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Supplemental Disclosure of Cash Flow Information - Supplemental Disclosure of Cash Flow Information (Details) - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020
Supplemental Cash Flow Information [Abstract] |  |  |
Interest paid | $ 200,308 | $ 188,791 | $ 204,696
Income taxes paid, net of refunds | (330) | 5,923 | 8,878
Capital expenditures, net of related payables | 196,924 | 176,657 | 185,871
Loss (gain) on debt modification and extinguishment, net | 1,357 | 1,932 | (10,896)
Accounts receivable, net | 4,624 | (502) | (24,277)
Investment in unconsolidated ventures | 218 | 5,436 | 4,082
Prepaid expenses and other assets, net | (21,240) | (15,483) | 24,707
Refundable fees and deferred revenue | (1,934) | (10,066) | 62,614
Non-operating loss (gain) on sale of assets, net | (74,445) | (288,835) | (374,532)
Capital expenditures, net of related payables: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Capital expenditures, net of related payables | 196,924 | 176,657 | 185,871
Trade accounts payable | (3,085) | (6,061) | 4,766
Acquisition of communities from Healthpeak: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Property, plant and equipment and leasehold intangibles, net | 0 | 0 | 286,734
Financing lease obligations | 0 | 0 | 129,196
Operating lease right-of-use assets | 0 | 0 | (63,285)
Operating lease obligations | 0 | 0 | 74,335
Loss (gain) on debt modification and extinguishment, net | 0 | 0 | (19,731)
Net cash paid | 0 | 0 | 407,249
Acquisition of other assets: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Property, plant and equipment and leasehold intangibles, net | 4 | 0 | 684
Financing lease obligations | 6,000 | 0 | 64,260
Net cash paid | 6,004 | 0 | 64,944
Proceeds from HCS Sale, net: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Trade accounts payable | 0 | 1,387 | 0
Property, plant and equipment and leasehold intangibles, net | 0 | (1,806) | 0
Operating lease right-of-use assets | 0 | (8,145) | 0
Operating lease obligations | 0 | 8,145 | 0
Accounts receivable, net | 0 | (57,582) | 0
Investment in unconsolidated ventures | 0 | 100,000 | 0
Goodwill | 0 | (126,810) | 0
Prepaid expenses and other assets, net | 0 | (32,963) | 0
Accrued expenses | 0 | 25,226 | 0
Refundable fees and deferred revenue | 0 | 57,314 | 0
Other liabilities | 0 | (9,165) | 0
Non-operating loss (gain) on sale of assets, net | 0 | (286,489) | 0
Net cash received | 0 | (312,558) | 0
Proceeds from sale of CCRC Venture, net: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Investment in unconsolidated ventures | 0 | 0 | 14,848
Other liabilities | 0 | 0 | (60,748)
Non-operating loss (gain) on sale of assets, net | 0 | 0 | (369,831)
Current portion of long-term debt | 0 | 0 | 34,706
Net cash received | 0 | 0 | (289,225)
Proceeds from sale of other assets, net: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Property, plant and equipment and leasehold intangibles, net | (107) | (878) | (938)
Prepaid expenses and other assets, net | (1,308) | (1,983) | (1,318)
Other liabilities | 1,025 | (75) | (786)
Non-operating loss (gain) on sale of assets, net | (595) | (2,346) | (4,701)
Assets held for sale | (3,668) | (16,166) | (34,348)
Net cash received | (4,653) | (21,448) | (42,091)
Master Agreement with Ventas: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Property, plant and equipment and leasehold intangibles, net | 0 | 0 | (66,444)
Financing lease obligations | 0 | 0 | 7,077
Operating lease right-of-use assets | 0 | 0 | (153,213)
Operating lease obligations | 0 | 0 | 362,944
Other assets, net | 0 | 0 | (42,354)
Long-term debt | 0 | 0 | 34,053
Additional paid-in-capital | 0 | 0 | (22,883)
Net cash received | 0 | 0 | 119,180
Non-Development | Capital expenditures, net of related payables: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Capital expenditures, net of related payables | 168,166 | 137,410 | 139,592
Development | Capital expenditures, net of related payables: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Capital expenditures, net of related payables | 6,193 | 3,208 | 13,667
Non-development - Reimbursable | Capital expenditures, net of related payables: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Capital expenditures, net of related payables | $ 25,650 | $ 42,100 | $ 27,846

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