Welltower (WELL) 10-Q 5 May 16 2016 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - USD ($)	3 Months Ended
	Mar. 31, 2016	Apr. 30, 2016	Jun. 30, 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	Mar. 31, 2016
Amendment Flag	false
Document Fiscal Year Focus	2,016
Document Fiscal Period Focus	Q1
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		356,995,083

Consolidated Balance Sheets (Un

Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Mar. 31, 2016		Dec. 31, 2015
Real property owned:
Land and land improvements	$ 2,596,670		$ 2,563,445
Buildings and improvements	25,712,496		25,522,542
Acquired lease intangibles	1,346,064		1,350,585
Real property held for sale, net of accumulated depreciation	293,806		169,950
Construction in progress	297,023		258,968
Gross real property owned	30,246,059		29,865,490
Less accumulated depreciation and amortization	(4,032,726)		(3,796,297)
Net real property owned	26,213,333		26,069,193
Real estate loans receivable:
Net real estate loans receivable	725,291		819,492
Net real estate investments	26,938,624		26,888,685
Other assets:
Investments in unconsolidated entities	545,070		542,281
Goodwill	68,321		68,321
Cash and cash equivalents	355,949		360,908
Restricted cash	62,176		61,782
Straight-line rent receivable	425,231		395,562
Receivables and other assets	692,922		706,306
Total other assets	2,149,669		2,135,160
Total assets	29,088,293		29,023,845
Liabilities:
Borrowings under primary unsecured credit facilities, Carrying Value	645,000	[1]	835,000
Senior unsecured notes	8,828,053		8,548,055
Secured debt	3,515,053		3,509,142
Capital lease obligations	75,092		75,489
Accrued expenses and other liabilities	665,645		697,191
Total liabilities	13,728,843		13,664,877
Redeemable noncontrolling interests	359,656		183,083
Equity:
Preferred stock	1,006,250		1,006,250
Common stock	356,953		354,811
Capital in excess of par value	16,589,738		16,478,300
Treasury stock	(51,271)		(44,372)
Cumulative net income	3,891,093		3,725,772
Cumulative dividends	(7,168,178)		(6,846,056)
Accumulated other comprehensive income (loss)	(109,053)		(88,243)
Other equity	4,062		4,098
Total Welltower Inc. stockholders' equity	14,519,594		14,590,560
Noncontrolling interests	480,200		585,325
Total equity	14,999,794		15,175,885
Total liabilities and equity	$ 29,088,293		$ 29,023,845
[1]	(1) As of March 31, 2016, letters of credit in the aggregate amount of $48,930,000 have been issued, which reduces the borrowing capacity on the unsecured revolving credit facility.

Consolidated Statements of Inco

Consolidated Statements of Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands		3 Months Ended
		Mar. 31, 2016	Mar. 31, 2015
Revenues:
Rental income		$ 415,663	$ 379,587
Resident fees and services		602,149	492,510
Interest income		25,188	16,994
Other income		4,050	5,086
Total revenues		1,047,050	894,177
Expenses:
Interest expense		132,960	121,080
Property operating expenses		449,636	376,461
Depreciation and amortization		228,696	188,829
General and administrative		45,691	35,138
Transaction costs		8,208	48,554
Loss (gain) on derivatives, net		0	(58,427)	[1]
Loss (gain) on extinguishment of debt, net		(24)	15,401
Impairment of Asset		14,314	2,220
Total expenses		879,481	729,256
Income (loss) from continuing operations before income taxes and income from unconsolidated entities, total		167,569	164,921
Income tax (expense) benefit		1,725	304
(Loss) income from unconsolidated entities		(3,820)	(12,648)
Income from continuing operations		165,474	152,577
Discontinued operations:
Gain (loss) on real estate dispositions, net		0	56,845
Net income		165,474	209,422
Less: Preferred stock dividends		16,352	16,352
Less: Net income (loss) attributable to noncontrolling interests	[2]	153	2,271
Net income (loss) attributable to common stockholders		$ 148,969	$ 190,799
Average number of common shares outstanding:
Basic		355,076	336,754
Diluted		356,051	337,812
Basic:
Income (loss) from continuing operations attributable to common stockholders, including real estate dispositions		$ 0.42	$ 0.57
Net income (loss) attributable to common stockholders, total		0.42	0.57
Diluted:
Income (loss) from continuing operations attributable to common stockholders, including real estate dispositions		0.42	0.56
Net income (loss) attributable to common stockholders, total		0.42	0.56
Dividends declared and paid per common share		$ 0.86	$ 0.825
[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 ($) $ in Thousands		3 Months Ended
		Mar. 31, 2016	Mar. 31, 2015
Statement of Comprehensive Income [Abstract]
Net income		$ 165,474	$ 209,422
Other comprehensive income (loss):
Unrecognized gain (loss) on equity investments		(7,549)	(11,687)
Unrecognized gain (loss) on cash flow hedges		483	(2,159)
Unrecognized actuarial gain/(loss)		2	0
Unrecognized gain (loss) on foreign currency translation		1,372	(29,197)
Total other comprehensive income (loss)		(5,692)	(43,043)
Total comprehensive income (loss), total		159,782	166,379
Total comprehensive income (loss) attributable to noncontrolling interests	[1]	15,271	(10,285)
Comprehensive income (loss) attributable to controlling interests		$ 144,511	$ 176,664
[1]	(1) Includes amounts attributable to redeemable noncontrolling interests.

Consolidated Statements of Equi

Consolidated Statements of Equity (Unaudited) - USD ($) $ in Thousands	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, 2014	$ 13,473,049	$ 1,006,250	$ 328,835	$ 14,740,712	$ (35,241)	$ 2,842,022	$ (5,635,923)	$ (77,009)	$ 5,507	$ 297,896
Comprehensive income:
Net income (loss)	209,076					207,151				1,925
Other comprehensive income	(43,043)							(30,487)		(12,556)
Total comprehensive income	166,033
Net change in noncontrolling interests	70,757			(4,540)						75,297
Amounts related to stock incentive plans, net of forfeitures	350		85	7,672	(6,132)				(1,275)
Proceeds from issuance of common stock	1,490,821		20,466	1,470,355
Equity component of convertible debt	5,643		1,048	4,595
Option compensation expense	217								217
Cash dividends paid:
Common stock	(272,569)						(272,569)
Preferred Stock	(16,352)						(16,352)
Balances at end of period at Mar. 31, 2015	14,917,949	1,006,250	350,434	16,218,794	(41,373)	3,049,173	(5,924,844)	(107,496)	4,449	362,562
Balances at beginning of period at Dec. 31, 2015	15,175,885	1,006,250	354,811	16,478,300	(44,372)	3,725,772	(6,846,056)	(88,243)	4,098	585,325
Comprehensive income:
Net income (loss)	166,403					165,321				1,082
Other comprehensive income	(5,692)							(20,810)		15,118
Total comprehensive income	160,711
Distributions to noncontrolling interests	(127,042)			(5,717)						(121,325)
Amounts related to stock incentive plans, net of forfeitures	19,178		637	25,555	(6,899)				(115)
Proceeds from issuance of common stock	93,105		1,505	91,600
Option compensation expense	79								79
Cash dividends paid:
Common stock	(305,770)						(305,770)
Preferred Stock	(16,352)						(16,352)
Balances at end of period at Mar. 31, 2016	$ 14,999,794	$ 1,006,250	$ 356,953	$ 16,589,738	$ (51,271)	$ 3,891,093	$ (7,168,178)	$ (109,053)	$ 4,062	$ 480,200

Consolidated Statements of Cash

Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2016	Mar. 31, 2015
Operating activities
Net income (loss)		$ 165,474	$ 209,422
Adjustments to reconcile net income to net cash provided from (used in) operating activities:
Depreciation and amortization		228,696	188,829
Other amortization expenses		1,118	1,320
Asset Impairment Charges		14,314	2,220
Stock-based compensation expense		8,186	9,054
Loss (gain) on derivatives, net		0	(58,427)	[1]
Loss (gain) on extinguishment of debt, net		(24)	15,401
Income from unconsolidated entities		3,820	12,648
Rental income in excess of cash received		(29,669)	(27,244)
Amortization related to above (below) market leases, net		230	113
Net loss (gain) on sales of properties		0	(56,845)
Distributions by unconsolidated entities		174	172
Increase (decrease) in accrued expenses and other liabilities		(20,423)	(47,489)
Decrease (increase) in receivables and other assets		1,816	(22,992)
Net cash provided from (used in) operating activities		373,712	226,182
Investing activities
Cash disbursed for acquisitions		(171,482)	(1,500,994)
Cash disbursed for capital improvements to existing properties		(35,025)	(29,828)
Cash disbursed for construction in progress		(66,739)	(59,552)
Capitalized interest		(3,037)	(2,387)
Investment in real estate loans receivable		(27,251)	(384,695)
Other investments, net of payments		(30,773)	(102,126)
Principal collected on real estate loans receivable		93,774	16,501
Contributions to unconsolidated entities		(12,784)	(83,964)
Distributions by unconsolidated entities		11,747	89,195
Proceeds from (payments on) derivatives investing		0	72,477
Decrease (increase) in restricted cash		(394)	(1,660)
Proceeds from sales of real property		0	177,265
Net cash provided from (used in) investing activities		(241,964)	(1,809,768)
Financing activities
Net increase (decrease) under unsecured lines of credit arrangements		(190,000)	410,000
Proceeds from issuance of senior unsecured notes		688,560	0
Payments to extinguish senior unsecured notes		(400,000)	(154,654)
Secured debt issued		75,136	82,724
Payments on secured debt		(130,343)	(208,057)
Net proceeds from the issuance of common stock		93,433	1,489,547
Decrease (increase) in deferred loan expenses		(1,217)	(4,485)
Contributions by noncontrolling interests	[2]	126,142	2,514
Distributions to noncontrolling interests	[2]	(76,222)	(7,417)
Cash distributions to stockholders		(322,122)	(288,921)
Other financing activities		(397)	(8,428)
Net cash provided from (used in) financing activities		(137,030)	1,312,823
Effect of foreign currency translation on cash and cash equivalents		323	(690)
Increase (decrease) in cash and cash equivalents		(4,959)	(271,453)
Cash and cash equivalents at beginning of period		360,908	473,726
Cash and cash equivalents at end of period		355,949	202,273
Supplemental cash flow information:
Interest paid		134,872	134,737
Income taxes paid		$ 2,431	$ 2,942
[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	3 Months Ended
	Mar. 31, 2016
Business [Abstract]
Business	1. Business Welltower 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 1,490 properties in major, 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	3 Months Ended
	Mar. 31, 2016
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. During the three months ended March 31, 2016, we determined that an immaterial portion of our noncontrolling interests re lated to a 2015 transaction was misclassified in permanent equity rather than temporary equity based on a redemption feature of the partnership agreement and we have corrected the $114,714,000 misclassification by recording the change in the consolidated s tatement of equity for the three months ended March 31, 2016. Operating results for the three months ended March 31, 2016 are not necessarily an indication of the results that may be expected for t he year ending December 31, 2016 . 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, 2015 . New Accounting Standards In May 2014, the Financial Accounting Standards Board (“FASB”) issued ASU No. 2014-09, “Revenue from Contracts with Customers (Topic 606)”. The standard is a comprehensive new revenue recognition model that requires revenue to be recognized in a manne r to depict 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, beg inning after 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 adopt the standard. In February 2015, the FASB issued ASU No. 2015-02, “Consolidation (Topic 810): Amendments to the Consoli dation Analysis” , which makes certain changes to both the variable interest model and the voting model, including chang es 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. We adopted ASU 2015-02 on January 1, 2016. This guidance did not have a significant impact on our consolidated financial statements. In September 2015, the FASB issued ASU No. 2015-16, “Simplifying the Accounting for Measurement-Period Adjustments” to simplify the accounting for business combinations, specifically as it relates to measurement-period adjustments. Acquiring entities in a business combination must recognize measurement-period adjustments in the reporting period in which the adjustment amounts are determined. Also, ASU 2015-16 requires entities to present separately on the face of the income statement (or disclose in the notes to the financial statements) the portion of the amount recorded in the current period earnings, by line item, that would ha ve been recorded in previous reporting periods if the adjustment to the provisional amounts had been recognized as of the acquisition date. We adopted ASU 2015-16 on January 1, 2016. This guidance did not have a significant impact on our consolidated fina ncial statements. In February 2016, the FASB issued ASU No. 2016-02, “Leases (Topic 8 4 2) ,” which requires lessees to recognize assets and liabilities on their balance sheet related to the rights and obligations created by most leases, while continuing to recognize expenses on their income statements over the lease term. It will also require disclosures designed to give financial statement users information regarding the amount, timing, and uncertainty of cash flows arising from leases. ASU 2016-02 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2018, and early adoption is permitted. Entities are required to use a modified retrospective approach for leases that exist or are entered into after the beg inning of the earliest comparative period in the financial statements. We are currently evaluating the impact that the standard will have on our consolidated financial statements.

Real Property Acquisitions and

Real Property Acquisitions and Development	3 Months Ended
	Mar. 31, 2016
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, 2015 for information regarding our foreign currency policies. Triple-n et Activity Three Months Ended (In thousands) March 31, 2016 (1) March 31, 2015 Land and land improvements $ 15,331 $ 22,983 Buildings and improvements 114,235 239,728 Acquired lease intangibles 1,623 799 Receivables and other assets - 7 Total assets acquired 131,189 263,517 Accrued expenses and other liabilities (809) (732) Total liabilities assumed (809) (732) Non-cash acquisition related activity (28,621) (357) Cash disbursed for acquisitions 101,759 262,428 Construction in progress additions 43,835 45,360 Less: Capitalized interest (1,684) (1,756) Foreign currency translation (583) (642) Cash disbursed for construction in progress 41,568 42,962 Capital improvements to existing properties 7,438 11,557 Total cash invested in real property, net of cash acquired $ 150,765 $ 316,947 (1) Includes acquisitions with an aggregate purchase price of $115,875,000 for which the allocation of the purchase price consideration is preliminary and subject to change. Seniors Housing Operating Activity Three Months Ended (In thousands) March 31, 2016 (1) March 31, 2015 Land and land improvements $ 3,440 $ 86,184 Building and improvements 48,218 1,016,426 Acquired lease intangibles 1,942 62,838 Restricted cash - 3,820 Receivables and other assets 36 23,014 Total assets acquired (2) 53,636 1,192,282 Secured debt - (208,960) Accrued expenses and other liabilities (11) (16,164) Total liabilities assumed (11) (225,124) Noncontrolling interests (549) (83,194) Cash disbursed for acquisitions 53,076 883,964 Construction in progress additions 4,033 4,193 Less: Capitalized interest (565) (394) Foreign currency translation (1,107) (1,472) Cash disbursed for construction in progress 2,361 2,327 Capital improvements to existing properties 16,808 11,632 Total cash invested in real property, net of cash acquired $ 72,245 $ 897,923 (1) Includes acquisitions with an aggregate purchase price of $53,636,000 for which the allocation of the purchase price consideration is preliminary and subject to change. (2) Excludes $113,000 and $1,677,000 of cash acquired during the three months ended March 31, 2016 and 2015, respectively. Outpatient Medical Activity Three Months Ended (In thousands) March 31, 2016 (1) March 31, 2015 Land and land improvements $ - $ 47,019 Buildings and improvements 17,637 307,072 Acquired lease intangibles - 511 Total assets acquired 17,637 354,602 Accrued expenses and other liabilities (990) - Total liabilities assumed (990) - Cash disbursed for acquisitions 16,647 354,602 Construction in progress additions 28,934 16,421 Less: Capitalized interest (788) (237) Accruals (2) (5,336) (1,921) Cash disbursed for construction in progress 22,810 14,263 Capital improvements to existing properties 10,779 6,639 Total cash invested in real property $ 50,236 $ 375,504 (1) Includes acquisitions with an aggregate purchase price of $17,637,000 for which the allocation of the purchase price consideration is preliminary and subject to change. (2) 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) : Three Months Ended March 31, 2016 March 31, 2015 Development projects: Outpatient medical $ 35,363 $ 16,592 Total development projects 35,363 16,592 Expansion projects - 19,541 Total construction in progress conversions $ 35,363 $ 36,133

Real Estate Intangibles

Real Estate Intangibles	3 Months Ended
	Mar. 31, 2016
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): March 31, 2016 December 31, 2015 Assets: In place lease intangibles $ 1,196,335 $ 1,179,537 Above market tenant leases 62,544 67,529 Below market ground leases 62,643 80,224 Lease commissions 24,542 23,295 Gross historical cost 1,346,064 1,350,585 Accumulated amortization (923,712) (881,096) Net book value $ 422,352 $ 469,489 Weighted-average amortization period in years 14.6 13.4 Liabilities: Below market tenant leases $ 93,054 $ 93,089 Above market ground leases 7,908 7,907 Gross historical cost 100,962 100,996 Accumulated amortization (47,983) (46,048) Net book value $ 52,979 $ 54,948 Weighted-average amortization period in years 14.7 14.5 The following is a summary of real estate intangible amortization for the periods presented (in thousands): Three Months Ended March 31, 2016 2015 Rental income related to above/below market tenant leases, net $ 81 $ 206 Property operating expenses related to above/below market ground leases, net (311) (319) Depreciation and amortization related to in place lease intangibles and lease commissions (34,454) (24,324) The future estimated aggregate amortization of intangible assets and liabilities is as follows for the periods presented (in thousands): Assets Liabilities 2016 $ 84,239 $ 3,894 2017 79,195 6,807 2018 44,698 6,181 2019 25,238 5,771 2020 22,341 5,290 Thereafter 166,641 25,036 Total $ 422,352 $ 52,979

Dispositions, Assets Held for S

Dispositions, Assets Held for Sale and Discontinued Operations	3 Months Ended
	Mar. 31, 2016
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. During the three months ended March 31, 2016 and 2015, we recorded impairment charges on certain held-for-sale triple-net properties as the fair values less estimated costs to sell exceeded our carrying values . The following is a summary of our real property disposition activity for the periods presented (in thousands): Three Months Ended March 31, 2016 March 31, 2015 Real estate dispositions: Triple-net $ - $ 110,998 Outpatient medical - 9,422 Total dispositions - 120,420 Gain (loss) on real estate dispositions, net - 56,845 Proceeds from real estate dispositions $ - $ 177,265 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”, 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 foll owing represents the activity related to these properties for the periods presented (in thousands): Three Months Ended March 31, 2016 2015 Revenues: Rental income $ 5,477 $ 12,166 Expenses: Interest expense 851 2,262 Property operating expenses 1,362 1,527 Provision for depreciation 820 3,256 Total expenses 3,033 7,045 Income (loss) from real estate dispositions, net $ 2,444 $ 5,121

Real Estate Loans Receivable

Real Estate Loans Receivable	3 Months Ended
	Mar. 31, 2016
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): Three Months Ended March 31, 2016 March 31, 2015 Outpatient Outpatient Triple-net Medical Totals Triple-net Medical Totals Advances on real estate loans receivable: Investments in new loans $ 8,013 $ - $ 8,013 $ 368,080 $ - $ 368,080 Draws on existing loans 19,206 32 19,238 14,330 2,285 16,615 Net cash advances on real estate loans 27,219 32 27,251 382,410 2,285 384,695 Receipts on real estate loans receivable: Loan payoffs 104,068 12,290 116,358 8,568 - 8,568 Principal payments on loans 3,107 - 3,107 7,933 - 7,933 Sub-total 107,175 12,290 119,465 16,501 - 16,501 Less: Non-cash activity (25,691) - (25,691) - - - Net cash receipts on real estate loans 81,484 12,290 93,774 16,501 - 16,501 Net cash advances (receipts) on real estate loans (54,265) (12,258) (66,523) 365,909 2,285 368,194 Change in balance due to foreign currency translation (1,987) - (1,987) (3,096) - (3,096) Net change in real estate loans receivable $ (81,943) $ (12,258) $ (94,201) $ 362,813 $ 2,285 $ 365,098 We recorded no provision for loan losses during the three months ended March 31, 2016 . At March 31, 2016 , we had no real estate loans w ith outstanding balances on non-accrual status and no allowances for loan losses were recorded.

Investments in Unconsolidated E

Investments in Unconsolidated Entities	3 Months Ended
	Mar. 31, 2016
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) March 31, 2016 December 31, 2015 Triple-net 10% to 49% $ 34,289 $ 36,351 Seniors housing operating 10% to 50% 504,355 499,537 Outpatient medical 43% 6,426 6,393 Total $ 545,070 $ 542,281 (1) Excludes ownership of in-substance real estate. At March 31, 2016, the aggregate unamortized basis difference of our joint venture investments of $155,831 ,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	3 Months Ended
	Mar. 31, 2016
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 three month period ended March 31, 2016 , 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 187 $ 99,894 17% Sunrise Senior Living (3) 150 75,953 13% Brookdale Senior Living 148 42,585 7% Revera (3) 97 35,654 6% Benchmark Senior Living 49 25,875 4% Remaining portfolio 803 317,453 53% Totals 1,434 $ 597,414 100% (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 46% of total NOI for the year ending December 31, 2015. (3) Revera owns a controlling interest in Sunrise Senior Living.

Borrowings Under Credit Facilit

Borrowings Under Credit Facilities and Related Items	3 Months Ended
	Mar. 31, 2016
Borrowings Under Credit Facilities and Related Items [Abstract]
Borrowings Under Credit Facilities and Related Items	9. Borrowings Under Credit Facilities and Related Items At March 31, 2016, 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 March 31, 2016 ). Borrowings under the unsecured revolving credit facility are subject to interest payable at the applicable margin over LIBOR interes t rate ( 1.36% at March 31, 2016 ). The applicable margin is based on certain of our debt ratings and was 0.925% at March 31, 2016 . 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 March 31, 2016 . 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 th ousands): Three Months Ended March 31, 2016 2015 Balance outstanding at quarter end (1) $ 645,000 $ 410,000 Maximum amount outstanding at any month end $ 945,000 $ 430,000 Average amount outstanding (total of daily principal balances divided by days in period) $ 671,044 $ 408,944 Weighted average interest rate (actual interest expense divided by average borrowings outstanding) 1.29% 1.21% (1) As of March 31, 2016, letters of credit in the aggregate amount of $48,930,000 have been issued, which reduces the borrowing capacity on the unsecured revolving credit facility.

Senior Unsecured Notes and Secu

Senior Unsecured Notes and Secured Debt	3 Months Ended
	Mar. 31, 2016
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 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 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 March 31, 2016 , 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 2016 $ - $ 434,322 $ 434,322 2017 450,000 490,995 940,995 2018 450,000 631,533 1,081,533 2019 (4,5) 1,292,767 385,748 1,678,515 2020 (6) 681,321 182,554 863,875 Thereafter (7,8,9,10) 6,060,005 1,363,336 7,423,341 Totals $ 8,934,093 $ 3,488,488 $ 12,422,581 (1) Amounts represent principal amounts due and do not include unamortized premiums/discounts, debt issuance costs, or other fair value adjustments as reflected on the balance sheet. (2) Annual interest rates range from 1.41% to 6.5%. (3) Annual interest rates range from 1.0% to 7.98%. Carrying value of the properties securing the debt totaled $6,226,111,000 at March 31, 2016. (4) On July 25, 2014, we refinanced the funding on a $250,000,000 Canadian-denominated unsecured term credit facility (approximately $192,767,000 based on the Canadian/U.S. Dollar exchange rate on March 31, 2016). 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 (1.85% at March 31, 2016). (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 (1.41% at March 31, 2016). (6) In November 2015, one of our wholly-owned subsidiaries issued and we guaranteed $300,000,000 of Canadian-denominated 3.35% senior unsecured notes due 2020 (approximately $231,321,000 based on the Canadian/U.S. Dollar exchange rate on March 31, 2016). (7) On November 20, 2013, we completed the sale of £ 550,000,000 (approximately $790,955,000 based on the Sterling/U.S. Dollar exchange rate in effect on March 31, 2016) of 4.8% senior unsecured notes due 2028. (8) On November 25, 2014, we completed the sale of £ 500,000,000 (approximately $719,050,000 based on the Sterling/U.S. Dollar exchange rate in effect on March 31, 2016) of 4.5% senior unsecured notes due 2034. (9) 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. (10) In March 2016, we issued $700,000,000 of 4.25% senior unsecured notes due 2026. The following is a summary of our senior unsecured notes principal activity during the periods presented (dollars in thousands) : Three Months Ended March 31, 2016 March 31, 2015 Weighted Avg. Weighted Avg. Amount Interest Rate Amount Interest Rate Beginning balance $ 8,645,758 4.237% $ 7,817,154 4.385% Debt issued 700,000 4.250% - 0.000% Debt extinguished (400,000) 3.625% - 0.000% Debt redeemed - 0.000% (154,654) 3.000% Foreign currency (11,665) 3.943% (94,579) 4.333% Ending balance $ 8,934,093 4.266% $ 7,567,921 4.352% The following is a summary of our secured debt principal activity for the periods presented (dollars in thousands): Three Months Ended March 31, 2016 March 31, 2015 Weighted Avg. Weighted Avg. Amount Interest Rate Amount Interest Rate Beginning balance $ 3,478,207 4.44% $ 2,941,765 4.94% Debt issued 75,136 3.06% 82,724 2.34% Debt assumed - 0.00% 205,897 3.98% Debt extinguished (111,701) 4.45% (192,427) 4.02% Foreign currency 65,488 3.67% (15,630) 5.01% Principal payments (18,642) 4.54% (49,672) 3.96% Ending balance $ 3,488,488 4.40% $ 2,972,657 4.88% 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 March 31, 2016 , we were in compliance with all of the cove nants under our debt agreements.

Derivative Instruments

Derivative Instruments	3 Months Ended
	Mar. 31, 2016
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 $1,412,000 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 three months ended March 31, 2016 and 2015, we settled certain net investment hedges generating cash proceeds of $0 and $72,477,000, respectively . 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 amount of derivatives and other financial instruments as of the dates indicated (in thousands): March 31, 2016 December 31, 2015 Derivatives designated as net investment hedges: Denominated in Canadian Dollars $ 1,175,000 $ 1,175,000 Denominated in Pounds Sterling £ 550,000 £ 550,000 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 $ 72,000 Denominated in Pounds Sterling £ 60,000 £ 60,000 Derivative instruments not designated: Denominated in Canadian Dollars $ 47,000 $ 47,000 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 March 31, Location 2016 2015 Gain (loss) on interest rate swaps reclassified from AOCI into income (effective portion) Interest expense $ (483) $ (466) Gain (loss) on forward exchange contracts recognized in income Interest expense (1,327) 2,747 Loss (gain) on option exercise (1) Loss (gain) on derivatives, net - (58,427) Gain (loss) on foreign exchange contracts and term loans designated as net investment hedge recognized in OCI OCI (2,739) 184,051 (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	3 Months Ended
	Mar. 31, 2016
Commitments and Contingencies [Abstract]
Commitments and Contingencies	12 . Commitments and Contingencies At March 31, 2016 , we had nine outstanding letter of credit obligations totaling $90,401 ,000 and expiring between 2016 and 2018 . At March 31, 2016 , we had outstanding construction in progress of $ 297,023,000 and were committed to providing additional funds of approximately $ 637,356,000 to complete construction. Purchase obligations include contingent purchase obligations totaling $ 28,713,000 which relate to unfunded capital improvement obligations and contingent obligati ons 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 lease term, contains a bargain purchase option, has a lease term greater than 75% of the economic life of the leased asse t, 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 leases contain bargain purchase options and have been classified as capital leases. At March 31, 2016 , we had operating lease obligations of $ 1,056,909,000 relating to certain ground leases and company office space and capital lease obligations of $ 97,385,000 relating 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 March 31, 2016 , aggregate future minimum rentals to be received under these noncancelable subleases totaled $ 75,296,000 .

Stockholders' Equity

Stockholders' Equity	3 Months Ended
	Mar. 31, 2016
Stockholders' Equity [Abstract]
Stockholders' Equity	13. Stockholders’ Equity The following is a summary of our stockholders’ equity capital accounts as of the dates indicated: March 31, 2016 December 31, 2015 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 357,697,257 355,594,373 Outstanding shares 356,772,720 354,777,670 Common Stock. The following is a summary of our common stock issuances during the three months ended March 31, 2016 and 2015 (dollars in thousands, except per share amounts): Shares Issued Average Price Gross Proceeds Net Proceeds February 2015 public issuance 19,550,000 $ 75.50 $ 1,476,025 $ 1,423,935 2015 Dividend reinvestment plan issuances 766,488 76.38 58,547 58,547 2015 Option exercises 149,788 47.17 7,065 7,065 2015 Stock incentive plans, net of forfeitures 166,815 - - 2015 Senior note conversions 1,048,641 - - 2015 Totals 21,681,732 $ 1,541,637 $ 1,489,547 2016 Dividend reinvestment plan issuances 1,058,085 60.00 $ 63,484 $ 63,484 2016 Option exercises 9,864 21.29 210 210 2016 Stock incentive plans, net of forfeitures 484,005 - - 2016 Equity shelf program issuances 443,096 67.12 30,192 29,739 2016 Totals 1,995,050 $ 93,886 $ 93,433 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): Three Months Ended March 31, 2016 March 31, 2015 Per Share Amount Per Share Amount Common Stock $ 0.8600 $ 305,770 $ 0.8250 $ 272,569 Series I Preferred Stock 0.8125 11,680 0.8125 11,680 Series J Preferred Stock 0.4064 4,672 0.4064 4,672 Totals $ 322,122 $ 288,921 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, 2015 $ (85,484) $ - $ (1,343) $ (1,416) $ (88,243) Other comprehensive income before reclassification adjustments (13,746) (7,549) 2 - (21,293) Reclassification amount to net income - - - 483 (1) 483 Net current-period other comprehensive income (13,746) (7,549) 2 483 (20,810) Balance at March 31, 2016 $ (99,230) $ (7,549) $ (1,341) $ (933) $ (109,053) Balance at December 31, 2014 $ (74,770) $ - $ (1,589) $ (650) $ (77,009) Other comprehensive income before reclassification adjustments (16,641) (11,687) - (2,625) (30,953) Reclassification amount to net income - - - 466 (1) 466 Net current-period other comprehensive income (16,641) (11,687) - (2,159) (30,487) Balance at March 31, 2015 $ (91,411) $ (11,687) $ (1,589) $ (2,809) $ (107,496) (1) Please see note 11 for additional information.

Stock Incentive Plans

Stock Incentive Plans	3 Months Ended
	Mar. 31, 2016
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 $8,186,000 for the three months ended March 31, 2016 and $9,054 , 000 for the same period in 2015 .

Earnings Per Share

Earnings Per Share	3 Months Ended
	Mar. 31, 2016
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 March 31, 2016 2015 Numerator for basic and diluted earnings per share - net income (loss) attributable to common stockholders $ 148,969 $ 190,799 Denominator for basic earnings per share - weighted average shares 355,076 336,754 Effect of dilutive securities: Employee stock options 101 200 Non-vested restricted shares 253 416 Redeemable shares 621 - Convertible senior unsecured notes - 442 Dilutive potential common shares 975 1,058 Denominator for diluted earnings per share - adjusted weighted average shares 356,051 337,812 Basic earnings per share $ 0.42 $ 0.57 Diluted earnings per share $ 0.42 $ 0.56 The Series I Cumulative Convertible 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	3 Months Ended
	Mar. 31, 2016
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, 2015 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 was estimated based on Level 1 publicly available trading prices. The carrying amount of variable rate senior unsecured notes approximates fair value because the y 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 exch ange 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 Interests — 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 holder f or 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): March 31, 2016 December 31, 2015 Carrying Amount Fair Value Carrying Amount Fair Value Financial assets: Mortgage loans receivable $ 546,573 $ 572,909 $ 635,492 $ 663,501 Other real estate loans receivable 178,718 182,829 184,000 185,693 Available-for-sale equity investments 15,230 15,230 22,779 22,779 Cash and cash equivalents 355,949 355,949 360,908 360,908 Foreign currency forward contracts 100,162 100,162 129,520 129,520 Financial liabilities: Borrowings under unsecured credit facilities $ 645,000 $ 645,000 $ 835,000 $ 835,000 Senior unsecured notes 8,828,053 9,391,062 8,548,055 9,020,529 Secured debt 3,515,053 3,724,054 3,509,142 3,678,564 Foreign currency forward contracts 2,308 2,308 - - Redeemable OP unitholder interests $ 114,481 $ 114,481 $ 112,029 $ 112,029 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 March 31, 2016 Total Level 1 Level 2 Level 3 Available-for-sale equity investments (1) $ 15,230 $ 15,230 $ - $ - Foreign currency forward contracts, net (2) 97,854 - 97,854 - Redeemable OP unitholder interests 114,481 - 114,481 - Totals $ 227,565 $ 15,230 $ 212,335 $ - (1) Unrealized gains or losses on equity investments are recorded in accumulated other comprehensive income (loss) at each measurement date. During the year ended December 31, 2015, we recognized an other than temporary impairment charge of $35,648,000 on the Genesis Healthcare stock investment. Also, see Note 11 for details related to the gain on the derivative asset originally recognized. (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	3 Months Ended
	Mar. 31, 2016
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 three operating segments: triple-net, seniors housing operating and outpatient medical . During the three months ended March 31, 2016, we reclassified four properties previously classified in the triple-net segment to the outpatient medical segment. Accordingly, the segment information provided in this note has been reclassi fied to conform to the current presentation for all periods presented. Our triple-net properties include long-term/post-acute care facilities, assisted living facilities, independent living/continuing care retirement communities, care homes (United Ki ngdom), 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 ar e owned and/or operated through RIDEA structures (see Notes 3 and 18). Our outpatient medical properties in clude outpatient medical buildings and , during past years, life science buildings which are aggregated into our outpatient medical reportable s egment. Our outpatient medical 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 provides 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 performance 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 revenues and expenses are not al located 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, 2015 ). 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 n o intersegment sales or transfers. Summary information for the reportable segments is as follows for the periods presented (in thousands): Three Months Ended March 31, 2016: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 283,825 $ - $ 131,838 $ - $ 415,663 Resident fees and services - 602,149 - - 602,149 Interest income 22,853 1,031 1,304 - 25,188 Other income 1,490 2,189 313 58 4,050 Total revenues 308,168 605,369 133,455 58 1,047,050 Property operating expenses - 408,894 40,742 - 449,636 Net operating income from continuing operations 308,168 196,475 92,713 58 597,414 Reconciling items: Interest expense 5,606 40,828 5,744 80,782 132,960 Depreciation and amortization 79,800 101,832 47,064 - 228,696 General and administrative - - - 45,691 45,691 Transaction costs 2,852 3,933 1,423 - 8,208 Loss (gain) on extinguishment of debt, net (24) - - - (24) Impairment of assets 14,314 - - - 14,314 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 205,620 49,882 38,482 (126,415) 167,569 Income tax expense (317) 2,767 (228) (497) 1,725 (Loss) income from unconsolidated entities 3,081 (6,935) 34 - (3,820) Income (loss) from continuing operations 208,384 45,714 38,288 (126,912) 165,474 Gain (loss) on real estate dispositions, net - - - - - Net income (loss) $ 208,384 $ 45,714 $ 38,288 $ (126,912) $ 165,474 Total assets $ 12,337,195 $ 11,595,907 $ 5,059,616 $ 95,575 $ 29,088,293 Three Months Ended March 31, 2015: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 261,993 $ - $ 117,594 $ - $ 379,587 Resident fees and services - 492,510 - - 492,510 Interest income 14,699 1,031 1,264 - 16,994 Other income 3,883 1,020 161 22 5,086 Total revenues 280,575 494,561 119,019 22 894,177 Property operating expenses - 338,507 37,954 - 376,461 Net operating income from continuing operations 280,575 156,054 81,065 22 517,716 Reconciling items: Interest expense 8,424 34,458 7,388 70,810 121,080 Loss (gain) on derivatives, net (58,427) - - - (58,427) Depreciation and amortization 69,420 76,636 42,773 - 188,829 General and administrative - - - 35,138 35,138 Transaction costs 36,171 12,042 341 - 48,554 Loss (gain) on extinguishment of debt, net 10,337 - - 5,064 15,401 Impairment of assets 2,220 - - - 2,220 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 212,430 32,918 30,563 (110,990) 164,921 Income tax expense 419 (533) 466 (48) 304 (Loss) income from unconsolidated entities 1,393 (15,073) 1,032 - (12,648) Income (loss) from continuing operations 214,242 17,312 32,061 (111,038) 152,577 Gain (loss) on real estate dispositions, net 54,096 - 2,749 - 56,845 Net income (loss) $ 268,338 $ 17,312 $ 34,810 $ (111,038) $ 209,422 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 March 31, 2016 March 31, 2015 Revenues: Amount % Amount % United States $ 842,357 80.5% $ 745,136 83.3% United Kingdom 100,555 9.6% 91,815 10.3% Canada 104,138 9.9% 57,226 6.4% Total $ 1,047,050 100.0% $ 894,177 100.0% As of March 31, 2016 December 31, 2015 Assets: Amount % Amount % United States $ 23,461,804 80.7% $ 25,995,793 89.6% United Kingdom 2,950,387 10.1% 1,741,973 6.0% Canada 2,676,102 9.2% 1,286,079 4.4% Total $ 29,088,293 100.0% $ 29,023,845 100.0%

Income Taxes and Distributions

Income Taxes and Distributions	3 Months Ended
	Mar. 31, 2016
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 es 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 jurisdictio ns outside the U.S. The income tax benefit for the three months ended March 31, 2016 and 2015, 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 material 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. federal incom e 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 cons olidated financial statements. Generally, given current statutes of limitation s, we are subject to audit by the Internal Revenue Service (“IRS”) for the year ended December 31, 2012 and subsequent years and by state taxing authorities for the year ended December 31, 201 1 and subsequent years. The company and its subsidiaries are al so 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 United Kingdom i n August 2012 and by Luxembourg taxing authorities generally for periods subsequent to our establishment of certain Luxembourg-based subsidiaries during 2014.

Variable Interest Entity Disclo

Variable Interest Entity Disclosure	3 Months Ended
	Mar. 31, 2016
Variable Interest Entity Disclosure [Abstract]
Variable Interest Entity Disclosure [Text Block]	19. VIE Disclosure We have entered into certain joint ventures to own certain seniors housing and outpatient medical assets which are deemed to be variable interest entities for which we have concluded that we are the primary beneficiary based on a combination of operational control of the joint venture and the rights to receive residual returns or the obligation to absorb losses arising from the joint ventures. Except for capital contributions associated with the initial joint venture formati ons , the joint ventures have been a nd are expected to be funded from the ongoing operations of the underlying properties. Accordingly, such joint ventures have been consolidated, and the table below summarizes the balance sheets of consolidated variable interest en tities in the aggregate: (In thousands) March 31, 2016 December 31, 2015 Assets Net real property owned $ 1,020,357 $ 453,889 Cash and cash equivalents 14,080 8,759 Receivables and other assets 10,450 8,082 Total assets (1) $ 1,044,887 $ 470,730 $ Liabilities and equity Secured debt $ 451,952 $ 147,021 Accrued expenses and other liabilities 12,845 7,732 Redeemable noncontrolling interests 71,440 70,090 Total equity 508,650 245,887 Total liabilities and equity $ 1,044,887 $ 470,730 (1) Note that assets of the consolidated variable interest entities can only be used to settle obligations relating to such variable interest entities. Liabilities of the consolidated variable interest entities represent claims against the specific assets of the variable interest entities.

Accounting Policies and Relat26

Accounting Policies and Related Matters (Policies)	3 Months Ended
	Mar. 31, 2016
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. During the three months ended March 31, 2016, we determined that an immaterial portion of our noncontrolling interests re lated to a 2015 transaction was misclassified in permanent equity rather than temporary equity based on a redemption feature of the partnership agreement and we have corrected the $114,714,000 misclassification by recording the change in the consolidated s tatement of equity for the three months ended March 31, 2016. Operating results for the three months ended March 31, 2016 are not necessarily an indication of the results that may be expected for t he year ending December 31, 2016 . 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, 2015 .
New Accounting Standards	New Accounting Standards In May 2014, the Financial Accounting Standards Board (“FASB”) issued ASU No. 2014-09, “Revenue from Contracts with Customers (Topic 606)”. The standard is a comprehensive new revenue recognition model that requires revenue to be recognized in a manne r to depict 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, beg inning after 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 adopt the standard. In February 2015, the FASB issued ASU No. 2015-02, “Consolidation (Topic 810): Amendments to the Consoli dation Analysis” , which makes certain changes to both the variable interest model and the voting model, including chang es 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. We adopted ASU 2015-02 on January 1, 2016. This guidance did not have a significant impact on our consolidated financial statements. In September 2015, the FASB issued ASU No. 2015-16, “Simplifying the Accounting for Measurement-Period Adjustments” to simplify the accounting for business combinations, specifically as it relates to measurement-period adjustments. Acquiring entities in a business combination must recognize measurement-period adjustments in the reporting period in which the adjustment amounts are determined. Also, ASU 2015-16 requires entities to present separately on the face of the income statement (or disclose in the notes to the financial statements) the portion of the amount recorded in the current period earnings, by line item, that would ha ve been recorded in previous reporting periods if the adjustment to the provisional amounts had been recognized as of the acquisition date. We adopted ASU 2015-16 on January 1, 2016. This guidance did not have a significant impact on our consolidated fina ncial statements. In February 2016, the FASB issued ASU No. 2016-02, “Leases (Topic 8 4 2) ,” which requires lessees to recognize assets and liabilities on their balance sheet related to the rights and obligations created by most leases, while continuing to recognize expenses on their income statements over the lease term. It will also require disclosures designed to give financial statement users information regarding the amount, timing, and uncertainty of cash flows arising from leases. ASU 2016-02 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2018, and early adoption is permitted. Entities are required to use a modified retrospective approach for leases that exist or are entered into after the beg inning of the earliest comparative period in the financial statements. We are currently evaluating the impact that the standard will have on our consolidated financial statements.

Real Property Acquisitions an27

Real Property Acquisitions and Development (Tables)	3 Months Ended
	Mar. 31, 2016
Real property acquisitions and development [Line Items]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities	Triple-n et Activity Three Months Ended (In thousands) March 31, 2016 (1) March 31, 2015 Land and land improvements $ 15,331 $ 22,983 Buildings and improvements 114,235 239,728 Acquired lease intangibles 1,623 799 Receivables and other assets - 7 Total assets acquired 131,189 263,517 Accrued expenses and other liabilities (809) (732) Total liabilities assumed (809) (732) Non-cash acquisition related activity (28,621) (357) Cash disbursed for acquisitions 101,759 262,428 Construction in progress additions 43,835 45,360 Less: Capitalized interest (1,684) (1,756) Foreign currency translation (583) (642) Cash disbursed for construction in progress 41,568 42,962 Capital improvements to existing properties 7,438 11,557 Total cash invested in real property, net of cash acquired $ 150,765 $ 316,947 (1) Includes acquisitions with an aggregate purchase price of $115,875,000 for which the allocation of the purchase price consideration is preliminary and subject to change. Seniors Housing Operating Activity Three Months Ended (In thousands) March 31, 2016 (1) March 31, 2015 Land and land improvements $ 3,440 $ 86,184 Building and improvements 48,218 1,016,426 Acquired lease intangibles 1,942 62,838 Restricted cash - 3,820 Receivables and other assets 36 23,014 Total assets acquired (2) 53,636 1,192,282 Secured debt - (208,960) Accrued expenses and other liabilities (11) (16,164) Total liabilities assumed (11) (225,124) Noncontrolling interests (549) (83,194) Cash disbursed for acquisitions 53,076 883,964 Construction in progress additions 4,033 4,193 Less: Capitalized interest (565) (394) Foreign currency translation (1,107) (1,472) Cash disbursed for construction in progress 2,361 2,327 Capital improvements to existing properties 16,808 11,632 Total cash invested in real property, net of cash acquired $ 72,245 $ 897,923 (1) Includes acquisitions with an aggregate purchase price of $53,636,000 for which the allocation of the purchase price consideration is preliminary and subject to change. (2) Excludes $113,000 and $1,677,000 of cash acquired during the three months ended March 31, 2016 and 2015, respectively. Outpatient Medical Activity Three Months Ended (In thousands) March 31, 2016 (1) March 31, 2015 Land and land improvements $ - $ 47,019 Buildings and improvements 17,637 307,072 Acquired lease intangibles - 511 Total assets acquired 17,637 354,602 Accrued expenses and other liabilities (990) - Total liabilities assumed (990) - Cash disbursed for acquisitions 16,647 354,602 Construction in progress additions 28,934 16,421 Less: Capitalized interest (788) (237) Accruals (2) (5,336) (1,921) Cash disbursed for construction in progress 22,810 14,263 Capital improvements to existing properties 10,779 6,639 Total cash invested in real property $ 50,236 $ 375,504 (1) Includes acquisitions with an aggregate purchase price of $17,637,000 for which the allocation of the purchase price consideration is preliminary and subject to change. (2) 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	Three Months Ended March 31, 2016 March 31, 2015 Development projects: Outpatient medical $ 35,363 $ 16,592 Total development projects 35,363 16,592 Expansion projects - 19,541 Total construction in progress conversions $ 35,363 $ 36,133

Real Estate Intangibles (Tables

Real Estate Intangibles (Tables)	3 Months Ended
	Mar. 31, 2016
Real Estate Intangibles (Tables) [Abstract]
Summary of real estate intangibles excluding those classified as held for sale	March 31, 2016 December 31, 2015 Assets: In place lease intangibles $ 1,196,335 $ 1,179,537 Above market tenant leases 62,544 67,529 Below market ground leases 62,643 80,224 Lease commissions 24,542 23,295 Gross historical cost 1,346,064 1,350,585 Accumulated amortization (923,712) (881,096) Net book value $ 422,352 $ 469,489 Weighted-average amortization period in years 14.6 13.4 Liabilities: Below market tenant leases $ 93,054 $ 93,089 Above market ground leases 7,908 7,907 Gross historical cost 100,962 100,996 Accumulated amortization (47,983) (46,048) Net book value $ 52,979 $ 54,948 Weighted-average amortization period in years 14.7 14.5
Schedule of Real Estate Intangible Amortization	Three Months Ended March 31, 2016 2015 Rental income related to above/below market tenant leases, net $ 81 $ 206 Property operating expenses related to above/below market ground leases, net (311) (319) Depreciation and amortization related to in place lease intangibles and lease commissions (34,454) (24,324)
Schedule of the future estimated aggregate amortization of intangible assets and liabilities	Assets Liabilities 2016 $ 84,239 $ 3,894 2017 79,195 6,807 2018 44,698 6,181 2019 25,238 5,771 2020 22,341 5,290 Thereafter 166,641 25,036 Total $ 422,352 $ 52,979

Dispositions, Assets Held for29

Dispositions, Assets Held for Sale and Discontinued Operations (Tables)	3 Months Ended
	Mar. 31, 2016
Dispositions, Assets Held for Sale and Discontinued Operations (Tables) [Abstract]
Summary of real property disposition activity	Three Months Ended March 31, 2016 March 31, 2015 Real estate dispositions: Triple-net $ - $ 110,998 Outpatient medical - 9,422 Total dispositions - 120,420 Gain (loss) on real estate dispositions, net - 56,845 Proceeds from real estate dispositions $ - $ 177,265
Summary of disposed properties.	Three Months Ended March 31, 2016 2015 Revenues: Rental income $ 5,477 $ 12,166 Expenses: Interest expense 851 2,262 Property operating expenses 1,362 1,527 Provision for depreciation 820 3,256 Total expenses 3,033 7,045 Income (loss) from real estate dispositions, net $ 2,444 $ 5,121

Real Estate Loans Receivable (T

Real Estate Loans Receivable (Tables)	3 Months Ended
	Mar. 31, 2016
Real Estate Loans Receivable (Tables) [Abstract]
Summary of real estate loan activity	Three Months Ended March 31, 2016 March 31, 2015 Outpatient Outpatient Triple-net Medical Totals Triple-net Medical Totals Advances on real estate loans receivable: Investments in new loans $ 8,013 $ - $ 8,013 $ 368,080 $ - $ 368,080 Draws on existing loans 19,206 32 19,238 14,330 2,285 16,615 Net cash advances on real estate loans 27,219 32 27,251 382,410 2,285 384,695 Receipts on real estate loans receivable: Loan payoffs 104,068 12,290 116,358 8,568 - 8,568 Principal payments on loans 3,107 - 3,107 7,933 - 7,933 Sub-total 107,175 12,290 119,465 16,501 - 16,501 Less: Non-cash activity (25,691) - (25,691) - - - Net cash receipts on real estate loans 81,484 12,290 93,774 16,501 - 16,501 Net cash advances (receipts) on real estate loans (54,265) (12,258) (66,523) 365,909 2,285 368,194 Change in balance due to foreign currency translation (1,987) - (1,987) (3,096) - (3,096) Net change in real estate loans receivable $ (81,943) $ (12,258) $ (94,201) $ 362,813 $ 2,285 $ 365,098

Investments in Unconsolidated31

Investments in Unconsolidated Entities (Tables)	3 Months Ended
	Mar. 31, 2016
Investments In Unconsolidated Entities [Abstract]
Summary Of Investments In Unconsolidated Entities [Text Block]	Percentage Ownership (1) March 31, 2016 December 31, 2015 Triple-net 10% to 49% $ 34,289 $ 36,351 Seniors housing operating 10% to 50% 504,355 499,537 Outpatient medical 43% 6,426 6,393 Total $ 545,070 $ 542,281 (1) Excludes ownership of in-substance real estate.

Credit Concentration (Tables)

Credit Concentration (Tables)	3 Months Ended
	Mar. 31, 2016
Customer Concentration (Tables) [Abstract]
Summary of credit concentration	Number of Total Percent of Concentration by relationship: (1) Properties NOI NOI (2) Genesis Healthcare 187 $ 99,894 17% Sunrise Senior Living (3) 150 75,953 13% Brookdale Senior Living 148 42,585 7% Revera (3) 97 35,654 6% Benchmark Senior Living 49 25,875 4% Remaining portfolio 803 317,453 53% Totals 1,434 $ 597,414 100% (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 46% of total NOI for the year ending December 31, 2015. (3) Revera owns a controlling interest in Sunrise Senior Living.

Borrowings Under Credit Facil33

Borrowings Under Credit Facilities and Related Items (Tables)	3 Months Ended
	Mar. 31, 2016
Borrowings Under Credit Facilities and Related Items (Tables) [Abstract]
Aggregate borrowings under the unsecured line of credit arrangements	Three Months Ended March 31, 2016 2015 Balance outstanding at quarter end (1) $ 645,000 $ 410,000 Maximum amount outstanding at any month end $ 945,000 $ 430,000 Average amount outstanding (total of daily principal balances divided by days in period) $ 671,044 $ 408,944 Weighted average interest rate (actual interest expense divided by average borrowings outstanding) 1.29% 1.21% (1) As of March 31, 2016, letters of credit in the aggregate amount of $48,930,000 have been issued, which reduces the borrowing capacity on the unsecured revolving credit facility.

Senior Unsecured Notes and Se34

Senior Unsecured Notes and Secured Debt (Tables)	3 Months Ended
	Mar. 31, 2016
Senior Unsecured Notes And Secured Debt (Tables) [Abstract]
Principal payments due on debt obligations	Senior Secured Unsecured Notes (1,2) Debt (1,3) Totals 2016 $ - $ 434,322 $ 434,322 2017 450,000 490,995 940,995 2018 450,000 631,533 1,081,533 2019 (4,5) 1,292,767 385,748 1,678,515 2020 (6) 681,321 182,554 863,875 Thereafter (7,8,9,10) 6,060,005 1,363,336 7,423,341 Totals $ 8,934,093 $ 3,488,488 $ 12,422,581 (1) Amounts represent principal amounts due and do not include unamortized premiums/discounts, debt issuance costs, or other fair value adjustments as reflected on the balance sheet. (2) Annual interest rates range from 1.41% to 6.5%. (3) Annual interest rates range from 1.0% to 7.98%. Carrying value of the properties securing the debt totaled $6,226,111,000 at March 31, 2016. (4) On July 25, 2014, we refinanced the funding on a $250,000,000 Canadian-denominated unsecured term credit facility (approximately $192,767,000 based on the Canadian/U.S. Dollar exchange rate on March 31, 2016). 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 (1.85% at March 31, 2016). (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 (1.41% at March 31, 2016). (6) In November 2015, one of our wholly-owned subsidiaries issued and we guaranteed $300,000,000 of Canadian-denominated 3.35% senior unsecured notes due 2020 (approximately $231,321,000 based on the Canadian/U.S. Dollar exchange rate on March 31, 2016). (7) On November 20, 2013, we completed the sale of £ 550,000,000 (approximately $790,955,000 based on the Sterling/U.S. Dollar exchange rate in effect on March 31, 2016) of 4.8% senior unsecured notes due 2028. (8) On November 25, 2014, we completed the sale of £ 500,000,000 (approximately $719,050,000 based on the Sterling/U.S. Dollar exchange rate in effect on March 31, 2016) of 4.5% senior unsecured notes due 2034. (9) 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. (10) In March 2016, we issued $700,000,000 of 4.25% senior unsecured notes due 2026.
Summary of senior unsecured note activity	Three Months Ended March 31, 2016 March 31, 2015 Weighted Avg. Weighted Avg. Amount Interest Rate Amount Interest Rate Beginning balance $ 8,645,758 4.237% $ 7,817,154 4.385% Debt issued 700,000 4.250% - 0.000% Debt extinguished (400,000) 3.625% - 0.000% Debt redeemed - 0.000% (154,654) 3.000% Foreign currency (11,665) 3.943% (94,579) 4.333% Ending balance $ 8,934,093 4.266% $ 7,567,921 4.352%
Secured debt principal activity	Three Months Ended March 31, 2016 March 31, 2015 Weighted Avg. Weighted Avg. Amount Interest Rate Amount Interest Rate Beginning balance $ 3,478,207 4.44% $ 2,941,765 4.94% Debt issued 75,136 3.06% 82,724 2.34% Debt assumed - 0.00% 205,897 3.98% Debt extinguished (111,701) 4.45% (192,427) 4.02% Foreign currency 65,488 3.67% (15,630) 5.01% Principal payments (18,642) 4.54% (49,672) 3.96% Ending balance $ 3,488,488 4.40% $ 2,972,657 4.88%

Derivative Instruments (Tables)

Derivative Instruments (Tables)	3 Months Ended
	Mar. 31, 2016
Derivative Instruments (Tables) [Abstract]
Impact of derivative instruments on the statement of operations and OCI	March 31, 2016 December 31, 2015 Derivatives designated as net investment hedges: Denominated in Canadian Dollars $ 1,175,000 $ 1,175,000 Denominated in Pounds Sterling £ 550,000 £ 550,000 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 $ 72,000 Denominated in Pounds Sterling £ 60,000 £ 60,000 Derivative instruments not designated: Denominated in Canadian Dollars $ 47,000 $ 47,000 Three Months Ended March 31, Location 2016 2015 Gain (loss) on interest rate swaps reclassified from AOCI into income (effective portion) Interest expense $ (483) $ (466) Gain (loss) on forward exchange contracts recognized in income Interest expense (1,327) 2,747 Loss (gain) on option exercise (1) Loss (gain) on derivatives, net - (58,427) Gain (loss) on foreign exchange contracts and term loans designated as net investment hedge recognized in OCI OCI (2,739) 184,051 (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)	3 Months Ended
	Mar. 31, 2016
Stockholders' Equity (Tables) [Abstract]
Summary of stockholder's equity capital accounts	March 31, 2016 December 31, 2015 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 357,697,257 355,594,373 Outstanding shares 356,772,720 354,777,670
Summary of common stock issuances	Shares Issued Average Price Gross Proceeds Net Proceeds February 2015 public issuance 19,550,000 $ 75.50 $ 1,476,025 $ 1,423,935 2015 Dividend reinvestment plan issuances 766,488 76.38 58,547 58,547 2015 Option exercises 149,788 47.17 7,065 7,065 2015 Stock incentive plans, net of forfeitures 166,815 - - 2015 Senior note conversions 1,048,641 - - 2015 Totals 21,681,732 $ 1,541,637 $ 1,489,547 2016 Dividend reinvestment plan issuances 1,058,085 60.00 $ 63,484 $ 63,484 2016 Option exercises 9,864 21.29 210 210 2016 Stock incentive plans, net of forfeitures 484,005 - - 2016 Equity shelf program issuances 443,096 67.12 30,192 29,739 2016 Totals 1,995,050 $ 93,886 $ 93,433
Summary of dividend payments	Three Months Ended March 31, 2016 March 31, 2015 Per Share Amount Per Share Amount Common Stock $ 0.8600 $ 305,770 $ 0.8250 $ 272,569 Series I Preferred Stock 0.8125 11,680 0.8125 11,680 Series J Preferred Stock 0.4064 4,672 0.4064 4,672 Totals $ 322,122 $ 288,921
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, 2015 $ (85,484) $ - $ (1,343) $ (1,416) $ (88,243) Other comprehensive income before reclassification adjustments (13,746) (7,549) 2 - (21,293) Reclassification amount to net income - - - 483 (1) 483 Net current-period other comprehensive income (13,746) (7,549) 2 483 (20,810) Balance at March 31, 2016 $ (99,230) $ (7,549) $ (1,341) $ (933) $ (109,053) Balance at December 31, 2014 $ (74,770) $ - $ (1,589) $ (650) $ (77,009) Other comprehensive income before reclassification adjustments (16,641) (11,687) - (2,625) (30,953) Reclassification amount to net income - - - 466 (1) 466 Net current-period other comprehensive income (16,641) (11,687) - (2,159) (30,487) Balance at March 31, 2015 $ (91,411) $ (11,687) $ (1,589) $ (2,809) $ (107,496) (1) Please see note 11 for additional information.

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2016
Earnings Per Share (Tables) [Abstract]
Computation of basic and diluted earnings per share	Three Months Ended March 31, 2016 2015 Numerator for basic and diluted earnings per share - net income (loss) attributable to common stockholders $ 148,969 $ 190,799 Denominator for basic earnings per share - weighted average shares 355,076 336,754 Effect of dilutive securities: Employee stock options 101 200 Non-vested restricted shares 253 416 Redeemable shares 621 - Convertible senior unsecured notes - 442 Dilutive potential common shares 975 1,058 Denominator for diluted earnings per share - adjusted weighted average shares 356,051 337,812 Basic earnings per share $ 0.42 $ 0.57 Diluted earnings per share $ 0.42 $ 0.56

Disclosure about Fair Value o38

Disclosure about Fair Value of Financial Instruments (Tables)	3 Months Ended
	Mar. 31, 2016
Disclosure about Fair Value of Financial Instruments (Tables) [Abstract]
Carrying amounts and estimated fair values of financial instruments	March 31, 2016 December 31, 2015 Carrying Amount Fair Value Carrying Amount Fair Value Financial assets: Mortgage loans receivable $ 546,573 $ 572,909 $ 635,492 $ 663,501 Other real estate loans receivable 178,718 182,829 184,000 185,693 Available-for-sale equity investments 15,230 15,230 22,779 22,779 Cash and cash equivalents 355,949 355,949 360,908 360,908 Foreign currency forward contracts 100,162 100,162 129,520 129,520 Financial liabilities: Borrowings under unsecured credit facilities $ 645,000 $ 645,000 $ 835,000 $ 835,000 Senior unsecured notes 8,828,053 9,391,062 8,548,055 9,020,529 Secured debt 3,515,053 3,724,054 3,509,142 3,678,564 Foreign currency forward contracts 2,308 2,308 - - Redeemable OP unitholder interests $ 114,481 $ 114,481 $ 112,029 $ 112,029
The Market approach utilized to measure fair value of financial assets and liabilities on recurring basis	Fair Value Measurements as of March 31, 2016 Total Level 1 Level 2 Level 3 Available-for-sale equity investments (1) $ 15,230 $ 15,230 $ - $ - Foreign currency forward contracts, net (2) 97,854 - 97,854 - Redeemable OP unitholder interests 114,481 - 114,481 - Totals $ 227,565 $ 15,230 $ 212,335 $ - (1) Unrealized gains or losses on equity investments are recorded in accumulated other comprehensive income (loss) at each measurement date. During the year ended December 31, 2015, we recognized an other than temporary impairment charge of $35,648,000 on the Genesis Healthcare stock investment. Also, see Note 11 for details related to the gain on the derivative asset originally recognized. (2) Please see Note 11 for additional information.

Segment Reporting (Tables)

Segment Reporting (Tables)	3 Months Ended
	Mar. 31, 2016
Segment Reporting (Tables) [Abstract]
Summary of information for reportable segments	Three Months Ended March 31, 2016: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 283,825 $ - $ 131,838 $ - $ 415,663 Resident fees and services - 602,149 - - 602,149 Interest income 22,853 1,031 1,304 - 25,188 Other income 1,490 2,189 313 58 4,050 Total revenues 308,168 605,369 133,455 58 1,047,050 Property operating expenses - 408,894 40,742 - 449,636 Net operating income from continuing operations 308,168 196,475 92,713 58 597,414 Reconciling items: Interest expense 5,606 40,828 5,744 80,782 132,960 Depreciation and amortization 79,800 101,832 47,064 - 228,696 General and administrative - - - 45,691 45,691 Transaction costs 2,852 3,933 1,423 - 8,208 Loss (gain) on extinguishment of debt, net (24) - - - (24) Impairment of assets 14,314 - - - 14,314 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 205,620 49,882 38,482 (126,415) 167,569 Income tax expense (317) 2,767 (228) (497) 1,725 (Loss) income from unconsolidated entities 3,081 (6,935) 34 - (3,820) Income (loss) from continuing operations 208,384 45,714 38,288 (126,912) 165,474 Gain (loss) on real estate dispositions, net - - - - - Net income (loss) $ 208,384 $ 45,714 $ 38,288 $ (126,912) $ 165,474 Total assets $ 12,337,195 $ 11,595,907 $ 5,059,616 $ 95,575 $ 29,088,293 Three Months Ended March 31, 2015: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 261,993 $ - $ 117,594 $ - $ 379,587 Resident fees and services - 492,510 - - 492,510 Interest income 14,699 1,031 1,264 - 16,994 Other income 3,883 1,020 161 22 5,086 Total revenues 280,575 494,561 119,019 22 894,177 Property operating expenses - 338,507 37,954 - 376,461 Net operating income from continuing operations 280,575 156,054 81,065 22 517,716 Reconciling items: Interest expense 8,424 34,458 7,388 70,810 121,080 Loss (gain) on derivatives, net (58,427) - - - (58,427) Depreciation and amortization 69,420 76,636 42,773 - 188,829 General and administrative - - - 35,138 35,138 Transaction costs 36,171 12,042 341 - 48,554 Loss (gain) on extinguishment of debt, net 10,337 - - 5,064 15,401 Impairment of assets 2,220 - - - 2,220 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 212,430 32,918 30,563 (110,990) 164,921 Income tax expense 419 (533) 466 (48) 304 (Loss) income from unconsolidated entities 1,393 (15,073) 1,032 - (12,648) Income (loss) from continuing operations 214,242 17,312 32,061 (111,038) 152,577 Gain (loss) on real estate dispositions, net 54,096 - 2,749 - 56,845 Net income (loss) $ 268,338 $ 17,312 $ 34,810 $ (111,038) $ 209,422 Three Months Ended March 31, 2016 March 31, 2015 Revenues: Amount % Amount % United States $ 842,357 80.5% $ 745,136 83.3% United Kingdom 100,555 9.6% 91,815 10.3% Canada 104,138 9.9% 57,226 6.4% Total $ 1,047,050 100.0% $ 894,177 100.0% As of March 31, 2016 December 31, 2015 Assets: Amount % Amount % United States $ 23,461,804 80.7% $ 25,995,793 89.6% United Kingdom 2,950,387 10.1% 1,741,973 6.0% Canada 2,676,102 9.2% 1,286,079 4.4% Total $ 29,088,293 100.0% $ 29,023,845 100.0%

Variable Interest Entity Disc40

Variable Interest Entity Disclosure (Tables)	3 Months Ended
	Mar. 31, 2016
Variable Interest Entity Disclosure [Abstract]
Schedule of Variable Interest Entities [Table Text Block]	(In thousands) March 31, 2016 December 31, 2015 Assets Net real property owned $ 1,020,357 $ 453,889 Cash and cash equivalents 14,080 8,759 Receivables and other assets 10,450 8,082 Total assets (1) $ 1,044,887 $ 470,730 $ Liabilities and equity Secured debt $ 451,952 $ 147,021 Accrued expenses and other liabilities 12,845 7,732 Redeemable noncontrolling interests 71,440 70,090 Total equity 508,650 245,887 Total liabilities and equity $ 1,044,887 $ 470,730 (1) Note that assets of the consolidated variable interest entities can only be used to settle obligations relating to such variable interest entities. Liabilities of the consolidated variable interest entities represent claims against the specific assets of the variable interest entities.

Business (Details)

Business (Details)	Mar. 31, 2016properties
Business [Line Items]
Number of properties in diversified portfolio	1,434	[1]
Controlling [Member]
Business [Line Items]
Number of properties in diversified portfolio	1,490
[1]	(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.

Accounting Policies and Relat42

Accounting Policies and Related Matters (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2016USD ($)
Accounting Policies and Related Matters [Abstract]
Reclassifications of Permanent to Temporary Equity	$ 114,714

Real Property Acquisitions an43

Real Property Acquisitions and Development (Details 1) - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2016		Mar. 31, 2015
Triple Net [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		$ 15,331	[1]	$ 22,983
Buildings and improvements		114,235	[1]	239,728
Acquired lease intangibles		1,623	[1]	799
Receivables and other assets		0	[1]	7
Total assets acquired		131,189	[1]	263,517
Accrued expenses and other liabilities		(809)	[1]	(732)
Total liabilities assumed		(809)	[1]	(732)
Non-cash acquisition related activity		(28,621)	[1]	(357)
Cash disbursed for acquisitions		101,759	[1]	262,428
Construction in progress additions		43,835	[1]	45,360
Less: Capitalized Interest		(1,684)	[1]	(1,756)
Less: Foreign currency translation		(583)	[1]	(642)
Cash disbursed for construction in progress		41,568	[1]	42,962
Capital improvements to existing properties		7,438	[1]	11,557
Total cash invested in real property		150,765	[1]	316,947
Triple Net [Member] | Preliminary [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Total cash invested in real property		115,875
Senior housing - operating [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		3,440	[2]	86,184
Buildings and improvements		48,218	[2]	1,016,426
Acquired lease intangibles		1,942	[2]	62,838
Restricted cash		0	[2]	3,820
Receivables and other assets		36	[2]	23,014
Total assets acquired	[3]	53,636	[2]	1,192,282
Secured debt		0	[2]	(208,960)
Accrued expenses and other liabilities		(11)	[2]	(16,164)
Total liabilities assumed		(11)	[2]	(225,124)
Noncontrolling interests		(549)	[2]	(83,194)
Cash disbursed for acquisitions		53,076	[2]	883,964
Construction in progress additions		4,033	[2]	4,193
Less: Capitalized Interest		(565)	[2]	(394)
Less: Foreign currency translation		(1,107)	[2]	(1,472)
Cash disbursed for construction in progress		2,361	[2]	2,327
Capital improvements to existing properties		16,808	[2]	11,632
Total cash invested in real property		72,245	[2]	897,923
Cash Acquired from Acquisition		113		1,667
Senior housing - operating [Member] | Preliminary [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Total cash invested in real property		53,636
Outpatient Medical [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		0	[4]	47,019
Buildings and improvements		17,637	[4]	307,072
Acquired lease intangibles		0	[4]	511
Total assets acquired	[5]	17,637	[4]	354,602
Accrued expenses and other liabilities		(990)	[4]	0
Total liabilities assumed		(990)	[4]	0
Cash disbursed for acquisitions		16,647	[4]	354,602
Construction in progress additions		28,934	[4]	16,421
Less: Capitalized Interest		(788)	[4]	(237)
Less: Accruals		(5,336)	[4]	(1,921)
Cash disbursed for construction in progress		22,810	[4]	14,263
Capital improvements to existing properties		10,779	[4]	6,639
Total cash invested in real property		50,236	[4]	$ 375,504
Outpatient Medical [Member] | Preliminary [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Total cash invested in real property		$ 17,637
[1]	(1) Includes acquisitions with an aggregate purchase price of $115,875,000 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 $53,636,000 for which the allocation of the purchase price consideration is preliminary and subject to change.
[3]	(2) Excludes $113,000 and $1,677,000 of cash acquired during the three months ended March 31, 2016 and 2015, respectively.
[4]	(1) Includes acquisitions with an aggregate purchase price of $17,637,000 for which the allocation of the purchase price consideration is preliminary and subject to change.
[5]	(2) 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 an44

Real Property Acquisitions and Development (Details 2) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Development projects:
Total development projects	$ 35,363	$ 16,592
Expansion projects	0	19,541
Total construction in progress conversions	35,363	36,133
Outpatient Medical [Member]
Development projects:
Total development projects	$ 35,363	$ 16,592

Real Estate Intangibles (Detail

Real Estate Intangibles (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2016	Dec. 31, 2015
Intangible Assets:
Gross historical cost	$ 1,346,064	$ 1,350,585
Accumulated amortization	923,712	881,096
Net book value	$ 422,352	$ 469,489
Weighted-average amortization period in years	14 years 7 months	13 years 5 months
Intangible Liabilities:
Gross historical cost	$ 100,962	$ 100,996
Accumulated amortization	47,983	46,048
Net book value	$ 52,979	$ 54,948
Weighted-average amortization period in years	14 years 9 months	14 years 6 months
In place lease intangibles [Member]
Intangible Assets:
Gross historical cost	$ 1,196,335	$ 1,179,537
Above market tenant leases [Member]
Intangible Assets:
Gross historical cost	62,544	67,529
Below market ground leases [Member]
Intangible Assets:
Gross historical cost	62,643	80,224
Lease commissions [Member]
Intangible Assets:
Gross historical cost	24,542	23,295
Below market tenant leases [Member]
Intangible Liabilities:
Gross historical cost	93,054	93,089
Above market ground leases [Member]
Intangible Liabilities:
Gross historical cost	$ 7,908	$ 7,907

Real Estate Intangibles (Real E

Real Estate Intangibles (Real Estate Intangible Maturity Schedule) (Details) - USD ($) $ in Thousands	Mar. 31, 2016	Dec. 31, 2015
Estimated Aggregate Amortization Expense For Acquired Lease Intangibles Expected To Be Recognized [Line Items]
Totals	$ 422,352	$ 469,489
Intangible Liability [Member]
Estimated Aggregate Amortization Expense For Acquired Lease Intangibles Expected To Be Recognized [Line Items]
2,016	3,894
2,017	6,807
2,018	6,181
2,019	5,771
2,020	5,290
Thereafter	25,036
Totals	52,979
Intangible Asset [Member]
Estimated Aggregate Amortization Expense For Acquired Lease Intangibles Expected To Be Recognized [Line Items]
2,016	84,239
2,017	79,195
2,018	44,698
2,019	25,238
2,020	22,341
Thereafter	166,641
Totals	$ 422,352

Real Estate Intangibles (Deta47

Real Estate Intangibles (Details 1) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Real Estate Intangible Amortization [Abstract]
Rental income related to above/below market tenant leases, net	$ 81	$ 206
Property operating expenses related to above/below market ground leases, net	(311)	(319)
Depreciation and amortization related to in place lease intangibles and lease commissions	$ (34,454)	$ (24,324)

Dispositions, Assets Held for48

Dispositions, Assets Held for Sale and Discontinued Operations (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Real property dispositions:
Total dispositions	$ 0	$ 120,420
Net loss (gain) on sales of properties	0	56,845
Proceeds from sales of real property	0	177,265
Triple Net [Member]
Real property dispositions:
Total dispositions	0	110,998
Outpatient Medical [Member]
Real property dispositions:
Total dispositions	$ 0	$ 9,422

Dispositions, Assets Held for49

Dispositions, Assets Held for Sale and Discontinued Operations (Details 2) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Revenues:
Rental income, disposed	$ 5,477	$ 12,166
Expenses:
Interest expense, disposed	851	2,262
Property operating expenses, disposed	1,362	1,527
Depreciation expense, disposed	820	3,256
Expenses, disposed	3,033	7,045
Income (loss) from disposed properties	$ 2,444	$ 5,121

Real Estate Loans Receivable (D

Real Estate Loans Receivable (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Advances on real estate loans receivable:
Investments in new loans	$ 8,013	$ 368,080
Draws on existing loans	19,238	16,615
Net cash advances on real estate loans	27,251	384,695
Receipts on real estate loans receivable:
Loan payoffs	116,358	8,568
Principal payments on loans	3,107	7,933
Sub-total	119,465	16,501
Less : Non-cash activity	(25,691)	0
Total receipts on real estate loans	93,774	16,501
Net advances (receipts) on real estate loans	(66,523)	368,194
Change in balance due to foreign currency translation	(1,987)	(3,096)
Net change Real Estate Loans Receivable	(94,201)	365,098
Triple Net [Member]
Advances on real estate loans receivable:
Investments in new loans	8,013	368,080
Draws on existing loans	19,206	14,330
Net cash advances on real estate loans	27,219	382,410
Receipts on real estate loans receivable:
Loan payoffs	104,068	8,568
Principal payments on loans	3,107	7,933
Sub-total	107,175	16,501
Less : Non-cash activity	(25,691)	0
Total receipts on real estate loans	81,484	16,501
Net advances (receipts) on real estate loans	(54,265)	365,909
Change in balance due to foreign currency translation	(1,987)	(3,096)
Net change Real Estate Loans Receivable	(81,943)	362,813
Outpatient Medical [Member]
Advances on real estate loans receivable:
Investments in new loans	0	0
Draws on existing loans	32	2,285
Net cash advances on real estate loans	32	2,285
Receipts on real estate loans receivable:
Loan payoffs	12,290	0
Principal payments on loans	0	0
Sub-total	12,290	0
Less : Non-cash activity	0	0
Total receipts on real estate loans	12,290	0
Net advances (receipts) on real estate loans	(12,258)	2,285
Change in balance due to foreign currency translation	0	0
Net change Real Estate Loans Receivable	$ (12,258)	$ 2,285

Investments in Unconsolidated51

Investments in Unconsolidated Entities (Summary of Investments in Unconsolidated Entities) (Details) - USD ($) $ in Thousands		Mar. 31, 2016	Dec. 31, 2015
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated entities		$ 545,070	$ 542,281
Triple Net [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated entities		$ 34,289	$ 36,351
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		$ 504,355	$ 499,537
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]
Equity Method Investment, Ownership Percentage	[1]	43.00%	43.00%
Investments in unconsolidated entities		$ 6,426	$ 6,393
[1]	(1) Excludes ownership of in-substance real estate.

Investments in Unconsolidated52

Investments in Unconsolidated Entities (Details) $ in Thousands	Mar. 31, 2016USD ($)
Schedule of Equity Method Investments [Line Items]
Unamortized Investment In Joint Venture Primarily Attributable To Real Estate And Related Intangible Assets	$ 155,831

Credit Concentration (Details)

Credit Concentration (Details) $ in Thousands		3 Months Ended
		Mar. 31, 2016USD ($)properties		Mar. 31, 2015USD ($)	Dec. 31, 2015
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	1,434
Percent of NOI	[1],[2]	100.00%
Net Operating Income		$ 597,414	[1]	$ 517,716
Credit Concentration (Textual) [Abstract]
Percentage total investments with top five customers					46.00%
Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]	100.00%
Net Operating Income	[1]	$ 597,414
Genesis HealthCare [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	187
Genesis HealthCare [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]	17.00%
Net Operating Income	[1]	$ 99,894
Sunrise Senior Living [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1],[3]	150
Sunrise Senior Living [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2],[3]	13.00%
Net Operating Income	[1],[3]	$ 75,953
Brookdale [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	148
Brookdale [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]	7.00%
Net Operating Income	[1]	$ 42,585
Benchmark Senior Living [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	49
Benchmark Senior Living [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]	4.00%
Net Operating Income	[1]	$ 25,875
Revera [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1],[3]	97
Revera [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2],[3]	6.00%
Net Operating Income	[1],[3]	$ 35,654
Remaining Portfolio [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	803
Remaining Portfolio [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]	53.00%
Net Operating Income	[1]	$ 317,453
[1]	(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]	(2) NOI with our top five relationships comprised 46% of total NOI for the year ending December 31, 2015.
[3]	(3) Revera owns a controlling interest in Sunrise Senior Living.

Borrowings Under Credit Facil54

Borrowings Under Credit Facilities and Related Items (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016		Mar. 31, 2015		Dec. 31, 2015
Aggregate borrowings under the unsecured line of credit arrangements
Balance outstanding at quarter end	$ 645,000	[1]	$ 410,000	[1]	$ 835,000
Maximum amount outstanding at any month end	945,000		430,000
Average amount outstanding (total of daily principal balances divided by days in period)	$ 671,044		$ 408,944
Weighted average interest rate (actual interest expense divided by average borrowings outstanding)	1.29%		1.21%
[1]	(1) As of March 31, 2016, letters of credit in the aggregate amount of $48,930,000 have been issued, which reduces the borrowing capacity on the unsecured revolving credit facility.

Borrowings Under Credit Facil55

Borrowings Under Credit Facilities and Related Items (Details Textual) $ in Thousands	3 Months Ended
	Mar. 31, 2016USD ($)properties		Dec. 31, 2015USD ($)	Mar. 31, 2015USD ($)	[1]
Line Of Credit Facility [Line Items]
Unsecured line of credit arrangement	$ 2,500,000
Number of banks in consortium | properties	28
Available to borrow in alternate currencies	$ 500,000
Agent bank's prime rate of interest	1.36%
Annual facility fee for each bank based on commitment amount	0.15%
Debt instrument maturity date	Oct. 31, 2018
Term Loan Interest Rate Margin	0.925%
HCN Term Loan	$ 500,000
HCN Canadian Denomiated Term Loan	250,000
Line Of Credit	645,000	[1]	$ 835,000	$ 410,000
Accordion Feature [Member]
Line Of Credit Facility [Line Items]
HCN Term Loan	1,000,000
HCN Canadian Denomiated Term Loan	$ 250,000
[1]	(1) As of March 31, 2016, letters of credit in the aggregate amount of $48,930,000 have been issued, which reduces the borrowing capacity on the unsecured revolving credit facility.

Senior Unsecured Notes and Se56

Senior Unsecured Notes and Secured Debt (Details) £ in Thousands, CAD in Thousands, $ in Thousands		3 Months Ended
		Mar. 31, 2016CAD	Mar. 31, 2016GBP (£)	Mar. 31, 2016USD ($)	Dec. 31, 2015USD ($)	Oct. 01, 2015USD ($)
Principal payments due on debt obligations
2,016				$ 434,322
2,017				940,995
2,018				1,081,533
2,019	[1],[2]			1,678,515
2,020	[3]			863,875
Thereafter	[4],[5],[6],[7]			7,423,341
Totals				12,422,581
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Senior unsecured notes				8,828,053	$ 8,548,055
Secured debt				3,515,053	$ 3,509,142
Debt instrument maturity date		Oct. 31, 2018
Senior Unsecured Notes [Member]
Principal payments due on debt obligations
2,016	[8],[9]			0
2,017	[8],[9]			450,000
2,018	[8],[9]			450,000
2,019	[1],[2],[8],[9]			1,292,767
2,020	[3],[8],[9]			681,321
Thereafter	[4],[5],[6],[7],[8],[9]			6,060,005
Totals	[8],[9]			8,934,093
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Notes, annual stated interest rates, Minimum		1.41%
Notes, annual stated interest rates, Maximum		6.50%
Secured Debt [Member]
Principal payments due on debt obligations
2,016	[8],[10]			434,322
2,017	[8],[10]			490,995
2,018	[8],[10]			631,533
2,019	[1],[2],[8],[10]			385,748
2,020	[3],[8],[10]			182,554
Thereafter	[4],[5],[6],[7],[8],[10]			1,363,336
Totals	[8],[10]			3,488,488
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				6,226,111
4.00% Senior Unsecured Notes Due 2025 [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Senior unsecured notes issued amount				750,000
Debt Instrument, Issuance Date		May 1, 2015
Senior Unsecured Notes Additional Issued Amount						$ 500,000
Canadian Denominated Unsecured Term Loan [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Senior unsecured notes		CAD 250,000		$ 192,767
Interest Rate margin		1.85%
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%
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	$ 719,050
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	$ 790,955
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
Interest Rate margin		1.41%
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%
4.25% Senior Unsecured Notes Due 2026
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Senior unsecured notes issued amount				700,000
Debt Instrument, Issuance Date		Mar. 1, 2016
3.35% senior unsecured note due 2020
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Senior unsecured notes issued amount		CAD 300,000		$ 231,321
Debt Instrument, Issuance Date		Nov. 1, 2015
[1]	(4) On July 25, 2014, we refinanced the funding on a $250,000,000 Canadian-denominated unsecured term credit facility (approximately $192,767,000 based on the Canadian/U.S. Dollar exchange rate on March 31, 2016). 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 (1.85% at March 31, 2016).
[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 (1.41% at March 31, 2016).
[3]	(6) In November 2015, one of our wholly-owned subsidiaries issued and we guaranteed $300,000,000 of Canadian-denominated 3.35% senior unsecured notes due 2020 (approximately $231,321,000 based on the Canadian/U.S. Dollar exchange rate on March 31, 2016).
[4]	(10) In March 2016, we issued $700,000,000 of 4.25% senior unsecured notes due 2026.
[5]	(7) On November 20, 2013, we completed the sale of £550,000,000 (approximately $790,955,000 based on the Sterling/U.S. Dollar exchange rate in effect on March 31, 2016) of 4.8% senior unsecured notes due 2028.
[6]	(8) On November 25, 2014, we completed the sale of £500,000,000 (approximately $719,050,000 based on the Sterling/U.S. Dollar exchange rate in effect on March 31, 2016) of 4.5% senior unsecured notes due 2034.
[7]	(9) 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.
[8]	(1) Amounts represent principal amounts due and do not include unamortized premiums/discounts, debt issuance costs, or other fair value adjustments as reflected on the balance sheet.
[9]	(2) Annual interest rates range from 1.41% to 6.5%.
[10]	(3) Annual interest rates range from 1.0% to 7.98%. Carrying value of the properties securing the debt totaled $6,226,111,000 at March 31, 2016.

Senior Unsecured Notes and Se57

Senior Unsecured Notes and Secured Debt (Details 1) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2016USD ($)	Mar. 31, 2015USD ($)	Dec. 31, 2015USD ($)	Dec. 31, 2014USD ($)
Unsecured note issuances
Senior unsecured debt issued	$ 688,560	$ 0
Senior unsecured debt redeemed	400,000	154,654
Excluding Fair Value Adjustments [Member]
Unsecured note issuances
Senior unsecured debt balance	8,934,093	7,567,921	$ 8,645,758	$ 7,817,154
Senior unsecured debt issued	700,000	0
Senior unsecured debt extinguished	(400,000)	0
Senior unsecured debt redeemed	0	(154,654)
Senior unsecured debt foreign currency	$ (11,665)	$ (94,579)
Senior unsecured debt balance average rate	0.04266	0.04352	0.04237	0.04385
Senior unsecured debt issued average rate	0.0425	0
Senior unsecured debt extinguished average rate	0.03625	0
Senior unsecured debt redeemed average rate	0	0.03
Senior unsecured debt foreign currency average rate	0.03943	0.04333

Senior Unsecured Notes and Se58

Senior Unsecured Notes and Secured Debt (Details 2) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2016USD ($)	Mar. 31, 2015USD ($)	Dec. 31, 2015USD ($)	Dec. 31, 2014USD ($)
Secured debt principal activity
Secured debt issued	$ 75,136	$ 82,724
Secured debt extinguished	130,343	208,057
Excluding Fair Value Adjustments [Member]
Secured debt principal activity
Secured debt principal balance	3,488,488	2,972,657	$ 3,478,207	$ 2,941,765
Secured debt issued	75,136	82,724
Secured debt assumed	0	205,897
Secured debt extinguished	(111,701)	(192,427)
Secured debt principal payments	(18,642)	(49,672)
Secured debt foreign currency	$ 65,488	$ (15,630)
Secured debt principal balance average rate	0.044	0.0488	0.0444	0.0494
Secured debt principal issued average rate	0.0306	0.0234
Secured debt principal assumed average rate	0	0.0398
Secured debt principal extinguished average rate	0.0445	0.0402
Secured debt principal payment average rate	0.0454	0.0396
Secured debt principal foreign currency average rate	0.0367	0.0501

Derivative Instrument (Notional

Derivative Instrument (Notional Table) (Details) - USD ($) $ in Thousands		3 Months Ended	12 Months Ended
		Mar. 31, 2016	Dec. 31, 2015
Designated as Hedging Instrument [Member] | Cash Flow Hedging [Member] | USD
Derivatives Fair Value [Line Items]
Derivative, Notional Amount		$ 57,000	$ 57,000
Designated as Hedging Instrument [Member] | Cash Flow Hedging [Member] | CAD
Derivatives Fair Value [Line Items]
Derivative, Notional Amount		72,000	72,000
Designated as Hedging Instrument [Member] | Cash Flow Hedging [Member] | GBP
Derivatives Fair Value [Line Items]
Derivative, Notional Amount		60,000	60,000
Designated as Hedging Instrument [Member] | Net Investment Hedging [Member] | CAD
Derivatives Fair Value [Line Items]
Derivative, Notional Amount		1,175,000	1,175,000
Notional Amount Of Nonderivative Instruments		250,000	250,000
Designated as Hedging Instrument [Member] | Net Investment Hedging [Member] | GBP
Derivatives Fair Value [Line Items]
Derivative, Notional Amount		550,000	550,000
Notional Amount Of Nonderivative Instruments		1,050,000	1,050,000
Not Designated as Hedging Instrument [Member] | CAD
Derivatives Fair Value [Line Items]
Derivative, Notional Amount	[1]	$ 47,000	$ 47,000
[1]

Derivative Instruments (Details

Derivative Instruments (Details 1) - USD ($)	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Derivative [Line Items]
Derivative Gain Loss On Derivative Net	$ 0	$ 58,427,000	[1]
Interest Rate Swap [Member]
Derivative [Line Items]
Gain (loss) on interest rate swaps recalssified from AOCI into income (effective portion)	(483,000)	(466,000)
Foreign Exchange Contract [Member]
Derivative [Line Items]
Gain (loss) on forward exchange contracts recognized in income.	(1,327,000)	2,747,000
Gain on Release of cumulative translation adjustment related to net investment hedge of an equity investment	$ (2,739,000)	$ 184,051,000
[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.

Derivative Instruments (Textual

Derivative Instruments (Textual) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Derivative Instruments [Abstract]
Cash Flow Hedge Gain Loss To Be Reclassified Within Twelve Months 2	$ 1,412
Derivative Cash Received On Hedge	$ 0	$ 72,477

Commitments and Contingencies (

Commitments and Contingencies (Details Textual) $ in Thousands	3 Months Ended
	Mar. 31, 2016USD ($)Number	Dec. 31, 2015USD ($)
Commitments and Contingencies (Textual) [Abstract]
Number of outstanding letters of credit | Number	9
Letter of credit obligation	$ 90,401
Line Of Credit Facility [Line Items]
Outstanding construction financings for leased properties	297,023	$ 258,968
Additional financing to complete construction	637,356
Total contingent purchase obligations	$ 28,713
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	$ 1,056,909
Operating Leases, Future Minimum Payments Due, Future Minimum Sublease Rentals	75,296
Capital Leases, Future Minimum Payments Due	$ 97,385
Letter Of Credit Expiration Date Maximum	Dec. 31, 2018
Letter Of Credit Expiration Date Minimum	Jan. 1, 2016

Stockholder's Equity (Details)

Stockholder's Equity (Details) - shares	Mar. 31, 2016	Dec. 31, 2015
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	357,697,257	355,594,373
Outstanding shares	356,772,720	354,777,670

Stockholder's Equity (Details 1

Stockholder's Equity (Details 1)	3 Months Ended
	Mar. 31, 2016USD ($)$ / sharesshares	Mar. 31, 2015USD ($)$ / sharesshares
Summary of common stock issuances
Equity shelf plan issuances, Shares Issued | shares	443,096
Equity shelf plan issuances, average price | $ / shares	67.12
Equity Shelf Plan Issuances Gross Proceeds	$ 30,192,000
Equity Shelf Plan Issuances Net Proceeds	$ 29,739,000
Dividend reinvestment plan issuances, Shares Issued | shares	1,058,085	766,488
Dividend reinvestment plan issuances, Average Price	60	76.38
Dividend reinvestment plan issuances, Net Proceeds	$ 63,484,000	$ 58,547,000
Dividend reinvestment plan issuances, Gross Proceeds	$ 63,484,000	$ 58,547,000
Option exercises, Shares | shares	9,864	149,788
Option exercises, Average Price	21.29	47.17
Option exercises, Gross Proceeds	$ 210,000	$ 7,065,000
Option exercises, Net Proceeds	$ 210,000	$ 7,065,000
Stock incentive plans, net of forfeitures, Shares Issued | shares	484,005	166,815
Senior note conversions | shares		1,048,641
Issuance of Common Stock, Shares | shares	1,995,050	21,681,732
Gross Proceeds From Issuance of Common Stock	$ 93,886,000	$ 1,541,637,000
Net proceeds from the issuance of common stock	$ 93,433,000	$ 1,489,547,000
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 ($) $ in Thousands		Mar. 31, 2016	Dec. 31, 2015	Mar. 31, 2015	Dec. 31, 2014
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges		$ (933)	$ (1,416)	$ (2,809)	$ (650)
Unrecognized losses on equity investments		(7,549)	0	(11,687)	0
Unrecognized gains (losses) on foreign currency translation		(99,230)	(85,484)	(91,411)	(74,770)
Unrecognized actuarial losses		(1,341)	(1,343)	(1,589)	(1,589)
Totals		(109,053)	$ (88,243)	(107,496)	$ (77,009)
Other comprehensive income before reclassification adjustments
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges		0		(2,625)
Unrecognized losses on equity investments		(7,549)		(11,687)
Unrecognized gains (losses) on foreign currency translation		(13,746)		(16,641)
Unrecognized actuarial losses		2		0
Totals		(21,293)		(30,953)
Reclassification amount to net income
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges	[1]	483		466
Unrecognized losses on equity investments		0		0
Unrecognized gains (losses) on foreign currency translation		0		0
Unrecognized actuarial losses		0		0
Totals		483		466
Net current period other comprehensive income
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges		483		(2,159)
Unrecognized losses on equity investments		(7,549)		(11,687)
Unrecognized gains (losses) on foreign currency translation		(13,746)		(16,641)
Unrecognized actuarial losses		2		0
Totals		$ (20,810)		$ (30,487)
[1]	(1) Please see note 11 for additional information.

Stockholder's Equity (Details 5

Stockholder's Equity (Details 5) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Summary of dividend payments
Dividends declared and paid per common share	$ 0.86	$ 0.825
Common stock cash dividends	$ 305,770	$ 272,569
Total dividends paid	$ 322,122	$ 288,921
Series I Preferred Stock [Member]
Summary of dividend payments
Dividends declared and paid per preferred share	$ 0.8125	$ 0.8125
Preferred stock cash dividends	$ 11,680	$ 11,680
Series J Preferred Stock [Member]
Summary of dividend payments
Dividends declared and paid per preferred share	$ 0.4064	$ 0.4064
Preferred stock cash dividends	$ 4,672	$ 4,672

Stock Incentive Plans (Details

Stock Incentive Plans (Details Textual) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Stock Incentive Plans [Line Items]
Number of common stock authorized for Long-Term Incentive Plan	6,200
Stock-based compensation expense	$ 8,186	$ 9,054
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] | Officer [Member]
Stock Incentive Plans [Line Items]
Vesting period	10 years

Earnings Per Share (Details)

Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Computation of basic and diluted earnings per share
Numerator for basic and diluted earnings per share - net income (loss) attributable to common stockholders	$ 148,969	$ 190,799
Denominator for basic earnings per share - weighted average shares	355,076	336,754
Effect of dilutive securities:
Employee stock options	101	200
Non-vested restricted shares	253	416
Redeemable shares	621	0
Convertible senior unsecured notes	0	442
Dilutive potential common shares	975	1,058
Denominator for diluted earnings per share - adjusted weighted average shares	356,051	337,812
Basic earnings per share	$ 0.42	$ 0.57
Diluted earnings per share	$ 0.42	$ 0.56

Disclosure about Fair Value o69

Disclosure about Fair Value of Financial Instruments (Details) - USD ($) $ in Thousands	Mar. 31, 2016		Dec. 31, 2015	Mar. 31, 2015		Dec. 31, 2014
Financial Assets:
Loans receivable, Fair value	$ 572,909		$ 663,501
Available-for-sale equity investments, Carrying Amount	15,230		22,779
Available-for-sale equity investments, Fair Value	15,230	[1]	22,779
Cash and cash equivalents, Carrying Amount	355,949		360,908	$ 202,273		$ 473,726
Cash and cash equivalents, Fair Value	355,949		360,908
Foreign Currency Forward Contracts Carrying Value	100,162		129,520
Foreign Currency Forward Contracts Fair Value	100,162		129,520
Financial Liabilities:
Borrowings under primary unsecured credit facilities, Carrying Value	645,000	[2]	835,000	$ 410,000	[2]
Borrowings under primary unsecured credit facilities, Fair Value	645,000		835,000
Senior unsecured notes, Carrying Amount	8,828,053		8,548,055
Senior unsecured notes, Fair Value	9,391,062		9,020,529
Secured debt, Carrying Amount	3,515,053		3,509,142
Secured debt, Fair Value	3,724,054		3,678,564
Foreign Currency Forward Contracts Carrying Value	2,308		0
Foreign Currency Forward Contracts, Fair Value	2,308		0
Redeemable OP unitholder interests carrying value	114,481		112,029
Redeemable OP unitholder interests fair value	114,481		112,029
Mortgage Loans on Real Estate [Member]
Financial Assets:
Loans receivable, Carrying Amount	546,573		635,492
Loans receivable, Fair value	572,909		663,501
Other Real Estate Loans Receivable [Member]
Financial Assets:
Loans receivable, Carrying Amount	178,718		184,000
Loans receivable, Fair value	$ 182,829		$ 185,693
[1]	(1) Unrealized gains or losses on equity investments are recorded in accumulated other comprehensive income (loss) at each measurement date. During the year ended December 31, 2015, we recognized an other than temporary impairment charge of $35,648,000 on the Genesis Healthcare stock investment. Also, see Note 11 for details related to the gain on the derivative asset originally recognized.
[2]	(1) As of March 31, 2016, letters of credit in the aggregate amount of $48,930,000 have been issued, which reduces the borrowing capacity on the unsecured revolving credit facility.

Disclosure about Fair Value o70

Disclosure about Fair Value of Financial Instruments (Details 1) - USD ($) $ in Thousands		Mar. 31, 2016		Dec. 31, 2015
The Market approach utilized to measure fair value of financial assets and liabilities on recurring basis
Available-for-sale equity investments		$ 15,230	[1]	$ 22,779
Foreign currency forward contracts	[2]	97,854
Totals		227,565
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]	15,230
Totals		15,230
Level 2 [Member]
The Market approach utilized to measure fair value of financial assets and liabilities on recurring basis
Foreign currency forward contracts	[2]	97,854
Redeemable OP unitholder interests		114,481
Totals		$ 212,335
[1]	(1) Unrealized gains or losses on equity investments are recorded in accumulated other comprehensive income (loss) at each measurement date. During the year ended December 31, 2015, we recognized an other than temporary impairment charge of $35,648,000 on the Genesis Healthcare stock investment. Also, see Note 11 for details related to the gain on the derivative asset originally recognized.
[2]	(2) Please see Note 11 for additional information.

Segment Reporting (Details)

Segment Reporting (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2016USD ($)		Mar. 31, 2015USD ($)		Dec. 31, 2015USD ($)
Summary of information for reportable segments
Rental income	$ 415,663		$ 379,587
Resident fees and services	602,149		492,510
Interest income	25,188		16,994
Other income	4,050		5,086
Total revenues	1,047,050		894,177
Property operating expenses	449,636		376,461
Net Operating Income from Continuing Operations	597,414	[1]	517,716
Interest expense	132,960		121,080
Loss (gain) on derivatives, net	0		(58,427)	[2]
Depreciation and amortization	228,696		188,829
General and administrative	45,691		35,138
Transaction costs	8,208		48,554
Loss (gain) on extinguishment of debt, net	(24)		15,401
Impairment of Asset	14,314		2,220
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	167,569		164,921
Income tax (expense) benefit	1,725		304
(Loss) income from unconsolidated entities	(3,820)		(12,648)
Income (loss) from continuing operations	165,474		152,577
Gain (loss) on real estate dispositions, net	0		56,845
Net income	165,474		$ 209,422
Total assets	$ 29,088,293				$ 29,023,845
Percent Of Assets	1				1
Percent Of Revenues	1		1
Triple Net [Member]
Summary of information for reportable segments
Rental income	$ 283,825		$ 261,993
Resident fees and services	0		0
Interest income	22,853		14,699
Other income	1,490		3,883
Total revenues	308,168		280,575
Property operating expenses	0		0
Net Operating Income from Continuing Operations	308,168		280,575
Interest expense	5,606		8,424
Loss (gain) on derivatives, net	0		(58,427)
Depreciation and amortization	79,800		69,420
General and administrative	0		0
Transaction costs	2,852		36,171
Loss (gain) on extinguishment of debt, net	(24)		10,337
Impairment of Asset	14,314		2,220
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	205,620		212,430
Income tax (expense) benefit	(317)		419
(Loss) income from unconsolidated entities	3,081		1,393
Income (loss) from continuing operations	208,384		214,242
Gain (loss) on real estate dispositions, net	0		54,096
Net income	208,384		268,338
Total assets	12,337,195
Senior housing - operating [Member]
Summary of information for reportable segments
Rental income	0		0
Resident fees and services	602,149		492,510
Interest income	1,031		1,031
Other income	2,189		1,020
Total revenues	605,369		494,561
Property operating expenses	408,894		338,507
Net Operating Income from Continuing Operations	196,475		156,054
Interest expense	40,828		34,458
Loss (gain) on derivatives, net	0		0
Depreciation and amortization	101,832		76,636
General and administrative	0		0
Transaction costs	3,933		12,042
Loss (gain) on extinguishment of debt, net	0		0
Impairment of Asset	0		0
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	49,882		32,918
Income tax (expense) benefit	2,767		(533)
(Loss) income from unconsolidated entities	(6,935)		(15,073)
Income (loss) from continuing operations	45,714		17,312
Gain (loss) on real estate dispositions, net	0		0
Net income	45,714		17,312
Total assets	11,595,907
Outpatient Medical [Member]
Summary of information for reportable segments
Rental income	131,838		117,594
Resident fees and services	0		0
Interest income	1,304		1,264
Other income	313		161
Total revenues	133,455		119,019
Property operating expenses	40,742		37,954
Net Operating Income from Continuing Operations	92,713		81,065
Interest expense	5,744		7,388
Loss (gain) on derivatives, net	0		0
Depreciation and amortization	47,064		42,773
General and administrative	0		0
Transaction costs	1,423		341
Loss (gain) on extinguishment of debt, net	0		0
Impairment of Asset	0		0
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	38,482		30,563
Income tax (expense) benefit	(228)		466
(Loss) income from unconsolidated entities	34		1,032
Income (loss) from continuing operations	38,288		32,061
Gain (loss) on real estate dispositions, net	0		2,749
Net income	38,288		34,810
Total assets	5,059,616
Non Segment Corporate [Member]
Summary of information for reportable segments
Rental income	0		0
Resident fees and services	0		0
Interest income	0		0
Other income	58		22
Total revenues	58		22
Property operating expenses	0		0
Net Operating Income from Continuing Operations	58		22
Interest expense	80,782		70,810
Loss (gain) on derivatives, net	0		0
Depreciation and amortization	0		0
General and administrative	45,691		35,138
Transaction costs	0		0
Loss (gain) on extinguishment of debt, net	0		5,064
Impairment of Asset	0		0
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	(126,415)		(110,990)
Income tax (expense) benefit	(497)		(48)
(Loss) income from unconsolidated entities	0		0
Income (loss) from continuing operations	(126,912)		(111,038)
Gain (loss) on real estate dispositions, net	0		0
Net income	(126,912)		(111,038)
Total assets	95,575
Canada [Member]
Summary of information for reportable segments
Total revenues	104,138		$ 57,226
Total assets	$ 2,676,102				$ 1,286,079
Percent Of Assets	0.092				0.044
Percent Of Revenues	0.099		0.064
United Kingdom [Member]
Summary of information for reportable segments
Total revenues	$ 100,555		$ 91,815
Total assets	$ 2,950,387				$ 1,741,973
Percent Of Assets	0.101				0.06
Percent Of Revenues	0.096		0.103
United States [Member]
Summary of information for reportable segments
Total revenues	$ 842,357		$ 745,136
Total assets	$ 23,461,804				$ 25,995,793
Percent Of Assets	0.807				0.896
Percent Of Revenues	0.805		0.833
[1]	(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]	(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.

Income Taxes and Distributions

Income Taxes and Distributions (Details)	3 Months Ended
	Mar. 31, 2016
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%

Variable Interest Entity Disc73

Variable Interest Entity Disclosure (Details) - Variable Interest Entity, Primary Beneficiary [Member] - USD ($) $ in Thousands		Mar. 31, 2016	Dec. 31, 2015
Variable Interest Entity [Line Items]
Total assets	[1]	$ 1,044,887	$ 470,730
Total equity		508,650	245,887
Total liabilities and equity		1,044,887	470,730
Net real property owned [Member]
Variable Interest Entity [Line Items]
Total assets		1,020,357	453,889
Cash and cash equivalents [Member]
Variable Interest Entity [Line Items]
Total assets		14,080	8,759
Receivables and other assets [Member]
Variable Interest Entity [Line Items]
Total assets		10,450	8,082
Secured Debt [Member]
Variable Interest Entity [Line Items]
Liabilities		451,952	147,021
Accrued expenses and other liabilities [Member]
Variable Interest Entity [Line Items]
Liabilities		12,845	7,732
Redeemable noncontrolling interests [Member]
Variable Interest Entity [Line Items]
Liabilities		$ 71,440	$ 70,090
[1]	Assets of the consolidated variable interest entities can only be used to settle obligations relating to such variable interest entities. Liabilities of the consolidated variable interest entities represent claims against the specific assets of the variable interest entities.