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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 6 Months Ended
Jun. 30, 2023
Jun. 30, 2022
Cash flows from operating activities:    
Net (loss) income $ (125,229) $ 131,040
Adjustments to reconcile net (loss) income to cash provided by (used in) operating activities:    
Depreciation and amortization 133,194 115,520
Net amortization of debt premiums, discounts and issuance costs 4,323 4,790
Straight line rental income 2,009 (4,455)
Amortization of acquired real estate leases (286) 162
Loss on modification or early extinguishment of debt 1,075 30,043
Impairment of assets 17,224 0
Gain on sale of properties (1,233) (327,108)
Gains and losses on equity securities, net (8,126) 18,710
Other non-cash adjustments, net (1,051) (905)
Unconsolidated joint venture distributions 2,640 5,660
Equity in net earnings of investees (2,282) (6,558)
Change in assets and liabilities:    
Deferred leasing costs, net (4,071) (4,968)
Other assets 29,992 25,922
Accrued interest (1,202) (2,206)
Other liabilities (15,254) (17,503)
Net cash provided by (used in) operating activities 31,723 (31,856)
Cash flows from investing activities:    
Real estate improvements (107,934) (116,640)
Proceeds from sale of properties, net 3,548 792
Proceeds from sale of properties to joint venture, net 0 643,892
Proceeds from sale of interest in joint venture, net 0 (330)
Proceeds from AlerisLife Inc. tender offer 14,006 0
Net cash (used in) provided by investing activities (90,380) 527,714
Cash flows from financing activities:    
Repayments of borrowings on credit facility (250,000) (100,000)
Redemption of senior unsecured notes 0 (500,000)
Repayment of other debt (15,678) (12,421)
Loss on early extinguishment of debt settled in cash 0 (24,375)
Payment of debt issuance costs (2,057) (2,820)
Repurchase of common shares (33) (5)
Distributions to shareholders (4,794) (4,780)
Net cash used in financing activities (272,562) (644,401)
Decrease in cash and cash equivalents and restricted cash (331,219) (148,543)
Cash and cash equivalents and restricted cash at beginning of period 688,302 1,016,945
Cash and cash equivalents and restricted cash at end of period $ 357,083 $ 868,402