HEALTHCARE REALTY TRUST INC, 10-K filed on 2/16/2024
Annual Report
v3.24.0.1
Cover Page - USD ($)
 12 Months Ended
Dec. 31, 2023
Feb. 12, 2024
Jun. 30, 2023
Cover [Abstract]      
Document Type 10-K    
Document Annual Report true    
Document Period End Date Dec. 31, 2023    
Current Fiscal Year End Date --12-31    
Document Transition Report false    
Entity File Number 001-35568    
Entity Registrant Name HEALTHCARE REALTY TRUST INCORPORATED    
Entity Incorporation, State or Country Code MD    
Entity Tax Identification Number 20-4738467    
Entity Address, Address Line One 3310 West End Avenue    
Entity Address, Address Line Two Suite 700    
Entity Address, City or Town Nashville    
Entity Address, State or Province TN    
Entity Address, Postal Zip Code 37203    
City Area Code 615    
Local Phone Number 269-8175    
Title of 12(b) Security Class A Common Stock, $0.01 par value per share    
Trading Symbol HR    
Security Exchange Name NYSE    
Entity Well-known Seasoned Issuer Yes    
Entity Voluntary Filers No    
Entity Current Reporting Status Yes    
Entity Interactive Data Current Yes    
Entity Filer Category Large Accelerated Filer    
Entity Small Business false    
Entity Emerging Growth Company false    
ICFR Auditor Attestation Flag true    
Document Financial Statement Error Correction Flag false    
Entity Shell Company false    
Entity Public Float     $ 7,130,838,614
Entity Common Stock, Shares Outstanding   381,180,874  
Documents Incorporated by Reference Portions of the Registrant’s definitive Proxy Statement relating to the Annual Meeting of Stockholders to be held on May 21, 2024, are incorporated by reference into Part III of this Report.    
Entity Central Index Key 0001360604    
Amendment Flag false    
Document Fiscal Year Focus 2023    
Document Fiscal Period Focus FY    
v3.24.0.1
Audit Information
 12 Months Ended
Dec. 31, 2023
Audit Information [Abstract]  
Auditor Name BDO USA, P.C.
Auditor Location Nashville, TN
Auditor Firm ID 243
v3.24.0.1
Consolidated Balance Sheets - USD ($)
$ in Thousands
Dec. 31, 2023
Dec. 31, 2022
Real estate properties    
Land $ 1,343,265 $ 1,439,798
Buildings and improvements 10,881,373 11,332,037
Lease intangibles 836,302 959,998
Personal property 12,718 11,907
Investment in financing receivables, net 122,602 120,236
Financing lease right-of-use assets 82,209 83,824
Construction in progress 60,727 35,560
Land held for development 59,871 74,265
Total real estate investments 13,399,067 14,057,625
Less accumulated depreciation (2,226,853) (1,645,271)
Total real estate investments, net 11,172,214 12,412,354
Cash and cash equivalents 25,699 60,961
Assets held for sale, net 8,834 18,893
Operating lease right-of-use assets 275,975 336,983
Investments in unconsolidated joint ventures 311,511 327,248
Goodwill 250,530 223,202
Other assets, net 592,368 469,990
Total assets 12,637,131 13,849,631
Liabilities    
Notes and bonds payable 4,994,859 5,351,827
Accounts payable and accrued liabilities 211,994 244,033
Liabilities of properties held for sale 295 437
Operating lease liabilities 229,714 279,895
Financing lease liabilities 74,503 72,939
Other liabilities 202,984 218,668
Total liabilities 5,714,349 6,167,799
Commitments and contingencies (See Footnote 15)
Redeemable non-controlling interests 3,868 2,014
Stockholders' equity    
Preferred stock, $0.01 par value; 200,000 shares authorized; none issued and outstanding 0 0
Common stock, $0.01 par value; 1,000,000 shares authorized; 380,964 and 380,590 shares issued and outstanding at December 31, 2023 and 2022, respectively. 3,810 3,806
Additional paid-in capital 9,602,592 9,587,637
Accumulated other comprehensive (loss) income (10,741) 2,140
Cumulative net income attributable to common stockholders 1,028,794 1,307,055
Cumulative dividends (3,801,793) (3,329,562)
Total stockholders’ equity 6,822,662 7,571,076
Non-controlling interest 96,252 108,742
Total equity 6,918,914 7,679,818
Total liabilities, redeemable non-controlling interests, and stockholders' equity $ 12,637,131 $ 13,849,631
v3.24.0.1
Consolidated Balance Sheets (Parenthetical) - $ / shares
Dec. 31, 2023
Dec. 31, 2022
Statement of Financial Position [Abstract]    
Preferred stock, par value (in dollars per share) $ 0.01 $ 0.01
Preferred stock, authorized (in shares) 200,000,000 200,000,000
Preferred stock, issued (in shares) 0 0
Preferred stock, outstanding (in shares) 0 0
Common stock, par value (in dollars per share) $ 0.01 $ 0.01
Common stock, authorized (in shares) 1,000,000,000 1,000,000,000
Common stock, issued (in shares) 380,964,000 380,590,000
Common stock, outstanding (in shares) 380,964,000 380,590,000
v3.24.0.1
Consolidated Statements of Operations - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Revenues      
Rental income $ 1,309,184 $ 907,451 $ 520,334
Interest income 17,134 11,480 4,192
Other operating 17,451 13,706 10,291
Total Revenue 1,343,769 932,637 534,817
Expenses      
Property operating 500,437 344,038 212,273
General and administrative 58,405 52,734 34,152
Acquisition and pursuit costs 2,026 3,229 3,930
Merger-related costs (1,952) 103,380 0
Depreciation and amortization 730,709 453,082 202,714
Total expenses 1,289,625 956,463 453,069
Other income (expense)      
Gain on sales of real estate properties 77,546 270,271 55,940
Interest expense (258,584) (146,691) (53,124)
Gain (loss) on extinguishment of debt 62 (2,401) 0
Impairment of real estate properties and credit loss reserves (154,912) (54,427) (17,101)
Equity loss from unconsolidated joint ventures (1,682) (687) (795)
Interest and other income (expense), net 1,343 (1,546) (9)
Total other income (expense) (336,227) 64,519 (15,089)
Net (loss) income (282,083) 40,693 66,659
Net loss attributable to non-controlling interests 3,822 204 0
Net (loss) income attributable to common stockholders $ (278,261) $ 40,897 $ 66,659
Basic and diluted earnings per share:      
Basic earnings per common share (in dollars per share) $ (0.74) $ 0.15 $ 0.45
Diluted earnings per common share (in dollars per share) $ (0.74) $ 0.15 $ 0.45
Weighted average number of shares outstanding, basic and diluted:      
Weighted average common shares outstanding - basic (in shares) 378,927,871 252,356,203 142,637,166
Weighted average common shares outstanding - diluted (in shares) 378,927,871 253,873,321 142,710,228
Revenue, Product and Service [Extensible List] Service [Member] Service [Member] Service [Member]
v3.24.0.1
Consolidated Statements of Comprehensive Income (Loss) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Statement of Comprehensive Income [Abstract]      
Net (loss) income $ (282,083) $ 40,693 $ 66,659
Interest rate swaps      
Reclassification adjustment for (gains) losses included in net income (interest expense) (14,488) 1,527 4,472
Gains arising during the period on interest rate swaps 1,463 10,630 3,379
Net current-period other comprehensive (loss) income (13,025) 12,157 7,851
Comprehensive (loss) income (295,108) 52,850 74,510
Less: Comprehensive loss attributable to non-controlling interests 3,966 168 0
Comprehensive (loss) income attributable to common stockholders $ (291,142) $ 53,018 $ 74,510
v3.24.0.1
Consolidated Statements of Equity and Redeemable Non-Controlling Interests - USD ($)
$ in Thousands
Total
Preferred Stock
Common Stock
Additional Paid-In Capital
Accumulated Other Comprehensive Income (Loss)
Cumulative Net Income
Cumulative Dividends
Total Stockholders’ Equity
Non- controlling Interests
Beginning Balance at Dec. 31, 2020 $ 1,948,376 $ 0 $ 1,395 $ 3,635,341 $ (17,832) $ 1,199,499 $ (2,870,027) $ 1,948,376  
Increase (Decrease) in Stockholders' Equity [Roll Forward]                  
Issuance of stock, net of costs 331,042   109 330,933       331,042  
Common stock redemption (4,085)   (1) (4,084)       (4,085)  
Share-based compensation 10,729   2 10,727       10,729  
Net (loss) income 66,659         66,659   66,659  
Loss on interest rate swaps and treasury locks 7,851       7,851     7,851  
Reclassification adjustments for losses (gains) included in net income (interest expense) 4,472                
Gains (losses) arising during the period on interest rate swaps and treasury locks 3,379                
Dividends to common stockholders (175,456)           (175,456) (175,456)  
Ending Balance at Dec. 31, 2021 2,185,116 0 1,505 3,972,917 (9,981) 1,266,158 (3,045,483) 2,185,116 $ 0
Redeemable Non-controlling Interests, beginning balance at Dec. 31, 2020 0                
Redeemable Non-controlling Interests, ending balance at Dec. 31, 2021 0                
Increase (Decrease) in Stockholders' Equity [Roll Forward]                  
Issuance of stock, net of costs 22,907   6 22,901       22,907  
Merger consideration transferred 5,687,165   2,289 5,574,174       5,576,463 110,702
Common stock redemption (2,792)   (1) (2,791)       (2,792)  
Share-based compensation 20,346   7 20,339       20,346  
Redemption of non-controlling interest 0     97       97 (97)
Net (loss) income 40,693         40,897   40,897 (204)
Loss on interest rate swaps and treasury locks 12,157                
Reclassification adjustments for losses (gains) included in net income (interest expense) 1,527       1,531     1,531 (4)
Gains (losses) arising during the period on interest rate swaps and treasury locks 10,630       10,590     10,590 40
Dividends to common stockholders (285,774)           (284,079) (284,079) (1,695)
Ending Balance at Dec. 31, 2022 7,679,818 0 3,806 9,587,637 2,140 1,307,055 (3,329,562) 7,571,076 108,742
Redeemable Non-controlling Interests                  
Contributions from redeemable non-controlling interests 2,014                
Redeemable Non-controlling Interests, ending balance at Dec. 31, 2022 2,014                
Increase (Decrease) in Stockholders' Equity [Roll Forward]                  
Issuance of stock, net of costs 130     130       130  
Common stock redemption (2,235)   (1) (2,234)       (2,235)  
Conversion of OP Units to common stock 0   2 2,774       2,776 (2,776)
Share-based compensation 14,288   3 14,285       14,288  
Net (loss) income (282,083)         (278,261)   (278,261) (3,822)
Loss on interest rate swaps and treasury locks (13,025)                
Reclassification adjustments for losses (gains) included in net income (interest expense) (14,488)       (14,315)     (14,315) (173)
Gains (losses) arising during the period on interest rate swaps and treasury locks 1,463       1,434     1,434 29
Dividends to common stockholders (477,979)           (472,231) (472,231) (5,748)
Ending Balance at Dec. 31, 2023 6,918,914 $ 0 $ 3,810 $ 9,602,592 $ (10,741) $ 1,028,794 $ (3,801,793) $ 6,822,662 $ 96,252
Redeemable Non-controlling Interests                  
Contributions from redeemable non-controlling interests 1,889                
Adjustments to redemption value of redeemable non-controlling interests (35)                
Redeemable Non-controlling Interests, ending balance at Dec. 31, 2023 $ 3,868                
v3.24.0.1
Consolidated Statements of Equity and Redeemable Non-Controlling Interests (Parenthetical) - $ / shares
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Statement of Stockholders' Equity [Abstract]      
Dividends to common stockholders (in dollars per share) $ 1.24 $ 1.24 $ 1.21
v3.24.0.1
Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
OPERATING ACTIVITIES      
Net (loss) income $ (282,083) $ 40,693 $ 66,659
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 730,709 453,082 202,714
Other amortization 45,181 24,695 3,793
Share-based compensation 14,288 20,346 10,729
Amortization of straight-line rent receivable (lessor) (38,676) (23,498) (5,801)
Amortization of straight-line rent on operating leases (lessee) 6,084 3,374 1,498
Gain on sales of real estate properties (77,546) (270,271) (55,940)
(Gain) loss on extinguishment of debt (62) 2,401 0
Impairment of real estate properties and credit loss reserves 154,912 54,427 17,101
Equity loss from unconsolidated joint ventures 1,682 687 795
Distributions from unconsolidated joint ventures 17,880 1,881 0
Non-cash interest from financing and real estate notes receivable (1,654) (2,257) (391)
Changes in operating assets and liabilities:      
Other assets, including right-of-use-assets (55,946) (26,098) (11,436)
Accounts payable and accrued liabilities (18,775) 24,191 (839)
Other liabilities 3,826 (30,906) 3,747
Net cash provided by operating activities 499,820 272,747 232,629
INVESTING ACTIVITIES      
Acquisitions of real estate (49,171) (402,529) (365,943)
Development of real estate (41,058) (37,862) (4,029)
Additional long-lived assets (231,026) (163,544) (100,689)
Funding of mortgages and notes receivable (26,803) (23,325) 0
Investments in unconsolidated joint ventures (3,824) (99,967) (89,600)
Investment in financing receivable (1,801) (1,002) (186,433)
Proceeds from sales of real estate properties and additional long-lived assets 701,434 1,201,068 184,221
Contributions from redeemable non-controlling interests 1,389 0 0
Proceeds from notes receivable repayments 0 1,688 0
Cash assumed in Merger, including restricted cash for special dividend payment 0 1,159,837
Net cash provided by (used in) investing activities 349,140 1,634,364 (562,473)
FINANCING ACTIVITIES      
Net (repayments) borrowing on unsecured credit facility (385,000) 40,000 210,000
Borrowings on term loans 0 666,500 0
Repayment on term loan 0 (1,141,500) 0
Repayments of notes and bonds payable (19,143) (20,042) (24,557)
Redemption of notes and bonds payable 0 (2,184) 0
Dividends paid (472,242) (283,713) (175,456)
Special dividend paid in relation to the Merger 0 (1,123,648) 0
Net proceeds from issuance of common stock 130 22,902 331,119
Common stock redemptions (2,298) (3,192) (3,803)
Distributions to non-controlling interest of limited partners (5,123) (1,695) 0
Debt issuance and assumption costs (529) (12,753) (405)
Payments made on finance leases (17) 0 (9,182)
Net cash (used in) provided by financing activities (884,222) (1,859,325) 327,716
(Decrease) increase in cash and cash equivalents (35,262) 47,786 (2,128)
Cash and cash equivalents cash at beginning of period 60,961 13,175 15,303
Cash and cash equivalents at end of period 25,699 60,961 13,175
Supplemental Cash Flow Information      
Interest paid 216,033 112,692 49,443
Mortgage notes payable assumed in connection with acquisition of real estate, net 5,284 0 11,790
Invoices accrued for construction, tenant improvements and other capitalized costs 31,469 48,292 17,655
Capitalized interest 2,961 1,410 221
Mortgage note receivables taken in connection with sale of real estate 51,000 0 0
Real estate notes receivable assumed in Merger (adjusted to fair value) 0 74,819 0
Unsecured credit facility and term loans assumed in Merger (adjusted to fair value) 0 1,758,650 0
Senior notes assumed in Merger (adjusted to fair value) 0 2,232,650 0
Consideration transferred in relation to the Merger $ 0 $ 5,576,463 $ 0
v3.24.0.1
Summary of Significant Accounting Policies
 12 Months Ended
Dec. 31, 2023
Accounting Policies [Abstract]  
Summary of Significant Accounting Policies Summary of Significant Accounting Policies
Business Overview
Healthcare Realty Trust Incorporated is a real estate investment trust ("REIT") that owns, leases, manages, acquires, finances, develops and redevelops income-producing real estate properties associated primarily with the delivery of outpatient healthcare services throughout the United States of America. Except as otherwise provided in the Notes to the Company’s Consolidated Financial Statements, references herein to the "Company" mean Healthcare Realty Trust Incorporated and its consolidated subsidiaries, including Healthcare Realty Holdings, L.P. (formerly known as Healthcare Trust of America Holdings, LP) (the "OP"), after giving effect to the Merger discussed in more detail in Note 2 below. As of December 31, 2023, the Company had gross investments of approximately $13.4 billion in 655 consolidated real estate properties, construction in progress, redevelopments, financing receivables, financing lease right-of-use assets, land held for development, corporate property and excluding held for sale assets. The Company’s real estate properties are located in 35 states and total approximately 38.5 million square feet. In addition, the Company had a weighted average ownership interest of approximately 43% in 33 real estate properties held in unconsolidated joint ventures.
See Note 5 below for more details regarding the Company's joint ventures. Square footage and property count disclosures in these Notes to the Company's Consolidated Financial Statements are unaudited.
Principles of Consolidation
The Company’s Consolidated Financial Statements include the accounts of the Company, its wholly owned subsidiaries, and joint ventures and partnerships where the Company controls the operating activities. GAAP requires the Company to identify entities for which control is achieved through means other than voting rights and to determine which business enterprise is the primary beneficiary of variable interest entities (“VIEs”). ASC Topic 810 broadly defines a VIE as an entity in which either (i) the equity investors as a group, if any, lack the power through voting or similar rights to direct the activities of such entity that most significantly impact such entity’s economic performance or (ii) the equity investment at risk is insufficient to finance that entity’s activities without additional subordinated financial support. The Company identifies the primary beneficiary of a VIE as the enterprise that has both of the following characteristics: (i) the power to direct the activities of the VIE that most significantly impact the entity’s economic performance and (ii) the obligation to absorb losses or receive benefits of the VIE that could potentially be significant to the entity. The Company consolidates its investment in a VIE when it determines that it is the VIE’s primary beneficiary, with any minority interests reflected as non-controlling interests or redeemable non-controlling interests in the accompanying Consolidated Financial Statements.
The Company may change its original assessment of a VIE upon subsequent events such as the modification of contractual arrangements that affect the characteristics or adequacy of the entity’s equity investments at risk, the disposition of all or a portion of an interest held by the primary beneficiary, or changes in facts and circumstances that impact the power to direct activities of the VIE that most significantly impacts economic performance. The Company performs this analysis on an ongoing basis.
For property holding entities not determined to be VIEs, the Company consolidates such entities in which it owns 100% of the equity or has a controlling financial interest evidenced by ownership of a majority voting interest. All intercompany balances and transactions are eliminated in consolidation. For entities in which the Company owns less than 100% of the equity interest, the Company consolidates the entity if it has the direct or indirect ability to control the entities’ activities based upon the terms of the respective entities’ ownership agreements.
The OP is 98.8% owned by the Company. Holders of operating partnership units (“OP Units”) are considered to be non-controlling interest holders in the OP and their ownership interests are reflected as equity on the accompanying Consolidated Balance Sheets. Further, a portion of the earnings and losses of the OP are allocated to non-controlling interest holders based on their respective ownership percentages. Upon conversion of OP Units to common stock, any difference between the fair value of the common stock issued and the carrying value of the OP Units converted to common stock is recorded as a component of equity. As of December 31, 2023, there were approximately 4.5 million, or 1.2%, of OP Units issued and outstanding held by non-controlling interest holders. Additionally, the Company is the primary beneficiary of this VIE. Accordingly, the Company consolidates its interests in the OP.
As of December 31, 2023, the Company had four consolidated VIEs in addition to the OP, consisting of joint venture investments in which the Company is the primary beneficiary of the VIE based on the combination of operational control and the rights to receive residual returns or the obligation to absorb losses arising from the joint ventures. Accordingly, such joint ventures have been consolidated, and the table below summarizes the balance sheets of consolidated VIEs, excluding the OP, in the aggregate:
(dollars in thousands)DECEMBER 31, 2023
Assets:
Net real estate investments$85,752 
Cash and cash equivalents2,144 
Receivables and other assets
2,704 
Total assets
$90,600 
Liabilities:
Accrued expenses and other liabilities
$17,835 
Total equity
72,765 
Total liabilities and equity
$90,600 
As of December 31, 2023, the Company had three unconsolidated VIEs consisting of two notes receivables and one joint venture. It was determined that the Company was not the primary beneficiary of the unconsolidated VIEs because the Company does not have the power or economics to direct the activities of the VIEs on a stand-alone basis. Therefore, the Company accounts for the two notes receivables as amortized cost and a joint venture arrangement under the equity method. See below for additional information regarding the Company's unconsolidated VIEs:
(dollars in thousands) ORIGINATION DATELOCATIONSOURCECARRYING AMOUNTMAXIMUM EXPOSURE TO LOSS
2021
Houston, TX 1
Note receivable$31,150 $31,150 
2021
Charlotte, NC 1
Note receivable5,796 6,000 
2022
Texas 2
Equity method61,801 61,801 
1Assumed mortgage note receivable in connection with the Merger.
2Includes investments in seven properties.

As of December 31, 2023, the Company's unconsolidated joint venture arrangements were accounted for using the equity method of accounting as the Company exercised significant influence over but did not control these entities. See Note 5 for more details regarding the Company's unconsolidated joint ventures.
Use of Estimates in the Consolidated Financial Statements
Preparation of the Consolidated Financial Statements in accordance with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect amounts reported in the Consolidated Financial Statements and accompanying notes. Actual results may differ from those estimates and assumptions. Management makes significant estimates regarding revenue recognition, purchase price allocations to record investments in real estate, impairments, collectability of tenant receivables, and fair value measurements, as applicable.
Segment Reporting
The Company owns, leases, acquires, manages, finances, develops and redevelops outpatient and other healthcare-related properties. The Company is managed as one reporting unit, rather than multiple reporting units, for internal reporting purposes and for internal decision-making. Therefore, the Company discloses its operating results in a single reportable segment.
Real Estate Properties
Real estate properties are recorded at cost or at fair value if acquired in a transaction that is a business combination under ASC Topic 805, Business Combinations. Cost or fair value at the time of acquisition is allocated among land, buildings, tenant improvements, lease and other intangibles, and personal property as applicable.
During 2023 and 2022, the Company eliminated against accumulated depreciation approximately $51.7 million and $19.6 million, respectively, of fully amortized real estate intangibles that were initially recorded as a component of certain real estate acquisitions. During 2022, approximately $4.1 million of fully depreciated tenant and capital improvements that were no longer in service were eliminated against accumulated depreciation.
Depreciation expense of real estate properties for the three years ended December 31, 2023, 2022 and 2021 was $518.6 million, $320.8 million and $170.0 million, respectively. Depreciation and amortization of real estate assets in place as of December 31, 2023, is provided for on a straight-line basis over the asset’s estimated useful life:
Land improvements
2.0 to 39.0 years
Buildings and improvements
3.3 to 49.0 years
Lease intangibles (including ground lease intangibles)
1.0 to 99.0 years
Personal property
3.0 to 20.0 years
The Company capitalizes direct costs, including costs such as construction costs and professional services, and indirect costs, including capitalized interest and overhead costs, associated with the development and construction of real estate assets while substantive activities are ongoing to prepare the assets for their intended use. Capitalized interest cost is calculated using the weighted average interest rate of the Company's unsecured debt or the interest rate on project specific debt, if applicable. The Company continues to capitalize interest on the unoccupied portion of the properties in stabilization for up to one year after the buildings have been placed into service, at which time the capitalization of interest must cease.
Asset Impairment
The Company assesses the potential for impairment of identifiable, definite-lived, intangible assets and long-lived assets, including real estate properties, whenever events occur or a change in circumstances indicates that the carrying value might not be fully recoverable. Indicators of impairment may include significant underperformance of an asset relative to historical or expected operating results; significant changes in the Company’s use of assets or the strategy for its overall business; plans to sell an asset before its depreciable life has ended; the expiration of a significant portion of leases in a property; or significant negative economic trends or negative industry trends for the Company or its tenants. In addition, the Company reviews for possible impairment, those assets subject to purchase options and those impacted by casualty losses, such as tornadoes and hurricanes. A property value is considered impaired only if management's estimate of current and projected (undiscounted and unleveraged) operating cash flows of the property is less than the net carrying value of the property. These estimates of future cash flows include only those that are directly associated with and that are expected to arise as a direct result of the use and eventual disposition of the property based on its estimated remaining useful life. These estimates, including the useful life determination which can be affected by any potential sale of the property, are based on management's assumptions about its use of the property. Therefore, significant judgment is involved in estimating the current and projected cash flows. If management determines that the carrying value of the Company’s assets may not be fully recoverable based on the existence of any of the factors above, or others, management would measure and record an impairment charge based on the estimated fair value of the property or the estimated fair value less costs to sell the property.
Acquisitions of Real Estate Properties with In-Place Leases
The Company's acquisitions of real estate properties typically do not meet the definition of a business and are accounted for as asset acquisitions. Acquisitions of real estate properties with in-place leases are accounted for at relative fair value. When a building with in-place leases is acquired, the cost of the acquisition must be allocated between the tangible real estate assets "as-if-vacant" and the intangible real estate assets related to in-place leases based on their estimated fair values. Land fair value is estimated by using an assessment of comparable transactions and other relevant data.
The Company considers whether any of the in-place lease rental rates are above- or below-market. An asset (if the actual rental rate is above-market) or a liability (if the actual rental rate is below-market) is calculated and recorded in an amount equal to the present value of the future cash flows that represent the difference between the actual lease rate and the estimated market rate. If an in-place lease is identified as a below-market rental rate, the Company would also evaluate any renewal options associated with that lease to determine if the intangible should include those periods. The values related to above- or below-market in-place lease intangibles are amortized over the remaining term of the leases upon acquisition to rental income where the Company is the lessor and to property operating expense where the Company is the lessee.
The Company also estimates an absorption period, which can vary by property, assuming the building is vacant and must be leased up to the actual level of occupancy when acquired. During that absorption period, the owner would incur direct costs, such as tenant improvements, and would suffer lost rental income. Likewise, the owner would have acquired a measurable asset in that, assuming the building was vacant, certain fixed costs would be avoided because the actual in-place lessees would reimburse a certain portion of fixed costs through expense reimbursements during the absorption period.
These assets (above- or below-market lease, tenant improvement, leasing costs avoided, rental income lost, and expenses recovered through in-place lessee reimbursements) are estimated and recorded in amounts equal to the present value of estimated future cash flows. The actual purchase price is allocated based on the various relative asset fair values described above.
The building and tenant improvement components of the purchase price are depreciated over the estimated useful life of the building or the weighted average remaining term of the in-place leases. The at-market, in-place lease intangibles are amortized to depreciation and amortization expense over the weighted average remaining term of the leases, and customer relationship assets are amortized to depreciation amortization expense over terms applicable to each acquisition. Any goodwill recorded through a business combination would be reviewed for impairment at least annually and is not amortized.
See Note 9 for more details on the Company’s intangible assets.
Fair Value Measurements
Fair value is defined as the price that would be received to sell an asset, or paid to transfer a liability, in an orderly transaction between market participants. In calculating fair value, a company must maximize the use of observable market inputs, minimize the use of unobservable market inputs and disclose in the form of an outlined hierarchy the details of such fair value measurements.
A hierarchy of valuation techniques is defined to determine whether the inputs to a fair value measurement are considered to be observable or unobservable in a marketplace. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect the Company’s market assumptions. This hierarchy requires the use of observable market data when available. These inputs have created the following fair value hierarchy:
•Level 1 – quoted prices for identical instruments in active markets;
•Level 2 – quoted prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are not active, and model-derived valuations in which significant inputs and significant value drivers are observable in active markets; and
•Level 3 – fair value measurements derived from valuation techniques in which one or more significant inputs or significant value drivers are unobservable.
Executed purchase and sale agreements, which are binding agreements, are categorized as level one inputs. Brokerage estimates, letters of intent, or unexecuted purchase and sale agreements are considered to be level three as they are nonbinding in nature.
Fair Value of Derivative Financial Instruments
Derivative financial instruments are recorded at fair value on the Company's Consolidated Balance Sheets as other assets or other liabilities. The valuation of derivative instruments requires the Company to make estimates and judgments that affect the fair value of the instruments. Fair values of derivatives are estimated by pricing models that consider the forward yield curves and discount rates. The fair value of the Company's forward starting interest
rate swap contracts are estimated by pricing models that consider foreign trade rates and discount rates. Such amounts and the recognition of such amounts are subject to significant estimates that may change in the future. For derivatives designated in qualifying cash flow hedging relationships, the change in fair value of the effective portion of the derivatives is recognized in accumulated other comprehensive income (loss). Gains and losses are reclassified from accumulated other comprehensive income (loss) into earnings once the underlying hedged transaction is recognized in earnings. As of December 31, 2023 and 2022, the Company had $10.7 million recorded in accumulated other comprehensive loss and $2.1 million recorded in accumulated other comprehensive (loss) income, respectively, related to forward starting interest rate swaps entered into and settled during 2015 and 2020 and a hedge of the Company's variable rate debt. See Note 11 for additional information.
Cash, Cash Equivalents and Restricted Cash
Cash and cash equivalents includes short-term investments with original maturities of three months or less when purchased. Restricted cash includes cash held in escrow in connection with proceeds from the sales of certain real estate properties. The Company did not have any restricted cash for the years ended December 31, 2023 or 2022.
Cash and cash equivalents are held in bank accounts and overnight investments. The Company maintains its bank deposits with large financial institutions in amounts that often exceed federally-insured limits. The Company has not experienced any losses in such accounts.
Goodwill and Other Intangible Assets
Goodwill and intangible assets with indefinite lives are not amortized, but are tested at least annually for impairment. Intangible assets with finite lives are amortized over their respective lives to their estimated residual values and are reviewed for impairment only when impairment indicators are present.
Identifiable intangible assets of the Company are comprised of enterprise goodwill, in-place lease intangible assets, customer relationship intangible assets, and debt issuance costs. In-place lease and customer relationship intangible assets are amortized on a straight-line basis over the applicable lives of the assets. Debt issuance costs are amortized over the term of the debt instrument on the effective interest method or the straight-line method when the effective interest method is not applicable. Goodwill is not amortized but is evaluated annually as of December 31 for impairment. The Company's goodwill asset increased $27.3 million to $250.5 million in 2023 compared to $223.2 million in 2022, as a result of the final purchase price allocation adjustments related to the Merger. The 2023 impairment evaluation indicated that no impairment had occurred with respect to the Company's goodwill asset. See Note 9 for more detail on the Company’s intangible assets.
Contingent Liabilities
From time to time, the Company may be subject to loss contingencies arising from legal proceedings and similar matters. Additionally, while the Company maintains comprehensive liability and property insurance with respect to each of its properties, the Company may be exposed to unforeseen losses related to uninsured or underinsured damages.
The Company continually monitors any matters that may present a contingent liability, and, on a quarterly basis, management reviews the Company’s reserves and accruals in relation to each of them, adjusting provisions as necessary in view of changes in available information. Liabilities for contingencies are first recorded when a loss is determined to be both probable and can be reasonably estimated. Changes in estimates regarding the exposure to a contingent loss are reflected as adjustments to the related liability in the periods when they occur.
Because of uncertainties inherent in the estimation of contingent liabilities, it is possible that the Company’s provision for contingent losses could change materially in the near term. To the extent that any significant losses, in addition to amounts recognized, are at least reasonably possible, such amounts will be disclosed in the notes to the Consolidated Financial Statements.
Share-Based Compensation
The Company has various employee and director share-based awards outstanding. These awards include non-vested common stock or other stock-based awards, including units in the OP, pursuant to the Company's Amended and Restated 2006 Incentive Plan, dated April 29, 2021 ("the Incentive Plan"). The Company recognizes share-based payments to employees and directors in the Consolidated Statements of Operations on a straight-line basis over the
requisite service period based on the fair value of the award on the measurement date. The Company recognizes the impact of forfeitures as they occur. See Note 13 for details on the Company’s share-based awards.
Accumulated Other Comprehensive (Loss) Income
Certain items must be included in comprehensive (loss) income, including items such as foreign currency translation adjustments, minimum pension liability adjustments, changes in the fair value of derivative instruments and unrealized gains or losses on available-for-sale securities. As of December 31, 2023, the Company’s accumulated other comprehensive (loss) income consists of the loss for changes in the fair value of active derivatives designated as cash flow hedges and the loss on the unamortized settlement of forward starting swaps and treasury hedges. See Note 11 for more details on the Company's derivative financial instruments.
Revenue from Contracts with Customers (Topic 606)
The Company recognizes certain revenue under the core principle of Topic 606. This requires an entity to recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. Lease revenue is not within the scope of Topic 606. To achieve the core principle, the Company applies the five-step model specified in the guidance.
Revenue that is accounted for under Topic 606 is segregated on the Company’s Consolidated Statements of Operations in the Other operating line item. This line item includes parking income, management fee income and other miscellaneous income. Below is a detail of the amounts by category:
YEAR ENDED DECEMBER 31,
in thousands202320222021
Type of Revenue
Parking income$9,903 $8,513 $7,859 
Management fee income/other 1
7,548 5,193 2,432 
$17,451 $13,706 $10,291 
1 Includes the recovery of certain expenses under the financing receivable as outlined in the management agreement.

The Company’s two major types of revenue that are accounted for under Topic 606 are all accounted for as the performance obligation is satisfied. The performance obligations that are identified for each of these items are satisfied over time and the Company recognizes revenue monthly based on this principle. In most cases, the revenue is due and payable on a monthly basis. The Company had a receivable balance of $1.9 million and $1.5 million, and $1.4 million for the years ended December 31, 2023, 2022 and 2021, respectively.
Management fee income includes property management services provided to third parties and certain of the properties in the Company's unconsolidated joint ventures and is generally calculated, accrued and billed monthly based on a percentage of cash collections of tenant receivables for the month or a stated amount per square foot. Management fee income also includes amounts paid to the Company for its asset management services for certain of its unconsolidated joint ventures. Internal management fee income, where the Company manages its owned properties, is eliminated in consolidation.
Rental Income
Rental income related to non-cancelable operating leases is recognized as earned over the life of the lease agreements on a straight-line basis. The Company's lease agreements generally include provisions for stated annual increases or increases based on a Consumer Price Index ("CPI"). Rental income from properties under multi-tenant office lease arrangements and rental income from properties with single-tenant lease arrangements are included in rental income on the Company's Consolidated Statements of Operations. For lessors, the standard requires a lessor to classify leases as either sales-type, direct-financing or operating. A lease will be treated as a sale if it is considered to transfer control of the underlying asset to the lessee. A lease will be classified as direct-financing if risks and rewards are conveyed without the transfer of control. Otherwise, the lease is treated as an operating lease.
Nonlease components, such as common area maintenance, are generally accounted for under Topic 606 and separated from the lease payments. However, the Company elected the lessor practical expedient allowing the Company to not separate these components when certain conditions are met. The combined component is accounted for under Accounting Standards Codification, Topic 842.
The components of rental income are as follows:
YEAR ENDED DECEMBER 31,
in thousands202320222021
Property operating income$1,270,508 $883,953 $514,533 
Straight-line rent38,676 23,498 5,801 
Rental income$1,309,184 $907,451 $520,334 
Federal Income Taxes
The Company believes it has qualified to be taxed as a REIT and intends at all times to continue to qualify as a REIT under Sections 856 through 860 of the Internal Revenue Code. The Company must distribute at least 90% per annum of its real estate investment trust taxable income to its stockholders and meet other requirements to continue to qualify as a real estate investment trust. As a REIT, the Company is generally not subject to federal income tax on net income it distributes to its stockholders, but may be subject to certain state and local taxes and fees. See Note 16 for further discussion.
If the Company fails to qualify as a REIT in any taxable year, it will be subject to U.S. federal income taxes on its taxable income and will not be permitted to qualify for treatment as a REIT for U.S. federal income tax purposes for four years following the year during which the qualification is lost unless the IRS grants it relief under certain statutory provisions. Such an event could have a material adverse effect on its business, financial condition, results of operations and net cash available for dividend distributions to its stockholders.
The Company conducts substantially all of its operations through the OP. As a partnership, the OP generally is not liable for federal income taxes. The income and loss from the operations of the OP is included in the tax returns of its partners, including the Company, who are responsible for reporting their allocable share of the partnership income and loss. Accordingly, no provision for income tax has been made in the accompanying consolidated financial statements.
The Company classifies interest and penalties related to uncertain tax positions, if any, in the Consolidated Financial Statements as a component of general and administrative expenses. No such amounts were recognized during the three years ended December 31, 2023.
Federal tax returns for the years 2020, 2021, 2022 and 2023 are currently subject to examination by taxing authorities.
State Income Taxes
The Company must pay certain state income taxes and the provisions for such taxes are generally included in general and administrative expenses on the Company’s Consolidated Statements of Operations. See Note 16 for further discussion.
Sales and Use Taxes
The Company must pay sales and use taxes to certain state tax authorities based on rents collected from tenants in properties located in those states. The Company is generally reimbursed for these taxes by the tenant. The Company accounts for the payments to the taxing authority and subsequent reimbursement from the tenant on a net basis in rental income in the Company’s Consolidated Statements of Operations.
Assets Held for Sale
Long-lived assets held for sale are reported at the lower of their carrying amount or their fair value less estimated cost to sell. Further, depreciation of these assets ceases at the time the assets are classified as held for sale. Losses resulting from the sale of such properties are characterized as impairment losses in the Consolidated Statements of Operations. See Note 6 for more detail on assets held for sale.
Earnings per Share
The Company uses the two-class method of computing net earnings per common share. Earnings per common share is calculated by considering share-based payment awards that contain nonforfeitable rights to dividends or dividend equivalents as participating securities. Undistributed earnings (excess net income over dividend payments) are allocated on a pro rata basis to common shareholders and restricted shareholders. Undistributed losses (dividends in excess of net income) do not get allocated to restricted stockholders as they do not have the contractual obligation to share in losses. The amount of undistributed losses that applies to the restricted stockholders is allocated to the common stockholders.
Basic earnings per common share is calculated using weighted average shares outstanding less issued and outstanding non-vested shares of common stock. Diluted earnings per common share is calculated using weighted average shares outstanding plus the dilutive effect of the outstanding stock options from the Legacy HR Employee Stock Purchase Plan using the treasury stock method and the average stock price during the period. Additionally, net income (loss) allocated to OP units has been included in the numerator and common stock related to redeemable OP units have been included in the denominator for the purpose of computing diluted earnings per share. See Note 14 for the calculations of earnings per share.
Redeemable Non-Controlling Interests
The Company accounts for redeemable equity securities in accordance with Accounting Standards Update ("ASU") 2009-04 Liabilities (Topic 480): Accounting for Redeemable Equity Instruments, which requires that equity securities contingently redeemable at the option of the holder, not solely within our control, be classified outside permanent stockholders’ equity. The Company classifies redeemable equity securities as redeemable non-controlling interests in the accompanying Consolidated Balance Sheet. Accordingly, the Company records the carrying amount at the greater of the initial carrying amount (increased or decreased for the non-controlling interest’s share of net income or loss and distributions) or the redemption value. We measure the redemption value and record an adjustment to the carrying value of the equity securities as a component of redeemable non-controlling interest. As of December 31, 2023, the Company had redeemable non-controlling interests of $3.9 million.
Investments in Leases - Financing Receivables, Net
In accordance with ASC Topic 842: Leases, for transactions in which the Company enters into a contract to acquire an asset and leases it back to the seller (i.e., a sale-leaseback transaction), control of the asset is not considered to have transferred when the seller-lessee has a purchase option. As a result, the Company does not recognize the underlying real estate asset but instead recognizes a financial asset in accordance with ASC Topic 310: Receivables. See below for additional information regarding the Company's financing receivables as of December 31, 2023.

(dollars in thousands) ORIGINATION DATELOCATIONINTEREST RATECARRYING VALUE as of DECEMBER 31, 2023
May 2021Poway, CA5.71%$115,239 
November 2021Columbus, OH6.48%7,363 
$122,602 
Real Estate Notes Receivable
Real estate notes receivable consists of mezzanine and other real estate loans, which are generally collateralized by a pledge of the borrower’s ownership interest in the respective real estate owner, a mortgage or deed of trust, and/or corporate guarantees. Real estate notes receivable are intended to be held-to-maturity and are recorded at amortized cost, net of unamortized loan origination costs and fees and allowance for credit losses. As of December 31, 2023, real estate notes receivable, net, which are included in Other assets, net on the Company's Consolidated Balance Sheets totaled $173.6 million.
(dollars in thousands)ORIGINATIONMATURITYSTATED INTEREST RATEMAXIMUM LOAN COMMITMENTOUTSTANDING as of
DEC 31, 2023		ALLOWANCE FOR CREDIT LOSSESFAIR VALUE DISCOUNT AND FEESCARRYING VALUE as of DEC 31, 2023
Mezzanine loans
Texas6/24/20216/24/20248.00 %$54,119 $54,119 $(5,196)$(3,067)$45,856 
Arizona12/21/202312/20/20269.00 %6,000 6,000 — — 6,000 
60,119 60,119 (5,196)(3,067)51,856 
Mortgage loans
Texas6/30/20217/01/20247.00 %31,150 31,150 — — 31,150 
North Carolina12/22/202112/22/20248.00 %6,000 6,000 — (204)5,796 
Florida5/17/20222/27/20266.00 %65,000 32,156 — (44)32,112 
California3/30/20233/29/20266.00 %45,000 45,000 — — 45,000 
Florida12/28/202312/28/20269.00 %7,700 7,700 — — 7,700 
154,850 122,006 — (248)121,758 
$214,969 $182,125 $(5,196)$(3,315)$173,614 

Allowance for Credit Losses
Pursuant to ASC Topic 326, Financial Instruments - Credit Losses, the Company adopted a policy to evaluate current expected credit losses at the inception of loans qualifying for treatment under ASC Topic 326. The Company utilizes a probability of default method approach for estimating current expected credit losses and evaluates the liquidity and creditworthiness of its borrowers on a quarterly basis to determine whether any updates to the future expected losses recognized upon inception are necessary. The Company’s evaluation considers industry and economic conditions, credit enhancements, liquidity, and other factors. The determination of the credit allowance is based on a quarterly evaluation of all outstanding loans, including general economic conditions and estimated collectability of loan payments. The Company evaluates the collectability of loan receivables based on a combination of credit quality indicators, including, but not limited to, payment status, historical loan charge-offs, financial strength of the borrower and guarantors, and nature, extent, and value of the underlying collateral. A loan is considered to have deteriorated credit quality when, based on current information and events, it is probable that the Company will be unable to collect all amounts due as scheduled according to the contractual terms of the loan agreement. For those loans identified as having deteriorated credit quality, the amount of credit loss is determined on an individual basis. Placement on non-accrual status may be required. Consistent with this definition, all loans on non-accrual status are
deemed to have deteriorated credit quality. To the extent circumstances improve and the risk of collectability is diminished, the loan may return to income accrual status. While a loan is on non-accrual status, any cash receipts are applied against the outstanding principal balance. As of December 31, 2023, the Company's carrying value of its outstanding loans was $173.6 million.
During the first quarter of 2023, the Company determined that the risk of credit loss on its mezzanine loans was no longer remote and recorded a credit loss reserve of $5.2 million. The following table summarizes the Company's allowance for credit losses on real estate notes receivable:
Dollars in thousandsTWELVE MONTHS ENDED DECEMBER 31, 2023TWELVE MONTHS ENDED DECEMBER 31, 2022
Allowance for credit losses, beginning of period$— $— 
Credit loss reserves5,196 — 
Allowance for credit losses, end of period$5,196 $— 
Interest Income
Income from Lease Finance Receivables
The Company recognized the related income from two financing receivables totaling $8.3 million and $8.1 million, respectively, for the years ended December 31, 2023 and 2022, based on an imputed interest rate over the terms of the applicable lease. As a result, the interest recognized from the financing receivable in any particular period will not equal the cash payments from the lease agreement in that period.
Acquisition costs incurred in connection with entering into the financing receivable are treated as loan origination fees. These costs are classified with the financing receivable and are included in the balance of the net investment. Amortization of these amounts will be recognized as a reduction to Interest income over the life of the lease.
Income from Real Estate Notes Receivable
For the years ended December 31, 2023 and 2022, the Company recognized interest income of $8.8 million and $3.4 million, respectively, related to real estate notes receivable. For 2021, the Company had no real estate notes receivable. The Company recognizes interest income on an accrual basis unless the Company has determined that collectability of contractual amounts is not reasonably assured, at which point the note is placed on non-accrual status and interest income is recognized on a cash basis. As of January 1, 2023, the Company placed real estate notes receivable with principal balances of $48.9 million on non-accrual status and accordingly did not recognize any interest income for the year ended December 31, 2023.
New Accounting Pronouncements
On November 27, 2023, the Financial Accounting Standards Board ("FASB") issued ASU 2023-07, Segment Reporting (Topic 280). Some of the main provisions of this update to segment reporting include; (i) a requirement to disclose significant segment expenses, on an annual and interim basis, that are regularly provided to the chief operating decision maker ("CODM") and included within each reported measure of segment profit or loss; (ii) a requirement to disclose the title and position of the CODM and an explanation of how the CODM uses the reported measures of segment profit or loss in assessing segment performance and deciding how to allocate resources, and (iii) a requirement that an entity that has a single reportable segment provide all the disclosures required by the amendments in this update.
The update is effective for reporting periods beginning after December 15, 2023, and interim periods beginning after December 15, 2024. Early adoption is permitted. At this time, the Company does not expect that the adoption of this ASU will have a material impact on its consolidated financial statements and compliance of these new disclosure requirements will begin with the Company's Annual Report on Form 10-K for the year ended December 31, 2024.
v3.24.0.1
Merger with HTA
 12 Months Ended
Dec. 31, 2023
Business Combination and Asset Acquisition [Abstract]  
Merger with HTA Merger with HTA
On July 20, 2022 (the “Closing Date”), pursuant to the Agreement and Plan of Merger dated as of February 28, 2022 (the “Merger Agreement”), by and among Healthcare Realty Trust Incorporated (now known as HRTI, LLC,) (“Legacy HR”), Healthcare Trust of America, Inc. (now known as Healthcare Realty Trust Incorporated) (“Legacy HTA”), the OP, and HR Acquisition 2, LLC (“Merger Sub”), Merger Sub merged with and into Legacy HR, with Legacy HR continuing as the surviving entity and a wholly-owned subsidiary of Legacy HTA (the “Merger”).
On the Closing Date, each outstanding share of Legacy HR common stock, $0.01 par value per share (the “Legacy HR Common Stock”), was cancelled and converted into the right to receive one share of Legacy HTA class A common stock at a fixed ratio of 1.00 to 1.00. Per the terms of the Merger Agreement, Legacy HTA declared a special dividend of $4.82 (the “Special Dividend”) for each outstanding share of Legacy HTA class A common stock, $0.01 par value per share ( the “Legacy HTA Common Stock”), and the OP declared a corresponding distribution to the holders of its partnership units, payable to Legacy HTA stockholders and OP unitholders of record on July 19, 2022.
Immediately following the Merger, Legacy HR converted to a Maryland limited liability company and changed its name to HRTI, LLC and Legacy HTA changed its name to “Healthcare Realty Trust Incorporated”. In addition, the equity interests of Legacy HR were contributed by Legacy HTA by means of a contribution and assignment agreement to the OP, and Legacy HR became a wholly-owned subsidiary of the OP. The Company operates under the name “Healthcare Realty Trust Incorporated” and its shares of class A common stock, $0.01 par value per share, trade on the New York Stock Exchange under the ticker symbol “HR”.
For accounting purposes, the Merger was treated as a “reverse acquisition” in which Legacy HTA was considered the legal acquirer and Legacy HR was considered the accounting acquirer based on various factors, including, but not limited to: (i) the composition of the board of directors of the combined company following the Merger, (ii) the composition of senior management of the combined company following the Merger, and (iii) the premium transferred to the Legacy HTA stockholders. As a result, the historical financial statements of the accounting acquirer, Legacy HR, became the historical financial statements of the Company.
The acquisition was accounted for using the acquisition method of accounting in accordance with ASC 805, Business Combinations, which requires, among other things, the assets acquired and the liabilities assumed and non-controlling interests, if any, to be recognized at their acquisition date fair value.
The implied consideration transferred on the Closing Date is as follows:
Dollars in thousands, except for per share data
Shares of Legacy HTA Common Stock outstanding as of July 20, 2022 as adjusted(a)
228,520,990 
Exchange ratio1.00 
Implied shares of Legacy HR Common Stock issued228,520,990 
Adjusted closing price of Legacy HR Common Stock on July 20, 2022(b)
$24.37 
Value of implied Legacy HR Common Stock issued$5,569,057 
Fair value of Legacy HTA restricted stock awards attributable to pre-Merger services(c)
7,406 
Consideration transferred$5,576,463 
(a) The number of shares of Legacy HTA Common Stock presented above was based on 228,857,717 total shares of Legacy HTA Common Stock outstanding as of the Closing Date, less 192 Legacy HTA fractional shares that were cancelled in lieu of cash and less 336,535 shares of Legacy HTA restricted stock (net of 215,764 shares of Legacy HTA restricted stock withheld). For accounting purposes, these shares were converted to Legacy HR Common Stock, at an exchange ratio of 1.00 share of Legacy HR Common Stock per share of Legacy HTA Common Stock.
(b) For accounting purposes, the fair value of Legacy HR Common Stock issued to former holders of Legacy HTA Common Stock was based on the per share closing price of Legacy HR Common Stock on July 20, 2022.
(c) Represents the fair value of Legacy HTA restricted shares which fully vested prior to the closing of the Merger or became fully vested as a result of the closing of the Merger and which are attributable to pre-combination services.
Final Purchase Price Allocation
The following table summarizes the estimated fair values of the assets acquired and liabilities assumed at the Closing Date:
Dollars in thousandsPRELIMINARY AMOUNTS RECOGNIZED ON THE CLOSING DATE CUMULATIVE MEASUREMENT PERIOD ADJUSTMENTSAMOUNTS RECOGNIZED ON THE CLOSING DATE
(as adjusted)
ASSETS
Real estate investments
Land $985,926 $18,359 $1,004,285 
Buildings and improvements6,960,418 (119,135)6,841,283 
Lease intangible assets(a)
831,920 1,839 833,759 
Financing lease right-of-use assets9,874 3,146 13,020 
Construction in progress10,071 (6,744)3,327 
Land held for development46,538 — 46,538 
Total real estate investments$8,844,747 $(102,535)$8,742,212 
Assets held for sale, net 707,442 (7,946)699,496 
Investments in unconsolidated joint ventures67,892 — 67,892 
Cash and cash equivalents26,034 11,403 37,437 
Restricted cash 1,123,647 (1,247)1,122,400 
Operating lease right-of-use assets198,261 16,370 214,631 
Other assets, net (b) (c)
209,163 (3,840)205,323 
Total assets acquired$11,177,186 $(87,795)$11,089,391 
LIABILITIES
Notes and bonds payable $3,991,300 $— $3,991,300 
Accounts payable and accrued liabilities 1,227,570 17,374 1,244,944 
Liabilities of assets held for sale28,677 (3,939)24,738 
Operating lease liabilities 173,948 10,173 184,121 
Financing lease liabilities 10,720 (855)9,865 
Other liabilities 203,210 (8,909)194,301 
Total liabilities assumed$5,635,425 $13,844 $5,649,269 
Net identifiable assets acquired$5,541,761 $(101,639)$5,440,122 
Non-controlling interest$110,702 $— $110,702 
Goodwill$145,404 $101,639 $247,043 
(a) The weighted average amortization period for the acquired lease intangible assets is approximately 6 years.
(b) Includes $15.9 million of contractual accounts receivable, which approximates fair value.
(c) Includes $78.7 million of gross contractual real estate notes receivable, the fair value of which was $74.8 million, and the Company preliminarily expects to collect substantially all of the real estate notes receivable proceeds as of the Closing Date.
The cumulative measurement period adjustments recorded through June 30, 2023 are final and primarily resulted from updated valuations related to the Company’s real estate assets and liabilities and additional information obtained by the Company related to the properties acquired in the Merger and their respective tenants, and resulted in an increase to goodwill of $101.6 million.
Based on the final purchase price allocation of fair value, approximately $247.0 million has been allocated to goodwill. Goodwill represents the excess of the purchase price over the fair value of the net tangible and intangible assets acquired and liabilities assumed. The recognized goodwill is attributable to expected synergies and benefits arising from the Merger, including anticipated general and administrative cost savings and potential economies of scale benefits in both tenant and vendor relationships following the closing of the Merger. None of the goodwill recognized is expected to be deductible for tax purposes.
Merger-related Costs
The Company incurred Merger-related costs of $(2.0) million and $103.4 million, respectively, for the years ended December 31, 2023 and 2022, which were included within Merger-related costs in results of operations. The Merger-related costs primarily consisted of legal, consulting, severance, and banking services and for the year ended December 31, 2023, including a refund of $17.8 million for transfer taxes paid during the year ended December 31, 2022.
v3.24.0.1
Property Investments
 12 Months Ended
Dec. 31, 2023
Real Estate Investment Property, Net [Abstract]  
Property Investments Property Investments
The Company invests in healthcare-related properties located throughout the United States. The Company provides management, leasing, development and redevelopment services, and capital for the construction of new facilities as well as for the acquisition of existing properties. The following table summarizes the Company’s consolidated investments at December 31, 2023.
Dollars in thousandsNUMBER OF PROPERTIESLANDBUILDINGS AND IMPROVEMENTSLEASE INTANGIBLESPERSONAL PROPERTYTOTALACCUMULATED DEPRECIATION
 Dallas, TX 43 $90,168 $1,004,810 $68,139 $550 $1,163,667 $(221,375)
 Houston, TX 31 76,959 614,531 60,651 57 752,198 (97,793)
 Seattle, WA 29 64,295 631,438 9,921 715 706,369 (186,903)
 Denver, CO 33 76,698 501,994 43,268 610 622,570 (94,906)
 Charlotte, NC 32 35,465 463,461 26,971 110 526,007 (116,578)
 Phoenix, AZ 35 20,262 437,804 36,384 425 494,875 (59,449)
 Atlanta, GA 27 49,095 417,112 28,204 100 494,511 (79,569)
 Boston, MA 17 127,447 299,742 41,183 14 468,386 (37,569)
 Raleigh, NC 28 56,620 371,932 36,411 9 464,972 (38,879)
 Nashville, TN 13 43,347 397,192 10,206 7,427 458,172 (115,979)
 Los Angeles, CA 20 72,086 360,330 16,481 453 449,350 (145,875)
 Miami, FL 19 53,994 326,343 35,014 178 415,529 (74,470)
 Tampa, FL 19 31,121 351,879 27,438 33 410,471 (36,726)
 Indianapolis, IN 36 54,899 285,806 32,780 13 373,498 (42,273)
 Austin, TX 13 27,063 274,229 18,568 142 320,002 (55,891)
 New York, NY 14 64,402 170,304 26,430 — 261,136 (15,887)
 Chicago, IL 6 13,804 216,473 13,011 81 243,369 (39,671)
 Memphis, TN 11 13,901 189,941 4,211 322 208,375 (71,813)
 Honolulu, HI 6 9,527 188,772 6,319 169 204,787 (61,575)
 Hartford, CT 30 29,381 138,713 21,848 — 189,942 (15,883)
 Other (49 markets)193 332,731 3,238,567 272,864 1,310 3,845,472 (617,789)
655 1,343,265 10,881,373 836,302 12,718 13,073,658 (2,226,853)
Investment in financing receivables, net— — — — 122,602 — 
Financing lease right-of-use assets— — — — — 82,209 — 
Construction in progress— — — — — 60,727 — 
Land held for development— — — — — 59,871 — 
Total real estate investments655 $1,343,265 $10,881,373 $836,302 $12,718 $13,399,067 $(2,226,853)
v3.24.0.1
Leases
 12 Months Ended
Dec. 31, 2023
Leases [Abstract]  
Leases Leases
Lessor Accounting Under ASC 842
The Company’s properties generally are leased pursuant to non-cancelable, fixed-term operating leases with expiration dates through 2052. Some leases provide tenants with fixed rent renewal terms while others have market rent renewal terms. Some leases provide the lessee, during the term of the lease, with an option or right of first
refusal to purchase the leased property. The Company’s single-tenant net leases generally require the lessee to pay minimum rent and all taxes (including property tax), insurance, maintenance and other operating costs associated with the leased property.
The Company's leases typically have escalators that are either based on a stated percentage or an index such as the CPI. In addition, most of the Company's leases include nonlease components, such as reimbursement of operating expenses as additional rent, or include the reimbursement of expected operating expenses as part of the lease payment. The Company adopted an accounting policy to combine lease and nonlease components. Rent escalators based on indices and reimbursements of operating expenses that are not included in the lease rate are considered variable lease payments. Variable payments are recognized in the period earned. Lease income for the Company's operating leases recognized for the years ended December 31, 2023 and 2022 was $1.3 billion and $907.5 million, respectively.
Future minimum lease payments under the non-cancelable operating leases, excluding any reimbursements, as of December 31, 2023 were as follows:
In thousands
2024$894,442 
2025801,973 
2026701,615 
2027582,028 
2028469,549 
2029 and thereafter1,579,010 
$5,028,617 

Revenue Concentrations
The Company’s real estate portfolio is leased to a diverse tenant base. The Company did not have any customers that account for 10% or more of the Company's revenues for the years ended December 31, 2023, 2022 and 2021.

Purchase Option Provisions
Certain of the Company’s leases include purchase option provisions. The provisions vary by agreement but generally allow the lessee to purchase the property covered by the agreement at fair market value or an amount equal to the Company’s gross investment. The Company expects that the purchase price from its purchase options will be greater than its net investment in the properties at the time of potential exercise by the lessee. The Company had investments of approximately $111.1 million in six real estate properties as of December 31, 2023 that were subject to purchase options that were exercisable.

Lessee Accounting Under ASC 842
As of December 31, 2023, the Company was obligated, as the lessee, under operating lease agreements consisting primarily of the Company’s ground leases. Contracts evaluated and treated as leases are those that convey the right to control the use of identified assets for a period of time in exchange for consideration. ASC 842 requires the recording of these leases based on the aggregate future cash flows, discounted utilizing the implicit rate in the lease, or, if not readily determinable, based upon the lessee's incremental borrowing rate, to which the Company utilizes market inputs that are both similar to the Company's credit profile and corresponding term of the leases. As of December 31, 2023, the Company had 232 properties totaling 16.9 million square feet that were held under ground leases. Some of the ground leases include fixed rent renewal terms and others have market rent renewal terms. The ground leases typically have initial terms of 40 to 99 years with expiration dates through 2119. Any rental increases related to the Company’s ground leases are generally either stated or based on the CPI. The Company had 75 prepaid ground leases as of December 31, 2023. The amortization of the prepaid rent, included in the operating lease right-of-use asset, represented approximately $1.3 million, $1.1 million and $0.6 million for the years ended December 31, 2023, 2022 and 2021, respectively.
The Company’s future lease payments (primarily for its 157 non-prepaid ground leases) as of December 31, 2023 were as follows:
In thousandsOPERATINGFINANCING
2024$12,263 $2,182 
202512,428 2,218 
202612,516 2,254 
202712,703 2,294 
202812,822 2,326 
2029 and thereafter698,905 394,072 
Total undiscounted lease payments$761,637 $405,346 
Discount(531,923)(330,843)
Lease liabilities$229,714 $74,503 

The following table provides details of the Company's total lease expense for the years ended December 31, 2023 and 2022:
In thousandsYEAR ENDED
Dec. 31, 2023		YEAR ENDED
Dec. 31, 2022
Operating lease cost
Operating lease expense$20,623 $12,699 
Variable lease expense8,979 4,529 
Finance lease cost
Amortization of right-of-use assets1,564 1,288 
Interest on lease liabilities3,718 2,876 
Total lease expense$34,884 $21,392 
Other information
Operating cash flows outflows related to operating leases$19,222$12,816
Operating cash flows outflows related to financing leases$2,122$1,838
Financing cash flows outflows related to financing leases$17$—
Right-of-use assets obtained in exchange for new finance lease liabilities$—$53,765
Right-of-use assets obtained in exchange for new operating lease liabilities$1,758$216,047
Weighted-average remaining lease term (excluding renewal options) - operating leases45.847.5
Weighted-average remaining lease term (excluding renewal options) - finance leases57.958.9
Weighted-average discount rate - operating leases5.7 %5.8 %
Weighted-average discount rate - finance leases5.0 %5.0 %
Leases Leases
Lessor Accounting Under ASC 842
The Company’s properties generally are leased pursuant to non-cancelable, fixed-term operating leases with expiration dates through 2052. Some leases provide tenants with fixed rent renewal terms while others have market rent renewal terms. Some leases provide the lessee, during the term of the lease, with an option or right of first
refusal to purchase the leased property. The Company’s single-tenant net leases generally require the lessee to pay minimum rent and all taxes (including property tax), insurance, maintenance and other operating costs associated with the leased property.
The Company's leases typically have escalators that are either based on a stated percentage or an index such as the CPI. In addition, most of the Company's leases include nonlease components, such as reimbursement of operating expenses as additional rent, or include the reimbursement of expected operating expenses as part of the lease payment. The Company adopted an accounting policy to combine lease and nonlease components. Rent escalators based on indices and reimbursements of operating expenses that are not included in the lease rate are considered variable lease payments. Variable payments are recognized in the period earned. Lease income for the Company's operating leases recognized for the years ended December 31, 2023 and 2022 was $1.3 billion and $907.5 million, respectively.
Future minimum lease payments under the non-cancelable operating leases, excluding any reimbursements, as of December 31, 2023 were as follows:
In thousands
2024$894,442 
2025801,973 
2026701,615 
2027582,028 
2028469,549 
2029 and thereafter1,579,010 
$5,028,617 

Revenue Concentrations
The Company’s real estate portfolio is leased to a diverse tenant base. The Company did not have any customers that account for 10% or more of the Company's revenues for the years ended December 31, 2023, 2022 and 2021.

Purchase Option Provisions
Certain of the Company’s leases include purchase option provisions. The provisions vary by agreement but generally allow the lessee to purchase the property covered by the agreement at fair market value or an amount equal to the Company’s gross investment. The Company expects that the purchase price from its purchase options will be greater than its net investment in the properties at the time of potential exercise by the lessee. The Company had investments of approximately $111.1 million in six real estate properties as of December 31, 2023 that were subject to purchase options that were exercisable.

Lessee Accounting Under ASC 842
As of December 31, 2023, the Company was obligated, as the lessee, under operating lease agreements consisting primarily of the Company’s ground leases. Contracts evaluated and treated as leases are those that convey the right to control the use of identified assets for a period of time in exchange for consideration. ASC 842 requires the recording of these leases based on the aggregate future cash flows, discounted utilizing the implicit rate in the lease, or, if not readily determinable, based upon the lessee's incremental borrowing rate, to which the Company utilizes market inputs that are both similar to the Company's credit profile and corresponding term of the leases. As of December 31, 2023, the Company had 232 properties totaling 16.9 million square feet that were held under ground leases. Some of the ground leases include fixed rent renewal terms and others have market rent renewal terms. The ground leases typically have initial terms of 40 to 99 years with expiration dates through 2119. Any rental increases related to the Company’s ground leases are generally either stated or based on the CPI. The Company had 75 prepaid ground leases as of December 31, 2023. The amortization of the prepaid rent, included in the operating lease right-of-use asset, represented approximately $1.3 million, $1.1 million and $0.6 million for the years ended December 31, 2023, 2022 and 2021, respectively.
The Company’s future lease payments (primarily for its 157 non-prepaid ground leases) as of December 31, 2023 were as follows:
In thousandsOPERATINGFINANCING
2024$12,263 $2,182 
202512,428 2,218 
202612,516 2,254 
202712,703 2,294 
202812,822 2,326 
2029 and thereafter698,905 394,072 
Total undiscounted lease payments$761,637 $405,346 
Discount(531,923)(330,843)
Lease liabilities$229,714 $74,503 

The following table provides details of the Company's total lease expense for the years ended December 31, 2023 and 2022:
In thousandsYEAR ENDED
Dec. 31, 2023		YEAR ENDED
Dec. 31, 2022
Operating lease cost
Operating lease expense$20,623 $12,699 
Variable lease expense8,979 4,529 
Finance lease cost
Amortization of right-of-use assets1,564 1,288 
Interest on lease liabilities3,718 2,876 
Total lease expense$34,884 $21,392 
Other information
Operating cash flows outflows related to operating leases$19,222$12,816
Operating cash flows outflows related to financing leases$2,122$1,838
Financing cash flows outflows related to financing leases$17$—
Right-of-use assets obtained in exchange for new finance lease liabilities$—$53,765
Right-of-use assets obtained in exchange for new operating lease liabilities$1,758$216,047
Weighted-average remaining lease term (excluding renewal options) - operating leases45.847.5
Weighted-average remaining lease term (excluding renewal options) - finance leases57.958.9
Weighted-average discount rate - operating leases5.7 %5.8 %
Weighted-average discount rate - finance leases5.0 %5.0 %
v3.24.0.1
Acquisitions, Dispositions and Mortgage Repayments
 12 Months Ended
Dec. 31, 2023
Business Combination and Asset Acquisition [Abstract]  
Acquisitions, Dispositions and Mortgage Repayments Acquisitions, Dispositions and Mortgage Repayments
2023 Acquisition Activity
The following table details the Company's real estate acquisition activity for the year ended December 31, 2023:
Dollars in thousandsDATE ACQUIREDPURCHASE PRICEMORTGAGE NOTES PAYABLE, NET
CASH
CONSIDERATION 1
REAL
ESTATE
OTHER 2
SQUARE FOOTAGE
Tampa, FL3/10/23$31,500 $— $30,499 $30,596 $(97)115,867 
Colorado Springs, CO7/28/2311,450 (5,284)6,024 11,416 (108)42,770 
Total real estate acquisitions$42,950 $(5,284)$36,523 $42,012 $(205)158,637 
1.Cash consideration excludes prorations of revenue and expense due to/from seller at the time of the acquisition.
2.Includes other assets acquired, liabilities assumed, and intangibles recognized at acquisition.

In the second quarter of 2023, the Company entered into a joint venture agreement for the development of a medical office building in Scottsdale, Arizona. The Company holds a 90% interest in the joint venture and determined the arrangement meets the criteria to be consolidated. The joint venture acquired an $8.8 million land parcel to be developed with the Company contributing cash of $8.3 million.
In the third quarter of 2023, the Company acquired the fee interest in a parcel of land previously held under a ground lease for $0.8 million and an additional interest in an operating property for $0.6 million.
The following table summarizes the estimated relative fair values of the assets acquired and liabilities assumed in the real estate acquisitions for 2023 as of the acquisition date:
ESTIMATED
FAIR VALUE
in millions		ESTIMATED
USEFUL LIFE
in years
Building$27.5 
17.0 - 30.0
Tenant Improvements3.4 
5.1 - 5.9
Land5.5 — 
Land Improvements1.1 
6.0 - 10.0
Intangibles
At-market lease intangibles4.5 
5.1 - 5.9
Above-market lease intangibles (lessor)0.2 
1.8 - 4.9
Below-market lease intangibles (lessor)(0.2)
6.4 - 13.9
Mortgage notes payable assumed, including fair value adjustments(5.3)
Other assets acquired0.1 
Accounts payable, accrued liabilities and other liabilities assumed(0.3)
Total cash paid$36.5 
Unconsolidated Joint Ventures
As of December 31, 2023, the Company had a weighted average ownership interest of approximately 43% in 33 real estate properties held in unconsolidated joint ventures. The Company recognizes distributions from unconsolidated joint ventures utilizing the nature of distribution approach and classifies the distributions based on the nature of the underlying activity that generated the distribution. The distributions from unconsolidated joint ventures for the years ended December 31, 2023 and 2022 were classified as operating activities.
The Company's investment in and loss recognized for the years ended December 31, 2023 and 2022 related to its unconsolidated joint ventures accounted for under the equity method are shown in the table below:
DECEMBER 31,
Dollars in millions20232022
Investments in unconsolidated joint ventures, beginning of period$327.2 $161.9 
New investments during the period3.8 167.9 
Equity loss recognized during the period(1.7)(0.7)
Owner distributions(17.8)(1.9)
Investments in unconsolidated joint ventures, end of period$311.5 $327.2 

2022 Acquisitions
The following table details the Company's acquisitions, exclusive of the Merger, for the year ended December 31, 2022:
Dollars in thousands
TYPE 1
DATE ACQUIREDPURCHASE PRICE
CASH
CONSIDERATION 2
REAL
ESTATE
OTHER 3
SQUARE FOOTAGE
unaudited
Dallas, TX 4
MOB2/11/22$8,175 $8,185 $8,202 $(17)18,000
San Francisco, CA 5
MOB3/7/22114,000 112,986 108,687 4,299 166,396
Atlanta, GAMOB4/7/226,912 7,054 7,178 (124)21,535
Denver, COMOB4/13/226,320 5,254 5,269 (15)12,207
Colorado Springs, CO 6
MOB4/13/2213,680 13,686 13,701 (15)25,800
Seattle, WAMOB4/28/228,350 8,334 8,370 (36)13,256
Houston, TXMOB4/28/2236,250 36,299 36,816 (517)76,781
Los Angeles, CAMOB4/29/2235,000 35,242 25,400 9,842 34,282
Oklahoma City, OKMOB4/29/2211,100 11,259 11,334 (75)34,944
Raleigh, NC 5
MOB5/31/2227,500 26,710 27,127 (417)85,113
Tampa, FL 6
MOB6/9/2218,650 18,619 18,212 407 55,788
Seattle, WAMOB8/1/224,850 4,806 4,882 (76)10,593
Raleigh, NCMOB8/9/223,783 3,878 3,932 (54)11,345
Jacksonville, FLMOB8/9/2218,195 18,508 18,583 (75)34,133
Atlanta, GAMOB8/10/2211,800 11,525 12,038 (513)43,496
Denver, COMOB8/11/2214,800 13,902 13,918 (16)34,785
Raleigh, NCMOB8/18/2211,375 10,670 10,547 123 31,318
Nashville, TNMOB9/15/2221,000 20,764 20,572 192 61,932
Austin, TXMOB9/29/225,450 5,449 5,572 (123)15,000
Jacksonville, FL 4
MOB10/12/223,600 3,530 3,609 (79)6,200
Houston, TXMOB11/21/225,500 5,469 5,513 (44)28,369
Austin, TX 7
MOB12/28/22888 890 889 1 2,219
Denver, COMOB12/28/2216,400 16,170 16,467 (297)39,692
$403,578 $399,189 $386,818 $12,371 863,184 
1MOB = medical outpatient building.
2Cash consideration excludes prorations of revenue and expense due to/from seller at the time of the acquisition.
3Includes other assets acquired, liabilities assumed, and intangibles recognized at acquisition.
4Represents a single-tenant property.
5Includes three properties.
6Includes two properties.
7The Company acquired additional ownership interests in an existing building bringing the Company's ownership to 71.4%.
The following table summarizes the estimated relative fair values of the assets acquired and liabilities assumed in the real estate acquisitions for 2022 as of the acquisition date:
ESTIMATED
FAIR VALUE
in millions		ESTIMATED
USEFUL LIFE
in years
Building$250.7 
14.0 - 38.0
Tenant Improvements20.7 
1.5 - 13.4
Land76.1 — 
Land Improvements11.2 
5.0 - 14.0
Intangibles
At-market lease intangibles28.1 
1.5 - 13.4
Above-market lease intangibles (lessor)15.9 
1.3 - 15.6
Below-market lease intangibles (lessor)(2.2)
1.3 - 19.3
Below-market lease intangibles (lessee)1.2 
13.1
Other assets acquired0.4 
Accounts payable, accrued liabilities and other liabilities assumed(2.9)
Total cash paid$399.2 

Unconsolidated Joint Ventures
The following table details the joint venture acquisitions for the year ended December 31, 2022:
Dollars in thousands
TYPE 1
DATE ACQUIREDPURCHASE PRICE
CASH
CONSIDERATION 2
REAL
ESTATE
OTHER 3
SQUARE FOOTAGE
unaudited
San Francisco, CA 4
MOB3/7/22$67,175 $66,789 $65,179 $1,610 110,865
Los Angeles, CA 5
MOB3/7/2233,800 32,384 32,390 (6)103,259
$100,975 $99,173 $97,569 $1,604 214,124 
1MOB = medical outpatient building.
2Cash consideration excludes prorations of revenue and expense due to/from seller at the time of the acquisition.
3Includes other assets acquired, liabilities assumed, and intangibles recognized at acquisition.
4Includes three properties.
5Includes two properties.
2023 Real Estate Asset Dispositions
The following table details the Company's dispositions for the year ended December 31, 2023:
Dollars in thousands
Type1
DATE DISPOSEDSALE PRICECLOSING ADJCOMPANY-FINANCED NOTESNET PROCEEDSNET REAL ESTATE
OTHER (INCLUDING RECEIVABLES) 2
GAIN/(IMPAIR-MENT)SQUARE FOOTAGE
Tampa/Miami, FL3
MOB1/12/23$93,250 $(5,875)$— $87,375 $87,302 $(888)$961 224,037 
Dallas, TX 4
MOB1/30/2319,210 (141)— 19,069 18,986 43 40 36,691 
St. Louis, MOMOB2/10/23350 (18)— 332 398 — (66)6,500 
Los Angeles, CAMOB3/23/2321,000 (526)— 20,474 20,610 52 (188)37,165 
Los Angeles, CA 5
MOB3/30/2375,000 (8,079)(45,000)21,921 88,624 (803)(20,900)147,078 
Los Angeles, CA 6
LAND5/12/233,300 (334)— 2,966 3,268 — (302)— 
Albany, NYMOB6/30/2310,000 (1,229)— 8,771 2,613 (1,040)7,198 40,870 
Houston, TXMOB8/2/238,320 (285)— 8,035 4,567 194 3,274 57,170 
Atlanta, GAMOB8/22/2325,140 (66)— 25,074 23,226 (536)2,386 55,195 
Dallas, TXINPATIENT9/15/23115,000 (1,504)— 113,496 64,183 6,094 43,219 161,264 
Houston, TXMOB9/18/23250 (24)— 226 1,998 — (1,772)52,040 
Chicago, ILMOB9/27/2359,950 (870)— 59,080 74,710 (380)(15,250)104,912 
Evansville, IN 7
MOB11/13/2318,500 (63)— 18,437 17,807 (149)779 260,520 
Houston, TXHOSPITAL12/1/234,100 (6)— 4,094 3,486 — 608 83,223 
Charleston, SC 8
OFFICE12/15/236,200 (401)— 5,799 3,415 — 2,384 15,014 
Dallas, TXMOB12/20/2343,295 (764)— 42,531 33,882 (3,782)12,431 77,827 
Los Angeles, CAOFFICE12/21/2319,000 (1,311)— 17,689 17,787 — (98)104,377 
Tucson, AZ 9,10
MOB12/22/2343,230 (3,770)(6,000)33,460 39,786 (26)(300)215,471 
Miami, FLMOB12/22/2318,250 (756)— 17,494 17,354 643 (503)48,000 
Sebring, FLMOB12/27/239,500 (81)— 9,419 10,438 (512)(507)38,949 
Boston, MAMOB12/28/23117,197 (2,079)— 115,118 107,803 9,828 (2,513)161,254 
Jacksonville/Orlando/Miami, FL 11
SNF12/29/2377,000 (8,678)(7,700)60,622 65,839 (294)2,777 354,500 
Total dispositions$787,042 $(36,860)$(58,700)$691,482 $708,082 $8,444 $33,658 2,282,057 
1.MOB = medical outpatient building; SNF = skilled nursing facility.
2.Includes straight-line rent receivables, leasing commissions and lease inducements.
3.Includes two properties sold in two separate transactions to the same buyer on the same date.
4.The Company sold this property to a joint venture in which it retained a 40% interest. Sales price and square footage reflect the total sales price paid by the joint venture and total square footage of the property.
5.The Company entered into a mortgage loan agreement with the buyer for $45.0 million.
6.The Company sold a land parcel totaling 0.34 acres.
7.Includes five properties sold in three separate transactions to the same buyer on the same date.
8.The Company sold a corporate office in Charleston, SC that was 100% occupied by the Company.
9.Includes 12 properties sold in one transaction to the same buyer.
10.The Company entered into a mezzanine loan with the buyer for $6.0 million.
11.Includes three properties sold in one transaction to the same buyer. The Company entered into a separate note receivable for $7.7 million related to this sale.
2022 Real Estate Asset Dispositions
The following table details the Company's dispositions for the year ended December 31, 2022:
Dollars in thousands
TYPE 1
DATE DISPOSEDSALES PRICECLOSING ADJUSTMENTSNET PROCEEDSNET REAL ESTATE INVESTMENT
OTHER
including
receivables 2
GAIN/
(IMPAIRMENT)		SQUARE FOOTAGE
unaudited
Loveland, CO 3, 4
MOB2/24/22$84,950 $(45)$84,905 $40,095 $4 $44,806 150,291 
San Antonio, TX 3
MOB4/15/2225,500 (2,272)23,228 14,381 284 8,563 201,523 
GA, FL, PA 5, 11
MOB7/29/22133,100 (8,109)124,991 124,991 — — 316,739 
GA, FL, TX 7, 11
MOB8/4/22160,917 (5,893)155,024 151,819 3,205 — 343,545 
Los Angeles, CA 5, 9, 11
MOB8/5/22134,845 (3,102)131,743 131,332 411 — 283,780 
Dallas, TX 7, 10, 11
MOB8/30/22114,290 (682)113,608 113,608 — — 189,385 
Indianapolis, IN 6, 12
MOB8/31/22238,845 (5,846)232,999 84,767 4,324 143,908 506,406 
Dallas, TX 3
MOB10/4/22104,025 (5,883)98,142 38,872 6,436 52,834 291,328 
Houston, TXMOB10/21/2232,000 (280)31,720 10,762 744 20,214 134,910 
College Station, TXMOB11/10/2249,177 (3,755)45,422 44,918 475 28 122,942 
El Paso, TXMOB12/22/2255,326 (4,002)51,324 56,427 (1,897)(3,205)110,465 
Atlanta, GA 8
MOB12/22/2291,243 (4,326)86,917 109,051 235 (22,369)348,416 
St. Louis, MOMOB12/28/2218,000 (1,471)16,529 18,340 4 (1,815)69,394 
$1,242,218 $(45,666)$1,196,552 $939,363 $14,225 $242,964 3,069,124 
1MOB = medical outpatient building
2Includes straight-line rent receivables, leasing commissions and lease inducements.
3Includes two properties.
4The Company deferred the tax gain through a 1031 exchange and reinvested the proceeds.
5Includes four properties.
6Includes five properties.
7Includes six properties.
8Includes nine properties.
9Values and square feet are represented at 100%. The Company retained a 20% ownership interest in the joint venture with an unrelated third party that purchased these properties.
10Values and square feet are represented at 100%. The Company retained a 40% ownership interest in the joint venture with an unrelated third party that purchased these properties.
11These properties were acquired as part of the Merger and were included as assets held for sale in the purchase price allocation.
12Two of the five properties included in this portfolio were acquired in the Merger and were included as assets held for sale in the purchase price allocation.
v3.24.0.1
Held for Sale
 12 Months Ended
Dec. 31, 2023
Discontinued Operations and Disposal Groups [Abstract]  
Held for Sale Held for Sale
The Company had one property classified as assets held for sale as of December 31, 2023. The net real estate assets held for sale includes the impact of $5.9 million of impairment charges for the year ended December 31, 2023. The Company had one property classified as assets held for sale as of December 31, 2022, which was sold in the first quarter of 2023.
The table below reflects the assets and liabilities classified as held for sale as of December 31, 2023 and 2022.
 DECEMBER 31,
Dollars in thousands20232022
Balance Sheet data
Land$1,850 $1,700 
Buildings and improvements6,779 15,164 
Lease intangibles1,017 1,986 
9,646 18,850 
Accumulated depreciation(913)— 
Real estate assets held for sale, net8,733 18,850 
Other assets, net101 43 
Assets held for sale, net$8,834 $18,893 
Accounts payable and accrued liabilities$23 $282 
Other liabilities272 155 
Liabilities of properties held for sale$295 $437 
v3.24.0.1
Impairment Charges
 12 Months Ended
Dec. 31, 2023
Property, Plant and Equipment [Abstract]  
Impairment Charges Impairment Charges
An asset is impaired when undiscounted cash flows expected to be generated by the asset are less than the carrying value of the asset. The Company must assess the potential for impairment of its long-lived assets, including real estate properties, whenever events occur or there is a change in circumstances, such as the sale of a property or the decision to sell a property, which indicate that the recorded value might not be fully recoverable.
The Company recorded impairment charges on 31 properties sold and six additional properties associated with planned disposition activity for the year ended December 31, 2023, totaling $149.7 million. The Company recorded impairment charges on 12 properties sold and three additional properties associated with planned disposition activity for the year ended December 31, 2022, totaling $54.4 million. Both level 1 and level 3 fair value techniques were used to derive these impairment charges.
As of December 31, 2023, six properties totaling $53.6 million were measured at fair value using level 3 fair value hierarchy. The level 3 fair value techniques included nonbinding letters of intent and unexecuted purchase and sale agreements, less estimated closing costs.
v3.24.0.1
Other Assets
 12 Months Ended
Dec. 31, 2023
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]  
Other Assets Other Assets
Other assets consist primarily of intangible assets, prepaid assets, real estate notes receivable, straight-line rent receivables, accounts receivable, additional long-lived assets and interest rate swaps. Items included in "Other assets, net" on the Company’s Consolidated Balance Sheets as of December 31, 2023 and 2022 are detailed in the table below:
Dollars in thousandsDecember 31, 2023December 31, 2022
Real estate notes receivable, net $173,614 $99,643 
Straight-line rent receivables 116,866 88,868 
Prepaid assets116,455 81,900 
Above-market intangible assets, net66,695 80,720 
Accounts receivable, net 1
63,203 54,667 
Additional long-lived assets, net20,717 21,446 
Interest rate swap assets4,634 14,512 
Investment in securities 2
6,011 6,011 
Debt issuance costs, net3,867 5,977 
Project costs6,187 4,337 
Net investment in lease2,112 1,828 
Customer relationship intangible assets, net1,066 1,120 
Other10,941 8,961 
$592,368 $469,990 
1The amounts for December 31, 2023 and 2022 are net of allowance for doubtful accounts of $8.4 million and $4.0 million, respectively. The amount for December 31, 2022 includes $7,169 of other receivables, net.
2This amount represents the value of the Company's preferred stock investment in a data analytics platform.
v3.24.0.1
Intangible Assets and Liabilities
 12 Months Ended
Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]  
Intangible Assets and Liabilities Intangible Assets and Liabilities
The Company has several types of intangible assets and liabilities included in its Consolidated Balance Sheets, including goodwill, debt issuance costs, above-, below-, and at-market lease intangibles, and customer relationship intangibles. For additional details on the Company's debt issuance costs, see Note 10 to the Consolidated Financial Statements. The Company’s intangible assets and liabilities, including assets held for sale and certain debt issuance costs, as of December 31, 2023 and 2022 consisted of the following:
 GROSS BALANCE
at December 31,		ACCUMULATED AMORTIZATION
at December 31,		WEIGHTED AVG.
REMAINING LIFE
in years		BALANCE SHEET CLASSIFICATION
Dollars in millions2023202220232022
Goodwill$250.5 $223.2 $— $— N/AGoodwill
Credit facility debt issuance costs6.9 6.9 3.1 0.9 1.9Other assets, net
Above-market lease intangibles (lessor)98.0 91.5 31.3 10.7 5.3Other assets, net
Customer relationship intangibles (lessor)2.1 2.1 1.1 1.0 19.6Other assets, net
Below-market lease intangibles (lessor)(112.5)(112.5)(35.7)(14.6)5.8Other liabilities
At-market lease intangibles837.3 1,067.4 301.7 188.3 4.0Real estate properties
$1,082.3 $1,278.6 $301.5 $186.3 4.3
For the years ended December 31, 2023 and 2022, the Company recognized approximately $214.8 million and $133.6 million of intangible amortization, respectively.
The following table represents expected amortization over the next five years of the Company’s intangible assets and liabilities in place as of December 31, 2023:
Dollars in millionsFUTURE AMORTIZATION OF INTANGIBLES, NET
2024$206.7 
2025109.1 
202684.3 
202753.0 
202831.9 
v3.24.0.1
Notes and Bonds Payable
 12 Months Ended
Dec. 31, 2023
Debt Disclosure [Abstract]  
Notes and Bonds Payable Notes and Bonds Payable
 DECEMBER 31,
MATURITY DATES
CONTRACTUAL INTEREST RATESEFFECTIVE INTEREST RATESPRINCIPAL PAYMENTSINTEREST PAYMENTS
Dollars in thousands20232022
$1.5B Unsecured Credit Facility
— 385,000 10/25
SOFR + 0.95%
6.24 %At maturityMonthly
$350M Unsecured Term Loan 1
349,798 349,114 7/24
SOFR + 1.05%
6.30 %At maturityMonthly
$200M Unsecured Term Loan 1
199,903 199,670 5/24
SOFR + 1.05%
6.30 %At maturityMonthly
$150M Unsecured Term Loan 1
149,643 149,495 6/26
SOFR + 1.05%
6.30 %At maturityMonthly
$300M Unsecured Term Loan 1
299,958 299,936 10/25
SOFR + 1.05%
6.30 %At maturityMonthly
$200M Unsecured Term Loan 1
199,502 199,362 7/27
SOFR + 1.05%
6.30 %At maturityMonthly
$300M Unsecured Term Loan 1
298,288 297,869 1/28
SOFR + 1.05%
6.30 %At maturityMonthly
Senior Notes due 2025 1
249,484 249,115 5/253.88 %4.12 %At maturitySemi-annual
Senior Notes due 2026 1
579,017 571,587 8/263.50 %4.94 %At maturitySemi-annual
Senior Notes due 2027 1
483,727 479,553 7/273.75 %4.76 %At maturitySemi-annual
Senior Notes due 2028 1
297,429 296,852 1/283.63 %3.85 %At maturitySemi-annual
Senior Notes due 2030 1
575,443 565,402 2/303.10 %5.30 %At maturitySemi-annual
Senior Notes due 2030 1
296,780 296,385 3/302.40 %2.72 %At maturitySemi-annual
Senior Notes due 2031 1
295,832 295,547 3/312.05 %2.25 %At maturitySemi-annual
Senior Notes due 2031 1
649,521 632,693 3/312.00 %5.13 %At maturitySemi-annual
Mortgage notes payable 2
70,534 84,247 1/24-12/26
    3.6%-4.77%
3.57%-6.88%
MonthlyMonthly
$4,994,859 $5,351,827 
1Balances are shown net of discounts and unamortized issuance costs.
2Balances are shown net of discounts and unamortized issuance costs and include premiums.

The Company’s various debt agreements contain certain representations, warranties, and financial and other covenants customary in such loan agreements. Among other things, these provisions require the Company to maintain certain financial ratios and impose certain limits on the Company’s ability to incur indebtedness and create liens or encumbrances. As of December 31, 2023, the Company was in compliance with its financial covenant provisions under its various debt instruments.

Senior Notes
The following table reconciles the Company’s aggregate Senior notes principal balance with the Company’s Consolidated Balance Sheets as of December 31, 2023 and 2022.
 DECEMBER 31,
Dollars in thousands20232022
Senior notes principal balance$3,699,285 $3,699,500 
Unaccreted discount(265,852)(304,919)
Debt issuance costs(6,200)(7,447)
Senior notes carrying amount$3,427,233 $3,387,134 
Term Loans
The following table reconciles the Company’s aggregate term loan principal balance with the Company’s Consolidated Balance Sheets as of December 31, 2023 and 2022.

 DECEMBER 31,
Dollars in thousands20232022
Term loan principal balances$1,500,000 $1,500,000 
Debt issuance costs(2,908)(4,554)
Term Loans carrying amount$1,497,092 $1,495,446 
Mortgage Notes Payable
The following table reconciles the Company’s aggregate mortgage notes principal balance with the Company’s Consolidated Balance Sheets as of December 31, 2023 and 2022.
 DECEMBER 31,
Dollars in thousands20232022
Mortgage notes payable principal balance$70,752 $84,122 
Unamortized premium285 486 
Unaccreted discount(237)(38)
Debt issuance costs(266)(323)
Mortgage notes payable carrying amount$70,534 $84,247 
Mortgage Activity
On July 28, 2023, the Company assumed a mortgage note payable of $5.6 million in connection with the acquisition of a 42,770 square foot property in Colorado Springs, Colorado. The note bears interest at a rate of 4.5% per annum and matures on April 1, 2026.
On August 1, 2023, the Company repaid in full at maturity a mortgage note payable bearing interest at a rate of 3.31% per annum with an outstanding principal of $9.8 million. The mortgage note encumbered a 66,984 square foot property in Marietta, Georgia.
On December 1, 2023, the Company repaid in full at maturity a mortgage note payable bearing interest at a rate of 4.51% per annum with an outstanding principal of $6.6 million. The mortgage note encumbered a 93,992 square foot property in Lakewood, Colorado.
Subsequent Changes in Debt Structure
On January 6, 2024, the Company repaid in full at maturity a mortgage note payable bearing interest at a rate of 4.77% per annum with an outstanding principal of $11.3 million. The mortgage note encumbered a 63,012 square foot property in California.
On February 1, 2024, the Company repaid in full at maturity a mortgage note payable bearing interest at a rate of 4.12% per annum with an outstanding principal of $5.6 million. The mortgage note encumbered a 40,324 square foot property in Georgia.
The following table details the Company’s mortgage notes payable, with related collateral.
 ORIGINAL BALANCE
EFFECTIVE INTEREST RATE 9
MATURITY
DATE
COLLATERAL 10
PRINCIPAL AND
INTEREST PAYMENTS 8
INVESTMENT IN COLLATERAL
at December 31,		BALANCE
at December 31,
Dollars in millions202320232022
Life Insurance Co. 1
12.3 3.86 %8/23MOB
Monthly/7-yr amort.
— — 10.0 
Life Insurance Co. 2
9.0 4.84 %12/23MOB,OFC
Monthly/10-yr amort.
— — 6.8 
Life Insurance Co. 3
13.3 4.13 %1/24MOB
Monthly/10-yr amort.
24.4 11.3 11.7 
Life Insurance Co. 4
6.8 3.96 %2/24MOB
Monthly/7-yr amort.
12.6 5.6 5.8 
Financial Services 5
9.7 4.32 %9/24MOB
Monthly/10-yr amort.
16.9 7.2 7.5 
Life Insurance Co. 6
16.5 3.43 %12/25MOB,OFC
Monthly/7-yr amort.
49.2 15.9 16.2 
Financial Services11.5 3.71 %1/26MOB
Monthly/10-yr amort.
41.7 7.8 8.3 
Life Insurance Co. 7
6.0 6.88 %4/26MOB
Monthly/7-yr amort.
11.6 5.2 — 
Life Insurance Co.
19.2 4.08 %12/26MOB
Monthly/10-yr amort.
45.7 17.5 17.9 
$202.1 $70.5 $84.2 
1The Company repaid this loan in August 2023. The Company's unencumbered gross investment was $26.0 million at December 31, 2023.
2The Company repaid this loan in December 2023. The Company's unencumbered gross investment was $24.5 million at December 31, 2023.
3The unamortized portion of the $0.8 million premium recorded on this note upon acquisition is included in the balance above.
4The unamortized portion of the $0.2 million premium recorded on this note upon acquisition is included in the balance above.
5The unamortized portion of the $0.1 million premium recorded on this note upon acquisition is included in the balance above.
6The unamortized portion of the $0.7 million premium recorded on this note upon acquisition is included in the balance above.
7The unaccreted portion of the $0.3 million discount recorded on this note upon acquisition is included in the balance above.
8Payable in monthly installments of principal and interest with the final payment due at maturity (unless otherwise noted).
9The contractual interest rates for the seven outstanding mortgage notes ranged from 3.6% to 4.8% as of December 31, 2023.
10MOB-Medical office building; OFC-Office
Other Long-Term Debt Information
Future maturities of the Company’s notes and bonds payable as of December 31, 2023, were as follows:
Dollars in thousandsPRINCIPAL MATURITIES
NET ACCRETION/
AMORTIZATION 1
DEBT
ISSUANCE COSTS 2
NOTES AND
BONDS PAYABLE		%
2024$575,473 $(41,050)$(2,438)$531,985 10.7 %
2025566,375 (43,163)(1,916)521,296 10.4 %
2026778,904 (41,837)(1,650)735,417 14.7 %
2027700,000 (36,192)(1,519)662,289 13.3 %
2028600,000 (35,179)(707)564,114 11.3 %
2029 and thereafter2,049,285 (68,382)(1,145)1,979,758 39.6 %
$5,270,037 $(265,803)$(9,375)$4,994,859 100.0 %
1Includes discount accretion and premium amortization related to the Company’s Senior Notes and four mortgage notes payable.
2Excludes approximately $3.9 million in debt issuance costs related to the Company's Unsecured Credit Facility included in other assets, net.
v3.24.0.1
Derivative Financial Instruments
 12 Months Ended
Dec. 31, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract]  
Derivative Financial Instruments Derivative Financial Instruments
Risk Management Objective of Using Derivatives
The Company is exposed to certain risks arising from both its business operations and economic conditions. The Company principally manages its exposures to a wide variety of business and operational risks through management of its core business activities. The Company manages economic risks, including interest rate, liquidity, and credit risk, primarily by managing the amount, sources, and duration of its assets and liabilities and the use of derivative financial instruments. Specifically, the Company enters into derivative financial instruments to manage exposures that arise from business activities that result in the receipt or payment of future known and uncertain cash amounts, the value of which are determined by interest rates. The Company’s derivative financial instruments are used to manage differences in the amount, timing, and duration of the Company’s known or expected cash receipts and its known or expected cash payments principally related to the Company’s borrowings.

Cash Flow Hedges of Interest Rate Risk
The Company’s objectives in using interest rate derivatives are to add stability to interest expense and to manage its exposure to interest rate movements. To accomplish this objective, the Company primarily uses interest rate swaps as part of its interest rate risk management strategy. Interest rate swaps designated as cash flow hedges involve the receipt of variable amounts from a counterparty in exchange for the Company making fixed-rate payments over the life of the agreements without exchange of the underlying notional amount. During 2023, 2022, and 2021, such derivatives were used to hedge the variable cash flows associated with existing variable-rate debt.
For derivatives designated and that qualify as cash flow hedges of interest rate risk, the gain or loss on the derivative is recorded in accumulated other comprehensive income (loss) and subsequently reclassified into interest expense in the same period(s) during which the hedged transaction affects earnings. Amounts reported in accumulated other comprehensive income (loss) related to derivatives will be reclassified to interest expense as interest payments are made on the Company’s variable-rate debt.
On February 16, 2023, the Company entered into a swap transaction with a notional amount of $50.0 million and a fixed rate of 4.16%. The swap agreement has an effective date of March 1, 2023 and a termination date of June 1, 2026.
On March 28, 2023, the Company entered into a swap transaction with a notional amount of $100.0 million and a fixed rate of 3.67%. The swap agreement has an effective date of April 3, 2023 and a termination date of June 1, 2026.
On October 19, 2023, the Company entered into two swap transactions totaling $100.0 million. The notional amounts were $50.0 million each with fixed rates of 4.71% and 4.67%. The swap agreements have effective dates of November 1, 2023 and termination dates of June 1, 2027 and December 1, 2027, respectively.
On October 23, 2023, the Company entered into two swap transactions totaling $100.0 million with an aggregate fixed rate of 4.73%. The swap agreements have effective dates of November 1, 2023 and termination dates of May 31, 2026.
On November 9, 2023, the Company entered into a swap transaction totaling $75.0 million with a fixed rate of 4.54%. The swap agreement has an effective date of December 1, 2023 and a termination date of May 31, 2026.
As of December 31, 2023, the Company had interest rate derivatives that were designated as cash flow hedges of interest rate risk. The table below presents the notional value and weighted average rates of the Company's derivative financial instruments as of December 31, 2023 and 2022:
NOTIONAL VALUE AS OF WEIGHTED AVERAGE RATENOTIONAL VALUE AS OFWEIGHTED AVERAGE RATE
EXPIRATIONDECEMBER 31, 2023EXPIRATIONDECEMBER 31, 2022
January 2024$200,000 1.21 %January 2023$300,000 1.42 %
May 2026275,000 3.74 %January 2024200,000 1.21 %
June 2026150,000 3.83 %May 2026100,000 2.15 %
December 2026150,000 3.84 %December 2026150,000 3.84 %
June 2027200,000 4.27 %June 2027150,000 4.13 %
December 2027300,000 3.93 %December 2027250,000 3.79 %
$1,275,000 3.49 %$1,150,000 2.63 %
Tabular Disclosure of Fair Values of Derivative Instruments on the Balance Sheet
The table below presents the fair value of the Company's derivative financial instruments as well as their classification on the Consolidated Balance Sheets as of December 31, 2023 and 2022.
AS OF DECEMBER 31, 2023AS OF DECEMBER 31, 2022
Dollars in thousandsBALANCE SHEET LOCATIONFAIR
VALUE		BALANCE SHEET LOCATIONFAIR
VALUE
Interest rate swaps 2019Other Assets$4,214 Other Assets$13,603 
Interest rate swaps 2022Other Assets909 
Interest rate swaps 2022Other Liabilities(5,067)Other Liabilities(4,269)
Interest rate swaps 2023Other Assets411 
Interest rate swaps 2023Other Liabilities(7,357)
Total derivatives designated as hedging instruments$(7,799)$10,243 
Tabular Disclosure of the Effect of Fair Value and Cash Flow Hedge Accounting on Accumulated Other Comprehensive
Income (Loss)
The table below presents the effect of cash flow hedge accounting on Accumulated other comprehensive income (loss) as of December 31, 2023 and 2022 related to the Company's outstanding interest rate swaps.
AMOUNT OF GAIN/(LOSS) RECOGNIZED
IN AOCI ON DERIVATIVE
for the year ended December 31,		AMOUNT OF (GAIN)/LOSS RECLASSIFIED
FROM AOCI INTO INCOME
for the year ended December 31,
Dollars in thousands2023202220232022
Interest rate swaps 2017$— $302 Interest expense$— $118 
Interest rate swaps 2018— 616 Interest expense— 361 
Interest rate swaps 20191,995 12,964 Interest expense(6,964)563 
Interest rate swaps 20224,583 (3,252)Interest expense(6,289)(109)
Interest rate swaps 2023(5,115)— Interest expense(1,829)— 
Settled treasury hedges— — Interest expense426 426 
Settled interest rate swaps— — Interest expense168 168 
$1,463 $10,630 Total interest expense$(14,488)$1,527 
The Company estimates that an additional $7.3 million will be reclassified from accumulated other comprehensive loss as a net decrease to interest expense over the next 12 months.

Tabular Disclosure Offsetting Derivatives
The table below presents a gross presentation, the effects of offsetting, and a net presentation of the Company's derivatives as of December 31, 2023. The net amounts of derivative liabilities can be reconciled to the tabular disclosure of fair value. The tabular disclosure of fair value provides the location that derivative liabilities are presented on the Company's Consolidated Balance Sheets.
Offsetting of Derivative Assets
GROSS AMOUNTS
of recognized assets		GROSS AMOUNTS OFFSET
in the Consolidated
Balance Sheets		NET AMOUNTS OF ASSETS
presented in the Consolidated Balance Sheets		GROSS AMOUNTS NOT OFFSET
in the Consolidated Balance Sheets
FINANCIAL INSTRUMENTSCASH
COLLATERAL		NET
AMOUNT
Derivatives$4,625 $— $4,625 $(4,625)$— $— 
Offsetting of Derivative Liabilities
GROSS AMOUNTS
of recognized liabilities		GROSS AMOUNTS OFFSET
in the Consolidated
Balance Sheets		NET AMOUNTS OF LIABILITIES
presented in the Consolidated Balance Sheets		GROSS AMOUNTS NOT OFFSET
in the Consolidated Balance Sheets
FINANCIAL INSTRUMENTSCASH
COLLATERAL		NET
AMOUNT
Derivatives$(12,424)$— $(12,424)$4,625 $— $(7,799)

Credit-risk-related Contingent Features
The Company has agreements with each of its derivative counterparties that contain a provision where the Company could be declared in default on its derivative obligations if repayment of the underlying indebtedness is accelerated by the lender due to the Company's default on the indebtedness. The Company has agreements with each of its derivative counterparties that contain a provision where if the Company either defaults or is capable of being declared in default on any of its indebtedness, then the Company could also be declared in default on its derivative obligations.
As of December 31, 2023, the fair value of derivatives in a net liability position including accrued interest but excluding any adjustment for nonperformance risk related to these agreements was $11.0 million. As of December 31, 2023, the Company has not posted any collateral related to these agreements and was not in breach of any agreement provisions.
v3.24.0.1
Stockholders' Equity
 12 Months Ended
Dec. 31, 2023
Equity [Abstract]  
Stockholders' Equity Stockholders’ Equity
Common Stock
The Company had no preferred shares outstanding and had common shares outstanding for the three years ended December 31, 2023, 2022, and 2021 as follows: 
 YEAR ENDED DECEMBER 31,
2023 2022 2021 
Balance, beginning of year380,589,894 150,457,433 139,487,375 
Issuance of common stock8,627 229,618,304 10,899,301 
Conversion of OP units to common stock190,544 — — 
Non-vested share-based awards, net of withheld shares and forfeitures 175,368 514,157 70,757 
Balance, end of year380,964,433 380,589,894 150,457,433 
At-The-Market Equity Offering Program
The Company has in place an ATM equity offering program to sell shares of the Company’s common stock from time to time in at-the-market sales transactions. The Company has equity distribution agreements with various sales agents with respect to the ATM offering program of common stock with an aggregate sales amount of up to $750.0 million. As of December 31, 2023, $750.0 million remained available for issuance under the current ATM offering program.
Dividends Declared
During 2023, the Company declared and paid common stock dividends aggregating $1.24 per share ($0.31 per share per quarter).
On February 13, 2024, the Company declared a quarterly common stock dividend in the amount of $0.31 per share payable on March 14, 2024, to stockholders of record on February 26, 2024.
Authorization to Repurchase Common Stock
On May 31, 2023, the Company’s Board of Directors authorized the repurchase of up to $500.0 million of outstanding shares of the Company’s common stock either in the open market or through privately negotiated transactions, subject to market conditions, regulatory constraints, and other customary conditions. The Company is not obligated under this authorization to repurchase any specific number of shares. This authorization supersedes all previous stock repurchase authorizations. As of the date of these Consolidated Financial Statements, the Company has not repurchased any shares of its common stock under this authorization.
Accumulated Other Comprehensive (Loss) Income
The following table represents the changes in accumulated other comprehensive income (loss) during the years ended December 31, 2023 and 2022:
INTEREST RATE SWAPS
as of December 31,
Dollars in thousands20232022
Beginning balance$2,140 $(9,981)
Other comprehensive income (loss) before reclassifications1,434 1,531 
Amounts reclassified from accumulated other comprehensive (loss) income(14,315)10,590 
Net current-period other comprehensive (loss) income(12,881)12,121 
Ending balance$(10,741)$2,140 
The following table represents the details regarding the reclassifications from accumulated other comprehensive income (loss) during the year ended December 31, 2023 (dollars in thousands):
DETAILS ABOUT ACCUMULATED OTHER COMPREHENSIVE
INCOME (LOSS) COMPONENTS		AMOUNT RECLASSIFIED
from accumulated other comprehensive income (loss)		AFFECTED LINE ITEM
in the statement where net
income is presented
Amounts reclassified from accumulated other comprehensive income (loss) related to settled interest rate swaps$594 Interest Expense
Amounts reclassified from accumulated other comprehensive income (loss) related to current interest rate swaps(15,082)Interest Expense
$(14,488)
v3.24.0.1
Stock and Other Incentive Plans
 12 Months Ended
Dec. 31, 2023
Share-Based Payment Arrangement [Abstract]  
Stock and Other Incentive Plans Stock and Other Incentive Plans
Stock Incentive Plan
The Company's Incentive Plan permits the grant of incentive awards to its employees and directors in any of the following forms: options, stock appreciation rights, restricted stock, restricted or deferred stock units, performance awards, dividend equivalents, or other stock-based awards, including units in the OP. The Incentive Plan replaced the Legacy HR Incentive Plan as of the merger date. Unvested awards under the Legacy HR Incentive Plan were assumed according to their existing terms by the Company in connection with the Merger. As of the Merger date, 9,647,839 share-based awards were available for grant under the Incentive Plan. As of December 31, 2023 and 2022, the Company had share-based awards available for grant under the Incentive Plan of 8,102,861 and 9,432,388 shares, respectively. Non-vested shares issued to employees under the Incentive Plan are generally subject to fixed vesting periods varying from three to eight years beginning on the date of issue. If a recipient voluntarily terminates his or her relationship with the Company or is terminated for cause before the end of the vesting period, the shares are forfeited, at no cost to the Company. Once the shares have been issued, the recipient has the right to receive dividends and the right to vote the shares through the vesting period. Compensation expense, included in general and administrative expense, recognized during the years ended December 31, 2023, 2022 and 2021 from the amortization of the value of shares over the vesting period issued to employees and directors was $14.6 million, $13.9 million and $10.4 million, respectively. The following table represents expected amortization of the Company's non-vested shares issued as of December 31, 2023:
Dollars in millionsFUTURE AMORTIZATION
of non-vested shares
2024$12.2 
20259.7 
20266.9 
20272.1 
2028 and thereafter0.5 
Total$31.4 
Executive Incentive Plan
The Compensation Committee has adopted an executive incentive plan pursuant to the Incentive Plan (the "Executive Incentive Plan") to provide specific award criteria with respect to incentive awards made under the Incentive Plan subject to the discretion of the Compensation Committee. Under the terms of the Executive Incentive Plan, the Company's named executive officers and certain other members of senior management may earn incentive awards in the form of cash, non-vested stock, restricted stock units ("RSUs"), and units in the OP ("OP Units"). For 2023, 2022 and 2021, compensation expense, included in general and administrative expense, resulting from the amortization of the Executive Incentive Plan non-vested share, RSU, and OP Unit grants to officers was approximately $9.0 million, $9.8 million, and $6.6 million, respectively. Details of equity awards that have been issued under this plan are as follows:
•On January 4, 2023, the Company granted non-vested stock awards to its named executive officers, senior vice presidents, and first vice presidents with a grant date fair value of $4.1 million, which consisted of an aggregate of 205,264 shares with a ratable five-year vesting period, which will result in an annual compensation expense of $0.8 million for 2024, 2025, 2026 and 2027.
•On January 4, 2023, the Company granted 165,174 RSUs to certain of its non-executive senior officers. These award are subject to a three-year performance period and if the performance criteria is met, the awards are then
subject to two additional years with ratable vesting of 50% in year four and 50% in year five. The expense will be recognized on the straight-line basis over the five-year vesting period.
◦Approximately 43% of the RSU awards are subject to two market performance conditions: relative and absolute total shareholder return ("TSR"). These components were valued using independent specialists utilizing a Monte Carlo simulation to calculate the weighted average grant date fair values of $24.23 for the absolute TSR component and $27.84 for the relative TSR component for the January 2023 grant using the following assumptions:
Volatility34.0 %
Dividend AssumptionAccrued
Expected term in years3 years
Risk-free rate4.42 %
Stock price (per share)$20.21
◦The remaining 57% of the RSU awards are subject to certain operating performance conditions. With respect to the operating performance conditions of these awards, the grant date fair value was $20.21 based on the Company's share price on the date of grant. The Company records amortization expense based on the probability of achieving certain operating performance conditions, which is evaluated throughout the performance period.
◦The combined weighted average grant date fair value of the January 2023 RSUs was $22.55 per share.
LTIP Series C Units
In January 2023, the Company modified its incentive compensation structure to award LTIP Series C units ("LTIP-C units) in the OP to named executive officers in lieu of RSUs. The LTIP-C units were granted with three-year forward-looking performance targets, with a grant date fair value of $7.1 million, which consisted of an aggregate 627,547 LTIP-C units with a five-year vesting period. LTIP-C units are granted notionally at the maximum value of the award.
•Approximately 43% of the LTIP-C units vest based on two market performance conditions. Relative and absolute TSR awards containing these market performance conditions were valued using independent specialists. The Company utilized a Monte Carlo simulation to calculate the weighted average grant date fair values of $12.24 for the absolute TSR component and $13.98 for the relative TSR component for the January 2023 grant using the following assumption:
Volatility34.0 %
Dividend assumptionAccrued
Expected term 3 years
Risk-free rate4.42 %
Stock price (per share)$20.21
•The remaining 57% of the LTIP-C units vest based upon certain operating performance conditions. With respect to the operating performance conditions of the January 4, 2023 grant, the grant date fair value was $20.21 based on the Company's share price on the date of grant. The Company records amortization expense based on the probability of achieving certain operating performance conditions, which is evaluated throughout the performance period.
•The combined weighted average grant date fair value of the January LTIP-C units was $15.85 per share.
For 2023, compensation expense resulting from the amortization of LTIP-C units awarded to officers was approximately $1.2 million.
Officer Incentive Program
In the first quarter of 2023 the Company granted a performance-based award to certain non-executive officers totaling approximately $0.7 million, which was granted in the form of 33,438 non-vested shares. The shares have vesting periods ranging from three to eight years with a weighted average vesting period of approximately five years.
For 2023, 2022 and 2021, compensation expense resulting from the amortization of these non-vested share grants awarded to officers was approximately $0.6 million, $0.9 million, and $1.0 million, respectively.
Salary Deferral Plan
The Company's salary deferral plan allows certain of its officers to elect to defer up to 50% of their base salary in the form of non-vested shares subject to long-term vesting. The number of shares will be increased through a Company match depending on the length of the vesting period selected by the officer. The officer's vesting period choices are: three years for a 30% match; five years for a 50% match; and eight years for a 100% match. During 2023, 2022 and 2021, the Company issued 31,792 shares, 17,381 shares and 21,396 shares, respectively, to its officers through the salary deferral plan. For 2023, 2022 and 2021, compensation expense resulting from the amortization of non-vested share grants to officers was approximately $0.9 million for each year, respectively.
Non-employee Directors Incentive Plan
The Company grants non-vested share-based awards to its non-employee directors under the Incentive Plan. The directors’ awards typically have a one-year vesting period and are subject to forfeiture prior to such date upon termination of the director’s service, at no cost to the Company. For each of the years 2023, 2022 and 2021, compensation expense resulting from the amortization of non-vested share-based grants to directors was approximately $2.1 million, $1.5 million, and $1.2 million, respectively.
•On June 5, 2023, the Company granted a non-vested stock award to six of its directors, with a grant date fair value of $0.7 million, which consisted of an aggregate of 42,768 non-vested shares, with a one-year vesting period.
•On June 5, 2023, the Company also granted LTIP-D units in the OP to six of its directors, with a grant fair value of $1.1 million, which consisted of an aggregate of 57,868 non-vested units, with a one-year vesting period.
The following table represents the summary of non-vested share-based awards (including restricted stock, RSUs, LTIP-C units and LTIP-D units) under the Incentive Plans and related information for the three years ended December 31, 2023: 
YEAR ENDED DECEMBER 31,
Dollars in thousands, except per share data202320222021
Share-based awards, beginning of year2,090,060 1,562,028 1,766,061 
Granted 1
1,164,359 952,407 203,701 
Vested(403,266)(418,949)(404,777)
Change in awards based on performance assessment 2
(205,668)— — 
Forfeited(29,923)(5,426)(2,957)
Share-based awards, end of year2,615,562 2,090,060 1,562,028 
Weighted-average grant date fair value of
Share-based awards, beginning of year$30.35 $31.10 $30.51 
Share-based awards granted during the year$18.70 $29.64 $30.86 
Share-based awards vested during the year$28.38 $31.52 $28.38 
Share-based awards change in performance assessment during the year$29.05 $— $— 
Stock-based awards forfeited during the year$31.16 $31.48 $33.04 
Share-based awards, end of year$25.56 $30.35 $31.10 
Grant date fair value of shares granted during the year$22,171 $28,225 $6,286 
1LTIP-C units are issued at the maximum possible value of the award and are reflected as such in this table until the performance period has been satisfied and the exact number of awards are determinable.
2The Company's RSUs that are based on operating performance metrics are evaluated on the probability of those performance metrics being achieved. During 2023, the Company determined that the operating performance goals related to the RSUs issued in 2022 are not probable of being achieved and reversed all of the outstanding amortization expense for that grant. In addition, the Company lowered the probability of achieving the operating performance goals related to the RSUs issued in 2023.
The vesting periods for the non-vested shares granted during 2023 ranged from one to eight years with a weighted-average amortization period remaining as of December 31, 2023 of approximately 4.8 years.
During 2023, 2022 and 2021, the Company withheld 126,085 shares, 137,892 shares and 129,987 shares, respectively, of common stock from its officers to pay estimated withholding taxes related to the vesting of shares.
401(k) Plan
The Company maintains a 401(k) plan that allows eligible employees to defer salary, subject to certain limitations imposed by the Internal Revenue Code. The Company provides a matching contribution up to $2,800 per employee, subject to certain limitations. The Company’s matching contributions were approximately $1.5 million for the year ended December 31, 2023, $1.2 million for 2022 and $0.7 million for 2021.
Employee Stock Purchase Plan
The outstanding options relate only to the Legacy HR Employee Stock Purchase Plan, which was terminated in November 2022. No new options will be issued under the Legacy HR Employee Stock Purchase Plan and existing options will expire in March 2024.
During the years ended December 31, 2022 and 2021, the Company recognized in general and administrative expenses approximately $0.4 million, and $0.4 million, respectively, of compensation expense related to the annual grant of options to its employees to purchase shares under the Legacy HR Employee Stock Purchase Plan.
Cash received from employees upon exercising options under the Legacy HR Employee Stock Purchase Plan was approximately $0.2 million for the year ended December 31, 2023, $0.4 million for the year ended December 31, 2022, and $0.8 million for the year ended December 31, 2021.
A summary of the Legacy HR Employee Stock Purchase Plan activity and related information for the three years ended December 31, 2023 is as follows:
YEAR ENDED DECEMBER 31,
Dollars in thousands, except per share data202320222021
Options outstanding, beginning of year340,976 348,514 341,647 
Granted— 255,960 253,200 
Exercised(8,627)(20,246)(30,281)
Forfeited(43,737)(102,619)(71,630)
Expired(132,999)(140,633)(144,422)
Options outstanding and exercisable, end of year155,613 340,976 348,514 
Weighted-average exercise price of
Options outstanding, beginning of year$16.38 $25.38 $24.70 
Options granted during the year$— $26.89 $25.16 
Options exercised during the year$15.07 $20.97 $25.03 
Options forfeited during the year$15.50 $21.88 $25.45 
Options expired during the year$16.43 $23.36 $24.17 
Options outstanding, end of year$12.98 $16.38 $25.38 
Weighted-average fair value of options granted during the year (calculated as of the grant date)$— $9.91 $9.05 
Intrinsic value of options exercised during the year$23 $75 $165 
Intrinsic value of options outstanding and exercisable
(calculated as of December 31)
$401 $985 $1,997 
Exercise prices of options outstanding
(calculated as of December 31)
$14.65 $16.38 $25.91 
Weighted-average contractual life of outstanding options (calculated as of December 31, in years)0.30.80.8
The fair values for these options were estimated at the date of grant using a Black-Scholes options pricing model with the weighted-average assumptions for the options granted during the period noted in the following table. The risk-
free interest rate was based on the U.S. Treasury constant maturity-nominal two-year rate whose maturity is nearest to the date of the expiration of the latest option outstanding and exercisable; the expected dividend yield was based on the expected dividends of the current year as a percentage of the average stock price of the prior year; the expected life of each option was estimated using the historical exercise behavior of employees; expected volatility was based on historical volatility of the Company’s common stock; and expected forfeitures were based on historical forfeiture rates within the look-back period. 
202320222021
Risk-free interest rates— %0.73 %0.13 %
Expected dividend yields— %3.97 %4.11 %
Expected life (in years)01.441.43
Expected volatility— %49.0 %48.2 %
Expected forfeiture rates— %85 %85 %
v3.24.0.1
Earnings Per Share
 12 Months Ended
Dec. 31, 2023
Earnings Per Share [Abstract]  
Earnings Per Share Earnings Per Share
The Company uses the two-class method of computing net earnings per common shares. The Company's non-vested share-based awards are considered participating securities pursuant to the two-class method.
The Company used the treasury method to determine the dilution from the forward equity agreements during the period of time prior to settlement. The number of weighted-average shares outstanding used in the computation of earnings per common share for the year ended December 31, 2021 included the effect from the assumed issuance of 0.7 million shares of common stock pursuant to the settlement of the forward equity agreements at the contractual price, less the assumed repurchase of the common stock at the average market price using the proceeds of approximately $23.1 million, adjusted for costs to borrow. For the year ended December 31, 2021, 1,682 weighted-average incremental shares of common stock were excluded from the computation of weighted-average common shares outstanding - diluted, as the impact was anti-dilutive. As of and for the year ended December 31, 2022, these forward equity agreements settled and consequently, the Company did not have any remaining shares subject to unsettled forward sale agreements.
The table below sets forth the computation of basic and diluted earnings per common share for the three years ended December 31, 2023.
 YEAR ENDED DECEMBER 31,
Dollars in thousands, except per share data202320222021
Weighted average common shares outstanding
Weighted average common shares outstanding380,850,967 254,296,810 144,411,835 
Non-vested shares(1,923,096)(1,940,607)(1,774,669)
Weighted average common shares outstanding - basic378,927,871 252,356,203 142,637,166 
Weighted average common shares outstanding - basic378,927,871 252,356,203 142,637,166 
Dilutive effect of forward equity shares— — — 
Dilutive effect of OP Units— 1,451,599 — 
Dilutive effect of employee stock purchase plan— 65,519 73,062 
Weighted average common shares outstanding - diluted378,927,871 253,873,321 142,710,228 
Net (loss) income$(282,083)$40,693 $66,659 
Net loss attributable to non-controlling interest3,822 204 — 
Net (loss) income attributable to common stockholders$(278,261)$40,897 $66,659 
Income allocated to participating securities (2,504)(2,437)(2,154)
Adjustment to loss attributable to non-controlling interest for legally outstanding restricted units(851)— — 
Net (loss) income applicable to common stockholders - basic$(281,616)$38,460 $64,505 
Net income attributable to OP Units— 81 — 
Net income applicable to common stockholders - diluted$(281,616)$38,541 $64,505 
Basic earnings per common share - net income$(0.74)$0.15 $0.45 
Diluted earnings per common share - net income$(0.74)$0.15 $0.45 
The effect of OP units convertible into shares totaling 4,023,679 shares and options to purchase 31,997 shares under the Company's Employee Stock Purchase Plan for the year ended December 31, 2023 were excluded from the calculation of diluted loss per common share because the effect was anti-dilutive due to the loss from continuing operations incurred during the year.
v3.24.0.1
Commitments and Contingencies
 12 Months Ended
Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]  
Commitments and Contingencies Commitments and Contingencies
Re/development Activity
During the year ended December 31, 2023, the Company invested $69.1 million and $20.5 million toward active development and redevelopment of properties, respectively, and $22.6 million toward recently completed development and redevelopment projects.
Tenant Improvements
The Company may provide a tenant improvement allowance in new or renewal leases for the purpose of refurbishing or renovating tenant space. As of December 31, 2023, the Company had commitments of approximately $222.4 million that are expected to be spent on tenant improvements throughout the portfolio, excluding development properties currently under construction.
Land Held for Development
Land held for development includes parcels of land owned by the Company, upon which the Company intends to develop and own outpatient healthcare facilities. The Company's land held for development included 17 parcels as of December 31, 2023 and 20 parcels as of December 31, 2022. The Company’s investments in land held for development totaled approximately $59.9 million as of December 31, 2023 and $74.3 million as of December 31, 2022.
The current land held for development is located adjacent to certain of the Company's existing medical office buildings in Colorado, Connecticut, Florida, Georgia, Massachusetts, New York, Tennessee, Texas, and Washington.
Security Deposits and Letters of Credit
As of December 31, 2023, the Company held approximately $38.5 million in letters of credit and security deposits for the benefit of the Company in the event the obligated tenant fails to perform under the terms of its respective lease. Generally, the Company may, at its discretion and upon notification to the tenant, draw upon these instruments if there are any defaults under the leases.
v3.24.0.1
Other Data
 12 Months Ended
Dec. 31, 2023
Income Tax Disclosure [Abstract]  
Other Data Other Data
Taxable Income (unaudited)
The Company has elected to be taxed as a REIT, as defined under the Internal Revenue Code. To qualify as a REIT, the Company must meet a number of organizational and operational requirements, including a requirement that it currently distribute at least 90% of its taxable income to its stockholders.
As a REIT, the Company generally will not be subject to federal income tax on taxable income it distributes currently to its stockholders. Accordingly, no provision for federal income taxes has been made in the accompanying Consolidated Financial Statements. If the Company fails to qualify as a REIT for any taxable year, then it will be subject to federal income taxes at regular corporate rates, including any applicable alternative minimum tax, and may not be able to qualify as a REIT for four subsequent taxable years. Even if the Company qualifies as a REIT, it may be subject to certain state and local taxes on its income and property and to federal income and excise tax on its undistributed taxable income.
Earnings and profits (as defined under the Internal Revenue Code), the current and accumulated amounts of which determine the taxability of distributions to stockholders, vary from net income attributable to common stockholders and taxable income because of different depreciation recovery periods, depreciation methods, and other items.
While Legacy HR was considered the accounting acquirer in the Merger for GAAP purposes, Legacy HR’s separate tax existence ceased with the Merger and Legacy HTA continues as the tax successor. On a tax basis, the Company’s gross real estate assets totaled approximately $12.6 billion and $13.0 billion as of December 31, 2023 and 2022, respectively. As of December 31, 2021, gross real estate assets on a tax basis were $5.0 billion for Legacy HR and $8.2 billion for Legacy HTA, respectively.
Characterization of Distributions (unaudited)
Distributions in excess of earnings and profits generally constitute a return of capital. The following table gives the characterization of the distributions of the Company’s common stock for the three years ended December 31, 2023.
For the three years ended December 31, 2023, there were no preferred shares outstanding. As such, no dividends were distributed related to preferred shares for those periods.
YEAR ENDED DECEMBER 31,
 
202320222021
 PER SHAREPER SHAREPER SHARE
Tax Treatment of Dividends Pre-Merger Healthcare Trust of America
Ordinary income 1
$— $0.5862 $0.7920 
Return of capital— 4.0162 0.4930 
Capital gain— 1.2216 — 
Common stock distributions$— $5.8240 $1.2850 
Tax Treatment of Dividends Pre-Merger Healthcare Realty
Ordinary income 1
$— $0.2655 $0.7500 
Return of capital— 0.5555 0.3600 
Capital gain— — 0.0964 
Common stock distributions$— $0.8210 $1.2064 
Tax Treatment of Dividends Post-Merger Healthcare Realty
Ordinary income 1
$0.5482 $0.0422 $— 
Return of capital0.5031 0.2889 — 
Capital gain0.1887 0.0879 — 
Common stock distributions$1.2400 $0.4190 $— 
1Reporting year ordinary income is also Code Section 199A eligible per the The Tax Cut and Jobs Act of 2017.

State Income Taxes
The Company must pay certain state income taxes, which are typically included in general and administrative expense on the Company’s Consolidated Statements of Operations.
The State of Texas gross margins tax on gross receipts from operations is disclosed in the table below as an income tax.
State income tax expense and state income tax payments for the three years ended December 31, 2023 are detailed in the table below: 
YEAR ENDED DECEMBER 31,
Dollars in thousands202320222021
State income tax expense
Texas gross margins tax $1,206 $1,693 $564 
Other133 151 8 
Total state income tax expense$1,339 $1,844 $572 
State income tax payments, net of refunds and collections$1,324 $1,834 $560 
v3.24.0.1
Fair Value of Financial Instruments
 12 Months Ended
Dec. 31, 2023
Fair Value Disclosures [Abstract]  
Fair Value of Financial Instruments Fair Value of Financial Instruments
The following methods and assumptions were used to estimate the fair value of each class of financial instrument for which it is practical to estimate that value.
•Cash, cash equivalents and restricted cash - The carrying amount approximates fair value.
•Borrowings under the Unsecured Credit Facility, Unsecured Term Loan due 2024 and Unsecured Term Loan due 2026 - The carrying amount approximates fair value because the borrowings are based on variable market interest rates.
•Senior unsecured notes payable - The fair value of notes and bonds payable is estimated using cash flow analyses, based on the Company’s current interest rates for similar types of borrowing arrangements.
•Mortgage notes payable - The fair value is estimated using cash flow analyses, based on the Company’s current interest rates for similar types of borrowing arrangements.
•Interest rate swap agreements - Interest rate swap agreements are recorded in other assets on the Company's Consolidated Balance Sheets at fair value. Fair value, using level 2 inputs, is estimated by utilizing pricing models that consider forward yield curves and discount rates.
The table below details the fair value and carrying values for our other financial instruments as of December 31, 2023 and 2022. 
 December 31, 2023December 31, 2022
Dollars in millionsCARRYING VALUEFAIR VALUECARRYING VALUEFAIR VALUE
Notes and bonds payable 1, 2
$4,994.9 $4,872.7 $5,351.8 $5,149.6 
Real estate notes receivable 1
$173.6 $172.5 $99.6 $99.6 
1Level 2 – model-derived valuations in which significant inputs and significant value drivers are observable in active markets.
2Fair value for senior notes includes accrued interest as of December 31, 2023.
v3.24.0.1
Related-Party Transactions
 12 Months Ended
Dec. 31, 2023
Related Party Transactions [Abstract]  
Related-Party Transactions Related-Party Transactions
In the ordinary course of conducting its business, the Company enters into agreements with affiliates in relation to the management and leasing of its real estate assets, including real estate assets owned through joint ventures.
v3.24.0.1
Schedule II - Valuation and Qualifying Accounts
 12 Months Ended
Dec. 31, 2023
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]  
Schedule II - Valuation and Qualifying Accounts
Schedule II – Valuation and Qualifying Accounts for the years ended December 31, 2023, 2022 and 2021
Dollars in thousandsADDITIONS AND DEDUCTIONS
DESCRIPTIONBALANCE
AT BEGINNING OF PERIOD		CHARGED/(CREDITED) TO COSTS AND EXPENSESCHARGED
TO OTHER ACCOUNTS		UNCOLLECTIBLE ACCOUNTS WRITTEN-OFFBALANCE
AT END OF PERIOD
2023Accounts receivable allowance$3,954 $5,119 $— $669 $8,404 
2022Accounts receivable allowance
$654 $3,306 $— $6 $3,954 
2021Accounts receivable allowance
$604 $72 $— $22 $654 
v3.24.0.1
Schedule III - Real Estate and Accumulated Depreciation
 12 Months Ended
Dec. 31, 2023
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]  
Real Estate and Accumulated Depreciation
Schedule III – Real Estate and Accumulated Depreciation as of December 31, 2023
Dollars in thousands
LAND 1
BUILDINGS, IMPROVEMENTS,
LEASE INTANGIBLES AND CIP 1
      
MARKETNUMBER OF PROP.INITIAL INVESTMENTCOST CAPITALIZED subsequent to acquisitionTOTALINITIAL INVESTMENTCOST CAPITALIZED subsequent to acquisitionTOTALPERSONAL PROPERTY2, 3, 5
TOTAL PROPERTY		1, 3 ACCUMULATED DEPRECIATION4 ENCUMBRANCES5
 DATE ACQUIRED		DATE CONST.
 Dallas, TX 43 $72,772 $17,396 $90,168 $925,170 $147,779 $1,072,949 $550 $1,163,667 $221,375 $— 2003-20221974-2021
 Houston, TX 31 63,942 13,018 76,960 642,626 32,557 675,183 57 752,200 97,793 — 2007-20221974-2018
 Seattle, WA 29 59,412 4,883 64,295 551,328 90,031 641,359 715 706,369 186,903 — 2008-20221977-2018
 Denver, CO 33 62,172 14,526 76,698 488,764 56,499 545,263 610 622,571 94,906 — 2007-20221942-2022
 Charlotte, NC 32 28,119 7,345 35,464 451,251 39,182 490,433 110 526,007 116,578 — 2008-20201961-2018
 Phoenix, AZ 35 12,205 8,057 20,262 447,753 26,436 474,189 425 494,876 59,449 — 2007-20171971-2008
 Atlanta, GA 27 40,227 8,868 49,095 429,729 15,587 445,316 100 494,511 79,569 5,572 2007-20221974-2014
 Boston, MA 17 117,857 9,590 127,447 336,670 4,255 340,925 14 468,386 37,569 — 2012-20161860-2011
 Raleigh, NC 28 44,530 12,090 56,620 393,245 15,098 408,343 9 464,972 38,879 — 2010-20221977-2020
 Nashville, TN 13 40,673 2,674 43,347 309,400 97,997 407,397 7,427 458,171 115,979 7,841 2004-20221976-2022
 Los Angeles, CA 20 68,225 3,861 72,086 305,221 71,590 376,811 453 449,350 145,875 28,870 1994-20221964-2008
 Miami, FL 19 47,092 6,902 53,994 325,814 35,543 361,357 178 415,529 74,470 — 1994-20211954-2021
 Tampa, FL 19 23,491 7,631 31,122 363,588 15,729 379,317 33 410,472 36,726 — 1994-20231975-2015
 Indianapolis, IN 36 45,914 8,985 54,899 308,044 10,542 318,586 13 373,498 42,273 — 2007-20191988-2013
 Austin, TX 13 22,178 4,885 27,063 261,585 31,211 292,796 142 320,001 55,891 — 2007-20221972-2015
 New York, NY 14 58,719 5,683 64,402 192,029 4,705 196,734 — 261,136 15,887 — 2014-20191920-2014
 Chicago, IL 6 11,250 2,554 13,804 212,170 17,314 229,484 81 243,369 39,671 — 2004-20191970-2017
 Memphis, TN 11 12,253 1,648 13,901 118,427 75,725 194,152 322 208,375 71,813 — 1999-20201982-2014
 Honolulu, HI 6 8,314 1,213 9,527 147,422 47,669 195,091 169 204,787 61,575 — 2003-20141975-2010
 Hartford, CT 30 24,167 5,214 29,381 159,178 1,383 160,561 — 189,942 15,883 — 2016-20191955-2017
 Other (49 markets) 194 272,785 61,795 334,580 3,308,020 211,205 3,519,225 1,310 3,855,115 618,702 28,251 1993-2023
Total real estate656 1,136,297 208,818 1,345,115 10,677,434 1,048,037 11,725,471 12,718 13,083,304 2,227,766 70,534 
Land held for develop.— 59,871 — 59,871 — — — — 59,871 — 
Construction in Progress— — — — 60,727 — 60,727 — 60,727 — — 
Financing lease right-of-use assets— — — — — — — — 82,209 — — 
Investment in financing receivables, net— — — — — — — — 122,602 — — 
Total properties656 1,196,168 $208,818 $1,404,986 $10,738,161 $1,048,037 $11,786,198 $12,718 $13,408,713 $2,227,766 $70,534 
1Includes one asset held for sale as of December 31, 2023 with gross real estate investments of approximately $9.6 million.
2Total properties as of December 31, 2023 have an estimated aggregate total cost of $12.6 billion for federal income tax purposes.
3Depreciation is provided for on a straight-line basis on buildings and improvements over 3.3 to 49.0 years, lease intangibles over 1.0 to 99.0 years, personal property over 3.0 to 20.0 years, and land improvements over 2.0 to 39.0 years.
4Includes unamortized premium of $0.3 million and unaccreted discount of $0.2 million and debt issuance costs of $0.3 million as of December 31, 2023.
5Includes merger of Healthcare Trust of America, Inc. buildings, acquired in 2022.
6Rollforward of Total Property and Accumulated Depreciation, including assets held for sale, for the year ended December 31, 2023, 2022 and 2021 follows:
 YEAR ENDED DEC. 31, 2023YEAR ENDED DEC. 31, 2022YEAR ENDED DEC. 31, 2021
Dollars in thousandsTOTAL PROPERTYACCUMULATED DEPRECIATIONTOTAL PROPERTYACCUMULATED DEPRECIATIONTOTAL PROPERTYACCUMULATED DEPRECIATION
Beginning balance$14,076,475 $1,645,271 $5,104,942 $1,338,743 $4,670,226 $1,249,679 
Additions during the period
Real estate acquired54,024 2,322 9,780,070 241,285 374,912 7,668 
Other improvements28,521 668,069 219,783 205,703 103,035 191,875 
Land held for development— 49,416 — 2,021 — 
Construction in progress49,901 — 31,586 — 3,974 — 
Investment in financing receivable, net2,366 — (66,509)— 186,745 — 
Financing lease right-of-use assets, net(1,616)— 52,249 — 11,909 — 
Corporate Properties— — 3,640 236 — — 
Retirement/dispositions
Real estate(800,958)(87,896)(1,098,702)(140,696)(247,880)(110,479)
Ending balance$13,408,713 $2,227,766 $14,076,475 $1,645,271 $5,104,942 $1,338,743 
v3.24.0.1
Schedule IV - Mortgage Loans on Real Estate Assets
 12 Months Ended
Dec. 31, 2023
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Abstract]  
Schedule IV - Mortgage Loans on Real Estate Assets
Schedule IV – Mortgage Loans on Real Estate Assets as of December 31, 2023
Dollars in thousandsFinal Maturity DatePayment TermsPrior LiensFace Amount Carrying AmountPrincipal Amount of Loans Subject to Delinquent Principal or Interest
Mortgage loan on real estate located in:
Texas7.00 %7/1/2024(1)$— $31,150 $31,150 $— 
North Carolina8.00 %12/22/2024(2)— 6,000 5,796 
Florida6.00 %2/27/2026(3)— 32,156 32,112 — 
California6.00 %3/29/2026(4)— 45,000 45,000 — 
Florida9.00 %12/28/2026(5)— 7,700 7,700 — 
Mezzanine loans on real estate located in:
Texas8.00 %6/24/2024(6)— 54,119 45,856 54,119 
Arizona9.00 %12/20/2026(4)— 6,000 6,000 — 
Total real estate notes receivable$— $182,125 $173,614 $54,119 
1 Twelve-month prefunded interest reserve, with principal sum and interest on unpaid principal due on the maturity date.
2 Capitalized interest through maturity, with outstanding principal and accrued interest due on the maturity date.
3 Construction loan up to $65 million with periodic disbursements. Interest only payments due with principal and any unpaid interest due on the maturity date.
4 Interest only payments due with principal and any unpaid interest due on the maturity date.
5 Monthly installment payments of principal and interest in the amount of $152,069.
6 Interest only payments due with principal and any unpaid interest due on the maturity date. Loan on non-accrual status as of December 31, 2023.
The following shows changes in the carrying amounts of mortgage loans on real estate assets during the years ended December 31, 2023, 2022 and 2021:
Year Ended December 31,
202320222021
Balance as of the beginning of the year$99,643 $— $— 
Additions:
Fair value real estate notes assumed— 74,819 — 
New real estate notes58,700 23,325 — 
Draws on existing real estate notes19,103 
Capitalized interest— 1,499 — 
Accretion of fees and other items1,364 — — 
Deductions:
Collection of real estate loans— — — 
Deferred fees and other items— — — 
Allowance for credit loss$(5,196)
Balance as of the end of the year$173,614 $99,643 $— 

All other schedules for which provision is made in the applicable accounting regulations of the Securities and Exchange Commission are omitted because they are not required under the related instructions or are not applicable, or because the required information is shown in the consolidated financial statements or notes thereto.
v3.24.0.1
Pay vs Performance Disclosure - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Pay vs Performance Disclosure      
Net Income (Loss) $ (278,261) $ 40,897 $ 66,659
v3.24.0.1
Insider Trading Arrangements
 3 Months Ended
Dec. 31, 2023
Trading Arrangements, by Individual  
Rule 10b5-1 Arrangement Adopted false
Non-Rule 10b5-1 Arrangement Adopted false
Rule 10b5-1 Arrangement Terminated false
Non-Rule 10b5-1 Arrangement Terminated false
v3.24.0.1
Summary of Significant Accounting Policies (Policies)
 12 Months Ended
Dec. 31, 2023
Accounting Policies [Abstract]  
Business Overview
Business Overview
Healthcare Realty Trust Incorporated is a real estate investment trust ("REIT") that owns, leases, manages, acquires, finances, develops and redevelops income-producing real estate properties associated primarily with the delivery of outpatient healthcare services throughout the United States of America. Except as otherwise provided in the Notes to the Company’s Consolidated Financial Statements, references herein to the "Company" mean Healthcare Realty Trust Incorporated and its consolidated subsidiaries, including Healthcare Realty Holdings, L.P. (formerly known as Healthcare Trust of America Holdings, LP) (the "OP"), after giving effect to the Merger discussed in more detail in Note 2 below. As of December 31, 2023, the Company had gross investments of approximately $13.4 billion in 655 consolidated real estate properties, construction in progress, redevelopments, financing receivables, financing lease right-of-use assets, land held for development, corporate property and excluding held for sale assets. The Company’s real estate properties are located in 35 states and total approximately 38.5 million square feet. In addition, the Company had a weighted average ownership interest of approximately 43% in 33 real estate properties held in unconsolidated joint ventures.
Principles of Consolidation
Principles of Consolidation
The Company’s Consolidated Financial Statements include the accounts of the Company, its wholly owned subsidiaries, and joint ventures and partnerships where the Company controls the operating activities. GAAP requires the Company to identify entities for which control is achieved through means other than voting rights and to determine which business enterprise is the primary beneficiary of variable interest entities (“VIEs”). ASC Topic 810 broadly defines a VIE as an entity in which either (i) the equity investors as a group, if any, lack the power through voting or similar rights to direct the activities of such entity that most significantly impact such entity’s economic performance or (ii) the equity investment at risk is insufficient to finance that entity’s activities without additional subordinated financial support. The Company identifies the primary beneficiary of a VIE as the enterprise that has both of the following characteristics: (i) the power to direct the activities of the VIE that most significantly impact the entity’s economic performance and (ii) the obligation to absorb losses or receive benefits of the VIE that could potentially be significant to the entity. The Company consolidates its investment in a VIE when it determines that it is the VIE’s primary beneficiary, with any minority interests reflected as non-controlling interests or redeemable non-controlling interests in the accompanying Consolidated Financial Statements.
The Company may change its original assessment of a VIE upon subsequent events such as the modification of contractual arrangements that affect the characteristics or adequacy of the entity’s equity investments at risk, the disposition of all or a portion of an interest held by the primary beneficiary, or changes in facts and circumstances that impact the power to direct activities of the VIE that most significantly impacts economic performance. The Company performs this analysis on an ongoing basis.
For property holding entities not determined to be VIEs, the Company consolidates such entities in which it owns 100% of the equity or has a controlling financial interest evidenced by ownership of a majority voting interest. All intercompany balances and transactions are eliminated in consolidation. For entities in which the Company owns less than 100% of the equity interest, the Company consolidates the entity if it has the direct or indirect ability to control the entities’ activities based upon the terms of the respective entities’ ownership agreements.
The OP is 98.8% owned by the Company. Holders of operating partnership units (“OP Units”) are considered to be non-controlling interest holders in the OP and their ownership interests are reflected as equity on the accompanying Consolidated Balance Sheets. Further, a portion of the earnings and losses of the OP are allocated to non-controlling interest holders based on their respective ownership percentages. Upon conversion of OP Units to common stock, any difference between the fair value of the common stock issued and the carrying value of the OP Units converted to common stock is recorded as a component of equity. As of December 31, 2023, there were approximately 4.5 million, or 1.2%, of OP Units issued and outstanding held by non-controlling interest holders. Additionally, the Company is the primary beneficiary of this VIE. Accordingly, the Company consolidates its interests in the OP.
Variable Interest Entities As of December 31, 2023, the Company's unconsolidated joint venture arrangements were accounted for using the equity method of accounting as the Company exercised significant influence over but did not control these entities.
Use of Estimates in the Consolidated Financial Statements
Use of Estimates in the Consolidated Financial Statements
Preparation of the Consolidated Financial Statements in accordance with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect amounts reported in the Consolidated Financial Statements and accompanying notes. Actual results may differ from those estimates and assumptions. Management makes significant estimates regarding revenue recognition, purchase price allocations to record investments in real estate, impairments, collectability of tenant receivables, and fair value measurements, as applicable.
Segment Reporting
Segment Reporting
The Company owns, leases, acquires, manages, finances, develops and redevelops outpatient and other healthcare-related properties. The Company is managed as one reporting unit, rather than multiple reporting units, for internal reporting purposes and for internal decision-making. Therefore, the Company discloses its operating results in a single reportable segment.
Real Estate Properties
Real Estate Properties
Real estate properties are recorded at cost or at fair value if acquired in a transaction that is a business combination under ASC Topic 805, Business Combinations. Cost or fair value at the time of acquisition is allocated among land, buildings, tenant improvements, lease and other intangibles, and personal property as applicable.
Asset Impairment
Asset Impairment
The Company assesses the potential for impairment of identifiable, definite-lived, intangible assets and long-lived assets, including real estate properties, whenever events occur or a change in circumstances indicates that the carrying value might not be fully recoverable. Indicators of impairment may include significant underperformance of an asset relative to historical or expected operating results; significant changes in the Company’s use of assets or the strategy for its overall business; plans to sell an asset before its depreciable life has ended; the expiration of a significant portion of leases in a property; or significant negative economic trends or negative industry trends for the Company or its tenants. In addition, the Company reviews for possible impairment, those assets subject to purchase options and those impacted by casualty losses, such as tornadoes and hurricanes. A property value is considered impaired only if management's estimate of current and projected (undiscounted and unleveraged) operating cash flows of the property is less than the net carrying value of the property. These estimates of future cash flows include only those that are directly associated with and that are expected to arise as a direct result of the use and eventual disposition of the property based on its estimated remaining useful life. These estimates, including the useful life determination which can be affected by any potential sale of the property, are based on management's assumptions about its use of the property. Therefore, significant judgment is involved in estimating the current and projected cash flows. If management determines that the carrying value of the Company’s assets may not be fully recoverable based on the existence of any of the factors above, or others, management would measure and record an impairment charge based on the estimated fair value of the property or the estimated fair value less costs to sell the property.
Acquisitions of Real Estate Properties with In-Place Leases
Acquisitions of Real Estate Properties with In-Place Leases
The Company's acquisitions of real estate properties typically do not meet the definition of a business and are accounted for as asset acquisitions. Acquisitions of real estate properties with in-place leases are accounted for at relative fair value. When a building with in-place leases is acquired, the cost of the acquisition must be allocated between the tangible real estate assets "as-if-vacant" and the intangible real estate assets related to in-place leases based on their estimated fair values. Land fair value is estimated by using an assessment of comparable transactions and other relevant data.
The Company considers whether any of the in-place lease rental rates are above- or below-market. An asset (if the actual rental rate is above-market) or a liability (if the actual rental rate is below-market) is calculated and recorded in an amount equal to the present value of the future cash flows that represent the difference between the actual lease rate and the estimated market rate. If an in-place lease is identified as a below-market rental rate, the Company would also evaluate any renewal options associated with that lease to determine if the intangible should include those periods. The values related to above- or below-market in-place lease intangibles are amortized over the remaining term of the leases upon acquisition to rental income where the Company is the lessor and to property operating expense where the Company is the lessee.
The Company also estimates an absorption period, which can vary by property, assuming the building is vacant and must be leased up to the actual level of occupancy when acquired. During that absorption period, the owner would incur direct costs, such as tenant improvements, and would suffer lost rental income. Likewise, the owner would have acquired a measurable asset in that, assuming the building was vacant, certain fixed costs would be avoided because the actual in-place lessees would reimburse a certain portion of fixed costs through expense reimbursements during the absorption period.
These assets (above- or below-market lease, tenant improvement, leasing costs avoided, rental income lost, and expenses recovered through in-place lessee reimbursements) are estimated and recorded in amounts equal to the present value of estimated future cash flows. The actual purchase price is allocated based on the various relative asset fair values described above.
The building and tenant improvement components of the purchase price are depreciated over the estimated useful life of the building or the weighted average remaining term of the in-place leases. The at-market, in-place lease intangibles are amortized to depreciation and amortization expense over the weighted average remaining term of the leases, and customer relationship assets are amortized to depreciation amortization expense over terms applicable to each acquisition. Any goodwill recorded through a business combination would be reviewed for impairment at least annually and is not amortized.
Fair Value Measurements
Fair Value Measurements
Fair value is defined as the price that would be received to sell an asset, or paid to transfer a liability, in an orderly transaction between market participants. In calculating fair value, a company must maximize the use of observable market inputs, minimize the use of unobservable market inputs and disclose in the form of an outlined hierarchy the details of such fair value measurements.
A hierarchy of valuation techniques is defined to determine whether the inputs to a fair value measurement are considered to be observable or unobservable in a marketplace. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect the Company’s market assumptions. This hierarchy requires the use of observable market data when available. These inputs have created the following fair value hierarchy:
•Level 1 – quoted prices for identical instruments in active markets;
•Level 2 – quoted prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are not active, and model-derived valuations in which significant inputs and significant value drivers are observable in active markets; and
•Level 3 – fair value measurements derived from valuation techniques in which one or more significant inputs or significant value drivers are unobservable.
Executed purchase and sale agreements, which are binding agreements, are categorized as level one inputs. Brokerage estimates, letters of intent, or unexecuted purchase and sale agreements are considered to be level three as they are nonbinding in nature.
Fair Value of Derivative Financial Instruments
Fair Value of Derivative Financial Instruments
Derivative financial instruments are recorded at fair value on the Company's Consolidated Balance Sheets as other assets or other liabilities. The valuation of derivative instruments requires the Company to make estimates and judgments that affect the fair value of the instruments. Fair values of derivatives are estimated by pricing models that consider the forward yield curves and discount rates. The fair value of the Company's forward starting interest
rate swap contracts are estimated by pricing models that consider foreign trade rates and discount rates. Such amounts and the recognition of such amounts are subject to significant estimates that may change in the future. For derivatives designated in qualifying cash flow hedging relationships, the change in fair value of the effective portion of the derivatives is recognized in accumulated other comprehensive income (loss). Gains and losses are reclassified from accumulated other comprehensive income (loss) into earnings once the underlying hedged transaction is recognized in earnings. As of December 31, 2023 and 2022, the Company had $10.7 million recorded in accumulated other comprehensive loss and $2.1 million recorded in accumulated other comprehensive (loss) income, respectively, related to forward starting interest rate swaps entered into and settled during 2015 and 2020 and a hedge of the Company's variable rate debt.
Cash, Cash Equivalents and Restricted Cash
Cash, Cash Equivalents and Restricted Cash
Cash and cash equivalents includes short-term investments with original maturities of three months or less when purchased. Restricted cash includes cash held in escrow in connection with proceeds from the sales of certain real estate properties. The Company did not have any restricted cash for the years ended December 31, 2023 or 2022.
Cash and cash equivalents are held in bank accounts and overnight investments. The Company maintains its bank deposits with large financial institutions in amounts that often exceed federally-insured limits. The Company has not experienced any losses in such accounts.
Goodwill and Other Intangible Assets
Goodwill and Other Intangible Assets
Goodwill and intangible assets with indefinite lives are not amortized, but are tested at least annually for impairment. Intangible assets with finite lives are amortized over their respective lives to their estimated residual values and are reviewed for impairment only when impairment indicators are present.
Identifiable intangible assets of the Company are comprised of enterprise goodwill, in-place lease intangible assets, customer relationship intangible assets, and debt issuance costs. In-place lease and customer relationship intangible assets are amortized on a straight-line basis over the applicable lives of the assets. Debt issuance costs are amortized over the term of the debt instrument on the effective interest method or the straight-line method when the effective interest method is not applicable. Goodwill is not amortized but is evaluated annually as of December 31 for impairment. The Company's goodwill asset increased $27.3 million to $250.5 million in 2023 compared to $223.2 million in 2022, as a result of the final purchase price allocation adjustments related to the Merger. The 2023 impairment evaluation indicated that no impairment had occurred with respect to the Company's goodwill asset.
Contingent Liabilities
Contingent Liabilities
From time to time, the Company may be subject to loss contingencies arising from legal proceedings and similar matters. Additionally, while the Company maintains comprehensive liability and property insurance with respect to each of its properties, the Company may be exposed to unforeseen losses related to uninsured or underinsured damages.
The Company continually monitors any matters that may present a contingent liability, and, on a quarterly basis, management reviews the Company’s reserves and accruals in relation to each of them, adjusting provisions as necessary in view of changes in available information. Liabilities for contingencies are first recorded when a loss is determined to be both probable and can be reasonably estimated. Changes in estimates regarding the exposure to a contingent loss are reflected as adjustments to the related liability in the periods when they occur.
Because of uncertainties inherent in the estimation of contingent liabilities, it is possible that the Company’s provision for contingent losses could change materially in the near term. To the extent that any significant losses, in addition to amounts recognized, are at least reasonably possible, such amounts will be disclosed in the notes to the Consolidated Financial Statements.
Stock-based Compensation
Share-Based Compensation
The Company has various employee and director share-based awards outstanding. These awards include non-vested common stock or other stock-based awards, including units in the OP, pursuant to the Company's Amended and Restated 2006 Incentive Plan, dated April 29, 2021 ("the Incentive Plan"). The Company recognizes share-based payments to employees and directors in the Consolidated Statements of Operations on a straight-line basis over the
requisite service period based on the fair value of the award on the measurement date.
Accumulated Other Comprehensive (Loss) Income
Accumulated Other Comprehensive (Loss) Income
Certain items must be included in comprehensive (loss) income, including items such as foreign currency translation adjustments, minimum pension liability adjustments, changes in the fair value of derivative instruments and unrealized gains or losses on available-for-sale securities. As of December 31, 2023, the Company’s accumulated other comprehensive (loss) income consists of the loss for changes in the fair value of active derivatives designated as cash flow hedges and the loss on the unamortized settlement of forward starting swaps and treasury hedges.
Revenue from Contracts with Customers (Topic 606)
Revenue from Contracts with Customers (Topic 606)
The Company recognizes certain revenue under the core principle of Topic 606. This requires an entity to recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. Lease revenue is not within the scope of Topic 606. To achieve the core principle, the Company applies the five-step model specified in the guidance.
Revenue that is accounted for under Topic 606 is segregated on the Company’s Consolidated Statements of Operations in the Other operating line item. This line item includes parking income, management fee income and other miscellaneous income.
The Company’s two major types of revenue that are accounted for under Topic 606 are all accounted for as the performance obligation is satisfied. The performance obligations that are identified for each of these items are satisfied over time and the Company recognizes revenue monthly based on this principle. In most cases, the revenue is due and payable on a monthly basis. The Company had a receivable balance of $1.9 million and $1.5 million, and $1.4 million for the years ended December 31, 2023, 2022 and 2021, respectively.
Management fee income includes property management services provided to third parties and certain of the properties in the Company's unconsolidated joint ventures and is generally calculated, accrued and billed monthly based on a percentage of cash collections of tenant receivables for the month or a stated amount per square foot. Management fee income also includes amounts paid to the Company for its asset management services for certain of its unconsolidated joint ventures. Internal management fee income, where the Company manages its owned properties, is eliminated in consolidation.
Rental Income
Rental income related to non-cancelable operating leases is recognized as earned over the life of the lease agreements on a straight-line basis. The Company's lease agreements generally include provisions for stated annual increases or increases based on a Consumer Price Index ("CPI"). Rental income from properties under multi-tenant office lease arrangements and rental income from properties with single-tenant lease arrangements are included in rental income on the Company's Consolidated Statements of Operations. For lessors, the standard requires a lessor to classify leases as either sales-type, direct-financing or operating. A lease will be treated as a sale if it is considered to transfer control of the underlying asset to the lessee. A lease will be classified as direct-financing if risks and rewards are conveyed without the transfer of control. Otherwise, the lease is treated as an operating lease.
Nonlease components, such as common area maintenance, are generally accounted for under Topic 606 and separated from the lease payments. However, the Company elected the lessor practical expedient allowing the Company to not separate these components when certain conditions are met. The combined component is accounted for under Accounting Standards Codification, Topic 842.
Federal Income Taxes
Federal Income Taxes
The Company believes it has qualified to be taxed as a REIT and intends at all times to continue to qualify as a REIT under Sections 856 through 860 of the Internal Revenue Code. The Company must distribute at least 90% per annum of its real estate investment trust taxable income to its stockholders and meet other requirements to continue to qualify as a real estate investment trust. As a REIT, the Company is generally not subject to federal income tax on net income it distributes to its stockholders, but may be subject to certain state and local taxes and fees. See Note 16 for further discussion.
If the Company fails to qualify as a REIT in any taxable year, it will be subject to U.S. federal income taxes on its taxable income and will not be permitted to qualify for treatment as a REIT for U.S. federal income tax purposes for four years following the year during which the qualification is lost unless the IRS grants it relief under certain statutory provisions. Such an event could have a material adverse effect on its business, financial condition, results of operations and net cash available for dividend distributions to its stockholders.
The Company conducts substantially all of its operations through the OP. As a partnership, the OP generally is not liable for federal income taxes. The income and loss from the operations of the OP is included in the tax returns of its partners, including the Company, who are responsible for reporting their allocable share of the partnership income and loss. Accordingly, no provision for income tax has been made in the accompanying consolidated financial statements.
The Company classifies interest and penalties related to uncertain tax positions, if any, in the Consolidated Financial Statements as a component of general and administrative expenses. No such amounts were recognized during the three years ended December 31, 2023.
Federal tax returns for the years 2020, 2021, 2022 and 2023 are currently subject to examination by taxing authorities.
State Income Taxes
State Income Taxes
The Company must pay certain state income taxes and the provisions for such taxes are generally included in general and administrative expenses on the Company’s Consolidated Statements of Operations.
Sales and Use Taxes
Sales and Use Taxes
The Company must pay sales and use taxes to certain state tax authorities based on rents collected from tenants in properties located in those states. The Company is generally reimbursed for these taxes by the tenant. The Company accounts for the payments to the taxing authority and subsequent reimbursement from the tenant on a net basis in rental income in the Company’s Consolidated Statements of Operations.
Assets Held for Sale
Assets Held for Sale
Long-lived assets held for sale are reported at the lower of their carrying amount or their fair value less estimated cost to sell. Further, depreciation of these assets ceases at the time the assets are classified as held for sale. Losses resulting from the sale of such properties are characterized as impairment losses in the Consolidated Statements of Operations.
Earnings Per Share
Earnings per Share
The Company uses the two-class method of computing net earnings per common share. Earnings per common share is calculated by considering share-based payment awards that contain nonforfeitable rights to dividends or dividend equivalents as participating securities. Undistributed earnings (excess net income over dividend payments) are allocated on a pro rata basis to common shareholders and restricted shareholders. Undistributed losses (dividends in excess of net income) do not get allocated to restricted stockholders as they do not have the contractual obligation to share in losses. The amount of undistributed losses that applies to the restricted stockholders is allocated to the common stockholders.
Basic earnings per common share is calculated using weighted average shares outstanding less issued and outstanding non-vested shares of common stock. Diluted earnings per common share is calculated using weighted average shares outstanding plus the dilutive effect of the outstanding stock options from the Legacy HR Employee Stock Purchase Plan using the treasury stock method and the average stock price during the period. Additionally, net income (loss) allocated to OP units has been included in the numerator and common stock related to redeemable OP units have been included in the denominator for the purpose of computing diluted earnings per share.
Redeemable Non-Controlling Interests
Redeemable Non-Controlling Interests
The Company accounts for redeemable equity securities in accordance with Accounting Standards Update ("ASU") 2009-04 Liabilities (Topic 480): Accounting for Redeemable Equity Instruments, which requires that equity securities contingently redeemable at the option of the holder, not solely within our control, be classified outside permanent stockholders’ equity. The Company classifies redeemable equity securities as redeemable non-controlling interests in the accompanying Consolidated Balance Sheet. Accordingly, the Company records the carrying amount at the greater of the initial carrying amount (increased or decreased for the non-controlling interest’s share of net income or loss and distributions) or the redemption value. We measure the redemption value and record an adjustment to the carrying value of the equity securities as a component of redeemable non-controlling interest.
Investments in Leases - Financing Receivables, Net and Real Estate Notes Receivable and Interest Income
Investments in Leases - Financing Receivables, Net
In accordance with ASC Topic 842: Leases, for transactions in which the Company enters into a contract to acquire an asset and leases it back to the seller (i.e., a sale-leaseback transaction), control of the asset is not considered to have transferred when the seller-lessee has a purchase option. As a result, the Company does not recognize the underlying real estate asset but instead recognizes a financial asset in accordance with ASC Topic 310: Receivables.
Real Estate Notes Receivable
Real estate notes receivable consists of mezzanine and other real estate loans, which are generally collateralized by a pledge of the borrower’s ownership interest in the respective real estate owner, a mortgage or deed of trust, and/or corporate guarantees. Real estate notes receivable are intended to be held-to-maturity and are recorded at amortized cost, net of unamortized loan origination costs and fees and allowance for credit losses.
Allowance for Credit Losses
Pursuant to ASC Topic 326, Financial Instruments - Credit Losses, the Company adopted a policy to evaluate current expected credit losses at the inception of loans qualifying for treatment under ASC Topic 326. The Company utilizes a probability of default method approach for estimating current expected credit losses and evaluates the liquidity and creditworthiness of its borrowers on a quarterly basis to determine whether any updates to the future expected losses recognized upon inception are necessary. The Company’s evaluation considers industry and economic conditions, credit enhancements, liquidity, and other factors. The determination of the credit allowance is based on a quarterly evaluation of all outstanding loans, including general economic conditions and estimated collectability of loan payments. The Company evaluates the collectability of loan receivables based on a combination of credit quality indicators, including, but not limited to, payment status, historical loan charge-offs, financial strength of the borrower and guarantors, and nature, extent, and value of the underlying collateral. A loan is considered to have deteriorated credit quality when, based on current information and events, it is probable that the Company will be unable to collect all amounts due as scheduled according to the contractual terms of the loan agreement. For those loans identified as having deteriorated credit quality, the amount of credit loss is determined on an individual basis. Placement on non-accrual status may be required. Consistent with this definition, all loans on non-accrual status are
deemed to have deteriorated credit quality. To the extent circumstances improve and the risk of collectability is diminished, the loan may return to income accrual status. While a loan is on non-accrual status, any cash receipts are applied against the outstanding principal balance.
Interest Income
Income from Lease Finance Receivables
The Company recognized the related income from two financing receivables totaling $8.3 million and $8.1 million, respectively, for the years ended December 31, 2023 and 2022, based on an imputed interest rate over the terms of the applicable lease. As a result, the interest recognized from the financing receivable in any particular period will not equal the cash payments from the lease agreement in that period.
Acquisition costs incurred in connection with entering into the financing receivable are treated as loan origination fees. These costs are classified with the financing receivable and are included in the balance of the net investment. Amortization of these amounts will be recognized as a reduction to Interest income over the life of the lease.
New Accounting Pronouncements
New Accounting Pronouncements
On November 27, 2023, the Financial Accounting Standards Board ("FASB") issued ASU 2023-07, Segment Reporting (Topic 280). Some of the main provisions of this update to segment reporting include; (i) a requirement to disclose significant segment expenses, on an annual and interim basis, that are regularly provided to the chief operating decision maker ("CODM") and included within each reported measure of segment profit or loss; (ii) a requirement to disclose the title and position of the CODM and an explanation of how the CODM uses the reported measures of segment profit or loss in assessing segment performance and deciding how to allocate resources, and (iii) a requirement that an entity that has a single reportable segment provide all the disclosures required by the amendments in this update.
The update is effective for reporting periods beginning after December 15, 2023, and interim periods beginning after December 15, 2024. Early adoption is permitted. At this time, the Company does not expect that the adoption of this ASU will have a material impact on its consolidated financial statements and compliance of these new disclosure requirements will begin with the Company's Annual Report on Form 10-K for the year ended December 31, 2024.
v3.24.0.1
Summary of Significant Accounting Policies (Tables)
 12 Months Ended
Dec. 31, 2023
Accounting Policies [Abstract]  
Schedule of consolidated balance sheets Accordingly, such joint ventures have been consolidated, and the table below summarizes the balance sheets of consolidated VIEs, excluding the OP, in the aggregate:
(dollars in thousands)DECEMBER 31, 2023
Assets:
Net real estate investments$85,752 
Cash and cash equivalents2,144 
Receivables and other assets
2,704 
Total assets
$90,600 
Liabilities:
Accrued expenses and other liabilities
$17,835 
Total equity
72,765 
Total liabilities and equity
$90,600 
Schedule of variable interest entity Therefore, the Company accounts for the two notes receivables as amortized cost and a joint venture arrangement under the equity method. See below for additional information regarding the Company's unconsolidated VIEs:
(dollars in thousands) ORIGINATION DATELOCATIONSOURCECARRYING AMOUNTMAXIMUM EXPOSURE TO LOSS
2021
Houston, TX 1
Note receivable$31,150 $31,150 
2021
Charlotte, NC 1
Note receivable5,796 6,000 
2022
Texas 2
Equity method61,801 61,801 
1Assumed mortgage note receivable in connection with the Merger.
2Includes investments in seven properties.
Schedule of assets' estimated useful life Depreciation and amortization of real estate assets in place as of December 31, 2023, is provided for on a straight-line basis over the asset’s estimated useful life:
Land improvements
2.0 to 39.0 years
Buildings and improvements
3.3 to 49.0 years
Lease intangibles (including ground lease intangibles)
1.0 to 99.0 years
Personal property
3.0 to 20.0 years
Schedule of disaggregation of revenue Below is a detail of the amounts by category:
YEAR ENDED DECEMBER 31,
in thousands202320222021
Type of Revenue
Parking income$9,903 $8,513 $7,859 
Management fee income/other 1
7,548 5,193 2,432 
$17,451 $13,706 $10,291 
1 Includes the recovery of certain expenses under the financing receivable as outlined in the management agreement.
Schedule of rental income
The components of rental income are as follows:
YEAR ENDED DECEMBER 31,
in thousands202320222021
Property operating income$1,270,508 $883,953 $514,533 
Straight-line rent38,676 23,498 5,801 
Rental income$1,309,184 $907,451 $520,334 
Schedule of notes receivable See below for additional information regarding the Company's financing receivables as of December 31, 2023.
(dollars in thousands) ORIGINATION DATELOCATIONINTEREST RATECARRYING VALUE as of DECEMBER 31, 2023
May 2021Poway, CA5.71%$115,239 
November 2021Columbus, OH6.48%7,363 
$122,602 
(dollars in thousands)ORIGINATIONMATURITYSTATED INTEREST RATEMAXIMUM LOAN COMMITMENTOUTSTANDING as of
DEC 31, 2023		ALLOWANCE FOR CREDIT LOSSESFAIR VALUE DISCOUNT AND FEESCARRYING VALUE as of DEC 31, 2023
Mezzanine loans
Texas6/24/20216/24/20248.00 %$54,119 $54,119 $(5,196)$(3,067)$45,856 
Arizona12/21/202312/20/20269.00 %6,000 6,000 — — 6,000 
60,119 60,119 (5,196)(3,067)51,856 
Mortgage loans
Texas6/30/20217/01/20247.00 %31,150 31,150 — — 31,150 
North Carolina12/22/202112/22/20248.00 %6,000 6,000 — (204)5,796 
Florida5/17/20222/27/20266.00 %65,000 32,156 — (44)32,112 
California3/30/20233/29/20266.00 %45,000 45,000 — — 45,000 
Florida12/28/202312/28/20269.00 %7,700 7,700 — — 7,700 
154,850 122,006 — (248)121,758 
$214,969 $182,125 $(5,196)$(3,315)$173,614 
Schedule of company's allowance for credit losses The following table summarizes the Company's allowance for credit losses on real estate notes receivable:
Dollars in thousandsTWELVE MONTHS ENDED DECEMBER 31, 2023TWELVE MONTHS ENDED DECEMBER 31, 2022
Allowance for credit losses, beginning of period$— $— 
Credit loss reserves5,196 — 
Allowance for credit losses, end of period$5,196 $— 
v3.24.0.1
Merger with HTA (Tables)
 12 Months Ended
Dec. 31, 2023
Business Combination and Asset Acquisition [Abstract]  
Schedule of consideration transferred
The implied consideration transferred on the Closing Date is as follows:
Dollars in thousands, except for per share data
Shares of Legacy HTA Common Stock outstanding as of July 20, 2022 as adjusted(a)
228,520,990 
Exchange ratio1.00 
Implied shares of Legacy HR Common Stock issued228,520,990 
Adjusted closing price of Legacy HR Common Stock on July 20, 2022(b)
$24.37 
Value of implied Legacy HR Common Stock issued$5,569,057 
Fair value of Legacy HTA restricted stock awards attributable to pre-Merger services(c)
7,406 
Consideration transferred$5,576,463 
(a) The number of shares of Legacy HTA Common Stock presented above was based on 228,857,717 total shares of Legacy HTA Common Stock outstanding as of the Closing Date, less 192 Legacy HTA fractional shares that were cancelled in lieu of cash and less 336,535 shares of Legacy HTA restricted stock (net of 215,764 shares of Legacy HTA restricted stock withheld). For accounting purposes, these shares were converted to Legacy HR Common Stock, at an exchange ratio of 1.00 share of Legacy HR Common Stock per share of Legacy HTA Common Stock.
(b) For accounting purposes, the fair value of Legacy HR Common Stock issued to former holders of Legacy HTA Common Stock was based on the per share closing price of Legacy HR Common Stock on July 20, 2022.
(c) Represents the fair value of Legacy HTA restricted shares which fully vested prior to the closing of the Merger or became fully vested as a result of the closing of the Merger and which are attributable to pre-combination services.
Schedule of fair values of the assets acquired and liabilities assumed
The following table summarizes the estimated fair values of the assets acquired and liabilities assumed at the Closing Date:
Dollars in thousandsPRELIMINARY AMOUNTS RECOGNIZED ON THE CLOSING DATE CUMULATIVE MEASUREMENT PERIOD ADJUSTMENTSAMOUNTS RECOGNIZED ON THE CLOSING DATE
(as adjusted)
ASSETS
Real estate investments
Land $985,926 $18,359 $1,004,285 
Buildings and improvements6,960,418 (119,135)6,841,283 
Lease intangible assets(a)
831,920 1,839 833,759 
Financing lease right-of-use assets9,874 3,146 13,020 
Construction in progress10,071 (6,744)3,327 
Land held for development46,538 — 46,538 
Total real estate investments$8,844,747 $(102,535)$8,742,212 
Assets held for sale, net 707,442 (7,946)699,496 
Investments in unconsolidated joint ventures67,892 — 67,892 
Cash and cash equivalents26,034 11,403 37,437 
Restricted cash 1,123,647 (1,247)1,122,400 
Operating lease right-of-use assets198,261 16,370 214,631 
Other assets, net (b) (c)
209,163 (3,840)205,323 
Total assets acquired$11,177,186 $(87,795)$11,089,391 
LIABILITIES
Notes and bonds payable $3,991,300 $— $3,991,300 
Accounts payable and accrued liabilities 1,227,570 17,374 1,244,944 
Liabilities of assets held for sale28,677 (3,939)24,738 
Operating lease liabilities 173,948 10,173 184,121 
Financing lease liabilities 10,720 (855)9,865 
Other liabilities 203,210 (8,909)194,301 
Total liabilities assumed$5,635,425 $13,844 $5,649,269 
Net identifiable assets acquired$5,541,761 $(101,639)$5,440,122 
Non-controlling interest$110,702 $— $110,702 
Goodwill$145,404 $101,639 $247,043 
(a) The weighted average amortization period for the acquired lease intangible assets is approximately 6 years.
(b) Includes $15.9 million of contractual accounts receivable, which approximates fair value.
(c) Includes $78.7 million of gross contractual real estate notes receivable, the fair value of which was $74.8 million, and the Company preliminarily expects to collect substantially all of the real estate notes receivable proceeds as of the Closing Date.
The following table summarizes the estimated relative fair values of the assets acquired and liabilities assumed in the real estate acquisitions for 2023 as of the acquisition date:
ESTIMATED
FAIR VALUE
in millions		ESTIMATED
USEFUL LIFE
in years
Building$27.5 
17.0 - 30.0
Tenant Improvements3.4 
5.1 - 5.9
Land5.5 — 
Land Improvements1.1 
6.0 - 10.0
Intangibles
At-market lease intangibles4.5 
5.1 - 5.9
Above-market lease intangibles (lessor)0.2 
1.8 - 4.9
Below-market lease intangibles (lessor)(0.2)
6.4 - 13.9
Mortgage notes payable assumed, including fair value adjustments(5.3)
Other assets acquired0.1 
Accounts payable, accrued liabilities and other liabilities assumed(0.3)
Total cash paid$36.5 
The following table summarizes the estimated relative fair values of the assets acquired and liabilities assumed in the real estate acquisitions for 2022 as of the acquisition date:
ESTIMATED
FAIR VALUE
in millions		ESTIMATED
USEFUL LIFE
in years
Building$250.7 
14.0 - 38.0
Tenant Improvements20.7 
1.5 - 13.4
Land76.1 — 
Land Improvements11.2 
5.0 - 14.0
Intangibles
At-market lease intangibles28.1 
1.5 - 13.4
Above-market lease intangibles (lessor)15.9 
1.3 - 15.6
Below-market lease intangibles (lessor)(2.2)
1.3 - 19.3
Below-market lease intangibles (lessee)1.2 
13.1
Other assets acquired0.4 
Accounts payable, accrued liabilities and other liabilities assumed(2.9)
Total cash paid$399.2 
v3.24.0.1
Property Investments (Tables)
 12 Months Ended
Dec. 31, 2023
Real Estate Investment Property, Net [Abstract]  
Schedule of property investment The following table summarizes the Company’s consolidated investments at December 31, 2023.
Dollars in thousandsNUMBER OF PROPERTIESLANDBUILDINGS AND IMPROVEMENTSLEASE INTANGIBLESPERSONAL PROPERTYTOTALACCUMULATED DEPRECIATION
 Dallas, TX 43 $90,168 $1,004,810 $68,139 $550 $1,163,667 $(221,375)
 Houston, TX 31 76,959 614,531 60,651 57 752,198 (97,793)
 Seattle, WA 29 64,295 631,438 9,921 715 706,369 (186,903)
 Denver, CO 33 76,698 501,994 43,268 610 622,570 (94,906)
 Charlotte, NC 32 35,465 463,461 26,971 110 526,007 (116,578)
 Phoenix, AZ 35 20,262 437,804 36,384 425 494,875 (59,449)
 Atlanta, GA 27 49,095 417,112 28,204 100 494,511 (79,569)
 Boston, MA 17 127,447 299,742 41,183 14 468,386 (37,569)
 Raleigh, NC 28 56,620 371,932 36,411 9 464,972 (38,879)
 Nashville, TN 13 43,347 397,192 10,206 7,427 458,172 (115,979)
 Los Angeles, CA 20 72,086 360,330 16,481 453 449,350 (145,875)
 Miami, FL 19 53,994 326,343 35,014 178 415,529 (74,470)
 Tampa, FL 19 31,121 351,879 27,438 33 410,471 (36,726)
 Indianapolis, IN 36 54,899 285,806 32,780 13 373,498 (42,273)
 Austin, TX 13 27,063 274,229 18,568 142 320,002 (55,891)
 New York, NY 14 64,402 170,304 26,430 — 261,136 (15,887)
 Chicago, IL 6 13,804 216,473 13,011 81 243,369 (39,671)
 Memphis, TN 11 13,901 189,941 4,211 322 208,375 (71,813)
 Honolulu, HI 6 9,527 188,772 6,319 169 204,787 (61,575)
 Hartford, CT 30 29,381 138,713 21,848 — 189,942 (15,883)
 Other (49 markets)193 332,731 3,238,567 272,864 1,310 3,845,472 (617,789)
655 1,343,265 10,881,373 836,302 12,718 13,073,658 (2,226,853)
Investment in financing receivables, net— — — — 122,602 — 
Financing lease right-of-use assets— — — — — 82,209 — 
Construction in progress— — — — — 60,727 — 
Land held for development— — — — — 59,871 — 
Total real estate investments655 $1,343,265 $10,881,373 $836,302 $12,718 $13,399,067 $(2,226,853)
v3.24.0.1
Leases (Tables)
 12 Months Ended
Dec. 31, 2023
Leases [Abstract]  
Schedule of future minimum lease payments due to the Company under property operating agreements
Future minimum lease payments under the non-cancelable operating leases, excluding any reimbursements, as of December 31, 2023 were as follows:
In thousands
2024$894,442 
2025801,973 
2026701,615 
2027582,028 
2028469,549 
2029 and thereafter1,579,010 
$5,028,617 
Schedule of future minimum operating lease payments
The Company’s future lease payments (primarily for its 157 non-prepaid ground leases) as of December 31, 2023 were as follows:
In thousandsOPERATINGFINANCING
2024$12,263 $2,182 
202512,428 2,218 
202612,516 2,254 
202712,703 2,294 
202812,822 2,326 
2029 and thereafter698,905 394,072 
Total undiscounted lease payments$761,637 $405,346 
Discount(531,923)(330,843)
Lease liabilities$229,714 $74,503 
Schedule of future minimum finance lease payments
The Company’s future lease payments (primarily for its 157 non-prepaid ground leases) as of December 31, 2023 were as follows:
In thousandsOPERATINGFINANCING
2024$12,263 $2,182 
202512,428 2,218 
202612,516 2,254 
202712,703 2,294 
202812,822 2,326 
2029 and thereafter698,905 394,072 
Total undiscounted lease payments$761,637 $405,346 
Discount(531,923)(330,843)
Lease liabilities$229,714 $74,503 
Schedule of lease cost
The following table provides details of the Company's total lease expense for the years ended December 31, 2023 and 2022:
In thousandsYEAR ENDED
Dec. 31, 2023		YEAR ENDED
Dec. 31, 2022
Operating lease cost
Operating lease expense$20,623 $12,699 
Variable lease expense8,979 4,529 
Finance lease cost
Amortization of right-of-use assets1,564 1,288 
Interest on lease liabilities3,718 2,876 
Total lease expense$34,884 $21,392 
Other information
Operating cash flows outflows related to operating leases$19,222$12,816
Operating cash flows outflows related to financing leases$2,122$1,838
Financing cash flows outflows related to financing leases$17$—
Right-of-use assets obtained in exchange for new finance lease liabilities$—$53,765
Right-of-use assets obtained in exchange for new operating lease liabilities$1,758$216,047
Weighted-average remaining lease term (excluding renewal options) - operating leases45.847.5
Weighted-average remaining lease term (excluding renewal options) - finance leases57.958.9
Weighted-average discount rate - operating leases5.7 %5.8 %
Weighted-average discount rate - finance leases5.0 %5.0 %
v3.24.0.1
Acquisitions, Dispositions and Mortgage Repayments (Tables)
 12 Months Ended
Dec. 31, 2023
Business Combination and Asset Acquisition [Abstract]  
Schedule of acquisitions
The following table details the Company's real estate acquisition activity for the year ended December 31, 2023:
Dollars in thousandsDATE ACQUIREDPURCHASE PRICEMORTGAGE NOTES PAYABLE, NET
CASH
CONSIDERATION 1
REAL
ESTATE
OTHER 2
SQUARE FOOTAGE
Tampa, FL3/10/23$31,500 $— $30,499 $30,596 $(97)115,867 
Colorado Springs, CO7/28/2311,450 (5,284)6,024 11,416 (108)42,770 
Total real estate acquisitions$42,950 $(5,284)$36,523 $42,012 $(205)158,637 
1.Cash consideration excludes prorations of revenue and expense due to/from seller at the time of the acquisition.
2.Includes other assets acquired, liabilities assumed, and intangibles recognized at acquisition.
The following table details the Company's acquisitions, exclusive of the Merger, for the year ended December 31, 2022:
Dollars in thousands
TYPE 1
DATE ACQUIREDPURCHASE PRICE
CASH
CONSIDERATION 2
REAL
ESTATE
OTHER 3
SQUARE FOOTAGE
unaudited
Dallas, TX 4
MOB2/11/22$8,175 $8,185 $8,202 $(17)18,000
San Francisco, CA 5
MOB3/7/22114,000 112,986 108,687 4,299 166,396
Atlanta, GAMOB4/7/226,912 7,054 7,178 (124)21,535
Denver, COMOB4/13/226,320 5,254 5,269 (15)12,207
Colorado Springs, CO 6
MOB4/13/2213,680 13,686 13,701 (15)25,800
Seattle, WAMOB4/28/228,350 8,334 8,370 (36)13,256
Houston, TXMOB4/28/2236,250 36,299 36,816 (517)76,781
Los Angeles, CAMOB4/29/2235,000 35,242 25,400 9,842 34,282
Oklahoma City, OKMOB4/29/2211,100 11,259 11,334 (75)34,944
Raleigh, NC 5
MOB5/31/2227,500 26,710 27,127 (417)85,113
Tampa, FL 6
MOB6/9/2218,650 18,619 18,212 407 55,788
Seattle, WAMOB8/1/224,850 4,806 4,882 (76)10,593
Raleigh, NCMOB8/9/223,783 3,878 3,932 (54)11,345
Jacksonville, FLMOB8/9/2218,195 18,508 18,583 (75)34,133
Atlanta, GAMOB8/10/2211,800 11,525 12,038 (513)43,496
Denver, COMOB8/11/2214,800 13,902 13,918 (16)34,785
Raleigh, NCMOB8/18/2211,375 10,670 10,547 123 31,318
Nashville, TNMOB9/15/2221,000 20,764 20,572 192 61,932
Austin, TXMOB9/29/225,450 5,449 5,572 (123)15,000
Jacksonville, FL 4
MOB10/12/223,600 3,530 3,609 (79)6,200
Houston, TXMOB11/21/225,500 5,469 5,513 (44)28,369
Austin, TX 7
MOB12/28/22888 890 889 1 2,219
Denver, COMOB12/28/2216,400 16,170 16,467 (297)39,692
$403,578 $399,189 $386,818 $12,371 863,184 
1MOB = medical outpatient building.
2Cash consideration excludes prorations of revenue and expense due to/from seller at the time of the acquisition.
3Includes other assets acquired, liabilities assumed, and intangibles recognized at acquisition.
4Represents a single-tenant property.
5Includes three properties.
6Includes two properties.
7The Company acquired additional ownership interests in an existing building bringing the Company's ownership to 71.4%.
Schedule of assets acquired and liabilities assumed
The following table summarizes the estimated fair values of the assets acquired and liabilities assumed at the Closing Date:
Dollars in thousandsPRELIMINARY AMOUNTS RECOGNIZED ON THE CLOSING DATE CUMULATIVE MEASUREMENT PERIOD ADJUSTMENTSAMOUNTS RECOGNIZED ON THE CLOSING DATE
(as adjusted)
ASSETS
Real estate investments
Land $985,926 $18,359 $1,004,285 
Buildings and improvements6,960,418 (119,135)6,841,283 
Lease intangible assets(a)
831,920 1,839 833,759 
Financing lease right-of-use assets9,874 3,146 13,020 
Construction in progress10,071 (6,744)3,327 
Land held for development46,538 — 46,538 
Total real estate investments$8,844,747 $(102,535)$8,742,212 
Assets held for sale, net 707,442 (7,946)699,496 
Investments in unconsolidated joint ventures67,892 — 67,892 
Cash and cash equivalents26,034 11,403 37,437 
Restricted cash 1,123,647 (1,247)1,122,400 
Operating lease right-of-use assets198,261 16,370 214,631 
Other assets, net (b) (c)
209,163 (3,840)205,323 
Total assets acquired$11,177,186 $(87,795)$11,089,391 
LIABILITIES
Notes and bonds payable $3,991,300 $— $3,991,300 
Accounts payable and accrued liabilities 1,227,570 17,374 1,244,944 
Liabilities of assets held for sale28,677 (3,939)24,738 
Operating lease liabilities 173,948 10,173 184,121 
Financing lease liabilities 10,720 (855)9,865 
Other liabilities 203,210 (8,909)194,301 
Total liabilities assumed$5,635,425 $13,844 $5,649,269 
Net identifiable assets acquired$5,541,761 $(101,639)$5,440,122 
Non-controlling interest$110,702 $— $110,702 
Goodwill$145,404 $101,639 $247,043 
(a) The weighted average amortization period for the acquired lease intangible assets is approximately 6 years.
(b) Includes $15.9 million of contractual accounts receivable, which approximates fair value.
(c) Includes $78.7 million of gross contractual real estate notes receivable, the fair value of which was $74.8 million, and the Company preliminarily expects to collect substantially all of the real estate notes receivable proceeds as of the Closing Date.
The following table summarizes the estimated relative fair values of the assets acquired and liabilities assumed in the real estate acquisitions for 2023 as of the acquisition date:
ESTIMATED
FAIR VALUE
in millions		ESTIMATED
USEFUL LIFE
in years
Building$27.5 
17.0 - 30.0
Tenant Improvements3.4 
5.1 - 5.9
Land5.5 — 
Land Improvements1.1 
6.0 - 10.0
Intangibles
At-market lease intangibles4.5 
5.1 - 5.9
Above-market lease intangibles (lessor)0.2 
1.8 - 4.9
Below-market lease intangibles (lessor)(0.2)
6.4 - 13.9
Mortgage notes payable assumed, including fair value adjustments(5.3)
Other assets acquired0.1 
Accounts payable, accrued liabilities and other liabilities assumed(0.3)
Total cash paid$36.5 
The following table summarizes the estimated relative fair values of the assets acquired and liabilities assumed in the real estate acquisitions for 2022 as of the acquisition date:
ESTIMATED
FAIR VALUE
in millions		ESTIMATED
USEFUL LIFE
in years
Building$250.7 
14.0 - 38.0
Tenant Improvements20.7 
1.5 - 13.4
Land76.1 — 
Land Improvements11.2 
5.0 - 14.0
Intangibles
At-market lease intangibles28.1 
1.5 - 13.4
Above-market lease intangibles (lessor)15.9 
1.3 - 15.6
Below-market lease intangibles (lessor)(2.2)
1.3 - 19.3
Below-market lease intangibles (lessee)1.2 
13.1
Other assets acquired0.4 
Accounts payable, accrued liabilities and other liabilities assumed(2.9)
Total cash paid$399.2 
Schedule of equity method investments
The Company's investment in and loss recognized for the years ended December 31, 2023 and 2022 related to its unconsolidated joint ventures accounted for under the equity method are shown in the table below:
DECEMBER 31,
Dollars in millions20232022
Investments in unconsolidated joint ventures, beginning of period$327.2 $161.9 
New investments during the period3.8 167.9 
Equity loss recognized during the period(1.7)(0.7)
Owner distributions(17.8)(1.9)
Investments in unconsolidated joint ventures, end of period$311.5 $327.2 
Schedule of Joint Venture Transactions
The following table details the joint venture acquisitions for the year ended December 31, 2022:
Dollars in thousands
TYPE 1
DATE ACQUIREDPURCHASE PRICE
CASH
CONSIDERATION 2
REAL
ESTATE
OTHER 3
SQUARE FOOTAGE
unaudited
San Francisco, CA 4
MOB3/7/22$67,175 $66,789 $65,179 $1,610 110,865
Los Angeles, CA 5
MOB3/7/2233,800 32,384 32,390 (6)103,259
$100,975 $99,173 $97,569 $1,604 214,124 
1MOB = medical outpatient building.
2Cash consideration excludes prorations of revenue and expense due to/from seller at the time of the acquisition.
3Includes other assets acquired, liabilities assumed, and intangibles recognized at acquisition.
4Includes three properties.
5Includes two properties.
Schedule of dispositions
The following table details the Company's dispositions for the year ended December 31, 2023:
Dollars in thousands
Type1
DATE DISPOSEDSALE PRICECLOSING ADJCOMPANY-FINANCED NOTESNET PROCEEDSNET REAL ESTATE
OTHER (INCLUDING RECEIVABLES) 2
GAIN/(IMPAIR-MENT)SQUARE FOOTAGE
Tampa/Miami, FL3
MOB1/12/23$93,250 $(5,875)$— $87,375 $87,302 $(888)$961 224,037 
Dallas, TX 4
MOB1/30/2319,210 (141)— 19,069 18,986 43 40 36,691 
St. Louis, MOMOB2/10/23350 (18)— 332 398 — (66)6,500 
Los Angeles, CAMOB3/23/2321,000 (526)— 20,474 20,610 52 (188)37,165 
Los Angeles, CA 5
MOB3/30/2375,000 (8,079)(45,000)21,921 88,624 (803)(20,900)147,078 
Los Angeles, CA 6
LAND5/12/233,300 (334)— 2,966 3,268 — (302)— 
Albany, NYMOB6/30/2310,000 (1,229)— 8,771 2,613 (1,040)7,198 40,870 
Houston, TXMOB8/2/238,320 (285)— 8,035 4,567 194 3,274 57,170 
Atlanta, GAMOB8/22/2325,140 (66)— 25,074 23,226 (536)2,386 55,195 
Dallas, TXINPATIENT9/15/23115,000 (1,504)— 113,496 64,183 6,094 43,219 161,264 
Houston, TXMOB9/18/23250 (24)— 226 1,998 — (1,772)52,040 
Chicago, ILMOB9/27/2359,950 (870)— 59,080 74,710 (380)(15,250)104,912 
Evansville, IN 7
MOB11/13/2318,500 (63)— 18,437 17,807 (149)779 260,520 
Houston, TXHOSPITAL12/1/234,100 (6)— 4,094 3,486 — 608 83,223 
Charleston, SC 8
OFFICE12/15/236,200 (401)— 5,799 3,415 — 2,384 15,014 
Dallas, TXMOB12/20/2343,295 (764)— 42,531 33,882 (3,782)12,431 77,827 
Los Angeles, CAOFFICE12/21/2319,000 (1,311)— 17,689 17,787 — (98)104,377 
Tucson, AZ 9,10
MOB12/22/2343,230 (3,770)(6,000)33,460 39,786 (26)(300)215,471 
Miami, FLMOB12/22/2318,250 (756)— 17,494 17,354 643 (503)48,000 
Sebring, FLMOB12/27/239,500 (81)— 9,419 10,438 (512)(507)38,949 
Boston, MAMOB12/28/23117,197 (2,079)— 115,118 107,803 9,828 (2,513)161,254 
Jacksonville/Orlando/Miami, FL 11
SNF12/29/2377,000 (8,678)(7,700)60,622 65,839 (294)2,777 354,500 
Total dispositions$787,042 $(36,860)$(58,700)$691,482 $708,082 $8,444 $33,658 2,282,057 
1.MOB = medical outpatient building; SNF = skilled nursing facility.
2.Includes straight-line rent receivables, leasing commissions and lease inducements.
3.Includes two properties sold in two separate transactions to the same buyer on the same date.
4.The Company sold this property to a joint venture in which it retained a 40% interest. Sales price and square footage reflect the total sales price paid by the joint venture and total square footage of the property.
5.The Company entered into a mortgage loan agreement with the buyer for $45.0 million.
6.The Company sold a land parcel totaling 0.34 acres.
7.Includes five properties sold in three separate transactions to the same buyer on the same date.
8.The Company sold a corporate office in Charleston, SC that was 100% occupied by the Company.
9.Includes 12 properties sold in one transaction to the same buyer.
10.The Company entered into a mezzanine loan with the buyer for $6.0 million.
11.Includes three properties sold in one transaction to the same buyer. The Company entered into a separate note receivable for $7.7 million related to this sale.
The following table details the Company's dispositions for the year ended December 31, 2022:
Dollars in thousands
TYPE 1
DATE DISPOSEDSALES PRICECLOSING ADJUSTMENTSNET PROCEEDSNET REAL ESTATE INVESTMENT
OTHER
including
receivables 2
GAIN/
(IMPAIRMENT)		SQUARE FOOTAGE
unaudited
Loveland, CO 3, 4
MOB2/24/22$84,950 $(45)$84,905 $40,095 $4 $44,806 150,291 
San Antonio, TX 3
MOB4/15/2225,500 (2,272)23,228 14,381 284 8,563 201,523 
GA, FL, PA 5, 11
MOB7/29/22133,100 (8,109)124,991 124,991 — — 316,739 
GA, FL, TX 7, 11
MOB8/4/22160,917 (5,893)155,024 151,819 3,205 — 343,545 
Los Angeles, CA 5, 9, 11
MOB8/5/22134,845 (3,102)131,743 131,332 411 — 283,780 
Dallas, TX 7, 10, 11
MOB8/30/22114,290 (682)113,608 113,608 — — 189,385 
Indianapolis, IN 6, 12
MOB8/31/22238,845 (5,846)232,999 84,767 4,324 143,908 506,406 
Dallas, TX 3
MOB10/4/22104,025 (5,883)98,142 38,872 6,436 52,834 291,328 
Houston, TXMOB10/21/2232,000 (280)31,720 10,762 744 20,214 134,910 
College Station, TXMOB11/10/2249,177 (3,755)45,422 44,918 475 28 122,942 
El Paso, TXMOB12/22/2255,326 (4,002)51,324 56,427 (1,897)(3,205)110,465 
Atlanta, GA 8
MOB12/22/2291,243 (4,326)86,917 109,051 235 (22,369)348,416 
St. Louis, MOMOB12/28/2218,000 (1,471)16,529 18,340 4 (1,815)69,394 
$1,242,218 $(45,666)$1,196,552 $939,363 $14,225 $242,964 3,069,124 
1MOB = medical outpatient building
2Includes straight-line rent receivables, leasing commissions and lease inducements.
3Includes two properties.
4The Company deferred the tax gain through a 1031 exchange and reinvested the proceeds.
5Includes four properties.
6Includes five properties.
7Includes six properties.
8Includes nine properties.
9Values and square feet are represented at 100%. The Company retained a 20% ownership interest in the joint venture with an unrelated third party that purchased these properties.
10Values and square feet are represented at 100%. The Company retained a 40% ownership interest in the joint venture with an unrelated third party that purchased these properties.
11These properties were acquired as part of the Merger and were included as assets held for sale in the purchase price allocation.
12Two of the five properties included in this portfolio were acquired in the Merger and were included as assets held for sale in the purchase price allocation.
v3.24.0.1
Held for Sale (Tables)
 12 Months Ended
Dec. 31, 2023
Discontinued Operations and Disposal Groups [Abstract]  
Schedule of disposal groups, including discontinued operations, income statement, balance sheet and additional disclosures The table below reflects the assets and liabilities classified as held for sale as of December 31, 2023 and 2022.
 DECEMBER 31,
Dollars in thousands20232022
Balance Sheet data
Land$1,850 $1,700 
Buildings and improvements6,779 15,164 
Lease intangibles1,017 1,986 
9,646 18,850 
Accumulated depreciation(913)— 
Real estate assets held for sale, net8,733 18,850 
Other assets, net101 43 
Assets held for sale, net$8,834 $18,893 
Accounts payable and accrued liabilities$23 $282 
Other liabilities272 155 
Liabilities of properties held for sale$295 $437 
v3.24.0.1
Other Assets (Tables)
 12 Months Ended
Dec. 31, 2023
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]  
Schedule of other assets Items included in "Other assets, net" on the Company’s Consolidated Balance Sheets as of December 31, 2023 and 2022 are detailed in the table below:
Dollars in thousandsDecember 31, 2023December 31, 2022
Real estate notes receivable, net $173,614 $99,643 
Straight-line rent receivables 116,866 88,868 
Prepaid assets116,455 81,900 
Above-market intangible assets, net66,695 80,720 
Accounts receivable, net 1
63,203 54,667 
Additional long-lived assets, net20,717 21,446 
Interest rate swap assets4,634 14,512 
Investment in securities 2
6,011 6,011 
Debt issuance costs, net3,867 5,977 
Project costs6,187 4,337 
Net investment in lease2,112 1,828 
Customer relationship intangible assets, net1,066 1,120 
Other10,941 8,961 
$592,368 $469,990 
1The amounts for December 31, 2023 and 2022 are net of allowance for doubtful accounts of $8.4 million and $4.0 million, respectively. The amount for December 31, 2022 includes $7,169 of other receivables, net.
2This amount represents the value of the Company's preferred stock investment in a data analytics platform.
v3.24.0.1
Intangible Assets and Liabilities (Tables)
 12 Months Ended
Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]  
Schedule of finite lived intangible assets and liabilities The Company’s intangible assets and liabilities, including assets held for sale and certain debt issuance costs, as of December 31, 2023 and 2022 consisted of the following:
 GROSS BALANCE
at December 31,		ACCUMULATED AMORTIZATION
at December 31,		WEIGHTED AVG.
REMAINING LIFE
in years		BALANCE SHEET CLASSIFICATION
Dollars in millions2023202220232022
Goodwill$250.5 $223.2 $— $— N/AGoodwill
Credit facility debt issuance costs6.9 6.9 3.1 0.9 1.9Other assets, net
Above-market lease intangibles (lessor)98.0 91.5 31.3 10.7 5.3Other assets, net
Customer relationship intangibles (lessor)2.1 2.1 1.1 1.0 19.6Other assets, net
Below-market lease intangibles (lessor)(112.5)(112.5)(35.7)(14.6)5.8Other liabilities
At-market lease intangibles837.3 1,067.4 301.7 188.3 4.0Real estate properties
$1,082.3 $1,278.6 $301.5 $186.3 4.3
Schedule of expected net future amortization expense
The following table represents expected amortization over the next five years of the Company’s intangible assets and liabilities in place as of December 31, 2023:
Dollars in millionsFUTURE AMORTIZATION OF INTANGIBLES, NET
2024$206.7 
2025109.1 
202684.3 
202753.0 
202831.9 
v3.24.0.1
Notes and Bonds Payable (Tables)
 12 Months Ended
Dec. 31, 2023
Debt Instrument [Line Items]  
Schedule of debt
 DECEMBER 31,
MATURITY DATES
CONTRACTUAL INTEREST RATESEFFECTIVE INTEREST RATESPRINCIPAL PAYMENTSINTEREST PAYMENTS
Dollars in thousands20232022
$1.5B Unsecured Credit Facility
— 385,000 10/25
SOFR + 0.95%
6.24 %At maturityMonthly
$350M Unsecured Term Loan 1
349,798 349,114 7/24
SOFR + 1.05%
6.30 %At maturityMonthly
$200M Unsecured Term Loan 1
199,903 199,670 5/24
SOFR + 1.05%
6.30 %At maturityMonthly
$150M Unsecured Term Loan 1
149,643 149,495 6/26
SOFR + 1.05%
6.30 %At maturityMonthly
$300M Unsecured Term Loan 1
299,958 299,936 10/25
SOFR + 1.05%
6.30 %At maturityMonthly
$200M Unsecured Term Loan 1
199,502 199,362 7/27
SOFR + 1.05%
6.30 %At maturityMonthly
$300M Unsecured Term Loan 1
298,288 297,869 1/28
SOFR + 1.05%
6.30 %At maturityMonthly
Senior Notes due 2025 1
249,484 249,115 5/253.88 %4.12 %At maturitySemi-annual
Senior Notes due 2026 1
579,017 571,587 8/263.50 %4.94 %At maturitySemi-annual
Senior Notes due 2027 1
483,727 479,553 7/273.75 %4.76 %At maturitySemi-annual
Senior Notes due 2028 1
297,429 296,852 1/283.63 %3.85 %At maturitySemi-annual
Senior Notes due 2030 1
575,443 565,402 2/303.10 %5.30 %At maturitySemi-annual
Senior Notes due 2030 1
296,780 296,385 3/302.40 %2.72 %At maturitySemi-annual
Senior Notes due 2031 1
295,832 295,547 3/312.05 %2.25 %At maturitySemi-annual
Senior Notes due 2031 1
649,521 632,693 3/312.00 %5.13 %At maturitySemi-annual
Mortgage notes payable 2
70,534 84,247 1/24-12/26
    3.6%-4.77%
3.57%-6.88%
MonthlyMonthly
$4,994,859 $5,351,827 
1Balances are shown net of discounts and unamortized issuance costs.
2Balances are shown net of discounts and unamortized issuance costs and include premiums.
Schedule of mortgage notes payable
The following table details the Company’s mortgage notes payable, with related collateral.
 ORIGINAL BALANCE
EFFECTIVE INTEREST RATE 9
MATURITY
DATE
COLLATERAL 10
PRINCIPAL AND
INTEREST PAYMENTS 8
INVESTMENT IN COLLATERAL
at December 31,		BALANCE
at December 31,
Dollars in millions202320232022
Life Insurance Co. 1
12.3 3.86 %8/23MOB
Monthly/7-yr amort.
— — 10.0 
Life Insurance Co. 2
9.0 4.84 %12/23MOB,OFC
Monthly/10-yr amort.
— — 6.8 
Life Insurance Co. 3
13.3 4.13 %1/24MOB
Monthly/10-yr amort.
24.4 11.3 11.7 
Life Insurance Co. 4
6.8 3.96 %2/24MOB
Monthly/7-yr amort.
12.6 5.6 5.8 
Financial Services 5
9.7 4.32 %9/24MOB
Monthly/10-yr amort.
16.9 7.2 7.5 
Life Insurance Co. 6
16.5 3.43 %12/25MOB,OFC
Monthly/7-yr amort.
49.2 15.9 16.2 
Financial Services11.5 3.71 %1/26MOB
Monthly/10-yr amort.
41.7 7.8 8.3 
Life Insurance Co. 7
6.0 6.88 %4/26MOB
Monthly/7-yr amort.
11.6 5.2 — 
Life Insurance Co.
19.2 4.08 %12/26MOB
Monthly/10-yr amort.
45.7 17.5 17.9 
$202.1 $70.5 $84.2 
1The Company repaid this loan in August 2023. The Company's unencumbered gross investment was $26.0 million at December 31, 2023.
2The Company repaid this loan in December 2023. The Company's unencumbered gross investment was $24.5 million at December 31, 2023.
3The unamortized portion of the $0.8 million premium recorded on this note upon acquisition is included in the balance above.
4The unamortized portion of the $0.2 million premium recorded on this note upon acquisition is included in the balance above.
5The unamortized portion of the $0.1 million premium recorded on this note upon acquisition is included in the balance above.
6The unamortized portion of the $0.7 million premium recorded on this note upon acquisition is included in the balance above.
7The unaccreted portion of the $0.3 million discount recorded on this note upon acquisition is included in the balance above.
8Payable in monthly installments of principal and interest with the final payment due at maturity (unless otherwise noted).
9The contractual interest rates for the seven outstanding mortgage notes ranged from 3.6% to 4.8% as of December 31, 2023.
10MOB-Medical office building; OFC-Office
Schedule of future contractual maturities of the company's notes and bonds payable
Future maturities of the Company’s notes and bonds payable as of December 31, 2023, were as follows:
Dollars in thousandsPRINCIPAL MATURITIES
NET ACCRETION/
AMORTIZATION 1
DEBT
ISSUANCE COSTS 2
NOTES AND
BONDS PAYABLE		%
2024$575,473 $(41,050)$(2,438)$531,985 10.7 %
2025566,375 (43,163)(1,916)521,296 10.4 %
2026778,904 (41,837)(1,650)735,417 14.7 %
2027700,000 (36,192)(1,519)662,289 13.3 %
2028600,000 (35,179)(707)564,114 11.3 %
2029 and thereafter2,049,285 (68,382)(1,145)1,979,758 39.6 %
$5,270,037 $(265,803)$(9,375)$4,994,859 100.0 %
1Includes discount accretion and premium amortization related to the Company’s Senior Notes and four mortgage notes payable.
2Excludes approximately $3.9 million in debt issuance costs related to the Company's Unsecured Credit Facility included in other assets, net.
Senior Notes  
Debt Instrument [Line Items]  
Schedule of senior notes assumed with the merger
The following table reconciles the Company’s aggregate Senior notes principal balance with the Company’s Consolidated Balance Sheets as of December 31, 2023 and 2022.
 DECEMBER 31,
Dollars in thousands20232022
Senior notes principal balance$3,699,285 $3,699,500 
Unaccreted discount(265,852)(304,919)
Debt issuance costs(6,200)(7,447)
Senior notes carrying amount$3,427,233 $3,387,134 
Term Loan Net | Term Loan  
Debt Instrument [Line Items]  
Schedule of debt
The following table reconciles the Company’s aggregate term loan principal balance with the Company’s Consolidated Balance Sheets as of December 31, 2023 and 2022.

 DECEMBER 31,
Dollars in thousands20232022
Term loan principal balances$1,500,000 $1,500,000 
Debt issuance costs(2,908)(4,554)
Term Loans carrying amount$1,497,092 $1,495,446 
Mortgage Notes Payable | Mortgage Notes  
Debt Instrument [Line Items]  
Schedule of debt
The following table reconciles the Company’s aggregate mortgage notes principal balance with the Company’s Consolidated Balance Sheets as of December 31, 2023 and 2022.
 DECEMBER 31,
Dollars in thousands20232022
Mortgage notes payable principal balance$70,752 $84,122 
Unamortized premium285 486 
Unaccreted discount(237)(38)
Debt issuance costs(266)(323)
Mortgage notes payable carrying amount$70,534 $84,247 
v3.24.0.1
Derivative Financial Instruments (Tables)
 12 Months Ended
Dec. 31, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract]  
Schedule of cash flow hedges included in accumulated other comprehensive income (loss)
As of December 31, 2023, the Company had interest rate derivatives that were designated as cash flow hedges of interest rate risk. The table below presents the notional value and weighted average rates of the Company's derivative financial instruments as of December 31, 2023 and 2022:
NOTIONAL VALUE AS OF WEIGHTED AVERAGE RATENOTIONAL VALUE AS OFWEIGHTED AVERAGE RATE
EXPIRATIONDECEMBER 31, 2023EXPIRATIONDECEMBER 31, 2022
January 2024$200,000 1.21 %January 2023$300,000 1.42 %
May 2026275,000 3.74 %January 2024200,000 1.21 %
June 2026150,000 3.83 %May 2026100,000 2.15 %
December 2026150,000 3.84 %December 2026150,000 3.84 %
June 2027200,000 4.27 %June 2027150,000 4.13 %
December 2027300,000 3.93 %December 2027250,000 3.79 %
$1,275,000 3.49 %$1,150,000 2.63 %
Tabular Disclosure of the Effect of Fair Value and Cash Flow Hedge Accounting on Accumulated Other Comprehensive
Income (Loss)
The table below presents the effect of cash flow hedge accounting on Accumulated other comprehensive income (loss) as of December 31, 2023 and 2022 related to the Company's outstanding interest rate swaps.
AMOUNT OF GAIN/(LOSS) RECOGNIZED
IN AOCI ON DERIVATIVE
for the year ended December 31,		AMOUNT OF (GAIN)/LOSS RECLASSIFIED
FROM AOCI INTO INCOME
for the year ended December 31,
Dollars in thousands2023202220232022
Interest rate swaps 2017$— $302 Interest expense$— $118 
Interest rate swaps 2018— 616 Interest expense— 361 
Interest rate swaps 20191,995 12,964 Interest expense(6,964)563 
Interest rate swaps 20224,583 (3,252)Interest expense(6,289)(109)
Interest rate swaps 2023(5,115)— Interest expense(1,829)— 
Settled treasury hedges— — Interest expense426 426 
Settled interest rate swaps— — Interest expense168 168 
$1,463 $10,630 Total interest expense$(14,488)$1,527 
Schedule of derivative instruments in statement of financial position, fair value
The table below presents the fair value of the Company's derivative financial instruments as well as their classification on the Consolidated Balance Sheets as of December 31, 2023 and 2022.
AS OF DECEMBER 31, 2023AS OF DECEMBER 31, 2022
Dollars in thousandsBALANCE SHEET LOCATIONFAIR
VALUE		BALANCE SHEET LOCATIONFAIR
VALUE
Interest rate swaps 2019Other Assets$4,214 Other Assets$13,603 
Interest rate swaps 2022Other Assets909 
Interest rate swaps 2022Other Liabilities(5,067)Other Liabilities(4,269)
Interest rate swaps 2023Other Assets411 
Interest rate swaps 2023Other Liabilities(7,357)
Total derivatives designated as hedging instruments$(7,799)$10,243 
Schedule of offsetting assets
The table below presents a gross presentation, the effects of offsetting, and a net presentation of the Company's derivatives as of December 31, 2023. The net amounts of derivative liabilities can be reconciled to the tabular disclosure of fair value. The tabular disclosure of fair value provides the location that derivative liabilities are presented on the Company's Consolidated Balance Sheets.
Offsetting of Derivative Assets
GROSS AMOUNTS
of recognized assets		GROSS AMOUNTS OFFSET
in the Consolidated
Balance Sheets		NET AMOUNTS OF ASSETS
presented in the Consolidated Balance Sheets		GROSS AMOUNTS NOT OFFSET
in the Consolidated Balance Sheets
FINANCIAL INSTRUMENTSCASH
COLLATERAL		NET
AMOUNT
Derivatives$4,625 $— $4,625 $(4,625)$— $— 
Offsetting of Derivative Liabilities
GROSS AMOUNTS
of recognized liabilities		GROSS AMOUNTS OFFSET
in the Consolidated
Balance Sheets		NET AMOUNTS OF LIABILITIES
presented in the Consolidated Balance Sheets		GROSS AMOUNTS NOT OFFSET
in the Consolidated Balance Sheets
FINANCIAL INSTRUMENTSCASH
COLLATERAL		NET
AMOUNT
Derivatives$(12,424)$— $(12,424)$4,625 $— $(7,799)
Schedule of offsetting liabilities
The table below presents a gross presentation, the effects of offsetting, and a net presentation of the Company's derivatives as of December 31, 2023. The net amounts of derivative liabilities can be reconciled to the tabular disclosure of fair value. The tabular disclosure of fair value provides the location that derivative liabilities are presented on the Company's Consolidated Balance Sheets.
Offsetting of Derivative Assets
GROSS AMOUNTS
of recognized assets		GROSS AMOUNTS OFFSET
in the Consolidated
Balance Sheets		NET AMOUNTS OF ASSETS
presented in the Consolidated Balance Sheets		GROSS AMOUNTS NOT OFFSET
in the Consolidated Balance Sheets
FINANCIAL INSTRUMENTSCASH
COLLATERAL		NET
AMOUNT
Derivatives$4,625 $— $4,625 $(4,625)$— $— 
Offsetting of Derivative Liabilities
GROSS AMOUNTS
of recognized liabilities		GROSS AMOUNTS OFFSET
in the Consolidated
Balance Sheets		NET AMOUNTS OF LIABILITIES
presented in the Consolidated Balance Sheets		GROSS AMOUNTS NOT OFFSET
in the Consolidated Balance Sheets
FINANCIAL INSTRUMENTSCASH
COLLATERAL		NET
AMOUNT
Derivatives$(12,424)$— $(12,424)$4,625 $— $(7,799)
v3.24.0.1
Stockholders' Equity (Tables)
 12 Months Ended
Dec. 31, 2023
Equity [Abstract]  
Schedule of reconciliation of the beginning and ending common stock outstanding
The Company had no preferred shares outstanding and had common shares outstanding for the three years ended December 31, 2023, 2022, and 2021 as follows: 
 YEAR ENDED DECEMBER 31,
2023 2022 2021 
Balance, beginning of year380,589,894 150,457,433 139,487,375 
Issuance of common stock8,627 229,618,304 10,899,301 
Conversion of OP units to common stock190,544 — — 
Non-vested share-based awards, net of withheld shares and forfeitures 175,368 514,157 70,757 
Balance, end of year380,964,433 380,589,894 150,457,433 
Schedule of reconciliation of beginning and ending balances of accumulated other comprehensive income (loss)
The following table represents the changes in accumulated other comprehensive income (loss) during the years ended December 31, 2023 and 2022:
INTEREST RATE SWAPS
as of December 31,
Dollars in thousands20232022
Beginning balance$2,140 $(9,981)
Other comprehensive income (loss) before reclassifications1,434 1,531 
Amounts reclassified from accumulated other comprehensive (loss) income(14,315)10,590 
Net current-period other comprehensive (loss) income(12,881)12,121 
Ending balance$(10,741)$2,140 
Schedule of reclassifications out of accumulated other comprehensive income (loss)
The following table represents the details regarding the reclassifications from accumulated other comprehensive income (loss) during the year ended December 31, 2023 (dollars in thousands):
DETAILS ABOUT ACCUMULATED OTHER COMPREHENSIVE
INCOME (LOSS) COMPONENTS		AMOUNT RECLASSIFIED
from accumulated other comprehensive income (loss)		AFFECTED LINE ITEM
in the statement where net
income is presented
Amounts reclassified from accumulated other comprehensive income (loss) related to settled interest rate swaps$594 Interest Expense
Amounts reclassified from accumulated other comprehensive income (loss) related to current interest rate swaps(15,082)Interest Expense
$(14,488)
v3.24.0.1
Stock and Other Incentive Plans (Tables)
 12 Months Ended
Dec. 31, 2023
Share-Based Payment Arrangement [Abstract]  
Schedule of unrecognized compensation cost, nonvested awards The following table represents expected amortization of the Company's non-vested shares issued as of December 31, 2023:
Dollars in millionsFUTURE AMORTIZATION
of non-vested shares
2024$12.2 
20259.7 
20266.9 
20272.1 
2028 and thereafter0.5 
Total$31.4 
Schedule of other than stock options, valuation assumptions a Monte Carlo simulation to calculate the weighted average grant date fair values of $24.23 for the absolute TSR component and $27.84 for the relative TSR component for the January 2023 grant using the following assumptions:
Volatility34.0 %
Dividend AssumptionAccrued
Expected term in years3 years
Risk-free rate4.42 %
Stock price (per share)$20.21
The Company utilized a Monte Carlo simulation to calculate the weighted average grant date fair values of $12.24 for the absolute TSR component and $13.98 for the relative TSR component for the January 2023 grant using the following assumption:
Volatility34.0 %
Dividend assumptionAccrued
Expected term 3 years
Risk-free rate4.42 %
Stock price (per share)$20.21
Schedule of the activity under the incentive plans the previous directors' plan
The following table represents the summary of non-vested share-based awards (including restricted stock, RSUs, LTIP-C units and LTIP-D units) under the Incentive Plans and related information for the three years ended December 31, 2023: 
YEAR ENDED DECEMBER 31,
Dollars in thousands, except per share data202320222021
Share-based awards, beginning of year2,090,060 1,562,028 1,766,061 
Granted 1
1,164,359 952,407 203,701 
Vested(403,266)(418,949)(404,777)
Change in awards based on performance assessment 2
(205,668)— — 
Forfeited(29,923)(5,426)(2,957)
Share-based awards, end of year2,615,562 2,090,060 1,562,028 
Weighted-average grant date fair value of
Share-based awards, beginning of year$30.35 $31.10 $30.51 
Share-based awards granted during the year$18.70 $29.64 $30.86 
Share-based awards vested during the year$28.38 $31.52 $28.38 
Share-based awards change in performance assessment during the year$29.05 $— $— 
Stock-based awards forfeited during the year$31.16 $31.48 $33.04 
Share-based awards, end of year$25.56 $30.35 $31.10 
Grant date fair value of shares granted during the year$22,171 $28,225 $6,286 
1LTIP-C units are issued at the maximum possible value of the award and are reflected as such in this table until the performance period has been satisfied and the exact number of awards are determinable.
2The Company's RSUs that are based on operating performance metrics are evaluated on the probability of those performance metrics being achieved. During 2023, the Company determined that the operating performance goals related to the RSUs issued in 2022 are not probable of being achieved and reversed all of the outstanding amortization expense for that grant. In addition, the Company lowered the probability of achieving the operating performance goals related to the RSUs issued in 2023.
Schedule of the employee stock purchase plan activity
A summary of the Legacy HR Employee Stock Purchase Plan activity and related information for the three years ended December 31, 2023 is as follows:
YEAR ENDED DECEMBER 31,
Dollars in thousands, except per share data202320222021
Options outstanding, beginning of year340,976 348,514 341,647 
Granted— 255,960 253,200 
Exercised(8,627)(20,246)(30,281)
Forfeited(43,737)(102,619)(71,630)
Expired(132,999)(140,633)(144,422)
Options outstanding and exercisable, end of year155,613 340,976 348,514 
Weighted-average exercise price of
Options outstanding, beginning of year$16.38 $25.38 $24.70 
Options granted during the year$— $26.89 $25.16 
Options exercised during the year$15.07 $20.97 $25.03 
Options forfeited during the year$15.50 $21.88 $25.45 
Options expired during the year$16.43 $23.36 $24.17 
Options outstanding, end of year$12.98 $16.38 $25.38 
Weighted-average fair value of options granted during the year (calculated as of the grant date)$— $9.91 $9.05 
Intrinsic value of options exercised during the year$23 $75 $165 
Intrinsic value of options outstanding and exercisable
(calculated as of December 31)
$401 $985 $1,997 
Exercise prices of options outstanding
(calculated as of December 31)
$14.65 $16.38 $25.91 
Weighted-average contractual life of outstanding options (calculated as of December 31, in years)0.30.80.8
Schedule of stock options, valuation assumptions
202320222021
Risk-free interest rates— %0.73 %0.13 %
Expected dividend yields— %3.97 %4.11 %
Expected life (in years)01.441.43
Expected volatility— %49.0 %48.2 %
Expected forfeiture rates— %85 %85 %
v3.24.0.1
Earnings Per Share (Tables)
 12 Months Ended
Dec. 31, 2023
Earnings Per Share [Abstract]  
Schedule of Earnings per Common Share
The table below sets forth the computation of basic and diluted earnings per common share for the three years ended December 31, 2023.
 YEAR ENDED DECEMBER 31,
Dollars in thousands, except per share data202320222021
Weighted average common shares outstanding
Weighted average common shares outstanding380,850,967 254,296,810 144,411,835 
Non-vested shares(1,923,096)(1,940,607)(1,774,669)
Weighted average common shares outstanding - basic378,927,871 252,356,203 142,637,166 
Weighted average common shares outstanding - basic378,927,871 252,356,203 142,637,166 
Dilutive effect of forward equity shares— — — 
Dilutive effect of OP Units— 1,451,599 — 
Dilutive effect of employee stock purchase plan— 65,519 73,062 
Weighted average common shares outstanding - diluted378,927,871 253,873,321 142,710,228 
Net (loss) income$(282,083)$40,693 $66,659 
Net loss attributable to non-controlling interest3,822 204 — 
Net (loss) income attributable to common stockholders$(278,261)$40,897 $66,659 
Income allocated to participating securities (2,504)(2,437)(2,154)
Adjustment to loss attributable to non-controlling interest for legally outstanding restricted units(851)— — 
Net (loss) income applicable to common stockholders - basic$(281,616)$38,460 $64,505 
Net income attributable to OP Units— 81 — 
Net income applicable to common stockholders - diluted$(281,616)$38,541 $64,505 
Basic earnings per common share - net income$(0.74)$0.15 $0.45 
Diluted earnings per common share - net income$(0.74)$0.15 $0.45 
v3.24.0.1
Other Data (Tables)
 12 Months Ended
Dec. 31, 2023
Income Tax Disclosure [Abstract]  
Schedule of characterization of distributions on common stock
For the three years ended December 31, 2023, there were no preferred shares outstanding. As such, no dividends were distributed related to preferred shares for those periods.
YEAR ENDED DECEMBER 31,
 
202320222021
 PER SHAREPER SHAREPER SHARE
Tax Treatment of Dividends Pre-Merger Healthcare Trust of America
Ordinary income 1
$— $0.5862 $0.7920 
Return of capital— 4.0162 0.4930 
Capital gain— 1.2216 — 
Common stock distributions$— $5.8240 $1.2850 
Tax Treatment of Dividends Pre-Merger Healthcare Realty
Ordinary income 1
$— $0.2655 $0.7500 
Return of capital— 0.5555 0.3600 
Capital gain— — 0.0964 
Common stock distributions$— $0.8210 $1.2064 
Tax Treatment of Dividends Post-Merger Healthcare Realty
Ordinary income 1
$0.5482 $0.0422 $— 
Return of capital0.5031 0.2889 — 
Capital gain0.1887 0.0879 — 
Common stock distributions$1.2400 $0.4190 $— 
1Reporting year ordinary income is also Code Section 199A eligible per the The Tax Cut and Jobs Act of 2017.
Schedule of state income taxes
State income tax expense and state income tax payments for the three years ended December 31, 2023 are detailed in the table below: 
YEAR ENDED DECEMBER 31,
Dollars in thousands202320222021
State income tax expense
Texas gross margins tax $1,206 $1,693 $564 
Other133 151 8 
Total state income tax expense$1,339 $1,844 $572 
State income tax payments, net of refunds and collections$1,324 $1,834 $560 
v3.24.0.1
Fair Value of Financial Instruments (Tables)
 12 Months Ended
Dec. 31, 2023
Fair Value Disclosures [Abstract]  
Schedule of fair value and carrying values for notes and bonds payable, mortgage notes receivable and notes receivable
The table below details the fair value and carrying values for our other financial instruments as of December 31, 2023 and 2022. 
 December 31, 2023December 31, 2022
Dollars in millionsCARRYING VALUEFAIR VALUECARRYING VALUEFAIR VALUE
Notes and bonds payable 1, 2
$4,994.9 $4,872.7 $5,351.8 $5,149.6 
Real estate notes receivable 1
$173.6 $172.5 $99.6 $99.6 
1Level 2 – model-derived valuations in which significant inputs and significant value drivers are observable in active markets.
2Fair value for senior notes includes accrued interest as of December 31, 2023.
v3.24.0.1
Summary of Significant Accounting Policies - Narrative (Details)
shares in Millions, ft² in Millions
 3 Months Ended 12 Months Ended
Mar. 31, 2023
USD ($)
Dec. 31, 2023
USD ($)
ft²
reporting_unit
financing_receivable
property
note_receivable
variable_interest_entity
state
joint_venture
shares
Dec. 31, 2022
USD ($)
Dec. 31, 2021
USD ($)
Jan. 01, 2023
USD ($)
Jul. 20, 2022
USD ($)
Dec. 31, 2020
USD ($)
Business Overview:              
Gross investment, amount, total   $ 13,400,000,000          
Number of owned real estate properties | property   655          
Number of states that the Company owns real estate in | state   35          
Approximate square feet invested in by company | ft²   38.5          
Number of properties | property   33          
Principles of Consolidation:              
Equity ownership for consolidation (percent)   100.00%          
Number of entities | variable_interest_entity   4          
Segment Reporting:              
Number of reporting units | reporting_unit   1          
Real Estate Properties:              
Elimination of real estate lease intangibles against accumulated depreciation   $ 214,800,000 $ 133,600,000        
Depreciation   $ 518,600,000 320,800,000 $ 170,000,000      
Maximum period up to which interest capitalize on properties in stabilization   1 year          
Goodwill and Other Intangible Assets:              
Goodwill   $ 250,530,000 223,202,000     $ 247,043,000  
Revenue from Contracts with Customers (Topic 606):              
Revenue Received   $ 1,900,000 1,500,000 1,400,000      
Federal Income Taxes:              
Percentage of distribution of taxable income for qualify as REIT   90.00%          
Unrecognized tax benefits, income tax penalties and interest expense   $ 0 0 0      
Redeemable Non-Controlling Interests:              
Redeemable non-controlling interests   3,868,000 2,014,000 0     $ 0
Real Estate Notes Receivable:              
Real estate notes receivable, net   173,614,000 99,643,000        
Allowance for Credit Losses, Interest Income, Income from Real Estate Notes Receivable:              
Carrying value   173,614,000          
Credit loss reserves $ 5,200,000 $ 5,196,000 0        
Number of recognized lease financial receivables | financing_receivable   2          
Income from financing receivables   $ 8,300,000 8,100,000        
Financing receivable, nonaccrual         $ 48,900,000    
Notes Receivable              
Allowance for Credit Losses, Interest Income, Income from Real Estate Notes Receivable:              
Interest income   $ 8,800,000 3,400,000 $ 0      
Variable Interest Entity              
Principles of Consolidation:              
Number of entities | variable_interest_entity   3          
Number of notes receivable | note_receivable   2          
Number of joint ventures | joint_venture   1          
Healthcare Trustof America Holdings L P | Non-Controlling Interest Holders              
Principles of Consolidation:              
Limited partners capital account outstanding (in units) | shares   4.5          
Limited partners ownership interest (in percent)   1.20%          
Property Entities Not Determined to be VIEs              
Principles of Consolidation:              
Equity interest owned (percent)   100.00%          
Healthcare Trustof America Holdings L P              
Principles of Consolidation:              
Equity interest owned (percent)   98.80%          
Minimum              
Goodwill and Other Intangible Assets:              
Goodwill, purchase accounting adjustments   $ 27,300,000          
Maximum              
Goodwill and Other Intangible Assets:              
Goodwill   250,500,000 223,200,000        
Interest Rate Swap              
Fair Value of Derivative Financial Instruments:              
Accumulated other comprehensive income (loss), net of tax   (10,700,000) 2,100,000        
Tenant and Capital Improvements              
Real Estate Properties:              
Fully depreciated tenant and capital improvements eliminated against accumulated depreciation     4,100,000        
At Market Lease Intangibles              
Real Estate Properties:              
Elimination of real estate lease intangibles against accumulated depreciation   $ 51,700,000 $ 19,600,000        
Real Estate Properties Held In Joint Ventures Member              
Business Overview:              
Weighted average ownership interest (percent)   43.00%          
Number of properties | property   33          
v3.24.0.1
Summary of Significant Accounting Policies - Consolidated balance sheets (Details) - USD ($)
$ in Thousands
Dec. 31, 2023
Dec. 31, 2022
Assets:    
Net real estate investments $ 11,172,214 $ 12,412,354
Cash and cash equivalents 25,699 60,961
Total assets 12,637,131 13,849,631
Liabilities:    
Total equity 6,822,662 7,571,076
Total liabilities, redeemable non-controlling interests, and stockholders' equity 12,637,131 $ 13,849,631
Variable interest entity    
Assets:    
Net real estate investments 85,752  
Cash and cash equivalents 2,144  
Receivables and other assets 2,704  
Total assets 90,600  
Liabilities:    
Accrued expenses and other liabilities 17,835  
Total equity 72,765  
Total liabilities, redeemable non-controlling interests, and stockholders' equity $ 90,600  
v3.24.0.1
Summary of Significant Accounting Policies - Variable interest entity (Details)
$ in Thousands
Dec. 31, 2023
USD ($)
note_receivable
property
Variable Interest Entity [Line Items]  
Number of owned real estate properties | property 655
Variable Interest Entity  
Variable Interest Entity [Line Items]  
Number of notes receivable | note_receivable 2
Houston, TX | Variable Interest Entity, Not Primary Beneficiary  
Variable Interest Entity [Line Items]  
Notes receivable, carrying amount $ 31,150
MAXIMUM EXPOSURE TO LOSS 31,150
Charlotte, NC | Variable Interest Entity, Not Primary Beneficiary  
Variable Interest Entity [Line Items]  
Notes receivable, carrying amount 5,796
MAXIMUM EXPOSURE TO LOSS 6,000
Texas | Variable Interest Entity, Not Primary Beneficiary  
Variable Interest Entity [Line Items]  
Joint venture, carrying amount 61,801
MAXIMUM EXPOSURE TO LOSS $ 61,801
Number of owned real estate properties | property 7
v3.24.0.1
Summary of Significant Accounting Policies - Useful lives of real estate assets and liabilities (Details)
Dec. 31, 2023
Land improvements | Minimum  
Property, Plant and Equipment [Line Items]  
Asset estimated useful life 2 years
Land improvements | Maximum  
Property, Plant and Equipment [Line Items]  
Asset estimated useful life 39 years
Buildings and improvements | Minimum  
Property, Plant and Equipment [Line Items]  
Asset estimated useful life 3 years 3 months 18 days
Buildings and improvements | Maximum  
Property, Plant and Equipment [Line Items]  
Asset estimated useful life 49 years
Lease intangibles (including ground lease intangibles) | Minimum  
Property, Plant and Equipment [Line Items]  
Asset estimated useful life 1 year
Intangible asset useful life 1 year
Lease intangibles (including ground lease intangibles) | Maximum  
Property, Plant and Equipment [Line Items]  
Asset estimated useful life 99 years
Intangible asset useful life 99 years
Personal property | Minimum  
Property, Plant and Equipment [Line Items]  
Asset estimated useful life 3 years
Personal property | Maximum  
Property, Plant and Equipment [Line Items]  
Asset estimated useful life 20 years
v3.24.0.1
Summary of Significant Accounting Policies - Revenue Recognition (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Disaggregation of Revenue [Line Items]      
Other operating $ 17,451 $ 13,706 $ 10,291
Parking income      
Disaggregation of Revenue [Line Items]      
Other operating 9,903 8,513 7,859
Management fee income      
Disaggregation of Revenue [Line Items]      
Other operating $ 7,548 $ 5,193 $ 2,432
v3.24.0.1
Summary of Significant Accounting Policies - Components of rental income (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Accounting Policies [Abstract]      
Property operating income $ 1,270,508 $ 883,953 $ 514,533
Straight-line rent 38,676 23,498 5,801
Rental income $ 1,309,184 $ 907,451 $ 520,334
v3.24.0.1
Summary of Significant Accounting Policies - Schedule of Notes Receivable (Details) - USD ($)
$ in Thousands
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Accounts, Notes, Loans and Financing Receivable [Line Items]      
Financing receivable, carrying value $ 122,602    
MAXIMUM LOAN COMMITMENT 214,969    
REAL ESTATE NOTES RECEIVABLE, GROSS 182,125    
ALLOWANCE FOR CREDIT LOSSES (5,196) $ 0 $ 0
FAIR VALUE DISCOUNT AND FEES (3,315)    
CARRYING VALUE 173,614    
Mezzanine loans      
Accounts, Notes, Loans and Financing Receivable [Line Items]      
MAXIMUM LOAN COMMITMENT 60,119    
REAL ESTATE NOTES RECEIVABLE, GROSS 60,119    
ALLOWANCE FOR CREDIT LOSSES (5,196)    
FAIR VALUE DISCOUNT AND FEES (3,067)    
CARRYING VALUE 51,856    
Mortgage loans      
Accounts, Notes, Loans and Financing Receivable [Line Items]      
MAXIMUM LOAN COMMITMENT 154,850    
REAL ESTATE NOTES RECEIVABLE, GROSS 122,006    
ALLOWANCE FOR CREDIT LOSSES 0    
FAIR VALUE DISCOUNT AND FEES (248)    
CARRYING VALUE $ 121,758    
Poway, CA      
Accounts, Notes, Loans and Financing Receivable [Line Items]      
STATED INTEREST RATE 5.71%    
Financing receivable, carrying value $ 115,239    
Columbus, OH      
Accounts, Notes, Loans and Financing Receivable [Line Items]      
STATED INTEREST RATE 6.48%    
Financing receivable, carrying value $ 7,363    
Texas | Mezzanine loans      
Accounts, Notes, Loans and Financing Receivable [Line Items]      
STATED INTEREST RATE 8.00%    
MAXIMUM LOAN COMMITMENT $ 54,119    
REAL ESTATE NOTES RECEIVABLE, GROSS 54,119    
ALLOWANCE FOR CREDIT LOSSES (5,196)    
FAIR VALUE DISCOUNT AND FEES (3,067)    
CARRYING VALUE $ 45,856    
Texas | Mortgage loans      
Accounts, Notes, Loans and Financing Receivable [Line Items]      
STATED INTEREST RATE 7.00%    
MAXIMUM LOAN COMMITMENT $ 31,150    
REAL ESTATE NOTES RECEIVABLE, GROSS 31,150    
ALLOWANCE FOR CREDIT LOSSES 0    
FAIR VALUE DISCOUNT AND FEES 0    
CARRYING VALUE $ 31,150    
Arizona | Mezzanine loans      
Accounts, Notes, Loans and Financing Receivable [Line Items]      
STATED INTEREST RATE 9.00%    
MAXIMUM LOAN COMMITMENT $ 6,000    
REAL ESTATE NOTES RECEIVABLE, GROSS 6,000    
ALLOWANCE FOR CREDIT LOSSES 0    
FAIR VALUE DISCOUNT AND FEES 0    
CARRYING VALUE $ 6,000    
North Carolina | Mortgage loans      
Accounts, Notes, Loans and Financing Receivable [Line Items]      
STATED INTEREST RATE 8.00%    
MAXIMUM LOAN COMMITMENT $ 6,000    
REAL ESTATE NOTES RECEIVABLE, GROSS 6,000    
ALLOWANCE FOR CREDIT LOSSES 0    
FAIR VALUE DISCOUNT AND FEES (204)    
CARRYING VALUE $ 5,796    
Florida | Mortgage loans      
Accounts, Notes, Loans and Financing Receivable [Line Items]      
STATED INTEREST RATE 6.00%    
MAXIMUM LOAN COMMITMENT $ 65,000    
REAL ESTATE NOTES RECEIVABLE, GROSS 32,156    
ALLOWANCE FOR CREDIT LOSSES 0    
FAIR VALUE DISCOUNT AND FEES (44)    
CARRYING VALUE $ 32,112    
California | Mortgage loans      
Accounts, Notes, Loans and Financing Receivable [Line Items]      
STATED INTEREST RATE 6.00%    
MAXIMUM LOAN COMMITMENT $ 45,000    
REAL ESTATE NOTES RECEIVABLE, GROSS 45,000    
ALLOWANCE FOR CREDIT LOSSES 0    
FAIR VALUE DISCOUNT AND FEES 0    
CARRYING VALUE $ 45,000    
Florida | Mortgage loans      
Accounts, Notes, Loans and Financing Receivable [Line Items]      
STATED INTEREST RATE 9.00%    
MAXIMUM LOAN COMMITMENT $ 7,700    
REAL ESTATE NOTES RECEIVABLE, GROSS 7,700    
ALLOWANCE FOR CREDIT LOSSES 0    
FAIR VALUE DISCOUNT AND FEES 0    
CARRYING VALUE $ 7,700    
v3.24.0.1
Summary of Significant Accounting Policies - Schedule of Company's Allowance For Credit Losses (Details) - USD ($)
$ in Thousands
 3 Months Ended 12 Months Ended
Mar. 31, 2023
Dec. 31, 2023
Dec. 31, 2022
Financing Receivable, Allowance for Credit Loss [Roll Forward]      
Allowance for credit losses, beginning of period $ 0 $ 0 $ 0
Credit loss reserves $ 5,200 5,196 0
Allowance for credit losses, end of period   $ 5,196 $ 0
v3.24.0.1
Merger with HTA - Narrative (Details) - USD ($)
 12 Months Ended
Jul. 20, 2022
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Business Acquisition [Line Items]        
Common stock, par value (in dollars per share)   $ 0.01 $ 0.01  
Goodwill $ 247,043,000 $ 250,530,000 $ 223,202,000  
Goodwill expected to be tax deductible 0      
Merger-related costs   (1,952,000) $ 103,380,000 $ 0
Refund of transfer taxes paid   $ 17,800,000    
Revision of Prior Period, Adjustment        
Business Acquisition [Line Items]        
Goodwill adjustment incomplete $ 101,600,000      
HealthCare Realty Trust Incorporated | Common Class A        
Business Acquisition [Line Items]        
Common stock, par value (in dollars per share) $ 0.01      
HealthCare Realty Trust, Inc.        
Business Acquisition [Line Items]        
Common stock, par value (in dollars per share) 0.01      
Healthcare Trust Of America, Inc        
Business Acquisition [Line Items]        
Common stock, par value (in dollars per share) $ 0.01      
Conversion ratio 1      
Dividends per share to common stockholders, declared (in USD per share) $ 4.82      
v3.24.0.1
Merger with HTA - Schedule of Consideration Transferred (Details)
 12 Months Ended
Jul. 20, 2022
USD ($)
$ / shares
shares
Dec. 31, 2023
USD ($)
shares
Dec. 31, 2022
shares
Business Acquisition [Line Items]      
Shares of Legacy HTA Common Stock outstanding as of July 20, 2022 as adjusted (in shares) 228,857,717 380,964,000 380,590,000
Implied shares of Legacy HR Common Stock issued (in shares) 228,520,990    
Adjusted closing price of Legacy HR Common Stock on July 20, 2022 (in dollars per share) | $ / shares $ 24.37    
Value of implied Legacy HR Common Stock issued | $ $ 5,569,057,000    
Fair value of Legacy HTA restricted stock awards attributable to pre-Merger services | $   $ 7,406,000  
Consideration transferred | $   $ 5,576,463,000  
Healthcare Trust Of America, Inc      
Business Acquisition [Line Items]      
Shares of Legacy HTA Common Stock outstanding as of July 20, 2022 as adjusted (in shares) 228,520,990    
Exchange ratio 1.00    
Common Stock, fractional (in shares) 192    
Healthcare Trust Of America, Inc | Restricted Stock      
Business Acquisition [Line Items]      
Shares of Legacy HTA Common Stock outstanding as of July 20, 2022 as adjusted (in shares) 336,535    
Common Stock, withheld (in shares) 215,764    
v3.24.0.1
Merger with HTA - Schedule of Fair Values of the Assets Acquired And Liabilities Assumed (Details) - USD ($)
$ in Thousands
Jul. 20, 2022
Dec. 31, 2023
Dec. 31, 2022
Real estate investments      
Land $ 1,004,285    
Buildings and improvements 6,841,283    
Lease intangible assets 833,759    
Financing lease right-of-use assets 13,020    
Construction in progress 3,327    
Land held for development 46,538    
Total real estate investments 8,742,212    
Assets held for sale, net 699,496    
Investments in unconsolidated joint ventures 67,892    
Cash and cash equivalents 37,437    
Restricted cash 1,122,400    
Operating lease right-of-use assets 214,631    
Other assets, net 205,323 $ 100 $ 400
Total assets acquired 11,089,391    
LIABILITIES      
Notes and bonds payable 3,991,300    
Accounts payable and accrued liabilities 1,244,944    
Liabilities of assets held for sale 24,738    
Operating lease liabilities 184,121    
Financing lease liabilities 9,865    
Other liabilities 194,301    
Total liabilities assumed 5,649,269    
Net identifiable assets acquired 5,440,122 36,500 399,200
Non-controlling interest 110,702    
Goodwill 247,043 $ 250,530 $ 223,202
Weighted average amortization period for the acquired lease intangible assets   6 years  
Gross contractual accounts receivable 15,900    
Gross contractual real estate notes receivable 78,700    
Gross contractual real estate notes receivable at fair value 74,800    
CUMULATIVE MEASUREMENT PERIOD ADJUSTMENTS      
Land 18,359    
Buildings and improvements (119,135)    
Lease intangible assets 1,839    
Financing lease right-of-use assets 3,146    
Construction in progress (6,744)    
Total real estate investments (102,535)    
Assets held for sale, net (7,946)    
Cash and cash equivalents 11,403    
Restricted cash (1,247)    
Operating lease right-of-use assets 16,370    
Other assets, net (3,840)    
Total assets acquired (87,795)    
Accounts payable and accrued liabilities 17,374    
Liabilities of assets held for sale (3,939)    
Operating lease liabilities 10,173    
Financing lease liabilities (855)    
Other liabilities (8,909)    
Total liabilities assumed 13,844    
Net identifiable assets acquired (101,639)    
Goodwill 101,639    
Previously Reported      
Real estate investments      
Land 985,926    
Buildings and improvements 6,960,418    
Lease intangible assets 831,920    
Financing lease right-of-use assets 9,874    
Construction in progress 10,071    
Land held for development 46,538    
Total real estate investments 8,844,747    
Assets held for sale, net 707,442    
Investments in unconsolidated joint ventures 67,892    
Cash and cash equivalents 26,034    
Restricted cash 1,123,647    
Operating lease right-of-use assets 198,261    
Other assets, net 209,163    
Total assets acquired 11,177,186    
LIABILITIES      
Notes and bonds payable 3,991,300    
Accounts payable and accrued liabilities 1,227,570    
Liabilities of assets held for sale 28,677    
Operating lease liabilities 173,948    
Financing lease liabilities 10,720    
Other liabilities 203,210    
Total liabilities assumed 5,635,425    
Net identifiable assets acquired 5,541,761    
Non-controlling interest 110,702    
Goodwill $ 145,404    
v3.24.0.1
Property Investments (Details)
$ in Thousands
Dec. 31, 2023
USD ($)
property
Dec. 31, 2022
USD ($)
Summary of Company's investment    
NUMBER OF PROPERTIES | property 655  
LAND $ 1,343,265  
BUILDINGS AND IMPROVEMENTS 10,881,373 $ 11,332,037
LEASE INTANGIBLES 836,302  
PERSONAL PROPERTY 12,718 11,907
Total real estate investments 13,399,067 14,057,625
ACCUMULATED DEPRECIATION $ (2,226,853) $ (1,645,271)
Investment in financing receivables, net    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 0  
LAND $ 0  
BUILDINGS AND IMPROVEMENTS 0  
LEASE INTANGIBLES  
PERSONAL PROPERTY 0  
Total real estate investments 122,602  
ACCUMULATED DEPRECIATION $ 0  
Financing lease right-of-use assets    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 0  
LAND $ 0  
BUILDINGS AND IMPROVEMENTS 0  
LEASE INTANGIBLES 0  
PERSONAL PROPERTY 0  
Total real estate investments 82,209  
ACCUMULATED DEPRECIATION $ 0  
Construction in progress    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 0  
LAND $ 0  
BUILDINGS AND IMPROVEMENTS 0  
LEASE INTANGIBLES 0  
PERSONAL PROPERTY 0  
Total real estate investments 60,727  
ACCUMULATED DEPRECIATION $ 0  
Land held for development    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 0  
LAND $ 0  
BUILDINGS AND IMPROVEMENTS 0  
LEASE INTANGIBLES 0  
PERSONAL PROPERTY 0  
Total real estate investments 59,871  
ACCUMULATED DEPRECIATION $ 0  
Medical office/outpatient    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 655  
LAND $ 1,343,265  
BUILDINGS AND IMPROVEMENTS 10,881,373  
LEASE INTANGIBLES 836,302  
PERSONAL PROPERTY 12,718  
Total real estate investments 13,073,658  
ACCUMULATED DEPRECIATION $ (2,226,853)  
Medical office/outpatient | Dallas, TX    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 43  
LAND $ 90,168  
BUILDINGS AND IMPROVEMENTS 1,004,810  
LEASE INTANGIBLES 68,139  
PERSONAL PROPERTY 550  
Total real estate investments 1,163,667  
ACCUMULATED DEPRECIATION $ (221,375)  
Medical office/outpatient | Houston, TX    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 31  
LAND $ 76,959  
BUILDINGS AND IMPROVEMENTS 614,531  
LEASE INTANGIBLES 60,651  
PERSONAL PROPERTY 57  
Total real estate investments 752,198  
ACCUMULATED DEPRECIATION $ (97,793)  
Medical office/outpatient | Seattle, WA    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 29  
LAND $ 64,295  
BUILDINGS AND IMPROVEMENTS 631,438  
LEASE INTANGIBLES 9,921  
PERSONAL PROPERTY 715  
Total real estate investments 706,369  
ACCUMULATED DEPRECIATION $ (186,903)  
Medical office/outpatient | Denver, CO    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 33  
LAND $ 76,698  
BUILDINGS AND IMPROVEMENTS 501,994  
LEASE INTANGIBLES 43,268  
PERSONAL PROPERTY 610  
Total real estate investments 622,570  
ACCUMULATED DEPRECIATION $ (94,906)  
Medical office/outpatient | Charlotte, NC    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 32  
LAND $ 35,465  
BUILDINGS AND IMPROVEMENTS 463,461  
LEASE INTANGIBLES 26,971  
PERSONAL PROPERTY 110  
Total real estate investments 526,007  
ACCUMULATED DEPRECIATION $ (116,578)  
Medical office/outpatient | Phoenix, AZ    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 35  
LAND $ 20,262  
BUILDINGS AND IMPROVEMENTS 437,804  
LEASE INTANGIBLES 36,384  
PERSONAL PROPERTY 425  
Total real estate investments 494,875  
ACCUMULATED DEPRECIATION $ (59,449)  
Medical office/outpatient | Atlanta, GA    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 27  
LAND $ 49,095  
BUILDINGS AND IMPROVEMENTS 417,112  
LEASE INTANGIBLES 28,204  
PERSONAL PROPERTY 100  
Total real estate investments 494,511  
ACCUMULATED DEPRECIATION $ (79,569)  
Medical office/outpatient | Boston, MA    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 17  
LAND $ 127,447  
BUILDINGS AND IMPROVEMENTS 299,742  
LEASE INTANGIBLES 41,183  
PERSONAL PROPERTY 14  
Total real estate investments 468,386  
ACCUMULATED DEPRECIATION $ (37,569)  
Medical office/outpatient | Raleigh, NC    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 28  
LAND $ 56,620  
BUILDINGS AND IMPROVEMENTS 371,932  
LEASE INTANGIBLES 36,411  
PERSONAL PROPERTY 9  
Total real estate investments 464,972  
ACCUMULATED DEPRECIATION $ (38,879)  
Medical office/outpatient | Nashville, TN    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 13  
LAND $ 43,347  
BUILDINGS AND IMPROVEMENTS 397,192  
LEASE INTANGIBLES 10,206  
PERSONAL PROPERTY 7,427  
Total real estate investments 458,172  
ACCUMULATED DEPRECIATION $ (115,979)  
Medical office/outpatient | Los Angeles, CA    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 20  
LAND $ 72,086  
BUILDINGS AND IMPROVEMENTS 360,330  
LEASE INTANGIBLES 16,481  
PERSONAL PROPERTY 453  
Total real estate investments 449,350  
ACCUMULATED DEPRECIATION $ (145,875)  
Medical office/outpatient | Miami, FL    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 19  
LAND $ 53,994  
BUILDINGS AND IMPROVEMENTS 326,343  
LEASE INTANGIBLES 35,014  
PERSONAL PROPERTY 178  
Total real estate investments 415,529  
ACCUMULATED DEPRECIATION $ (74,470)  
Medical office/outpatient | Tampa, FL    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 19  
LAND $ 31,121  
BUILDINGS AND IMPROVEMENTS 351,879  
LEASE INTANGIBLES 27,438  
PERSONAL PROPERTY 33  
Total real estate investments 410,471  
ACCUMULATED DEPRECIATION $ (36,726)  
Medical office/outpatient | Indianapolis, IN    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 36  
LAND $ 54,899  
BUILDINGS AND IMPROVEMENTS 285,806  
LEASE INTANGIBLES 32,780  
PERSONAL PROPERTY 13  
Total real estate investments 373,498  
ACCUMULATED DEPRECIATION $ (42,273)  
Medical office/outpatient | Austin, TX    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 13  
LAND $ 27,063  
BUILDINGS AND IMPROVEMENTS 274,229  
LEASE INTANGIBLES 18,568  
PERSONAL PROPERTY 142  
Total real estate investments 320,002  
ACCUMULATED DEPRECIATION $ (55,891)  
Medical office/outpatient | New York, NY    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 14  
LAND $ 64,402  
BUILDINGS AND IMPROVEMENTS 170,304  
LEASE INTANGIBLES 26,430  
PERSONAL PROPERTY 0  
Total real estate investments 261,136  
ACCUMULATED DEPRECIATION $ (15,887)  
Medical office/outpatient | Chicago, IL    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 6  
LAND $ 13,804  
BUILDINGS AND IMPROVEMENTS 216,473  
LEASE INTANGIBLES 13,011  
PERSONAL PROPERTY 81  
Total real estate investments 243,369  
ACCUMULATED DEPRECIATION $ (39,671)  
Medical office/outpatient | Memphis, TN    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 11  
LAND $ 13,901  
BUILDINGS AND IMPROVEMENTS 189,941  
LEASE INTANGIBLES 4,211  
PERSONAL PROPERTY 322  
Total real estate investments 208,375  
ACCUMULATED DEPRECIATION $ (71,813)  
Medical office/outpatient | Honolulu, HI    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 6  
LAND $ 9,527  
BUILDINGS AND IMPROVEMENTS 188,772  
LEASE INTANGIBLES 6,319  
PERSONAL PROPERTY 169  
Total real estate investments 204,787  
ACCUMULATED DEPRECIATION $ (61,575)  
Medical office/outpatient | Hartford, CT    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 30  
LAND $ 29,381  
BUILDINGS AND IMPROVEMENTS 138,713  
LEASE INTANGIBLES 21,848  
PERSONAL PROPERTY 0  
Total real estate investments 189,942  
ACCUMULATED DEPRECIATION $ (15,883)  
Medical office/outpatient | Other (49 markets)    
Summary of Company's investment    
NUMBER OF PROPERTIES | property 193  
LAND $ 332,731  
BUILDINGS AND IMPROVEMENTS 3,238,567  
LEASE INTANGIBLES 272,864  
PERSONAL PROPERTY 1,310  
Total real estate investments 3,845,472  
ACCUMULATED DEPRECIATION $ (617,789)  
v3.24.0.1
Leases - Narrative (Details)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
USD ($)
renewal_option
Dec. 31, 2022
USD ($)
Dec. 31, 2021
USD ($)
Leases [Abstract]      
Rental income $ 1,309,184 $ 907,451 $ 520,334
Approximate Investment in real estate properties subject to outstanding contractual option to purchase $ 111,100    
Number of exercisable purchase options | renewal_option 6    
v3.24.0.1
Leases - Non-cancelable Operating Leases (Details)
$ in Thousands
Dec. 31, 2023
USD ($)
Leases [Abstract]  
2024 $ 894,442
2025 801,973
2026 701,615
2027 582,028
2028 469,549
2029 and thereafter 1,579,010
Lease payments receivable $ 5,028,617
v3.24.0.1
Leases - Ground Leases (Details)
ft² in Millions, $ in Millions
 12 Months Ended
Dec. 31, 2023
USD ($)
ft²
lease
property
Dec. 31, 2022
USD ($)
Dec. 31, 2021
USD ($)
Real Estate [Line Items]      
Number of properties subject to ground leases | property 232    
Square feet subject to ground leases | ft² 16.9    
Number of ground leases prepaid 75    
Amortization of prepaid rent | $ $ 1.3 $ 1.1 $ 0.6
Number of ground leases, excluding prepaid leases 157    
Minimum      
Real Estate [Line Items]      
Ground leases, initial term 40 years    
Maximum      
Real Estate [Line Items]      
Ground leases, initial term 99 years    
v3.24.0.1
Leases - Future Minimum Lease Payments (Details) - USD ($)
$ in Thousands
Dec. 31, 2023
Dec. 31, 2022
OPERATING    
2024 $ 12,263  
2025 12,428  
2026 12,516  
2027 12,703  
2028 12,822  
2029 and thereafter 698,905  
Total undiscounted lease payments 761,637  
Discount (531,923)  
Lease liabilities 229,714 $ 279,895
FINANCING    
2024 2,182  
2025 2,218  
2026 2,254  
2027 2,294  
2028 2,326  
2029 and thereafter 394,072  
Total undiscounted lease payments 405,346  
Discount (330,843)  
Lease liabilities $ 74,503 $ 72,939
v3.24.0.1
Leases - Lease Cost (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Operating lease cost      
Operating lease expense $ 20,623 $ 12,699  
Variable lease expense 8,979 4,529  
Finance lease cost      
Amortization of right-of-use assets 1,564 1,288  
Interest on lease liabilities 3,718 2,876  
Total lease expense 34,884 21,392  
Other information      
Operating cash flows outflows related to operating leases 19,222 12,816  
Operating cash flows outflows related to financing leases 2,122 1,838  
Financing cash flows outflows related to financing leases 17 0 $ 9,182
Right-of-use assets obtained in exchange for new finance lease liabilities 0 53,765  
Right-of-use assets obtained in exchange for new operating lease liabilities $ 1,758 $ 216,047  
Weighted-average remaining lease term (excluding renewal options) - operating leases 45 years 9 months 18 days 47 years 6 months  
Weighted-average remaining lease term (excluding renewal options) - finance leases 57 years 10 months 24 days 58 years 10 months 24 days  
Weighted-average discount rate - operating leases 5.70% 5.80%  
Weighted-average discount rate - finance leases 5.00% 5.00%  
v3.24.0.1
Acquisitions, Dispositions and Mortgage Repayments - Real Estate Acquisitions (Details)
$ in Thousands
 12 Months Ended
Jul. 28, 2023
USD ($)
ft²
Mar. 10, 2023
USD ($)
ft²
Jun. 09, 2022
USD ($)
ft²
Dec. 31, 2023
USD ($)
ft²
Dec. 31, 2022
USD ($)
ft²
Business Acquisition [Line Items]          
PURCHASE PRICE       $ 5,576,463  
MORTGAGE NOTES PAYABLE, NET       (5,300)  
Total real estate acquisitions          
Business Acquisition [Line Items]          
PURCHASE PRICE       42,950  
MORTGAGE NOTES PAYABLE, NET       (5,284)  
CASH CONSIDERATION       36,523  
REAL ESTATE       42,012  
OTHER       $ (205)  
SQUARE FOOTAGE | ft²       158,637  
Medical Office Building          
Business Acquisition [Line Items]          
PURCHASE PRICE         $ 403,578
CASH CONSIDERATION         399,189
REAL ESTATE         386,818
OTHER         $ 12,371
SQUARE FOOTAGE | ft²         863,184
Tampa, FL | Medical Office Building          
Business Acquisition [Line Items]          
PURCHASE PRICE   $ 31,500 $ 18,650    
MORTGAGE NOTES PAYABLE, NET   0      
CASH CONSIDERATION   30,499 18,619    
REAL ESTATE   30,596 18,212    
OTHER   $ (97) $ 407    
SQUARE FOOTAGE | ft²   115,867 55,788    
Colorado Springs, CO | Medical Office Building          
Business Acquisition [Line Items]          
PURCHASE PRICE $ 11,450        
MORTGAGE NOTES PAYABLE, NET (5,284)        
CASH CONSIDERATION 6,024        
REAL ESTATE 11,416        
OTHER $ (108)        
SQUARE FOOTAGE | ft² 42,770        
v3.24.0.1
Acquisitions, Dispositions and Mortgage Repayments - Narrative (Details)
$ in Thousands
 3 Months Ended 12 Months Ended
Sep. 30, 2023
USD ($)
Jun. 30, 2023
USD ($)
Dec. 31, 2022
USD ($)
Dec. 31, 2023
property
Real Estate Acquisitions and Mortgage Note Financing [Line Items]        
Payments to acquired a parcel of land $ 800      
Payments to acquire additional interest in an operating property $ 600      
Number of properties | property       33
Real Estate Properties Held In Joint Ventures Member        
Real Estate Acquisitions and Mortgage Note Financing [Line Items]        
Weighted average ownership interest (percent)       43.00%
Number of properties | property       33
Medical Office Building        
Real Estate Acquisitions and Mortgage Note Financing [Line Items]        
Cash consideration     $ 399,189  
Medical Office Building | Scottsdale, Arizona        
Real Estate Acquisitions and Mortgage Note Financing [Line Items]        
Joint venture, ownership (in percentage)   90.00%    
Payments to acquired a parcel of land   $ 8,800    
Cash consideration   $ 8,300    
v3.24.0.1
Acquisitions, Dispositions and Mortgage Repayments - Assets Acquired and Liabilities Assumed (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Jul. 20, 2022
Business Acquisition [Line Items]      
Building     $ 6,841,283
Land     1,004,285
MORTGAGE NOTES PAYABLE, NET $ (5,300)    
Other assets acquired 100 $ 400 205,323
Accounts payable, accrued liabilities and other liabilities assumed (300) (2,900)  
Total cash paid 36,500 399,200 $ 5,440,122
At-market lease intangibles      
Business Acquisition [Line Items]      
Intangibles 4,500 28,100  
Above-market lease intangibles (lessor)      
Business Acquisition [Line Items]      
Intangibles 200 15,900  
Below-market lease intangibles (lessor)      
Business Acquisition [Line Items]      
Below-market lease intangibles (lessor) (200) (2,200)  
Below-market lease intangibles (lessee)      
Business Acquisition [Line Items]      
Intangibles   $ 1,200  
Intangible asset useful life   13 years 1 month 6 days  
Building      
Business Acquisition [Line Items]      
Building 27,500 $ 250,700  
Tenant Improvements      
Business Acquisition [Line Items]      
Tenant Improvements 3,400 20,700  
Land      
Business Acquisition [Line Items]      
Land 5,500 76,100  
Land Improvements      
Business Acquisition [Line Items]      
Land Improvements $ 1,100 $ 11,200  
Minimum | At-market lease intangibles      
Business Acquisition [Line Items]      
Intangible asset useful life 5 years 1 month 6 days 1 year 6 months  
Minimum | Above-market lease intangibles (lessor)      
Business Acquisition [Line Items]      
Intangible asset useful life 1 year 9 months 18 days 1 year 3 months 18 days  
Minimum | Below-market lease intangibles (lessor)      
Business Acquisition [Line Items]      
Intangible asset useful life 6 years 4 months 24 days 1 year 3 months 18 days  
Minimum | Building      
Business Acquisition [Line Items]      
Asset estimated useful life 17 years 14 years  
Minimum | Tenant Improvements      
Business Acquisition [Line Items]      
Asset estimated useful life 5 years 1 month 6 days 1 year 6 months  
Minimum | Land Improvements      
Business Acquisition [Line Items]      
Asset estimated useful life 6 years 5 years  
Maximum | At-market lease intangibles      
Business Acquisition [Line Items]      
Intangible asset useful life 5 years 10 months 24 days 13 years 4 months 24 days  
Maximum | Above-market lease intangibles (lessor)      
Business Acquisition [Line Items]      
Intangible asset useful life 4 years 10 months 24 days 15 years 7 months 6 days  
Maximum | Below-market lease intangibles (lessor)      
Business Acquisition [Line Items]      
Intangible asset useful life 13 years 10 months 24 days 19 years 3 months 18 days  
Maximum | Building      
Business Acquisition [Line Items]      
Asset estimated useful life 30 years 38 years  
Maximum | Tenant Improvements      
Business Acquisition [Line Items]      
Asset estimated useful life 5 years 10 months 24 days 13 years 4 months 24 days  
Maximum | Land Improvements      
Business Acquisition [Line Items]      
Asset estimated useful life 10 years 14 years  
v3.24.0.1
Acquisitions, Dispositions and Mortgage Repayments - Joint Ventures (Details)
$ in Thousands
 12 Months Ended
Mar. 07, 2022
USD ($)
ft²
property
Dec. 31, 2023
USD ($)
Dec. 31, 2022
USD ($)
ft²
property
Dec. 31, 2021
USD ($)
Equity Method Investments [Roll Forward]        
Equity loss recognized during the period   $ (1,682) $ (687) $ (795)
PURCHASE PRICE     100,975  
CASH CONSIDERATION     99,173  
REAL ESTATE     97,569  
OTHER     $ 1,604  
SQUARE FOOTAGE unaudited | ft²     214,124  
San Francisco, CA        
Equity Method Investments [Roll Forward]        
PURCHASE PRICE $ 67,175      
CASH CONSIDERATION 66,789      
REAL ESTATE 65,179      
OTHER $ 1,610      
SQUARE FOOTAGE unaudited | ft² 110,865      
Number of buildings acquired | property 3   3  
Los Angeles, CA        
Equity Method Investments [Roll Forward]        
PURCHASE PRICE $ 33,800      
CASH CONSIDERATION 32,384      
REAL ESTATE 32,390      
OTHER $ (6)      
SQUARE FOOTAGE unaudited | ft² 103,259      
Number of buildings acquired | property     2  
Parking Garages        
Equity Method Investments [Roll Forward]        
Investments in unconsolidated joint ventures, beginning of period   327,200 $ 161,900  
New investments during the period   3,800 167,900  
Equity loss recognized during the period   (1,700) (700)  
Owner distributions   (17,800) (1,900)  
Investments in unconsolidated joint ventures, end of period   $ 311,500 $ 327,200 $ 161,900
v3.24.0.1
Acquisitions, Dispositions and Mortgage Repayments - Acquisitions (Details)
$ in Thousands
 12 Months Ended
Mar. 10, 2023
USD ($)
ft²
Dec. 28, 2022
USD ($)
ft²
Nov. 21, 2022
USD ($)
ft²
Oct. 12, 2022
USD ($)
ft²
Sep. 29, 2022
USD ($)
ft²
Sep. 15, 2022
USD ($)
ft²
Aug. 18, 2022
USD ($)
ft²
Aug. 11, 2022
USD ($)
ft²
Aug. 10, 2022
USD ($)
ft²
Aug. 09, 2022
USD ($)
ft²
Aug. 01, 2022
USD ($)
ft²
Jun. 09, 2022
USD ($)
ft²
property
May 31, 2022
USD ($)
ft²
property
Apr. 29, 2022
USD ($)
ft²
Apr. 28, 2022
USD ($)
ft²
Apr. 13, 2022
USD ($)
ft²
property
Apr. 07, 2022
USD ($)
ft²
Mar. 07, 2022
USD ($)
ft²
property
Feb. 11, 2022
USD ($)
ft²
Dec. 31, 2023
USD ($)
Dec. 31, 2022
USD ($)
ft²
property
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
PURCHASE PRICE                                       $ 5,576,463  
San Francisco, CA                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
Number of properties acquired | property                                   3     3
Colorado Springs, CO                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
Number of properties acquired | property                               2          
Charlotte, NC                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
Number of properties acquired | property                         3                
Tampa, FL                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
Number of properties acquired | property                       2                  
Austin, TX                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
Additional of ownership existing   71.40%                                      
Medical Office Building                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
PURCHASE PRICE                                         $ 403,578
CASH CONSIDERATION                                         399,189
REAL ESTATE                                         386,818
OTHER                                         $ 12,371
SQUARE FOOTAGE | ft²                                         863,184
Medical Office Building | Dallas, TX                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
PURCHASE PRICE                                     $ 8,175    
CASH CONSIDERATION                                     8,185    
REAL ESTATE                                     8,202    
OTHER                                     $ (17)    
SQUARE FOOTAGE | ft²                                     18,000    
Medical Office Building | San Francisco, CA                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
PURCHASE PRICE                                   $ 114,000      
CASH CONSIDERATION                                   112,986      
REAL ESTATE                                   108,687      
OTHER                                   $ 4,299      
SQUARE FOOTAGE | ft²                                   166,396      
Medical Office Building | Atlanta, GA                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
PURCHASE PRICE                 $ 11,800               $ 6,912        
CASH CONSIDERATION                 11,525               7,054        
REAL ESTATE                 12,038               7,178        
OTHER                 $ (513)               $ (124)        
SQUARE FOOTAGE | ft²                 43,496               21,535        
Medical Office Building | Denver, CO                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
PURCHASE PRICE   $ 16,400           $ 14,800               $ 6,320          
CASH CONSIDERATION   16,170           13,902               5,254          
REAL ESTATE   16,467           13,918               5,269          
OTHER   $ (297)           $ (16)               $ (15)          
SQUARE FOOTAGE | ft²   39,692           34,785               12,207          
Medical Office Building | Colorado Springs, CO                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
PURCHASE PRICE                               $ 13,680          
CASH CONSIDERATION                               13,686          
REAL ESTATE                               13,701          
OTHER                               $ (15)          
SQUARE FOOTAGE | ft²                               25,800          
Medical Office Building | Seattle, WA                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
PURCHASE PRICE                     $ 4,850       $ 8,350            
CASH CONSIDERATION                     4,806       8,334            
REAL ESTATE                     4,882       8,370            
OTHER                     $ (76)       $ (36)            
SQUARE FOOTAGE | ft²                     10,593       13,256            
Medical Office Building | Houston, TX                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
PURCHASE PRICE     $ 5,500                       $ 36,250            
CASH CONSIDERATION     5,469                       36,299            
REAL ESTATE     5,513                       36,816            
OTHER     $ (44)                       $ (517)            
SQUARE FOOTAGE | ft²     28,369                       76,781            
Medical Office Building | Los Angeles, CA                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
PURCHASE PRICE                           $ 35,000              
CASH CONSIDERATION                           35,242              
REAL ESTATE                           25,400              
OTHER                           $ 9,842              
SQUARE FOOTAGE | ft²                           34,282              
Medical Office Building | Oklahoma City, OK                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
PURCHASE PRICE                           $ 11,100              
CASH CONSIDERATION                           11,259              
REAL ESTATE                           11,334              
OTHER                           $ (75)              
SQUARE FOOTAGE | ft²                           34,944              
Medical Office Building | Charlotte, NC                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
PURCHASE PRICE             $ 11,375     $ 3,783     $ 27,500                
CASH CONSIDERATION             10,670     3,878     26,710                
REAL ESTATE             10,547     3,932     27,127                
OTHER             $ 123     $ (54)     $ (417)                
SQUARE FOOTAGE | ft²             31,318     11,345     85,113                
Medical Office Building | Tampa, FL                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
PURCHASE PRICE $ 31,500                     $ 18,650                  
CASH CONSIDERATION 30,499                     18,619                  
REAL ESTATE 30,596                     18,212                  
OTHER $ (97)                     $ 407                  
SQUARE FOOTAGE | ft² 115,867                     55,788                  
Medical Office Building | Florida                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
PURCHASE PRICE       $ 3,600           $ 18,195                      
CASH CONSIDERATION       3,530           18,508                      
REAL ESTATE       3,609           18,583                      
OTHER       $ (79)           $ (75)                      
SQUARE FOOTAGE | ft²       6,200           34,133                      
Medical Office Building | Nashville, TN                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
PURCHASE PRICE           $ 21,000                              
CASH CONSIDERATION           20,764                              
REAL ESTATE           20,572                              
OTHER           $ 192                              
SQUARE FOOTAGE | ft²           61,932                              
Medical Office Building | Austin, TX                                          
Real Estate Acquisitions and Mortgage Note Financing [Line Items]                                          
PURCHASE PRICE   $ 888     $ 5,450                                
CASH CONSIDERATION   890     5,449                                
REAL ESTATE   889     5,572                                
OTHER   $ 1     $ (123)                                
SQUARE FOOTAGE | ft²   2,219     15,000                                
v3.24.0.1
Acquisitions, Dispositions and Mortgage Repayments - Dispositions (Details)
$ in Thousands
 12 Months Ended
Dec. 29, 2023
USD ($)
ft²
disposition_transaction
property
Dec. 28, 2023
USD ($)
ft²
Dec. 27, 2023
USD ($)
ft²
Dec. 22, 2023
USD ($)
ft²
property
disposition_transaction
Dec. 21, 2023
USD ($)
ft²
Dec. 20, 2023
USD ($)
ft²
Dec. 15, 2023
USD ($)
ft²
Dec. 01, 2023
USD ($)
ft²
Nov. 13, 2023
USD ($)
ft²
disposition_transaction
property
Sep. 27, 2023
USD ($)
ft²
Sep. 18, 2023
USD ($)
ft²
Sep. 15, 2023
USD ($)
ft²
Aug. 22, 2023
USD ($)
ft²
Aug. 02, 2023
USD ($)
ft²
Jun. 30, 2023
USD ($)
ft²
May 12, 2023
USD ($)
ft²
a
Mar. 30, 2023
USD ($)
ft²
Mar. 23, 2023
USD ($)
ft²
Feb. 10, 2023
USD ($)
ft²
Jan. 30, 2023
USD ($)
ft²
Jan. 12, 2023
USD ($)
ft²
property
disposition_transaction
Dec. 28, 2022
USD ($)
ft²
Dec. 22, 2022
USD ($)
ft²
property
Nov. 10, 2022
USD ($)
ft²
Oct. 21, 2022
USD ($)
ft²
Oct. 04, 2022
USD ($)
ft²
property
Aug. 31, 2022
USD ($)
ft²
property
Aug. 30, 2022
USD ($)
ft²
property
Aug. 05, 2022
USD ($)
ft²
property
Aug. 04, 2022
USD ($)
ft²
property
Jul. 29, 2022
USD ($)
ft²
property
Apr. 15, 2022
USD ($)
ft²
property
Feb. 24, 2022
USD ($)
ft²
property
Dec. 31, 2023
USD ($)
ft²
property
Dec. 31, 2022
USD ($)
ft²
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE                                                                     $ 1,242,218
CLOSING ADJUSTMENTS                                                                     (45,666)
NET PROCEEDS                                                                     1,196,552
NET REAL ESTATE INVESTMENT                                                                     939,363
OTHER (INCLUDING RECEIVABLES)                                                                     14,225
GAIN/ (IMPAIRMENT)                                                                     $ 242,964
SQUARE FOOTAGE unaudited | ft²                                                                     3,069,124
Number of owned real estate properties | property                                                                   655  
Tampa FL & Miami FL                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE                                         $ 93,250                            
CLOSING ADJUSTMENTS                                         (5,875)                            
COMPANY-FINANCED NOTES                                         0                            
NET PROCEEDS                                         87,375                            
NET REAL ESTATE INVESTMENT                                         87,302                            
OTHER (INCLUDING RECEIVABLES)                                         (888)                            
GAIN/ (IMPAIRMENT)                                         $ 961                            
SQUARE FOOTAGE unaudited | ft²                                         224,037                            
Number of owned real estate properties | property                                         2                            
Number of Property Dispositions | disposition_transaction                                         2                            
Dallas, TX                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE           $ 43,295           $ 115,000               $ 19,210           $ 104,025   $ 114,290              
CLOSING ADJUSTMENTS           (764)           (1,504)               (141)           (5,883)   (682)              
COMPANY-FINANCED NOTES           0           0               0                              
NET PROCEEDS           42,531           113,496               19,069           98,142   113,608              
NET REAL ESTATE INVESTMENT           33,882           64,183               18,986           38,872   113,608              
OTHER (INCLUDING RECEIVABLES)           (3,782)           6,094               43           6,436   0              
GAIN/ (IMPAIRMENT)           $ 12,431           $ 43,219               $ 40           $ 52,834   $ 0              
SQUARE FOOTAGE unaudited | ft²           77,827           161,264               36,691           291,328   189,385              
Joint venture, ownership (in percentage)                                       40.00%               40.00%              
Number of buildings acquired | property                                                   2   6              
Values and square feet, represented percentage (in percent)                                                       100.00%              
St. Louis, MO                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE                                     $ 350     $ 18,000                          
CLOSING ADJUSTMENTS                                     (18)     (1,471)                          
COMPANY-FINANCED NOTES                                     0                                
NET PROCEEDS                                     332     16,529                          
NET REAL ESTATE INVESTMENT                                     398     18,340                          
OTHER (INCLUDING RECEIVABLES)                                     0     4                          
GAIN/ (IMPAIRMENT)                                     $ (66)     $ (1,815)                          
SQUARE FOOTAGE unaudited | ft²                                     6,500     69,394                          
Los Angeles, CA                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE         $ 19,000                     $ 3,300 $ 75,000 $ 21,000                     $ 134,845            
CLOSING ADJUSTMENTS         (1,311)                     (334) (8,079) (526)                     (3,102)            
COMPANY-FINANCED NOTES         0                     0 (45,000) 0                                  
NET PROCEEDS         17,689                     2,966 21,921 20,474                     131,743            
NET REAL ESTATE INVESTMENT         17,787                     3,268 88,624 20,610                     131,332            
OTHER (INCLUDING RECEIVABLES)         0                     0 (803) 52                     411            
GAIN/ (IMPAIRMENT)         $ (98)                     $ (302) $ (20,900) $ (188)                     $ 0            
SQUARE FOOTAGE unaudited | ft²         104,377                     0 147,078 37,165                     283,780            
Joint venture, ownership (in percentage)                                                         20.00%            
Mortgage Note                                 $ 45,000                                    
Area of land | a                               0.34                                      
Number of buildings acquired | property                                                         4            
Values and square feet, represented percentage (in percent)                                                         100.00%            
Albany, NY                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE                             $ 10,000                                        
CLOSING ADJUSTMENTS                             (1,229)                                        
COMPANY-FINANCED NOTES                             0                                        
NET PROCEEDS                             8,771                                        
NET REAL ESTATE INVESTMENT                             2,613                                        
OTHER (INCLUDING RECEIVABLES)                             (1,040)                                        
GAIN/ (IMPAIRMENT)                             $ 7,198                                        
SQUARE FOOTAGE unaudited | ft²                             40,870                                        
Houston, TX                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE               $ 4,100     $ 250     $ 8,320                     $ 32,000                    
CLOSING ADJUSTMENTS               (6)     (24)     (285)                     (280)                    
COMPANY-FINANCED NOTES               0     0     0                                          
NET PROCEEDS               4,094     226     8,035                     31,720                    
NET REAL ESTATE INVESTMENT               3,486     1,998     4,567                     10,762                    
OTHER (INCLUDING RECEIVABLES)               0     0     194                     744                    
GAIN/ (IMPAIRMENT)               $ 608     $ (1,772)     $ 3,274                     $ 20,214                    
SQUARE FOOTAGE unaudited | ft²               83,223     52,040     57,170                     134,910                    
Atlanta, GA                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE                         $ 25,140                   $ 91,243                        
CLOSING ADJUSTMENTS                         (66)                   (4,326)                        
COMPANY-FINANCED NOTES                         0                                            
NET PROCEEDS                         25,074                   86,917                        
NET REAL ESTATE INVESTMENT                         23,226                   109,051                        
OTHER (INCLUDING RECEIVABLES)                         (536)                   235                        
GAIN/ (IMPAIRMENT)                         $ 2,386                   $ (22,369)                        
SQUARE FOOTAGE unaudited | ft²                         55,195                   348,416                        
Number of buildings acquired | property                                             9                        
Chicago, IL                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE                   $ 59,950                                                  
CLOSING ADJUSTMENTS                   (870)                                                  
COMPANY-FINANCED NOTES                   0                                                  
NET PROCEEDS                   59,080                                                  
NET REAL ESTATE INVESTMENT                   74,710                                                  
OTHER (INCLUDING RECEIVABLES)                   (380)                                                  
GAIN/ (IMPAIRMENT)                   $ (15,250)                                                  
SQUARE FOOTAGE unaudited | ft²                   104,912                                                  
Evansville, IN                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE                 $ 18,500                                                    
CLOSING ADJUSTMENTS                 (63)                                                    
COMPANY-FINANCED NOTES                 0                                                    
NET PROCEEDS                 18,437                                                    
NET REAL ESTATE INVESTMENT                 17,807                                                    
OTHER (INCLUDING RECEIVABLES)                 (149)                                                    
GAIN/ (IMPAIRMENT)                 $ 779                                                    
SQUARE FOOTAGE unaudited | ft²                 260,520                                                    
Number of owned real estate properties | property                 5                                                    
Number of Property Dispositions | disposition_transaction                 3                                                    
Charleston, SC                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE             $ 6,200                                                        
CLOSING ADJUSTMENTS             (401)                                                        
COMPANY-FINANCED NOTES             0                                                        
NET PROCEEDS             5,799                                                        
NET REAL ESTATE INVESTMENT             3,415                                                        
OTHER (INCLUDING RECEIVABLES)             0                                                        
GAIN/ (IMPAIRMENT)             $ 2,384                                                        
SQUARE FOOTAGE unaudited | ft²             15,014                                                        
Joint venture, ownership (in percentage)             100.00%                                                        
Tucson, AZ                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE       $ 43,230                                                              
CLOSING ADJUSTMENTS       (3,770)                                                              
COMPANY-FINANCED NOTES       (6,000)                                                              
NET PROCEEDS       33,460                                                              
NET REAL ESTATE INVESTMENT       39,786                                                              
OTHER (INCLUDING RECEIVABLES)       (26)                                                              
GAIN/ (IMPAIRMENT)       $ (300)                                                              
SQUARE FOOTAGE unaudited | ft²       215,471                                                              
Number of owned real estate properties | property       12                                                              
Number of Property Dispositions | disposition_transaction       1                                                              
Mortgage Note       $ 6,000                                                              
Miami, FL                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE       18,250                                                              
CLOSING ADJUSTMENTS       (756)                                                              
COMPANY-FINANCED NOTES       0                                                              
NET PROCEEDS       17,494                                                              
NET REAL ESTATE INVESTMENT       17,354                                                              
OTHER (INCLUDING RECEIVABLES)       643                                                              
GAIN/ (IMPAIRMENT)       $ (503)                                                              
SQUARE FOOTAGE unaudited | ft²       48,000                                                              
Sebring, FL                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE     $ 9,500                                                                
CLOSING ADJUSTMENTS     (81)                                                                
COMPANY-FINANCED NOTES     0                                                                
NET PROCEEDS     9,419                                                                
NET REAL ESTATE INVESTMENT     10,438                                                                
OTHER (INCLUDING RECEIVABLES)     (512)                                                                
GAIN/ (IMPAIRMENT)     $ (507)                                                                
SQUARE FOOTAGE unaudited | ft²     38,949                                                                
Boston, MA                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE   $ 117,197                                                                  
CLOSING ADJUSTMENTS   (2,079)                                                                  
COMPANY-FINANCED NOTES   0                                                                  
NET PROCEEDS   115,118                                                                  
NET REAL ESTATE INVESTMENT   107,803                                                                  
OTHER (INCLUDING RECEIVABLES)   9,828                                                                  
GAIN/ (IMPAIRMENT)   $ (2,513)                                                                  
SQUARE FOOTAGE unaudited | ft²   161,254                                                                  
Jacksonville/Orlando/Miami, FL                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE $ 77,000                                                                    
CLOSING ADJUSTMENTS (8,678)                                                                    
COMPANY-FINANCED NOTES (7,700)                                                                    
NET PROCEEDS 60,622                                                                    
NET REAL ESTATE INVESTMENT 65,839                                                                    
OTHER (INCLUDING RECEIVABLES) (294)                                                                    
GAIN/ (IMPAIRMENT) $ 2,777                                                                    
SQUARE FOOTAGE unaudited | ft² 354,500                                                                    
Number of owned real estate properties | property 3                                                                    
Number of Property Dispositions | disposition_transaction 1                                                                    
Mortgage Note $ 7,700                                                                    
Loveland, CO                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE                                                                 $ 84,950    
CLOSING ADJUSTMENTS                                                                 (45)    
NET PROCEEDS                                                                 84,905    
NET REAL ESTATE INVESTMENT                                                                 40,095    
OTHER (INCLUDING RECEIVABLES)                                                                 4    
GAIN/ (IMPAIRMENT)                                                                 $ 44,806    
SQUARE FOOTAGE unaudited | ft²                                                                 150,291    
Number of buildings acquired | property                                                                 2    
San Antonio, TX                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE                                                               $ 25,500      
CLOSING ADJUSTMENTS                                                               (2,272)      
NET PROCEEDS                                                               23,228      
NET REAL ESTATE INVESTMENT                                                               14,381      
OTHER (INCLUDING RECEIVABLES)                                                               284      
GAIN/ (IMPAIRMENT)                                                               $ 8,563      
SQUARE FOOTAGE unaudited | ft²                                                               201,523      
Number of buildings acquired | property                                                               2      
GA, FL, PA                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE                                                             $ 133,100        
CLOSING ADJUSTMENTS                                                             (8,109)        
NET PROCEEDS                                                             124,991        
NET REAL ESTATE INVESTMENT                                                             124,991        
OTHER (INCLUDING RECEIVABLES)                                                             0        
GAIN/ (IMPAIRMENT)                                                             $ 0        
SQUARE FOOTAGE unaudited | ft²                                                             316,739        
Number of buildings acquired | property                                                             4        
GA, FL, TX                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE                                                           $ 160,917          
CLOSING ADJUSTMENTS                                                           (5,893)          
NET PROCEEDS                                                           155,024          
NET REAL ESTATE INVESTMENT                                                           151,819          
OTHER (INCLUDING RECEIVABLES)                                                           3,205          
GAIN/ (IMPAIRMENT)                                                           $ 0          
SQUARE FOOTAGE unaudited | ft²                                                           343,545          
Number of buildings acquired | property                                                           6          
Indianapolis, IN                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE                                                     $ 238,845                
CLOSING ADJUSTMENTS                                                     (5,846)                
NET PROCEEDS                                                     232,999                
NET REAL ESTATE INVESTMENT                                                     84,767                
OTHER (INCLUDING RECEIVABLES)                                                     4,324                
GAIN/ (IMPAIRMENT)                                                     $ 143,908                
SQUARE FOOTAGE unaudited | ft²                                                     506,406                
Number of buildings acquired | property                                                     5                
Number of properties acquired in the merger | property                                                     2                
College Station, TX                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE                                               $ 49,177                      
CLOSING ADJUSTMENTS                                               (3,755)                      
NET PROCEEDS                                               45,422                      
NET REAL ESTATE INVESTMENT                                               44,918                      
OTHER (INCLUDING RECEIVABLES)                                               475                      
GAIN/ (IMPAIRMENT)                                               $ 28                      
SQUARE FOOTAGE unaudited | ft²                                               122,942                      
El Paso, TX                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE                                             $ 55,326                        
CLOSING ADJUSTMENTS                                             (4,002)                        
NET PROCEEDS                                             51,324                        
NET REAL ESTATE INVESTMENT                                             56,427                        
OTHER (INCLUDING RECEIVABLES)                                             (1,897)                        
GAIN/ (IMPAIRMENT)                                             $ (3,205)                        
SQUARE FOOTAGE unaudited | ft²                                             110,465                        
Real Estate Dispositions                                                                      
Real Estate Dispositions [Line Items]                                                                      
SALES PRICE                                                                   $ 787,042  
CLOSING ADJUSTMENTS                                                                   (36,860)  
COMPANY-FINANCED NOTES                                                                   (58,700)  
NET PROCEEDS                                                                   691,482  
NET REAL ESTATE INVESTMENT                                                                   708,082  
OTHER (INCLUDING RECEIVABLES)                                                                   8,444  
GAIN/ (IMPAIRMENT)                                                                   $ 33,658  
SQUARE FOOTAGE unaudited | ft²                                                                   2,282,057  
v3.24.0.1
Held for Sale - Narrative (Details)
$ in Millions
 12 Months Ended
Dec. 31, 2023
USD ($)
property
Dec. 31, 2022
property
Discontinued Operations and Disposal Groups [Abstract]    
Number of properties classified as held for sale | property 1 1
Impairment charges on net real estate assets held for sale | $ $ 5.9  
v3.24.0.1
Held for - Sale Assets Held for Sale (Details) - USD ($)
$ in Thousands
Dec. 31, 2023
Dec. 31, 2022
Balance Sheet data    
Land $ 1,343,265 $ 1,439,798
Buildings and improvements 10,881,373 11,332,037
Total real estate investments 13,399,067 14,057,625
Less accumulated depreciation (2,226,853) (1,645,271)
Total real estate investments, net 11,172,214 12,412,354
Assets held for sale, net 8,834 18,893
Liabilities of properties held for sale 295 437
Disposal Group, Held-for-sale, Not Discontinued Operations    
Balance Sheet data    
Land 1,850 1,700
Buildings and improvements 6,779 15,164
Lease intangibles 1,017 1,986
Total real estate investments 9,646 18,850
Less accumulated depreciation (913) 0
Total real estate investments, net 8,733 18,850
Other assets, net 101 43
Assets held for sale, net 8,834 18,893
Accounts payable and accrued liabilities 23 282
Other liabilities 272 155
Liabilities of properties held for sale $ 295 $ 437
v3.24.0.1
Impairment Charges (Details)
$ in Millions
 12 Months Ended
Dec. 31, 2023
USD ($)
property
Dec. 31, 2022
USD ($)
property
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Number of properties sold 31 12
Number of properties redeveloped 6 3
Impairment charges | $ $ 149.7 $ 54.4
Number of owned real estate properties 655  
Fair Value, Inputs, Level 3    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Number of owned real estate properties 6  
Fair value | $ $ 53.6  
v3.24.0.1
Other Assets - Other Assets (Details) - USD ($)
$ in Thousands
Dec. 31, 2023
Dec. 31, 2022
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]    
Real estate notes receivable, net $ 173,614 $ 99,643
Straight-line rent receivables 116,866 88,868
Prepaid assets 116,455 81,900
Above-market intangible assets, net 66,695 80,720
Accounts receivable, net 63,203 54,667
Additional long-lived assets, net 20,717 21,446
Interest rate swap assets 4,634 14,512
Investment in securities 6,011 6,011
Debt issuance costs, net 3,867 5,977
Project costs 6,187 4,337
Net investment in lease 2,112 1,828
Customer relationship intangible assets, net 1,066 1,120
Other 10,941 8,961
Other assets 592,368 469,990
Allowance for doubtful accounts $ 8,400 4,000
Other receivables, net   $ 7,169
v3.24.0.1
Intangible Assets and Liabilities - Components of intangible assets and liabilities (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Schedule of finite lived intangible assets and liabilities    
Intangible assets and liabilities, gross $ 1,082.3 $ 1,278.6
Intangible assets and liabilities, accumulated amortization $ 301.5 186.3
Assets and liabilities, weighted avg. life (years) 4 years 3 months 18 days  
Below-market lease intangibles (lessor) | Other liabilities    
Schedule of finite lived intangible assets and liabilities    
Liabilities gross balance $ (112.5) (112.5)
Liabilities accumulated amortization $ (35.7) (14.6)
Liabilities, weighted avg. life (years) 5 years 9 months 18 days  
Goodwill | Other Assets    
Schedule of finite lived intangible assets and liabilities    
Assets gross balance $ 250.5 223.2
Assets accumulated amortization 0.0 0.0
Credit facility debt issuance costs | Other Assets    
Schedule of finite lived intangible assets and liabilities    
Assets gross balance 6.9 6.9
Assets accumulated amortization $ 3.1 0.9
Assets, weighted avg. life (years) 1 year 10 months 24 days  
Above-market lease intangibles (lessor) | Other Assets    
Schedule of finite lived intangible assets and liabilities    
Assets gross balance $ 98.0 91.5
Assets accumulated amortization $ 31.3 10.7
Assets, weighted avg. life (years) 5 years 3 months 18 days  
Customer relationship intangibles (lessor) | Other Assets    
Schedule of finite lived intangible assets and liabilities    
Assets gross balance $ 2.1 2.1
Assets accumulated amortization $ 1.1 1.0
Assets, weighted avg. life (years) 19 years 7 months 6 days  
At-market lease intangibles | At-market lease intangibles    
Schedule of finite lived intangible assets and liabilities    
Assets gross balance $ 837.3 1,067.4
Assets accumulated amortization $ 301.7 $ 188.3
Assets, weighted avg. life (years) 4 years  
v3.24.0.1
Intangible Assets and Liabilities - Expected future amortization expense (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]    
Intangible amortization expense $ 214.8 $ 133.6
Future Amortization of Intangibles, Net [Abstract]    
2024 206.7  
2025 109.1  
2026 84.3  
2027 53.0  
2028 $ 31.9  
v3.24.0.1
Notes and Bonds Payable (Details) - USD ($)
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Debt Instrument [Line Items]    
Senior notes carrying amount $ 4,994,859,000 $ 5,351,827,000
Line of Credit | $1.5B Unsecured Credit Facility    
Debt Instrument [Line Items]    
Credit facility 1,500,000,000  
Senior notes carrying amount $ 0 385,000,000
EFFECTIVE INTEREST RATES 6.24%  
Line of Credit | $1.5B Unsecured Credit Facility | Secured Overnight Financing Rate (SOFR)    
Debt Instrument [Line Items]    
Contractual interest rates, basis spread on variable rate 0.95%  
Medium-term Notes | $350 million Unsecured Term Loan due 2023, net of issuance costs    
Debt Instrument [Line Items]    
Face value $ 350,000,000  
Senior notes carrying amount $ 349,798,000 349,114,000
EFFECTIVE INTEREST RATES 6.30%  
Medium-term Notes | $350 million Unsecured Term Loan due 2023, net of issuance costs | Secured Overnight Financing Rate (SOFR)    
Debt Instrument [Line Items]    
Contractual interest rates, basis spread on variable rate 1.05%  
Medium-term Notes | $200 million Unsecured Term Loan due 2024, net of issuance costs    
Debt Instrument [Line Items]    
Face value $ 200,000,000  
Senior notes carrying amount $ 199,903,000 199,670,000
EFFECTIVE INTEREST RATES 6.30%  
Medium-term Notes | $200 million Unsecured Term Loan due 2024, net of issuance costs | Secured Overnight Financing Rate (SOFR)    
Debt Instrument [Line Items]    
Contractual interest rates, basis spread on variable rate 1.05%  
Medium-term Notes | $150 million Unsecured Term Loan due 2026, net of issuance costs    
Debt Instrument [Line Items]    
Face value $ 150,000,000  
Senior notes carrying amount $ 149,643,000 149,495,000
EFFECTIVE INTEREST RATES 6.30%  
Medium-term Notes | $150 million Unsecured Term Loan due 2026, net of issuance costs | Secured Overnight Financing Rate (SOFR)    
Debt Instrument [Line Items]    
Contractual interest rates, basis spread on variable rate 1.05%  
Medium-term Notes | $300 million Unsecured Term Loan due 2025, net of issuance costs    
Debt Instrument [Line Items]    
Face value $ 300,000,000  
Senior notes carrying amount $ 299,958,000 299,936,000
EFFECTIVE INTEREST RATES 6.30%  
Medium-term Notes | $300 million Unsecured Term Loan due 2025, net of issuance costs | Secured Overnight Financing Rate (SOFR)    
Debt Instrument [Line Items]    
Contractual interest rates, basis spread on variable rate 1.05%  
Medium-term Notes | $200 million Unsecured Term Loan due 2027, net of issuance costs    
Debt Instrument [Line Items]    
Face value $ 200,000,000  
Senior notes carrying amount $ 199,502,000 199,362,000
EFFECTIVE INTEREST RATES 6.30%  
Medium-term Notes | $200 million Unsecured Term Loan due 2027, net of issuance costs | Secured Overnight Financing Rate (SOFR)    
Debt Instrument [Line Items]    
Contractual interest rates, basis spread on variable rate 1.05%  
Medium-term Notes | $300 million Unsecured Term Loan due 2028, net of issuance costs    
Debt Instrument [Line Items]    
Face value $ 300,000,000  
Senior notes carrying amount $ 298,288,000 297,869,000
EFFECTIVE INTEREST RATES 6.30%  
Medium-term Notes | $300 million Unsecured Term Loan due 2028, net of issuance costs | Secured Overnight Financing Rate (SOFR)    
Debt Instrument [Line Items]    
Contractual interest rates, basis spread on variable rate 1.05%  
Senior Notes | Senior Notes due 2025    
Debt Instrument [Line Items]    
Senior notes carrying amount $ 249,484,000 249,115,000
Contractual interest rates 3.88%  
EFFECTIVE INTEREST RATES 4.12%  
Senior Notes | Senior Notes due 2026    
Debt Instrument [Line Items]    
Senior notes carrying amount $ 579,017,000 571,587,000
Contractual interest rates 3.50%  
EFFECTIVE INTEREST RATES 4.94%  
Senior Notes | Senior Notes Due 2027    
Debt Instrument [Line Items]    
Senior notes carrying amount $ 483,727,000 479,553,000
Contractual interest rates 3.75%  
EFFECTIVE INTEREST RATES 4.76%  
Senior Notes | Senior Notes due 2028    
Debt Instrument [Line Items]    
Senior notes carrying amount $ 297,429,000 296,852,000
Contractual interest rates 3.63%  
EFFECTIVE INTEREST RATES 3.85%  
Senior Notes | Senior Notes Due 2030 One    
Debt Instrument [Line Items]    
Senior notes carrying amount $ 575,443,000 565,402,000
Contractual interest rates 3.10%  
EFFECTIVE INTEREST RATES 5.30%  
Senior Notes | Senior Notes Due 2030 Two    
Debt Instrument [Line Items]    
Senior notes carrying amount $ 296,780,000 296,385,000
Contractual interest rates 2.40%  
EFFECTIVE INTEREST RATES 2.72%  
Senior Notes | Senior Notes Due 2031 One    
Debt Instrument [Line Items]    
Senior notes carrying amount $ 295,832,000 295,547,000
Contractual interest rates 2.05%  
EFFECTIVE INTEREST RATES 2.25%  
Senior Notes | Senior Notes Due 2031 Two    
Debt Instrument [Line Items]    
Senior notes carrying amount $ 649,521,000 632,693,000
Contractual interest rates 2.00%  
EFFECTIVE INTEREST RATES 5.13%  
Mortgage Notes | Mortgage Notes Payable    
Debt Instrument [Line Items]    
Face value $ 70,752,000 84,122,000
Senior notes carrying amount $ 70,534,000 $ 84,247,000
Minimum | Mortgage Notes    
Debt Instrument [Line Items]    
Contractual interest rates 3.60%  
Minimum | Mortgage Notes | Mortgage Notes Payable    
Debt Instrument [Line Items]    
Contractual interest rates 3.60%  
EFFECTIVE INTEREST RATES 3.57%  
Maximum | Mortgage Notes    
Debt Instrument [Line Items]    
Contractual interest rates 4.80%  
Maximum | Mortgage Notes | Mortgage Notes Payable    
Debt Instrument [Line Items]    
Contractual interest rates 4.77%  
EFFECTIVE INTEREST RATES 6.88%  
v3.24.0.1
Notes and Bonds Payable - Senior and Term Notes (Details) - USD ($)
$ in Thousands
Dec. 31, 2023
Dec. 31, 2022
Debt Instrument [Line Items]    
Debt issuance costs $ (3,867) $ (5,977)
Senior notes carrying amount 4,994,859 5,351,827
Healthcare Trust Of America, Inc    
Debt Instrument [Line Items]    
Principal balance 3,699,285 3,699,500
Unaccreted discount (265,852) (304,919)
Debt issuance costs (6,200) (7,447)
Senior notes carrying amount $ 3,427,233 $ 3,387,134
v3.24.0.1
Notes and Bonds Payable - Mortgage Notes (Details) - USD ($)
Dec. 31, 2023
Dec. 31, 2022
Debt Instrument [Line Items]    
Debt issuance costs $ (3,867,000) $ (5,977,000)
NOTES AND BONDS PAYABLE 4,994,859,000 5,351,827,000
Term Loan Net | Term Loan    
Debt Instrument [Line Items]    
Face value 1,500,000,000 1,500,000,000
Debt issuance costs (2,908,000) (4,554,000)
NOTES AND BONDS PAYABLE 1,497,092,000 1,495,446,000
Mortgage Notes Payable | Mortgage Notes    
Debt Instrument [Line Items]    
Face value 70,752,000 84,122,000
Unamortized premium 285,000 486,000
Unaccreted discount (237,000) (38,000)
Debt issuance costs (266,000) (323,000)
NOTES AND BONDS PAYABLE $ 70,534,000 $ 84,247,000
v3.24.0.1
Notes and Bonds Payable - Narrative (Details)
$ in Thousands
Feb. 01, 2024
USD ($)
ft²
Jan. 06, 2024
USD ($)
ft²
Dec. 01, 2023
USD ($)
ft²
Aug. 01, 2023
USD ($)
ft²
Dec. 31, 2023
USD ($)
Jul. 28, 2023
USD ($)
ft²
Dec. 31, 2022
USD ($)
Debt Instrument [Line Items]              
Senior notes carrying amount | $         $ 4,994,859   $ 5,351,827
Mortgage Notes              
Debt Instrument [Line Items]              
EFFECTIVE INTEREST RATES     4.51% 3.31%      
Amount of debt repaid | $     $ 6,600 $ 9,800      
Mortgage Notes | Subsequent Event              
Debt Instrument [Line Items]              
EFFECTIVE INTEREST RATES 4.12% 4.77%          
Amount of debt repaid | $ $ 5,600 $ 11,300          
Mortgage Notes Payable              
Debt Instrument [Line Items]              
Percentage of interest-bearing in mortgage notes payable           4.50%  
Mortgage Notes Payable | Mortgage Notes              
Debt Instrument [Line Items]              
Senior notes carrying amount | $         $ 70,534   $ 84,247
Colorado Springs, CO | Mortgage Notes              
Debt Instrument [Line Items]              
Encumbered square footage | ft²     93,992        
Colorado Springs, CO | Mortgage Notes Payable | Mortgage Notes              
Debt Instrument [Line Items]              
Senior notes carrying amount | $           $ 5,600  
Square feet subject to mortgage notes payable | ft²           42,770  
Atlanta, GA | Mortgage Notes              
Debt Instrument [Line Items]              
Encumbered square footage | ft²       66,984      
Atlanta, GA | Mortgage Notes | Subsequent Event              
Debt Instrument [Line Items]              
Encumbered square footage | ft² 40,324            
California | Mortgage Notes | Subsequent Event              
Debt Instrument [Line Items]              
Encumbered square footage | ft²   63,012          
v3.24.0.1
Notes and Bonds Payable - Details of Mortgage Notes (Details)
 12 Months Ended
Dec. 31, 2023
USD ($)
mortage_note_payable
Dec. 31, 2022
USD ($)
Debt Instrument [Line Items]    
Number of outstanding mortgage notes | mortage_note_payable 4  
Mortgage Notes    
Debt Instrument [Line Items]    
Investment in collateral $ 202,100,000  
Mortgage notes payable carrying amount $ 70,500,000 $ 84,200,000
Number of outstanding mortgage notes | mortage_note_payable 7  
Mortgage Notes | Minimum    
Debt Instrument [Line Items]    
Contractual interest rates 3.60%  
Mortgage Notes | Maximum    
Debt Instrument [Line Items]    
Contractual interest rates 4.80%  
Mortgage Notes | Mortgage Notes 3.86% | Life Insurance Co.    
Debt Instrument [Line Items]    
Principal balance $ 12,300,000  
Effective interest rate 3.86%  
Collateral MOB  
Principal and interest amortization period 7 years  
Investment in collateral $ 0  
Mortgage notes payable carrying amount 0 10,000,000.0
Unencumbered gross investment 26,000,000  
Mortgage Notes | Mortgage Notes 4.84% | Life Insurance Co.    
Debt Instrument [Line Items]    
Principal balance $ 9,000,000.0  
Effective interest rate 4.84%  
Collateral MOB,OFC  
Principal and interest amortization period 10 years  
Investment in collateral $ 0  
Mortgage notes payable carrying amount 0 6,800,000
Unencumbered gross investment 24,500,000  
Mortgage Notes | Mortgage Notes 4.13% | Life Insurance Co.    
Debt Instrument [Line Items]    
Principal balance $ 13,300,000  
Effective interest rate 4.13%  
Collateral MOB  
Principal and interest amortization period 10 years  
Investment in collateral $ 24,400,000  
Mortgage notes payable carrying amount 11,300,000 11,700,000
Unamortized premium 800,000  
Mortgage Notes | Mortgage Notes 3.96% | Life Insurance Co.    
Debt Instrument [Line Items]    
Principal balance $ 6,800,000  
Effective interest rate 3.96%  
Collateral MOB  
Principal and interest amortization period 7 years  
Investment in collateral $ 12,600,000  
Mortgage notes payable carrying amount 5,600,000 5,800,000
Unamortized premium 200,000  
Mortgage Notes | Mortgage Notes 4.32% | Life Insurance Co.    
Debt Instrument [Line Items]    
Mortgage notes payable carrying amount   7,500,000
Mortgage Notes | Mortgage Notes 4.32% | Financial Services    
Debt Instrument [Line Items]    
Principal balance $ 9,700,000  
Effective interest rate 4.32%  
Collateral MOB  
Principal and interest amortization period 10 years  
Investment in collateral $ 16,900,000  
Mortgage notes payable carrying amount 7,200,000  
Unamortized premium 100,000  
Mortgage Notes | Mortgage Notes 3.43% | Life Insurance Co.    
Debt Instrument [Line Items]    
Principal balance $ 16,500,000  
Effective interest rate 3.43%  
Collateral MOB,OFC  
Principal and interest amortization period 7 years  
Investment in collateral $ 49,200,000  
Mortgage notes payable carrying amount 15,900,000 16,200,000
Unamortized premium 700,000  
Mortgage Notes | Mortgage Notes 3.71% | Financial Services    
Debt Instrument [Line Items]    
Principal balance $ 11,500,000  
Effective interest rate 3.71%  
Collateral MOB  
Principal and interest amortization period 10 years  
Investment in collateral $ 41,700,000  
Mortgage notes payable carrying amount 7,800,000 8,300,000
Mortgage Notes | Mortgage Notes 6.883% | Life Insurance Co.    
Debt Instrument [Line Items]    
Principal balance $ 6,000,000.0  
Effective interest rate 6.88%  
Principal and interest amortization period 7 years  
Unaccreted discount $ 300,000  
Mortgage Notes | Mortgage Notes 6.883% | Financial Services    
Debt Instrument [Line Items]    
Investment in collateral 11,600,000  
Mortgage notes payable carrying amount 5,200,000 0
Mortgage Notes | Mortgage Notes 4.08% | Life Insurance Co.    
Debt Instrument [Line Items]    
Principal balance $ 19,200,000  
Effective interest rate 4.08%  
Collateral MOB  
Principal and interest amortization period 10 years  
Investment in collateral $ 45,700,000  
Mortgage notes payable carrying amount $ 17,500,000 $ 17,900,000
v3.24.0.1
Notes and Bonds Payable - Future Maturities (Details)
$ in Thousands
Dec. 31, 2023
USD ($)
mortage_note_payable
Dec. 31, 2022
USD ($)
Long Term Debt Maturities [Line Items]    
Number of outstanding mortgage notes | mortage_note_payable 4  
Excluded debt issuance costs $ 3,900  
Future contractual maturities of the Company's notes and bonds payable    
Debt issuance costs (3,867) $ (5,977)
NOTES AND BONDS PAYABLE 4,994,859 $ 5,351,827
2024    
Future contractual maturities of the Company's notes and bonds payable    
PRINCIPAL MATURITIES 575,473  
Net Accretion/Amortization (41,050)  
Debt issuance costs (2,438)  
NOTES AND BONDS PAYABLE $ 531,985  
% 10.70%  
2025    
Future contractual maturities of the Company's notes and bonds payable    
PRINCIPAL MATURITIES $ 566,375  
Net Accretion/Amortization (43,163)  
Debt issuance costs (1,916)  
NOTES AND BONDS PAYABLE $ 521,296  
% 10.40%  
2026    
Future contractual maturities of the Company's notes and bonds payable    
PRINCIPAL MATURITIES $ 778,904  
Net Accretion/Amortization (41,837)  
Debt issuance costs (1,650)  
NOTES AND BONDS PAYABLE $ 735,417  
% 14.70%  
2027    
Future contractual maturities of the Company's notes and bonds payable    
PRINCIPAL MATURITIES $ 700,000  
Net Accretion/Amortization (36,192)  
Debt issuance costs (1,519)  
NOTES AND BONDS PAYABLE $ 662,289  
% 13.30%  
2028    
Future contractual maturities of the Company's notes and bonds payable    
PRINCIPAL MATURITIES $ 600,000  
Net Accretion/Amortization (35,179)  
Debt issuance costs (707)  
NOTES AND BONDS PAYABLE $ 564,114  
% 11.30%  
2029 and thereafter    
Future contractual maturities of the Company's notes and bonds payable    
PRINCIPAL MATURITIES $ 2,049,285  
Net Accretion/Amortization (68,382)  
Debt issuance costs (1,145)  
NOTES AND BONDS PAYABLE $ 1,979,758  
% 39.60%  
Net of Unsecured Credit Facility    
Future contractual maturities of the Company's notes and bonds payable    
PRINCIPAL MATURITIES $ 5,270,037  
Net Accretion/Amortization (265,803)  
Debt issuance costs (9,375)  
NOTES AND BONDS PAYABLE $ 4,994,859  
% 100.00%  
v3.24.0.1
Derivative Financial Instruments - Narrative (Details)
$ in Millions
Dec. 31, 2023
USD ($)
Nov. 09, 2023
USD ($)
Oct. 23, 2023
USD ($)
transaction
Oct. 19, 2023
USD ($)
transaction
Mar. 28, 2023
USD ($)
Feb. 16, 2023
USD ($)
Derivative [Line Items]            
Reclassified from accumulated other comprehensive loss $ 7.3          
Fair value of derivatives in a net liability position $ 11.0          
Designated as Hedging Instrument | Cash Flow Hedging | Interest Rate Swap, Expiring June 1, 2026            
Derivative [Line Items]            
Derivative notional amount         $ 100.0 $ 50.0
Derivative, fixed interest rate         3.67% 4.16%
Designated as Hedging Instrument | Cash Flow Hedging | Interest Rate Swap, Effective November 1, 2023            
Derivative [Line Items]            
Derivative notional amount       $ 100.0    
Number of swap transactions | transaction       2    
Designated as Hedging Instrument | Cash Flow Hedging | Interest Rate Swap, Expiring June 1, 2027            
Derivative [Line Items]            
Derivative notional amount       $ 50.0    
Derivative, fixed interest rate       4.71%    
Designated as Hedging Instrument | Cash Flow Hedging | Interest Rate Swap, Expiring December 1, 2027            
Derivative [Line Items]            
Derivative notional amount       $ 50.0    
Derivative, fixed interest rate       4.67%    
Designated as Hedging Instrument | Cash Flow Hedging | Interest Rate Swap, Expiring May 31, 2026            
Derivative [Line Items]            
Derivative notional amount   $ 75.0 $ 100.0      
Derivative, fixed interest rate   4.54% 4.73%      
Number of swap transactions | transaction     2      
v3.24.0.1
Derivative Financial Instruments - Cash Flow Hedges of Interest Rate Risk (Details) - Cash Flow Hedging - Designated as Hedging Instrument - USD ($)
$ in Thousands
Dec. 31, 2023
Dec. 31, 2022
Interest Rate Swap    
Derivative [Line Items]    
Derivative notional amount $ 1,275,000 $ 1,150,000
Derivative, fixed interest rate 3.49% 2.63%
Interest Rate Swap, Expiring January 2023    
Derivative [Line Items]    
Derivative notional amount   $ 300,000
Derivative, fixed interest rate   1.42%
Interest Rate Swap, Expiring January 2024    
Derivative [Line Items]    
Derivative notional amount $ 200,000 $ 200,000
Derivative, fixed interest rate 1.21% 1.21%
Interest Rate Swap, Expiring May 2026    
Derivative [Line Items]    
Derivative notional amount $ 275,000 $ 100,000
Derivative, fixed interest rate 3.74% 2.15%
Interest Rate Swap, Expiring June 2026    
Derivative [Line Items]    
Derivative notional amount $ 150,000  
Derivative, fixed interest rate 3.83%  
Interest Rate Swap, Expiring December 2026    
Derivative [Line Items]    
Derivative notional amount $ 150,000 $ 150,000
Derivative, fixed interest rate 3.84% 3.84%
Interest Rate Swap, Expiring June 2027    
Derivative [Line Items]    
Derivative notional amount $ 200,000 $ 150,000
Derivative, fixed interest rate 4.27% 4.13%
Interest Rate Swap, Expiring December 2027    
Derivative [Line Items]    
Derivative notional amount $ 300,000 $ 250,000
Derivative, fixed interest rate 3.93% 3.79%
v3.24.0.1
Derivative Financial Instruments - Fair Value of Derivative Instruments on the Balance Sheet (Details) - USD ($)
$ in Thousands
Dec. 31, 2023
Dec. 31, 2022
Derivatives, Fair Value [Line Items]    
GROSS AMOUNTS of recognized assets $ 4,625  
GROSS AMOUNTS of recognized liabilities (12,424)  
Interest rate swaps 2019 | Designated as Hedging Instrument | Other Assets    
Derivatives, Fair Value [Line Items]    
GROSS AMOUNTS of recognized assets 4,214 $ 13,603
Interest rate swaps 2022 | Designated as Hedging Instrument | Other Assets    
Derivatives, Fair Value [Line Items]    
GROSS AMOUNTS of recognized assets   909
Interest rate swaps 2022 | Designated as Hedging Instrument | Other liabilities    
Derivatives, Fair Value [Line Items]    
GROSS AMOUNTS of recognized liabilities (5,067) (4,269)
Interest rate swaps 2023 | Designated as Hedging Instrument | Other Assets    
Derivatives, Fair Value [Line Items]    
GROSS AMOUNTS of recognized assets 411  
Interest rate swaps 2023 | Designated as Hedging Instrument | Other liabilities    
Derivatives, Fair Value [Line Items]    
GROSS AMOUNTS of recognized liabilities (7,357)  
Interest Rate Swap | Designated as Hedging Instrument    
Derivatives, Fair Value [Line Items]    
GROSS AMOUNTS of recognized assets   $ 10,243
GROSS AMOUNTS of recognized liabilities $ (7,799)  
v3.24.0.1
Derivative Financial Instruments - Effect of Cash Flow Hedging on AOCI (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Derivative [Line Items]      
Amount of gain/(loss) recognized in AOCI on derivative $ 1,463 $ 10,630 $ 3,379
Amount of (gain)/loss reclassified from AOCI into income 14,488 (1,527) $ (4,472)
Interest rate swaps 2017      
Derivative [Line Items]      
Amount of gain/(loss) recognized in AOCI on derivative 0 302  
Interest rate swaps 2018      
Derivative [Line Items]      
Amount of gain/(loss) recognized in AOCI on derivative 0 616  
Interest rate swaps 2019      
Derivative [Line Items]      
Amount of gain/(loss) recognized in AOCI on derivative 1,995 12,964  
Interest rate swaps 2022      
Derivative [Line Items]      
Amount of gain/(loss) recognized in AOCI on derivative 4,583 (3,252)  
Interest rate swaps 2023      
Derivative [Line Items]      
Amount of gain/(loss) recognized in AOCI on derivative (5,115) 0  
Settled treasury hedges      
Derivative [Line Items]      
Amount of gain/(loss) recognized in AOCI on derivative 0 0  
Settled interest rate swaps      
Derivative [Line Items]      
Amount of gain/(loss) recognized in AOCI on derivative 0 0  
Interest expense      
Derivative [Line Items]      
Amount of (gain)/loss reclassified from AOCI into income (14,488) 1,527  
Interest expense | Interest rate swaps 2017      
Derivative [Line Items]      
Amount of (gain)/loss reclassified from AOCI into income 0 118  
Interest expense | Interest rate swaps 2018      
Derivative [Line Items]      
Amount of (gain)/loss reclassified from AOCI into income 0 361  
Interest expense | Interest rate swaps 2019      
Derivative [Line Items]      
Amount of (gain)/loss reclassified from AOCI into income (6,964) 563  
Interest expense | Interest rate swaps 2022      
Derivative [Line Items]      
Amount of (gain)/loss reclassified from AOCI into income (6,289) (109)  
Interest expense | Interest rate swaps 2023      
Derivative [Line Items]      
Amount of (gain)/loss reclassified from AOCI into income (1,829) 0  
Interest expense | Settled treasury hedges      
Derivative [Line Items]      
Amount of (gain)/loss reclassified from AOCI into income 426 426  
Interest expense | Settled interest rate swaps      
Derivative [Line Items]      
Amount of (gain)/loss reclassified from AOCI into income $ 168 $ 168  
v3.24.0.1
Derivative Financial Instruments - Offsetting Derivatives (Details)
$ in Thousands
Dec. 31, 2023
USD ($)
Offsetting of Derivative Assets  
GROSS AMOUNTS of recognized assets $ 4,625
GROSS AMOUNTS OFFSET in the Consolidated Balance Sheets 0
NET AMOUNTS OF ASSETS presented in the Consolidated Balance Sheets 4,625
FINANCIAL INSTRUMENTS (4,625)
CASH COLLATERAL 0
NET AMOUNT $ 0
Derivative Asset, Statement of Financial Position [Extensible Enumeration] Other Assets
Offsetting of Derivative Liabilities  
GROSS AMOUNTS of recognized liabilities $ (12,424)
GROSS AMOUNTS OFFSET in the Consolidated Balance Sheets 0
NET AMOUNTS OF LIABILITIES presented in the Consolidated Balance Sheets (12,424)
FINANCIAL INSTRUMENTS 4,625
CASH COLLATERAL 0
NET AMOUNT $ (7,799)
Derivative Liability, Statement of Financial Position [Extensible Enumeration] Other Liabilities
v3.24.0.1
Stockholders' Equity - Common shares (Details) - shares
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Class of Stock [Line Items]      
Preferred stock, outstanding (in shares) 0 0  
Reconciliation of the beginning and ending common stock outstanding      
Balance, beginning of year (in shares) 380,590,000    
Balance, end of year (in shares) 380,964,000 380,590,000  
Common Stock      
Class of Stock [Line Items]      
Preferred stock, outstanding (in shares) 0 0 0
Reconciliation of the beginning and ending common stock outstanding      
Balance, beginning of year (in shares) 380,589,894 150,457,433 139,487,375
Issuance of common stock (in shares) 8,627 229,618,304 10,899,301
Conversion of OP units to common stock (in shares) 190,544 0 0
Non-vested share-based awards, net of withheld shares and forfeitures (in shares) 175,368 514,157 70,757
Balance, end of year (in shares) 380,964,433 380,589,894 150,457,433
v3.24.0.1
Stockholders' Equity - Narrative (Details) - USD ($)
 12 Months Ended
Feb. 13, 2024
Dec. 31, 2023
May 31, 2023
Class of Stock [Line Items]      
Dividends per share to common stockholders, paid per quarter (in USD per share)   $ 0.31  
Stock repurchase, amount authorized     $ 500,000,000
Subsequent Event      
Class of Stock [Line Items]      
Dividends per share to common stockholders, declared (in USD per share) $ 0.31    
Dividend Declared      
Class of Stock [Line Items]      
Dividends per share to common stockholders, declared (in USD per share)   $ 1.24  
Common Stock      
Class of Stock [Line Items]      
Equity offering program of common stock   $ 750,000,000  
v3.24.0.1
Stockholders' Equity - Accumulated Other Comprehensive Income (Loss) (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
AOCI Attributable to Parent, Net of Tax [Roll Forward]      
Net current-period other comprehensive (loss) income $ (13,025) $ 12,157 $ 7,851
Forward Starting Swaps | Reclassification out of Accumulated Other Comprehensive Income (Loss)      
AOCI Attributable to Parent, Net of Tax [Roll Forward]      
Balance, beginning of period 2,140 (9,981)  
Other comprehensive income (loss) before reclassifications 1,434 1,531  
Amounts reclassified from accumulated other comprehensive (loss) income (14,315) 10,590  
Net current-period other comprehensive (loss) income (12,881) 12,121  
Balance, end of period $ (10,741) $ 2,140 $ (9,981)
v3.24.0.1
Stockholders' Equity - Reclassifications out of Accumulated Other Comprehensive Income (Loss) (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]      
Interest Expense $ 258,584 $ 146,691 $ 53,124
Net (loss) income 282,083 $ (40,693) $ (66,659)
Reclassification out of Accumulated Other Comprehensive Income (Loss)      
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]      
Net (loss) income (14,488)    
Amounts reclassified from accumulated other comprehensive income (loss) related to settled interest rate swaps | Reclassification out of Accumulated Other Comprehensive Income (Loss)      
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]      
Interest Expense 594    
Amounts reclassified from accumulated other comprehensive income (loss) related to current interest rate swaps | Reclassification out of Accumulated Other Comprehensive Income (Loss)      
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]      
Interest Expense $ (15,082)    
v3.24.0.1
Stock and Other Incentive Plans - Stock Incentive Plan Narrative (Details) - Restricted Stock - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Jul. 20, 2022
Stock Incentive Plan        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Number of shares available for grant (in shares) 8,102,861 9,432,388   9,647,839
Accelerated stock compensation expense $ 14.6 $ 13.9 $ 10.4  
Legacy HR Incentive Plan | Minimum        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Award vesting period 3 years      
Legacy HR Incentive Plan | Maximum        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Award vesting period 8 years      
v3.24.0.1
Stock and Other Incentive Plans - Amortization of Compensation for Nonvested Shares (Details)
$ in Millions
Dec. 31, 2023
USD ($)
Share-Based Payment Arrangement [Abstract]  
2024 $ 12.2
2025 9.7
2026 6.9
2027 2.1
2028 and thereafter 0.5
Total $ 31.4
v3.24.0.1
Stock and Other Incentive Plans - Executive Incentive Plan Narrative (Details) - Executive Incentive Plan - USD ($)
$ / shares in Units, $ in Millions
 12 Months Ended
Jan. 04, 2027
Jan. 04, 2026
Jan. 04, 2025
Jan. 04, 2024
Jan. 04, 2023
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Vested grant date fair value (in dollars per share)         $ 22.55      
At the Market Equity Offering Program                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Percentage of RSUnits         43.00%      
Market Condition 1                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Granted, fair value (in dollars per share)         $ 24.23      
Market Condition 2                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Granted, fair value (in dollars per share)         $ 27.84      
Performance Conditions                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Percentage of RSUnits         57.00%      
Vested grant date fair value (in dollars per share)         $ 20.21      
Performance Shares                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Accelerated stock compensation expense           $ 9.0 $ 9.8 $ 6.6
Performance Shares | Share-Based Payment Arrangement, Nonemployee                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Performance period         3 years      
Non Vested Stock Award                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Granted in period         $ 4.1      
Shares issued under the plan (in shares)         205,264      
Award vesting period         5 years      
Non Vested Stock Award | Subsequent Event                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Accelerated stock compensation expense       $ 0.8        
Non Vested Stock Award | Forecast                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Accelerated stock compensation expense $ 0.8 $ 0.8 $ 0.8          
Restricted Stock Units (RSUs)                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Award vesting period         5 years      
Restricted Stock Units (RSUs) | Share-Based Payment Arrangement, Nonemployee                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Shares issued under the plan (in shares)         165,174      
Restricted Stock Units (RSUs) | Share-based Payment Arrangement, Tranche Two                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Award vesting percentage         50.00%      
Restricted Stock Units (RSUs) | Share-Based Payment Arrangement, Tranche Three                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Award vesting percentage         50.00%      
v3.24.0.1
Stock and Other Incentive Plans - Schedule of Stock Options, Valuation Assumptions (Details) - $ / shares
 1 Months Ended
Jan. 04, 2023
Jan. 31, 2023
Restricted Stock    
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]    
Volatility 34.00%  
Expected term in years 3 years  
Risk-free rate 4.42%  
Stock price (in dollar per share) $ 20.21  
Operating Partnership Performance Units    
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]    
Volatility   34.00%
Expected term in years   3 years
Risk-free rate   4.42%
Stock price (in dollar per share)   $ 20.21
v3.24.0.1
Stock and Other Incentive Plans - LTIP Series C Units Narrative (Details) - USD ($)
$ / shares in Units, $ in Millions
 1 Months Ended 12 Months Ended
Jan. 31, 2023
Dec. 31, 2023
Operating Partnership Performance Units | Market Condition 1    
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]    
Granted, fair value (in dollars per share) $ 12.24  
Operating Partnership Performance Units | Market Condition 2    
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]    
Granted, fair value (in dollars per share) $ 13.98  
LTIP Series C Units    
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]    
Award performance period 3 years  
LTIP Series C Units | Operating Partnership Performance Units    
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]    
Percentage of RSUnits 43.00%  
Granted, fair value (in dollars per share) $ 15.85  
LTIP Series C Units | Operating Partnership Performance Units | Performance Conditions    
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]    
Percentage of RSUnits 57.00%  
Granted, fair value (in dollars per share) $ 20.21  
LTIP Series C Units | Share-Based Payment Arrangement, Employee | Operating Partnership Performance Units    
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]    
Granted in period (in shares) 627,547  
Award vesting period 5 years  
LTIP Series C Units | Directors | Share-Based Payment Arrangement, Employee    
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]    
Grant date fair value $ 7.1  
LTIP Series C Units | Officer | LTIP-C Unit Award    
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]    
Accelerated stock compensation expense   $ 1.2
v3.24.0.1
Stock and Other Incentive Plans - Officer Incentive Program Narrative (Details) - Officer Incentive Program
$ in Millions
 3 Months Ended 12 Months Ended
Mar. 31, 2023
USD ($)
shares
Dec. 31, 2023
USD ($)
Dec. 31, 2022
USD ($)
Dec. 31, 2021
USD ($)
Non-Executive Officers        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Value of performance based awards released $ 0.7      
Number of executive officers granted awards (in shares) | shares 33,438      
Non-Executive Officers | Minimum | Performance Shares        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Award vesting period 3 years      
Non-Executive Officers | Maximum | Performance Shares        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Award vesting period 8 years      
Non-Executive Officers | Weighted Average | Performance Shares        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Award vesting period 5 years      
Officer        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Accelerated stock compensation expense   $ 0.6 $ 0.9 $ 1.0
v3.24.0.1
Stock and Other Incentive Plans - Salary Deferral Plan Narrative (Details) - Salary Deferral Plan - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Maximum salary deferral for officers under the plan, percent 50.00%    
Shares issued under the plan (in shares) 31,792 17,381 21,396
Accelerated stock compensation expense $ 0.9 $ 0.9 $ 0.9
Deferral Option One      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Award vesting period 3 years    
Employer matching contribution, percent 30.00%    
Deferral Option Two      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Award vesting period 5 years    
Employer matching contribution, percent 50.00%    
Deferral Option Three      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Award vesting period 8 years    
Employer matching contribution, percent 100.00%    
v3.24.0.1
Stock and Other Incentive Plans - Non-employee Directors Incentive Plan Narrative (Details) - Non-Employee Directors Incentive Plan
$ in Millions
 12 Months Ended
Jun. 05, 2023
USD ($)
director
shares
May 13, 2022
Dec. 31, 2023
USD ($)
shares
Dec. 31, 2022
USD ($)
shares
Dec. 31, 2021
USD ($)
shares
Non Vested Stock Award          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Award vesting period 1 year        
Granted in period | $ $ 0.7        
Granted in period (in shares) | shares 42,768        
LTIP-D units          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Award vesting period 1 year        
Granted in period | $ $ 1.1        
Granted in period (in shares) | shares 57,868        
Restricted Stock and Performance Based Awards | Minimum          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Award vesting period     1 year    
Restricted Stock and Performance Based Awards | Maximum          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Award vesting period     8 years    
Restricted Stock          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Weighted average remaining contractual terms     4 years 9 months 18 days    
Withheld of common stock (in shares) | shares     126,085 137,892 129,987
Director          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Award vesting period   1 year      
Accelerated stock compensation expense | $     $ 2.1 $ 1.5 $ 1.2
Director | Non Vested Stock Award          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Number of directors | director 6        
Director | LTIP-D units          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Number of directors | director 6        
v3.24.0.1
Stock and Other Incentive Plans - 2015 Incentive Plan and related information (Details) - Stock Incentive Plan - USD ($)
$ / shares in Units, $ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Summary of the activity under the incentive plans      
Share-based awards, beginning of year (in shares) 2,090,060 1,562,028 1,766,061
Granted (in shares) 1,164,359 952,407 203,701
Vested (in shares) (403,266) (418,949) (404,777)
Change in awards based on performance assessment (in shares) (205,668) 0 0
Forfeited (in shares) (29,923) (5,426) (2,957)
Share-based awards, end of year (in shares) 2,615,562 2,090,060 1,562,028
Weighted-average grant date fair value of:      
Share-based awards, beginning of year (in dollars per share) $ 30.35 $ 31.10 $ 30.51
Share-based awards granted during the year (in dollars per share) 18.70 29.64 30.86
Share-based awards vested during the years (in dollars per share) 28.38 31.52 28.38
Share-based awards change in performance assessment during the year (in dollars per share) 29.05 0 0
Share-based awards forfeitures during the year (in dollars per share) 31.16 31.48 33.04
Share-based awards, end of year (in dollars per share) $ 25.56 $ 30.35 $ 31.10
Grant date fair value of shares granted during the year $ 22,171 $ 28,225 $ 6,286
v3.24.0.1
Stock and Other Incentive Plans - 401(k) Plan/Employee Stock Purchase Plan Narrative (Details) - USD ($)
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
401(k) Plan      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Defined contribution plan, employer matching contribution, amount of employees gross pay $ 2,800    
Value of matching contribution 1,500,000 $ 1,200,000 $ 700,000
Employee Stock Purchase Plan | Employee Stock Purchase Plan      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Cash received from employees upon exercising options $ 200,000 400,000 800,000
Employee Stock Purchase Plan | Employee Stock Purchase Plan | General and Administrative Expense      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Accelerated stock compensation expense   $ 400,000 $ 400,000
v3.24.0.1
Stock and Other Incentive Plans - Employee Stock Purchase Plan (Details) - Employee Stock Purchase Plan - USD ($)
$ / shares in Units, $ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Stock Options Outstanding:      
Options outstanding, beginning of year (in shares) 340,976 348,514 341,647
Granted (in shares) 0 255,960 253,200
Exercised (in shares) (8,627) (20,246) (30,281)
Forfeited (in shares) (43,737) (102,619) (71,630)
Expired (in shares) (132,999) (140,633) (144,422)
Outstanding, end of period (in shares) 155,613 340,976 348,514
Weighted-average exercise price:      
Options outstanding, beginning of year (in dollars per share) $ 16.38 $ 25.38 $ 24.70
Options granted during the year (in dollars per share) 0 26.89 25.16
Options exercised during the year (in dollars per share) 15.07 20.97 25.03
Options forfeited during the year (in dollars per share) 15.50 21.88 25.45
Options expired during the year (in dollars per share) 16.43 23.36 24.17
Options outstanding, end of year (in dollars per share) 12.98 16.38 25.38
Weighted-average fair value of options granted during the year (calculated as of the grant date) (in dollars per share) $ 0 $ 9.91 $ 9.05
Intrinsic value of options exercised during the year $ 23 $ 75 $ 165
Intrinsic value of options outstanding (calculated as of December 31) $ 401 $ 985 $ 1,997
Exercise prices of options outstanding (calculated as of December 31) (in dollars per share) $ 14.65 $ 16.38 $ 25.91
Weighted-average contractual life of outstanding options (calculated as of December 31, in years) 3 months 18 days 9 months 18 days 9 months 18 days
v3.24.0.1
Stock and Other Incentive Plans - Black-Scholes Options Pricing Model (Details) - Employee Stock Purchase Plan
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Fair value of options issued based on weighted-average assumptions      
Risk-free interest rates 0.00% 0.73% 0.13%
Expected dividend yields 0.00% 3.97% 4.11%
Expected life (in years)   1 year 5 months 8 days 1 year 5 months 4 days
Expected volatility 0.00% 49.00% 48.20%
Expected forfeiture rates 0.00% 85.00% 85.00%
v3.24.0.1
Earnings Per Share - Additional Information (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Class of Stock [Line Items]      
Dilutive effect of forward equity (in shares) 0 0 0
Proceeds from issuance of common stock, adjusted for costs to borrow     $ 23.1
Weighted-average incremental shares of common stock excluded from the computation (in shares)     1,682
Employee Stock Option      
Class of Stock [Line Items]      
Weighted-average incremental shares of common stock excluded from the computation (in shares) 31,997    
Employee Stock Option | Operating Partnership Performance Units      
Class of Stock [Line Items]      
Nonvested shares (in shares) 4,023,679    
At the Market Equity Offering Program      
Class of Stock [Line Items]      
Dilutive effect of forward equity (in shares)     700,000
v3.24.0.1
Earnings Per Share - Schedule of Earnings per Common Share (Details) - USD ($)
$ / shares in Units, $ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Weighted average common shares outstanding      
Weighted average common shares outstanding (in shares) 380,850,967 254,296,810 144,411,835
Non-vested shares (in shares) (1,923,096) (1,940,607) (1,774,669)
Weighted average common shares outstanding - Basic (in shares) 378,927,871 252,356,203 142,637,166
Dilutive effect of forward equity (in shares) 0 0 0
Dilutive effect of OP Units (in shares) 0 1,451,599 0
Dilutive effect of employee stock purchase plan (in shares) 0 65,519 73,062
Weighted average common shares outstanding - diluted (in shares) 378,927,871 253,873,321 142,710,228
Net (loss) income $ (282,083) $ 40,693 $ 66,659
Net loss attributable to non-controlling interest 3,822 204 0
Net (loss) income attributable to common stockholders (278,261) 40,897 66,659
Income allocated to participating securities (2,504) (2,437) (2,154)
Adjustment to loss attributable to non-controlling interest for legally outstanding restricted units (851) 0 0
Net (loss) income applicable to common stockholders - basic (281,616) 38,460 64,505
Net income attributable to OP Units 0 81 0
Net income applicable to common stockholders - diluted $ (281,616) $ 38,541 $ 64,505
Basic earnings per common share - net income (in dollars per share) $ (0.74) $ 0.15 $ 0.45
Diluted earnings per common share- net income (in dollars per share) $ (0.74) $ 0.15 $ 0.45
v3.24.0.1
Commitments and Contingencies - Narrative (Details)
$ in Millions
 12 Months Ended
Dec. 31, 2023
USD ($)
property
Dec. 31, 2022
USD ($)
property
Property, Plant and Equipment [Line Items]    
Number of land parcels held for development | property 17 20
Investment in land held for development $ 59.9 $ 74.3
Letter of Credit    
Property, Plant and Equipment [Line Items]    
Deposits 38.5  
Active Development Properties    
Property, Plant and Equipment [Line Items]    
Construction activity and development properties 69.1  
Redevelopment Properties    
Property, Plant and Equipment [Line Items]    
Construction activity and development properties 20.5  
Completed Develpoment and Redevelopment Properties    
Property, Plant and Equipment [Line Items]    
Construction activity and development properties 22.6  
First and Second Generation Leases | Tenant Improvement Allowances    
Property, Plant and Equipment [Line Items]    
Anticipated amount of investment $ 222.4  
v3.24.0.1
Other Data - Narrative (Details) - USD ($)
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Tax Credit Carryforward [Line Items]      
Number of preferred shares outstanding (in shares) 0 0  
Dividends distributed to preferred shares $ 0    
Legacy HR      
Tax Credit Carryforward [Line Items]      
Estimated aggregate total cost of total assets for federal income tax purposes $ 12,600,000,000 $ 13,000,000,000 $ 5,000,000,000
Legacy HTA      
Tax Credit Carryforward [Line Items]      
Estimated aggregate total cost of total assets for federal income tax purposes     $ 8,200,000,000
v3.24.0.1
Other Data - Characterization of Distributions (Details) - $ / shares
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Tax Treatment of Dividends Pre-Merger Healthcare Trust of America      
Characterization of distributions on common stock      
Ordinary income (in dollars per share) $ 0 $ 0.5862 $ 0.7920
Return of capital (in dollars per share) 0 4.0162 0.4930
Capital gain (in dollars per share) 0 1.2216 0
Common stock distributions (in dollars per share) 0 5.8240 1.2850
Tax Treatment of Dividends Pre-Merger Healthcare Realty      
Characterization of distributions on common stock      
Ordinary income (in dollars per share) 0 0.2655 0.7500
Return of capital (in dollars per share) 0 0.5555 0.3600
Capital gain (in dollars per share) 0 0 0.0964
Common stock distributions (in dollars per share) 0 0.8210 1.2064
Tax Treatment of Dividends Post-Merger Healthcare Realty      
Characterization of distributions on common stock      
Ordinary income (in dollars per share) 0.5482 0.0422 0
Return of capital (in dollars per share) 0.5031 0.2889 0
Capital gain (in dollars per share) 0.1887 0.0879 0
Common stock distributions (in dollars per share) $ 1.2400 $ 0.4190 $ 0
v3.24.0.1
Other Data - State Income Taxes (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
State income tax expense      
Texas gross margins tax $ 1,206 $ 1,693 $ 564
Other 133 151 8
Total state income tax expense 1,339 1,844 572
State income tax payments, net of refunds and collections $ 1,324 $ 1,834 $ 560
v3.24.0.1
Fair Value of Financial Instruments (Details) - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
CARRYING VALUE    
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]    
Notes and bonds payable $ 4,994.9 $ 5,351.8
Real estate notes receivable 173.6 99.6
FAIR VALUE    
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]    
Notes and bonds payable 4,872.7 5,149.6
Real estate notes receivable $ 172.5 $ 99.6
v3.24.0.1
Schedule II - Valuation and Qualifying Accounts (Details) - Accounts receivable allowance - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]      
Balance at beginning of period $ 3,954 $ 654 $ 604
Charged/(Credited) to costs and expenses, additions and deductions 5,119 3,306 72
Charged to other accounts, additions and deductions 0 0 0
Uncollectible accounts written-off 669 6 22
Balance at end of period $ 8,404 $ 3,954 $ 654
v3.24.0.1
Schedule III - Real Estate and Accumulated Depreciation (Details)
$ in Thousands
Dec. 31, 2023
USD ($)
property
Dec. 31, 2022
USD ($)
Dec. 31, 2021
USD ($)
Dec. 31, 2020
USD ($)
Summary of real estate properties        
NUMBER OF PROPERTIES | property 655      
Buildings, Improvements, Lease Intangibles, and CIP        
Gross real estate asset, Total $ 13,408,713 $ 14,076,475 $ 5,104,942 $ 4,670,226
Accumulated depreciation $ 2,227,766 $ 1,645,271 $ 1,338,743 $ 1,249,679
Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 656      
Land        
INITIAL INVESTMENT $ 1,136,297      
COST CAPITALIZED subsequent to acquisition 208,818      
TOTAL 1,345,115      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 10,677,434      
COST CAPITALIZED subsequent to acquisition 1,048,037      
TOTAL 11,725,471      
PERSONAL PROPERTY 12,718      
Gross real estate asset, Total 13,083,304      
Accumulated depreciation 2,227,766      
Encumbrances $ 70,534      
Land held for develop.        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 0      
Land        
INITIAL INVESTMENT $ 59,871      
COST CAPITALIZED subsequent to acquisition 0      
TOTAL 59,871      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 0      
COST CAPITALIZED subsequent to acquisition 0      
TOTAL 0      
PERSONAL PROPERTY 0      
Gross real estate asset, Total 59,871      
Accumulated depreciation      
Encumbrances $ 0      
Construction in progress        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 0      
Land        
INITIAL INVESTMENT $ 0      
COST CAPITALIZED subsequent to acquisition 0      
TOTAL 0      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 60,727      
COST CAPITALIZED subsequent to acquisition 0      
TOTAL 60,727      
PERSONAL PROPERTY 0      
Gross real estate asset, Total 60,727      
Accumulated depreciation 0      
Encumbrances $ 0      
Financing lease right-of-use assets        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 0      
Land        
INITIAL INVESTMENT $ 0      
COST CAPITALIZED subsequent to acquisition 0      
TOTAL 0      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 0      
COST CAPITALIZED subsequent to acquisition 0      
TOTAL 0      
PERSONAL PROPERTY 0      
Gross real estate asset, Total 82,209      
Accumulated depreciation 0      
Encumbrances $ 0      
Investment in financing receivables, net        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 0      
Land        
INITIAL INVESTMENT $ 0      
COST CAPITALIZED subsequent to acquisition 0      
TOTAL 0      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 0      
COST CAPITALIZED subsequent to acquisition 0      
TOTAL 0      
PERSONAL PROPERTY 0      
Gross real estate asset, Total 122,602      
Accumulated depreciation 0      
Encumbrances $ 0      
Total properties        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 656      
Land        
INITIAL INVESTMENT $ 1,196,168      
COST CAPITALIZED subsequent to acquisition 208,818      
TOTAL 1,404,986      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 10,738,161      
COST CAPITALIZED subsequent to acquisition 1,048,037      
TOTAL 11,786,198      
PERSONAL PROPERTY 12,718      
Gross real estate asset, Total 13,408,713      
Accumulated depreciation 2,227,766      
Encumbrances $ 70,534      
Dallas, TX | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 43      
Land        
INITIAL INVESTMENT $ 72,772      
COST CAPITALIZED subsequent to acquisition 17,396      
TOTAL 90,168      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 925,170      
COST CAPITALIZED subsequent to acquisition 147,779      
TOTAL 1,072,949      
PERSONAL PROPERTY 550      
Gross real estate asset, Total 1,163,667      
Accumulated depreciation 221,375      
Encumbrances $ 0      
Houston, TX | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 31      
Land        
INITIAL INVESTMENT $ 63,942      
COST CAPITALIZED subsequent to acquisition 13,018      
TOTAL 76,960      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 642,626      
COST CAPITALIZED subsequent to acquisition 32,557      
TOTAL 675,183      
PERSONAL PROPERTY 57      
Gross real estate asset, Total 752,200      
Accumulated depreciation 97,793      
Encumbrances $ 0      
Seattle, WA | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 29      
Land        
INITIAL INVESTMENT $ 59,412      
COST CAPITALIZED subsequent to acquisition 4,883      
TOTAL 64,295      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 551,328      
COST CAPITALIZED subsequent to acquisition 90,031      
TOTAL 641,359      
PERSONAL PROPERTY 715      
Gross real estate asset, Total 706,369      
Accumulated depreciation 186,903      
Encumbrances $ 0      
Denver, CO | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 33      
Land        
INITIAL INVESTMENT $ 62,172      
COST CAPITALIZED subsequent to acquisition 14,526      
TOTAL 76,698      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 488,764      
COST CAPITALIZED subsequent to acquisition 56,499      
TOTAL 545,263      
PERSONAL PROPERTY 610      
Gross real estate asset, Total 622,571      
Accumulated depreciation 94,906      
Encumbrances $ 0      
Charlotte, NC | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 32      
Land        
INITIAL INVESTMENT $ 28,119      
COST CAPITALIZED subsequent to acquisition 7,345      
TOTAL 35,464      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 451,251      
COST CAPITALIZED subsequent to acquisition 39,182      
TOTAL 490,433      
PERSONAL PROPERTY 110      
Gross real estate asset, Total 526,007      
Accumulated depreciation 116,578      
Encumbrances $ 0      
Phoenix, AZ | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 35      
Land        
INITIAL INVESTMENT $ 12,205      
COST CAPITALIZED subsequent to acquisition 8,057      
TOTAL 20,262      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 447,753      
COST CAPITALIZED subsequent to acquisition 26,436      
TOTAL 474,189      
PERSONAL PROPERTY 425      
Gross real estate asset, Total 494,876      
Accumulated depreciation 59,449      
Encumbrances $ 0      
Atlanta, GA | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 27      
Land        
INITIAL INVESTMENT $ 40,227      
COST CAPITALIZED subsequent to acquisition 8,868      
TOTAL 49,095      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 429,729      
COST CAPITALIZED subsequent to acquisition 15,587      
TOTAL 445,316      
PERSONAL PROPERTY 100      
Gross real estate asset, Total 494,511      
Accumulated depreciation 79,569      
Encumbrances $ 5,572      
Boston, MA | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 17      
Land        
INITIAL INVESTMENT $ 117,857      
COST CAPITALIZED subsequent to acquisition 9,590      
TOTAL 127,447      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 336,670      
COST CAPITALIZED subsequent to acquisition 4,255      
TOTAL 340,925      
PERSONAL PROPERTY 14      
Gross real estate asset, Total 468,386      
Accumulated depreciation 37,569      
Encumbrances $ 0      
Raleigh, NC | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 28      
Land        
INITIAL INVESTMENT $ 44,530      
COST CAPITALIZED subsequent to acquisition 12,090      
TOTAL 56,620      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 393,245      
COST CAPITALIZED subsequent to acquisition 15,098      
TOTAL 408,343      
PERSONAL PROPERTY 9      
Gross real estate asset, Total 464,972      
Accumulated depreciation 38,879      
Encumbrances $ 0      
Nashville, TN | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 13      
Land        
INITIAL INVESTMENT $ 40,673      
COST CAPITALIZED subsequent to acquisition 2,674      
TOTAL 43,347      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 309,400      
COST CAPITALIZED subsequent to acquisition 97,997      
TOTAL 407,397      
PERSONAL PROPERTY 7,427      
Gross real estate asset, Total 458,171      
Accumulated depreciation 115,979      
Encumbrances $ 7,841      
Los Angeles, CA | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 20      
Land        
INITIAL INVESTMENT $ 68,225      
COST CAPITALIZED subsequent to acquisition 3,861      
TOTAL 72,086      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 305,221      
COST CAPITALIZED subsequent to acquisition 71,590      
TOTAL 376,811      
PERSONAL PROPERTY 453      
Gross real estate asset, Total 449,350      
Accumulated depreciation 145,875      
Encumbrances $ 28,870      
Miami, FL | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 19      
Land        
INITIAL INVESTMENT $ 47,092      
COST CAPITALIZED subsequent to acquisition 6,902      
TOTAL 53,994      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 325,814      
COST CAPITALIZED subsequent to acquisition 35,543      
TOTAL 361,357      
PERSONAL PROPERTY 178      
Gross real estate asset, Total 415,529      
Accumulated depreciation 74,470      
Encumbrances $ 0      
Tampa, FL | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 19      
Land        
INITIAL INVESTMENT $ 23,491      
COST CAPITALIZED subsequent to acquisition 7,631      
TOTAL 31,122      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 363,588      
COST CAPITALIZED subsequent to acquisition 15,729      
TOTAL 379,317      
PERSONAL PROPERTY 33      
Gross real estate asset, Total 410,472      
Accumulated depreciation 36,726      
Encumbrances $ 0      
Indianapolis, IN | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 36      
Land        
INITIAL INVESTMENT $ 45,914      
COST CAPITALIZED subsequent to acquisition 8,985      
TOTAL 54,899      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 308,044      
COST CAPITALIZED subsequent to acquisition 10,542      
TOTAL 318,586      
PERSONAL PROPERTY 13      
Gross real estate asset, Total 373,498      
Accumulated depreciation 42,273      
Encumbrances $ 0      
Austin, TX | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 13      
Land        
INITIAL INVESTMENT $ 22,178      
COST CAPITALIZED subsequent to acquisition 4,885      
TOTAL 27,063      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 261,585      
COST CAPITALIZED subsequent to acquisition 31,211      
TOTAL 292,796      
PERSONAL PROPERTY 142      
Gross real estate asset, Total 320,001      
Accumulated depreciation 55,891      
Encumbrances $ 0      
New York, NY | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 14      
Land        
INITIAL INVESTMENT $ 58,719      
COST CAPITALIZED subsequent to acquisition 5,683      
TOTAL 64,402      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 192,029      
COST CAPITALIZED subsequent to acquisition 4,705      
TOTAL 196,734      
PERSONAL PROPERTY 0      
Gross real estate asset, Total 261,136      
Accumulated depreciation 15,887      
Encumbrances $ 0      
Chicago, IL | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 6      
Land        
INITIAL INVESTMENT $ 11,250      
COST CAPITALIZED subsequent to acquisition 2,554      
TOTAL 13,804      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 212,170      
COST CAPITALIZED subsequent to acquisition 17,314      
TOTAL 229,484      
PERSONAL PROPERTY 81      
Gross real estate asset, Total 243,369      
Accumulated depreciation 39,671      
Encumbrances $ 0      
Memphis, TN | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 11      
Land        
INITIAL INVESTMENT $ 12,253      
COST CAPITALIZED subsequent to acquisition 1,648      
TOTAL 13,901      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 118,427      
COST CAPITALIZED subsequent to acquisition 75,725      
TOTAL 194,152      
PERSONAL PROPERTY 322      
Gross real estate asset, Total 208,375      
Accumulated depreciation 71,813      
Encumbrances $ 0      
Honolulu, HI | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 6      
Land        
INITIAL INVESTMENT $ 8,314      
COST CAPITALIZED subsequent to acquisition 1,213      
TOTAL 9,527      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 147,422      
COST CAPITALIZED subsequent to acquisition 47,669      
TOTAL 195,091      
PERSONAL PROPERTY 169      
Gross real estate asset, Total 204,787      
Accumulated depreciation 61,575      
Encumbrances $ 0      
Hartford, CT | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 30      
Land        
INITIAL INVESTMENT $ 24,167      
COST CAPITALIZED subsequent to acquisition 5,214      
TOTAL 29,381      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 159,178      
COST CAPITALIZED subsequent to acquisition 1,383      
TOTAL 160,561      
PERSONAL PROPERTY 0      
Gross real estate asset, Total 189,942      
Accumulated depreciation 15,883      
Encumbrances $ 0      
Other (49 markets) | Real estate acquired        
Summary of real estate properties        
NUMBER OF PROPERTIES | property 194      
Land        
INITIAL INVESTMENT $ 272,785      
COST CAPITALIZED subsequent to acquisition 61,795      
TOTAL 334,580      
Buildings, Improvements, Lease Intangibles, and CIP        
INITIAL INVESTMENT 3,308,020      
COST CAPITALIZED subsequent to acquisition 211,205      
TOTAL 3,519,225      
PERSONAL PROPERTY 1,310      
Gross real estate asset, Total 3,855,115      
Accumulated depreciation 618,702      
Encumbrances $ 28,251      
v3.24.0.1
Schedule III - Real Estate and Accumulated Depreciation - Narrative (Details)
$ in Thousands
Dec. 31, 2023
USD ($)
property
Dec. 31, 2022
USD ($)
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]    
Federal income tax purposes $ 12,600,000  
Issuance costs 3,867 $ 5,977
Mortgage Notes Payable | Mortgage Notes    
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]    
Unamortized premium 285 486
Unaccreted discount 237 38
Issuance costs $ 266 $ 323
Minimum | Buildings and improvements    
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]    
Asset estimated useful life 3 years 3 months 18 days  
Minimum | Lease intangibles    
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]    
Asset estimated useful life 1 year  
Minimum | Personal Property    
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]    
Asset estimated useful life 3 years  
Minimum | Land improvements    
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]    
Asset estimated useful life 2 years  
Maximum | Buildings and improvements    
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]    
Asset estimated useful life 49 years  
Maximum | Lease intangibles    
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]    
Asset estimated useful life 99 years  
Maximum | Personal Property    
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]    
Asset estimated useful life 20 years  
Maximum | Land improvements    
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]    
Asset estimated useful life 39 years  
Asset Held-for-sale    
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]    
Number of real estate assets held for sale | property 1  
Amount of ​assets ​held for ​sale $ 9,600  
v3.24.0.1
Schedule III - Real Estate and Accumulated Depreciation - Rollforward (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Reconciliation of Carrying Amount of Real Estate Investments [Roll Forward]      
Beginning Balance, Total Property $ 14,076,475 $ 5,104,942 $ 4,670,226
Retirement/dispositions      
Ending Balance, Total Property 13,408,713 14,076,475 5,104,942
Reconciliation of Real Estate Accumulated Depreciation [Roll Forward]      
Beginning Balance, Accumulated Depreciation 1,645,271 1,338,743 1,249,679
Retirement/dispositions      
Ending Balance, Accumulated Depreciation 2,227,766 1,645,271 1,338,743
Real estate acquired      
Additions during the period      
Total Property 54,024 9,780,070 374,912
Retirement/dispositions      
TOTAL PROPERTY (800,958) (1,098,702) (247,880)
Ending Balance, Total Property 13,083,304    
Additions during the period      
ACCUMULATED DEPRECIATION 2,322 241,285 7,668
Retirement/dispositions      
Accumulated Depreciation (87,896) (140,696) (110,479)
Ending Balance, Accumulated Depreciation 2,227,766    
Other improvements      
Additions during the period      
Total Property 28,521 219,783 103,035
Additions during the period      
ACCUMULATED DEPRECIATION 668,069 205,703 191,875
Land held for development      
Additions during the period      
Total Property 49,416 2,021
Additions during the period      
ACCUMULATED DEPRECIATION 0 0 0
Construction in progress      
Additions during the period      
Total Property 49,901 31,586 3,974
Retirement/dispositions      
Ending Balance, Total Property 60,727    
Additions during the period      
ACCUMULATED DEPRECIATION 0 0 0
Retirement/dispositions      
Ending Balance, Accumulated Depreciation 0    
Investment in financing receivables, net      
Additions during the period      
Total Property 2,366   186,745
Total Property Reclassified   (66,509)  
Additions during the period      
ACCUMULATED DEPRECIATION 0 0 0
Financing lease right-of-use assets      
Additions during the period      
Total Property   52,249 11,909
Total Property Reclassified (1,616)    
Retirement/dispositions      
Ending Balance, Total Property 82,209    
Additions during the period      
ACCUMULATED DEPRECIATION 0 0 0
Retirement/dispositions      
Ending Balance, Accumulated Depreciation 0    
Corporate Properties      
Additions during the period      
Total Property 0 3,640 0
Additions during the period      
ACCUMULATED DEPRECIATION $ 0 $ 236 $ 0
v3.24.0.1
Schedule IV - Mortgage Loans on Real Estate Assets (Details) - USD ($)
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]      
Prior Liens $ 0    
Face Amount 182,125,000    
Carrying Amount 173,614,000    
Principal Amount of Loans Subject to Delinquent Principal or Interest 54,119,000    
SEC Schedule, 12-29, Real Estate Companies, Investment in Movement in Mortgage Loans on Real Estate [Roll Forward]      
Balance as of the beginning of the year 99,643,000 $ 0 $ 0
Additions:      
Fair value real estate notes assumed 0 74,819,000 0
New real estate notes 58,700,000 23,325,000 0
Draws on existing real estate notes 19,103,000
Capitalized interest 0 1,499,000 0
Accretion of fees and other items 1,364,000 0 0
Deductions:      
Collection of real estate loans 0 0 0
Deferred fees and other items 0 0 0
Allowance for credit loss (5,196,000)
Balance as of the end of the year $ 173,614,000 $ 99,643,000 $ 0
Texas | Medical Real Estate, Maturing in July 2024      
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]      
Interest rate 7.00%    
Prior Liens $ 0    
Face Amount 31,150,000    
Carrying Amount 31,150,000    
Principal Amount of Loans Subject to Delinquent Principal or Interest $ 0    
Texas | Property 1      
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]      
Interest rate 8.00%    
Prior Liens $ 0    
Face Amount 54,119,000    
Carrying Amount 45,856,000    
Principal Amount of Loans Subject to Delinquent Principal or Interest $ 54,119,000    
North Carolina | Medical Real Estate, Maturing in December 2024      
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]      
Interest rate 8.00%    
Prior Liens $ 0    
Face Amount 6,000,000    
Carrying Amount 5,796,000    
Principal Amount of Loans Subject to Delinquent Principal or Interest    
Florida | Medical Real Estate Maturing in February 2026      
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]      
Interest rate 6.00%    
Prior Liens $ 0    
Face Amount 32,156,000    
Carrying Amount 32,112,000    
Principal Amount of Loans Subject to Delinquent Principal or Interest 0    
Construction loan, maximum $ 65,000,000    
Florida | Medical Real Estate, Maturing in December 2026      
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]      
Interest rate 9.00%    
Prior Liens $ 0    
Face Amount 7,700,000    
Carrying Amount 7,700,000    
Principal Amount of Loans Subject to Delinquent Principal or Interest 0    
Monthly installment payments of principal and interest amount $ 152,069    
California | Medical Real Estate, Maturing in March 2026      
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]      
Interest rate 6.00%    
Prior Liens $ 0    
Face Amount 45,000,000    
Carrying Amount 45,000,000    
Principal Amount of Loans Subject to Delinquent Principal or Interest $ 0    
Arizona | Property 2      
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]      
Interest rate 9.00%    
Prior Liens $ 0    
Face Amount 6,000,000    
Carrying Amount 6,000,000    
Principal Amount of Loans Subject to Delinquent Principal or Interest $ 0