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Leases (Tables) | 12 Months Ended
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Dec. 31, 2021
Leases [Abstract] |
Lease Cost | A summary of operating and financing lease expense (including the respective presentation on the consolidated statements of operations) and net cash outflows from leases is as follows.
| Years Ended December 31,
Operating Leases (in thousands) | 2021 |  | 2020 |  | 2019
Facility operating expense | $ | 12,606 |  |  | $ | 19,241 |  |  | $ | 18,677 |
Facility lease expense | 174,358 |  |  | 224,033 |  |  | 269,666 |
Operating lease expense | 186,964 |  |  | 243,274 |  |  | 288,343 |
Operating lease expense adjustment (1) | 23,280 |  |  | 136,276 |  |  | 19,453 |
Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements | (30,965) |  |  | (22,242) |  |  | (31,305) |
Operating net cash outflows from operating leases | $ | 179,279 |  |  | $ | 357,308 |  |  | $ | 276,491 |
(1) Represents the difference between the amount of cash operating lease payments and the amount of operating lease expense. Operating cash flows from operating leases for the year ended December 31, 2020 includes the $119.2 million one-time cash lease payment made to Ventas in connection with the Company's lease restructuring transaction effective July 26, 2020.
| Years Ended December 31,
Financing Leases (in thousands) | 2021 |  | 2020 |  | 2019
Depreciation and amortization | $ | 30,542 |  |  | $ | 32,647 |  |  | $ | 46,646 |
Interest expense: financing lease obligations | 46,282 |  |  | 48,534 |  |  | 66,353 |
Financing lease expense | $ | 76,824 |  |  | $ | 81,181 |  |  | $ | 112,999 |
Operating cash outflows from financing leases | $ | 46,282 |  |  | $ | 48,534 |  |  | $ | 66,353 |
Financing cash outflows from financing leases | 19,874 |  |  | 18,867 |  |  | 22,242 |
Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement | (11,135) |  |  | (5,603) |  |  | (3,504) |
Total net cash outflows from financing leases | $ | 55,021 |  |  | $ | 61,798 |  |  | $ | 85,091 |
Lessee, Operating Lease, Liability, Maturity | The aggregate amounts of future minimum lease payments, including community, office, and equipment leases, recognized on the consolidated balance sheet as of December 31, 2021 are as follows (in thousands).
Year Ending December 31, | Operating Leases |  | Financing Leases
2022 | $ | 204,702 |  |  | $ | 68,101 |
2023 | 193,070 |  |  | 68,840 |
2024 | 193,796 |  |  | 70,044 |
2025 | 191,439 |  |  | 59,413 |
2026 | 76,228 |  |  | 60,659 |
Thereafter | 206,388 |  |  | 52,881 |
Total lease payments | 1,065,623 |  |  | 379,938 |
Purchase option liability and non-cash gain on future sale of property | — |  |  | 418,542 |
Imputed interest and variable lease payments | (235,105) |  |  | (244,193) |
Total lease obligations | $ | 830,518 |  |  | $ | 554,287 |

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- Definition Tabular disclosure of lessee's lease cost. Includes, but is not limited to, interest expense for finance lease, amortization of right-of-use asset for finance lease, operating lease cost, short-term lease cost, variable lease cost and sublease income. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 842 -SubTopic 20 -Section 50 -Paragraph 4 -URI http://asc.fasb.org/extlink&oid=123408670&loc=SL77918686-209980 + Details
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- Definition Tabular disclosure of undiscounted cash flows of lessee's operating lease liability. Includes, but is not limited to, reconciliation of undiscounted cash flows to operating lease liability recognized in statement of financial position. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 842 -SubTopic 20 -Section 50 -Paragraph 6 -URI http://asc.fasb.org/extlink&oid=123408670&loc=SL77918701-209980 + Details
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