Welltower (WELL) 10-Q 2 Nov 16 2016 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - USD ($)	9 Months Ended
	Sep. 30, 2016	Oct. 31, 2016	Jun. 30, 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	Sep. 30, 2016
Amendment Flag	false
Document Fiscal Year Focus	2,016
Document Fiscal Period Focus	Q3
Current Fiscal Year End Date	--12-31
Entity Well Known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Filer Category	Large Accelerated Filer
Entity Public Float			$ 27,176,263,145
Entity Common Stock Shares Outstanding		362,531,659

Consolidated Balance Sheets (Un

Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2016		Dec. 31, 2015
Real property owned:
Land and land improvements	$ 2,603,590		$ 2,563,445
Buildings and improvements	25,671,913		25,522,542
Acquired lease intangibles	1,423,032		1,350,585
Real property held for sale, net of accumulated depreciation	913,157		169,950
Construction in progress	529,471		258,968
Gross real property owned	31,141,163		29,865,490
Less accumulated depreciation and amortization	(4,243,038)		(3,796,297)
Net real property owned	26,898,125		26,069,193
Real estate loans receivable:
Net real estate loans receivable	630,020		819,492
Net real estate investments	27,528,145		26,888,685
Other assets:
Investments in unconsolidated entities	479,382		542,281
Goodwill	68,321		68,321
Cash and cash equivalents	428,617		360,908
Restricted cash	83,137		61,782
Straight-line rent receivable	455,774		395,562
Receivables and other assets	812,963		706,306
Total other assets	2,328,194		2,135,160
Total assets	29,856,339		29,023,845
Liabilities:
Borrowings under primary unsecured credit facilities, Carrying Value	1,350,000	[1]	835,000
Senior unsecured notes	8,688,585		8,548,055
Secured debt	3,317,933		3,509,142
Capital lease obligations	74,370		75,489
Accrued expenses and other liabilities	767,683		697,191
Total liabilities	14,198,571		13,664,877
Redeemable noncontrolling interests	393,530		183,083
Equity:
Preferred stock	1,006,250		1,006,250
Common stock	362,703		354,811
Capital in excess of par value	16,983,562		16,478,300
Treasury stock	(52,194)		(44,372)
Cumulative net income	4,454,180		3,725,772
Cumulative dividends	(7,816,492)		(6,846,056)
Accumulated other comprehensive income (loss)	(151,184)		(88,243)
Other equity	3,020		4,098
Total Welltower Inc. stockholders' equity	14,789,845		14,590,560
Noncontrolling interests	474,393		585,325
Total equity	15,264,238		15,175,885
Total liabilities and equity	$ 29,856,339		$ 29,023,845
[1]	(1) As of September 30, 2016, letters of credit in the aggregate amount of $45,335,000 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		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Revenues:
Rental income	$ 421,152	$ 409,290	$ 1,259,442	$ 1,185,502
Resident fees and services	630,017	545,255	1,847,386	1,573,318
Interest income	25,080	22,380	74,275	59,950
Other income	2,884	2,072	21,735	11,572
Total revenues	1,079,133	978,997	3,202,838	2,830,342
Expenses:
Interest expense	129,699	121,130	394,985	361,071
Property operating expenses	473,680	408,703	1,382,148	1,183,519
Depreciation and amortization	218,061	205,799	673,326	603,431
General and administrative	36,828	36,950	122,434	110,562
Transaction costs	19,842	9,333	33,207	70,379
Loss (gain) on derivatives, net	(2,516)	0	(2,516)	(58,427)
Loss (gain) on extinguishment of debt, net	0	584	9	34,872
Impairment of Asset	9,705	0	24,019	2,220
Other expenses	0	0	3,161	10,583
Total expenses	885,299	782,499	2,630,773	2,318,210
Income (loss) from continuing operations before income taxes and income from unconsolidated entities, total	193,834	196,498	572,065	512,132
Income tax (expense) benefit	305	3,344	2,543	(3,769)
(Loss) income from unconsolidated entities	(1,749)	(2,631)	(7,528)	(18,231)
Income from continuing operations	192,390	197,211	567,080	490,132
Gain (loss) on real estate dispositions, net	162,351	2,046	163,881	249,002
Net income	354,741	199,257	730,961	739,134
Less: Preferred stock dividends	16,352	16,352	49,055	49,055
Less: Net income (loss) attributable to noncontrolling interests	3,479	862	2,553	4,666
Net income (loss) attributable to common stockholders	$ 334,910	$ 182,043	$ 679,353	$ 685,413
Average number of common shares outstanding:
Basic	358,932	351,765	356,911	346,425
Diluted	361,237	353,107	358,752	347,547
Basic:
Income (loss) from continuing operations attributable to common stockholders, including real estate dispositions	$ 0.93	$ 0.52	$ 1.9	$ 1.98
Discontinued operations, net	0	0	0	0
Net income (loss) attributable to common stockholders, total	0.93	0.52	1.9	1.98
Diluted:
Income (loss) from continuing operations attributable to common stockholders, including real estate dispositions	0.93	0.52	1.89	1.97
Discontinued operations, net	0	0	0	0
Net income (loss) attributable to common stockholders, total	0.93	0.52	1.89	1.97
Dividends declared and paid per common share	$ 0.86	$ 0.825	$ 2.58	$ 2.475

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Statement of Comprehensive Income [Abstract]
Net income	$ 354,741	$ 199,257	$ 730,961	$ 739,134
Other comprehensive income (loss):
Unrecognized gain (loss) on equity investments	5,908	(3,086)	(5,252)	(18,186)
Unrecognized gain (loss) on cash flow hedges	401	462	1,371	(1,235)
Unrecognized actuarial gain/(loss)	(2)	0	0	0
Unrecognized gain (loss) on foreign currency translation	516	(25,198)	(48,496)	(22,011)
Total other comprehensive income (loss)	6,823	(27,822)	(52,377)	(41,432)
Total comprehensive income (loss), total	361,564	171,435	678,584	697,702
Total comprehensive income (loss) attributable to noncontrolling interests	1,846	(14,271)	13,117	(19,416)
Comprehensive income (loss) attributable to controlling interests	$ 359,718	$ 185,706	$ 665,467	$ 717,118

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)	738,944					734,468				4,476
Other comprehensive income	(41,432)							(17,350)		(24,082)
Total comprehensive income	697,512
Net change in noncontrolling interests	209,014			(4,778)						213,792
Amounts related to stock incentive plans, net of forfeitures	10,788		125	21,855	(9,095)				(2,097)
Proceeds from issuance of common stock	1,641,082		22,733	1,618,349
Equity component of convertible debt -total amount	6,761
Equity component of convertible debt				5,431
Equity componenet of convertible debt - common stock			1,330
Option compensation expense	587								587
Cash dividends paid:
Common stock	(852,563)						(852,563)
Preferred Stock	(49,055)						(49,055)
Balances at end of period at Sep. 30, 2015	15,137,175	1,006,250	353,023	16,381,569	(44,336)	3,576,490	(6,537,541)	(94,359)	3,997	492,082
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)	735,771					728,408				7,363
Other comprehensive income	(52,377)							(62,941)		10,564
Total comprehensive income	683,394
Distributions to noncontrolling interests	(174,624)			(45,765)						(128,859)
Amounts related to stock incentive plans, net of forfeitures	30,470		689	38,888	(7,822)				(1,285)
Proceeds from issuance of common stock	519,342		7,203	512,139
Option compensation expense	207								207
Cash dividends paid:
Common stock	(921,381)						(921,381)
Preferred Stock	(49,055)						(49,055)
Balances at end of period at Sep. 30, 2016	$ 15,264,238	$ 1,006,250	$ 362,703	$ 16,983,562	$ (52,194)	$ 4,454,180	$ (7,816,492)	$ (151,184)	$ 3,020	$ 474,393

Consolidated Statements of Cash

Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands		9 Months Ended
		Sep. 30, 2016	Sep. 30, 2015
Operating activities
Net income (loss)		$ 730,961	$ 739,134
Adjustments to reconcile net income to net cash provided from (used in) operating activities:
Depreciation and amortization		673,326	603,431
Other amortization expenses		5,419	3,867
Asset Impairment Charges		24,019	2,220
Stock-based compensation expense		20,618	25,655
Loss (gain) on derivatives, net		(2,516)	(58,427)
Loss (gain) on extinguishment of debt, net		9	34,872
Income from unconsolidated entities		7,528	18,231
Rental income in excess of cash received		(60,212)	(86,739)
Amortization related to above (below) market leases, net		362	2,863
Net loss (gain) on sales of properties		(163,881)	(249,002)
Distributions by unconsolidated entities		473	435
Increase (decrease) in accrued expenses and other liabilities		71,797	42,759
Decrease (increase) in receivables and other assets		(35,557)	(42,975)
Net cash provided from (used in) operating activities		1,272,346	1,036,324
Investing activities
Cash disbursed for acquisitions		(1,448,126)	(2,489,345)
Cash disbursed for capital improvements to existing properties		(141,200)	(122,640)
Cash disbursed for construction in progress		(325,372)	(165,311)
Capitalized interest		(12,109)	(6,311)
Investment in real estate loans receivable		(105,496)	(445,985)
Other investments, net of payments		(88,398)	(129,311)
Principal collected on real estate loans receivable		225,092	71,111
Contributions to unconsolidated entities		(41,747)	(139,295)
Distributions by unconsolidated entities		72,564	139,557
Proceeds from (payments on) derivatives investing		56,842	103,615
Decrease (increase) in restricted cash		(21,218)	10,512
Proceeds from sales of real property		538,032	667,761
Net cash provided from (used in) investing activities		(1,291,136)	(2,505,642)
Financing activities
Net increase (decrease) under unsecured lines of credit arrangements		515,000	490,000
Proceeds from issuance of senior unsecured notes		693,560	743,407
Payments to extinguish senior unsecured notes		(400,000)	(534,546)
Secured debt issued		193,541	222,612
Payments on secured debt		(471,898)	(469,455)
Net proceeds from the issuance of common stock		520,067	1,641,981
Decrease (increase) in deferred loan costs		(18,831)	(7,834)
Contributions by noncontrolling interests	[1]	142,381	163,105
Distributions to noncontrolling interests	[1]	(106,076)	(27,439)
Acquisitions of noncontrolling interests		0	(3,154)
Cash distributions to stockholders		(970,436)	(901,618)
Other financing activities		(1,119)	(27,114)
Net cash provided from (used in) financing activities		96,189	1,289,945
Effect of foreign currency translation on cash and cash equivalents		(9,690)	(2,311)
Increase (decrease) in cash and cash equivalents		67,709	(181,684)
Cash and cash equivalents at beginning of period		360,908	473,726
Cash and cash equivalents at end of period		428,617	292,042
Supplemental cash flow information:
Interest paid		360,421	334,511
Income taxes paid		$ 7,070	$ 11,489
[1]	(1) Includes amounts attributable to redeemable noncontrolling interests.

Business

Business	9 Months Ended
	Sep. 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”), own s interests in 1,464 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 tru st to invest exclusively in health care facilities.

Accounting Policies and Related

Accounting Policies and Related Matters	9 Months Ended
	Sep. 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 nine months ended September 30 , 2016. Operating results for the nine months ended September 30, 2016 are not necessarily an indication of the results that may be expected for the year ending December 31, 2016. For further informati on, refer to the financial statements and notes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2015 . New Accounting Standards In May 2014, the Financial Accounting Standards Board (“FASB”) issued ASU No. 2014-09, “R evenue 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 con sideration 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, 2 016. 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 provider), (2) the variable interest entity characteristics for a limited partnership or similar entity and (3) the primary beneficiary determination. We adopted ASU 2015-02 on January 1, 20 16. This guidance did not have a significant impact on our consolidated financial statements. In September 2015, the FASB issued ASU No. 2015-16, “Simplifying the Accounting for Measurement-Period Adjustments” to simplify the accounting for business combinations, specifically as it relates to measurement-period adjustments. Acquiring entities in a business combination must recognize measurement-period adjustments in the reporting period in which the adjustment amounts are determined. Also, ASU 2015- 16 requires entities to present separately on the face of the income statement (or disclose in the notes to the financial statements) the portion of the amount recorded in the current period earnings, by line item, that would have been recorded in previous reporting periods if the adjustment to the provisional amounts had been recognized as of the acquisition date. We adopted ASU 2015-16 on January 1, 2016. This guidance did not have a significant impact on our consolidated financial statements. In Ja nuary 2016, the FASB issued ASU No. 2016-01, “Financial Instruments – 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 f air value in net income unless the investments qualify for the new 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 liabilities on their balance sheet related to the rights and obligations created by most leases, while continuing to recognize expenses on their income statements over the lease term. It will also req uire disclosures designed to give financial statement users information regarding the amount, timing, and uncertainty of cash flows arising from leases. ASU 2016-02 is effective for fiscal years, and interim periods within those years, beginning after Dec ember 15, 2018, and early adoption is permitted. Entities are required to use a modified retrospective approach for leases that exist or are entered into after the beginning of the earliest comparative period in the financial statements. We are currently evaluating the impact that the standard will have on our consolidated financial statements. In March 2016 , the FASB issued ASU No. 2016 -09, “ Improvements to Employee Share-Based Payment Accounting ”. This standard simplifies the accounting treatment f or excess tax benefits and deficiencies, forfeitures, and cash flow 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 standard; 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 financia l statements.

Real Property Acquisitions and

Real Property Acquisitions and Development	9 Months Ended
	Sep. 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 Nine Months Ended (In thousands) September 30, 2016 (1) September 30, 2015 Land and land improvements $ 21,713 $ 64,655 Buildings and improvements 220,274 727,946 Acquired lease intangibles 2,876 3,888 Restricted cash - 6 Receivables and other assets - 60 Total assets acquired 244,863 796,555 Accrued expenses and other liabilities (2,145) (2,447) Total liabilities assumed (2,145) (2,447) Noncontrolling interests (3,162) - Non-cash acquisition related activity (2) (51,733) (2,780) Cash disbursed for acquisitions 187,823 791,328 Construction in progress additions 133,611 96,403 Less: Capitalized interest (6,263) (4,453) Foreign currency translation (3,179) 73 Cash disbursed for construction in progress 124,169 92,023 Capital improvements to existing properties 21,447 35,042 Total cash invested in real property, net of cash acquired $ 333,439 $ 918,393 (1) Includes acquisitions with an aggregate purchase price of $183,547,000 for which the allocation of the purchase price consideration is preliminary and subject to change. (2) For the nine months ended September 30, 2016, $45,044,000 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 Nine Months Ended (In thousands) September 30, 2016 (1) September 30, 2015 Land and land improvements $ 122,649 $ 98,444 Building and improvements 1,108,195 1,229,017 Acquired lease intangibles 90,771 74,091 Restricted cash 137 5,567 Receivables and other assets 2,179 23,928 Total assets acquired (2) 1,323,931 1,431,047 Secured debt (49,381) (234,597) Accrued expenses and other liabilities (12,328) (19,016) Total liabilities assumed (61,709) (253,613) Noncontrolling interests (1,089) (86,842) Non-cash acquisition related activity (3) (17,477) - Cash disbursed for acquisitions 1,243,656 1,090,592 Construction in progress additions 139,160 39,493 Less: Capitalized interest (3,923) (1,116) Foreign currency translation (5,953) (1,345) Cash disbursed for construction in progress 129,284 37,032 Capital improvements to existing properties 84,444 61,911 Total cash invested in real property, net of cash acquired $ 1,457,384 $ 1,189,535 (1) Includes acquisitions with an aggregate purchase price of $1,194,765,000 for which the allocation of the purchase price consideration is preliminary and subject to change. (2) Excludes $135,000 and $3,390,000 of cash acquired during the nine months ended September 30, 2016 and 2015, respectively. (3) Relates to the acquisition of assets previously financed as equity investments. Outpatient Medical Activity Nine Months Ended (In thousands) September 30, 2016 September 30, 2015 Land and land improvements $ 1,466 $ 47,756 Buildings and improvements 27,272 723,574 Acquired lease intangibles 4,592 19,373 Total assets acquired (1) 33,330 790,703 Secured debt - (112,000) Accrued expenses and other liabilities (1,670) (2,743) Total liabilities assumed (1,670) (114,743) Noncontrolling interests - (68,535) Non-cash acquisition activity (2) (15,013) - Cash disbursed for acquisitions 16,647 607,425 Construction in progress additions 81,843 38,919 Less: Capitalized interest (2,588) (742) Accruals (3) (7,336) (1,921) Cash disbursed for construction in progress 71,919 36,256 Capital improvements to existing properties 35,309 25,687 Total cash invested in real property $ 123,875 $ 669,368 (1) Excludes $0 and $4,372,000 of cash acquired during the nine months ended September 30, 2016 and 2015, respectively. (2) Relates to an acquisition of assets previously financed as a real estate loan. Refer to Note 6 for additional information. (3) Represents non-cash consideration accruals for amounts to be paid in future periods relating to properties that converted in the periods noted above. Construction Activity The following is a summary of the construction projects that were placed into service and began generating revenues during the periods presented (in thousands) : Nine Months Ended September 30, 2016 September 30, 2015 Development projects: Triple-net $ 24,535 $ 85,902 Seniors housing operating - 19,869 Outpatient medical 44,113 16,592 Total development projects 68,648 122,363 Expansion projects 2,879 38,808 Total construction in progress conversions $ 71,527 $ 161,171

Real Estate Intangibles

Real Estate Intangibles	9 Months Ended
	Sep. 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): September 30, 2016 December 31, 2015 Assets: In place lease intangibles $ 1,272,177 $ 1,179,537 Above market tenant leases 62,544 67,529 Below market ground leases 62,257 80,224 Lease commissions 26,054 23,295 Gross historical cost 1,423,032 1,350,585 Accumulated amortization (971,883) (881,096) Net book value $ 451,149 $ 469,489 Weighted-average amortization period in years 14.0 13.4 Liabilities: Below market tenant leases $ 93,507 $ 93,089 Above market ground leases 8,107 7,907 Gross historical cost 101,614 100,996 Accumulated amortization (51,727) (46,048) Net book value $ 49,887 $ 54,948 Weighted-average amortization period in years 15.4 14.5 The following is a summary of real estate intangible amortization for the periods presented (in thousands): Three Months Ended Nine Months Ended September 30, September 30, 2016 2015 2016 2015 Rental income related to above/below market tenant leases, net $ 278 $ (1,684) $ 569 $ (1,901) Property operating expenses related to above/below market ground leases, net (309) (308) (931) (962) Depreciation and amortization related to in place lease intangibles and lease commissions (30,137) (26,137) (95,610) (82,434) The future estimated aggregate amortization of intangible assets and liabilities is as follows for the periods presented (in thousands): Assets Liabilities 2016 $ 45,156 $ 1,810 2017 122,892 6,819 2018 70,566 6,234 2019 29,877 5,825 2020 22,830 5,344 Thereafter 159,828 23,855 Total $ 451,149 $ 49,887

Dispositions, Assets Held for S

Dispositions, Assets Held for Sale and Discontinued Operations	9 Months Ended
	Sep. 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. Of our total sales proceeds, $27,803,000 was deposited in an Internal Revenue Code Section 1031 exchange escrow account with a qualified intermediary. During the nine months ended September 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 presented (in thousands): Nine Months Ended September 30, 2016 September 30, 2015 Real estate dispositions: Triple-net $ 295,365 $ 246,116 Outpatient medical 78,786 166,919 (1) Land parcels - 5,724 Total dispositions 374,151 418,759 Gain (loss) on real estate dispositions, net 163,881 249,002 Proceeds from real estate dispositions $ 538,032 $ 667,761 (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 Nine Months Ended September 30, September 30, 2016 2015 2016 2015 Revenues: Rental income $ 31,966 $ 36,626 $ 99,057 $ 113,950 Expenses: Interest expense 4,939 7,282 16,697 23,594 Property operating expenses 1,476 1,695 4,411 4,944 Provision for depreciation 4,604 9,119 20,873 31,568 Total expenses 11,019 18,096 41,981 60,106 Income (loss) from real estate dispositions, net $ 20,947 $ 18,530 $ 57,076 $ 53,844

Real Estate Loans Receivable

Real Estate Loans Receivable	9 Months Ended
	Sep. 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): Nine Months Ended September 30, 2016 September 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 $ 392,278 $ - $ 392,278 Draws on existing loans 94,622 2,651 97,273 51,422 2,285 53,707 Net cash advances on real estate loans 102,845 2,651 105,496 443,700 2,285 445,985 Receipts on real estate loans receivable: Loan payoffs 251,293 27,303 278,596 52,088 - 52,088 Principal payments on loans 6,553 - 6,553 19,023 - 19,023 Sub-total 257,846 27,303 285,149 71,111 - 71,111 Less: Non-cash activity (45,044) (15,013) (60,057) - - - Net cash receipts on real estate loans 212,802 12,290 225,092 71,111 - 71,111 Net cash advances (receipts) on real estate loans (109,957) (9,639) (119,596) 372,589 2,285 374,874 Change in balance due to foreign currency translation (9,819) - (9,819) (2,131) - (2,131) Net change in real estate loans receivable $ (164,820) $ (24,652) $ (189,472) $ 370,458 $ 2,285 $ 372,743 We recorded no provision for loan losses during the nine months ended September 30, 2016 . At September 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	9 Months Ended
	Sep. 30, 2016
Investments In Unconsolidated Entities [Abstract]
Investments in Unconsolidated Entities	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) September 30, 2016 December 31, 2015 Triple-net 10% to 49% $ 24,499 $ 36,351 Seniors housing operating 10% to 50% 447,987 499,537 Outpatient medical 43% 6,896 6,393 Total $ 479,382 $ 542,281 (1) Excludes ownership of in-substance real estate. At September 30, 2016, the aggregate unamortized basis difference of our joint venture investments of $150,644 ,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	9 Months Ended
	Sep. 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 nine month period ended September 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 185 $ 293,406 16% Sunrise Senior Living (3) 151 234,313 13% Brookdale Senior Living 148 126,824 7% Revera (3) 97 112,211 6% Benchmark Senior Living 49 73,524 4% Remaining portfolio 769 980,412 54% Totals 1,399 $ 1,820,690 100% (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 in both 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	9 Months Ended
	Sep. 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 September 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 al ternate currencies ( none outstanding at September 30, 2016 ). Borrowings under the unsecured revolving credit facility are subject to interest payable at the applicable margin over LIBOR interest rate ( 1.43% at September 30, 2016 ). The applicable margin is based on certai n of our debt ratings and was 0.90% at September 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 September 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 presented (dollars in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Balance outstanding at quarter end (1) $ 1,350,000 $ 490,000 $ 1,350,000 $ 490,000 Maximum amount outstanding at any month end $ 1,560,000 $ 490,000 $ 1,560,000 $ 535,000 Average amount outstanding (total of daily principal balances divided by days in period) $ 1,050,217 $ 298,370 $ 782,427 $ 402,619 Weighted average interest rate (actual interest expense divided by average borrowings outstanding) 1.44% 1.16% 1.35% 1.17% (1) As of September 30, 2016, letters of credit in the aggregate amount of $45,335,000 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	9 Months Ended
	Sep. 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 September 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 $ - $ 76,773 $ 76,773 2017 450,000 556,774 1,006,774 2018 450,000 660,201 1,110,201 2019 605,000 425,991 1,030,991 2020 (4) 678,746 176,860 855,606 Thereafter (5,6,7,8,9,10) 6,607,196 1,404,043 8,011,239 Totals $ 8,790,942 $ 3,300,642 $ 12,091,584 (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 1.23% to 6.5%. (3) Annual interest rates range from 0.89% to 7.98%. Carrying value of the properties securing the debt totaled $5,844,048,000 at September 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 $228,746,000 based on the Canadian/U.S. Dollar exchange rate on September 30, 2016). (5) On May 13, 2016, we refinanced the funding on a $250,000,000 Canadian-denominated unsecured term credit facility (approximately $190,621,000 based on the Canadian/U.S. Dollar exchange rate on September 30, 2016). The loan matures on May 13, 2021 and bears interest at the Canadian Dealer Offered Rate plus 95 basis points (1.83% at September 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 (1.48% at September 30, 2016). (7) On November 20, 2013, we completed the sale of £ 550,000,000 (approximately $715,825,000 based on the Sterling/U.S. Dollar exchange rate in effect on September 30, 2016) of 4.8% senior unsecured notes due 2028. (8) On November 25, 2014, we completed the sale of £ 500,000,000 (approximately $650,750,000 based on the Sterling/U.S. Dollar exchange rate in effect on September 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) : Nine Months Ended September 30, 2016 September 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% (215,965) 3.000% Foreign currency (159,816) 4.443% (76,649) 8.065% Ending balance $ 8,790,942 4.264% $ 7,974,540 4.210% The following is a summary of our secured debt principal activity for the periods presented (dollars in thousands): Nine Months Ended September 30, 2016 September 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 193,541 3.053% 222,612 2.760% Debt assumed 47,156 4.132% 339,929 3.340% Debt extinguished (416,009) 4.986% (420,672) 4.270% Foreign currency 53,636 3.631% (89,154) 3.880% Principal payments (55,889) 4.478% (48,783) 4.850% Ending balance $ 3,300,642 4.272% $ 2,945,697 4.720% Our debt agreements contain various covenants, restrictions and events of default. Certain agreements require us to maintain certain financial ratios and minimum net worth and impose certain limits on our ability to incur indebtedness, create liens and make investments or acquisitions. As of September 30, 2016 , we were in compliance with all of the cove nants under our debt agreements.

Derivative Instruments

Derivative Instruments	9 Months Ended
	Sep. 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 $5,555 ,000 of gains, which are included in accumulated other comprehensive income (“AOCI”), are expected to be reclassified into earnings in the next 12 months. Foreign Currency Hedges For instruments that are designated and qualify as net investment hedges, the variability in the foreign currency to U.S. Dollar of the instrument is recorded as a cumulative translation adjustment component of OCI. During the nine months ended September 30 , 2016 and 2015, we se ttled certain net investment hedges generating cash proceeds of $ 56,842,000 and $103,615 ,000, respectively . The balance of the cumulative translation adjustment will be reclassified to earnings when the hedged investment is sold or substantially liquidated. The following presents the notional amount of derivatives and other financial instruments as of the dates indicated (in thousands): September 30, 2016 December 31, 2015 Derivatives designated as net investment hedges: Denominated in Canadian Dollars $ 900,000 $ 1,175,000 Denominated in Pounds Sterling £ 550,000 £ 550,000 Financial instruments designated as net investment hedges: Denominated in Canadian Dollars $ 250,000 $ 250,000 Denominated in Pounds Sterling £ 1,050,000 £ 1,050,000 Derivatives designated as cash flow hedges: Denominated in U.S. Dollars $ 57,000 $ 57,000 Denominated in Canadian Dollars $ 72,000 $ 72,000 Denominated in Pounds Sterling £ 63,000 £ 60,000 Derivative instruments not designated: Denominated in Canadian Dollars $ 37,000 $ 47,000 Denominated in Pounds Sterling £ 20,100 £ - The following presents the impact of derivative instruments on the Consolidated S tatement s of C omprehensive I ncome for the periods presented (in thousands) : Three Months Ended Nine Months Ended September 30, September 30, Location 2016 2015 2016 2015 Gain (loss) on forward exchange contracts recognized in income Interest expense $ 3,420 $ 2,347 $ 4,789 $ 6,285 Loss (gain) on option exercise (1) Loss (gain) on derivatives, net - - - (58,427) (Gain) on release of cumulative translation adjustment related to ineffectiveness on net investment hedge Loss (gain) on derivatives, net (2,516) - (2,516) - Gain (loss) on foreign exchange contracts and term loans designated as net investment hedge recognized in OCI OCI 53,421 174,239 229,256 208,854 (1) In April 2011, we completed the acquisition of substantially all of the real estate assets of privately-owned Genesis Healthcare Corporation. In conjunction with this transaction, we received the option to acquire an ownership interest in Genesis Healthcare. In February 2015, Genesis Healthcare closed on a transaction to merge with Skilled Healthcare Group to become a publicly traded company which required us to record the value of the derivative asset due to the net settlement feature.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2016
Commitments and Contingencies [Abstract]
Commitments and Contingencies	12 . Commitments and Contingencies At September 30, 2016 , we had ten outstanding letter of credit obligations totaling $88 ,188,000 and expiring between 2016 and 2018. At September 30, 2016 , we had outstanding construction in progress of $ 529,471,000 and were committed to providing additional funds of approximately $ 515,980,000 to complete c onstruction. Purchase obligations include contingent purchase obligations totaling $ 18,566,000 which relate to unfunded capital improvement obligations and contingent obligations on acquisitions. Rents due from the tenant are increased to reflect the additional investment in the property. We evaluate our leases for operating versus capital lease treatment in accordance with Accounting Standards Codification (“ASC” ) Topic 840 “Leases.” A lease is classified as a capital lease if it provides for transfer of ownership of the leased asset at the end of the lease term, contains a bargain purchase option, has a lease term greater than 75% of the economic life of the lea sed asset, or if the net present value of the future minimum lease payments are in excess of 90% of the fair value of the leased asset. Certain leases contain bargain purchase options and have been classified as capital leases. At September 30, 2016 , we had operati ng lease obligations of $ 1,109,001,000 relating to certain ground leases and company office space and capital lease obligations of $ 95,018,000 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 September 30, 2016 , aggregate future minimum rentals to be received under these noncancelable subleases totaled $ 74,069,000 .

Stockholders' Equity

Stockholders' Equity	9 Months Ended
	Sep. 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: September 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 363,361,460 355,594,373 Outstanding shares 362,424,770 354,777,670 Common Stock. The following is a summary of our common stock issuances during the nine months ended September 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 2,935,950 70.28 206,334 206,334 2015 Option exercises 247,005 47.42 11,712 11,712 2015 Stock incentive plans, net of forfeitures 144,779 - - 2015 Senior note conversions 1,330,474 - - 2015 Totals 24,208,208 $ 1,694,071 $ 1,641,981 2016 Dividend reinvestment plan issuances 3,946,821 $ 70.51 $ 278,578 $ 278,297 2016 Option exercises 137,579 50.57 6,958 6,958 2016 Equity shelf program issuances 3,119,801 75.27 237,131 234,812 2016 Stock incentive plans, net of forfeitures 442,899 - - 2016 Totals 7,647,100 $ 522,667 $ 520,067 Dividends . The increase in dividends is primarily attributable to increases in our common shares outstanding as described above and an increase in common dividends per share. The following is a summary of our dividend payments (in thousands, except per share amounts): Nine Months Ended September 30, 2016 September 30, 2015 Per Share Amount Per Share Amount Common Stock $ 2.5800 $ 921,381 $ 2.4750 $ 852,563 Series I Preferred Stock 2.4375 35,039 2.4375 35,039 Series J Preferred Stock 1.2189 14,016 1.2189 14,016 Totals $ 970,436 $ 901,618 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 (59,060) (5,252) - 11 (64,301) Reclassification amount to net income - - - 1,360 (1) 1,360 Net current-period other comprehensive income (59,060) (5,252) - 1,371 (62,941) Balance at September 30, 2016 $ (144,544) $ (5,252) $ (1,343) $ (45) $ (151,184) Balance at December 31, 2014 $ (74,770) $ - $ (1,589) $ (650) $ (77,009) Other comprehensive income before reclassification adjustments 2,071 (18,186) - (2,625) (18,740) Reclassification amount to net income - - - 1,390 (1) 1,390 Net current-period other comprehensive income 2,071 (18,186) - (1,235) (17,350) Balance at September 30, 2015 $ (72,699) $ (18,186) $ (1,589) $ (1,885) $ (94,359) (1) Please see Note 11 for additional information.

Stock Incentive Plans

Stock Incentive Plans	9 Months Ended
	Sep. 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 $ 5,40 1 ,000 an d $ 20,6 18 ,000 for the three and nine months ended September 30, 2016 , respectively, and $5,477,000 and $25,655,000 for the same periods in 2015.

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 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 Nine Months Ended September 30, September 30, 2016 2015 2016 2015 Numerator for basic and diluted earnings per share - net income (loss) attributable to common stockholders $ 334,910 $ 182,043 $ 679,353 $ 685,413 Denominator for basic earnings per share - weighted average shares 358,932 351,765 356,911 346,425 Effect of dilutive securities: Employee stock options 128 114 119 155 Non-vested restricted shares 526 607 414 498 Redeemable shares 1,651 621 1,308 207 Convertible senior unsecured notes - - - 262 Dilutive potential common shares 2,305 1,342 1,841 1,122 Denominator for diluted earnings per share - adjusted weighted average shares 361,237 353,107 358,752 347,547 Basic earnings per share $ 0.93 $ 0.52 $ 1.90 $ 1.98 Diluted earnings per share $ 0.93 $ 0.52 $ 1.89 $ 1.97 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	9 Months Ended
	Sep. 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): September 30, 2016 December 31, 2015 Carrying Amount Fair Value Carrying Amount Fair Value Financial assets: Mortgage loans receivable $ 498,993 $ 525,400 $ 635,492 $ 663,501 Other real estate loans receivable 131,027 132,999 184,000 185,693 Available-for-sale equity investments 17,527 17,527 22,779 22,779 Cash and cash equivalents 428,617 428,617 360,908 360,908 Foreign currency forward contracts 130,454 130,454 129,520 129,520 Financial liabilities: Borrowings under unsecured credit facilities $ 1,350,000 $ 1,350,000 $ 835,000 $ 835,000 Senior unsecured notes 8,688,585 9,823,661 8,548,055 9,020,529 Secured debt 3,317,933 3,509,792 3,509,142 3,678,564 Foreign currency forward contracts 615 615 - - Redeemable OP unitholder interests $ 123,446 $ 123,446 $ 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 September 30, 2016 Total Level 1 Level 2 Level 3 Available-for-sale equity investments (1) $ 17,527 $ 17,527 $ - $ - Foreign currency forward contracts, net (2) 129,839 - 129,839 - Redeemable OP unitholder interests 123,446 - 123,446 - Totals $ 270,812 $ 17,527 $ 253,285 $ - (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 impairments (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 esides within Level 3 of the fair value hierarchy. We estimate the fair value of real estate and related intangibles using the income approach and unobservable data such as net operating income and estimated capitalization and discount rates. We also consi der local and national industry market data including comparable sales, and commonly engage an external real estate appraiser to assist us in our estimation of fair value. We estimate the fair value of assets held for sale based on current sales price exp ectations or, in the absence of such price expectations, Level 3 inputs described above. We estimate the fair value of secured debt assumed in business combinations using current interest rates at which similar borrowings could be obtained on the transact ion date .

Segment Reporting

Segment Reporting	9 Months Ended
	Sep. 30, 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 segmen t information provided in this N ote 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 September 30, 2016: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 286,226 $ - $ 134,926 $ - $ 421,152 Resident fees and services - 630,017 - - 630,017 Interest income 23,017 1,054 1,009 - 25,080 Other income 1,621 716 358 189 2,884 Total revenues 310,864 631,787 136,293 189 1,079,133 Property operating expenses - 432,292 41,388 - 473,680 Net operating income from continuing operations 310,864 199,495 94,905 189 605,453 Interest expense 985 39,927 3,986 84,801 129,699 Loss (gain) on derivatives, net - - - (2,516) (2,516) Depreciation and amortization 74,296 97,210 46,555 - 218,061 General and administrative - - - 36,828 36,828 Transaction costs 1,613 18,083 146 - 19,842 Impairment of assets 5,070 - 4,635 - 9,705 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 228,900 44,275 39,583 (118,924) 193,834 Income tax expense (896) 515 417 269 305 (Loss) income from unconsolidated entities 1,998 (3,891) 144 - (1,749) Income (loss) from continuing operations 230,002 40,899 40,144 (118,655) 192,390 Gain (loss) on real estate dispositions, net 163,579 - (1,228) - 162,351 Net income (loss) $ 393,581 $ 40,899 $ 38,916 $ (118,655) $ 354,741 Total assets $ 11,988,519 $ 12,580,092 $ 4,899,012 $ 388,716 $ 29,856,339 Three Months Ended September 30, 2015: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 277,614 $ - $ 131,676 $ - $ 409,290 Resident fees and services - 545,255 - - 545,255 Interest income 19,454 1,054 1,872 - 22,380 Other income 969 772 309 22 2,072 Total revenues 298,037 547,081 133,857 22 978,997 Property operating expenses - 368,050 40,653 - 408,703 Net operating income from continuing operations 298,037 179,031 93,204 22 570,294 Interest expense 11,347 30,990 6,811 71,982 121,130 Depreciation and amortization 72,589 87,306 45,904 - 205,799 General and administrative - - - 36,950 36,950 Transaction costs 1,865 7,630 (162) - 9,333 Loss (gain) on extinguishment of debt, net (139) - - 723 584 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 212,375 53,105 40,651 (109,633) 196,498 Income tax expense 87 3,237 154 (134) 3,344 (Loss) income from unconsolidated entities 2,851 (5,629) 147 - (2,631) Income (loss) from continuing operations 215,313 50,713 40,952 (109,767) 197,211 Gain (loss) on real estate dispositions, net 2,155 - (109) - 2,046 Net income (loss) $ 217,468 $ 50,713 $ 40,843 $ (109,767) $ 199,257 Nine Months Ended September 30, 2016: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 857,184 $ - $ 402,258 $ - $ 1,259,442 Resident fees and services - 1,847,386 - - 1,847,386 Interest income 67,842 3,126 3,307 - 74,275 Other income 4,317 11,889 4,824 705 21,735 Total revenues 929,343 1,862,401 410,389 705 3,202,838 Property operating expenses - 1,259,182 122,966 - 1,382,148 Net operating income from continuing operations 929,343 603,219 287,423 705 1,820,690 Interest expense 8,608 123,445 15,132 247,800 394,985 Loss (gain) on derivatives, net - - - (2,516) (2,516) Depreciation and amortization 229,906 301,354 142,066 - 673,326 General and administrative - - - 122,434 122,434 Transaction costs 5,760 25,259 2,188 - 33,207 Loss (gain) on extinguishment of debt, net 97 (88) - - 9 Impairment of assets 19,384 - 4,635 - 24,019 Other expenses - - - 3,161 3,161 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 665,588 153,249 123,402 (370,174) 572,065 Income tax expense (1,425) 5,304 (59) (1,277) 2,543 (Loss) income from unconsolidated entities 8,097 (15,713) 88 - (7,528) Income (loss) from continuing operations 672,260 142,840 123,431 (371,451) 567,080 Gain (loss) on real estate dispositions, net 165,109 - (1,228) - 163,881 Net income (loss) $ 837,369 $ 142,840 $ 122,203 $ (371,451) $ 730,961 Nine Months Ended September 30, 2015: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 812,179 $ - $ 373,323 $ - $ 1,185,502 Resident fees and services - 1,573,318 - - 1,573,318 Interest income 52,343 3,126 4,481 - 59,950 Other income 5,823 5,001 665 83 11,572 Total revenues 870,345 1,581,445 378,469 83 2,830,342 Property operating expenses - 1,067,127 116,392 - 1,183,519 Net operating income from continuing operations 870,345 514,318 262,077 83 1,646,823 Interest expense 21,083 104,283 21,192 214,513 361,071 Loss (gain) on derivatives, net (58,427) - - - (58,427) Depreciation and amortization 212,537 252,785 138,109 - 603,431 General and administrative - - - 110,562 110,562 Transaction costs 45,615 23,610 1,154 - 70,379 Loss (gain) on extinguishment of debt, net 10,096 - - 24,776 34,872 Impairment of assets 2,220 - - - 2,220 Other expenses - - - 10,583 10,583 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 637,221 133,640 101,622 (360,351) 512,132 Income tax expense (2,617) (745) 460 (867) (3,769) (Loss) income from unconsolidated entities 5,697 (26,785) 2,857 - (18,231) Income (loss) from continuing operations 640,301 106,110 104,939 (361,218) 490,132 Gain (loss) on real estate dispositions, net 56,251 - 192,751 - 249,002 Net income (loss) $ 696,552 $ 106,110 $ 297,690 $ (361,218) $ 739,134 Our portfolio of properties and other investments are located in the United States, the United Kingdom and Canada. Revenues and assets are attributed to the country in which the property is physically located . The following is a summary of geographic information for our operations for the periods presented (dollars in thousands): Three Months Ended Nine Months Ended September 30, 2016 September 30, 2015 September 30, 2016 September 30, 2015 Revenues: Amount % Amount % Amount % Amount % United States $ 874,050 81.0% $ 793,429 81.0% $ 2,581,533 80.7% $ 2,309,596 81.6% United Kingdom 95,068 8.8% 106,372 10.9% 295,203 9.1% 301,718 10.7% Canada 110,015 10.2% 79,196 8.1% 326,102 10.2% 219,028 7.7% Total $ 1,079,133 100.0% $ 978,997 100.0% $ 3,202,838 100.0% $ 2,830,342 100.0% As of September 30, 2016 December 31, 2015 Assets: Amount % Amount % United States $ 24,600,436 82.4% $ 25,995,793 89.6% United Kingdom 2,715,817 9.1% 1,741,973 6.0% Canada 2,540,086 8.5% 1,286,079 4.4% Total $ 29,856,339 100.0% $ 29,023,845 100.0%

Income Taxes and Distributions

Income Taxes and Distributions	9 Months Ended
	Sep. 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 nine months ended September 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	9 Months Ended
	Sep. 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): September 30, 2016 December 31, 2015 Assets Net real property owned $ 997,442 $ 453,889 Cash and cash equivalents 11,124 8,759 Receivables and other assets 13,436 8,082 Total assets (1) $ 1,022,002 $ 470,730 Liabilities and equity Secured debt $ 450,944 $ 147,021 Accrued expenses and other liabilities 15,460 7,732 Redeemable noncontrolling interests 77,034 70,090 Total equity 478,564 245,887 Total liabilities and equity $ 1,022,002 $ 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.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2016
Subsequent Events [Abstract]
Subsequent Events	20 . S ubsequent Events On November 1, 2016, we completed a disposition of properties leased to Genesis Healthcare generating approximately $1.1 billion in proceeds. These assets did not meet held for sale classification at September 30, 2016 due to the execution risk assoc iated with the transaction.

Accounting Policies and Relat27

Accounting Policies and Related Matters (Policies)	9 Months Ended
	Sep. 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 nine months ended September 30 , 2016. Operating results for the nine months ended September 30, 2016 are not necessarily an indication of the results that may be expected for the year ending December 31, 2016. For further informati on, refer to the financial statements and notes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2015 .
New Accounting Standards	New Accounting Standards In May 2014, the Financial Accounting Standards Board (“FASB”) issued ASU No. 2014-09, “R evenue 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 con sideration 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, 2 016. 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 provider), (2) the variable interest entity characteristics for a limited partnership or similar entity and (3) the primary beneficiary determination. We adopted ASU 2015-02 on January 1, 20 16. This guidance did not have a significant impact on our consolidated financial statements. In September 2015, the FASB issued ASU No. 2015-16, “Simplifying the Accounting for Measurement-Period Adjustments” to simplify the accounting for business combinations, specifically as it relates to measurement-period adjustments. Acquiring entities in a business combination must recognize measurement-period adjustments in the reporting period in which the adjustment amounts are determined. Also, ASU 2015- 16 requires entities to present separately on the face of the income statement (or disclose in the notes to the financial statements) the portion of the amount recorded in the current period earnings, by line item, that would have been recorded in previous reporting periods if the adjustment to the provisional amounts had been recognized as of the acquisition date. We adopted ASU 2015-16 on January 1, 2016. This guidance did not have a significant impact on our consolidated financial statements. In Ja nuary 2016, the FASB issued ASU No. 2016-01, “Financial Instruments – 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 f air value in net income unless the investments qualify for the new 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 liabilities on their balance sheet related to the rights and obligations created by most leases, while continuing to recognize expenses on their income statements over the lease term. It will also req uire disclosures designed to give financial statement users information regarding the amount, timing, and uncertainty of cash flows arising from leases. ASU 2016-02 is effective for fiscal years, and interim periods within those years, beginning after Dec ember 15, 2018, and early adoption is permitted. Entities are required to use a modified retrospective approach for leases that exist or are entered into after the beginning of the earliest comparative period in the financial statements. We are currently evaluating the impact that the standard will have on our consolidated financial statements. In March 2016 , the FASB issued ASU No. 2016 -09, “ Improvements to Employee Share-Based Payment Accounting ”. This standard simplifies the accounting treatment f or excess tax benefits and deficiencies, forfeitures, and cash flow 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 standard; 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 financia l statements.

Real Property Acquisitions an28

Real Property Acquisitions and Development (Tables)	9 Months Ended
	Sep. 30, 2016
Real property acquisitions and development [Line Items]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities	Triple-n et Activity Nine Months Ended (In thousands) September 30, 2016 (1) September 30, 2015 Land and land improvements $ 21,713 $ 64,655 Buildings and improvements 220,274 727,946 Acquired lease intangibles 2,876 3,888 Restricted cash - 6 Receivables and other assets - 60 Total assets acquired 244,863 796,555 Accrued expenses and other liabilities (2,145) (2,447) Total liabilities assumed (2,145) (2,447) Noncontrolling interests (3,162) - Non-cash acquisition related activity (2) (51,733) (2,780) Cash disbursed for acquisitions 187,823 791,328 Construction in progress additions 133,611 96,403 Less: Capitalized interest (6,263) (4,453) Foreign currency translation (3,179) 73 Cash disbursed for construction in progress 124,169 92,023 Capital improvements to existing properties 21,447 35,042 Total cash invested in real property, net of cash acquired $ 333,439 $ 918,393 (1) Includes acquisitions with an aggregate purchase price of $183,547,000 for which the allocation of the purchase price consideration is preliminary and subject to change. (2) For the nine months ended September 30, 2016, $45,044,000 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 Nine Months Ended (In thousands) September 30, 2016 (1) September 30, 2015 Land and land improvements $ 122,649 $ 98,444 Building and improvements 1,108,195 1,229,017 Acquired lease intangibles 90,771 74,091 Restricted cash 137 5,567 Receivables and other assets 2,179 23,928 Total assets acquired (2) 1,323,931 1,431,047 Secured debt (49,381) (234,597) Accrued expenses and other liabilities (12,328) (19,016) Total liabilities assumed (61,709) (253,613) Noncontrolling interests (1,089) (86,842) Non-cash acquisition related activity (3) (17,477) - Cash disbursed for acquisitions 1,243,656 1,090,592 Construction in progress additions 139,160 39,493 Less: Capitalized interest (3,923) (1,116) Foreign currency translation (5,953) (1,345) Cash disbursed for construction in progress 129,284 37,032 Capital improvements to existing properties 84,444 61,911 Total cash invested in real property, net of cash acquired $ 1,457,384 $ 1,189,535 (1) Includes acquisitions with an aggregate purchase price of $1,194,765,000 for which the allocation of the purchase price consideration is preliminary and subject to change. (2) Excludes $135,000 and $3,390,000 of cash acquired during the nine months ended September 30, 2016 and 2015, respectively. (3) Relates to the acquisition of assets previously financed as equity investments. Outpatient Medical Activity Nine Months Ended (In thousands) September 30, 2016 September 30, 2015 Land and land improvements $ 1,466 $ 47,756 Buildings and improvements 27,272 723,574 Acquired lease intangibles 4,592 19,373 Total assets acquired (1) 33,330 790,703 Secured debt - (112,000) Accrued expenses and other liabilities (1,670) (2,743) Total liabilities assumed (1,670) (114,743) Noncontrolling interests - (68,535) Non-cash acquisition activity (2) (15,013) - Cash disbursed for acquisitions 16,647 607,425 Construction in progress additions 81,843 38,919 Less: Capitalized interest (2,588) (742) Accruals (3) (7,336) (1,921) Cash disbursed for construction in progress 71,919 36,256 Capital improvements to existing properties 35,309 25,687 Total cash invested in real property $ 123,875 $ 669,368 (1) Excludes $0 and $4,372,000 of cash acquired during the nine months ended September 30, 2016 and 2015, respectively. (2) Relates to an acquisition of assets previously financed as a real estate loan. Refer to Note 6 for additional information. (3) Represents non-cash consideration accruals for amounts to be paid in future periods relating to properties that converted in the periods noted above.
Summary of construction projects placed into service and generating revenues	Nine Months Ended September 30, 2016 September 30, 2015 Development projects: Triple-net $ 24,535 $ 85,902 Seniors housing operating - 19,869 Outpatient medical 44,113 16,592 Total development projects 68,648 122,363 Expansion projects 2,879 38,808 Total construction in progress conversions $ 71,527 $ 161,171

Real Estate Intangibles (Tables

Real Estate Intangibles (Tables)	9 Months Ended
	Sep. 30, 2016
Real Estate Intangibles (Tables) [Abstract]
Summary of real estate intangibles excluding those classified as held for sale	September 30, 2016 December 31, 2015 Assets: In place lease intangibles $ 1,272,177 $ 1,179,537 Above market tenant leases 62,544 67,529 Below market ground leases 62,257 80,224 Lease commissions 26,054 23,295 Gross historical cost 1,423,032 1,350,585 Accumulated amortization (971,883) (881,096) Net book value $ 451,149 $ 469,489 Weighted-average amortization period in years 14.0 13.4 Liabilities: Below market tenant leases $ 93,507 $ 93,089 Above market ground leases 8,107 7,907 Gross historical cost 101,614 100,996 Accumulated amortization (51,727) (46,048) Net book value $ 49,887 $ 54,948 Weighted-average amortization period in years 15.4 14.5
Schedule of Real Estate Intangible Amortization	Three Months Ended Nine Months Ended September 30, September 30, 2016 2015 2016 2015 Rental income related to above/below market tenant leases, net $ 278 $ (1,684) $ 569 $ (1,901) Property operating expenses related to above/below market ground leases, net (309) (308) (931) (962) Depreciation and amortization related to in place lease intangibles and lease commissions (30,137) (26,137) (95,610) (82,434)
Schedule of the future estimated aggregate amortization of intangible assets and liabilities	Assets Liabilities 2016 $ 45,156 $ 1,810 2017 122,892 6,819 2018 70,566 6,234 2019 29,877 5,825 2020 22,830 5,344 Thereafter 159,828 23,855 Total $ 451,149 $ 49,887

Dispositions, Assets Held for30

Dispositions, Assets Held for Sale and Discontinued Operations (Tables)	9 Months Ended
	Sep. 30, 2016
Dispositions, Assets Held for Sale and Discontinued Operations (Tables) [Abstract]
Summary of real property disposition activity	Nine Months Ended September 30, 2016 September 30, 2015 Real estate dispositions: Triple-net $ 295,365 $ 246,116 Outpatient medical 78,786 166,919 (1) Land parcels - 5,724 Total dispositions 374,151 418,759 Gain (loss) on real estate dispositions, net 163,881 249,002 Proceeds from real estate dispositions $ 538,032 $ 667,761 (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 Nine Months Ended September 30, September 30, 2016 2015 2016 2015 Revenues: Rental income $ 31,966 $ 36,626 $ 99,057 $ 113,950 Expenses: Interest expense 4,939 7,282 16,697 23,594 Property operating expenses 1,476 1,695 4,411 4,944 Provision for depreciation 4,604 9,119 20,873 31,568 Total expenses 11,019 18,096 41,981 60,106 Income (loss) from real estate dispositions, net $ 20,947 $ 18,530 $ 57,076 $ 53,844

Real Estate Loans Receivable (T

Real Estate Loans Receivable (Tables)	9 Months Ended
	Sep. 30, 2016
Real Estate Loans Receivable (Tables) [Abstract]
Summary of real estate loan activity	Nine Months Ended September 30, 2016 September 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 $ 392,278 $ - $ 392,278 Draws on existing loans 94,622 2,651 97,273 51,422 2,285 53,707 Net cash advances on real estate loans 102,845 2,651 105,496 443,700 2,285 445,985 Receipts on real estate loans receivable: Loan payoffs 251,293 27,303 278,596 52,088 - 52,088 Principal payments on loans 6,553 - 6,553 19,023 - 19,023 Sub-total 257,846 27,303 285,149 71,111 - 71,111 Less: Non-cash activity (45,044) (15,013) (60,057) - - - Net cash receipts on real estate loans 212,802 12,290 225,092 71,111 - 71,111 Net cash advances (receipts) on real estate loans (109,957) (9,639) (119,596) 372,589 2,285 374,874 Change in balance due to foreign currency translation (9,819) - (9,819) (2,131) - (2,131) Net change in real estate loans receivable $ (164,820) $ (24,652) $ (189,472) $ 370,458 $ 2,285 $ 372,743

Investments in Unconsolidated32

Investments in Unconsolidated Entities (Tables)	9 Months Ended
	Sep. 30, 2016
Investments In Unconsolidated Entities [Abstract]
Summary Of Investments In Unconsolidated Entities [Text Block]	Percentage Ownership (1) September 30, 2016 December 31, 2015 Triple-net 10% to 49% $ 24,499 $ 36,351 Seniors housing operating 10% to 50% 447,987 499,537 Outpatient medical 43% 6,896 6,393 Total $ 479,382 $ 542,281 (1) Excludes ownership of in-substance real estate.

Credit Concentration (Tables)

Credit Concentration (Tables)	9 Months Ended
	Sep. 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 185 $ 293,406 16% Sunrise Senior Living (3) 151 234,313 13% Brookdale Senior Living 148 126,824 7% Revera (3) 97 112,211 6% Benchmark Senior Living 49 73,524 4% Remaining portfolio 769 980,412 54% Totals 1,399 $ 1,820,690 100% (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 in both 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 Facil34

Borrowings Under Credit Facilities and Related Items (Tables)	9 Months Ended
	Sep. 30, 2016
Borrowings Under Credit Facilities and Related Items (Tables) [Abstract]
Aggregate borrowings under the unsecured line of credit arrangements	Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Balance outstanding at quarter end (1) $ 1,350,000 $ 490,000 $ 1,350,000 $ 490,000 Maximum amount outstanding at any month end $ 1,560,000 $ 490,000 $ 1,560,000 $ 535,000 Average amount outstanding (total of daily principal balances divided by days in period) $ 1,050,217 $ 298,370 $ 782,427 $ 402,619 Weighted average interest rate (actual interest expense divided by average borrowings outstanding) 1.44% 1.16% 1.35% 1.17% (1) As of September 30, 2016, letters of credit in the aggregate amount of $45,335,000 have been issued, which reduces the borrowing capacity on the unsecured revolving credit facility.

Senior Unsecured Notes and Se35

Senior Unsecured Notes and Secured Debt (Tables)	9 Months Ended
	Sep. 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 $ - $ 76,773 $ 76,773 2017 450,000 556,774 1,006,774 2018 450,000 660,201 1,110,201 2019 605,000 425,991 1,030,991 2020 (4) 678,746 176,860 855,606 Thereafter (5,6,7,8,9,10) 6,607,196 1,404,043 8,011,239 Totals $ 8,790,942 $ 3,300,642 $ 12,091,584 (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 1.23% to 6.5%. (3) Annual interest rates range from 0.89% to 7.98%. Carrying value of the properties securing the debt totaled $5,844,048,000 at September 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 $228,746,000 based on the Canadian/U.S. Dollar exchange rate on September 30, 2016). (5) On May 13, 2016, we refinanced the funding on a $250,000,000 Canadian-denominated unsecured term credit facility (approximately $190,621,000 based on the Canadian/U.S. Dollar exchange rate on September 30, 2016). The loan matures on May 13, 2021 and bears interest at the Canadian Dealer Offered Rate plus 95 basis points (1.83% at September 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 (1.48% at September 30, 2016). (7) On November 20, 2013, we completed the sale of £ 550,000,000 (approximately $715,825,000 based on the Sterling/U.S. Dollar exchange rate in effect on September 30, 2016) of 4.8% senior unsecured notes due 2028. (8) On November 25, 2014, we completed the sale of £ 500,000,000 (approximately $650,750,000 based on the Sterling/U.S. Dollar exchange rate in effect on September 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	Nine Months Ended September 30, 2016 September 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% (215,965) 3.000% Foreign currency (159,816) 4.443% (76,649) 8.065% Ending balance $ 8,790,942 4.264% $ 7,974,540 4.210%
Secured debt principal activity	Nine Months Ended September 30, 2016 September 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 193,541 3.053% 222,612 2.760% Debt assumed 47,156 4.132% 339,929 3.340% Debt extinguished (416,009) 4.986% (420,672) 4.270% Foreign currency 53,636 3.631% (89,154) 3.880% Principal payments (55,889) 4.478% (48,783) 4.850% Ending balance $ 3,300,642 4.272% $ 2,945,697 4.720%

Derivative Instruments (Tables)

Derivative Instruments (Tables)	9 Months Ended
	Sep. 30, 2016
Derivative Instruments (Tables) [Abstract]
Impact of derivative instruments on the statement of operations and OCI	September 30, 2016 December 31, 2015 Derivatives designated as net investment hedges: Denominated in Canadian Dollars $ 900,000 $ 1,175,000 Denominated in Pounds Sterling £ 550,000 £ 550,000 Financial instruments designated as net investment hedges: Denominated in Canadian Dollars $ 250,000 $ 250,000 Denominated in Pounds Sterling £ 1,050,000 £ 1,050,000 Derivatives designated as cash flow hedges: Denominated in U.S. Dollars $ 57,000 $ 57,000 Denominated in Canadian Dollars $ 72,000 $ 72,000 Denominated in Pounds Sterling £ 63,000 £ 60,000 Derivative instruments not designated: Denominated in Canadian Dollars $ 37,000 $ 47,000 Denominated in Pounds Sterling £ 20,100 £ - Three Months Ended Nine Months Ended September 30, September 30, Location 2016 2015 2016 2015 Gain (loss) on forward exchange contracts recognized in income Interest expense $ 3,420 $ 2,347 $ 4,789 $ 6,285 Loss (gain) on option exercise (1) Loss (gain) on derivatives, net - - - (58,427) (Gain) on release of cumulative translation adjustment related to ineffectiveness on net investment hedge Loss (gain) on derivatives, net (2,516) - (2,516) - Gain (loss) on foreign exchange contracts and term loans designated as net investment hedge recognized in OCI OCI 53,421 174,239 229,256 208,854 (1) In April 2011, we completed the acquisition of substantially all of the real estate assets of privately-owned Genesis Healthcare Corporation. In conjunction with this transaction, we received the option to acquire an ownership interest in Genesis Healthcare. In February 2015, Genesis Healthcare closed on a transaction to merge with Skilled Healthcare Group to become a publicly traded company which required us to record the value of the derivative asset due to the net settlement feature.

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	9 Months Ended
	Sep. 30, 2016
Stockholders' Equity (Tables) [Abstract]
Summary of stockholder's equity capital accounts	September 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 363,361,460 355,594,373 Outstanding shares 362,424,770 354,777,670
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 2,935,950 70.28 206,334 206,334 2015 Option exercises 247,005 47.42 11,712 11,712 2015 Stock incentive plans, net of forfeitures 144,779 - - 2015 Senior note conversions 1,330,474 - - 2015 Totals 24,208,208 $ 1,694,071 $ 1,641,981 2016 Dividend reinvestment plan issuances 3,946,821 $ 70.51 $ 278,578 $ 278,297 2016 Option exercises 137,579 50.57 6,958 6,958 2016 Equity shelf program issuances 3,119,801 75.27 237,131 234,812 2016 Stock incentive plans, net of forfeitures 442,899 - - 2016 Totals 7,647,100 $ 522,667 $ 520,067
Summary of dividend payments	Nine Months Ended September 30, 2016 September 30, 2015 Per Share Amount Per Share Amount Common Stock $ 2.5800 $ 921,381 $ 2.4750 $ 852,563 Series I Preferred Stock 2.4375 35,039 2.4375 35,039 Series J Preferred Stock 1.2189 14,016 1.2189 14,016 Totals $ 970,436 $ 901,618
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 (59,060) (5,252) - 11 (64,301) Reclassification amount to net income - - - 1,360 (1) 1,360 Net current-period other comprehensive income (59,060) (5,252) - 1,371 (62,941) Balance at September 30, 2016 $ (144,544) $ (5,252) $ (1,343) $ (45) $ (151,184) Balance at December 31, 2014 $ (74,770) $ - $ (1,589) $ (650) $ (77,009) Other comprehensive income before reclassification adjustments 2,071 (18,186) - (2,625) (18,740) Reclassification amount to net income - - - 1,390 (1) 1,390 Net current-period other comprehensive income 2,071 (18,186) - (1,235) (17,350) Balance at September 30, 2015 $ (72,699) $ (18,186) $ (1,589) $ (1,885) $ (94,359) (1) Please see Note 11 for additional information.

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2016
Earnings Per Share (Tables) [Abstract]
Computation of basic and diluted earnings per share	Three Months Ended Nine Months Ended September 30, September 30, 2016 2015 2016 2015 Numerator for basic and diluted earnings per share - net income (loss) attributable to common stockholders $ 334,910 $ 182,043 $ 679,353 $ 685,413 Denominator for basic earnings per share - weighted average shares 358,932 351,765 356,911 346,425 Effect of dilutive securities: Employee stock options 128 114 119 155 Non-vested restricted shares 526 607 414 498 Redeemable shares 1,651 621 1,308 207 Convertible senior unsecured notes - - - 262 Dilutive potential common shares 2,305 1,342 1,841 1,122 Denominator for diluted earnings per share - adjusted weighted average shares 361,237 353,107 358,752 347,547 Basic earnings per share $ 0.93 $ 0.52 $ 1.90 $ 1.98 Diluted earnings per share $ 0.93 $ 0.52 $ 1.89 $ 1.97

Disclosure about Fair Value o39

Disclosure about Fair Value of Financial Instruments (Tables)	9 Months Ended
	Sep. 30, 2016
Disclosure about Fair Value of Financial Instruments (Tables) [Abstract]
Carrying amounts and estimated fair values of financial instruments	September 30, 2016 December 31, 2015 Carrying Amount Fair Value Carrying Amount Fair Value Financial assets: Mortgage loans receivable $ 498,993 $ 525,400 $ 635,492 $ 663,501 Other real estate loans receivable 131,027 132,999 184,000 185,693 Available-for-sale equity investments 17,527 17,527 22,779 22,779 Cash and cash equivalents 428,617 428,617 360,908 360,908 Foreign currency forward contracts 130,454 130,454 129,520 129,520 Financial liabilities: Borrowings under unsecured credit facilities $ 1,350,000 $ 1,350,000 $ 835,000 $ 835,000 Senior unsecured notes 8,688,585 9,823,661 8,548,055 9,020,529 Secured debt 3,317,933 3,509,792 3,509,142 3,678,564 Foreign currency forward contracts 615 615 - - Redeemable OP unitholder interests $ 123,446 $ 123,446 $ 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 September 30, 2016 Total Level 1 Level 2 Level 3 Available-for-sale equity investments (1) $ 17,527 $ 17,527 $ - $ - Foreign currency forward contracts, net (2) 129,839 - 129,839 - Redeemable OP unitholder interests 123,446 - 123,446 - Totals $ 270,812 $ 17,527 $ 253,285 $ - (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)	9 Months Ended
	Sep. 30, 2016
Segment Reporting (Tables) [Abstract]
Summary of information for reportable segments	Three Months Ended September 30, 2016: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 286,226 $ - $ 134,926 $ - $ 421,152 Resident fees and services - 630,017 - - 630,017 Interest income 23,017 1,054 1,009 - 25,080 Other income 1,621 716 358 189 2,884 Total revenues 310,864 631,787 136,293 189 1,079,133 Property operating expenses - 432,292 41,388 - 473,680 Net operating income from continuing operations 310,864 199,495 94,905 189 605,453 Interest expense 985 39,927 3,986 84,801 129,699 Loss (gain) on derivatives, net - - - (2,516) (2,516) Depreciation and amortization 74,296 97,210 46,555 - 218,061 General and administrative - - - 36,828 36,828 Transaction costs 1,613 18,083 146 - 19,842 Impairment of assets 5,070 - 4,635 - 9,705 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 228,900 44,275 39,583 (118,924) 193,834 Income tax expense (896) 515 417 269 305 (Loss) income from unconsolidated entities 1,998 (3,891) 144 - (1,749) Income (loss) from continuing operations 230,002 40,899 40,144 (118,655) 192,390 Gain (loss) on real estate dispositions, net 163,579 - (1,228) - 162,351 Net income (loss) $ 393,581 $ 40,899 $ 38,916 $ (118,655) $ 354,741 Total assets $ 11,988,519 $ 12,580,092 $ 4,899,012 $ 388,716 $ 29,856,339 Three Months Ended September 30, 2015: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 277,614 $ - $ 131,676 $ - $ 409,290 Resident fees and services - 545,255 - - 545,255 Interest income 19,454 1,054 1,872 - 22,380 Other income 969 772 309 22 2,072 Total revenues 298,037 547,081 133,857 22 978,997 Property operating expenses - 368,050 40,653 - 408,703 Net operating income from continuing operations 298,037 179,031 93,204 22 570,294 Interest expense 11,347 30,990 6,811 71,982 121,130 Depreciation and amortization 72,589 87,306 45,904 - 205,799 General and administrative - - - 36,950 36,950 Transaction costs 1,865 7,630 (162) - 9,333 Loss (gain) on extinguishment of debt, net (139) - - 723 584 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 212,375 53,105 40,651 (109,633) 196,498 Income tax expense 87 3,237 154 (134) 3,344 (Loss) income from unconsolidated entities 2,851 (5,629) 147 - (2,631) Income (loss) from continuing operations 215,313 50,713 40,952 (109,767) 197,211 Gain (loss) on real estate dispositions, net 2,155 - (109) - 2,046 Net income (loss) $ 217,468 $ 50,713 $ 40,843 $ (109,767) $ 199,257 Nine Months Ended September 30, 2016: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 857,184 $ - $ 402,258 $ - $ 1,259,442 Resident fees and services - 1,847,386 - - 1,847,386 Interest income 67,842 3,126 3,307 - 74,275 Other income 4,317 11,889 4,824 705 21,735 Total revenues 929,343 1,862,401 410,389 705 3,202,838 Property operating expenses - 1,259,182 122,966 - 1,382,148 Net operating income from continuing operations 929,343 603,219 287,423 705 1,820,690 Interest expense 8,608 123,445 15,132 247,800 394,985 Loss (gain) on derivatives, net - - - (2,516) (2,516) Depreciation and amortization 229,906 301,354 142,066 - 673,326 General and administrative - - - 122,434 122,434 Transaction costs 5,760 25,259 2,188 - 33,207 Loss (gain) on extinguishment of debt, net 97 (88) - - 9 Impairment of assets 19,384 - 4,635 - 24,019 Other expenses - - - 3,161 3,161 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 665,588 153,249 123,402 (370,174) 572,065 Income tax expense (1,425) 5,304 (59) (1,277) 2,543 (Loss) income from unconsolidated entities 8,097 (15,713) 88 - (7,528) Income (loss) from continuing operations 672,260 142,840 123,431 (371,451) 567,080 Gain (loss) on real estate dispositions, net 165,109 - (1,228) - 163,881 Net income (loss) $ 837,369 $ 142,840 $ 122,203 $ (371,451) $ 730,961 Nine Months Ended September 30, 2015: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 812,179 $ - $ 373,323 $ - $ 1,185,502 Resident fees and services - 1,573,318 - - 1,573,318 Interest income 52,343 3,126 4,481 - 59,950 Other income 5,823 5,001 665 83 11,572 Total revenues 870,345 1,581,445 378,469 83 2,830,342 Property operating expenses - 1,067,127 116,392 - 1,183,519 Net operating income from continuing operations 870,345 514,318 262,077 83 1,646,823 Interest expense 21,083 104,283 21,192 214,513 361,071 Loss (gain) on derivatives, net (58,427) - - - (58,427) Depreciation and amortization 212,537 252,785 138,109 - 603,431 General and administrative - - - 110,562 110,562 Transaction costs 45,615 23,610 1,154 - 70,379 Loss (gain) on extinguishment of debt, net 10,096 - - 24,776 34,872 Impairment of assets 2,220 - - - 2,220 Other expenses - - - 10,583 10,583 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 637,221 133,640 101,622 (360,351) 512,132 Income tax expense (2,617) (745) 460 (867) (3,769) (Loss) income from unconsolidated entities 5,697 (26,785) 2,857 - (18,231) Income (loss) from continuing operations 640,301 106,110 104,939 (361,218) 490,132 Gain (loss) on real estate dispositions, net 56,251 - 192,751 - 249,002 Net income (loss) $ 696,552 $ 106,110 $ 297,690 $ (361,218) $ 739,134 Three Months Ended Nine Months Ended September 30, 2016 September 30, 2015 September 30, 2016 September 30, 2015 Revenues: Amount % Amount % Amount % Amount % United States $ 874,050 81.0% $ 793,429 81.0% $ 2,581,533 80.7% $ 2,309,596 81.6% United Kingdom 95,068 8.8% 106,372 10.9% 295,203 9.1% 301,718 10.7% Canada 110,015 10.2% 79,196 8.1% 326,102 10.2% 219,028 7.7% Total $ 1,079,133 100.0% $ 978,997 100.0% $ 3,202,838 100.0% $ 2,830,342 100.0% As of September 30, 2016 December 31, 2015 Assets: Amount % Amount % United States $ 24,600,436 82.4% $ 25,995,793 89.6% United Kingdom 2,715,817 9.1% 1,741,973 6.0% Canada 2,540,086 8.5% 1,286,079 4.4% Total $ 29,856,339 100.0% $ 29,023,845 100.0%

Variable Interest Entity Disc41

Variable Interest Entity Disclosure (Tables)	9 Months Ended
	Sep. 30, 2016
Variable Interest Entity Disclosure [Abstract]
Schedule of Variable Interest Entities [Table Text Block]	September 30, 2016 December 31, 2015 Assets Net real property owned $ 997,442 $ 453,889 Cash and cash equivalents 11,124 8,759 Receivables and other assets 13,436 8,082 Total assets (1) $ 1,022,002 $ 470,730 Liabilities and equity Secured debt $ 450,944 $ 147,021 Accrued expenses and other liabilities 15,460 7,732 Redeemable noncontrolling interests 77,034 70,090 Total equity 478,564 245,887 Total liabilities and equity $ 1,022,002 $ 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)	Sep. 30, 2016properties
Business [Line Items]
Number of properties in diversified portfolio	1,399	[1]
Controlling [Member]
Business [Line Items]
Number of properties in diversified portfolio	1,464
[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 in both our triple-net and seniors housing operating segments.

Accounting Policies and Relat43

Accounting Policies and Related Matters (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2016USD ($)
Accounting Policies and Related Matters [Abstract]
Reclassifications of Permanent to Temporary Equity	$ 114,714

Real Property Acquisitions an44

Real Property Acquisitions and Development (Details 1) - USD ($) $ in Thousands		9 Months Ended
		Sep. 30, 2016		Sep. 30, 2015
Triple Net [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		$ 21,713	[1]	$ 64,655
Buildings and improvements		220,274	[1]	727,946
Acquired lease intangibles		2,876	[1]	3,888
Restricted cash		0	[1]	6
Receivables and other assets		0	[1]	60
Total assets acquired		244,863	[1]	796,555
Accrued expenses and other liabilities		(2,145)	[1]	(2,447)
Total liabilities assumed		(2,145)	[1]	(2,447)
Noncontrolling interests		(3,162)	[1]	0
Non-cash acquisition related activity	[2]	(51,733)	[1]	(2,780)
Cash disbursed for acquisitions		187,823	[1]	791,328
Construction in progress additions		133,611	[1]	96,403
Less: Capitalized Interest		(6,263)	[1]	(4,453)
Less: Foreign currency translation		(3,179)	[1]	73
Cash disbursed for construction in progress		124,169	[1]	92,023
Capital improvements to existing properties		21,447	[1]	35,042
Total cash invested in real property		333,439	[1]	918,393
Non Cash Acquisition Financed As Real Estate Loan Receivable		45,044
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		183,547
Senior housing - operating [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		122,649	[3]	98,444
Buildings and improvements		1,108,195	[3]	1,229,017
Acquired lease intangibles		90,771	[3]	74,091
Restricted cash		137	[3]	5,567
Receivables and other assets		2,179	[3]	23,928
Total assets acquired	[4]	1,323,931	[3]	1,431,047
Secured debt		(49,381)	[3]	(234,597)
Accrued expenses and other liabilities		(12,328)	[3]	(19,016)
Total liabilities assumed		(61,709)	[3]	(253,613)
Noncontrolling interests		(1,089)	[3]	(86,842)
Non-cash acquisition related activity	[5]	(17,477)		0
Cash disbursed for acquisitions		1,243,656	[3]	1,090,592
Construction in progress additions		139,160	[3]	39,493
Less: Capitalized Interest		(3,923)	[3]	(1,116)
Less: Foreign currency translation		(5,953)	[3]	(1,345)
Cash disbursed for construction in progress		129,284	[3]	37,032
Capital improvements to existing properties		84,444	[3]	61,911
Total cash invested in real property		1,457,384	[3]	1,189,535
Cash Acquired from Acquisition		135		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		1,194,746
Outpatient Medical [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		1,466		47,756
Buildings and improvements		27,272		723,574
Acquired lease intangibles		4,592		19,373
Total assets acquired	[6]	33,330		790,703
Secured debt		0		(112,000)
Accrued expenses and other liabilities		(1,670)		(2,743)
Total liabilities assumed		(1,670)		(114,743)
Noncontrolling interests		0		(68,535)
Non-cash acquisition related activity	[7]	(15,013)		0
Cash disbursed for acquisitions		16,647		607,425
Construction in progress additions		81,843		38,919
Less: Capitalized Interest		(2,588)		(742)
Less: Accruals	[8]	(7,336)		(1,921)
Cash disbursed for construction in progress		71,919		36,256
Capital improvements to existing properties		35,309		25,687
Total cash invested in real property		123,875		669,368
Cash Acquired from Acquisition		$ 0		$ 4,372
[1]	(1) Includes acquisitions with an aggregate purchase price of $183,547,000 for which the allocation of the purchase price consideration is preliminary and subject to change.
[2]	(2) For the nine months ended September 30, 2016, $45,044,000 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 $1,194,765,000 for which the allocation of the purchase price consideration is preliminary and subject to change.
[4]	(2) Excludes $135,000 and $3,390,000 of cash acquired during the nine months ended September 30, 2016 and 2015, respectively.
[5]	(3) Relates to the acquisition of assets previously financed as equity investments.
[6]	(1) Excludes $0 and $4,372,000 of cash acquired during the nine months ended September 30, 2016 and 2015, respectively.
[7]	(2) Relates to an acquisition of assets previously financed as a real estate loan. Refer to Note 6 for additional information.
[8]	(3) 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 an45

Real Property Acquisitions and Development (Details 2) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015
Development projects:
Total development projects	$ 68,648	$ 122,363
Expansion projects	2,879	38,808
Total construction in progress conversions	71,527	161,171
Triple Net [Member]
Development projects:
Total development projects	24,535	85,902
Seniors housing operating [Member]
Development projects:
Total development projects	0	19,869
Outpatient Medical [Member]
Development projects:
Total development projects	$ 44,113	$ 16,592

Real Estate Intangibles (Detail

Real Estate Intangibles (Details) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2016	Dec. 31, 2015
Intangible Assets:
Gross historical cost	$ 1,423,032	$ 1,350,585
Accumulated amortization	971,883	881,096
Net book value	$ 451,149	$ 469,489
Weighted-average amortization period in years	14 years	13 years 5 months
Intangible Liabilities:
Gross historical cost	$ 101,614	$ 100,996
Accumulated amortization	51,727	46,048
Net book value	$ 49,887	$ 54,948
Weighted-average amortization period in years	15 years 5 months	14 years 6 months
In place lease intangibles [Member]
Intangible Assets:
Gross historical cost	$ 1,272,177	$ 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	62,257	80,224
Lease commissions [Member]
Intangible Assets:
Gross historical cost	26,054	23,295
Below market tenant leases [Member]
Intangible Liabilities:
Gross historical cost	93,507	93,089
Above market ground leases [Member]
Intangible Liabilities:
Gross historical cost	$ 8,107	$ 7,907

Real Estate Intangibles (Real E

Real Estate Intangibles (Real Estate Intangible Maturity Schedule) (Details) - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Estimated Aggregate Amortization Expense For Acquired Lease Intangibles Expected To Be Recognized [Line Items]
Totals	$ 451,149	$ 469,489
Intangible Liability [Member]
Estimated Aggregate Amortization Expense For Acquired Lease Intangibles Expected To Be Recognized [Line Items]
2,016	1,810
2,017	6,819
2,018	6,234
2,019	5,825
2,020	5,344
Thereafter	23,855
Totals	49,887
Intangible Asset [Member]
Estimated Aggregate Amortization Expense For Acquired Lease Intangibles Expected To Be Recognized [Line Items]
2,016	45,156
2,017	122,892
2,018	70,566
2,019	29,877
2,020	22,830
Thereafter	159,828
Totals	$ 451,149

Real Estate Intangibles (Deta48

Real Estate Intangibles (Details 1) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Real Estate Intangible Amortization [Abstract]
Rental income related to above/below market tenant leases, net	$ 278	$ (1,684)	$ 569	$ (1,901)
Property operating expenses related to above/below market ground leases, net	(309)	(308)	(931)	(962)
Depreciation and amortization related to in place lease intangibles and lease commissions	$ (30,137)	$ (26,137)	$ (95,610)	$ (82,434)

Dispositions, Assets Held for49

Dispositions, Assets Held for Sale and Discontinued Operations (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015
Real property dispositions:
Total dispositions	$ 374,151	$ 418,759
Net loss (gain) on sales of properties	163,881	249,002
Proceeds from sales of real property	538,032	667,761
Escrow Deposits Related To Property Sales	27,803
Triple Net [Member]
Real property dispositions:
Total dispositions	295,365	246,116
Outpatient Medical [Member]
Real property dispositions:
Total dispositions	78,786	166,919	[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 for50

Dispositions, Assets Held for Sale and Discontinued Operations (Details 2) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Revenues:
Rental income, disposed	$ 31,966	$ 36,626	$ 99,057	$ 113,950
Expenses:
Interest expense, disposed	4,939	7,282	16,697	23,594
Property operating expenses, disposed	1,476	1,695	4,411	4,944
Depreciation expense, disposed	4,604	9,119	20,873	31,568
Expenses, disposed	11,019	18,096	41,981	60,106
Income (loss) from disposed properties	$ 20,947	$ 18,530	$ 57,076	$ 53,844

Real Estate Loans Receivable (D

Real Estate Loans Receivable (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015
Advances on real estate loans receivable:
Investments in new loans	$ 8,223	$ 392,278
Draws on existing loans	97,273	53,707
Net cash advances on real estate loans	105,496	445,985
Receipts on real estate loans receivable:
Loan payoffs	278,596	52,088
Principal payments on loans	6,553	19,023
Sub-total	285,149	71,111
Less : Non-cash activity	(60,057)	0
Total receipts on real estate loans	225,092	71,111
Net advances (receipts) on real estate loans	(119,596)	374,874
Change in balance due to foreign currency translation	(9,819)	(2,131)
Net change Real Estate Loans Receivable	(189,472)	372,743
Triple Net [Member]
Advances on real estate loans receivable:
Investments in new loans	8,223	392,278
Draws on existing loans	94,622	51,422
Net cash advances on real estate loans	102,845	443,700
Receipts on real estate loans receivable:
Loan payoffs	251,293	52,088
Principal payments on loans	6,553	19,023
Sub-total	257,846	71,111
Less : Non-cash activity	(45,044)	0
Total receipts on real estate loans	212,802	71,111
Net advances (receipts) on real estate loans	(109,957)	372,589
Change in balance due to foreign currency translation	(9,819)	(2,131)
Net change Real Estate Loans Receivable	(164,820)	370,458
Outpatient Medical [Member]
Advances on real estate loans receivable:
Investments in new loans	0	0
Draws on existing loans	2,651	2,285
Net cash advances on real estate loans	2,651	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	(9,639)	2,285
Change in balance due to foreign currency translation	0	0
Net change Real Estate Loans Receivable	$ (24,652)	$ 2,285

Investments in Unconsolidated52

Investments in Unconsolidated Entities (Summary of Investments in Unconsolidated Entities) (Details) - USD ($) $ in Thousands		Sep. 30, 2016	Dec. 31, 2015
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated entities		$ 479,382	$ 542,281
Triple Net [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated entities		$ 24,499	$ 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		$ 447,987	$ 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		$ 6,896	$ 6,393
[1]	(1) Excludes ownership of in-substance real estate.

Investments in Unconsolidated53

Investments in Unconsolidated Entities (Details) $ in Thousands	Sep. 30, 2016USD ($)
Schedule of Equity Method Investments [Line Items]
Unamortized Investment In Joint Venture Primarily Attributable To Real Estate And Related Intangible Assets	$ 150,644

Credit Concentration (Details)

Credit Concentration (Details) $ in Thousands		3 Months Ended			9 Months Ended
		Sep. 30, 2016USD ($)properties		Sep. 30, 2015USD ($)	Sep. 30, 2016USD ($)properties		Sep. 30, 2015USD ($)	Dec. 31, 2015
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	1,399			1,399
Percent of NOI	[1],[2]				100.00%
Net Operating Income | $		$ 605,453	[1]	$ 570,294	$ 1,820,690	[1]	$ 1,646,823
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]	185			185
Genesis HealthCare [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]				16.00%
Net Operating Income | $	[1]				$ 293,406
Sunrise Senior Living [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1],[3]	151			151
Sunrise Senior Living [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2],[3]				13.00%
Net Operating Income | $	[1],[3]				$ 234,313
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]				$ 126,824
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]				$ 73,524
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]				$ 112,211
Remaining Portfolio [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	769			769
Remaining Portfolio [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]				54.00%
Net Operating Income | $	[1]				$ 980,412
[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 in both 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 Facil55

Borrowings Under Credit Facilities and Related Items (Details) - USD ($) $ in Thousands	3 Months Ended				9 Months Ended
	Sep. 30, 2016		Sep. 30, 2015		Sep. 30, 2016		Sep. 30, 2015		Dec. 31, 2015
Aggregate borrowings under the unsecured line of credit arrangements
Balance outstanding at quarter end	$ 1,350,000	[1]	$ 490,000	[1]	$ 1,350,000	[1]	$ 490,000	[1]	$ 835,000
Maximum amount outstanding at any month end	1,560,000		490,000		1,560,000		535,000
Average amount outstanding (total of daily principal balances divided by days in period)	$ 1,050,217		$ 298,370		$ 782,427		$ 402,619
Weighted average interest rate (actual interest expense divided by average borrowings outstanding)	1.44%		1.16%		1.35%		1.17%
[1]	(1) As of September 30, 2016, letters of credit in the aggregate amount of $45,335,000 have been issued, which reduces the borrowing capacity on the unsecured revolving credit facility.

Borrowings Under Credit Facil56

Borrowings Under Credit Facilities and Related Items (Details Textual) $ in Thousands	9 Months Ended
	Sep. 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	1.43%
Annual facility fee for each bank based on commitment amount	0.15%
Debt instrument maturity date	May 13, 2021
Term Loan Interest Rate Margin	1.4291%
HCN Term Loan	$ 500,000
HCN Canadian Denomiated Term Loan	250,000
Letter of credit that reduces the borrowing capacity	45,335
Accordion Feature [Member]
Line Of Credit Facility [Line Items]
HCN Term Loan	1,000,000
HCN Canadian Denomiated Term Loan	$ 250,000
Revolving Credit Facility [Member]
Line Of Credit Facility [Line Items]
Interest Rate margin	0.90%
Debt instrument maturity date	May 13, 2020

Senior Unsecured Notes and Se57

Senior Unsecured Notes and Secured Debt (Details) £ in Thousands, CAD in Thousands, $ in Thousands		9 Months Ended
		Sep. 30, 2016CAD	Sep. 30, 2016GBP (£)	Sep. 30, 2016USD ($)	Dec. 31, 2015USD ($)	Oct. 01, 2015USD ($)
Principal payments due on debt obligations
2,016				$ 76,773
2,017				1,006,774
2,018				1,110,201
2,019				1,030,991
2,020	[1]			855,606
Thereafter	[2],[3],[4],[5],[6],[7]			8,011,239
Totals				12,091,584
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Senior unsecured notes				8,688,585	$ 8,548,055
Secured debt				3,317,933	$ 3,509,142
Debt instrument maturity date		May 13, 2021
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]			678,746
Thereafter	[2],[3],[4],[5],[6],[7],[8],[9]			6,607,196
Totals	[8],[9]			8,790,942
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Notes, annual stated interest rates, Minimum		1.23%
Notes, annual stated interest rates, Maximum		6.50%
Secured Debt [Member]
Principal payments due on debt obligations
2,016	[8],[10]			76,773
2,017	[8],[10]			556,774
2,018	[8],[10]			660,201
2,019	[8],[10]			425,991
2,020	[1],[8],[10]			176,860
Thereafter	[2],[3],[4],[5],[6],[7],[8],[10]			1,404,043
Totals	[8],[10]			3,300,642
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Notes, annual stated interest rates, Minimum		0.89%
Notes, annual stated interest rates, Maximum		7.98%
Carrying values of properties securing the debt				5,844,048
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		$ 190,621
Interest Rate margin		1.83%
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	$ 650,750
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	$ 715,825
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		1.48%
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		$ 228,746
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 $228,746,000 based on the Canadian/U.S. Dollar exchange rate on September 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 $190,621,000 based on the Canadian/U.S. Dollar exchange rate on September 30, 2016). The loan matures on May 13, 2021 and bears interest at the Canadian Dealer Offered Rate plus 95 basis points (1.83% at September 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 (1.48% at September 30, 2016).
[5]	(7) On November 20, 2013, we completed the sale of £550,000,000 (approximately $715,825,000 based on the Sterling/U.S. Dollar exchange rate in effect on September 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 $650,750,000 based on the Sterling/U.S. Dollar exchange rate in effect on September 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 1.23% to 6.5%.
[10]	(3) Annual interest rates range from 0.89% to 7.98%. Carrying value of the properties securing the debt totaled $5,844,048,000 at September 30, 2016.

Senior Unsecured Notes and Se58

Senior Unsecured Notes and Secured Debt (Details 1) $ in Thousands	9 Months Ended		12 Months Ended
	Sep. 30, 2016USD ($)	Sep. 30, 2015USD ($)	Dec. 31, 2015USD ($)	Dec. 31, 2014USD ($)
Unsecured note issuances
Senior unsecured debt issued	$ 693,560	$ 743,407
Senior unsecured debt redeemed	400,000	534,546
Excluding Fair Value Adjustments [Member]
Unsecured note issuances
Senior unsecured debt balance	8,790,942	7,974,540	$ 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	(215,965)
Senior unsecured debt foreign currency	$ (159,816)	$ (76,649)
Senior unsecured debt balance average rate	0.04264	0.0421	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	0.04443	0.08065

Senior Unsecured Notes and Se59

Senior Unsecured Notes and Secured Debt (Details 2) $ in Thousands	9 Months Ended		12 Months Ended
	Sep. 30, 2016USD ($)	Sep. 30, 2015USD ($)	Dec. 31, 2015USD ($)	Dec. 31, 2014USD ($)
Secured debt principal activity
Secured debt issued	$ 193,541	$ 222,612
Secured debt extinguished	471,898	469,455
Excluding Fair Value Adjustments [Member]
Secured debt principal activity
Secured debt principal balance	3,300,642	2,945,697	$ 3,478,207	$ 2,941,765
Secured debt issued	193,541	222,612
Secured debt assumed	47,156	339,929
Secured debt extinguished	(416,009)	(420,672)
Secured debt principal payments	(55,889)	(48,783)
Secured debt foreign currency	$ 53,636	$ (89,154)
Secured debt principal balance average rate	0.04272	0.0472	0.0444	0.0494
Secured debt principal issued average rate	0.03053	0.0276
Secured debt principal assumed average rate	0.04132	0.0334
Secured debt principal extinguished average rate	0.04986	0.0427
Secured debt principal payment average rate	0.04478	0.0485
Secured debt principal foreign currency average rate	0.03631	0.0388

Derivative Instrument (Notional

Derivative Instrument (Notional Table) (Details) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 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	72,000	72,000
Designated as Hedging Instrument [Member] | Cash Flow Hedging [Member] | GBP
Derivatives Fair Value [Line Items]
Derivative, Notional Amount	63,000	60,000
Designated as Hedging Instrument [Member] | Net Investment Hedging [Member] | CAD
Derivatives Fair Value [Line Items]
Derivative, Notional Amount	900,000	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	37,000	47,000
Not Designated as Hedging Instrument [Member] | GBP
Derivatives Fair Value [Line Items]
Derivative, Notional Amount	$ 20,100	$ 0

Derivative Instruments (Details

Derivative Instruments (Details 1) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Derivative [Line Items]
Derivative Gain Loss On Derivative Net	$ 2,516	$ 0	$ 2,516	$ 58,427
Interest Rate Swap [Member]
Derivative [Line Items]
Gain (loss) on forward exchange contracts recognized in income.	3,420	2,347	4,789	6,285
Foreign Exchange Contract [Member]
Derivative [Line Items]
Gain (loss) recognized in OCI	53,421	174,239	229,256	208,854
Gain on Release of cumulative translation adjustment related to net investment hedge of an equity investment	(2,516)	0	(2,516)	0
Foreign Exchange Option Member
Derivative [Line Items]
Derivative Gain Loss On Derivative Net	$ 0	$ 0	$ 0	$ (58,427)	[1]
[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	9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015
Derivative Instruments [Abstract]
Cash Flow Hedge Gain Loss To Be Reclassified Within Twelve Months	$ 5,555
Derivative Cash Received On Hedge	$ 56,842	$ 103,615

Commitments and Contingencies (

Commitments and Contingencies (Details Textual) $ in Thousands	9 Months Ended
	Sep. 30, 2016USD ($)Number	Dec. 31, 2015USD ($)
Commitments and Contingencies (Textual) [Abstract]
Number of outstanding letters of credit | Number	10
Letter of credit obligation	$ 88,188
Line Of Credit Facility [Line Items]
Outstanding construction financings for leased properties	529,471	$ 258,968
Additional financing to complete construction	515,980
Total contingent purchase obligations	$ 18,566
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	$ 1,109,001
Operating Leases, Future Minimum Payments Due, Future Minimum Sublease Rentals	74,069
Capital Leases, Future Minimum Payments Due	$ 95,018
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	Sep. 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	363,361,460	355,594,373
Outstanding shares	362,424,770	354,777,670

Stockholder's Equity (Details 1

Stockholder's Equity (Details 1)	9 Months Ended
	Sep. 30, 2016USD ($)$ / sharesshares	Sep. 30, 2015USD ($)$ / sharesshares
Summary of common stock issuances
Equity shelf plan issuances, Shares Issued | shares	3,119,801
Equity shelf plan issuances, average price | $ / shares	75.27
Equity Shelf Plan Issuances Gross Proceeds	$ 237,131,000
Equity Shelf Plan Issuances Net Proceeds	$ 234,812,000
Dividend reinvestment plan issuances, Shares Issued | shares	3,946,821	2,935,950
Dividend reinvestment plan issuances, Average Price	70.51	70.28
Dividend reinvestment plan issuances, Net Proceeds	$ 278,297,000	$ 206,334,000
Dividend reinvestment plan issuances, Gross Proceeds	$ 278,578,000	$ 206,334,000
Option exercises, Shares | shares	137,579	247,005
Option exercises, Average Price	50.57	47.42
Option exercises, Gross Proceeds	$ 6,958,000	$ 11,712,000
Option exercises, Net Proceeds	$ 6,958,000	$ 11,712,000
Stock incentive plans, net of forfeitures, Shares Issued | shares	442,899	144,779
Senior note conversions | shares		1,330,474
Issuance of Common Stock, Shares | shares	7,647,100	24,208,208
Gross Proceeds From Issuance of Common Stock	$ 522,667,000	$ 1,694,071,000
Net proceeds from the issuance of common stock	$ 520,067,000	$ 1,641,981,000
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		Sep. 30, 2016	Dec. 31, 2015	Sep. 30, 2015	Dec. 31, 2014
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges		$ (45)	$ (1,416)	$ (1,885)	$ (650)
Unrecognized losses on equity investments		(5,252)	0	(18,186)	0
Unrecognized gains (losses) on foreign currency translation		(144,544)	(85,484)	(72,699)	(74,770)
Unrecognized actuarial losses		(1,343)	(1,343)	(1,589)	(1,589)
Totals		(151,184)	$ (88,243)	(94,359)	$ (77,009)
Other comprehensive income before reclassification adjustments
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges		11		(2,625)
Unrecognized losses on equity investments		(5,252)		(18,186)
Unrecognized gains (losses) on foreign currency translation		(59,060)		2,071
Unrecognized actuarial losses		0		0
Totals		(64,301)		(18,740)
Reclassification amount to net income
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges	[1]	1,360		1,390
Unrecognized losses on equity investments		0		0
Unrecognized gains (losses) on foreign currency translation		0		0
Unrecognized actuarial losses		0		0
Totals		1,360		1,390
Net current period other comprehensive income
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges		1,371		(1,235)
Unrecognized losses on equity investments		(5,252)		(18,186)
Unrecognized gains (losses) on foreign currency translation		(59,060)		2,071
Unrecognized actuarial losses		0		0
Totals		$ (62,941)		$ (17,350)
[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		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Summary of dividend payments
Dividends declared and paid per common share	$ 0.86	$ 0.825	$ 2.58	$ 2.475
Common stock cash dividends			$ 921,381	$ 852,563
Total dividends paid			$ 970,436	$ 901,618
Series I Preferred Stock [Member]
Summary of dividend payments
Dividends declared and paid per preferred share			$ 2.4375	$ 2.4375
Preferred stock cash dividends			$ 35,039	$ 35,039
Series J Preferred Stock [Member]
Summary of dividend payments
Dividends declared and paid per preferred share			$ 1.2189	$ 1.2189
Preferred stock cash dividends			$ 14,016	$ 14,016

Stock Incentive Plans (Details

Stock Incentive Plans (Details Textual) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 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	$ 5,401	$ 5,477	$ 20,618	$ 25,655
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		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 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	$ 334,910	$ 182,043	$ 679,353	$ 685,413
Denominator for basic earnings per share - weighted average shares	358,932	351,765	356,911	346,425
Effect of dilutive securities:
Employee stock options	128	114	119	155
Non-vested restricted shares	526	607	414	498
Redeemable shares	1,651	621	1,308	207
Convertible senior unsecured notes	0	0	0	262
Dilutive potential common shares	2,305	1,342	1,841	1,122
Denominator for diluted earnings per share - adjusted weighted average shares	361,237	353,107	358,752	347,547
Basic earnings per share	$ 0.93	$ 0.52	$ 1.9	$ 1.98
Diluted earnings per share	$ 0.93	$ 0.52	$ 1.89	$ 1.97

Disclosure about Fair Value o70

Disclosure about Fair Value of Financial Instruments (Details) - USD ($) $ in Thousands	Sep. 30, 2016		Dec. 31, 2015	Sep. 30, 2015		Dec. 31, 2014
Financial Assets:
Loans receivable, Fair value	$ 525,400		$ 663,501
Available-for-sale equity investments, Carrying Amount	17,527		22,779
Available-for-sale equity investments, Fair Value	17,527	[1]	22,779
Cash and cash equivalents, Carrying Amount	428,617		360,908	$ 292,042		$ 473,726
Cash and cash equivalents, Fair Value	428,617		360,908
Foreign Currency Forward Contracts Carrying Value	130,454		129,520
Foreign Currency Forward Contracts Fair Value	130,454		129,520
Financial Liabilities:
Borrowings under primary unsecured credit facilities, Carrying Value	1,350,000	[2]	835,000	$ 490,000	[2]
Borrowings under primary unsecured credit facilities, Fair Value	1,350,000		835,000
Senior unsecured notes, Carrying Amount	8,688,585		8,548,055
Senior unsecured notes, Fair Value	9,823,661		9,020,529
Secured debt, Carrying Amount	3,317,933		3,509,142
Secured debt, Fair Value	3,509,792		3,678,564
Foreign Currency Forward Contracts Carrying Value	615		0
Foreign Currency Forward Contracts, Fair Value	615		0
Redeemable OP unitholder interests carrying value	123,446		112,029
Redeemable OP unitholder interests fair value	123,446		112,029
Mortgage Loans on Real Estate [Member]
Financial Assets:
Loans receivable, Carrying Amount	498,993		635,492
Loans receivable, Fair value	525,400		663,501
Other Real Estate Loans Receivable [Member]
Financial Assets:
Loans receivable, Carrying Amount	131,027		184,000
Loans receivable, Fair value	$ 132,999		$ 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 September 30, 2016, letters of credit in the aggregate amount of $45,335,000 have been issued, which reduces the borrowing capacity on the unsecured revolving credit facility.

Disclosure about Fair Value o71

Disclosure about Fair Value of Financial Instruments (Details 1) - USD ($) $ in Thousands		Sep. 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		$ 17,527	[1]	$ 22,779
Foreign currency forward contracts	[2]	129,839
Redeemable OP unitholder interests		123,446
Totals		270,812
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]	17,527
Totals		17,527
Level 2 [Member]
The Market approach utilized to measure fair value of financial assets and liabilities on recurring basis
Foreign currency forward contracts	[2]	129,839
Redeemable OP unitholder interests		123,446
Totals		$ 253,285
[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 o72

Disclosure about Fair Value of Financial Instruments (Details Textuals) $ in Thousands	Sep. 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			9 Months Ended
	Sep. 30, 2016USD ($)		Sep. 30, 2015USD ($)	Sep. 30, 2016USD ($)		Sep. 30, 2015USD ($)	Dec. 31, 2015USD ($)
Summary of information for reportable segments
Rental income	$ 421,152		$ 409,290	$ 1,259,442		$ 1,185,502
Resident fees and services	630,017		545,255	1,847,386		1,573,318
Interest income	25,080		22,380	74,275		59,950
Other income	2,884		2,072	21,735		11,572
Total revenues	1,079,133		978,997	3,202,838		2,830,342
Property operating expenses	473,680		408,703	1,382,148		1,183,519
Net Operating Income from Continuing Operations	605,453	[1]	570,294	1,820,690	[1]	1,646,823
Interest expense	129,699		121,130	394,985		361,071
Loss (gain) on derivatives, net	(2,516)		0	(2,516)		(58,427)
Depreciation and amortization	218,061		205,799	673,326		603,431
General and administrative	36,828		36,950	122,434		110,562
Transaction costs	19,842		9,333	33,207		70,379
Loss (gain) on extinguishment of debt, net	0		584	9		34,872
Impairment of Asset	9,705		0	24,019		2,220
Other expenses	0		0	3,161		10,583
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	193,834		196,498	572,065		512,132
Income tax (expense) benefit	305		3,344	2,543		(3,769)
(Loss) income from unconsolidated entities	(1,749)		(2,631)	(7,528)		(18,231)
Income (loss) from continuing operations	192,390		197,211	567,080		490,132
Gain (loss) on real estate dispositions, net	162,351		2,046	163,881		249,002
Net income	354,741		$ 199,257	730,961		$ 739,134
Total assets	$ 29,856,339			$ 29,856,339			$ 29,023,845
Percent Of Assets	1			1			1
Percent Of Revenues	1		1	1		1
United States
Summary of information for reportable segments
Total revenues	$ 874,050		$ 793,429	$ 2,581,533		$ 2,309,596
Total assets	$ 24,600,436			$ 24,600,436			$ 25,995,793
Percent Of Assets	0.824			0.824			0.896
Percent Of Revenues	0.81		0.81	0.807		0.816
United Kingdom
Summary of information for reportable segments
Total revenues	$ 95,068		$ 106,372	$ 295,203		$ 301,718
Total assets	$ 2,715,817			$ 2,715,817			$ 1,741,973
Percent Of Assets	0.091			0.091			0.06
Percent Of Revenues	0.088		0.109	0.091		0.107
Canada
Summary of information for reportable segments
Total revenues	$ 110,015		$ 79,196	$ 326,102		$ 219,028
Total assets	$ 2,540,086			$ 2,540,086			$ 1,286,079
Percent Of Assets	0.085			0.085			0.044
Percent Of Revenues	0.102		0.081	0.102		0.077
Triple Net [Member]
Summary of information for reportable segments
Rental income	$ 286,226		$ 277,614	$ 857,184		$ 812,179
Resident fees and services	0		0	0		0
Interest income	23,017		19,454	67,842		52,343
Other income	1,621		969	4,317		5,823
Total revenues	310,864		298,037	929,343		870,345
Property operating expenses	0		0	0		0
Net Operating Income from Continuing Operations	310,864		298,037	929,343		870,345
Interest expense	985		11,347	8,608		21,083
Loss (gain) on derivatives, net	0			0		(58,427)
Depreciation and amortization	74,296		72,589	229,906		212,537
General and administrative	0		0	0		0
Transaction costs	1,613		1,865	5,760		45,615
Loss (gain) on extinguishment of debt, net			(139)	97		10,096
Impairment of Asset	5,070			19,384		2,220
Other expenses				0		0
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	228,900		212,375	665,588		637,221
Income tax (expense) benefit	(896)		87	(1,425)		(2,617)
(Loss) income from unconsolidated entities	1,998		2,851	8,097		5,697
Income (loss) from continuing operations	230,002		215,313	672,260		640,301
Gain (loss) on real estate dispositions, net	163,579		2,155	165,109		56,251
Net income	393,581		217,468	837,369		696,552
Total assets	11,988,519			11,988,519
Senior housing - operating [Member]
Summary of information for reportable segments
Rental income	0		0	0		0
Resident fees and services	630,017		545,255	1,847,386		1,573,318
Interest income	1,054		1,054	3,126		3,126
Other income	716		772	11,889		5,001
Total revenues	631,787		547,081	1,862,401		1,581,445
Property operating expenses	432,292		368,050	1,259,182		1,067,127
Net Operating Income from Continuing Operations	199,495		179,031	603,219		514,318
Interest expense	39,927		30,990	123,445		104,283
Loss (gain) on derivatives, net	0			0		0
Depreciation and amortization	97,210		87,306	301,354		252,785
General and administrative	0		0	0		0
Transaction costs	18,083		7,630	25,259		23,610
Loss (gain) on extinguishment of debt, net			0	(88)		0
Impairment of Asset	0			0		0
Other expenses				0		0
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	44,275		53,105	153,249		133,640
Income tax (expense) benefit	515		3,237	5,304		(745)
(Loss) income from unconsolidated entities	(3,891)		(5,629)	(15,713)		(26,785)
Income (loss) from continuing operations	40,899		50,713	142,840		106,110
Gain (loss) on real estate dispositions, net	0		0	0		0
Net income	40,899		50,713	142,840		106,110
Total assets	12,580,092			12,580,092
Outpatient Medical [Member]
Summary of information for reportable segments
Rental income	134,926		131,676	402,258		373,323
Resident fees and services	0		0	0		0
Interest income	1,009		1,872	3,307		4,481
Other income	358		309	4,824		665
Total revenues	136,293		133,857	410,389		378,469
Property operating expenses	41,388		40,653	122,966		116,392
Net Operating Income from Continuing Operations	94,905		93,204	287,423		262,077
Interest expense	3,986		6,811	15,132		21,192
Loss (gain) on derivatives, net	0			0		0
Depreciation and amortization	46,555		45,904	142,066		138,109
General and administrative	0		0	0		0
Transaction costs	146		(162)	2,188		1,154
Loss (gain) on extinguishment of debt, net			0	0		0
Impairment of Asset	4,635			4,635		0
Other expenses				0		0
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	39,583		40,651	123,402		101,622
Income tax (expense) benefit	417		154	(59)		460
(Loss) income from unconsolidated entities	144		147	88		2,857
Income (loss) from continuing operations	40,144		40,952	123,431		104,939
Gain (loss) on real estate dispositions, net	(1,228)		(109)	(1,228)		192,751
Net income	38,916		40,843	122,203		297,690
Total assets	4,899,012			4,899,012
Corporate, Non-Segment [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	189		22	705		83
Total revenues	189		22	705		83
Property operating expenses	0		0	0		0
Net Operating Income from Continuing Operations	189		22	705		83
Interest expense	84,801		71,982	247,800		214,513
Loss (gain) on derivatives, net	(2,516)			(2,516)		0
Depreciation and amortization	0		0	0		0
General and administrative	36,828		36,950	122,434		110,562
Transaction costs	0		0	0		0
Loss (gain) on extinguishment of debt, net			723	0		24,776
Impairment of Asset	0			0		0
Other expenses				3,161		10,583
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	(118,924)		(109,633)	(370,174)		(360,351)
Income tax (expense) benefit	269		(134)	(1,277)		(867)
(Loss) income from unconsolidated entities	0		0	0		0
Income (loss) from continuing operations	(118,655)		(109,767)	(371,451)		(361,218)
Gain (loss) on real estate dispositions, net	0		0	0		0
Net income	(118,655)		$ (109,767)	(371,451)		$ (361,218)
Total assets	$ 388,716			$ 388,716
[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 in both our triple-net and seniors housing operating segments.

Income Taxes and Distributions

Income Taxes and Distributions (Details)	9 Months Ended
	Sep. 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 Disc75

Variable Interest Entity Disclosure (Details) - Variable Interest Entity, Primary Beneficiary [Member] - USD ($) $ in Thousands		Sep. 30, 2016	Dec. 31, 2015
Variable Interest Entity [Line Items]
Total assets	[1]	$ 1,022,002	$ 470,730
Total equity		478,564	245,887
Total liabilities and equity		1,022,002	470,730
Net real property owned [Member]
Variable Interest Entity [Line Items]
Total assets		997,442	453,889
Cash and cash equivalents [Member]
Variable Interest Entity [Line Items]
Total assets		11,124	8,759
Receivables and other assets [Member]
Variable Interest Entity [Line Items]
Total assets		13,436	8,082
Secured Debt [Member]
Variable Interest Entity [Line Items]
Liabilities		450,944	147,021
Accrued expenses and other liabilities [Member]
Variable Interest Entity [Line Items]
Liabilities		15,460	7,732
Redeemable noncontrolling interests [Member]
Variable Interest Entity [Line Items]
Liabilities		$ 77,034	$ 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.

Subsequent Events (Details)

Subsequent Events (Details) - USD ($) $ in Thousands	1 Months Ended	3 Months Ended		9 Months Ended
	Nov. 01, 2016	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Subsequent Event [Line Items]
Gain (loss) on real estate dispositions, net		$ 162,351	$ 2,046	$ 163,881	$ 249,002
Subsequent Event [Member] | Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member] | Genesis Health Care Corporation [Member]
Subsequent Event [Line Items]
Subsequent Event, Date	Nov. 1, 2016
Gain (loss) on real estate dispositions, net	$ 1,100,000