Ventas (VTR) 10-K 18 Feb 22 2021 FY Annual report Financial data

Cover

Cover - USD ($) $ in Billions	12 Months Ended
	Dec. 31, 2021	Feb. 15, 2022	Jun. 30, 2021
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Current Fiscal Year End Date	--12-31
Document Period End Date	Dec. 31, 2021
Document Transition Report	false
Entity File Number	1-10989
Entity Registrant Name	Ventas, Inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	61-1055020
Entity Address, Address Line One	353 N. Clark Street
Entity Address, Address Line Two	Suite 3300
Entity Address, City or Town	Chicago
Entity Address, State or Province	IL
Entity Address, Postal Zip Code	60654
City Area Code	877
Local Phone Number	483-6827
Trading Symbol	VTR
Title of 12(b) Security	Common Stock, $0.25 par value
Security Exchange Name	NYSE
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
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
ICFR Auditor Attestation Flag	true
Entity Shell Company	false
Entity Public Float			$ 18
Entity Common Stock, Shares Outstanding (in shares)		399,496,132
Documents Incorporated by Reference	Portions of the registrant’s definitive Proxy Statement for the 2022 Annual Meeting of Stockholders are incorporated by reference into Part III, Items 10 through 14 of this Annual Report on Form 10-K to the extent stated herein. Such proxy statement will be filed with the Securities and Exchange commission within 120 days of the registrant’s fiscal year ended December 31, 2021.
Entity Central Index Key	0000740260
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	FY
Amendment Flag	false

Audit Information

Audit Information	12 Months Ended
	Dec. 31, 2021
Auditor Information [Abstract]
Auditor Firm ID	185
Auditor Name	KPMG LLP
Auditor Location	Chicago, Illinois

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2021
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	NOTE 14 – COMMITMENTS AND CONTINGENCIES From time to time, we are party to various lawsuits, investigations, claims and other legal and regulatory proceedings arising in connection with our business. In certain circumstances, regardless of whether we are a named party in a lawsuit, investigation, claim or other legal or regulatory proceeding, we may be contractually obligated to indemnify, defend and hold harmless our tenants, operators, managers or other third parties against, or may otherwise be responsible for, such actions, proceedings or claims. These claims may include, among other things, professional liability and general liability claims, commercial liability claims, unfair business practices claims and employment claims, as well as regulatory proceedings, including proceedings related to our senior living operations, where we are typically the holder of the applicable healthcare license. These claims may not be fully insured and some may allege large damage amounts. It is the opinion of management, that the disposition of any such lawsuits, investigations, claims and other legal and regulatory proceedings that are currently pending will not, individually or in the aggregate, have a material adverse effect on us. However, regardless of the merits of a particular action, investigation or claim, we may be forced to expend significant financial resources to defend and resolve these matters. We are unable to predict the ultimate outcome of these lawsuits, investigations, claims and other legal and regulatory proceedings, and if management’s assessment of our liability with respect thereto is incorrect, such actions, investigations and claims could have a material adverse effect on us. Operating Leases We lease land, equipment and corporate office space. At inception, we establish an operating lease asset and operating lease liability represented as the present value of future minimum lease payments. As our leases do not provide an implicit rate, we use a discount rate that approximates our incremental borrowing rate available at lease commencement to determine the present value of lease payments. The incremental borrowing rates were adjusted for the length of the individual lease term. The weighted average discount rate and remaining lease term of our leases are 7.22% and 35.2 years, respectively. Operating lease assets and liabilities are not recognized for leases with an initial term of 12 months or less, as these short-term leases are accounted for similar to previous guidance. Our lease expense primarily consists of ground and corporate office leases. Ground lease expense is included in interest expense and corporate office lease expense is included in general, administrative and professional fees in our Consolidated Statements of Income. For the years ended December 31, 2021, 2020 and 2019, we recognized $31.9 million, $32.1 million and $32.6 million of expense relating to our leases. For the years ended December 31, 2021, 2020 and 2019, cash paid for leases was $25.1 million, $25.4 million and $25.8 million, respectively as reported within operating cash outflows in our Consolidated Statements of Cash Flows. The following table summarizes future minimum lease obligations under non-cancelable ground and other operating leases as of December 31, 2021 (dollars in thousands): 2022 $ 21,328 2023 21,468 2024 20,346 2025 15,918 2026 15,836 Thereafter 585,762 Total undiscounted minimum lease payments 680,658 Less: imputed interest (483,424) Operating lease liabilities $ 197,234

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Real estate investments:
Land and improvements	$ 2,432,065	$ 2,261,415
Buildings and improvements	25,778,490	24,323,279
Construction in progress	269,315	265,748
Acquired lease intangibles	1,369,747	1,230,886
Operating lease assets	317,858	346,372
Gross real estate investment	30,167,475	28,427,700
Accumulated depreciation and amortization	(8,350,637)	(7,877,665)
Net real estate property	21,816,838	20,550,035
Secured loans receivable and investments, net	530,126	605,567
Investments in unconsolidated real estate entities	523,465	443,688
Net real estate investments	22,870,429	21,599,290
Cash and cash equivalents	149,725	413,327
Escrow deposits and restricted cash	46,872	38,313
Goodwill	1,046,140	1,051,650
Assets held for sale	28,399	9,608
Deferred income tax assets, net	11,152	9,987
Other assets	565,069	807,229
Total assets	24,717,786	23,929,404
Liabilities:
Senior notes payable and other debt	12,027,544	11,895,412
Accrued interest	106,602	111,444
Operating lease liabilities	197,234	209,917
Accounts payable and other liabilities	1,090,254	1,133,066
Liabilities related to assets held for sale	10,850	3,246
Deferred income tax liabilities	59,259	62,638
Total liabilities	13,491,743	13,415,723
Redeemable OP unitholder and noncontrolling interests	280,283	235,490
Commitments and contingencies
Ventas stockholders’ equity:
Preferred stock, $1.00 par value; 10,000 shares authorized, unissued	0	0
Common stock, $0.25 par value; 600,000 shares authorized, 399,420 and 374,609 shares issued at December 31, 2021 and 2020, respectively	99,838	93,635
Capital in excess of par value	15,498,956	14,171,262
Accumulated other comprehensive loss	(64,520)	(54,354)
Retained earnings (deficit)	(4,679,889)	(4,030,376)
Treasury stock, 0 shares at both December 31, 2021 and 2020	0	0
Total Ventas stockholders’ equity	10,854,385	10,180,167
Noncontrolling interests	91,375	98,024
Total equity	10,945,760	10,278,191
Total liabilities and equity	$ 24,717,786	$ 23,929,404

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Dec. 31, 2021	Dec. 31, 2020
Statement of Financial Position [Abstract]
Preferred stock, par value (in dollars per share)	$ 1	$ 1
Preferred stock, shares authorized (in shares)	10,000,000	10,000,000
Preferred stock, shares issued (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.25	$ 0.25
Common stock, shares authorized (in shares)	600,000,000	600,000,000
Common stock, shares issued (in shares)	399,420,000	374,609,000
Treasury stock, shares (in shares)	0	0

CONSOLIDATED STATEMENTS OF INCO

CONSOLIDATED STATEMENTS OF INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Rental income:
Total rental income	$ 1,448,120	$ 1,494,892	$ 1,609,876
Income from loans and investments	74,981	80,505	89,201
Interest and other income	14,809	7,609	10,984
Total revenues	3,828,007	3,795,357	3,872,750
Expenses
Interest	440,089	469,541	451,662
Depreciation and amortization	1,197,403	1,109,763	1,045,620
Property-level operating expenses:
Property-level operating expenses	2,084,064	1,937,443	1,808,208
Office building and other services costs	4,433	2,315	2,319
General, administrative and professional fees	129,758	130,158	158,726
Loss on extinguishment of debt, net	59,299	10,791	41,900
Transaction expenses and deal costs	47,318	29,812	15,235
Allowance on loans receivable and investments	(9,082)	24,238	0
Other	37,110	707	(10,339)
Total expenses	3,990,392	3,714,768	3,513,331
(Loss) income before unconsolidated entities, real estate dispositions, income taxes and noncontrolling interests	(162,385)	80,589	359,419
Income (loss) from unconsolidated entities	4,983	1,844	(2,454)
Gain on real estate dispositions	218,788	262,218	26,022
Income tax (expense) benefit	(4,827)	96,534	56,310
Income from continuing operations	56,559	441,185	439,297
Net income	56,559	441,185	439,297
Net income attributable to noncontrolling interests	7,551	2,036	6,281
Net income attributable to common stockholders	$ 49,008	$ 439,149	$ 433,016
Basic:
Income from continuing operations (USD per share)	$ 0.15	$ 1.18	$ 1.20
Net income attributable to common stockholders (USD per share)	0.13	1.18	1.18
Diluted:
Income from continuing operations (USD per share)	0.15	1.17	1.19
Net income attributable to common stockholders (USD per share)	$ 0.13	$ 1.17	$ 1.17
Retained Earnings (Deficit)
Property-level operating expenses:
Net income	$ 49,008	$ 439,149	$ 433,016
Net income attributable to common stockholders	49,008
Triple-net leased properties
Rental income:
Total rental income	653,823	695,265	780,898
Property-level operating expenses:
Property-level operating expenses	15,335	22,160	26,561
Office operations
Rental income:
Total rental income	794,297	799,627	828,978
Property-level operating expenses:
Property-level operating expenses	257,001	256,612	260,249
Resident fees and services
Rental income:
Revenue from contracts with customers	2,270,001	2,197,160	2,151,533
Office building and other services revenue
Rental income:
Revenue from contracts with customers	20,096	15,191	11,156
Senior living operations
Property-level operating expenses:
Property-level operating expenses	$ 1,811,728	$ 1,658,671	$ 1,521,398

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Statement of Comprehensive Income [Abstract]
Net income	$ 56,559	$ 441,185	$ 439,297
Other comprehensive loss:
Foreign currency translation	(3,357)	3,254	5,729
Unrealized (loss) gain on available for sale securities	(23,875)	(3,549)	11,634
Derivative instruments	19,934	(17,918)	(30,814)
Total other comprehensive loss	(7,298)	(18,213)	(13,451)
Comprehensive income	49,261	422,972	425,846
Comprehensive income attributable to noncontrolling interests	10,418	3,613	7,649
Comprehensive income attributable to common stockholders	$ 38,843	$ 419,359	$ 418,197

CONSOLIDATED STATEMENTS OF EQUI

CONSOLIDATED STATEMENTS OF EQUITY - USD ($) $ in Thousands	Total	Cumulative Effect, Period of Adoption, Adjustment	Total Ventas Stockholders’ Equity	Total Ventas Stockholders’ EquityCumulative Effect, Period of Adoption, Adjustment	Common Stock Par Value	Capital in Excess of Par Value	Accumulated Other Comprehensive Loss	Accumulated Other Comprehensive LossCumulative Effect, Period of Adoption, Adjustment	Retained Earnings (Deficit)	Retained Earnings (Deficit)Cumulative Effect, Period of Adoption, Adjustment	Treasury Stock	Non- controlling Interests
Balance at beginning of period at Dec. 31, 2018	$ 10,271,594	$ 638	$ 10,215,857	$ 638	$ 89,125	$ 13,076,528	$ (19,582)	$ (163)	$ (2,930,214)	$ 801	$ 0	$ 55,737
Increase (decrease) in shareholders' equity
Net income	439,297		433,016						433,016			6,281
Other comprehensive (loss) income	(13,451)		(14,819)				(14,819)					1,368
Net change in noncontrolling interests	23,842		(12,332)			(12,332)						36,174
Dividends to common stockholders—$1.80 per share	(1,172,653)		(1,172,653)						(1,172,653)
Issuance of common stock	942,338		942,338		3,829	938,509
Issuance of common stock for stock plans, restricted stock grants and other	61,973		61,973		230	61,875					(132)
Adjust redeemable OP unitholder interests to current fair value	(7,388)		(7,388)			(7,388)
Redemption of OP Units	(738)		(738)		1	(739)
Balance at end of period at Dec. 31, 2019	10,545,452		10,445,892		93,185	14,056,453	(34,564)		(3,669,050)		(132)	99,560
Increase (decrease) in shareholders' equity
Net income	441,185		439,149						439,149			2,036
Other comprehensive (loss) income	(18,213)		(19,790)				(19,790)					1,577
Net change in noncontrolling interests	3,078		8,227			8,227						(5,149)
Dividends to common stockholders—$1.80 per share	(800,475)		(800,475)						(800,475)
Issuance of common stock	66,011		66,011		371	65,640
Issuance of common stock for stock plans, restricted stock grants and other	22,779		22,779		79	22,568					132
Adjust redeemable OP unitholder interests to current fair value	18,638		18,638			18,638
Redemption of OP Units	(264)		(264)			(264)
Balance at end of period at Dec. 31, 2020	10,278,191		10,180,167		93,635	14,171,262	(54,354)		(4,030,376)			98,024
Increase (decrease) in shareholders' equity
Net income	56,559		49,008						49,008			7,551
Other comprehensive (loss) income	(7,298)		(10,166)				(10,166)					2,868
Acquisition-related activity	751,248		751,248		3,332	747,916
Net change in noncontrolling interests	(75,993)		(58,925)			(58,925)						(17,068)
Dividends to common stockholders—$1.80 per share	(698,521)		(698,521)						(698,521)
Issuance of common stock	0		0		0	0
Issuance of common stock for stock plans, restricted stock grants and other	652,736		652,736		2,871	649,941					(76)
Adjust redeemable OP unitholder interests to current fair value	(11,178)		(11,178)			(11,178)
Redemption of OP Units	16		16			(60)					76
Balance at end of period at Dec. 31, 2021	$ 10,945,760		$ 10,854,385		$ 99,838	$ 15,498,956	$ (64,520)		$ (4,679,889)		$ 0	$ 91,375

CONSOLIDATED STATEMENTS OF EQ_2

CONSOLIDATED STATEMENTS OF EQUITY (Parenthetical) - $ / shares	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Statement of Stockholders' Equity [Abstract]
Dividends to common stockholders, per share (in dollars per share)	$ 1.80000	$ 2.1425	$ 3.170

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Cash flows from operating activities:
Net income	$ 56,559	$ 441,185	$ 439,297
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	1,197,403	1,109,763	1,045,620
Amortization of deferred revenue and lease intangibles, net	(88,795)	(40,856)	(7,967)
Other non-cash amortization	17,709	20,719	22,985
Allowance on loans receivable and investments	(9,082)	24,238	0
Stock-based compensation	31,966	21,487	33,923
Straight-lining of rental income	(14,468)	103,082	(30,073)
Loss on extinguishment of debt, net	59,299	10,791	41,900
Gain on real estate dispositions	(218,788)	(262,218)	(26,022)
Gain on real estate loan investments	(1,448)	(167)	0
Income tax benefit	(1,224)	(101,985)	(58,918)
(Income) loss from unconsolidated entities	(4,973)	(1,832)	2,464
Distributions from unconsolidated entities	19,326	4,920	1,600
Other	26,404	(779)	13,264
Changes in operating assets and liabilities:
Increase in other assets	(54,571)	(68,233)	(76,693)
(Decrease) increase in accrued interest	(5,922)	276	9,737
Increase in accounts payable and other liabilities	16,721	189,785	26,666
Net cash provided by operating activities	1,026,116	1,450,176	1,437,783
Cash flows from investing activities:
Net investment in real estate property	(1,369,052)	(78,648)	(958,125)
Investment in loans receivable	(489)	(115,163)	(1,258,187)
Proceeds from real estate disposals	840,438	1,044,357	147,855
Proceeds from loans receivable	348,091	119,011	1,017,309
Development project expenditures	(247,694)	(380,413)	(403,923)
Capital expenditures	(185,275)	(148,234)	(156,724)
Distributions from unconsolidated entities	17,847	0	172
Investment in unconsolidated entities	(129,291)	(286,822)	(3,855)
Insurance proceeds for property damage claims	1,285	207	30,179
Net cash (used in) provided by investing activities	(724,140)	154,295	(1,585,299)
Cash flows from financing activities:
Net change in borrowings under revolving credit facilities	(125,399)	(88,868)	(569,891)
Net change in borrowings under commercial paper program	279,929	(565,524)	565,524
Proceeds from debt	1,534,298	733,298	3,013,191
Repayments of debt	(2,109,617)	(479,539)	(2,623,916)
Purchase of noncontrolling interests	(24,224)	(8,239)	0
Payment of deferred financing costs	(27,166)	(8,379)	(21,403)
Issuance of common stock, net	617,438	55,362	942,085
Cash distribution to common stockholders	(686,888)	(928,809)	(1,157,720)
Cash distribution to redeemable OP unitholders	(6,761)	(7,283)	(9,218)
Cash issued for redemption of OP Units	(96)	(575)	(2,203)
Contributions from noncontrolling interests	1,731	1,314	6,282
Distributions to noncontrolling interests	(13,577)	(12,946)	(9,717)
Proceeds from stock option exercises	8,169	15,103	36,179
Other	(6,303)	(4,936)	(8,519)
Net cash (used in) provided by financing activities	(558,466)	(1,300,021)	160,674
Net (decrease) increase in cash, cash equivalents and restricted cash	(256,490)	304,450	13,158
Effect of foreign currency translation	1,447	1,088	1,480
Cash, cash equivalents and restricted cash at beginning of year	451,640	146,102	131,464
Cash, cash equivalents and restricted cash at end of year	196,597	451,640	146,102
Supplemental disclosure of cash flow information:
Interest paid including payments and receipts for derivative instruments	402,025	429,636	410,854
Assets acquired and liabilities assumed from acquisitions and other:
Real estate investments	1,319,988	170,484	1,057,138
Other assets	16,913	1,224	11,140
Debt	482,482	55,368	907,746
Other liabilities	102,256	2,707	47,121
Deferred income tax liability	446	337	95
Noncontrolling interests	468	20,259	113,316
Equity issued	751,248	0	0
Equity issued for redemption of OP Units	$ 76	$ 0	$ 127

Description of Business

Description of Business	12 Months Ended
	Dec. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Description of Business	NOTE 1 – DESCRIPTION OF BUSINESS Ventas, Inc., an S&P 500 company, is a real estate investment trust (“REIT”) operating at the intersection of healthcare and real estate. We hold a highly diversified portfolio of senior housing communities, medical office buildings (“MOBs”), life science, research and innovation centers, hospitals and other healthcare facilities, which we generally refer to as “healthcare real estate”, located throughout the United States, Canada, and the United Kingdom. As of December 31, 2021, we owned or had investments in approximately 1,200 properties (including properties classified as held for sale). Our company was originally founded in 1983 and is headquartered in Chicago, Illinois with additional corporate offices in Louisville, Kentucky and New York, New York. We primarily invest in a diversified portfolio of healthcare real estate assets through wholly owned subsidiaries and other co-investment entities. We operate through three reportable business segments: triple-net leased properties, senior living operations, which we also refer to as SHOP, and office operations. See “Note 2 – Accounting Policies” and “Note 18 – Segment Information.” Our senior housing communities are either subject to triple-net leases, in which case they are included in our triple-net leased properties reportable business segment or operated by independent third-party managers, in which case they are included in our senior living operations reportable business segment. As of December 31, 2021, we leased a total of 332 properties (excluding properties within our office operations reportable business segment) to various healthcare operating companies under triple-net or absolute-net leases that obligate the tenants to pay all property-related expenses, including maintenance, utilities, repairs, taxes, insurance and capital expenditures. Our three largest tenants, Brookdale Senior Living Inc. (together with its subsidiaries, “Brookdale Senior Living”), Ardent Health Partners, LLC (together with its subsidiaries, “Ardent”) and Kindred Healthcare, LLC (together with its subsidiaries, “Kindred”) leased from us 121 properties, 12 properties and 31 properties, respectively, as of December 31, 2021. As of December 31, 2021, pursuant to long-term management agreements, we engaged independent managers, such as Atria Senior Living, Inc. (“Atria”) and Sunrise Senior Living, LLC (together with its subsidiaries, “Sunrise”), to manage 554 senior housing communities in our senior living operations segment for us. Through our Lillibridge Healthcare Services, Inc. subsidiary and our ownership interest in PMB Real Estate Services LLC, we also provide MOB management, leasing, marketing, facility development and advisory services to highly rated hospitals and health systems throughout the United States. In addition, from time to time, we make secured and non-mortgage loans and other investments relating to senior housing and healthcare operators or properties. COVID-19 Update During fiscal 2020 and continuing into fiscal 2021, our business has been and is expected to continue to be impacted by both the COVID-19 pandemic itself, including actions taken to prevent the spread of the virus and its variants, and its extended consequences. Operating Results . Our senior living operations segment, which we also refer to as SHOP, continued to be impacted by the COVID-19 pandemic. Occupancy began to improve starting in the second quarter of 2021 and continued over the course of 2021. During 2021, a broader macro labor shortage drove increased labor costs at our communities, resulting in continued decline in NOI compared to 2020. Provider Relief Grants. In 2020 and 2021, we applied for grants under Phase 2, Phase 3 and Phase 4 of the Provider Relief Fund administered by the U.S. Department of Health & Human Services (“HHS”) on behalf of the assisted living communities in our senior living operations segment to partially mitigate losses attributable to COVID-19. These grants are intended to reimburse eligible providers for expenses incurred to prevent, prepare for and respond to COVID-19 and lost revenues attributable to COVID-19. Recipients are not required to repay distributions from the Provider Relief Fund, provided that they attest to and comply with certain terms and conditions. See “Government Regulation—Governmental Response to the COVID-19 Pandemic” in Part I, Item 1 of this Annual Report. During 2021 and 2020, we received $15.4 million and $35.1 million, respectively, in grants in connection with our applications and recognized these grants within property-level operating expenses in our Consolidated Statements of Income in the period in which they were received. Subsequent to December 31, 2021, we received $34.0 million in grants in connection with our Phase 4 applications, which we expect to recognize in 2022. Any grants that are ultimately received and retained by us are not expected to fully offset the losses incurred in our senior living operating portfolio that are attributable to COVID-19. Further, although we continue to monitor and evaluate the terms and conditions associated with the Provider Relief Fund distributions, we cannot assure you that we will be in compliance with all requirements related to the payments received under the Provider Relief Fund. Continuing Impact . The trajectory and future impact of the COVID-19 pandemic remains highly uncertain. The extent of the pandemic’s continuing and ultimate effect on our operational and financial performance will depend on a variety of factors, including the impact of new variants of the virus and the effectiveness of available vaccines against those variants; ongoing clinical experience, which may differ considerably across regions and fluctuate over time; and on other future developments, including the ultimate duration, spread and intensity of the outbreak, the availability of testing, the extent to which governments impose, roll-back or re-impose preventative restrictions and the availability of ongoing government financial support to our business, tenants and operators. Due to these uncertainties, we are not able at this time to estimate the ultimate impact of the COVID-19 pandemic on our business, results of operations, financial condition and cash flows. We have not identified the COVID-19 pandemic, on its own, as a “triggering event” for purposes of evaluating impairment of real estate assets, goodwill and other intangibles, investments in unconsolidated entities and financial instruments. However, as of December 31, 2021 and 2020, we considered the effect of the pandemic on certain of our assets (described below) and our ability to recover the respective carrying values of these assets. We applied our considerations to existing critical accounting policies that require us to make estimates and assumptions regarding future events that affect the reported amounts of assets and liabilities. We based our estimates on our experience and on assumptions we believe to be reasonable under the circumstances. As a result, we recognized no COVID-19 related charges during 2021 but recognized the following charges for the year ended December 31, 2020: • Adjustment to rental income: As of December 31, 2020, we concluded that it is probable we will not collect substantially all rents from certain tenants, primarily within our triple-net leased properties segment. As a result, we recognized adjustments to rental income of $74.6 million for the year ended December 31, 2020. Rental payments from these tenants will be recognized in rental income when received. • Impairment of real estate assets: During 2020, we compared our estimate of undiscounted cash flows, including a hypothetical terminal value, for certain real estate assets to the assets’ respective carrying values. During 2020, we recognized $126.5 million of impairments representing the difference between the assets’ carrying value and the then-estimated fair valu e of $239.9 million. The impaired assets, primarily senior housing communities, represent approximately 1% of our consolidated net real estate property as of December 31, 2020. Impairments are recorded within depreciation and amortization in our Consolidated Statements of Income and are primarily related to our senior living operations reportable business segment. • Loss on financial instruments and impairment of unconsolidated entities: As of December 31, 2020, we concluded that credit losses exist within certain of our non-mortgage loans receivable and government-sponsored pooled loan investments. As a result, we recognized credit loss charges of $34.7 million for the year ended December 31, 2020 within allowance on loans receivable and investments in our Consolidated Statements of Income. During the fourth quarter of 2020, we received $10.5 million as a principal payment on previously reserved loans. In addition, during 2020 we recognized an impairment of $10.7 million in an equity investment in an unconsolidated entity also recorded within allowance on loans receivable and investments in our Consolidated Statements of Income. • Deferred tax asset valuation allowance: During 2020, we concluded that it was not more likely than not that deferred tax assets (primarily US federal NOL carryforwards which begin to expire in 2032) would be realized based on our cumulative loss in recent years for certain of our taxable REIT subsidiaries. As a result, we recorded a valuation allowance of $56.4 million against these deferred tax assets on our Consolidated Balance Sheets with a corresponding charge to income tax benefit (expense) in our Consolidated State ments of Income. We maintained our conclusions regarding the realizability of deferred tax assets as of December 31, 2020.

Accounting Policies

Accounting Policies	12 Months Ended
	Dec. 31, 2021
Accounting Policies [Abstract]
Accounting Policies	NOTE 2 – ACCOUNTING POLICIES Principles of Consolidation The accompanying Consolidated Financial Statements include our accounts and the accounts of our wholly owned subsidiaries and the joint venture entities over which we exercise control. All intercompany transactions and balances have been eliminated in consolidation, and our net earnings are reduced by the portion of net earnings attributable to noncontrolling interests. U.S. generally accepted accounting principles (“GAAP”) require us to identify entities for which control is achieved through means other than voting rights and to determine which business enterprise is the primary beneficiary of variable interest entities (“VIEs”). A VIE is broadly defined 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; and (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. We consolidate our investment in a VIE when we determine that we are its primary beneficiary. We may change our original assessment of a VIE upon subsequent events such as the modification of contractual arrangements that affects the characteristics or adequacy of the entity’s equity investments at risk and the disposition of all or a portion of an interest held by the primary beneficiary. We identify the primary beneficiary of a VIE as the enterprise that has both: (i) the power to direct the activities of the VIE that most significantly impact the entity’s economic performance and (ii) the obligation to absorb losses or the right to receive benefits of the VIE that could be significant to the entity. We perform this analysis on an ongoing basis. As it relates to investments in joint ventures, GAAP may preclude consolidation by the sole general partner in certain circumstances based on the type of rights held by the limited partner or partners. We assess limited partners’ rights and their impact on our consolidation conclusions, and we reassess if there is a change to the terms or in the exercisability of the rights of the limited partners, the sole general partner increases or decreases its ownership of limited partnership (“LP”) interests or there is an increase or decrease in the number of outstanding LP interests. We also apply this guidance to managing member interests in limited liability companies (“LLCs”). We consolidate several VIEs that share the following common characteristics: • the VIE is in the legal form of an LP or LLC; • the VIE was designed to own and manage its underlying real estate investments; • we are the general partner or managing member of the VIE; • we own a majority of the voting interests in the VIE; • a minority of voting interests in the VIE are owned by external third parties, unrelated to us; • the minority owners do not have substantive kick-out or participating rights in the VIE; and • we are the primary beneficiary of the VIE. We have separately identified certain special purpose entities that were established to allow investments in life science, research and innovation projects by tax credit investors (“TCIs”). We have determined that these special purpose entities are VIEs, we are a holder of variable interests and we are the primary beneficiary of the VIEs, and therefore, we consolidate these special purpose entities. Our primary beneficiary determination is based upon several factors, including but not limited to the rights we have in directing the activities which most significantly impact the VIEs’ economic performance as well as certain guarantees which protect the TCIs from losses should a tax credit recapture event occur. In general, the assets of consolidated VIEs are available only for the settlement of the obligations of the respective entities. Unless otherwise required by the LP or LLC agreement, any mortgage loans of the consolidated VIEs are non-recourse to us. The table below summarizes the total assets and liabilities of our consolidated VIEs as reported on our Consolidated Balance Sheets (dollars in thousands): December 31, 2021 December 31, 2020 Total Assets Total Liabilities Total Assets Total Liabilities NHP/PMB L.P. $ 749,834 $ 251,352 $ 649,128 $ 238,168 Other identified VIEs 3,949,294 1,556,136 4,095,102 1,653,036 Tax credit VIEs 458,953 103,992 614,490 204,746 Investments in Unconsolidated Entities We report investments in unconsolidated entities over whose operating and financial policies we have the ability to exercise significant influence under the equity method of accounting. We adjust our investment in unconsolidated entities for additional contributions made, distributions received as well as our share of the investee’s earnings or losses, which is included in income (loss) from unconsolidated entities in our Consolidated Statements of Income. We base the initial carrying value of investments in unconsolidated entities on the fair value of the assets at the time we acquired the joint venture interest. We estimate fair values for our equity method investments based on discounted cash flow models that include all estimated cash inflows and outflows over a specified holding period and, where applicable, any estimated debt premiums or discounts. The capitalization rates, discount rates and credit spreads we use in these models are based upon assumptions that we believe to be within a reasonable range of current market rates for the respective investments. We generally amortize any difference between our cost basis and the basis reflected at the joint venture level, if any, over the lives of the related assets and liabilities and include that amortization in our share of income or loss from unconsolidated entities. For earnings of equity method investments with pro rata distribution allocations, net income or loss is allocated between the partners in the joint venture based on their respective stated ownership percentages. In other instances, net income or loss may be allocated between the partners in the joint venture based on the hypothetical liquidation at book value method (the “HLBV method”). Under the HLBV method, net income or loss is allocated between the partners based on the difference between each partner’s claim on the net assets of the joint venture at the end and beginning of the period, after taking into account contributions and distributions. Each partner’s share of the net assets of the joint venture is calculated as the amount that the partner would receive if the joint venture were to liquidate all of its assets at net book value and distribute the resulting cash to creditors and partners in accordance with their respective priorities. Under the HLBV method, in any given period, we could record more or less income than the joint venture has generated, than actual cash distributions we receive or than the amount we may receive in the event of an actual liquidation. Redeemable OP Unitholder and Noncontrolling Interests We own a majority interest in NHP/PMB L.P. (“NHP/PMB”), a limited partnership formed in 2008 to acquire properties from entities affiliated with Pacific Medical Buildings LLC (“PMB”). Given our wholly owned subsidiary is the general partner and the primary beneficiary of NHP/PMB, we consolidate NHP/PMB as a VIE. As of December 31, 2021, third-party investors owned 3.9 million Class A limited partnership units in NHP/PMB (“OP Units”), which represented 34% of the total units then outstanding, and we owned 7.5 million Class B limited partnership units in NHP/PMB, representing the remaining 66%. The OP Units may be redeemed at any time at the election of the holder for cash or, at our option, 0.9051 shares of our common stock per OP Unit, subject to adjustment in certain circumstances. We are party by assumption to a registration rights agreement with the holders of the OP Units that requires us, subject to the terms and conditions and certain exceptions set forth therein, to file and maintain a registration statement relating to the issuance of shares of our common stock upon redemption of OP Units. In September, NHP/PMB completed the buy-out of PMB’s interest in the newly developed Sutter Van Ness Medical Office Building. In connection with that transaction, NHP/PMB issued 0.6 million OP Units to third party investors. The OP Units are classified outside of permanent equity on our Consolidated Balance Sheets because they may be redeemed by third parties under circumstances that are outside of our control. We reflect the OP Units at the greater of cost or redemption value. As of December 31, 2021 and 2020, the fair value of the OP Units was $182.1 million and $146.0 million, respectively. We recognize changes in fair value through capital in excess of par value, net of cash distributions paid and purchases by us of any OP Units. Our diluted earnings per share includes the effect of any potential shares outstanding from redemption of the OP Units. Certain noncontrolling interests of other consolidated joint ventures were also classified as redeemable at December 31, 2021 and 2020. We record the carrying amount of these noncontrolling interests at the greater of their initial carrying amount (increased or decreased for the noncontrolling interests’ share of net income or loss and distributions) or the redemption value, which is primarily based on the fair value of the underlying real estate asset. Our joint venture partners have certain redemption rights with respect to their noncontrolling interests in these joint ventures that are outside of our control, and the redeemable noncontrolling interests are classified outside of permanent equity on our Consolidated Balance Sheets. We recognize changes in the carrying value of redeemable noncontrolling interests through capital in excess of par value on our Consolidated Balance Sheets. Noncontrolling Interests Excluding the redeemable noncontrolling interests described above, we present the portion of any equity that we do not own in entities that we control (and thus consolidate) as noncontrolling interests and classify those interests as a component of consolidated equity, separate from total Ventas stockholders’ equity, on our Consolidated Balance Sheets. For consolidated joint ventures with pro rata distribution allocations, net income or loss, and comprehensive income, is allocated between the joint venture partners based on their respective stated ownership percentages. In other cases, net income or loss is allocated between the joint venture partners based on the HLBV method. We account for purchases or sales of equity interests that do not result in a change of control as equity transactions, through capital in excess of par value. We include net income attributable to the noncontrolling interests in net income in our Consolidated Statements of Income and we include the noncontrolling interests’ share of comprehensive income in our Consolidated Statements of Comprehensive Income. Accounting for Historic and New Markets Tax Credits For certain of our life science, research and innovation centers, we are party to contractual arrangements with TCIs that were established to enable the TCIs to receive benefits of historic tax credits (“HTCs”), new markets tax credits (“NMTCs”) or both. As of December 31, 2021, we owned six properties that had syndicated HTCs or NMTCs, or both, to TCIs. In general, TCIs invest cash into special purpose entities that invest in entities that own the subject property and generate the tax credits. The TCIs receive substantially all of the tax credits and hold only a nominal interest in the economic risk and benefits of the special purpose entities. HTCs are delivered to the TCIs upon substantial completion of the project. NMTCs are allowed for up to 39% of a qualified investment and are delivered to the TCIs after the investment has been funded and spent on a qualified business. HTCs are subject to 20% recapture per year beginning one year after the completion of the historic rehabilitation of the subject property. NMTCs are subject to 100% recapture until the end of the seventh year following the qualifying investment. We have provided the TCIs with certain guarantees which protect the TCIs from losses should a tax credit recapture event occur. The contractual arrangements with the TCIs include a put/call provision whereby we may be obligated or entitled to repurchase the interest of the TCIs in the special purpose entities at the end of the tax credit recapture period. We anticipate that either the TCIs will exercise their put rights or we will exercise our call rights prior to the applicable tax credit recapture periods. The portion of the TCI’s investment that is attributed to the put is recorded at fair value at inception in accounts payable and other liabilities on our Consolidated Balance Sheets, and is accreted to the expected put price as interest expense in our Consolidated Statements of Income over the recapture period. The remaining balance of the TCI’s investment is initially recorded in accounts payable and other liabilities on our Consolidated Balance Sheets and will be relieved upon delivery of the tax credit to the TCI, as a reduction in the carrying value of the subject property, net of allocated expenses. Direct and incremental costs incurred in structuring the transaction are deferred and will be recognized as an increase in the cost basis of the subject property upon the recognition of the related tax credit as discussed above. Accounting Estimates The preparation of financial statements in accordance with GAAP requires us to make estimates and assumptions regarding future events that affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. Accounting for Real Estate Acquisitions When we acquire real estate, we first make reasonable judgments about whether the transaction involves an asset or a business. Our real estate acquisitions are generally accounted for as asset acquisitions as substantially all of the fair value of the gross assets acquired is concentrated in a single identifiable asset or group of similar identifiable assets. Regardless of whether an acquisition is considered a business combination or an asset acquisition, we record the cost of the businesses or assets acquired as tangible and intangible assets and liabilities based upon their estimated fair values as of the acquisition date. We estimate the fair value of buildings acquired on an as-if-vacant basis or replacement cost basis and depreciate the building value over the estimated remaining life of the building, generally not to exceed 35 years. We determine the fair value of other fixed assets, such as site improvements, and furniture, fixtures and equipment, based upon the replacement cost and depreciate such value over the assets’ estimated remaining useful lives as determined at the applicable acquisition date. We determine the value of land either by considering the sales prices of similar properties in recent transactions or based on internal analyses of recently acquired and existing comparable properties within our portfolio. We generally determine the value of construction in progress based upon the replacement cost. However, for certain acquired properties that are part of a ground-up development, we determine fair value by using the same valuation approach as for all other properties and deducting the estimated cost to complete the development. During the remaining construction period, we capitalize project costs until the development has reached substantial completion. Construction in progress, including capitalized interest, is not depreciated until the development has reached substantial completion. Intangibles primarily include the value of in-place leases and acquired lease contracts. We include all lease-related intangible assets and liabilities within acquired lease intangibles and accounts payable and other liabilities, respectively, on our Consolidated Balance Sheets. The fair value of acquired lease-related intangibles, if any, reflects: (i) the estimated value of any above or below market leases, determined by discounting the difference between the estimated market rent and in-place lease rent; and (ii) the estimated value of in-place leases related to the cost to obtain tenants, including leasing commissions, and an estimated value of the absorption period to reflect the value of the rent and recovery costs foregone during a reasonable lease-up period as if the acquired space was vacant. We amortize any acquired lease-related intangibles to revenue or amortization expense over the remaining life of the associated lease plus any assumed bargain renewal periods. If a lease is terminated prior to its stated expiration or not renewed upon expiration, we recognize all unamortized amounts of lease-related intangibles associated with that lease in operations over the shortened lease term. We estimate the fair value of purchase option intangible assets and liabilities, if any, by discounting the difference between the applicable property’s acquisition date fair value and an estimate of its future option price. We do not amortize the resulting intangible asset or liability over the term of the lease, but rather adjust the recognized value of the asset or liability upon sale. In connection with an acquisition, we may assume rights and obligations under certain lease agreements pursuant to which we become the lessee of a given property. We generally assume the lease classification previously determined by the prior lessee absent a modification in the assumed lease agreement. We assess assumed operating leases, including ground leases, to determine whether the lease terms are favorable or unfavorable to us given current market conditions on the acquisition date. To the extent the lease terms are favorable or unfavorable to us relative to market conditions on the acquisition date, we recognize an intangible asset or liability at fair value and amortize that asset or liability to interest or rental expense in our Consolidated Statements of Income over the applicable lease term. Where we are the lessee, we record the acquisition date values of leases, including any above or below market value, within operating lease assets and operating lease liabilities on our Consolidated Balance Sheets. We estimate the fair value of noncontrolling interests assumed consistent with the manner in which we value all of the underlying assets and liabilities. We calculate the fair value of long-term assumed debt by discounting the remaining contractual cash flows on each instrument at the current market rate for those borrowings, which we approximate based on the rate at which we would expect to incur a replacement instrument on the date of acquisition, and recognize any fair value adjustments related to long-term debt as effective yield adjustments over the remaining term of the instrument. Impairment of Long-Lived and Intangible Assets We periodically evaluate our long-lived assets, primarily consisting of investments in real estate, for impairment indicators. If indicators of impairment are present, we evaluate the carrying value of the related real estate investments in relation to the future undiscounted cash flows of the underlying operations. In performing this evaluation, we consider market conditions and our current intentions with respect to holding or disposing of the asset. We adjust the net book value of properties and other long-lived assets to fair value if the sum of the expected future undiscounted cash flows, including sales proceeds, is less than book value. We recognize an impairment loss at the time we make any such determination. If impairment indicators arise with respect to intangible assets with finite useful lives, we evaluate impairment by comparing the carrying amount of the asset to the estimated future undiscounted net cash flows expected to be generated by the asset. If estimated future undiscounted net cash flows are less than the carrying amount of the asset, then we estimate the fair value of the asset and compare the estimated fair value to the intangible asset’s carrying value. We recognize any shortfall from carrying value as an impairment loss in the current period. We evaluate our investments in unconsolidated entities for impairment at least annually, and whenever events or changes in circumstances indicate that the carrying value of our investment may exceed its fair value. If we determine that a decline in the fair value of our investment in an unconsolidated entity is other-than-temporary, and if such reduced fair value is below the carrying value, we record an impairment. We test goodwill for impairment at least annually, and more frequently if indicators of impairment arise. We first assess qualitative factors, such as current macroeconomic conditions, state of the equity and capital markets and our overall financial and operating performance, to determine the likelihood that the fair value of a reporting unit is less than its carrying amount. If we determine it is more likely than not that the fair value of a reporting unit is less than its carrying amount, we proceed with estimating the fair value of the reporting unit. A goodwill impairment, if any, will be recognized in the period it is determined and is measured as the amount by which a reporting unit’s carrying value exceeds its fair value. Estimates of fair value used in our evaluation of goodwill (if necessary based on our qualitative assessment), investments in real estate, investments in unconsolidated entities and intangible assets are based upon discounted future cash flow projections or other acceptable valuation techniques that are based, in turn, upon all available evidence including level three inputs, such as revenue and expense growth rates, estimates of future cash flows, capitalization rates, discount rates, general economic conditions and trends, or other available market data such as replacement cost or comparable sales. Our ability to accurately predict future operating results and cash flows and to estimate and determine fair values impacts the timing and recognition of impairments. While we believe our assumptions are reasonable, changes in these assumptions may have a material impact on our financial results. Assets Held for Sale and Discontinued Operations We sell properties from time to time for various reasons, including favorable market conditions or the exercise of purchase options by tenants. We classify certain long-lived assets as held for sale once the criteria, as defined by GAAP, have been met. Long-lived assets to be disposed of are reported at the lower of their carrying amount or fair value minus cost to sell and are no longer depreciated. If at any time we determine that the criteria for classifying assets as held for sale are no longer met, we reclassify assets within net real estate investments on our Consolidated Balance Sheets for all periods presented. The carrying amount of these assets is adjusted (in the period in which a change in classification is determined) to reflect any depreciation expense that would have been recognized had the asset been continuously classified as net real estate investments. We report discontinued operations when the following criteria are met: (1) a component of an entity or group of components that has been disposed of or classified as held for sale and represents a strategic shift that has or will have a major effect on an entity’s operations and financial results; or (2) an acquired business is classified as held for sale on the acquisition date. The results of operations for assets meeting the definition of discontinued operations are reflected in our Consolidated Statements of Income as discontinued operations for all periods presented. We allocate estimated interest expense to discontinued operations based on property values and our weighted average interest rate or the property’s actual mortgage interest. Loans Receivable We record loans receivable, other than those acquired in connection with a business combination, on our Consolidated Balance Sheets (either in secured loans receivable and investments, net or other assets, in the case of non-mortgage loans receivable) at the unpaid principal balance, net of any deferred origination fees, purchase discounts or premiums and valuation allowances. We amortize net deferred origination fees, which are comprised of loan fees collected from the borrower net of certain direct costs, and purchase discounts or premiums over the contractual life of the loan using the effective interest method and immediately recognize in income any unamortized balances if the loan is repaid before its contractual maturity. Cash Equivalents Cash equivalents consist of highly liquid investments with a maturity date of three months or less when purchased. These investments are stated at cost, which approximates fair value. Escrow Deposits and Restricted Cash Escrow deposits consist of amounts held by us or our lenders to provide for future real estate tax, insurance expenditures and tenant improvements related to our properties and operations. Restricted cash generally represents amounts paid to us for security deposits and other similar purposes. Deferred Financing Costs We amortize deferred financing costs, which are reported as a reduction to senior notes payable and other debt on our Consolidated Balance Sheets, as a component of interest expense over the terms of the related borrowings using a method that approximates a level yield. Amortized costs of approximately $19.7 million, $23.0 million and $20.2 million were included in interest expense for the years ended December 31, 2021, 2020 and 2019, respectively. Available for Sale Securities We classify available for sale securities as a component of other assets on our Consolidated Balance Sheets (other than our interests in government-sponsored pooled loan investments, which are classified as secured loans receivable and investments, net on our Consolidated Balance Sheets). We record these securities at fair value and include unrealized gains and losses recorded in stockholders’ equity as a component of accumulated other comprehensive income on our Consolidated Balance Sheets. If we determine that a credit loss exists with respect to individual investments, we will recognize an allowance against the amortized cost basis of the investment with a corresponding charge to net income (in allowance on loans receivable and investments) in our Consolidated Statements of Income. We report interest income, including discount or premium amortization, on available for sale securities and gains or losses on securities sold, which are based on the specific identification method, in income from loans and investments in our Consolidated Statements of Income. Derivative Instruments We recognize all derivative instruments in other assets or accounts payable and other liabilities on our Consolidated Balance Sheets at fair value as of the reporting date. We recognize changes in the fair value of derivative instruments in other expense in our Consolidated Statements of Income or accumulated other comprehensive income on our Consolidated Balance Sheets, depending on the intended use of the derivative and our designation of the instrument. We do not use our derivative financial instruments, including interest rate caps, interest rate swaps and foreign currency forward contracts, for trading or speculative purposes. Our foreign currency forward contracts and certain of our interest rate swaps (including the interest rate swap contracts of consolidated and unconsolidated joint ventures) are designated as effectively hedging the variability of expected cash flows related to their underlying securities and, therefore, also are recorded on our Consolidated Balance Sheets at fair value, with changes in the fair value of these instruments recognized in accumulated other comprehensive income on our Consolidated Balance Sheets. We recognize any noncontrolling interests’ proportionate share of the changes in fair value of swap contracts of our consolidated joint ventures in noncontrolling interests on our Consolidated Balance Sheets. We recognize our proportionate share of the change in fair value of swap contracts of our unconsolidated joint ventures in accumulated other comprehensive income on our Consolidated Balance Sheets. Certain of our other interest rate swaps and rate caps were not designated as having a hedging relationship with the underlying securities and therefore do not meet the criteria for hedge accounting under GAAP. Accordingly, these derivative instruments are recorded on our Consolidated Balance Sheets at fair value, and changes in the fair value of these instruments are recognized in current earnings (in other expense) in our Consolidated Statements of Income. Fair Values of Financial Instruments Fair value is a market-based measurement, not an entity-specific measurement, and we determine fair value based on the assumptions that we expect market participants would use in pricing the asset or liability. As a basis for considering market participant assumptions in fair value measurements, GAAP establishes a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of the reporting entity (observable inputs that are classified within levels one and two of the hierarchy) and the reporting entity’s own assumptions about market participant assumptions (unobservable inputs classified within level three of the hierarchy). Level one inputs utilize unadjusted quoted prices for identical assets or liabilities in active markets that we have the ability to access. Level two inputs are inputs other than quoted prices included in level one that are directly or indirectly observable for the asset or liability. Level two inputs may include quoted prices for similar assets and liabilities in active markets and other inputs for the asset or liability that are observable at commonly quoted intervals, such as interest rates, foreign exchange rates and yield curves. Level three inputs are unobservable inputs for the asset or liability, which typically are based on our own assumptions, because there is little, if any, related market activity. If the determination of the fair value measurement is based on inputs from different levels of the hierarchy, the level within which the entire fair value measurement falls is the lowest-level input that is significant to the fair value measurement in its entirety. If the volume and level of market activity for an asset or liability has decreased significantly relative to the normal market activity for such asset or liability (or similar assets or liabilities), then transactions or quoted prices may not accurately reflect fair value. In addition, if there is evidence that a transaction for an asset or liability is not orderly, little, if any, weight is placed on that transaction price as an indicator of fair value. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability. We use the following methods and assumptions in estimating the fair value of our financial instruments whose fair value is determined on a recurring basis. • Cash and cash equivalents - The carrying amount of unrestricted cash and cash equivalents reported on our Consolidated Balance Sheets approximates fair value due to the short maturity of these instruments. • Escrow deposits and restricted cash - The carrying amount of escrow deposits and restricted cash reported on our Consolidated Balance Sheets approximates fair value due to the short maturity of these instruments. • Loans receivable - We estimate the fair value of loans receivable using level two and level three inputs. We disc

Concentration of Credit Risk

Concentration of Credit Risk	12 Months Ended
	Dec. 31, 2021
Risks and Uncertainties [Abstract]
Concentration of Credit Risk	NOTE 3 – CONCENTRATION OF CREDIT RISK As of December 31, 2021, Atria, Sunrise, Brookdale Senior Living, Ardent and Kindred managed or operated approximately 19.8%, 10.0%, 7.8%, 4.7% and 1.0%, respectively, of our consolidated real estate investments based on gross book value (excluding properties classified as held for sale as of December 31, 2021). Because Atria and Sunrise manage our properties in exchange for a management fee from us, we are not directly exposed to their credit risk in the same manner or to the same extent as triple-net tenants like Brookdale Senior Living, Ardent and Kindred. Based on gross book value, approximately 13.0% and 54.4% of our consolidated real estate investments were senior housing communities included in the triple-net leased properties and senior living operations reportable business segments, respectively (excluding properties classified as held for sale as of December 31, 2021). MOBs, life science, research and innovation centers, IRFs and LTACs, health systems, skilled nursing facilities (“SNFs”) and secured loans receivable and investments collectively comprised the remaining 32.6%. Our consolidated properties were located in 47 states, the District of Columbia, seven Canadian provinces and the United Kingdom as of December 31, 2021, with properties in one state (California) accounting for more than 10% of our total consolidated revenues and net operating income (“NOI,” which is defined as total revenues, excluding interest and other income, less property-level operating expenses and office building and other services costs) for each of the years ended December 31, 2021, 2020 and 2019. Triple-Net Leased Properties The following table reflects the concentration risk related to our triple-net leased properties including assets held for sale for the periods presented: For the Years Ended December 31, 2021 2020 2019 Revenues (1) : Brookdale Senior Living (2) 3.9 % 4.4 % 4.7 % Ardent 3.3 3.2 3.1 Kindred 3.8 3.5 3.3 NOI: Brookdale Senior Living (2) 8.6 % 9.0 % 8.7 % Ardent 7.4 6.6 5.8 Kindred 7.8 7.1 6.3 (1) Total revenues include office building and other services revenue, income from loans and investments and interest and other income. (2) 2021 and 2020 results include $42.6 million and $21.3 million, respectively, of amortization of up-front consideration received in 2020 from the Brookdale Lease. Each of our leases with Brookdale Senior Living, Ardent and Kindred is a triple-net lease that obligates the tenant to pay all property-related expenses, including maintenance, utilities, repairs, taxes, insurance and capital expenditures, and to comply with the terms of the mortgage financing documents, if any, affecting the properties. In addition, each of our Brookdale Senior Living, Ardent and Kindred leases has a corporate guaranty. The properties we lease to Brookdale Senior Living, Ardent and Kindred accounted for a significant portion of our triple-net leased properties segment revenues and NOI for the years ended December 31, 2021, 2020 and 2019. Refer to Item 1A. Risk Factors. Eclipse Senior Living and Operator Transitions We successfully transitioned the operations of 90 senior living communities owned by us and operated under management agreements with Eclipse Senior Living, Inc. (“ESL”) to seven experienced managers by the start of January 2022. ESL is expected to cease operation of its management business in 2022 following completion of the transitions. We incurred certain one-time transition costs and expenses in connection with the transitions, which was recognized within transaction expenses and deal costs in our Consolidated Statements of Income. Kindred and Related Transactions In June 2021, Kindred and LifePoint Health announced that they entered into a definitive agreement pursuant to which Kindred would be acquired (the “Kindred Acquisition”). This transaction closed in December 2021. In connection with the Kindred Transaction, Kindred began operating under a new healthcare system called ScionHealth. Under our agreements with Kindred, we earned a fee of $13.1 million in connection with this transaction, which was recognized within interest and other income in our Consolidated Statements of Income. Brookdale Transactions In July 2020, we entered into a revised master lease agreement (the “Brookdale Lease”) and certain other agreements (together with the Brookdale Lease, the “Agreements”) with Brookdale Senior Living. The Agreements modify our current arrangements with Brookdale Senior Living as follows: We received up-front consideration of $235 million, which is being amortized over the remaining lease term and consisted of: (a) $162 million in cash including $47 million from the transfer to Ventas of deposits under the Brookdale Lease; (b) a $45 million note; (c) $28 million in warrants exercisable for 16.3 million shares of Brookdale Senior Living common stock, which are exercisable at any time prior to December 31, 2025 and have an exercise price of $3.00 per share. In October 2021, we received full repayment of the note from Brookdale. Base cash rent under the Brookdale Lease is set at $100 million per annum starting in July 2020, with three percent annual escalators commencing on January 1, 2022. The Brookdale Lease is guaranteed by Brookdale Senior Living. The warrants are classified within other assets on our Consolidated Balance Sheets. These warrants are measured at fair value with changes in fair value being recognized within other expense in our Consolidated Statements of Income. Also in July 2020, Brookdale Senior Living transferred fee ownership of five senior living communities to us, in full satisfaction and repayment of a $78 million loan to Brookdale Senior Living from us that was secured by the five communities. Brookdale Senior Living manages those communities for us under a terminable management agreement. Holiday Transaction In April 2020, we completed a transaction with affiliates of Holiday Retirement (collectively, “Holiday”), including (a) entry into a new, terminable management agreement with Holiday Management Company for our 26 independent living assets previously subject to a triple-net lease (the “Holiday Lease”) with Holiday; (b) termination of the Holiday Lease; and (c) our receipt from Holiday of $33.8 million in cash from the transfer to us of deposits under the Holiday Lease and $66.0 million in principal amount of secured notes. As a result of the Holiday Lease termination, we recognized $50.2 million within triple-net leased rental income, composed of $99.8 million of cash and notes received less $49.6 million from the write-off of accumulated straight-line receivable. Future Contractual Rents The following table sets forth the future contracted minimum rentals, excluding contingent rent escalations, but including straight-line rent adjustments where applicable, for all of our consolidated triple-net and office building leases as of December 31, 2021 (excluding properties classified as held for sale as of December 31, 2021, dollars in thousands): Brookdale Senior Living Ardent Kindred Other Total 2022 $ 147,951 $ 130,834 $ 135,262 $ 700,544 $ 1,114,591 2023 147,693 130,834 114,356 648,401 1,041,284 2024 147,709 130,834 104,083 597,681 980,307 2025 147,725 130,834 36,015 514,305 828,879 2026 — 130,370 1,921 439,705 571,996 Thereafter — 1,122,180 2,444 1,592,355 2,716,979 Total $ 591,078 $ 1,775,886 $ 394,081 $ 4,492,991 $ 7,254,036 Senior Living Operations As of December 31, 2021, Atria and Sunrise, collectively, provided comprehensive property management and accounting services with respect to 256 of our 545 consolidated senior housing communities, for which we pay annual management fees pursuant to long-term management agreements. On July 30, 2021, Atria, which at the time managed a pool of 165 communities for Ventas, acquired the management services division of Holiday Retirement, which at the time managed a pool of 26 communities for Ventas. Following such transaction, Atria and Holiday each continued to manage their respective pools of communities under their own distinct management contracts with Ventas. On September 21, 2021, Ventas consummated the acquisition of New Senior Investment Group, Inc., whose portfolio included 21 Atria-managed communities and 65 Holiday-managed communities. As of December 31, 2021, Atria managed a pool of 162 communities and Holiday managed a pool of 91 communities for Ventas under their own distinct management contracts. Ventas has the ongoing right to terminate the management contract for 91 of the Holiday-managed communities with short term notice. As disclosed and presented herein, (a) references to communities managed by Atria means all communities subject to our management contracts with Atria, including the Atria-managed New Senior communities, but excluding the Holiday-managed communities; and (b) references to communities managed by Holiday means all communities subject to our management contracts with Holiday, including the Holiday-managed New Senior communities, but excluding the Atria-managed communities.

Acquisitions of Real Estate Pro

Acquisitions of Real Estate Property	12 Months Ended
	Dec. 31, 2021
Business Combinations [Abstract]
Acquisitions of Real Estate Property	NOTE 4 – ACQUISITIONS OF REAL ESTATE PROPERTY The following summarizes our acquisition activities during 2021, 2020 and 2019. We acquire and invest in senior housing, medical office buildings, life science, research and innovation centers and other healthcare properties primarily to achieve an expected yield on our investment, to grow and diversify our portfolio and revenue base, and to reduce our dependence on any single tenant, operator or manager, geographic location, asset type, business model or revenue source. Each of our acquisitions disclosed below was accounted for as an asset acquisition. 2021 Acquisitions On September 21, 2021, we acquired New Senior Investment Group Inc. (“New Senior”) for a purchase price of $2.3 billion in an all-stock transaction pursuant to an Agreement and Plan of Merger dated as of June 28, 2021 (the “Merger Agreement”) by and among Ventas, Cadence Merger Sub LLC, our wholly owned subsidiary (“Merger Sub”), and New Senior. Under the Merger Agreement, on the acquisition date, Merger Sub merged with and into New Senior, with New Senior surviving the merger as our wholly owned subsidiary (the “New Senior Acquisition”). The New Senior Acquisition was valued at approximately $2.4 billion. We funded the transaction through the issuance of approximately 13.3 million shares of our common stock, with each New Senior stockholder receiving 0.1561 shares of Ventas common stock for each share of New Senior common stock that they owned immediately prior to the acquisition. In addition to the equity issuance, we funded the acquisition through the assumption of $482.5 million of New Senior mortgage debt and $1.1 billion of cash paid at closing. The New Senior Acquisition added 102 independent living communities to our senior living operations reportable business segment and one independent living community to our triple-net lease properties reportable business segment. We accounted for this transaction as an asset acquisition and the financial results of New Senior have been included in our consolidated financial statements from the acquisition date. During the year ended December 31, 2021, we acquired six Canadian senior housing communities reported within our senior living operations reportable business segment and a behavioral health center in Plano, Texas reported within our office operations reportable business segment for aggregate consideration of $240.7 million. 2020 Acquisitions During the year ended December 31, 2020, we acquired two research and innovation centers reported within our office operations reportable business segment, seven senior housing communities reported within our senior living operations reportable business segment and one LTAC reported within our triple-net leased properties reportable business segment for an aggregate consideration of $249.5 million. 2019 Acquisitions In September 2019, we acquired an 87% interest in 34 Canadian senior housing communities (including five in-process developments) valued at $1.8 billion through an equity partnership (the “LGM Acquisition”) with Le Groupe Maurice (“LGM”). The portfolio continues to be managed by LGM. We also have rights to fund and own all additional developments under an exclusive pipeline agreement with LGM. During the year ended December 31, 2019, we also acquired two properties reported within our office operations reportable business segment (one research and innovation center and one MOB), two senior housing communities reported within our senior living operations reportable business segment and one vacant land parcel for an aggregate purchase price of $237.0 million. 2022 Acquisitions In February 2022, we closed on the acquisitions of 18 MOBs leased to affiliates of Ardent for $204 million and one senior housing community within our senior living operations reportable business segment for $105.4 million.

Dispositions and Impairments

Dispositions and Impairments	12 Months Ended
	Dec. 31, 2021
Discontinued Operations and Disposal Groups [Abstract]
Dispositions and Impairments	NOTE 5 – DISPOSITIONS AND IMPAIRMENTS 2021 Activity During the year ended December 31, 2021, we sold 34 MOBs, eight triple-net leased properties and 23 senior housing communities for aggregate consideration of $859.7 million and recognized gains on the sale of these assets of $218.8 million in our Consolidated Statements of Income. 2020 Activity During the year ended December 31, 2020, we recognized $262.2 million of gains on sale of real estate in our Consolidated Statements of Income as described below. In March 2020, we formed the Ventas Life Science and Healthcare Real Estate Fund, L.P. (the “Ventas Fund”), a perpetual life vehicle that focuses on investments in research and innovation centers, medical office buildings and senior housing communities in North America. To seed the Ventas Fund, we contributed six (two of which are on the same campus) stabilized research and innovation and medical office properties. We received cash consideration of $620 million and a 21% interest in the Ventas Fund. We recognized a gain on the transactions of $225.1 million. In October 2020, we formed a joint venture (the “R&I Development JV”) with GIC. To seed the R&I Development JV, we contributed our controlling ownership interest in four in-progress university-based research and innovation development projects (the “Initial R&I JV Projects”). At closing, GIC reimbursed us for its share of costs incurred to date and we recognized a gain of $13.7 million. We own an over 50% interest and GIC owns a 45% interest in the Initial R&I JV Projects. The R&I Development JV may be expanded in the future to include other pre-identified research and innovation development projects. See “Note 7 – Investments in Unconsolidated Entities” for additional details on the Ventas Fund and the JV. Also during 2020, we sold four MOBs, four senior housing communities, 22 triple-net leased properties and one land parcel for aggregate consideration of $249.6 million, and we recognized a gain on the sale of these assets of $23.4 million. 2019 Activity During the year ended December 31, 2019, we sold ten triple-net leased properties, eight MOBs, six senior housing assets and our leasehold interest in one vacant land parcel for aggregate consideration of $147.5 million, and recognized a gain on the sale of these assets of $26.0 million in our Consolidated Statements of Income. Assets Held for Sale The table below summarizes our real estate assets classified as held for sale including the amounts reported on our Consolidated Balance Sheets, which may include anticipated post-closing settlements of working capital for disposed properties. December 31, 2021 December 31, 2020 Number of Properties Held for Sale Assets Held for Sale Liabilities Held for Sale Number of Properties Held for Sale Assets Held for Sale Liabilities Held for Sale Triple-net leased properties — $ — $ — 1 $ 4,960 $ 2,690 Office operations 2 3,435 1,529 — 15 101 Senior living operations 2 24,964 9,321 1 4,633 455 Total 4 $ 28,399 $ 10,850 2 $ 9,608 $ 3,246 Real Estate Impairment We recognized impairments of $219.4 million, $153.8 million and $133.6 million for the years ended December 31, 2021, 2020 and 2019, respectively, which are recorded primarily as a component of depreciation and amortization in our Consolidated Statements of Income. The impairments recorded during 2021 and 2019 were primarily a result of a change in our intent to hold the impaired assets. A significant portion of our 2020 charges resulted from the impact of COVID-19 and others were primarily the result of a change in our intent to hold the impaired assets (See “Note 1 – Description of Business - COVID-19 Update”).

Loans Receivable and Investment

Loans Receivable and Investments	12 Months Ended
	Dec. 31, 2021
Loans Receivable And Investments [Abstract]
Loans Receivable and Investments	NOTE 6 – LOANS RECEIVABLE AND INVESTMENTS As of December 31, 2021 and 2020, we had $549.2 million and $900.2 million, respectively, of net loans receivable and investments relating to senior housing and healthcare operators or properties. The following is a summary of our loans receivable and investments, net, including amortized cost, fair value and unrealized gains or losses on available for sale investments (dollars in thousands): Amortized Cost Allowance Unrealized Gain Carrying Amount Fair Value As of December 31, 2021: Secured/mortgage loans and other, net $ 488,913 $ — $ — $ 488,913 $ 478,931 Government-sponsored pooled loan investments, net (1) 39,376 — 1,836 41,213 41,213 Total investments reported as secured loans receivable and investments, net 528,289 — 1,836 530,126 520,144 Non-mortgage loans receivable, net (2) 24,418 (5,394) — 19,024 19,039 Total loans receivable and investments, net $ 552,707 $ (5,394) $ 1,836 $ 549,150 $ 539,183 As of December 31, 2020: Secured/mortgage loans and other, net $ 555,840 $ — $ — $ 555,840 $ 508,707 Government-sponsored pooled loan investments, net 55,154 (8,846) 3,419 49,727 49,727 Total investments reported as secured loans receivable and investments, net 610,994 (8,846) 3,419 605,567 558,434 Non-mortgage loans receivable, net (2) 74,700 (17,623) — 57,077 57,009 Marketable debt securities (2) 213,334 — 24,219 237,553 237,553 Total loans receivable and investments, net $ 899,028 $ (26,469) $ 27,638 $ 900,197 $ 852,996 (1) Investment in government-sponsored pool loans has a contractual maturity date in 2023. (2) Included in other assets on our Consolidated Balance Sheets. 2021 Activity In October 2021, we received proceeds of $45.0 million in full repayment of a note (which was included above in Non-mortgage loans receivable, net) from Brookdale Senior Living. The note was issued to us in connection with the modification of our lease with Brookdale Senior Living in the third quarter of 2020. In July 2021, we received $66.0 million from Holiday Retirement as repayment in full of secured notes which Holiday Retirement previously issued to us as part of a lease termination transaction entered into in April 2020. In July 2021, we received aggregate proceeds of $224 million from the redemption of Ardent’s outstanding 9.75% Senior Notes due 2026 (which was included above in Marketable debt securities) at a price equal to 107.313% of the principal amount of the notes, plus accrued and unpaid interest. The redemption resulted in a gain of $16.6 million, which is recorded in income from loans and investments in our Consolidated Statements of Income. As of December 31, 2021, $23.0 million of unrealized gain related to these securities was included in accumulated other comprehensive income on our Consolidated Balance Sheet. In April 2021, we received $19.2 million in full repayment of certain government-sponsored pooled loan investments. In the first quarter of 2021, prior to such repayment, we reversed an $8.8 million allowance we had previously recorded in 2020 on this investment with a corresponding adjustment to allowance on loans receivable and investments in our Consolidated Statements of Income. There was no impact to our Consolidated Statements of Income from the loan repayment. During the first quarter of 2021, we received aggregate proceeds of $16.5 million for the redemption and sale of marketable debt securities, resulting in total gains of $1.0 million, which is recorded in income from loans and investments in our Consolidated Statements of Income. As of December 31, 2021, $1.2 million of unrealized gain was presented within accumulated other comprehensive income on our Consolidated Balance Sheet related to these securities. These securities had a weighted average interest rate of 8.3% and were due to mature between 2024 and 2026. In March 2021, $11.9 million of previously reserved non-mortgage loans were forgiven. We derecognized both the amortized cost bases and allowances for these loans during the quarter ended March 31, 2021. There was no impact to our Consolidated Statements of Income from the loan forgiveness. 2020 Activity During the year ended December 31, 2020, we recognized $34.7 million in expense in establishing allowances on our loan and investment portfolio. See “Note 1 - Description Of Business - COVID-19 Update.” In December 2020, we received $10.5 million for partial repayment of previously reserved loans, which was recorded as a reduction to allowance on loans receivables and investments in our Consolidated Statements of Income. During the year ended December 31, 2020, we received aggregate proceeds of $106.1 million for the full repayment of the principal balances of various loans receivable with a weighted average interest rate of 8.3% that were due to mature between 2020 and 2025, which resulted in total gains of $1.4 million, which is recorded in income from loans and investments in our Consolidated Statements of Income. In April 2020, we received as consideration $66 million of notes secured by equity pledges on real estate assets with an effective interest rate of 9.2% in connection with the termination of the Holiday Lease. See “Note 3 – Concentration of Credit Risk.” In July 2020, Brookdale Senior Living issued a $45 million note to Ventas maturing on December 31, 2025, which is included in Non-mortgage loans receivable, net. In addition, Brookdale transferred fee ownership of five senior living communities to us, in full satisfaction and repayment of a $78 million loan to Brookdale Senior Living from us that was secured by the five communities. See “Note 3 – Concentration of Credit Risk.”

Investments in Unconsolidated E

Investments in Unconsolidated Entities	12 Months Ended
	Dec. 31, 2021
Equity Method Investments and Joint Ventures [Abstract]
Investments in Unconsolidated Entities	NOTE 7 – INVESTMENTS IN UNCONSOLIDATED ENTITIES We report investments in unconsolidated entities over whose operating and financial policies we have the ability to exercise significant influence under the equity method of accounting. We are not required to consolidate these entities because our joint venture partners have significant participating rights, nor are these entities considered VIEs, as they are controlled by equity holders with sufficient capital. We invest in both real estate entities and operating entities which are described further below. Investments in Unconsolidated Real Estate Entities Through our Ventas Investment Management Platform, which consolidates our extensive third-party capital ventures under a single brand and umbrella, we partner with third-party institutional investors to invest in healthcare real estate through various joint ventures and other co-investment vehicles where we are the sponsor or general partner. Below is a summary of our investments in unconsolidated real estate entities as of December 31, 2021 and 2020, respectively (dollars in thousands): Ownership (1) Carrying Amount As of December 31, As of December 31, 2021 2020 2021 2020 Investment in unconsolidated real estate entities: Ventas Life Science & Healthcare Real Estate Fund 21.1% 22.9% $ 267,475 $ 279,983 Pension Fund Joint Venture 22.9% 22.8% 29,192 34,690 Research & Innovation Development Joint Venture 51.0% 50.3% 221,363 123,445 Ventas Investment Management Platform 518,030 438,118 All other (2) 34.0%-50.0% 34.0%-50.0% 5,435 5,570 Total investments in unconsolidated real estate entities $ 523,465 $ 443,688 (1) The entities in which we have an ownership interest may have less than a 100% interest in the underlying real estate. The ownership percentages in the table reflect our interest in the underlying real estate. Joint venture members, including us in some instances, have equity participation rights based on the underlying performance of the investments, which could result in non pro rata distributions. (2) Includes investments in land parcels, parking structures and other de minimis investments in unconsolidated real estate entities. In March 2021, the Ventas Life Science and Healthcare Real Estate Fund, L.P. (the “Ventas Fund”) acquired two Class-A life science properties in the Baltimore-DC life science cluster for $272 million, which increased assets under management of the Ventas Fund to $2.1 billion. In March 2020, we formed the Ventas Fund, in which we are the sponsor and general partner. See “Note 5 – Dispositions and Impairments.” In October 2020, the Ventas Fund acquired a portfolio of three life science properties in the South San Francisco life science cluster for $1.0 billion, which increased assets under management to $1.8 billion as of December 31, 2020. The acquisition was financed with a $415 million mortgage loan bearing interest at a fixed rate of 2.6% per annum. In October 2020, we formed the R&I Development JV. See “Note 5 – Dispositions and Impairments.” We own an over 50% interest and GIC owns a 45% interest in the Initial R&I JV Projects. We act as manager of the R&I Development JV, with customary rights and obligations, and will receive customary fees and incentives. Our exclusive development partner, Wexford Science & Technology, remains the developer of, and a minority partner in, all of the projects. The R&I Development JV may be expanded in the future to include other pre-identified R&I development projects. We provide various services to our unconsolidated real estate entities in exchange for fees and reimbursements. Total management fees earned in connection with these services were $12.4 million, $6.7 million and $3.4 million for the years ended December 31, 2021, 2020 and 2019, respectively. Such amounts are included in office building and other services revenue in our Consolidated Statements of Income. Investments in Unconsolidated Operating Entities We own investments in unconsolidated operating entities such as Ardent and Atria, which are included within other assets on our Consolidated Balance Sheets. Our 34% ownership interest in Atria entitles us to customary minority rights and protections, including the right to appoint two of six members to the Atria Board of Directors. Our 9.8% ownership interest in Ardent entitles us to customary minority rights and protections, including the right to appoint one of 10 members of the Ardent Board of Directors. In June 2020, as a result of COVID-19, we recognized an impairment charge of $10.7 million related to our investment in an unconsolidated operating entity, which was recorded within allowance on loans receivable and investments in our Consolidated Statements of Income. See “Note 1 – Description of Business - COVID-19 Update.”

Intangibles

Intangibles	12 Months Ended
	Dec. 31, 2021
Intangible Assets, Intangible Liabilities, And Goodwill Disclosure [Abstract]
Intangibles	NOTE 8 – INTANGIBLES The following is a summary of our intangibles (dollars in thousands): As of December 31, 2021 As of December 31, 2020 Balance Weighted Average Balance Weighted Average Intangible assets: Above-market lease intangibles (1) $ 129,121 5.9 $ 140,096 6.4 In-place and other lease intangibles (2) 1,240,626 7.2 1,090,790 10.7 Goodwill 1,046,140 N/A 1,051,650 N/A Other intangibles (2) 34,517 6.5 35,870 10.0 Accumulated amortization (944,403) N/A (941,462) N/A Net intangible assets $ 1,506,001 7.1 $ 1,376,944 10.3 Intangible liabilities: Below-market lease intangibles (1) $ 334,365 9.7 $ 339,265 14.3 Other lease intangibles 13,608 N/A 13,498 N/A Accumulated amortization (244,975) N/A (212,655) N/A Purchase option intangibles 3,568 N/A 3,568 N/A Net intangible liabilities $ 106,566 9.7 $ 143,676 14.3 (1) Amortization of above- and below-market lease intangibles is recorded as a decrease and an increase to revenues, respectively, in our Consolidated Statements of Income. (2) Amortization of lease intangibles is recorded in depreciation and amortization in our Consolidated Statements of Income. N/A—Not Applicable Above-market lease intangibles and in-place and other lease intangibles are included in acquired lease intangibles within real estate investments on our Consolidated Balance Sheets. Other intangibles (including non-compete agreements, trade names and trademarks) are included in other assets on our Consolidated Balance Sheets. Below-market lease intangibles, other lease intangibles and purchase option intangibles are included in accounts payable and other liabilities on our Consolidated Balance Sheets. For the years ended December 31, 2021, 2020 and 2019, our net amortization related to these intangibles was $29.3 million, $45.7 million and $59.2 million, respectively. The following is a summary of the estimated net amortization related to these intangibles for each of the next five years (dollars in thousands): Estimated Net Amortization 2022 $ 123,144 2023 111,976 2024 57,729 2025 9,764 2026 5,972 The table below reflects the carrying amount of goodwill, by segment, as of December 31, 2021 (dollars in thousands): Goodwill Triple-net leased properties $ 322,097 Senior living operations 259,482 Office operations 464,561 Total goodwill $ 1,046,140

Other Assets

Other Assets	12 Months Ended
	Dec. 31, 2021
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Other Assets	NOTE 9 – OTHER ASSETS The following is a summary of our other assets (dollars in thousands): As of December 31, 2021 2020 Straight-line rent receivables $ 176,877 $ 169,711 Non-mortgage loans receivable, net 19,024 57,077 Stock warrants 48,884 50,098 Marketable debt securities — 237,553 Other intangibles, net 7,270 4,659 Investment in unconsolidated operating entities 73,602 63,768 Other 239,412 224,363 Total other assets $ 565,069 $ 807,229 Stock warrants represent warrants exercisable at any time prior to December 31, 2025, in whole or in part, for 16.3 million shares of Brookdale Senior Living common stock at an exercise price of $3.00 per share. These warrants are measured at fair value with changes in fair value being recognized within other expense in our Consolidated Statements of Income.

Senior Notes Payable and Other

Senior Notes Payable and Other Debt	12 Months Ended
	Dec. 31, 2021
Debt Disclosure [Abstract]
Senior Notes Payable and Other Debt	NOTE 10 – SENIOR NOTES PAYABLE AND OTHER DEBT The following is a summary of our senior notes payable and other debt (dollars in thousands): As of December 31, 2021 2020 Unsecured revolving credit facility (1) $ 56,448 $ 39,395 Commercial paper notes 280,000 — Secured revolving construction credit facility due 2022 — 154,098 Floating Rate Senior Notes, Series F due 2021 (2) — 235,664 3.25% Senior Notes due 2022 — 263,687 3.30% Senior Notes, Series C due 2022 (2) — 196,386 Unsecured term loan due 2023 200,000 200,000 3.125% Senior Notes due 2023 — 400,000 3.10% Senior Notes due 2023 — 400,000 2.55% Senior Notes, Series D due 2023 (2) 217,667 216,025 3.50% Senior Notes due 2024 400,000 400,000 3.75% Senior Notes due 2024 400,000 400,000 4.125% Senior Notes, Series B due 2024 (2) 197,879 196,386 2.80% Senior Notes, Series E due 2024 (2) 474,909 471,328 Unsecured term loan due 2025 (2) 395,757 392,773 3.50% Senior Notes due 2025 600,000 600,000 2.65% Senior Notes due 2025 450,000 450,000 4.125% Senior Notes due 2026 500,000 500,000 3.25% Senior Notes due 2026 450,000 450,000 2.45% Senior Notes, Series G due 2027 (2) 375,970 — 3.85% Senior Notes due 2027 400,000 400,000 4.00% Senior Notes due 2028 650,000 650,000 4.40% Senior Notes due 2029 750,000 750,000 3.00% Senior Notes due 2030 650,000 650,000 4.75% Senior Notes due 2030 500,000 500,000 2.50% Senior Notes due 2031 500,000 — 3.30% Senior Notes, Series H due 2031 (2) 237,454 — 6.90% Senior Notes due 2037 (3) 52,400 52,400 6.59% Senior Notes due 2038 (3) 22,823 22,823 5.70% Senior Notes due 2043 300,000 300,000 4.375% Senior Notes due 2045 300,000 300,000 4.875% Senior Notes due 2049 300,000 300,000 Mortgage loans and other 2,431,831 2,092,106 Total 12,093,138 11,983,071 Deferred financing costs, net (69,925) (68,343) Unamortized fair value adjustment 32,888 12,618 Unamortized discounts (28,557) (31,934) Senior notes payable and other debt $ 12,027,544 $ 11,895,412 (1) As of December 31, 2021 and 2020, respectively, $30.9 million and $12.2 million of aggregate borrowings were denominated in Canadian dollars. Aggregate borrowings of $25.6 million and $27.2 million were denominated in British pounds as of December 31, 2021 and 2020, respectively. (2) Canadian Dollar debt obligations shown in US Dollars. (3) Our 6.90% senior notes due 2037 are subject to repurchase at the option of the holders, at par, on October 1, 2027, and our 6.59% senior notes due 2038 are subject to repurchase at the option of the holders, at par, on July 7 in each of 2023 and 2028. Credit Facilities, Commercial Paper and Unsecured Term Loans In January 2021, we entered into an amended and restated unsecured credit facility (the “New Credit Facility”) comprised of a $2.75 billion unsecured revolving credit facility initially priced at LIBOR plus 0.825% based on the Company’s debt rating. The New Credit Facility replaced our previous $3.0 billion unsecured revolving credit facility priced at 0.875%. The New Credit Facility matures in January 2025, but may be extended at our option, subject to the satisfaction of certain conditions, for two additional periods of six months each. The New Credit Facility also includes an accordion feature that permits us to increase our aggregate borrowing capacity thereunder to up to $3.75 billion, subject to the satisfaction of certain conditions. Our unsecured credit facility imposed certain customary restrictions on us, including restrictions pertaining to: (i) liens; (ii) investments; (iii) the incurrence of additional indebtedness; (iv) mergers and dissolutions; (v) certain dividend, distribution and other payments; (vi) permitted businesses; (vii) transactions with affiliates; (viii) agreements limiting certain liens; and (ix) the maintenance of certain consolidated total leverage, secured debt leverage, unsecured debt leverage and fixed charge coverage ratios and minimum consolidated adjusted net worth, and contains customary events of default. As of December 31, 2021, we had $2.7 billion of undrawn capacity on our New Credit Facility with $56.4 million borrowings outstanding and an additional $24.9 million restricted to support outstanding letters of credit. We limit our use of the New Credit Facility, to the extent necessary, to support our commercial paper program when commercial paper notes are outstanding. As of December 31, 2021, we had $280.0 million of commercial paper outstanding. Our wholly owned subsidiary, Ventas Realty, Limited Partnership (“Ventas Realty”), may issue from time to time unsecured commercial paper notes up to a maximum aggregate amount outstanding at any time of $1.0 billion. The notes are sold under customary terms in the U.S. commercial paper note market and are ranked pari passu with all of Ventas Realty’s other unsecured senior indebtedness. The notes are fully and unconditionally guaranteed by Ventas, Inc. As of December 31, 2021, we had $280.0 million borrowings outstanding under our commercial paper program. As of December 31, 2021, we had a $200.0 million unsecured term loan priced at LIBOR plus 0.90% that matures in 2023. The term loan also includes an accordion feature that effectively permits us to increase our aggregate borrowings thereunder to up to $800.0 million. As of December 31, 2021, we had a C$500 million unsecured term loan facility priced at Canadian Dollar Offered Rate (“CDOR”) plus 0.90% that matures in 2025. During the year ended December 31, 2021, we terminated the $400.0 million secured revolving construction credit facility, resulting in a loss on extinguishment of debt of $0.5 million. Senior Notes As of December 31, 2021, we had outstanding $7.2 billion aggregate principal amount of senior notes issued by Ventas Realty, approximately $75.2 million aggregate principal amount of senior notes issued by Nationwide Health Properties, Inc. (“NHP”) and assumed by our subsidiary, Nationwide Health Properties, LLC (“NHP LLC”), as successor to NHP, in connection with our acquisition of NHP, and C$1.9 billion aggregate principal amount of senior notes issued by our subsidiary, Ventas Canada Finance Limited (“Ventas Canada”). All of the senior notes issued by Ventas Realty and Ventas Canada are unconditionally guaranteed by Ventas, Inc. Ventas Realty’s senior notes are part of our and Ventas Realty’s general unsecured obligations, ranking equal in right of payment with all of our and Ventas Realty’s existing and future senior obligations and ranking senior in right of payment to all of our and Ventas Realty’s existing and future subordinated indebtedness. However, Ventas Realty’s senior notes are effectively subordinated to our and Ventas Realty’s secured indebtedness, if any, to the extent of the value of the assets securing that indebtedness. Ventas Realty’s senior notes are also structurally subordinated to the preferred equity and indebtedness, whether secured or unsecured, of our subsidiaries (other than Ventas Realty and, with respect to those senior notes co-issued by Ventas Capital Corporation, Ventas Capital Corporation). Ventas Canada’s senior notes are part of our and Ventas Canada’s general unsecured obligations, ranking equal in right of payment with all of Ventas Canada’s existing and future subordinated indebtedness. However, Ventas Canada’s senior notes are effectively subordinated to our and Ventas Canada’s secured indebtedness, if any, to the extent of the value of the assets securing that indebtedness. Ventas Canada’s senior notes are also structurally subordinated to the preferred equity and indebtedness, whether secured or unsecured, of our subsidiaries (other than Ventas Canada). NHP LLC’s senior notes are part of NHP LLC’s general unsecured obligations, ranking equal in right of payment with all of NHP LLC’s existing and future senior obligations and ranking senior to all of NHP LLC’s existing and future subordinated indebtedness. However, NHP LLC’s senior notes are effectively subordinated to NHP LLC’s secured indebtedness, if any, to the extent of the value of the assets securing that indebtedness. NHP LLC’s senior notes are also structurally subordinated to the preferred equity and indebtedness, whether secured or unsecured, of its subsidiaries. Ventas Realty and Ventas Canada may redeem each series of their respective senior notes in whole at any time or in part from time to time, prior to maturity at the redemption prices set forth in the applicable indenture (which include, in many instances, a make-whole premium), plus, in each case, accrued and unpaid interest thereon to the redemption date. NHP LLC’s 6.90% senior notes due 2037 are subject to repurchase at the option of the holders, at par, on October 1, 2027, and its 6.59% senior notes due 2038 are subject to repurchase at the option of the holders, at par, on July 7 in each of 2023 and 2028. 2021 Senior Notes Activity In December 2021, Ventas Canada issued and sold C$475.0 million aggregate principal amount of 2.45% senior notes, Series G and C$300.0 million aggregate principal amount of 3.30% senior notes, Series H, due 2027 and 2031 at 99.79% and 99.65% of par, respectively. In November 2021, Ventas Canada issued a make whole notice of redemption for the entirety of the C$250.0 million aggregate principal amount of 3.30% senior notes due 2022, resulting in a loss on extinguishment of debt of $0.8 million during the year ended December 31, 2021. The redemption settled in December 2021, principally using cash on hand. In November 2021, Ventas Canada repaid in full, at par, our variable rate C$300.0 million principal amount then outstanding senior notes due 2021 upon maturity. In August 2021, Ventas Realty issued and sold $500.0 million aggregate principal amount of 2.50% senior notes due 2031 at 99.74% of par. In August 2021, Ventas Realty issued a make whole notice of redemption for the entirety of the $400.0 million aggregate principal amount of 3.125% senior notes due 2023, resulting in a loss on extinguishment of debt of $20.9 million during the year ended December 31, 2021. The redemption settled in September 2021, principally using cash on hand. In July 2021, Ventas Realty and Ventas Capital Corporation issued a make whole notice of redemption for the entirety of the $263.7 million aggregate principal amount of 3.25% senior notes due 2022, resulting in a loss on extinguishment of debt of $8.2 million during the year ended December 31, 2021. The redemption settled in August 2021, principally using cash on hand. In February 2021, Ventas Realty issued a make whole notice of redemption for the entirety of the $400.0 million aggregate principal amount of 3.10% senior notes due January 2023, resulting in a loss on extinguishment of debt of $27.3 million during the year ended December 31, 2021. The redemption settled in March 2021, principally using cash on hand. 2020 Senior Notes Activity In April 2020, Ventas Realty issued and sold $500.0 million aggregate principal amount of 4.75% senior notes due 2030 at an amount equal to 97.86% of par. In October 2020, we redeemed, pursuant to a cash tender offer, $236.3 million aggregate principal amount then outstanding of our 3.25% senior notes due 2022 at 104.14% of par value, plus accrued and unpaid interest to the payment date. As a result, we recognized a loss on extinguishment of debt of $11.1 million during the year ended December 31, 2020. Mortgages At December 31, 2021, we had 112 mortgage loans outstanding in the aggregate principal amount of $2.4 billion, which is secured by 102 of our properties. Of these loans, 95 loans in the aggregate principal amount of $2.1 billion bear interest at fixed rates ranging from 1.99% to 13.01% per annum, and 17 loans in the aggregate principal amount of $370.0 million bear interest at variable rates ranging from 0.08% to 2.85% per annum as of December 31, 2021. At December 31, 2021, the weighted average annual rate on our fixed rate mortgage loans was 3.6%, and the weighted average annual rate on our variable rate mortgage loans was 1.7%. Our mortgage loans had a weighted average maturity of 4.2 years as of December 31, 2021. During the years ended December 31, 2021 and 2020, we repaid in full mortgage loans in the aggregate principal amount of $284.7 million and $60.9 million, respectively. In September 2021, we assumed $482.5 million in mortgage debt maturing in 2025 in connection with the New Senior Acquisition including a $25.4 million fair value premium, which is amortized over the remaining term through interest expense in our Consolidated Statement of Income. See “Note 4 – Acquisitions of Real Estate Property”. Scheduled Maturities of Borrowing Arrangements and Other Provisions The following summarizes the maturities of our senior notes payable and other debt as of December 31, 2021 (dollars in thousands): Principal Amount Unsecured Revolving Credit Facility and Commercial Paper Notes (1) Scheduled Periodic Total Maturities 2022 $ 389,966 $ 280,000 $ 51,887 $ 721,853 2023 696,075 — 38,757 734,832 2024 1,651,162 — 32,974 1,684,136 2025 2,047,551 56,448 26,810 2,130,809 2026 1,035,585 — 19,869 1,055,454 Thereafter 5,656,800 — 109,254 5,766,054 Total maturities $ 11,477,139 $ 336,448 $ 279,551 $ 12,093,138 (1) At December 31, 2021, we had $186.7 million of borrowings outstanding under our unsecured revolving credit facility and commercial paper program, net of $149.7 million of unrestricted cash and cash equivalents. The instruments governing our outstanding indebtedness contain covenants that limit our ability and the ability of certain of our subsidiaries to, among other things: (i) incur debt; (ii) make certain dividends, distributions and investments; (iii) enter into certain transactions; and/or (iv) merge, consolidate or sell certain assets. Ventas Realty’s and Ventas Canada’s senior notes also require us and our subsidiaries to maintain total unencumbered assets of at least 150% of our unsecured debt. Our credit facilities also require us to maintain certain financial covenants pertaining to, among other things, our consolidated total leverage, secured debt, unsecured debt, fixed charge coverage and net worth. As of December 31, 2021, we were in compliance with all of these covenants. Derivatives and Hedging In the normal course of our business, interest rate fluctuations affect future cash flows under our variable rate debt obligations, loans receivable and marketable debt securities, and foreign currency exchange rate fluctuations affect our operating results. We follow established risk management policies and procedures, including the use of derivative instruments, to mitigate the impact of these risks. We do not use derivative instruments for trading or speculative purposes, and we have a policy of entering into contracts only with major financial institutions based upon their credit ratings and other factors. When considered together with the underlying exposure that the derivative is designed to hedge, we do not expect that the use of derivatives in this manner would have any material adverse effect on our future financial condition or results of operations.

Fair Values of Financial Instru

Fair Values of Financial Instruments	12 Months Ended
	Dec. 31, 2021
Fair Value Disclosures [Abstract]
Fair Values of Financial Instruments	NOTE 11 – FAIR VALUES OF FINANCIAL INSTRUMENTS The carrying amounts and fair values of our financial instruments were as follows (dollars in thousands): As of December 31, 2021 As of December 31, 2020 Carrying Amount Fair Value Carrying Amount Fair Value Assets: Cash and cash equivalents $ 149,725 $ 149,725 $ 413,327 $ 413,327 Escrow deposits and restricted cash 46,872 46,872 38,313 38,313 Stock warrants 48,884 48,884 50,098 50,098 Secured mortgage loans and other, net 488,913 478,931 555,840 508,707 Non-mortgage loans receivable, net 19,024 19,039 57,077 57,009 Marketable debt securities — — 237,553 237,553 Government-sponsored pooled loan investments, net 41,213 41,213 49,727 49,727 Derivative instruments 1,128 1,128 2 2 Liabilities: Senior notes payable and other debt, gross 12,093,138 12,891,937 11,983,071 13,075,337 Derivative instruments 12,290 12,290 28,338 28,338 Redeemable OP Units 182,112 182,112 145,983 145,983 For a discussion of the assumptions considered, refer to “Note 2 – Accounting Policies.” The use of different market assumptions and estimation methodologies may have a material effect on the reported estimated fair value amounts. Accordingly, the estimates presented above are not necessarily indicative of the amounts we would realize in a current market exchange.

Stock-Based Compensation

Stock-Based Compensation	12 Months Ended
	Dec. 31, 2021
Share-based Payment Arrangement [Abstract]
Stock-Based Compensation	NOTE 12 – STOCK- BASED COMPENSATION Compensation Plans We currently have: three plans under which outstanding options to purchase common stock, shares of restricted stock or restricted stock units have been, or may in the future be, granted to our officers, employees and non-employee directors (the 2006 Incentive Plan, the 2006 Stock Plan for Directors, and the 2012 Incentive Plan); one plan under which executive officers may receive deferred common stock in lieu of compensation (the Executive Deferred Stock Compensation Plan); and one plan under which certain non-employee directors have received or may receive deferred common stock in lieu of director fees (the Nonemployee Directors’ Deferred Stock Compensation Plan). These plans are referred to collectively as the “Plans.” During the year ended December 31, 2021, we were permitted to issue shares and grant options, restricted stock and restricted stock units only under the Executive Deferred Stock Compensation Plan, the Nonemployee Directors’ Deferred Stock Compensation Plan and the 2012 Incentive Plan. The 2006 Incentive Plan and the 2006 Stock Plan for Directors (collectively, the “2006 Plans”) expired on December 31, 2012, and no additional grants were permitted under those Plans after that date. The number of shares initially reserved for issuance and the number of shares available for future grants or issuance under these Plans as of December 31, 2021 were as follows: • Executive Deferred Stock Compensation Plan—0.6 million shares were reserved initially for issuance to our executive officers in lieu of the payment of all or a portion of their salary, at their option, and 0.6 million shares were available for future issuance as of December 31, 2021. • Nonemployee Directors’ Deferred Stock Compensation Plan—0.6 million shares were reserved initially for issuance to non-employee directors in lieu of the payment of all or a portion of their retainer and meeting fees, at their option, and 0.4 million shares were available for future issuance as of December 31, 2021. • 2012 Incentive Plan—10.7 million shares (plus the number of shares or options outstanding under the 2006 Plans as of December 31, 2012 that were or are subsequently forfeited or expire unexercised) were reserved initially for grants or issuance to employees and non-employee directors, and 2.7 million shares (plus the number of shares or options outstanding under the 2006 Plans as of December 31, 2021 that were or are subsequently forfeited or expire unexercised) were available for future issuance as of December 31, 2021. Outstanding options issued under the Plans are exercisable at the market price on the date of grant, expire ten years from the date of grant, and vest or have vested over periods of two Stock Options The following is a summary of stock option activity in 2021: Shares (000’s) Weighted Average Weighted Intrinsic Outstanding as of December 31, 2020 3,954 $ 60.90 Options granted — — Options exercised (193) 46.73 Options forfeited — — Options expired — — Outstanding as of December 31, 2021 3,761 61.63 3.9 $ 29 Exercisable as of December 31, 2021 3,761 61.63 3.9 $ 29 Compensation costs for all share-based awards are based on the grant date fair value and are recognized on a straight-line basis during the requisite service periods, with charges primarily recorded in general, administrative and professional fees in our Consolidated Statements of Income. As of December 31, 2021 and 2020, there was no unrecognized compensation expense relating to stock options. Compensation costs related to stock options for the year ended December 31, 2019 was $0.3 million, which was included in general, administrative and professional fees in our Consolidated Statements of Income. Aggregate proceeds received from options exercised under the Plans for the years ended December 31, 2021, 2020 and 2019 were $9.0 million, $5.1 million and $36.1 million, respectively. The total intrinsic value at exercise of options exercised during the years ended December 31, 2021, 2020 and 2019 was $1.5 million, $1.3 million and $12.3 million, respectively. There was no deferred income tax benefit for stock options exercised. Restricted Stock and Restricted Stock Units We recognize the fair value of shares of restricted stock and restricted stock units (including time-based and performance-based awards) on the grant date of the award as stock-based compensation expense over the requisite service period, with charges primarily to general, administrative and professional fees of $31.9 million, $21.4 million and $33.6 million in 2021, 2020 and 2019, respectively, in our Consolidated Statements of Income. Restricted stock and restricted stock units generally vest over periods ranging from two The following is a summary of the status of our non-vested restricted stock and restricted stock units (including time-based and performance-based awards) as of December 31, 2021, and changes during the year ended December 31, 2021: Restricted Weighted Restricted Weighted Non-vested at December 31, 2020 233 $ 49.94 714 $ 59.46 Granted 358 51.71 654 47.87 Vested (121) 51.51 (321) 57.44 Forfeited (22) 49.38 — — Non-vested at December 31, 2021 448 50.96 1,047 52.84 As of December 31, 2021, we had $34.6 million of unrecognized compensation cost related to non-vested restricted stock and restricted stock units under the Plans. We expect to recognize that cost over a weighted average period of 2.0 years. The total fair value at the vesting date for restricted stock and restricted stock units that vested during the years ended December 31, 2021, 2020 and 2019 was $23.4 million, $19.8 million and $31.6 million, respectively. Employee and Director Stock Purchase Plan We have in effect an Employee and Director Stock Purchase Plan (“ESPP”) under which our employees and directors may purchase shares of our common stock at a discount. Pursuant to the terms of the ESPP, on each purchase date, participants may purchase shares of common stock at a price not less than 90% of the market price on that date (with respect to the employee tax-favored portion of the plan) and not less than 95% of the market price on that date (with respect to the additional employee and director portion of the plan). We initially reserved 3.0 million shares for issuance under the ESPP. As of December 31, 2021, 0.2 million shares had been purchased under the ESPP and 2.8 million shares were available for future issuance. Employee Benefit Plan We maintain a 401(k) plan that allows eligible employees to defer compensation subject to certain limitations imposed by the Code. In 2021, we made contributions for each qualifying employee of up to 3.5% of his or her salary, subject to certain limitations. During 2021, 2020 and 2019, our aggregate contributions were approximately $1.5 million, $1.6 million and $1.5 million, respectively.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Income Taxes	NOTE 13 – INCOME TAXES We have elected to be taxed as a REIT under the applicable provisions of the Code, as amended, for every year beginning with the year ended December 31, 1999. We have also elected for certain of our subsidiaries to be treated as TRS entities, which are subject to federal, state and foreign income taxes. All entities other than the TRS entities are collectively referred to as the “REIT” within this note. Certain REIT entities are subject to foreign income tax. Although we intend to continue to operate in a manner that will enable us to qualify as a REIT, such qualification depends upon our ability to meet, on a continuing basis, various distribution, stock ownership and other tests. Our tax treatment of distributions per common share was as follows: For the Years Ended December 31, 2021 2020 2019 Tax treatment of distributions: Ordinary income $ — $ — $ — Qualified ordinary income 0.00330 0.00696 0.12230 199A qualified business income 1.25274 2.14381 2.22898 Long-term capital gain 0.16448 0.28450 — Unrecaptured Section 1250 gain 0.37948 0.04973 0.03434 Non-dividend distribution — — 0.78438 Distribution reported for 1099-DIV purposes 1.80000 2.48500 3.17000 Add: Dividend declared in current year and taxable in following year 0.45000 0.45000 0.79250 Less: Dividend declared in prior year and taxable in current year (0.45000) (0.79250) (0.79250) Distribution declared per common share outstanding $ 1.80000 $ 2.14250 $ 3.17000 We believe we have met the annual REIT distribution requirement by payment of at least 90% of our estimated taxable income for 2021, 2020 and 2019. Our consolidated expense (benefit) for income taxes was as follows (dollars in thousands): For the Years Ended December 31, 2021 2020 2019 Current - Federal $ 662 $ 402 $ (1,840) Current - State 2,116 2,107 2,118 Deferred - Federal 6,431 (56,835) (49,532) Deferred - State 72 (35,447) (3,353) Current - Foreign 3,439 2,929 2,335 Deferred - Foreign (7,893) (9,690) (6,038) Total $ 4,827 $ (96,534) $ (56,310) The 2021 income tax expense is due to a $3.5 million deferred tax expense related to an internal restructuring of certain U.S. taxable REIT subsidiaries, a $3.3 million deferred tax expense related to the revaluation of certain deferred tax liabilities as a result of enacted tax rate changes in the United Kingdom, and a $3.7 million deferred tax expense related to the release of certain residual tax effects from marketable debt securities. The 2020 income tax benefit was primarily due to a $95.9 million net deferred tax benefit from an internal restructuring of certain TRS entities, partially offset by a valuation allowance recorded against certain deferred tax assets. The 2019 income tax benefit was primarily due to the $57.7 million reversal of valuation allowance recorded against the net deferred tax assets of certain of our TRS entities. Although the TRS entities and certain other foreign entities have paid minimal cash federal, state and foreign income taxes for the year ended December 31, 2021, their income tax liabilities may increase in future years as we exhaust net operating loss (“NOL”) carryforwards and as our senior living and other operations grow. Such increases could be significant. A reconciliation of income tax expense and benefit, which is computed by applying the federal corporate tax rate for the years ended December 31, 2021, 2020 and 2019, to the income tax expense and benefit is as follows (dollars in thousands): For the Years Ended December 31, 2021 2020 2019 Tax at statutory rate on earnings from continuing operations before unconsolidated entities, noncontrolling interest and income taxes $ (34,127) $ 27,132 $ 77,803 State income taxes, net of federal benefit (8,256) (1,967) 2,341 Change in valuation allowance from ordinary operations 59,572 86,359 (47,227) Tax at statutory rate on earnings not subject to federal income taxes (22,869) (53,808) (90,862) Foreign rate differential and foreign taxes 4,405 3,342 1,407 Change in tax status of TRS 3,485 (150,287) (52) Other differences 2,617 (7,305) 280 Income tax expense (benefit) $ 4,827 $ (96,534) $ (56,310) Each TRS is a tax-paying component for purposes of classifying deferred tax assets and liabilities. The tax effects of temporary differences and carryforwards included in the net deferred tax liabilities are summarized as follows (dollars in thousands): As of December 31, 2021 2020 2019 Property, primarily differences in depreciation and amortization, the tax basis of land assets and the treatment of interests and certain costs $ (58,691) $ (60,494) $ (257,373) Operating loss and interest deduction carryforwards 187,407 124,606 136,771 Expense accruals and other 21,628 10,516 7,380 Valuation allowance (198,450) (127,279) (40,114) Net deferred tax liabilities $ (48,106) $ (52,651) $ (153,336) Our net deferred tax liability decreased $4.5 million during 2021 due to a $3.5 million deferred tax expense related to an internal restructuring of certain U.S. taxable REIT subsidiaries, a $3.3 million deferred tax expense related to the revaluation of certain deferred tax liabilities as a result of enacted tax rate changes in the United Kingdom, and a $3.7 million deferred tax expense related to the release of certain residual tax effects from marketable debt securities. Our net deferred tax liability decreased $100.7 million during 2020 primarily due to a change in the tax status of certain of our TRS entities. This was offset by the recording of valuation allowances against $54.4 million of other deferred tax assets. Our net deferred tax liability decreased $51.9 million during 2019 primarily due to the $57.7 million reversal of valuation allowances recorded against the net deferred tax assets of certain of our TRS entities. Due to uncertainty regarding the realization of certain deferred tax assets, we have established valuation allowances, primarily in connection with the NOL carryforwards related to certain TRSs. The amounts related to NOLs at the TRS entities for 2021, 2020 and 2019 are $140.6 million, $83.2 million and $21.2 million, respectively. We are subject to corporate-level taxes (“built-in gains tax”) for any asset dispositions during the five year period immediately after the assets were owned by a C corporation (either prior to our REIT election, through stock acquisition or merger). The amount of income potentially subject to built-in gains tax is generally equal to the lesser of the excess of the fair value of the asset over its adjusted tax basis as of the date it became a REIT asset or the actual amount of gain. Some, but not all, future gains could be offset by available NOL carryforwards. At December 31, 2021, 2020 and 2019, the REIT had NOL carryforwards of $1.1 billion, $896.4 million and $858.6 million, respectively. Additionally, the REIT has $10.8 million of federal income tax credits that were carried over from acquisitions. These amounts can be used to offset future taxable income (or taxable income for prior years if an audit determines that tax is owed), if any. The REIT will be entitled to utilize NOLs and tax credit carryforwards only to the extent that REIT taxable income exceeds our deduction for dividends paid. Certain NOL and credit carryforwards are limited as to their utilization by Section 382 of the Code. The remaining REIT carryforwards begin to expire in 2022. For the years ended December 31, 2021 and 2020, the net difference between tax bases and the reported amount of REIT assets and liabilities for federal income tax purposes was approximately $3.3 billion and $3.6 billion, respectively, less than the book bases of those assets and liabilities for financial reporting purposes. Generally, we are subject to audit under the statute of limitations by the Internal Revenue Service (“IRS”) for the year ended December 31, 2018 and subsequent years and are subject to audit by state taxing authorities for the year ended December 31, 2017 and subsequent years. We are subject to audit generally under the statutes of limitation by the Canada Revenue Agency and provincial authorities with respect to the Canadian entities for the year ended December 31, 2017 and subsequent years. We are subject to audit in the United Kingdom generally for the periods ended in and subsequent to 2020. The following table summarizes the activity related to our unrecognized tax benefits (dollars in thousands): 2021 2020 Balance as of January 1 $ 6,057 $ 12,127 Additions to tax positions related to prior years 29 74 Subtractions to tax positions related to prior years (4) (6,144) Balance as of December 31 $ 6,082 $ 6,057 Included in these unrecognized tax benefits of $6.1 million and $6.1 million at December 31, 2021 and 2020, respectively, were $5.3 million and $5.3 million of tax benefits at December 31, 2021 and 2020, respectively, that, if recognized, would reduce our annual effective tax rate. We accrued no interest or penalties related to the unrecognized tax benefits during 2021. We do not expect our unrecognized tax benefits to increase or decrease materially in 2022. As a part of the transfer pricing structure in the normal course of business, the REIT enters into transactions with certain TRSs, such as leasing transactions, other capital financing and allocation of general and administrative costs, which transactions are intended to comply with the IRS and foreign tax authority transfer pricing rules.

Earnings Per Share

Earnings Per Share	12 Months Ended
	Dec. 31, 2021
Earnings Per Share [Abstract]
Earnings Per Share	NOTE 15 – EARNINGS PER SHARE The following table shows the amounts used in computing our basic and diluted earnings per share (in thousands, except per share amounts): For the Years Ended December 31, 2021 2020 2019 Numerator for basic and diluted earnings per share: Income from continuing operations $ 56,559 $ 441,185 $ 439,297 Net income 56,559 441,185 439,297 Net income attributable to noncontrolling interests 7,551 2,036 6,281 Net income attributable to common stockholders $ 49,008 $ 439,149 $ 433,016 Denominator: Denominator for basic earnings per share—weighted average shares 382,785 373,368 365,977 Effect of dilutive securities: Stock options 34 — 391 Restricted stock awards 365 171 527 OP unitholder interests 3,120 2,964 2,991 Denominator for diluted earnings per share—adjusted weighted average shares 386,304 376,503 369,886 Basic earnings per share: Income from continuing operations $ 0.15 $ 1.18 $ 1.20 Net income attributable to common stockholders 0.13 1.18 1.18 Diluted earnings per share: Income from continuing operations $ 0.15 $ 1.17 $ 1.19 Net income attributable to common stockholders 0.13 1.17 1.17 There were 3.1 million, 4.0 million and 1.1 million anti-dilutive options outstanding for the years ended December 31, 2021, 2020 and 2019, respectively.

Permanent and Temporary Equity

Permanent and Temporary Equity	12 Months Ended
	Dec. 31, 2021
Equity [Abstract]
Permanent and Temporary Equity	NOTE 16 – PERMANENT AND TEMPORARY EQUITY Capital Stock In September 2021, we issued approximately 13.3 million shares of our common stock at a value of $751.2 million in connection with the New Senior Acquisition. From time to time, we may sell our common stock under an “at-the-market” equity offering program (“ATM program”). In November 2021, we replaced our ATM program with a similar program, under which we may sell up to an aggregate of $1.0 billion of our common stock. As of December 31, 2021, we have $1.0 billion remaining under our existing ATM program. During the years ended December 31, 2021, 2020 and 2019, we sold 10.9 million, 1.5 million and 2.7 million shares of our common stock under our previous ATM program for gross proceeds of $626.4 million, $66.6 million and $177.9 million, respectively, at an average gross price of $57.71, $44.88 and $66.75 per share, respectively. Excess Share Provision In order to preserve our ability to maintain REIT status, our Amended and Restated Certificate of Incorporation (our “Charter”) provides that if a person acquires beneficial ownership of more than 9% of our outstanding common stock or 9.9% of our outstanding preferred stock, the shares that are beneficially owned in excess of such limit are deemed to be excess shares. These shares are automatically deemed transferred to a trust for the benefit of a charitable institution or other qualifying organization selected by our Board of Directors. The trust is entitled to all dividends with respect to the shares, and the trustee may exercise all voting power over the shares. We have the right to buy the excess shares for a purchase price equal to the lesser of the price per share in the transaction that created the excess shares or the market price on the date we buy the shares, and we may defer payment of the purchase price for the excess shares for up to five years. If we do not purchase the excess shares, the trustee of the trust is required to transfer the excess shares at the direction of the Board of Directors. The owner of the excess shares is entitled to receive the lesser of the proceeds from the sale or the original purchase price for such excess shares, and any additional amounts are payable to the beneficiary of the trust. As of December 31, 2021, there were no shares in the trust. Our Board of Directors is empowered to grant waivers from the excess share provisions of our Charter. Accumulated Other Comprehensive Loss The following is a summary of our accumulated other comprehensive loss (dollars in thousands): As of December 31, 2021 2020 Foreign currency translation $ (56,227) $ (51,947) Available for sale securities 1,836 25,712 Derivative instruments (10,129) (28,119) Total accumulated other comprehensive loss $ (64,520) $ (54,354) Redeemable OP Unitholder and Noncontrolling Interests The following is a roll-forward of our redeemable OP unitholder and noncontrolling interests for 2021 (dollars in thousands): Redeemable OP Unitholder Interests Redeemable Noncontrolling Interests Total Redeemable OP Unitholder and Noncontrolling Interests Balance as of December 31, 2020 $ 145,983 $ 89,507 $ 235,490 New issuances 31,524 — 31,524 Change in fair value 11,178 21,655 32,833 Dispositions — — — Distributions and other (6,461) (1,422) (7,883) Redemptions (112) (11,569) (11,681) Balance as of December 31, 2021 $ 182,112 $ 98,171 $ 280,283

Related Party Transactions

Related Party Transactions	12 Months Ended
	Dec. 31, 2021
Related Party Transactions [Abstract]
Related Party Transactions	NOTE 17 – RELATED PARTY TRANSACTIONS Atria provides comprehensive property management and accounting services with respect to our senior housing communities that Atria operates, for which we pay annual management fees pursuant to long-term management agreements. For the years ended December 31, 2021, 2020 and 2019, we incurred fees to Atria of $50.8 million, $54.1 million and $61.4 million, respectively, the majority of which are recorded within property-level operating expenses in our Consolidated Statements of Income. For the years ended December 31, 2021, 2020 and 2019, we paid Atria fees of $20.3 million, $1.1 million and $0.7 million, respectively, in connection with the sale or transition of senior housing communities operated by Atria which are considered transaction costs and are primarily recorded within depreciation and amortization expense in our Consolidated Statements of Income. We hold a 34% ownership interest in Atria, which entitles us to customary minority rights and protections, including the right to appoint two of six members to the Atria Board of Directors. As of December 31, 2021, we leased 11 hospital campuses to Ardent pursuant to a single, triple-net master lease agreement. For the years ended December 31, 2021, 2020 and 2019, we recognized rental income from Ardent of $127.2 million, $122.6 million and $118.8 million, respectively, relating to the Ardent master lease. We hold a 9.8% ownership interest in Ardent, which entitles us to customary minority rights and protections, including the right to appoint one of 10 members of the Ardent Board of Directors. ESL is expected to cease operation of its management business in 2022 following completion of the transition of 90 senior housing communities to other operators. We hold a 34% ownership interest in ESL, which entitles us to customary minority rights and protections, including the right to appoint two of six members to the ESL Board of Directors. ESL management owns the 66% controlling interest. ESL provided comprehensive property management and accounting services with respect to our senior housing communities that ESL operated, for which we paid annual management fees pursuant to a management agreement. For the years ended December 31, 2021, 2020 and 2019, we incurred fees to ESL of $11.8 million, $15.1 million and $14.6 million, respectively, the majority of which are recorded within property-level operating expenses in our Consolidated Statements of Income. In connection with the transition of the operations of 90 senior housing communities, in 2021 we paid ESL $24.0 million, which is recorded within transaction expenses and deal costs in our Consolidated Statements of Income. For the years ended December 31, 2020 and 2019, we incurred fees paid to ESL of $5.2 million and $8.2 million, respectively, which are primarily recorded within transaction expenses and deal costs in our Consolidated Statements of Income.

Segment Information

Segment Information	12 Months Ended
	Dec. 31, 2021
Segment Reporting [Abstract]
Segment Information	NOTE 18 – SEGMENT INFORMATION As of December 31, 2021, we operated through three reportable business segments: triple-net leased properties, senior living operations and office operations. In our triple-net leased properties segment, we invest in and own senior housing and healthcare properties throughout the United States and the United Kingdom and lease those properties to healthcare operating companies under triple-net or absolute-net leases that obligate the tenants to pay all property-related expenses. In our senior living operations segment, we invest in senior housing communities throughout the United States and Canada and engage independent operators, such as Atria and Sunrise, to manage those communities. In our office operations segment, we primarily acquire, own, develop, lease and manage MOBs and life science, research and innovation centers throughout the United States. Information provided for “all other” includes income from loans and investments and other miscellaneous income and various corporate-level expenses not directly attributable to any of our three reportable business segments. Assets included in “all other” consist primarily of corporate assets, including cash, restricted cash, loans receivable and investments, and miscellaneous accounts receivable. Our chief operating decision makers evaluate performance of the combined properties in each reportable business segment and determine how to allocate resources to those segments, in significant part, based on segment NOI and related measures. We define segment NOI as total revenues, less interest and other income, property-level operating expenses and office building and other services costs. We consider segment NOI useful because it allows investors, analysts and our management to measure unlevered property-level operating results and to compare our operating results to the operating results of other real estate companies between periods on a consistent basis. In order to facilitate a clear understanding of our historical consolidated operating results, segment NOI should be examined in conjunction with net income attributable to common stockholders as presented in our Consolidated Financial Statements and other financial data included elsewhere in this Annual Report on Form 10-K. Interest expense, depreciation and amortization, general, administrative and professional fees, income tax expense and other non-property-specific revenues and expenses are not allocated to individual reportable business segments for purposes of assessing segment performance. There are no intersegment sales or transfers. Summary information by reportable business segment is as follows (dollars in thousands): For the Year Ended December 31, 2021 Triple-Net Senior Office All Total Revenues: Rental income $ 653,823 $ — $ 794,297 $ — $ 1,448,120 Resident fees and services — 2,270,001 — — 2,270,001 Office building and other services revenue — — 8,384 11,712 20,096 Income from loans and investments — — — 74,981 74,981 Interest and other income — — — 14,809 14,809 Total revenues $ 653,823 $ 2,270,001 $ 802,681 $ 101,502 $ 3,828,007 Total revenues $ 653,823 $ 2,270,001 $ 802,681 $ 101,502 $ 3,828,007 Less: Interest and other income — — — 14,809 14,809 Property-level operating expenses 15,335 1,811,728 257,001 — 2,084,064 Office building and other services costs — — 1,798 2,635 4,433 Segment NOI $ 638,488 $ 458,273 $ 543,882 $ 84,058 1,724,701 Interest and other income 14,809 Interest expense (440,089) Depreciation and amortization (1,197,403) General, administrative and professional fees (129,758) Loss on extinguishment of debt, net (59,299) Transaction expenses and deal costs (47,318) Allowance on loans receivable and investments 9,082 Other (37,110) Income from unconsolidated entities 4,983 Gain on real estate dispositions 218,788 Income tax expense (4,827) Income from continuing operations 56,559 Net income 56,559 Net income attributable to noncontrolling interests 7,551 Net income attributable to common stockholders $ 49,008 For the Year Ended December 31, 2020 Triple-Net Senior Office All Total Revenues: Rental income $ 695,265 $ — $ 799,627 $ — $ 1,494,892 Resident fees and services — 2,197,160 — — 2,197,160 Office building and other services revenue — — 8,675 6,516 15,191 Income from loans and investments — — — 80,505 80,505 Interest and other income — — — 7,609 7,609 Total revenues $ 695,265 $ 2,197,160 $ 808,302 $ 94,630 $ 3,795,357 Total revenues $ 695,265 $ 2,197,160 $ 808,302 $ 94,630 $ 3,795,357 Less: Interest and other income — — — 7,609 7,609 Property-level operating expenses 22,160 1,658,671 256,612 — 1,937,443 Office building and other services costs — — 2,315 — 2,315 Segment NOI $ 673,105 $ 538,489 $ 549,375 $ 87,021 1,847,990 Interest and other income 7,609 Interest expense (469,541) Depreciation and amortization (1,109,763) General, administrative and professional fees (130,158) Loss on extinguishment of debt, net (10,791) Transaction expenses and deal costs (29,812) Allowance on loans receivable and investments (24,238) Other (707) Income from unconsolidated entities 1,844 Gain on real estate dispositions 262,218 Income tax benefit 96,534 Income from continuing operations 441,185 Net income 441,185 Net income attributable to noncontrolling interests 2,036 Net income attributable to common stockholders $ 439,149 For the Year Ended December 31, 2019 Triple-Net Senior Office All Total Revenues: Rental income $ 780,898 $ — $ 828,978 $ — $ 1,609,876 Resident fees and services — 2,151,533 — — 2,151,533 Office building and other services revenue — — 7,747 3,409 11,156 Income from loans and investments — — — 89,201 89,201 Interest and other income — — — 10,984 10,984 Total revenues $ 780,898 $ 2,151,533 $ 836,725 $ 103,594 $ 3,872,750 Total revenues $ 780,898 $ 2,151,533 $ 836,725 $ 103,594 $ 3,872,750 Less: Interest and other income — — — 10,984 10,984 Property-level operating expenses 26,561 1,521,398 260,249 — 1,808,208 Office building and other services costs — — 2,319 — 2,319 Segment NOI $ 754,337 $ 630,135 $ 574,157 $ 92,610 2,051,239 Interest and other income 10,984 Interest expense (451,662) Depreciation and amortization (1,045,620) General, administrative and professional fees (158,726) Loss on extinguishment of debt, net (41,900) Transaction expenses and deal costs (15,235) Other 10,339 Loss from unconsolidated entities (2,454) Gain on real estate dispositions 26,022 Income tax benefit 56,310 Income from continuing operations 439,297 Net income 439,297 Net income attributable to noncontrolling interests 6,281 Net income attributable to common stockholders $ 433,016 Assets by reportable business segment are as follows (dollars in thousands): As of December 31, Assets: 2021 2020 Triple-net leased properties $ 4,578,534 18.5 % $ 5,147,503 21.6 % Senior living operations 12,811,611 51.8 10,653,428 44.5 Office operations 6,341,888 25.7 6,709,602 28.0 All other assets 985,753 4.0 1,418,871 5.9 Total assets $ 24,717,786 100.0 % $ 23,929,404 100.0 % Capital expenditures, including investments in real estate property and development project expenditures, by reportable business segment are as follows (dollars in thousands): For the Years Ended December 31, Capital expenditures: 2021 2020 2019 Triple-net leased properties $ 92,924 $ 42,930 $ 55,429 Senior living operations 1,463,551 191,891 944,214 Office operations 245,546 372,475 519,129 Total capital expenditures $ 1,802,021 $ 607,296 $ 1,518,772 Our portfolio of properties and mortgage loan and other investments are located in the United States, Canada and the United Kingdom. Revenues are attributed to an individual country based on the location of each property. Geographic information regarding our operations is as follows (dollars in thousands): For the Years Ended December 31, Revenues: 2021 2020 2019 United States $ 3,363,197 $ 3,381,357 $ 3,578,341 Canada 434,862 389,205 266,946 United Kingdom 29,948 24,795 27,463 Total revenues $ 3,828,007 $ 3,795,357 $ 3,872,750 As of December 31, Net real estate property: 2021 2020 United States $ 18,562,738 $ 17,303,816 Canada 3,007,008 2,983,924 United Kingdom 247,092 262,295 Total net real estate property $ 21,816,838 $ 20,550,035

Schedule III_ Real Estate and A

Schedule III: Real Estate and Accumulated Depreciation	12 Months Ended
	Dec. 31, 2021
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]
SCHEDULE III REAL ESTATE AND ACCUMULATED DEPRECIATION	SCHEDULE III REAL ESTATE AND ACCUMULATED DEPRECIATION (Dollars in thousands) For the Years Ended December 31, 2021 2020 2019 Reconciliation of real estate: Carrying cost: Balance at beginning of period $ 26,850,442 $ 27,133,514 $ 24,973,983 Additions during period: Acquisitions 2,413,570 249,290 1,941,018 Capital expenditures 423,752 485,479 575,624 Deductions during period: Foreign currency translation 17,030 80,302 107,508 Other (1) (1,224,924) (1,098,143) (464,619) Balance at end of period $ 28,479,870 $ 26,850,442 $ 27,133,514 Accumulated depreciation: Balance at beginning of period $ 6,967,413 $ 6,200,230 $ 5,492,310 Additions during period: Depreciation expense 865,627 809,067 811,936 Dispositions: Sales and/or transfers to assets held for sale (401,208) (82,559) (116,771) Foreign currency translation 1,648 40,675 12,755 Balance at end of period $ 7,433,480 $ 6,967,413 $ 6,200,230 (1) Other may include sales, transfers to assets held for sale and impairments. SCHEDULE III REAL ESTATE AND ACCUMULATED DEPRECIATION December 31, 2021 (Dollars in thousands ) Initial Cost to Company Gross Amount Carried Description Count Encumbrances Land and Buildings and Costs Capitalized Subsequent to Acquisition 1 Land and Buildings and Total Accumulated NBV Year of Year Life on which UNITED STATES PROPERTIES Senior Housing Atria Senior Living 134 $ 243,330 $ 454,983 $ 3,891,742 $ 571,695 $ 479,650 $ 4,438,770 $ 4,918,420 $ 1,445,165 $ 3,473,255 1835 - 2013 2007 - 2021 19 - 52 years Brookdale Senior Living 128 48,040 190,736 2,018,166 135,697 190,786 2,153,813 2,344,599 886,010 1,458,589 1915 - 2012 2004 - 2020 35 - 35 years Holiday Retirement 91 284,894 186,176 1,869,082 (734) 186,528 1,867,996 2,054,524 193,361 1,861,163 1978 - 2009 2013 - 2021 13 - 54 years Sunrise Senior Living 80 — 198,915 2,113,355 209,680 210,789 2,311,161 2,521,950 1,002,870 1,519,080 1987 - 2009 2007 - 2012 35 - 35 years Sinceri Senior Living 36 — 59,551 597,082 28,117 58,139 626,611 684,750 222,131 462,619 1974 - 2005 2006 - 2015 35 - 35 years Discovery Senior Living 19 — 21,906 251,919 13,347 22,213 264,959 287,172 87,695 199,477 1984 - 2005 2006 - 2014 35 - 35 years Koelsch Senior Communities 19 75,179 27,721 292,414 13,578 28,424 305,289 333,713 55,138 278,575 1972 - 2017 2011 - 2017 35 - 35 years Priority Life Care Properties 19 — 13,296 147,310 14,854 13,594 161,866 175,460 57,014 118,446 1986 - 2008 2006 - 2019 35 - 35 years Sodalis Senior Living 18 — 21,451 208,224 (7,052) 21,613 201,010 222,623 76,312 146,311 1996 - 2007 2006 - 2015 35 - 35 years Eclipse Senior Living 14 — 15,697 205,506 10,649 15,940 215,912 231,852 82,504 149,348 1964 - 2000 2006 - 2014 35 - 35 years Matthews Senior Living 14 — 11,470 25,011 (15,253) 8,906 12,322 21,228 9,516 11,712 1985 - 2007 2011 - 2011 35 - 35 years Avamere Family of Companies 13 — 24,248 151,017 10,151 24,494 160,922 185,416 48,942 136,474 1972 - 2012 2011 - 2015 35 - 35 years Azura Memory Care 13 — 6,361 53,002 10,850 7,200 63,013 70,213 18,470 51,743 1990 - 2019 2011 - 2019 35 - 35 years Milestone Retirement Communities 13 — 19,769 197,527 2,434 19,769 199,961 219,730 50,706 169,024 1965 - 2011 2011 - 2014 35 - 35 years Hawthorn Senior Living 10 58,406 35,668 220,099 — 35,668 220,099 255,767 2,601 253,166 1998 - 2008 2021 - 2021 27 - 50 years Meridian Senior Living 10 — 17,977 77,599 1,416 17,977 79,015 96,992 25,575 71,417 1972 - 2012 2011 - 2015 35 - 35 years Sonida Senior Living 10 — 14,080 118,512 21,910 14,735 139,767 154,502 53,137 101,365 1977 - 1998 2005 - 2012 35 - 35 years Other Senior Housing Operators 77 85,131 115,316 1,038,608 41,486 114,078 1,081,332 1,195,410 293,406 902,004 1964 - 2010 2004 - 2021 8 - 39 years Other Senior Housing CIP 2 — 2,983 150 — 2,983 150 3,133 — 3,133 CIP CIP CIP Total Senior Housing 720 794,980 1,438,304 13,476,325 1,062,825 1,473,486 14,503,968 15,977,454 4,610,553 11,366,901 Medical Office Lillibridge 207 38,872 153,578 2,047,079 438,907 152,144 2,487,420 2,639,564 914,439 1,725,125 1960 - 2016 2004 - 2021 4 - 39 years PMB RES 38 235,418 73,863 972,701 103,220 75,134 1,074,650 1,149,784 316,853 832,931 1972 - 2019 2011 - 2019 19 - 35 years Other MOBs 65 1,089 113,350 847,812 45,326 110,122 896,366 1,006,488 261,021 745,467 1984 - 2014 2004 - 2018 25 - 35 years Other MOBs CIP 1 — — — — — — — — — CIP CIP CIP Total Medical Office 311 275,379 340,791 3,867,592 587,453 337,400 4,458,436 4,795,836 1,492,313 3,303,523 Life Science, Research & Innovation Wexford 31 206,799 85,744 1,541,924 125,731 85,705 1,667,694 1,753,399 247,370 1,506,029 1923 - 2019 2016 - 2019 15 - 60 years Other Life Science 2 — 1,194 76,515 — 1,194 76,515 77,709 4,655 73,054 2010 - 2016 2020 - 2020 35 - 35 years Initial Cost to Company Gross Amount Carried Description Count Encumbrances Land and Buildings and Costs Capitalized Subsequent to Acquisition 1 Land and Buildings and Total Accumulated NBV Year of Year Life on which Other Life Science CIP 8 — 25,910 37,762 — 25,910 37,762 63,672 2,591 61,081 CIP CIP CIP Total Life Science, Research & Innovation 41 206,799 112,848 1,656,201 125,731 112,809 1,781,971 1,894,780 254,616 1,640,164 IRFs & LTACs Kindred Healthcare 30 — 35,185 238,600 (1,000) 34,185 238,600 272,785 209,361 63,424 1937 - 2013 1976 - 2020 20 - 40 years Other IRFs & LTACs 6 — 9,257 151,238 1,068 9,257 152,306 161,563 35,659 125,904 1989 - 2012 2011 - 2015 35 - 36 years Total IRFs & LTACs 36 — 44,442 389,838 68 43,442 390,906 434,348 245,020 189,328 Health Systems Ardent Health Services 10 — 98,428 1,126,010 78,104 97,416 1,205,126 1,302,542 216,935 1,085,607 1928 - 2020 2015 - 2020 20 - 47 years Skilled Nursing Genesis Healthcare 12 — 11,350 164,745 (5,708) 11,350 159,037 170,387 68,573 101,814 1897 - 1995 2004 - 2011 30 - 35 years Other Skilled Nursing 4 — 1,636 18,793 1,405 1,816 20,018 21,834 12,970 8,864 1955 - 1990 1991 - 2009 29 - 40 years Total Skilled Nursing 16 — 12,986 183,538 (4,303) 13,166 179,055 192,221 81,543 110,678 CANADIAN PROPERTIES Senior Housing Le Groupe Maurice 34 1,097,568 141,123 1,743,734 116,229 147,622 1,853,464 2,001,086 103,029 1,898,057 2000 - 2020 2019 - 2020 40 - 60 years Atria Senior Living 29 — 75,553 845,363 (15,001) 71,248 834,667 905,915 225,639 680,276 1988 - 2008 2014 - 2014 35 - 35 years Sunrise Senior Living 12 — 46,600 418,821 (43,105) 40,692 381,624 422,316 167,340 254,976 2000 - 2007 2007 - 2007 35 - 35 years Hawthorn Senior Living 6 — 25,172 146,694 — 25,172 146,694 171,866 842 171,024 2006 - 2012 2021 - 2021 35 - 35 years Other Senior Housing CIP 2 56,338 20,085 114,855 — 20,085 114,855 134,940 — 134,940 CIP CIP CIP Total Senior Housing 83 1,153,906 308,533 3,269,467 58,123 304,819 3,331,304 3,636,123 496,850 3,139,273 UNITED KINGDOM PROPERTIES Senior Housing Canford Healthcare Limited 12 — 42,445 84,181 (9,093) 39,186 78,347 117,533 16,602 100,931 1980 - 2014 2015 - 2017 40 - 40 years International Hospital Spire Healthcare 3 — 11,903 136,628 (19,499) 10,341 118,692 129,033 19,048 109,985 1980 - 2010 2014 - 2014 50 - 50 years TOTAL 1,232 $ 2,431,064 $ 2,410,680 $ 24,189,780 $ 1,879,409 $ 2,432,065 $ 26,047,805 $ 28,479,870 $ 7,433,480 $ 121,046,390

Schedule IV - Real Estate Mortg

Schedule IV - Real Estate Mortgage Loans	12 Months Ended
	Dec. 31, 2021
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Abstract]
Schedule IV - Real Estate Mortgage Loans	SCHEDULE IV MORTGAGE LOANS ON REAL ESTATE December 31, 2021 (Dollars in thousands) Location Number of RE Assets Interest Rate Fixed / Variable Maturity Date Monthly Debt Service Face Value Net Book Value Prior Liens Mezzanine Loans Multiple 154 6.53% V 6/9/2022 2,684 486,200 486,200 1,018,440 Total $ 2,684 $ 486,200 $ 486,200 $ 1,018,440 Mortgage Loan Reconciliation 2021 2020 2019 Beginning Balance $ 552,797 $ 642,218 $ 427,117 Additions: New loans — 66,000 1,234,244 Construction draws — — — Total additions — 66,000 1,234,244 Deductions: Principal repayments (66,597) (155,170) (1,011,353) Total deductions (66,597) (155,170) (1,011,353) Effect of foreign currency translation — (251) (7,790) Ending Balance $ 486,200 $ 552,797 $ 642,218

Accounting Policies (Policies)

Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2021
Accounting Policies [Abstract]
Principles of Consolidation	Principles of Consolidation The accompanying Consolidated Financial Statements include our accounts and the accounts of our wholly owned subsidiaries and the joint venture entities over which we exercise control. All intercompany transactions and balances have been
Variable Interest Entities	We identify the primary beneficiary of a VIE as the enterprise that has both: (i) the power to direct the activities of the VIE that most significantly impact the entity’s economic performance and (ii) the obligation to absorb losses or the right to receive benefits of the VIE that could be significant to the entity. We perform this analysis on an ongoing basis. As it relates to investments in joint ventures, GAAP may preclude consolidation by the sole general partner in certain circumstances based on the type of rights held by the limited partner or partners. We assess limited partners’ rights and their impact on our consolidation conclusions, and we reassess if there is a change to the terms or in the exercisability of the rights of the limited partners, the sole general partner increases or decreases its ownership of limited partnership (“LP”) interests or there is an increase or decrease in the number of outstanding LP interests. We also apply this guidance to managing member interests in limited liability companies (“LLCs”). We consolidate several VIEs that share the following common characteristics: • the VIE is in the legal form of an LP or LLC; • the VIE was designed to own and manage its underlying real estate investments; • we are the general partner or managing member of the VIE; • we own a majority of the voting interests in the VIE; • a minority of voting interests in the VIE are owned by external third parties, unrelated to us; • the minority owners do not have substantive kick-out or participating rights in the VIE; and • we are the primary beneficiary of the VIE. We have separately identified certain special purpose entities that were established to allow investments in life science, research and innovation projects by tax credit investors (“TCIs”). We have determined that these special purpose entities are VIEs, we are a holder of variable interests and we are the primary beneficiary of the VIEs, and therefore, we consolidate these special purpose entities. Our primary beneficiary determination is based upon several factors, including but not limited to the rights we have in directing the activities which most significantly impact the VIEs’ economic performance as well as certain guarantees which protect the TCIs from losses should a tax credit recapture event occur. In general, the assets of consolidated VIEs are available only for the settlement of the obligations of the respective entities. Unless otherwise required by the LP or LLC agreement, any mortgage loans of the consolidated VIEs are non-recourse to us. The table below summarizes the total assets and liabilities of our consolidated VIEs as reported on our Consolidated Balance Sheets (dollars in thousands): December 31, 2021 December 31, 2020 Total Assets Total Liabilities Total Assets Total Liabilities NHP/PMB L.P. $ 749,834 $ 251,352 $ 649,128 $ 238,168 Other identified VIEs 3,949,294 1,556,136 4,095,102 1,653,036 Tax credit VIEs 458,953 103,992 614,490 204,746
Investments in Unconsolidated Entities	Investments in Unconsolidated Entities We report investments in unconsolidated entities over whose operating and financial policies we have the ability to exercise significant influence under the equity method of accounting. We adjust our investment in unconsolidated entities for additional contributions made, distributions received as well as our share of the investee’s earnings or losses, which is included in income (loss) from unconsolidated entities in our Consolidated Statements of Income. We base the initial carrying value of investments in unconsolidated entities on the fair value of the assets at the time we acquired the joint venture interest. We estimate fair values for our equity method investments based on discounted cash flow models that include all estimated cash inflows and outflows over a specified holding period and, where applicable, any estimated debt premiums or discounts. The capitalization rates, discount rates and credit spreads we use in these models are based upon assumptions that we believe to be within a reasonable range of current market rates for the respective investments. We generally amortize any difference between our cost basis and the basis reflected at the joint venture level, if any, over the lives of the related assets and liabilities and include that amortization in our share of income or loss from unconsolidated entities. For earnings of equity method investments with pro rata distribution allocations, net income or loss is allocated between the partners in the joint venture based on their respective stated ownership percentages. In other instances, net income or loss may be allocated between the partners in the joint venture based on the hypothetical liquidation at book value method (the “HLBV method”). Under the HLBV method, net income or loss is allocated between the partners based on the difference between each partner’s claim on the net assets of the joint venture at the end and beginning of the period, after taking into account contributions and distributions. Each partner’s share of the net assets of the joint venture is calculated as the amount that the partner would receive if the joint venture were to liquidate all of its assets at net book value and distribute the resulting cash to creditors and partners in accordance with their respective priorities. Under the HLBV method, in any given period, we could record more or less income than the joint venture has generated, than actual cash distributions we receive or than the amount we may receive in the event of an actual liquidation.
Redeemable OP Unitholder and Noncontrolling Interests	Redeemable OP Unitholder and Noncontrolling Interests We own a majority interest in NHP/PMB L.P. (“NHP/PMB”), a limited partnership formed in 2008 to acquire properties from entities affiliated with Pacific Medical Buildings LLC (“PMB”). Given our wholly owned subsidiary is the general partner and the primary beneficiary of NHP/PMB, we consolidate NHP/PMB as a VIE. As of December 31, 2021, third-party investors owned 3.9 million Class A limited partnership units in NHP/PMB (“OP Units”), which represented 34% of the total units then outstanding, and we owned 7.5 million Class B limited partnership units in NHP/PMB, representing the remaining 66%. The OP Units may be redeemed at any time at the election of the holder for cash or, at our option, 0.9051 shares of our common stock per OP Unit, subject to adjustment in certain circumstances. We are party by assumption to a registration rights agreement with the holders of the OP Units that requires us, subject to the terms and conditions and certain exceptions set forth therein, to file and maintain a registration statement relating to the issuance of shares of our common stock upon redemption of OP Units. In September, NHP/PMB completed the buy-out of PMB’s interest in the newly developed Sutter Van Ness Medical Office Building. In connection with that transaction, NHP/PMB issued 0.6 million OP Units to third party investors. The OP Units are classified outside of permanent equity on our Consolidated Balance Sheets because they may be redeemed by third parties under circumstances that are outside of our control. We reflect the OP Units at the greater of cost or redemption value. As of December 31, 2021 and 2020, the fair value of the OP Units was $182.1 million and $146.0 million, respectively. We recognize changes in fair value through capital in excess of par value, net of cash distributions paid and purchases by us of any OP Units. Our diluted earnings per share includes the effect of any potential shares outstanding from redemption of the OP Units. Certain noncontrolling interests of other consolidated joint ventures were also classified as redeemable at December 31, 2021 and 2020. We record the carrying amount of these noncontrolling interests at the greater of their initial carrying amount (increased or decreased for the noncontrolling interests’ share of net income or loss and distributions) or the redemption value, which is primarily based on the fair value of the underlying real estate asset. Our joint venture partners have certain redemption rights with respect to their noncontrolling interests in these joint ventures that are outside of our control, and the redeemable noncontrolling interests are classified outside of permanent equity on our Consolidated Balance Sheets. We recognize changes in the carrying value of redeemable noncontrolling interests through capital in excess of par value on our Consolidated Balance Sheets. Noncontrolling Interests
Historic and New Market Tax Credits, Policy	Accounting for Historic and New Markets Tax Credits For certain of our life science, research and innovation centers, we are party to contractual arrangements with TCIs that were established to enable the TCIs to receive benefits of historic tax credits (“HTCs”), new markets tax credits (“NMTCs”) or both. As of December 31, 2021, we owned six properties that had syndicated HTCs or NMTCs, or both, to TCIs. In general, TCIs invest cash into special purpose entities that invest in entities that own the subject property and generate the tax credits. The TCIs receive substantially all of the tax credits and hold only a nominal interest in the economic risk and benefits of the special purpose entities. HTCs are delivered to the TCIs upon substantial completion of the project. NMTCs are allowed for up to 39% of a qualified investment and are delivered to the TCIs after the investment has been funded and spent on a qualified business. HTCs are subject to 20% recapture per year beginning one year after the completion of the historic rehabilitation of the subject property. NMTCs are subject to 100% recapture until the end of the seventh year following the qualifying investment. We have provided the TCIs with certain guarantees which protect the TCIs from losses should a tax credit recapture event occur. The contractual arrangements with the TCIs include a put/call provision whereby we may be obligated or entitled to repurchase the interest of the TCIs in the special purpose entities at the end of the tax credit recapture period. We anticipate that either the TCIs will exercise their put rights or we will exercise our call rights prior to the applicable tax credit recapture periods. The portion of the TCI’s investment that is attributed to the put is recorded at fair value at inception in accounts payable and other liabilities on our Consolidated Balance Sheets, and is accreted to the expected put price as interest expense in our Consolidated Statements of Income over the recapture period. The remaining balance of the TCI’s investment is initially recorded in accounts payable and other liabilities on our Consolidated Balance Sheets and will be relieved upon delivery of the tax credit to the TCI, as a reduction in the carrying value of the subject property, net of allocated expenses. Direct and incremental costs incurred in structuring the transaction are deferred and will be recognized as an increase in the cost basis of the subject property upon the recognition of the related tax credit as discussed above.
Accounting Estimates	Accounting Estimates The preparation of financial statements in accordance with GAAP requires us to make estimates and assumptions regarding future events that affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.
Accounting for Real Estate Acquisitions	Accounting for Real Estate Acquisitions When we acquire real estate, we first make reasonable judgments about whether the transaction involves an asset or a business. Our real estate acquisitions are generally accounted for as asset acquisitions as substantially all of the fair value of the gross assets acquired is concentrated in a single identifiable asset or group of similar identifiable assets. Regardless of whether an acquisition is considered a business combination or an asset acquisition, we record the cost of the businesses or assets acquired as tangible and intangible assets and liabilities based upon their estimated fair values as of the acquisition date. We estimate the fair value of buildings acquired on an as-if-vacant basis or replacement cost basis and depreciate the building value over the estimated remaining life of the building, generally not to exceed 35 years. We determine the fair value of other fixed assets, such as site improvements, and furniture, fixtures and equipment, based upon the replacement cost and depreciate such value over the assets’ estimated remaining useful lives as determined at the applicable acquisition date. We determine the value of land either by considering the sales prices of similar properties in recent transactions or based on internal analyses of recently acquired and existing comparable properties within our portfolio. We generally determine the value of construction in progress based upon the replacement cost. However, for certain acquired properties that are part of a ground-up development, we determine fair value by using the same valuation approach as for all other properties and deducting the estimated cost to complete the development. During the remaining construction period, we capitalize project costs until the development has reached substantial completion. Construction in progress, including capitalized interest, is not depreciated until the development has reached substantial completion. Intangibles primarily include the value of in-place leases and acquired lease contracts. We include all lease-related intangible assets and liabilities within acquired lease intangibles and accounts payable and other liabilities, respectively, on our Consolidated Balance Sheets. The fair value of acquired lease-related intangibles, if any, reflects: (i) the estimated value of any above or below market leases, determined by discounting the difference between the estimated market rent and in-place lease rent; and (ii) the estimated value of in-place leases related to the cost to obtain tenants, including leasing commissions, and an estimated value of the absorption period to reflect the value of the rent and recovery costs foregone during a reasonable lease-up period as if the acquired space was vacant. We amortize any acquired lease-related intangibles to revenue or amortization expense over the remaining life of the associated lease plus any assumed bargain renewal periods. If a lease is terminated prior to its stated expiration or not renewed upon expiration, we recognize all unamortized amounts of lease-related intangibles associated with that lease in operations over the shortened lease term. We estimate the fair value of purchase option intangible assets and liabilities, if any, by discounting the difference between the applicable property’s acquisition date fair value and an estimate of its future option price. We do not amortize the resulting intangible asset or liability over the term of the lease, but rather adjust the recognized value of the asset or liability upon sale. In connection with an acquisition, we may assume rights and obligations under certain lease agreements pursuant to which we become the lessee of a given property. We generally assume the lease classification previously determined by the prior lessee absent a modification in the assumed lease agreement. We assess assumed operating leases, including ground leases, to determine whether the lease terms are favorable or unfavorable to us given current market conditions on the acquisition date. To the extent the lease terms are favorable or unfavorable to us relative to market conditions on the acquisition date, we recognize an intangible asset or liability at fair value and amortize that asset or liability to interest or rental expense in our Consolidated Statements of Income over the applicable lease term. Where we are the lessee, we record the acquisition date values of leases, including any above or below market value, within operating lease assets and operating lease liabilities on our Consolidated Balance Sheets. We estimate the fair value of noncontrolling interests assumed consistent with the manner in which we value all of the underlying assets and liabilities. We calculate the fair value of long-term assumed debt by discounting the remaining contractual cash flows on each instrument at the current market rate for those borrowings, which we approximate based on the rate at which we would expect to incur a replacement instrument on the date of acquisition, and recognize any fair value adjustments related to long-term debt as effective yield adjustments over the remaining term of the instrument.
Impairment of Long-Lived and Intangible Assets	Impairment of Long-Lived and Intangible Assets We periodically evaluate our long-lived assets, primarily consisting of investments in real estate, for impairment indicators. If indicators of impairment are present, we evaluate the carrying value of the related real estate investments in relation to the future undiscounted cash flows of the underlying operations. In performing this evaluation, we consider market conditions and our current intentions with respect to holding or disposing of the asset. We adjust the net book value of properties and other long-lived assets to fair value if the sum of the expected future undiscounted cash flows, including sales proceeds, is less than book value. We recognize an impairment loss at the time we make any such determination. If impairment indicators arise with respect to intangible assets with finite useful lives, we evaluate impairment by comparing the carrying amount of the asset to the estimated future undiscounted net cash flows expected to be generated by the asset. If estimated future undiscounted net cash flows are less than the carrying amount of the asset, then we estimate the fair value of the asset and compare the estimated fair value to the intangible asset’s carrying value. We recognize any shortfall from carrying value as an impairment loss in the current period. We evaluate our investments in unconsolidated entities for impairment at least annually, and whenever events or changes in circumstances indicate that the carrying value of our investment may exceed its fair value. If we determine that a decline in the fair value of our investment in an unconsolidated entity is other-than-temporary, and if such reduced fair value is below the carrying value, we record an impairment. We test goodwill for impairment at least annually, and more frequently if indicators of impairment arise. We first assess qualitative factors, such as current macroeconomic conditions, state of the equity and capital markets and our overall financial and operating performance, to determine the likelihood that the fair value of a reporting unit is less than its carrying amount. If we determine it is more likely than not that the fair value of a reporting unit is less than its carrying amount, we proceed with estimating the fair value of the reporting unit. A goodwill impairment, if any, will be recognized in the period it is determined and is measured as the amount by which a reporting unit’s carrying value exceeds its fair value.
Assets Held-for-Sale and Discontinued Operations	Assets Held for Sale and Discontinued Operations We sell properties from time to time for various reasons, including favorable market conditions or the exercise of purchase options by tenants. We classify certain long-lived assets as held for sale once the criteria, as defined by GAAP, have been met. Long-lived assets to be disposed of are reported at the lower of their carrying amount or fair value minus cost to sell and are no longer depreciated. If at any time we determine that the criteria for classifying assets as held for sale are no longer met, we reclassify assets within net real estate investments on our Consolidated Balance Sheets for all periods presented. The carrying amount of these assets is adjusted (in the period in which a change in classification is determined) to reflect any depreciation expense that would have been recognized had the asset been continuously classified as net real estate investments. We report discontinued operations when the following criteria are met: (1) a component of an entity or group of components that has been disposed of or classified as held for sale and represents a strategic shift that has or will have a major effect on an entity’s operations and financial results; or (2) an acquired business is classified as held for sale on the acquisition date. The results of operations for assets meeting the definition of discontinued operations are reflected in our Consolidated Statements of Income as discontinued operations for all periods presented. We allocate estimated interest expense to discontinued operations based on property values and our weighted average interest rate or the property’s actual mortgage interest.
Loans Receivable	Loans ReceivableWe record loans receivable, other than those acquired in connection with a business combination, on our Consolidated Balance Sheets (either in secured loans receivable and investments, net or other assets, in the case of non-mortgage loans receivable) at the unpaid principal balance, net of any deferred origination fees, purchase discounts or premiums and valuation allowances. We amortize net deferred origination fees, which are comprised of loan fees collected from the borrower net of certain direct costs, and purchase discounts or premiums over the contractual life of the loan using the effective interest method and immediately recognize in income any unamortized balances if the loan is repaid before its contractual maturity.
Cash Equivalents	Cash Equivalents Cash equivalents consist of highly liquid investments with a maturity date of three months or less when purchased. These investments are stated at cost, which approximates fair value.
Escrow Deposits and Restricted Cash	Escrow Deposits and Restricted Cash Escrow deposits consist of amounts held by us or our lenders to provide for future real estate tax, insurance expenditures and tenant improvements related to our properties and operations. Restricted cash generally represents amounts paid to us for security deposits and other similar purposes.
Deferred Financing Costs	Deferred Financing Costs We amortize deferred financing costs, which are reported as a reduction to senior notes payable and other debt on our Consolidated Balance Sheets, as a component of interest expense over the terms of the related borrowings using a method that approximates a level yield. Amortized costs of approximately $19.7 million, $23.0 million and $20.2 million were included in interest expense for the years ended December 31, 2021, 2020 and 2019, respectively.
Marketable Debt Securities	Available for Sale Securities We classify available for sale securities as a component of other assets on our Consolidated Balance Sheets (other than our interests in government-sponsored pooled loan investments, which are classified as secured loans receivable and investments, net on our Consolidated Balance Sheets). We record these securities at fair value and include unrealized gains and losses recorded in stockholders’ equity as a component of accumulated other comprehensive income on our Consolidated Balance Sheets. If we determine that a credit loss exists with respect to individual investments, we will recognize an allowance against the amortized cost basis of the investment with a corresponding charge to net income (in allowance on loans receivable and investments) in our Consolidated Statements of Income. We report interest income, including discount or premium amortization, on available for sale securities and gains or losses on securities sold, which are based on the specific identification method, in income from loans and investments in our Consolidated Statements of Income.
Derivative Instruments	Derivative Instruments We recognize all derivative instruments in other assets or accounts payable and other liabilities on our Consolidated Balance Sheets at fair value as of the reporting date. We recognize changes in the fair value of derivative instruments in other expense in our Consolidated Statements of Income or accumulated other comprehensive income on our Consolidated Balance Sheets, depending on the intended use of the derivative and our designation of the instrument.
Fair Values of Financial Instruments	Fair Values of Financial Instruments Fair value is a market-based measurement, not an entity-specific measurement, and we determine fair value based on the assumptions that we expect market participants would use in pricing the asset or liability. As a basis for considering market participant assumptions in fair value measurements, GAAP establishes a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of the reporting entity (observable inputs that are classified within levels one and two of the hierarchy) and the reporting entity’s own assumptions about market participant assumptions (unobservable inputs classified within level three of the hierarchy). Level one inputs utilize unadjusted quoted prices for identical assets or liabilities in active markets that we have the ability to access. Level two inputs are inputs other than quoted prices included in level one that are directly or indirectly observable for the asset or liability. Level two inputs may include quoted prices for similar assets and liabilities in active markets and other inputs for the asset or liability that are observable at commonly quoted intervals, such as interest rates, foreign exchange rates and yield curves. Level three inputs are unobservable inputs for the asset or liability, which typically are based on our own assumptions, because there is little, if any, related market activity. If the determination of the fair value measurement is based on inputs from different levels of the hierarchy, the level within which the entire fair value measurement falls is the lowest-level input that is significant to the fair value measurement in its entirety. If the volume and level of market activity for an asset or liability has decreased significantly relative to the normal market activity for such asset or liability (or similar assets or liabilities), then transactions or quoted prices may not accurately reflect fair value. In addition, if there is evidence that a transaction for an asset or liability is not orderly, little, if any, weight is placed on that transaction price as an indicator of fair value. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability. We use the following methods and assumptions in estimating the fair value of our financial instruments whose fair value is determined on a recurring basis. • Cash and cash equivalents - The carrying amount of unrestricted cash and cash equivalents reported on our Consolidated Balance Sheets approximates fair value due to the short maturity of these instruments. • Escrow deposits and restricted cash - The carrying amount of escrow deposits and restricted cash reported on our Consolidated Balance Sheets approximates fair value due to the short maturity of these instruments. • Loans receivable - We estimate the fair value of loans receivable using level two and level three inputs. We discount future cash flows using current interest rates at which similar loans with the same terms and length to maturity would be made to borrowers with similar credit ratings. • Available for sale securities - We estimate the fair value of marketable debt securities using level two inputs. We observe quoted prices for similar assets or liabilities in active markets that we have the ability to access. We estimate the fair value of certain government-sponsored pooled loan investments using level three inputs. We consider credit spreads, underlying asset performance and credit quality, and default rates. • Derivative instruments - With the assistance of a third party, we estimate the fair value of derivative instruments, including interest rate caps, interest rate swaps, and foreign currency forward contracts, using level two inputs. ◦ Interest rate caps - We observe forward yield curves and other relevant information. ◦ Interest rate swaps - We observe alternative financing rates derived from market-based financing rates, forward yield curves and discount rates. ◦ Foreign currency forward contracts - We estimate the future values of the two currency tranches using forward exchange rates that are based on traded forward points and calculate a present value of the net amount using a discount factor based on observable traded interest rates. • Stock warrants - We estimate the fair value of stock warrants using level two inputs that are obtained from public sources. Inputs include equity spot price, dividend yield, volatility and risk-free rate. • Senior notes payable and other debt - We estimate the fair value of senior notes payable and other debt using level two inputs. We discount the future cash flows using current interest rates at which we could obtain similar borrowings. For mortgage debt, we may estimate fair value using level three inputs, similar to those used in determining fair value of loans receivable (above). • Redeemable OP unitholder interests - We estimate the fair value of our redeemable OP unitholder interests using level one inputs. We base fair value on the closing price of our common stock, as OP Units may be redeemed at the election of the holder for cash or, at our option, shares of our common stock, subject to adjustment in certain circumstances.
Revenue Recognition	Revenue Recognition Triple-Net Leased Properties and Office Operations Certain of our triple-net leases and most of our MOB and life science, research and innovation centers (collectively, “office operations”) leases provide for periodic and determinable increases in base rent. We recognize base rental revenues under these leases on a straight-line basis over the applicable lease term when collectability of substantially all rents is probable. Recognizing rental income on a straight-line basis generally results in recognized revenues during the first half of a lease term exceeding the cash amounts contractually due from our tenants, creating a straight-line rent receivable that is included in other assets on our Consolidated Balance Sheets. At December 31, 2021 and 2020, this cumulative excess totaled $176.9 million and $169.7 million, respectively (excluding properties classified as held for sale). Certain of our leases provide for periodic increases in base rent only if certain revenue parameters or other substantive contingencies are met. We recognize the increased rental revenue under these leases as the related parameters or contingencies are met, rather than on a straight-line basis over the applicable lease term. We assess the probability of collecting substantially all rents under our leases based on several factors, including, among other things, payment history, the financial strength of the tenant and any guarantors, the historical operations and operating trends of the property, the historical payment pattern of the tenant, the type of property, the value of the underlying collateral, if any, expected future performance of the property and current economic conditions. If our evaluation of these factors indicates it is not probable that we will be able to collect substantially all rents under the lease, we record a charge to rental income. If we change our conclusions regarding the probability of collecting rent payments required by a lease, we may recognize adjustments to rental income in the period we make such change in our conclusions. Senior Living Operations Our resident agreements are accounted for as leases and we recognize resident fees and services, other than move-in fees, monthly as services are provided. We recognize move-in fees on a straight-line basis over the average resident stay. Other We recognize interest income from loans and investments, including discounts and premiums, using the effective interest method when collectability is reasonably assured. We apply the effective interest method on a loan-by-loan basis and recognize discounts and premiums as yield adjustments over the related loan term. We evaluate collectability of accrued interest receivables separate from the amortized cost basis of our loans. As such, we recognize interest income on an impaired loan to the extent we believe accrued contractual interest payments are collectable. Otherwise, interest income is recognized on a cash basis. We evaluate a current estimate of all expected credit losses over the life of a financial instrument, which may result in recognition of credit losses on loans and other financial instruments before an actual event of default. We establish reserves for any estimated credit losses with a corresponding charge to allowance on loans receivable and investments in our Consolidated Statements of Income. Subsequent changes in our estimate of credit losses may result in a corresponding increase or decrease to allowance on loans receivable and investments in our Consolidated Statements of Income.
Operating Leases	Accounting for Leased Property We lease real property, primarily land and corporate office space, and equipment, primarily vehicles at our senior housing communities. At lease inception, we establish an operating lease asset and operating lease liability, calculated as the present value of future minimum lease payments, on our Consolidated Balance Sheets. As our leases do not provide an implicit rate, we use a discount rate that approximates our incremental borrowing rate available at lease commencement to determine the present value. Our lease expense primarily consists of ground and corporate office leases. Ground lease expense is included in interest expense and corporate office lease expense is included in general, administrative and professional fees in our Consolidated Statements of Income.
Stock-Based Compensation	Stock-Based Compensation We recognize share-based payments to employees and directors, including grants of stock options and restricted stock, included in general, administrative and professional fees in our Consolidated Statements of Income generally on a straight-line basis over the requisite service period based on the grant date fair value of the award.
Gain on Sale of Assets	Gain on Real Estate Dispositions We recognize a gain on real estate disposition when we transfer control of a property and when it is probable that we will collect substantially all of the related consideration.
Federal Income Tax	Federal Income Tax We have elected to be treated as a REIT under the applicable provisions of the Internal Revenue Code of 1986, as amended (the “Code”), for every year beginning with the year ended December 31, 1999. Accordingly, we generally are not subject to federal income tax on net income that we distribute to our stockholders, provided that we continue to qualify as a REIT. However, with respect to certain of our subsidiaries that have elected to be treated as taxable REIT subsidiaries (“TRS” or “TRS entities”), we record income tax expense or benefit, as those entities are subject to federal income tax similar to regular corporations. Certain foreign subsidiaries are subject to foreign income tax, although they did not elect to be treated as TRSs. We account for deferred income taxes using the asset and liability method and recognize deferred tax assets and liabilities for the expected future tax consequences of events that have been included in our financial statements or tax returns. Under this method, we determine deferred tax assets and liabilities based on the differences between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Any increase or decrease in the deferred tax liability that results from a change in circumstances, and that causes us to change our judgment about expected future tax consequences of events, is included in the tax provision when such changes occur. Deferred income taxes also reflect the impact of operating loss and tax credit carryforwards. A valuation allowance is provided if we believe it is more likely than not that all or some portion of the deferred tax asset will not be realized. Any increase or decrease in the valuation allowance that results from a change in circumstances, and that causes us to change our judgment about the realizability of the related deferred tax asset, is included in the tax provision when such changes occur.
Foreign Currency	Foreign Currency Certain of our subsidiaries’ functional currencies are the local currencies of their respective foreign jurisdictions. We translate the results of operations of our foreign subsidiaries into U.S. dollars using average rates of exchange in effect during the period, and we translate balance sheet accounts using exchange rates in effect at the end of the period. We record the resulting currency translation adjustments in accumulated other comprehensive income, a component of stockholders’ equity, on our Consolidated Balance Sheets, and we record foreign currency transaction gains and losses in other expense in our Consolidated Statements of Income. We recognize any noncontrolling interests’ proportionate share of currency translation adjustments of our foreign consolidated joint ventures in noncontrolling interests on our Consolidated Balance Sheets.
Segment Reporting	Segment ReportingAs of December 31, 2021, 2020 and 2019, we operated through three reportable business segments: triple-net leased properties, senior living operations and office operations. In our triple-net leased properties segment, we invest in and own senior housing and healthcare properties throughout the United States and the United Kingdom and lease those properties to healthcare operating companies under triple-net or absolute-net leases that obligate the tenants to pay all property-related expenses. In our senior living operations segment, we invest in senior housing communities throughout the United States and Canada and engage independent operators, such as Atria and Sunrise, to manage those communities. In our office operations segment, we primarily acquire, own, develop, lease and manage MOBs and life science, research and innovation centers throughout the United States. See “Note 18 – Segment Information.”
Recently Issued or Adopted Accounting Standards	Recently Issued Accounting Standards In November 2021, the FASB issued ASU 2021-10, Disclosures by Business Entities about Government Assistance, (“ASU 2022-10”) which requires expanded disclosure for transactions involving the receipt of government assistance. Required disclosures include a description of the nature of transactions with government entities, our accounting policies for such transactions and their impact to our Consolidated Financial Statements. ASU 2021-10 is effective for us beginning January 1, 2022 and adoption of this standard is not expected to have a significant impact on our Consolidated Financial Statements.
Reclassifications	ReclassificationsCertain prior year amounts have been reclassified to conform to the current year presentation.

Accounting Policies (Tables)

Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2021
Accounting Policies [Abstract]
Schedule of Variable Interest Entities	The table below summarizes the total assets and liabilities of our consolidated VIEs as reported on our Consolidated Balance Sheets (dollars in thousands): December 31, 2021 December 31, 2020 Total Assets Total Liabilities Total Assets Total Liabilities NHP/PMB L.P. $ 749,834 $ 251,352 $ 649,128 $ 238,168 Other identified VIEs 3,949,294 1,556,136 4,095,102 1,653,036 Tax credit VIEs 458,953 103,992 614,490 204,746

Concentration of Credit Risk (T

Concentration of Credit Risk (Tables)	12 Months Ended
	Dec. 31, 2021
Risks and Uncertainties [Abstract]
Concentration risk for triple-net leased properties	The following table reflects the concentration risk related to our triple-net leased properties including assets held for sale for the periods presented: For the Years Ended December 31, 2021 2020 2019 Revenues (1) : Brookdale Senior Living (2) 3.9 % 4.4 % 4.7 % Ardent 3.3 3.2 3.1 Kindred 3.8 3.5 3.3 NOI: Brookdale Senior Living (2) 8.6 % 9.0 % 8.7 % Ardent 7.4 6.6 5.8 Kindred 7.8 7.1 6.3 (1) Total revenues include office building and other services revenue, income from loans and investments and interest and other income. (2) 2021 and 2020 results include $42.6 million and $21.3 million, respectively, of amortization of up-front consideration received in 2020 from the Brookdale Lease.
Schedule of future contracted minimum rentals for all of triple-net and MOB leases	The following table sets forth the future contracted minimum rentals, excluding contingent rent escalations, but including straight-line rent adjustments where applicable, for all of our consolidated triple-net and office building leases as of December 31, 2021 (excluding properties classified as held for sale as of December 31, 2021, dollars in thousands): Brookdale Senior Living Ardent Kindred Other Total 2022 $ 147,951 $ 130,834 $ 135,262 $ 700,544 $ 1,114,591 2023 147,693 130,834 114,356 648,401 1,041,284 2024 147,709 130,834 104,083 597,681 980,307 2025 147,725 130,834 36,015 514,305 828,879 2026 — 130,370 1,921 439,705 571,996 Thereafter — 1,122,180 2,444 1,592,355 2,716,979 Total $ 591,078 $ 1,775,886 $ 394,081 $ 4,492,991 $ 7,254,036

Dispositions and Impairments (T

Dispositions and Impairments (Tables)	12 Months Ended
	Dec. 31, 2021
Discontinued Operations and Disposal Groups [Abstract]
Assets Held-for-sale	The table below summarizes our real estate assets classified as held for sale including the amounts reported on our Consolidated Balance Sheets, which may include anticipated post-closing settlements of working capital for disposed properties. December 31, 2021 December 31, 2020 Number of Properties Held for Sale Assets Held for Sale Liabilities Held for Sale Number of Properties Held for Sale Assets Held for Sale Liabilities Held for Sale Triple-net leased properties — $ — $ — 1 $ 4,960 $ 2,690 Office operations 2 3,435 1,529 — 15 101 Senior living operations 2 24,964 9,321 1 4,633 455 Total 4 $ 28,399 $ 10,850 2 $ 9,608 $ 3,246

Loans Receivable and Investme_2

Loans Receivable and Investments - Loans Receivable and Investments (Tables)	12 Months Ended
	Dec. 31, 2021
Loans Receivable And Investments [Abstract]
Loans Receivable And Investments	The following is a summary of our loans receivable and investments, net, including amortized cost, fair value and unrealized gains or losses on available for sale investments (dollars in thousands): Amortized Cost Allowance Unrealized Gain Carrying Amount Fair Value As of December 31, 2021: Secured/mortgage loans and other, net $ 488,913 $ — $ — $ 488,913 $ 478,931 Government-sponsored pooled loan investments, net (1) 39,376 — 1,836 41,213 41,213 Total investments reported as secured loans receivable and investments, net 528,289 — 1,836 530,126 520,144 Non-mortgage loans receivable, net (2) 24,418 (5,394) — 19,024 19,039 Total loans receivable and investments, net $ 552,707 $ (5,394) $ 1,836 $ 549,150 $ 539,183 As of December 31, 2020: Secured/mortgage loans and other, net $ 555,840 $ — $ — $ 555,840 $ 508,707 Government-sponsored pooled loan investments, net 55,154 (8,846) 3,419 49,727 49,727 Total investments reported as secured loans receivable and investments, net 610,994 (8,846) 3,419 605,567 558,434 Non-mortgage loans receivable, net (2) 74,700 (17,623) — 57,077 57,009 Marketable debt securities (2) 213,334 — 24,219 237,553 237,553 Total loans receivable and investments, net $ 899,028 $ (26,469) $ 27,638 $ 900,197 $ 852,996 (1) Investment in government-sponsored pool loans has a contractual maturity date in 2023. (2) Included in other assets on our Consolidated Balance Sheets.

Intangibles (Tables)

Intangibles (Tables)	12 Months Ended
	Dec. 31, 2021
Intangible Assets, Intangible Liabilities, And Goodwill Disclosure [Abstract]
Schedule of Intangibles	The following is a summary of our intangibles (dollars in thousands): As of December 31, 2021 As of December 31, 2020 Balance Weighted Average Balance Weighted Average Intangible assets: Above-market lease intangibles (1) $ 129,121 5.9 $ 140,096 6.4 In-place and other lease intangibles (2) 1,240,626 7.2 1,090,790 10.7 Goodwill 1,046,140 N/A 1,051,650 N/A Other intangibles (2) 34,517 6.5 35,870 10.0 Accumulated amortization (944,403) N/A (941,462) N/A Net intangible assets $ 1,506,001 7.1 $ 1,376,944 10.3 Intangible liabilities: Below-market lease intangibles (1) $ 334,365 9.7 $ 339,265 14.3 Other lease intangibles 13,608 N/A 13,498 N/A Accumulated amortization (244,975) N/A (212,655) N/A Purchase option intangibles 3,568 N/A 3,568 N/A Net intangible liabilities $ 106,566 9.7 $ 143,676 14.3 (1) Amortization of above- and below-market lease intangibles is recorded as a decrease and an increase to revenues, respectively, in our Consolidated Statements of Income. (2) Amortization of lease intangibles is recorded in depreciation and amortization in our Consolidated Statements of Income.
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense	The following is a summary of the estimated net amortization related to these intangibles for each of the next five years (dollars in thousands): Estimated Net Amortization 2022 $ 123,144 2023 111,976 2024 57,729 2025 9,764 2026 5,972
Schedule of Goodwill	The table below reflects the carrying amount of goodwill, by segment, as of December 31, 2021 (dollars in thousands): Goodwill Triple-net leased properties $ 322,097 Senior living operations 259,482 Office operations 464,561 Total goodwill $ 1,046,140

Other Assets (Tables)

Other Assets (Tables)	12 Months Ended
	Dec. 31, 2021
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Summary of other assets	The following is a summary of our other assets (dollars in thousands): As of December 31, 2021 2020 Straight-line rent receivables $ 176,877 $ 169,711 Non-mortgage loans receivable, net 19,024 57,077 Stock warrants 48,884 50,098 Marketable debt securities — 237,553 Other intangibles, net 7,270 4,659 Investment in unconsolidated operating entities 73,602 63,768 Other 239,412 224,363 Total other assets $ 565,069 $ 807,229

Senior Notes Payable and Othe_2

Senior Notes Payable and Other Debt (Tables)	12 Months Ended
	Dec. 31, 2021
Debt Disclosure [Abstract]
Summary of senior notes payable and other debt	The following is a summary of our senior notes payable and other debt (dollars in thousands): As of December 31, 2021 2020 Unsecured revolving credit facility (1) $ 56,448 $ 39,395 Commercial paper notes 280,000 — Secured revolving construction credit facility due 2022 — 154,098 Floating Rate Senior Notes, Series F due 2021 (2) — 235,664 3.25% Senior Notes due 2022 — 263,687 3.30% Senior Notes, Series C due 2022 (2) — 196,386 Unsecured term loan due 2023 200,000 200,000 3.125% Senior Notes due 2023 — 400,000 3.10% Senior Notes due 2023 — 400,000 2.55% Senior Notes, Series D due 2023 (2) 217,667 216,025 3.50% Senior Notes due 2024 400,000 400,000 3.75% Senior Notes due 2024 400,000 400,000 4.125% Senior Notes, Series B due 2024 (2) 197,879 196,386 2.80% Senior Notes, Series E due 2024 (2) 474,909 471,328 Unsecured term loan due 2025 (2) 395,757 392,773 3.50% Senior Notes due 2025 600,000 600,000 2.65% Senior Notes due 2025 450,000 450,000 4.125% Senior Notes due 2026 500,000 500,000 3.25% Senior Notes due 2026 450,000 450,000 2.45% Senior Notes, Series G due 2027 (2) 375,970 — 3.85% Senior Notes due 2027 400,000 400,000 4.00% Senior Notes due 2028 650,000 650,000 4.40% Senior Notes due 2029 750,000 750,000 3.00% Senior Notes due 2030 650,000 650,000 4.75% Senior Notes due 2030 500,000 500,000 2.50% Senior Notes due 2031 500,000 — 3.30% Senior Notes, Series H due 2031 (2) 237,454 — 6.90% Senior Notes due 2037 (3) 52,400 52,400 6.59% Senior Notes due 2038 (3) 22,823 22,823 5.70% Senior Notes due 2043 300,000 300,000 4.375% Senior Notes due 2045 300,000 300,000 4.875% Senior Notes due 2049 300,000 300,000 Mortgage loans and other 2,431,831 2,092,106 Total 12,093,138 11,983,071 Deferred financing costs, net (69,925) (68,343) Unamortized fair value adjustment 32,888 12,618 Unamortized discounts (28,557) (31,934) Senior notes payable and other debt $ 12,027,544 $ 11,895,412 (1) As of December 31, 2021 and 2020, respectively, $30.9 million and $12.2 million of aggregate borrowings were denominated in Canadian dollars. Aggregate borrowings of $25.6 million and $27.2 million were denominated in British pounds as of December 31, 2021 and 2020, respectively. (2) Canadian Dollar debt obligations shown in US Dollars.
Scheduled maturities of borrowing arrangements and other provisions excluding capital lease obligations	The following summarizes the maturities of our senior notes payable and other debt as of December 31, 2021 (dollars in thousands): Principal Amount Unsecured Revolving Credit Facility and Commercial Paper Notes (1) Scheduled Periodic Total Maturities 2022 $ 389,966 $ 280,000 $ 51,887 $ 721,853 2023 696,075 — 38,757 734,832 2024 1,651,162 — 32,974 1,684,136 2025 2,047,551 56,448 26,810 2,130,809 2026 1,035,585 — 19,869 1,055,454 Thereafter 5,656,800 — 109,254 5,766,054 Total maturities $ 11,477,139 $ 336,448 $ 279,551 $ 12,093,138

Fair Values of Financial Inst_2

Fair Values of Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2021
Fair Value Disclosures [Abstract]
Carrying amounts and fair values of financial instruments	The carrying amounts and fair values of our financial instruments were as follows (dollars in thousands): As of December 31, 2021 As of December 31, 2020 Carrying Amount Fair Value Carrying Amount Fair Value Assets: Cash and cash equivalents $ 149,725 $ 149,725 $ 413,327 $ 413,327 Escrow deposits and restricted cash 46,872 46,872 38,313 38,313 Stock warrants 48,884 48,884 50,098 50,098 Secured mortgage loans and other, net 488,913 478,931 555,840 508,707 Non-mortgage loans receivable, net 19,024 19,039 57,077 57,009 Marketable debt securities — — 237,553 237,553 Government-sponsored pooled loan investments, net 41,213 41,213 49,727 49,727 Derivative instruments 1,128 1,128 2 2 Liabilities: Senior notes payable and other debt, gross 12,093,138 12,891,937 11,983,071 13,075,337 Derivative instruments 12,290 12,290 28,338 28,338 Redeemable OP Units 182,112 182,112 145,983 145,983

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	12 Months Ended
	Dec. 31, 2021
Share-based Payment Arrangement [Abstract]
Summary of stock option activity	The following is a summary of stock option activity in 2021: Shares (000’s) Weighted Average Weighted Intrinsic Outstanding as of December 31, 2020 3,954 $ 60.90 Options granted — — Options exercised (193) 46.73 Options forfeited — — Options expired — — Outstanding as of December 31, 2021 3,761 61.63 3.9 $ 29 Exercisable as of December 31, 2021 3,761 61.63 3.9 $ 29
Summary of status of nonvested restricted stock and restricted stock units and changes during the year	The following is a summary of the status of our non-vested restricted stock and restricted stock units (including time-based and performance-based awards) as of December 31, 2021, and changes during the year ended December 31, 2021: Restricted Weighted Restricted Weighted Non-vested at December 31, 2020 233 $ 49.94 714 $ 59.46 Granted 358 51.71 654 47.87 Vested (121) 51.51 (321) 57.44 Forfeited (22) 49.38 — — Non-vested at December 31, 2021 448 50.96 1,047 52.84

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Schedule of tax treatment of distributions per common share	Our tax treatment of distributions per common share was as follows: For the Years Ended December 31, 2021 2020 2019 Tax treatment of distributions: Ordinary income $ — $ — $ — Qualified ordinary income 0.00330 0.00696 0.12230 199A qualified business income 1.25274 2.14381 2.22898 Long-term capital gain 0.16448 0.28450 — Unrecaptured Section 1250 gain 0.37948 0.04973 0.03434 Non-dividend distribution — — 0.78438 Distribution reported for 1099-DIV purposes 1.80000 2.48500 3.17000 Add: Dividend declared in current year and taxable in following year 0.45000 0.45000 0.79250 Less: Dividend declared in prior year and taxable in current year (0.45000) (0.79250) (0.79250) Distribution declared per common share outstanding $ 1.80000 $ 2.14250 $ 3.17000
Schedule of provision (benefit) for income taxes	Our consolidated expense (benefit) for income taxes was as follows (dollars in thousands): For the Years Ended December 31, 2021 2020 2019 Current - Federal $ 662 $ 402 $ (1,840) Current - State 2,116 2,107 2,118 Deferred - Federal 6,431 (56,835) (49,532) Deferred - State 72 (35,447) (3,353) Current - Foreign 3,439 2,929 2,335 Deferred - Foreign (7,893) (9,690) (6,038) Total $ 4,827 $ (96,534) $ (56,310)
Schedule of reconciliation of income tax expense	A reconciliation of income tax expense and benefit, which is computed by applying the federal corporate tax rate for the years ended December 31, 2021, 2020 and 2019, to the income tax expense and benefit is as follows (dollars in thousands): For the Years Ended December 31, 2021 2020 2019 Tax at statutory rate on earnings from continuing operations before unconsolidated entities, noncontrolling interest and income taxes $ (34,127) $ 27,132 $ 77,803 State income taxes, net of federal benefit (8,256) (1,967) 2,341 Change in valuation allowance from ordinary operations 59,572 86,359 (47,227) Tax at statutory rate on earnings not subject to federal income taxes (22,869) (53,808) (90,862) Foreign rate differential and foreign taxes 4,405 3,342 1,407 Change in tax status of TRS 3,485 (150,287) (52) Other differences 2,617 (7,305) 280 Income tax expense (benefit) $ 4,827 $ (96,534) $ (56,310)
Summary of tax effects of temporary differences and carryforwards included in the net deferred tax liabilities	The tax effects of temporary differences and carryforwards included in the net deferred tax liabilities are summarized as follows (dollars in thousands): As of December 31, 2021 2020 2019 Property, primarily differences in depreciation and amortization, the tax basis of land assets and the treatment of interests and certain costs $ (58,691) $ (60,494) $ (257,373) Operating loss and interest deduction carryforwards 187,407 124,606 136,771 Expense accruals and other 21,628 10,516 7,380 Valuation allowance (198,450) (127,279) (40,114) Net deferred tax liabilities $ (48,106) $ (52,651) $ (153,336)
Summary of activity related to unrecognized tax benefits	The following table summarizes the activity related to our unrecognized tax benefits (dollars in thousands): 2021 2020 Balance as of January 1 $ 6,057 $ 12,127 Additions to tax positions related to prior years 29 74 Subtractions to tax positions related to prior years (4) (6,144) Balance as of December 31 $ 6,082 $ 6,057

Commitments and Contingencies (

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2021
Commitments and Contingencies Disclosure [Abstract]
Schedule of Future Minimum Rental Payments for Operating Leases	The following table summarizes future minimum lease obligations under non-cancelable ground and other operating leases as of December 31, 2021 (dollars in thousands): 2022 $ 21,328 2023 21,468 2024 20,346 2025 15,918 2026 15,836 Thereafter 585,762 Total undiscounted minimum lease payments 680,658 Less: imputed interest (483,424) Operating lease liabilities $ 197,234

Earnings Per Share (Tables)

Earnings Per Share (Tables)	12 Months Ended
	Dec. 31, 2021
Earnings Per Share [Abstract]
Computation of basic and diluted earnings per common share	The following table shows the amounts used in computing our basic and diluted earnings per share (in thousands, except per share amounts): For the Years Ended December 31, 2021 2020 2019 Numerator for basic and diluted earnings per share: Income from continuing operations $ 56,559 $ 441,185 $ 439,297 Net income 56,559 441,185 439,297 Net income attributable to noncontrolling interests 7,551 2,036 6,281 Net income attributable to common stockholders $ 49,008 $ 439,149 $ 433,016 Denominator: Denominator for basic earnings per share—weighted average shares 382,785 373,368 365,977 Effect of dilutive securities: Stock options 34 — 391 Restricted stock awards 365 171 527 OP unitholder interests 3,120 2,964 2,991 Denominator for diluted earnings per share—adjusted weighted average shares 386,304 376,503 369,886 Basic earnings per share: Income from continuing operations $ 0.15 $ 1.18 $ 1.20 Net income attributable to common stockholders 0.13 1.18 1.18 Diluted earnings per share: Income from continuing operations $ 0.15 $ 1.17 $ 1.19 Net income attributable to common stockholders 0.13 1.17 1.17

Permanent and Temporary Equity

Permanent and Temporary Equity (Tables)	12 Months Ended
	Dec. 31, 2021
Equity [Abstract]
Schedule of Accumulated Other Comprehensive Income	The following is a summary of our accumulated other comprehensive loss (dollars in thousands): As of December 31, 2021 2020 Foreign currency translation $ (56,227) $ (51,947) Available for sale securities 1,836 25,712 Derivative instruments (10,129) (28,119) Total accumulated other comprehensive loss $ (64,520) $ (54,354)
Redeemable OP Unitholder and Noncontrolling Interest	The following is a roll-forward of our redeemable OP unitholder and noncontrolling interests for 2021 (dollars in thousands): Redeemable OP Unitholder Interests Redeemable Noncontrolling Interests Total Redeemable OP Unitholder and Noncontrolling Interests Balance as of December 31, 2020 $ 145,983 $ 89,507 $ 235,490 New issuances 31,524 — 31,524 Change in fair value 11,178 21,655 32,833 Dispositions — — — Distributions and other (6,461) (1,422) (7,883) Redemptions (112) (11,569) (11,681) Balance as of December 31, 2021 $ 182,112 $ 98,171 $ 280,283

Segment Information (Tables)

Segment Information (Tables)	12 Months Ended
	Dec. 31, 2021
Segment Reporting [Abstract]
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Table Text Block]	Summary information by reportable business segment is as follows (dollars in thousands): For the Year Ended December 31, 2021 Triple-Net Senior Office All Total Revenues: Rental income $ 653,823 $ — $ 794,297 $ — $ 1,448,120 Resident fees and services — 2,270,001 — — 2,270,001 Office building and other services revenue — — 8,384 11,712 20,096 Income from loans and investments — — — 74,981 74,981 Interest and other income — — — 14,809 14,809 Total revenues $ 653,823 $ 2,270,001 $ 802,681 $ 101,502 $ 3,828,007 Total revenues $ 653,823 $ 2,270,001 $ 802,681 $ 101,502 $ 3,828,007 Less: Interest and other income — — — 14,809 14,809 Property-level operating expenses 15,335 1,811,728 257,001 — 2,084,064 Office building and other services costs — — 1,798 2,635 4,433 Segment NOI $ 638,488 $ 458,273 $ 543,882 $ 84,058 1,724,701 Interest and other income 14,809 Interest expense (440,089) Depreciation and amortization (1,197,403) General, administrative and professional fees (129,758) Loss on extinguishment of debt, net (59,299) Transaction expenses and deal costs (47,318) Allowance on loans receivable and investments 9,082 Other (37,110) Income from unconsolidated entities 4,983 Gain on real estate dispositions 218,788 Income tax expense (4,827) Income from continuing operations 56,559 Net income 56,559 Net income attributable to noncontrolling interests 7,551 Net income attributable to common stockholders $ 49,008 For the Year Ended December 31, 2020 Triple-Net Senior Office All Total Revenues: Rental income $ 695,265 $ — $ 799,627 $ — $ 1,494,892 Resident fees and services — 2,197,160 — — 2,197,160 Office building and other services revenue — — 8,675 6,516 15,191 Income from loans and investments — — — 80,505 80,505 Interest and other income — — — 7,609 7,609 Total revenues $ 695,265 $ 2,197,160 $ 808,302 $ 94,630 $ 3,795,357 Total revenues $ 695,265 $ 2,197,160 $ 808,302 $ 94,630 $ 3,795,357 Less: Interest and other income — — — 7,609 7,609 Property-level operating expenses 22,160 1,658,671 256,612 — 1,937,443 Office building and other services costs — — 2,315 — 2,315 Segment NOI $ 673,105 $ 538,489 $ 549,375 $ 87,021 1,847,990 Interest and other income 7,609 Interest expense (469,541) Depreciation and amortization (1,109,763) General, administrative and professional fees (130,158) Loss on extinguishment of debt, net (10,791) Transaction expenses and deal costs (29,812) Allowance on loans receivable and investments (24,238) Other (707) Income from unconsolidated entities 1,844 Gain on real estate dispositions 262,218 Income tax benefit 96,534 Income from continuing operations 441,185 Net income 441,185 Net income attributable to noncontrolling interests 2,036 Net income attributable to common stockholders $ 439,149 For the Year Ended December 31, 2019 Triple-Net Senior Office All Total Revenues: Rental income $ 780,898 $ — $ 828,978 $ — $ 1,609,876 Resident fees and services — 2,151,533 — — 2,151,533 Office building and other services revenue — — 7,747 3,409 11,156 Income from loans and investments — — — 89,201 89,201 Interest and other income — — — 10,984 10,984 Total revenues $ 780,898 $ 2,151,533 $ 836,725 $ 103,594 $ 3,872,750 Total revenues $ 780,898 $ 2,151,533 $ 836,725 $ 103,594 $ 3,872,750 Less: Interest and other income — — — 10,984 10,984 Property-level operating expenses 26,561 1,521,398 260,249 — 1,808,208 Office building and other services costs — — 2,319 — 2,319 Segment NOI $ 754,337 $ 630,135 $ 574,157 $ 92,610 2,051,239 Interest and other income 10,984 Interest expense (451,662) Depreciation and amortization (1,045,620) General, administrative and professional fees (158,726) Loss on extinguishment of debt, net (41,900) Transaction expenses and deal costs (15,235) Other 10,339 Loss from unconsolidated entities (2,454) Gain on real estate dispositions 26,022 Income tax benefit 56,310 Income from continuing operations 439,297 Net income 439,297 Net income attributable to noncontrolling interests 6,281 Net income attributable to common stockholders $ 433,016
Reconciliation of Assets from Segment to Consolidated [Table Text Block]	Assets by reportable business segment are as follows (dollars in thousands): As of December 31, Assets: 2021 2020 Triple-net leased properties $ 4,578,534 18.5 % $ 5,147,503 21.6 % Senior living operations 12,811,611 51.8 10,653,428 44.5 Office operations 6,341,888 25.7 6,709,602 28.0 All other assets 985,753 4.0 1,418,871 5.9 Total assets $ 24,717,786 100.0 % $ 23,929,404 100.0 %
Segment Reporting Information Expenditures for Additions to Long-Lived Assets [Table Text Block]	Capital expenditures, including investments in real estate property and development project expenditures, by reportable business segment are as follows (dollars in thousands): For the Years Ended December 31, Capital expenditures: 2021 2020 2019 Triple-net leased properties $ 92,924 $ 42,930 $ 55,429 Senior living operations 1,463,551 191,891 944,214 Office operations 245,546 372,475 519,129 Total capital expenditures $ 1,802,021 $ 607,296 $ 1,518,772
Long-lived Assets by Geographic Areas	As of December 31, Net real estate property: 2021 2020 United States $ 18,562,738 $ 17,303,816 Canada 3,007,008 2,983,924 United Kingdom 247,092 262,295 Total net real estate property $ 21,816,838 $ 20,550,035
Schedule of Revenue from External Customers and Long-Lived Assets, by Geographical Areas	Geographic information regarding our operations is as follows (dollars in thousands): For the Years Ended December 31, Revenues: 2021 2020 2019 United States $ 3,363,197 $ 3,381,357 $ 3,578,341 Canada 434,862 389,205 266,946 United Kingdom 29,948 24,795 27,463 Total revenues $ 3,828,007 $ 3,795,357 $ 3,872,750

Description of Business (Detail

Description of Business (Details)	1 Months Ended	2 Months Ended	12 Months Ended
	Jun. 30, 2020USD ($)	Feb. 18, 2022USD ($)	Dec. 31, 2021USD ($)propertytenant	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)
Real estate properties
Number of real estate properties | property			1,200
Real Estate Investments, Net			$ 22,870,429,000	$ 21,599,290,000
Deferred Tax Assets, Valuation Allowance			198,450,000	127,279,000	$ 40,114,000
COVID-19 Impact
Real estate properties
HHS Grants Received of Provider Relief Fund			15,400,000	35,100,000
Unusual or Infrequent Item, or Both, Charges, Amount			$ 0
Allowance for Loan and Lease Losses, Write-offs				74,600,000
Real estate impairments related to natural disasters				$ 126,500,000
Impairment Of Real Estate Percent Of Total				1.00%
Financing Receivable, Allowance for Credit Loss, Writeoff				$ 34,700,000
Financing Receivable, Allowance for Credit Loss				10,500,000
Equity Method Investment, Other than Temporary Impairment	$ 10,700,000			10,700,000
Deferred Tax Assets, Valuation Allowance				56,400,000
COVID-19 Impact | Subsequent Event
Real estate properties
HHS Grants Received of Provider Relief Fund		$ 34,000,000
COVID-19 Impact | Fair Value
Real estate properties
Real Estate Investments, Net				$ 239,900,000
Brookdale Senior Living
Real estate properties
Number of real estate properties | property			121
Concentration risk, number of tenants | tenant			3
Ardent
Real estate properties
Number of real estate properties | property			12
Kindred
Real estate properties
Number of real estate properties | property			31
Triple-net leased properties
Real estate properties
Number of real estate properties | property			332
Senior Housing
Real estate properties
Number of independent third party managed properties | property			554

Schedule of VIEs (Details)

Schedule of VIEs (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Variable Interest Entity [Line Items]
Total Assets	$ 24,717,786	$ 23,929,404
Total Liabilities	13,491,743	13,415,723
NHP/PMB L.P. | Variable Interest Entity, Primary Beneficiary
Variable Interest Entity [Line Items]
Total Assets	749,834	649,128
Total Liabilities	251,352	238,168
Other identified VIEs | Variable Interest Entity, Primary Beneficiary
Variable Interest Entity [Line Items]
Total Assets	3,949,294	4,095,102
Total Liabilities	1,556,136	1,653,036
Tax credit VIEs | Variable Interest Entity, Primary Beneficiary
Variable Interest Entity [Line Items]
Total Assets	458,953	614,490
Total Liabilities	$ 103,992	$ 204,746

Redeemable OP Unitholder and No

Redeemable OP Unitholder and Noncontrolling Interests (Details) shares in Millions, $ in Millions	1 Months Ended	12 Months Ended
	Sep. 30, 2021shares	Dec. 31, 2021USD ($)shares	Dec. 31, 2020USD ($)
Redeemable OP Unitholder Interests [Line Items]
Redeemable OP Unitholder interests | $		$ 182.1	$ 146
NHP/PMB L.P.
Redeemable OP Unitholder Interests [Line Items]
Unit conversion factor for common stock		0.9051
Capital Unit, Class A | NHP/PMB L.P.
Redeemable OP Unitholder Interests [Line Items]
Units issued to third party investors	0.6
Capital Unit, Class A | LImited Partner | NHP/PMB L.P.
Redeemable OP Unitholder Interests [Line Items]
Limited partners' units outstanding		3.9
Capital Unit, Class A | LImited Partner | NHP/PMB L.P. | NHP/PMB L.P.
Redeemable OP Unitholder Interests [Line Items]
Percentage of ownership interest on total units outstanding		34.00%
Capital Unit, Class B | General Partner | NHP/PMB L.P.
Redeemable OP Unitholder Interests [Line Items]
General partner's units outstanding		7.5
Capital Unit, Class B | General Partner | NHP/PMB L.P. | NHP/PMB L.P.
Redeemable OP Unitholder Interests [Line Items]
Percentage of ownership interest on total units outstanding		66.00%

Accounting for Historic and New

Accounting for Historic and New Markets Tax Credits (Details)	Dec. 31, 2021property
Real Estate [Line Items]
Number of real estate properties	1,200
Maximum of qualified investment potentially received as new market tax credit	39.00%
Amount of recapture per year historic tax credits are subject to one year after completion of project	20.00%
Amount of recapture new market tax credits are subject to until the end of the seventh year following the qualified investment	100.00%
Real Estate Properties That Qualify For Certain Tax Credits
Real Estate [Line Items]
Number of real estate properties	6

Accounting for Real Estate Acqu

Accounting for Real Estate Acquisitions (Details)	12 Months Ended
	Dec. 31, 2021
Building
Business Acquisition [Line Items]
Estimated remaining life (in years)	35 years

Deferred Financing Costs (Detai

Deferred Financing Costs (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Accounting Policies [Abstract]
Amortization of debt issuance costs	$ 19.7	$ 23	$ 20.2

Revenue Recognition (Details)

Revenue Recognition (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Revenue from Contract with Customer [Abstract]
Straight-line rent receivables, net	$ 176,877	$ 169,711

Segments (Details)

Segments (Details) - segment	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Accounting Policies [Abstract]
Number of reportable segments	3	3	3

Concentration of Credit Risk (D

Concentration of Credit Risk (Details) $ in Millions	Sep. 21, 2021senior_housingproperty	Dec. 31, 2021USD ($)propertystate	Dec. 31, 2021propertystate	Jul. 30, 2021property
Concentration Risk [Line Items]
Number of real estate properties		1,200	1,200
Kindred | LifePoint-Kindred Transaction Fees
Concentration Risk [Line Items]
Revenue from related parties | $		$ 13.1
Brookdale Senior Living
Concentration Risk [Line Items]
Number of real estate properties		121	121
Atria | Senior Living Communities, Operations to be Transitioned
Concentration Risk [Line Items]
Number of independent third party managed properties		162	162	165
Number of real estate properties acquired | senior_housing	21
Holiday Retirement | Senior Living Communities, Operations to be Transitioned
Concentration Risk [Line Items]
Number of independent third party managed properties		91	91	26
Number of real estate properties acquired	65
Customer Concentration Risk
Concentration Risk [Line Items]
Continuing revenues and NOI from properties located in California			10.00%
Customer Concentration Risk | CALIFORNIA
Concentration Risk [Line Items]
Number of states accounting for more than ten percent of revenues and net operating income | state		1	1
Customer Concentration Risk | Total Gross Book Value of Properties | Hospitals, Medical Office Building and other
Concentration Risk [Line Items]
Percentage of real estate investments based on gross book value (as a percent)			32.60%
Customer Concentration Risk | Total Gross Book Value of Properties | Triple-net leased properties | Senior Housing
Concentration Risk [Line Items]
Percentage of real estate investments based on gross book value (as a percent)			13.00%
Customer Concentration Risk | Total Gross Book Value of Properties | Senior living operations | Senior Housing
Concentration Risk [Line Items]
Percentage of real estate investments based on gross book value (as a percent)			54.40%
Customer Concentration Risk | Total Gross Book Value of Properties | Atria
Concentration Risk [Line Items]
Percentage of real estate investments based on gross book value (as a percent)			19.80%
Customer Concentration Risk | Total Gross Book Value of Properties | Sunrise
Concentration Risk [Line Items]
Percentage of real estate investments based on gross book value (as a percent)			10.00%
Customer Concentration Risk | Total Gross Book Value of Properties | Brookdale Senior Living
Concentration Risk [Line Items]
Percentage of real estate investments based on gross book value (as a percent)			7.80%
Customer Concentration Risk | Total Gross Book Value of Properties | Ardent
Concentration Risk [Line Items]
Percentage of real estate investments based on gross book value (as a percent)			4.70%
Customer Concentration Risk | Total Gross Book Value of Properties | Kindred
Concentration Risk [Line Items]
Percentage of real estate investments based on gross book value (as a percent)			1.00%
Geographic Concentration Risk [Member]
Concentration Risk [Line Items]
Number of US states in which entity operates | state		47	47

Concentration of Credit Risk -

Concentration of Credit Risk - Triple-Net Leased Properties (Details) $ / shares in Units, $ in Thousands, shares in Millions	1 Months Ended	12 Months Ended
	Apr. 30, 2020USD ($)senior_housing	Dec. 31, 2021USD ($)property$ / sharesshares	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)	Jul. 31, 2020USD ($)	Jul. 31, 2020property	Jul. 31, 2020	Jul. 31, 2020shares	Jul. 31, 2020$ / shares	Jul. 31, 2020senior_housing
Real estate properties
Other noncash expense		$ (26,404)	$ 779	$ (13,264)
Cash and cash equivalents		149,725	413,327
Non-mortgage loans receivable, net		$ 19,024	57,077
Operating Lease, Lease Income, Lease Payments, Annual Increase							3.00%
Number of real estate properties | property		1,200
Secured/mortgage loans and other, net
Real estate properties
Debt Securities, Held-to-maturity		$ 488,913	555,840
Brookdale Senior Living
Real estate properties
Other noncash expense		$ (42,600)	$ (21,300)
Cash and cash equivalents					$ 162,000
Non-mortgage loans receivable, net					45,000
Stock warrants					28,000
Class of Warrant or Right, Number of Securities Called by Warrants or Rights | shares		16.3						16.3
Class of Warrant or Right, Exercise Price of Warrants or Rights | $ / shares		$ 3							$ 3
Lessor, Operating Lease, Payments to be Received, Next Rolling Twelve Months					100,000
Brookdale Senior Living | Secured/mortgage loans and other, net
Real estate properties
Debt Securities, Held-to-maturity					78,000
Brookdale Senior Living | Collateral Pledged
Real estate properties
Number of real estate properties						5				5
Brookdale Senior Living | Transfer Of Lease Deposit To Cash
Real estate properties
Cash and cash equivalents					47,000
Brookdale Senior Living | Up-front Payment Arrangement
Real estate properties
Contract with Customer, Liability					$ 235,000
Brookdale Senior Living | Customer Concentration Risk | Revenues
Real estate properties
Concentration risk		3.90%	4.40%	4.70%
Brookdale Senior Living | Customer Concentration Risk | Net Operating Income
Real estate properties
Concentration risk		8.60%	9.00%	8.70%
Ardent | Customer Concentration Risk | Revenues
Real estate properties
Concentration risk		3.30%	3.20%	3.10%
Ardent | Customer Concentration Risk | Net Operating Income
Real estate properties
Concentration risk		7.40%	6.60%	5.80%
Kindred | Customer Concentration Risk | Revenues
Real estate properties
Concentration risk		3.80%	3.50%	3.30%
Kindred | Customer Concentration Risk | Net Operating Income
Real estate properties
Concentration risk		7.80%	7.10%	6.30%
Holiday Management Company Member
Real estate properties
Number of real estate properties | senior_housing	26
Gain (Loss) on Contract Termination	$ 50,200
Operating Lease, Lease Termination Consideration Received	99,800
Loans and Leases Receivable, Allowance	49,600
Holiday Management Company Member | Secured/mortgage loans and other, net
Real estate properties
Debt Securities, Held-to-maturity	66,000
Holiday Management Company Member | Transfer Of Lease Deposit To Cash
Real estate properties
Cash and cash equivalents	$ 33,800
Experienced Operators | Senior Living Communities, Operations to be Transitioned
Real estate properties
Number of real estate properties | property		90

Concentration of Credit Risk _2

Concentration of Credit Risk - Minimum Rents (Details) $ in Thousands	Dec. 31, 2021USD ($)
Concentration Risk [Line Items]
2022	$ 1,114,591
2023	1,041,284
2024	980,307
2025	828,879
2026	571,996
Thereafter	2,716,979
Total	7,254,036
Brookdale Senior Living
Concentration Risk [Line Items]
2022	147,951
2023	147,693
2024	147,709
2025	147,725
2026	0
Thereafter	0
Total	591,078
Ardent
Concentration Risk [Line Items]
2022	130,834
2023	130,834
2024	130,834
2025	130,834
2026	130,370
Thereafter	1,122,180
Total	1,775,886
Kindred
Concentration Risk [Line Items]
2022	135,262
2023	114,356
2024	104,083
2025	36,015
2026	1,921
Thereafter	2,444
Total	394,081
Other
Concentration Risk [Line Items]
2022	700,544
2023	648,401
2024	597,681
2025	514,305
2026	439,705
Thereafter	1,592,355
Total	$ 4,492,991

Concentration of Credit Risk _3

Concentration of Credit Risk - Senior Living Operations (Details)	Dec. 31, 2021property
Consolidated Seniors Housing Communities
Concentration Risk [Line Items]
Number of independent third party managed properties	545
Atria and Sunrise | Senior Housing
Concentration Risk [Line Items]
Number of independent third party managed properties	256

Acquisitions of Real Estate P_2

Acquisitions of Real Estate Property - 2021 Acquisitions (Details) $ in Millions	Sep. 21, 2021USD ($)shares	Sep. 30, 2021shares	Dec. 31, 2021USD ($)property
New Senior Investment Group Inc. Acquisition
Business Acquisition [Line Items]
Payments for asset acquisitions	$ 2,300
Value of assets acquired	$ 2,400
Number of shares issued in transaction (in shares) | shares		13,300,000
Number of shares issued for each acquiree share | shares	0.1561
Mortgage debt assumed in transaction	$ 482.5
Cash paid for transaction at closing	$ 1,100
Canadian Senior Housing Community And Behavior Health Center Acquisition [Member]
Business Acquisition [Line Items]
Value of assets acquired			$ 240.7
Number of real estate properties acquired | property			6

Acquisitions of Real Estate P_3

Acquisitions of Real Estate Property - 2020 Acquisitions (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2021USD ($)property	Dec. 31, 2020USD ($)property	Dec. 31, 2019USD ($)property
Business Acquisition [Line Items]
Number of real estate properties	1,200
Payments to acquire real estate | $	$ 1,369,052	$ 78,648	$ 958,125
2020 Acquisitions
Business Acquisition [Line Items]
Payments to acquire real estate | $		$ 249,500
Other 2019 Acquisitions
Business Acquisition [Line Items]
Number of real estate properties			2
Payments to acquire real estate | $			$ 237,000
Office operations | Other 2019 Acquisitions
Business Acquisition [Line Items]
Number of real estate properties			1
Office operations | Research and Innovation Center
Business Acquisition [Line Items]
Number of real estate properties acquired		2
Senior living operations | 2020 Acquisitions
Business Acquisition [Line Items]
Number of real estate properties		7
Senior living operations | Other 2019 Acquisitions
Business Acquisition [Line Items]
Number of real estate properties			2
Triple-net leased properties | LTAC [Member] | 2020 Acquisitions
Business Acquisition [Line Items]
Number of real estate properties		1

Acquisitions of Real Estate P_4

Acquisitions of Real Estate Property - 2019 Acquisitions (Details) $ in Thousands	1 Months Ended	12 Months Ended
	Sep. 30, 2019USD ($)property	Dec. 31, 2021USD ($)property	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)property
Business Acquisition [Line Items]
Number of real estate properties		1,200
Payments to acquire real estate | $		$ 1,369,052	$ 78,648	$ 958,125
L G M Acquisition
Business Acquisition [Line Items]
Variable Interest Entity, Qualitative or Quantitative Information, Ownership Percentage	87.00%
Number of real estate properties	34
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Property, Plant, and Equipment | $	$ 1,800,000
L G M Acquisition | Development Projects
Business Acquisition [Line Items]
Number of real estate properties	5
Other 2019 Acquisitions
Business Acquisition [Line Items]
Number of real estate properties				2
Vacant Land Parcels Acquired				1
Payments to acquire real estate | $				$ 237,000
Office operations | Other 2019 Acquisitions
Business Acquisition [Line Items]
Number of real estate properties				1
Senior living operations | Other 2019 Acquisitions
Business Acquisition [Line Items]
Number of real estate properties				2

Acquisitions of Real Estate P_5

Acquisitions of Real Estate Property - 2022 Acquisitions (Details) - Subsequent Event	Feb. 09, 2022USD ($)property
Medical Office Buildings
Business Acquisition [Line Items]
Number of real estate properties acquired | property	18
Value of assets acquired | $	$ 204,000,000
Seniors Housing Communities
Business Acquisition [Line Items]
Number of real estate properties acquired | property	1
Value of assets acquired | $	$ 105,400,000

Dispositions and Impairments -

Dispositions and Impairments - 2020 Dispositions Activity (Details) $ in Thousands	1 Months Ended		12 Months Ended
	Oct. 31, 2020USD ($)	Mar. 31, 2020USD ($)property	Dec. 31, 2021USD ($)property	Dec. 31, 2020USD ($)propertysenior_housing	Dec. 31, 2019USD ($)propertysenior_housing	Oct. 30, 2020
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties			1,200
Proceeds from real estate disposals | $			$ 840,438	$ 1,044,357	$ 147,855
Gain on real estate dispositions | $			$ 218,788	262,218	26,022
The Fund [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from real estate disposals | $		$ 620,000
Gain on real estate dispositions | $		$ 225,100
Ownership interests in properties accounted for under the equity method		21.00%
Triple-net leased properties
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties			332
Research and Innovation Center | GIC JV Project [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain on real estate dispositions | $	$ 13,700
Ownership interests in properties accounted for under the equity method						50.00%
Research and Innovation Center | GIC JV Project [Member] | R&I JV [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Equity Method Investment, Ownership Percentage By Other Owners						45.00%
Dispositions [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from real estate disposals | $			$ 859,700
Gain on real estate dispositions | $			$ 218,800
Dispositions [Member] | The Fund [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties		6
Dispositions [Member] | The Fund [Member] | Same Campus [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties		2
Dispositions [Member] | Medical Office Buildings
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties			34
Dispositions [Member] | Triple-net leased properties
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties			8
Dispositions [Member] | Senior living operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties			23
2019 Dispositions [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain on real estate dispositions | $					26,000
Proceeds from sale of real estate | $					$ 147,500
Vacant Land Parcels Sold | senior_housing					1
2019 Dispositions [Member] | Medical Office Buildings
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties					8
2019 Dispositions [Member] | Triple-net leased properties
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties					10
2020 Dispositions [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain on real estate dispositions | $				23,400
Proceeds from sale of real estate | $				$ 249,600
Vacant Land Parcels Sold | senior_housing				1
2020 Dispositions [Member] | Medical Office Buildings
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties				4
2020 Dispositions [Member] | Triple-net leased properties
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties				22
2020 Dispositions [Member] | Senior living operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties				4

Dispositions and Impairments _2

Dispositions and Impairments - 2019 Dispositions Activity (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2021USD ($)property	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)propertysenior_housing
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties	1,200
Gain on real estate dispositions | $	$ 218,788	$ 262,218	$ 26,022
2019 Dispositions [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Vacant Land Parcels Sold | senior_housing			1
Proceeds from sale of real estate | $			$ 147,500
Gain on real estate dispositions | $			$ 26,000
Triple-net leased properties
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties	332
Triple-net leased properties | 2019 Dispositions [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties			10
Medical Office Buildings | 2019 Dispositions [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties			8
Seniors Housing Communities | 2019 Dispositions [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties			6

Dispositions and Impairments _3

Dispositions and Impairments - 2018 Dispositions Activity (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2021USD ($)property	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties	1,200
Gain on real estate dispositions | $	$ 218,788	$ 262,218	$ 26,022
Triple-net leased properties
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of real estate properties	332

Dispositions and Impairments _4

Dispositions and Impairments - Assets Held For Sale and Impairment (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2021USD ($)property	Dec. 31, 2020USD ($)property	Dec. 31, 2019USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Assets held for sale	$ 28,399	$ 9,608
Liabilities held for sale	$ 10,850	$ 3,246
Disposal Group, Held-for-sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of properties held for sale | property	4	2
Triple-net leased properties
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Assets held for sale	$ 0	$ 4,960
Liabilities held for sale	$ 0	$ 2,690
Triple-net leased properties | Disposal Group, Held-for-sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of properties held for sale | property	0	1
Office operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Assets held for sale	$ 3,435	$ 15
Liabilities held for sale	$ 1,529	$ 101
Office operations | Disposal Group, Held-for-sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of properties held for sale | property	2	0
Senior living operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Assets held for sale	$ 24,964	$ 4,633
Liabilities held for sale	$ 9,321	$ 455
Senior living operations | Disposal Group, Held-for-sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of properties held for sale | property	2	1
Depreciation and amortization
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Real estate impairments related to natural disasters	$ 219,400	$ 153,800	$ 133,600

Loans Receivables and Investmen

Loans Receivables and Investments (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Loans Receivable And Investments [Abstract]
Secured Loans, Unsecured Loans, And Other Available-For-Sale Securities	$ 549,150	$ 900,197

Loans Receivables and Investm_2

Loans Receivables and Investments (Details) 2 - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020	Jul. 31, 2020	Apr. 30, 2020
Accounts, Notes, Loans and Financing Receivable [Line Items]
Debt Securities, Held-to-maturity, Allowance for Credit Loss	$ (5,394)	$ (26,469)
Debt Securities, Available-for-sale	0	237,553
Non-mortgage loans receivable, net	19,024	57,077
Secured loans, unsecured loans, and other available-for-sale securities, amortized cost	552,707	899,028
Secured Loans, Unsecured Loans And Other Available-For-Sale Securities, Unrealized gain	1,836	27,638
Total loans receivable and investments, net	549,150	900,197
Secured loans, unsecured loans, and other available-for-sale securities, fair value	539,183	852,996
Brookdale Senior Living
Accounts, Notes, Loans and Financing Receivable [Line Items]
Non-mortgage loans receivable, net			$ 45,000
Non-mortgage loans receivable, net (2)
Accounts, Notes, Loans and Financing Receivable [Line Items]
Debt Securities, Held-to-maturity, Allowance for Credit Loss	(5,394)	(17,623)
Non-mortgage loans receivable, amortized cost	24,418	74,700
Non-mortgage loans receivable, net, unrealized gain	0	0
Non-mortgage loans receivable, net	19,024	57,077
Non-mortgage loans receivable, fair value	19,039	57,009
Secured/mortgage loans and other, net
Accounts, Notes, Loans and Financing Receivable [Line Items]
Debt Securities, Held-to-maturity	488,913	555,840
Debt Securities, Held-to-maturity, Allowance for Credit Loss	0	0
Debt Securities, Held-to-maturity, Accumulated Unrecognized Gain	0	0
Debt Securities, Held-to-maturity, Fair Value	478,931	508,707
Secured/mortgage loans and other, net | Holiday Management Company Member
Accounts, Notes, Loans and Financing Receivable [Line Items]
Debt Securities, Held-to-maturity				$ 66,000
Secured/mortgage loans and other, net | Brookdale Senior Living
Accounts, Notes, Loans and Financing Receivable [Line Items]
Debt Securities, Held-to-maturity			$ 78,000
Government-sponsored pooled loan investments
Accounts, Notes, Loans and Financing Receivable [Line Items]
Debt Securities, Held-to-maturity, Allowance for Credit Loss	0	(8,846)
Debt Securities, Available-for-sale, Amortized Cost	39,376	55,154
Available-for-sale securities, unrealized gain (loss)	1,836	3,419
Debt Securities, Available-for-sale	41,213	49,727
Total investments reported as secured loans receivable and investments, net
Accounts, Notes, Loans and Financing Receivable [Line Items]
Debt Securities, Held-to-maturity, Allowance for Credit Loss	0	(8,846)
Available-for-sale securities, unrealized gain (loss)	1,836	3,419
Debt securities, available-for-sale and held-to-maturity, amortized cost	528,289	610,994
Debt securities, available-for-sale and held-to-maturity, carrying amount	530,126	605,567
Debt securities, Held-to-Maturity and Available-for-Sale, Fair Value	$ 520,144	558,434
Senior Unsecured Notes
Accounts, Notes, Loans and Financing Receivable [Line Items]
Debt Securities, Held-to-maturity, Allowance for Credit Loss		0
Debt Securities, Available-for-sale, Amortized Cost		213,334
Available-for-sale securities, unrealized gain (loss)		24,219
Debt Securities, Available-for-sale		$ 237,553

Loans Receivable and Investme_3

Loans Receivable and Investments - 2021 Activity (Details) $ in Thousands	1 Months Ended				3 Months Ended	12 Months Ended
	Oct. 31, 2021USD ($)	Jul. 31, 2021USD ($)	Apr. 30, 2021USD ($)	Mar. 31, 2021USD ($)	Mar. 31, 2021USD ($)	Dec. 31, 2021USD ($)	Dec. 31, 2020USD ($)	Apr. 30, 2020
Accounts, Notes, Loans and Financing Receivable [Line Items]
Available for sale securities						$ 1,836	$ 25,712
Full Repayments on Loans Receivable
Accounts, Notes, Loans and Financing Receivable [Line Items]
Proceeds from collection of loans receivable					$ 16,500		$ 106,100
Gains (Losses) On Real Estate Loan Investments					1,000
Available for sale securities						$ 1,200
Debt Instrument, Weighted Average Interest						8.30%	8.30%
Government-sponsored pooled loan investments
Accounts, Notes, Loans and Financing Receivable [Line Items]
Debt Securities, Held-to-maturity, Allowance for Credit Loss, Period Increase (Decrease)					$ 8,800
Government-sponsored pooled loan investments | Full Repayments on Loans Receivable
Accounts, Notes, Loans and Financing Receivable [Line Items]
Proceeds from collection of loans receivable			$ 19,200
Non-mortgage loans receivable, net (2)
Accounts, Notes, Loans and Financing Receivable [Line Items]
Debt Securities, Held-to-maturity, Allowance for Credit Loss, Period Increase (Decrease)				$ 11,900
Brookdale Senior Living | Non-mortgage loans receivable, net (2)
Accounts, Notes, Loans and Financing Receivable [Line Items]
Proceeds From Collection Of Debt Securities, Held-to-maturity	$ 45,000
Holiday Management Company [Member] | Secured/mortgage loans and other, net
Accounts, Notes, Loans and Financing Receivable [Line Items]
Proceeds From Collection Of Debt Securities, Held-to-maturity		$ 66,000
Debt securities, effective interest rate								9.20%
Ardent | Full Repayments on Loans Receivable
Accounts, Notes, Loans and Financing Receivable [Line Items]
Proceeds from collection of loans receivable		$ 224,000
Debt securities, effective interest rate						9.75%
Redemption Price, Percentage of Principal		1.07313
Gains (Losses) On Real Estate Loan Investments						$ 16,600
Unrealized Gains (Losses) On Real Estate Loan Investments						$ 23,000

Loans Receivable and Investme_4

Loans Receivable and Investments - 2020 Activity (Details) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2021USD ($)	Dec. 31, 2021USD ($)property	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)	Jul. 31, 2020USD ($)	Jul. 31, 2020property	Jul. 31, 2020senior_housing	Apr. 30, 2020USD ($)
Accounts, Notes, Loans and Financing Receivable [Line Items]
Allowance on loans receivable and investments		$ (9,082)	$ 24,238	$ 0
Gains (losses) on real estate loan investments		1,448	167	$ 0
Non-mortgage loans receivable, net		$ 19,024	57,077
Number of real estate properties | property		1,200
Secured/mortgage loans and other, net
Accounts, Notes, Loans and Financing Receivable [Line Items]
Debt Securities, Held-to-maturity		$ 488,913	555,840
COVID-19 Impact
Accounts, Notes, Loans and Financing Receivable [Line Items]
Financing Receivable, Allowance for Credit Loss, Writeoff			34,700
Financing Receivable, Allowance for Credit Loss			10,500
Holiday Management Company [Member] | Secured/mortgage loans and other, net
Accounts, Notes, Loans and Financing Receivable [Line Items]
Debt Securities, Held-to-maturity								$ 66,000
Debt securities, effective interest rate								9.20%
Brookdale Senior Living
Accounts, Notes, Loans and Financing Receivable [Line Items]
Non-mortgage loans receivable, net					$ 45,000
Brookdale Senior Living | Collateral Pledged
Accounts, Notes, Loans and Financing Receivable [Line Items]
Number of real estate properties						5	5
Brookdale Senior Living | Secured/mortgage loans and other, net
Accounts, Notes, Loans and Financing Receivable [Line Items]
Debt Securities, Held-to-maturity					$ 78,000
Full Repayments on Loans Receivable
Accounts, Notes, Loans and Financing Receivable [Line Items]
Proceeds from collection of loans receivable	$ 16,500		$ 106,100
Debt Instrument, Weighted Average Interest		8.30%	8.30%
Gains (losses) on real estate loan investments			$ 1,400

Investments in Unconsolidated_2

Investments in Unconsolidated Entities (Details) $ in Thousands	1 Months Ended			12 Months Ended
	Mar. 31, 2021USD ($)property	Oct. 31, 2020USD ($)	Jun. 30, 2020USD ($)	Dec. 31, 2021USD ($)board_memberproperty	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)	Oct. 30, 2020	Oct. 15, 2020USD ($)senior_housing	Jan. 31, 2018
Equity method investments
Number of real estate properties | property				1,200
Non-mortgage loans receivable, net				$ 19,024	$ 57,077
Real Estate Investments, Unconsolidated Real Estate and Other Joint Ventures				$ 523,465	443,688
COVID-19 Impact
Equity method investments
Equity Method Investment, Other than Temporary Impairment			$ 10,700		10,700
The Fund [Member]
Equity method investments
Payments to Acquire Real Estate and Real Estate Joint Ventures		$ 1,000,000
The Fund [Member] | 2020 Acquisitions
Equity method investments
Number of real estate properties | senior_housing								3
Assets under Management, Carrying Amount					$ 1,800,000
Non-mortgage loans receivable, net								$ 415,000
Loan receivable Stated Interest Rate								2.60%
The Fund [Member] | Other 2021 acquisitions
Equity method investments
Number of real estate properties | property	2
Assets under Management, Carrying Amount	$ 2,100,000
Payments to Acquire Real Estate and Real Estate Joint Ventures	$ 272,000
Atria
Equity method investments
Ownership interests in properties accounted for under the equity method				34.00%
Number of board members appointed | board_member				2
Number of board members | board_member				6
Eclipse Senior Living
Equity method investments
Ownership interests in properties accounted for under the equity method									34.00%
Number of board members appointed | board_member				2
Number of board members | board_member				6
Remaining ownership percentage retained by investee				66.00%
Ardent
Equity method investments
Ownership interests in properties accounted for under the equity method				9.80%
Number of board members appointed | board_member				1
Unconsolidated Properties | The Fund [Member]
Equity method investments
Ownership interests in properties accounted for under the equity method				21.10%	22.90%
Real Estate Investments, Unconsolidated Real Estate and Other Joint Ventures				$ 267,475	$ 279,983
Unconsolidated Properties | VTRAZ JV [Member]
Equity method investments
Ownership interests in properties accounted for under the equity method				22.90%	22.80%
Real Estate Investments, Unconsolidated Real Estate and Other Joint Ventures				$ 29,192	$ 34,690
Unconsolidated Properties | R&I JV [Member]
Equity method investments
Ownership interests in properties accounted for under the equity method				51.00%	50.30%
Real Estate Investments, Unconsolidated Real Estate and Other Joint Ventures				$ 221,363	$ 123,445
Unconsolidated Properties | Equity Method Investment, Nonconsolidated Investee [Member]
Equity method investments
Real Estate Investments, Unconsolidated Real Estate and Other Joint Ventures				$ 5,435	$ 5,570
Unconsolidated Properties | Equity Method Investment, Nonconsolidated Investee [Member] | Minimum
Equity method investments
Ownership interests in properties accounted for under the equity method				34.00%	34.00%
Unconsolidated Properties | Equity Method Investment, Nonconsolidated Investee [Member] | Maximum
Equity method investments
Ownership interests in properties accounted for under the equity method				50.00%	50.00%
Unconsolidated Properties | Ventas Investment Management Platform (VIM)
Equity method investments
Real Estate Investments, Unconsolidated Real Estate and Other Joint Ventures				$ 518,030	$ 438,118
Management Service
Equity method investments
Revenue from contracts with customers				$ 12,400	$ 6,700	$ 3,400
GIC JV Project [Member] | Research and Innovation Center
Equity method investments
Ownership interests in properties accounted for under the equity method							50.00%
GIC JV Project [Member] | Research and Innovation Center | R&I JV [Member]
Equity method investments
Equity Method Investment, Ownership Percentage By Other Owners							45.00%

Intangibles (Details)

Intangibles (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Intangible assets:
Acquired lease intangibles	$ 1,369,747	$ 1,230,886
Goodwill	1,046,140	1,051,650
Accumulated amortization	(944,403)	(941,462)
Net intangible assets	$ 1,506,001	$ 1,376,944
Weighted Average Remaining Amortization Period in Years	7 years 1 month 6 days	10 years 3 months 18 days
Intangible liabilities:
Below-market lease intangibles (1)	$ 334,365	$ 339,265
Other lease intangibles	13,608	13,498
Accumulated amortization	(244,975)	(212,655)
Purchase option intangibles	3,568	3,568
Net intangible liabilities	$ 106,566	$ 143,676
Below market leases, remaining weighted average amortization period	9 years 8 months 12 days	14 years 3 months 18 days
Net intangible liabilities, remaining weighted average amortization period	9 years 8 months 12 days	14 years 3 months 18 days
Intangibles
Net amortization expense	$ 29,300	$ 45,700	$ 59,200
2022	123,144
2023	111,976
2024	57,729
2025	9,764
2026	5,972
Above Market Lease Intangibles
Intangible assets:
Acquired lease intangibles	$ 129,121	$ 140,096
Weighted Average Remaining Amortization Period in Years	5 years 10 months 24 days	6 years 4 months 24 days
In-Place and Other Lease Intangibles
Intangible assets:
Acquired lease intangibles	$ 1,240,626	$ 1,090,790
Weighted Average Remaining Amortization Period in Years	7 years 2 months 12 days	10 years 8 months 12 days
Other Intangibles
Intangible assets:
Other intangibles (2)	$ 34,517	$ 35,870
Weighted Average Remaining Amortization Period in Years	6 years 6 months	10 years

Intangibles - Goodwill (Details

Intangibles - Goodwill (Details) $ in Thousands	Dec. 31, 2021USD ($)
Goodwill [Line Items]
Goodwill	$ 1,046,140
Triple-net leased properties
Goodwill [Line Items]
Goodwill	322,097
Senior living operations
Goodwill [Line Items]
Goodwill	259,482
Office operations
Goodwill [Line Items]
Goodwill	$ 464,561

Other Assets (Details)

Other Assets (Details) - USD ($) $ / shares in Units, $ in Thousands, shares in Millions	Dec. 31, 2021	Dec. 31, 2020	Jul. 31, 2020
Other Assets Disclosure [Line Item]
Straight-line rent receivables	$ 176,877	$ 169,711
Non-mortgage loans receivable, net	19,024	57,077
Marketable debt securities	0	237,553
Other intangibles, net	7,270	4,659
Investment in unconsolidated operating entities	73,602	63,768
Other	239,412	224,363
Total other assets	$ 565,069	807,229
Brookdale Senior Living
Other Assets Disclosure [Line Item]
Non-mortgage loans receivable, net			$ 45,000
Stock warrants			$ 28,000
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	16.3		16.3
Class of Warrant or Right, Exercise Price of Warrants or Rights	$ 3		$ 3
Brookdale Senior Living | Carrying Amount
Other Assets Disclosure [Line Item]
Stock warrants	$ 48,884	$ 50,098

Senior Notes Payable and Othe_3

Senior Notes Payable and Other Debt - Summary of Senior Notes Payable and Other Debt (Details) $ in Thousands, $ in Millions	Dec. 31, 2021USD ($)	Dec. 31, 2021CAD ($)	Aug. 31, 2021USD ($)	Dec. 31, 2020USD ($)	Aug. 31, 2020USD ($)
Debt Instrument [Line Items]
Long-term debt, gross	$ 12,093,138			$ 11,983,071
Commercial Paper	280,000			0
Debt issuance costs, net	(69,925)			(68,343)
Unamortized fair value adjustment	32,888			12,618
Debt instrument, unamortized discount	(28,557)			(31,934)
Long-term Debt	12,027,544			11,895,412
Unsecured Debt | Revolving Credit Facility
Debt Instrument [Line Items]
Line of credit facility, amount outstanding	56,448			39,395
Long-term debt, gross	56,400
Secured revolving construction credit facility due 2022
Debt Instrument [Line Items]
Line of credit facility, amount outstanding	0
Long-term debt, gross				154,098
Floating Rate Series F Due 2021
Debt Instrument [Line Items]
Senior Notes	0			235,664
Three Point Two Five Percent Senior Notes due 2022 [Member]
Debt Instrument [Line Items]
Senior Notes	0			263,687
3.30% Senior Notes due 2022
Debt Instrument [Line Items]
Senior Notes	0			196,386
Unsecured Term Loan Due 2023
Debt Instrument [Line Items]
Unsecured Debt	200,000			200,000
3.125 Senior Notes [Member]
Debt Instrument [Line Items]
Senior Notes	0			400,000
Three Point One Senior Notes Due 2023 [Member]
Debt Instrument [Line Items]
Senior Notes	0			400,000
2.55% Senior Notes, Series D due 2023
Debt Instrument [Line Items]
Senior Notes	217,667			216,025
3.50% Senior Notes due 2024 [Member]
Debt Instrument [Line Items]
Senior Notes	400,000			400,000
Three Point Seven Five Zero Percent Senior Notes, Due 2024 [Member]
Debt Instrument [Line Items]
Senior Notes	400,000			400,000
4.125% Senior Notes, Series B due 2024
Debt Instrument [Line Items]
Senior Notes	197,879			196,386
2.80% Senior Notes, Series E due 2024 [Member]
Debt Instrument [Line Items]
Senior Notes	474,909			471,328
Unsecured Term Loan due 2025 [Member]
Debt Instrument [Line Items]
Unsecured Debt	395,757	$ 500		392,773
Three Point Five Zero Zero Senior Notes, Due 2025 [Member]
Debt Instrument [Line Items]
Senior Notes	600,000			600,000
2.65% Senior Notes due 2025 [Member]
Debt Instrument [Line Items]
Senior Notes	450,000			450,000
Four Point One Two Five Senior Notes, Due 2026 [Member]
Debt Instrument [Line Items]
Senior Notes	500,000			500,000
3.25% Senior Notes due 2026
Debt Instrument [Line Items]
Senior Notes	450,000			450,000
2.45% Senior Notes, Series G Due 2027
Debt Instrument [Line Items]
Senior Notes	$ 375,970	$ 475		0
Interest rate	2.45%	2.45%
3.850 Senior Notes Due 2037 [Member]
Debt Instrument [Line Items]
Senior Notes	$ 400,000			400,000
4.00% Senior Notes due 2028
Debt Instrument [Line Items]
Senior Notes	650,000			650,000
4.40% Senior Notes due 2029
Debt Instrument [Line Items]
Senior Notes	750,000			750,000
3.00% Senior Notes due 2030 [Member]
Debt Instrument [Line Items]
Senior Notes	650,000			650,000
4.75% Senior Notes due 2030 [Member]
Debt Instrument [Line Items]
Senior Notes	500,000			500,000	$ 500,000
Interest rate					4.75%
2.50% Senior Notes Due 2031
Debt Instrument [Line Items]
Senior Notes	500,000		$ 500,000	0
Interest rate			2.50%
2.50% Senior Notes, Series H Due 2031
Debt Instrument [Line Items]
Senior Notes	$ 237,454	$ 300		0
Interest rate	3.30%	3.30%
Six Point Nine Zero Percent Senior Notes, Due 2037 [Member]
Debt Instrument [Line Items]
Senior Notes	$ 52,400			52,400
Six Point Five Nine Percent Senior Notes, Due 2038 [Member]
Debt Instrument [Line Items]
Senior Notes	$ 22,823			22,823
Interest rate	6.59%	6.59%
Five Point Seven Zero Percent Senior Notes, Due 2043 [Member]
Debt Instrument [Line Items]
Senior Notes	$ 300,000			300,000
Four Point Three Seven Five Percent Senior Notes, Due 2045 [Member]
Debt Instrument [Line Items]
Senior Notes	300,000			300,000
4.875% Senior Notes due 2049 [Member]
Debt Instrument [Line Items]
Senior Notes	300,000			300,000
Mortgage loans and other
Debt Instrument [Line Items]
Long-term debt, gross	$ 2,431,831			2,092,106
6.90% Senior Notes due 2037
Debt Instrument [Line Items]
Interest rate	6.90%	6.90%
6.59% Senior Notes due 2038
Debt Instrument [Line Items]
Interest rate	6.59%	6.59%
Borrowings originally denominated in CAD | Unsecured Debt | Revolving Credit Facility
Debt Instrument [Line Items]
Long-term debt, gross	$ 30,900			12,200
Borrowings originally denominated in GBP | Unsecured Debt | Revolving Credit Facility
Debt Instrument [Line Items]
Long-term debt, gross	$ 25,600			$ 27,200

Senior Notes Payable and Othe_4

Senior Notes Payable and Other Debt - Credit Facilities and Unsecured Term Loans (Details) $ in Millions	1 Months Ended	12 Months Ended
	Jan. 31, 2021USD ($)period	Dec. 31, 2021USD ($)	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)	Dec. 31, 2021CAD ($)
Debt Instrument [Line Items]
Commercial paper program capacity		$ 1,000,000,000
Commercial Paper		280,000,000	$ 0
Loss on extinguishment of debt, net		(59,299,000)	(10,791,000)	$ (41,900,000)
Long-term debt, gross		12,093,138,000	11,983,071,000
Unsecured Term Loan Due 2023
Debt Instrument [Line Items]
Accordion feature of debt		800,000,000
Unsecured Debt		$ 200,000,000	200,000,000
Unsecured Term Loan Due 2023 | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate		0.90%
Unsecured Term Loan due 2025 [Member]
Debt Instrument [Line Items]
Unsecured Debt		$ 395,757,000	392,773,000		$ 500
Unsecured Term Loan due 2025 [Member] | Canadian Dollar Offered Rate (CDOR) [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate		0.90%
Revolving Credit Facility
Debt Instrument [Line Items]
Letters of credit outstanding		$ 24,900,000
Revolving Credit Facility | Unsecured Debt
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity	$ 2,750,000,000		3,000,000,000
Additional periods | period	2
Additional period term	6 months
Line of credit facility, amount outstanding		56,448,000	$ 39,395,000
Accordion Feature Of Debt	$ 3,750,000,000
Line of credit facility, remaining borrowing capacity		2,700,000,000
Long-term debt, gross		56,400,000
Revolving Credit Facility | Unsecured Debt | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate	0.825%		0.875%
Revolving Credit Facility | Secured Debt [Member]
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity		400,000,000
Loss on extinguishment of debt, net		$ (500,000)

Senior Notes Payable and Othe_5

Senior Notes Payable and Other Debt - Senior Notes (Details) $ in Thousands, $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2021USD ($)	Dec. 31, 2021USD ($)	Dec. 31, 2021CAD ($)	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)	Dec. 31, 2021CAD ($)	Nov. 30, 2021CAD ($)	Aug. 31, 2021USD ($)	Jul. 31, 2021USD ($)	Feb. 28, 2021USD ($)	Oct. 30, 2020USD ($)	Aug. 31, 2020USD ($)
Debt Instrument [Line Items]
Loss on extinguishment of debt, net		$ 59,299		$ 10,791	$ 41,900
Long-term debt, gross		$ 12,093,138		11,983,071
6.90% Senior Notes Due 2037
Debt Instrument [Line Items]
Interest rate		6.90%				6.90%
Six Point Five Nine Percent Senior Notes, Due 2038 [Member]
Debt Instrument [Line Items]
Interest rate		6.59%				6.59%
Senior Notes		$ 22,823		22,823
4.75% Senior Notes due 2030 [Member]
Debt Instrument [Line Items]
Interest rate												4.75%
Senior Notes		500,000		500,000								$ 500,000
Offering price, percentage of par value												97.86%
3.25% Senior Notes due 2022 [Member]
Debt Instrument [Line Items]
Interest rate									3.25%		3.25%
Senior Notes									$ 263,700
Offering price, percentage of par value											104.14%
Debt instrument, repurchase amount											$ 236,300
Loss on extinguishment of debt, net		8,200		(11,100)
4.875% Senior Notes due 2049 [Member]
Debt Instrument [Line Items]
Senior Notes		300,000		300,000
3.50% Senior Notes due 2024 [Member]
Debt Instrument [Line Items]
Senior Notes		400,000		400,000
2.65% Senior Notes due 2025 [Member]
Debt Instrument [Line Items]
Senior Notes		450,000		450,000
3.00% Senior Notes due 2030 [Member]
Debt Instrument [Line Items]
Senior Notes		650,000		650,000
2.80% Senior Notes, Series E due 2024 [Member]
Debt Instrument [Line Items]
Senior Notes		474,909		471,328
Floating Rate Series F Due 2021
Debt Instrument [Line Items]
Senior Notes		0		235,664
2.50% Senior Notes Due 2031
Debt Instrument [Line Items]
Interest rate								2.50%
Senior Notes		500,000		0				$ 500,000
Public offering price as percent of par								99.74%
3.125% Senior Notes due 2023
Debt Instrument [Line Items]
Interest rate								3.125%
Senior Notes								$ 400,000
Loss on extinguishment of debt, net		$ 20,900
3.10% Senior Notes due 2023
Debt Instrument [Line Items]
Interest rate										3.10%
Senior Notes										$ 400,000
Loss on extinguishment of debt, net	$ 27,300
2.45% Senior Notes, Series G Due 2027
Debt Instrument [Line Items]
Interest rate		2.45%				2.45%
Senior Notes		$ 375,970		0		$ 475,000
Public offering price as percent of par		99.79%				99.79%
2.50% Senior Notes, Series H Due 2031
Debt Instrument [Line Items]
Interest rate		3.30%				3.30%
Senior Notes		$ 237,454		0		$ 300,000
Public offering price as percent of par		99.65%				99.65%
3.30% Senior Notes, due 2022
Debt Instrument [Line Items]
Interest rate							3.30%
Senior Notes							$ 250,000
Loss on extinguishment of debt, net		$ (800)
Repayments of debt			$ 300,000
Mortgage loans and other
Debt Instrument [Line Items]
Repayments of debt		284,700		60,900
Long-term debt, gross		2,431,831		$ 2,092,106
Mortgage loans with fixed interest rate		2,100,000
Ventas Realty Limited Partnership | Senior Notes
Debt Instrument [Line Items]
Senior Notes		7,200,000
Nationwide Health Properties, LLC | Senior Notes
Debt Instrument [Line Items]
Senior Notes		$ 75,200
Ventas Canada Finance Limited | Senior Notes
Debt Instrument [Line Items]
Senior Notes						$ 1,900,000

Senior Notes Payable and Othe_6

Senior Notes Payable and Other Debt - Mortgages (Details) $ in Thousands, $ in Millions	Sep. 21, 2021USD ($)	Sep. 30, 2021USD ($)	Dec. 31, 2021USD ($)propertysenior_housingloan	Dec. 31, 2020USD ($)	Sep. 30, 2021CAD ($)
Debt Instrument [Line Items]
Weighted average maturity period of mortgage loans			4 years 2 months 12 days
Unamortized fair value adjustment			$ 32,888	$ 12,618
Minimum percentage of total unencumbered assets as a percentage of unsecured debt required to be maintained (as a percent)			150.00%
Senior notes payable and other debt			$ 12,027,544	11,895,412
New Senior Investment Group Inc. Acquisition
Debt Instrument [Line Items]
Mortgage debt assumed in transaction	$ 482,500
Mortgage Loans and Other
Debt Instrument [Line Items]
Number of mortgage loans | loan			112
Principal amount of debt			$ 2,400,000
Long-Term Debt, Number Of Properties Secured | property			102
Number of mortgage loans with fixed interest rate | senior_housing			95
Mortgage loans with fixed interest rate			$ 2,100,000
Number of mortgage loans with variable interest rate | senior_housing			17
Mortgage loans with variable interest rate			$ 370,000
Repayments of debt			$ 284,700	$ 60,900
Mortgage Loans and Other | New Senior Investment Group Inc. Acquisition
Debt Instrument [Line Items]
Mortgage debt assumed in transaction		$ 482,500
Mortgage Loans and Other | New Senior Investment Group Inc. Acquisition
Debt Instrument [Line Items]
Unamortized fair value adjustment					$ 25.4
Mortgage Loans and Other | Fixed Rate Debt
Debt Instrument [Line Items]
Weighted interest rate			3.60%
Mortgage Loans and Other | Variable Rate Debt
Debt Instrument [Line Items]
Weighted interest rate			1.70%
Mortgage Loans and Other | Minimum
Debt Instrument [Line Items]
Long-term debt, percentage bearing fixed interest			1.99%
Long-term debt, percentage bearing variable interest			0.08%
Mortgage Loans and Other | Maximum
Debt Instrument [Line Items]
Long-term debt, percentage bearing fixed interest			13.01%
Long-term debt, percentage bearing variable interest			2.85%

Senior Notes Payable and Othe_7

Senior Notes Payable and Other Debt - Scheduled Maturities (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Scheduled maturities of borrowing arrangements and other provisions excluding capital lease obligations
2022	$ 721,853
2023	734,832
2024	1,684,136
2025	2,130,809
2026	1,055,454
Thereafter	5,766,054
Total maturities	12,093,138	$ 11,983,071
Unrestricted cash and cash equivalents	149,725	$ 413,327
Unsecured Revolving Credit Facility and Commercial Paper
Scheduled maturities of borrowing arrangements and other provisions excluding capital lease obligations
2022	280,000
2023	0
2024	0
2025	56,448
Thereafter	0
Line of credit facility, remaining borrowing capacity	186,700
Principal Amount Due at Maturity
Scheduled maturities of borrowing arrangements and other provisions excluding capital lease obligations
2022	389,966
2023	696,075
2024	1,651,162
2025	2,047,551
2026	1,035,585
Thereafter	5,656,800
Total maturities	11,477,139
Unsecured Revolving Credit Facility
Scheduled maturities of borrowing arrangements and other provisions excluding capital lease obligations
2026	0
Total maturities	336,448
Scheduled Periodic Amortization
Scheduled maturities of borrowing arrangements and other provisions excluding capital lease obligations
2022	51,887
2023	38,757
2024	32,974
2025	26,810
2026	19,869
Thereafter	109,254
Total maturities	$ 279,551

Senior Notes Payable and Othe_8

Senior Notes Payable and Other Debt - Derivatives and Hedging (Details) - Dec. 31, 2021 - Swap $ in Millions, $ in Millions	USD ($)	CAD ($)
Variable Rate Debt
Derivative [Line Items]
Variable rate debt amount	$ 1,100
Derivative, Notional Amount	145.6
Fixed Rate Debt
Derivative [Line Items]
Variable rate debt amount	11,000
Derivative, Notional Amount	$ 303.1	$ 274

Fair Values of Financial Inst_3

Fair Values of Financial Instruments (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020	Jul. 31, 2020
Assets:
Cash and cash equivalents	$ 149,725	$ 413,327
Non-mortgage loans receivable, net	19,024	57,077
Debt Securities, Available-for-sale	0	237,553
Liabilities:
Long-term debt, gross	12,093,138	11,983,071
Redeemable OP Unitholder interests, Fair Value	182,100	146,000
Brookdale Senior Living
Assets:
Cash and cash equivalents			$ 162,000
Stock warrants			28,000
Non-mortgage loans receivable, net			45,000
Secured/mortgage loans and other, net
Assets:
Debt Securities, Held-to-maturity	488,913	555,840
Debt Securities, Held-to-maturity, Fair Value	478,931	508,707
Secured/mortgage loans and other, net | Brookdale Senior Living
Assets:
Debt Securities, Held-to-maturity			$ 78,000
Government-Sponsored Pooled Loan Investments
Assets:
Debt Securities, Available-for-sale	41,213	49,727
Non-mortgage loans receivable, net (2)
Assets:
Non-mortgage loans receivable, net	19,024	57,077
Non-mortgage loans receivable, fair value	19,039	57,009
Fair Value
Assets:
Cash and Cash Equivalents, Fair Value Disclosure	149,725	413,327
Escrow deposits and restricted cash	46,872	38,313
Derivative Asset	1,128	2
Liabilities:
Long-term Debt, Fair Value	12,891,937	13,075,337
Derivative Liability	12,290	28,338
Redeemable OP Unitholder interests, Fair Value	182,112	145,983
Fair Value | Brookdale Senior Living
Assets:
Stock warrants	48,884	50,098
Fair Value | Secured/mortgage loans and other, net
Assets:
Debt Securities, Held-to-maturity, Fair Value	478,931	508,707
Fair Value | Debt Securities
Assets:
Debt Securities, Available-for-sale	0	237,553
Fair Value | Government-Sponsored Pooled Loan Investments
Assets:
Debt Securities, Available-for-sale	41,213	49,727
Fair Value | Non-mortgage loans receivable, net (2)
Assets:
Non-mortgage loans receivable, fair value	19,039	57,009
Carrying Amount
Assets:
Cash and cash equivalents	149,725	413,327
Escrow deposits and restricted cash	46,872	38,313
Derivative Asset	1,128	2
Liabilities:
Long-term debt, gross	12,093,138	11,983,071
Derivative Liability	12,290	28,338
Redeemable Noncontrolling Interest, Equity, Carrying Amount	182,112	145,983
Carrying Amount | Brookdale Senior Living
Assets:
Stock warrants	48,884	50,098
Carrying Amount | Secured/mortgage loans and other, net
Assets:
Debt Securities, Held-to-maturity	488,913	555,840
Carrying Amount | Debt Securities
Assets:
Debt Securities, Available-for-sale	0	237,553
Carrying Amount | Government-Sponsored Pooled Loan Investments
Assets:
Debt Securities, Available-for-sale	41,213	49,727
Carrying Amount | Non-mortgage loans receivable, net (2)
Assets:
Non-mortgage loans receivable, net	$ 19,024	$ 57,077

Stock-Based Compensation (Detai

Stock-Based Compensation (Details)	12 Months Ended
	Dec. 31, 2021USD ($)plan$ / sharesshares	Dec. 31, 2020USD ($)$ / sharesshares	Dec. 31, 2019USD ($)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of share-based compensation plans covering employees, officers and directors | plan	3
Expiration period of stock options (in years)	10 years
Stock Option, Intrinsic Value
Proceeds from stock option exercises | $	$ 8,169,000	$ 15,103,000	$ 36,179,000
Employee Benefit Plan
Maximum 401(K) plan contribution by employer as a percent of employee's salary	3.50%
Aggregate employer 401(K) plan contribution during the period | $	$ 1,500,000	$ 1,600,000	1,500,000
Employee Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares available for future issuance	2,800,000
Number of shares authorized for issuance	3,000,000
Nonvested Restricted Stock and Restricted Stock Units, Weighted Average Grant Date Fair Value
Number of shares purchased	200,000
Employee Stock | Director
Nonvested Restricted Stock and Restricted Stock Units, Weighted Average Grant Date Fair Value
Discount related to the Employee Stock Purchase Plan	95.00%
Employee Stock | Employee
Nonvested Restricted Stock and Restricted Stock Units, Weighted Average Grant Date Fair Value
Discount related to the Employee Stock Purchase Plan	90.00%
Stock Options
Stock Option, Shares
Outstanding at the beginning of the period (in shares)	3,954,000
Granted (in shares)	0
Options exercised (in shares)	(193,000)
Options forfeited (in shares)	0
Options exercised (in shares)	0
Outstanding at the end of the period (in shares)	3,761,000	3,954,000
Exercisable at the end of the period (in shares)	3,761,000
Stock Option, Weighted Average Exercise Price
Outstanding at the beginning of the period (in dollars per share) | $ / shares	$ 60.90
Options granted (in dollars per share) | $ / shares	0
Options exercised (in dollars per share) | $ / shares	0
Options exercised (in dollars per share) | $ / shares	46.73
Options forfeited (in dollars per share) | $ / shares	0
Outstanding at the end of the period (in dollars per share) | $ / shares	61.63	$ 60.90
Exercisable at the end of the period (in dollars per share) | $ / shares	$ 61.63
Stock Option, Intrinsic Value
Outstanding at the end of the period | $	$ 29,000
Exercisable at the end of the period | $	29,000
Proceeds from stock option exercises | $	9,000,000	$ 5,100,000	36,100,000
Intrinsic value for options exercised | $	1,500,000	1,300,000	12,300,000
Deferred income tax expense (benefit) | $	$ 0
Nonvested Restricted Stock and Restricted Stock Units, Weighted Average Grant Date Fair Value
Outstanding at the end of the period (in years)	3 years 10 months 24 days
Exercisable at the end of the period (in years)	3 years 10 months 24 days
Stock Options | General and administrative expenses
Stock Option, Intrinsic Value
Compensation cost | $	$ 0	0	300,000
Restricted Stock or Restricted Stock Units
Nonvested Restricted Stock and Restricted Stock Units, Weighted Average Grant Date Fair Value
Unrecognized compensation cost related to nonvested awards | $	$ 34,600,000
Weighted average period over which cost is recognized (in years)	2 years
Intrinsic value for options vested during period | $	$ 23,400,000	19,800,000	31,600,000
Restricted Stock or Restricted Stock Units | General and administrative expenses
Stock Option, Intrinsic Value
Compensation cost | $	$ 31,900,000	$ 21,400,000	$ 33,600,000
Restricted Stock
Nonvested Restricted Stock and Restricted Stock Units, Shares
Nonvested at the beginning of the period (in shares)	233,000
Granted (in shares)	358,000
Vested (in shares)	(121,000)
Forfeited (in shares)	(22,000)
Nonvested at the end of the period (in shares)	448,000	233,000
Nonvested Restricted Stock and Restricted Stock Units, Weighted Average Grant Date Fair Value
Nonvested at the beginning of the period (in dollars per share) | $ / shares	$ 49.94
Granted (in dollars per share) | $ / shares	51.71
Vested (in dollars per share) | $ / shares	51.51
Forfeited (in dollars per share) | $ / shares	49.38
Nonvested at the end of the period (in dollars per share) | $ / shares	$ 50.96	$ 49.94
Restricted Stock Units
Nonvested Restricted Stock and Restricted Stock Units, Shares
Nonvested at the beginning of the period (in shares)	714,000
Granted (in shares)	654,000
Vested (in shares)	(321,000)
Forfeited (in shares)	0
Nonvested at the end of the period (in shares)	1,047,000	714,000
Nonvested Restricted Stock and Restricted Stock Units, Weighted Average Grant Date Fair Value
Nonvested at the beginning of the period (in dollars per share) | $ / shares	$ 59.46
Granted (in dollars per share) | $ / shares	47.87
Vested (in dollars per share) | $ / shares	57.44
Forfeited (in dollars per share) | $ / shares	0
Nonvested at the end of the period (in dollars per share) | $ / shares	$ 52.84	$ 59.46
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)	2 years
Minimum | Restricted Stock or Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)	2 years
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)	3 years
Maximum | Restricted Stock or Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)	5 years
2006 Plans
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares available for future issuance	0
2012 Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares available for future issuance	2,700,000
Number of shares authorized for issuance	10,700,000
Executive Deferred Stock Compensation Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of share-based compensation plans for executive officers | plan	1
Number of shares available for future issuance	600,000
Number of shares authorized for issuance	600,000
Nonemployee Directors' Deferred Stock Compensation Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of share-based compensation plans for directors | plan	1
Number of shares available for future issuance	400,000
Number of shares authorized for issuance	600,000

Income Taxes (Tax Treatment of

Income Taxes (Tax Treatment of Distributions and Consolidated Benefit for Income Taxes) (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Tax treatment of distributions:
Ordinary income (in dollars per share)	$ 0	$ 0	$ 0
Qualified ordinary income (in dollars per share)	0.00330	0.00696	0.12230
199A qualified business income	1.25274	2.14381	2.22898
Long-term capital gain (in dollars per share)	0.16448	0.28450	0
Unrecaptured Section 1250 gain (in dollars per share)	0.37948	0.04973	0.03434
Tax Treatment Of Non-dividend Distributions	0	0	0.78438
Distribution reported for 1099-DIV purposes (in dollars per share)	1.80000	2.48500	3.17000
Add: Dividend declared in current year and taxable in following year (in dollars per share)	0.45000	0.45000	0.79250
Less: Dividend declared in prior year and taxable in current year	(0.45000)	(0.79250)	(0.79250)
Dividends declared per common share (in dollars per share)	$ 1.80000	$ 2.1425	$ 3.170
Provision (benefit) for income taxes
Current - Federal	$ 662	$ 402	$ (1,840)
Current - State	2,116	2,107	2,118
Deferred - Federal	6,431	(56,835)	(49,532)
Deferred - State	72	(35,447)	(3,353)
Current - Foreign	3,439	2,929	2,335
Deferred - Foreign	(7,893)	(9,690)	(6,038)
Income tax expense (benefit)	$ 4,827	$ (96,534)	$ (56,310)

Income Taxes (Reconciliation of

Income Taxes (Reconciliation of Income Taxes) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Reconciliation of income tax expense computed by applying federal corporate tax rate
Tax at statutory rate on earnings from continuing operations before unconsolidated entities, noncontrolling interest and income taxes	$ (34,127)	$ 27,132	$ 77,803
State income taxes, net of federal benefit	(8,256)	(1,967)	2,341
Change in valuation allowance from ordinary operations	59,572	86,359	(47,227)
Tax at statutory rate on earnings not subject to federal income taxes	(22,869)	(53,808)	(90,862)
Foreign rate differential and foreign taxes	4,405	3,342	1,407
Change in tax status of TRS	3,485	(150,287)	(52)
Other differences	2,617	(7,305)	280
Income tax expense (benefit)	$ 4,827	$ (96,534)	$ (56,310)

Income Taxes (Tax Effects of Te

Income Taxes (Tax Effects of Temporary Differences and Carryforwards Included in Net Deferred Tax Liabilities) (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Property, primarily differences in depreciation and amortization, the tax basis of land assets and the treatment of interests and certain costs	$ (58,691)	$ (60,494)	$ (257,373)
Operating loss and interest deduction carryforwards	187,407	124,606	136,771
Expense accruals and other	21,628	10,516	7,380
Valuation allowance	(198,450)	(127,279)	(40,114)
Net deferred tax liabilities	$ (48,106)	$ (52,651)	$ (153,336)

Income Taxes (Unrecognized Tax

Income Taxes (Unrecognized Tax Benefits) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Summary of activities related to unrecognized tax benefits
Balance at the beginning of the period	$ 6,057	$ 12,127
Additions to tax positions related to prior years	29	74
Subtractions to tax positions related to prior years	(4)	(6,144)
Balance at the end of the period	6,082	$ 6,057
Increase (decrease) in net deferred tax liability	$ 4,500

Income Taxes (Narrative) (Detai

Income Taxes (Narrative) (Details) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Operating Loss Carryforwards [Line Items]
REIT distribution requirement (as a percent)	90.00%	90.00%	90.00%
Deferred Tax Assets, Valuation Allowance	$ (198,450,000)	$ (127,279,000)	$ (40,114,000)
Period in which assets disposition subject to built in gains tax	5 years
Difference in bases for entity not subject to income taxes	$ 3,300,000,000	3,600,000,000
Unrecognized Tax Benefits	6,082,000	6,057,000	12,127,000
Unrecognized tax benefits that, if recognized, would reduce annual effective tax rate	5,300,000	5,300,000
Unrecognized tax benefits, income tax penalties and interest accrued	0
Increase (decrease) in net deferred tax liability	4,500,000
Internal Restructuring, Taxable REIT Subsidiaries
Operating Loss Carryforwards [Line Items]
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount	3,500,000
Increase (decrease) in net deferred tax liability	3,500,000
Deferred Tax Liabilities, Revaluation
Operating Loss Carryforwards [Line Items]
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount	3,300,000
Increase (decrease) in net deferred tax liability	3,300,000
Release Of Residual Tax Effect, Marketable Debt Securities
Operating Loss Carryforwards [Line Items]
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount	3,700,000
Increase (decrease) in net deferred tax liability	3,700,000
Net Operating Losses More Likely Than Not To Be Realized [Member]
Operating Loss Carryforwards [Line Items]
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount		95,900,000
Interest Expense Limitation due to Tax Cuts and Jobs Act of 2017
Operating Loss Carryforwards [Line Items]
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount			57,700,000
Taxable Reit Subsidiaries
Operating Loss Carryforwards [Line Items]
Operating loss carryforwards, valuation allowance	140,600,000	83,200,000	21,200,000
REIT
Operating Loss Carryforwards [Line Items]
Operating loss carryforwards, valuation allowance	1,100,000,000	$ 896,400,000	$ 858,600,000
Tax credit carryforward	$ 10,800,000

Commitments and Contingencies_2

Commitments and Contingencies (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Operating Lease, Weighted Average Discount Rate, Percent	7.22%
Operating Lease, Weighted Average Remaining Lease Term	35 years 2 months 12 days
Operating Lease, Payments	$ 25,100	$ 25,400	$ 25,800
Future minimum lease obligations under non-cancelable operating and ground leases
2022	21,328
2023	21,468
2024	20,346
2025	15,918
2026	15,836
Thereafter	585,762
Total undiscounted minimum lease payments	680,658
Less: imputed interest	(483,424)
Operating lease liabilities	197,234	209,917
General and administrative expenses
Operating Leases, Rent Expense	$ 31,900	$ 32,100	$ 32,600

Earnings Per Share (Details)

Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Numerator for basic and diluted earnings per share:
Income from continuing operations	$ 56,559	$ 441,185	$ 439,297
Net income	56,559	441,185	439,297
Other comprehensive (loss) income	7,551	2,036	6,281
Net income attributable to common stockholders	$ 49,008	$ 439,149	$ 433,016
Denominator:
Denominator for basic earnings per share - weighted average shares (in shares)	382,785	373,368	365,977
Incremental Common Shares Attributable to Dilutive Effect of Call Options and Warrants	34	0	391
Stock options (in shares)	365	171	527
Incremental Common Shares Attributable to Dilutive Effect of Contingently Issuable Shares	3,120	2,964	2,991
Denominator for diluted earnings per share - adjusted weighted average shares (in shares)	386,304	376,503	369,886
Basic earnings per share:
Income from continuing operations (USD per share)	$ 0.15	$ 1.18	$ 1.20
Net income attributable to common stockholders (USD per share)	0.13	1.18	1.18
Diluted earnings per share:
Income from continuing operations (USD per share)	0.15	1.17	1.19
Net income attributable to common stockholders (USD per share)	$ 0.13	$ 1.17	$ 1.17
Anti-dilutive options outstanding (in shares)	3,100	4,000	1,100

Permanent and Temporary Equit_2

Permanent and Temporary Equity (Details) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended	12 Months Ended
	Sep. 30, 2021	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Temporary Equity [Line Items]
Acquisition-related activity	$ 751,200	$ 751,248
Common stock outstanding percentage of beneficial ownership acquired threshold for excess shares		9.00%
Preferred stock outstanding percentage of beneficial ownership acquired threshold for excess shares		9.90%
Maximum deferral payment period of purchase price for excess shares		5 years
Number of excess shares held by trustee		0
New Senior Investment Group Inc. Acquisition
Temporary Equity [Line Items]
Number of shares issued in transaction (in shares)	13,300,000
At The Market Equity Offering Program [Member]
Temporary Equity [Line Items]
Equity offering program, remaining authorized offering amount		$ 1,000,000
Stock issued during period, shares, new issues, equity offering program		10,900,000	1,500,000	2,700,000
Stock Issued During Period, Value, New Issues, Equity Offering Program		$ 626,400	$ 66,600	$ 177,900
Shares Issued, Price Per Share		$ 57.71	$ 44.88	$ 66.75

Permanent and Temporary Equit_3

Permanent and Temporary Equity Permanent and Temporary Equity (Accumulated Other Comprehensive Loss) (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Equity [Abstract]
Foreign currency translation	$ (56,227)	$ (51,947)
Available for sale securities	1,836	25,712
Derivative instruments	(10,129)	(28,119)
Accumulated other comprehensive loss	$ (64,520)	$ (54,354)

Permanent and Temporary Equit_4

Permanent and Temporary Equity (Redeemable OP Unitholder and Noncontrolling Interest) (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2021USD ($)
Increase (Decrease) in Temporary Equity [Roll Forward]
December 31, 2020	$ 235,490
New issuances	31,524
Change in fair value	32,833
Temporary Equity, Elimination as Part of Reorganization	0
Distributions and other	(7,883)
Redemptions	(11,681)
December 31, 2021	280,283
Non- controlling Interests
Increase (Decrease) in Temporary Equity [Roll Forward]
December 31, 2020	89,507
New issuances	0
Change in fair value	21,655
Temporary Equity, Elimination as Part of Reorganization	0
Distributions and other	(1,422)
Redemptions	(11,569)
December 31, 2021	98,171
General Partner
Increase (Decrease) in Temporary Equity [Roll Forward]
December 31, 2020	145,983
New issuances	31,524
Change in fair value	11,178
Temporary Equity, Elimination as Part of Reorganization	0
Distributions and other	(6,461)
Redemptions	(112)
December 31, 2021	$ 182,112

Related Party Transactions (Det

Related Party Transactions (Details) $ in Millions	12 Months Ended
	Dec. 31, 2021USD ($)board_memberproperty	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)	Jan. 31, 2018
Related party transaction
Number of real estate properties | property	1,200
Ardent
Related party transaction
Ownership interests in properties accounted for under the equity method	9.80%
Number of board members appointed	1
Eclipse Senior Living
Related party transaction
Ownership interests in properties accounted for under the equity method				34.00%
Number of board members appointed	2
Number of board members	6
Remaining ownership percentage retained by investee	66.00%
Ardent | Triple-net leased properties
Related party transaction
Number of real estate properties | property	11
Ardent
Related party transaction
Number of board members appointed	1
Number of board members	10
Atria
Related party transaction
Ownership interests in properties accounted for under the equity method	34.00%
Number of board members appointed	2
Number of board members	6
Atria
Related party transaction
Related party fees | $	$ 50.8	$ 54.1	$ 61.4
Atria | Sale Or Transition Of Senior Housing Communities Operated By Related Party
Related party transaction
Related party fees | $	20.3	1.1	0.7
Ardent
Related party transaction
Revenue from related parties | $	127.2	122.6	118.8
Eclipse Senior Living (ESL)
Related party transaction
Related party fees | $	11.8	15.1	14.6
Eclipse Senior Living (ESL) | Transition Of Operations At Senior Housing Communities
Related party transaction
Related party fees | $	$ 24	$ 5.2	$ 8.2

Segment Information (Narrative)

Segment Information (Narrative) (Details)	12 Months Ended
	Dec. 31, 2021USD ($)segment	Dec. 31, 2020USD ($)segment	Dec. 31, 2019USD ($)segment
Segment Reporting [Abstract]
Number of reportable segments | segment	3	3	3
Intersegment activity	$ 0
Segment Reporting Information
Office building and other services costs	4,433,000	$ 2,315,000	$ 2,319,000
Operating Segments | Triple-net leased properties
Segment Reporting Information
Office building and other services costs	0	0	0
Operating Segments | Senior living operations
Segment Reporting Information
Office building and other services costs	0	0	0
Operating Segments | Office operations
Segment Reporting Information
Office building and other services costs	1,798,000	2,315,000	2,319,000
All Other
Segment Reporting Information
Office building and other services costs	$ 2,635,000	$ 0	$ 0

Segment Information (Income Sta

Segment Information (Income Statement by Segment) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Revenues
Rental income	$ 1,448,120	$ 1,494,892	$ 1,609,876
Interest and other income	14,809	7,609	10,984
Total revenues	3,828,007	3,795,357	3,872,750
Less:
Interest and other income	14,809	7,609	10,984
Property-level operating expenses	2,084,064	1,937,443	1,808,208
Office building and other services costs	4,433	2,315	2,319
Segment NOI	1,724,701	1,847,990	2,051,239
Interest expense	(440,089)	(469,541)	(451,662)
Depreciation and amortization	(1,197,403)	(1,109,763)	(1,045,620)
General, administrative and professional fees	(129,758)	(130,158)	(158,726)
Loss on extinguishment of debt, net	(59,299)	(10,791)	(41,900)
Transaction expenses and deal costs	(47,318)	(29,812)	(15,235)
Allowance on loans receivable and investments	9,082	(24,238)
Other	37,110	707	(10,339)
Income (loss) from unconsolidated entities	4,983	1,844	(2,454)
Gain on real estate dispositions	218,788	262,218	26,022
Income tax (expense) benefit	(4,827)	96,534	56,310
Income from continuing operations	56,559	441,185	439,297
Net income	56,559	441,185	439,297
Other comprehensive (loss) income	7,551	2,036	6,281
Net income	49,008	439,149	433,016
Income from loans and investments	74,981	80,505	89,201
Other	37,110	707	(10,339)
Income from loans and investments	74,981	80,505	89,201
Operating Segments | Triple-net leased properties
Revenues
Rental income	653,823	695,265	780,898
Interest and other income	0	0	0
Total revenues	653,823	695,265	780,898
Less:
Interest and other income	0	0	0
Property-level operating expenses	15,335	22,160	26,561
Office building and other services costs	0	0	0
Segment NOI	638,488	673,105	754,337
Income from loans and investments	0	0	0
Income from loans and investments	0	0	0
Operating Segments | Senior living operations
Revenues
Rental income	0	0	0
Interest and other income	0	0	0
Total revenues	2,270,001	2,197,160	2,151,533
Less:
Interest and other income	0	0	0
Property-level operating expenses	1,811,728	1,658,671	1,521,398
Office building and other services costs	0	0	0
Segment NOI	458,273	538,489	630,135
Income from loans and investments	0	0	0
Income from loans and investments	0	0	0
Operating Segments | Office operations
Revenues
Rental income	794,297	799,627	828,978
Interest and other income	0	0	0
Total revenues	802,681	808,302	836,725
Less:
Interest and other income	0	0	0
Property-level operating expenses	257,001	256,612	260,249
Office building and other services costs	1,798	2,315	2,319
Segment NOI	543,882	549,375	574,157
Income from loans and investments	0	0	0
Income from loans and investments	0	0	0
All Other
Revenues
Rental income	0	0	0
Interest and other income	14,809	7,609	10,984
Total revenues	101,502	94,630	103,594
Less:
Interest and other income	14,809	7,609	10,984
Property-level operating expenses	0	0	0
Office building and other services costs	2,635	0	0
Segment NOI	84,058	87,021	92,610
Income from loans and investments	74,981	80,505	89,201
Income from loans and investments	74,981	80,505	89,201
Resident fees and services
Revenues
Revenue from contracts with customers	2,270,001	2,197,160	2,151,533
Resident fees and services | Operating Segments | Triple-net leased properties
Revenues
Revenue from contracts with customers	0	0	0
Resident fees and services | Operating Segments | Senior living operations
Revenues
Revenue from contracts with customers	2,270,001	2,197,160	2,151,533
Resident fees and services | Operating Segments | Office operations
Revenues
Revenue from contracts with customers	0	0	0
Resident fees and services | All Other
Revenues
Revenue from contracts with customers	0	0	0
Office building and other services revenue
Revenues
Revenue from contracts with customers	20,096	15,191	11,156
Office building and other services revenue | Operating Segments | Triple-net leased properties
Revenues
Revenue from contracts with customers	0	0	0
Office building and other services revenue | Operating Segments | Senior living operations
Revenues
Revenue from contracts with customers	0	0	0
Office building and other services revenue | Operating Segments | Office operations
Revenues
Revenue from contracts with customers	8,384	8,675	7,747
Office building and other services revenue | All Other
Revenues
Revenue from contracts with customers	$ 11,712	$ 6,516	$ 3,409

Segment Information (Assets) (D

Segment Information (Assets) (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Assets
Total assets	$ 24,717,786	$ 23,929,404
Percentage of total assets	100.00%	100.00%
Operating Segments | Triple-net leased properties
Assets
Total assets	$ 4,578,534	$ 5,147,503
Percentage of total assets	18.50%	21.60%
Operating Segments | Senior living operations
Assets
Total assets	$ 12,811,611	$ 10,653,428
Percentage of total assets	51.80%	44.50%
Operating Segments | Office operations
Assets
Total assets	$ 6,341,888	$ 6,709,602
Percentage of total assets	25.70%	28.00%
All Other
Assets
Total assets	$ 985,753	$ 1,418,871
Percentage of total assets	4.00%	5.90%

Segment Information (Capital Ex

Segment Information (Capital Expenditures) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Segment Reporting Information
Total capital expenditures	$ 1,802,021	$ 607,296	$ 1,518,772
Operating Segments | Triple-net leased properties
Segment Reporting Information
Total capital expenditures	92,924	42,930	55,429
Operating Segments | Senior living operations
Segment Reporting Information
Total capital expenditures	1,463,551	191,891	944,214
Operating Segments | Office operations
Segment Reporting Information
Total capital expenditures	$ 245,546	$ 372,475	$ 519,129

Segment Information (Geographic

Segment Information (Geographic Information) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Revenue
Revenues	$ 3,828,007	$ 3,795,357	$ 3,872,750
Net real estate property:
Net real estate property	21,816,838	20,550,035
United States
Revenue
Revenues	3,363,197	3,381,357	3,578,341
Net real estate property:
Net real estate property	18,562,738	17,303,816
Canada
Revenue
Revenues	434,862	389,205	266,946
Net real estate property:
Net real estate property	3,007,008	2,983,924
United Kingdom
Revenue
Revenues	29,948	24,795	$ 27,463
Net real estate property:
Net real estate property	$ 247,092	$ 262,295

Schedule III_ Real Estate and_2

Schedule III: Real Estate and Accumulated Depreciation (Rollforward) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Carrying cost:
Balance at beginning of period	$ 26,850,442	$ 27,133,514	$ 24,973,983
Additions during period:
Acquisitions	2,413,570	249,290	1,941,018
Capital expenditures	423,752	485,479	575,624
Deductions during period:
Foreign currency translation	17,030	80,302	107,508
Other	(1,224,924)	(1,098,143)	(464,619)
Balance at end of period	28,479,870	26,850,442	27,133,514
Accumulated depreciation:
Balance at beginning of period	6,967,413	6,200,230	5,492,310
Additions during period:
Depreciation expense	865,627	809,067	811,936
Dispositions:
Sales and/or transfers to assets held for sale	(401,208)	(82,559)	(116,771)
Foreign currency translation	1,648	40,675	12,755
Balance at end of period	$ 7,433,480	$ 6,967,413	$ 6,200,230

Schedule III_ Real Estate and_3

Schedule III: Real Estate and Accumulated Depreciation (Properties) (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Real Estate and Accumulated Depreciation
Encumbrances	$ 2,431,064
Initial Cost to Company
Land and Improvements	2,410,680
Buildings and Improvements	24,189,780
Costs Capitalized Subsequent to Acquisition	1,879,409
Gross Amount Carried at Close of Period
Land and Improvements	2,432,065
Buildings and Improvements	26,047,805
Total	28,479,870	$ 26,850,442	$ 27,133,514	$ 24,973,983
Accumulated Depreciation	7,433,480	$ 6,967,413	$ 6,200,230	$ 5,492,310
NBV	121,046,390
UNITED STATES PROPERTIES | Senior Housing
Real Estate and Accumulated Depreciation
Encumbrances	794,980
Initial Cost to Company
Land and Improvements	1,438,304
Buildings and Improvements	13,476,325
Costs Capitalized Subsequent to Acquisition	1,062,825
Gross Amount Carried at Close of Period
Land and Improvements	1,473,486
Buildings and Improvements	14,503,968
Total	15,977,454
Accumulated Depreciation	4,610,553
NBV	11,366,901
UNITED STATES PROPERTIES | Senior Housing | Atria Senior Living
Real Estate and Accumulated Depreciation
Encumbrances	243,330
Initial Cost to Company
Land and Improvements	454,983
Buildings and Improvements	3,891,742
Costs Capitalized Subsequent to Acquisition	571,695
Gross Amount Carried at Close of Period
Land and Improvements	479,650
Buildings and Improvements	4,438,770
Total	4,918,420
Accumulated Depreciation	1,445,165
NBV	3,473,255
UNITED STATES PROPERTIES | Senior Housing | Brookdale Senior Living
Real Estate and Accumulated Depreciation
Encumbrances	48,040
Initial Cost to Company
Land and Improvements	190,736
Buildings and Improvements	2,018,166
Costs Capitalized Subsequent to Acquisition	135,697
Gross Amount Carried at Close of Period
Land and Improvements	190,786
Buildings and Improvements	2,153,813
Total	2,344,599
Accumulated Depreciation	886,010
NBV	1,458,589
UNITED STATES PROPERTIES | Senior Housing | Holiday Retirement
Real Estate and Accumulated Depreciation
Encumbrances	284,894
Initial Cost to Company
Land and Improvements	186,176
Buildings and Improvements	1,869,082
Costs Capitalized Subsequent to Acquisition	(734)
Gross Amount Carried at Close of Period
Land and Improvements	186,528
Buildings and Improvements	1,867,996
Total	2,054,524
Accumulated Depreciation	193,361
NBV	1,861,163
UNITED STATES PROPERTIES | Senior Housing | Sunrise Senior Living
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	198,915
Buildings and Improvements	2,113,355
Costs Capitalized Subsequent to Acquisition	209,680
Gross Amount Carried at Close of Period
Land and Improvements	210,789
Buildings and Improvements	2,311,161
Total	2,521,950
Accumulated Depreciation	1,002,870
NBV	1,519,080
UNITED STATES PROPERTIES | Senior Housing | Sinceri Senior Living
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	59,551
Buildings and Improvements	597,082
Costs Capitalized Subsequent to Acquisition	28,117
Gross Amount Carried at Close of Period
Land and Improvements	58,139
Buildings and Improvements	626,611
Total	684,750
Accumulated Depreciation	222,131
NBV	462,619
UNITED STATES PROPERTIES | Senior Housing | Discovery Senior Living
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	21,906
Buildings and Improvements	251,919
Costs Capitalized Subsequent to Acquisition	13,347
Gross Amount Carried at Close of Period
Land and Improvements	22,213
Buildings and Improvements	264,959
Total	287,172
Accumulated Depreciation	87,695
NBV	199,477
UNITED STATES PROPERTIES | Senior Housing | Koelsch Senior Communities
Real Estate and Accumulated Depreciation
Encumbrances	75,179
Initial Cost to Company
Land and Improvements	27,721
Buildings and Improvements	292,414
Costs Capitalized Subsequent to Acquisition	13,578
Gross Amount Carried at Close of Period
Land and Improvements	28,424
Buildings and Improvements	305,289
Total	333,713
Accumulated Depreciation	55,138
NBV	278,575
UNITED STATES PROPERTIES | Senior Housing | Priority Life Care Properties
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	13,296
Buildings and Improvements	147,310
Costs Capitalized Subsequent to Acquisition	14,854
Gross Amount Carried at Close of Period
Land and Improvements	13,594
Buildings and Improvements	161,866
Total	175,460
Accumulated Depreciation	57,014
NBV	118,446
UNITED STATES PROPERTIES | Senior Housing | Sodalis Senior Living
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	21,451
Buildings and Improvements	208,224
Costs Capitalized Subsequent to Acquisition	(7,052)
Gross Amount Carried at Close of Period
Land and Improvements	21,613
Buildings and Improvements	201,010
Total	222,623
Accumulated Depreciation	76,312
NBV	146,311
UNITED STATES PROPERTIES | Senior Housing | Eclipse Senior Living
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	15,697
Buildings and Improvements	205,506
Costs Capitalized Subsequent to Acquisition	10,649
Gross Amount Carried at Close of Period
Land and Improvements	15,940
Buildings and Improvements	215,912
Total	231,852
Accumulated Depreciation	82,504
NBV	149,348
UNITED STATES PROPERTIES | Senior Housing | Matthews Senior Living
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	11,470
Buildings and Improvements	25,011
Costs Capitalized Subsequent to Acquisition	(15,253)
Gross Amount Carried at Close of Period
Land and Improvements	8,906
Buildings and Improvements	12,322
Total	21,228
Accumulated Depreciation	9,516
NBV	11,712
UNITED STATES PROPERTIES | Senior Housing | Avamere Family of Companies
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	24,248
Buildings and Improvements	151,017
Costs Capitalized Subsequent to Acquisition	10,151
Gross Amount Carried at Close of Period
Land and Improvements	24,494
Buildings and Improvements	160,922
Total	185,416
Accumulated Depreciation	48,942
NBV	136,474
UNITED STATES PROPERTIES | Senior Housing | Azura Memory Care
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	6,361
Buildings and Improvements	53,002
Costs Capitalized Subsequent to Acquisition	10,850
Gross Amount Carried at Close of Period
Land and Improvements	7,200
Buildings and Improvements	63,013
Total	70,213
Accumulated Depreciation	18,470
NBV	51,743
UNITED STATES PROPERTIES | Senior Housing | Milestone Retirement Communities
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	19,769
Buildings and Improvements	197,527
Costs Capitalized Subsequent to Acquisition	2,434
Gross Amount Carried at Close of Period
Land and Improvements	19,769
Buildings and Improvements	199,961
Total	219,730
Accumulated Depreciation	50,706
NBV	169,024
UNITED STATES PROPERTIES | Senior Housing | Hawthorn Senior Living
Real Estate and Accumulated Depreciation
Encumbrances	58,406
Initial Cost to Company
Land and Improvements	35,668
Buildings and Improvements	220,099
Costs Capitalized Subsequent to Acquisition	0
Gross Amount Carried at Close of Period
Land and Improvements	35,668
Buildings and Improvements	220,099
Total	255,767
Accumulated Depreciation	2,601
NBV	253,166
UNITED STATES PROPERTIES | Senior Housing | Meridian Senior Living
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	17,977
Buildings and Improvements	77,599
Costs Capitalized Subsequent to Acquisition	1,416
Gross Amount Carried at Close of Period
Land and Improvements	17,977
Buildings and Improvements	79,015
Total	96,992
Accumulated Depreciation	25,575
NBV	71,417
UNITED STATES PROPERTIES | Senior Housing | Sonida Senior Living
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	14,080
Buildings and Improvements	118,512
Costs Capitalized Subsequent to Acquisition	21,910
Gross Amount Carried at Close of Period
Land and Improvements	14,735
Buildings and Improvements	139,767
Total	154,502
Accumulated Depreciation	53,137
NBV	101,365
UNITED STATES PROPERTIES | Senior Housing | Other Senior Housing Operators
Real Estate and Accumulated Depreciation
Encumbrances	85,131
Initial Cost to Company
Land and Improvements	115,316
Buildings and Improvements	1,038,608
Costs Capitalized Subsequent to Acquisition	41,486
Gross Amount Carried at Close of Period
Land and Improvements	114,078
Buildings and Improvements	1,081,332
Total	1,195,410
Accumulated Depreciation	293,406
NBV	902,004
UNITED STATES PROPERTIES | Senior Housing | Other Senior Housing CIP
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	2,983
Buildings and Improvements	150
Costs Capitalized Subsequent to Acquisition	0
Gross Amount Carried at Close of Period
Land and Improvements	2,983
Buildings and Improvements	150
Total	3,133
Accumulated Depreciation	0
NBV	3,133
UNITED STATES PROPERTIES | Medical Office
Real Estate and Accumulated Depreciation
Encumbrances	275,379
Initial Cost to Company
Land and Improvements	340,791
Buildings and Improvements	3,867,592
Costs Capitalized Subsequent to Acquisition	587,453
Gross Amount Carried at Close of Period
Land and Improvements	337,400
Buildings and Improvements	4,458,436
Total	4,795,836
Accumulated Depreciation	1,492,313
NBV	3,303,523
UNITED STATES PROPERTIES | Medical Office | Lillibridge
Real Estate and Accumulated Depreciation
Encumbrances	38,872
Initial Cost to Company
Land and Improvements	153,578
Buildings and Improvements	2,047,079
Costs Capitalized Subsequent to Acquisition	438,907
Gross Amount Carried at Close of Period
Land and Improvements	152,144
Buildings and Improvements	2,487,420
Total	2,639,564
Accumulated Depreciation	914,439
NBV	1,725,125
UNITED STATES PROPERTIES | Medical Office | PMB RES
Real Estate and Accumulated Depreciation
Encumbrances	235,418
Initial Cost to Company
Land and Improvements	73,863
Buildings and Improvements	972,701
Costs Capitalized Subsequent to Acquisition	103,220
Gross Amount Carried at Close of Period
Land and Improvements	75,134
Buildings and Improvements	1,074,650
Total	1,149,784
Accumulated Depreciation	316,853
NBV	832,931
UNITED STATES PROPERTIES | Medical Office | Other MOBs
Real Estate and Accumulated Depreciation
Encumbrances	1,089
Initial Cost to Company
Land and Improvements	113,350
Buildings and Improvements	847,812
Costs Capitalized Subsequent to Acquisition	45,326
Gross Amount Carried at Close of Period
Land and Improvements	110,122
Buildings and Improvements	896,366
Total	1,006,488
Accumulated Depreciation	261,021
NBV	745,467
UNITED STATES PROPERTIES | Medical Office | Other MOBs CIP
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	0
Buildings and Improvements	0
Costs Capitalized Subsequent to Acquisition	0
Gross Amount Carried at Close of Period
Land and Improvements	0
Buildings and Improvements	0
Total	0
Accumulated Depreciation	0
NBV	0
UNITED STATES PROPERTIES | Life Science, Research & Innovation
Real Estate and Accumulated Depreciation
Encumbrances	206,799
Initial Cost to Company
Land and Improvements	112,848
Buildings and Improvements	1,656,201
Costs Capitalized Subsequent to Acquisition	125,731
Gross Amount Carried at Close of Period
Land and Improvements	112,809
Buildings and Improvements	1,781,971
Total	1,894,780
Accumulated Depreciation	254,616
NBV	1,640,164
UNITED STATES PROPERTIES | Life Science, Research & Innovation | Wexford
Real Estate and Accumulated Depreciation
Encumbrances	206,799
Initial Cost to Company
Land and Improvements	85,744
Buildings and Improvements	1,541,924
Costs Capitalized Subsequent to Acquisition	125,731
Gross Amount Carried at Close of Period
Land and Improvements	85,705
Buildings and Improvements	1,667,694
Total	1,753,399
Accumulated Depreciation	247,370
NBV	1,506,029
UNITED STATES PROPERTIES | Life Science, Research & Innovation | Other Life Science
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	1,194
Buildings and Improvements	76,515
Costs Capitalized Subsequent to Acquisition	0
Gross Amount Carried at Close of Period
Land and Improvements	1,194
Buildings and Improvements	76,515
Total	77,709
Accumulated Depreciation	4,655
NBV	73,054
UNITED STATES PROPERTIES | Life Science, Research & Innovation | Other Life Science CIP
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	25,910
Buildings and Improvements	37,762
Costs Capitalized Subsequent to Acquisition	0
Gross Amount Carried at Close of Period
Land and Improvements	25,910
Buildings and Improvements	37,762
Total	63,672
Accumulated Depreciation	2,591
NBV	61,081
UNITED STATES PROPERTIES | IRFs & LTACs
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	44,442
Buildings and Improvements	389,838
Costs Capitalized Subsequent to Acquisition	68
Gross Amount Carried at Close of Period
Land and Improvements	43,442
Buildings and Improvements	390,906
Total	434,348
Accumulated Depreciation	245,020
NBV	189,328
UNITED STATES PROPERTIES | IRFs & LTACs | Kindred Healthcare
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	35,185
Buildings and Improvements	238,600
Costs Capitalized Subsequent to Acquisition	(1,000)
Gross Amount Carried at Close of Period
Land and Improvements	34,185
Buildings and Improvements	238,600
Total	272,785
Accumulated Depreciation	209,361
NBV	63,424
UNITED STATES PROPERTIES | IRFs & LTACs | Other IRFs & LTACs
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	9,257
Buildings and Improvements	151,238
Costs Capitalized Subsequent to Acquisition	1,068
Gross Amount Carried at Close of Period
Land and Improvements	9,257
Buildings and Improvements	152,306
Total	161,563
Accumulated Depreciation	35,659
NBV	125,904
UNITED STATES PROPERTIES | Health Systems | Ardent Health Services
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	98,428
Buildings and Improvements	1,126,010
Costs Capitalized Subsequent to Acquisition	78,104
Gross Amount Carried at Close of Period
Land and Improvements	97,416
Buildings and Improvements	1,205,126
Total	1,302,542
Accumulated Depreciation	216,935
NBV	1,085,607
UNITED STATES PROPERTIES | Skilled Nursing
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	12,986
Buildings and Improvements	183,538
Costs Capitalized Subsequent to Acquisition	(4,303)
Gross Amount Carried at Close of Period
Land and Improvements	13,166
Buildings and Improvements	179,055
Total	192,221
Accumulated Depreciation	81,543
NBV	110,678
UNITED STATES PROPERTIES | Skilled Nursing | Genesis Healthcare
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	11,350
Buildings and Improvements	164,745
Costs Capitalized Subsequent to Acquisition	(5,708)
Gross Amount Carried at Close of Period
Land and Improvements	11,350
Buildings and Improvements	159,037
Total	170,387
Accumulated Depreciation	68,573
NBV	101,814
UNITED STATES PROPERTIES | Skilled Nursing | Other Skilled Nursing
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	1,636
Buildings and Improvements	18,793
Costs Capitalized Subsequent to Acquisition	1,405
Gross Amount Carried at Close of Period
Land and Improvements	1,816
Buildings and Improvements	20,018
Total	21,834
Accumulated Depreciation	12,970
NBV	8,864
CANADIAN PROPERTIES | Senior Housing
Real Estate and Accumulated Depreciation
Encumbrances	1,153,906
Initial Cost to Company
Land and Improvements	308,533
Buildings and Improvements	3,269,467
Costs Capitalized Subsequent to Acquisition	58,123
Gross Amount Carried at Close of Period
Land and Improvements	304,819
Buildings and Improvements	3,331,304
Total	3,636,123
Accumulated Depreciation	496,850
NBV	3,139,273
CANADIAN PROPERTIES | Senior Housing | Atria Senior Living
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	75,553
Buildings and Improvements	845,363
Costs Capitalized Subsequent to Acquisition	(15,001)
Gross Amount Carried at Close of Period
Land and Improvements	71,248
Buildings and Improvements	834,667
Total	905,915
Accumulated Depreciation	225,639
NBV	680,276
CANADIAN PROPERTIES | Senior Housing | Sunrise Senior Living
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	46,600
Buildings and Improvements	418,821
Costs Capitalized Subsequent to Acquisition	(43,105)
Gross Amount Carried at Close of Period
Land and Improvements	40,692
Buildings and Improvements	381,624
Total	422,316
Accumulated Depreciation	167,340
NBV	254,976
CANADIAN PROPERTIES | Senior Housing | Hawthorn Senior Living
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	25,172
Buildings and Improvements	146,694
Costs Capitalized Subsequent to Acquisition	0
Gross Amount Carried at Close of Period
Land and Improvements	25,172
Buildings and Improvements	146,694
Total	171,866
Accumulated Depreciation	842
NBV	171,024
CANADIAN PROPERTIES | Senior Housing | Other Senior Housing CIP
Real Estate and Accumulated Depreciation
Encumbrances	56,338
Initial Cost to Company
Land and Improvements	20,085
Buildings and Improvements	114,855
Costs Capitalized Subsequent to Acquisition	0
Gross Amount Carried at Close of Period
Land and Improvements	20,085
Buildings and Improvements	114,855
Total	134,940
Accumulated Depreciation	0
NBV	134,940
CANADIAN PROPERTIES | Senior Housing | Le Groupe Maurice
Real Estate and Accumulated Depreciation
Encumbrances	1,097,568
Initial Cost to Company
Land and Improvements	141,123
Buildings and Improvements	1,743,734
Costs Capitalized Subsequent to Acquisition	116,229
Gross Amount Carried at Close of Period
Land and Improvements	147,622
Buildings and Improvements	1,853,464
Total	2,001,086
Accumulated Depreciation	103,029
NBV	1,898,057
UNITED KINGDOM PROPERTIES | Senior Housing | Canford Healthcare Limited
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	42,445
Buildings and Improvements	84,181
Costs Capitalized Subsequent to Acquisition	(9,093)
Gross Amount Carried at Close of Period
Land and Improvements	39,186
Buildings and Improvements	78,347
Total	117,533
Accumulated Depreciation	16,602
NBV	100,931
UNITED KINGDOM PROPERTIES | International Hospital | Spire Healthcare
Real Estate and Accumulated Depreciation
Encumbrances	0
Initial Cost to Company
Land and Improvements	11,903
Buildings and Improvements	136,628
Costs Capitalized Subsequent to Acquisition	(19,499)
Gross Amount Carried at Close of Period
Land and Improvements	10,341
Buildings and Improvements	118,692
Total	129,033
Accumulated Depreciation	19,048
NBV	$ 109,985

Schedule IV - Real Estate Mor_2

Schedule IV - Real Estate Mortgage Loans (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2021USD ($)loan	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Monthly Debt Service	$ 2,684
Face Value	486,200
Net Book Value	486,200	$ 552,797	$ 642,218	$ 427,117
Prior Liens	$ 1,018,440
Mezzanine Loans | Multiple
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Number of RE Assets | loan	154
Interest Rate	6.53%
Maturity Date	Jun. 9, 2022
Monthly Debt Service	$ 2,684
Face Value	486,200
Net Book Value	486,200
Prior Liens	$ 1,018,440

Schedule IV - Real Estate Mor_3

Schedule IV - Real Estate Mortgage Loans (Mortgage Loan Reconciliation) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
SEC Schedule, 12-29, Real Estate Companies, Investment in Movement in Mortgage Loans on Real Estate [Roll Forward]
Beginning Balance	$ 552,797	$ 642,218	$ 427,117
New loans	0	66,000	1,234,244
Construction draws	0	0	0
Total additions	0	66,000	1,234,244
Principal repayments	(66,597)	(155,170)	(1,011,353)
Total deductions	(66,597)	(155,170)	(1,011,353)
Effect of foreign currency translation	0	(251)	(7,790)
Ending Balance	$ 486,200	$ 552,797	$ 642,218