| Intangible Assets and Goodwill |
Intangible Assets and Goodwill The following is a summary of our real estate intangibles, excluding those related to ground leases or classified as held for sale, as of the dates indicated (in thousands): | | | | | | | | | | | | | | | | | | June 30, 2026 | | December 31, 2025 | | Assets: | | | | | | | | | | | | | | | | | | | | | Gross acquired lease intangibles | | $ | 3,167,918 | | | $ | 2,845,686 | | | Accumulated amortization | | (2,290,397) | | | (1,936,939) | | | Net book value | | $ | 877,521 | | | $ | 908,747 | | | | | | | | Liabilities: | | | | | | Below market tenant leases | | $ | 11,488 | | | $ | 25,546 | | | Accumulated amortization | | (6,109) | | | (18,825) | | | Net book value | | $ | 5,379 | | | $ | 6,721 | |
The following is a summary of real estate intangible amortization income (expense) for the periods presented (in thousands): | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Three Months Ended June 30, | | Six Months Ended June 30, | | | 2026 | | 2025 | | 2026 | | 2025 | | Rental income related to (above)/below market tenant leases, net | | $ | 71 | | | $ | (148) | | | $ | 196 | | | $ | (310) | | | Amortization related to in-place lease intangibles and lease commissions | | (229,775) | | | (101,546) | | | (391,314) | | | (210,529) | |
Goodwill The change in the carrying amount of goodwill by reportable segment is as follows (in thousands): | | | | | | | | | | | | | | | | | | | | | | | Seniors Housing Operating | | Outpatient Medical | | Total | Balance at December 31, 2025 | | $ | 277,995 | | | $ | 68,321 | | | $ | 346,316 | | | | | | | | | | | | | | | | | Acquisition measurement period adjustments | | $ | 6,897 | | | $ | — | | | $ | 6,897 | | | | | | | | | | Effect of foreign currency translation | | (3,984) | | | — | | | (3,984) | | Balance at June 30, 2026 | | $ | 280,908 | | | $ | 68,321 | | | $ | 349,229 | |
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