| 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): | | | | | | | | | | | | | | | | | September 30, 2026 | | December 31, 2025 | | Assets: | | | | | | | | | | | | | | | | | | | | | Gross acquired lease intangibles | | $ | 3,298,487 | | | $ | 2,845,686 | | | Accumulated amortization | | (2,458,663) | | | (1,936,939) | | | Net book value | | $ | 839,824 | | | $ | 908,747 | | | | | | | | Liabilities: | | | | | | Below market tenant leases | | $ | 11,284 | | | $ | 25,546 | | | Accumulated amortization | | (6,017) | | | (18,825) | | | Net book value | | $ | 5,267 | | | $ | 6,721 | |
The following is a summary of real estate intangible amortization income (expense) for the periods presented (in thousands): | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Three Months Ended | | Nine Months Ended | | | September 30, 2026 | | September 30, 2025 | | September 30, 2026 | | September 30, 2025 | | Rental income related to (above)/below market tenant leases, net | | $ | 94 | | | $ | (156) | | | $ | 290 | | | $ | (466) | | | Amortization related to in-place lease intangibles | | (174,974) | | | (95,694) | | | (566,288) | | | (306,223) | |
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 | | $ | (6,477) | | | $ | — | | | $ | (6,477) | | | | | | | | | | Effect of foreign currency translation | | (3,622) | | | — | | | (3,622) | | Balance at September 30, 2026 | | $ | 267,896 | | | $ | 68,321 | | | $ | 336,217 | |
|