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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Cash flows from operating activities:    
Net loss $ (86,259) $ (52,658)
Adjustments to reconcile net loss to cash provided by operating activities:    
Depreciation and amortization 70,133 64,800
Net amortization of debt discounts, premiums and issuance costs 24,863 2,074
Straight line rental income (291) (2,448)
Amortization of acquired real estate leases and other intangible assets, net 28 (311)
Loss on modification or early extinguishment of debt 0 1,075
Impairment of assets 12,142 5,925
Loss (gain) on sale of properties 5,874 (1,233)
Gains and losses on equity securities, net 0 (8,126)
Other non-cash adjustments, net (385) (674)
Unconsolidated joint venture distributions 1,231 1,411
Equity in net (earnings) losses of investees (1,898) 647
Change in assets and liabilities:    
Deferred leasing costs, net (669) (1,954)
Other assets 10,102 15,499
Accrued interest 904 2,540
Other liabilities (7,173) (20,525)
Net cash provided by operating activities 28,602 6,042
Cash flows from investing activities:    
Real estate improvements (46,723) (60,292)
Proceeds from sale of properties, net 3,343 3,548
Investment in AlerisLife Inc. (15,459) 0
Net cash used in investing activities (58,839) (56,744)
Cash flows from financing activities:    
Repayments of borrowings on credit facility 0 (250,000)
Repayment of other debt (822) (538)
Payment of debt issuance costs (5,257) (1,990)
Repurchase of common shares (78) (6)
Distributions to shareholders (2,404) (2,397)
Net cash used in financing activities (8,561) (254,931)
Decrease in cash and cash equivalents and restricted cash (38,798) (305,633)
Cash and cash equivalents and restricted cash at beginning of period 246,961 688,302
Cash and cash equivalents and restricted cash at end of period $ 208,163 $ 382,669