Welltower (WELL) 10-Q 2 Aug 16 2016 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - USD ($)	6 Months Ended
	Jun. 30, 2016	Jul. 31, 2016
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	Jun. 30, 2016
Amendment Flag	false
Document Fiscal Year Focus	2,016
Document Fiscal Period Focus	Q2
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	$ 27,176,263,145
Entity Common Stock Shares Outstanding		357,915,158

Consolidated Balance Sheets (Un

Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Jun. 30, 2016		Dec. 31, 2015
Real property owned:
Land and land improvements	$ 2,537,508		$ 2,563,445
Buildings and improvements	25,293,007		25,522,542
Acquired lease intangibles	1,345,424		1,350,585
Real property held for sale, net of accumulated depreciation	501,192		169,950
Construction in progress	475,203		258,968
Gross real property owned	30,152,334		29,865,490
Less accumulated depreciation and amortization	(4,109,585)		(3,796,297)
Net real property owned	26,042,749		26,069,193
Real estate loans receivable:
Net real estate loans receivable	647,677		819,492
Net real estate investments	26,690,426		26,888,685
Other assets:
Investments in unconsolidated entities	543,068		542,281
Goodwill	68,321		68,321
Cash and cash equivalents	466,585		360,908
Restricted cash	58,440		61,782
Straight-line rent receivable	449,617		395,562
Receivables and other assets	688,044		706,306
Total other assets	2,274,075		2,135,160
Total assets	28,964,501		29,023,845
Liabilities:
Borrowings under primary unsecured credit facilities, Carrying Value	745,000	[1]	835,000
Senior unsecured notes	8,711,790		8,548,055
Secured debt	3,442,178		3,509,142
Capital lease obligations	74,759		75,489
Accrued expenses and other liabilities	728,080		697,191
Total liabilities	13,701,807		13,664,877
Redeemable noncontrolling interests	394,126		183,083
Equity:
Preferred stock	1,006,250		1,006,250
Common stock	357,950		354,811
Capital in excess of par value	16,625,186		16,478,300
Treasury stock	(51,288)		(44,372)
Cumulative net income	4,102,919		3,725,772
Cumulative dividends	(7,491,922)		(6,846,056)
Accumulated other comprehensive income (loss)	(159,638)		(88,243)
Other equity	3,917		4,098
Total Welltower Inc. stockholders' equity	14,393,374		14,590,560
Noncontrolling interests	475,194		585,325
Total equity	14,868,568		15,175,885
Total liabilities and equity	$ 28,964,501		$ 29,023,845
[1]	(1) As of June 30, 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		6 Months Ended
		Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016		Jun. 30, 2015
Revenues:
Rental income		$ 422,628	$ 396,626	$ 838,290		$ 776,213
Resident fees and services		615,220	535,553	1,217,369		1,028,063
Interest income		24,007	20,576	49,195		37,570
Other income		14,802	4,414	18,851		9,500
Total revenues		1,076,657	957,169	2,123,705		1,851,346
Expenses:
Interest expense		132,326	118,861	265,285		239,942
Property operating expenses		458,832	398,354	908,468		774,815
Depreciation and amortization		226,569	208,802	455,265		397,631
General and administrative		39,914	38,474	85,606		73,612
Transaction costs		5,157	12,491	13,365		61,045
Loss (gain) on derivatives, net		0	0	0	[1]	(58,427)
Loss (gain) on extinguishment of debt, net		33	18,887	9		34,288
Impairment of Asset		0	0	14,314		2,220
Other expenses		3,161	10,583	3,161		10,583
Total expenses		865,992	806,452	1,745,473		1,535,709
Income (loss) from continuing operations before income taxes and income from unconsolidated entities, total		210,665	150,717	378,232		315,637
Income tax (expense) benefit		513	(7,417)	2,239		(7,113)
(Loss) income from unconsolidated entities		(1,959)	(2,952)	(5,778)		(15,600)
Income from continuing operations		209,219	140,348	374,693		292,924
Gain (loss) on real estate dispositions, net		1,530	190,111	1,530		246,956
Net income		210,749	330,459	376,223		539,880
Less: Preferred stock dividends		16,352	16,352	32,703		32,703
Less: Net income (loss) attributable to noncontrolling interests	[2]	(1,077)	1,534	(924)		3,804
Net income (loss) attributable to common stockholders		$ 195,474	$ 312,573	$ 344,444		$ 503,373
Average number of common shares outstanding:
Basic		356,646	350,399	355,879		343,624
Diluted		358,891	351,366	357,489		344,623
Basic:
Income (loss) from continuing operations attributable to common stockholders, including real estate dispositions		$ 0.55	$ 0.89	$ 0.97		$ 1.46
Discontinued operations, net		0	0	0		0
Net income (loss) attributable to common stockholders, total		0.55	0.89	0.97		1.46
Diluted:
Income (loss) from continuing operations attributable to common stockholders, including real estate dispositions		0.54	0.89	0.96		1.46
Discontinued operations, net		0	0	0		0
Net income (loss) attributable to common stockholders, total		0.54	0.89	0.96		1.46
Dividends declared and paid per common share		$ 0.86	$ 0.825	$ 1.72		$ 1.65
[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		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016		Jun. 30, 2015
Statement of Comprehensive Income [Abstract]
Net income	$ 210,749	$ 330,459	$ 376,223		$ 539,880
Other comprehensive income (loss):
Unrecognized gain (loss) on equity investments	(3,611)	(3,413)	(11,160)		(15,100)
Unrecognized gain (loss) on cash flow hedges	487	462	970		(1,697)
Unrecognized actuarial gain/(loss)	0	0	2		0
Unrecognized gain (loss) on foreign currency translation	(50,384)	32,384	(49,012)		3,187
Total other comprehensive income (loss)	(53,508)	29,433	(59,200)		(13,610)
Total comprehensive income (loss), total	157,241	359,892	317,023		526,270
Total comprehensive income (loss) attributable to noncontrolling interests	(4,000)	5,140	11,271	[1]	(5,145)
Comprehensive income (loss) attributable to controlling interests	$ 161,241	$ 354,752	$ 305,752		$ 531,415
[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)	540,049					536,074				3,975
Other comprehensive income	(13,610)							(4,661)		(8,949)
Total comprehensive income	526,439
Net change in noncontrolling interests	62,398			(2,786)						65,184
Amounts related to stock incentive plans, net of forfeitures	8,342		211	16,304	(6,452)				(1,721)
Proceeds from issuance of common stock	1,563,401		21,528	1,541,873
Equity component of convertible debt	5,815		1,077	4,738
Option compensation expense	452								452
Cash dividends paid:
Common stock	(561,914)						(561,914)
Preferred Stock	(32,703)						(32,703)
Balances at end of period at Jun. 30, 2015	15,045,279	1,006,250	351,651	16,300,841	(41,693)	3,378,096	(6,230,540)	(81,670)	4,238	358,106
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)	380,236					377,147				3,089
Other comprehensive income	(59,200)							(71,395)		12,195
Total comprehensive income	321,036
Distributions to noncontrolling interests	(167,073)			(41,658)						(125,415)
Amounts related to stock incentive plans, net of forfeitures	25,727		688	32,284	(6,916)				(329)
Proceeds from issuance of common stock	158,711		2,451	156,260
Option compensation expense	148								148
Cash dividends paid:
Common stock	(613,163)						(613,163)
Preferred Stock	(32,703)						(32,703)
Balances at end of period at Jun. 30, 2016	$ 14,868,568	$ 1,006,250	$ 357,950	$ 16,625,186	$ (51,288)	$ 4,102,919	$ (7,491,922)	$ (159,638)	$ 3,917	$ 475,194

Consolidated Statements of Cash

Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands		6 Months Ended
		Jun. 30, 2016		Jun. 30, 2015
Operating activities
Net income (loss)		$ 376,223		$ 539,880
Adjustments to reconcile net income to net cash provided from (used in) operating activities:
Depreciation and amortization		455,265		397,631
Other amortization expenses		3,141		2,458
Asset Impairment Charges		14,314		2,220
Stock-based compensation expense		15,217		20,178
Loss (gain) on derivatives, net		0	[1]	(58,427)
Loss (gain) on extinguishment of debt, net		9		34,288
Income from unconsolidated entities		5,778		15,600
Rental income in excess of cash received		(54,055)		(57,047)
Amortization related to above (below) market leases, net		332		870
Net loss (gain) on sales of properties		(1,530)		(246,956)
Distributions by unconsolidated entities		351		282
Increase (decrease) in accrued expenses and other liabilities		36,705		10,417
Decrease (increase) in receivables and other assets		(3,009)		(42,048)
Net cash provided from (used in) operating activities		848,741		619,346
Investing activities
Cash disbursed for acquisitions		(287,455)		(2,153,970)
Cash disbursed for capital improvements to existing properties		(87,529)		(67,086)
Cash disbursed for construction in progress		(249,867)		(114,478)
Capitalized interest		(7,343)		(4,446)
Investment in real estate loans receivable		(51,059)		(416,588)
Other investments, net of payments		(16,664)		(110,531)
Principal collected on real estate loans receivable		168,343		37,342
Contributions to unconsolidated entities		(39,644)		(117,047)
Distributions by unconsolidated entities		19,301		116,288
Proceeds from (payments on) derivatives investing		56,842		72,477
Decrease (increase) in restricted cash		3,342		12,422
Proceeds from sales of real property		130,298		523,175
Net cash provided from (used in) investing activities		(361,435)		(2,222,442)
Financing activities
Net increase (decrease) under unsecured lines of credit arrangements		(90,000)		350,000
Proceeds from issuance of senior unsecured notes		693,560		743,407
Payments to extinguish senior unsecured notes		(400,000)		(477,550)
Secured debt issued		161,992		136,801
Payments on secured debt		(281,051)		(323,950)
Net proceeds from the issuance of common stock		159,032		1,562,350
Decrease (increase) in deferred loan costs		(17,439)		(5,285)
Contributions by noncontrolling interests	[2]	138,458		4,926
Distributions to noncontrolling interests	[2]	(91,133)		(19,371)
Acquisitions of noncontrolling interests		0		(4,741)
Cash distributions to stockholders		(645,866)		(594,617)
Other financing activities		(730)		(27,253)
Net cash provided from (used in) financing activities		(373,177)		1,344,717
Effect of foreign currency translation on cash and cash equivalents		(8,452)		2,595
Increase (decrease) in cash and cash equivalents		105,677		(255,784)
Cash and cash equivalents at beginning of period		360,908		473,726
Cash and cash equivalents at end of period		466,585		217,942
Supplemental cash flow information:
Interest paid		236,861		208,885
Income taxes paid		$ 3,889		$ 10,140
[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	6 Months Ended
	Jun. 30, 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 1,486 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	6 Months Ended
	Jun. 30, 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 six months ended June 30 , 2016. Operating results for the six months ended June 30, 2016 are not necessarily an indication of the results that may be expected for the year ending December 31, 2016. For further information, re fer 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 manner to depict the transfer of goods or services to a customer at an amount that reflects the considera tion expected to be received in exchange for those goods or services. ASU 2014-09 is effective for fiscal years, and interim periods within those years, beginning 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 Consolidation Analysis”, which makes certain changes to both the variable interest model and the voting model, including changes to (1) the identification of variable interests (fees paid to a decision maker or service provid er), (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 consolidate d 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 adjustme nts. 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 st atement (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 have been recorded in previous reporting periods if the adjustment to the provisional amounts had bee n 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 financial statements. In January 2016, th e FASB issued ASU No. 2016-01, “Financial Instrumen ts – Overall: Recognition and Measurement of Financial Assets and Financial Liabilities,” which will require entities to measure their investments at fair value and recognize any changes in fair value in net income unless the investments qualify for the ne w practicability exception. The practicability exception will be available for equity investments that do not have readily determinable fair values. ASU 2016-01 is effective for fiscal years and interim periods within those years, beginning after December 15, 2017. We are currently evaluating the impact that the standard will have on our consolidated financial statements. In February 2016, the FASB issued ASU No. 2016-02, “Leases (Topic 842),” which requires lessees to recognize assets and liabilitie s 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 infor mation 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 re quired to use a modified retrospective approach for leases that exist or are entered into after the beginning of the earliest comparative period in the financial statements. We are currently evaluating the impact that the standard will have on our consoli dated financial statements. In March 2016 , the FASB issued ASU No. 2016 -09, “ Improvements to Employee Share-Based Payment Accounting ”. This standard simplifies the accounting treatment for excess tax benefits and deficiencies, forfeitures, and cash fl ow considerations related to share-based compensation. ASU 201 6 -09 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2016, and early adoption is permitted. We are currently evaluating the impact of the sta ndard; however, we do not expect its adoption to have a significant impact on our consolidated financial statements. In June 2016, the FASB issued ASU No. 2016-13, “Measurement of Credit Losses on Financial Instruments”. This standard requires a new forward-looking “expected loss” model to be used for receivables, held-to-maturity debt, loans, and other instruments. ASU 2016-13 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2019, and early adoption is permitted for fiscal year s beginning after December 15, 2018. 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	6 Months Ended
	Jun. 30, 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 Six Months Ended (In thousands) June 30, 2016 (1) June 30, 2015 Land and land improvements $ 18,901 $ 45,268 Buildings and improvements 160,209 447,229 Acquired lease intangibles 2,876 2,817 Restricted cash - 6 Receivables and other assets - 60 Total assets acquired 181,986 495,380 Accrued expenses and other liabilities (1,459) (1,845) Total liabilities assumed (1,459) (1,845) Non-cash acquisition related activity (2) (37,703) (936) Cash disbursed for acquisitions 142,824 492,599 Construction in progress additions 85,687 74,694 Less: Capitalized interest (3,771) (3,303) Foreign currency translation (2,712) 240 Cash disbursed for construction in progress 79,204 71,631 Capital improvements to existing properties 14,877 19,029 Total cash invested in real property, net of cash acquired $ 236,905 $ 583,259 (1) Includes acquisitions with an aggregate purchase price of $166,343,000 for which the allocation of the purchase price consideration is preliminary and subject to change. (2) For the six months ended June 30, 2016, $31,014,000 relates to the acquisition of assets previously financed as real estate loans receivable and $6,630,000 previously financed as equity investments. Seniors Housing Operating Activity Six Months Ended (In thousands) June 30, 2016 (1) June 30, 2015 Land and land improvements $ 5,617 $ 94,294 Building and improvements 128,200 1,174,465 Acquired lease intangibles 6,334 71,089 Restricted cash - 5,425 Receivables and other assets 894 23,645 Total assets acquired (2) 141,045 1,368,918 Secured debt - (208,960) Accrued expenses and other liabilities (4,853) (19,011) Total liabilities assumed (4,853) (227,971) Noncontrolling interests (549) (86,842) Non-cash acquisition related activity (3) (7,659) - Cash disbursed for acquisitions 127,984 1,054,105 Construction in progress additions 134,019 19,926 Less: Capitalized interest (2,011) (715) Foreign currency translation (5,344) (40) Cash disbursed for construction in progress 126,664 19,171 Capital improvements to existing properties 47,553 32,766 Total cash invested in real property, net of cash acquired $ 302,201 $ 1,106,042 (1) Includes acquisitions with an aggregate purchase price of $117,545,000 for which the allocation of the purchase price consideration is preliminary and subject to change. (2) Excludes $134,000 and $3,390,000 of cash acquired during the six months ended June 30, 2016 and 2015, respectively. (3) Relates to the acquisition of assets previously financed as equity investments. Outpatient Medical Activity Six Months Ended (In thousands) June 30, 2016 (1) June 30, 2015 Land and land improvements $ - $ 737 Buildings and improvements 32,650 426,130 Acquired lease intangibles - 19,372 Total assets acquired (2) 32,650 446,239 Secured debt - (112,000) Accrued expenses and other liabilities (990) (2,743) Total liabilities assumed (990) (114,743) Noncontrolling interests - (68,535) Non-cash acquisition activity (3) (15,013) - Cash disbursed for acquisitions 16,647 262,961 Construction in progress additions 50,896 26,025 Less: Capitalized interest (1,561) (428) Accruals (4) (5,336) (1,921) Cash disbursed for construction in progress 43,999 23,676 Capital improvements to existing properties 25,099 15,291 Total cash invested in real property $ 85,745 $ 301,928 (1) Includes acquisitions with an aggregate purchase price of $32,650,000 for which the allocation of the purchase price consideration is preliminary and subject to change. (2) Excludes $0 and $4,372,000 of cash acquired during the six months ended June 30, 2016 and 2015, respectively. (3) Relates to an acquisition of assets previously financed as a real estate loan. Refer to Note 6 for additional information. (4) Represents non-cash consideration accruals for amounts to be paid in future periods relating to properties that converted in the periods noted above. Construction Activity The following is a summary of the construction projects that were placed into service and began generating revenues during the periods presented (in thousands) : Six Months Ended June 30, 2016 June 30, 2015 Development projects: Triple-net $ - $ 72,775 Seniors housing operating - 19,869 Outpatient medical 35,363 16,592 Total development projects 35,363 109,236 Expansion projects 2,879 38,808 Total construction in progress conversions $ 38,242 $ 148,044

Real Estate Intangibles

Real Estate Intangibles	6 Months Ended
	Jun. 30, 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): June 30, 2016 December 31, 2015 Assets: In place lease intangibles $ 1,194,925 $ 1,179,537 Above market tenant leases 62,544 67,529 Below market ground leases 62,447 80,224 Lease commissions 25,508 23,295 Gross historical cost 1,345,424 1,350,585 Accumulated amortization (949,727) (881,096) Net book value $ 395,697 $ 469,489 Weighted-average amortization period in years 15.8 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 (49,874) (46,048) Net book value $ 51,088 $ 54,948 Weighted-average amortization period in years 15.0 14.5 The following is a summary of real estate intangible amortization for the periods presented (in thousands): Three Months Ended Six Months Ended June 30, June 30, 2016 2015 2016 2015 Rental income related to above/below market tenant leases, net $ 210 $ (424) $ 290 $ (217) Property operating expenses related to above/below market ground leases, net (311) (334) (622) (653) Depreciation and amortization related to in place lease intangibles and lease commissions (31,019) (31,973) (65,473) (56,297) The future estimated aggregate amortization of intangible assets and liabilities is as follows for the periods presented (in thousands): Assets Liabilities 2016 $ 63,361 $ 3,809 2017 81,279 6,807 2018 44,816 6,181 2019 25,471 5,771 2020 22,563 5,290 Thereafter 158,207 23,230 Total $ 395,697 $ 51,088

Dispositions, Assets Held for S

Dispositions, Assets Held for Sale and Discontinued Operations	6 Months Ended
	Jun. 30, 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 six months ended June 30, 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 prese nted (in thousands): Six Months Ended June 30, 2016 June 30, 2015 Real estate dispositions: Triple-net $ 128,768 $ 105,274 Outpatient medical - 165,221 (1) Land parcels - 5,724 Total dispositions 128,768 276,219 Gain (loss) on real estate dispositions, net 1,530 246,956 Proceeds from real estate dispositions $ 130,298 $ 523,175 (1) Primarily related to the disposition of an unconsolidated equity investment with Forest City Enterprises. Dispositions and Assets Held for Sale Pursuant to our adoption of ASU No. 2014-08, “Presentation of Financial Statements (Topic 205) and Property, Plant and Equipment (Topic 360): Reporting Discontinued Operations and Disclosures of Disposals of Components of an Entity”, 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 Six Months Ended June 30, June 30, 2016 2015 2016 2015 Revenues: Rental income $ 19,990 $ 24,789 $ 38,552 $ 50,146 Expenses: Interest expense 2,506 4,948 5,032 8,847 Property operating expenses 1,338 1,482 2,700 3,009 Provision for depreciation 3,071 7,042 7,022 13,473 Total expenses 6,915 13,472 14,754 25,329 Income (loss) from real estate dispositions, net $ 13,075 $ 11,317 $ 23,798 $ 24,817

Real Estate Loans Receivable

Real Estate Loans Receivable	6 Months Ended
	Jun. 30, 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): Six Months Ended June 30, 2016 June 30, 2015 Outpatient Outpatient Triple-net Medical Totals Triple-net Medical Totals Advances on real estate loans receivable: Investments in new loans $ 8,223 $ - $ 8,223 $ 379,604 $ - $ 379,604 Draws on existing loans 42,803 33 42,836 34,699 2,285 36,984 Net cash advances on real estate loans 51,026 33 51,059 414,303 2,285 416,588 Receipts on real estate loans receivable: Loan payoffs 182,613 27,303 209,916 25,656 - 25,656 Principal payments on loans 4,454 - 4,454 11,686 - 11,686 Sub-total 187,067 27,303 214,370 37,342 - 37,342 Less: Non-cash activity (31,014) (15,013) (46,027) - - - Net cash receipts on real estate loans 156,053 12,290 168,343 37,342 - 37,342 Net cash advances (receipts) on real estate loans (105,027) (12,257) (117,284) 376,961 2,285 379,246 Change in balance due to foreign currency translation (8,504) - (8,504) 1,127 - 1,127 Net change in real estate loans receivable $ (144,545) $ (27,270) $ (171,815) $ 378,088 $ 2,285 $ 380,373 We recorded no provision for loan losses during the six months ended June 30, 2016 . At June 30, 2016 , we had no real estate loans with outstanding balances on non-accrual status and no allowances for loan losses were recorded.

Investments in Unconsolidated E

Investments in Unconsolidated Entities	6 Months Ended
	Jun. 30, 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 by the joint ventures and are reflected in our Consolidated Statements of Comprehensive Income as income or loss from unconsolidated entities. The following is a summary of our investments in unconsolidated entities (dollars in thousands): Percentage Ownership (1) June 30, 2016 December 31, 2015 Triple-net 10% to 49% $ 28,794 $ 36,351 Seniors housing operating 10% to 50% 507,540 499,537 Outpatient medical 43% 6,734 6,393 Total $ 543,068 $ 542,281 (1) Excludes ownership of in-substance real estate. At June 30, 2016, the aggregate unamortized basis difference of our joint venture investments of $153,126,000 is primarily attributable to the difference between the amount for which we purchase our interest in the entity, including transaction costs, and the historical carrying value of the net assets of the entity. 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	6 Months Ended
	Jun. 30, 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 six month period ended June 30, 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 $ 195,171 16% Sunrise Senior Living (3) 143 160,057 13% Brookdale Senior Living 148 84,526 7% Revera (3) 97 73,992 6% Benchmark Senior Living 49 48,880 4% Remaining portfolio 796 652,611 54% Totals 1,420 $ 1,215,237 100% (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	6 Months Ended
	Jun. 30, 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 June 30 , 2016, we had a primary unsecured credit facility with a consortium of 29 banks that includes a $3,0 00,000,000 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 , in the aggregate, 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 $1,0 00,000,000 in alternate currencies (none outstanding at June 30, 2016 ). Borrowings under the unsecured revolving credit facility are subject to interest payable at the applicable margin over LIBOR interest rate ( 1.35% at June 30, 2016 ). The applicable margin is based on certain of our debt ratin gs and was 0.90% at June 30, 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 June 30, 2016 . The term credit facilities mature on May 13, 2021. The revolving credit facility i s scheduled to mature on May 13, 2020 and can be extended for two successive terms of six months each at our option. The following information relates to aggregate borrowings under the primary unsecured revolving credit facility for the periods pres ented (dollars in thousands): Three Months Ended June 30, Six Months Ended June 30, 2016 2015 2016 2015 Balance outstanding at quarter end (1) $ 745,000 $ 350,000 $ 745,000 $ 350,000 Maximum amount outstanding at any month end $ 745,000 $ 535,000 $ 945,000 $ 535,000 Average amount outstanding (total of daily principal balances divided by days in period) $ 623,077 $ 501,758 $ 647,060 $ 455,608 Weighted average interest rate (actual interest expense divided by average borrowings outstanding) 1.26% 1.13% 1.28% 1.17% (1) As of June 30, 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	6 Months Ended
	Jun. 30, 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 June 30, 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 $ - $ 304,577 $ 304,577 2017 450,000 556,382 1,006,382 2018 450,000 631,424 1,081,424 2019 605,000 385,735 990,735 2020 (4) 680,645 176,284 856,929 Thereafter (5,6,7,8,9,10) 6,631,879 1,366,864 7,998,743 Totals $ 8,817,524 $ 3,421,266 $ 12,238,790 (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 1.15% to 6.5%. (3) Annual interest rates range from 0.91% to 7.98%. Carrying value of the properties securing the debt totaled $5,972,202,000 at June 30, 2016. (4) 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 $230,645,000 based on the Canadian/U.S. Dollar exchange rate on June 30, 2016). (5) On May 13, 2016, we refinanced the funding on a $250,000,000 Canadian-denominated unsecured term credit facility (approximately $192,204,000 based on the Canadian/U.S. Dollar exchange rate on June 30, 2016). The loan matures on May 13, 2021 and bears interest at the Canadian Dealer Offered Rate plus 95 basis points (1.84% at June 30, 2016). (6) On May 13, 2016, we refinanced the funding on a $500,000,000 unsecured term credit facility. The loan matures on May 13, 2021 and bears interest at LIBOR plus 95 basis points (1.40% at June 30, 2016). (7) On November 20, 2013, we completed the sale of £ 550,000,000 (approximately $727,925,000 based on the Sterling/U.S. Dollar exchange rate in effect on June 30, 2016) of 4.8% senior unsecured notes due 2028. (8) On November 25, 2014, we completed the sale of £ 500,000,000 (approximately $661,750,000 based on the Sterling/U.S. Dollar exchange rate in effect on June 30, 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) : Six Months Ended June 30, 2016 June 30, 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 705,000 4.228% 750,000 4.000% Debt extinguished (400,000) 3.625% (300,000) 6.200% Debt redeemed - 0.000% (158,990) 3.000% Foreign currency (133,234) 4.417% 1,298 3.601% Ending balance $ 8,817,524 4.263% $ 8,109,462 4.252% The following is a summary of our secured debt principal activity for the periods presented (dollars in thousands): Six Months Ended June 30, 2016 June 30, 2015 Weighted Avg. Weighted Avg. Amount Interest Rate Amount Interest Rate Beginning balance $ 3,478,207 4.440% $ 2,941,765 4.940% Debt issued 161,992 3.051% 136,801 2.845% Debt assumed - 0.000% 317,897 3.223% Debt extinguished (243,314) 4.874% (290,984) 4.208% Foreign currency 62,118 3.652% (38,642) 3.994% Principal payments (37,737) 4.579% (32,966) 4.775% Ending balance $ 3,421,266 4.328% $ 3,033,871 4.750% 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 June 30, 2016 , we were in compliance with all of the cove nants under our debt agreements.

Derivative Instruments

Derivative Instruments	6 Months Ended
	Jun. 30, 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 $4,911,000 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 six months ended June 30 , 2016 and 2015, we settled certain net investment hedges generating cash proceeds of $ 56,842,000 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 foll owing presents the notional amount of derivatives and other financial instruments as of the dates indicated (in thousands): June 30, 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 $ 90,000 $ 72,000 Denominated in Pounds Sterling £ 75,000 £ 60,000 Derivative instruments not designated: Denominated in Canadian Dollars $ 43,329 $ 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 Six Months Ended June 30, June 30, Location 2016 2015 2016 2015 Gain (loss) on interest rate swaps reclassified from AOCI into income (effective portion) Interest expense (477) (462) (960) (928) Gain (loss) on forward exchange contracts recognized in income Interest expense 2,697 1,191 1,369 3,938 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 178,575 (149,436) 175,836 34,615 (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	6 Months Ended
	Jun. 30, 2016
Commitments and Contingencies [Abstract]
Commitments and Contingencies	12 . Commitments and Contingencies At June 30, 2016 , we had ten outstanding letter of credit obligations totaling $ 91,783 ,000 and expiring between 2016 and 2018. At June 30, 2016 , we had outstanding construction in progress of $ 475,203,000 a nd were committed to providing additional funds of approximately $ 627,775,000 to complete construction. Purchase obligations at June 30, 2016 include $1,150,000,000 representing acquisitions expected to be completed before year-end. Purchase obligations also include contingent purchase obligations totaling $ 22,475,000 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 June 30, 2016 , we had operating lease obligations of $ 1,088,213,000 relating to certain ground leases and company office space and capital lease obligations of $ 96,201,000 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 June 30, 2016 , aggregate future minimum rentals to be received under these noncancelable subleases totaled $ 76,954,000 .

Stockholders' Equity

Stockholders' Equity	6 Months Ended
	Jun. 30, 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: June 30, 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 358,624,595 355,594,373 Outstanding shares 357,689,980 354,777,670 Common Stock. The following is a summary of our common stock issuances during the six months ended June 30, 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 1,766,585 72.83 128,653 128,653 2015 Option exercises 211,041 46.26 9,762 9,762 2015 Stock incentive plans, net of forfeitures 179,037 - - 2015 Senior note conversions 1,076,971 - - 2015 Totals 22,783,634 $ 1,614,440 $ 1,562,350 2016 Dividend reinvestment plan issuances 1,971,758 64.65 $ 127,470 $ 127,470 2016 Option exercises 37,409 48.73 1,823 1,823 2016 Equity shelf program issuances 443,096 67.12 30,192 29,739 2016 Stock incentive plans, net of forfeitures 460,047 - - 2016 Totals 2,912,310 $ 159,485 $ 159,032 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): Six Months Ended June 30, 2016 June 30, 2015 Per Share Amount Per Share Amount Common Stock $ 1.7200 $ 613,163 $ 1.6500 $ 561,914 Series I Preferred Stock 1.6250 23,359 1.6250 23,359 Series J Preferred Stock 0.8126 9,344 0.8126 9,344 Totals $ 645,866 $ 594,617 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 (61,207) (11,160) 2 10 (72,355) Reclassification amount to net income - - - 960 (1) 960 Net current-period other comprehensive income (61,207) (11,160) 2 970 (71,395) Balance at June 30, 2016 $ (146,691) $ (11,160) $ (1,341) $ (446) $ (159,638) Balance at December 31, 2014 $ (74,770) $ - $ (1,589) $ (650) $ (77,009) Other comprehensive income before reclassification adjustments 12,136 (15,100) - (2,625) (5,589) Reclassification amount to net income - - - 928 (1) 928 Net current-period other comprehensive income 12,136 (15,100) - (1,697) (4,661) Balance at June 30, 2015 $ (62,634) $ (15,100) $ (1,589) $ (2,347) $ (81,670) (1) Please see note 11 for additional information.

Stock Incentive Plans

Stock Incentive Plans	6 Months Ended
	Jun. 30, 2016
Stock Incentive Plans [Abstract]
Stock Incentive Plans	14 . Stock Incentive Plans Our 2016 Long-Term Incentive Plan (“2016 Plan”) authorizes up to 10,0 00,000 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 20 16 Plan. The 20 16 Plan allows for the issuance of, among other things, stock options, stock appreciation rights, restricted stock, deferred stock units and dividend equivalent rights. Vesting periods 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 $7,03 1 ,000 an d $15,217,000 for the three and six months end ed June 30, 2016 , respectively, and $11,124,000 and $20,178,000 for the same periods in 2015.

Earnings Per Share

Earnings Per Share	6 Months Ended
	Jun. 30, 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 Six Months Ended June 30, June 30, 2016 2015 2016 2015 Numerator for basic and diluted earnings per share - net income (loss) attributable to common stockholders $ 195,474 $ 312,573 $ 344,444 $ 503,373 Denominator for basic earnings per share - weighted average shares 356,646 350,399 355,879 343,624 Effect of dilutive securities: Employee stock options 129 153 115 176 Non-vested restricted shares 465 471 359 444 Redeemable shares 1,651 - 1,136 - Convertible senior unsecured notes - 343 - 379 Dilutive potential common shares 2,245 967 1,610 999 Denominator for diluted earnings per share - adjusted weighted average shares 358,891 351,366 357,489 344,623 Basic earnings per share $ 0.55 $ 0.89 $ 0.97 $ 1.46 Diluted earnings per share $ 0.54 $ 0.89 $ 0.96 $ 1.46 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	6 Months Ended
	Jun. 30, 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 borrowers with sim ilar 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 value 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 Unsecured Not es — 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 similar loans would be made with similar credit ratings and for the same remaining ma turities. The carrying amount of variable rate secured debt approximates fair value because the borrowings are interest rate adjustable. Foreign Currency Forward Contracts — Foreign currency f orward contracts are recorded in other assets or other liabilities on the balance sheet at fair market value. Fair market value is determined using Level 2 inputs by estimating the future value of the currency pair based on existing exchange rates , comprised of current spot and traded forward points , and calc ulating 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 for cas h 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): June 30, 2016 December 31, 2015 Carrying Amount Fair Value Carrying Amount Fair Value Financial assets: Mortgage loans receivable $ 479,062 $ 506,072 $ 635,492 $ 663,501 Other real estate loans receivable 168,615 172,425 184,000 185,693 Available-for-sale equity investments 11,619 11,619 22,779 22,779 Cash and cash equivalents 466,585 466,585 360,908 360,908 Foreign currency forward contracts 102,231 102,231 129,520 129,520 Financial liabilities: Borrowings under unsecured credit facilities $ 745,000 $ 745,000 $ 835,000 $ 835,000 Senior unsecured notes 8,711,790 9,683,007 8,548,055 9,020,529 Secured debt 3,442,178 3,674,116 3,509,142 3,678,564 Foreign currency forward contracts 3,047 3,047 - - Redeemable OP unitholder interests $ 125,758 $ 125,758 $ 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 June 30, 2016 Total Level 1 Level 2 Level 3 Available-for-sale equity investments (1) $ 11,619 $ 11,619 $ - $ - Foreign currency forward contracts, net (2) 99,184 - 99,184 - Redeemable OP unitholder interests 125,758 - 125,758 - Totals $ 236,561 $ 11,619 $ 224,942 $ - (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	6 Months Ended
	Jun. 30, 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 reclassified to conform to the curren t 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 Kingdom), independent support l iving 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. Pr operties acquired are primarily leased under triple-net leases and we are not involved in the management of the property. Our seniors housing operating properties include the seniors housing communities referenced above that are owned and/or operated throu gh 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 segment. 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 investme nts 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 allocated to individual segments in determinin g 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 no intersegment sales or transfers. Summ ary information for the reportable segments is as follows for the periods presented (in thousands): Three Months Ended June 30, 2016: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 287,134 $ - $ 135,494 $ - $ 422,628 Resident fees and services - 615,220 - - 615,220 Interest income 21,971 1,042 994 - 24,007 Other income 1,206 8,989 4,153 454 14,802 Total revenues 310,311 625,251 140,641 454 1,076,657 Property operating expenses - 417,996 40,836 - 458,832 Net operating income from continuing operations 310,311 207,255 99,805 454 617,825 Interest expense 2,019 42,689 5,402 82,216 132,326 Depreciation and amortization 75,809 102,312 48,448 - 226,569 General and administrative - - - 39,914 39,914 Transaction costs 1,291 3,247 619 - 5,157 Loss (gain) on extinguishment of debt, net 121 (88) - - 33 Other expenses - - - 3,161 3,161 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 231,071 59,095 45,336 (124,837) 210,665 Income tax expense (213) 2,023 (248) (1,049) 513 (Loss) income from unconsolidated entities 3,018 (4,887) (90) - (1,959) Income (loss) from continuing operations 233,876 56,231 44,998 (125,886) 209,219 Gain (loss) on real estate dispositions, net 1,530 - - - 1,530 Net income (loss) $ 235,406 $ 56,231 $ 44,998 $ (125,886) $ 210,749 Total assets $ 12,201,470 $ 11,626,090 $ 5,020,102 $ 116,839 $ 28,964,501 Three Months Ended June 30, 2015: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 272,573 $ - $ 124,053 $ - $ 396,626 Resident fees and services - 535,553 - - 535,553 Interest income 18,189 1,042 1,345 - 20,576 Other income 970 3,210 195 39 4,414 Total revenues 291,732 539,805 125,593 39 957,169 Property operating expenses - 360,569 37,785 - 398,354 Net operating income from continuing operations 291,732 179,236 87,808 39 558,815 Interest expense 1,313 38,834 6,993 71,721 118,861 Depreciation and amortization 70,525 88,844 49,433 - 208,802 General and administrative - - - 38,474 38,474 Transaction costs 7,579 3,937 975 - 12,491 Loss (gain) on extinguishment of debt, net (102) - - 18,989 18,887 Other expenses - - - 10,583 10,583 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 212,417 47,621 30,407 (139,728) 150,717 Income tax expense (3,121) (3,449) (161) (686) (7,417) (Loss) income from unconsolidated entities 1,453 (6,083) 1,678 - (2,952) Income (loss) from continuing operations 210,749 38,089 31,924 (140,414) 140,348 Gain (loss) on real estate dispositions, net - - 190,111 - 190,111 Net income (loss) $ 210,749 $ 38,089 $ 222,035 $ (140,414) $ 330,459 Six Months Ended June 30, 2016: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 570,958 $ - $ 267,332 $ - $ 838,290 Resident fees and services - 1,217,369 - - 1,217,369 Interest income 44,824 2,073 2,298 - 49,195 Other income 2,695 11,178 4,466 512 18,851 Total revenues 618,477 1,230,620 274,096 512 2,123,705 Property operating expenses - 826,890 81,578 - 908,468 Net operating income from continuing operations 618,477 403,730 192,518 512 1,215,237 Interest expense 7,623 83,518 11,146 162,998 265,285 Loss (gain) on derivatives, net - - - - - Depreciation and amortization 155,609 204,144 95,512 - 455,265 General and administrative - - - 85,606 85,606 Transaction costs 4,143 7,180 2,042 - 13,365 Loss (gain) on extinguishment of debt, net 97 (88) - - 9 Impairment of assets 14,314 - - - 14,314 Other expenses - - - 3,161 3,161 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 436,691 108,976 83,818 (251,253) 378,232 Income tax expense (528) 4,789 (476) (1,546) 2,239 (Loss) income from unconsolidated entities 6,100 (11,822) (56) - (5,778) Income (loss) from continuing operations 442,263 101,943 83,286 (252,799) 374,693 Gain (loss) on real estate dispositions, net 1,530 - - - 1,530 Net income (loss) $ 443,793 $ 101,943 $ 83,286 $ (252,799) $ 376,223 Six Months Ended June 30, 2015: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 534,565 $ - $ 241,648 $ - $ 776,213 Resident fees and services - 1,028,063 - - 1,028,063 Interest income 32,888 2,073 2,609 - 37,570 Other income 4,853 4,229 356 62 9,500 Total revenues 572,306 1,034,365 244,613 62 1,851,346 Property operating expenses - 699,076 75,739 - 774,815 Net operating income from continuing operations 572,306 335,289 168,874 62 1,076,531 Interest expense 9,736 73,293 14,382 142,531 239,942 Loss (gain) on derivatives, net (58,427) - - - (58,427) Depreciation and amortization 139,946 165,479 92,206 - 397,631 General and administrative - - - 73,612 73,612 Transaction costs 43,750 15,979 1,316 - 61,045 Loss (gain) on extinguishment of debt, net 10,235 - - 24,053 34,288 Impairment of assets 2,220 - - - 2,220 Other expenses - - - 10,583 10,583 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 424,846 80,538 60,970 (250,717) 315,637 Income tax expense (2,703) (3,982) 305 (733) (7,113) (Loss) income from unconsolidated entities 2,846 (21,156) 2,710 - (15,600) Income (loss) from continuing operations 424,989 55,400 63,985 (251,450) 292,924 Gain (loss) on real estate dispositions, net 54,097 - 192,859 - 246,956 Net income (loss) $ 479,086 $ 55,400 $ 256,844 $ (251,450) $ 539,880 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 Six Months Ended June 30, 2016 June 30, 2015 June 30, 2016 June 30, 2015 Revenues: Amount % Amount % Amount % Amount % United States $ 862,115 80.1% $ 771,031 80.6% $ 1,704,470 80.3% $ 1,516,168 81.9% United Kingdom 102,593 9.5% 103,531 10.8% 203,148 9.5% 195,345 10.6% Canada 111,949 10.4% 82,607 8.6% 216,087 10.2% 139,833 7.6% Total $ 1,076,657 100.0% $ 957,169 100.0% $ 2,123,705 100.0% $ 1,851,346 100.0% As of June 30, 2016 December 31, 2015 Assets: Amount % Amount % United States $ 23,546,510 81.3% $ 25,995,793 89.6% United Kingdom 2,789,104 9.6% 1,741,973 6.0% Canada 2,628,887 9.1% 1,286,079 4.4% Total $ 28,964,501 100.0% $ 29,023,845 100.0%

Income Taxes and Distributions

Income Taxes and Distributions	6 Months Ended
	Jun. 30, 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 Diversification 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 taxes 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 provision for income tax es for the three and six months ended June 30, 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-ow ned 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 m aterial 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 income tax purposes. The company reflects current and deferred tax liabilities for any such withholding taxes incurred as a result of this holding company structure in its consolidated financial statements. Generally, given current statutes of l imitations, 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, 2011 and subsequent years. The company and its subsidiari es are also subject to audit by the Canada Revenue Agency and provincial authorities generally for periods subsequent to our initial investments in Canada in May 2012, by HM Revenue & Customs for periods subsequent to our initial investments in the United Kingdom in 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	6 Months Ended
	Jun. 30, 2016
Variable Interest Entity Disclosure [Abstract]
Variable Interest Entity Disclosure [Text Block]	19. Variable Interest Entities We have entered into joint ventures to own certain seniors housing and outpatient medical assets which are deemed to be variable interest entities (“VIE”). We have concluded that we are the primary beneficiary of these VIE’s 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 formations , 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 VIE’s in the aggregate (in thousands): June 30, 2016 December 31, 2015 Assets Net real property owned $ 1,006,674 $ 453,889 Cash and cash equivalents 10,946 8,759 Receivables and other assets 11,828 8,082 Total assets (1) $ 1,029,448 $ 470,730 Liabilities and equity Secured debt $ 451,450 $ 147,021 Accrued expenses and other liabilities 12,807 7,732 Redeemable noncontrolling interests 78,477 70,090 Total equity 486,714 245,887 Total liabilities and equity $ 1,029,448 $ 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)	6 Months Ended
	Jun. 30, 2016
Accounting Policies and Related Matters (Policies) [Abstract]
Basis of Presentation	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 six months ended June 30 , 2016. Operating results for the six months ended June 30, 2016 are not necessarily an indication of the results that may be expected for the year ending December 31, 2016. For further information, re fer 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 manner to depict the transfer of goods or services to a customer at an amount that reflects the considera tion expected to be received in exchange for those goods or services. ASU 2014-09 is effective for fiscal years, and interim periods within those years, beginning 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 Consolidation Analysis”, which makes certain changes to both the variable interest model and the voting model, including changes to (1) the identification of variable interests (fees paid to a decision maker or service provid er), (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 consolidate d 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 adjustme nts. 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 st atement (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 have been recorded in previous reporting periods if the adjustment to the provisional amounts had bee n 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 financial statements. In January 2016, th e FASB issued ASU No. 2016-01, “Financial Instrumen ts – Overall: Recognition and Measurement of Financial Assets and Financial Liabilities,” which will require entities to measure their investments at fair value and recognize any changes in fair value in net income unless the investments qualify for the ne w practicability exception. The practicability exception will be available for equity investments that do not have readily determinable fair values. ASU 2016-01 is effective for fiscal years and interim periods within those years, beginning after December 15, 2017. We are currently evaluating the impact that the standard will have on our consolidated financial statements. In February 2016, the FASB issued ASU No. 2016-02, “Leases (Topic 842),” which requires lessees to recognize assets and liabilitie s 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 infor mation 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 re quired to use a modified retrospective approach for leases that exist or are entered into after the beginning of the earliest comparative period in the financial statements. We are currently evaluating the impact that the standard will have on our consoli dated financial statements. In March 2016 , the FASB issued ASU No. 2016 -09, “ Improvements to Employee Share-Based Payment Accounting ”. This standard simplifies the accounting treatment for excess tax benefits and deficiencies, forfeitures, and cash fl ow considerations related to share-based compensation. ASU 201 6 -09 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2016, and early adoption is permitted. We are currently evaluating the impact of the sta ndard; however, we do not expect its adoption to have a significant impact on our consolidated financial statements. In June 2016, the FASB issued ASU No. 2016-13, “Measurement of Credit Losses on Financial Instruments”. This standard requires a new forward-looking “expected loss” model to be used for receivables, held-to-maturity debt, loans, and other instruments. ASU 2016-13 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2019, and early adoption is permitted for fiscal year s beginning after December 15, 2018. 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)	6 Months Ended
	Jun. 30, 2016
Real property acquisitions and development [Line Items]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities	Triple-n et Activity Six Months Ended (In thousands) June 30, 2016 (1) June 30, 2015 Land and land improvements $ 18,901 $ 45,268 Buildings and improvements 160,209 447,229 Acquired lease intangibles 2,876 2,817 Restricted cash - 6 Receivables and other assets - 60 Total assets acquired 181,986 495,380 Accrued expenses and other liabilities (1,459) (1,845) Total liabilities assumed (1,459) (1,845) Non-cash acquisition related activity (2) (37,703) (936) Cash disbursed for acquisitions 142,824 492,599 Construction in progress additions 85,687 74,694 Less: Capitalized interest (3,771) (3,303) Foreign currency translation (2,712) 240 Cash disbursed for construction in progress 79,204 71,631 Capital improvements to existing properties 14,877 19,029 Total cash invested in real property, net of cash acquired $ 236,905 $ 583,259 (1) Includes acquisitions with an aggregate purchase price of $166,343,000 for which the allocation of the purchase price consideration is preliminary and subject to change. (2) For the six months ended June 30, 2016, $31,014,000 relates to the acquisition of assets previously financed as real estate loans receivable and $6,630,000 previously financed as equity investments. Seniors Housing Operating Activity Six Months Ended (In thousands) June 30, 2016 (1) June 30, 2015 Land and land improvements $ 5,617 $ 94,294 Building and improvements 128,200 1,174,465 Acquired lease intangibles 6,334 71,089 Restricted cash - 5,425 Receivables and other assets 894 23,645 Total assets acquired (2) 141,045 1,368,918 Secured debt - (208,960) Accrued expenses and other liabilities (4,853) (19,011) Total liabilities assumed (4,853) (227,971) Noncontrolling interests (549) (86,842) Non-cash acquisition related activity (3) (7,659) - Cash disbursed for acquisitions 127,984 1,054,105 Construction in progress additions 134,019 19,926 Less: Capitalized interest (2,011) (715) Foreign currency translation (5,344) (40) Cash disbursed for construction in progress 126,664 19,171 Capital improvements to existing properties 47,553 32,766 Total cash invested in real property, net of cash acquired $ 302,201 $ 1,106,042 (1) Includes acquisitions with an aggregate purchase price of $117,545,000 for which the allocation of the purchase price consideration is preliminary and subject to change. (2) Excludes $134,000 and $3,390,000 of cash acquired during the six months ended June 30, 2016 and 2015, respectively. (3) Relates to the acquisition of assets previously financed as equity investments. Outpatient Medical Activity Six Months Ended (In thousands) June 30, 2016 (1) June 30, 2015 Land and land improvements $ - $ 737 Buildings and improvements 32,650 426,130 Acquired lease intangibles - 19,372 Total assets acquired (2) 32,650 446,239 Secured debt - (112,000) Accrued expenses and other liabilities (990) (2,743) Total liabilities assumed (990) (114,743) Noncontrolling interests - (68,535) Non-cash acquisition activity (3) (15,013) - Cash disbursed for acquisitions 16,647 262,961 Construction in progress additions 50,896 26,025 Less: Capitalized interest (1,561) (428) Accruals (4) (5,336) (1,921) Cash disbursed for construction in progress 43,999 23,676 Capital improvements to existing properties 25,099 15,291 Total cash invested in real property $ 85,745 $ 301,928 (1) Includes acquisitions with an aggregate purchase price of $32,650,000 for which the allocation of the purchase price consideration is preliminary and subject to change. (2) Excludes $0 and $4,372,000 of cash acquired during the six months ended June 30, 2016 and 2015, respectively. (3) Relates to an acquisition of assets previously financed as a real estate loan. Refer to Note 6 for additional information. (4) Represents non-cash consideration accruals for amounts to be paid in future periods relating to properties that converted in the periods noted above.
Summary of construction projects placed into service and generating revenues	Six Months Ended June 30, 2016 June 30, 2015 Development projects: Triple-net $ - $ 72,775 Seniors housing operating - 19,869 Outpatient medical 35,363 16,592 Total development projects 35,363 109,236 Expansion projects 2,879 38,808 Total construction in progress conversions $ 38,242 $ 148,044

Real Estate Intangibles (Tables

Real Estate Intangibles (Tables)	6 Months Ended
	Jun. 30, 2016
Real Estate Intangibles (Tables) [Abstract]
Summary of real estate intangibles excluding those classified as held for sale	June 30, 2016 December 31, 2015 Assets: In place lease intangibles $ 1,194,925 $ 1,179,537 Above market tenant leases 62,544 67,529 Below market ground leases 62,447 80,224 Lease commissions 25,508 23,295 Gross historical cost 1,345,424 1,350,585 Accumulated amortization (949,727) (881,096) Net book value $ 395,697 $ 469,489 Weighted-average amortization period in years 15.8 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 (49,874) (46,048) Net book value $ 51,088 $ 54,948 Weighted-average amortization period in years 15.0 14.5
Schedule of Real Estate Intangible Amortization	Three Months Ended Six Months Ended June 30, June 30, 2016 2015 2016 2015 Rental income related to above/below market tenant leases, net $ 210 $ (424) $ 290 $ (217) Property operating expenses related to above/below market ground leases, net (311) (334) (622) (653) Depreciation and amortization related to in place lease intangibles and lease commissions (31,019) (31,973) (65,473) (56,297)
Schedule of the future estimated aggregate amortization of intangible assets and liabilities	Assets Liabilities 2016 $ 63,361 $ 3,809 2017 81,279 6,807 2018 44,816 6,181 2019 25,471 5,771 2020 22,563 5,290 Thereafter 158,207 23,230 Total $ 395,697 $ 51,088

Dispositions, Assets Held for29

Dispositions, Assets Held for Sale and Discontinued Operations (Tables)	6 Months Ended
	Jun. 30, 2016
Dispositions, Assets Held for Sale and Discontinued Operations (Tables) [Abstract]
Summary of real property disposition activity	Six Months Ended June 30, 2016 June 30, 2015 Real estate dispositions: Triple-net $ 128,768 $ 105,274 Outpatient medical - 165,221 (1) Land parcels - 5,724 Total dispositions 128,768 276,219 Gain (loss) on real estate dispositions, net 1,530 246,956 Proceeds from real estate dispositions $ 130,298 $ 523,175 (1) Primarily related to the disposition of an unconsolidated equity investment with Forest City Enterprises.
Reclassification impact as result of classifying properties as discontinued operations	Three Months Ended Six Months Ended June 30, June 30, 2016 2015 2016 2015 Revenues: Rental income $ 19,990 $ 24,789 $ 38,552 $ 50,146 Expenses: Interest expense 2,506 4,948 5,032 8,847 Property operating expenses 1,338 1,482 2,700 3,009 Provision for depreciation 3,071 7,042 7,022 13,473 Total expenses 6,915 13,472 14,754 25,329 Income (loss) from real estate dispositions, net $ 13,075 $ 11,317 $ 23,798 $ 24,817

Real Estate Loans Receivable (T

Real Estate Loans Receivable (Tables)	6 Months Ended
	Jun. 30, 2016
Real Estate Loans Receivable (Tables) [Abstract]
Summary of real estate loan activity	Six Months Ended June 30, 2016 June 30, 2015 Outpatient Outpatient Triple-net Medical Totals Triple-net Medical Totals Advances on real estate loans receivable: Investments in new loans $ 8,223 $ - $ 8,223 $ 379,604 $ - $ 379,604 Draws on existing loans 42,803 33 42,836 34,699 2,285 36,984 Net cash advances on real estate loans 51,026 33 51,059 414,303 2,285 416,588 Receipts on real estate loans receivable: Loan payoffs 182,613 27,303 209,916 25,656 - 25,656 Principal payments on loans 4,454 - 4,454 11,686 - 11,686 Sub-total 187,067 27,303 214,370 37,342 - 37,342 Less: Non-cash activity (31,014) (15,013) (46,027) - - - Net cash receipts on real estate loans 156,053 12,290 168,343 37,342 - 37,342 Net cash advances (receipts) on real estate loans (105,027) (12,257) (117,284) 376,961 2,285 379,246 Change in balance due to foreign currency translation (8,504) - (8,504) 1,127 - 1,127 Net change in real estate loans receivable $ (144,545) $ (27,270) $ (171,815) $ 378,088 $ 2,285 $ 380,373

Investments in Unconsolidated31

Investments in Unconsolidated Entities (Tables)	6 Months Ended
	Jun. 30, 2016
Investments In Unconsolidated Entities [Abstract]
Summary Of Investments In Unconsolidated Entities [Text Block]	Percentage Ownership (1) June 30, 2016 December 31, 2015 Triple-net 10% to 49% $ 28,794 $ 36,351 Seniors housing operating 10% to 50% 507,540 499,537 Outpatient medical 43% 6,734 6,393 Total $ 543,068 $ 542,281 (1) Excludes ownership of in-substance real estate.

Credit Concentration (Tables)

Credit Concentration (Tables)	6 Months Ended
	Jun. 30, 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 $ 195,171 16% Sunrise Senior Living (3) 143 160,057 13% Brookdale Senior Living 148 84,526 7% Revera (3) 97 73,992 6% Benchmark Senior Living 49 48,880 4% Remaining portfolio 796 652,611 54% Totals 1,420 $ 1,215,237 100% (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)	6 Months Ended
	Jun. 30, 2016
Borrowings Under Credit Facilities and Related Items (Tables) [Abstract]
Aggregate borrowings under the unsecured line of credit arrangements	Three Months Ended June 30, Six Months Ended June 30, 2016 2015 2016 2015 Balance outstanding at quarter end (1) $ 745,000 $ 350,000 $ 745,000 $ 350,000 Maximum amount outstanding at any month end $ 745,000 $ 535,000 $ 945,000 $ 535,000 Average amount outstanding (total of daily principal balances divided by days in period) $ 623,077 $ 501,758 $ 647,060 $ 455,608 Weighted average interest rate (actual interest expense divided by average borrowings outstanding) 1.26% 1.13% 1.28% 1.17% (1) As of June 30, 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)	6 Months Ended
	Jun. 30, 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 $ - $ 304,577 $ 304,577 2017 450,000 556,382 1,006,382 2018 450,000 631,424 1,081,424 2019 605,000 385,735 990,735 2020 (4) 680,645 176,284 856,929 Thereafter (5,6,7,8,9,10) 6,631,879 1,366,864 7,998,743 Totals $ 8,817,524 $ 3,421,266 $ 12,238,790 (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 1.15% to 6.5%. (3) Annual interest rates range from 0.91% to 7.98%. Carrying value of the properties securing the debt totaled $5,972,202,000 at June 30, 2016. (4) 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 $230,645,000 based on the Canadian/U.S. Dollar exchange rate on June 30, 2016). (5) On May 13, 2016, we refinanced the funding on a $250,000,000 Canadian-denominated unsecured term credit facility (approximately $192,204,000 based on the Canadian/U.S. Dollar exchange rate on June 30, 2016). The loan matures on May 13, 2021 and bears interest at the Canadian Dealer Offered Rate plus 95 basis points (1.84% at June 30, 2016). (6) On May 13, 2016, we refinanced the funding on a $500,000,000 unsecured term credit facility. The loan matures on May 13, 2021 and bears interest at LIBOR plus 95 basis points (1.40% at June 30, 2016). (7) On November 20, 2013, we completed the sale of £ 550,000,000 (approximately $727,925,000 based on the Sterling/U.S. Dollar exchange rate in effect on June 30, 2016) of 4.8% senior unsecured notes due 2028. (8) On November 25, 2014, we completed the sale of £ 500,000,000 (approximately $661,750,000 based on the Sterling/U.S. Dollar exchange rate in effect on June 30, 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	Six Months Ended June 30, 2016 June 30, 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 705,000 4.228% 750,000 4.000% Debt extinguished (400,000) 3.625% (300,000) 6.200% Debt redeemed - 0.000% (158,990) 3.000% Foreign currency (133,234) 4.417% 1,298 3.601% Ending balance $ 8,817,524 4.263% $ 8,109,462 4.252%
Secured debt principal activity	Six Months Ended June 30, 2016 June 30, 2015 Weighted Avg. Weighted Avg. Amount Interest Rate Amount Interest Rate Beginning balance $ 3,478,207 4.440% $ 2,941,765 4.940% Debt issued 161,992 3.051% 136,801 2.845% Debt assumed - 0.000% 317,897 3.223% Debt extinguished (243,314) 4.874% (290,984) 4.208% Foreign currency 62,118 3.652% (38,642) 3.994% Principal payments (37,737) 4.579% (32,966) 4.775% Ending balance $ 3,421,266 4.328% $ 3,033,871 4.750%

Derivative Instruments (Tables)

Derivative Instruments (Tables)	6 Months Ended
	Jun. 30, 2016
Derivative Instruments (Tables) [Abstract]
Impact of derivative instruments on the statement of operations and OCI	June 30, 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 $ 90,000 $ 72,000 Denominated in Pounds Sterling £ 75,000 £ 60,000 Derivative instruments not designated: Denominated in Canadian Dollars $ 43,329 $ 47,000 Three Months Ended Six Months Ended June 30, June 30, Location 2016 2015 2016 2015 Gain (loss) on interest rate swaps reclassified from AOCI into income (effective portion) Interest expense (477) (462) (960) (928) Gain (loss) on forward exchange contracts recognized in income Interest expense 2,697 1,191 1,369 3,938 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 178,575 (149,436) 175,836 34,615 (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)	6 Months Ended
	Jun. 30, 2016
Stockholders' Equity (Tables) [Abstract]
Summary of stockholder's equity capital accounts	June 30, 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 358,624,595 355,594,373 Outstanding shares 357,689,980 354,777,670
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 1,766,585 72.83 128,653 128,653 2015 Option exercises 211,041 46.26 9,762 9,762 2015 Stock incentive plans, net of forfeitures 179,037 - - 2015 Senior note conversions 1,076,971 - - 2015 Totals 22,783,634 $ 1,614,440 $ 1,562,350 2016 Dividend reinvestment plan issuances 1,971,758 64.65 $ 127,470 $ 127,470 2016 Option exercises 37,409 48.73 1,823 1,823 2016 Equity shelf program issuances 443,096 67.12 30,192 29,739 2016 Stock incentive plans, net of forfeitures 460,047 - - 2016 Totals 2,912,310 $ 159,485 $ 159,032
Summary of dividend payments	Six Months Ended June 30, 2016 June 30, 2015 Per Share Amount Per Share Amount Common Stock $ 1.7200 $ 613,163 $ 1.6500 $ 561,914 Series I Preferred Stock 1.6250 23,359 1.6250 23,359 Series J Preferred Stock 0.8126 9,344 0.8126 9,344 Totals $ 645,866 $ 594,617
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 (61,207) (11,160) 2 10 (72,355) Reclassification amount to net income - - - 960 (1) 960 Net current-period other comprehensive income (61,207) (11,160) 2 970 (71,395) Balance at June 30, 2016 $ (146,691) $ (11,160) $ (1,341) $ (446) $ (159,638) Balance at December 31, 2014 $ (74,770) $ - $ (1,589) $ (650) $ (77,009) Other comprehensive income before reclassification adjustments 12,136 (15,100) - (2,625) (5,589) Reclassification amount to net income - - - 928 (1) 928 Net current-period other comprehensive income 12,136 (15,100) - (1,697) (4,661) Balance at June 30, 2015 $ (62,634) $ (15,100) $ (1,589) $ (2,347) $ (81,670) (1) Please see note 11 for additional information.

Earnings Per Share (Tables)

Earnings Per Share (Tables)	6 Months Ended
	Jun. 30, 2016
Earnings Per Share (Tables) [Abstract]
Computation of basic and diluted earnings per share	Three Months Ended Six Months Ended June 30, June 30, 2016 2015 2016 2015 Numerator for basic and diluted earnings per share - net income (loss) attributable to common stockholders $ 195,474 $ 312,573 $ 344,444 $ 503,373 Denominator for basic earnings per share - weighted average shares 356,646 350,399 355,879 343,624 Effect of dilutive securities: Employee stock options 129 153 115 176 Non-vested restricted shares 465 471 359 444 Redeemable shares 1,651 - 1,136 - Convertible senior unsecured notes - 343 - 379 Dilutive potential common shares 2,245 967 1,610 999 Denominator for diluted earnings per share - adjusted weighted average shares 358,891 351,366 357,489 344,623 Basic earnings per share $ 0.55 $ 0.89 $ 0.97 $ 1.46 Diluted earnings per share $ 0.54 $ 0.89 $ 0.96 $ 1.46

Disclosure about Fair Value o38

Disclosure about Fair Value of Financial Instruments (Tables)	6 Months Ended
	Jun. 30, 2016
Disclosure about Fair Value of Financial Instruments (Tables) [Abstract]
Carrying amounts and estimated fair values of financial instruments	June 30, 2016 December 31, 2015 Carrying Amount Fair Value Carrying Amount Fair Value Financial assets: Mortgage loans receivable $ 479,062 $ 506,072 $ 635,492 $ 663,501 Other real estate loans receivable 168,615 172,425 184,000 185,693 Available-for-sale equity investments 11,619 11,619 22,779 22,779 Cash and cash equivalents 466,585 466,585 360,908 360,908 Foreign currency forward contracts 102,231 102,231 129,520 129,520 Financial liabilities: Borrowings under unsecured credit facilities $ 745,000 $ 745,000 $ 835,000 $ 835,000 Senior unsecured notes 8,711,790 9,683,007 8,548,055 9,020,529 Secured debt 3,442,178 3,674,116 3,509,142 3,678,564 Foreign currency forward contracts 3,047 3,047 - - Redeemable OP unitholder interests $ 125,758 $ 125,758 $ 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 June 30, 2016 Total Level 1 Level 2 Level 3 Available-for-sale equity investments (1) $ 11,619 $ 11,619 $ - $ - Foreign currency forward contracts, net (2) 99,184 - 99,184 - Redeemable OP unitholder interests 125,758 - 125,758 - Totals $ 236,561 $ 11,619 $ 224,942 $ - (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)	6 Months Ended
	Jun. 30, 2016
Segment Reporting (Tables) [Abstract]
Summary of information for reportable segments	Three Months Ended June 30, 2016: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 287,134 $ - $ 135,494 $ - $ 422,628 Resident fees and services - 615,220 - - 615,220 Interest income 21,971 1,042 994 - 24,007 Other income 1,206 8,989 4,153 454 14,802 Total revenues 310,311 625,251 140,641 454 1,076,657 Property operating expenses - 417,996 40,836 - 458,832 Net operating income from continuing operations 310,311 207,255 99,805 454 617,825 Interest expense 2,019 42,689 5,402 82,216 132,326 Depreciation and amortization 75,809 102,312 48,448 - 226,569 General and administrative - - - 39,914 39,914 Transaction costs 1,291 3,247 619 - 5,157 Loss (gain) on extinguishment of debt, net 121 (88) - - 33 Other expenses - - - 3,161 3,161 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 231,071 59,095 45,336 (124,837) 210,665 Income tax expense (213) 2,023 (248) (1,049) 513 (Loss) income from unconsolidated entities 3,018 (4,887) (90) - (1,959) Income (loss) from continuing operations 233,876 56,231 44,998 (125,886) 209,219 Gain (loss) on real estate dispositions, net 1,530 - - - 1,530 Net income (loss) $ 235,406 $ 56,231 $ 44,998 $ (125,886) $ 210,749 Total assets $ 12,201,470 $ 11,626,090 $ 5,020,102 $ 116,839 $ 28,964,501 Three Months Ended June 30, 2015: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 272,573 $ - $ 124,053 $ - $ 396,626 Resident fees and services - 535,553 - - 535,553 Interest income 18,189 1,042 1,345 - 20,576 Other income 970 3,210 195 39 4,414 Total revenues 291,732 539,805 125,593 39 957,169 Property operating expenses - 360,569 37,785 - 398,354 Net operating income from continuing operations 291,732 179,236 87,808 39 558,815 Interest expense 1,313 38,834 6,993 71,721 118,861 Depreciation and amortization 70,525 88,844 49,433 - 208,802 General and administrative - - - 38,474 38,474 Transaction costs 7,579 3,937 975 - 12,491 Loss (gain) on extinguishment of debt, net (102) - - 18,989 18,887 Other expenses - - - 10,583 10,583 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 212,417 47,621 30,407 (139,728) 150,717 Income tax expense (3,121) (3,449) (161) (686) (7,417) (Loss) income from unconsolidated entities 1,453 (6,083) 1,678 - (2,952) Income (loss) from continuing operations 210,749 38,089 31,924 (140,414) 140,348 Gain (loss) on real estate dispositions, net - - 190,111 - 190,111 Net income (loss) $ 210,749 $ 38,089 $ 222,035 $ (140,414) $ 330,459 Six Months Ended June 30, 2016: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 570,958 $ - $ 267,332 $ - $ 838,290 Resident fees and services - 1,217,369 - - 1,217,369 Interest income 44,824 2,073 2,298 - 49,195 Other income 2,695 11,178 4,466 512 18,851 Total revenues 618,477 1,230,620 274,096 512 2,123,705 Property operating expenses - 826,890 81,578 - 908,468 Net operating income from continuing operations 618,477 403,730 192,518 512 1,215,237 Interest expense 7,623 83,518 11,146 162,998 265,285 Loss (gain) on derivatives, net - - - - - Depreciation and amortization 155,609 204,144 95,512 - 455,265 General and administrative - - - 85,606 85,606 Transaction costs 4,143 7,180 2,042 - 13,365 Loss (gain) on extinguishment of debt, net 97 (88) - - 9 Impairment of assets 14,314 - - - 14,314 Other expenses - - - 3,161 3,161 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 436,691 108,976 83,818 (251,253) 378,232 Income tax expense (528) 4,789 (476) (1,546) 2,239 (Loss) income from unconsolidated entities 6,100 (11,822) (56) - (5,778) Income (loss) from continuing operations 442,263 101,943 83,286 (252,799) 374,693 Gain (loss) on real estate dispositions, net 1,530 - - - 1,530 Net income (loss) $ 443,793 $ 101,943 $ 83,286 $ (252,799) $ 376,223 Six Months Ended June 30, 2015: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 534,565 $ - $ 241,648 $ - $ 776,213 Resident fees and services - 1,028,063 - - 1,028,063 Interest income 32,888 2,073 2,609 - 37,570 Other income 4,853 4,229 356 62 9,500 Total revenues 572,306 1,034,365 244,613 62 1,851,346 Property operating expenses - 699,076 75,739 - 774,815 Net operating income from continuing operations 572,306 335,289 168,874 62 1,076,531 Interest expense 9,736 73,293 14,382 142,531 239,942 Loss (gain) on derivatives, net (58,427) - - - (58,427) Depreciation and amortization 139,946 165,479 92,206 - 397,631 General and administrative - - - 73,612 73,612 Transaction costs 43,750 15,979 1,316 - 61,045 Loss (gain) on extinguishment of debt, net 10,235 - - 24,053 34,288 Impairment of assets 2,220 - - - 2,220 Other expenses - - - 10,583 10,583 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 424,846 80,538 60,970 (250,717) 315,637 Income tax expense (2,703) (3,982) 305 (733) (7,113) (Loss) income from unconsolidated entities 2,846 (21,156) 2,710 - (15,600) Income (loss) from continuing operations 424,989 55,400 63,985 (251,450) 292,924 Gain (loss) on real estate dispositions, net 54,097 - 192,859 - 246,956 Net income (loss) $ 479,086 $ 55,400 $ 256,844 $ (251,450) $ 539,880 Three Months Ended Six Months Ended June 30, 2016 June 30, 2015 June 30, 2016 June 30, 2015 Revenues: Amount % Amount % Amount % Amount % United States $ 862,115 80.1% $ 771,031 80.6% $ 1,704,470 80.3% $ 1,516,168 81.9% United Kingdom 102,593 9.5% 103,531 10.8% 203,148 9.5% 195,345 10.6% Canada 111,949 10.4% 82,607 8.6% 216,087 10.2% 139,833 7.6% Total $ 1,076,657 100.0% $ 957,169 100.0% $ 2,123,705 100.0% $ 1,851,346 100.0% As of June 30, 2016 December 31, 2015 Assets: Amount % Amount % United States $ 23,546,510 81.3% $ 25,995,793 89.6% United Kingdom 2,789,104 9.6% 1,741,973 6.0% Canada 2,628,887 9.1% 1,286,079 4.4% Total $ 28,964,501 100.0% $ 29,023,845 100.0%

Variable Interest Entity Disc40

Variable Interest Entity Disclosure (Tables)	6 Months Ended
	Jun. 30, 2016
Variable Interest Entity Disclosure [Abstract]
Schedule of Variable Interest Entities [Table Text Block]	June 30, 2016 December 31, 2015 Assets Net real property owned $ 1,006,674 $ 453,889 Cash and cash equivalents 10,946 8,759 Receivables and other assets 11,828 8,082 Total assets (1) $ 1,029,448 $ 470,730 Liabilities and equity Secured debt $ 451,450 $ 147,021 Accrued expenses and other liabilities 12,807 7,732 Redeemable noncontrolling interests 78,477 70,090 Total equity 486,714 245,887 Total liabilities and equity $ 1,029,448 $ 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)	Jun. 30, 2016properties
Business [Line Items]
Number of properties in diversified portfolio	1,420	[1]
Controlling [Member]
Business [Line Items]
Number of properties in diversified portfolio	1,486
[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	6 Months Ended
	Jun. 30, 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		6 Months Ended
		Jun. 30, 2016		Jun. 30, 2015
Triple Net [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		$ 18,901	[1]	$ 45,268
Buildings and improvements		160,209	[1]	447,229
Acquired lease intangibles		2,876	[1]	2,817
Restricted cash		0	[1]	6
Receivables and other assets		0	[1]	60
Total assets acquired		181,986	[1]	495,380
Accrued expenses and other liabilities		(1,459)	[1]	(1,845)
Total liabilities assumed		(1,459)	[1]	(1,845)
Non-cash acquisition related activity	[2]	(37,703)	[1]	(936)
Cash disbursed for acquisitions		142,824	[1]	492,599
Construction in progress additions		85,687	[1]	74,694
Less: Capitalized Interest		(3,771)	[1]	(3,303)
Less: Foreign currency translation		(2,712)	[1]	240
Cash disbursed for construction in progress		79,204	[1]	71,631
Capital improvements to existing properties		14,877	[1]	19,029
Total cash invested in real property		236,905	[1]	583,259
Non Cash Acquisition Financed As Real Estate Loan Receivable		31,014
Non cash acquisition financed as equity investments		6,630
Triple Net [Member] | Preliminary [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Total cash invested in real property		166,343
Senior housing - operating [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		5,617	[3]	94,294
Buildings and improvements		128,200	[3]	1,174,465
Acquired lease intangibles		6,334	[3]	71,089
Restricted cash		0	[3]	5,425
Receivables and other assets		894	[3]	23,645
Total assets acquired	[4]	141,045	[3]	1,368,918
Secured debt		0	[3]	(208,960)
Accrued expenses and other liabilities		(4,853)	[3]	(19,011)
Total liabilities assumed		(4,853)	[3]	(227,971)
Noncontrolling interests		(549)	[3]	(86,842)
Non-cash acquisition related activity	[5]	(7,659)		0
Cash disbursed for acquisitions		127,984	[3]	1,054,105
Construction in progress additions		134,019	[3]	19,926
Less: Capitalized Interest		(2,011)	[3]	(715)
Less: Foreign currency translation		(5,344)	[3]	(40)
Cash disbursed for construction in progress		126,664	[3]	19,171
Capital improvements to existing properties		47,553	[3]	32,766
Total cash invested in real property		302,201	[3]	1,106,042
Cash Acquired from Acquisition		134		3,390
Senior housing - operating [Member] | Preliminary [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Total cash invested in real property		117,545
Outpatient Medical [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		0	[6]	737
Buildings and improvements		32,650	[6]	426,130
Acquired lease intangibles		0	[6]	19,372
Total assets acquired	[7]	32,650	[6]	446,239
Secured debt		0	[6]	(112,000)
Accrued expenses and other liabilities		(990)	[6]	(2,743)
Total liabilities assumed		(990)	[6]	(114,743)
Noncontrolling interests		0	[6]	(68,535)
Non-cash acquisition related activity	[8]	(15,013)		0
Cash disbursed for acquisitions		16,647	[6]	262,961
Construction in progress additions		50,896	[6]	26,025
Less: Capitalized Interest		(1,561)	[6]	(428)
Less: Accruals	[9]	(5,336)	[6]	(1,921)
Cash disbursed for construction in progress		43,999	[6]	23,676
Capital improvements to existing properties		25,099	[6]	15,291
Total cash invested in real property		85,745	[6]	301,928
Cash Acquired from Acquisition		0		$ 4,372
Outpatient Medical [Member] | Preliminary [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Total cash invested in real property		$ 32,650
[1]	(1) Includes acquisitions with an aggregate purchase price of $166,343,000 for which the allocation of the purchase price consideration is preliminary and subject to change.
[2]	(2) For the six months ended June 30, 2016, $31,014,000 relates to the acquisition of assets previously financed as real estate loans receivable and $6,630,000 previously financed as equity investments.
[3]	(1) Includes acquisitions with an aggregate purchase price of $117,545,000 for which the allocation of the purchase price consideration is preliminary and subject to change.
[4]	(2) Excludes $134,000 and $3,390,000 of cash acquired during the six months ended June 30, 2016 and 2015, respectively.
[5]	(3) Relates to the acquisition of assets previously financed as equity investments.
[6]	(1) Includes acquisitions with an aggregate purchase price of $32,650,000 for which the allocation of the purchase price consideration is preliminary and subject to change.
[7]	(2) Excludes $0 and $4,372,000 of cash acquired during the six months ended June 30, 2016 and 2015, respectively.
[8]	(3) Relates to an acquisition of assets previously financed as a real estate loan. Refer to Note 6 for additional information.
[9]	(4) Represents non-cash consideration accruals for amounts to be paid in future periods relating to properties that converted in the periods noted above.

Real Property Acquisitions an44

Real Property Acquisitions and Development (Details 2) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Development projects:
Total development projects	$ 35,363	$ 109,236
Expansion projects	2,879	38,808
Total construction in progress conversions	38,242	148,044
Triple Net [Member]
Development projects:
Total development projects	0	72,775
Seniors housing operating [Member]
Development projects:
Total development projects	0	19,869
Outpatient Medical [Member]
Development projects:
Total development projects	$ 35,363	$ 16,592

Real Estate Intangibles (Detail

Real Estate Intangibles (Details) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2016	Dec. 31, 2015
Intangible Assets:
Gross historical cost	$ 1,345,424	$ 1,350,585
Accumulated amortization	949,727	881,096
Net book value	$ 395,697	$ 469,489
Weighted-average amortization period in years	15 years 10 months	13 years 5 months
Intangible Liabilities:
Gross historical cost	$ 100,962	$ 100,996
Accumulated amortization	49,874	46,048
Net book value	$ 51,088	$ 54,948
Weighted-average amortization period in years	15 years	14 years 6 months
In place lease intangibles [Member]
Intangible Assets:
Gross historical cost	$ 1,194,925	$ 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	62,447	80,224
Lease commissions [Member]
Intangible Assets:
Gross historical cost	25,508	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	Jun. 30, 2016	Dec. 31, 2015
Estimated Aggregate Amortization Expense For Acquired Lease Intangibles Expected To Be Recognized [Line Items]
Totals	$ 395,697	$ 469,489
Intangible Liability [Member]
Estimated Aggregate Amortization Expense For Acquired Lease Intangibles Expected To Be Recognized [Line Items]
2,016	3,809
2,017	6,807
2,018	6,181
2,019	5,771
2,020	5,290
Thereafter	23,230
Totals	51,088
Intangible Asset [Member]
Estimated Aggregate Amortization Expense For Acquired Lease Intangibles Expected To Be Recognized [Line Items]
2,016	63,361
2,017	81,279
2,018	44,816
2,019	25,471
2,020	22,563
Thereafter	158,207
Totals	$ 395,697

Real Estate Intangibles (Deta47

Real Estate Intangibles (Details 1) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Real Estate Intangible Amortization [Abstract]
Rental income related to above/below market tenant leases, net	$ 210	$ (424)	$ 290	$ (217)
Property operating expenses related to above/below market ground leases, net	(311)	(334)	(622)	(653)
Depreciation and amortization related to in place lease intangibles and lease commissions	$ (31,019)	$ (31,973)	$ (65,473)	$ (56,297)

Dispositions, Assets Held for48

Dispositions, Assets Held for Sale and Discontinued Operations (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Real property dispositions:
Total dispositions	$ 128,768	$ 276,219
Net loss (gain) on sales of properties	1,530	246,956
Proceeds from sales of real property	130,298	523,175
Triple Net [Member]
Real property dispositions:
Total dispositions	128,768	105,274
Outpatient Medical [Member]
Real property dispositions:
Total dispositions	0	165,221	[1]
Land parcels [Member]
Real property dispositions:
Total dispositions	$ 0	$ 5,724
[1]	(1) Primarily related to the disposition of an unconsolidated equity investment with Forest City Enterprises.

Dispositions, Assets Held for49

Dispositions, Assets Held for Sale and Discontinued Operations (Details 2) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Revenues:
Rental income, disposed	$ 19,990	$ 24,789	$ 38,552	$ 50,146
Expenses:
Interest expense, disposed	2,506	4,948	5,032	8,847
Property operating expenses, disposed	1,338	1,482	2,700	3,009
Depreciation expense, disposed	3,071	7,042	7,022	13,473
Expenses, disposed	6,915	13,472	14,754	25,329
Income (loss) from disposed properties	$ 13,075	$ 11,317	$ 23,798	$ 24,817

Real Estate Loans Receivable (D

Real Estate Loans Receivable (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Advances on real estate loans receivable:
Investments in new loans	$ 8,223	$ 379,604
Draws on existing loans	42,836	36,984
Net cash advances on real estate loans	51,059	416,588
Receipts on real estate loans receivable:
Loan payoffs	209,916	25,656
Principal payments on loans	4,454	11,686
Sub-total	214,370	37,342
Less : Non-cash activity	(46,027)	0
Total receipts on real estate loans	168,343	37,342
Net advances (receipts) on real estate loans	(117,284)	379,246
Change in balance due to foreign currency translation	(8,504)	1,127
Net change Real Estate Loans Receivable	(171,815)	380,373
Triple Net [Member]
Advances on real estate loans receivable:
Investments in new loans	8,223	379,604
Draws on existing loans	42,803	34,699
Net cash advances on real estate loans	51,026	414,303
Receipts on real estate loans receivable:
Loan payoffs	182,613	25,656
Principal payments on loans	4,454	11,686
Sub-total	187,067	37,342
Less : Non-cash activity	(31,014)	0
Total receipts on real estate loans	156,053	37,342
Net advances (receipts) on real estate loans	(105,027)	376,961
Change in balance due to foreign currency translation	(8,504)	1,127
Net change Real Estate Loans Receivable	(144,545)	378,088
Outpatient Medical [Member]
Advances on real estate loans receivable:
Investments in new loans	0	0
Draws on existing loans	33	2,285
Net cash advances on real estate loans	33	2,285
Receipts on real estate loans receivable:
Loan payoffs	27,303	0
Principal payments on loans	0	0
Sub-total	27,303	0
Less : Non-cash activity	(15,013)	0
Total receipts on real estate loans	12,290	0
Net advances (receipts) on real estate loans	(12,257)	2,285
Change in balance due to foreign currency translation	0	0
Net change Real Estate Loans Receivable	$ (27,270)	$ 2,285

Investments in Unconsolidated51

Investments in Unconsolidated Entities (Summary of Investments in Unconsolidated Entities) (Details) - USD ($) $ in Thousands		Jun. 30, 2016	Dec. 31, 2015
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated entities		$ 543,068	$ 542,281
Triple Net [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated entities		$ 28,794	$ 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		$ 507,540	$ 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		$ 6,734	$ 6,393
[1]	(1) Excludes ownership of in-substance real estate.

Investments in Unconsolidated52

Investments in Unconsolidated Entities (Details) $ in Thousands	Jun. 30, 2016USD ($)
Schedule of Equity Method Investments [Line Items]
Unamortized Investment In Joint Venture Primarily Attributable To Real Estate And Related Intangible Assets	$ 153,126

Credit Concentration (Details)

Credit Concentration (Details) $ in Thousands		3 Months Ended			6 Months Ended
		Jun. 30, 2016USD ($)properties		Jun. 30, 2015USD ($)	Jun. 30, 2016USD ($)properties		Jun. 30, 2015USD ($)	Dec. 31, 2015
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	1,420			1,420
Percent of NOI	[1],[2]				100.00%
Net Operating Income | $		$ 617,825	[1]	$ 558,815	$ 1,215,237	[1]	$ 1,076,531
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%
Genesis HealthCare [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	187			187
Genesis HealthCare [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]				16.00%
Net Operating Income | $	[1]				$ 195,171
Sunrise Senior Living [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1],[3]	143			143
Sunrise Senior Living [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2],[3]				13.00%
Net Operating Income | $	[1],[3]				$ 160,057
Brookdale [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	148			148
Brookdale [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]				7.00%
Net Operating Income | $	[1]				$ 84,526
Benchmark Senior Living [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	49			49
Benchmark Senior Living [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]				4.00%
Net Operating Income | $	[1]				$ 48,880
Revera [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1],[3]	97			97
Revera [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2],[3]				6.00%
Net Operating Income | $	[1],[3]				$ 73,992
Remaining Portfolio [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	796			796
Remaining Portfolio [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]				54.00%
Net Operating Income | $	[1]				$ 652,611
[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				6 Months Ended
	Jun. 30, 2016		Jun. 30, 2015		Jun. 30, 2016		Jun. 30, 2015		Dec. 31, 2015
Aggregate borrowings under the unsecured line of credit arrangements
Balance outstanding at quarter end	$ 745,000	[1]	$ 350,000	[1]	$ 745,000	[1]	$ 350,000	[1]	$ 835,000
Maximum amount outstanding at any month end	745,000		535,000		945,000		535,000
Average amount outstanding (total of daily principal balances divided by days in period)	$ 623,077		$ 501,758		$ 647,060		$ 455,608
Weighted average interest rate (actual interest expense divided by average borrowings outstanding)	1.26%		1.13%		1.28%		1.17%
[1]	(1) As of June 30, 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	6 Months Ended
	Jun. 30, 2016USD ($)Number
Line Of Credit Facility [Line Items]
Unsecured line of credit arrangement	$ 3,000,000
Number of banks in consortium | Number	29
Available to borrow in alternate currencies	$ 1,000,000
Agent bank's prime rate of interest	1.35%
Interest Rate margin	0.90%
Annual facility fee for each bank based on commitment amount	0.15%
Debt instrument maturity date	May 13, 2020
Term Loan Interest Rate Margin	1.3971%
HCN Term Loan	$ 500,000
HCN Canadian Denomiated Term Loan	250,000
Letter of credit that reduces the borrowing capacity	48,930
Accordion Feature [Member]
Line Of Credit Facility [Line Items]
HCN Term Loan	1,000,000
HCN Canadian Denomiated Term Loan	$ 250,000

Senior Unsecured Notes and Se56

Senior Unsecured Notes and Secured Debt (Details) £ in Thousands, CAD in Thousands, $ in Thousands		6 Months Ended
		Jun. 30, 2016CAD	Jun. 30, 2016GBP (£)	Jun. 30, 2016USD ($)	Dec. 31, 2015USD ($)	Oct. 01, 2015USD ($)
Principal payments due on debt obligations
2,016				$ 304,577
2,017				1,006,382
2,018				1,081,424
2,019				990,735
2,020	[1]			856,929
Thereafter	[2],[3],[4],[5],[6],[7]			7,998,743
Totals				12,238,790
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Senior unsecured notes				8,711,790	$ 8,548,055
Secured debt				3,442,178	$ 3,509,142
Interest Rate margin		0.90%
Debt instrument maturity date		May 13, 2020
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	[8],[9]			605,000
2,020	[1],[8],[9]			680,645
Thereafter	[2],[3],[4],[5],[6],[7],[8],[9]			6,631,879
Totals	[8],[9]			8,817,524
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Notes, annual stated interest rates, Minimum		1.15%
Notes, annual stated interest rates, Maximum		6.50%
Secured Debt [Member]
Principal payments due on debt obligations
2,016	[8],[10]			304,577
2,017	[8],[10]			556,382
2,018	[8],[10]			631,424
2,019	[8],[10]			385,735
2,020	[1],[8],[10]			176,284
Thereafter	[2],[3],[4],[5],[6],[7],[8],[10]			1,366,864
Totals	[8],[10]			3,421,266
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Notes, annual stated interest rates, Minimum		0.91%
Notes, annual stated interest rates, Maximum		7.98%
Carrying values of properties securing the debt				5,972,202
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		$ 192,204
Interest Rate margin		1.84%
Debt Instrument, Issuance Date		May 13, 2016
Debt instrument maturity date		May 13, 2021
Canadian Denominated Unsecured Term Loan [Member] | London Interbank Offered Rate (LIBOR) [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Interest Rate margin		0.95%
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	$ 661,750
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	$ 727,925
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		1.40%
Debt Instrument, Issuance Date		May 13, 2016
Debt instrument maturity date		May 13, 2021
Unsecured term credit facility [Member] | London Interbank Offered Rate (LIBOR) [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Interest Rate margin		0.95%
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		$ 230,645
Debt Instrument, Issuance Date		Nov. 1, 2015
[1]	(4) 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 $230,645,000 based on the Canadian/U.S. Dollar exchange rate on June 30, 2016).
[2]	(10) In March 2016, we issued $700,000,000 of 4.25% senior unsecured notes due 2026.
[3]	(5) On May 13, 2016, we refinanced the funding on a $250,000,000 Canadian-denominated unsecured term credit facility (approximately $192,204,000 based on the Canadian/U.S. Dollar exchange rate on June 30, 2016). The loan matures on May 13, 2021 and bears interest at the Canadian Dealer Offered Rate plus 95 basis points (1.84% at June 30, 2016).
[4]	(6) On May 13, 2016, we refinanced the funding on a $500,000,000 unsecured term credit facility. The loan matures on May 13, 2021 and bears interest at LIBOR plus 95 basis points (1.40% at June 30, 2016).
[5]	(7) On November 20, 2013, we completed the sale of £550,000,000 (approximately $727,925,000 based on the Sterling/U.S. Dollar exchange rate in effect on June 30, 2016) of 4.8% senior unsecured notes due 2028.
[6]	(8) On November 25, 2014, we completed the sale of £500,000,000 (approximately $661,750,000 based on the Sterling/U.S. Dollar exchange rate in effect on June 30, 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 1.15% to 6.5%.
[10]	(3) Annual interest rates range from 0.91% to 7.98%. Carrying value of the properties securing the debt totaled $5,972,202,000 at June 30, 2016.

Senior Unsecured Notes and Se57

Senior Unsecured Notes and Secured Debt (Details 1) $ in Thousands	6 Months Ended		12 Months Ended
	Jun. 30, 2016USD ($)	Jun. 30, 2015USD ($)	Dec. 31, 2015USD ($)	Dec. 31, 2014USD ($)
Unsecured note issuances
Senior unsecured debt issued	$ 693,560	$ 743,407
Senior unsecured debt redeemed	400,000	477,550
Excluding Fair Value Adjustments [Member]
Unsecured note issuances
Senior unsecured debt balance	8,817,524	8,109,462	$ 8,645,758	$ 7,817,154
Senior unsecured debt issued	705,000	750,000
Senior unsecured debt extinguished	(400,000)	(300,000)
Senior unsecured debt redeemed	0	(158,990)
Senior unsecured debt foreign currency	$ (133,234)	$ 1,298
Senior unsecured debt balance average rate	0.04263	0.04252	0.04237	0.04385
Senior unsecured debt issued average rate	0.04228	0.04
Senior unsecured debt extinguished average rate	0.03625	0.062
Senior unsecured debt redeemed average rate	0	0.03
Senior unsecured debt foreign currency average rate	0.04417	0.03601

Senior Unsecured Notes and Se58

Senior Unsecured Notes and Secured Debt (Details 2) $ in Thousands	6 Months Ended		12 Months Ended
	Jun. 30, 2016USD ($)	Jun. 30, 2015USD ($)	Dec. 31, 2015USD ($)	Dec. 31, 2014USD ($)
Secured debt principal activity
Secured debt issued	$ 161,992	$ 136,801
Secured debt extinguished	281,051	323,950
Excluding Fair Value Adjustments [Member]
Secured debt principal activity
Secured debt principal balance	3,421,266	3,033,871	$ 3,478,207	$ 2,941,765
Secured debt issued	161,992	136,801
Secured debt assumed	0	317,897
Secured debt extinguished	(243,314)	(290,984)
Secured debt principal payments	(37,737)	(32,966)
Secured debt foreign currency	$ 62,118	$ (38,642)
Secured debt principal balance average rate	0.04328	0.0475	0.0444	0.0494
Secured debt principal issued average rate	0.03051	0.02845
Secured debt principal assumed average rate	0	0.03223
Secured debt principal extinguished average rate	0.04874	0.04208
Secured debt principal payment average rate	0.04579	0.04775
Secured debt principal foreign currency average rate	0.03652	0.03994

Derivative Instrument (Notional

Derivative Instrument (Notional Table) (Details) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 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	90,000	72,000
Designated as Hedging Instrument [Member] | Cash Flow Hedging [Member] | GBP
Derivatives Fair Value [Line Items]
Derivative, Notional Amount	75,000	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	$ 43,329	$ 47,000

Derivative Instruments (Details

Derivative Instruments (Details 1) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016		Jun. 30, 2015
Derivative [Line Items]
Derivative Gain Loss On Derivative Net	$ 0	$ 0	$ 0	[1]	$ 58,427
Interest Rate Swap [Member]
Derivative [Line Items]
Gain (loss) on interest rate swaps recalssified from AOCI into income (effective portion)	(477)	(462)	(960)		(928)
Gain (loss) on forward exchange contracts recognized in income.	2,697	1,191	1,369		3,938
Foreign Exchange Contract [Member]
Derivative [Line Items]
Gain (loss) recognized in OCI	178,575	(149,436)	175,836		34,615
Derivative Gain Loss On Derivative Net	0	0	0		0
Gain on Release of cumulative translation adjustment related to net investment hedge of an equity investment	0	0	0		0
Foreign Exchange Option Member
Derivative [Line Items]
Derivative Gain Loss On Derivative Net	$ 0	$ 0	$ 0		$ (58,427)
[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	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Derivative Instruments [Abstract]
Cash Flow Hedge Gain Loss To Be Reclassified Within Twelve Months 2	$ 4,911
Derivative Cash Received On Hedge	$ 56,842	$ 72,477

Commitments and Contingencies (

Commitments and Contingencies (Details Textual) $ in Thousands	6 Months Ended
	Jun. 30, 2016USD ($)Number	Dec. 31, 2015USD ($)
Commitments and Contingencies (Textual) [Abstract]
Number of outstanding letters of credit | Number	10
Letter of credit obligation	$ 91,783
Line Of Credit Facility [Line Items]
Outstanding construction financings for leased properties	475,203	$ 258,968
Additional financing to complete construction	627,775
Total contingent purchase obligations	$ 22,475
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	$ 1,088,213
Operating Leases, Future Minimum Payments Due, Future Minimum Sublease Rentals	76,954
Capital Leases, Future Minimum Payments Due	96,201
Purchase Obligation for Acquisitions Expected to be Completed before YE	$ 1,150,000
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	Jun. 30, 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	358,624,595	355,594,373
Outstanding shares	357,689,980	354,777,670

Stockholder's Equity (Details 1

Stockholder's Equity (Details 1)	6 Months Ended
	Jun. 30, 2016USD ($)$ / sharesshares	Jun. 30, 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	1,971,758	1,766,585
Dividend reinvestment plan issuances, Average Price	64.65	72.83
Dividend reinvestment plan issuances, Net Proceeds	$ 127,470,000	$ 128,653,000
Dividend reinvestment plan issuances, Gross Proceeds	$ 127,470,000	$ 128,653,000
Option exercises, Shares | shares	37,409	211,041
Option exercises, Average Price	48.73	46.26
Option exercises, Gross Proceeds	$ 1,823,000	$ 9,762,000
Option exercises, Net Proceeds	$ 1,823,000	$ 9,762,000
Stock incentive plans, net of forfeitures, Shares Issued | shares	460,047	179,037
Senior note conversions | shares		1,076,971
Issuance of Common Stock, Shares | shares	2,912,310	22,783,634
Gross Proceeds From Issuance of Common Stock	$ 159,485,000	$ 1,614,440,000
Net proceeds from the issuance of common stock	$ 159,032,000	$ 1,562,350,000
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		Jun. 30, 2016	Dec. 31, 2015	Jun. 30, 2015	Dec. 31, 2014
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges		$ (446)	$ (1,416)	$ (2,347)	$ (650)
Unrecognized losses on equity investments		(11,160)	0	(15,100)	0
Unrecognized gains (losses) on foreign currency translation		(146,691)	(85,484)	(62,634)	(74,770)
Unrecognized actuarial losses		(1,341)	(1,343)	(1,589)	(1,589)
Totals		(159,638)	$ (88,243)	(81,670)	$ (77,009)
Other comprehensive income before reclassification adjustments
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges		10		(2,625)
Unrecognized losses on equity investments		(11,160)		(15,100)
Unrecognized gains (losses) on foreign currency translation		(61,207)		12,136
Unrecognized actuarial losses		2		0
Totals		(72,355)		(5,589)
Reclassification amount to net income
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges	[1]	960		928
Unrecognized losses on equity investments		0		0
Unrecognized gains (losses) on foreign currency translation		0		0
Unrecognized actuarial losses		0		0
Totals		960		928
Net current period other comprehensive income
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges		970		(1,697)
Unrecognized losses on equity investments		(11,160)		(15,100)
Unrecognized gains (losses) on foreign currency translation		(61,207)		12,136
Unrecognized actuarial losses		2		0
Totals		$ (71,395)		$ (4,661)
[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		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Summary of dividend payments
Dividends declared and paid per common share	$ 0.86	$ 0.825	$ 1.72	$ 1.65
Common stock cash dividends			$ 613,163	$ 561,914
Total dividends paid			$ 645,866	$ 594,617
Series I Preferred Stock [Member]
Summary of dividend payments
Dividends declared and paid per preferred share			$ 1.625	$ 1.625
Preferred stock cash dividends			$ 23,359	$ 23,359
Series J Preferred Stock [Member]
Summary of dividend payments
Dividends declared and paid per preferred share			$ 0.8126	$ 0.8126
Preferred stock cash dividends			$ 9,344	$ 9,344

Stock Incentive Plans (Details

Stock Incentive Plans (Details Textual) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Stock Incentive Plans [Line Items]
Number of common stock authorized for Long-Term Incentive Plan	10,000		10,000
Stock-based compensation expense	$ 7,031	$ 11,124	$ 15,217	$ 20,178
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		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Computation of basic and diluted earnings per share
Numerator for basic and diluted earnings per share - net income (loss) attributable to common stockholders	$ 195,474	$ 312,573	$ 344,444	$ 503,373
Denominator for basic earnings per share - weighted average shares	356,646	350,399	355,879	343,624
Effect of dilutive securities:
Employee stock options	129	153	115	176
Non-vested restricted shares	465	471	359	444
Redeemable shares	1,651	0	1,136	0
Convertible senior unsecured notes	0	343	0	379
Dilutive potential common shares	2,245	967	1,610	999
Denominator for diluted earnings per share - adjusted weighted average shares	358,891	351,366	357,489	344,623
Basic earnings per share	$ 0.55	$ 0.89	$ 0.97	$ 1.46
Diluted earnings per share	$ 0.54	$ 0.89	$ 0.96	$ 1.46

Disclosure about Fair Value o69

Disclosure about Fair Value of Financial Instruments (Details) - USD ($) $ in Thousands	Jun. 30, 2016		Dec. 31, 2015	Jun. 30, 2015		Dec. 31, 2014
Financial Assets:
Loans receivable, Fair value	$ 506,072		$ 663,501
Available-for-sale equity investments, Carrying Amount	11,619		22,779
Available-for-sale equity investments, Fair Value	11,619	[1]	22,779
Cash and cash equivalents, Carrying Amount	466,585		360,908	$ 217,942		$ 473,726
Cash and cash equivalents, Fair Value	466,585		360,908
Foreign Currency Forward Contracts Carrying Value	102,231		129,520
Foreign Currency Forward Contracts Fair Value	102,231		129,520
Financial Liabilities:
Borrowings under primary unsecured credit facilities, Carrying Value	745,000	[2]	835,000	$ 350,000	[2]
Borrowings under primary unsecured credit facilities, Fair Value	745,000		835,000
Senior unsecured notes, Carrying Amount	8,711,790		8,548,055
Senior unsecured notes, Fair Value	9,683,007		9,020,529
Secured debt, Carrying Amount	3,442,178		3,509,142
Secured debt, Fair Value	3,674,116		3,678,564
Foreign Currency Forward Contracts Carrying Value	3,047		0
Foreign Currency Forward Contracts, Fair Value	3,047		0
Redeemable OP unitholder interests carrying value	125,758		112,029
Redeemable OP unitholder interests fair value	125,758		112,029
Mortgage Loans on Real Estate [Member]
Financial Assets:
Loans receivable, Carrying Amount	479,062		635,492
Loans receivable, Fair value	506,072		663,501
Other Real Estate Loans Receivable [Member]
Financial Assets:
Loans receivable, Carrying Amount	168,615		184,000
Loans receivable, Fair value	$ 172,425		$ 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 June 30, 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		Jun. 30, 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		$ 11,619	[1]	$ 22,779
Foreign currency forward contracts	[2]	99,184
Redeemable OP unitholder interests		125,758
Totals		236,561
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]	11,619
Totals		11,619
Level 2 [Member]
The Market approach utilized to measure fair value of financial assets and liabilities on recurring basis
Foreign currency forward contracts	[2]	99,184
Redeemable OP unitholder interests		125,758
Totals		$ 224,942
[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.

Disclosure about Fair Value o71

Disclosure about Fair Value of Financial Instruments (Details Textuals) $ in Thousands	Jun. 30, 2016USD ($)
Disclosure about Fair Value of Financial Instruments (Details) [Abstract]
Other than temporary asset impairment charges	$ 35,648

Segment Reporting (Details)

Segment Reporting (Details) $ in Thousands	3 Months Ended			6 Months Ended
	Jun. 30, 2016USD ($)		Jun. 30, 2015USD ($)	Jun. 30, 2016USD ($)		Jun. 30, 2015USD ($)	Dec. 31, 2015USD ($)
Summary of information for reportable segments
Rental income	$ 422,628		$ 396,626	$ 838,290		$ 776,213
Resident fees and services	615,220		535,553	1,217,369		1,028,063
Interest income	24,007		20,576	49,195		37,570
Other income	14,802		4,414	18,851		9,500
Total revenues	1,076,657		957,169	2,123,705		1,851,346
Property operating expenses	458,832		398,354	908,468		774,815
Net Operating Income from Continuing Operations	617,825	[1]	558,815	1,215,237	[1]	1,076,531
Interest expense	132,326		118,861	265,285		239,942
Loss (gain) on derivatives, net	0		0	0	[2]	(58,427)
Depreciation and amortization	226,569		208,802	455,265		397,631
General and administrative	39,914		38,474	85,606		73,612
Transaction costs	5,157		12,491	13,365		61,045
Loss (gain) on extinguishment of debt, net	33		18,887	9		34,288
Impairment of Asset	0		0	14,314		2,220
Other expenses	3,161		10,583	3,161		10,583
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	210,665		150,717	378,232		315,637
Income tax (expense) benefit	513		(7,417)	2,239		(7,113)
(Loss) income from unconsolidated entities	(1,959)		(2,952)	(5,778)		(15,600)
Income (loss) from continuing operations	209,219		140,348	374,693		292,924
Gain (loss) on real estate dispositions, net	1,530		190,111	1,530		246,956
Net income	210,749		$ 330,459	376,223		$ 539,880
Total assets	$ 28,964,501			$ 28,964,501			$ 29,023,845
Percent Of Assets	1			1			1
Percent Of Revenues	1		1	1		1
Triple Net [Member]
Summary of information for reportable segments
Rental income	$ 287,134		$ 272,573	$ 570,958		$ 534,565
Resident fees and services	0		0	0		0
Interest income	21,971		18,189	44,824		32,888
Other income	1,206		970	2,695		4,853
Total revenues	310,311		291,732	618,477		572,306
Property operating expenses	0		0	0		0
Net Operating Income from Continuing Operations	310,311		291,732	618,477		572,306
Interest expense	2,019		1,313	7,623		9,736
Loss (gain) on derivatives, net	0		0	0		(58,427)
Depreciation and amortization	75,809		70,525	155,609		139,946
General and administrative	0		0	0		0
Transaction costs	1,291		7,579	4,143		43,750
Loss (gain) on extinguishment of debt, net	121		(102)	97		10,235
Impairment of Asset	0		0	14,314		2,220
Other expenses	0		0	0		0
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	231,071		212,417	436,691		424,846
Income tax (expense) benefit	(213)		(3,121)	(528)		(2,703)
(Loss) income from unconsolidated entities	3,018		1,453	6,100		2,846
Income (loss) from continuing operations	233,876		210,749	442,263		424,989
Gain (loss) on real estate dispositions, net	1,530		0	1,530		54,097
Net income	235,406		210,749	443,793		479,086
Total assets	12,201,470			12,201,470
Senior housing - operating [Member]
Summary of information for reportable segments
Rental income	0		0	0		0
Resident fees and services	615,220		535,553	1,217,369		1,028,063
Interest income	1,042		1,042	2,073		2,073
Other income	8,989		3,210	11,178		4,229
Total revenues	625,251		539,805	1,230,620		1,034,365
Property operating expenses	417,996		360,569	826,890		699,076
Net Operating Income from Continuing Operations	207,255		179,236	403,730		335,289
Interest expense	42,689		38,834	83,518		73,293
Loss (gain) on derivatives, net	0		0	0		0
Depreciation and amortization	102,312		88,844	204,144		165,479
General and administrative	0		0	0		0
Transaction costs	3,247		3,937	7,180		15,979
Loss (gain) on extinguishment of debt, net	(88)		0	(88)		0
Impairment of Asset	0		0	0		0
Other expenses	0		0	0		0
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	59,095		47,621	108,976		80,538
Income tax (expense) benefit	2,023		(3,449)	4,789		(3,982)
(Loss) income from unconsolidated entities	(4,887)		(6,083)	(11,822)		(21,156)
Income (loss) from continuing operations	56,231		38,089	101,943		55,400
Gain (loss) on real estate dispositions, net	0		0	0		0
Net income	56,231		38,089	101,943		55,400
Total assets	11,626,090			11,626,090
Outpatient Medical [Member]
Summary of information for reportable segments
Rental income	135,494		124,053	267,332		241,648
Resident fees and services	0		0	0		0
Interest income	994		1,345	2,298		2,609
Other income	4,153		195	4,466		356
Total revenues	140,641		125,593	274,096		244,613
Property operating expenses	40,836		37,785	81,578		75,739
Net Operating Income from Continuing Operations	99,805		87,808	192,518		168,874
Interest expense	5,402		6,993	11,146		14,382
Loss (gain) on derivatives, net	0		0	0		0
Depreciation and amortization	48,448		49,433	95,512		92,206
General and administrative	0		0	0		0
Transaction costs	619		975	2,042		1,316
Loss (gain) on extinguishment of debt, net	0		0	0		0
Impairment of Asset	0		0	0		0
Other expenses	0		0	0		0
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	45,336		30,407	83,818		60,970
Income tax (expense) benefit	(248)		(161)	(476)		305
(Loss) income from unconsolidated entities	(90)		1,678	(56)		2,710
Income (loss) from continuing operations	44,998		31,924	83,286		63,985
Gain (loss) on real estate dispositions, net	0		190,111	0		192,859
Net income	44,998		222,035	83,286		256,844
Total assets	5,020,102			5,020,102
Non Segment Corporate [Member]
Summary of information for reportable segments
Rental income	0		0	0		0
Resident fees and services	0		0	0		0
Interest income	0		0	0		0
Other income	454		39	512		62
Total revenues	454		39	512		62
Property operating expenses	0		0	0		0
Net Operating Income from Continuing Operations	454		39	512		62
Interest expense	82,216		71,721	162,998		142,531
Loss (gain) on derivatives, net	0		0	0		0
Depreciation and amortization	0		0	0		0
General and administrative	39,914		38,474	85,606		73,612
Transaction costs	0		0	0		0
Loss (gain) on extinguishment of debt, net	0		18,989	0		24,053
Impairment of Asset	0		0	0		0
Other expenses	3,161		10,583	3,161		10,583
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	(124,837)		(139,728)	(251,253)		(250,717)
Income tax (expense) benefit	(1,049)		(686)	(1,546)		(733)
(Loss) income from unconsolidated entities	0		0	0		0
Income (loss) from continuing operations	(125,886)		(140,414)	(252,799)		(251,450)
Gain (loss) on real estate dispositions, net	0		0	0		0
Net income	(125,886)		(140,414)	(252,799)		(251,450)
Total assets	116,839			116,839
Canada [Member]
Summary of information for reportable segments
Total revenues	111,949		$ 82,607	216,087		$ 139,833
Total assets	$ 2,628,887			$ 2,628,887			$ 1,286,079
Percent Of Assets	0.091			0.091			0.044
Percent Of Revenues	0.104		0.086	0.102		0.076
United Kingdom [Member]
Summary of information for reportable segments
Total revenues	$ 102,593		$ 103,531	$ 203,148		$ 195,345
Total assets	$ 2,789,104			$ 2,789,104			$ 1,741,973
Percent Of Assets	0.096			0.096			0.06
Percent Of Revenues	0.095		0.108	0.095		0.106
United States [Member]
Summary of information for reportable segments
Total revenues	$ 862,115		$ 771,031	$ 1,704,470		$ 1,516,168
Total assets	$ 23,546,510			$ 23,546,510			$ 25,995,793
Percent Of Assets	0.813			0.813			0.896
Percent Of Revenues	0.801		0.806	0.803		0.819
[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)	6 Months Ended
	Jun. 30, 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 Disc74

Variable Interest Entity Disclosure (Details) - Variable Interest Entity, Primary Beneficiary [Member] - USD ($) $ in Thousands		Jun. 30, 2016	Dec. 31, 2015
Variable Interest Entity [Line Items]
Total assets	[1]	$ 1,029,448	$ 470,730
Total equity		486,714	245,887
Total liabilities and equity		1,029,448	470,730
Net real property owned [Member]
Variable Interest Entity [Line Items]
Total assets		1,006,674	453,889
Cash and cash equivalents [Member]
Variable Interest Entity [Line Items]
Total assets		10,946	8,759
Receivables and other assets [Member]
Variable Interest Entity [Line Items]
Total assets		11,828	8,082
Secured Debt [Member]
Variable Interest Entity [Line Items]
Liabilities		451,450	147,021
Accrued expenses and other liabilities [Member]
Variable Interest Entity [Line Items]
Liabilities		12,807	7,732
Redeemable noncontrolling interests [Member]
Variable Interest Entity [Line Items]
Liabilities		$ 78,477	$ 70,090
[1]	(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.