Welltower (WELL) 10-Q 5 May 17 2017 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - USD ($)	3 Months Ended
	Mar. 31, 2017	Apr. 28, 2017	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	Mar. 31, 2017
Amendment Flag	false
Document Fiscal Year Focus	2,017
Document Fiscal Period Focus	Q1
Current Fiscal Year End Date	--12-31
Entity Well Known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Filer Category	Large Accelerated Filer
Entity Public Float			$ 27,176,263,145
Entity Common Stock Shares Outstanding		366,166,605

Consolidated Balance Sheets (Un

Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Mar. 31, 2017		Dec. 31, 2016
Real property owned:
Land and land improvements	$ 2,650,473		$ 2,591,071
Buildings and improvements	24,930,472		24,496,153
Acquired lease intangibles	1,421,277		1,402,884
Real property held for sale, net of accumulated depreciation	178,260		1,044,859
Construction in progress	390,180		506,091
Gross real property owned	29,570,662		30,041,058
Less accumulated depreciation and amortization	(4,335,160)		(4,093,494)
Net real property owned	25,235,502		25,947,564
Real estate loans receivable:
Real estate loans receivable	574,080		622,628
Allowance for losses on loans receivable	(6,196)		(6,563)
Net real estate loans receivable	567,884		616,065
Net real estate investments	25,803,386		26,563,629
Other assets:
Investments in unconsolidated entities	416,110		457,138
Goodwill	68,321		68,321
Cash and cash equivalents	380,360		419,378
Restricted cash	42,777		187,842
Straight-line rent receivable	348,085		342,578
Receivables and other assets	708,238		826,298
Total other assets	1,963,891		2,301,555
Total assets	27,767,277		28,865,184
Liabilities:
Borrowings under primary unsecured credit facilities, Carrying Value	522,000	[1]	645,000
Senior unsecured notes	8,188,928		8,161,619
Secured debt	2,669,787		3,477,699
Capital lease obligations	73,470		73,927
Accrued expenses and other liabilities	817,411		827,034
Total liabilities	12,271,596		13,185,279
Redeemable noncontrolling interests	385,418		398,433
Equity:
Preferred stock	718,750		1,006,250
Common stock	365,187		363,071
Capital in excess of par value	17,134,490		16,999,691
Treasury stock	(62,306)		(54,741)
Cumulative net income	5,130,593		4,803,575
Cumulative dividends	(8,474,775)		(8,144,981)
Accumulated other comprehensive income (loss)	(177,200)		(169,531)
Other equity	1,464		3,059
Total Welltower Inc. stockholders' equity	14,636,203		14,806,393
Noncontrolling interests	474,060		475,079
Total equity	15,110,263		15,281,472
Total liabilities and equity	$ 27,767,277		$ 28,865,184
[1]	As of March 31, 2017, letters of credit in the aggregate amount of $32,456,000 have been issued, which reduces the borrowing capacity on the unsecured revolving credit facility.

Consolidated Statements of Inco

Consolidated Statements of Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Revenues:
Rental income	$ 367,141	$ 415,663
Resident fees and services	670,337	602,149
Interest income	20,748	25,188
Other income	4,072	4,050
Total revenues	1,062,298	1,047,050
Expenses:
Interest expense	118,597	132,960
Property operating expenses	510,169	449,636
Depreciation and amortization	228,276	228,696
General and administrative	31,101	45,691
Transaction costs	0	8,208
Loss (gain) on derivatives, net	1,224	0
Loss (gain) on extinguishment of debt, net	31,356	(24)
Impairment of Asset	11,031	14,314
Other expenses	11,675	0
Total expenses	943,429	879,481
Income (loss) from continuing operations before income taxes and income from unconsolidated entities, total	118,869	167,569
Income tax expense	(2,245)	1,725
(Loss) income from unconsolidated entities	(23,106)	(3,820)
Income from continuing operations	93,518	165,474
Gain (loss) on real estate dispositions, net	244,092	0
Net income	337,610	165,474
Less: Preferred stock dividends	14,379	16,352
Preferred stock redemption charge	9,769	0
Less: Net income (loss) attributable to noncontrolling interests	823	153
Net income (loss) attributable to common stockholders	$ 312,639	$ 148,969
Average number of common shares outstanding:
Basic	362,534	355,076
Diluted	364,652	356,051
Basic:
Income (loss) from continuing operations attributable to common stockholders, including real estate dispositions	$ 0.86	$ 0.42
Net income (loss) attributable to common stockholders, total	0.86	0.42
Diluted:
Income (loss) from continuing operations attributable to common stockholders, including real estate dispositions	0.86	0.42
Net income (loss) attributable to common stockholders, total	0.86	0.42
Dividends declared and paid per common share	$ 0.87	$ 0.86

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2017	Mar. 31, 2016
Statement of Comprehensive Income [Abstract]
Net income		$ 337,610	$ 165,474
Other comprehensive income (loss):
Unrecognized gain (loss) on equity investments		(10,569)	(7,549)
Unrecognized gain (loss) on cash flow hedges		0	483
Unrecognized actuarial gain/(loss)		0	2
Unrecognized gain (loss) on foreign currency translation		5,713	1,372
Total other comprehensive income (loss)		(4,856)	(5,692)
Total comprehensive income (loss), total		332,754	159,782
Total comprehensive income (loss) attributable to noncontrolling interests	[1]	3,636	15,271
Comprehensive income (loss) attributable to controlling interests		$ 329,118	$ 144,511
[1]	Includes amounts attributable to redeemable noncontrolling interests.

Consolidated Statements of Equi

Consolidated Statements of Equity (Unaudited) - USD ($) $ in Thousands	Total	Preferred Stock	Common Stock	Capital in Excess of Par Value	Treasury Stock	Cumulative Net Income	Cumulative Dividends	Accumulated Other Comprehensive Income (Loss)	Other Equity	Noncontrolling Interests
Balances at beginning of period at Dec. 31, 2015	$ 15,175,885	$ 1,006,250	$ 354,811	$ 16,478,300	$ (44,372)	$ 3,725,772	$ (6,846,056)	$ (88,243)	$ 4,098	$ 585,325
Comprehensive income:
Net income (loss)	166,403					165,321				1,082
Other comprehensive income	(5,692)							(20,810)		15,118
Total comprehensive income	160,711
Decrease in noncontrolling interests	(127,042)			(5,717)						(121,325)
Amounts related to stock incentive plans, net of forfeitures	19,178		637	25,555	(6,899)				(115)
Proceeds from issuance of common stock	93,105		1,505	91,600
Option compensation expense	79								79
Cash dividends paid:
Common stock	(305,770)						(305,770)
Preferred Stock	(16,352)						(16,352)
Balances at end of period at Mar. 31, 2016	14,999,794	1,006,250	356,953	16,589,738	(51,271)	3,891,093	(7,168,178)	(109,053)	4,062	480,200
Balances at beginning of period at Dec. 31, 2016	15,281,472	1,006,250	363,071	16,999,691	(54,741)	4,803,575	(8,144,981)	(169,531)	3,059	475,079
Comprehensive income:
Net income (loss)	338,567					336,787				1,780
Other comprehensive income	(4,856)							(7,669)		2,813
Total comprehensive income	333,711
Increase in noncontrolling interests				932
Decrease in noncontrolling interests	(4,680)									(5,612)
Amounts related to stock incentive plans, net of forfeitures	(1,931)		336	6,903	(7,565)				(1,605)
Proceeds from issuance of common stock	118,984		1,780	117,204
Redemption of preferred stock	(287,509)	(287,500)		9,760		(9,769)
Option compensation expense	10								10
Cash dividends paid:
Common stock	(315,415)						(315,415)
Preferred Stock	(14,379)						(14,379)
Balances at end of period at Mar. 31, 2017	$ 15,110,263	$ 718,750	$ 365,187	$ 17,134,490	$ (62,306)	$ 5,130,593	$ (8,474,775)	$ (177,200)	$ 1,464	$ 474,060

Consolidated Statements of Cash

Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2017	Mar. 31, 2016
Operating activities
Net income (loss)		$ 337,610	$ 165,474
Adjustments to reconcile net income to net cash provided from (used in) operating activities:
Depreciation and amortization		228,276	228,696
Other amortization expenses		3,361	1,118
Asset Impairment Charges		11,031	14,314
Stock-based compensation expense		4,906	8,186
Loss (gain) on derivatives, net		1,224	0
Loss (gain) on extinguishment of debt, net		31,356	(24)
Income from unconsolidated entities		23,106	3,820
Rental income in excess of cash received		(18,141)	(29,669)
Amortization related to above (below) market leases, net		8	230
Net loss (gain) on sales of properties		(244,092)	0
Distributions by unconsolidated entities		474	174
Increase (decrease) in accrued expenses and other liabilities		19,478	(13,526)
Decrease (increase) in receivables and other assets		(13,071)	1,816
Net cash provided from (used in) operating activities		385,526	380,609
Investing activities
Cash disbursed for acquisitions		(102,356)	(171,482)
Cash disbursed for capital improvements to existing properties		(42,115)	(35,025)
Cash disbursed for construction in progress		(69,334)	(66,739)
Capitalized interest		(4,129)	(3,037)
Investment in real estate loans receivable		(25,375)	(27,251)
Other investments, net of payments		48,311	(30,773)
Principal collected on real estate loans receivable		8,792	93,774
Contributions to unconsolidated entities		(13,073)	(12,784)
Distributions by unconsolidated entities		24,161	11,747
Proceeds from (payments on) derivatives investing		8,218	0
Decrease (increase) in restricted cash		145,065	(394)
Proceeds from sales of real property		1,087,074	0
Net cash provided from (used in) investing activities		1,065,239	(241,964)
Financing activities
Net increase (decrease) under unsecured lines of credit arrangements		(123,000)	(190,000)
Proceeds from issuance of senior unsecured notes		0	688,560
Payments to extinguish senior unsecured notes		0	(400,000)
Secured debt issued		12,536	75,136
Payments on secured debt		(822,438)	(130,343)
Net proceeds from the issuance of common stock		119,651	93,433
Redemption of preferred stock		(287,500)	0
Decrease (increase) in deferred loan costs		(36,674)	(1,217)
Contributions by noncontrolling interests	[1]	2,667	126,142
Distributions to noncontrolling interests	[1]	(20,014)	(76,222)
Acquisitions of noncontrolling interests		(38)	0
Cash distributions to stockholders		(329,794)	(322,122)
Other financing activities		(8,022)	(7,294)
Net cash provided from (used in) financing activities		(1,492,626)	(143,927)
Effect of foreign currency translation on cash and cash equivalents		2,843	323
Increase (decrease) in cash and cash equivalents		(39,018)	(4,959)
Cash and cash equivalents at beginning of period		419,378	360,908
Cash and cash equivalents at end of period		380,360	355,949
Supplemental cash flow information:
Interest paid		109,438	134,872
Income taxes paid		$ 3,349	$ 2,431
[1]	(1) Includes amounts attributable to redeemable noncontrolling interests.

Business

Business	3 Months Ended
	Mar. 31, 2017
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 properties concentrated 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 investm ent trust to invest exclusively in health care facilities.

Accounting Policies and Related

Accounting Policies and Related Matters	3 Months Ended
	Mar. 31, 2017
Accounting Policies and Related Matters [Abstract]
Accounting Policies and Related Matters	2 . Accounting Policies and Related Matters Basis of Presentation The accompanying unaudited consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial information and with instructions to Quarterly Report on Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by U.S. GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation have been included. Operating results for the three months ended March 31, 2017 are not necessarily an indication of the results that may be expected for the year ending December 31, 2017 . For further information, refer to the financial statements and notes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2016 . New Accounting Standards In May 2014, the Financial Accounting Standards Board (the “ FASB ”) issued ASU No. 2014-09, “Revenue from Contracts with Customers (Topic 606)”. The standard is a comprehensive new revenue recognition model that requires revenue to be recognized in a manner to depict the transfer of goods or services to a customer at an a mount that reflects the consideration expected to be received in exchange for those goods or services. ASU 2014-09 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2017, and early adoption is permitted be ginning after December 15, 2016. A reporting entity may apply the new standard using either a modified retrospective approach by recording a cumulative-effect adjustment to equity as of the beginning of the fiscal year of adoption or a full retrospective approach . We are currently evaluating the impact that the adoption of the standard will have on our consolidated financial statements and have not yet determined the method by which we will adopt the new standard. A significant source of our revenue is g enerated through leasing arrangements, which are specifically excluded from the new standard. We expect that the new standard will affect our accounting policies related to non-lease revenue, including certain fees in our RIDEA joint ventures, common area maintenance in our outpatient medical properties and real estate sales. Under ASU 2014-09, revenue recognition for real estate sales is mainly based on the transfer of control versus current guidance of continuing involvement. We expect that the new gui dance will result in more transactions qualifying as sales of real estate and being recognized at an earlier date than under the current guidance. In January 2016, the FASB issued ASU No. 2016-01, “Financial Instruments – Overall: Recognition and Meas urement of Financial Assets and Financial Liabilities,” which will require entities to measure their investments at fair value and recognize any changes in fair value in net income unless the investments qualify for the new practicability exception. The p racticability 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 evalu ating 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 t o the rights and obligations created by most leases, while continuing to recognize expenses on their income statements over the lease term. It will also require disclosures designed to give financial statement users information regarding amount, timing, a nd uncertainty of cash flows arising from leases. ASU 2016-02 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2018, and early adoption is permitted. Entities are required to use a modified retrospective approach for leases that exist or are entered into after the beginning of the earliest comparative period in the financial statements. We are currently evaluating the impact of this standard on our consolidated financial statements. We believe that the adoption of this standard will likely have a material impact to our consolidated balance sheet for the recognition of certain operating leases as right-of-use assets and lease liabilities. We are in the process of analyzing our lease portfolio and evaluat ing systems to comply with the standard’s retrospective adoption requirements . In March 2016, the FASB issued ASU No. 2016-09, “Improvements to Employee Share-Based Payment Accounting”. ASU 2016-09 is effective for fiscal years, and interim periods w ithin those years, beginning after December 15, 2016, and early adoption is permitted. We adopted ASU 2016-09 on January 1, 2017. The standard allows companies to make a policy election as to whether they will include an estimate of awards expected to be forfeited or whether they will account for forfeitures as they occur. We have elected to account for forfeitures as they occur. This election had an immaterial impact on our consolidated financial statements. The standard also requires an employer to cl assify as a financing activity in the statement of cash flow the cash paid to a tax authority when shares are withheld to satisfy the employer’s statutory income tax withholding obligation. This standard is required to be applied on a retrospective basis and resulted in an increase in net cash provided by operating activities and a decrease in net cash used in financing activities of $6,897,000 for the three months ended March 31, 2016. Upon adoption, no other provisions of ASU 2016-09 had an effect on ou r unaudited consolidated financial statements or related footnote disclosures. 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 a doption is permitted for fiscal years beginning after December 15, 2018. We are currently evaluating the impact that the standard will have on our consolidated financial statements . In January 2017, the FASB issued ASU No. 2017-01, “Clarifying the De finition of a Business”. This standard changes the definition of a business to assist entities with evaluating when a set of transferred assets and activities is a business. ASU 2017-01 is effective for fiscal years, and interim periods within those year s, beginning after December 15, 2017, and early adoption is permitted. A reporting entity must apply ASU 2017-01 using a prospective approach. We adopted ASU 2017-01 on January 1, 2017 and as a result, have classified our real estate acquisitions complet ed during the three months ended March 31, 2017 as asset acquisitions rather than business combinations due to the fact that substantially all of the fair value of the gross assets acquired were concentrated in a single asset or group of similar identifiab le assets . We have recorded identifiable assets acquired, liabilities assumed and any noncontrolling interests associated with any asset acquisitions at cost on a relative fair value basis and have capitalized transaction costs incurred.

Real Property Acquisitions and

Real Property Acquisitions and Development	3 Months Ended
	Mar. 31, 2017
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 relative fair values in accordance with our accounting policies. The results of operations for these acquis itions have been included in our consolidated results of operations since the date of acquisition and are a component of the appropriate segments. Transacti on costs primarily represent costs incurred with acquisitions, including due diligence costs, fees for legal and valuation services and termination of pre-existing relationships computed based on the fair value of the assets acquired, lease termination fee s and other acquisition-rel ated costs. Effective January 1 , 2017 , with our adoption of ASU 2017- 01, transaction costs related to asset acquisitions are capitalized as a component of purchase price and all other non-capitalizable costs are reflected in “ Oth er Expenses” on our Consolidated Statements of Comprehensive Income. 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, 2016 for information regarding our foreign currency policies. Triple-n et Activity Three Months Ended (In thousands) March 31, 2017 March 31, 2016 Land and land improvements $ 4,017 $ 15,331 Buildings and improvements 37,241 114,235 Acquired lease intangibles - 1,623 Total assets acquired 41,258 131,189 Accrued expenses and other liabilities - (809) Total liabilities assumed - (809) Non-cash acquisition related activity (1) - (28,621) Cash disbursed for acquisitions 41,258 101,759 Construction in progress additions 46,754 43,835 Less: Capitalized interest (2,028) (1,684) Foreign currency translation (164) (583) Cash disbursed for construction in progress 44,562 41,568 Capital improvements to existing properties 10,495 7,438 Total cash invested in real property, net of cash acquired $ 96,315 $ 150,765 (1) Includes $25,691,000 related to the acquisition of assets previously financed as real estate loans receivable and $2,871,000 related to the acquisition of assets previously financed as an investment in an unconsolidated entity. Seniors Housing Operating Activity Three Months Ended (In thousands) March 31, 2017 March 31, 2016 Land and land improvements $ 4,304 $ 3,440 Building and improvements 44,075 48,218 Acquired lease intangibles 1,741 1,942 Receivables and other assets 74 36 Total assets acquired (1) 50,194 53,636 Accrued expenses and other liabilities (2,755) (11) Total liabilities assumed (2,755) (11) Noncontrolling interests (647) (549) Non-cash acquisition related activity (2) (14,148) - Cash disbursed for acquisitions 32,644 53,076 Construction in progress additions 8,062 4,033 Less: Capitalized interest (1,707) (565) Foreign currency translation 691 (1,107) Cash disbursed for construction in progress 7,046 2,361 Capital improvements to existing properties 24,254 16,808 Total cash invested in real property, net of cash acquired $ 63,944 $ 72,245 (1) Excludes $400,000 and $113,000 of cash acquired during the three months ended March 31, 2017 and 2016, respectively. (2) Includes $6,349,000 related to the acquisition of assets previously financed as real estate loans receivable and $7,799,000 previously financed as an investment in an unconsolidated entity. Outpatient Medical Activity Three Months Ended (In thousands) March 31, 2017 March 31, 2016 Land and land improvements $ 2,895 $ - Buildings and improvements 23,310 17,637 Acquired lease intangibles 3,496 - Receivables and other assets 3 - Total assets acquired 29,704 17,637 Accrued expenses and other liabilities (1,250) (990) Total liabilities assumed (1,250) (990) Cash disbursed for acquisitions 28,454 16,647 Construction in progress additions 14,921 28,934 Less: Capitalized interest (717) (788) Accruals (1) 3,522 (5,336) Cash disbursed for construction in progress 17,726 22,810 Capital improvements to existing properties 7,366 10,779 Total cash invested in real property $ 53,546 $ 50,236 (1) Represents the change in non-cash consideration accruals for amounts to be paid in periods other than the period in which the construction projects converted to operations. Construction Activity The following is a summary of the construction projects that were placed into service and began generating revenues during the periods presented (in thousands) : Three Months Ended March 31, 2017 March 31, 2016 Development projects: Triple-net $ 157,460 $ - Seniors housing operating 3,634 - Outpatient medical 25,910 35,363 Total development projects 187,004 35,363 Total construction in progress conversions $ 187,004 $ 35,363

Real Estate Intangibles

Real Estate Intangibles	3 Months Ended
	Mar. 31, 2017
Real Estate Intangibles [Abstract]
Real Estate Intangibles	4 . Real Estate Intangibles The following is a summary of our real estate intangibles , excluding those classified as held for sale, as of the dates indicated (dollars in thousands): March 31, 2017 December 31, 2016 Assets: In place lease intangibles $ 1,267,280 $ 1,252,143 Above market tenant leases 63,184 61,700 Below market ground leases 62,224 61,628 Lease commissions 28,589 27,413 Gross historical cost 1,421,277 1,402,884 Accumulated amortization (1,010,364) (966,714) Net book value $ 410,913 $ 436,170 Weighted-average amortization period in years 14.4 13.7 Liabilities: Below market tenant leases $ 90,745 $ 89,468 Above market ground leases 8,107 8,107 Gross historical cost 98,852 97,575 Accumulated amortization (54,354) (52,134) Net book value $ 44,498 $ 45,441 Weighted-average amortization period in years 15.1 15.2 The following is a summary of real estate intangible amortization for the periods presented (in thousands): Three Months Ended March 31, 2017 2016 Rental income related to above/below market tenant leases, net $ 304 $ 81 Property operating expenses related to above/below market ground leases, net (312) (311) Depreciation and amortization related to in place lease intangibles and lease commissions (39,302) (34,454) The future estimated aggregate amortization of intangible assets and liabilities is as follows for the periods presented (in thousands): Assets Liabilities 2017 $ 105,454 $ 4,959 2018 77,561 6,106 2019 37,948 5,685 2020 24,169 5,208 2021 20,191 4,720 Thereafter 145,590 17,820 Total $ 410,913 $ 44,498

Dispositions, Assets Held for S

Dispositions, Assets Held for Sale and Discontinued Operations	3 Months Ended
	Mar. 31, 2017
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 , the exer cise of tenant purchase options or reduction of concentrations (e.g., property type, operator or geography). During the three months ended March 31, 2017 and 2016 , we recorded impairment charges on certain held-for-sale seniors housing operating and outpatient medical properties as the fair values less estimated costs to sell exceede d our carrying values. The following is a summary of our real property disposition activity for the periods presented (in thousands): Three Months Ended March 31, 2017 March 31, 2016 Real estate dispositions: Triple-net $ 808,204 $ - Seniors housing operating 13,845 - Total dispositions 822,049 - Gain (loss) on real estate dispositions, net 244,092 - Net other assets/liabilities disposed 20,933 - Proceeds from real estate dispositions $ 1,087,074 $ - 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 following represents the activity related to these properties for the periods presented (in thousands): Three Months Ended March 31, 2017 2016 Revenues: Rental income $ 16,734 $ 5,477 Expenses: Interest expense 1,301 851 Property operating expenses 1,855 1,362 Provision for depreciation 245 820 Total expenses 3,401 3,033 Income (loss) from real estate dispositions, net $ 13,333 $ 2,444

Real Estate Loans Receivable

Real Estate Loans Receivable	3 Months Ended
	Mar. 31, 2017
Real Estate Loans Receivable [Abstract]
Real Estate Loans Receivable	Please see Note 2 to the financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2016 for discussion of our accounting policies for real estate loans receivable and related interest income. The following is a summary of our real estate loan activity for the periods presented (in thousands): Three Months Ended March 31, 2017 March 31, 2016 Outpatient Outpatient Triple-net Medical Totals Triple-net Medical Totals Advances on real estate loans receivable: Investments in new loans $ 7,828 $ - $ 7,828 $ 8,013 $ - $ 8,013 Draws on existing loans 17,547 - 17,547 19,206 32 19,238 Net cash advances on real estate loans 25,375 - 25,375 27,219 32 27,251 Receipts on real estate loans receivable: Loan payoffs 14,474 60,500 74,974 104,068 12,290 116,358 Principal payments on loans 667 - 667 3,107 - 3,107 Sub-total 15,141 60,500 75,641 107,175 12,290 119,465 Less: Non-cash activity (1)(2) (6,349) (60,500) (66,849) (25,691) - (25,691) Net cash receipts on real estate loans 8,792 - 8,792 81,484 12,290 93,774 Net cash advances (receipts) on real estate loans 16,583 - 16,583 (54,265) (12,258) (66,523) Change in balance due to foreign currency translation 1,718 - 1,718 (1,987) - (1,987) Net change in real estate loans receivable $ 11,952 $ (60,500) $ (48,548) $ (81,943) $ (12,258) $ (94,201) (1) Triple-net represents acquisitions of assets previously financed as real estate loans. Please see Note 3 for additional information. (2) Outpatient medical represents a deed in lieu of foreclosure on a previously financed first mortgage property. In 2016, we restructured two existing real estate loans in the triple-net segment with Genesis Healthcare. The two existing loans, with a combined principal balance of $317,000,000, were scheduled to mature in 2017 and 2018. These loans were restructured into four separate loans effective October 1, 2016. Each loan has a five- year term, a 10% interest rate and 25 basis point annual escalator. In 2016, we recorded a loan loss charge in the amount of $6,935,000 on one of the loans as the prese nt value of expected future cash flows was less than the carrying value of the loan. We expect to collect all principal amounts due under the loans and, due to the passage of time, a t March 31, 2017 , the allowance for loan lo sses related to these loans is $6,19 6,000. At March 31, 2017 , we had no real es tate loans with outstanding balances on non-accrual status and recorded no provision for loan losses during the three months ended March 31, 2017 . Three Months Ended March 31, 2017 March 31, 2016 Balance of impaired loans at end of period $ 317,049 $ - Allowance for loan losses 6,196 - Balance of impaired loans not reserved $ 310,853 $ - Average impaired loans for the period $ 340,920 $ - Interest recognized on impaired loans (1) 8,243 - (1) Represents interest recognized in period since loans were identified as impaired.

Investments in Unconsolidated E

Investments in Unconsolidated Entities	3 Months Ended
	Mar. 31, 2017
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) March 31, 2017 December 31, 2016 Triple-net 10% to 49% $ 23,108 $ 27,005 Seniors housing operating 10% to 50% 360,260 407,172 Outpatient medical 43% 32,742 22,961 Total $ 416,110 $ 457,138 (1) Excludes ownership of in-substance real estate. At March 31, 2017 , the aggregate unamortized basis difference of our joint venture investments of $211,268,000 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 is being amortized over the remaining useful life of the related properties and included in the reported amount of income from unconsolidated entities.

Credit Concentration

Credit Concentration	3 Months Ended
	Mar. 31, 2017
Customer Concentration [Abstract]
Credit Concentration	8 . Credit Concentration We use net operating income from continuing operations (“NOICO”) as our credit concentration metric. See Note 17 for additional information and reconciliation. The following table summarizes certain information about our credit concentration for the three months ended March 31, 2017 , excluding our share of NOICO in unconsolidated entities (dollars in thousands): Number of Total Percent of Concentration by relationship: (1) Properties NOICO NOICO (2) Genesis Healthcare 86 $ 49,048 9% Sunrise Senior Living (3) 153 74,893 14% Brookdale Senior Living 137 38,372 7% Revera (3) 98 37,802 7% Benchmark Senior Living 48 22,614 4% Remaining portfolio 755 329,400 59% Totals 1,277 $ 552,129 100% (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) NOICO with our top five relationships comprised 45% of total NOICO for the year ending December 31, 2016. (3) Revera owns a controlling interest in Sunrise Senior Living.

Borrowings Under Credit Facilit

Borrowings Under Credit Facilities and Related Items	3 Months Ended
	Mar. 31, 2017
Borrowings Under Credit Facilities and Related Items [Abstract]
Borrowings Under Credit Facilities and Related Items	9 . Borrowings Under Credit Facilities and Related Items At March 31, 2017 , 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 March 31, 2017 ). Borrowings under the unsecured revolving credit facility are subject to interest payable at the applicable margin over LIBOR interest rate ( 1.88% at March 31, 2017 ). The applicable margin is based on certai n of our debt ratings and was 0.90% at March 31, 2017 . In addition, we pay a facility fee quarterly to each bank based on the bank’s commitment amount. The facility fee depends on certain of our debt ratings and was 0.15% at March 31, 2017 . 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 March 31, 2017 2016 Balance outstanding at quarter end (1) $ 522,000 $ 645,000 Maximum amount outstanding at any month end $ 1,010,000 $ 945,000 Average amount outstanding (total of daily principal balances divided by days in period) $ 796,356 $ 671,044 Weighted average interest rate (actual interest expense divided by average borrowings outstanding) 1.81% 1.29% (1) As of March 31, 2017, letters of credit in the aggregate amount of $32,456,000 have been issued, which reduces the borrowing capacity on the unsecured revolving credit facility.

Senior Unsecured Notes and Secu

Senior Unsecured Notes and Secured Debt	3 Months Ended
	Mar. 31, 2017
Senior Unsecured Notes and Secured Debt [Abstract]
Senior Unsecured Notes and Secured Debt	10 . Senior Unsecured Notes and Secured Debt We may repurchase, redeem or refinance senior unsecured notes from time to time, taking advantage of favorable market conditions when available. We may purchase senior notes for cash through open market purchases, privately negotiated transactions, a tender offer or, in some cases, through the early redemption of such securities pursuant to their terms. The senior unsecured notes are redeemable at our option, at any time in whole or from time to time in part , at a redemption price equal to the sum of (1) the principal amount of the notes (or portion of such notes) being redeemed plus accrued and unpaid interest thereon up to the redemption date and (2) any “make-whole” amount due under the terms of the notes in connection with early redemptions. Redemptions and repurchases of debt, if any, will depend on prevailing market conditions, our liquidity requirements, contractual restrictions and other factors. At March 31, 2017 , 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 2017 $ - $ 284,879 $ 284,879 2018 450,000 421,751 871,751 2019 605,000 499,895 1,104,895 2020 (4) 675,208 149,888 825,096 2021 (5,6) 1,137,674 228,993 1,366,667 Thereafter (7,8,9,10) 5,416,385 1,080,071 6,496,456 Totals $ 8,284,267 $ 2,665,477 $ 10,949,744 (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 1.6% to 6.5%. (3) Annual interest rates range from 1.32% to 7.93%. Carrying value of the properties securing the debt totaled $4,947,646,000 at March 31, 2017. (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 $225,208,000 based on the Canadian/U.S. Dollar exchange rate on March 31, 2017). (5) On May 13, 2016, we refinanced the funding on a $250,000,000 Canadian-denominated unsecured term credit facility (approximately $187,674,000 based on the Canadian/U.S. Dollar exchange rate on March 31, 2017). The loan matures on May 13, 2021 and bears interest at the Canadian Dealer Offered Rate plus 95 basis points (1.84% at March 31, 2017). (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 (1.83% at March 31, 2017). (7) On November 20, 2013, we completed the sale of £ 550,000,000 (approximately $689,535,000 based on the Sterling/U.S. Dollar exchange rate in effect on March 31, 2017) of 4.8% senior unsecured notes due 2028. (8) On November 25, 2014, we completed the sale of £ 500,000,000 (approximately $626,850,000 based on the Sterling/U.S. Dollar exchange rate in effect on March 31, 2017) of 4.5% senior unsecured notes due 2034. (9) In May 2015, we issued $750,000,000 of 4.0% senior unsecured notes due 2025. In October 2015, we issued an additional $500,000,000 of these notes under a re-opening of the offer. (10) In March 2016, we issued $700,000,000 of 4.25% senior unsecured notes due 2026. The following is a summary of our senior unsecured notes principal activity during the periods presented (dollars in thousands) : Three Months Ended March 31, 2017 March 31, 2016 Weighted Avg. Weighted Avg. Amount Interest Rate Amount Interest Rate Beginning balance $ 8,260,038 4.245% $ 8,645,758 4.237% Debt issued - 0.000% 700,000 4.250% Debt extinguished - 0.000% (400,000) 3.625% Foreign currency 24,229 4.391% (11,665) 3.943% Ending balance $ 8,284,267 4.262% $ 8,934,093 4.266% The following is a summary of our secured debt principal activity for the periods presented (dollars in thousands): Three Months Ended March 31, 2017 March 31, 2016 Weighted Avg. Weighted Avg. Amount Interest Rate Amount Interest Rate Beginning balance $ 3,465,066 4.094% $ 3,478,207 4.440% Debt issued 12,536 2.340% 75,136 3.060% Debt extinguished (806,189) 5.580% (111,701) 4.450% Principal payments (16,249) 4.469% (18,642) 4.539% Foreign currency 10,313 3.262% 65,488 3.669% Ending balance $ 2,665,477 3.744% $ 3,488,488 4.400% Our debt agreements contain various covenants, restrictions and events of default. Certain agreements require us to maintain certain financial ratios and minimum net worth and impose certain limits on our ability to incur indebtedness, create liens and make investments or acquisitions. As of March 31, 2017 , we were in compliance with all of the cove nants under our debt agreements.

Derivative Instruments

Derivative Instruments	3 Months Ended
	Mar. 31, 2017
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 $3,395,000 of gains , which are included in accumulated other comprehensive income (“AOCI”), are expected to be reclassified into earnings in the next 12 months. Foreign Currency Hedges For instruments that are designated and qualify as net investment hedges, the variability in the foreign currency to U.S. Dollar of the instrument is recorded as a cumulative translation adjustment component of OCI. During the three months ended March 31, 2017 and 2016 , we settled certain net investment hedges generating cash proceeds of $8,218,000 and $ 0, respectively . The balance of the cumulative translation adjustment will be reclassified to earnings when the hedged investment is sold or substantially liquidated. The fol lowing presents the notional amount of derivatives and other financial instruments as of the dates indicated (in thousands): March 31, 2017 December 31, 2016 Derivatives designated as net investment hedges: Denominated in Canadian Dollars $ 875,000 $ 900,000 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 Denominated in Canadian Dollars $ 72,000 $ 54,000 Denominated in Pounds Sterling £ 69,000 £ 48,000 Derivative instruments not designated: Denominated in Canadian Dollars $ 37,000 $ 37,000 The following presents the impact of derivative instruments on the Consolidated S tatement s of C omprehensive I ncome for the periods presented (in thousands) : Three Months Ended March 31, Location 2017 2016 Gain (loss) on interest rate swaps reclassified from AOCI into income (effective portion) Interest expense $ - $ (483) Gain (loss) on forward exchange contracts recognized in income Interest expense 2,457 (1,327) Gain (loss) on foreign exchange contracts and term loans designated as net investment hedge recognized in OCI OCI (44,341) (2,739)

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2017
Commitments and Contingencies [Abstract]
Commitments and Contingencies	12 . Commitments and Contingencies At March 31, 2017 , we had 14 outstanding letter of credit obligations totaling $169,961,000 and e xpiring between 2017 and 2024 . At March 31, 2017 , we had outstanding construction in progress of $ 390,180,000 and were committed to providing additional funds of approximately $ 466,031,000 to complete construction. At March 31, 2017 , we had contingent purchase obligations totaling $ 17,058,000 . These contingent purchase obligations relate to unfunded capital improvement obligation s 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 lea se treatment in accordance with ASC Topic 840 “Leases.” A lease is classified as a capital lease if it provides for transfer of ownership of the leased asset at the end of the lease term, contains a bargain purchase option, has a lease term greater than 75% of the economic life of the leased asset, o r if the net present value of the future minimum lease payments are in excess of 90% of the fair value of the leased asset. Certain leases contain bargain purchase options and have been classified as capital leases. At March 31, 2017 , we had operating lease obl igations of $ 1,092,169,000 relating to certain ground leases and c ompany office space and capital lease obligations of $ 93,697,000 rel ating primarily to certain investment properties. Regarding ground leases, we have sublease agreements with certain of our oper ators that require the operators to reimburse us for our monthly operating lease obligations. At March 31, 2017 , aggregate future minimum rentals to be received under these noncancelable subleases totaled $ 73,840,000 .

Stockholders' Equity

Stockholders' Equity	3 Months Ended
	Mar. 31, 2017
Stockholders' Equity [Abstract]
Stockholders' Equity	13 . Stockholders’ Equity The following is a summary of our stockholders’ equity capital accounts as of the dates indicated: March 31, 2017 December 31, 2016 Preferred Stock: Authorized shares 50,000,000 50,000,000 Issued shares 14,375,000 25,875,000 Outstanding shares 14,375,000 25,875,000 Common Stock, $1.00 par value: Authorized shares 700,000,000 700,000,000 Issued shares 365,651,576 363,576,924 Outstanding shares 364,563,653 362,602,173 Preferred Stock. The following is a summary of our preferred stock activity during the periods indicated : Three Months Ended March 31, 2017 March 31, 2016 Weighted Avg. Weighted Avg. Shares Dividend Rate Shares Dividend Rate Beginning balance 25,875,000 6.500% 25,875,000 6.500% Shares redeemed (11,500,000) 6.500% - 0.000% Ending balance 14,375,000 6.500% 25,875,000 6.500% During the three months ended March 31, 2017, we recognized a charge of $ 9,769 ,000 in connection with the redemption of the Series J preferred stock. Common Stock. The following is a summary of our common stock issuances during the three months ended March 31, 2017 and 2016 (dollars in thousands, except per share amounts): Shares Issued Average Price Gross Proceeds Net Proceeds 2016 Dividend reinvestment plan issuances 1,058,085 $ 60.00 $ 63,484 $ 63,484 2016 Option exercises 9,864 21.29 210 210 2016 Equity shelf program issuances 443,096 67.12 30,192 29,739 2016 Stock incentive plans, net of forfeitures 484,005 - - 2016 Totals 1,995,050 $ 93,886 $ 93,433 2017 Dividend reinvestment plan issuances 1,284,719 $ 68.33 $ 87,985 $ 87,784 2017 Option exercises 156,675 52.71 8,258 8,258 2017 Equity shelf program issuances 338,486 69.75 23,776 23,609 2017 Stock incentive plans, net of forfeitures 181,600 - - 2017 Totals 1,961,480 $ 120,019 $ 119,651 Dividends . The increase in dividends is primarily attributable to increases in our common shares outstanding as described above and an increase in common dividends per share. The following is a summary of our dividend payments (in thousands, except per share amounts): Three Months Ended March 31, 2017 March 31, 2016 Per Share Amount Per Share Amount Common Stock $ 0.8700 $ 315,415 $ 0.8600 $ 305,770 Series I Preferred Stock 0.8125 11,680 0.8125 11,680 Series J Preferred Stock 0.2347 2,699 0.4064 4,672 Totals $ 329,794 $ 322,122 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, 2016 $ (173,496) $ 5,120 $ (1,153) $ (2) $ (169,531) Other comprehensive income before reclassification adjustments 2,900 (10,569) - - (7,669) Net current-period other comprehensive income 2,900 (10,569) - - (7,669) Balance at March 31, 2017 $ (170,596) $ (5,449) $ (1,153) $ (2) $ (177,200) Balance at December 31, 2015 $ (85,484) $ - $ (1,343) $ (1,416) $ (88,243) Other comprehensive income before reclassification adjustments (13,746) (7,549) 2 - (21,293) Reclassification amount to net income - - - 483 (1) 483 Net current-period other comprehensive income (13,746) (7,549) 2 483 (20,810) Balance at March 31, 2016 $ (99,230) $ (7,549) $ (1,341) $ (933) $ (109,053) (1) Please see Note 11 for additional information.

Stock Incentive Plans

Stock Incentive Plans	3 Months Ended
	Mar. 31, 2017
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 $4,906 ,000 for the three months ended March 31, 2017 and $ 8,186,000 for the same period in 2016 .

Earnings Per Share

Earnings Per Share	3 Months Ended
	Mar. 31, 2017
Earnings Per Share [Abstract]
Earnings Per Share	15 . Earnings Per Share The following table sets forth the computation of basic and diluted earnings per share (in thousands, except per share data): Three Months Ended March 31, 2017 2016 Numerator for basic and diluted earnings per share - net income (loss) attributable to common stockholders $ 312,639 $ 148,969 Denominator for basic earnings per share - weighted average shares 362,534 355,076 Effect of dilutive securities: Employee stock options 70 101 Non-vested restricted shares 397 253 Redeemable shares 1,651 621 Dilutive potential common shares 2,118 975 Denominator for diluted earnings per share - adjusted weighted average shares 364,652 356,051 Basic earnings per share $ 0.86 $ 0.42 Diluted earnings per share $ 0.86 $ 0.42 The Series I Cumulative Convertible Perpetual Preferre d Stock was not included in the calculations as the effect of conversions into common stock was anti-dilutive.

Disclosure about Fair Value of

Disclosure about Fair Value of Financial Instruments	3 Months Ended
	Mar. 31, 2017
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 price) 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 establi shes a fair value hierarchy which requires an entity to maximize the use of observable inputs and minimize the use of unobservable inp uts when measuring fair value. Please see Note 2 to the financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2016 for additional information. The guidance describes three levels of inputs that may be used to measure fair value: Lev el 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 a re observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. 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 similar credit ratings and for the same remaining maturities. Cash and Cash Equivalents — The carrying amount approximates fair value. Available-for-sale Equity Investments — Available-for-sale equity investments are recorded at their fair value based on Level 1 publicly available trading prices. Borrowings Under Primary Unsecured Credit Facility — The c arrying amount of the primary unsecured credit facility approximates fair value because the borrowings are interest rate adjustable. Senior Unsecured Notes — The fair value of the senior unsecured notes payable was estimated based on Level 1 publicly avai lable trading prices. The carrying amount of the variable rate senior unsecured notes approximates fair value because they are interest rate adjustable. Secured Debt — The fair value of fixed rate secured deb t 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 maturities. The car rying amount of variable rate secured debt approximates fair value because the borrowings are interest rate adjustable. Foreign Currency Forward Contracts — Foreign currency forward contracts are recorded in other assets or other liabilities on the balanc e sheet at fair market value. Fair market value is determined using Level 2 inputs by estimating the future value of the currency pair based on existing exchange rates, comprised of current spot and traded forward points, and calculating a present value o f the net amount using a discount factor based on observable traded interest rates. Redeemable OP Unitholder Interests — 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 cash or, at our option, one share of our common stock per unit, subject to adjustment in certain circumstances. The carrying amounts and estimated fair values of our financial instruments are as follows (in thousands): March 31, 2017 December 31, 2016 Carrying Amount Fair Value Carrying Amount Fair Value Financial assets: Mortgage loans receivable $ 430,607 $ 465,548 $ 485,735 $ 521,773 Other real estate loans receivable 143,473 149,151 136,893 138,050 Available-for-sale equity investments 17,330 17,330 27,899 27,899 Cash and cash equivalents 380,360 380,360 419,378 419,378 Foreign currency forward contracts 110,439 110,439 135,561 135,561 Financial liabilities: Borrowings under unsecured credit facilities $ 522,000 $ 522,000 $ 645,000 $ 645,000 Senior unsecured notes 8,188,928 8,965,318 8,161,619 8,879,176 Secured debt 2,669,787 2,728,171 3,477,699 3,558,378 Foreign currency forward contracts 9,840 9,840 4,342 4,342 Redeemable OP unitholder interests $ 116,917 $ 116,917 $ 110,502 $ 110,502 Items Measured at Fair Value on a Recurring Basis The market approach is utilized to measure fair value for our financial assets and liabilities reported at fair value on a recurring basis. The market approach uses prices and other relevant information generated by market transactions involving identical or comparable assets or liabilities. The following summarizes items measured at fair value on a recurring basis (in thousands): Fair Value Measurements as of March 31, 2017 Total Level 1 Level 2 Level 3 Available-for-sale equity investments (1) $ 17,330 $ 17,330 $ - $ - Foreign currency forward contracts, net (2) 100,599 - 100,599 - Redeemable OP unitholder interests 116,917 - 116,917 - Totals $ 234,846 $ 17,330 $ 217,516 $ - (1) Unrealized gains or losses on equity investments are recorded in accumulated other comprehensive income (loss) at each measurement date. (2) Please see Note 11 for additional information. Items Measured at Fair Value on a Nonrecurring Basis In addition to items that are measured at fair value on a recurring basis, we also have assets and liabilities in our balance sheet that are measured at fair value on a nonrecurring basis. As these assets and liabilities are not measured at fair value on a recurring basis, they are not included in the tables above. Assets, liabilities and noncontrolling interests that are measured at fair value on a nonrecurring basis include those acquired/assumed. Asset impairments (if applicable, see Note 5 for impairments of real property and Note 6 for impairments of loans receivable) are also measured at fair value on a nonrecurring basis . 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 cons ider 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 expectations or, in the absence of such price expectations, Level 3 inputs described above. We estimate t he fair value of secured debt assumed in business combinations using current interest rates at which similar borrowings could be obtained on the transaction date .

Segment Reporting

Segment Reporting	3 Months Ended
	Mar. 31, 2017
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 December 31, 2016, we reclassified interest expense on our foreign-denominated senior notes from the seniors housing operating segment to non-segment . Accordingly, the segmen t information provided in this N ote has been reclassified to c onform to the current presentation for all periods presented. Our triple-net properties include long-term/post-acute care facilities, assisted living facilities, independent living/continuing care retirement communities, care homes (United Kingdom), independent support living facilities (Canada), care homes with nursing (United Kingdom) and combinations thereof. Under the triple-net segment, we invest in seniors housing and health care real estate through acquisition and financing of primarily single tenant properties. Properties acquired are primarily leased und er triple-net leases and we are not involved in the management of the property. Our seniors housing operating properties include the seniors housing communities referenced above that are owned and/or operated through RIDEA structures (see Notes 3 and 18). Our outpatient medical properties are typically leased to multiple tenants and generally require a certai n level of property management. We evaluate performan ce based upon net operating income from continuing operations (“ NOI CO”) of each segment . We d efine NOI CO as total revenues, including tenant reimbursements, less pr operty operating expenses . We believe NOI CO provides investors relevant and useful information as it measures the operating performance of our properties at the property level on an unl everaged basis. We use NOI CO 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 certain non-real estate investments and other income. Non-segment assets consist of corporate assets including cash, deferred loan expenses and corporate offices and equipment among others. Non-property specific revenues and expenses are not allocated to individual segments in determining NOI CO . The accountin g 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, 2016 ). The results of operati ons for all acquisitions described in Note 3 are included in our consolidated results of operations from the acquisition dates and are components of the appropriate segments. There are no intersegment sales or transfers. Summary information for the report able segments (which excludes unconsolidated entities) is as follows (in thousands): Three Months Ended March 31, 2017: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 227,290 $ - $ 139,851 $ - $ 367,141 Resident fees and services - 670,337 - - 670,337 Interest income 20,679 69 - - 20,748 Other income 1,766 1,461 612 233 4,072 Total revenues 249,735 671,867 140,463 233 1,062,298 Property operating expenses - 462,425 47,744 - 510,169 Net operating income from continuing operations 249,735 209,442 92,719 233 552,129 Interest expense 5,511 15,816 2,291 94,979 118,597 Loss (gain) on derivatives, net 1,224 - - - 1,224 Depreciation and amortization 59,608 119,737 48,931 - 228,276 General and administrative - - - 31,101 31,101 Loss (gain) on extinguishment of debt, net 29,084 890 1,382 - 31,356 Impairment of assets - 5,406 5,625 - 11,031 Other expenses 5,010 1,778 360 4,527 11,675 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 149,298 65,815 34,130 (130,374) 118,869 Income tax (expense) benefit (800) (1,087) (335) (23) (2,245) Income (loss) from unconsolidated entities 5,638 (29,191) (1) 447 - (23,106) Income (loss) from continuing operations 154,136 35,537 34,242 (130,397) 93,518 Gain (loss) on real estate dispositions, net 231,081 13,011 - - 244,092 Net income (loss) $ 385,217 $ 48,548 $ 34,242 $ (130,397) $ 337,610 Total assets $ 9,906,585 $ 12,646,321 $ 4,947,544 $ 266,827 $ 27,767,277 (1) Primarily due to the recognition of goodwill and intangible asset impairments, as well as non-recurring income tax expense. Three Months Ended March 31, 2016: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 283,825 $ - $ 131,838 $ - $ 415,663 Resident fees and services - 602,149 - - 602,149 Interest income 22,853 1,031 1,304 - 25,188 Other income 1,490 2,189 313 58 4,050 Total revenues 308,168 605,369 133,455 58 1,047,050 Property operating expenses - 408,894 40,742 - 449,636 Net operating income from continuing operations 308,168 196,475 92,713 58 597,414 Interest expense 6,364 20,523 5,744 100,329 132,960 Depreciation and amortization 79,800 101,832 47,064 - 228,696 General and administrative - - - 45,691 45,691 Transaction costs 2,852 3,933 1,423 - 8,208 Loss (gain) on extinguishment of debt, net (24) - - - (24) Impairment of assets 14,314 - - - 14,314 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 204,862 70,187 38,482 (145,962) 167,569 Income tax (expense) benefit (317) 2,767 (228) (497) 1,725 Income (loss) from unconsolidated entities 3,081 (6,935) 34 - (3,820) Income (loss) from continuing operations 207,626 66,019 38,288 (146,459) 165,474 Net income (loss) $ 207,626 $ 66,019 $ 38,288 $ (146,459) $ 165,474 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 the periods presented (dollars in thousands): Three Months Ended March 31, 2017 March 31, 2016 Revenues: Amount % Amount % United States $ 858,668 80.9% $ 842,357 80.5% United Kingdom 93,843 8.8% 100,555 9.6% Canada 109,787 10.3% 104,138 9.9% Total $ 1,062,298 100.0% $ 1,047,050 100.0% As of March 31, 2017 December 31, 2016 Assets: Amount % Amount % United States $ 22,425,964 80.8% $ 23,572,459 81.7% United Kingdom 2,835,782 10.2% 2,782,489 9.6% Canada 2,505,531 9.0% 2,510,236 8.7% Total $ 27,767,277 100.0% $ 28,865,184 100.0%

Income Taxes and Distributions

Income Taxes and Distributions	3 Months Ended
	Mar. 31, 2017
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 taxes for the three months ended March 31, 2017 and 2016, was primarily due to operating income or losses, offset by certain discrete items at our TRS entities. In 2014 , we established certain wholly-owned dir ect and indirect subsidiaries in Luxembourg and Jersey and transferred interests in certain foreign investments into this holding company structure. The structure includes a property holding company that is tax resident in the United Kingdom. No material adverse curr ent 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. feder al 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 limitati ons, we are subject to audit by the Internal Revenue Service (“IRS”) for the year ended December 31, 2013 and subsequent years and by state taxing authorities for the year ended December 31, 201 2 and subsequent years. The company and its subsidiaries 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	3 Months Ended
	Mar. 31, 2017
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): March 31, 2017 December 31, 2016 Assets Net real property owned $ 980,570 $ 989,596 Cash and cash equivalents 7,390 10,501 Receivables and other assets 16,530 12,102 Total assets (1) $ 1,004,490 $ 1,012,199 Liabilities and equity Secured debt $ 449,163 $ 450,255 Accrued expenses and other liabilities 13,880 13,803 Redeemable noncontrolling interests 72,957 185,556 Total equity 468,490 362,585 Total liabilities and equity $ 1,004,490 $ 1,012,199 (1) Note that assets of the consolidated variable interest entities can only be used to settle obligations relating to such variable interest entities. Liabilities of the consolidated variable interest entities represent claims against the specific assets of the variable interest entities.

Accounting Policies and Relat26

Accounting Policies and Related Matters (Policies)	3 Months Ended
	Mar. 31, 2017
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. Operating results for the three months ended March 31, 2017 are not necessarily an indication of the results that may be expected for the year ending December 31, 2017 . For further information, refer to the financial statements and notes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2016 .
New Accounting Standards	New Accounting Standards In May 2014, the Financial Accounting Standards Board (the “ FASB ”) issued ASU No. 2014-09, “Revenue from Contracts with Customers (Topic 606)”. The standard is a comprehensive new revenue recognition model that requires revenue to be recognized in a manner to depict the transfer of goods or services to a customer at an a mount that reflects the consideration expected to be received in exchange for those goods or services. ASU 2014-09 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2017, and early adoption is permitted be ginning after December 15, 2016. A reporting entity may apply the new standard using either a modified retrospective approach by recording a cumulative-effect adjustment to equity as of the beginning of the fiscal year of adoption or a full retrospective approach . We are currently evaluating the impact that the adoption of the standard will have on our consolidated financial statements and have not yet determined the method by which we will adopt the new standard. A significant source of our revenue is g enerated through leasing arrangements, which are specifically excluded from the new standard. We expect that the new standard will affect our accounting policies related to non-lease revenue, including certain fees in our RIDEA joint ventures, common area maintenance in our outpatient medical properties and real estate sales. Under ASU 2014-09, revenue recognition for real estate sales is mainly based on the transfer of control versus current guidance of continuing involvement. We expect that the new gui dance will result in more transactions qualifying as sales of real estate and being recognized at an earlier date than under the current guidance. In January 2016, the FASB issued ASU No. 2016-01, “Financial Instruments – Overall: Recognition and Meas urement of Financial Assets and Financial Liabilities,” which will require entities to measure their investments at fair value and recognize any changes in fair value in net income unless the investments qualify for the new practicability exception. The p racticability 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 evalu ating 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 t o the rights and obligations created by most leases, while continuing to recognize expenses on their income statements over the lease term. It will also require disclosures designed to give financial statement users information regarding amount, timing, a nd uncertainty of cash flows arising from leases. ASU 2016-02 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2018, and early adoption is permitted. Entities are required to use a modified retrospective approach for leases that exist or are entered into after the beginning of the earliest comparative period in the financial statements. We are currently evaluating the impact of this standard on our consolidated financial statements. We believe that the adoption of this standard will likely have a material impact to our consolidated balance sheet for the recognition of certain operating leases as right-of-use assets and lease liabilities. We are in the process of analyzing our lease portfolio and evaluat ing systems to comply with the standard’s retrospective adoption requirements . In March 2016, the FASB issued ASU No. 2016-09, “Improvements to Employee Share-Based Payment Accounting”. ASU 2016-09 is effective for fiscal years, and interim periods w ithin those years, beginning after December 15, 2016, and early adoption is permitted. We adopted ASU 2016-09 on January 1, 2017. The standard allows companies to make a policy election as to whether they will include an estimate of awards expected to be forfeited or whether they will account for forfeitures as they occur. We have elected to account for forfeitures as they occur. This election had an immaterial impact on our consolidated financial statements. The standard also requires an employer to cl assify as a financing activity in the statement of cash flow the cash paid to a tax authority when shares are withheld to satisfy the employer’s statutory income tax withholding obligation. This standard is required to be applied on a retrospective basis and resulted in an increase in net cash provided by operating activities and a decrease in net cash used in financing activities of $6,897,000 for the three months ended March 31, 2016. Upon adoption, no other provisions of ASU 2016-09 had an effect on ou r unaudited consolidated financial statements or related footnote disclosures. 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 a doption is permitted for fiscal years beginning after December 15, 2018. We are currently evaluating the impact that the standard will have on our consolidated financial statements . In January 2017, the FASB issued ASU No. 2017-01, “Clarifying the De finition of a Business”. This standard changes the definition of a business to assist entities with evaluating when a set of transferred assets and activities is a business. ASU 2017-01 is effective for fiscal years, and interim periods within those year s, beginning after December 15, 2017, and early adoption is permitted. A reporting entity must apply ASU 2017-01 using a prospective approach. We adopted ASU 2017-01 on January 1, 2017 and as a result, have classified our real estate acquisitions complet ed during the three months ended March 31, 2017 as asset acquisitions rather than business combinations due to the fact that substantially all of the fair value of the gross assets acquired were concentrated in a single asset or group of similar identifiab le assets . We have recorded identifiable assets acquired, liabilities assumed and any noncontrolling interests associated with any asset acquisitions at cost on a relative fair value basis and have capitalized transaction costs incurred.

Real Property Acquisitions an27

Real Property Acquisitions and Development (Tables)	3 Months Ended
	Mar. 31, 2017
Real property acquisitions and development [Line Items]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities	Triple-n et Activity Three Months Ended (In thousands) March 31, 2017 March 31, 2016 Land and land improvements $ 4,017 $ 15,331 Buildings and improvements 37,241 114,235 Acquired lease intangibles - 1,623 Total assets acquired 41,258 131,189 Accrued expenses and other liabilities - (809) Total liabilities assumed - (809) Non-cash acquisition related activity (1) - (28,621) Cash disbursed for acquisitions 41,258 101,759 Construction in progress additions 46,754 43,835 Less: Capitalized interest (2,028) (1,684) Foreign currency translation (164) (583) Cash disbursed for construction in progress 44,562 41,568 Capital improvements to existing properties 10,495 7,438 Total cash invested in real property, net of cash acquired $ 96,315 $ 150,765 (1) Includes $25,691,000 related to the acquisition of assets previously financed as real estate loans receivable and $2,871,000 related to the acquisition of assets previously financed as an investment in an unconsolidated entity. Seniors Housing Operating Activity Three Months Ended (In thousands) March 31, 2017 March 31, 2016 Land and land improvements $ 4,304 $ 3,440 Building and improvements 44,075 48,218 Acquired lease intangibles 1,741 1,942 Receivables and other assets 74 36 Total assets acquired (1) 50,194 53,636 Accrued expenses and other liabilities (2,755) (11) Total liabilities assumed (2,755) (11) Noncontrolling interests (647) (549) Non-cash acquisition related activity (2) (14,148) - Cash disbursed for acquisitions 32,644 53,076 Construction in progress additions 8,062 4,033 Less: Capitalized interest (1,707) (565) Foreign currency translation 691 (1,107) Cash disbursed for construction in progress 7,046 2,361 Capital improvements to existing properties 24,254 16,808 Total cash invested in real property, net of cash acquired $ 63,944 $ 72,245 (1) Excludes $400,000 and $113,000 of cash acquired during the three months ended March 31, 2017 and 2016, respectively. (2) Includes $6,349,000 related to the acquisition of assets previously financed as real estate loans receivable and $7,799,000 previously financed as an investment in an unconsolidated entity. Outpatient Medical Activity Three Months Ended (In thousands) March 31, 2017 March 31, 2016 Land and land improvements $ 2,895 $ - Buildings and improvements 23,310 17,637 Acquired lease intangibles 3,496 - Receivables and other assets 3 - Total assets acquired 29,704 17,637 Accrued expenses and other liabilities (1,250) (990) Total liabilities assumed (1,250) (990) Cash disbursed for acquisitions 28,454 16,647 Construction in progress additions 14,921 28,934 Less: Capitalized interest (717) (788) Accruals (1) 3,522 (5,336) Cash disbursed for construction in progress 17,726 22,810 Capital improvements to existing properties 7,366 10,779 Total cash invested in real property $ 53,546 $ 50,236 (1) Represents the change in non-cash consideration accruals for amounts to be paid in periods other than the period in which the construction projects converted to operations.
Summary of construction projects placed into service and generating revenues	Three Months Ended March 31, 2017 March 31, 2016 Development projects: Triple-net $ 157,460 $ - Seniors housing operating 3,634 - Outpatient medical 25,910 35,363 Total development projects 187,004 35,363 Total construction in progress conversions $ 187,004 $ 35,363

Real Estate Intangibles (Tables

Real Estate Intangibles (Tables)	3 Months Ended
	Mar. 31, 2017
Real Estate Intangibles (Tables) [Abstract]
Summary of real estate intangibles excluding those classified as held for sale	March 31, 2017 December 31, 2016 Assets: In place lease intangibles $ 1,267,280 $ 1,252,143 Above market tenant leases 63,184 61,700 Below market ground leases 62,224 61,628 Lease commissions 28,589 27,413 Gross historical cost 1,421,277 1,402,884 Accumulated amortization (1,010,364) (966,714) Net book value $ 410,913 $ 436,170 Weighted-average amortization period in years 14.4 13.7 Liabilities: Below market tenant leases $ 90,745 $ 89,468 Above market ground leases 8,107 8,107 Gross historical cost 98,852 97,575 Accumulated amortization (54,354) (52,134) Net book value $ 44,498 $ 45,441 Weighted-average amortization period in years 15.1 15.2
Schedule of Real Estate Intangible Amortization	Three Months Ended March 31, 2017 2016 Rental income related to above/below market tenant leases, net $ 304 $ 81 Property operating expenses related to above/below market ground leases, net (312) (311) Depreciation and amortization related to in place lease intangibles and lease commissions (39,302) (34,454)
Schedule of the future estimated aggregate amortization of intangible assets and liabilities	Assets Liabilities 2017 $ 105,454 $ 4,959 2018 77,561 6,106 2019 37,948 5,685 2020 24,169 5,208 2021 20,191 4,720 Thereafter 145,590 17,820 Total $ 410,913 $ 44,498

Dispositions, Assets Held for29

Dispositions, Assets Held for Sale and Discontinued Operations (Tables)	3 Months Ended
	Mar. 31, 2017
Dispositions, Assets Held for Sale and Discontinued Operations (Tables) [Abstract]
Summary of real property disposition activity	Three Months Ended March 31, 2017 March 31, 2016 Real estate dispositions: Triple-net $ 808,204 $ - Seniors housing operating 13,845 - Total dispositions 822,049 - Gain (loss) on real estate dispositions, net 244,092 - Net other assets/liabilities disposed 20,933 - Proceeds from real estate dispositions $ 1,087,074 $ -
Summary of disposed properties.	Three Months Ended March 31, 2017 2016 Revenues: Rental income $ 16,734 $ 5,477 Expenses: Interest expense 1,301 851 Property operating expenses 1,855 1,362 Provision for depreciation 245 820 Total expenses 3,401 3,033 Income (loss) from real estate dispositions, net $ 13,333 $ 2,444

Real Estate Loans Receivable (T

Real Estate Loans Receivable (Tables)	3 Months Ended
	Mar. 31, 2017
Real Estate Loans Receivable (Tables) [Abstract]
Summary of real estate loan activity	Three Months Ended March 31, 2017 March 31, 2016 Outpatient Outpatient Triple-net Medical Totals Triple-net Medical Totals Advances on real estate loans receivable: Investments in new loans $ 7,828 $ - $ 7,828 $ 8,013 $ - $ 8,013 Draws on existing loans 17,547 - 17,547 19,206 32 19,238 Net cash advances on real estate loans 25,375 - 25,375 27,219 32 27,251 Receipts on real estate loans receivable: Loan payoffs 14,474 60,500 74,974 104,068 12,290 116,358 Principal payments on loans 667 - 667 3,107 - 3,107 Sub-total 15,141 60,500 75,641 107,175 12,290 119,465 Less: Non-cash activity (1)(2) (6,349) (60,500) (66,849) (25,691) - (25,691) Net cash receipts on real estate loans 8,792 - 8,792 81,484 12,290 93,774 Net cash advances (receipts) on real estate loans 16,583 - 16,583 (54,265) (12,258) (66,523) Change in balance due to foreign currency translation 1,718 - 1,718 (1,987) - (1,987) Net change in real estate loans receivable $ 11,952 $ (60,500) $ (48,548) $ (81,943) $ (12,258) $ (94,201) (1) Triple-net represents acquisitions of assets previously financed as real estate loans. Please see Note 3 for additional information. (2) Outpatient medical represents a deed in lieu of foreclosure on a previously financed first mortgage property. Three Months Ended March 31, 2017 March 31, 2016 Balance of impaired loans at end of period $ 317,049 $ - Allowance for loan losses 6,196 - Balance of impaired loans not reserved $ 310,853 $ - Average impaired loans for the period $ 340,920 $ - Interest recognized on impaired loans (1) 8,243 - (1) Represents interest recognized in period since loans were identified as impaired.

Investments in Unconsolidated31

Investments in Unconsolidated Entities (Tables)	3 Months Ended
	Mar. 31, 2017
Investments In Unconsolidated Entities [Abstract]
Summary Of Investments In Unconsolidated Entities [Text Block]	Percentage Ownership (1) March 31, 2017 December 31, 2016 Triple-net 10% to 49% $ 23,108 $ 27,005 Seniors housing operating 10% to 50% 360,260 407,172 Outpatient medical 43% 32,742 22,961 Total $ 416,110 $ 457,138 (1) Excludes ownership of in-substance real estate.

Credit Concentration (Tables)

Credit Concentration (Tables)	3 Months Ended
	Mar. 31, 2017
Customer Concentration (Tables) [Abstract]
Summary of credit concentration	Number of Total Percent of Concentration by relationship: (1) Properties NOICO NOICO (2) Genesis Healthcare 86 $ 49,048 9% Sunrise Senior Living (3) 153 74,893 14% Brookdale Senior Living 137 38,372 7% Revera (3) 98 37,802 7% Benchmark Senior Living 48 22,614 4% Remaining portfolio 755 329,400 59% Totals 1,277 $ 552,129 100% (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) NOICO with our top five relationships comprised 45% of total NOICO for the year ending December 31, 2016. (3) Revera owns a controlling interest in Sunrise Senior Living.

Borrowings Under Credit Facil33

Borrowings Under Credit Facilities and Related Items (Tables)	3 Months Ended
	Mar. 31, 2017
Borrowings Under Credit Facilities and Related Items (Tables) [Abstract]
Aggregate borrowings under the unsecured line of credit arrangements	Three Months Ended March 31, 2017 2016 Balance outstanding at quarter end (1) $ 522,000 $ 645,000 Maximum amount outstanding at any month end $ 1,010,000 $ 945,000 Average amount outstanding (total of daily principal balances divided by days in period) $ 796,356 $ 671,044 Weighted average interest rate (actual interest expense divided by average borrowings outstanding) 1.81% 1.29% (1) As of March 31, 2017, letters of credit in the aggregate amount of $32,456,000 have been issued, which reduces the borrowing capacity on the unsecured revolving credit facility.

Senior Unsecured Notes and Se34

Senior Unsecured Notes and Secured Debt (Tables)	3 Months Ended
	Mar. 31, 2017
Senior Unsecured Notes And Secured Debt (Tables) [Abstract]
Principal payments due on debt obligations	Senior Secured Unsecured Notes (1,2) Debt (1,3) Totals 2017 $ - $ 284,879 $ 284,879 2018 450,000 421,751 871,751 2019 605,000 499,895 1,104,895 2020 (4) 675,208 149,888 825,096 2021 (5,6) 1,137,674 228,993 1,366,667 Thereafter (7,8,9,10) 5,416,385 1,080,071 6,496,456 Totals $ 8,284,267 $ 2,665,477 $ 10,949,744 (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 1.6% to 6.5%. (3) Annual interest rates range from 1.32% to 7.93%. Carrying value of the properties securing the debt totaled $4,947,646,000 at March 31, 2017. (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 $225,208,000 based on the Canadian/U.S. Dollar exchange rate on March 31, 2017). (5) On May 13, 2016, we refinanced the funding on a $250,000,000 Canadian-denominated unsecured term credit facility (approximately $187,674,000 based on the Canadian/U.S. Dollar exchange rate on March 31, 2017). The loan matures on May 13, 2021 and bears interest at the Canadian Dealer Offered Rate plus 95 basis points (1.84% at March 31, 2017). (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 (1.83% at March 31, 2017). (7) On November 20, 2013, we completed the sale of £ 550,000,000 (approximately $689,535,000 based on the Sterling/U.S. Dollar exchange rate in effect on March 31, 2017) of 4.8% senior unsecured notes due 2028. (8) On November 25, 2014, we completed the sale of £ 500,000,000 (approximately $626,850,000 based on the Sterling/U.S. Dollar exchange rate in effect on March 31, 2017) of 4.5% senior unsecured notes due 2034. (9) In May 2015, we issued $750,000,000 of 4.0% senior unsecured notes due 2025. In October 2015, we issued an additional $500,000,000 of these notes under a re-opening of the offer. (10) In March 2016, we issued $700,000,000 of 4.25% senior unsecured notes due 2026.
Summary of senior unsecured note activity	Three Months Ended March 31, 2017 March 31, 2016 Weighted Avg. Weighted Avg. Amount Interest Rate Amount Interest Rate Beginning balance $ 8,260,038 4.245% $ 8,645,758 4.237% Debt issued - 0.000% 700,000 4.250% Debt extinguished - 0.000% (400,000) 3.625% Foreign currency 24,229 4.391% (11,665) 3.943% Ending balance $ 8,284,267 4.262% $ 8,934,093 4.266%
Secured debt principal activity	Three Months Ended March 31, 2017 March 31, 2016 Weighted Avg. Weighted Avg. Amount Interest Rate Amount Interest Rate Beginning balance $ 3,465,066 4.094% $ 3,478,207 4.440% Debt issued 12,536 2.340% 75,136 3.060% Debt extinguished (806,189) 5.580% (111,701) 4.450% Principal payments (16,249) 4.469% (18,642) 4.539% Foreign currency 10,313 3.262% 65,488 3.669% Ending balance $ 2,665,477 3.744% $ 3,488,488 4.400%

Derivative Instruments (Tables)

Derivative Instruments (Tables)	3 Months Ended
	Mar. 31, 2017
Derivative Instruments (Tables) [Abstract]
Impact of derivative instruments on the statement of operations and OCI	March 31, 2017 December 31, 2016 Derivatives designated as net investment hedges: Denominated in Canadian Dollars $ 875,000 $ 900,000 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 Denominated in Canadian Dollars $ 72,000 $ 54,000 Denominated in Pounds Sterling £ 69,000 £ 48,000 Derivative instruments not designated: Denominated in Canadian Dollars $ 37,000 $ 37,000 Three Months Ended March 31, Location 2017 2016 Gain (loss) on interest rate swaps reclassified from AOCI into income (effective portion) Interest expense $ - $ (483) Gain (loss) on forward exchange contracts recognized in income Interest expense 2,457 (1,327) Gain (loss) on foreign exchange contracts and term loans designated as net investment hedge recognized in OCI OCI (44,341) (2,739)

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	3 Months Ended
	Mar. 31, 2017
Stockholders' Equity (Tables) [Abstract]
Summary of stockholder's equity capital accounts	March 31, 2017 December 31, 2016 Preferred Stock: Authorized shares 50,000,000 50,000,000 Issued shares 14,375,000 25,875,000 Outstanding shares 14,375,000 25,875,000 Common Stock, $1.00 par value: Authorized shares 700,000,000 700,000,000 Issued shares 365,651,576 363,576,924 Outstanding shares 364,563,653 362,602,173
Summary of preferred stock activity	Three Months Ended March 31, 2017 March 31, 2016 Weighted Avg. Weighted Avg. Shares Dividend Rate Shares Dividend Rate Beginning balance 25,875,000 6.500% 25,875,000 6.500% Shares redeemed (11,500,000) 6.500% - 0.000% Ending balance 14,375,000 6.500% 25,875,000 6.500%
Summary of common stock issuances	Shares Issued Average Price Gross Proceeds Net Proceeds 2016 Dividend reinvestment plan issuances 1,058,085 $ 60.00 $ 63,484 $ 63,484 2016 Option exercises 9,864 21.29 210 210 2016 Equity shelf program issuances 443,096 67.12 30,192 29,739 2016 Stock incentive plans, net of forfeitures 484,005 - - 2016 Totals 1,995,050 $ 93,886 $ 93,433 2017 Dividend reinvestment plan issuances 1,284,719 $ 68.33 $ 87,985 $ 87,784 2017 Option exercises 156,675 52.71 8,258 8,258 2017 Equity shelf program issuances 338,486 69.75 23,776 23,609 2017 Stock incentive plans, net of forfeitures 181,600 - - 2017 Totals 1,961,480 $ 120,019 $ 119,651
Summary of dividend payments	Three Months Ended March 31, 2017 March 31, 2016 Per Share Amount Per Share Amount Common Stock $ 0.8700 $ 315,415 $ 0.8600 $ 305,770 Series I Preferred Stock 0.8125 11,680 0.8125 11,680 Series J Preferred Stock 0.2347 2,699 0.4064 4,672 Totals $ 329,794 $ 322,122
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, 2016 $ (173,496) $ 5,120 $ (1,153) $ (2) $ (169,531) Other comprehensive income before reclassification adjustments 2,900 (10,569) - - (7,669) Net current-period other comprehensive income 2,900 (10,569) - - (7,669) Balance at March 31, 2017 $ (170,596) $ (5,449) $ (1,153) $ (2) $ (177,200) Balance at December 31, 2015 $ (85,484) $ - $ (1,343) $ (1,416) $ (88,243) Other comprehensive income before reclassification adjustments (13,746) (7,549) 2 - (21,293) Reclassification amount to net income - - - 483 (1) 483 Net current-period other comprehensive income (13,746) (7,549) 2 483 (20,810) Balance at March 31, 2016 $ (99,230) $ (7,549) $ (1,341) $ (933) $ (109,053) (1) Please see Note 11 for additional information.

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2017
Earnings Per Share (Tables) [Abstract]
Computation of basic and diluted earnings per share	Three Months Ended March 31, 2017 2016 Numerator for basic and diluted earnings per share - net income (loss) attributable to common stockholders $ 312,639 $ 148,969 Denominator for basic earnings per share - weighted average shares 362,534 355,076 Effect of dilutive securities: Employee stock options 70 101 Non-vested restricted shares 397 253 Redeemable shares 1,651 621 Dilutive potential common shares 2,118 975 Denominator for diluted earnings per share - adjusted weighted average shares 364,652 356,051 Basic earnings per share $ 0.86 $ 0.42 Diluted earnings per share $ 0.86 $ 0.42

Disclosure about Fair Value o38

Disclosure about Fair Value of Financial Instruments (Tables)	3 Months Ended
	Mar. 31, 2017
Disclosure about Fair Value of Financial Instruments (Tables) [Abstract]
Carrying amounts and estimated fair values of financial instruments	March 31, 2017 December 31, 2016 Carrying Amount Fair Value Carrying Amount Fair Value Financial assets: Mortgage loans receivable $ 430,607 $ 465,548 $ 485,735 $ 521,773 Other real estate loans receivable 143,473 149,151 136,893 138,050 Available-for-sale equity investments 17,330 17,330 27,899 27,899 Cash and cash equivalents 380,360 380,360 419,378 419,378 Foreign currency forward contracts 110,439 110,439 135,561 135,561 Financial liabilities: Borrowings under unsecured credit facilities $ 522,000 $ 522,000 $ 645,000 $ 645,000 Senior unsecured notes 8,188,928 8,965,318 8,161,619 8,879,176 Secured debt 2,669,787 2,728,171 3,477,699 3,558,378 Foreign currency forward contracts 9,840 9,840 4,342 4,342 Redeemable OP unitholder interests $ 116,917 $ 116,917 $ 110,502 $ 110,502
The Market approach utilized to measure fair value of financial assets and liabilities on recurring basis	Fair Value Measurements as of March 31, 2017 Total Level 1 Level 2 Level 3 Available-for-sale equity investments (1) $ 17,330 $ 17,330 $ - $ - Foreign currency forward contracts, net (2) 100,599 - 100,599 - Redeemable OP unitholder interests 116,917 - 116,917 - Totals $ 234,846 $ 17,330 $ 217,516 $ - (1) Unrealized gains or losses on equity investments are recorded in accumulated other comprehensive income (loss) at each measurement date. (2) Please see Note 11 for additional information.

Segment Reporting (Tables)

Segment Reporting (Tables)	3 Months Ended
	Mar. 31, 2017
Segment Reporting (Tables) [Abstract]
Summary of information for reportable segments	Three Months Ended March 31, 2017: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 227,290 $ - $ 139,851 $ - $ 367,141 Resident fees and services - 670,337 - - 670,337 Interest income 20,679 69 - - 20,748 Other income 1,766 1,461 612 233 4,072 Total revenues 249,735 671,867 140,463 233 1,062,298 Property operating expenses - 462,425 47,744 - 510,169 Net operating income from continuing operations 249,735 209,442 92,719 233 552,129 Interest expense 5,511 15,816 2,291 94,979 118,597 Loss (gain) on derivatives, net 1,224 - - - 1,224 Depreciation and amortization 59,608 119,737 48,931 - 228,276 General and administrative - - - 31,101 31,101 Loss (gain) on extinguishment of debt, net 29,084 890 1,382 - 31,356 Impairment of assets - 5,406 5,625 - 11,031 Other expenses 5,010 1,778 360 4,527 11,675 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 149,298 65,815 34,130 (130,374) 118,869 Income tax (expense) benefit (800) (1,087) (335) (23) (2,245) Income (loss) from unconsolidated entities 5,638 (29,191) (1) 447 - (23,106) Income (loss) from continuing operations 154,136 35,537 34,242 (130,397) 93,518 Gain (loss) on real estate dispositions, net 231,081 13,011 - - 244,092 Net income (loss) $ 385,217 $ 48,548 $ 34,242 $ (130,397) $ 337,610 Total assets $ 9,906,585 $ 12,646,321 $ 4,947,544 $ 266,827 $ 27,767,277 (1) Primarily due to the recognition of goodwill and intangible asset impairments, as well as non-recurring income tax expense. Three Months Ended March 31, 2016: Triple-net Seniors Housing Operating Outpatient Medical Non-segment / Corporate Total Rental income $ 283,825 $ - $ 131,838 $ - $ 415,663 Resident fees and services - 602,149 - - 602,149 Interest income 22,853 1,031 1,304 - 25,188 Other income 1,490 2,189 313 58 4,050 Total revenues 308,168 605,369 133,455 58 1,047,050 Property operating expenses - 408,894 40,742 - 449,636 Net operating income from continuing operations 308,168 196,475 92,713 58 597,414 Interest expense 6,364 20,523 5,744 100,329 132,960 Depreciation and amortization 79,800 101,832 47,064 - 228,696 General and administrative - - - 45,691 45,691 Transaction costs 2,852 3,933 1,423 - 8,208 Loss (gain) on extinguishment of debt, net (24) - - - (24) Impairment of assets 14,314 - - - 14,314 Income (loss) from continuing operations before income taxes and income from unconsolidated entities 204,862 70,187 38,482 (145,962) 167,569 Income tax (expense) benefit (317) 2,767 (228) (497) 1,725 Income (loss) from unconsolidated entities 3,081 (6,935) 34 - (3,820) Income (loss) from continuing operations 207,626 66,019 38,288 (146,459) 165,474 Net income (loss) $ 207,626 $ 66,019 $ 38,288 $ (146,459) $ 165,474 Three Months Ended March 31, 2017 March 31, 2016 Revenues: Amount % Amount % United States $ 858,668 80.9% $ 842,357 80.5% United Kingdom 93,843 8.8% 100,555 9.6% Canada 109,787 10.3% 104,138 9.9% Total $ 1,062,298 100.0% $ 1,047,050 100.0% As of March 31, 2017 December 31, 2016 Assets: Amount % Amount % United States $ 22,425,964 80.8% $ 23,572,459 81.7% United Kingdom 2,835,782 10.2% 2,782,489 9.6% Canada 2,505,531 9.0% 2,510,236 8.7% Total $ 27,767,277 100.0% $ 28,865,184 100.0%

Variable Interest Entity Disc40

Variable Interest Entity Disclosure (Tables)	3 Months Ended
	Mar. 31, 2017
Variable Interest Entity Disclosure [Abstract]
Schedule of Variable Interest Entities [Table Text Block]	March 31, 2017 December 31, 2016 Assets Net real property owned $ 980,570 $ 989,596 Cash and cash equivalents 7,390 10,501 Receivables and other assets 16,530 12,102 Total assets (1) $ 1,004,490 $ 1,012,199 Liabilities and equity Secured debt $ 449,163 $ 450,255 Accrued expenses and other liabilities 13,880 13,803 Redeemable noncontrolling interests 72,957 185,556 Total equity 468,490 362,585 Total liabilities and equity $ 1,004,490 $ 1,012,199 (1) Note that assets of the consolidated variable interest entities can only be used to settle obligations relating to such variable interest entities. Liabilities of the consolidated variable interest entities represent claims against the specific assets of the variable interest entities.

Accounting Policies and Relat41

Accounting Policies and Related Matters (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2017USD ($)
Accounting Policies and Related Matters [Abstract]
Payments Related to Tax Withholding for Share-based Compensation	$ 6,897

Real Property Acquisitions an42

Real Property Acquisitions and Development (Details 1) - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2017	Mar. 31, 2016
Triple Net [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		$ 4,017	$ 15,331
Buildings and improvements		37,241	114,235
Acquired lease intangibles		0	1,623
Total assets acquired		41,258	131,189
Accrued expenses and other liabilities		0	(809)
Total liabilities assumed		0	(809)
Non-cash acquisition related activity	[1]	0	(28,621)
Cash disbursed for acquisitions		41,258	101,759
Construction in progress additions		46,754	43,835
Less: Capitalized Interest		(2,028)	(1,684)
Less: Foreign currency translation		(164)	(583)
Cash disbursed for construction in progress		44,562	41,568
Capital improvements to existing properties		10,495	7,438
Total cash invested in real property		96,315	150,765
Non Cash Acquisition Financed As Real Estate Loan Receivable		25,691
Non cash acquisition financed as equity investments		2,871
Senior housing - operating [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		4,304	3,440
Buildings and improvements		44,075	48,218
Acquired lease intangibles		1,741	1,942
Receivables and other assets		74	36
Total assets acquired	[2]	50,194	53,636
Accrued expenses and other liabilities		(2,755)	(11)
Total liabilities assumed		(2,755)	(11)
Noncontrolling interests		(647)	(549)
Non-cash acquisition related activity	[3]	(14,148)	0
Cash disbursed for acquisitions		32,644	53,076
Construction in progress additions		8,062	4,033
Less: Capitalized Interest		(1,707)	(565)
Less: Foreign currency translation		691	(1,107)
Cash disbursed for construction in progress		7,046	2,361
Capital improvements to existing properties		24,254	16,808
Total cash invested in real property		63,944	72,245
Cash Acquired from Acquisition		400	113
Non Cash Acquisition Financed As Real Estate Loan Receivable		6,349
Non cash acquisition financed as equity investments		7,799
Outpatient Medical [Member]
Estimated Fair Value of Allocated Purchase Price of Asset and Liabilities
Land and land improvements		2,895	0
Buildings and improvements		23,310	17,637
Acquired lease intangibles		3,496	0
Receivables and other assets		3	0
Total assets acquired		29,704	17,637
Accrued expenses and other liabilities		(1,250)	(990)
Total liabilities assumed		(1,250)	(990)
Cash disbursed for acquisitions		28,454	16,647
Construction in progress additions		14,921	28,934
Less: Capitalized Interest		(717)	(788)
Less: Accruals	[4]	3,522	(5,336)
Cash disbursed for construction in progress		17,726	22,810
Capital improvements to existing properties		7,366	10,779
Total cash invested in real property		$ 53,546	$ 50,236
[1]	Includes $25,691,000 related to the acquisition of assets previously financed as real estate loans receivable and $2,871,000 related to the acquisition of assets previously financed as an investment in an unconsolidated entity.
[2]	Excludes $400,000 and $113,000 of cash acquired during the three months ended March 31, 2017 and 2016, respectively.
[3]	Includes $6,349,000 related to the acquisition of assets previously financed as real estate loans receivable and $7,799,000 previously financed as an investment in an unconsolidated entity.
[4]	Represents the change in non-cash consideration accruals for amounts to be paid in periods other than the period in which the construction projects converted to operations.

Real Property Acquisitions an43

Real Property Acquisitions and Development (Details 2) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Development projects:
Total development projects	$ 187,004	$ 35,363
Total construction in progress conversions	187,004	35,363
Triple Net [Member]
Development projects:
Total development projects	157,460	0
Seniors housing operating [Member]
Development projects:
Total development projects	3,634	0
Outpatient Medical [Member]
Development projects:
Total development projects	$ 25,910	$ 35,363

Real Estate Intangibles (Detail

Real Estate Intangibles (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2017	Dec. 31, 2016
Intangible Assets:
Gross historical cost	$ 1,421,277	$ 1,402,884
Accumulated amortization	1,010,364	966,714
Net book value	$ 410,913	$ 436,170
Weighted-average amortization period in years	14 years 5 months	13 years 8 months
Intangible Liabilities:
Gross historical cost	$ 98,852	$ 97,575
Accumulated amortization	54,354	52,134
Net book value	$ 44,498	$ 45,441
Weighted-average amortization period in years	15 years 1 month	15 years 2 months
In place lease intangibles [Member]
Intangible Assets:
Gross historical cost	$ 1,267,280	$ 1,252,143
Above market tenant leases [Member]
Intangible Assets:
Gross historical cost	63,184	61,700
Below market ground leases [Member]
Intangible Assets:
Gross historical cost	62,224	61,628
Lease commissions [Member]
Intangible Assets:
Gross historical cost	28,589	27,413
Below market tenant leases [Member]
Intangible Liabilities:
Gross historical cost	90,745	89,468
Above market ground leases [Member]
Intangible Liabilities:
Gross historical cost	$ 8,107	$ 8,107

Real Estate Intangibles (Real E

Real Estate Intangibles (Real Estate Intangible Maturity Schedule) (Details) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Estimated Aggregate Amortization Expense For Acquired Lease Intangibles Expected To Be Recognized [Line Items]
Totals	$ 410,913	$ 436,170
Intangible Liability [Member]
Estimated Aggregate Amortization Expense For Acquired Lease Intangibles Expected To Be Recognized [Line Items]
2,017	4,959
2,018	6,106
2,019	5,685
2,020	5,208
2,021	4,720
Thereafter	17,820
Totals	44,498
Intangible Asset [Member]
Estimated Aggregate Amortization Expense For Acquired Lease Intangibles Expected To Be Recognized [Line Items]
2,017	105,454
2,018	77,561
2,019	37,948
2,020	24,169
2,021	20,191
Thereafter	145,590
Totals	$ 410,913

Real Estate Intangibles (Deta46

Real Estate Intangibles (Details 1) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Real Estate Intangible Amortization [Abstract]
Rental income related to above/below market tenant leases, net	$ 304	$ 81
Property operating expenses related to above/below market ground leases, net	(312)	(311)
Depreciation and amortization related to in place lease intangibles and lease commissions	$ (39,302)	$ (34,454)

Dispositions, Assets Held for47

Dispositions, Assets Held for Sale and Discontinued Operations (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Real property dispositions:
Total dispositions	$ 822,049	$ 0
Gain Loss On Sale Of Properties	244,092	0
Net other assets/liabilities disposed	20,933	0
Proceeds from sales of real property	1,087,074	0
Triple Net [Member]
Real property dispositions:
Total dispositions	808,204	0
Senior housing - operating [Member]
Real property dispositions:
Total dispositions	$ 13,845	$ 0

Dispositions, Assets Held for48

Dispositions, Assets Held for Sale and Discontinued Operations (Details 2) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Revenues:
Rental income, disposed	$ 16,734	$ 5,477
Expenses:
Interest expense, disposed	1,301	851
Property operating expenses, disposed	1,855	1,362
Depreciation expense, disposed	245	820
Expenses, disposed	3,401	3,033
Income (loss) from disposed properties	$ 13,333	$ 2,444

Real Estate Loans Receivable (D

Real Estate Loans Receivable (Details) - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2017	Mar. 31, 2016
Advances on real estate loans receivable:
Investments in new loans		$ 7,828	$ 8,013
Draws on existing loans		17,547	19,238
Net cash advances on real estate loans		25,375	27,251
Receipts on real estate loans receivable:
Loan payoffs		74,974	116,358
Principal payments on loans		667	3,107
Sub-total		75,641	119,465
Less : Non-cash activity	[1],[2]	(66,849)	(25,691)
Total receipts on real estate loans		8,792	93,774
Net advances (receipts) on real estate loans		16,583	(66,523)
Change in balance due to foreign currency translation		1,718	(1,987)
Net change Real Estate Loans Receivable		(48,548)	(94,201)
Triple Net [Member]
Advances on real estate loans receivable:
Investments in new loans		7,828	8,013
Draws on existing loans		17,547	19,206
Net cash advances on real estate loans		25,375	27,219
Receipts on real estate loans receivable:
Loan payoffs		14,474	104,068
Principal payments on loans		667	3,107
Sub-total		15,141	107,175
Less : Non-cash activity	[1],[2]	(6,349)	(25,691)
Total receipts on real estate loans		8,792	81,484
Net advances (receipts) on real estate loans		16,583	(54,265)
Change in balance due to foreign currency translation		1,718	(1,987)
Net change Real Estate Loans Receivable		11,952	(81,943)
Outpatient Medical [Member]
Advances on real estate loans receivable:
Investments in new loans		0	0
Draws on existing loans		0	32
Net cash advances on real estate loans		0	32
Receipts on real estate loans receivable:
Loan payoffs		60,500	12,290
Principal payments on loans		0	0
Sub-total		60,500	12,290
Less : Non-cash activity	[1],[2]	(60,500)	0
Total receipts on real estate loans		0	12,290
Net advances (receipts) on real estate loans		0	(12,258)
Change in balance due to foreign currency translation		0	0
Net change Real Estate Loans Receivable		$ (60,500)	$ (12,258)
[1]	Outpatient medical represents a deed in lieu of foreclosure on a previously financed first mortgage property.
[2]	Triple-net represents acquisitions of assets previously financed as real estate loans. Please see Note 3 for additional information.

Real Estate Loans Receivable 50

Real Estate Loans Receivable (Details 1) - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2017	Mar. 31, 2016
Summary of loan impairments
Balance of impaired loans at end of period		$ 317,049	$ 0
Allowance for loan losses		6,196	0
Balance of impaired loans not reserved		310,853	0
Average impaired loans for the period		340,920	0
Interest recognized on impaired loans	[1]	$ 8,243	$ 0
[1]	Represents interest recognized in period since loans were identified as impaired.

Real Estate Loans Receivable 51

Real Estate Loans Receivable (Textuals) (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2017	Dec. 31, 2016	Mar. 31, 2016
Financing Receivable, Modifications [Line Items]
Allowance for loan losses	$ 6,196	$ 6,563	$ 0
Genesis Healthcare Loans [Member] | Triple Net [Member]
Financing Receivable, Modifications [Line Items]
Long-term Debt, Gross	$ 317,000
Provision For Loan And Lease Losses Real Estate Excluding Write Off		$ 6,935
Gensis Healthcare Loan Maturing In 2017 [Member] | Triple Net [Member]
Financing Receivable, Modifications [Line Items]
Maturity Date	Feb. 28, 2017
Gensis Healthcare Loan Maturing In 2018 [Member] | Triple Net [Member]
Financing Receivable, Modifications [Line Items]
Maturity Date	Sep. 30, 2018
Genesis Healthcare Four Restructured Loans [Member] | Triple Net [Member]
Financing Receivable, Modifications [Line Items]
Debt Instrument Restructured Loan Effective Date	Oct. 1, 2016
Debt Instrument, Term	5 years
Debt Instrument Interest Rate Stated Percentage	10.00%
Debt Instrument Basis Spread On Variable Rate1	0.25%

Investments in Unconsolidated52

Investments in Unconsolidated Entities (Summary of Investments in Unconsolidated Entities) (Details) - USD ($) $ in Thousands		Mar. 31, 2017	Dec. 31, 2016
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated entities		$ 416,110	$ 457,138
Triple Net [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated entities		$ 23,108	$ 27,005
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		$ 360,260	$ 407,172
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		$ 32,742	$ 22,961
[1]	Excludes ownership of in-substance real estate.

Investments in Unconsolidated53

Investments in Unconsolidated Entities (Details) $ in Thousands	Mar. 31, 2017USD ($)
Schedule of Equity Method Investments [Line Items]
Unamortized Investment In Joint Venture Primarily Attributable To Real Estate And Related Intangible Assets	$ 211,268

Credit Concentration (Details)

Credit Concentration (Details) $ in Thousands		3 Months Ended
		Mar. 31, 2017USD ($)properties	Mar. 31, 2016USD ($)	Dec. 31, 2016
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	1,277
Percent of NOI	[1],[2]	100.00%
Net Operating Income | $		$ 552,129	$ 597,414
Credit Concentration (Textual) [Abstract]
Percentage total investments with top five customers				45.00%
Genesis HealthCare [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	86
Genesis HealthCare [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]	9.00%
Net Operating Income | $	[1]	$ 49,048
Sunrise Senior Living [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1],[3]	153
Sunrise Senior Living [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2],[3]	14.00%
Net Operating Income | $	[1],[3]	$ 74,893
Brookdale [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	137
Brookdale [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]	7.00%
Net Operating Income | $	[1]	$ 38,372
Revera [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1],[3]	98
Revera [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2],[3]	7.00%
Net Operating Income | $	[1],[3]	$ 37,802
Benchmark Senior Living [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	48
Benchmark Senior Living [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]	4.00%
Net Operating Income | $	[1]	$ 22,614
Remaining Portfolio [Member]
Concentration by investment:
Number of properties in diversified portfolio | properties	[1]	755
Remaining Portfolio [Member] | Net Operating Income [Member]
Concentration by investment:
Percent of NOI	[1],[2]	59.00%
Net Operating Income | $	[1]	$ 329,400
[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]	NOICO with our top five relationships comprised 45% of total NOICO for the year ending December 31, 2016.
[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
	Mar. 31, 2017		Mar. 31, 2016		Dec. 31, 2016
Aggregate borrowings under the unsecured line of credit arrangements
Balance outstanding at quarter end	$ 522,000	[1]	$ 645,000	[1]	$ 645,000
Maximum amount outstanding at any month end	1,010,000		945,000
Average amount outstanding (total of daily principal balances divided by days in period)	$ 796,356		$ 671,044
Weighted average interest rate (actual interest expense divided by average borrowings outstanding)	1.81%		1.29%
[1]	As of March 31, 2017, letters of credit in the aggregate amount of $32,456,000 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	3 Months Ended
	Mar. 31, 2017USD ($)properties
Line Of Credit Facility [Line Items]
Unsecured line of credit arrangement	$ 3,000,000
Number of banks in consortium | properties	29
Available to borrow in alternate currencies	$ 1,000,000
Annual facility fee for each bank based on commitment amount	0.15%
Term Loan Interest Rate Margin	0.90%
HCN Term Loan	$ 500,000
HCN Canadian Denomiated Term Loan	250,000
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]
Agent bank's prime rate of interest	1.88%
Maturity Date	May 13, 2020
Letter of credit that reduces the borrowing capacity	$ 32,456

Senior Unsecured Notes and Se57

Senior Unsecured Notes and Secured Debt (Details) £ in Thousands, CAD in Thousands, $ in Thousands		3 Months Ended
		Mar. 31, 2017CAD	Mar. 31, 2017GBP (£)	Mar. 31, 2017USD ($)	Dec. 31, 2016USD ($)	Oct. 01, 2015USD ($)
Principal payments due on debt obligations
2,017				$ 284,879
2,018				871,751
2,019				1,104,895
2,020	[1]			825,096
2,021	[2],[3]			1,366,667
Thereafter	[4],[5],[6],[7]			6,496,456
Totals				10,949,744
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Senior unsecured notes				8,188,928	$ 8,161,619
Secured debt				2,669,787	$ 3,477,699
Senior Unsecured Notes [Member]
Principal payments due on debt obligations
2,017	[8],[9]			0
2,018	[8],[9]			450,000
2,019	[8],[9]			605,000
2,020	[1],[8],[9]			675,208
2,021	[2],[3],[8],[9]			1,137,674
Thereafter	[4],[5],[6],[7],[8],[9]			5,416,385
Totals	[8],[9]			$ 8,284,267
Senior Unsecured Notes [Member] | Maximum [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Interest rate		6.50%	6.50%	6.50%
Senior Unsecured Notes [Member] | Minimum [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Interest rate		1.60%	1.60%	1.60%
Secured Debt [Member]
Principal payments due on debt obligations
2,017	[8],[10]			$ 284,879
2,018	[8],[10]			421,751
2,019	[8],[10]			499,895
2,020	[1],[8],[10]			149,888
2,021	[2],[3],[8],[10]			228,993
Thereafter	[4],[5],[6],[7],[8],[10]			1,080,071
Totals	[8],[10]			2,665,477
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Carrying values of properties securing the debt				$ 4,947,646
Secured Debt [Member] | Maximum [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Interest rate		7.93%	7.93%	7.93%
Secured Debt [Member] | Minimum [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Interest rate		1.32%	1.32%	1.32%
3.35% senior unsecured note due 2020
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Senior unsecured notes issued amount		CAD 300,000		$ 225,208
Debt Instrument, Issuance Date		Nov. 1, 2015
Canadian Denominated Unsecured Term Loan [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Senior unsecured notes		CAD 250,000		187,674
Debt Instrument Basis Spread On Variable Rate1		1.84%
Debt Instrument, Issuance Date		May 13, 2016
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]
Debt Instrument Basis Spread On Variable Rate1		0.95%
Unsecured term credit facility [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Senior unsecured notes				$ 500,000
Debt Instrument Basis Spread On Variable Rate1		1.83%
Debt Instrument, Issuance Date		May 13, 2016
Maturity Date		May 13, 2021
Unsecured term credit facility [Member] | London Interbank Offered Rate (LIBOR) [Member]
Senior Unsecured Notes and Secured Debt (Textual) [Abstract]
Debt Instrument Basis Spread On Variable Rate1		0.95%
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	$ 689,535
Debt Instrument, Issuance Date		Nov. 20, 2013
Maturity Date		Nov. 20, 2028
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	$ 626,850
Debt Instrument, Issuance Date		Nov. 25, 2014
Maturity Date		Nov. 24, 2034
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
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
Maturity Date		Mar. 1, 2026
[1]	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 $225,208,000 based on the Canadian/U.S. Dollar exchange rate on March 31, 2017).
[2]	On May 13, 2016, we refinanced the funding on a $250,000,000 Canadian-denominated unsecured term credit facility (approximately $187,674,000 based on the Canadian/U.S. Dollar exchange rate on March 31, 2017). The loan matures on May 13, 2021 and bears interest at the Canadian Dealer Offered Rate plus 95 basis points (1.84% at March 31, 2017).
[3]	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 (1.83% at March 31, 2017).
[4]	In March 2016, we issued $700,000,000 of 4.25% senior unsecured notes due 2026.
[5]	In May 2015, we issued $750,000,000 of 4.0% senior unsecured notes due 2025. In October 2015, we issued an additional $500,000,000 of these notes under a re-opening of the offer.
[6]	On November 20, 2013, we completed the sale of £550,000,000 (approximately $689,535,000 based on the Sterling/U.S. Dollar exchange rate in effect on March 31, 2017) of 4.8% senior unsecured notes due 2028.
[7]	On November 25, 2014, we completed the sale of £500,000,000 (approximately $626,850,000 based on the Sterling/U.S. Dollar exchange rate in effect on March 31, 2017) of 4.5% senior unsecured notes due 2034.
[8]	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]	Annual interest rates range from 1.6% to 6.5%.
[10]	Annual interest rates range from 1.32% to 7.93%. Carrying value of the properties securing the debt totaled $4,947,646,000 at March 31, 2017.

Senior Unsecured Notes and Se58

Senior Unsecured Notes and Secured Debt (Details 1) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2017USD ($)	Mar. 31, 2016USD ($)	Dec. 31, 2016USD ($)	Dec. 31, 2015USD ($)
Unsecured note issuances
Senior unsecured debt issued	$ 0	$ 688,560
Senior unsecured debt redeemed	0	400,000
Excluding Fair Value Adjustments [Member]
Unsecured note issuances
Senior unsecured debt balance	8,284,267	8,934,093	$ 8,260,038	$ 8,645,758
Senior unsecured debt issued	0	700,000
Senior unsecured debt extinguished	0	(400,000)
Senior unsecured debt foreign currency	$ 24,229	$ (11,665)
Senior unsecured debt balance average rate	0.04262	0.04266	0.04245	0.04237
Senior unsecured debt issued average rate	0	0.0425
Senior unsecured debt extinguished average rate	0	0.03625
Senior unsecured debt foreign currency average rate	0.04391	0.03943

Senior Unsecured Notes and Se59

Senior Unsecured Notes and Secured Debt (Details 2) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2017USD ($)	Mar. 31, 2016USD ($)	Dec. 31, 2016USD ($)	Dec. 31, 2015USD ($)
Secured debt principal activity
Secured debt issued	$ 12,536	$ 75,136
Secured debt extinguished	822,438	130,343
Excluding Fair Value Adjustments [Member]
Secured debt principal activity
Secured debt principal balance	2,665,477	3,488,488	$ 3,465,066	$ 3,478,207
Secured debt issued	12,536	75,136
Secured debt extinguished	(806,189)	(111,701)
Secured debt principal payments	10,313	65,488
Secured debt foreign currency	$ (16,249)	$ (18,642)
Secured debt principal balance average rate	0.03744	0.044	0.04094	0.0444
Secured debt principal issued average rate	0.0234	0.0306
Secured debt principal extinguished average rate	0.0558	0.0445
Secured debt principal payment average rate	0.03262	0.03669
Secured debt principal foreign currency average rate	0.04469	0.04539

Derivative Instrument (Notional

Derivative Instrument (Notional Table) (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2017	Dec. 31, 2016
Designated as Hedging Instrument [Member] | Cash Flow Hedging [Member] | USD
Derivatives Fair Value [Line Items]
Derivative, Notional Amount	$ 0	$ 57,000
Designated as Hedging Instrument [Member] | Cash Flow Hedging [Member] | CAD
Derivatives Fair Value [Line Items]
Derivative, Notional Amount	72,000	54,000
Designated as Hedging Instrument [Member] | Cash Flow Hedging [Member] | GBP
Derivatives Fair Value [Line Items]
Derivative, Notional Amount	69,000	48,000
Designated as Hedging Instrument [Member] | Net Investment Hedging [Member] | CAD
Derivatives Fair Value [Line Items]
Derivative, Notional Amount	875,000	900,000
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	37,000
Not Designated as Hedging Instrument [Member] | GBP
Derivatives Fair Value [Line Items]
Derivative, Notional Amount	$ 0	$ 0

Derivative Instruments (Details

Derivative Instruments (Details 1) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Derivative [Line Items]
Derivative Gain Loss On Derivative Net	$ (1,224)	$ 0
Interest Rate Swap [Member]
Derivative [Line Items]
Gain (loss) on interest rate swaps recalssified from AOCI into income (effective portion)	0	(483)
Foreign Exchange Contract [Member]
Derivative [Line Items]
Gain (loss) on forward exchange contracts recognized in income.	2,457	(1,327)
Gain on Release of cumulative translation adjustment related to net investment hedge of an equity investment	$ (44,341)	$ (2,739)

Derivative Instruments (Textual

Derivative Instruments (Textual) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Derivative Instruments [Abstract]
Cash Flow Hedge Gain Loss To Be Reclassified Within Twelve Months	$ 3,395
Derivative Cash Received On Hedge	$ 8,218	$ 0

Commitments and Contingencies (

Commitments and Contingencies (Details Textual) $ in Thousands	3 Months Ended
	Mar. 31, 2017USD ($)Number	Dec. 31, 2016USD ($)
Commitments and Contingencies (Textual) [Abstract]
Number of outstanding letters of credit | Number	14
Letter of credit obligation	$ 169,961
Line Of Credit Facility [Line Items]
Outstanding construction financings for leased properties	390,180	$ 506,091
Additional financing to complete construction	466,031
Total contingent purchase obligations	$ 17,058
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	$ 1,092,169
Operating Leases, Future Minimum Payments Due, Future Minimum Sublease Rentals	73,840
Capital Leases, Future Minimum Payments Due	$ 93,697
Letter Of Credit Expiration Date Maximum	Dec. 31, 2024
Letter Of Credit Expiration Date Minimum	Jan. 1, 2017

Stockholder's Equity (Details)

Stockholder's Equity (Details) - shares	Mar. 31, 2017	Dec. 31, 2016	Mar. 31, 2016	Dec. 31, 2015
Preferred Stock:
Authorized shares	50,000,000	50,000,000
Issued shares	14,375,000	25,875,000
Outstanding shares	14,375,000	25,875,000	25,875,000	25,875,000
Common Stock, $1.00 par value:
Authorized shares	700,000,000	700,000,000
Issued shares	365,651,576	363,576,924
Outstanding shares	364,563,653	362,602,173

Stockholder's Equity (Details 1

Stockholder's Equity (Details 1)	3 Months Ended
	Mar. 31, 2017USD ($)$ / sharesshares	Mar. 31, 2016USD ($)$ / sharesshares
Summary of common stock issuances
Equity shelf plan issuances, Shares Issued | shares	338,486	443,096
Equity shelf plan issuances, average price | $ / shares	69.75	67.12
Equity Shelf Plan Issuances Gross Proceeds	$ 23,776,000	$ 30,192,000
Equity Shelf Plan Issuances Net Proceeds	$ 23,609,000	$ 29,739,000
Dividend reinvestment plan issuances, Shares Issued | shares	1,284,719	1,058,085
Dividend reinvestment plan issuances, Average Price	68.33	60
Dividend reinvestment plan issuances, Net Proceeds	$ 87,784,000	$ 63,484,000
Dividend reinvestment plan issuances, Gross Proceeds	$ 87,985,000	$ 63,484,000
Option exercises, Shares | shares	156,675	9,864
Option exercises, Average Price	52.71	21.29
Option exercises, Gross Proceeds	$ 8,258,000	$ 210,000
Option exercises, Net Proceeds	$ 8,258,000	$ 210,000
Stock incentive plans, net of forfeitures, Shares Issued | shares	181,600	484,005
Issuance of Common Stock, Shares | shares	1,961,480	1,995,050
Gross Proceeds From Issuance of Common Stock	$ 120,019,000	$ 93,886,000
Net proceeds from the issuance of common stock	$ 119,651,000	$ 93,433,000

Stockholder's Equity (Details 2

Stockholder's Equity (Details 2) - USD ($) $ in Thousands		Mar. 31, 2017	Dec. 31, 2016	Mar. 31, 2016	Dec. 31, 2015
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges		$ (2)	$ (2)	$ (933)	$ (1,416)
Unrecognized losses on equity investments		(5,449)	5,120	(7,549)	0
Unrecognized gains (losses) on foreign currency translation		(170,596)	(173,496)	(99,230)	(85,484)
Unrecognized actuarial losses		(1,153)	(1,153)	(1,341)	(1,343)
Totals		(177,200)	$ (169,531)	(109,053)	$ (88,243)
Other comprehensive income before reclassification adjustments
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges		0		0
Unrecognized losses on equity investments		(10,569)		(7,549)
Unrecognized gains (losses) on foreign currency translation		2,900		(13,746)
Unrecognized actuarial losses		0		2
Totals		(7,669)		(21,293)
Reclassification amount to net income
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges	[1]			483
Unrecognized losses on equity investments				0
Unrecognized gains (losses) on foreign currency translation				0
Unrecognized actuarial losses				0
Totals				483
Net current period other comprehensive income
Summary of accumulated other comprehensive income/(loss) [Line Items]
Unrecognized losses on cash flow hedges		0		483
Unrecognized losses on equity investments		(10,569)		(7,549)
Unrecognized gains (losses) on foreign currency translation		2,900		(13,746)
Unrecognized actuarial losses		0		2
Totals		$ (7,669)		$ (20,810)
[1]	Please see Note 11 for additional information.

Stockholder's Equity (Details 3

Stockholder's Equity (Details 3) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2017	Mar. 31, 2016	Dec. 31, 2016	Dec. 31, 2015
Stockholders' Equity (Details) [Abstract]
Preferred Stock, Shares Outstanding	14,375,000	25,875,000	25,875,000	25,875,000
Preferred stock, shares redeemed	(11,500,000)	0
Preferred stock balance weighted average rate	6.50%	6.50%	6.50%	6.50%
Preferred stock balance redeemed weighted average rate	6.50%	0.00%
Preferred stock redemption charge	$ 9,769	$ 0

Stockholder's Equity (Details 5

Stockholder's Equity (Details 5) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Summary of dividend payments
Dividends declared and paid per common share	$ 0.87	$ 0.86
Common stock cash dividends	$ 315,415	$ 305,770
Total dividends paid	$ 329,794	$ 322,122
Series I Preferred Stock [Member]
Summary of dividend payments
Dividends declared and paid per preferred share	$ 0.8125	$ 0.8125
Preferred stock cash dividends	$ 11,680	$ 11,680
Series J Preferred Stock [Member]
Summary of dividend payments
Dividends declared and paid per preferred share	$ 0.2347	$ 0.4064
Preferred stock cash dividends	$ 2,699	$ 4,672

Stock Incentive Plans (Details

Stock Incentive Plans (Details Textual) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Stock Incentive Plans [Line Items]
Number of common stock authorized for 2016 Long-Term Incentive Plan	10,000
Stock-based compensation expense	$ 4,906	$ 8,186
Maximum [Member]
Stock Incentive Plans [Line Items]
Vesting period	5 years
Minimum [Member]
Stock Incentive Plans [Line Items]
Vesting period	3 years
Employee Stock Option [Member] | Employee Stock Option [Member] | Officer [Member]
Stock Incentive Plans [Line Items]
Vesting period	10 years

Earnings Per Share (Details)

Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Computation of basic and diluted earnings per share
Numerator for basic and diluted earnings per share - net income (loss) attributable to common stockholders	$ 312,639	$ 148,969
Denominator for basic earnings per share - weighted average shares	362,534	355,076
Effect of dilutive securities:
Employee stock options	70	101
Non-vested restricted shares	397	253
Redeemable shares	1,651	621
Dilutive potential common shares	2,118	975
Denominator for diluted earnings per share - adjusted weighted average shares	364,652	356,051
Basic earnings per share	$ 0.86	$ 0.42
Diluted earnings per share	$ 0.86	$ 0.42

Disclosure about Fair Value o71

Disclosure about Fair Value of Financial Instruments (Details) - USD ($) $ in Thousands	Mar. 31, 2017		Dec. 31, 2016	Mar. 31, 2016		Dec. 31, 2015
Financial Assets:
Loans receivable, Carrying Amount	$ 574,080		$ 622,628
Loans receivable, Fair value	465,548		521,773
Available-for-sale equity investments, Carrying Amount	17,330		27,899
Available-for-sale equity investments, Fair Value	17,330	[1]	27,899
Cash and cash equivalents, Carrying Amount	380,360		419,378	$ 355,949		$ 360,908
Cash and cash equivalents, Fair Value	380,360		419,378
Foreign Currency Forward Contracts Carrying Value	110,439		135,561
Foreign Currency Forward Contracts Fair Value	110,439		135,561
Financial Liabilities:
Borrowings under primary unsecured credit facilities, Carrying Value	522,000	[2]	645,000	$ 645,000	[2]
Borrowings under primary unsecured credit facilities, Fair Value	522,000		645,000
Senior unsecured notes, Carrying Amount	8,188,928		8,161,619
Senior unsecured notes, Fair Value	8,965,318		8,879,176
Secured debt, Carrying Amount	2,669,787		3,477,699
Secured debt, Fair Value	2,728,171		3,558,378
Foreign Currency Forward Contracts Carrying Value	9,840		4,342
Foreign Currency Forward Contracts, Fair Value	9,840		4,342
Redeemable OP unitholder interests carrying value	116,917		110,502
Redeemable OP unitholder interests fair value	116,917		110,502
Mortgage Loans on Real Estate [Member]
Financial Assets:
Loans receivable, Carrying Amount	430,607		485,735
Loans receivable, Fair value	465,548		521,773
Other Real Estate Loans Receivable [Member]
Financial Assets:
Loans receivable, Carrying Amount	143,473		136,893
Loans receivable, Fair value	$ 149,151		$ 138,050
[1]	Unrealized gains or losses on equity investments are recorded in accumulated other comprehensive income (loss) at each measurement date.
[2]	As of March 31, 2017, letters of credit in the aggregate amount of $32,456,000 have been issued, which reduces the borrowing capacity on the unsecured revolving credit facility.

Disclosure about Fair Value o72

Disclosure about Fair Value of Financial Instruments (Details 1) - USD ($) $ in Thousands		Mar. 31, 2017		Dec. 31, 2016
The Market approach utilized to measure fair value of financial assets and liabilities on recurring basis
Available-for-sale equity investments		$ 17,330	[1]	$ 27,899
Foreign currency forward contracts	[2]	100,599
Redeemable OP unitholder interests		116,917
Totals		234,846
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]	17,330
Totals		17,330
Level 2 [Member]
The Market approach utilized to measure fair value of financial assets and liabilities on recurring basis
Foreign currency forward contracts	[2]	100,599
Redeemable OP unitholder interests		116,917
Totals		$ 217,516
[1]	Unrealized gains or losses on equity investments are recorded in accumulated other comprehensive income (loss) at each measurement date.
[2]	Please see Note 11 for additional information.

Segment Reporting (Details)

Segment Reporting (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2017USD ($)		Mar. 31, 2016USD ($)	Dec. 31, 2016USD ($)
Summary of information for reportable segments
Rental income	$ 367,141		$ 415,663
Resident fees and services	670,337		602,149
Interest income	20,748		25,188
Other income	4,072		4,050
Total revenues	1,062,298		1,047,050
Property operating expenses	510,169		449,636
Net Operating Income from Continuing Operations	552,129		597,414
Interest expense	118,597		132,960
Loss (gain) on derivatives, net	1,224		0
Depreciation and amortization	228,276		228,696
General and administrative	31,101		45,691
Transaction costs	0		8,208
Loss (gain) on extinguishment of debt, net	31,356		(24)
Impairment of Asset	11,031		14,314
Other expenses	11,675		0
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	118,869		167,569
Income tax expense	(2,245)		1,725
(Loss) income from unconsolidated entities	(23,106)		(3,820)
Income (loss) from continuing operations	93,518		165,474
Gain (loss) on real estate dispositions, net	244,092		0
Net income	337,610		$ 165,474
Total assets	$ 27,767,277			$ 28,865,184
Percent Of Assets	1			1
Percent Of Revenues	1		1
United States
Summary of information for reportable segments
Total revenues	$ 858,668		$ 842,357
Total assets	$ 22,425,964			$ 23,572,459
Percent Of Assets	0.808			0.817
Percent Of Revenues	0.8093		0.805
United Kingdom
Summary of information for reportable segments
Total revenues	$ 93,843		$ 100,555
Total assets	$ 2,835,782			$ 2,782,489
Percent Of Assets	0.102			0.096
Percent Of Revenues	0.088		0.096
Canada
Summary of information for reportable segments
Total revenues	$ 109,787		$ 104,138
Total assets	$ 2,505,531			$ 2,510,236
Percent Of Assets	0.09			0.087
Percent Of Revenues	0.103		0.099
Triple Net [Member]
Summary of information for reportable segments
Rental income	$ 227,290		$ 283,825
Resident fees and services	0		0
Interest income	20,679		22,853
Other income	1,766		1,490
Total revenues	249,735		308,168
Property operating expenses	0		0
Net Operating Income from Continuing Operations	249,735		308,168
Interest expense	5,511		6,364
Loss (gain) on derivatives, net	1,224
Depreciation and amortization	59,608		79,800
General and administrative	0		0
Transaction costs			2,852
Loss (gain) on extinguishment of debt, net	29,084		(24)
Impairment of Asset	0		14,314
Other expenses	5,010
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	149,298		204,862
Income tax expense	(800)		(317)
(Loss) income from unconsolidated entities	5,638		3,081
Income (loss) from continuing operations	154,136		207,626
Gain (loss) on real estate dispositions, net	231,081		0
Net income	385,217		207,626
Total assets	9,906,585
Senior housing - operating [Member]
Summary of information for reportable segments
Rental income	0		0
Resident fees and services	670,337		602,149
Interest income	69		1,031
Other income	1,461		2,189
Total revenues	671,867		605,369
Property operating expenses	462,425		408,894
Net Operating Income from Continuing Operations	209,442		196,475
Interest expense	15,816		20,523
Loss (gain) on derivatives, net	0
Depreciation and amortization	119,737		101,832
General and administrative	0		0
Transaction costs			3,933
Loss (gain) on extinguishment of debt, net	890		0
Impairment of Asset	5,406		0
Other expenses	1,778
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	65,815		70,187
Income tax expense	(1,087)		2,767
(Loss) income from unconsolidated entities	(29,191)	[1]	(6,935)
Income (loss) from continuing operations	35,537		66,019
Gain (loss) on real estate dispositions, net	13,011		0
Net income	48,548		66,019
Total assets	12,646,321
Outpatient Medical [Member]
Summary of information for reportable segments
Rental income	139,851		131,838
Resident fees and services	0		0
Interest income	0		1,304
Other income	612		313
Total revenues	140,463		133,455
Property operating expenses	47,744		40,742
Net Operating Income from Continuing Operations	92,719		92,713
Interest expense	2,291		5,744
Loss (gain) on derivatives, net	0
Depreciation and amortization	48,931		47,064
General and administrative	0		0
Transaction costs			1,423
Loss (gain) on extinguishment of debt, net	1,382		0
Impairment of Asset	5,625		0
Other expenses	360
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	34,130		38,482
Income tax expense	(335)		(228)
(Loss) income from unconsolidated entities	447		34
Income (loss) from continuing operations	34,242		38,288
Gain (loss) on real estate dispositions, net	0		0
Net income	34,242		38,288
Total assets	4,947,544
Corporate, Non-Segment [Member]
Summary of information for reportable segments
Rental income	0		0
Resident fees and services	0		0
Interest income	0		0
Other income	233		58
Total revenues	233		58
Property operating expenses	0		0
Net Operating Income from Continuing Operations	233		58
Interest expense	94,979		100,329
Loss (gain) on derivatives, net	0
Depreciation and amortization	0		0
General and administrative	31,101		45,691
Transaction costs			0
Loss (gain) on extinguishment of debt, net	0		0
Impairment of Asset	0		0
Other expenses	4,527
Income (loss) from continuing operations before income taxes and income from unconsolidated entities	(130,374)		(145,962)
Income tax expense	(23)		(497)
(Loss) income from unconsolidated entities	0		0
Income (loss) from continuing operations	(130,397)		(146,459)
Gain (loss) on real estate dispositions, net	0		0
Net income	(130,397)		$ (146,459)
Total assets	$ 266,827
[1]	Primarily due to the recognition of goodwill and intangible asset impairments, as well as non-recurring income tax expense.

Income Taxes and Distributions

Income Taxes and Distributions (Details)	3 Months Ended
	Mar. 31, 2017
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		Mar. 31, 2017	Dec. 31, 2016
Variable Interest Entity [Line Items]
Total assets	[1]	$ 1,004,490	$ 1,012,199
Total equity		468,490	362,585
Total liabilities and equity		1,004,490	1,012,199
Net real property owned [Member]
Variable Interest Entity [Line Items]
Total assets		980,570	989,596
Cash and cash equivalents [Member]
Variable Interest Entity [Line Items]
Total assets		7,390	10,501
Receivables and other assets [Member]
Variable Interest Entity [Line Items]
Total assets		16,530	12,102
Secured Debt [Member]
Variable Interest Entity [Line Items]
Liabilities		449,163	450,255
Accrued expenses and other liabilities [Member]
Variable Interest Entity [Line Items]
Liabilities		13,880	13,803
Redeemable noncontrolling interests [Member]
Variable Interest Entity [Line Items]
Liabilities		$ 72,957	$ 185,556
[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.