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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
CASH FLOWS FROM OPERATING ACTIVITIES:      
Net loss $ (370,255) $ (293,572) $ (15,774)
Adjustments to reconcile net loss to cash provided by (used in) operating activities:      
Depreciation and amortization 284,957 284,083 239,280
Net amortization of debt premiums, discounts and issuance costs 103,437 11,811 8,658
Straight line rental income (1,445) 1,095 (8,916)
Amortization of acquired real estate leases and other intangible assets, net 106 (242) 245
Loss on modification or early extinguishment of debt 324 2,468 30,043
Impairment of assets 70,734 18,380 0
Loss (gain) on sale of properties 18,938 (1,205) (321,862)
Gains and losses on equity securities, net 0 (8,126) 25,660
Other non-cash adjustments, net (1,025) (1,932) (2,038)
Unconsolidated joint venture distributions 1,231 5,100 8,769
Equity in net (earnings) losses of investees (1,597) 20,461 (6,055)
Change in assets and liabilities:      
Deferred leasing costs, net (3,578) (9,834) (7,874)
Other assets 16,672 10,672 10,946
Accrued interest 245 (6,570) (428)
Other liabilities (6,521) (22,106) (1,007)
Net cash provided by (used in) operating activities 112,223 10,483 (40,353)
CASH FLOWS FROM INVESTING ACTIVITIES:      
Real estate acquisitions and deposits 0 0 (75,105)
Real estate improvements (201,702) (235,007) (299,387)
Proceeds from sale of properties, net 34,167 18,356 822
Proceeds from sale of properties to joint venture, net 0 0 638,488
Proceeds from sale of interest in joint venture, net 0 0 108,424
Proceeds from insurance recoveries 1,698 534 14,466
Investment in AlerisLife Inc. (15,459) 0 0
Proceeds from AlerisLife Inc. tender offer 0 14,006 0
Contributions to unconsolidated joint ventures (5,723) 0 0
Net cash (used in) provided by investing activities (187,019) (202,111) 387,708
CASH FLOWS FROM FINANCING ACTIVITIES:      
Proceeds from issuance of senior secured notes, net 0 750,001 0
Proceeds from mortgage notes payable 120,000 0 0
Repayments of borrowings on credit facility 0 (700,000) (100,000)
Redemption of senior unsecured notes (120,000) (250,000) (500,000)
Repayment of other debt (3,218) (17,049) (39,067)
Loss on early extinguishment of debt settled in cash 0 (978) (24,375)
Payment of debt issuance costs (8,562) (21,699) (2,817)
Repurchase of common shares (904) (393) (171)
Distributions to shareholders (9,627) (9,595) (9,568)
Net cash used in financing activities (22,311) (249,713) (675,998)
Decrease in cash and cash equivalents and restricted cash (97,107) (441,341) (328,643)
Cash and cash equivalents and restricted cash at beginning of period 246,961 688,302 1,016,945
Cash and cash equivalents and restricted cash at end of period $ 149,854 $ 246,961 $ 688,302