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Segment Information
 12 Months Ended
Dec. 31, 2020
Segment Reporting [Abstract]  
Segment Information Segment Information
The Company has five reportable segments: Independent Living; Assisted Living and Memory Care; CCRCs; Health Care Services; and Management Services. Operating segments are defined as components of an enterprise that engage in business activities from which it may earn revenues and incur expenses; for which separate financial information is available; and whose operating results are regularly reviewed by the chief operating decision maker to assess the performance of the individual segment and make decisions about resources to be allocated to the segment.

Independent Living. The Company's Independent Living segment includes owned or leased communities are primarily designed for middle to upper income seniors who desire to live in a residential setting that feels like home, without the efforts of ownership. The majority of the Company's independent living communities consist of both independent and assisted living units in a single community, which allows residents to age-in-place by providing them with a broad continuum of senior independent and assisted living services to accommodate their changing needs.

Assisted Living and Memory Care. The Company's Assisted Living and Memory Care segment includes owned or leased communities that offer housing and 24-hour assistance with ADLs for mid-acuity and frail elderly residents. The Company's assisted living and memory care communities include both freestanding, multi-story communities, as well as smaller, freestanding, single story communities. The Company also provides memory care services at freestanding memory care communities that are specially designed for residents with Alzheimer's disease and other dementias.

CCRCs. The Company's CCRCs segment includes large owned or leased communities that offer a variety of living arrangements and services to accommodate a broad spectrum of physical ability and healthcare needs. Most of the Company's
CCRCs have independent living, assisted living, memory care, and skilled nursing available on one campus or within the immediate area.

Health Care Services. The Company's Health Care Services segment includes the home health, hospice, and outpatient therapy services provided to residents of many of its communities and to seniors living outside its communities. The Health Care Services segment does not include the skilled nursing and inpatient healthcare services provided in the Company's skilled nursing units, which are included in the Company's CCRCs segment.

Management Services. The Company's Management Services segment includes communities operated by the Company pursuant to management agreements. In some of the cases, the controlling financial interest in the community is held by third parties and, in other cases, the community is owned in a venture structure in which the Company has an ownership interest. Under the management agreements for these communities, the Company receives management fees as well as reimbursed expenses, which represent the reimbursement of expenses it incurs on behalf of the owners.

The accounting policies of the Company's reportable segments are the same as those described in the summary of significant accounting policies in Note 2.

The following table sets forth selected segment financial data:
For the Years Ended December 31,
(in thousands)202020192018
Revenue and other operating income:
Independent Living (1)(2)
$524,421 $544,558 $599,977 
Assisted Living and Memory Care (1)(2)
1,753,861 1,815,938 1,995,851 
CCRCs (1)(2)
340,337 402,175 416,408 
Health Care Services (1)(2)
389,697 447,260 436,975 
Management Services (3)
531,879 847,157 1,082,215 
Total revenue and other operating income$3,540,195 $4,057,088 $4,531,426 
Segment operating income:(4)
Independent Living$182,813 $203,741 $240,609 
Assisted Living and Memory Care428,601 518,636 628,982 
CCRCs53,180 72,072 92,212 
Health Care Services1,863 24,987 34,080 
Management Services130,690 57,108 71,986 
Total segment operating income797,147 876,544 1,067,869 
General and administrative (including non-cash stock-based compensation expense)206,575 219,289 259,475 
Facility operating lease expense:
Independent Living60,445 81,680 93,496 
Assisted Living and Memory Care137,900 157,823 178,716 
CCRCs20,406 24,248 24,856 
Corporate and Management Services5,282 5,915 6,226 
Depreciation and amortization:
Independent Living70,803 81,745 91,899 
Assisted Living and Memory Care224,790 222,574 261,365 
CCRCs38,426 44,163 53,551 
Health Care Services749 2,247 3,201 
Corporate and Management Services24,458 28,704 37,439 
For the Years Ended December 31,
(in thousands)202020192018
Asset impairment:
Independent Living31,317 1,812 2,013 
Assisted Living and Memory Care61,640 32,229 436,892 
CCRCs12,413 4,983 6,669 
Health Care Services— 7,578 9,055 
Corporate and Management Services1,938 2,664 35,264 
Loss (gain) on facility lease termination and modification, net(2,303)3,388 162,001 
Income (loss) from operations$(97,692)$(44,498)$(594,249)
Total interest expense:
Independent Living$44,682 $46,713 $58,783 
Assisted Living and Memory Care134,015 166,097 174,459 
CCRCs19,928 27,426 26,746 
Corporate and Management Services10,154 8,105 20,281 
$208,779 $248,341 $280,269 
Total capital expenditures for property, plant and equipment, and leasehold intangibles:
Independent Living$47,889 $78,831 $51,510 
Assisted Living and Memory Care90,354 157,845 125,750 
CCRCs18,709 33,535 26,615 
Health Care Services515 484 902 
Corporate and Management Services23,638 24,506 16,033 
$181,105 $295,201 $220,810 

As of December 31,
(in thousands)20202019
Total assets:
Independent Living$1,419,838 $1,441,652 
Assisted Living and Memory Care3,787,611 4,157,610 
CCRCs738,121 742,809 
Health Care Services233,178 256,715 
Corporate and Management Services723,010 595,647 
Total assets$6,901,758 $7,194,433 

(1)All revenue is earned from external third parties in the United States.
(2)The Independent Living, Assisted Living and Memory Care, CCRCs, and Health Care Services segments include $11.8 million, $62.6 million, $18.5 million, and $22.9 million, respectively, for the year ended December 31, 2020 of other operating income recognized for grants pursuant to the Provider Relief Fund described in Note 3 and other government sources. Allocations to the applicable segment generally reflect the segment's receipt and acceptance of the amounts or the segment's proportional utilization of the grant.
(3)Management services segment revenue includes reimbursements for which the Company is the primary obligor of costs incurred on behalf of managed communities.
(4)Segment operating income is defined as segment revenues less segment facility operating expenses (excluding facility depreciation and amortization) and costs incurred on behalf of managed communities.