Segment Reporting
We invest in seniors housing and healthcare real estate. We evaluate our business and make resource allocations for our three operating segments: Seniors Housing Operating, Triple-net and Outpatient Medical. Our Seniors Housing Operating properties include wellness housing, assisted living communities, independent living/continuing care retirement communities, independent supportive living communities (Canada), care homes with and without nursing (U.K.) and combinations thereof. Seniors Housing Operating properties that are deemed qualified healthcare properties are owned and operated through RIDEA structures (see Note 2). Our Triple-net properties include the property types described above, as well as long-term/post-acute care facilities. Under the Triple-net segment, we invest in seniors housing and healthcare real estate through acquisition of single tenant properties. Properties acquired are generally leased under triple-net leases and we are not involved in the management of the property. Prior to the Outpatient Medical Portfolio Disposition discussed in Note 5, our Outpatient Medical properties were typically leased to multiple tenants and generally required a certain level of property management. Our remaining Outpatient Medical portfolio, exclusive of held for sale properties, primarily consists of properties triple-net leased to healthcare providers.
We evaluate performance based on consolidated NOI of each segment. We define NOI as total revenues, including tenant reimbursements, less property operating expenses. We believe NOI provides investors relevant and useful information as it
measures the operating performance of our properties at the property level on an unleveraged basis. The Chief Operating Decision Maker (“CODM”), who is our Vice Chairman & Chief Operating Officer, uses NOI to make decisions about resource allocations and to assess the property-level performance of our properties.
During the year ended December 31, 2024, we reclassified loans receivable balances and equity warrants received through lending activities (see Note 12 for further details), the related interest income, provision for loan losses and change in the fair value of the equity warrants from our three operating segments to Non-segment/Corporate to better align with the manner in which the CODM reviews results. Accordingly, the segment information provided in this Note has been updated to conform to the current presentation for all periods presented.
Non-segment revenue consists mainly of interest income on loans receivable balances. Additionally, it includes interest income earned on cash investments recorded in other income. Non-segment assets consist of corporate assets including loans receivable, 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.
The accounting policies of the segments are the same as those described in the summary of significant accounting policies (see Note 2). The results of operations for all acquisitions described in Note 3 are included in our consolidated results of operations from the acquisition dates and are components of the appropriate segments. All inter-segment transactions are eliminated.
The following table summarizes information for the reportable segments during the years ended December 31, 2025 (in thousands):
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| | Seniors Housing Operating | | Triple-net | | Outpatient Medical | | Non-segment/Corporate | | Total |
| Resident fees and services | | $ | 8,452,996 | | | $ | — | | | $ | — | | | $ | — | | | $ | 8,452,996 | |
| Rental income | | — | | | 1,193,514 | | | 774,421 | | | — | | | 1,967,935 | |
| Interest income | | — | | | 2,111 | | | — | | | 244,094 | | | 246,205 | |
| Other income | | 36,099 | | | 1,417 | | | 7,511 | | | 125,871 | | | 170,898 | |
| Total revenues | | 8,489,095 | | | 1,197,042 | | | 781,932 | | | 369,965 | | | 10,838,034 | |
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| Total property operating expenses | | 6,199,620 | | | 33,229 | | | 233,233 | | | 21,999 | | | 6,488,081 | |
| Consolidated net operating income (loss) | | $ | 2,289,475 | | | $ | 1,163,813 | | | $ | 548,699 | | | $ | 347,966 | | | 4,349,953 | |
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| Depreciation and amortization | | | | | | | | | | 2,084,868 | |
| Interest expense | | | | | | | | | | 651,955 | |
| General and administrative expenses | | | | | | | | | | 1,748,435 | |
| Loss (gain) on derivatives and financial instruments, net | | | | | | | | | | 22,407 | |
| Loss (gain) on extinguishment of debt, net | | | | | | | | | | 9,245 | |
| Provision for loan losses, net | | | | | | | | | | (9,416) | |
| Impairment of assets | | | | | | | | | | 121,283 | |
| Other expenses | | | | | | | | | | 201,201 | |
| Income (loss) from continuing operations before income taxes and other items | | | | | | | | | | (480,025) | |
| Income tax (expense) benefit | | | | | | | | | | 7,116 | |
| Income (loss) from unconsolidated entities | | | | | | | | | | (14,297) | |
| Gain (loss) on real estate dispositions and acquisitions of controlling interests, net | | | | | | | | | | 1,449,043 | |
| Income (loss) from continuing operations | | | | | | | | | | 961,837 | |
| Net income (loss) | | | | | | | | | | $ | 961,837 | |
The following table summarizes significant expense categories by segment for the year ended December 31, 2025 (in thousands):
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| | Seniors Housing Operating | | Triple-net | | Outpatient Medical | | Non-segment/Corporate | | Total |
| Compensation | | $ | 3,730,884 | | | $ | 75 | | | $ | 51,943 | | | $ | — | | | $ | 3,782,902 | |
| Utilities | | 362,361 | | | 390 | | | 50,241 | | | — | | | 412,992 | |
| Food | | 330,805 | | | — | | | — | | | — | | | 330,805 | |
| Repairs and maintenance | | 242,330 | | | 184 | | | 40,140 | | | — | | | 282,654 | |
| Property taxes | | 257,895 | | | 23,658 | | | 63,290 | | | — | | | 344,843 | |
Other segment expenses(1) | | 1,275,345 | | | 8,922 | | | 27,619 | | | 21,999 | | | 1,333,885 | |
| Total property operating expenses | | $ | 6,199,620 | | | $ | 33,229 | | | $ | 233,233 | | | $ | 21,999 | | | $ | 6,488,081 | |
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(1) Other segment expenses for Seniors Housing Operating include management fees, insurance expense, marketing, supplies, other miscellaneous expenses and right of use asset amortization for properties subject to lease. Triple-net other segment expenses include right of use asset amortization for properties subject to ground leases and other miscellaneous expenses. Outpatient Medical other segment expenses include insurance expense, right of use asset amortization for properties subject to ground leases and other miscellaneous expenses. Non-segment/Corporate other segment expenses primarily represent insurance costs related to our captive insurance program. |
The following table summarizes information for the reportable segments for the year ended December 31, 2024 (in thousands):
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| | Seniors Housing Operating | | Triple-net | | Outpatient Medical | | Non-segment/Corporate | | Total |
| Resident fees and services | | $ | 6,027,149 | | | $ | — | | | $ | — | | | $ | — | | | $ | 6,027,149 | |
| Rental income | | — | | | 777,297 | | | 792,981 | | | — | | | 1,570,278 | |
| Interest income | | — | | | 8,167 | | | — | | | 248,024 | | | 256,191 | |
| Other income | | 8,312 | | | 3,307 | | | 9,132 | | | 116,749 | | | 137,500 | |
| Total revenues | | 6,035,461 | | | 788,771 | | | 802,113 | | | 364,773 | | | 7,991,118 | |
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| Total property operating expenses | | 4,523,780 | | | 40,722 | | | 245,636 | | | 20,073 | | | 4,830,211 | |
| Consolidated net operating income (loss) | | $ | 1,511,681 | | | $ | 748,049 | | | $ | 556,477 | | | $ | 344,700 | | | 3,160,907 | |
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| Depreciation and amortization | | | | | | | | | | 1,632,093 | |
| Interest expense | | | | | | | | | | 574,261 | |
| General and administrative expenses | | | | | | | | | | 235,491 | |
| Loss (gain) on derivatives and financial instruments, net | | | | | | | | | | (27,887) | |
| Loss (gain) on extinguishment of debt, net | | | | | | | | | | 2,130 | |
| Provision for loan losses, net | | | | | | | | | | 10,125 | |
| Impairment of assets | | | | | | | | | | 92,793 | |
| Other expenses | | | | | | | | | | 117,459 | |
| Income (loss) from continuing operations before income taxes and other items | | | | | | | | | | 524,442 | |
| Income tax (expense) benefit | | | | | | | | | | (2,700) | |
| Income (loss) from unconsolidated entities | | | | | | | | | | (496) | |
| Gain (loss) on real estate dispositions and acquisitions of controlling interests, net | | | | | | | | | | 451,611 | |
| Income (loss) from continuing operations | | | | | | | | | | 972,857 | |
| Net income (loss) | | | | | | | | | | $ | 972,857 | |
The following table summarizes significant expense categories by segment for the year ended December 31, 2024 (in thousands):
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| | Seniors Housing Operating | | Triple-net | | Outpatient Medical | | Non-segment/Corporate | | Total |
| Compensation | | $ | 2,659,251 | | | $ | 77 | | | $ | 55,817 | | | $ | — | | | $ | 2,715,145 | |
| Utilities | | 275,885 | | | 266 | | | 52,141 | | | — | | | 328,292 | |
| Food | | 246,893 | | | — | | | — | | | — | | | 246,893 | |
| Repairs and maintenance | | 171,155 | | | 73 | | | 40,977 | | | — | | | 212,205 | |
| Property taxes | | 210,028 | | | 29,918 | | | 70,626 | | | — | | | 310,572 | |
Other segment expenses(1) | | 960,568 | | | 10,388 | | | 26,075 | | | 20,073 | | | 1,017,104 | |
| Total property operating expenses | | $ | 4,523,780 | | | $ | 40,722 | | | $ | 245,636 | | | $ | 20,073 | | | $ | 4,830,211 | |
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(1) Other segment expenses for Seniors Housing Operating include management fees, insurance expense, marketing, supplies, other miscellaneous expenses and right of use asset amortization for properties subject to lease. Triple-net other segment expenses include right of use asset amortization for properties subject to ground leases and other miscellaneous expenses. Outpatient Medical other segment expenses include insurance expense, right of use asset amortization for properties subject to ground leases and other miscellaneous expenses. Non-segment/Corporate other segment expenses primarily represent insurance costs related to our captive insurance program. |
The following table summarizes information for the reportable segments for the year ended December 31, 2023 (in thousands):
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| | Seniors Housing Operating | | Triple-net | | Outpatient Medical | | Non-segment/Corporate | | Total |
| Resident fees and services | | $ | 4,753,804 | | | $ | — | | | $ | — | | | $ | — | | | $ | 4,753,804 | |
| Rental income | | — | | | 814,751 | | | 741,322 | | | — | | | 1,556,073 | |
| Interest income | | — | | | 1,369 | | | — | | | 166,985 | | | 168,354 | |
| Other income | | 9,743 | | | 70,986 | | | 9,167 | | | 69,868 | | | 159,764 | |
| Total revenues | | 4,763,547 | | | 887,106 | | | 750,489 | | | 236,853 | | | 6,637,995 | |
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| Total property operating expenses | | 3,655,508 | | | 42,194 | | | 231,956 | | | 18,118 | | | 3,947,776 | |
| Consolidated net operating income (loss) | | $ | 1,108,039 | | | $ | 844,912 | | | $ | 518,533 | | | $ | 218,735 | | | 2,690,219 | |
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| Depreciation and amortization | | | | | | | | | | 1,401,101 | |
| Interest expense | | | | | | | | | | 607,846 | |
| General and administrative expenses | | | | | | | | | | 179,091 | |
| Loss (gain) on derivatives and financial instruments, net | | | | | | | | | | (2,120) | |
| Loss (gain) on extinguishment of debt, net | | | | | | | | | | 7 | |
| Provision for loan losses, net | | | | | | | | | | 9,809 | |
| Impairment of assets | | | | | | | | | | 36,097 | |
| Other expenses | | | | | | | | | | 108,341 | |
| Income (loss) from continuing operations before income taxes and other items | | | | | | | | | | 350,047 | |
| Income tax (expense) benefit | | | | | | | | | | (6,364) | |
| Income (loss) from unconsolidated entities | | | | | | | | | | (53,442) | |
| Gain (loss) on real estate dispositions and acquisitions of controlling interests, net | | | | | | | | | | 67,898 | |
| Income (loss) from continuing operations | | | | | | | | | | 358,139 | |
| Net income (loss) | | | | | | | | | | $ | 358,139 | |
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The following table summarizes significant expense categories by segment for the year ended December 31, 2023 (in thousands):
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| | Seniors Housing Operating | | Triple-net | | Outpatient Medical | | Non-segment/Corporate | | Total |
| Compensation | | $ | 2,179,578 | | | $ | 61 | | | $ | 50,900 | | | $ | — | | | $ | 2,230,539 | |
| Utilities | | 237,438 | | | 380 | | | 48,248 | | | — | | | 286,066 | |
| Food | | 195,410 | | | — | | | — | | | — | | | 195,410 | |
| Repairs and maintenance | | 141,566 | | | 138 | | | 36,991 | | | — | | | 178,695 | |
| Property taxes | | 172,567 | | | 32,957 | | | 71,448 | | | — | | | 276,972 | |
Other segment expenses(1) | | 728,949 | | | 8,658 | | | 24,369 | | | 18,118 | | | 780,094 | |
| Total property operating expenses | | $ | 3,655,508 | | | $ | 42,194 | | | $ | 231,956 | | | $ | 18,118 | | | $ | 3,947,776 | |
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(1) Other segment expenses for Seniors Housing Operating include management fees, insurance expense, marketing, supplies, other miscellaneous expenses and right of use asset amortization for properties subject to lease. Triple-net other segment expenses include right of use asset amortization for properties subject to ground leases and other miscellaneous expenses. Outpatient Medical other segment expenses include insurance expense, right of use asset amortization for properties subject to ground leases and other miscellaneous expenses. Non-segment/Corporate other segment expenses primarily represent insurance costs related to our captive insurance program. |
The following table summarizes our total assets by segment for the periods presented (in thousands):
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| | As of |
| | December 31, 2025 | | December 31, 2024 |
| Assets: | | Amount | | % | | Amount | | % |
| Seniors Housing Operating | | $ | 42,014,932 | | | 62.4 | % | | $ | 30,094,016 | | | 59.0 | % |
| Triple-Net | | 13,448,058 | | | 20.0 | % | | 7,934,415 | | | 15.5 | % |
| Outpatient Medical | | 3,322,225 | | | 4.9 | % | | 7,530,815 | | | 14.8 | % |
| Non-segment/Corporate | | 8,517,832 | | | 12.7 | % | | 5,485,062 | | | 10.7 | % |
| Total | | $ | 67,303,047 | | | 100.0 | % | | $ | 51,044,308 | | | 100.0 | % |
Our portfolio of properties and other investments is located in the U.S., the U.K. 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):
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| | | Year Ended |
| | | December 31, 2025 | | December 31, 2024 | | December 31, 2023 |
| Revenues: | | Amount | | % | | Amount | | % | | Amount | | % |
| United States | | $ | 7,936,873 | | | 73.2 | % | | $ | 6,564,077 | | | 82.1 | % | | $ | 5,521,933 | | | 83.2 | % |
| United Kingdom | | 2,166,820 | | | 20.0 | % | | 872,479 | | | 10.9 | % | | 606,750 | | | 9.1 | % |
| Canada | | 734,341 | | | 6.8 | % | | 554,562 | | | 7.0 | % | | 509,312 | | | 7.7 | % |
| Total | | $ | 10,838,034 | | | 100.0 | % | | $ | 7,991,118 | | | 100.0 | % | | $ | 6,637,995 | | | 100.0 | % |
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| | Year Ended |
| | December 31, 2025 | | December 31, 2024 | | December 31, 2023 |
| Resident fees and services: | | Amount | | % | | Amount | | % | | Amount | | % |
| United States | | $ | 5,897,698 | | | 69.8 | % | | $ | 4,808,221 | | | 79.8 | % | | $ | 3,811,915 | | | 80.2 | % |
| United Kingdom | | 1,886,954 | | | 22.3 | % | | 683,803 | | | 11.3 | % | | 447,219 | | | 9.4 | % |
| Canada | | 668,344 | | | 7.9 | % | | 535,125 | | | 8.9 | % | | 494,670 | | | 10.4 | % |
| Total | | $ | 8,452,996 | | | 100.0 | % | | $ | 6,027,149 | | | 100.0 | % | | $ | 4,753,804 | | | 100.0 | % |
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| | | As of | | | | |
| | | December 31, 2025 | | December 31, 2024 | | | | |
| Assets: | | Amount | | % | | Amount | | % | | | | |
| United States | | $ | 43,536,068 | | | 64.7 | % | | $ | 41,966,871 | | | 82.2 | % | | | | |
| United Kingdom | | 18,056,095 | | | 26.8 | % | | 5,892,598 | | | 11.5 | % | | | | |
| Canada | | 5,710,884 | | | 8.5 | % | | 3,184,839 | | | 6.3 | % | | | | |
| Total | | $ | 67,303,047 | | | 100.0 | % | | $ | 51,044,308 | | | 100.0 | % | | | | |