Welltower (WELL) 10-Q 30 Oct 15 2015 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - USD ($)	9 Months Ended
	Sep. 30, 2015	Oct. 23, 2015
Document And Entity Information [Abstract]
Entity Registrant Name	WELLTOWER INC. /DE/
Entity Central Index Key	766,704
Document Type	10-Q
Document Period End date	Sep. 30, 2015
Amendment Flag	false
Document Fiscal Year Focus	2,015
Document Fiscal Period Focus	Q3
Current Fiscal Year End Date	--12-31
Entity Well Known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Filer Category	Large Accelerated Filer
Entity Public Float	$ 23,029,716,957
Entity Common Stock Shares Outstanding		353,879,510

Consolidated Balance Sheets (Un

Consolidated Balance Sheets (Unaudited) - USD ($)	Sep. 30, 2015		Dec. 31, 2014
Real property owned:
Land and land improvements	$ 2,241,210,000		$ 2,046,541,000
Buildings and improvements	24,273,654,000		21,799,313,000
Acquired lease intangibles	1,208,510,000		1,135,936,000
Real property held for sale, net of accumulated depreciation	229,038,000		323,818,000
Construction in progress	197,639,000		186,327,000
Gross real property owned	28,150,051,000		25,491,935,000
Less accumulated depreciation and amortization	(3,553,171,000)		(3,020,908,000)
Net real property owned	24,596,880,000		22,471,027,000
Real estate loans receivable:
Real estate loans receivable	752,912,000		380,169,000
Net real estate investments	25,349,792,000		22,851,196,000
Other assets:
Investments in unconsolidated entities	558,354,000		744,151,000
Goodwill	68,321,000		68,321,000
Deferred loan expenses	64,190,000		69,282,000
Cash and cash equivalents	292,042,000		473,726,000
Restricted cash	74,758,000		79,697,000
Straight-line rent receivable	366,545,000		279,806,000
Receivables and other assets	682,364,000		448,117,000
Total other assets	2,106,574,000		2,163,100,000
Total assets	27,456,366,000		25,014,296,000
Liabilities:
Borrowings under primary unsecured credit facilities, Carrying Value	490,000,000	[1]	0
Senior unsecured notes	7,926,757,000		7,766,251,000
Secured debt	2,975,639,000		2,977,713,000
Capital lease obligations	75,379,000		84,049,000
Accrued expenses and other liabilities	686,651,000		626,825,000
Total liabilities	12,154,426,000		11,454,838,000
Redeemable noncontrolling interests	164,765,000		86,409,000
Equity:
Preferred stock	1,006,250,000		1,006,250,000
Common stock	353,023,000		328,835,000
Capital in excess of par value	16,381,569,000		14,740,712,000
Treasury stock	(44,336,000)		(35,241,000)
Cumulative net income	3,576,490,000		2,842,022,000
Cumulative dividends	(6,537,541,000)		(5,635,923,000)
Accumulated other comprehensive income (loss)	(94,359,000)		(77,009,000)
Other equity	3,997,000		5,507,000
Total Welltower Inc. stockholders' equity	14,645,093,000		13,175,153,000
Noncontrolling interests	492,082,000		297,896,000
Total equity	15,137,175,000		13,473,049,000
Total liabilities and equity	$ 27,456,366,000		$ 25,014,296,000
[1]	(1) As of September 30, 2015, letters of credit in the aggregate amount of $58,484,000 have been issued, which reduces the borrowing capacity on the primary unsecured revolving credit facility.

Consolidated Statements of Inco

Consolidated Statements of Income (Unaudited) - USD ($)		3 Months Ended		9 Months Ended
		Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015		Sep. 30, 2014
Revenues:
Rental income		$ 409,290,000	$ 354,148,000	$ 1,185,502,000		$ 1,038,451,000
Resident fees and services		545,255,000	482,412,000	1,573,318,000		1,406,316,000
Interest income		22,380,000	9,344,000	59,950,000		26,871,000
Other income		2,072,000	1,619,000	11,572,000		4,139,000
Total revenues		978,997,000	847,523,000	2,830,342,000		2,475,777,000
Expenses:
Interest expense		121,130,000	118,435,000	361,071,000		360,334,000
Property operating expenses		408,703,000	355,157,000	1,183,519,000		1,040,342,000
Depreciation and amortization		205,799,000	200,970,000	603,431,000		648,737,000
General and administrative		36,950,000	30,803,000	110,562,000		115,327,000
Transaction costs		9,333,000	13,554,000	70,379,000		21,546,000
Loss (gain) on derivatives, net		0	49,000	(58,427,000)	[1]	400,000
Loss (gain) on extinguishment of debt, net		584,000	2,692,000	34,872,000		3,075,000
Impairment of Asset		0	0	2,220,000		0
Other expenses		0	10,262,000	10,583,000		10,262,000
Total expenses		782,499,000	731,922,000	2,318,210,000		2,200,023,000
Income (loss) from continuing operations before income taxes and income from unconsolidated entities, total		196,498,000	115,601,000	512,132,000		275,754,000
Income tax (expense) benefit		3,344,000	10,198,000	(3,769,000)		6,369,000
(Loss) income from unconsolidated entities		(2,631,000)	(2,632,000)	(18,231,000)		(19,705,000)
Income from continuing operations		197,211,000	123,167,000	490,132,000		262,418,000
Discontinued operations:
Gain (loss) on sales of properties, net		0	0	0		6,411,000
Income (loss) from discontinued operations, net		0	0	0		724,000
Discontinued operations, net		0	0	0		7,135,000
Gain (loss) on real estate dispositions, net		2,046,000	29,604,000	249,002,000		36,272,000
Net income		199,257,000	152,771,000	739,134,000		305,825,000
Less: Preferred stock dividends		16,352,000	16,352,000	49,055,000		49,057,000
Less: Net income (loss) attributable to noncontrolling interests	[2]	862,000	164,000	4,666,000		(1,339,000)
Net income (loss) attributable to common stockholders		$ 182,043,000	$ 136,255,000	$ 685,413,000		$ 258,107,000
Average number of common shares outstanding:
Basic		351,765,000	311,117,000	346,425,000		299,137,000
Diluted		353,107,000	312,812,000	347,547,000		300,645,000
Basic:
Income (loss) from continuing operations attributable to common stockholders, including real estate dispositions		$ 0.52	$ 0.44	$ 1.98		$ 0.84
Discontinued operations, net		0	0	0		0.02
Net income (loss) attributable to common stockholders, total		0.52	0.44	1.98		0.86
Diluted:
Income (loss) from continuing operations attributable to common stockholders, including real estate dispositions		0.52	0.44	1.97		0.83
Discontinued operations, net		0	0	0		0.02
Net income (loss) attributable to common stockholders, total		0.52	0.44	1.97		0.86
Dividends declared and paid per common share		$ 0.825	$ 0.795	$ 2.475		$ 2.385
[1]	(1) In April 2011, we completed the acquisition of substantially all of the real estate assets of privately-owned Genesis Healthcare Corporation. In conjunction with this transaction, we received the option to acquire an ownership interest in Genesis Healthcare. In February 2015, Genesis Healthcare closed on a transaction to merge with Skilled Healthcare Group to become a publicly traded company which required us to record the value of the derivative asset due to the net settlement feature.
[2]	(1) Includes amounts attributable to redeemable noncontrolling interests.

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income (Unaudited) - USD ($)		3 Months Ended		9 Months Ended
		Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Statement of Comprehensive Income [Abstract]
Net income		$ 199,257,000	$ 152,771,000	$ 739,134,000	$ 305,825,000
Other comprehensive income (loss):
Unrecognized gain (loss) on equity investments		(3,086,000)	0	(18,186,000)	389,000
Unrecognized gain (loss) on cash flow hedges		462,000	455,000	(1,235,000)	1,327,000
Unrecognized gain (loss) on foreign currency translation		(25,198,000)	(42,664,000)	(22,011,000)	(39,444,000)
Total other comprehensive income (loss)		(27,822,000)	(42,209,000)	(41,432,000)	(37,728,000)
Total comprehensive income (loss), total		171,435,000	110,562,000	697,702,000	268,097,000
Total comprehensive income (loss) attributable to noncontrolling interests	[1]	(14,271,000)	(7,984,000)	(19,416,000)	(10,894,000)
Comprehensive income (loss) attributable to controlling interests		$ 185,706,000	$ 118,546,000	$ 717,118,000	$ 278,991,000
[1]	(1) Includes amounts attributable to redeemable noncontrolling interests.

Consolidated Statements of Equi

Consolidated Statements of Equity (Unaudited) - USD ($)	Total	Preferred Stock	Common Stock	Capital in Excess of Par Value	Treasury Stock	Cumulative Net Income	Cumulative Dividends	Accumulated Other Comprehensive Income (Loss)	Other Equity	Noncontrolling Interests
Balances at beginning of period at Dec. 31, 2013	$ 11,756,331,000	$ 1,017,361,000	$ 289,461,000	$ 12,418,520,000	$ (21,263,000)	$ 2,329,869,000	$ (4,600,854,000)	$ (24,531,000)	$ 6,020,000	$ 341,748,000
Comprehensive income:
Net income (loss)	305,846,000					307,164,000				(1,318,000)
Other comprehensive income	(37,728,000)							(28,173,000)		(9,555,000)
Total comprehensive income	268,118,000
Net change in noncontrolling interests	(28,880,000)			(7,818,000)						(21,062,000)
Amounts related to issuance of common stock from dividend reinvestment and stock incentive plans, net of forfeitures	201,868,000		3,614,000	212,718,000	(13,978,000)				(486,000)
Proceeds from issuance of common stock	2,064,401,000		33,925,000	2,030,476,000
Conversion of preferred stock		(11,111,000)	233,000	10,878,000
Equity component of convertible debt	875,000		200,000	675,000
Option compensation expense	689,000								689,000
Cash dividends paid:
Common stock	(708,923,000)						(708,923,000)
Preferred Stock	(49,057,000)						(49,057,000)
Balances at end of period at Sep. 30, 2014	13,505,422,000	1,006,250,000	327,433,000	14,665,449,000	(35,241,000)	2,637,033,000	(5,358,834,000)	(52,704,000)	6,223,000	309,813,000
Balances at beginning of period at Dec. 31, 2014	13,473,049,000	1,006,250,000	328,835,000	14,740,712,000	(35,241,000)	2,842,022,000	(5,635,923,000)	(77,009,000)	5,507,000	297,896,000
Comprehensive income:
Net income (loss)	738,944,000					734,468,000				4,476,000
Other comprehensive income	(41,432,000)							(17,350,000)		(24,082,000)
Total comprehensive income	697,512,000
Net change in noncontrolling interests	209,014,000			(4,778,000)						213,792,000
Amounts related to issuance of common stock from dividend reinvestment and stock incentive plans, net of forfeitures	228,834,000		3,308,000	236,718,000	(9,095,000)				(2,097,000)
Proceeds from issuance of common stock	1,423,036,000		19,550,000	1,403,486,000
Conversion of preferred stock	0
Equity component of convertible debt	6,761,000		1,330,000	5,431,000
Option compensation expense	587,000								587,000
Cash dividends paid:
Common stock	(852,563,000)						(852,563,000)
Preferred Stock	(49,055,000)						(49,055,000)
Balances at end of period at Sep. 30, 2015	$ 15,137,175,000	$ 1,006,250,000	$ 353,023,000	$ 16,381,569,000	$ (44,336,000)	$ 3,576,490,000	$ (6,537,541,000)	$ (94,359,000)	$ 3,997,000	$ 492,082,000

Consolidated Statements of Cash

Consolidated Statements of Cash Flows (Unaudited) - USD ($)		9 Months Ended
		Sep. 30, 2015		Sep. 30, 2014
Operating activities
Net income (loss)		$ 739,134,000		$ 305,825,000
Adjustments to reconcile net income to net cash provided from (used in) operating activities:
Depreciation and amortization		603,431,000		648,737,000
Other amortization expenses		3,867,000		5,626,000
Asset Impairment Charges		2,220,000		0
Stock-based compensation expense		25,655,000		26,108,000
Loss (gain) on derivatives, net		(58,427,000)	[1]	400,000
Loss (gain) on extinguishment of debt, net		34,872,000		3,075,000
Income from unconsolidated entities		18,231,000		19,705,000
Rental income in excess of cash received		(86,739,000)		(51,017,000)
Amortization related to above (below) market leases, net		2,863,000		503,000
Net loss (gain) on sales of properties		(249,002,000)		(42,683,000)
Distributions by unconsolidated entities		435,000		8,883,000
Increase (decrease) in accrued expenses and other liabilities		42,759,000		(19,259,000)
Decrease (increase) in receivables and other assets		(42,975,000)		(51,734,000)
Net cash provided from (used in) operating activities		1,036,324,000		854,169,000
Investing activities
Cash disbursed for acquisitions		(2,489,345,000)		(991,315,000)
Cash disbursed for capital improvements to existing properties		(122,640,000)		(86,324,000)
Cash disbursed for construction in progress		(165,311,000)		(140,829,000)
Capitalized interest		(6,311,000)		(5,084,000)
Investment in real estate loans receivable		(445,985,000)		(79,264,000)
Other investments, net of payments		(129,311,000)		(39,202,000)
Principal collected on real estate loans receivable		71,111,000		46,268,000
Contributions to unconsolidated entities		(139,295,000)		(246,794,000)
Distributions by unconsolidated entities		139,557,000		38,261,000
Proceeds from (payments on) derivatives investing		103,615,000		0
Decrease (increase) in restricted cash		10,512,000		(45,346,000)
Proceeds from sales of real property		667,761,000		442,733,000
Net cash provided from (used in) investing activities		(2,505,642,000)		(1,106,896,000)
Financing activities
Net increase (decrease) under unsecured lines of credit arrangements		490,000,000		(130,000,000)
Proceeds from issuance of senior unsecured notes		743,407,000		0
Payments to extinguish senior unsecured notes		(534,546,000)		(47,591,000)
Secured debt issued		222,612,000		98,100,000
Payments on secured debt		(469,455,000)		(286,162,000)
Net proceeds from the issuance of common stock		1,641,981,000		2,260,908,000
Decrease (increase) in deferred loan expenses		(7,834,000)		(17,429,000)
Contributions by noncontrolling interests	[2]	163,105,000		5,572,000
Distributions to noncontrolling interests	[2]	(27,439,000)		(30,909,000)
Acquisitions of noncontrolling interests		(3,154,000)		(1,175,000)
Cash distributions to stockholders		(901,618,000)		(757,980,000)
Other financing activities		(27,114,000)		(844,000)
Net cash provided from (used in) financing activities		1,289,945,000		1,092,490,000
Effect of foreign currency translation on cash and cash equivalents		(2,311,000)		135,000
Increase (decrease) in cash and cash equivalents		(181,684,000)		839,898,000
Cash and cash equivalents at beginning of period		473,726,000		158,780,000
Cash and cash equivalents at end of period		292,042,000		998,678,000
Supplemental cash flow information:
Interest paid		334,511,000		365,738,000
Income taxes paid		$ 11,489,000		$ 16,672,000
[1]	(1) In April 2011, we completed the acquisition of substantially all of the real estate assets of privately-owned Genesis Healthcare Corporation. In conjunction with this transaction, we received the option to acquire an ownership interest in Genesis Healthcare. In February 2015, Genesis Healthcare closed on a transaction to merge with Skilled Healthcare Group to become a publicly traded company which required us to record the value of the derivative asset due to the net settlement feature.
[2]	(1) Includes amounts attributable to redeemable noncontrolling interests.

Business

Business	9 Months Ended
	Sep. 30, 2015
Business [Abstract]
Business	1. Business Welltower Inc. (formerly Health Care REIT, Inc. ) , an S&P 500 company headquartered in Toledo, Ohio, is driving the transformation of health care infrastructure. The company invests with leading seniors housing operators , post-acute providers and health systems to fund the real estate and infrastructure needed to scale innovative care delivery models and improve people’s wellness and overall health care experience. Welltower™, a real estate investment trust (REIT), owns 1,414 properties in ma jor, high-growth markets in the United States, Canada and the United Kingdom, consisting of seniors housing and post-acute communities and outpatient medical properties . Founded in 1970, we were the first real estate investment trust to invest exclusively in health care facilities.

Accounting Policies and Related

Accounting Policies and Related Matters	9 Months Ended
	Sep. 30, 2015
Accounting Policies and Related Matters [Abstract]
Accounting Policies and Related Matters	2. Accounting Policies and Related Matters Basis of Presentation The accompanying unaudited consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial information and with instructions to Quarterly Report on Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by U.S. GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation have been included. Operating results for the nine months ended September 30, 2015 are not necessarily an indication of the results that may be expected for the year ending December 31, 2015. For further information, refer to the financial statements and notes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2014 . New Accounting Standards In May 2014, the Fin ancial Accounting Standards Board (“FASB”) issued ASU No. 2014-09, “Revenue from Contracts with Customers (Topic 606)” (“ASU 2014-09”). The standard is a comprehensive new revenue recognition model that requires revenue to be recognized in a manner to depi ct the transfer of goods or services to a customer at an amount that reflects the consideration expected to be received in exchange for those goods or services. ASU 2014-09 is effective for fiscal years, and interim periods within those years, beginning af ter December 15, 2017, and early adoption is permitted beginning after December 15, 2016. We are currently evaluating the impact that the standard will have on our consolidated financial statements and have not yet determined the method by which we will a dopt the standard. In February 2015, the FASB issued AS U No. 2015-02, “Consolidation (Topic 810): Amendments to the Consolidation Analysis” (“ASU 2015-02”), which makes certain changes to both the variable interest model and the voting model, includin g changes to (1) the identification of variable interests (fees paid to a decision maker or service provider), (2) the variable interest entity characteristics for a limited partnership or similar entity and (3) the primary beneficiary determination. ASU 2015-02 is effective beginning January 1, 2016. We are continuing to evaluate this guidance; however, we do not expect its adoption to have a significant impact on our consolidated financial statements. In April 2015, the FASB issued ASU No. 2015-03, “Simplifying the Presentation of Debt Issuance Costs” (“ASU 2015-03”), which requires that debt issuance costs related to a recognized debt liability be presented in the balance sheet as a direct deduction from the carrying amount of that debt liability. The recognition and measurement guidance for debt issuance costs are not affected. Upon adoption, we will apply the new guidance on a retrospective basis and adjust the balance sheet of each individual period presented to reflect the period-specific effe cts of applying the new guidance. The guidance is effective beginning January 1, 2016. We are continuing to evaluate this guidance; however, we do not expect its adoption to have a significant impact on our consolidated financial statements.

Real Property Acquisitions and

Real Property Acquisitions and Development	9 Months Ended
	Sep. 30, 2015
Real Property Acquisitions and Development [Abstract]
Real Property Acquisitions and Development	3. Real Property Acquisition s and Development The total purchase price for all properties acquired has been allocated to the tangible and identifiable intangible assets, liabilities and noncontrolling interests based upon their respective fair values in accordance with our accounting policies. The results of operations for these acquisitions have been included in our consolidated results of operations since the date of acquisition and are a component o f the appropriate segments. Transaction costs primarily represent costs incurred with property acquisitions, including due diligence costs, fees for legal and valuation services and termination of pre-existing relationships computed based on the fair valu e of the assets acquired, lease termination fees and other acquisition-related costs . Certain of our subsidiaries’ functional currencies are the local currencies of their respective countries. See Note 2 to the financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2014 for information regarding our foreign currency policies. Triple-n et Activity Nine Months Ended (In thousands) September 30, 2015 (1) September 30, 2014 Land and land improvements $ 111,674 $ 36,427 Buildings and improvements 1,025,232 303,273 Acquired lease intangibles 3,888 - Restricted cash 6 - Receivables and other assets 60 - Total assets acquired 1,140,860 339,700 Accrued expenses and other liabilities (2,447) - Total liabilities assumed (2,447) - Non-cash acquisition related activity (2,780) (1,937) Cash disbursed for acquisitions 1,135,633 337,763 Construction in progress additions 96,403 79,668 Less: Capitalized interest (4,453) (3,258) Foreign currency translation 73 116 Cash disbursed for construction in progress 92,023 76,526 Capital improvements to existing properties 35,042 14,375 Total cash invested in real property, net of cash acquired $ 1,262,698 $ 428,664 (1) Includes acquisitions with an aggregate purchase price of $844,298,000 for which the allocation of the purchase price consideration is preliminary and subject to change. Seniors Housing Operating Activity Nine Months Ended (In thousands) September 30, 2015 (1) September 30, 2014 Land and land improvements $ 98,444 $ 40,764 Building and improvements 1,229,017 224,936 Acquired lease intangibles 74,091 10,021 Construction in progress - 27,957 Restricted cash 5,567 - Receivables and other assets 23,928 5,679 Total assets acquired (2) 1,431,047 309,357 Secured debt (234,597) (12,846) Accrued expenses and other liabilities (19,016) (17,011) Total liabilities assumed (253,613) (29,857) Noncontrolling interests (86,842) - Cash disbursed for acquisitions 1,090,592 279,500 Construction in progress additions 39,493 6,984 Less: Capitalized interest (1,116) (293) Foreign currency translation (1,345) (810) Cash disbursed for construction in progress 37,032 5,881 Capital improvements to existing properties 61,911 52,177 Total cash invested in real property, net of cash acquired $ 1,189,535 $ 337,558 (1) Includes acquisitions with an aggregate purchase price of $1,268,031,000 for which the allocation of the purchase price consideration is preliminary and subject to change. (2) Excludes $3,390,000 and $8,476,000 of cash acquired during the nine months ended September 30, 2015 and 2014, respectively. Outpatient Medical Activity Nine Months Ended (In thousands) September 30, 2015 (1) September 30, 2014 Land and land improvements $ 737 $ 29,588 Buildings and improvements 426,288 471,410 Acquired lease intangibles 19,373 17,440 Receivables and other assets - 1,245 Total assets acquired (2) 446,398 519,683 Secured debt (112,000) (50,500) Accrued expenses and other liabilities (2,743) (9,308) Total liabilities assumed (114,743) (59,808) Noncontrolling interests (68,535) (39,987) Non-cash acquisition activity (3) - (45,836) Cash disbursed for acquisitions 263,120 374,052 Construction in progress additions 38,919 71,245 Less: Capitalized interest (742) (1,533) Accruals (4) (1,921) (11,290) Cash disbursed for construction in progress 36,256 58,422 Capital improvements to existing properties 25,687 19,772 Total cash invested in real property $ 325,063 $ 452,246 (1) Includes acquisitions with an aggregate purchase price of $440,220,000 for which the allocation of the purchase price consideration is preliminary and subject to change. (2) Excludes $4,372,000 and $0 of cash acquired during the nine months ended September 30, 2015 and 2014, respectively. (3) Relates to an acquisition of assets previously financed as real estate loans. Please refer to Note 6 for additional information. (4) Represents non-cash consideration accruals for amounts to be paid in future periods relating to properties that converted in the periods noted above. Construction Activity The following is a summary of the construction projects that were placed into service and began generating revenues during the periods presented (in thousands) : Nine Months Ended September 30, 2015 September 30, 2014 Development projects: Triple-net $ 85,902 $ 71,569 Seniors housing operating 19,869 - Outpatient medical 16,592 56,807 Total development projects 122,363 128,376 Expansion projects 38,808 17,586 Total construction in progress conversions $ 161,171 $ 145,962

Real Estate Intangibles

Real Estate Intangibles	9 Months Ended
	Sep. 30, 2015
Real Estate Intangibles [Abstract]
Real Estate Intangibles	4 . Real Estate Intangibles The following is a summary of our real estate intangibles , excluding those classified as held for sale, as of the dates indicated (dollars in thousands): September 30, 2015 December 31, 2014 Assets: In place lease intangibles $ 1,042,770 $ 988,290 Above market tenant leases 82,083 65,684 Below market ground leases 61,159 62,426 Lease commissions 22,498 19,536 Gross historical cost 1,208,510 1,135,936 Accumulated amortization (836,684) (776,501) Net book value $ 371,826 $ 359,435 Weighted-average amortization period in years 17.2 17.7 Liabilities: Below market tenant leases $ 89,891 $ 91,168 Above market ground leases 7,860 7,859 Gross historical cost 97,751 99,027 Accumulated amortization (44,609) (40,891) Net book value $ 53,142 $ 58,136 Weighted-average amortization period in years 15.6 14.4 The following is a summary of real estate intangible amortization for the periods presented (in thousands): Three Months Ended Nine Months Ended September 30, September 30, 2015 2014 2015 2014 Rental income related to above/below market tenant leases, net $ (1,684) $ 179 $ (1,901) $ 423 Property operating expenses related to above/below market ground leases, net (308) (317) (962) (926) Depreciation and amortization related to in place lease intangibles and lease commissions (26,137) (46,366) (82,434) (185,363) The future estimated aggregate amortization of intangible assets and liabilities is as follows for the periods presented (in thousands): Assets Liabilities 2015 $ 39,972 $ 3,279 2016 71,453 6,512 2017 43,426 6,052 2018 30,094 5,583 2019 24,033 5,325 Thereafter 162,848 26,391 Total $ 371,826 $ 53,142

Dispositions, Assets Held for S

Dispositions, Assets Held for Sale and Discontinued Operations	9 Months Ended
	Sep. 30, 2015
Disclosure Dispositions, Assets Held for Sale and Discontinued Operations [Abstract]
Dispositions, Assets Held for Sale and Discontinued Operations	5 . Dispositions, Assets Held for Sale and Discontinued Operations We periodically sell properties for various reasons, including favorable market conditions or the exercise of tenant purchase options. The following is a summary of our real property disposition activity for the periods presented (in thousands): Nine Months Ended September 30, 2015 September 30, 2014 Real estate dispositions: Triple-net $ 246,116 $ 56,713 Outpatient medical (1) 166,919 343,337 Land parcels 5,724 - Total dispositions 418,759 400,050 Gain (loss) on real estate dispositions, net 249,002 42,683 Proceeds from real estate dispositions $ 667,761 $ 442,733 (1) Dispositions occurring in the nine-month period ending September 30, 2015 primarily related to the disposition of an unconsolidated equity investment with Forest City Enterprises. Dispositions and Assets Held for Sale Pursuant to our adoption of ASU No. 2014-08, “Presentation of Financial Statements (Topic 205) and Property, Plant and Equipment (Topic 360): Reporting Discontinued Operations and Disclosures of Disposals of Components of an Entity” (“ASU 2014-08”), operating results attributable to properties sold subsequent to or classified as held for sale after January 1, 2014 and which do not meet the definition of discontinued operations are no longer reclassified on our Consolidated Statements of Comprehensive Income. The following represents the activity related to these properties for the pe riods presented (in thousands): Three Months Ended Nine Months Ended September 30, September 30, 2015 2014 2015 2014 Revenues: Rental income $ 7,164 $ 26,123 $ 24,237 $ 89,593 Expenses: Interest expense 1,041 4,507 3,991 18,512 Property operating expenses 1,577 1,595 4,586 6,017 Provision for depreciation 123 7,878 4,760 27,106 Total expenses 2,741 13,980 13,337 51,635 Income (loss) from real estate dispositions, net $ 4,423 $ 12,143 $ 10,900 $ 37,958 Discontinued Operations We have reclassified the income and expenses attributable to all properties sold prior to or held for sale at January 1, 2014 to discontinued operations in accordance with ASU 2014-08. The following illustrates the reclassification impact as reported in our C onsolidated Statements of Comprehensive Income as a result of classifying these properties as discontinued operations for the periods presented (in thousands): Three Months Ended Nine Months Ended September 30, September 30, 2015 2014 2015 2014 Revenues: Rental income $ - $ - $ - $ 881 Expenses: Interest expense - - - 157 Total expenses - - - 157 Income (loss) from discontinued operations, net $ - $ - $ - $ 724

Real Estate Loans Receivable

Real Estate Loans Receivable	9 Months Ended
	Sep. 30, 2015
Real Estate Loans Receivable [Abstract]
Real Estate Loans Receivable	6 . Real Estate Loans Receivable The following is a summary of our real estate loan activity for the periods presented (in thousands): Nine Months Ended September 30, 2015 September 30, 2014 Outpatient Outpatient Triple-net Medical Totals Triple-net Medical Totals Advances on real estate loans receivable: Investments in new loans $ 392,278 $ - $ 392,278 $ 10,674 $ - $ 10,674 Draws on existing loans 51,422 2,285 53,707 50,446 18,144 68,590 Net cash advances on real estate loans 443,700 2,285 445,985 61,120 18,144 79,264 Receipts on real estate loans receivable: Loan payoffs 52,088 - 52,088 24,522 42,036 66,558 Principal payments on loans 19,023 - 19,023 25,494 52 25,546 Sub-total 71,111 - 71,111 50,016 42,088 92,104 Less: Non-cash activity (1) - - - - (45,836) (45,836) Net cash receipts on real estate loans 71,111 - 71,111 50,016 (3,748) 46,268 Net cash advances (receipts) on real estate loans 372,589 2,285 374,874 11,104 21,892 32,996 Change in balance due to foreign currency translation (2,131) - (2,131) (1,085) - (1,085) Net change in real estate loans receivable $ 370,458 $ 2,285 $ 372,743 $ 10,019 $ (23,944) $ (13,925) (1) Represents an acquisition of assets previously financed as a real estate loan. Please see Note 3 for additional information. We recorded no provision for loan losses during the nine months ended September 30, 2015 . At September 30, 2015 , we had no real estate loans with outstanding balances on non -accrual status and no allowances for loan losses were recorded .

Investments in Unconsolidated E

Investments in Unconsolidated Entities	9 Months Ended
	Sep. 30, 2015
Investments In Unconsolidated Entities [Abstract]
Equity Method Investments Disclosure [Text Block]	7 . Investments in Unconsolidated Entities We participate in a number of joint ventures, which generally invest in seniors housing and health care real estate. The results of operations for these properties have been included in our consolidated results of operations from the date of acquisition b y the joint ventures and are reflected in our C onsolidated S tatements of C omprehensive I ncome as income or loss from unconsolidated entities. The following is a summary of our investments in unconsolidated entities (dollars in thousands): Percentage Ownership (1) September 30, 2015 December 31, 2014 Triple-net 10% to 49% $ 35,657 $ 31,511 Seniors housing operating 10% to 50% 485,278 539,147 Outpatient medical 36% to 49% 37,419 173,493 Total $ 558,354 $ 744,151 (1) Excludes ownership of in-substance real estate. At September 30, 2015, the aggregate unamortized basis difference of our joint venture investments of $161,882 ,000 is primarily attributable to appreciation of the underlying properties and transaction costs. This difference will be amortized over the remaining useful life of the related properties and included in the reported amount of income from unconsolidated entities.

Credit Concentration

Credit Concentration	9 Months Ended
	Sep. 30, 2015
Customer Concentration [Abstract]
Credit Concentration	8 . Credit Concentration We use net operating income from continuing operations (“NOI”) as our credit concentration metric. See Note 17 for additional information and reconciliation. The following table summarizes certain information about our credit concentration for the nine month period ended September 30, 2015 , excluding our share of NOI in unconsolidated entities (dollars in thousands): Number of Total Percent of Concentration by relationship: (1) Properties NOI NOI (2) Genesis Healthcare 180 $ 273,922 17% Sunrise Senior Living (3) 147 225,580 14% Brookdale Senior Living 146 124,843 8% Revera (3) 71 75,973 5% Benchmark Senior Living 50 73,788 4% Remaining portfolio 759 872,717 52% Totals 1,353 $ 1,646,823 100% (1) Genesis Healthcare is in our triple-net segment. Sunrise Senior Living and Revera are in our seniors housing operating segment. Benchmark Senior Living and Brookdale Senior Living are both in our triple-net and seniors housing operating segments. (2) NOI with our top five relationships comprised 49% of total NOI for the year ending December 31, 2014. (3) Revera owns a controlling interest in Sunrise Senior Living.

Borrowings Under Credit Facilit

Borrowings Under Credit Facilities and Related Items	9 Months Ended
	Sep. 30, 2015
Borrowings Under Credit Facilities and Related Items [Abstract]
Borrowings Under Credit Facilities and Related Items	9 . Borrowings Under Credit Facilities and Related Items At September 30, 2015, we had a primary unsecured credit facility with a consortium of 28 banks that includes a $2,500,000,000 unsecured revolving credit facility , a $500,000,000 unsecured term credit facility and a $250,000,000 Canadian- denominated unsecured term credit facility . We have an option , through an accordion feature, to upsize the unsecured revolving credit facility and the $500,000,000 unsecured term credit facility b y up to an additional $1,000,000,000 and the $250,000,000 Canadian-denominated unsecured term credit facility by up to an additional $250,000,000 . The primary unsecured credit facility also allows us to borrow up to $500,000,000 in alternate currencies (n one outstanding at September 30, 2015 ). Borrowings under the unsecured revolving credit facility are subject to interest payable at the applicable margin over LIBOR interest rate ( 1.119% at September 30, 2015 ). The applicable margin is based on certain of our debt ratings and was 0.925% at September 30, 2015 . In addition, we pay a facility fee quarterly to each bank based on the bank’s commitment amount. The facility fee depends on certain of our debt ratings and was 0.15% at September 30, 2015 . The primary unsecured credit facility is scheduled to expire October 31, 2018 and can be extended for an additional year at our option. The following information relates to aggregate borrowings under the primary unsecured revolving credit facility for the periods presented (dollars in thousands) : Three Months Ended September 30, Nine Months Ended September 30, 2015 2014 2015 2014 Balance outstanding at quarter end (1) $ 490,000 $ - $ 490,000 $ - Maximum amount outstanding at any month end $ 490,000 $ 235,000 $ 535,000 $ 637,000 Average amount outstanding (total of daily principal balances divided by days in period) $ 298,370 $ 100,380 $ 402,619 $ 253,681 Weighted average interest rate (actual interest expense divided by average borrowings outstanding) 1.16% 1.67% 1.17% 1.40% (1) As of September 30, 2015, letters of credit in the aggregate amount of $58,484,000 have been issued, which reduces the borrowing capacity on the primary unsecured revolving credit facility.

Senior Unsecured Notes and Secu

Senior Unsecured Notes and Secured Debt	9 Months Ended
	Sep. 30, 2015
Senior Unsecured Notes and Secured Debt [Abstract]
Senior Unsecured Notes and Secured Debt	10 . Senior Unsecured Notes and Secured Debt We may repurchase, redeem or refinance convertible and non-convertible senior unsecured notes from time to time, taking advantage of favorable market conditions when available. We may purchase senior notes for cash through open market purchases, privately negotiated transactions, a tender offer or, in some cases, through the early redemption of such securities pursuant to their terms. The non-convertible senior unsecured notes are redeemable at our option, at any time in whole or from time to time in part , at a redemption price equal to the sum of (1) the principal amount of the notes (or portion of such notes) being redeemed plus accrued and unpaid interest thereon up to the redemption date and (2) any “make-whole” amount due under the terms of the notes in connection with early redemptions. Redemptions and repurchases of debt, if any, will depend on prevailing market conditions, our liquidity requirements, contractual restrictions and other factors. At September 30, 2015 , the annual principal payments due on the se debt obligations were as follows (in thousands): Senior Secured Unsecured Notes (1,2) Debt (1,3) Totals 2015 $ - $ 106,190 $ 106,190 2016 400,000 464,519 864,519 2017 450,000 399,670 849,670 2018 450,000 558,656 1,008,656 2019 (4,5) 1,286,625 374,769 1,661,394 Thereafter (6,7,8) 5,387,915 1,041,893 6,429,808 Totals $ 7,974,540 $ 2,945,697 $ 10,920,237 (1) Amounts represent principal amounts due and do not include unamortized premiums/discounts or other fair value adjustments as reflected on the balance sheet. (2) Annual interest rates range from 1.169% to 6.5%. (3) Annual interest rates range from 1.0% to 7.98%. Carrying value of the properties securing the debt totaled $5,205,803,000 at September 30, 2015. (4) On July 25, 2014, we refinanced the funding on a $250,000,000 Canadian-denominated unsecured term credit facility (approximately $186,625,000 based on the Canadian/U.S. Dollar exchange rate on September 30, 2015). The loan matures on October 31, 2018 (with an option to extend for an additional year at our discretion) and bears interest at the Canadian Dealer Offered Rate plus 97.5 basis points (1.8% at September 30, 2015). (5) On July 25, 2014, we refinanced the funding on a $500,000,000 unsecured term credit facility. The loan matures on October 31, 2018 (with an option to extend for an additional year at our discretion) and bears interest at LIBOR plus 97.5 basis points (1.17% at September 30, 2015). (6) On November 20, 2013, we completed the sale of £ 550,000,000 (approximately $831,765,000 based on the Sterling/U.S. Dollar exchange rate in effect on September 30, 2015) of 4.8% senior unsecured notes due 2028. (7) On November 25, 2014, we completed the sale of £ 500,000,000 (approximately $756,150,000 based on the Sterling/U.S. Dollar exchange rate in effect on September 30, 2015) of 4.5% senior unsecured notes due 2034. (8) In May 2015, we issued $750,000,000 of 4.0% senior unsecured notes due 2025. In October 2015, we issued an additional $500,000,000 of these notes under a re-opening of the offer. The following is a summary of our senior unsecured notes principal activity during the periods presented (dollars in thousands) : Nine Months Ended September 30, 2015 September 30, 2014 Weighted Avg. Weighted Avg. Amount Interest Rate Amount Interest Rate Beginning balance $ 7,817,154 4.385% $ 7,421,707 4.400% Debt issued 750,000 4.000% - 0.000% Debt extinguished (300,000) 6.200% - 0.000% Debt redeemed (215,965) 3.000% (47,660) 3.000% Foreign currency (76,649) 8.065% (31,719) 3.892% Ending balance $ 7,974,540 4.210% $ 7,342,328 4.388% The following is a summary of our secured debt principal activity for the periods presented (dollars in thousands): Nine Months Ended September 30, 2015 September 30, 2014 Weighted Avg. Weighted Avg. Amount Interest Rate Amount Interest Rate Beginning balance $ 2,941,765 4.94% $ 3,010,711 5.10% Debt issued 222,612 2.76% 98,100 3.23% Debt assumed 339,929 3.34% 62,505 3.11% Debt extinguished (420,672) 4.27% (240,355) 5.66% Foreign currency (89,154) 3.88% (45,807) 4.97% Principal payments (48,783) 4.85% (23,434) 3.78% Ending balance $ 2,945,697 4.72% $ 2,861,720 4.94% Our debt agreements contain various covenants, restrictions and events of default. Certain agreements require us to maintain certain financial ratios and minimum net worth and impose certain limits on our ability to incur indebtedness, create liens and make investments or acquisitions. As of September 30, 2015 , we were in compliance with all of the cove nants under our debt agreements.

Derivative Instruments

Derivative Instruments	9 Months Ended
	Sep. 30, 2015
Summary of Derivative Instruments [Abstract]
Derivative Instruments	11. Derivative Instruments We are exposed to various market risks, including the potential loss arising from adverse changes in interest rates. We may elect to use financial derivative instruments to hedge interest rate exposure. These decisions are principally based on our policy to manage the general trend in interest rates at the applicable dates and our perception of the future volatility of interest rates. In addition, non-U.S. investments expose us to the potential losses associat ed with adverse changes in foreign currency to U.S. Dollar exchange rates. We may elect to manage this risk through the use of forward contracts and issuing debt in foreign currencies. Interest Rate Swap Contracts and Foreign Currency Forward Contrac ts Designated as Cash Flow Hedges For instruments that are designated and qualify as a cash flow hedge, the effective portion of the gain or loss on the derivative is reported as a component of other comprehensive income (“OCI”), and reclassified into earnings in the same period or periods, during which the hedged transaction affects earnings. Gains and losses on the derivative representing either hedge ineffectiveness or hedge components excluded from the assessment of effectiveness are recognized in earnings. Approximately $2,775,000 of gains, which are included in accumulated other comprehensive income (“AOCI”), are expected to be reclassified into earnings in the next 12 months. Foreign Currency Hedges For instruments that are designated and qualify as net investment hedges, the variability in the foreign currency to U.S. Dollar of the instrument is recorded as a cumulative translation adjustment component of OCI. During the nine months ended September 30, 2015, we settled certain net in vestment hedges generating cash proceeds of $103,615,000. The balance of the cumulative translation adjustment will be reclassified to earnings when the hedged investment is sold or substantially liquidated. The following presents the notional amou nt of derivatives and other financial instruments as of the dates indicated (in thousands): September 30, 2015 December 31, 2014 Derivatives designated as net investment hedges: Denominated in Canadian Dollars $ 1,175,000 $ 900,000 Denominated in Pounds Sterling £ 550,000 £ 350,000 Financial instruments designated as net investment hedges: Denominated in Canadian Dollars $ 250,000 $ 250,000 Denominated in Pounds Sterling £ 1,050,000 £ 1,050,000 Derivatives designated as cash flow hedges Denominated in U.S. Dollars $ 57,000 $ 57,000 Denominated in Canadian Dollars $ 72,000 $ 58,000 Denominated in Pounds Sterling £ 57,000 £ 40,000 Derivative instruments not designated: (1) Denominated in Canadian Dollars $ 700,000 $ 12,000 (1) These non-designated instruments represent off-setting forward exchange contracts to manage against adverse movements in exchange rates with regards to the purchase price on pending foreign acquisitions. The following presents the impact of derivative instruments on the Consolidated S tatement s of C omprehensive I ncome for the periods presented (in thousands) : Three Months Ended Nine Months Ended September 30, September 30, Location 2015 2014 2015 2014 Gain (loss) on interest rate swap recognized in OCI (effective portion) OCI $ - $ (4) $ (1) $ (11) Gain (loss) on interest rate swaps reclassified from AOCI into income (effective portion) Interest expense (462) (459) (1,390) (1,338) Gain (loss) on forward exchange contracts recognized in income Interest expense 2,347 - 6,285 - Gain (loss) on forward exchange contracts recognized in income Gain (loss) on derivatives, net - (49) - (400) Loss (gain) on option exercise (1) Loss (gain) on derivatives, net - - (58,427) - Gain on release of cumulative translation adjustment related to net investment hedge of an equity investment Income (loss) from unconsolidated entities - 528 - 528 Gain (loss) on foreign exchange contracts and term loans designated as net investment hedge recognized in OCI OCI 174,239 12,880 208,854 6,833 (1) In April 2011, we completed the acquisition of substantially all of the real estate assets of privately-owned Genesis Healthcare Corporation. In conjunction with this transaction, we received the option to acquire an ownership interest in Genesis Healthcare. In February 2015, Genesis Healthcare closed on a transaction to merge with Skilled Healthcare Group to become a publicly traded company which required us to record the value of the derivative asset due to the net settlement feature.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2015
Commitments and Contingencies [Abstract]
Commitments and Contingencies	12 . Commitments and Contingencies At September 30, 2015 , we had eight outstanding letter of credit obligations totaling $73,655 ,000 and expiring between 2015 and 2018. At September 30, 2015 , we had outstanding construction in progress of $ 197,639,000 and were committed to providing additional funds of approximately $ 408,372,000 to complete construction. Purchase obligations also include $236,068,000 representing the cash portion of an acquisition that occurred in October 2015 and contingent purchase obligations totaling $ 29,427,000 . These contingent purchase obligations relate to unfunded capital improvement obligations and contingent obligations on acquisitions. Rents due from the tenant are increased to reflect the additional investment in the property. We evaluate our leases for operating versus capital lease treatment in accordance with Accounting Standards Codification (“ASC”) Topic 840 “Leases.” A lease is classified as a capital lease if it provides for transfer of ownership of the leased asset at the end of the le ase term, contains a bargain purchase option, has a lease term greater than 75% of the economic life of the leased asset, or if the net present value of the future minimum lease payments are in excess of 90% of the fair value of the leased asset. Certain l eases contain bargain purchase options and have been classified as capital leases. At September 30, 2015 , we had operating lease obligations of $ 988,564,000 relating to certain ground leases and company office space and capital lease obligations of $ 99,751,000 relatin g primarily to certain investment properties. Regarding ground leases, we have sublease agreements with certain of our operators that require the operators to reimburse us for our monthly operating lease obligations. At September 30, 2015 , aggregate future minimum rentals to be received under these noncancelable subleases totaled $ 27,126,000 .

Stockholders' Equity

Stockholders' Equity	9 Months Ended
	Sep. 30, 2015
Stockholders' Equity [Abstract]
Stockholders' Equity	13. Stockholders’ Equity The following is a summary of our stockholders’ equity capital accounts as of the dates indicated: September 30, 2015 December 31, 2014 Preferred Stock: Authorized shares 50,000,000 50,000,000 Issued shares 25,875,000 25,875,000 Outstanding shares 25,875,000 25,875,000 Common Stock, $1.00 par value: Authorized shares 700,000,000 700,000,000 Issued shares 353,814,909 329,487,615 Outstanding shares 352,998,274 328,790,066 Preferred Stock. The following is a summary of our preferred stock activity during the periods indicated : Nine Months Ended September 30, 2015 September 30, 2014 Weighted Avg. Weighted Avg. Shares Dividend Rate Shares Dividend Rate Beginning balance 25,875,000 6.500% 26,108,236 6.496% Shares converted - 0.000% (233,236) 6.000% Ending balance 25,875,000 6.500% 25,875,000 6.500% Common Stock. The following is a summary of our common stock issuances during the nine months ended September 30, 2015 and 2014 (dollars in thousands, except per share amounts): Shares Issued Average Price Gross Proceeds Net Proceeds June 2014 public issuance 16,100,000 $ 62.35 $ 1,003,835 $ 968,517 September 2014 public issuance 17,825,000 63.75 1,136,344 1,095,883 2014 Dividend reinvestment plan issuances 3,114,052 60.05 186,996 186,996 2014 Option exercises 207,046 45.94 9,512 9,512 2014 Stock incentive plans, net of forfeitures 186,837 - - 2014 Senior note conversions 199,943 - - 2014 Preferred stock conversions 233,236 - - 2014 Totals 37,866,114 $ 2,336,687 $ 2,260,908 February 2015 public issuance 19,550,000 $ 75.50 $ 1,476,025 $ 1,423,935 2015 Dividend reinvestment plan issuances 2,935,950 70.28 206,334 206,334 2015 Option exercises 247,005 47.42 11,712 11,712 2015 Stock incentive plans, net of forfeitures 144,779 - - 2015 Senior note conversions 1,330,474 - - 2015 Totals 24,208,208 $ 1,694,071 $ 1,641,981 Dividends . The increase in dividends is primarily attributable to increases in our common shares outstanding as described above and an increase in common dividends per share. The following is a summary of our dividend payments (in thousands, except per share amounts): Nine Months Ended September 30, 2015 September 30, 2014 Per Share Amount Per Share Amount Common Stock $ 2.4750 $ 852,563 $ 2.3850 $ 708,923 Series H Preferred Stock - - 0.0079 1 Series I Preferred Stock 2.4375 35,039 2.4375 35,040 Series J Preferred Stock 1.2189 14,016 1.2189 14,016 Totals $ 901,618 $ 757,980 Accumulated Other Comprehensive Income . The following is a summary of accumulated other comprehensive income (loss) for the periods presented (in thousands): Unrecognized gains (losses) related to: Foreign Currency Translation Available for Sale Securities Actuarial Losses Cash Flow Hedges Total Balance at December 31, 2014 $ (74,770) $ - $ (1,589) $ (650) $ (77,009) Other comprehensive income before reclassification adjustments 2,071 (18,186) - (2,625) (18,740) Reclassification amount to net income - - - 1,390 (1) 1,390 Net current-period other comprehensive income 2,071 (18,186) - (1,235) (17,350) Balance at September 30, 2015 $ (72,699) $ (18,186) $ (1,589) $ (1,885) $ (94,359) Balance at December 31, 2013 $ (17,631) $ (389) $ (1,452) $ (5,059) $ (24,531) Other comprehensive income before reclassification adjustments (29,361) 389 - (11) (28,983) Reclassification amount to net income (528) - - 1,338 (1) 810 Net current-period other comprehensive income (29,889) 389 - 1,327 (28,173) Balance at September 30, 2014 $ (47,520) $ - $ (1,452) $ (3,732) $ (52,704) (1) Please see note 11 for additional information.

Stock Incentive Plans

Stock Incentive Plans	9 Months Ended
	Sep. 30, 2015
Stock Incentive Plans [Abstract]
Stock Incentive Plans	14 . Stock Incentive Plans Our Amended and Restated 2005 Long-Term Incentive Plan (“2005 Plan”) authorizes up to 6,200,000 shares of comm o n stock to be issued at the discretion of the Compensation Committee of the Board of Directors. Our non-employee directors, officers and key employees are eligible to participate in the 2005 Plan. The 2005 Plan allows for the issuance of, among other things, stock options, restricted stock, deferred stock units and dividend equivalent rights. Vesting per iods for options, deferred stock units and restricted shares generally range from three to five years. Options expire ten years from the date of grant. Stock-based compensation expense totaled $ 5,477,000 and $2 5 , 655 ,000 for the three and nine months ended September 30, 2015 , respectively, and $4,271,000 and $26 ,108,000 for the same period s in 201 4.

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 2015
Earnings Per Share [Abstract]
Earnings Per Share	15 . Earnings Per Share The following table sets forth the computation of basic and diluted earnings per share (in thousands, except per share data): Three Months Ended Nine Months Ended September 30, September 30, 2015 2014 2015 2014 Numerator for basic and diluted earnings per share - net income (loss) attributable to common stockholders $ 182,043 $ 136,255 $ 685,413 $ 258,107 Denominator for basic earnings per share - weighted average shares 351,765 311,117 346,425 299,137 Effect of dilutive securities: Employee stock options 114 202 155 181 Non-vested restricted shares 607 505 498 506 Redeemable shares 621 - 207 - Convertible senior unsecured notes - 988 262 821 Dilutive potential common shares 1,342 1,695 1,122 1,508 Denominator for diluted earnings per share - adjusted weighted average shares 353,107 312,812 347,547 300,645 Basic earnings per share $ 0.52 $ 0.44 $ 1.98 $ 0.86 Diluted earnings per share $ 0.52 $ 0.44 $ 1.97 $ 0.86 The Series I Cumulative Convertibl e Perpetual Preferred Stock was not included in the calculations as the effect of conversions into common stock was anti-dilutive.

Disclosure about Fair Value of

Disclosure about Fair Value of Financial Instruments	9 Months Ended
	Sep. 30, 2015
Disclosure About Fair Value of Financial Instruments [Abstract]
Disclosure about Fair Value of Financial Instruments	16. Disclosure about Fair Value of Financial Instruments U.S. GAAP provides authoritative guidance for measuring and disclosing fair value measurements of assets and liabilities. The guidance defines fair value as the exchange price that would be received for an asset or paid to transfer a liability (an exit pr ice) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. The guidance also establishes a fair value hierarchy which requires an entity to maximize the use o f observable inputs and minimize the use of unobservable inputs when measuring fair value. The guidance describes three levels of inputs that may be used to measure fair value: Level 1 - Quoted prices in active markets for identical assets or liabilities . Level 2 - Observable inputs other than Level 1 prices such as quoted prices for similar assets or liabilities , quoted prices in markets that are not active , or other inputs that are observable or can be corroborated by observable market data for substan tially the full term of the assets or liabilities. Please see Note 2 to the financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2014 for additional information. Level 3 - Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities. The following methods and assumptions were used to estimate the fair value of each class of financial instruments for which it is practicable to estimate that value. Mortgage Loans and Other Real Estate Loans Receivable — The fair value of mortgage loans and other real estate loans receivable is generally estimated by using Level 2 and Level 3 inputs such as discounting the estimated future cash flows using the current rates at which similar loans would be made to borrow ers with similar credit ratings and for the same remaining maturities. Cash and Cash Equivalents — The carrying amount approximates fair value. Available-for-sale Equity Investments — Available-for-sale equity investments are recorded at their fair val ue based on Level 1 publicly available trading prices . Borrowings Under Primary Unsecured Credit Facility — The carrying amount of the primary unsecured credit facility approximates fair value because the borrowings are interest rate adjustable. Senior U nsecured Notes — T he fair value of the fixed rate senior unsecured notes payable was estimated based on Level 1 publicly available trading prices. The carrying amount of variable rate senior unsecured notes payable approximates fair value because the borrowings are interest rate adjustable. Secured Debt — The fair value of fixed rate secured debt is estimated using Level 2 inputs by discounting the estimated future cash flows using the current rates at which simila r loans would be made with similar credit ratings and for the same remaining maturities. The carrying amount of variable rate secured debt approximates fair value because the borrowings are interest rate adjustable. Foreign Currency Forward Contracts — Foreign currency f orward contracts are recorded in other assets or other liabilities on the balance sheet at fair market value. Fair market value is determined using Level 2 inputs by estimating the future value of the currency pair based on existing exchange rates , comprised of current spot and traded forward points , and calculating a present valu e of the net amount using a discount factor based on observable traded interest rates. Redeemable OP Unitholder Inte rests — The fair value of our redeemable unitholder interests are recorded on the balance sheet at fair value using Level 2 inputs. The fair value is measured using the closing price of our common stock, as units may be redeemed at the election of the hol der for cash or, at our option, one share of our common stock per unit, subject to adjustment in certain circumstances. The carrying amounts and estimated fair values of our financial instruments are as follows (in thousands): September 30, 2015 December 31, 2014 Carrying Amount Fair Value Carrying Amount Fair Value Financial assets: Mortgage loans receivable $ 570,997 $ 606,910 $ 188,651 $ 194,935 Other real estate loans receivable 181,915 181,585 191,518 195,375 Available-for-sale equity investments 40,241 40,241 - - Cash and cash equivalents 292,042 292,042 473,726 473,726 Foreign currency forward contracts 105,856 105,856 57,087 57,087 Financial liabilities: Borrowings under unsecured credit facilities $ 490,000 $ 490,000 $ - $ - Senior unsecured notes 7,926,757 8,489,584 7,766,251 8,613,702 Secured debt 2,975,639 3,024,245 2,977,713 3,053,067 Foreign currency forward contracts 21,909 21,909 1,495 1,495 Redeemable OP unitholder interests $ 111,380 $ 111,380 $ 46,722 $ 46,722 Items Measured at Fair Value on a Recurring Basis The market approach is utilized to measure fair value for our financial assets and liabilities reported at fair value on a recurring basis. The market approach uses prices and other relevant information generated by market transactions involving identical or comparable assets or liabilities. The following summarizes items measured at fair value on a recurring basis (in thousands): Fair Value Measurements as of September 30, 2015 Total Level 1 Level 2 Level 3 Available-for-sale equity investments (1) $ 40,241 $ 40,241 $ - $ - Foreign currency forward contracts, net (2) 83,947 - 83,947 - Redeemable OP unitholder interests 111,380 - 111,380 - Totals $ 235,568 $ 40,241 $ 195,327 $ - (1) Unrealized gains or losses on equity investments are recorded in accumulated other comprehensive income (loss) at each measurement date. (2) Please see Note 11 for additional information. Items Measured at Fair Value on a Nonrecurring Basis In addition to items that are measured at fair value on a recurring basis, we also have assets and liabilities in our balance sheet that are measured at fair value on a nonrecurring basis. As these assets and liabilities are not measured at fair value on a recurring basis, they are not included in the tables above. Assets, liabilities and noncontrolling interests that are measured at fair value on a nonrecurring basis include those acquired/assumed i n business combinations (see Note 3) and asset impai rments (if applicable, see Note 5 for impairments of real property and Note 6 for impairments of loans receivable). We have determined that the fair value measurements included in each of these assets and liabilities rely primarily on company-specific inputs and our assumptions about the use of the assets and settlement of liabilities, as observable inputs are not available. As such, we have determined that each of these fair value measurements generally r eside within Level 3 of the fair value hierarchy. We estimate the fair value of real estate and related intangibles using the income approach and unobservable data such as net operating income and estimated capitalization and discount rates. We also consi der local and national industry market data including comparable sales, and commonly engage an external real estate appraiser to assist us in our estimation of fair value. We estimate the fair value of assets held for sale based on current sales price exp ectations or, in the absence of such price expectations, Level 3 inputs described above. We estimate the fair value of secured debt assumed in business combinations using current interest rates at which similar borrowings could be obtained on the transact ion date .

Segment Reporting

Segment Reporting	9 Months Ended
	Sep. 30, 2015
Segment Reporting [Abstract]
Segment Reporting	17 . Segment Reporting We invest in seniors housing and health care real estate. We evaluate our business and make resource allocations on our four operating segments: triple-net, seniors housing operating, outpatient medical and life science. During the quarter ended March 31, 2015, we changed the names of our seniors housing triple-net segment to triple-net and our medical facilities segment to outpatient medical. Our triple-net properties include long-term/post-acute care facilities, hos pitals, assisted living facilities, independent living/continuing care retirement communities, care homes (United Kingdom), independent support living facilities (Canada), care homes with nursing (United Kingdom) and combinations thereof. Under the triple- net segment, we invest in seniors housing and health care real estate through acquisition and financing of primarily single tenant properties. Properties acquired are primarily leased under triple-net leases and we are not involved in the management of the property. Our seniors housing operating properties include the seniors housing communities referenced above that are owned and/or operated through RIDEA structures (see Notes 3 and 18). Our outpatient medical properties in clude medical office buildin gs and life science buildings which are aggregated into our outpatient medical reportable segment. Our medical office buildings are typically leased to multiple tenants and generally require a certain level of property management. During the three months ended June 30, 2015, we disposed of our life science investments. We evaluate performan ce based upon NOI by segment . We define NOI as total revenues, including tenant reimbursements, less pr operty level operating expenses . We believe NOI p rovides investors relevant and useful information because it measures the operating performance of our properties at the property level on an unleveraged basis. We use NOI to make decisions about resource allocations and to assess the property level perfor mance of our properties. Non-segment revenue consists mainly of interest income on non-real estate investments and other income. Non-segment assets consist of corporate assets including cash, deferred loan expenses and corporate offices and equipment among others. Non-property specific reve nues and expenses are not allocated to individual segments in determining NOI. The accounting policies of the segments are the same as those described in the summary of significant accounting policies (see Note 2 to the financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2014 ). The results of operations for all acquisitions described in Note 3 are included in our consolidated results of operations from the acquisition dates and are components of the appropriate segments. There are no intersegment sales or transfers. Summary information for the reportable segments is as follows for the periods presented (in thousands): Three Months Ended September 30, 2015: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 285,027 $ - $ 124,263 $ - $ 409,290 Resident fees and services - 545,255 - - 545,255 Interest income 19,454 1,054 1,872 - 22,380 Other income 969 772 309 22 2,072 Total revenues 305,450 547,081 126,444 22 978,997 Property operating expenses - 368,050 40,653 - 408,703 Net operating income from continuing operations 305,450 179,031 85,791 22 570,294 Reconciling items: Interest expense 12,359 30,990 7,120 70,661 121,130 Depreciation and amortization 74,486 87,306 44,007 - 205,799 General and administrative - - - 36,950 36,950 Transaction costs 1,865 7,630 (162) - 9,333 Loss (gain) on extinguishment of debt, net (139) - - 723 584 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 216,879 53,105 34,826 (108,312) 196,498 Income tax expense 87 3,237 154 (134) 3,344 (Loss) income from unconsolidated entities 2,851 (5,629) 147 - (2,631) Income (loss) from continuing operations 219,817 50,713 35,127 (108,446) 197,211 Gain (loss) on real estate dispositions, net 2,155 - (109) - 2,046 Net income (loss) $ 221,972 $ 50,713 $ 35,018 $ (108,446) $ 199,257 Total assets $ 12,346,157 $ 10,325,540 $ 4,699,643 $ 85,026 $ 27,456,366 Three Months Ended September 30, 2014: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 250,748 $ - $ 103,400 $ - $ 354,148 Resident fees and services - 482,412 - - 482,412 Interest income 7,520 1,054 770 - 9,344 Other income 981 325 207 106 1,619 Total revenues 259,249 483,791 104,377 106 847,523 Property operating expenses 41 320,895 34,221 - 355,157 Net operating income from continuing operations 259,208 162,896 70,156 106 492,366 Reconciling items: Interest expense 10,294 26,612 7,692 73,837 118,435 Loss (gain) on derivatives, net 52 (3) - - 49 Depreciation and amortization 68,027 95,819 37,124 - 200,970 General and administrative - - - 30,803 30,803 Transaction costs 1,619 10,572 1,363 - 13,554 Loss (gain) on extinguishment of debt, net (36) - - 2,728 2,692 Other Expenses 8,825 1,437 - - 10,262 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 170,427 28,459 23,977 (107,262) 115,601 Income tax expense 5,986 3,746 466 - 10,198 (Loss) income from unconsolidated entities 1,353 (5,550) 1,565 - (2,632) Income (loss) from continuing operations 177,766 26,655 26,008 (107,262) 123,167 Gain (loss) on real estate dispositions, net 29,604 - - - 29,604 Net income (loss) $ 207,370 $ 26,655 $ 26,008 $ (107,262) $ 152,771 Nine Months Ended September 30, 2015: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 829,422 $ - $ 356,080 $ - $ 1,185,502 Resident fees and services - 1,573,318 - - 1,573,318 Interest income 52,343 3,126 4,481 - 59,950 Other income 5,823 5,001 665 83 11,572 Total revenues 887,588 1,581,445 361,226 83 2,830,342 Property operating expenses - 1,067,127 116,392 - 1,183,519 Net operating income from continuing operations 887,588 514,318 244,834 83 1,646,823 Reconciling items: Interest expense 25,064 104,245 21,929 209,833 361,071 Loss (gain) on derivatives, net (58,427) - - - (58,427) Depreciation and amortization 216,921 252,785 133,725 - 603,431 General and administrative - - - 110,562 110,562 Transaction costs 45,615 23,610 1,154 - 70,379 Loss (gain) on extinguishment of debt, net 10,096 - - 24,776 34,872 Impairment of assets 2,220 - - - 2,220 Other expenses - - - 10,583 10,583 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 646,099 133,678 88,026 (355,671) 512,132 Income tax expense (2,617) (745) 460 (867) (3,769) (Loss) income from unconsolidated entities 5,697 (26,785) 2,857 - (18,231) Income (loss) from continuing operations 649,179 106,148 91,343 (356,538) 490,132 Gain (loss) on real estate dispositions, net 56,251 - 192,751 - 249,002 Net income (loss) $ 705,430 $ 106,148 $ 284,094 $ (356,538) $ 739,134 Nine Months Ended September 30, 2014: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 736,599 $ - $ 301,852 $ - $ 1,038,451 Resident fees and services - 1,406,316 - - 1,406,316 Interest income 23,220 1,065 2,586 - 26,871 Other income 1,448 1,643 850 198 4,139 Total revenues 761,267 1,409,024 305,288 198 2,475,777 Property operating expenses 732 939,108 100,502 - 1,040,342 Net operating income from continuing operations 760,535 469,916 204,786 198 1,435,435 Reconciling items: Interest expense 28,063 82,924 25,423 223,924 360,334 Loss (gain) on derivatives, net 125 275 - - 400 Depreciation and amortization 202,668 334,625 111,444 - 648,737 General and administrative - - - 115,327 115,327 Transaction costs 5,900 12,863 2,783 - 21,546 Loss (gain) on extinguishment of debt, net (36) 383 - 2,728 3,075 Other expenses 8,825 1,437 - - 10,262 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 514,990 37,409 65,136 (341,781) 275,754 Income tax expense 5,194 1,302 (127) - 6,369 (Loss) income from unconsolidated entities 4,157 (29,007) 5,145 - (19,705) Income (loss) from continuing operations 524,341 9,704 70,154 (341,781) 262,418 Income (loss) from discontinued operations 7,135 - - - 7,135 Gain (loss) on real estate dispositions, net 35,366 - 906 - 36,272 Net income (loss) $ 566,842 $ 9,704 $ 71,060 $ (341,781) $ 305,825 Our portfolio of properties and other investments are located in the United States, the United Kingdom and Canada. Revenues and assets are attributed to the country in which the property is physically located . The following is a summary of geographic information for our operations for the periods presented (dollars in thousands): Three Months Ended Nine Months Ended September 30, 2015 September 30, 2014 September 30, 2015 September 30, 2014 Revenues: Amount % Amount % Amount % Amount % United States $ 793,429 81.0% $ 707,842 83.5% $ 2,309,596 81.6% $ 2,078,863 84.0% International 185,568 19.0% 139,681 16.5% 520,746 18.4% 396,914 16.0% Total $ 978,997 100.0% $ 847,523 100.0% $ 2,830,342 100.0% $ 2,475,777 100.0% As of September 30, 2015 December 31, 2014 Assets: Amount % Amount % United States $ 22,508,234 82.0% $ 20,728,477 82.9% International 4,948,132 18.0% 4,285,819 17.1% Total $ 27,456,366 100.0% $ 25,014,296 100.0%

Income Taxes and Distributions

Income Taxes and Distributions	9 Months Ended
	Sep. 30, 2015
Income Taxes And Distributions [Abstract]
Income Taxes And Distributions	18. Income Taxes and Distributions We elected to be taxed as a REIT commencing with our first taxable year. To qualify as a REIT for federal income tax purposes, at least 90% of taxable income (excluding 100% of net capital gains) must be distributed to stockholders. REITs that do not distribute a certain amount of current year taxable income in the current year are also subject to a 4% federal excise tax. The main differences between undistributed net income for federal income tax purposes and financial statement purposes are the recognition of straight-line rent for reporting purposes, basis differences in acquisitions, recording of impairments, differing useful lives and depreciation and amortization methods for real property and the prov ision for loan losses for reporting purp o ses versus bad debt expense for tax purposes. Under the provisions of the REIT Investment Diversificatio n and Empowerment Act of 2007 ( “RIDEA”), for taxable years beginning after July 30, 2008, a REIT may lease “qualified health care properties” on an arm’s-length basis to a taxable REIT subsidiary (“TRS”) if the property is operated on behalf of such TRS by a person who qualifies as an “eligible independent contractor.” Generally, the rent received from the TRS will meet the related party rent exception and will be treated as “rents from real property.” A “qualified health care property” includes real property and any personal property that is, or is necessary or incidental to the use of, a hospital, nursing facility, assisted living facility, congregate care facility, qualified continuin g care facility, or other licensed facility which extends medical or nursing or ancillary services to patients. We have entered into various joint ventures that were structured under RIDEA. Resident level rents and related operating expenses for these faci lities are reported in the unaudited consolidated financial statements and are subject to federal and state income taxes as the operations of such facilities are included in TRS entities. Certain net operating loss carryforwards could be utilized to offset taxable income in future years. Income tax expense reflected in the financial statements primarily represents U.S. federal and state and local income taxes as well as non-U.S. income based or withholding taxes on certain investments located in juris dictions outside the U.S. The income tax benefit for the three months ended September 30, 2015 and 2014, was primarily due to operating income or losses, offset by certain discrete items at our TRS entities. In 2014, we established certain wholly-owned direct and indirect subsidiaries in Luxembourg and Jersey and transferred interests in certain foreign investments into this holding company structure. The structure includes a property holding company that is tax resident in the United Kingdom. No mater ial adverse current tax consequences in Luxembourg, Jersey or the United Kingdom resulted from the creation of this holding company structure and all of the subsidiary entities in the structure are treated as disregarded entities of the company for U.S. fe deral income tax purposes. The company reflects current and deferred tax liabilities for any such withholding taxes incurred as a result of this holding company structure in its consolidated financial statements. Generally, given current statutes of limitations, we are subject to audit by the Internal Revenue Service (“IRS”) for the year ended December 31, 2011 and subsequent years and by state taxing authorities for the year ended December 31, 2 010 and subsequent years. The c ompany and its subsid iaries are also subject to audit by the Canada Revenue Agency and provincial authorities generally for periods subsequent to our initial investments in Canada in May 2012, by HM Revenue & Customs for periods subsequent to our initial investments in the Uni ted Kingdom in August 2012 and by Luxembourg taxing authorities generally for periods subsequent to our esta blishment of certain Luxembourg- based subsidiaries during 2014.

Accounting Policies and Relat25

Accounting Policies and Related Matters (Policies)	9 Months Ended
	Sep. 30, 2015
Accounting Policies and Related Matters (Policies) [Abstract]
Basis of Presentation	Basis of Presentation The accompanying unaudited consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial information and with instructions to Quarterly Report on Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by U.S. GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation have been included. Operating results for the nine months ended September 30, 2015 are not necessarily an indication of the results that may be expected for the year ending December 31, 2015. For further information, refer to the financial statements and notes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2014 .
New Accounting Standards	New Accounting Standards In May 2014, the Fin ancial Accounting Standards Board (“FASB”) issued ASU No. 2014-09, “Revenue from Contracts with Customers (Topic 606)” (“ASU 2014-09”). The standard is a comprehensive new revenue recognition model that requires revenue to be recognized in a manner to depi ct the transfer of goods or services to a customer at an amount that reflects the consideration expected to be received in exchange for those goods or services. ASU 2014-09 is effective for fiscal years, and interim periods within those years, beginning af ter December 15, 2017, and early adoption is permitted beginning after December 15, 2016. We are currently evaluating the impact that the standard will have on our consolidated financial statements and have not yet determined the method by which we will a dopt the standard. In February 2015, the FASB issued AS U No. 2015-02, “Consolidation (Topic 810): Amendments to the Consolidation Analysis” (“ASU 2015-02”), which makes certain changes to both the variable interest model and the voting model, includin g changes to (1) the identification of variable interests (fees paid to a decision maker or service provider), (2) the variable interest entity characteristics for a limited partnership or similar entity and (3) the primary beneficiary determination. ASU 2015-02 is effective beginning January 1, 2016. We are continuing to evaluate this guidance; however, we do not expect its adoption to have a significant impact on our consolidated financial statements. In April 2015, the FASB issued ASU No. 2015-03, “Simplifying the Presentation of Debt Issuance Costs” (“ASU 2015-03”), which requires that debt issuance costs related to a recognized debt liability be presented in the balance sheet as a direct deduction from the carrying amount of that debt liability. The recognition and measurement guidance for debt issuance costs are not affected. Upon adoption, we will apply the new guidance on a retrospective basis and adjust the balance sheet of each individual period presented to reflect the period-specific effe cts of applying the new guidance. The guidance is effective beginning January 1, 2016. We are continuing to evaluate this guidance; however, we do not expect its adoption to have a significant impact on our consolidated financial statements.

Real Property Acquisitions an26

Real Property Acquisitions and Development (Tables)	9 Months Ended
	Sep. 30, 2015
Real property acquisitions and development [Line Items]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities	Triple-n et Activity Nine Months Ended (In thousands) September 30, 2015 (1) September 30, 2014 Land and land improvements $ 111,674 $ 36,427 Buildings and improvements 1,025,232 303,273 Acquired lease intangibles 3,888 - Restricted cash 6 - Receivables and other assets 60 - Total assets acquired 1,140,860 339,700 Accrued expenses and other liabilities (2,447) - Total liabilities assumed (2,447) - Non-cash acquisition related activity (2,780) (1,937) Cash disbursed for acquisitions 1,135,633 337,763 Construction in progress additions 96,403 79,668 Less: Capitalized interest (4,453) (3,258) Foreign currency translation 73 116 Cash disbursed for construction in progress 92,023 76,526 Capital improvements to existing properties 35,042 14,375 Total cash invested in real property, net of cash acquired $ 1,262,698 $ 428,664 (1) Includes acquisitions with an aggregate purchase price of $844,298,000 for which the allocation of the purchase price consideration is preliminary and subject to change. Seniors Housing Operating Activity Nine Months Ended (In thousands) September 30, 2015 (1) September 30, 2014 Land and land improvements $ 98,444 $ 40,764 Building and improvements 1,229,017 224,936 Acquired lease intangibles 74,091 10,021 Construction in progress - 27,957 Restricted cash 5,567 - Receivables and other assets 23,928 5,679 Total assets acquired (2) 1,431,047 309,357 Secured debt (234,597) (12,846) Accrued expenses and other liabilities (19,016) (17,011) Total liabilities assumed (253,613) (29,857) Noncontrolling interests (86,842) - Cash disbursed for acquisitions 1,090,592 279,500 Construction in progress additions 39,493 6,984 Less: Capitalized interest (1,116) (293) Foreign currency translation (1,345) (810) Cash disbursed for construction in progress 37,032 5,881 Capital improvements to existing properties 61,911 52,177 Total cash invested in real property, net of cash acquired $ 1,189,535 $ 337,558 (1) Includes acquisitions with an aggregate purchase price of $1,268,031,000 for which the allocation of the purchase price consideration is preliminary and subject to change. (2) Excludes $3,390,000 and $8,476,000 of cash acquired during the nine months ended September 30, 2015 and 2014, respectively. Outpatient Medical Activity Nine Months Ended (In thousands) September 30, 2015 (1) September 30, 2014 Land and land improvements $ 737 $ 29,588 Buildings and improvements 426,288 471,410 Acquired lease intangibles 19,373 17,440 Receivables and other assets - 1,245 Total assets acquired (2) 446,398 519,683 Secured debt (112,000) (50,500) Accrued expenses and other liabilities (2,743) (9,308) Total liabilities assumed (114,743) (59,808) Noncontrolling interests (68,535) (39,987) Non-cash acquisition activity (3) - (45,836) Cash disbursed for acquisitions 263,120 374,052 Construction in progress additions 38,919 71,245 Less: Capitalized interest (742) (1,533) Accruals (4) (1,921) (11,290) Cash disbursed for construction in progress 36,256 58,422 Capital improvements to existing properties 25,687 19,772 Total cash invested in real property $ 325,063 $ 452,246 (1) Includes acquisitions with an aggregate purchase price of $440,220,000 for which the allocation of the purchase price consideration is preliminary and subject to change. (2) Excludes $4,372,000 and $0 of cash acquired during the nine months ended September 30, 2015 and 2014, respectively. (3) Relates to an acquisition of assets previously financed as real estate loans. Please refer to Note 6 for additional information. (4) Represents non-cash consideration accruals for amounts to be paid in future periods relating to properties that converted in the periods noted above.
Summary of construction projects placed into service and generating revenues	Nine Months Ended September 30, 2015 September 30, 2014 Development projects: Triple-net $ 85,902 $ 71,569 Seniors housing operating 19,869 - Outpatient medical 16,592 56,807 Total development projects 122,363 128,376 Expansion projects 38,808 17,586 Total construction in progress conversions $ 161,171 $ 145,962

Real Estate Intangibles (Tables

Real Estate Intangibles (Tables)	9 Months Ended
	Sep. 30, 2015
Real Estate Intangibles (Tables) [Abstract]
Summary of real estate intangibles excluding those classified as held for sale	September 30, 2015 December 31, 2014 Assets: In place lease intangibles $ 1,042,770 $ 988,290 Above market tenant leases 82,083 65,684 Below market ground leases 61,159 62,426 Lease commissions 22,498 19,536 Gross historical cost 1,208,510 1,135,936 Accumulated amortization (836,684) (776,501) Net book value $ 371,826 $ 359,435 Weighted-average amortization period in years 17.2 17.7 Liabilities: Below market tenant leases $ 89,891 $ 91,168 Above market ground leases 7,860 7,859 Gross historical cost 97,751 99,027 Accumulated amortization (44,609) (40,891) Net book value $ 53,142 $ 58,136 Weighted-average amortization period in years 15.6 14.4
Schedule of Real Estate Intangible Amortization	Three Months Ended Nine Months Ended September 30, September 30, 2015 2014 2015 2014 Rental income related to above/below market tenant leases, net $ (1,684) $ 179 $ (1,901) $ 423 Property operating expenses related to above/below market ground leases, net (308) (317) (962) (926) Depreciation and amortization related to in place lease intangibles and lease commissions (26,137) (46,366) (82,434) (185,363)
Schedule of the future estimated aggregate amortization of intangible assets and liabilities	Assets Liabilities 2015 $ 39,972 $ 3,279 2016 71,453 6,512 2017 43,426 6,052 2018 30,094 5,583 2019 24,033 5,325 Thereafter 162,848 26,391 Total $ 371,826 $ 53,142

Dispositions, Assets Held for28

Dispositions, Assets Held for Sale and Discontinued Operations (Tables)	9 Months Ended
	Sep. 30, 2015
Dispositions, Assets Held for Sale and Discontinued Operations (Tables) [Abstract]
Summary of real property disposition activity	Nine Months Ended September 30, 2015 September 30, 2014 Real estate dispositions: Triple-net $ 246,116 $ 56,713 Outpatient medical (1) 166,919 343,337 Land parcels 5,724 - Total dispositions 418,759 400,050 Gain (loss) on real estate dispositions, net 249,002 42,683 Proceeds from real estate dispositions $ 667,761 $ 442,733 (1) Dispositions occurring in the nine-month period ending September 30, 2015 primarily related to the disposition of an unconsolidated equity investment with Forest City Enterprises.
Reclassification impact as result of classifying properties as discontinued operations	Three Months Ended Nine Months Ended September 30, September 30, 2015 2014 2015 2014 Revenues: Rental income $ 7,164 $ 26,123 $ 24,237 $ 89,593 Expenses: Interest expense 1,041 4,507 3,991 18,512 Property operating expenses 1,577 1,595 4,586 6,017 Provision for depreciation 123 7,878 4,760 27,106 Total expenses 2,741 13,980 13,337 51,635 Income (loss) from real estate dispositions, net $ 4,423 $ 12,143 $ 10,900 $ 37,958
Summary of disposed properties.	Three Months Ended Nine Months Ended September 30, September 30, 2015 2014 2015 2014 Revenues: Rental income $ - $ - $ - $ 881 Expenses: Interest expense - - - 157 Total expenses - - - 157 Income (loss) from discontinued operations, net $ - $ - $ - $ 724

Real Estate Loans Receivable (T

Real Estate Loans Receivable (Tables)	9 Months Ended
	Sep. 30, 2015
Real Estate Loans Receivable (Tables) [Abstract]
Summary of real estate loan activity	Nine Months Ended September 30, 2015 September 30, 2014 Outpatient Outpatient Triple-net Medical Totals Triple-net Medical Totals Advances on real estate loans receivable: Investments in new loans $ 392,278 $ - $ 392,278 $ 10,674 $ - $ 10,674 Draws on existing loans 51,422 2,285 53,707 50,446 18,144 68,590 Net cash advances on real estate loans 443,700 2,285 445,985 61,120 18,144 79,264 Receipts on real estate loans receivable: Loan payoffs 52,088 - 52,088 24,522 42,036 66,558 Principal payments on loans 19,023 - 19,023 25,494 52 25,546 Sub-total 71,111 - 71,111 50,016 42,088 92,104 Less: Non-cash activity (1) - - - - (45,836) (45,836) Net cash receipts on real estate loans 71,111 - 71,111 50,016 (3,748) 46,268 Net cash advances (receipts) on real estate loans 372,589 2,285 374,874 11,104 21,892 32,996 Change in balance due to foreign currency translation (2,131) - (2,131) (1,085) - (1,085) Net change in real estate loans receivable $ 370,458 $ 2,285 $ 372,743 $ 10,019 $ (23,944) $ (13,925) (1) Represents an acquisition of assets previously financed as a real estate loan. Please see Note 3 for additional information.

Investments in Unconsolidated30

Investments in Unconsolidated Entities (Tables)	9 Months Ended
	Sep. 30, 2015
Investments In Unconsolidated Entities [Abstract]
Summary Of Investments In Unconsolidated Entities [Text Block]	Percentage Ownership (1) September 30, 2015 December 31, 2014 Triple-net 10% to 49% $ 35,657 $ 31,511 Seniors housing operating 10% to 50% 485,278 539,147 Outpatient medical 36% to 49% 37,419 173,493 Total $ 558,354 $ 744,151 (1) Excludes ownership of in-substance real estate.

Credit Concentration (Tables)

Credit Concentration (Tables)	9 Months Ended
	Sep. 30, 2015
Customer Concentration (Tables) [Abstract]
Summary of credit concentration	Number of Total Percent of Concentration by relationship: (1) Properties NOI NOI (2) Genesis Healthcare 180 $ 273,922 17% Sunrise Senior Living (3) 147 225,580 14% Brookdale Senior Living 146 124,843 8% Revera (3) 71 75,973 5% Benchmark Senior Living 50 73,788 4% Remaining portfolio 759 872,717 52% Totals 1,353 $ 1,646,823 100% (1) Genesis Healthcare is in our triple-net segment. Sunrise Senior Living and Revera are in our seniors housing operating segment. Benchmark Senior Living and Brookdale Senior Living are both in our triple-net and seniors housing operating segments. (2) NOI with our top five relationships comprised 49% of total NOI for the year ending December 31, 2014. (3) Revera owns a controlling interest in Sunrise Senior Living.

Borrowings Under Credit Facil32

Borrowings Under Credit Facilities and Related Items (Tables)	9 Months Ended
	Sep. 30, 2015
Borrowings Under Credit Facilities and Related Items (Tables) [Abstract]
Aggregate borrowings under the unsecured line of credit arrangements	Three Months Ended September 30, Nine Months Ended September 30, 2015 2014 2015 2014 Balance outstanding at quarter end (1) $ 490,000 $ - $ 490,000 $ - Maximum amount outstanding at any month end $ 490,000 $ 235,000 $ 535,000 $ 637,000 Average amount outstanding (total of daily principal balances divided by days in period) $ 298,370 $ 100,380 $ 402,619 $ 253,681 Weighted average interest rate (actual interest expense divided by average borrowings outstanding) 1.16% 1.67% 1.17% 1.40% (1) As of September 30, 2015, letters of credit in the aggregate amount of $58,484,000 have been issued, which reduces the borrowing capacity on the primary unsecured revolving credit facility.

Senior Unsecured Notes and Se33

Senior Unsecured Notes and Secured Debt (Tables)	9 Months Ended
	Sep. 30, 2015
Senior Unsecured Notes And Secured Debt (Tables) [Abstract]
Principal payments due on debt obligations	Senior Secured Unsecured Notes (1,2) Debt (1,3) Totals 2015 $ - $ 106,190 $ 106,190 2016 400,000 464,519 864,519 2017 450,000 399,670 849,670 2018 450,000 558,656 1,008,656 2019 (4,5) 1,286,625 374,769 1,661,394 Thereafter (6,7,8) 5,387,915 1,041,893 6,429,808 Totals $ 7,974,540 $ 2,945,697 $ 10,920,237 (1) Amounts represent principal amounts due and do not include unamortized premiums/discounts or other fair value adjustments as reflected on the balance sheet. (2) Annual interest rates range from 1.169% to 6.5%. (3) Annual interest rates range from 1.0% to 7.98%. Carrying value of the properties securing the debt totaled $5,205,803,000 at September 30, 2015. (4) On July 25, 2014, we refinanced the funding on a $250,000,000 Canadian-denominated unsecured term credit facility (approximately $186,625,000 based on the Canadian/U.S. Dollar exchange rate on September 30, 2015). The loan matures on October 31, 2018 (with an option to extend for an additional year at our discretion) and bears interest at the Canadian Dealer Offered Rate plus 97.5 basis points (1.8% at September 30, 2015). (5) On July 25, 2014, we refinanced the funding on a $500,000,000 unsecured term credit facility. The loan matures on October 31, 2018 (with an option to extend for an additional year at our discretion) and bears interest at LIBOR plus 97.5 basis points (1.17% at September 30, 2015). (6) On November 20, 2013, we completed the sale of £ 550,000,000 (approximately $831,765,000 based on the Sterling/U.S. Dollar exchange rate in effect on September 30, 2015) of 4.8% senior unsecured notes due 2028. (7) On November 25, 2014, we completed the sale of £ 500,000,000 (approximately $756,150,000 based on the Sterling/U.S. Dollar exchange rate in effect on September 30, 2015) of 4.5% senior unsecured notes due 2034. (8) In May 2015, we issued $750,000,000 of 4.0% senior unsecured notes due 2025. In October 2015, we issued an additional $500,000,000 of these notes under a re-opening of the offer.
Summary of senior unsecured note activity	Nine Months Ended September 30, 2015 September 30, 2014 Weighted Avg. Weighted Avg. Amount Interest Rate Amount Interest Rate Beginning balance $ 7,817,154 4.385% $ 7,421,707 4.400% Debt issued 750,000 4.000% - 0.000% Debt extinguished (300,000) 6.200% - 0.000% Debt redeemed (215,965) 3.000% (47,660) 3.000% Foreign currency (76,649) 8.065% (31,719) 3.892% Ending balance $ 7,974,540 4.210% $ 7,342,328 4.388%
Secured debt principal activity	Nine Months Ended September 30, 2015 September 30, 2014 Weighted Avg. Weighted Avg. Amount Interest Rate Amount Interest Rate Beginning balance $ 2,941,765 4.94% $ 3,010,711 5.10% Debt issued 222,612 2.76% 98,100 3.23% Debt assumed 339,929 3.34% 62,505 3.11% Debt extinguished (420,672) 4.27% (240,355) 5.66% Foreign currency (89,154) 3.88% (45,807) 4.97% Principal payments (48,783) 4.85% (23,434) 3.78% Ending balance $ 2,945,697 4.72% $ 2,861,720 4.94%

Derivative Instruments (Tables)

Derivative Instruments (Tables)	9 Months Ended
	Sep. 30, 2015
Derivative Instruments (Tables) [Abstract]
Impact of derivative instruments on the statement of operations and OCI	September 30, 2015 December 31, 2014 Derivatives designated as net investment hedges: Denominated in Canadian Dollars $ 1,175,000 $ 900,000 Denominated in Pounds Sterling £ 550,000 £ 350,000 Financial instruments designated as net investment hedges: Denominated in Canadian Dollars $ 250,000 $ 250,000 Denominated in Pounds Sterling £ 1,050,000 £ 1,050,000 Derivatives designated as cash flow hedges Denominated in U.S. Dollars $ 57,000 $ 57,000 Denominated in Canadian Dollars $ 72,000 $ 58,000 Denominated in Pounds Sterling £ 57,000 £ 40,000 Derivative instruments not designated: (1) Denominated in Canadian Dollars $ 700,000 $ 12,000 (1) These non-designated instruments represent off-setting forward exchange contracts to manage against adverse movements in exchange rates with regards to the purchase price on pending foreign acquisitions. Three Months Ended Nine Months Ended September 30, September 30, Location 2015 2014 2015 2014 Gain (loss) on interest rate swap recognized in OCI (effective portion) OCI $ - $ (4) $ (1) $ (11) Gain (loss) on interest rate swaps reclassified from AOCI into income (effective portion) Interest expense (462) (459) (1,390) (1,338) Gain (loss) on forward exchange contracts recognized in income Interest expense 2,347 - 6,285 - Gain (loss) on forward exchange contracts recognized in income Gain (loss) on derivatives, net - (49) - (400) Loss (gain) on option exercise (1) Loss (gain) on derivatives, net - - (58,427) - Gain on release of cumulative translation adjustment related to net investment hedge of an equity investment Income (loss) from unconsolidated entities - 528 - 528 Gain (loss) on foreign exchange contracts and term loans designated as net investment hedge recognized in OCI OCI 174,239 12,880 208,854 6,833 (1) In April 2011, we completed the acquisition of substantially all of the real estate assets of privately-owned Genesis Healthcare Corporation. In conjunction with this transaction, we received the option to acquire an ownership interest in Genesis Healthcare. In February 2015, Genesis Healthcare closed on a transaction to merge with Skilled Healthcare Group to become a publicly traded company which required us to record the value of the derivative asset due to the net settlement feature.

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	9 Months Ended
	Sep. 30, 2015
Stockholders' Equity (Tables) [Abstract]
Summary of stockholder's equity capital accounts	September 30, 2015 December 31, 2014 Preferred Stock: Authorized shares 50,000,000 50,000,000 Issued shares 25,875,000 25,875,000 Outstanding shares 25,875,000 25,875,000 Common Stock, $1.00 par value: Authorized shares 700,000,000 700,000,000 Issued shares 353,814,909 329,487,615 Outstanding shares 352,998,274 328,790,066
Summary of preferred stock activity	Nine Months Ended September 30, 2015 September 30, 2014 Weighted Avg. Weighted Avg. Shares Dividend Rate Shares Dividend Rate Beginning balance 25,875,000 6.500% 26,108,236 6.496% Shares converted - 0.000% (233,236) 6.000% Ending balance 25,875,000 6.500% 25,875,000 6.500%
Summary of common stock issuances	Shares Issued Average Price Gross Proceeds Net Proceeds June 2014 public issuance 16,100,000 $ 62.35 $ 1,003,835 $ 968,517 September 2014 public issuance 17,825,000 63.75 1,136,344 1,095,883 2014 Dividend reinvestment plan issuances 3,114,052 60.05 186,996 186,996 2014 Option exercises 207,046 45.94 9,512 9,512 2014 Stock incentive plans, net of forfeitures 186,837 - - 2014 Senior note conversions 199,943 - - 2014 Preferred stock conversions 233,236 - - 2014 Totals 37,866,114 $ 2,336,687 $ 2,260,908 February 2015 public issuance 19,550,000 $ 75.50 $ 1,476,025 $ 1,423,935 2015 Dividend reinvestment plan issuances 2,935,950 70.28 206,334 206,334 2015 Option exercises 247,005 47.42 11,712 11,712 2015 Stock incentive plans, net of forfeitures 144,779 - - 2015 Senior note conversions 1,330,474 - - 2015 Totals 24,208,208 $ 1,694,071 $ 1,641,981
Summary of dividend payments	Nine Months Ended September 30, 2015 September 30, 2014 Per Share Amount Per Share Amount Common Stock $ 2.4750 $ 852,563 $ 2.3850 $ 708,923 Series H Preferred Stock - - 0.0079 1 Series I Preferred Stock 2.4375 35,039 2.4375 35,040 Series J Preferred Stock 1.2189 14,016 1.2189 14,016 Totals $ 901,618 $ 757,980
Summary of accumulated other comprehensive income/(loss)	Unrecognized gains (losses) related to: Foreign Currency Translation Available for Sale Securities Actuarial Losses Cash Flow Hedges Total Balance at December 31, 2014 $ (74,770) $ - $ (1,589) $ (650) $ (77,009) Other comprehensive income before reclassification adjustments 2,071 (18,186) - (2,625) (18,740) Reclassification amount to net income - - - 1,390 (1) 1,390 Net current-period other comprehensive income 2,071 (18,186) - (1,235) (17,350) Balance at September 30, 2015 $ (72,699) $ (18,186) $ (1,589) $ (1,885) $ (94,359) Balance at December 31, 2013 $ (17,631) $ (389) $ (1,452) $ (5,059) $ (24,531) Other comprehensive income before reclassification adjustments (29,361) 389 - (11) (28,983) Reclassification amount to net income (528) - - 1,338 (1) 810 Net current-period other comprehensive income (29,889) 389 - 1,327 (28,173) Balance at September 30, 2014 $ (47,520) $ - $ (1,452) $ (3,732) $ (52,704) (1) Please see note 11 for additional information.

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2015
Earnings Per Share (Tables) [Abstract]
Computation of basic and diluted earnings per share	Three Months Ended Nine Months Ended September 30, September 30, 2015 2014 2015 2014 Numerator for basic and diluted earnings per share - net income (loss) attributable to common stockholders $ 182,043 $ 136,255 $ 685,413 $ 258,107 Denominator for basic earnings per share - weighted average shares 351,765 311,117 346,425 299,137 Effect of dilutive securities: Employee stock options 114 202 155 181 Non-vested restricted shares 607 505 498 506 Redeemable shares 621 - 207 - Convertible senior unsecured notes - 988 262 821 Dilutive potential common shares 1,342 1,695 1,122 1,508 Denominator for diluted earnings per share - adjusted weighted average shares 353,107 312,812 347,547 300,645 Basic earnings per share $ 0.52 $ 0.44 $ 1.98 $ 0.86 Diluted earnings per share $ 0.52 $ 0.44 $ 1.97 $ 0.86

Disclosure about Fair Value o37

Disclosure about Fair Value of Financial Instruments (Tables)	9 Months Ended
	Sep. 30, 2015
Disclosure about Fair Value of Financial Instruments (Tables) [Abstract]
Carrying amounts and estimated fair values of financial instruments	September 30, 2015 December 31, 2014 Carrying Amount Fair Value Carrying Amount Fair Value Financial assets: Mortgage loans receivable $ 570,997 $ 606,910 $ 188,651 $ 194,935 Other real estate loans receivable 181,915 181,585 191,518 195,375 Available-for-sale equity investments 40,241 40,241 - - Cash and cash equivalents 292,042 292,042 473,726 473,726 Foreign currency forward contracts 105,856 105,856 57,087 57,087 Financial liabilities: Borrowings under unsecured credit facilities $ 490,000 $ 490,000 $ - $ - Senior unsecured notes 7,926,757 8,489,584 7,766,251 8,613,702 Secured debt 2,975,639 3,024,245 2,977,713 3,053,067 Foreign currency forward contracts 21,909 21,909 1,495 1,495 Redeemable OP unitholder interests $ 111,380 $ 111,380 $ 46,722 $ 46,722
The Market approach utilized to measure fair value of financial assets and liabilities on recurring basis	Fair Value Measurements as of September 30, 2015 Total Level 1 Level 2 Level 3 Available-for-sale equity investments (1) $ 40,241 $ 40,241 $ - $ - Foreign currency forward contracts, net (2) 83,947 - 83,947 - Redeemable OP unitholder interests 111,380 - 111,380 - Totals $ 235,568 $ 40,241 $ 195,327 $ - (1) Unrealized gains or losses on equity investments are recorded in accumulated other comprehensive income (loss) at each measurement date. (2) Please see Note 11 for additional information.

Segment Reporting (Tables)

Segment Reporting (Tables)	9 Months Ended
	Sep. 30, 2015
Segment Reporting (Tables) [Abstract]
Summary of information for reportable segments	Three Months Ended September 30, 2015: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 285,027 $ - $ 124,263 $ - $ 409,290 Resident fees and services - 545,255 - - 545,255 Interest income 19,454 1,054 1,872 - 22,380 Other income 969 772 309 22 2,072 Total revenues 305,450 547,081 126,444 22 978,997 Property operating expenses - 368,050 40,653 - 408,703 Net operating income from continuing operations 305,450 179,031 85,791 22 570,294 Reconciling items: Interest expense 12,359 30,990 7,120 70,661 121,130 Depreciation and amortization 74,486 87,306 44,007 - 205,799 General and administrative - - - 36,950 36,950 Transaction costs 1,865 7,630 (162) - 9,333 Loss (gain) on extinguishment of debt, net (139) - - 723 584 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 216,879 53,105 34,826 (108,312) 196,498 Income tax expense 87 3,237 154 (134) 3,344 (Loss) income from unconsolidated entities 2,851 (5,629) 147 - (2,631) Income (loss) from continuing operations 219,817 50,713 35,127 (108,446) 197,211 Gain (loss) on real estate dispositions, net 2,155 - (109) - 2,046 Net income (loss) $ 221,972 $ 50,713 $ 35,018 $ (108,446) $ 199,257 Total assets $ 12,346,157 $ 10,325,540 $ 4,699,643 $ 85,026 $ 27,456,366 Three Months Ended September 30, 2014: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 250,748 $ - $ 103,400 $ - $ 354,148 Resident fees and services - 482,412 - - 482,412 Interest income 7,520 1,054 770 - 9,344 Other income 981 325 207 106 1,619 Total revenues 259,249 483,791 104,377 106 847,523 Property operating expenses 41 320,895 34,221 - 355,157 Net operating income from continuing operations 259,208 162,896 70,156 106 492,366 Reconciling items: Interest expense 10,294 26,612 7,692 73,837 118,435 Loss (gain) on derivatives, net 52 (3) - - 49 Depreciation and amortization 68,027 95,819 37,124 - 200,970 General and administrative - - - 30,803 30,803 Transaction costs 1,619 10,572 1,363 - 13,554 Loss (gain) on extinguishment of debt, net (36) - - 2,728 2,692 Other Expenses 8,825 1,437 - - 10,262 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 170,427 28,459 23,977 (107,262) 115,601 Income tax expense 5,986 3,746 466 - 10,198 (Loss) income from unconsolidated entities 1,353 (5,550) 1,565 - (2,632) Income (loss) from continuing operations 177,766 26,655 26,008 (107,262) 123,167 Gain (loss) on real estate dispositions, net 29,604 - - - 29,604 Net income (loss) $ 207,370 $ 26,655 $ 26,008 $ (107,262) $ 152,771 Nine Months Ended September 30, 2015: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 829,422 $ - $ 356,080 $ - $ 1,185,502 Resident fees and services - 1,573,318 - - 1,573,318 Interest income 52,343 3,126 4,481 - 59,950 Other income 5,823 5,001 665 83 11,572 Total revenues 887,588 1,581,445 361,226 83 2,830,342 Property operating expenses - 1,067,127 116,392 - 1,183,519 Net operating income from continuing operations 887,588 514,318 244,834 83 1,646,823 Reconciling items: Interest expense 25,064 104,245 21,929 209,833 361,071 Loss (gain) on derivatives, net (58,427) - - - (58,427) Depreciation and amortization 216,921 252,785 133,725 - 603,431 General and administrative - - - 110,562 110,562 Transaction costs 45,615 23,610 1,154 - 70,379 Loss (gain) on extinguishment of debt, net 10,096 - - 24,776 34,872 Impairment of assets 2,220 - - - 2,220 Other expenses - - - 10,583 10,583 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 646,099 133,678 88,026 (355,671) 512,132 Income tax expense (2,617) (745) 460 (867) (3,769) (Loss) income from unconsolidated entities 5,697 (26,785) 2,857 - (18,231) Income (loss) from continuing operations 649,179 106,148 91,343 (356,538) 490,132 Gain (loss) on real estate dispositions, net 56,251 - 192,751 - 249,002 Net income (loss) $ 705,430 $ 106,148 $ 284,094 $ (356,538) $ 739,134 Nine Months Ended September 30, 2014: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 736,599 $ - $ 301,852 $ - $ 1,038,451 Resident fees and services - 1,406,316 - - 1,406,316 Interest income 23,220 1,065 2,586 - 26,871 Other income 1,448 1,643 850 198 4,139 Total revenues 761,267 1,409,024 305,288 198 2,475,777 Property operating expenses 732 939,108 100,502 - 1,040,342 Net operating income from continuing operations 760,535 469,916 204,786 198 1,435,435 Reconciling items: Interest expense 28,063 82,924 25,423 223,924 360,334 Loss (gain) on derivatives, net 125 275 - - 400 Depreciation and amortization 202,668 334,625 111,444 - 648,737 General and administrative - - - 115,327 115,327 Transaction costs 5,900 12,863 2,783 - 21,546 Loss (gain) on extinguishment of debt, net (36) 383 - 2,728 3,075 Other expenses 8,825 1,437 - - 10,262 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 514,990 37,409 65,136 (341,781) 275,754 Income tax expense 5,194 1,302 (127) - 6,369 (Loss) income from unconsolidated entities 4,157 (29,007) 5,145 - (19,705) Income (loss) from continuing operations 524,341 9,704 70,154 (341,781) 262,418 Income (loss) from discontinued operations 7,135 - - - 7,135 Gain (loss) on real estate dispositions, net 35,366 - 906 - 36,272 Net income (loss) $ 566,842 $ 9,704 $ 71,060 $ (341,781) $ 305,825 Three Months Ended Nine Months Ended September 30, 2015 September 30, 2014 September 30, 2015 September 30, 2014 Revenues: Amount % Amount % Amount % Amount % United States $ 793,429 81.0% $ 707,842 83.5% $ 2,309,596 81.6% $ 2,078,863 84.0% International 185,568 19.0% 139,681 16.5% 520,746 18.4% 396,914 16.0% Total $ 978,997 100.0% $ 847,523 100.0% $ 2,830,342 100.0% $ 2,475,777 100.0% As of September 30, 2015 December 31, 2014 Assets: Amount % Amount % United States $ 22,508,234 82.0% $ 20,728,477 82.9% International 4,948,132 18.0% 4,285,819 17.1% Total $ 27,456,366 100.0% $ 25,014,296 100.0%

Business (Details)

Business (Details)	Sep. 30, 2015properties
Business [Line Items]
Number of properties in diversified portfolio	1,353	[1]
Controlling [Member]
Business [Line Items]
Number of properties in diversified portfolio	1,414
[1]	(1)     Genesis Healthcare is in our triple-net segment. Sunrise Senior Living and Revera are in our seniors housing operating segment. Brookdale Senior Living and Benchmark Senior Living are in both our triple-net and seniors housing operating segments.

Real Property Acquisitions an40

Real Property Acquisitions and Development (Details 1) - USD ($)		9 Months Ended
		Sep. 30, 2015		Sep. 30, 2014
Triple Net [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		$ 111,674,000	[1]	$ 36,427,000
Buildings and improvements		1,025,232,000	[1]	303,273,000
Acquired lease intangibles		3,888,000	[1]	0
Restricted cash		6,000	[1]	0
Receivables and other assets		60,000	[1]	0
Total assets acquired		1,140,860,000	[1]	339,700,000
Accrued expenses and other liabilities		(2,447,000)	[1]	0
Total liabilities assumed		(2,447,000)	[1]	0
Non-cash acquisition related activity		(2,780,000)	[1]	(1,937,000)
Cash disbursed for acquisitions		1,135,633,000	[1]	337,763,000
Construction in progress additions		96,403,000	[1]	79,668,000
Less: Capitalized Interest		(4,453,000)	[1]	(3,258,000)
Less: Foreign currency translation		73,000	[1]	116,000
Cash disbursed for construction in progress		92,023,000	[1]	76,526,000
Capital improvements to existing properties		35,042,000	[1]	14,375,000
Total cash invested in real property		1,262,698,000	[1]	428,664,000
Triple Net [Member] | Preliminary [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Total cash invested in real property		688,288,000
Senior housing - operating [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		98,444,000	[2]	40,764,000
Buildings and improvements		1,229,017,000	[2]	224,936,000
Acquired lease intangibles		74,091,000	[2]	10,021,000
Acquired Construction in Progress		0	[2]	27,957,000
Restricted cash		5,567,000	[2]	0
Receivables and other assets		23,928,000	[2]	5,679,000
Total assets acquired	[3]	1,431,047,000	[2]	309,357,000
Secured debt		(234,597,000)	[2]	(12,846,000)
Accrued expenses and other liabilities		(19,016,000)	[2]	(17,011,000)
Total liabilities assumed		(253,613,000)	[2]	(29,857,000)
Noncontrolling interests		(86,842,000)	[2]	0
Non-cash acquisition related activity		0	[2]	0
Cash disbursed for acquisitions		1,090,592,000	[2]	279,500,000
Construction in progress additions		39,493,000	[2]	6,984,000
Less: Capitalized Interest		(1,116,000)	[2]	(293,000)
Less: Foreign currency translation		(1,345,000)	[2]	(810,000)
Cash disbursed for construction in progress		37,032,000	[2]	5,881,000
Capital improvements to existing properties		61,911,000	[2]	52,177,000
Total cash invested in real property		1,189,535,000	[2]	337,558,000
Cash Acquired from Acquisition		3,390,000		8,476,000
Senior housing - operating [Member] | Preliminary [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Total cash invested in real property		1,344,831,000
Outpatient Medical [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements	[4]	737,000		29,588,000
Buildings and improvements	[4]	426,288,000		471,410,000
Acquired lease intangibles	[4]	19,373,000		17,440,000
Receivables and other assets		0	[4]	1,245,000
Total assets acquired	[4],[5]	446,398,000		519,683,000
Secured debt		(112,000,000)	[4]	(50,500,000)
Accrued expenses and other liabilities		(2,743,000)	[4]	(9,308,000)
Total liabilities assumed		(114,743,000)	[4]	(59,808,000)
Noncontrolling interests		(68,535,000)	[4]	(39,987,000)
Non-cash acquisition related activity	[6]	0	[4]	(45,836,000)
Cash disbursed for acquisitions		263,120,000	[4]	374,052,000
Construction in progress additions		38,919,000	[4]	71,245,000
Less: Capitalized Interest		(742,000)	[4]	(1,533,000)
Less: Accruals	[7]	(1,921,000)	[4]	(11,290,000)
Cash disbursed for construction in progress		36,256,000	[4]	58,422,000
Capital improvements to existing properties		25,687,000	[4]	19,772,000
Total cash invested in real property		325,063,000	[4]	452,246,000
Cash Acquired from Acquisition		4,372,000		$ 0
Outpatient Medical [Member] | Preliminary [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Total cash invested in real property		$ 440,220,000
[1]	(1) Includes acquisitions with an aggregate purchase price of $844,298,000 for which the allocation of the purchase price consideration is preliminary and subject to change.
[2]	(1) Includes acquisitions with an aggregate purchase price of $1,268,031,000 for which the allocation of the purchase price consideration is preliminary and subject to change.
[3]	(2) Excludes $3,390,000 and $8,476,000 of cash acquired during the nine months ended September 30, 2015 and 2014, respectively.
[4]	(1) Includes acquisitions with an aggregate purchase price of $440,220,000 for which the allocation of the purchase price consideration is preliminary and subject to change.
[5]	(2) Excludes $4,372,000 and $0 of cash acquired during the nine months ended September 30, 2015 and 2014, respectively.
[6]	(3) Relates to an acquisition of assets previously financed as real estate loans. Please refer to Note 6 for additional information.
[7]	(4) Represents non-cash consideration accruals for amounts to be paid in future periods relating to properties that converted in the periods noted above.

Real Property Acquisitions an41

Real Property Acquisitions and Development (Details 2) - USD ($)	9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014
Development projects:
Total development projects	$ 122,363,000	$ 128,376,000
Expansion projects	38,808,000	17,586,000
Total construction in progress conversions	161,171,000	145,962,000
Outpatient Medical [Member]
Development projects:
Total development projects	16,592,000	56,807,000
Seniors Housing Facilities Operating [Member]
Development projects:
Total development projects	19,869,000
Triple Net [Member]
Development projects:
Total development projects	$ 85,902,000	$ 71,569,000

Real Estate Intangibles (Detail

Real Estate Intangibles (Details) - USD ($)	9 Months Ended	12 Months Ended
	Sep. 30, 2015	Dec. 31, 2014
Intangible Assets:
Gross historical cost	$ 1,208,510,000	$ 1,135,936,000
Accumulated amortization	836,684,000	776,501,000
Net book value	$ 371,826,000	$ 359,435,000
Weighted-average amortization period in years	17 years 2 months	17 years 8 months
Intangible Liabilities:
Gross historical cost	$ 97,751,000	$ 99,027,000
Accumulated amortization	44,609,000	40,891,000
Net book value	$ 53,142,000	$ 58,136,000
Weighted-average amortization period in years	15 years 7 months	14 years 5 months
In place lease intangibles [Member]
Intangible Assets:
Gross historical cost	$ 1,042,770,000	$ 988,290,000
Above market tenant leases [Member]
Intangible Assets:
Gross historical cost	82,083,000	65,684,000
Below market ground leases [Member]
Intangible Assets:
Gross historical cost	61,159,000	62,426,000
Lease commissions [Member]
Intangible Assets:
Gross historical cost	22,498,000	19,536,000
Below market tenant leases [Member]
Intangible Liabilities:
Gross historical cost	89,891,000	91,168,000
Above market ground leases [Member]
Intangible Liabilities:
Gross historical cost	$ 7,860,000	$ 7,859,000

Real Estate Intangibles (Real E

Real Estate Intangibles (Real Estate Intangible Maturity Schedule) (Details) - USD ($)	Sep. 30, 2015	Dec. 31, 2014
Estimated Aggregate Amortization Expense For Acquired Lease Intangibles Expected To Be Recognized [Line Items]
Totals	$ 371,826,000	$ 359,435,000
Intangible Liability [Member]
Estimated Aggregate Amortization Expense For Acquired Lease Intangibles Expected To Be Recognized [Line Items]
2,015	3,279,000
2,016	6,512,000
2,017	6,052,000
2,018	5,583,000
2,019	5,325,000
Thereafter	26,391,000
Totals	53,142,000
Intangible Asset [Member]
Estimated Aggregate Amortization Expense For Acquired Lease Intangibles Expected To Be Recognized [Line Items]
2,015	39,972,000
2,016	71,453,000
2,017	43,426,000
2,018	30,094,000
2,019	24,033,000
Thereafter	162,848,000
Totals	$ 371,826,000

Real Estate Intangibles (Deta44

Real Estate Intangibles (Details 1) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Real Estate Intangible Amortization [Abstract]
Rental income related to above/below market tenant leases, net	$ (1,684,000)	$ 179,000	$ (1,901,000)	$ 423,000
Property operating expenses related to above/below market ground leases, net	(308,000)	(317,000)	(962,000)	(926,000)
Depreciation and amortization related to in place lease intangibles and lease commissions	$ (26,137,000)	$ (46,366,000)	$ (82,434,000)	$ (185,363,000)

Dispositions, Assets Held for45

Dispositions, Assets Held for Sale and Discontinued Operations (Details) - USD ($)		9 Months Ended
		Sep. 30, 2015	Sep. 30, 2014
Real property dispositions:
Total dispositions		$ 418,759,000	$ 400,050,000
Net loss (gain) on sales of properties		(249,002,000)	(42,683,000)
Proceeds from sales of real property		667,761,000	442,733,000
Triple Net [Member]
Real property dispositions:
Total dispositions		246,116,000	56,713,000
Outpatient Medical [Member]
Real property dispositions:
Total dispositions	[1]	166,919,000	343,337,000
Land parcels [Member]
Real property dispositions:
Total dispositions		$ 5,724,000	$ 0
[1]	(1) Dispositions occurring in the nine-month period ending September 30, 2015 primarily related to the disposition of an unconsolidated equity investment with Forest City Enterprises.

Dispositions, Assets Held for46

Dispositions, Assets Held for Sale and Discontinued Operations (Details 1) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Revenues:
Rental income, discontinued	$ 0	$ 0	$ 0	$ 881,000
Expenses:
Interest expense, discontinued	0	0	0	157,000
Property operating expenses, discontinued	0	0	0	0
Provision for depreciation, discontinued	0	0	0	0
Expenses, discontinued	0	0	0	157,000
Income (loss) from discontinued operations, net	$ 0	$ 0	$ 0	$ 724,000

Dispositions, Assets Held for47

Dispositions, Assets Held for Sale and Discontinued Operations (Details 2) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Revenues:
Rental income, disposed	$ 7,164,000	$ 26,123,000	$ 24,237,000	$ 89,593,000
Expenses:
Interest expense, disposed	1,041,000	4,507,000	3,991,000	18,512,000
Property operating expenses, disposed	1,577,000	1,595,000	4,586,000	6,017,000
Depreciation expense, disposed	123,000	7,878,000	4,760,000	27,106,000
Expenses, disposed	2,741,000	13,980,000	13,337,000	51,635,000
Income (loss) from disposed properties	$ 4,423,000	$ 12,143,000	$ 10,900,000	$ 37,958,000

Real Estate Loans Receivable (D

Real Estate Loans Receivable (Details) - USD ($)		9 Months Ended
		Sep. 30, 2015	Sep. 30, 2014
Advances on real estate loans receivable:
Investments in new loans		$ 392,278,000	$ 10,674,000
Draws on existing loans		53,707,000	68,590,000
Net cash advances on real estate loans		445,985,000	79,264,000
Receipts on real estate loans receivable:
Loan payoffs		52,088,000	66,558,000
Principal payments on loans		19,023,000	25,546,000
Total receipts on real estate loans		71,111,000	46,268,000
Net advances (receipts) on real estate loans		374,874,000	32,996,000
Non Cash Decrease In Real Estate Loans Receivable	[1]	0	(45,836,000)
Change in balance due to foreign currency translation		(2,131,000)	(1,085,000)
Net change Real Estate Loans Receivable		372,743,000	(13,925,000)
Triple Net [Member]
Advances on real estate loans receivable:
Investments in new loans		392,278,000	10,674,000
Draws on existing loans		51,422,000	50,446,000
Net cash advances on real estate loans		443,700,000	61,120,000
Receipts on real estate loans receivable:
Loan payoffs		52,088,000	24,522,000
Principal payments on loans		19,023,000	25,494,000
Total receipts on real estate loans		71,111,000	50,016,000
Net advances (receipts) on real estate loans		372,589,000	11,104,000
Non Cash Decrease In Real Estate Loans Receivable	[1]	0	0
Change in balance due to foreign currency translation		(2,131,000)	(1,085,000)
Net change Real Estate Loans Receivable		370,458,000	10,019,000
Outpatient Medical [Member]
Advances on real estate loans receivable:
Investments in new loans		0	0
Draws on existing loans		2,285,000	18,144,000
Net cash advances on real estate loans		2,285,000	18,144,000
Receipts on real estate loans receivable:
Loan payoffs		0	42,036,000
Principal payments on loans		0	52,000
Total receipts on real estate loans		0	(3,748,000)
Net advances (receipts) on real estate loans		2,285,000	21,892,000
Non Cash Decrease In Real Estate Loans Receivable	[1]	0	(45,836,000)
Change in balance due to foreign currency translation		0	0
Net change Real Estate Loans Receivable		$ 2,285,000	$ (23,944,000)
[1]	(1) Represents an acquisition of assets previously financed as a real estate loan. Please see Note 3 for additional information.

Real Estate Loans Receivable 49

Real Estate Loans Receivable (Textuals) (Details)	Sep. 30, 2015USD ($)
Real Estate Loans Receivable (Textual) [Abstract]
Real estate loans with outstanding balances	$ 0

Investments in Unconsolidated50

Investments in Unconsolidated Entities (Summary of Investments in Unconsolidated Entities) (Details) - USD ($)		Sep. 30, 2015	Dec. 31, 2014
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated entities		$ 558,354,000	$ 744,151,000
Triple Net [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated entities		$ 35,657,000	$ 31,511,000
Triple Net [Member] | Minimum [Member]
Schedule of Equity Method Investments [Line Items]
Equity Method Investment, Ownership Percentage	[1]	10.00%	10.00%
Triple Net [Member] | Maximum [Member]
Schedule of Equity Method Investments [Line Items]
Equity Method Investment, Ownership Percentage	[1]	49.00%	49.00%
Seniors Housing Facilities Operating [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated entities		$ 485,278,000	$ 539,147,000
Seniors Housing Facilities Operating [Member] | Minimum [Member]
Schedule of Equity Method Investments [Line Items]
Equity Method Investment, Ownership Percentage	[1]	10.00%	10.00%
Seniors Housing Facilities Operating [Member] | Maximum [Member]
Schedule of Equity Method Investments [Line Items]
Equity Method Investment, Ownership Percentage	[1]	50.00%	50.00%
Outpatient Medical [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated entities		$ 37,419,000	$ 173,493,000
Outpatient Medical [Member] | Minimum [Member]
Schedule of Equity Method Investments [Line Items]
Equity Method Investment, Ownership Percentage	[1]	36.00%	36.00%
Outpatient Medical [Member] | Maximum [Member]
Schedule of Equity Method Investments [Line Items]
Equity Method Investment, Ownership Percentage	[1]	49.00%	49.00%
[1]	(1) Excludes ownership of in-substance real estate.

Investments in Unconsolidated51

Investments in Unconsolidated Entities (Details)	Sep. 30, 2015USD ($)
Schedule of Equity Method Investments [Line Items]
Unamortized Investment In Joint Venture Primarily Attributable To Real Estate And Related Intangible Assets	$ 161,882,000

Credit Concentration (Details)

Credit Concentration (Details)		3 Months Ended			9 Months Ended
		Sep. 30, 2015USD ($)properties		Sep. 30, 2014USD ($)	Sep. 30, 2015USD ($)properties	Sep. 30, 2014USD ($)	Dec. 31, 2014
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	1,353			1,353
Percent of NOI	[1],[2]				100.00%
Net Operating Income		$ 570,294,000	[1]	$ 492,366,000	$ 1,646,823,000	$ 1,435,435,000
Credit Concentration (Textual) [Abstract]
Percentage total investments with top five customers							49.00%
Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]				100.00%
Net Operating Income	[1]				$ 1,646,823,000
Genesis HealthCare [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	180			180
Genesis HealthCare [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]				17.00%
Net Operating Income	[1]				$ 273,922,000
Sunrise Senior Living [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1],[3]	147			147
Sunrise Senior Living [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2],[3]				14.00%
Net Operating Income	[1],[3]				$ 225,580,000
Brookdale [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	146			146
Brookdale [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]				8.00%
Net Operating Income	[1]				$ 124,843,000
Benchmark Senior Living [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	50			50
Benchmark Senior Living [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]				4.00%
Net Operating Income	[1]				$ 73,788,000
Revera [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1],[3]	71			71
Revera [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2],[3]				5.00%
Net Operating Income	[1],[3]				$ 75,973,000
Remaining Portfolio [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	759			759
Remaining Portfolio [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]				52.00%
Net Operating Income	[1]				$ 872,717,000
[1]	(1)     Genesis Healthcare is in our triple-net segment. Sunrise Senior Living and Revera are in our seniors housing operating segment. Brookdale Senior Living and Benchmark Senior Living are in both our triple-net and seniors housing operating segments.
[2]	(2)     NOI with our top five relationships comprised 49% of total NOI for the year ending December 31, 2014
[3]	(3) Revera owns a controlling interest in Sunrise Senior Living.

Borrowings Under Credit Facil53

Borrowings Under Credit Facilities and Related Items (Details) - USD ($)	3 Months Ended			9 Months Ended
	Sep. 30, 2015		Sep. 30, 2014	Sep. 30, 2015		Sep. 30, 2014	Dec. 31, 2014
Aggregate borrowings under the unsecured line of credit arrangements
Balance outstanding at quarter end	$ 490,000,000	[1]	$ 0	$ 490,000,000	[1]	$ 0	$ 0
Maximum amount outstanding at any month end	490,000,000		235,000,000	535,000,000		637,000,000
Average amount outstanding (total of daily principal balances divided by days in period)	$ 298,370,000		$ 100,380,000	$ 402,619,000		$ 253,681,000
Weighted average interest rate (actual interest expense divided by average borrowings outstanding)	1.16%		1.67%	1.17%		1.40%
[1]	(1) As of September 30, 2015, letters of credit in the aggregate amount of $58,484,000 have been issued, which reduces the borrowing capacity on the primary unsecured revolving credit facility.

Borrowings Under Credit Facil54

Borrowings Under Credit Facilities and Related Items (Details Textual)	9 Months Ended
	Sep. 30, 2015USD ($)Number		Dec. 31, 2014USD ($)	Sep. 30, 2014USD ($)
Line Of Credit Facility [Line Items]
Unsecured line of credit arrangement	$ 2,500,000,000
Additional unsecured line of credit arrangement	$ 1,000,000,000
Number of banks in consortium | Number	28
Available to borrow in alternate currencies	$ 500,000,000
Agent bank's prime rate of interest	1.119%
Interest Rate margin	0.925%
Annual facility fee for each bank based on commitment amount	0.15%
Debt instrument maturity date	Oct. 31, 2018
Balance outstanding at quarter end	$ 490,000,000	[1]	$ 0	$ 0
Term Loan Interest Rate Margin	1.169%
HCN Term Loan	$ 500,000,000
HCN Canadian Denomiated Term Loan	250,000,000
Accordion Feature [Member]
Line Of Credit Facility [Line Items]
HCN Canadian Denomiated Term Loan	250,000,000
Financial Stand by Letter Of Credit [Member]
Line Of Credit Facility [Line Items]
Balance outstanding at quarter end	$ 58,484,000
[1]	(1) As of September 30, 2015, letters of credit in the aggregate amount of $58,484,000 have been issued, which reduces the borrowing capacity on the primary unsecured revolving credit facility.

Senior Unsecured Notes and Se55

Senior Unsecured Notes and Secured Debt (Details)		9 Months Ended
		Sep. 30, 2015CAD	Oct. 01, 2015USD ($)	Sep. 30, 2015GBP (£)	Sep. 30, 2015USD ($)	Dec. 31, 2014USD ($)
Principal payments due on debt obligations
2,015					$ 106,190,000
2,016					864,519,000
2,017					849,670,000
2,018					1,008,656,000
2,019	[1],[2]				1,661,394,000
Thereafter	[3],[4],[5]				6,429,808,000
Totals					10,920,237,000
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Senior unsecured notes					7,926,757,000	$ 7,766,251,000
Secured debt					2,975,639,000	$ 2,977,713,000
Interest Rate margin		0.925%
Debt instrument maturity date		Oct. 31, 2018
Senior Unsecured Notes [Member]
Principal payments due on debt obligations
2,015	[6],[7]				0
2,016	[6],[7]				400,000,000
2,017	[6],[7]				450,000,000
2,018	[6],[7]				450,000,000
2,019	[1],[2],[6],[7]				1,286,625,000
Thereafter	[3],[4],[5],[6],[7]				5,387,915,000
Totals	[6],[7]				7,974,540,000
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Notes, annual stated interest rates, Minimum		1.169%
Notes, annual stated interest rates, Maximum		6.50%
Secured Debt [Member]
Principal payments due on debt obligations
2,015	[6],[8]				106,190,000
2,016	[6],[8]				464,519,000
2,017	[6],[8]				399,670,000
2,018	[6],[8]				558,656,000
2,019	[1],[2],[6],[8]				374,769,000
Thereafter	[3],[4],[5],[6],[8]				1,041,893,000
Totals	[6],[8]				2,945,697,000
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Notes, annual stated interest rates, Minimum		1.00%
Notes, annual stated interest rates, Maximum		7.98%
Carrying values of properties securing the debt					5,205,803,000
4.00% Senior Unsecured Notes Due 2025 [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Senior unsecured notes issued amount					750,000,000
Debt Instrument, Issuance Date		May 1, 2015
Senior Unsecured Notes Additional Issued Amount			$ 500,000,000
Canadian Denominated Unsecured Term Loan [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Senior unsecured notes		CAD 250,000,000			186,625,000
Interest Rate margin		1.80%
Debt Instrument, Issuance Date		Jul. 25, 2014
Debt instrument maturity date		Oct. 31, 2018
Canadian Denominated Unsecured Term Loan [Member] | London Interbank Offered Rate (LIBOR) [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Interest Rate margin		0.975%
Unsecured Line of Credit Term Loan [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Senior unsecured notes					$ 490,000,000
UK Debt Due 2034 [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Interest rate		4.50%		4.50%	4.50%
Senior unsecured notes issued amount				£ 500,000,000	$ 756,150,000
Debt Instrument, Issuance Date		Nov. 25, 2014
Debt instrument maturity date		Nov. 24, 2034
UK Debt Due 2028 [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Interest rate		4.80%		4.80%	4.80%
Senior unsecured notes issued amount				£ 550,000,000	$ 831,765,000
Debt Instrument, Issuance Date		Nov. 20, 2013
Debt instrument maturity date		Nov. 20, 2028
Unsecured term credit facility [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Senior unsecured notes					500,000,000
Interest Rate margin		1.1689%
Debt Instrument, Issuance Date		Jul. 25, 2014
Debt instrument maturity date		Oct. 31, 2018
Unsecured term credit facility [Member] | London Interbank Offered Rate (LIBOR) [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Interest Rate margin		0.975%
3.00% Senior Unsecured Convertible Notes due 2029 | Redemption 2015
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Debt Instrument, Redemption, Principle Amount Redeemed					$ 22,415,000
Debt Instrument, Redemption Period, End Date		Jul. 17, 2015
Debt Redemption Announcement Date		Aug. 17, 2015
[1]	(4) On July 25, 2014, we refinanced the funding on a $250,000,000 Canadian-denominated unsecured term credit facility (approximately $186,625,000 based on the Canadian/U.S. Dollar exchange rate on September 30, 2015). The loan matures on October 31, 2018 (with an option to extend for an additional year at our discretion) and bears interest at the Canadian Dealer Offered Rate plus 97.5 basis points (1.8% at September 30, 2015).
[2]	(5) On July 25, 2014, we refinanced the funding on a $500,000,000 unsecured term credit facility. The loan matures on October 31, 2018 (with an option to extend for an additional year at our discretion) and bears interest at LIBOR plus 97.5 basis points (1.17% at September 30, 2015).
[3]	(6) On November 20, 2013, we completed the sale of £550,000,000 (approximately $831,765,000 based on the Sterling/U.S. Dollar exchange rate in effect on September 30, 2015) of 4.8% senior unsecured notes due 2028.
[4]	(7) On November 25, 2014, we completed the sale of £500,000,000 (approximately $756,150,000 based on the Sterling/U.S. Dollar exchange rate in effect on September 30, 2015) of 4.5% senior unsecured notes due 2034.
[5]	(8) In May 2015, we issued $750,000,000 of 4.0% senior unsecured notes due 2025. In October 2015, we issued an additional $500,000,000 of these notes under a re-opening of the offer.
[6]	(1) Amounts represent principal amounts due and do not include unamortized premiums/discounts or other fair value adjustments as reflected on the balance sheet.
[7]	(2) Annual interest rates range from 1.169% to 6.5%.
[8]	(3) Annual interest rates range from 1.0% to 7.98%. Carrying value of the properties securing the debt totaled $5,205,803,000 at September 30, 2015.

Senior Unsecured Notes and Se56

Senior Unsecured Notes and Secured Debt (Details 1)	9 Months Ended		12 Months Ended
	Sep. 30, 2015USD ($)	Sep. 30, 2014USD ($)	Dec. 31, 2014USD ($)	Dec. 31, 2013USD ($)
Unsecured note issuances
Senior unsecured debt issued	$ 743,407,000	$ 0
Senior unsecured debt redeemed	534,546,000	47,591,000
Excluding Fair Value Adjustments [Member]
Unsecured note issuances
Senior unsecured debt balance	7,974,540,000	7,342,328,000	$ 7,817,154,000	$ 7,421,707,000
Senior unsecured debt issued	750,000,000	0
Senior unsecured debt extinguished	(300,000,000)
Senior unsecured debt redeemed	(215,965,000)	(47,660,000)
Senior unsecured debt foreign currency	$ (76,649,000)	$ (31,719,000)
Senior unsecured debt balance average rate	0.0421	0.04388	0.04385	0.044
Senior unsecured debt issued average rate	0.04	0
Senior unsecured debt extinguished average rate	0.062	0
Senior unsecured debt redeemed average rate	0.03	0.03
Senior unsecured debt foreign currency average rate	0.08065	0.03892

Senior Unsecured Notes and Se57

Senior Unsecured Notes and Secured Debt (Details 2)	3 Months Ended		9 Months Ended
	Dec. 31, 2014USD ($)	Dec. 31, 2013USD ($)	Sep. 30, 2015USD ($)	Sep. 30, 2014USD ($)
Secured debt principal activity
Secured debt issued			$ 222,612,000	$ 98,100,000
Secured debt extinguished			469,455,000	286,162,000
Excluding Fair Value Adjustments [Member]
Secured debt principal activity
Secured debt principal balance	$ 2,941,765,000	$ 3,010,711,000	2,945,697,000	2,861,720,000
Secured debt issued			222,612,000	98,100,000
Secured debt assumed			339,929,000	62,505,000
Secured debt extinguished			(420,672,000)	(240,355,000)
Secured debt principal payments			(48,783,000)	(23,434,000)
Secured debt foreign currency			$ (89,154,000)	$ (45,807,000)
Secured debt principal balance average rate	0.0494	0.051	0.0472	0.0494
Secured debt principal issued average rate			0.0276	0.0323
Secured debt principal assumed average rate			0.0334	0.0311
Secured debt principal extinguished average rate			0.0427	0.0566
Secured debt principal payment average rate			0.0485	0.0378
Secured debt principal foreign currency average rate			0.0388	0.0497

Derivative Instrument (Notional

Derivative Instrument (Notional Table) (Details) - USD ($)		9 Months Ended	12 Months Ended
		Sep. 30, 2015	Dec. 31, 2014
Net Investment Hedging [Member] | CAD
Derivatives Fair Value [Line Items]
Notional Amount Of Nonderivative Instruments			$ 250,000,000
Net Investment Hedging [Member] | GBP
Derivatives Fair Value [Line Items]
Notional Amount Of Nonderivative Instruments			1,050,000,000
Designated as Hedging Instrument [Member] | Cash Flow Hedging [Member] | USD
Derivatives Fair Value [Line Items]
Derivative, Notional Amount		$ 57,000,000	57,000,000
Designated as Hedging Instrument [Member] | Cash Flow Hedging [Member] | CAD
Derivatives Fair Value [Line Items]
Derivative, Notional Amount		72,000,000	58,000,000
Designated as Hedging Instrument [Member] | Cash Flow Hedging [Member] | GBP
Derivatives Fair Value [Line Items]
Derivative, Notional Amount		57,000,000	40,000,000
Designated as Hedging Instrument [Member] | Net Investment Hedging [Member] | CAD
Derivatives Fair Value [Line Items]
Derivative, Notional Amount		1,175,000,000	900,000,000
Notional Amount Of Nonderivative Instruments		250,000,000
Designated as Hedging Instrument [Member] | Net Investment Hedging [Member] | GBP
Derivatives Fair Value [Line Items]
Derivative, Notional Amount		550,000,000	350,000,000
Notional Amount Of Nonderivative Instruments		1,050,000,000
Not Designated as Hedging Instrument [Member] | CAD
Derivatives Fair Value [Line Items]
Derivative, Notional Amount	[1]	$ 700,000,000	$ 12,000,000
[1]	(1) These non-designated instruments represent off-setting forward exchange contracts to manage against adverse movements in exchange rates with regards to the purchase price on pending foreign acquisitions.

Derivative Instruments (Details

Derivative Instruments (Details 1) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015		Sep. 30, 2014
Derivative [Line Items]
Derivative Gain Loss On Derivative Net	$ 0	$ (49,000)	$ 58,427,000	[1]	$ (400,000)
Interest Rate Swap [Member]
Derivative [Line Items]
Gain (loss) recognized in OCI	0	(4,000)	(1,000)		(11,000)
Gain (loss) on interest rate swaps recalssified from AOCI into income (effective portion)	(462,000)	(459,000)	(1,390,000)		(1,338,000)
Gain (loss) on forward exchange contracts recognized in income.	2,347,000	0	6,285,000		0
Foreign Exchange Contract [Member]
Derivative [Line Items]
Gain (loss) recognized in OCI	174,239,000	12,880,000	208,854,000		6,833,000
Derivative Gain Loss On Derivative Net	0	(49,000)	0		(400,000)
Gain on Release of cumulative translation adjustment related to net investment hedge of an equity investment	0	528,000	0		528,000
Foreign Exchange Option Member
Derivative [Line Items]
Derivative Gain Loss On Derivative Net	$ 0	$ 0	$ (58,427,000)		$ 0
[1]	(1) In April 2011, we completed the acquisition of substantially all of the real estate assets of privately-owned Genesis Healthcare Corporation. In conjunction with this transaction, we received the option to acquire an ownership interest in Genesis Healthcare. In February 2015, Genesis Healthcare closed on a transaction to merge with Skilled Healthcare Group to become a publicly traded company which required us to record the value of the derivative asset due to the net settlement feature.

Derivative Instruments (Textual

Derivative Instruments (Textual) (Details)	9 Months Ended
	Sep. 30, 2015USD ($)
Derivative Instruments [Abstract]
Cash Flow Hedge Gain Loss To Be Reclassified Within Twelve Months 2	$ 2,775,000
Derivative Cash Received On Hedge	$ 103,615,000

Commitments and Contingencies (

Commitments and Contingencies (Details Textual)	9 Months Ended
	Sep. 30, 2015USD ($)Number	Dec. 31, 2014USD ($)
Commitments and Contingencies (Textual) [Abstract]
Number of outstanding letters of credit | Number	8
Letter of credit obligation	$ 73,655,000
Line Of Credit Facility [Line Items]
Outstanding construction financings for leased properties	197,639,000	$ 186,327,000
Additional financing to complete construction	408,372,000
Total contingent purchase obligations	$ 29,427,000
Minimum part of economic life of the leased asset to be classified as capital lease	75.00%
Minimum net present value of the future minimum lease payments to be classified as capital lease.	90.00%
Operating lease obligations relating to certain ground leases	$ 988,564,000
Operating Leases, Future Minimum Payments Due, Future Minimum Sublease Rentals	27,126,000
Capital Leases, Future Minimum Payments Due	99,751,000
Purchase Obligation for Acquisitions Expected to be Completed before YE	$ 236,068,000
Letter Of Credit Expiration Date Maximum	Dec. 31, 2018
Letter Of Credit Expiration Date Minimum	Jan. 1, 2015

Stockholder's Equity (Details)

Stockholder's Equity (Details) - shares	Sep. 30, 2015	Dec. 31, 2014	Sep. 30, 2014	Dec. 31, 2013
Preferred Stock:
Authorized shares	50,000,000	50,000,000
Issued shares	25,875,000	25,875,000
Outstanding shares	25,875,000	25,875,000	25,875,000	26,108,236
Common Stock, $1.00 par value:
Authorized shares	700,000,000	700,000,000
Issued shares	353,814,909	329,487,615
Outstanding shares	352,998,274	328,790,066

Stockholder's Equity (Details 1

Stockholder's Equity (Details 1)	9 Months Ended
	Sep. 30, 2015USD ($)$ / sharesshares	Sep. 30, 2014USD ($)$ / sharesshares
Summary of common stock issuances
Dividend reinvestment plan issuances, Shares Issued | shares	2,935,950	3,114,052
Dividend reinvestment plan issuances, Average Price	70.28	60.05
Dividend reinvestment plan issuances, Net Proceeds	$ 206,334,000	$ 186,996,000
Dividend reinvestment plan issuances, Gross Proceeds	$ 206,334,000	$ 186,996,000
Option exercises, Shares | shares	247,005	207,046
Option exercises, Average Price	47.42	45.94
Option exercises, Gross Proceeds	$ 11,712,000	$ 9,512,000
Option exercises, Net Proceeds	$ 11,712,000	$ 9,512,000
Stock incentive plans, net of forfeitures, Shares Issued | shares	144,779	186,837
Issuance of Common Stock, Shares | shares	24,208,208	37,866,114
Senior note conversions | shares	1,330,474	199,943
Equity issued in acquisition of noncontrolling interest | shares		233,236
Gross Proceeds From Issuance of Common Stock	$ 1,694,071,000	$ 2,336,687,000
Net proceeds from the issuance of common stock	$ 1,641,981,000	$ 2,260,908,000
June 2014 Public Issuance [Member]
Summary of common stock issuances
Public issuance, Shares Issued | shares		16,100,000
Public issuance, Average Price | $ / shares		62.35
Public issuance, Gross Proceeds		$ 1,003,835,000
Public issuance, Net Proceeds		$ 968,517,000
September 2014 Public Issuance [Member]
Summary of common stock issuances
Public issuance, Shares Issued | shares		17,825,000
Public issuance, Average Price | $ / shares		63.75
Public issuance, Gross Proceeds		$ 1,136,344,000
Public issuance, Net Proceeds		$ 1,095,883,000
February 2015 Public Issuance [Member]
Summary of common stock issuances
Public issuance, Shares Issued | shares	19,550,000
Public issuance, Average Price | $ / shares	75.5
Public issuance, Gross Proceeds	$ 1,476,025,000
Public issuance, Net Proceeds	$ 1,423,935,000

Stockholder's Equity (Details 2

Stockholder's Equity (Details 2) - USD ($)		Sep. 30, 2015	Dec. 31, 2014	Sep. 30, 2014	Dec. 31, 2013
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges		$ (1,885,000)	$ (650,000)	$ (3,732,000)	$ (5,059,000)
Unrecognized losses on equity investments		(18,186,000)	0	0	(389,000)
Unrecognized gains (losses) on foreign currency translation		(72,699,000)	(74,770,000)	(47,520,000)	(17,631,000)
Unrecognized actuarial losses		(1,589,000)	(1,589,000)	(1,452,000)	(1,452,000)
Totals		(94,359,000)	$ (77,009,000)	(52,704,000)	$ (24,531,000)
Other comprehensive income before reclassification adjustments
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges		(2,625,000)		(11,000)
Unrecognized losses on equity investments		(18,186,000)		389,000
Unrecognized gains (losses) on foreign currency translation		2,071,000		(29,361,000)
Unrecognized actuarial losses		0		0
Totals		(18,740,000)		(28,983,000)
Reclassification amount to net income
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges	[1]	1,390,000		1,338,000
Unrecognized losses on equity investments		0		0
Unrecognized gains (losses) on foreign currency translation		0		(528,000)
Unrecognized actuarial losses		0		0
Totals		1,390,000		810,000
Net current period other comprehensive income
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges		(1,235,000)		1,327,000
Unrecognized losses on equity investments		(18,186,000)		389,000
Unrecognized gains (losses) on foreign currency translation		2,071,000		(29,889,000)
Unrecognized actuarial losses		0		0
Totals		$ (17,350,000)		$ (28,173,000)
[1]	(1) Please see note 11 for additional information.

Stockholder's Equity (Details 4

Stockholder's Equity (Details 4) - shares	9 Months Ended		12 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Dec. 31, 2014	Dec. 31, 2013
Stockholders' Equity [Line Items]
Preferred stock conversions	0	(233,236)
Preferred Stock, Shares Outstanding	25,875,000	25,875,000	25,875,000	26,108,236
Preferred stock balance weighted average rate	6.50%	6.50%	6.50%	6.496%
Preferred stock converted weighted average rate	0.00%	6.00%

Stockholder's Equity (Details 5

Stockholder's Equity (Details 5) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Summary of dividend payments
Dividends declared and paid per common share	$ 0.825	$ 0.795	$ 2.475	$ 2.385
Common stock cash dividends			$ 852,563,000	$ 708,923,000
Total dividends paid			$ 901,618,000	$ 757,980,000
Series H Preferred Stock [Member]
Summary of dividend payments
Dividends declared and paid per preferred share				$ 0.0079
Preferred stock cash dividends				$ 1,000
Series I Preferred Stock [Member]
Summary of dividend payments
Dividends declared and paid per preferred share			$ 2.4375	$ 2.4375
Preferred stock cash dividends			$ 35,039,000	$ 35,040,000
Series J Preferred Stock [Member]
Summary of dividend payments
Dividends declared and paid per preferred share			$ 1.2189	$ 1.2189
Preferred stock cash dividends			$ 14,016,000	$ 14,016,000

Stock Incentive Plans (Details

Stock Incentive Plans (Details Textual) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Stock Incentive Plans [Line Items]
Number of common stock authorized for Long-Term Incentive Plan	6,200,000		6,200,000
Stock-based compensation expense	$ 5,477,000	$ 4,271,000	$ 25,655,000	$ 26,108,000
Maximum [Member]
Stock Incentive Plans [Line Items]
Vesting period			5 years
Minimum [Member]
Stock Incentive Plans [Line Items]
Vesting period			3 years
Employee Stock Option [Member] | Employee Stock Option [Member]
Stock Incentive Plans [Line Items]
Vesting period			10 years
Employee Stock Option [Member] | Employee Stock Option [Member] | Director [Member]
Stock Incentive Plans [Line Items]
Vesting period			3 years
Employee Stock Option [Member] | Employee Stock Option [Member] | Officer [Member]
Stock Incentive Plans [Line Items]
Vesting period			5 years

Earnings Per Share (Details)

Earnings Per Share (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Computation of basic and diluted earnings per share
Numerator for basic and diluted earnings per share - net income (loss) attributable to common stockholders	$ 182,043,000	$ 136,255,000	$ 685,413,000	$ 258,107,000
Denominator for basic earnings per share - weighted average shares	351,765,000	311,117,000	346,425,000	299,137,000
Effect of dilutive securities:
Employee stock options	114,000	202,000	155,000	181,000
Non-vested restricted shares	607,000	505,000	498,000	506,000
Redeemable shares	621,000	0	207,000	0
Convertible senior unsecured notes	0	988,000	262,000	821,000
Dilutive potential common shares	1,342,000	1,695,000	1,122,000	1,508,000
Denominator for diluted earnings per share - adjusted weighted average shares	353,107,000	312,812,000	347,547,000	300,645,000
Basic earnings per share	$ 0.52	$ 0.44	$ 1.98	$ 0.86
Diluted earnings per share	$ 0.52	$ 0.44	$ 1.97	$ 0.86

Disclosure about Fair Value o69

Disclosure about Fair Value of Financial Instruments (Details) - USD ($)	Sep. 30, 2015		Dec. 31, 2014	Sep. 30, 2014	Dec. 31, 2013
Financial Assets:
Loans receivable, Carrying Amount	$ 752,912,000		$ 380,169,000
Available-for-sale equity investments, Carrying Amount	40,241,000		0
Available-for-sale equity investments, Fair Value	40,241,000	[1]	0
Cash and cash equivalents, Carrying Amount	292,042,000		473,726,000	$ 998,678,000	$ 158,780,000
Cash and cash equivalents, Fair Value	292,042,000		473,726,000
Foreign currency forward contract, asset	105,856,000		57,087,000
Financial Liabilities:
Borrowings under primary unsecured credit facilities, Carrying Value	490,000,000	[2]	0	$ 0
Borrowings under primary unsecured credit facilities, Fair Value	490,000,000		0
Senior unsecured notes, Carrying Amount	7,926,757,000		7,766,251,000
Senior unsecured notes, Fair Value	8,489,584,000		8,613,702,000
Secured debt, Carrying Amount	2,975,639,000		2,977,713,000
Secured debt, Fair Value	3,024,245,000		3,053,067,000
Foreign currency forward contact, liability	21,909,000		1,495,000
Redeemable OP unitholder interests	111,380,000		46,722,000
Mortgage Loans on Real Estate [Member]
Financial Assets:
Loans receivable, Carrying Amount	570,997,000		188,651,000
Loans receivable, Fair value	606,910,000		194,935,000
Other Real Estate Loans Receivable [Member]
Financial Assets:
Loans receivable, Carrying Amount	181,915,000		191,518,000
Loans receivable, Fair value	$ 181,585,000		$ 195,375,000
[1]	(1) Unrealized gains or losses on equity investments are recorded in accumulated other comprehensive income (loss) at each measurement date.
[2]	(1) As of September 30, 2015, letters of credit in the aggregate amount of $58,484,000 have been issued, which reduces the borrowing capacity on the primary unsecured revolving credit facility.

Disclosure about Fair Value o70

Disclosure about Fair Value of Financial Instruments (Details 1) - USD ($)		Sep. 30, 2015		Dec. 31, 2014
The Market approach utilized to measure fair value of financial assets and liabilities on recurring basis
Available-for-sale equity investments		$ 40,241,000	[1]	$ 0
Foreign currency forward contracts	[2]	83,947,000
Redeemable OP unitholder interests		111,380,000		$ 46,722,000
Totals		235,568,000
Level 1 [Member]
The Market approach utilized to measure fair value of financial assets and liabilities on recurring basis
Available-for-sale equity investments	[1]	40,241,000
Totals		40,241,000
Level 2 [Member]
The Market approach utilized to measure fair value of financial assets and liabilities on recurring basis
Foreign currency forward contracts	[2]	83,947,000
Redeemable OP unitholder interests		111,380,000
Totals		$ 195,327,000
[1]	(1) Unrealized gains or losses on equity investments are recorded in accumulated other comprehensive income (loss) at each measurement date.
[2]	(2) Please see Note 11 for additional information.

Segment Reporting (Details)

Segment Reporting (Details)	3 Months Ended			9 Months Ended
	Sep. 30, 2015USD ($)		Sep. 30, 2014USD ($)	Sep. 30, 2015USD ($)		Sep. 30, 2014USD ($)	Dec. 31, 2014USD ($)
Summary of information for reportable segments
Rental income	$ 409,290,000		$ 354,148,000	$ 1,185,502,000		$ 1,038,451,000
Resident fees and services	545,255,000		482,412,000	1,573,318,000		1,406,316,000
Interest income	22,380,000		9,344,000	59,950,000		26,871,000
Other income	2,072,000		1,619,000	11,572,000		4,139,000
Total revenues	978,997,000		847,523,000	2,830,342,000		2,475,777,000
Property operating expenses	408,703,000		355,157,000	1,183,519,000		1,040,342,000
Net Operating Income from Continuing Operations	570,294,000	[1]	492,366,000	1,646,823,000		1,435,435,000
Interest expense	121,130,000		118,435,000	361,071,000		360,334,000
Loss (gain) on derivatives, net	0		49,000	(58,427,000)	[2]	400,000
Depreciation and amortization	205,799,000		200,970,000	603,431,000		648,737,000
General and administrative	36,950,000		30,803,000	110,562,000		115,327,000
Transaction costs	9,333,000		13,554,000	70,379,000		21,546,000
Loss (gain) on extinguishment of debt, net	584,000		2,692,000	34,872,000		3,075,000
Impairment of Asset	0		0	2,220,000		0
Other expenses	0		10,262,000	10,583,000		10,262,000
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	196,498,000		115,601,000	512,132,000		275,754,000
Income tax (expense) benefit	3,344,000		10,198,000	(3,769,000)		6,369,000
(Loss) income from unconsolidated entities	(2,631,000)		(2,632,000)	(18,231,000)		(19,705,000)
Income (loss) from continuing operations	197,211,000		123,167,000	490,132,000		262,418,000
Discontinued operations, net	0		0	0		7,135,000
Gain (loss) on real estate dispositions, net	2,046,000		29,604,000	249,002,000		36,272,000
Net income	199,257,000		$ 152,771,000	739,134,000		$ 305,825,000
Total assets	$ 27,456,366,000			$ 27,456,366,000			$ 25,014,296,000
Percent Of Assets	1			1
Percent Of Revenues	1		1	1		1
Triple Net [Member]
Summary of information for reportable segments
Rental income	$ 285,027,000		$ 250,748,000	$ 829,422,000		$ 736,599,000
Resident fees and services	0		0	0		0
Interest income	19,454,000		7,520,000	52,343,000		23,220,000
Other income	969,000		981,000	5,823,000		1,448,000
Total revenues	305,450,000		259,249,000	887,588,000		761,267,000
Property operating expenses	0		41,000	0		732,000
Net Operating Income from Continuing Operations	305,450,000		259,208,000	887,588,000		760,535,000
Interest expense	12,359,000		10,294,000	25,064,000		28,063,000
Loss (gain) on derivatives, net	0		52,000	(58,427,000)		125,000
Depreciation and amortization	74,486,000		68,027,000	216,921,000		202,668,000
General and administrative	0		0	0		0
Transaction costs	1,865,000		1,619,000	45,615,000		5,900,000
Loss (gain) on extinguishment of debt, net	(139,000)		(36,000)	10,096,000		(36,000)
Impairment of Asset	0			2,220,000
Other expenses	0		8,825,000	0		8,825,000
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	216,879,000		170,427,000	646,099,000		514,990,000
Income tax (expense) benefit	87,000		5,986,000	(2,617,000)		5,194,000
(Loss) income from unconsolidated entities	2,851,000		1,353,000	5,697,000		4,157,000
Income (loss) from continuing operations	219,817,000		177,766,000	649,179,000		524,341,000
Discontinued operations, net			0			7,135,000
Gain (loss) on real estate dispositions, net	2,155,000		29,604,000	56,251,000		35,366,000
Net income	221,972,000		207,370,000	705,430,000		566,842,000
Total assets	12,346,157,000			12,346,157,000
Senior housing - operating [Member]
Summary of information for reportable segments
Rental income	0		0	0		0
Resident fees and services	545,255,000		482,412,000	1,573,318,000		1,406,316,000
Interest income	1,054,000		1,054,000	3,126,000		1,065,000
Other income	772,000		325,000	5,001,000		1,643,000
Total revenues	547,081,000		483,791,000	1,581,445,000		1,409,024,000
Property operating expenses	368,050,000		320,895,000	1,067,127,000		939,108,000
Net Operating Income from Continuing Operations	179,031,000		162,896,000	514,318,000		469,916,000
Interest expense	30,990,000		26,612,000	104,245,000		82,924,000
Loss (gain) on derivatives, net	0		(3,000)	0		275,000
Depreciation and amortization	87,306,000		95,819,000	252,785,000		334,625,000
General and administrative	0		0	0		0
Transaction costs	7,630,000		10,572,000	23,610,000		12,863,000
Loss (gain) on extinguishment of debt, net	0		0	0		383,000
Impairment of Asset	0			0
Other expenses	0		1,437,000	0		1,437,000
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	53,105,000		28,459,000	133,678,000		37,409,000
Income tax (expense) benefit	3,237,000		3,746,000	(745,000)		1,302,000
(Loss) income from unconsolidated entities	(5,629,000)		(5,550,000)	(26,785,000)		(29,007,000)
Income (loss) from continuing operations	50,713,000		26,655,000	106,148,000		9,704,000
Discontinued operations, net			0			0
Gain (loss) on real estate dispositions, net	0		0	0		0
Net income	50,713,000		26,655,000	106,148,000		9,704,000
Total assets	10,325,540,000			10,325,540,000
Outpatient Medical [Member]
Summary of information for reportable segments
Rental income	124,263,000		103,400,000	356,080,000		301,852,000
Resident fees and services	0		0	0		0
Interest income	1,872,000		770,000	4,481,000		2,586,000
Other income	309,000		207,000	665,000		850,000
Total revenues	126,444,000		104,377,000	361,226,000		305,288,000
Property operating expenses	40,653,000		34,221,000	116,392,000		100,502,000
Net Operating Income from Continuing Operations	85,791,000		70,156,000	244,834,000		204,786,000
Interest expense	7,120,000		7,692,000	21,929,000		25,423,000
Loss (gain) on derivatives, net	0		0	0		0
Depreciation and amortization	44,007,000		37,124,000	133,725,000		111,444,000
General and administrative	0		0	0		0
Transaction costs	(162,000)		1,363,000	1,154,000		2,783,000
Loss (gain) on extinguishment of debt, net	0		0	0		0
Impairment of Asset	0			0
Other expenses	0			0
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	34,826,000		23,977,000	88,026,000		65,136,000
Income tax (expense) benefit	154,000		466,000	460,000		(127,000)
(Loss) income from unconsolidated entities	147,000		1,565,000	2,857,000		5,145,000
Income (loss) from continuing operations	35,127,000		26,008,000	91,343,000		70,154,000
Discontinued operations, net			0			0
Gain (loss) on real estate dispositions, net	(109,000)		0	192,751,000		906,000
Net income	35,018,000		26,008,000	284,094,000		71,060,000
Total assets	4,699,643,000			4,699,643,000
Non Segment Corporate [Member]
Summary of information for reportable segments
Rental income	0		0	0		0
Resident fees and services	0		0	0		0
Interest income	0		0	0		0
Other income	22,000		106,000	83,000		198,000
Total revenues	22,000		106,000	83,000		198,000
Property operating expenses	0		0	0		0
Net Operating Income from Continuing Operations	22,000		106,000	83,000		198,000
Interest expense	70,661,000		73,837,000	209,833,000		223,924,000
Loss (gain) on derivatives, net	0		0	0		0
Depreciation and amortization	0		0	0		0
General and administrative	36,950,000		30,803,000	110,562,000		115,327,000
Transaction costs	0		0	0		0
Loss (gain) on extinguishment of debt, net	723,000		2,728,000	24,776,000		2,728,000
Impairment of Asset	0			0
Other expenses	0	[3]		10,583,000
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	(108,312,000)		(107,262,000)	(355,671,000)		(341,781,000)
Income tax (expense) benefit	(134,000)		0	(867,000)		0
(Loss) income from unconsolidated entities	0		0	0		0
Income (loss) from continuing operations	(108,446,000)		(107,262,000)	(356,538,000)		(341,781,000)
Discontinued operations, net			0			0
Gain (loss) on real estate dispositions, net	0		0	0		0
Net income	(108,446,000)		(107,262,000)	(356,538,000)		(341,781,000)
Total assets	85,026,000			85,026,000
International [Member]
Summary of information for reportable segments
Total revenues	185,568,000		$ 139,681,000	520,746,000		$ 396,914,000
Total assets	$ 4,948,132,000			$ 4,948,132,000			$ 4,285,819,000
Percent Of Assets	0.18			0.18			0.171
Percent Of Revenues	0.19		0.165	0.184		0.16
United States [Member]
Summary of information for reportable segments
Total revenues	$ 793,429,000		$ 707,842,000	$ 2,309,596,000		$ 2,078,863,000
Total assets	$ 22,508,234,000			$ 22,508,234,000			$ 20,728,477,000
Percent Of Assets	0.82			0.82			0.829
Percent Of Revenues	0.81		0.835	0.816		0.84
[1]	(1)     Genesis Healthcare is in our triple-net segment. Sunrise Senior Living and Revera are in our seniors housing operating segment. Brookdale Senior Living and Benchmark Senior Living are in both our triple-net and seniors housing operating segments.
[2]	(1) In April 2011, we completed the acquisition of substantially all of the real estate assets of privately-owned Genesis Healthcare Corporation. In conjunction with this transaction, we received the option to acquire an ownership interest in Genesis Healthcare. In February 2015, Genesis Healthcare closed on a transaction to merge with Skilled Healthcare Group to become a publicly traded company which required us to record the value of the derivative asset due to the net settlement feature.
[3]

Income Taxes and Distributions

Income Taxes and Distributions (Details)	9 Months Ended
	Sep. 30, 2015
Additional Income Taxes and Distributions (Textuals) [Abstract]
Percentage of Taxable income to be distributed to stockholders for federal tax purposes	90.00%
Percentage of capital gains excluded from taxable income distributed to shareholders	100.00%
Percentage of federal excise tax on real estate investment trusts that do not distribute income.	4.00%