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Supplemental Disclosure of Cash Flow Information (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended
--- | --- | ---
Sep. 30, 2020 | Sep. 30, 2019 | Sep. 30, 2020 | Sep. 30, 2019
Supplemental Cash Flow Information [Abstract] |  |  |  |
Interest paid |  |  | $ 157,688 | $ 185,722
Income taxes paid, net of refunds |  |  | 4,236 | 1,909
Net cash paid |  |  | 140,690 | 206,385
Operating lease right-of-use assets | $ 3,300 |  | 75,600 |
Loss (gain) on debt modification and extinguishment, net | (7,917) | $ (2,455) | 11,107 | (5,194)
Investments in unconsolidated ventures |  |  | (1,809) | (4,294)
Loss (gain) on sale of assets, net | 2,209 | 579 | 374,019 | 2,723
Prepaid expenses and other assets, net |  |  | 27,504 | 50,387
Loss (gain) on facility lease termination and modification, net | $ 0 | $ 0 | 0 | 2,006
Additions to property, plant and equipment and leasehold improvements |  |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |  |
Net cash paid |  |  | 140,690 | 206,385
Trade accounts payable |  |  | 7,849 | (4,522)
Acquisition of communities from Healthpeak |  |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |  |
Property, plant and equipment and leasehold intangibles, net |  |  | 286,734 | 0
Operating lease right-of-use assets |  |  | (63,285) | 0
Financing lease obligations |  |  | 129,196 | 0
Operating lease obligations |  |  | 74,335 | 0
Loss (gain) on debt modification and extinguishment, net |  |  | (19,731) | 0
Net cash paid |  |  | 407,249 | 0
Ventas master lease and debt modification |  |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |  |
Property, plant and equipment and leasehold intangibles, net |  |  | (66,444) | 0
Operating lease right-of-use assets |  |  | (153,213) | 0
Financing lease obligations |  |  | 7,077 | 0
Operating lease obligations |  |  | 362,944 | 0
Net cash paid |  |  | 119,180 | 0
Other assets, net |  |  | (42,354) | 0
Long-term debt |  |  | 34,053 | 0
Additional paid-in-capital |  |  | (22,883) | 0
Acquisition of assets, net of related payables and cash received |  |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |  |
Property, plant and equipment and leasehold intangibles, net |  |  | 684 | 0
Financing lease obligations |  |  | 64,260 | 0
Net cash paid |  |  | 64,944 | 453
Other intangible assets, net |  |  | 0 | 453
Proceeds from sale of CCRC Venture, net: |  |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |  |
Investments in unconsolidated ventures |  |  | (14,848) | 0
Current portion of long-term debt |  |  | 34,706 | 0
Other liabilities |  |  | 60,748 | 0
Loss (gain) on sale of assets, net |  |  | (369,831) | 0
Net cash received |  |  | (289,225) | 0
Proceeds from sale of assets, net |  |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |  |
Property, plant and equipment and leasehold intangibles, net |  |  | (938) | (647)
Investments in unconsolidated ventures |  |  | 0 | (156)
Other liabilities |  |  | (1,086) | (2,724)
Loss (gain) on sale of assets, net |  |  | (4,188) | (2,723)
Prepaid expenses and other assets, net |  |  | (1,318) | (5,298)
Assets held for sale |  |  | (34,348) | (41,882)
Net cash received |  |  | (41,878) | (53,430)
Assets designated as held for sale |  |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |  |
Property, plant and equipment and leasehold intangibles, net |  |  | 0 | (9,164)
Prepaid expenses and other assets, net |  |  | 0 | (5)
Assets held for sale |  |  | 0 | 9,169
Net |  |  | 0 | 0
Healthpeak master lease modification: |  |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |  |
Property, plant and equipment and leasehold intangibles, net |  |  | (57,462) | 0
Operating lease right-of-use assets |  |  | 88,044 | 0
Financing lease obligations |  |  | 70,874 | 0
Operating lease obligations |  |  | (101,456) | 0
Net |  |  | 0 | 0
Noncash lease termination and modification, net |  |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |  |
Property, plant and equipment and leasehold intangibles, net |  |  | 13,498 | (1,666)
Operating lease right-of-use assets |  |  | 7,291 | (8,644)
Financing lease obligations |  |  | (15,483) | 0
Operating lease obligations |  |  | (5,199) | 9,289
Other liabilities |  |  | (107) | (337)
Prepaid expenses and other assets, net |  |  | 0 | (648)
Loss (gain) on facility lease termination and modification, net |  |  | 0 | 2,006
Net |  |  | 0 | 0
Non-development | Additions to property, plant and equipment and leasehold improvements |  |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |  |
Net cash paid |  |  | 104,949 | 180,187
Development | Additions to property, plant and equipment and leasehold improvements |  |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |  |
Net cash paid |  |  | 9,913 | 18,677
Non-development - reimbursable | Additions to property, plant and equipment and leasehold improvements |  |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |  |
Net cash paid |  |  | $ 17,979 | $ 12,043

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