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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Cash flows from operating activities:    
Net loss $ (264,665) $ (282,809)
Adjustments to reconcile net loss to cash provided by operating activities:    
Depreciation and amortization 199,915 207,449
Net amortization of debt discounts, premiums and issuance costs 66,094 76,642
Payment of accreted interest on senior secured notes (86,992) 0
Straight line rental income (759) (1,605)
Amortization of acquired real estate leases and other intangible assets, net 83 84
Loss on modification or early extinguishment of debt 40,388 209
Impairment of assets 162,708 41,718
(Gain) loss on sale of properties (103,971) 18,976
Gain on insurance recoveries (7,522) 0
Other non-cash adjustments, net (10) (405)
Unconsolidated joint venture distributions 250 1,231
Equity in net (earnings) losses of investees (9,652) 9,882
Change in assets and liabilities:    
Deferred leasing costs, net (3,273) (2,199)
Other assets (11,173) 2,828
Accrued interest (10,684) (258)
Other liabilities 29,755 22,285
Net cash provided by operating activities 492 94,028
Cash flows from investing activities:    
Real estate improvements (114,389) (134,966)
Proceeds from sale of properties, net 349,382 27,845
Investment in AlerisLife Inc. 0 (15,459)
Equity method investment distributions 48,400 0
Contributions to unconsolidated joint ventures (8,500) 0
Proceeds from insurance recoveries 1,308 1,698
Purchase of interest rate cap (47) 0
Net cash provided by (used in) investing activities 276,154 (120,882)
Cash flows from financing activities:    
Proceeds from issuance of senior secured notes, net 369,375 0
Proceeds from mortgage notes payable 343,157 120,000
Redemption of senior secured notes (483,368) 0
Redemption of senior unsecured notes (380,000) (60,000)
Repayment of other debt (2,728) (2,388)
Early extinguishment of debt settled in cash (35,804) 0
Payment of debt issuance costs (19,206) (8,203)
Repurchase of common shares (1,063) (902)
Distributions to shareholders (7,240) (7,214)
Net cash (used in) provided by financing activities (216,877) 41,293
Increase in cash and cash equivalents and restricted cash 59,769 14,439
Cash and cash equivalents and restricted cash at beginning of period 149,854 246,961
Cash and cash equivalents and restricted cash at end of period $ 209,623 $ 261,400