follows (in thousands). Year Ending December 31, Operating Leases Financing Leases 2022 (three months) $ 51,658 $ 17,168 2023 210,831 69,739 2024 196,311 70,957 2025 194,019 60,340 2026 78,660 61,600 Thereafter 210,253 54,305 Total lease payments 941,732 334,109 Purchase option liability and non-cash gain on future sale of property — 426,656 Imputed interest and variable lease payments (202,874) (214,221) Total lease obligations $ 738,858 $ 546,544 In October 2022, the Company and a lessor entered into an amendment to the Company's existing master lease pursuant to which the Company continues to lease 24 communities. The amendment removed certain asset repurchase clauses and adjusted the extension option provisions. The amendment did not change the amount of required lease payments or the initial term of the lease. The leases for certain communities are accounted for as failed sale-leaseback transactions as of September 30, 2022 and the Company expects the amended leases to result in sale accounting for such communities and a non-cash gain on sale of assets recognized in the three months ended December 31, 2022. In addition, the Company expects the amended leases for such communities to be prospectively classified as operating leases subsequent to December 31, 2022, the effective date of the amendment.
Leases	8. Leases As of September 30, 2022, the Company operated 295 communities under long-term leases (230 operating leases and 65 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 September 30, 2022, the Company is in compliance with the financial covenants of its long-term leases. 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. The Company recognized $1.9 million and $11.5 million for the three and nine months ended September 30, 2022, respectively, of non-cash impairment charges in its operating results for its operating lease right-of-use assets, primarily due to decreased occupancy and future cash flow estimates at certain communities as a result of the continuing impacts of the COVID-19 pandemic and property damage sustained at certain communities. The Company recognized $10.5 million for the nine months ended September 30, 2021, of non-cash impairment charges in its operating results for its operating lease right-of-use assets, of which none were recognized for the three months ended September 30, 2021, primarily due to decreased occupancy and future cash flow estimates at certain communities as a result of the continuing impacts of the COVID-19 pandemic. 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 Nine Months Ended Operating Leases (in thousands) 2022 2021 2022 2021 Facility operating expense $ 1,621 $ 1,634 $ 4,705 $ 10,996 Facility lease expense 41,317 43,226 124,419 131,508 Operating lease expense 42,938 44,860 129,124 142,504 Operating lease expense adjustment (1) 8,714 6,273 25,329 16,263 Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements (4,367) (11,551) (9,224) (27,057) Operating net cash outflows from operating leases $ 47,285 $ 39,582 $ 145,229 $ 131,710 (1) Represents the difference between the amount of cash operating lease payments and the amount of operating lease expense. Three Months Ended Nine Months Ended Financing Leases (in thousands) 2022 2021 2022 2021 Depreciation and amortization $ 7,405 $ 7,677 $ 22,678 $ 22,901 Interest expense: financing lease obligations 11,916 11,674 35,968 34,549 Financing lease expense $ 19,321 $ 19,351 $ 58,646 $ 57,450 Operating cash outflows from financing leases $ 11,916 $ 11,674 $ 35,968 $ 34,549 Financing cash outflows from financing leases 5,506 5,039 16,606 14,692 Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement (2,727) (4,136) (9,704) (7,583) Total net cash outflows from financing leases $ 14,695 $ 12,577 $ 42,870 $ 41,658 The aggregate amounts of future minimum lease payments, including community, office, and equipment leases recognized on the condensed consolidated balance sheet as of September 30, 2022 are as follows (in thousands). Year Ending December 31, Operating Leases Financing Leases 2022 (three months) $ 51,658 $ 17,168 2023 210,831 69,739 2024 196,311 70,957 2025 194,019 60,340 2026 78,660 61,600 Thereafter 210,253 54,305 Total lease payments 941,732 334,109 Purchase option liability and non-cash gain on future sale of property — 426,656 Imputed interest and variable lease payments (202,874) (214,221) Total lease obligations $ 738,858 $ 546,544 In October 2022, the Company and a lessor entered into an amendment to the Company's existing master lease pursuant to which the Company continues to lease 24 communities. The amendment removed certain asset repurchase clauses and adjusted the extension option provisions. The amendment did not change the amount of required lease payments or the initial term of the lease. The leases for certain communities are accounted for as failed sale-leaseback transactions as of September 30, 2022 and the Company expects the amended leases to result in sale accounting for such communities and a non-cash gain on sale of assets recognized in the three months ended December 31, 2022. In addition, the Company expects the amended leases for such communities to be prospectively classified as operating leases subsequent to December 31, 2022, the effective date of the amendment.

Investment in Unconsolidated Ve

Investment in Unconsolidated Ventures	9 Months Ended
	Sep. 30, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Investment in Unconsolidated Ventures	9. Investment in Unconsolidated Ventures As of September 30, 2022, the Company holds a 20% equity interest, and affiliates of HCA Healthcare Inc. ("HCA Healthcare") own an 80% interest, in the HCS Venture, and the Company has determined the HCS Venture is a VIE. The HCS Venture operates home health and hospice agencies in the United States. The Company does not consolidate this VIE because it does not have the ability to control the activities that most significantly impact this VIE's economic performance. The Company's interest in the HCS Venture is accounted for under the equity method of accounting. The carrying amount of the Company's investment in the unconsolidated venture and maximum exposure to loss as a result of the Company's ownership interest in the HCS Venture was $52.3 million, which is included in investment in unconsolidated ventures on the accompanying unaudited condensed consolidated balance sheet as of September 30, 2022. As of September 30, 2022, the Company is not required to provide financial support, through a liquidity arrangement or otherwise, to the HCS Venture.

Litigation

Litigation	9 Months Ended
	Sep. 30, 2022
Litigation [Abstract]
Litigation	10. 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. The senior living and healthcare industries are continuously subject to scrutiny by governmental regulators, which could result in reviews, audits, investigations, enforcement actions, or litigation related to regulatory compliance matters. In addition, the Company is subject to various government reviews, audits, and investigations to verify compliance with Medicare and Medicaid programs and other applicable laws and regulations. The Centers for Medicare & Medicaid Services ("CMS") has engaged third-party firms to review claims data to evaluate appropriateness of billings. In addition to identifying overpayments, audit contractors can refer suspected violations to government authorities. An adverse outcome of government scrutiny may result in citations, sanctions, other criminal or civil fines and penalties, the refund of overpayments, payment suspensions, termination of participation in Medicare and Medicaid programs, and damage to the Company's business reputation. The Company's costs to respond to and defend any such audits, reviews, and investigations may be significant. 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 asserted that the defendants made material misstatements and omissions concerning the Company's business, operational and compliance policies, compliance with applicable regulations and statutes, and staffing practices that caused the Company's stock price to be artificially inflated between August 2016 and April 2020. The district court dismissed the lawsuit and entered judgment in favor of the defendants in September 2021, and the plaintiffs did not file an appeal. Between October 2020 and June 2021, alleged stockholders of the Company filed several stockholder derivative lawsuits in the federal courts for the Middle District of Tennessee and the District of Delaware, which were subsequently transferred to the Middle District of Tennessee. The derivative lawsuits are currently pending and assert 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 incorporate substantively similar allegations to the securities lawsuit described above.

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2022
Share-Based Payment Arrangement [Abstract]
Stock-Based Compensation	11. Stock-Based Compensation Grants of restricted stock units and stock awards under the Company's 2014 Omnibus Incentive Plan were as follows. (in thousands, except weighted average amounts) Restricted Stock Unit and Stock Award Grants Weighted Average Grant Date Fair Value Total Grant Date Fair Value Three months ended March 31, 2022 2,862 $ 5.50 $ 15,743 Three months ended June 30, 2022 26 $ 6.40 $ 166 Three months ended September 30, 2022 7 $ 4.86 $ 33

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 2022
Earnings Per Share [Abstract]
Earnings Per Share	12. Earnings Per Share The following table summarizes the computation of basic and diluted earnings (loss) per share amounts presented in the condensed consolidated statements of operations: Three Months Ended Nine Months Ended (in thousands, except for per share amounts) 2022 2021 2022 2021 Income attributable to common stockholders: Net income (loss) $ (28,359) $ 174,282 $ (212,790) $ (17,588) Weighted average shares outstanding - basic 186,790 185,317 186,493 184,841 Effect of dilutive securities: Warrants — 9,451 — — Restricted stock and restricted stock units — 1,462 — — Weighted average shares outstanding - diluted 186,790 196,230 186,493 184,841 Net income (loss) per share attributable to common stockholders - basic $ (0.15) $ 0.94 $ (1.14) $ (0.10) Net income (loss) per share attributable to common stockholders - diluted $ (0.15) $ 0.89 $ (1.14) $ (0.10) For the purposes of computing diluted earnings per share, weighted average shares outstanding do not include potentially dilutive securities that are anti-dilutive under the treasury stock method or if-converted 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 Company has the following potentially outstanding shares of common stock, which were excluded from the computation of diluted net income (loss) per share attributable to common stockholders in periods in which including them would have been antidilutive. As of September 30, (in millions) 2022 2021 Restricted stock and restricted stock units 5.4 5.2 Warrants 16.3 16.3 Convertible senior notes 38.3 — Total 60.0 21.5 On July 26, 2020, the Company issued to Ventas, Inc. ("Ventas") a warrant (the "Warrant") to purchase 16.3 million shares of the Company’s common stock, $0.01 par value per share, at a price per share of $3.00. The Warrant is exercisable at Ventas' option at any time and from time to time, in whole or in part, until December 31, 2025. The exercise price and the number of shares issuable on exercise of the Warrant are subject to certain anti-dilution adjustments, including for cash dividends, stock dividends, stock splits, reclassifications, non-cash distributions, certain repurchases of common stock, and business combination transactions. As of September 30, 2022, the maximum number of shares issuable upon conversion of convertible senior notes is 38.3 million (after giving effect to additional shares that would be issuable upon conversion in connection with the occurrence of certain corporate or other events).

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2022
Income Tax Disclosure [Abstract]
Income Taxes	13. Income Taxes The difference between the Company's effective tax rate for the three and nine months ended September 30, 2022 and 2021 was primarily due to the HCS Sale in the three months ended September 30, 2021. The Company recorded an aggregate deferred federal, state, and local tax benefit of $7.3 million for the three months ended September 30, 2022, which was partially offset by an increase to the valuation allowance of $6.7 million. The Company recorded an aggregate deferred federal, state, and local tax benefit of $52.8 million for the nine months ended September 30, 2022, which was partially offset by an increase to the valuation allowance of $50.7 million. The Company recorded an aggregate deferred federal, state, and local tax expense of $81.0 million for the three months ended September 30, 2021, which was partially offset by a reduction to the valuation allowance of $71.8 million. The Company recorded an aggregate deferred federal, state, and local tax expense of $35.0 million for the nine months ended September 30, 2021, which was partially offset by a reduction to the valuation allowance of $26.5 million. The deferred income tax expense for the nine months ended September 30, 2021 included $104.3 million as a result of the gain on the HCS Sale, partially offset by a benefit of $69.3 million as a result of operating losses (exclusive of the HCS Sale). 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 September 30, 2022 and December 31, 2021 was $418.7 million and $368.0 million, respectively. The increase in the valuation allowance for the nine months ended September 30, 2022 is the result of current operating losses during the nine months ended September 30, 2022 and by the anticipated reversal of future tax liabilities offset by future tax deductions. The decrease in the valuation allowance for the nine months ended September 30, 2021 is primarily the result of a $95.2 million reduction recorded as a result of the HCS Sale, partially offset by an increase in the valuation allowance of $68.6 million established against current operating losses during the nine months ended September 30, 2021.

Supplemental Disclosure of Cash

Supplemental Disclosure of Cash Flow Information	9 Months Ended
	Sep. 30, 2022
Supplemental Cash Flow Elements [Abstract]
Supplemental Disclosure of Cash Flow Information	14. Supplemental Disclosure of Cash Flow Information During the period from January 1, 2021 through September 30, 2022, the Company disposed of five owned communities and the Company's triple-net lease obligations on six communities were terminated (including through the acquisition of one formerly leased community). During the nine months ended September 30, 2022, the Company completed the sale of two owned communities for cash proceeds of $4.4 million, net of transaction costs, and recognized a net gain on sale of assets of $0.7 million for these sales. During the nine months ended September 30, 2021, the Company completed the sale of two owned communities for cash proceeds of $8.5 million, net of transaction costs, and recognized a net gain on sale of assets of $0.5 million for these sales. On July 1, 2021, the Company completed the sale of 80% of its equity in its Health Care Services segment to affiliates of HCA Healthcare for a purchase price of $400.0 million in cash, subject to certain adjustments set forth in the Securities Purchase Agreement (the "Purchase Agreement") dated February 24, 2021, including a reduction for the remaining outstanding balance as of the closing of Medicare advance payments and deferred payroll tax payments related to the HCS Sale. The Company received net cash proceeds of $312.6 million, including $305.8 million at closing on July 1, 2021 and $6.8 million upon completion of the post-closing net working capital adjustment in October 2021. The Purchase Agreement also contained certain agreed upon indemnities for the benefit of the purchaser. As of July 1, 2021, the Company recognized a $100.0 million asset within investment in unconsolidated ventures on its condensed consolidated balance sheet for the estimated fair value of its retained 20% noncontrolling interest in the HCS Venture. Refer to Note 15 for selected financial data for the Health Care Services segment through June 30, 2021. Nine Months Ended (in thousands) 2022 2021 Supplemental Disclosure of Cash Flow Information: Interest paid $ 142,242 $ 142,268 Income taxes paid, net of refunds $ 581 $ 6,447 Capital expenditures, net of related payables: Capital expenditures - non-development, net $ 128,831 $ 91,438 Capital expenditures - development, net 4,357 2,726 Capital expenditures - non-development - reimbursable 18,927 34,640 Trade accounts payable (1,543) (2,987) Net cash paid $ 150,572 $ 125,817 Proceeds from HCS Sale, net: Accounts receivable, net $ — $ (57,582) Property, plant and equipment and leasehold intangibles, net — (1,806) Operating lease right-of-use assets — (8,145) Investment in unconsolidated ventures — 100,000 Goodwill — (126,810) Prepaid expenses and other assets, net — (26,409) Trade accounts payable — 1,387 Accrued expenses — 25,226 Refundable fees and deferred revenue — 57,314 Operating lease obligations — 8,145 Other liabilities — 11,135 Loss (gain) on sale of assets, net — (288,233) Net cash received $ — $ (305,778) Proceeds from sale of assets, net (excluding HCS Sale): Prepaid expenses and other assets, net $ (1,301) $ — Assets held for sale (3,668) (8,040) Property, plant and equipment and leasehold intangibles, net (100) (568) Other liabilities (164) (22) Loss (gain) on sale of assets, net (611) (1,175) Net cash received $ (5,844) $ (9,805) Supplemental Schedule of Non-cash Operating, Investing, and Financing Activities: Assets designated as held for sale: Assets held for sale $ — $ 3,612 Property, plant and equipment and leasehold intangibles, net — (3,612) Net $ — $ — Non-cash lease transactions, net: Property, plant and equipment and leasehold intangibles, net $ 11,067 $ 3,521 Operating lease right-of-use assets 11,219 17,013 Financing lease obligations (6,307) (3,521) Operating lease obligations (15,979) (17,013) Net $ — $ — Restricted cash consists principally of deposits as security for self-insured retention risk under workers' compensation programs and property insurance programs, escrow deposits for real estate taxes, property insurance, and capital expenditures, and debt service reserve accounts required by certain lenders under mortgage debt agreements. 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) September 30, 2022 December 31, 2021 Reconciliation of cash, cash equivalents, and restricted cash: Cash and cash equivalents $ 299,201 $ 347,031 Restricted cash 37,258 26,845 Long-term restricted cash 58,358 64,438 Total cash, cash equivalents, and restricted cash $ 394,817 $ 438,314

Segment Information

Segment Information	9 Months Ended
	Sep. 30, 2022
Segment Reporting [Abstract]
Segment Information	15. Segment Information As of September 30, 2022, the Company has three reportable segments: Independent Living; Assisted Living and Memory Care; and CCRCs. 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. Prior to July 1, 2021, the Company had an additional reportable segment, Health Care Services. On July 1, 2021, the Company sold 80% of its equity in its Health Care Services segment. For periods beginning July 1, 2021, the results and financial position of its Health Care Services segment were deconsolidated from the Company's consolidated financial statements and its 20% equity interest in the HCS Venture is accounted for under the equity method of accounting as of that date. 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 the Company's 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. All Other. All Other includes communities operated by the Company pursuant to management agreements. Under the management agreements for these communities, the Company receives management fees as well as reimbursement of expenses it incurs on behalf of the owners. Health Care Services . The Company's former Health Care Services segment included 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 did 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. The following tables set forth selected segment financial data. Three Months Ended Nine Months Ended (in thousands) 2022 2021 2022 2021 Revenue and other operating income: Independent Living (1)(2) $ 137,626 $ 119,593 $ 388,769 $ 357,855 Assisted Living and Memory Care (1)(2) 491,818 402,696 1,365,172 1,187,085 CCRCs (1)(2) 87,563 77,895 249,215 228,346 All Other 40,451 41,470 121,638 163,836 Health Care Services (1)(2) — — — 177,269 Total revenue and other operating income $ 757,458 $ 641,654 $ 2,124,794 $ 2,114,391 Segment operating income: (3) Independent Living $ 46,395 $ 36,733 $ 122,788 $ 109,354 Assisted Living and Memory Care 130,039 75,324 294,490 223,819 CCRCs 15,063 7,704 33,940 23,985 All Other 2,967 3,621 9,625 17,185 Health Care Services — — — 5,816 Total segment operating income 194,464 123,382 460,843 380,159 General and administrative expense (including non-cash stock-based compensation expense) 41,331 43,812 128,209 146,155 Facility operating lease expense 41,317 43,226 124,419 131,508 Depreciation and amortization 86,922 84,560 259,229 252,042 Asset impairment 5,688 639 17,362 13,394 Income (loss) from operations $ 19,206 $ (48,855) $ (68,376) $ (162,940) As of (in thousands) September 30, 2022 December 31, 2021 Total assets: Independent Living (4) $ 1,297,172 $ 1,349,341 Assisted Living and Memory Care 3,527,339 3,601,144 CCRCs 674,449 693,386 Corporate and All Other 594,993 766,596 Total assets $ 6,093,953 $ 6,410,467 (1) All revenue and other operating income is earned from external third parties in the United States. (2) Includes other operating income recognized for the credits or grants pursuant to the Provider Relief Fund, employee retention credit, 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. Other operating income by segment is as follows. Three Months Ended Nine Months Ended (in thousands) 2022 2021 2022 2021 Other operating income: Independent Living $ 9,520 $ 9 $ 10,681 $ 1,484 Assisted Living and Memory Care 49,721 75 56,489 5,808 CCRCs 7,518 5 8,376 1,735 Health Care Services — — — 3,105 Total other operating income $ 66,759 $ 89 $ 75,546 $ 12,132 (3) Segment operating income is defined as segment revenues and other operating income less segment facility operating expenses (excluding facility depreciation and amortization) and costs incurred on behalf of managed communities. (4) The Company's Independent Living segment had a carrying amount of goodwill of $27.3 million as of both September 30, 2022 and December 31, 2021.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2022
Accounting Policies [Abstract]
Basis of Presentation	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, 2021 filed with the SEC on February 15, 2022.
Principles of Consolidation	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 unaudited 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. The Company continually evaluates its potential variable interest entity ("VIE") relationships under certain criteria as provided for in Financial Accounting Standards Board Accounting Standards Codification 810, Consolidation
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.
Reclassifications	Reclassifications Certain prior period amounts have been reclassified to conform to the current financial statement presentation, with no effect on the Company's condensed consolidated financial position or results of operations.

Revenue (Tables)

Revenue (Tables)	9 Months Ended
	Sep. 30, 2022
Revenue from Contract with Customer [Abstract]
Disaggregation of Revenue	Resident fee revenue by payor source is as follows. Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Private pay 93.6 % 93.0 % 93.5 % 84.9 % Government reimbursement 5.1 % 5.5 % 5.1 % 11.8 % Other third-party payor programs 1.3 % 1.5 % 1.4 % 3.3 %

Property, Plant and Equipment_2

Property, Plant and Equipment and Leasehold Intangibles, Net (Tables)	9 Months Ended
	Sep. 30, 2022
Property, Plant and Equipment [Abstract]
Property, Plant and Equipment and Leasehold Intangibles, Net	As of September 30, 2022 and December 31, 2021, net property, plant and equipment and leasehold intangibles, which include assets under financing leases, consisted of the following. (in thousands) September 30, 2022 December 31, 2021 Land $ 508,110 $ 502,610 Buildings and improvements 5,311,077 5,262,136 Furniture and equipment 1,036,181 990,006 Resident and leasehold operating intangibles 301,732 303,737 Construction in progress 51,665 51,037 Assets under financing leases and leasehold improvements 1,655,718 1,609,217 Property, plant and equipment and leasehold intangibles 8,864,483 8,718,743 Accumulated depreciation and amortization (4,062,495) (3,814,451) Property, plant and equipment and leasehold intangibles, net $ 4,801,988 $ 4,904,292

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2022
Debt Disclosure [Abstract]
Schedule of Debt	Long-term debt consists of the following. (in thousands) September 30, 2022 December 31, 2021 Fixed rate mortgage notes payable due 2023 through 2047; weighted average interest rate of 4.14% as of both September 30, 2022 and December 31, 2021 $ 2,148,850 $ 2,164,115 Variable rate mortgage notes payable due 2023 through 2030; weighted average interest rate of 5.40% and 2.44% as of September 30, 2022 and December 31, 2021, respectively 1,463,868 1,476,943 Convertible notes payable due October 2026; interest rate of 2.00% as of both September 30, 2022 and December 31, 2021 230,000 230,000 Other notes payable due 2022, interest rate of 2.10% as of September 30, 2022 3,083 — Deferred financing costs, net (25,872) (29,846) Total long-term debt 3,819,929 3,841,212 Current portion 61,000 63,125 Total long-term debt, less current portion $ 3,758,929 $ 3,778,087

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 2022
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 Nine Months Ended Operating Leases (in thousands) 2022 2021 2022 2021 Facility operating expense $ 1,621 $ 1,634 $ 4,705 $ 10,996 Facility lease expense 41,317 43,226 124,419 131,508 Operating lease expense 42,938 44,860 129,124 142,504 Operating lease expense adjustment (1) 8,714 6,273 25,329 16,263 Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements (4,367) (11,551) (9,224) (27,057) Operating net cash outflows from operating leases $ 47,285 $ 39,582 $ 145,229 $ 131,710 (1) Represents the difference between the amount of cash operating lease payments and the amount of operating lease expense. Three Months Ended Nine Months Ended Financing Leases (in thousands) 2022 2021 2022 2021 Depreciation and amortization $ 7,405 $ 7,677 $ 22,678 $ 22,901 Interest expense: financing lease obligations 11,916 11,674 35,968 34,549 Financing lease expense $ 19,321 $ 19,351 $ 58,646 $ 57,450 Operating cash outflows from financing leases $ 11,916 $ 11,674 $ 35,968 $ 34,549 Financing cash outflows from financing leases 5,506 5,039 16,606 14,692 Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement (2,727) (4,136) (9,704) (7,583) Total net cash outflows from financing leases $ 14,695 $ 12,577 $ 42,870 $ 41,658
Finance Lease, Liability, Maturity	The aggregate amounts of future minimum lease payments, including community, office, and equipment leases recognized on the condensed consolidated balance sheet as of September 30, 2022 are as follows (in thousands). Year Ending December 31, Operating Leases Financing Leases 2022 (three months) $ 51,658 $ 17,168 2023 210,831 69,739 2024 196,311 70,957 2025 194,019 60,340 2026 78,660 61,600 Thereafter 210,253 54,305 Total lease payments 941,732 334,109 Purchase option liability and non-cash gain on future sale of property — 426,656 Imputed interest and variable lease payments (202,874) (214,221) Total lease obligations $ 738,858 $ 546,544
Lessee, Operating Lease, Liability, Maturity	The aggregate amounts of future minimum lease payments, including community, office, and equipment leases recognized on the condensed consolidated balance sheet as of September 30, 2022 are as follows (in thousands). Year Ending December 31, Operating Leases Financing Leases 2022 (three months) $ 51,658 $ 17,168 2023 210,831 69,739 2024 196,311 70,957 2025 194,019 60,340 2026 78,660 61,600 Thereafter 210,253 54,305 Total lease payments 941,732 334,109 Purchase option liability and non-cash gain on future sale of property — 426,656 Imputed interest and variable lease payments (202,874) (214,221) Total lease obligations $ 738,858 $ 546,544

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2022
Share-Based Payment Arrangement [Abstract]
Grants of Restricted Stock and Restricted Stock Units	Grants of restricted stock units and stock awards under the Company's 2014 Omnibus Incentive Plan were as follows. (in thousands, except weighted average amounts) Restricted Stock Unit and Stock Award Grants Weighted Average Grant Date Fair Value Total Grant Date Fair Value Three months ended March 31, 2022 2,862 $ 5.50 $ 15,743 Three months ended June 30, 2022 26 $ 6.40 $ 166 Three months ended September 30, 2022 7 $ 4.86 $ 33

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2022
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 statements of operations: Three Months Ended Nine Months Ended (in thousands, except for per share amounts) 2022 2021 2022 2021 Income attributable to common stockholders: Net income (loss) $ (28,359) $ 174,282 $ (212,790) $ (17,588) Weighted average shares outstanding - basic 186,790 185,317 186,493 184,841 Effect of dilutive securities: Warrants — 9,451 — — Restricted stock and restricted stock units — 1,462 — — Weighted average shares outstanding - diluted 186,790 196,230 186,493 184,841 Net income (loss) per share attributable to common stockholders - basic $ (0.15) $ 0.94 $ (1.14) $ (0.10) Net income (loss) per share attributable to common stockholders - diluted $ (0.15) $ 0.89 $ (1.14) $ (0.10)
Schedule of Potentially Dilutive Securities	The Company has the following potentially outstanding shares of common stock, which were excluded from the computation of diluted net income (loss) per share attributable to common stockholders in periods in which including them would have been antidilutive. As of September 30, (in millions) 2022 2021 Restricted stock and restricted stock units 5.4 5.2 Warrants 16.3 16.3 Convertible senior notes 38.3 — Total 60.0 21.5

Supplemental Disclosure of Ca_2

Supplemental Disclosure of Cash Flow Information (Tables)	9 Months Ended
	Sep. 30, 2022
Supplemental Cash Flow Elements [Abstract]
Supplemental Cash Flow Information	Nine Months Ended (in thousands) 2022 2021 Supplemental Disclosure of Cash Flow Information: Interest paid $ 142,242 $ 142,268 Income taxes paid, net of refunds $ 581 $ 6,447 Capital expenditures, net of related payables: Capital expenditures - non-development, net $ 128,831 $ 91,438 Capital expenditures - development, net 4,357 2,726 Capital expenditures - non-development - reimbursable 18,927 34,640 Trade accounts payable (1,543) (2,987) Net cash paid $ 150,572 $ 125,817 Proceeds from HCS Sale, net: Accounts receivable, net $ — $ (57,582) Property, plant and equipment and leasehold intangibles, net — (1,806) Operating lease right-of-use assets — (8,145) Investment in unconsolidated ventures — 100,000 Goodwill — (126,810) Prepaid expenses and other assets, net — (26,409) Trade accounts payable — 1,387 Accrued expenses — 25,226 Refundable fees and deferred revenue — 57,314 Operating lease obligations — 8,145 Other liabilities — 11,135 Loss (gain) on sale of assets, net — (288,233) Net cash received $ — $ (305,778) Proceeds from sale of assets, net (excluding HCS Sale): Prepaid expenses and other assets, net $ (1,301) $ — Assets held for sale (3,668) (8,040) Property, plant and equipment and leasehold intangibles, net (100) (568) Other liabilities (164) (22) Loss (gain) on sale of assets, net (611) (1,175) Net cash received $ (5,844) $ (9,805) Supplemental Schedule of Non-cash Operating, Investing, and Financing Activities: Assets designated as held for sale: Assets held for sale $ — $ 3,612 Property, plant and equipment and leasehold intangibles, net — (3,612) Net $ — $ — Non-cash lease transactions, net: Property, plant and equipment and leasehold intangibles, net $ 11,067 $ 3,521 Operating lease right-of-use assets 11,219 17,013 Financing lease obligations (6,307) (3,521) Operating lease obligations (15,979) (17,013) 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) September 30, 2022 December 31, 2021 Reconciliation of cash, cash equivalents, and restricted cash: Cash and cash equivalents $ 299,201 $ 347,031 Restricted cash 37,258 26,845 Long-term restricted cash 58,358 64,438 Total cash, cash equivalents, and restricted cash $ 394,817 $ 438,314

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 2022
Segment Reporting [Abstract]
Schedule of Segment Reporting Information	The following tables set forth selected segment financial data. Three Months Ended Nine Months Ended (in thousands) 2022 2021 2022 2021 Revenue and other operating income: Independent Living (1)(2) $ 137,626 $ 119,593 $ 388,769 $ 357,855 Assisted Living and Memory Care (1)(2) 491,818 402,696 1,365,172 1,187,085 CCRCs (1)(2) 87,563 77,895 249,215 228,346 All Other 40,451 41,470 121,638 163,836 Health Care Services (1)(2) — — — 177,269 Total revenue and other operating income $ 757,458 $ 641,654 $ 2,124,794 $ 2,114,391 Segment operating income: (3) Independent Living $ 46,395 $ 36,733 $ 122,788 $ 109,354 Assisted Living and Memory Care 130,039 75,324 294,490 223,819 CCRCs 15,063 7,704 33,940 23,985 All Other 2,967 3,621 9,625 17,185 Health Care Services — — — 5,816 Total segment operating income 194,464 123,382 460,843 380,159 General and administrative expense (including non-cash stock-based compensation expense) 41,331 43,812 128,209 146,155 Facility operating lease expense 41,317 43,226 124,419 131,508 Depreciation and amortization 86,922 84,560 259,229 252,042 Asset impairment 5,688 639 17,362 13,394 Income (loss) from operations $ 19,206 $ (48,855) $ (68,376) $ (162,940) As of (in thousands) September 30, 2022 December 31, 2021 Total assets: Independent Living (4) $ 1,297,172 $ 1,349,341 Assisted Living and Memory Care 3,527,339 3,601,144 CCRCs 674,449 693,386 Corporate and All Other 594,993 766,596 Total assets $ 6,093,953 $ 6,410,467 (1) All revenue and other operating income is earned from external third parties in the United States. (2) Includes other operating income recognized for the credits or grants pursuant to the Provider Relief Fund, employee retention credit, 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. Other operating income by segment is as follows. Three Months Ended Nine Months Ended (in thousands) 2022 2021 2022 2021 Other operating income: Independent Living $ 9,520 $ 9 $ 10,681 $ 1,484 Assisted Living and Memory Care 49,721 75 56,489 5,808 CCRCs 7,518 5 8,376 1,735 Health Care Services — — — 3,105 Total other operating income $ 66,759 $ 89 $ 75,546 $ 12,132 (3) Segment operating income is defined as segment revenues and other operating income less segment facility operating expenses (excluding facility depreciation and amortization) and costs incurred on behalf of managed communities. (4) The Company's Independent Living segment had a carrying amount of goodwill of $27.3 million as of both September 30, 2022 and December 31, 2021.

Description of Business (Detail

Description of Business (Details) - community	Jul. 01, 2021	Sep. 30, 2022
Segment Reporting Information [Line Items]
Operating and financing leases, number of communities		295
Current Property Ownership Status
Segment Reporting Information [Line Items]
Number of senior living communities		672
Number of communities owned		346
Operating and financing leases, number of communities		295
Number of communities managed by third party		31
Securities Purchase Agreement | HCA Healthcare, Inc. | Health Care Services
Segment Reporting Information [Line Items]
Sale of stock, percentage of ownership sold in transaction (as a percent)	80%
Sale of stock, percentage of ownership after transaction (as a percent)	20%

COVID-19 Pandemic (Details)

COVID-19 Pandemic (Details) - CARES Act - USD ($) $ in Millions	3 Months Ended	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2022	Sep. 30, 2021
Unusual or Infrequent Item, or Both [Line Items]
Employee retention credit, amount recognized	$ 4.7	$ 9.4	$ 9.9
Employee retention credit, amount received		4.6
Prepaid Expenses and Other Current Assets
Unusual or Infrequent Item, or Both [Line Items]
Employee related liabilities		$ 14.7
Loans Insured or Guaranteed by US Government Authorities
Unusual or Infrequent Item, or Both [Line Items]
Relief received from Provider Relief Fund	$ 61.1

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities	$ 89,504	$ 182,393
Total long-term debt	3,819,929	3,841,212
Long-term debt, fair value	3,300,000
Long-term debt and lines of credit
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total long-term debt	3,800,000	3,800,000
Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities	$ 89,500	$ 182,400

Revenue - Additional Informatio

Revenue - Additional Information (Details) - USD ($) $ in Millions		3 Months Ended		9 Months Ended
	Jul. 01, 2021	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Disaggregation of Revenue [Line Items]
Monthly resident fees		$ 31.9		$ 31.9		$ 27.5
Revenue recognized				$ 53.1	$ 56.2
Securities Purchase Agreement | HCA Healthcare, Inc. | Health Care Services
Disaggregation of Revenue [Line Items]
Sale of stock, percentage of ownership sold in transaction (as a percent)	80%
Private pay | Revenue Benchmark | Customer Concentration Risk
Disaggregation of Revenue [Line Items]
Concentration risk, percentage		93.60%	93%	93.50%	84.90%
Government reimbursement | Revenue Benchmark | Customer Concentration Risk
Disaggregation of Revenue [Line Items]
Concentration risk, percentage		5.10%	5.50%	5.10%	11.80%
Other third-party payor programs | Revenue Benchmark | Customer Concentration Risk
Disaggregation of Revenue [Line Items]
Concentration risk, percentage		1.30%	1.50%	1.40%	3.30%
Deferred Revenue and Credits
Disaggregation of Revenue [Line Items]
Contract with customer, liability		$ 74.9		$ 74.9		$ 67.5

Property, Plant and Equipment_3

Property, Plant and Equipment and Leasehold Intangibles, Net (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	$ 8,864,483		$ 8,864,483		$ 8,718,743
Accumulated depreciation and amortization	(4,062,495)		(4,062,495)		(3,814,451)
Property, plant and equipment and leasehold intangibles, net	4,801,988		4,801,988		4,904,292
Finance lease, right-of-use asset	307,800		307,800		332,300
Depreciation and amortization expense	86,900	$ 84,600	259,200	$ 252,000
Nonrecurring
Property, Plant and Equipment [Line Items]
Non-cash impairment charges	3,800	$ 600	5,900	$ 2,900
Land
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	508,110		508,110		502,610
Buildings and improvements
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	5,311,077		5,311,077		5,262,136
Furniture and equipment
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	1,036,181		1,036,181		990,006
Resident and leasehold operating intangibles
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	301,732		301,732		303,737
Construction in progress
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	51,665		51,665		51,037
Assets under financing leases and leasehold improvements
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	$ 1,655,718		$ 1,655,718		$ 1,609,217

Debt - Schedule of Debt (Detail

Debt - Schedule of Debt (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Long-Term Debt, Capital and Financing Leases and Financing Obligations [Line Items]
Deferred financing costs, net	$ (25,872)	$ (29,846)
Total long-term debt	3,819,929	3,841,212
Current portion	61,000	63,125
Long-term debt, less current portion	3,758,929	3,778,087
Mortgage notes payable
Long-Term Debt, Capital and Financing Leases and Financing Obligations [Line Items]
Total long-term debt	$ 2,148,850	$ 2,164,115
Weighted average interest rate	4.14%	4.14%
Variable Mortgages
Long-Term Debt, Capital and Financing Leases and Financing Obligations [Line Items]
Total long-term debt	$ 1,463,868	$ 1,476,943
Weighted average interest rate	5.40%	2.44%
Convertible Debt
Long-Term Debt, Capital and Financing Leases and Financing Obligations [Line Items]
Total long-term debt	$ 230,000	$ 230,000
Convertible Debt | Convertible senior notes
Long-Term Debt, Capital and Financing Leases and Financing Obligations [Line Items]
Weighted average interest rate	2%	2%
Other notes payable
Long-Term Debt, Capital and Financing Leases and Financing Obligations [Line Items]
Total long-term debt	$ 3,083	$ 0
Weighted average interest rate	2.10%

Debt (Details)

Debt (Details)		9 Months Ended
	Oct. 13, 2022 USD ($) renewal_options community	Sep. 30, 2022 USD ($)
Credit Facilities [Line Items]
Percentage of total debt (as a percent)		93.90%
Interest Rate Swap
Credit Facilities [Line Items]
Derivative purchased amount		$ 6,100,000
Derivative, term		18 months
Notional amount		$ 220,000,000
Derivative fixed interest rate		300%
First Mortgage | Subsequent Event
Credit Facilities [Line Items]
Number of communities securing debt | community	24
Number of renewal options | renewal_options	2
Term of renewal option	1 year
Liquidity maintenance amount	$ 130,000,000
Percentage of debt subject to guaranty	25%
Mortgage Debt Due 2023 | Subsequent Event
Credit Facilities [Line Items]
Outstanding mortgage debt	$ 199,600,000
Mortgages
Credit Facilities [Line Items]
Mortgage debt		$ 3,600,000,000
Mortgages | First Mortgage | Subsequent Event
Credit Facilities [Line Items]
Debt face amount	$ 220,000,000
Term of SOFR rate	1 month
Term of interest	3 years
Mortgages | First Mortgage | SOFR | Subsequent Event
Credit Facilities [Line Items]
Applicable margin (as a percent)	2.45%
Line of Credit | Fifth Amended and Restated Credit Agreement | Letter of Credit Sublimit
Credit Facilities [Line Items]
Letters of credit issued		72,600,000
Line of Credit | Fifth Amended and Restated Credit Agreement | Letter of Credit
Credit Facilities [Line Items]
Letters of credit issued		13,900,000
Credit facility, maximum borrowing capacity		15,000,000
Line of Credit | Credit Agreement With Capital One, National Association | Revolving Credit Facility
Credit Facilities [Line Items]
Credit facility, maximum borrowing capacity		$ 80,000,000

Leases (Details)

Leases (Details) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022 USD ($) community lease	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($) community lease	Sep. 30, 2021 USD ($)	Oct. 31, 2022 community
Lessee, Lease, Description [Line Items]
Operating and financing leases, number of communities | community	295		295
Operating lease, number of communities | lease	230		230
Financing leases, number of communities | lease	65		65
Subsequent Event
Lessee, Lease, Description [Line Items]
Operating and financing leases, number of communities | community					24
CARES Act
Lessee, Lease, Description [Line Items]
Operating lease right-of-use assets | $	$ 1.9	$ 0	$ 11.5	$ 10.5
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		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Leases [Abstract]
Facility operating expense	$ 1,621	$ 1,634	$ 4,705	$ 10,996
Facility lease expense	41,317	43,226	124,419	131,508
Operating lease expense	42,938	44,860	129,124	142,504
Operating lease expense adjustment	8,714	6,273	25,329	16,263
Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements	(4,367)	(11,551)	(9,224)	(27,057)
Operating net cash outflows from operating leases	47,285	39,582	145,229	131,710
Depreciation and amortization	7,405	7,677	22,678	22,901
Interest expense: financing lease obligations	11,916	11,674	35,968	34,549
Financing lease expense	19,321	19,351	58,646	57,450
Operating cash outflows from financing leases	11,916	11,674	35,968	34,549
Financing cash outflows from financing leases	5,506	5,039	16,606	14,692
Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement	(2,727)	(4,136)	(9,704)	(7,583)
Total net cash outflows from financing leases	$ 14,695	$ 12,577	$ 42,870	$ 41,658

Leases - Maturity ASC 842 (Deta

Leases - Maturity ASC 842 (Details) $ in Thousands	Sep. 30, 2022 USD ($)
Operating Leases
2022 (three months)	$ 51,658
2023	210,831
2024	196,311
2025	194,019
2026	78,660
Thereafter	210,253
Total lease payments	941,732
Purchase option liability and non-cash gain on future sale of property	0
Imputed interest and variable lease payments	(202,874)
Total lease obligations	738,858
Financing Leases
2022 (three months)	17,168
2023	69,739
2024	70,957
2025	60,340
2026	61,600
Thereafter	54,305
Total lease payments	334,109
Purchase option liability and non-cash gain on future sale of property	426,656
Imputed interest and variable lease payments	(214,221)
Total lease obligations	$ 546,544

Investment in Unconsolidated _2

Investment in Unconsolidated Ventures (Details) - Healthcare Services Venture - Variable Interest Entity, Not Primary Beneficiary $ in Millions	9 Months Ended
	Sep. 30, 2022 USD ($)
Investments in and Advances to Affiliates [Line Items]
Ownership percentage (as a percent)	20%
Maximum exposure to loss	$ 52.3
HCA Healthcare, Inc.
Investments in and Advances to Affiliates [Line Items]
Ownership percentage (as a percent)	80%

Stock-Based Compensation (Detai

Stock-Based Compensation (Details) - Unvested Restricted Stock - Omnibus Incentive Plan 2014 - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted Stock Unit and Stock Award Grants (in shares)	7	26	2,862
Weighted Average Grant Date Fair Value (in dollars per share)	$ 4.86	$ 6.40	$ 5.50
Total Grant Date Fair Value	$ 33	$ 166	$ 15,743

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		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Net income (loss)	$ (28,359)	$ 174,282	$ (212,790)	$ (17,588)
Weighted average common shares outstanding:
Weighted average shares outstanding - basic (in shares)	186,790	185,317	186,493	184,841
Weighted average shares outstanding - diluted (in shares)	186,790	196,230	186,493	184,841
Earnings Per Share, Basic and Diluted EPS [Abstract]
Net income (loss) per share attributable to common stockholders (in dollars per share)	$ (0.15)	$ 0.94	$ (1.14)	$ (0.10)
Net income (loss) per share attributable to common stockholders (in dollars per share)	$ (0.15)	$ 0.89	$ (1.14)	$ (0.10)
Warrants
Weighted average common shares outstanding:
Effect of dilutive securities (in shares)	0	9,451	0	0
Restricted stock and restricted stock units
Weighted average common shares outstanding:
Effect of dilutive securities (in shares)	0	1,462	0	0

Earnings Per Share - Schedule_2

Earnings Per Share - Schedule of Potentially Dilutive Securities (Details) - shares shares in Millions	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities (in shares)	60	21.5
Restricted stock and restricted stock units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities (in shares)	5.4	5.2
Warrants
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities (in shares)	16.3	16.3
Convertible senior notes
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities (in shares)	38.3	0

Earnings Per Share - Narrative

Earnings Per Share - Narrative (Details) - $ / shares shares in Millions	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021	Jul. 26, 2020
Class of Stock [Line Items]
Common stock, par value (in dollars per share)	$ 0.01		$ 0.01
Antidilutive securities (in shares)	60	21.5
Convertible senior notes
Class of Stock [Line Items]
Antidilutive securities (in shares)	38.3	0
Ventas, Inc | The Warrant
Class of Stock [Line Items]
Number of shares authorized to be purchased				16.3
Common stock, par value (in dollars per share)				$ 0.01
Share price (in dollars per share)				$ 3

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Valuation Allowance [Line Items]
Gross deferred federal, state and local tax expense (benefit)	$ 7.3	$ 81	$ 52.8	$ 35
Increase (decrease) in valuation allowance	6.7	$ 71.8	50.7	26.5
Deferred federal, state and local tax benefit				69.3
Valuation allowance	$ 418.7		$ 418.7		$ 368
Current Operating Loss
Valuation Allowance [Line Items]
Increase (decrease) in valuation allowance				68.6
HCA Healthcare, Inc. | Health Care Services | Securities Purchase Agreement
Valuation Allowance [Line Items]
Gross deferred federal, state and local tax expense (benefit)				104.3
Increase (decrease) in valuation allowance				$ 95.2

Supplemental Disclosure of Ca_3

Supplemental Disclosure of Cash Flow Information - Narrative (Details) $ in Thousands		1 Months Ended	3 Months Ended		9 Months Ended		21 Months Ended
	Jul. 01, 2021 USD ($)	Oct. 31, 2021 USD ($)	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($) community	Sep. 30, 2021 USD ($) community	Sep. 30, 2022 USD ($) community	Dec. 31, 2021 USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of communities acquired | community							1
Gain (loss) on sale of assets, net			$ (56)	$ 288,375	$ 611	$ 289,408
Investment in unconsolidated ventures			$ 57,701		$ 57,701		$ 57,701	$ 67,424
Securities Purchase Agreement | HCA Healthcare, Inc. | Health Care Services
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Net cash proceeds	$ 305,800
Sale of stock, percentage of ownership sold in transaction (as a percent)	80%
Purchase price	$ 400,000
Net cash proceeds	312,600
Proceeds from post closing working capital adjustment		$ 6,800
Investment in unconsolidated ventures	$ 100,000
Sale of stock, percentage of ownership after transaction (as a percent)	20%
Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of communities disposed of | community					2	2	5
Net cash proceeds					$ 4,400	$ 8,500
Gain (loss) on sale of assets, net					$ 700	$ 500
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							6

Supplemental Disclosure of Ca_4

Supplemental Disclosure of Cash Flow Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Supplemental Disclosure of Cash Flow Information:
Interest paid			$ 142,242	$ 142,268
Income taxes paid, net of refunds			581	6,447
Net cash paid			150,572	125,817
Accounts receivable, net			411	584
Investment in unconsolidated ventures			192	5,359
Prepaid expenses and other assets, net			(11,807)	(7,487)
Refundable fees and deferred revenue			7,265	(10,492)
Loss (gain) on sale of assets, net	$ 56	$ (288,375)	(611)	(289,408)
Capital expenditures, net of related payables
Supplemental Disclosure of Cash Flow Information:
Net cash paid			150,572	125,817
Trade accounts payable			(1,543)	(2,987)
Proceeds from HCS Sale, net
Supplemental Disclosure of Cash Flow Information:
Trade accounts payable			0	(1,387)
Accounts receivable, net			0	(57,582)
Property, plant and equipment and leasehold intangibles, net			0	(1,806)
Operating lease right-of-use assets			0	(8,145)
Investment in unconsolidated ventures			0	100,000
Goodwill			0	(126,810)
Prepaid expenses and other assets, net			0	(26,409)
Accrued expenses			0	25,226
Refundable fees and deferred revenue			0	57,314
Operating lease obligations			0	8,145
Other liabilities			0	11,135
Loss (gain) on sale of assets, net			0	(288,233)
Net cash received			0	(305,778)
Proceeds from sale of other assets, net
Supplemental Disclosure of Cash Flow Information:
Property, plant and equipment and leasehold intangibles, net			(100)	(568)
Prepaid expenses and other assets, net			(1,301)	0
Loss (gain) on sale of assets, net			(611)	(1,175)
Assets held for sale			(3,668)	(8,040)
Other liabilities			(164)	(22)
Net cash received			(5,844)	(9,805)
Assets designated as held for sale
Supplemental Disclosure of Cash Flow Information:
Property, plant and equipment and leasehold intangibles, net			0	3,612
Assets held for sale			0	(3,612)
Net			0	0
Other non-cash lease transactions, net
Supplemental Disclosure of Cash Flow Information:
Property, plant and equipment and leasehold intangibles, net			(11,067)	(3,521)
Operating lease right-of-use assets			11,219	17,013
Operating lease obligations			(15,979)	(17,013)
Financing lease obligations			(6,307)	(3,521)
Net			0	0
Non-development | Capital expenditures, net of related payables
Supplemental Disclosure of Cash Flow Information:
Net cash paid			128,831	91,438
Development | Capital expenditures, net of related payables
Supplemental Disclosure of Cash Flow Information:
Net cash paid			4,357	2,726
Non-development - reimbursable | Capital expenditures, net of related payables
Supplemental Disclosure of Cash Flow Information:
Net cash paid			$ 18,927	$ 34,640

Supplemental Disclosure of Ca_5

Supplemental Disclosure of Cash Flow Information - Schedule of cash, cash equivalents, and restricted cash (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021	Sep. 30, 2021	Dec. 31, 2020
Supplemental Cash Flow Elements [Abstract]
Cash and cash equivalents	$ 299,201	$ 347,031
Restricted cash	37,258	26,845
Long-term restricted cash	58,358	64,438
Total cash, cash equivalents, and restricted cash	$ 394,817	$ 438,314	$ 577,899	$ 465,148

Segment Information (Details)

Segment Information (Details) $ in Thousands		3 Months Ended		9 Months Ended
	Jul. 01, 2021	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($) segment	Sep. 30, 2021 USD ($)	Dec. 31, 2021 USD ($)
Segment Reporting Information [Line Items]
Number of reportable segments | segment				3
Revenue		$ 757,458	$ 641,654	$ 2,124,794	$ 2,114,391
Segment operating income		194,464	123,382	460,843	380,159
General and administrative expense (including non-cash stock-based compensation expense)		41,331	43,812	128,209	146,155
Facility lease expense		41,317	43,226	124,419	131,508
Depreciation and amortization		86,922	84,560	259,229	252,042
Asset impairment		5,688	639	17,362	13,394
Income (loss) from operations		19,206	(48,855)	(68,376)	(162,940)
Total assets		6,093,953		6,093,953		$ 6,410,467
Goodwill		27,321		27,321		27,321
Other operating income
Segment Reporting Information [Line Items]
Revenue		66,759	89	75,546	12,132
Independent Living
Segment Reporting Information [Line Items]
Goodwill		27,300		27,300		27,300
Independent Living | Other operating income
Segment Reporting Information [Line Items]
Revenue		9,520	9	10,681	1,484
Assisted Living and Memory Care | Other operating income
Segment Reporting Information [Line Items]
Revenue		49,721	75	56,489	5,808
CCRCs | Other operating income
Segment Reporting Information [Line Items]
Revenue		7,518	5	8,376	1,735
Health Care Services | HCA Healthcare, Inc. | Securities Purchase Agreement
Segment Reporting Information [Line Items]
Sale of stock, percentage of ownership sold in transaction (as a percent)	80%
Sale of stock, percentage of ownership after transaction (as a percent)	20%
Health Care Services | Other operating income
Segment Reporting Information [Line Items]
Revenue		0	0	0	3,105
Operating Segments | Independent Living
Segment Reporting Information [Line Items]
Revenue		137,626	119,593	388,769	357,855
Segment operating income		46,395	36,733	122,788	109,354
Total assets		1,297,172		1,297,172		1,349,341
Operating Segments | Assisted Living and Memory Care
Segment Reporting Information [Line Items]
Revenue		491,818	402,696	1,365,172	1,187,085
Segment operating income		130,039	75,324	294,490	223,819
Total assets		3,527,339		3,527,339		3,601,144
Operating Segments | CCRCs
Segment Reporting Information [Line Items]
Revenue		87,563	77,895	249,215	228,346
Segment operating income		15,063	7,704	33,940	23,985
Total assets		674,449		674,449		693,386
Operating Segments | Corporate and All Other
Segment Reporting Information [Line Items]
Revenue		40,451	41,470	121,638	163,836
Segment operating income		2,967	3,621	9,625	17,185
Total assets		594,993		594,993		$ 766,596
Operating Segments | Health Care Services
Segment Reporting Information [Line Items]
Revenue		0	0	0	177,269
Segment operating income		$ 0	$ 0	$ 0	$ 5,816