CARETRUST REIT, INC., 10-K filed on 2/16/2022
Annual Report
v3.22.0.1
Cover - USD ($)
$ in Billions
12 Months Ended
Dec. 31, 2021
Feb. 15, 2022
Jun. 30, 2021
Cover [Abstract]      
Document Type 10-K    
Document Annual Report true    
Document Period End Date Dec. 31, 2021    
Current Fiscal Year End Date --12-31    
Document Transition Report false    
Entity File Number 001-36181    
Entity Registrant Name CareTrust REIT, Inc.    
Entity Incorporation, State or Country Code MD    
Entity Tax Identification Number 46-3999490    
Entity Address, Address Line One 905 Calle Amanecer    
Entity Address, Address Line Two Suite 300    
Entity Address, City or Town San Clemente    
Entity Address, State or Province CA    
Entity Address, Postal Zip Code 92673    
City Area Code 949    
Local Phone Number 542-3130    
Title of 12(b) Security Common Stock, par value $0.01 per share    
Trading Symbol CTRE    
Security Exchange Name NASDAQ    
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    
Entity Shell Company false    
Entity Public Float     $ 2.2
Entity Common Stock, Shares Outstanding   97,049,319  
Documents Incorporated by Reference Portions of the definitive Proxy Statement for the registrant’s 2022 Annual Meeting of Stockholders, which will be filed with the Securities and Exchange Commission within 120 days after the end of fiscal year 2021, are incorporated by reference into Part III of this Report.    
Entity Central Index Key 0001590717    
Document Fiscal Year Focus 2021    
Document Fiscal Period Focus FY    
Amendment Flag false    
v3.22.0.1
Audit Information
12 Months Ended
Dec. 31, 2021
Audit Information [Abstract]  
Auditor Name DELOITTE & TOUCHE LLP
Auditor Location Costa Mesa, California
Auditor Firm ID 34
v3.22.0.1
Consolidated Balance Sheets - USD ($)
$ in Thousands
Dec. 31, 2021
Dec. 31, 2020
Assets:    
Real estate investments, net $ 1,589,971 $ 1,448,099
Other real estate investments 15,155 15,000
Assets held for sale, net 4,835 7,226
Cash and cash equivalents 19,895 18,919
Accounts and other receivables 2,418 1,823
Prepaid expenses and other assets, net 7,512 10,450
Deferred financing costs, net 1,062 2,042
Total assets 1,640,848 1,503,559
Liabilities and Equity:    
Senior unsecured notes payable, net 394,262 296,669
Senior unsecured term loan, net 199,136 198,925
Unsecured revolving credit facility 80,000 50,000
Accounts payable, accrued liabilities and deferred rent liabilities 25,408 19,572
Dividends payable 26,285 24,251
Total liabilities 725,091 589,417
Commitments and contingencies (Note 10)
Equity:    
Preferred stock, $0.01 par value; 100,000,000 shares authorized, 0 shares issued and outstanding as of December 31, 2021 and December 31, 2020 0 0
Common stock, $0.01 par value; 500,000,000 shares authorized, 96,296,673 and 95,215,797 shares issued and outstanding as of December 31, 2021 and December 31, 2020, respectively 963 952
Additional paid-in capital 1,196,839 1,164,402
Cumulative distributions in excess of earnings (282,045) (251,212)
Total equity 915,757 914,142
Total liabilities and equity $ 1,640,848 $ 1,503,559
v3.22.0.1
Consolidated Balance Sheets (Parenthetical) - $ / shares
Dec. 31, 2021
Dec. 31, 2020
Statement of Financial Position [Abstract]    
Preferred stock, par value (usd per share) $ 0.01 $ 0.01
Preferred stock, authorized (shares) 100,000,000 100,000,000
Preferred stock, issued (shares) 0 0
Preferred stock, outstanding (shares) 0 0
Common stock, par value (usd per share) $ 0.01 $ 0.01
Common stock, authorized (shares) 500,000,000 500,000,000
Common stock, issued (shares) 96,296,673 95,215,797
Common stock, outstanding (shares) 96,296,673 95,215,797
v3.22.0.1
Consolidated Income Statements - USD ($)
12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Revenues:      
Rental income $ 190,195,000 $ 173,612,000 $ 155,667,000
Independent living facilities 0 2,077,000 3,389,000
Interest and other income 2,156,000 2,643,000 4,345,000
Total revenues 192,351,000 178,332,000 163,401,000
Expenses:      
Depreciation and amortization 55,340,000 52,760,000 51,822,000
Interest expense 23,677,000 23,661,000 28,125,000
Property taxes 3,574,000 2,836,000 3,048,000
Independent living facilities 0 1,869,000 2,898,000
Impairment of real estate investments 0 0 16,692,000
Provision for loan losses 0 0 1,076,000
General and administrative 26,874,000 16,302,000 15,158,000
Total expenses 109,465,000 97,428,000 118,819,000
Other (loss) income:      
Loss on extinguishment of debt (10,827,000) 0 0
(Loss) gain on sale of real estate (77,000) (37,000) 1,777,000
Total other (loss) income (10,904,000) (37,000) 1,777,000
Net income $ 71,982,000 $ 80,867,000 $ 46,359,000
Earnings per common share:      
Basic (usd per share) $ 0.74 $ 0.85 $ 0.49
Diluted (usd per share) $ 0.74 $ 0.85 $ 0.49
Weighted-average number of common shares:      
Basic (shares) 96,017,000 95,200,000 93,088,000
Diluted (shares) 96,092,000 95,207,000 93,098,000
Independent living facilities, revenue services Health Care, Resident Service [Member] Health Care, Resident Service [Member] Health Care, Resident Service [Member]
Independent living facilities, cost of services Health Care, Resident Service [Member] Health Care, Resident Service [Member] Health Care, Resident Service [Member]
v3.22.0.1
Consolidated Statements of Equity - USD ($)
$ in Thousands
Total
Common Stock
Additional Paid-in Capital
Cumulative Distributions in Excess of Earnings
Beginning balance at Dec. 31, 2018 $ 768,247 $ 859 $ 965,578 $ (198,190)
Beginning balance (shares) at Dec. 31, 2018   85,867,044    
Increase (Decrease) in Stockholders' Equity [Roll Forward]        
Issuance of common stock, net 195,924 $ 91 195,833  
Issuance of common stock, net (shares)   9,100,250    
Vesting of restricted common stock, net of shares withheld for employee taxes (2,524) $ 1 (2,525)  
Vesting of restricted common stock, net of shares withheld for employee taxes (shares)   135,976    
Amortization of stock-based compensation 4,104   4,104  
Common dividends ($1.06, $1.00 and $0.90 per share for the years ended 2021, 2020 and 2019, respectively) (84,519)     (84,519)
Net income 46,359     46,359
Ending balance at Dec. 31, 2019 927,591 $ 951 1,162,990 (236,350)
Ending balance (shares) at Dec. 31, 2019   95,103,270    
Increase (Decrease) in Stockholders' Equity [Roll Forward]        
Issuance of common stock, net (404)   (404)  
Vesting of restricted common stock, net of shares withheld for employee taxes (1,995) $ 1 (1,996)  
Vesting of restricted common stock, net of shares withheld for employee taxes (shares)   112,527    
Amortization of stock-based compensation 3,812   3,812  
Common dividends ($1.06, $1.00 and $0.90 per share for the years ended 2021, 2020 and 2019, respectively) (95,729)     (95,729)
Net income 80,867     80,867
Ending balance at Dec. 31, 2020 914,142 $ 952 1,164,402 (251,212)
Ending balance (shares) at Dec. 31, 2020   95,215,797    
Increase (Decrease) in Stockholders' Equity [Roll Forward]        
Issuance of common stock, net 22,946 $ 10 22,936  
Issuance of common stock, net (shares)   990,000    
Vesting of restricted common stock, net of shares withheld for employee taxes (1,330) $ 1 (1,331)  
Vesting of restricted common stock, net of shares withheld for employee taxes (shares)   90,876    
Amortization of stock-based compensation 10,832   10,832  
Common dividends ($1.06, $1.00 and $0.90 per share for the years ended 2021, 2020 and 2019, respectively) (102,815)     (102,815)
Net income 71,982     71,982
Ending balance at Dec. 31, 2021 $ 915,757 $ 963 $ 1,196,839 $ (282,045)
Ending balance (shares) at Dec. 31, 2021   96,296,673    
v3.22.0.1
Consolidated Statements of Equity (Parenthetical) - $ / shares
3 Months Ended 12 Months Ended
Dec. 31, 2021
Sep. 30, 2021
Jun. 30, 2021
Mar. 31, 2021
Dec. 31, 2020
Sep. 30, 2020
Jun. 30, 2020
Mar. 31, 2020
Dec. 31, 2019
Sep. 30, 2019
Jun. 30, 2019
Mar. 31, 2019
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Statement of Stockholders' Equity [Abstract]                              
Common dividend (usd per share) $ 0.265 $ 0.265 $ 0.265 $ 0.265 $ 0.25 $ 0.25 $ 0.25 $ 0.25 $ 0.225 $ 0.225 $ 0.225 $ 0.225 $ 1.06 $ 1.00 $ 0.90
v3.22.0.1
Consolidated Statements of Cash Flows - USD ($)
12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Cash flows from operating activities:      
Net income $ 71,982,000 $ 80,867,000 $ 46,359,000
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization (including below-market ground leases) 55,394,000 52,819,000 51,866,000
Amortization of deferred financing costs 2,052,000 1,950,000 2,003,000
Loss on extinguishment of debt 10,827,000 0 0
Amortization of stock-based compensation 10,832,000 3,790,000 4,104,000
Straight-line rental income (32,000) (77,000) (1,385,000)
Adjustment for collectibility of rental income 0 0 11,774,000
Noncash interest income (155,000) 0 (797,000)
Loss (gain) on sale of real estate 77,000 37,000 (1,777,000)
Interest income distribution from other real estate investment 0 1,346,000 463,000
Impairment of real estate investments 0 0 16,692,000
Provision for loan losses 0 0 1,076,000
Change in operating assets and liabilities:      
Accounts and other receivables (562,000) 825,000 (6,283,000)
Prepaid expenses and other assets, net 399,000 387,000 (495,000)
Accounts payable, accrued liabilities and deferred rent liabilities 6,057,000 3,791,000 2,695,000
Net cash provided by operating activities 156,871,000 145,735,000 126,295,000
Cash flows from investing activities:      
Acquisitions of real estate, net of deposits applied (192,718,000) (89,650,000) (321,458,000)
Purchases of equipment, furniture and fixtures and improvements to real estate (6,013,000) (8,297,000) (6,289,000)
Investment in real estate mortgage and other loans receivable (1,253,000) (30,498,000) (18,246,000)
Principal payments received on real estate mortgage and other loans receivable 393,000 80,928,000 24,283,000
Repayment of other real estate investment 0 2,327,000 2,204,000
Escrow deposits for potential acquisitions of real estate 0 (3,000,000) 0
Net proceeds from sales of real estate 6,958,000 6,608,000 3,499,000
Net cash used in investing activities (192,633,000) (41,582,000) (316,007,000)
Cash flows from financing activities:      
Proceeds from (costs paid for) the issuance of common stock, net 22,946,000   195,924,000
Proceeds from (costs paid for) the issuance of common stock, net   (404,000)  
Proceeds from the issuance of senior unsecured notes payable 400,000,000 0 0
Proceeds from the issuance of senior unsecured term loan 0 0 200,000,000
Borrowings under unsecured revolving credit facility 220,000,000 65,000,000 243,000,000
Payments on senior unsecured notes payable (300,000,000) 0 0
Payments on senior unsecured term loan 0 0 (100,000,000)
Payments on unsecured revolving credit facility (190,000,000) (75,000,000) (278,000,000)
Payments on debt extinguishment and deferred financing costs (14,095,000) 0 (4,534,000)
Net-settle adjustment on restricted stock (1,331,000) (1,996,000) (2,524,000)
Dividends paid on common stock (100,782,000) (93,161,000) (80,619,000)
Net cash provided by (used in) financing activities 36,738,000 (105,561,000) 173,247,000
Net increase (decrease) in cash and cash equivalents 976,000 (1,408,000) (16,465,000)
Cash and cash equivalents as of the beginning of period 18,919,000 20,327,000 36,792,000
Cash and cash equivalents as of the end of period 19,895,000 18,919,000 20,327,000
Supplemental disclosures of cash flow information:      
Interest paid 22,838,000 21,691,000 26,005,000
Supplemental schedule of noncash investing and financing activities:      
Increase in dividends payable 2,033,000 2,568,000 3,900,000
Right-of-use asset obtained in exchange for new operating lease obligation 0 599,000 1,010,000
Transfer of pre-acquisition costs to acquired assets 358,000 168,000 242,000
Sale of real estate settled with notes receivable $ 0 $ 32,400,000 $ 27,500,000
v3.22.0.1
Organization
12 Months Ended
Dec. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Organization ORGANIZATION
Description of Business—CareTrust REIT, Inc.’s (“CareTrust REIT” or the “Company”) primary business consists of acquiring, financing, developing and owning real property to be leased to third-party tenants in the healthcare sector. As of December 31, 2021, the Company owned and leased to independent operators, 227 skilled nursing, multi-service campuses, assisted living and independent living facilities consisting of 23,650 operational beds and units located in 29 states with the highest concentration of properties by rental income located in California, Texas, Louisiana, Idaho and Arizona. As of December 31, 2021, the Company also had other real estate investments consisting of one mezzanine loan receivable with a carrying value of $15.2 million.
COVID-19—The COVID-19 pandemic led governments and other authorities around the world, including federal, state and local authorities in the United States, to impose measures intended to reduce its spread, including restrictions on freedom of movement and business operations such as travel bans, border closings, business limitations and closures (subject to exceptions for essential operations and businesses), quarantines and shelter-in-place orders. Although most of these governmental restrictions have since been lifted or scaled back, resurgences of COVID-19 and the emergence of new variants thereof have resulted in the reimposition of certain restrictions and requirements, including restrictions imposed on unvaccinated individuals and employee vaccine mandates, and may lead to other restrictions and requirements being reimplemented in response to efforts to reduce the spread of COVID-19. Given the dynamic nature of these circumstances and the related adverse impact these restrictions have had, and may continue to have, on the economy generally, the Company’s business, results of operations and financial condition may be adversely impacted by the COVID-19 pandemic.
The duration and extent of the COVID-19 pandemic’s effect on the Company’s operational and financial performance, and the operational and financial performance of the Company’s tenants, will depend on future developments, which are highly uncertain and cannot be predicted at this time, including the rate of public acceptance and usage of vaccines and the effectiveness of vaccines in limiting the spread of COVID-19 and its variants, resurgences of COVID-19 and, in particular, new and more contagious and/or vaccine resistant variants, actions taken to contain the spread of COVID-19 and how quickly and to what extent normal economic and operating conditions can resume. The adverse impact of the COVID-19 pandemic on the Company’s business, results of operations and financial condition could be material.
v3.22.0.1
Summary of Significant Accounting Policies
12 Months Ended
Dec. 31, 2021
Accounting Policies [Abstract]  
Summary of Significant Accounting Policies SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Basis of Presentation—The accompanying consolidated financial statements of the Company reflect, for all periods presented, the historical financial position, results of operations and cash flows of the Company and its wholly-owned subsidiaries prepared in accordance with accounting principles generally accepted in the United States (“GAAP”). All intercompany transactions and account balances within the Company have been eliminated.
Lessor Accounting—The Company recognizes lease revenue in accordance with Accounting Standards Codification (“ASC”) 842, Leases. The Company’s lease agreements typically contain annual escalators based on the percentage change in the Consumer Price Index which are accounted for as variable lease payments in the period in which the change occurs. For lease agreements that contain fixed rent escalators, the Company generally recognizes lease revenue on a straight-line basis of accounting. The Company generates revenues primarily by leasing healthcare-related properties to healthcare operators in triple-net lease arrangements, under which the tenant is solely responsible for the costs related to the property. Tenant reimbursements related to property taxes and insurance paid by the lessee directly to a third party on behalf of a lessor are required to be excluded from variable payments and from recognition in the lessor’s income statements. Otherwise, tenant recoveries for taxes and insurance are classified as additional rental revenues recognized by the lessor on a gross basis in its income statements.
The Company’s assessment of collectibility of its tenant receivables includes a binary assessment of whether or not substantially all of the amounts due under a tenant’s lease agreement are probable of collection. The Company considers the operator’s performance and anticipated trends, payment history, and the existence and creditworthiness of guarantees, among other factors, in making this determination. For such leases that are deemed probable of collection, revenue continues to be recorded on a straight-line basis over the lease term, if applicable. For such leases that are deemed not probable of collection, revenue is recorded as the lesser of (i) the amount which would be recognized on a straight-line basis or (ii) cash that has been received from the tenant, with any tenant and deferred rent receivable balances charged as a direct write-off against rental income in the period of the change in the collectibility determination. Such write-offs and recoveries are recorded as decreases
or increases through rental income on the Company’s consolidated income statements. For the year ended December 31, 2021, the Company did not record any recovery adjustments or write-off adjustments to rental income. For the year ended December 31, 2020, the Company recorded recovery adjustments of $1.0 million and did not recognize any write-off adjustments to rental income. For the year ended December 31, 2019, the Company recorded $11.8 million of write-off adjustments to rental income related to rental income recognized in prior periods. See Note 3, Real Estate Investments, Net for further detail.
Estimates and Assumptions—The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting periods. Management believes that the assumptions and estimates used in preparation of the underlying consolidated financial statements are reasonable. Actual results, however, could differ from those estimates and assumptions. 
 
Real Estate Acquisition Valuation— In accordance with ASC 805, Business Combinations, the Company’s acquisitions of real estate investments generally do not meet the definition of a business, and are treated as asset acquisitions. The assets acquired and liabilities assumed are measured at their acquisition date relative fair values. Acquisition costs are capitalized as incurred. The Company allocates the acquisition costs to the tangible assets, identifiable intangible assets/liabilities and assumed liabilities on a relative fair value basis. The Company assesses fair value based on available market information, such as capitalization and discount rates, comparable sale transactions and relevant per square foot or unit cost information. A real estate asset’s fair value may be determined utilizing cash flow projections that incorporate such market information. Estimates of future cash flows are based on a number of factors including historical operating results, known and anticipated trends, as well as market and economic conditions. The fair value of tangible assets of an acquired property is based on the value of the property as if it is vacant.

As part of the Company’s real estate acquisitions, the Company may commit to provide contingent payments to a seller or lessee (e.g., an earn-out payable upon the applicable property achieving certain financial metrics). Typically, when the contingent payments are funded, cash rent is increased by the amount funded multiplied by a rate stipulated in the agreement. Generally, if the contingent payment is an earn-out provided to the seller, the payment is capitalized to the property’s basis when earn-out becomes probable and estimable. If the contingent payment is an earn-out provided to the lessee, the payment is recorded as a lease incentive and is amortized as a yield adjustment over the life of the lease.
Impairment of Long-Lived Assets—At each reporting period, the Company evaluates its real estate investments to be held and used for potential impairment whenever events or changes in circumstances indicate that the carrying amount of the assets may not be recoverable. The judgment regarding the existence of impairment indicators, used to determine if an impairment assessment is necessary, is based on factors such as, but not limited to, market conditions, operator performance and legal structure. If indicators of impairment are present, the Company evaluates the carrying value of the related real estate investments in relation to the future undiscounted cash flows of the underlying facilities. The most significant inputs to the undiscounted cash flows include, but are not limited to, facility level financial results, a lease coverage ratio, the intended hold period by the Company, and a terminal capitalization rate. The analysis is also significantly impacted by determining the lowest level of cash flows, which generally would be at the master lease level of cash flows. Provisions for impairment losses related to long-lived assets are recognized when expected future undiscounted cash flows are determined to be less than the carrying values of the assets. The impairment is measured as the excess of carrying value over fair value. All impairments are taken as a period cost at that time, and depreciation is adjusted going forward to reflect the new value assigned to the asset. For the year ended December 31, 2019, the Company recorded an impairment expense of $16.7 million. See Note 3, Real Estate Investments, Net, for additional information.

The Company classifies its real estate investments as held for sale when the applicable criteria have been met, which entails a formal plan to sell the properties that is expected to be completed within one year, among other criteria. Upon designation as held for sale, the Company writes down the excess of the carrying value over the estimated fair value less costs to sell, resulting in an impairment of the real estate investments, if necessary, and ceases depreciation.

In the event of impairment, the fair value of the real estate investment is based on current market conditions and considers matters such as the forecasted operating cash flows, lease coverage ratios, capitalization rates, comparable sales data, and, where applicable, contracts or the results of negotiations with purchasers or prospective purchasers.

The Company’s ability to accurately estimate future cash flows and estimate and allocate fair values impacts the timing and recognition of impairments. While the Company believes its assumptions are reasonable, changes in these assumptions may have a material impact on financial results.
Other Real Estate Investments—Included in other real estate investments on the Company’s consolidated balance sheets at December 31, 2021 and 2020, is one mezzanine loan receivable for which the Company elected the fair value option. Instruments for which the fair value option has been elected are measured at fair value on a recurring basis with changes in fair value recognized in other income (loss) on the consolidated income statements. Fair value was estimated using an internal valuation model that considered the expected future cash flows of the investment, the underlying collateral value, market interest rates and other credit enhancements. Interest income is recognized as earned within interest and other income in the consolidated income statements.
Prepaid expenses and other assets—Prepaid expenses and other assets consist of prepaid expenses, deposits, pre-acquisition costs and other loans receivable. During the year ended December 31, 2019, the Company determined that the remaining contractual obligations under one other loan receivable were not collectible and recorded a $1.1 million provision for loan losses in the Company’s consolidated income statements.
The Company’s other loans receivable are reflected at amortized cost, net of an allowance for credit loss, on the accompanying consolidated balance sheets. The amortized cost of a loan receivable is the outstanding unpaid principal balance, net of unamortized discounts, costs and fees directly associated with the origination of the loan.
Income Taxes—The Company has elected to be taxed as a real estate investment trust (“REIT”) under the Internal Revenue Code of 1986, as amended (the “Code”). The Company believes it has been organized and has operated, and the Company intends to continue to operate, in a manner to qualify for taxation as a REIT under the Code. To qualify as a REIT, the Company must meet certain organizational and operational requirements, including a requirement to distribute to its stockholders at least 90% of the Company’s annual REIT taxable income (computed without regard to the dividends paid deduction or net capital gain and which does not necessarily equal net income as calculated in accordance with GAAP). As a REIT, the Company generally will not be subject to federal income tax to the extent it distributes as qualifying dividends all of its REIT taxable income to its stockholders. If the Company fails to qualify as a REIT in any taxable year, it will be subject to federal income tax on its taxable income at regular corporate income tax rates and generally will not be permitted to qualify for treatment as a REIT for federal income tax purposes for the four taxable years following the year during which qualification is lost unless the Internal Revenue Service grants the Company relief under certain statutory provisions. 
Real Estate Depreciation and Amortization—Real estate costs related to the acquisition and improvement of properties are capitalized and amortized over the expected useful life of the asset on a straight-line basis. Repair and maintenance costs are charged to expense as incurred and significant replacements and betterments are capitalized. Repair and maintenance costs include all costs that do not extend the useful life of the real estate asset. The Company considers the period of future benefit of an asset to determine its appropriate useful life. Expenditures for tenant improvements are capitalized and amortized over the shorter of the tenant’s lease term or expected useful life. The Company anticipates the estimated useful lives of its assets by class to be generally as follows:
Building
25-40 years
Building improvements
10-25 years
Tenant improvementsShorter of lease term or expected useful life
Integral equipment, furniture and fixtures
5 years
Identified intangible assetsShorter of lease term or expected useful life
 Cash and Cash Equivalents—Cash and cash equivalents consist of bank term deposits and money market funds with original maturities of three months or less at time of purchase and therefore approximate fair value. The fair value of these investments is determined based on “Level 1” inputs, which consist of unadjusted quoted prices in active markets that are accessible at the measurement date for identical, unrestricted assets. The Company places its cash and short-term investments with high credit quality financial institutions.
The Company’s cash and cash equivalents balance periodically exceeds federally insurable limits. The Company monitors the cash balances in its operating accounts and adjusts the cash balances as appropriate; however, these cash balances could be impacted if the underlying financial institutions fail or are subject to other adverse conditions in the financial markets. To date, the Company has experienced no loss or lack of access to cash in its operating accounts.
Deferred Financing Costs—External costs incurred from placement of the Company’s debt are capitalized and amortized on a straight-line basis over the terms of the related borrowings, which approximates the effective interest method.
For senior unsecured notes payable and the senior unsecured term loan, deferred financing costs are netted against the outstanding debt amounts on the balance sheet. For the unsecured revolving credit facility, deferred financing costs are included in assets on the Company’s balance sheet. Amortization of deferred financing costs is classified as interest expense in the consolidated income statements. Accumulated amortization of deferred financing costs was $8.0 million and $9.0 million at December 31, 2021 and 2020, respectively.
When financings are terminated, unamortized deferred financing costs, as well as charges incurred for the termination, are expensed at the time the termination is made. Gains and losses from the extinguishment of debt are presented within other income (loss) in the Company’s consolidated income statements. During the year ended December 31, 2021, the Company recorded a loss on extinguishment of debt of $10.8 million. See Note 6, Debt, for further detail.
Stock-Based Compensation—The Company accounts for share-based payment awards in accordance with ASC Topic 718, Compensation – Stock Compensation (“ASC 718”). ASC 718 requires all entities to apply a fair value-based measurement method in accounting for share-based payment transactions with directors, officers and employees. The Company measures and recognizes compensation expense for all share-based payment awards made to directors, officers and employees based on the grant date fair value, amortized over the requisite service period of the award. Compensation expense for awards with performance-based vesting conditions is recognized based upon the probability that the performance target will be met. Compensation expense for awards with market-based vesting conditions is recognized based upon the estimated number of awards to be earned after considering the Company’s expectation of future performance and is recognized provided that the requisite service is rendered, regardless of when, if ever, the market condition is satisfied. Forfeitures of stock-based awards are recognized as they occur. Net income reflects stock-based compensation expense of $10.8 million, $3.8 million and $4.1 million for the years ended December 31, 2021, 2020 and 2019, respectively.
Concentration of Credit Risk—The Company is subject to concentrations of credit risk consisting primarily of operating leases on its owned properties. See Note 11, Concentration of Risk, for a discussion of major operator concentration.
Segment Disclosures —The Company is subject to disclosures about segments of an enterprise and related information in accordance with ASC Topic 280, Segment Reporting. The Company has one reportable segment consisting of investments in healthcare-related real estate assets.
Earnings Per Share—The Company calculates earnings per share (“EPS”) in accordance with ASC 260, Earnings Per Share. Basic EPS is computed by dividing net income applicable to common stock by the weighted-average number of common shares outstanding during the period. Diluted EPS reflects the additional dilution for all potentially-dilutive securities.
Beds, Units, Occupancy and Other Measures—Beds, units, occupancy and other non-financial measures used to describe real estate investments included in these Notes to the consolidated financial statements are presented on an unaudited basis and are not subject to audit by the independent registered public accounting firm in accordance with the standards of the Public Company Accounting Oversight Board.
Recent Accounting Pronouncements— In March 2020, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2020-04, Reference Rate Reform (Topic 848) - Facilitation of the Effects of Reference Rate Reform on Financial Reporting (“ASU 2020-04”), that provides optional relief to applying reference rate reform to contracts, hedging relationships, and other transactions that reference the London Interbank Offered Rate (“LIBOR”). For U.S. Dollar LIBOR, the overnight, one-month, three-month, six-month and one-year LIBOR rates will be discontinued in June 2023, while other U.S. Dollar LIBOR rates were discontinued at the end of 2021. The amendments in this update are effective immediately and may be applied through December 31, 2022. The Company does not expect the adoption of the standard to have a material impact on the Company’s consolidated financial statements.
v3.22.0.1
Real Estate Investments, Net
12 Months Ended
Dec. 31, 2021
Real Estate [Abstract]  
Real Estate Investments, Net REAL ESTATE INVESTMENTS, NET
The following table summarizes the Company’s investment in owned properties at December 31, 2021 and 2020 (dollars in thousands):
 
December 31, 2021December 31, 2020
Land$251,787 $205,356 
Buildings and improvements1,622,019 1,477,849 
Integral equipment, furniture and fixtures104,722 97,836 
Identified intangible assets1,257 2,352 
Real estate investments1,979,785 1,783,393 
Accumulated depreciation and amortization(389,814)(335,294)
Real estate investments, net$1,589,971 $1,448,099 
As of December 31, 2021, 91 of the Company’s 227 facilities were leased to subsidiaries of The Ensign Group, Inc. (“Ensign”) on a triple-net basis under multiple long-term leases (each, an “Ensign Master Lease” and, collectively, the “Ensign Master Leases”) which commenced on June 1, 2014 and were subsequently modified (see “Pennant Spin” below for further information). The obligations under the Ensign Master Leases are guaranteed by Ensign. A default by any subsidiary of Ensign with regard to any facility leased pursuant to an Ensign Master Lease will result in a default under all of the Ensign Master Leases. As of December 31, 2021, annualized contractual rental income from the Ensign Master leases was $59.7 million and is escalated annually, in June, by an amount equal to the product of (1) the lesser of the percentage change in the Consumer Price Index (“CPI”) (but not less than zero) or 2.5%, and (2) the prior year’s rent. In addition to rent, the subsidiaries of Ensign that are tenants under the Ensign Master Leases are solely responsible for the costs related to the leased properties (including property taxes, insurance, and maintenance and repair costs). During the year ended December 31, 2020, the Company acquired four additional facilities leased to subsidiaries of Ensign on a triple-net basis under two separate master lease agreements, each of which contains a purchase option. As of December 31, 2021, annualized contractual rental income from the four additional Ensign facilities was $3.8 million and is escalated annually, in December, by an amount equal to the product of (1) the lesser of the percentage change in the CPI (but not less than zero) or 2.5%, and (2) the prior year’s rent. In addition to rent, the subsidiaries of Ensign that are tenants under the four additional facilities are solely responsible for the costs related to the leased properties (including property taxes, insurance, and maintenance and repair costs). The obligations under the lease agreements for the four additional facilities are guaranteed by Ensign but do not contain cross-default provisions with the Ensign Master Leases. See below under “Lease Amendments” for further detail on Ensign lease amendments.
As of December 31, 2021, 15 of the Company’s facilities were leased to subsidiaries of Priority Management Group (“PMG”) on a triple-net basis under one long-term lease (the “PMG Master Lease”). The PMG Master Lease commenced on December 1, 2016, and provides an initial term of fifteen years, with two five-year renewal options. As of December 31, 2021, annualized contractual rental income from the PMG Master Lease was $28.9 million and is escalated annually by an amount equal to the product of (1) the lesser of the percentage change in the CPI (but not less than zero) or 3.0%, and (2) the prior year’s rent. In addition to rent, the subsidiaries of PMG that are tenants under the PMG Master Lease are solely responsible for the costs related to the leased properties (including property taxes, insurance, and maintenance and repair costs).
As of December 31, 2021, 115 of the Company’s 227 facilities were leased to various other operators under triple-net leases. All of these leases contain annual escalators based on the percentage change in the CPI (but not less than zero), some of which are subject to a cap, or fixed rent escalators. Two of the Company’s 227 facilities are leased under a short-term lease with an expected term of less than one year as of December 31, 2021, as the Company is currently identifying a long-term operator for these properties.
As of December 31, 2021, the Company’s total future contractual minimum rental income for all of its tenants, excluding operating expense reimbursements, was (dollars in thousands):
YearAmount
2022$192,897 
2023192,693 
2024191,347 
2025191,319 
2026191,424 
Thereafter1,138,179 
$2,097,859 
Tenant Purchase Options
Certain of the Company’s operators hold purchase options allowing them to acquire properties they currently lease from the Company. A summary of these purchase options is presented below (dollars in thousands):
Asset TypePropertiesLease ExpirationNext Option Open Date
Option Type(1)
Current Cash Rent(2)
ALF7October 20341/1/2022
(3)
A$3,383 
SNF11November 20301/1/2022
(3)
C4,944 
SNF1March 20294/1/2022
B / C(4)
779 
SNF / Campus2October 20321/1/2023B1,028 
SNF4November 203412/1/2024B3,796 
ALF2October 20341/1/2026A1,598 
(1) Option type includes:
A - Fixed base price plus a specified share on any appreciation.
B - Fixed base price.
C - Fixed capitalization rate on lease revenue.
(2) Based on annualized cash revenue for contracts in place at December 31, 2021.
(3) Option window is open for six months.
(4) Purchase option reflects two option types.
Rental Income
The following table summarizes components of the Company’s rental income (dollars in thousands):
For the Year Ended December 31,
202120202019
Rental Income
Contractual rent due(1)
$190,100 $171,309 $166,056 
Straight-line rent32 77 1,385 
Adjustment for collectibility(2)
— — (11,774)
Recovery of previously reversed rent(3)
— 1,047 — 
Lease termination revenue(3)
63 1,179 — 
Total$190,195 $173,612 $155,667 

(1)Includes initial cash rent and tenant operating expense reimbursements, as adjusted for applicable rental escalators and rent increases due to capital expenditures funded by the Company. For tenants on a cash basis, this represents the lesser of the amount that would be recognized on a straight-line basis or cash that has been received.
(2)During the year ended December 31, 2019, and in accordance with ASC 842, the Company evaluated the collectibility of lease payments through maturity and determined that it was not probable that the Company would collect substantially all of the contractual obligations from five operators through maturity. As such, the Company reversed
$7.8 million of contractual rent, $3.5 million of straight-line rent and $0.5 million of property tax reimbursements during the year ended December 31, 2019.
(3)During the year ended December 31, 2020, the Company recovered $1.0 million in rental income related to affiliates of Metron Integrated Health Systems (“Metron”) that was previously written off. In addition, in connection with the agreement to terminate its lease agreements with Metron and to sell the facilities to a third-party, the Company received certain lease termination payments from Metron. During the years ended December 31, 2021 and 2020, the Company recognized approximately $0.1 million and $1.2 million in lease termination revenue, respectively.

Recent Real Estate Acquisitions
The following table summarizes the Company’s acquisitions for the years ended December 31, 2021, 2020 and 2019 (dollar amounts in thousands):
Type of Property
Purchase Price(1)
Initial Annual Cash Rent(2)
Number of Properties
Number of Beds/Units(3)
December 31, 2021
Skilled nursing$57,973 $4,499 (4)4 509 
Multi-service campuses125,708 8,604 (5)4 640 
Assisted living12,395 — (6)2 98 
Total$196,076 $13,103 10 1,247 
December 31, 2020
Skilled nursing$75,545 $6,453 6 715 
Multi-service campuses6,876 555 1 184 
Assisted living7,396 590 1 62 
Total$89,817 $7,598 8 961 
December 31, 2019
Skilled nursing$254,760 $22,909 17 2,099 
Multi-service campuses59,344 5,203 4 762 
Assisted living12,596 1,031 1 96 
Total$326,700 $29,143 22 2,957 
(1)    Purchase price includes capitalized acquisition costs.
(2)    Initial annual cash rent excludes ground lease income.
(3)    The number of beds/units includes operating beds at acquisition date.
(4)    Initial annual cash rent represents initial cash rent for the first twelve months excluding any impact of straight-line rent.
(5)    Initial annual cash rent represents the first twelve months of rent upon commencement of the Company’s long-term net leases, which occurred during the three months ended June 30, 2021, upon the tenant’s receipt of licensing approval and increases to $9.4 million in the second year with CPI-based annual escalators thereafter.
(6)    Initial annual cash rent is zero until transfer of operations upon receipt of licensing approval.
Lease Amendments
Amended Noble Master Leases and New Noble NJ Master Lease. During the three months ended September 30, 2021, the Company did not collect a portion of rent from affiliates of Noble Senior Services and Noble VA Holdings, LLC (collectively, “Noble”). On September 23, 2021, the Company amended its two existing triple-net master leases with Noble. The lease amendment granted a deferral for a total of $1.8 million of unpaid base rent, which represented approximately 4% of the Company’s total contractual base rent for the three months ended September 30, 2021. In connection with its agreement to the rent deferral, the Company also entered into a purchase agreement with Noble to acquire two assisted living facilities owned by Noble. The lease amendment required the deferred rent, as well as all contractual rent for the fourth quarter of 2021, to be paid in full upon the closing of the purchase of the two facilities. The Company closed on the acquisition of the two facilities in December 2021 and the deferred rent, as well as all contractual rent for the fourth quarter of 2021, was paid in full. The two facilities are currently leased back to Noble under a short-term lease agreement while the Company pursues other tenants for the long-term.
Amended Ensign Master Lease. On August 1, 2021, the Company acquired two skilled nursing facilities. The facilities were leased to affiliates of Ensign. In conjunction with the acquisition of the two facilities, the Company amended and extended the initial term of an existing triple-net master lease with Ensign to include the two skilled nursing facilities. The Ensign lease, as amended, has a remaining initial term of approximately 17 years, with three five-year renewal options and CPI-based rent escalators. Annual cash rent under the amended lease increased by approximately $2.2 million, with GAAP rent increasing by $2.5 million due to a $5.0 million prepayment of rent made at closing, which is being amortized on a straight-line basis over the remaining lease term.
Five Oaks Lease Termination and Amended Ensign Master Lease. On June 1, 2021, operating affiliates of Ensign acquired certain operations and assets of Five Oaks Healthcare, LLC (“Five Oaks”) under an agreement with Five Oaks. The agreement granted Ensign the right to occupy and operate four of the Company’s skilled nursing facilities in Washington that were previously being operated by Five Oaks. In conjunction with consenting to the transfer, the Company terminated the existing Five Oaks master lease, and amended and extended the term of an existing triple-net master lease with Ensign to include the four skilled nursing facilities. The Ensign lease, as amended, has a remaining term of approximately 15 years, with three five-year renewal options and CPI-based rent escalators. Annual cash rent under the terminated Five Oaks master lease was approximately $2.6 million, and annual cash rent under the amended Ensign lease increased by the same amount.
Premier Partial Lease Termination and Amended Noble VA Master Lease. On March 10, 2021 and July 1, 2021, two assisted living facilities in Wisconsin operated by affiliates of Premier Senior Living, LLC (“Premier”) were transferred to affiliates of Noble VA Holdings, LLC (“Noble VA”). In connection with the transfer, the Company partially terminated the Premier master lease and amended the existing triple-net master lease with Noble VA to include the two assisted living facilities. The Noble VA master lease, as amended, has a remaining term of approximately 13 years, with two five-year renewal options and CPI-based rent escalators. Initial annual cash rent under the amended Noble VA master lease increased by approximately $1.3 million on March 10, 2021 and approximately $1.0 million on July 1, 2021 and annual cash rent under the partially terminated Premier master lease decreased by approximately the same amount. See above under “Amended Noble Master Leases and New Noble NJ Master Lease” for additional information regarding the Company’s leases with Noble.
Twenty/20 Lease Termination and New Noble VA Master Lease. On December 1, 2020, five assisted living facilities in Virginia operated by Twenty/20 Management, Inc. (“Twenty/20”) were transferred to affiliates of Noble VA. In connection with the transfer, the Company entered into a new triple-net master lease with Noble VA. The lease had an initial term of approximately 14 years as of December 1, 2020, with two five-year renewal options and CPI-based rent escalators. Initial annual cash rent under the new lease is approximately $3.2 million. See above under “Amended Noble Master Leases and New Noble NJ Master Lease” for additional information regarding the Company’s leases with Noble.
Pennant Spin. On October 1, 2019, Ensign completed its previously announced separation of its home health and hospice operations and substantially all of its senior living operations into a separate independent publicly traded company through the distribution of shares of common stock of The Pennant Group, Inc. (“Pennant”). As a result of the Pennant Spin, as of October 1, 2019, the Company amended the Ensign Master Leases to lease 85 facilities to subsidiaries of Ensign, which had a total of 8,908 operational beds, and entered into a new triple-net master lease with subsidiaries of Pennant (the “Pennant Master Lease”) to lease 11 facilities, which had a total of 1,151 operational beds. The contractual initial annual cash rent under the Pennant Master Lease was approximately $7.8 million. The Pennant Master Lease carried an initial term of 15 years, with two five-year renewal options and CPI-based rent escalators. The contractual annual cash rent under the amended Ensign
Master Leases was reduced by approximately $7.8 million. Ensign continues to guarantee obligations under the Ensign Master Leases and the Pennant Master Lease. If Pennant achieves a specified portfolio coverage and continuously maintains it for a specified period, Ensign’s obligations under the guaranty with respect to the Pennant Master Lease would be released.
Trillium Lease Termination and New Master Lease. On July 15, 2019, the Company terminated its existing master lease (the “Original Trillium Lease”) with affiliates of Trillium Healthcare Group, LLC (“Trillium”), which covered ten properties in Iowa, seven properties in Ohio and one property in Georgia.  On August 16, 2019, the Company entered into a new master lease (the “New Trillium Lease”) with Trillium’s Iowa and Georgia affiliates covering the ten properties in Iowa and the one property in Georgia. The Company recorded an adjustment to reduce rental income recognized under the Original Trillium Lease for unpaid contractual rent, straight-line rent and property tax reimbursements by approximately $3.8 million in the three months ended September 30, 2019.
On September 1, 2019, four of the seven skilled nursing properties in Ohio operated by Trillium under the Original Trillium Lease were transferred to affiliates of Providence Group, Inc. (“Providence”). In connection with the transfer, the Company amended its triple-net master lease with Providence. The amended lease had a remaining initial term of approximately 13 years as of September 1, 2019, and includes two five-year renewal options and CPI-based rent escalators. Annual cash rent under the amended lease increased by approximately $2.1 million.
Trio Lease Amendment. On November 4, 2019, the Company amended its existing master lease with affiliates of Trio Healthcare, Inc. (“Trio”), which covered seven facilities based in Dayton, Ohio. The amended lease had a remaining initial term of approximately 13 years as of November 4, 2019, with two five-year renewal options and CPI-based rent escalators. The annual base rent due under the amended lease with Trio was approximately $4.7 million and provides for payment of percentage rent if Trio achieves certain increases in portfolio revenue.
Impairment of Real Estate Investments, Asset Sales and Assets Held for Sale
On September 1, 2019, the Company sold three of the seven skilled nursing properties in Ohio operated by Trillium under the Original Trillium Lease for a purchase price of $28.0 million. During the three months ended September 30, 2019 and prior to the disposition, the Company recorded an impairment expense of approximately $7.8 million. In connection with the sale, the Company provided affiliates of CommuniCare Family of Companies (“CommuniCare”), the purchaser of the three Ohio properties, with a mortgage loan secured by the three Ohio properties for approximately $26.5 million. See Note 4, Other Real Estate Investments, for additional information.
On February 14, 2020, the Company sold six skilled nursing properties in Michigan operated by affiliates of Metron for a purchase price of $36.0 million. During the three months ended September 30, 2019 and prior to the disposition, the Company recorded an impairment expense of approximately $8.8 million related to these properties. In connection with the sale for $36.0 million, the Company received $3.5 million in cash and provided subsidiaries of Cascade Capital Group, LLC (“Cascade”), the purchaser of the properties, with a short-term mortgage loan secured by these properties for $32.4 million. The mortgage loan bore interest at 7.5% and initially had a maturity date of March 31, 2020. In connection with the sale, the Company recognized a loss of approximately $0.1 million during the three months ended March 31, 2020. In April 2020, the mortgage loan was settled in connection with a new mortgage loan transaction between the Company and a third-party institutional lender as co-lenders, pursuant to which the Company received $18.9 million in cash and a new mortgage loan for $13.9 million. In July 2020, the Company received prepayment in full, including accrued interest, for the new $13.9 million mortgage loan. See Note 4, Other Real Estate Investments, for further detail on the mortgage loan.
On February 1, 2021, the Company closed on the sale of one skilled nursing facility consisting of 90 beds located in Washington with a carrying value of $7.2 million, for net sales proceeds of $7.0 million. The Company recorded a loss of $0.2 million in connection with the sale. The facility was classified as held for sale as of December 31, 2020.
On November 1, 2020, the Company sold its one remaining owned and operated independent living facility consisting of 168 units located in Texas with an aggregate carrying value of $4.2 million for net sales proceeds of $4.2 million. In connection with the sale, the Company recognized a gain of $20,000.
On December 23, 2019, the Company sold one of its owned and operated independent living facilities consisting of 38 units located in Texas with an aggregate carrying value of $1.7 million for net proceeds of $3.3 million. In connection with the sale, the Company recognized a gain of $1.6 million.
As of December 31, 2021, one assisted living facility was classified as held for sale, with a carrying value of $4.8 million, primarily comprised of real estate assets.
v3.22.0.1
Other Real Estate Investments
12 Months Ended
Dec. 31, 2021
Investments, All Other Investments [Abstract]  
Other Real Estate Investments OTHER REAL ESTATE INVESTMENTS
As of December 31, 2021 and 2020, the Company’s loans receivable and other investments consisted of the following (dollar amounts in thousands):
As of December 31, 2021
InvestmentFinancial Statement Line ItemPrincipal Balance as of December 31, 2021Book Value as of December 31, 2021Book Value as of December 31, 2020Weighted Average Contractual Interest RateMaturity Date
Mezzanine loan receivableOther real estate investments$15,000 $15,155 $15,000 12.0 %11/30/2025
Other loans receivablePrepaid expenses and other assets, net3,154 3,161 2,308 8.0 %9/1/2023 - 12/31/2023
Total$18,154 $18,316 $17,308 
2020 Loans Receivable Transactions—In November 2020, the Company provided Next VA Star Realty Holdings, LLC a mezzanine loan for nine skilled nursing facilities secured by membership interests in affiliates of Next VA Star Realty Holdings, LLC for approximately $15.0 million, at an annual interest rate of 12%. The loan requires monthly interest payments, is set to mature on November 30, 2025, and may (subject to certain restrictions) be prepaid before the maturity date if paid in full and for an exit fee ranging from 1% to 3% of the loan plus unpaid interest payments equal to 24 months (less the amount of monthly interest payments made by the borrower through the date of prepayment).
The following table summarizes the interest and other income recognized during the years ended December 31, 2021, 2020 and 2019 (dollar amounts in thousands):
For Year Ended December 31,
Investment202120202019
Mezzanine loan receivable$1,825 $305 $— 
Mortgage loans receivable(1)
— 2,044 2,838 
Preferred equity investments(1)
— 24 1,343 
Other331 270 164 
Total$2,156 $2,643 $4,345 
(1) As of December 31, 2021 and 2020, the Company had no mortgage loans receivable or preferred equity investments.
As of December 31, 2021 and 2020, the Company had no loan loss reserve and did not consider any loans receivable investments to be impaired.
v3.22.0.1
Fair Value Measurements
12 Months Ended
Dec. 31, 2021
Fair Value Disclosures [Abstract]  
Fair Value Measurements FAIR VALUE MEASUREMENTS
The Company determines fair value based on quoted prices when available or through the use of alternative approaches, such as discounting the expected cash flows using market interest rates commensurate with the credit quality and duration of the investment. GAAP guidance defines three levels of inputs that may be used to measure fair value:

Level 1 – Quoted prices in active markets for identical assets and liabilities that the reporting entity has the ability to access at the measurement date.

Level 2 – Inputs other than quoted prices included within Level 1 that are observable for the asset or liability or can be corroborated with observable market data for substantially the entire contractual term of the asset or liability.
Level 3 – Unobservable inputs reflect the entity’s own assumptions about the assumptions that market participants would use in the pricing of the asset or liability and are consequently not based on market activity, but rather through particular valuation techniques.

The determination of where an asset or liability falls in the hierarchy requires significant judgment and considers factors specific to the asset or liability. In instances where the determination of the fair value measurement is based on inputs from different levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is based on the lowest level input that is significant to the fair value measurement in its entirety. The Company evaluates its hierarchy disclosures each quarter and, depending on various factors, it is possible that an asset or liability may be classified differently from quarter to quarter. Changes in the type of inputs may result in a reclassification for certain assets. The Company does not expect that changes in classifications between levels will be frequent.
Items Measured at Fair Value on a Recurring Basis
The following table presents information about the Company’s assets and liabilities measured at fair value on a recurring basis as of December 31, 2021 and 2020, aggregated by the level in the fair value hierarchy within which those instruments fall (dollars in thousands):
Level 1Level 2Level 3
Balance as of December 31, 2021
Assets:
Mezzanine loan receivable$— $— $15,155 $15,155 
Level 1Level 2Level 3
Balance as of December 31, 2020
Assets:
Mezzanine loan receivable$— $— $15,000 $15,000 
Mezzanine loan receivable: The fair value of the mezzanine loan receivable was estimated using an internal valuation model that considered the expected future cash flows of the investment, the underlying collateral value, market interest rates and other credit enhancements. As such, the Company classifies the instrument as Level 3 due to the significant unobservable inputs used in determining market interest rates for investments with similar terms. Future changes in market interest rates could materially impact the estimated discounted cash flows. As of December 31, 2021 and 2020, the Company did not have any loans that were 90 days or more past due.
For the year ended December 31, 2021, there were no classification changes in assets and liabilities with Level 3 inputs in the fair value hierarchy.
Items Measured at Fair Value on a Non-Recurring Basis
Real Estate Investments: The Company performs quarterly impairment review procedures, primarily through continuous monitoring of events and changes in circumstances that could indicate the carrying value of its real estate assets may not be recoverable. The Company estimates fair values using Level 3 inputs and uses a combined income and market approach. Specifically, the fair value of the real estate investment is based on current market conditions and considers matters such as the forecasted operating cash flows, lease coverage ratios, capitalization rates, comparable sales data, and, where applicable, contracts or the results of negotiations with purchasers or prospective purchasers. For the year ended December 31, 2021 and 2020, there were no real estate assets deemed to be impaired. For the year ended December 31, 2019, the Company recorded an impairment expense of $16.7 million. See Note 3, Real Estate Investments, Net, for additional information.
Items Disclosed at Fair Value
Considerable judgment is necessary to estimate the fair value disclosure of financial instruments. The estimates of fair value presented herein are not necessarily indicative of the amounts that could be realized upon disposition of the financial instruments. A summary of the face values, carrying amounts and fair values of the Company’s financial instruments as of December 31, 2021 and 2020 using Level 2 inputs for the Notes and the 2025 Notes (each as defined in Note 6, Debt, below) is as follows (dollars in thousands):  
 December 31, 2021December 31, 2020
Face
Value
Carrying
Amount
Fair
Value
Face
Value
Carrying
Amount
Fair
Value
Financial liabilities:
2028 Senior unsecured notes payable$400,000 $394,262 $410,500 $— $— $— 
2025 Senior unsecured notes payable— — — 300,000 296,669 311,430 
Cash and cash equivalents, accounts and other receivables, other loans receivable, accounts payable, and accrued liabilities: These balances approximate their fair values due to the short-term nature of these instruments.
Senior unsecured notes payable: The fair value of the Notes and the 2025 Notes (as defined in Note 6, Debt, below) were determined using third-party quotes derived from orderly trades.
Unsecured revolving credit facility and senior unsecured term loan: The fair values approximate their carrying values as the interest rates are variable and approximate prevailing market interest rates for similar debt arrangements.
v3.22.0.1
Debt
12 Months Ended
Dec. 31, 2021
Debt Disclosure [Abstract]  
Debt DEBT
The following table summarizes the balance of the Company’s indebtedness as of December 31, 2021 and 2020 (in thousands):
December 31, 2021December 31, 2020
PrincipalDeferredCarryingPrincipalDeferredCarrying
AmountLoan FeesAmountAmountLoan FeesAmount
2028 Senior unsecured notes payable$400,000 $(5,738)$394,262 $— $— $— 
2025 Senior unsecured notes payable— — — 300,000 (3,331)296,669 
Senior unsecured term loan200,000 (864)199,136 200,000 (1,075)198,925 
Unsecured revolving credit facility80,000 — 80,000 50,000 — 50,000 
$680,000 $(6,602)$673,398 $550,000 $(4,406)$545,594 
Senior Unsecured Notes Payable
2028 Senior Notes. On June 17, 2021, the Company’s wholly owned subsidiary, CTR Partnership, L.P. (the “Operating Partnership”), and its wholly owned subsidiary, CareTrust Capital Corp. (together with the Operating Partnership, the “Issuers”) completed a private offering of $400.0 million aggregate principal amount of 3.875% Senior Notes due 2028 (the “Notes”) to persons reasonably believed to be qualified institutional buyers pursuant to Rule 144A and to non-U.S. persons outside the United States in reliance on Regulation S under the Securities Act of 1933, as amended. The Notes were issued at par, resulting in gross proceeds of $400.0 million and net proceeds of approximately $393.8 million after deducting underwriting fees and other offering expenses. The Notes mature on June 30, 2028. The Notes accrue interest at a rate of 3.875% per annum payable semiannually in arrears on June 30 and December 30 of each year, commencing on December 30, 2021.
The Issuers may redeem some or all of the Notes at any time prior to March 30, 2028 at a price equal to 100% of the principal amount of the Notes redeemed plus accrued and unpaid interest on the Notes, if any, to, but not including, the redemption date, plus a “make-whole” premium. At any time on or after March 30, 2028, the Issuers may redeem some or all of the Notes at a redemption price equal to 100% of the principal amount of the Notes redeemed plus accrued interest on the Notes, if any, to, but not including, the redemption date. In addition, at any time on or prior to June 30, 2024, up to 40% of the
aggregate principal amount of the Notes may be redeemed with the net proceeds of certain equity offerings at a redemption price of 103.875% of the aggregate principal amount of Notes to be redeemed plus accrued and unpaid interest on the Notes, if any, to, but not including, the redemption date. If certain changes of control of the Company occur, the Issuers will be required to make an offer to holders of the Notes to repurchase their Notes at a price of 101% of their principal amount plus accrued and unpaid interest, if any, to, but not including, the repurchase date.
The obligations under the Notes are fully and unconditionally guaranteed, jointly and severally, on an unsecured basis, by the Company and all of CareTrust’s existing and future subsidiaries (other than the Issuers) that guarantee obligations under the Amended Credit Facility (as defined below); provided, however, that such guarantees are subject to automatic release under certain customary circumstances.
The indenture governing the Notes contains customary covenants such as limiting the ability of the Company and its restricted subsidiaries to: incur or guarantee additional indebtedness; incur or guarantee secured indebtedness; pay dividends or distributions on, or redeem or repurchase, capital stock; make certain investments or other restricted payments; sell assets; enter into transactions with affiliates; merge or consolidate or sell all or substantially all of their assets; and create restrictions on the ability of the Issuers and their restricted subsidiaries to pay dividends or other amounts to the Issuers. The indenture governing the Notes also requires the Company and its restricted subsidiaries to maintain a specified ratio of unencumbered assets to unsecured indebtedness. These covenants are subject to a number of important and significant limitations, qualifications and exceptions. The indenture governing the Notes also contains customary events of default.
As of December 31, 2021, the Company was in compliance with all applicable financial covenants under the indenture governing the Notes.
2025 Senior Notes. On May 10, 2017, the Issuers completed an underwritten public offering of $300.0 million aggregate principal amount of 5.25% Senior Notes due 2025 (the “2025 Notes”). The 2025 Notes were issued at par, resulting in gross proceeds of $300.0 million and net proceeds of approximately $294.0 million after deducting underwriting fees and other offering expenses. The 2025 Notes were scheduled to mature on June 1, 2025 and bore interest at a rate of 5.25% per year. Interest on the 2025 Notes was payable on June 1 and December 1 of each year. On July 1, 2021 (the “Redemption Date”), the Issuers redeemed all $300.0 million aggregate principal amount of the 2025 Notes at a redemption price equal to 102.625% of the principal amount of the 2025 Notes, plus accrued and unpaid interest thereon up to, but not including, the Redemption Date. During the year ended December 31 2021, the Company recorded a loss on extinguishment of debt of $10.8 million in the consolidated income statements, including a prepayment penalty of $7.9 million and a $2.9 million write-off of deferred financing costs associated with the redemption of the 2025 Notes.

Unsecured Revolving Credit Facility and Term Loan
On February 8, 2019, the Operating Partnership, as the borrower, the Company, as guarantor, CareTrust GP, LLC, and certain of the Operating Partnership’s wholly owned subsidiaries entered into an amended and restated credit and guaranty agreement with KeyBank National Association, as administrative agent, an issuing bank and swingline lender, and the lenders party thereto (the “Amended Credit Agreement”). The Amended Credit Agreement, which amended and restated the Company’s prior credit agreement, provides for: (i) an unsecured revolving credit facility (the “Revolving Facility”) with revolving commitments in an aggregate principal amount of $600.0 million, including a letter of credit subfacility for 10% of the then available revolving commitments and a swingline loan subfacility for 10% of the then available revolving commitments and (ii) an unsecured term loan credit facility (the “Term Loan” and, together with the Revolving Facility, the “Amended Credit Facility”) in an aggregate principal amount of $200.0 million. Borrowing availability under the Revolving Facility is subject to no default or event of default under the Amended Credit Agreement having occurred at the time of borrowing. The proceeds of the Term Loan were used, in part, to repay in full all outstanding borrowings under the Company’s prior credit agreement. Future borrowings under the Amended Credit Facility will be used for working capital purposes, for capital expenditures, to fund acquisitions and for general corporate purposes.
The interest rates applicable to loans under the Revolving Facility are, at the Operating Partnership’s option, equal to either a base rate plus a margin ranging from 0.10% to 0.55% per annum or LIBOR plus a margin ranging from 1.10% to 1.55% per annum based on the debt to asset value ratio of the Company and its consolidated subsidiaries (subject to decrease at the Operating Partnership’s election if the Company obtains certain specified investment grade ratings on its senior long-term unsecured debt). The interest rates applicable to loans under the Term Loan are, at the Operating Partnership’s option, equal to either a base rate plus a margin ranging from 0.50% to 1.20% per annum or LIBOR plus a margin ranging from 1.50% to 2.20% per annum based on the debt to asset value ratio of the Company and its consolidated subsidiaries (subject to decrease at
the Operating Partnership’s election if the Company obtains certain specified investment grade ratings on its senior long-term unsecured debt). In addition, the Operating Partnership will pay a facility fee on the revolving commitments under the Revolving Facility ranging from 0.15% to 0.35% per annum, based on the debt to asset value ratio of the Company and its consolidated subsidiaries (unless the Company obtains certain specified investment grade ratings on its senior long-term unsecured debt and the Operating Partnership elects to decrease the applicable margin as described above, in which case the Operating Partnership will pay a facility fee on the revolving commitments ranging from 0.125% to 0.30% per annum based on the credit ratings of the Company’s senior long-term unsecured debt). As of December 31, 2021, the Operating Partnership had $200.0 million of borrowings outstanding under the Term Loan and $80.0 million outstanding under the Revolving Facility.
The Revolving Facility has a maturity date of February 8, 2023, and includes, at the sole discretion of the Operating Partnership, two, six-month extension options. The Term Loan has a maturity date of February 8, 2026.
The Amended Credit Facility is guaranteed, jointly and severally, by the Company and its wholly owned subsidiaries that are party to the Amended Credit Agreement (other than the Operating Partnership). The Amended Credit Agreement contains customary covenants that, among other things, restrict, subject to certain exceptions, the ability of the Company and its subsidiaries to grant liens on their assets, incur indebtedness, sell assets, make investments, engage in acquisitions, mergers or consolidations, amend organizational documents and pay certain dividends and other restricted payments. The Amended Credit Agreement requires the Company to comply with financial maintenance covenants to be tested quarterly, consisting of a maximum debt to asset value ratio, a minimum fixed charge coverage ratio, a minimum tangible net worth, a maximum cash distributions to operating income ratio, a maximum secured debt to asset value ratio, a maximum secured recourse debt to asset value ratio, a maximum unsecured debt to unencumbered properties asset value ratio, a minimum unsecured interest coverage ratio and a minimum rent coverage ratio. The Amended Credit Agreement also contains certain customary events of default, including the failure to make timely payments under the Amended Credit Facility or other material indebtedness, the failure to satisfy certain covenants (including the financial maintenance covenants), the occurrence of change of control and specified events of bankruptcy and insolvency.
As of December 31, 2021, the Company was in compliance with all applicable financial covenants under the Amended Credit Agreement.
Schedule of Debt Maturities
As of December 31, 2021, the Company’s debt maturities were (dollars in thousands):  
Year
Amount
2022$— 
202380,000 
2024— 
2025— 
2026200,000 
Thereafter400,000 
 $680,000 
v3.22.0.1
Equity
12 Months Ended
Dec. 31, 2021
Equity [Abstract]  
Equity EQUITY
Common Stock
Public Offering of Common Stock—On April 15, 2019, the Company completed an underwritten public offering of 6,641,250 shares of its common stock, par value $0.01 per share, at an initial price to the public of $23.35, including 866,250 shares of common stock sold pursuant to the full exercise of an option to purchase additional shares of common stock granted to the underwriters, resulting in approximately $149.0 million in net proceeds, after deducting the underwriting discount and offering expenses. The Company used the proceeds from the offering to repay a portion of the outstanding borrowings on its Revolving Facility, which had been used to fund a portion of the purchase price of acquisitions in the second quarter of 2019.
At-The-Market Offering—On March 10, 2020, the Company entered into a new equity distribution agreement to issue and sell, from time to time, up to $500.0 million in aggregate offering price of its common stock through an “at-the-market” equity offering program (the “ATM Program”). In connection with the entry into the equity distribution agreement and
the commencement of the ATM Program, the Company’s “at-the-market” equity offering program pursuant to the Company’s prior equity distribution agreement, dated as of March 4, 2019, was terminated.
There was no ATM Program activity (or activity under any predecessor at-the-market equity offering programs) for the year ended December 31, 2020. The following table summarizes ATM Program activity and predecessor at-the-market equity offering program activity for the years ended December 31, 2021 and 2019 (in thousands, except per share amounts):
For the Year Ended December 31,
20212019
Number of shares990 2,459 
Average sales price per share$23.74 $19.48 
Gross proceeds(1)
$23,505 $47,893 
(1)    Total gross proceeds is before $0.3 million and $0.6 million of commissions paid to the sales agents during the year ended December 31, 2021 and December 31, 2019 under the ATM Program and a predecessor at-the-market equity offering program.
As of December 31, 2021, the Company had $476.5 million available for future issuances under the ATM Program.
Share Repurchase Program — On March 20, 2020, the Company’s Board of Directors authorized a share repurchase program up to $150.0 million of outstanding shares of the Company’s common stock (the “Repurchase Program”). Repurchases under the Repurchase Program, which expires on March 31, 2023, may be made through open market purchases, privately negotiated transactions, structured or derivative transactions, including accelerated share repurchase transactions, or other methods of acquiring shares, in each case subject to market conditions and at such times as shall be permitted by applicable securities laws and determined by management. Repurchases under the Repurchase Program may also be made pursuant to a plan adopted under Rule 10b5-1 promulgated under the Exchange Act. The Company expects to finance any share repurchases under the Repurchase Program using available cash and may also use short-term borrowings under the Revolving Facility. The Company did not repurchase any shares of common stock under the Repurchase Program during the years ended December 31, 2021, and 2020. The Repurchase Program may be modified, discontinued or suspended at any time.
Dividends on Common Stock — The following table summarizes the cash dividends per share of common stock declared by the Company’s Board of Directors for 2021, 2020 and 2019 (dollars in thousands, except per share amounts):
For the Three Months Ended
2021March 31,June 30,September 30,December 31,
Dividends declared$0.265 $0.265 $0.265 $0.265 
Dividends payment dateApril 15, 2021July 15, 2021October 15, 2021January 14, 2022
Dividends payable as of record date$25,633 $25,714 $25,714 $25,755 
Dividends record dateMarch 31, 2021June 30, 2021September 30, 2021December 31, 2021
2020
Dividends declared$0.25 $0.25 $0.25 $0.25 
Dividends payment dateApril 15, 2020July 15, 2020October 15, 2020January 15, 2021
Dividends payable as of record date$23,931 $23,931 $23,934 $23,933 
Dividends record dateMarch 31, 2020June 30, 2020September 30, 2020December 31, 2020
2019
Dividends declared$0.225 $0.225 $0.225 $0.225 
Dividends payment dateApril 15, 2019July 15, 2019October 15, 2019January 15, 2020
Dividends payable as of record date$20,011 $21,508 $21,500 $21,500 
Dividends record dateMarch 29, 2019June 28, 2019September 30, 2019December 31, 2019
v3.22.0.1
Stock-Based Compensation
12 Months Ended
Dec. 31, 2021
Share-based Payment Arrangement [Abstract]  
Stock-Based Compensation STOCK-BASED COMPENSATION
All stock-based awards are subject to the terms of the CareTrust REIT, Inc. and CTR Partnership, L.P. Incentive Award Plan (the “Plan”). The Plan provides for the granting of stock-based compensation, including stock options, restricted stock, performance awards, restricted stock units, relative total stockholder return-based stock awards and other incentive awards to officers, employees and directors in connection with their employment with or services provided to the Company. Under the Plan, 5,000,000 shares have been authorized for awards.
Under the Plan, restricted stock awards (“RSAs”) vest in equal annual installments beginning on the first anniversary of the grant date over a three year period for the RSAs granted in 2021 and a four year period for the RSAs granted in 2020 and 2019. RSAs granted to non-employee members of the Board of Directors (“Board Awards”) vest in full on the earlier to occur of the Company’s next Annual Meeting of Stockholders or one year. Performance stock awards (“PSA”) granted are subject to both time and performance based conditions and vest over a one-to three year period for PSAs granted in 2021 and over a one-to-four year period for PSAs granted in 2020 and 2019. The amount of such PSAs that will ultimately vest is dependent on the Company’s Normalized Funds from Operations (“NFFO”) per share, as defined by the Compensation Committee, meeting or exceeding a specified per share amount for the applicable vesting period. Relative total shareholder return awards (“TSR Awards”) granted in 2021 are subject to both time and market based conditions and cliff vest after a three-year period. The amount of such market awards that will ultimately vest is dependent on the Company’s total shareholder return (“TSR”) performance relative to a custom TSR peer group consisting of other publicly traded healthcare REITs and will range from 0% to 200% of the TSR Awards initially granted. The RSAs, PSAs, and Board Awards are valued on the date of grant based on the closing price of the Company’s common stock, while the TSR Awards are valued on the date of grant using a Monte Carlo valuation model. The vesting of certain awards may accelerate, as defined in the grant agreement, upon retirement, a change in control or other events.
The following table summarizes the status of the restricted stock award and performance award activity for the year ended December 31, 2021:
SharesWeighted Average Share Price
Unvested balance at December 31, 2020517,686 $18.71 
Granted:
RSAs394,863 21.92 
PSAs108,414 22.48 
Board Awards20,266 24.18 
Vested(147,646)17.43 
Forfeited(2,250)22.38 
Unvested balance at December 31, 2021891,333 $20.91 
As of December 31, 2021, the weighted-average remaining vesting period of such awards was 2.0 years.
The following table summarizes the Company’s RSA, PSA and Board Award grants during the year ended December 31, 2021 (dollars in thousands, except per share amounts):
GrantsVested
SharesWeighted Average Share PriceGrant Date Fair ValueSharesVest Date Fair Value
During year ended December 31, 2021(1)
RSAs394,863 $21.92 $8,654 89,921 $2,105 
PSAs108,414 22.48 2,437 30,114 707 
Board Awards20,266 24.18 490 27,611 668 
(1) In 2021, the Compensation Committee changed the structure of the grants that resulted in two long-term equity incentive awards being granted to the Company’s named executive officers in 2021. The Compensation Committee also granted annual awards for 2022 in December 2021.
The following table summarizes the Company’s RSA, PSA and Board Award grants during the years ended December 31, 2020 and 2019 (dollars in thousands, except per share amounts):
Grants
SharesWeighted Average Share PriceGrant Date Fair Value
During year ended December 31, 2020
RSAs134,790 19.68 2,653 
PSAs107,790 19.06 2,054 
Board Awards27,611 16.48 455 
During year ended December 31, 2019
RSAs91,440 22.00 2,012 
PSAs71,440 22.00 1,572 
Board Awards17,749 24.23 430 
The fair value of the TSR Awards is estimated on the date of the grant using a Monte Carlo valuation model. The risk-free rate is based on the U.S. Treasury yield curve in effect at the grant date for the expected performance period. Expected volatility is based on historical volatility for the most recent 2.93 year weighted average period ending on the grant date for the Company and the selected TSR peer group, and is calculated on a daily basis. The following table reflects the weighted-average key assumptions used in this valuation for awards granted during the year ended December 31, 2021:
Risk-free interest rate0.60 %
Expected stock price volatility52.42 %
Expected service period2.93 years
Expected dividend yield (assuming full reinvestment)— %
Fair value per share at date of grant$29.10 
The total fair value of the TSR Awards granted during the year ended December 31, 2021 was $5.3 million.
The following table summarizes the stock-based compensation expense recognized (dollars in thousands):
 For Year Ended December 31,
 202120202019
Stock-based compensation expense$10,832 $3,790 $4,104 

The Company recorded a cumulative out of period adjustment in the fourth quarter of 2021 related to stock compensation of $3.5 million, of which $2.6 million related to the quarters of 2021 and $0.9 million related to earlier periods. The adjustment was not material to the previously issued financial statements.
As of December 31, 2021, there was $11.5 million of unamortized stock-based compensation expense related to the unvested RSAs, PSAs, Board Awards, and TSR Awards.
v3.22.0.1
Earnings Per Common Share
12 Months Ended
Dec. 31, 2021
Earnings Per Share [Abstract]  
Earnings Per Common Share EARNINGS PER COMMON SHARE
The following table presents the calculation of basic and diluted EPS for the Company’s common stock for the years ended December 31, 2021, 2020 and 2019, and reconciles the weighted-average common shares outstanding used in the calculation of basic EPS to the weighted-average common shares outstanding used in the calculation of diluted EPS for the years ended December 31, 2021, 2020 and 2019 (amounts in thousands, except per share amounts):
 
 Year Ended December 31,
 202120202019
Numerator:
Net income$71,982 $80,867 $46,359 
Less: Net income allocated to participating securities(507)(298)(296)
Numerator for basic and diluted earnings available to common stockholders$71,475 $80,569 $46,063 
Denominator:
Weighted-average basic common shares outstanding96,017 95,200 93,088 
   Dilutive performance stock awards75 7 10 
Weighted-average diluted common shares outstanding96,092 95,207 93,098 
Earnings per common share, basic$0.74 $0.85 $0.49 
Earnings per common share, diluted$0.74 $0.85 $0.49 
Antidilutive unvested restricted stock awards and performance awards excluded from the computation591 296 292 
v3.22.0.1
Commitments and Contingencies
12 Months Ended
Dec. 31, 2021
Commitments and Contingencies Disclosure [Abstract]  
Commitments and Contingencies COMMITMENTS AND CONTINGENCIES The Company and its subsidiaries are and may become from time to time a party to various claims and lawsuits arising in the ordinary course of business, which are not individually or in the aggregate anticipated to have a material adverse effect on the Company’s results of operations, financial condition or cash flows. Claims and lawsuits may include matters involving general or professional liability asserted against the Company’s tenants, which are the responsibility of the Company’s tenants and for which the Company is entitled to be indemnified by its tenants under the insurance and indemnification provisions in the applicable leases.Capital expenditures for each property leased under the Company’s triple-net leases are generally the responsibility of the tenant, except that, for the facilities leased to subsidiaries of Ensign, under the Ensign Master Leases, and Pennant, the tenant will have an option to require the Company to finance certain capital expenditures up to an aggregate of 20% of its initial investment in such property, subject to a corresponding rent increase at the time of funding. For the Company’s other triple-net master leases, the tenants also have the option to request capital expenditure funding that would generally be subject to a corresponding rent increase at the time of funding, which are subject to tenant compliance with the conditions to the Company’s approval and funding of their requests. As of December 31, 2021, the Company had committed to fund expansions, construction and capital improvements at certain triple-net leased facilities totaling $7.3 million, of which $6.3 million is subject to rent increase at the time of funding.
v3.22.0.1
Concentration of Risk
12 Months Ended
Dec. 31, 2021
Risks and Uncertainties [Abstract]  
Concentration of Risk CONCENTRATION OF RISKConcentrations of credit risk arise when one or more tenants, operators, or obligors related to the Company’s investments are engaged in similar business activities or activities in the same geographic region, or have similar economic features that would cause their ability to meet contractual obligations, including those to the Company, to be similarly affected by changes in economic conditions.
Major operator concentration – The Company has operators from which it derived 10% or more of its rental revenue for the years ended December 31, 2021, 2020 and 2019. The following table sets forth information regarding the Company’s major operators as of December 31, 2021, 2020 and 2019:
 Number of FacilitiesNumber of Beds/Units
Percentage of Total Revenue(1)
Operator(2)
SNFCampusALF/ILFSNFCampusALF/ILF
December 31, 2021
Ensign83 84 8,756 997395 32 %
PMG13 2— 1,742 402— 15 %
December 31, 2020
Ensign77 84 8,129 1,027 390 32 %
PMG13 2— 1,742 403 — 16 %
December 31, 2019
Ensign75 64 7,945 573 390 38 %
PMG13 2— 1,742 403 — 15 %
(1)    The Company’s rental income, exclusive of operating expense reimbursements.
(2)    See Note 3, Real Estate Investments, Net, for further information regarding Ensign and PMG. Ensign is subject to the registration and reporting requirements of the SEC and is required to file with the SEC annual reports containing audited financial information and quarterly reports containing unaudited financial information. Ensign’s financial statements, as filed with the SEC, can be found at http://www.sec.gov. The Company has not verified this information through an independent investigation or otherwise.
Major geographic concentration – The following table provides information regarding the Company’s concentrations with respect to certain states, from which the Company derived 10% or more of its rental revenue for the year ended December 31, 2021:
 Number of FacilitiesNumber of Beds/Units
Percentage of Total Revenue(1)
StateSNFCampusALF/ILFSNFCampusALF/ILF
CA27 85 3,048 1,359 449 25 %
TX37 33 4,694 536242 20 %
(1)    The Company’s rental income, exclusive of operating expense reimbursements.
v3.22.0.1
Subsequent Events
12 Months Ended
Dec. 31, 2021
Subsequent Events [Abstract]  
Subsequent Events SUBSEQUENT EVENTS
The Company evaluates subsequent events in accordance with ASC 855, Subsequent Events. The Company evaluates subsequent events up until the date the consolidated financial statements are issued.
Recent Acquisition and Amended Lease Agreement
In February 2022, the Company acquired one skilled nursing facility for approximately $8.9 million, which includes estimated capitalized acquisition costs. The facilities were leased to affiliates of Eduro Healthcare, LLC (“Eduro”). In conjunction with the acquisition of the facility, the Company amended its existing triple-net master lease with Eduro to include the skilled nursing facility and extended the initial term of the lease. The Eduro lease, as amended, has a remaining initial term of approximately 12 years, with two five-year renewal options and CPI-based rent escalators. Annual cash rent under the amended lease increased by approximately $0.8 million. The acquisition was funded using cash on hand.
v3.22.0.1
Schedule III - Real Estate Assets and Accumulated Depreciation
12 Months Ended
Dec. 31, 2021
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]  
Schedule III - Real Estate Assets and Accumulated Depreciation
Initial Cost to Company Gross Carrying Value
DescriptionFacilityLocationEncum.LandBuilding
Improvs.
Costs
Cap.
Since
Acq.
LandBuilding
Improvs.
Total (1)Accum. Depr.Const./Ren. DateAcq.
Date
Skilled Nursing Properties:
Ensign Highland LLCHighland ManorPhoenix, AZ$— $257 $976 $926 $257 $1,902 $2,159 $(1,397)20132000
Meadowbrook Health Associates LLCSabino CanyonTucson, AZ— 425 3,716 1,940 425 5,656 6,081 (3,308)20122000
Terrace Holdings AZ LLCDesert TerracePhoenix, AZ— 113 504 971 113 1,475 1,588 (945)20042002
Rillito Holdings LLCCatalinaTucson, AZ— 471 2,041 3,055 471 5,096 5,567 (3,296)20132003
Valley Health Holdings LLCNorth MountainPhoenix, AZ— 629 5,154 1,519 629 6,673 7,302 (4,079)20092004
Cedar Avenue Holdings LLCUplandUpland, CA— 2,812 3,919 1,994 2,812 5,913 8,725 (3,672)20112005
Granada Investments LLCCamarilloCamarillo, CA— 3,526 2,827 1,522 3,526 4,349 7,875 (2,780)20102005
Plaza Health Holdings LLCPark ManorWalla Walla, WA— 450 5,566 1,055 450 6,621 7,071 (4,143)20092006
Mountainview Communitycare LLCPark View GardensSanta Rosa, CA— 931 2,612 653 931 3,265 4,196 (2,199)19632006
CM Health Holdings LLCCarmel MountainSan Diego, CA— 3,028 3,119 2,071 3,028 5,190 8,218 (3,184)20122006
Polk Health Holdings LLCTimberwoodLivingston, TX— 60 4,391 1,167 60 5,558 5,618 (3,320)20092006
Snohomish Health Holdings LLCEmerald HillsLynnwood, WA— 741 1,663 1,998 741 3,661 4,402 (2,714)20092006
Cherry Health Holdings LLCPacific CareHoquiam, WA— 171 1,828 2,038 171 3,866 4,037 (2,738)20102006
Golfview Holdings LLCCambridge SNFRichmond, TX— 1,105 3,110 1,067 1,105 4,177 5,282 (2,402)20072006
Tenth East Holdings LLCArlington HillsSalt Lake City, UT— 332 2,426 2,507 332 4,933 5,265 (3,337)20132006
Trinity Mill Holdings LLCCarrolltonCarrollton, TX— 664 2,294 902 664 3,196 3,860 (2,416)20072006
Cottonwood Health Holdings LLCHolladaySalt Lake City, UT— 965 2,070 958 965 3,028 3,993 (2,428)20082007
Verde Villa Holdings LLCLake VillageLewisville, TX— 600 1,890 470 600 2,360 2,960 (1,544)20112007
Mesquite Health Holdings LLCWillow BendMesquite, TX— 470 1,715 8,632 441 10,376 10,817 (7,709)20122007
Arrow Tree Health Holdings LLCArbor GlenGlendora, CA— 2,165 1,105 324 2,165 1,429 3,594 (1,080)19652007
Fort Street Health Holdings LLCDraperDraper, UT— 443 2,394 759 443 3,153 3,596 (1,722)20082007
Trousdale Health Holdings LLCBrookfieldDowney, CA— 1,415 1,841 1,861 1,415 3,702 5,117 (2,225)20132007
Ensign Bellflower LLCRose VillaBellflower, CA— 937 1,168 357 937 1,525 2,462 (982)20092007
RB Heights Health Holdings LLCOsbornScottsdale, AZ— 2,007 2,793 1,762 2,007 4,555 6,562 (2,714)20092008
San Corrine Health Holdings LLCSalado CreekSan Antonio, TX— 310 2,090 719 310 2,809 3,119 (1,523)20052008
Temple Health Holdings LLCWellingtonTemple, TX— 529 2,207 1,163 529 3,370 3,899 (1,932)20082008
Anson Health Holdings LLCNorthern OaksAbilene, TX— 369 3,220 1,725 369 4,945 5,314 (2,736)20122008
Willits Health Holdings LLCNorthbrookWillits, CA— 490 1,231 500 490 1,731 2,221 (957)20112008
Lufkin Health Holdings LLCSouthlandLufkin, TX— 467 4,644 782 467 5,426 5,893 (1,782)19882009
Lowell Health Holdings LLCLittletonLittleton, CO— 217 856 1,735 217 2,591 2,808 (1,564)20122009
Jefferson Ralston Holdings LLCArvadaArvada, CO— 280 1,230 834 280 2,064 2,344 (1,003)20122009
Lafayette Health Holdings LLCJulia TempleEnglewood, CO— 1,607 4,222 6,195 1,607 10,417 12,024 (5,530)20122009
Hillendahl Health Holdings LLCGolden AcresDallas, TX— 2,133 11,977 1,421 2,133 13,398 15,531 (6,037)19842009
Price Health Holdings LLCPinnaclePrice, UT— 193 2,209 849 193 3,058 3,251 (1,209)20122009
Silver Lake Health Holdings LLCProvoProvo, UT— 2,051 8,362 2,011 2,051 10,373 12,424 (3,492)20112009
Jordan Health Properties LLCCopper RidgeWest Jordan, UT— 2,671 4,244 1,507 2,671 5,751 8,422 (2,003)20132009
Regal Road Health Holdings LLCSunviewYoungstown, AZ— 767 4,648 729 767 5,377 6,144 (2,250)20122009
Paredes Health Holdings LLCAlta VistaBrownsville, TX— 373 1,354 190 373 1,544 1,917 (507)19692009
Expressway Health Holdings LLCVerandaHarlingen, TX— 90 675 430 90 1,105 1,195 (503)20112009
Rio Grande Health Holdings LLCGrand TerraceMcAllen, TX— 642 1,085 870 642 1,955 2,597 (1,040)20122009
Fifth East Holdings LLCParamountSalt Lake City, UT— 345 2,464 1,065 345 3,529 3,874 (1,480)20112009
Emmett Healthcare Holdings LLCRiver's EdgeEmmet, ID— 591 2,383 69 591 2,452 3,043 (875)19722010
Burley Healthcare Holdings LLCParke ViewBurley, ID— 250 4,004 424 250 4,428 4,678 (1,723)20112010
Josey Ranch Healthcare Holdings LLCHeritage GardensCarrollton, TX— 1,382 2,293 478 1,382 2,771 4,153 (1,026)19962010
Everglades Health Holdings LLCVictoria VenturaVentura, CA— 1,847 5,377 682 1,847 6,059 7,906 (1,793)19902011
Irving Health Holdings LLCBeatrice ManorBeatrice, NE— 60 2,931 245 60 3,176 3,236 (1,174)20112011
Falls City Health Holdings LLCCareage Estates of Falls CityFalls City, NE— 170 2,141 82 170 2,223 2,393 (749)19722011
Gillette Park Health Holdings LLCCareage of CherokeeCherokee, IA— 163 1,491 12 163 1,503 1,666 (636)19672011
Gazebo Park Health Holdings LLCCareage of ClarionClarion, IA— 80 2,541 97 80 2,638 2,718 (1,162)19782011
Oleson Park Health Holdings LLCCareage of Ft. DodgeFt. Dodge, IA— 90 2,341 759 90 3,100 3,190 (1,696)20122011
Arapahoe Health Holdings LLCOceanviewTexas City, TX— 158 4,810 759 128 5,599 5,727 (2,248)20122011
Dixie Health Holdings LLCHurricaneHurricane, UT— 487 1,978 98 487 2,076 2,563 (582)19782011
Memorial Health Holdings LLCPocatelloPocatello, ID— 537 2,138 698 537 2,836 3,373 (1,185)20072011
Bogardus Health Holdings LLCWhittier EastWhittier, CA— 1,425 5,307 1,079 1,425 6,386 7,811 (2,468)20112011
South Dora Health Holdings LLCUkiahUkiah, CA— 297 2,087 1,621 297 3,708 4,005 (2,181)20132011
Silverada Health Holdings LLCRosewoodReno, NV— 1,012 3,282 103 1,012 3,385 4,397 (892)19702011
Orem Health Holdings LLCOremOrem, UT— 1,689 3,896 3,235 1,689 7,131 8,820 (3,225)20112011
Wisteria Health Holdings LLCWisteriaAbilene, TX— 746 9,903 290 746 10,193 10,939 (2,456)20082011
Renee Avenue Health Holdings LLCMonte VistaPocatello, ID— 180 2,481 966 180 3,447 3,627 (1,368)20132012
Stillhouse Health Holdings LLCStillhouseParis, TX— 129 7,139 6 129 7,145 7,274 (1,205)20092012
Fig Street Health Holdings LLCPalomar VistaEscondido, CA— 329 2,653 1,094 329 3,747 4,076 (1,723)20072012
Lowell Lake Health Holdings LLCOwyheeOwyhee, ID— 49 1,554 29 49 1,583 1,632 (350)19902012
Queensway Health Holdings LLCAtlantic MemorialLong Beach, CA— 999 4,237 2,331 999 6,568 7,567 (2,999)20082012
Long Beach Health Associates LLCShorelineLong Beach, CA— 1,285 2,343 2,172 1,285 4,515 5,800 (2,101)20132012
Kings Court Health Holdings LLCRichland HillsFt. Worth, TX— 193 2,311 318 193 2,629 2,822 (712)19652012
51st Avenue Health Holdings LLCLegacyAmarillo, TX— 340 3,925 32 340 3,957 4,297 (1,009)19702013
Ives Health Holdings LLCSan MarcosSan Marcos, TX— 371 2,951 274 371 3,225 3,596 (789)19722013
Guadalupe Health Holdings LLCThe Courtyard (Victoria East)Victoria, TX— 80 2,391 15 80 2,406 2,486 (477)20132013
49th Street Health Holdings LLCOmahaOmaha, NE— 129 2,418 24 129 2,442 2,571 (711)19602013
Willows Health Holdings LLCCascade VistaRedmond, WA— 1,388 2,982 202 1,388 3,184 4,572 (1,021)19702013
Tulalip Bay Health Holdings LLCMountain ViewMarysville, WA— 1,722 2,642 (980)742 2,642 3,384 (748)19662013
Sky Holdings AZ LLCBella Vita Health and Rehabilitation CenterGlendale, AZ— 228 1,124 1,380 228 2,504 2,731 (1,830)20042002
Lemon River Holdings LLCPlymouth TowerRiverside, CA— 152 357 1,493 152 1,850 2,002 (1,285)20122009
CTR Partnership, L.P.Bethany Rehabilitation CenterLakewood, CO— 1,668 15,375 56 1,668 15,431 17,099 (2,671)19892015
CTR Partnership, L.P.Mira Vista Care CenterMount Vernon, WA— 1,601 7,425 — 1,601 7,425 9,026 (1,253)19892015
CTR Partnership, L.P.Shoreline Health and Rehabilitation CenterShoreline, WA— 1,462 5,034 — 1,462 5,034 6,496 (829)19872015
CTR Partnership, L.P.Shamrock Nursing and Rehabilitation CenterDublin, GA— 251 7,855 — 251 7,855 8,106 (1,276)20102015
CTR Partnership, L.P.BeaverCreek Health and RehabBeavercreek, OH— 892 17,159 13 892 17,172 18,064 (2,684)20142015
CTR Partnership, L.P.Premier Estates of Cincinnati-RiverviewCincinnati, OH— 833 18,086 474 833 18,560 19,393 (2,884)19922015
CTR Partnership, L.P.Englewood Health and RehabEnglewood, OH— 1,014 18,541 88 1,014 18,629 19,643 (2,937)19622015
CTR Partnership, L.P.Portsmouth Health and RehabPortsmouth, OH— 282 9,726 428 282 10,154 10,436 (1,679)20082015
CTR Partnership, L.P.West Cove Care & Rehabilitation CenterToledo, OH— 93 10,365 — 93 10,365 10,458 (1,619)20072015
CTR Partnership, L.P.BellBrook Health and RehabBellbrook, OH— 214 2,573 231 214 2,804 3,018 (466)20032015
CTR Partnership, L.P.Xenia Health and RehabXenia, OH— 205 3,564 23 205 3,587 3,792 (562)19812015
CTR Partnership, L.P.Jamestown Place Health and RehabJamestown, OH— 266 4,725 268 266 4,993 5,259 (834)19672015
CTR Partnership, L.P.Casa de PazSioux City, IA— 119 7,727 — 119 7,727 7,846 (1,143)19742016
CTR Partnership, L.P.Denison Care CenterDenison, IA— 96 2,784 — 96 2,784 2,880 (412)20152016
CTR Partnership, L.P.Garden View Care CenterShenandoah, IA— 105 3,179 — 105 3,179 3,284 (470)20132016
CTR Partnership, L.P.Grandview Health Care CenterDayton, IA— 39 1,167 — 39 1,167 1,206 (173)20142016
CTR Partnership, L.P.Grundy Care CenterGrundy Center, IA— 65 1,935 — 65 1,935 2,000 (286)20112016
CTR Partnership, L.P.Iowa City Rehab and Health Care CenterIowa City, IA— 522 5,690 — 522 5,690 6,212 (842)20142016
CTR Partnership, L.P.Lenox Care CenterLenox, IA— 31 1,915 — 31 1,915 1,946 (283)20122016
CTR Partnership, L.P.OsageOsage, IA— 126 2,255 — 126 2,255 2,381 (334)20142016
CTR Partnership, L.P.Pleasant Acres Care CenterHull, IA— 189 2,544 — 189 2,544 2,733 (376)20142016
CTR Partnership, L.P.Cedar Falls Health Care CenterCedar Falls, IA— 324 4,366 — 324 4,366 4,690 (628)20152016
CTR Partnership, L.P.Premier Estates of HighlandsNorwood, OH— 364 2,199 439 364 2,638 3,002 (369)20122016
CTR Partnership, L.P.Shaw Mountain at CascadiaBoise, ID— 1,801 6,572 395 1,801 6,967 8,768 (1,112)19892016
CTR Partnership, L.P.The OaksPetaluma, CA— 3,646 2,873 110 3,646 2,983 6,629 (436)20152016
CTR Partnership, L.P.Arbor Nursing CenterLodi, CA— 768 10,712 — 768 10,712 11,480 (1,451)19822016
CTR Partnership, L.P.Broadmoor Medical LodgeRockwall, TX— 1,232 22,152 — 1,232 22,152 23,384 (2,816)19842016
CTR Partnership, L.P.Decatur Medical LodgeDecatur, TX— 990 24,909 — 990 24,909 25,899 (3,166)20132016
CTR Partnership, L.P.Royse City Medical LodgeRoyse City, TX— 606 14,660 — 606 14,660 15,266 (1,863)20092016
CTR Partnership, L.P.Saline Care Nursing & Rehabilitation CenterHarrisburg, IL— 1,022 5,713 — 1,022 5,713 6,735 (690)20092017
CTR Partnership, L.P.Carrier Mills Nursing & Rehabilitation CenterCarrier Mills, IL— 775 8,377 — 775 8,377 9,152 (1,012)19682017
CTR Partnership, L.P.StoneBridge Nursing & Rehabilitation CenterBenton, IL— 439 3,475 — 439 3,475 3,914 (420)20142017
CTR Partnership, L.P.DuQuoin Nursing & Rehabilitation CenterDuQuoin, IL— 511 3,662 — 511 3,662 4,173 (442)20142017
CTR Partnership, L.P.Pinckneyville Nursing & Rehabilitation CenterPinckneyville, IL— 406 3,411 — 406 3,411 3,817 (412)20142017
CTR Partnership, L.P.Wellspring Health and Rehabilitation of CascadiaNampa, ID— 774 5,044 111 774 5,155 5,929 (588)20112017
CTR Partnership, L.P.The Rio at Fox HollowBrownsville, TX— 1,178 12,059 — 1,178 12,059 13,237 (1,382)20162017
CTR Partnership, L.P.The Rio at CabezonAlbuquerque, NM— 2,055 9,749 — 2,055 9,749 11,804 (1,117)20162017
CTR Partnership, L.P.Eldorado Rehab & HealthcareEldorado, IL— 940 2,093 — 940 2,093 3,033 (235)19932017
CTR Partnership, L.P.Secora Health and Rehabilitation of CascadiaPortland, OR— 1,481 2,216 110 1,481 2,326 3,807 (249)20122017
CTR Partnership, L.P.Mountain ValleyKellogg, ID— 916 7,874 — 916 7,874 8,790 (853)19712017
CTR Partnership, L.P.Caldwell CareCaldwell, ID— 906 7,020 516 906 7,536 8,442 (761)19472017
CTR Partnership, L.P.Canyon WestCaldwell, ID— 312 10,410 431 312 10,841 11,153 (1,128)19692017
CTR Partnership, L.P.Lewiston Health and RehabilitationLewiston, ID— 625 12,087 152 625 12,239 12,864 (1,284)19642017
CTR Partnership, L.P.The OrchardsNampa, ID— 785 8,923 47 785 8,970 9,755 (948)19582017
CTR Partnership, L.P.Weiser CareWeiser, ID— 80 4,419 30 80 4,449 4,529 (470)19642017
CTR Partnership, L.P.Aspen ParkMoscow, ID— 698 5,092 274 698 5,366 6,064 (584)19652017
CTR Partnership, L.P.Ridgmar Medical LodgeFort Worth, TX— 681 6,587 1,256 681 7,843 8,524 (950)20062017
CTR Partnership, L.P.Mansfield Medical LodgeMansfield, TX— 607 4,801 1,073 607 5,874 6,481 (701)20062017
CTR Partnership, L.P.Grapevine Medical LodgeGrapevine, TX— 1,602 4,536 891 1,602 5,427 7,029 (659)20062017
CTR Partnership, L.P.Brookfield Health and RehabBattle Ground, WA— 320 500 — 320 500 820 (54)20122017
CTR Partnership, L.P.The Oaks at LakewoodTacoma, WA— 1,000 1,779 — 1,000 1,779 2,779 (189)19892017
CTR Partnership, L.P.The Oaks at TimberlineVancouver, WA— 445 869 — 445 869 1,314 (92)19722017
CTR Partnership, L.P.Providence Waterman Nursing CenterSan Bernardino, CA— 3,831 19,791 — 3,831 19,791 23,622 (2,103)19672017
CTR Partnership, L.P.Providence Orange TreeRiverside, CA— 2,897 14,700 345 2,897 15,045 17,942 (1,585)19692017
CTR Partnership, L.P.Providence OntarioOntario, CA— 4,204 21,880 — 4,204 21,880 26,084 (2,325)19802017
CTR Partnership, L.P.Greenville Nursing & Rehabilitation CenterGreenville, IL— 188 3,972 — 188 3,972 4,160 (484)19732017
CTR Partnership, L.P.Copper Ridge Health and Rehabilitation CenterButte, MT— 220 4,974 22 220 4,996 5,216 (536)20102018
CTR Partnership, L.P.Prairie Heights Healthcare CenterAberdeen, SD— 1,372 7,491 — 1,372 7,491 8,863 (718)19652018
CTR Partnership, L.P.The Meadows on UniversityFargo, ND— 989 3,275 — 989 3,275 4,264 (287)19662018
CTR Partnership, L.P.The Suites - ParkerParker, CO— 1,178 17,857 — 1,178 17,857 19,035 (1,408)20122018
CTR Partnership, L.P.Huntington Park Nursing CenterHuntington Park, CA— 3,131 8,876 299 3,131 9,175 12,306 (720)19552019
CTR Partnership, L.P.Shoreline Care CenterOxnard, CA— 1,699 9,004 — 1,699 9,004 10,703 (674)19622019
CTR Partnership, L.P.Downey Care CenterDowney, CA— 2,502 6,141 — 2,502 6,141 8,643 (461)19672019
CTR Partnership, L.P.Courtyard Healthcare CenterDavis, CA— 2,351 9,256 — 2,351 9,256 11,607 (706)19692019
Gulf Coast Buyer 1 LLCAlpine Skilled Nursing and RehabilitationRuston, LA— 2,688 23,825 — 2,688 23,825 26,513 (1,728)20142019
Gulf Coast Buyer 1 LLCThe Bradford Skilled Nursing and RehabilitationShreveport, LA— 3,758 21,325 17 3,758 21,342 25,100 (1,559)19802019
Gulf Coast Buyer 1 LLCColonial Oaks Skilled Nursing and RehabilitationBossier City, LA— 1,635 21,180 — 1,635 21,180 22,815 (1,500)20132019
Gulf Coast Buyer 1 LLCThe Guest House Skilled Nursing and RehabilitationShreveport, LA— 3,437 20,889 1,226 3,437 22,115 25,552 (1,550)20062019
Gulf Coast Buyer 1 LLCPilgrim Manor Skilled Nursing and RehabilitationBossier City, LA— 2,979 24,617 — 2,979 24,617 27,596 (1,765)20082019
Gulf Coast Buyer 1 LLCShreveport Manor Skilled Nursing and RehabilitationShreveport, LA— 676 10,238 361 676 10,599 11,275 (769)20082019
Gulf Coast Buyer 1 LLCBooker T. Washington Skilled Nursing and RehabilitationShreveport, LA— 2,452 9,148 113 2,452 9,261 11,713 (705)20132019
Gulf Coast Buyer 1 LLCLegacy West Rehabilitation and HealthcareCorsicana, TX— 120 6,682 436 120 7,118 7,238 (560)20022019
Gulf Coast Buyer 1 LLCLegacy at JacksonvilleJacksonville, TX— 173 7,481 127 173 7,608 7,781 (588)20062019
Gulf Coast Buyer 1 LLCPecan Tree Rehabilitation and HealthcareGainesville, TX— 219 10,097 255 219 10,352 10,571 (772)19902019
Lakewest SNF Realty, LLCLakewest Rehabilitation and Skilled CareDallas, TX— — 6,905 — — 6,905 6,905 (515)20112019
CTR Partnership, L.P.Cascadia of NampaNampa, ID— 880 14,117 — 880 14,117 14,997 (969)20172019
CTR Partnership, L.P.Valley Skilled NursingModesto, CA— 798 7,671 — 798 7,671 8,469 (448)20162019
CTR Partnership, L.P.Cascadia of BoiseBoise, ID— 1,597 15,692 — 1,597 15,692 17,289 (824)20182020
CTR Partnership, L.P.Cooney Healthcare and RehabilitationHelena, MT— 867 7,431 — 867 7,431 8,298 (262)19842020
CTR Partnership, L.P.Elkhorn Healthcare and RehabilitationClancy, MT— 183 7,380 174 183 7,554 7,737 (264)19602020
CTR Partnership, L.P.Beacon Harbor Healthcare and RehabilitationRockwall, TX— 1,295 17,069 — 1,295 17,069 18,364 (533)19962020
CTR Partnership, L.P.Pleasant Manor Healthcare and RehabilitationWaxahachie, TX— 629 7,433 — 629 7,433 8,062 (234)19722020
CTR Partnership, L.P.Rowlett Health and Rehabilitation CenterRowlett, TX— 1,036 10,516 — 1,036 10,516 11,552 (326)19902020
160 North Patterson Avenue, LLCBuena Vista Care CenterGoleta, CA— 7,987 7,237 — 7,987 7,237 15,224 (160)19672021
CTR Partnership, L.P.El Centro Post-Acute CareEl Centro, CA— 1,283 8,133 76 1,283 8,209 9,492 (143)19622021
CTR Partnership, L.P.Sedona Trace Health and WellnessAustin, TX— 3,282 12,763 — 3,282 12,763 16,045 (149)20172021
CTR Partnership, L.P.Cedar Pointe Health and Wellness SuitesCedar Park, TX— 3,325 11,738 — 3,325 11,738 15,063 (135)20172021
— 161,032 1,003,798 94,187 159,993 1,099,024 1,259,016 (225,820)
Multi-Service Campus Properties:
Ensign Southland LLCSouthland CareNorwalk, CA— 966 5,082 2,213 966 7,295 8,261 (5,588)20111999
Mission CCRC LLCSt. Joseph's VillaSalt Lake City, UT— 1,962 11,035 464 1,962 11,499 13,461 (3,634)19942011
Wayne Health Holdings LLCCareage of WayneWayne, NE— 130 3,061 122 130 3,183 3,313 (1,100)19782011
4th Street Holdings LLCWest Bend Care CenterWest Bend, IA— 180 3,352 — 180 3,352 3,532 (1,095)20062011
Big Sioux River Health Holdings LLCHillcrest HealthHawarden, IA— 110 3,522 75 110 3,597 3,707 (1,104)19742011
Prairie Health Holdings LLCColonial Manor of RandolphRandolph, NE— 130 1,571 22 130 1,593 1,723 (838)20112011
Salmon River Health Holdings LLCDiscovery Care CenterSalmon, ID— 168 2,496 — 168 2,496 2,664 (588)20122012
CTR Partnership, L.P.Centerville Senior Independent LivingDayton, OH— 3,912 22,458 117 3,781 22,706 26,487 (3,605)20072015
CTR Partnership, L.P.Liberty Nursing Center of WillardWillard, OH— 143 11,097 50 143 11,147 11,290 (1,760)19852015
CTR Partnership, L.P.Premier Estates of Middletown/Premier Retirement Estates of MiddletownMiddletown, OH— 990 7,484 371 990 7,855 8,845 (1,229)19852015
CTR Partnership, L.P.Premier Estates of Norwood Towers/Premier Retirement Estates of Norwood TowersNorwood, OH— 1,316 10,071 799 1,316 10,870 12,186 (1,538)19912016
CTR Partnership, L.P.Turlock Nursing and Rehabilitation CenterTurlock, CA— 1,258 16,526 — 1,258 16,526 17,784 (2,238)19862016
CTR Partnership, L.P.Bridgeport Medical LodgeBridgeport, TX— 980 27,917 — 980 27,917 28,897 (3,548)20142016
CTR Partnership, L.P.The Villas at SaratogaSaratoga, CA— 8,709 9,736 1,396 8,709 11,132 19,841 (1,008)20042018
CTR Partnership, L.P.Madison Park HealthcareHuntington, WV— 601 6,385 — 601 6,385 6,986 (525)19242018
CTR Partnership, L.P.Oakview Heights Nursing & Rehabilitation CenterMt. Carmel, IL— 298 8,393 — 298 8,393 8,691 (692)20042019
Gulf Coast Buyer 1 LLCSpring Lake Skilled Nursing and RehabilitationShreveport, LA— 3,217 21,195 2,730 3,217 23,925 27,142 (1,666)20082019
Gulf Coast Buyer 1 LLCThe Village at Heritage OaksCorsicana, TX— 143 11,429 482 143 11,911 12,054 (913)20072019
CTR Partnership, L.P.City Creek Post-Acute and Assisted LivingSacramento, CA— 3,980 10,106 1,488 3,980 11,594 15,574 (655)19902019
CTR Partnership, L.P.Crestwood Health and Rehabilitation CenterWills Point, TX— 143 6,075 — 143 6,075 6,218 (198)19802020
Northshore Healthcare Holdings LLCSan Juan Capistrano Senior LivingSan Juan Capistrano, CA— 11,176 25,298 — 11,176 25,298 36,474 (548)19992021
Northshore Healthcare Holdings LLCCamarillo Senior LivingCamarillo, CA— 7,516 30,552 — 7,516 30,552 38,068 (655)20002021
Northshore Healthcare Holdings LLCBayshire CarlsbadCarlsbad, CA— 7,398 19,714 — 7,398 19,714 27,112 (429)19992021
Northshore Healthcare Holdings LLCBayshire Rancho MirageRancho Mirage, CA— 4,024 16,790 — 4,024 16,790 20,814 (373)20002021
— 59,450 291,345 10,329 59,319 301,805 361,124 (35,527)
Assisted and Independent Living Properties:
Avenue N Holdings LLCCambridge ALFRosenburg, TX— 124 2,301 392 124 2,693 2,817 (1,453)20072006
Moenium Holdings LLCGrand CourtMesa, AZ— 1,893 5,268 1,210 1,893 6,478 8,371 (3,672)19862007
Lafayette Health Holdings LLCChateau Des MonsEnglewood, CO— 420 1,160 189 420 1,349 1,769 (471)20112009
Expo Park Health Holdings LLCCanterbury GardensAurora, CO— 570 1,692 248 570 1,940 2,510 (942)19862010
Wisteria Health Holdings LLCWisteria INDAbilene, TX— 244 3,241 81 244 3,322 3,566 (1,675)20082011
Everglades Health Holdings LLCLexingtonVentura, CA— 1,542 4,012 113 1,542 4,125 5,667 (977)19902011
Flamingo Health Holdings LLCDesert Springs ALFLas Vegas, NV— 908 4,767 281 908 5,048 5,956 (2,770)19862011
18th Place Health Holdings LLCRose CourtPhoenix, AZ— 1,011 2,053 490 1,011 2,543 3,554 (1,042)19742011
Boardwalk Health Holdings LLCPark PlaceReno, NV— 367 1,633 51 367 1,684 2,051 (568)19932012
Willows Health Holdings LLCCascade PlazaRedmond, WA— 2,835 3,784 395 2,835 4,179 7,014 (1,350)20132013
Lockwood Health Holdings LLCSanta MariaSanta Maria, CA— 1,792 2,253 585 1,792 2,838 4,630 (1,410)19672013
Saratoga Health Holdings LLCLake RidgeOrem, UT— 444 2,265 176 444 2,441 2,885 (520)19952013
Sky Holdings AZ LLCDesert Sky Assisted LivingGlendale, AZ— 61 304 372 61 676 738 (494)20042002
Lemon River Holdings LLCThe Grove Assisted LivingRiverside, CA— 342 802 3,360 342 4,162 4,504 (2,892)20122009
Mission CCRC LLCSt. Joseph's Villa INDSalt Lake City, UT— 411 2,312 258 411 2,570 2,981 (1,616)19942011
CTR Partnership, L.P.Prelude Cottages of WoodburyWoodbury, MN— 430 6,714 76 430 6,790 7,220 (1,179)20112014
CTR Partnership, L.P.English Meadows Senior Living CommunityChristiansburg, VA— 250 6,114 175 250 6,289 6,539 (1,076)20112014
CTR Partnership, L.P.Bristol Court Assisted LivingSaint Petersburg, FL— 645 7,322 408 645 7,730 8,375 (1,198)20102015
CTR Partnership, L.P.Asbury Place Assisted LivingPensacola, FL— 212 4,992 222 212 5,214 5,426 (802)19972015
CTR Partnership, L.P.New Haven Assisted Living of San AngeloSan Angelo, TX— 284 4,478 — 284 4,478 4,762 (662)20122016
CTR Partnership, L.P.Lamplight Inn of Fort WayneFort Wayne, IN— 452 8,703 304 452 9,007 9,459 (1,269)20152016
CTR Partnership, L.P.Lamplight Inn of West AllisWest Allis, WI— 97 6,102 106 97 6,208 6,305 (890)20132016
CTR Partnership, L.P.Fort Myers Assisted LivingFort Myers, FL— 1,489 3,531 786 1,489 4,317 5,806 (556)19802016
CTR Partnership, L.P.English Meadows Elks Home CampusBedford, VA— 451 9,023 287 451 9,310 9,761 (1,360)20142016
CTR Partnership, L.P.Croatan VillageNew Bern, NC— 312 6,919 — 312 6,919 7,231 (980)20102016
CTR Partnership, L.P.Countryside VillagePikeville, NC— 131 4,157 — 131 4,157 4,288 (589)20112016
CTR Partnership, L.P.The Pines of ClarkstonVillage of Clarkston, MI— 603 9,326 — 603 9,326 9,929 (1,302)20102016
CTR Partnership, L.P.The Pines of GoodrichGoodrich, MI— 241 4,112 130 241 4,242 4,483 (574)20142016
CTR Partnership, L.P.The Pines of BurtonBurton, MI— 492 9,199 — 492 9,199 9,691 (1,284)20142016
CTR Partnership, L.P.The Pines of LapeerLapeer, MI— 302 5,773 — 302 5,773 6,075 (806)20082016
CTR Partnership, L.P.Arbor PlaceLodi, CA— 392 3,605 — 392 3,605 3,997 (488)19842016
CTR Partnership, L.P.Applewood of BrookfieldBrookfield, WI— 493 14,002 — 493 14,002 14,495 (1,721)20132017
CTR Partnership, L.P.Applewood of New BerlinNew Berlin, WI— 356 10,812 13 356 10,825 11,181 (1,329)20162017
CTR Partnership, L.P.Tangerine Cove of BrooksvilleBrooksville, FL— 995 927 493 995 1,420 2,415 (151)19842017
CTR Partnership, L.P.Memory Care Cottages in White Bear LakeWhite Bear Lake, MN— 1,611 5,633 — 1,611 5,633 7,244 (634)20162017
CTR Partnership, L.P.CulpeperCulpepper, VA— 318 3,897 197 318 4,094 4,412 (492)19972017
CTR Partnership, L.P.LouisaLouisa, VA— 407 4,660 240 407 4,900 5,307 (599)20022017
CTR Partnership, L.P.WarrentonWarrenton, VA— 1,238 7,247 194 1,238 7,441 8,679 (880)19992017
CTR Partnership, L.P.Vista Del LagoEscondido, CA— 4,362 7,997 — 4,362 7,997 12,359 (489)20152019
CTR Partnership, L.P.Inn at Barton CreekBountiful, UT— 2,479 4,804 15 2,479 4,819 7,298 (249)19992020
CTR Partnership, L.P.Bridgeton Essentia NeighborhoodBridgeton, NJ— 245 5,795 — 245 5,795 6,040 (14)20212021
CTR Partnership, L.P.Rio Grande Essentia NeighborhoodRio Grande, NJ— 224 5,652 — 224 5,652 5,876 (13)20212021
— 32,475 209,343 11,847 32,475 221,190 253,666 (43,438)
— $252,957 $1,504,486 $116,363 $251,787 $1,622,019 $1,873,806 $(304,785)
(1) The aggregate cost of real estate for federal income tax purposes was $1.9 billion.
 Year Ended December 31,
Real estate:202120202019
Balance at the beginning of the period$1,683,205 $1,605,081 $1,368,157 
Acquisitions190,133 84,630 318,070 
Improvements4,521 7,223 3,103 
Impairment— — (21,465)
Sales of real estate(4,053)(13,729)(62,784)
Balance at the end of the period$1,873,806 $1,683,205 $1,605,081 
Accumulated depreciation:
Balance at the beginning of the period$(259,803)$(220,359)$(185,926)
Depreciation expense(45,498)(41,914)(40,373)
Impairment— — 5,220 
Sales of real estate516 2,470 720 
Balance at the end of the period$(304,785)$(259,803)$(220,359)
v3.22.0.1
Schedule IV - Mortgage Loans on Real Estate
12 Months Ended
Dec. 31, 2021
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Abstract]  
Schedule IV - Mortgage Loans on Real Estate
DescriptionContractual Interest RateMaturity DatePeriodic Payment TermsPrior LiensPrincipal Balance
Book Value (2)
Carrying Amount of Loans Subject to Delinquent Principal or Interest
Mezzanine Loan:
Virginia (9 SNF facilities)12.0 %2025(1)$112,278 (3)$15,000 $15,155 N/A
$112,278 $15,000 $15,155 

(1)     Interest is due monthly, and principal is due at the maturity date.
(2)    The aggregate cost of investments in real estate mortgage loans for federal income tax purposes was $15.0 million.
(3)    The first mortgage loans on these properties are not held by the Company. Accordingly, the amounts of the prior liens at December 31, 2021 are estimated.

Changes in mortgage loans are summarized as follows (in thousands):
Year Ended December 31,
202120202019
Balance at beginning of period$15,000 $29,500 $12,375 
Additions during period:
New mortgage loans— 61,258 40,889 
Interest income added to principal155 — — 
Deductions during period:
Paydowns/Repayments— (75,758)(23,764)
Balance at end of period$15,155 $15,000 $29,500 
v3.22.0.1
Summary of Significant Accounting Policies (Policies)
12 Months Ended
Dec. 31, 2021
Accounting Policies [Abstract]  
Basis of Presentation Basis of Presentation—The accompanying consolidated financial statements of the Company reflect, for all periods presented, the historical financial position, results of operations and cash flows of the Company and its wholly-owned subsidiaries prepared in accordance with accounting principles generally accepted in the United States (“GAAP”). All intercompany transactions and account balances within the Company have been eliminated.
Lessor Accounting
Lessor Accounting—The Company recognizes lease revenue in accordance with Accounting Standards Codification (“ASC”) 842, Leases. The Company’s lease agreements typically contain annual escalators based on the percentage change in the Consumer Price Index which are accounted for as variable lease payments in the period in which the change occurs. For lease agreements that contain fixed rent escalators, the Company generally recognizes lease revenue on a straight-line basis of accounting. The Company generates revenues primarily by leasing healthcare-related properties to healthcare operators in triple-net lease arrangements, under which the tenant is solely responsible for the costs related to the property. Tenant reimbursements related to property taxes and insurance paid by the lessee directly to a third party on behalf of a lessor are required to be excluded from variable payments and from recognition in the lessor’s income statements. Otherwise, tenant recoveries for taxes and insurance are classified as additional rental revenues recognized by the lessor on a gross basis in its income statements.
The Company’s assessment of collectibility of its tenant receivables includes a binary assessment of whether or not substantially all of the amounts due under a tenant’s lease agreement are probable of collection. The Company considers the operator’s performance and anticipated trends, payment history, and the existence and creditworthiness of guarantees, among other factors, in making this determination. For such leases that are deemed probable of collection, revenue continues to be recorded on a straight-line basis over the lease term, if applicable. For such leases that are deemed not probable of collection, revenue is recorded as the lesser of (i) the amount which would be recognized on a straight-line basis or (ii) cash that has been received from the tenant, with any tenant and deferred rent receivable balances charged as a direct write-off against rental income in the period of the change in the collectibility determination. Such write-offs and recoveries are recorded as decreases
or increases through rental income on the Company’s consolidated income statements. For the year ended December 31, 2021, the Company did not record any recovery adjustments or write-off adjustments to rental income. For the year ended December 31, 2020, the Company recorded recovery adjustments of $1.0 million and did not recognize any write-off adjustments to rental income. For the year ended December 31, 2019, the Company recorded $11.8 million of write-off adjustments to rental income related to rental income recognized in prior periods. See Note 3, Real Estate Investments, Net for further detail.
Estimates and Assumptions Estimates and Assumptions—The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting periods. Management believes that the assumptions and estimates used in preparation of the underlying consolidated financial statements are reasonable. Actual results, however, could differ from those estimates and assumptions.
Real Estate Acquisition Valuation
Real Estate Acquisition Valuation— In accordance with ASC 805, Business Combinations, the Company’s acquisitions of real estate investments generally do not meet the definition of a business, and are treated as asset acquisitions. The assets acquired and liabilities assumed are measured at their acquisition date relative fair values. Acquisition costs are capitalized as incurred. The Company allocates the acquisition costs to the tangible assets, identifiable intangible assets/liabilities and assumed liabilities on a relative fair value basis. The Company assesses fair value based on available market information, such as capitalization and discount rates, comparable sale transactions and relevant per square foot or unit cost information. A real estate asset’s fair value may be determined utilizing cash flow projections that incorporate such market information. Estimates of future cash flows are based on a number of factors including historical operating results, known and anticipated trends, as well as market and economic conditions. The fair value of tangible assets of an acquired property is based on the value of the property as if it is vacant.

As part of the Company’s real estate acquisitions, the Company may commit to provide contingent payments to a seller or lessee (e.g., an earn-out payable upon the applicable property achieving certain financial metrics). Typically, when the contingent payments are funded, cash rent is increased by the amount funded multiplied by a rate stipulated in the agreement. Generally, if the contingent payment is an earn-out provided to the seller, the payment is capitalized to the property’s basis when earn-out becomes probable and estimable. If the contingent payment is an earn-out provided to the lessee, the payment is recorded as a lease incentive and is amortized as a yield adjustment over the life of the lease.
Impairment of Long-Lived Assets
Impairment of Long-Lived Assets—At each reporting period, the Company evaluates its real estate investments to be held and used for potential impairment whenever events or changes in circumstances indicate that the carrying amount of the assets may not be recoverable. The judgment regarding the existence of impairment indicators, used to determine if an impairment assessment is necessary, is based on factors such as, but not limited to, market conditions, operator performance and legal structure. If indicators of impairment are present, the Company evaluates the carrying value of the related real estate investments in relation to the future undiscounted cash flows of the underlying facilities. The most significant inputs to the undiscounted cash flows include, but are not limited to, facility level financial results, a lease coverage ratio, the intended hold period by the Company, and a terminal capitalization rate. The analysis is also significantly impacted by determining the lowest level of cash flows, which generally would be at the master lease level of cash flows. Provisions for impairment losses related to long-lived assets are recognized when expected future undiscounted cash flows are determined to be less than the carrying values of the assets. The impairment is measured as the excess of carrying value over fair value. All impairments are taken as a period cost at that time, and depreciation is adjusted going forward to reflect the new value assigned to the asset. For the year ended December 31, 2019, the Company recorded an impairment expense of $16.7 million. See Note 3, Real Estate Investments, Net, for additional information.

The Company classifies its real estate investments as held for sale when the applicable criteria have been met, which entails a formal plan to sell the properties that is expected to be completed within one year, among other criteria. Upon designation as held for sale, the Company writes down the excess of the carrying value over the estimated fair value less costs to sell, resulting in an impairment of the real estate investments, if necessary, and ceases depreciation.

In the event of impairment, the fair value of the real estate investment is based on current market conditions and considers matters such as the forecasted operating cash flows, lease coverage ratios, capitalization rates, comparable sales data, and, where applicable, contracts or the results of negotiations with purchasers or prospective purchasers.

The Company’s ability to accurately estimate future cash flows and estimate and allocate fair values impacts the timing and recognition of impairments. While the Company believes its assumptions are reasonable, changes in these assumptions may have a material impact on financial results.
Other Real Estate Investments Other Real Estate Investments—Included in other real estate investments on the Company’s consolidated balance sheets at December 31, 2021 and 2020, is one mezzanine loan receivable for which the Company elected the fair value option. Instruments for which the fair value option has been elected are measured at fair value on a recurring basis with changes in fair value recognized in other income (loss) on the consolidated income statements. Fair value was estimated using an internal valuation model that considered the expected future cash flows of the investment, the underlying collateral value, market interest rates and other credit enhancements. Interest income is recognized as earned within interest and other income in the consolidated income statements.
Prepaid expenses and other assets
Prepaid expenses and other assets—Prepaid expenses and other assets consist of prepaid expenses, deposits, pre-acquisition costs and other loans receivable. During the year ended December 31, 2019, the Company determined that the remaining contractual obligations under one other loan receivable were not collectible and recorded a $1.1 million provision for loan losses in the Company’s consolidated income statements.
The Company’s other loans receivable are reflected at amortized cost, net of an allowance for credit loss, on the accompanying consolidated balance sheets. The amortized cost of a loan receivable is the outstanding unpaid principal balance, net of unamortized discounts, costs and fees directly associated with the origination of the loan.
Income Taxes Income Taxes—The Company has elected to be taxed as a real estate investment trust (“REIT”) under the Internal Revenue Code of 1986, as amended (the “Code”). The Company believes it has been organized and has operated, and the Company intends to continue to operate, in a manner to qualify for taxation as a REIT under the Code. To qualify as a REIT, the Company must meet certain organizational and operational requirements, including a requirement to distribute to its stockholders at least 90% of the Company’s annual REIT taxable income (computed without regard to the dividends paid deduction or net capital gain and which does not necessarily equal net income as calculated in accordance with GAAP). As a REIT, the Company generally will not be subject to federal income tax to the extent it distributes as qualifying dividends all of its REIT taxable income to its stockholders. If the Company fails to qualify as a REIT in any taxable year, it will be subject to federal income tax on its taxable income at regular corporate income tax rates and generally will not be permitted to qualify for treatment as a REIT for federal income tax purposes for the four taxable years following the year during which qualification is lost unless the Internal Revenue Service grants the Company relief under certain statutory provisions.
Real Estate Depreciation and Amortization Real Estate Depreciation and Amortization—Real estate costs related to the acquisition and improvement of properties are capitalized and amortized over the expected useful life of the asset on a straight-line basis. Repair and maintenance costs are charged to expense as incurred and significant replacements and betterments are capitalized. Repair and maintenance costs include all costs that do not extend the useful life of the real estate asset. The Company considers the period of future benefit of an asset to determine its appropriate useful life. Expenditures for tenant improvements are capitalized and amortized over the shorter of the tenant’s lease term or expected useful life. The Company anticipates the estimated useful lives of its assets by class to be generally as follows:
Building
25-40 years
Building improvements
10-25 years
Tenant improvementsShorter of lease term or expected useful life
Integral equipment, furniture and fixtures
5 years
Identified intangible assetsShorter of lease term or expected useful life
Cash and Cash Equivalents Cash and Cash Equivalents—Cash and cash equivalents consist of bank term deposits and money market funds with original maturities of three months or less at time of purchase and therefore approximate fair value. The fair value of these investments is determined based on “Level 1” inputs, which consist of unadjusted quoted prices in active markets that are accessible at the measurement date for identical, unrestricted assets. The Company places its cash and short-term investments with high credit quality financial institutions.The Company’s cash and cash equivalents balance periodically exceeds federally insurable limits. The Company monitors the cash balances in its operating accounts and adjusts the cash balances as appropriate; however, these cash balances could be impacted if the underlying financial institutions fail or are subject to other adverse conditions in the financial markets. To date, the Company has experienced no loss or lack of access to cash in its operating accounts.
Deferred Financing Costs Deferred Financing Costs—External costs incurred from placement of the Company’s debt are capitalized and amortized on a straight-line basis over the terms of the related borrowings, which approximates the effective interest method.
For senior unsecured notes payable and the senior unsecured term loan, deferred financing costs are netted against the outstanding debt amounts on the balance sheet. For the unsecured revolving credit facility, deferred financing costs are included in assets on the Company’s balance sheet. Amortization of deferred financing costs is classified as interest expense in the consolidated income statements. Accumulated amortization of deferred financing costs was $8.0 million and $9.0 million at December 31, 2021 and 2020, respectively.
When financings are terminated, unamortized deferred financing costs, as well as charges incurred for the termination, are expensed at the time the termination is made. Gains and losses from the extinguishment of debt are presented within other income (loss) in the Company’s consolidated income statements. During the year ended December 31, 2021, the Company recorded a loss on extinguishment of debt of $10.8 million. See Note 6, Debt, for further detail.
Stock-Based Compensation Stock-Based Compensation—The Company accounts for share-based payment awards in accordance with ASC Topic 718, Compensation – Stock Compensation (“ASC 718”). ASC 718 requires all entities to apply a fair value-based measurement method in accounting for share-based payment transactions with directors, officers and employees. The Company measures and recognizes compensation expense for all share-based payment awards made to directors, officers and employees based on the grant date fair value, amortized over the requisite service period of the award. Compensation expense for awards with performance-based vesting conditions is recognized based upon the probability that the performance target will be met. Compensation expense for awards with market-based vesting conditions is recognized based upon the estimated number of awards to be earned after considering the Company’s expectation of future performance and is recognized provided that the requisite service is rendered, regardless of when, if ever, the market condition is satisfied. Forfeitures of stock-based awards are recognized as they occur.
Concentration of Credit Risk Concentration of Credit Risk—The Company is subject to concentrations of credit risk consisting primarily of operating leases on its owned properties. See Note 11, Concentration of Risk, for a discussion of major operator concentration.
Segment Disclosures Segment Disclosures —The Company is subject to disclosures about segments of an enterprise and related information in accordance with ASC Topic 280, Segment Reporting. The Company has one reportable segment consisting of investments in healthcare-related real estate assets.
Earnings Per Share Earnings Per Share—The Company calculates earnings per share (“EPS”) in accordance with ASC 260, Earnings Per Share. Basic EPS is computed by dividing net income applicable to common stock by the weighted-average number of common shares outstanding during the period. Diluted EPS reflects the additional dilution for all potentially-dilutive securities.
Beds, Units, Occupancy and Other Measures Beds, Units, Occupancy and Other Measures—Beds, units, occupancy and other non-financial measures used to describe real estate investments included in these Notes to the consolidated financial statements are presented on an unaudited basis and are not subject to audit by the independent registered public accounting firm in accordance with the standards of the Public Company Accounting Oversight Board.
Recent Accounting Pronouncements Recent Accounting Pronouncements— In March 2020, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2020-04, Reference Rate Reform (Topic 848) - Facilitation of the Effects of Reference Rate Reform on Financial Reporting (“ASU 2020-04”), that provides optional relief to applying reference rate reform to contracts, hedging relationships, and other transactions that reference the London Interbank Offered Rate (“LIBOR”). For U.S. Dollar LIBOR, the overnight, one-month, three-month, six-month and one-year LIBOR rates will be discontinued in June 2023, while other U.S. Dollar LIBOR rates were discontinued at the end of 2021. The amendments in this update are effective immediately and may be applied through December 31, 2022. The Company does not expect the adoption of the standard to have a material impact on the Company’s consolidated financial statements.
Fair Value Measurements
The Company determines fair value based on quoted prices when available or through the use of alternative approaches, such as discounting the expected cash flows using market interest rates commensurate with the credit quality and duration of the investment. GAAP guidance defines three levels of inputs that may be used to measure fair value:

Level 1 – Quoted prices in active markets for identical assets and liabilities that the reporting entity has the ability to access at the measurement date.

Level 2 – Inputs other than quoted prices included within Level 1 that are observable for the asset or liability or can be corroborated with observable market data for substantially the entire contractual term of the asset or liability.
Level 3 – Unobservable inputs reflect the entity’s own assumptions about the assumptions that market participants would use in the pricing of the asset or liability and are consequently not based on market activity, but rather through particular valuation techniques.

The determination of where an asset or liability falls in the hierarchy requires significant judgment and considers factors specific to the asset or liability. In instances where the determination of the fair value measurement is based on inputs from different levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is based on the lowest level input that is significant to the fair value measurement in its entirety. The Company evaluates its hierarchy disclosures each quarter and, depending on various factors, it is possible that an asset or liability may be classified differently from quarter to quarter. Changes in the type of inputs may result in a reclassification for certain assets. The Company does not expect that changes in classifications between levels will be frequent.
v3.22.0.1
Summary of Significant Accounting Policies (Tables)
12 Months Ended
Dec. 31, 2021
Accounting Policies [Abstract]  
Summary of Estimated Useful Lives of Assets The Company anticipates the estimated useful lives of its assets by class to be generally as follows:
Building
25-40 years
Building improvements
10-25 years
Tenant improvementsShorter of lease term or expected useful life
Integral equipment, furniture and fixtures
5 years
Identified intangible assetsShorter of lease term or expected useful life
v3.22.0.1
Real Estate Investments, Net (Tables)
12 Months Ended
Dec. 31, 2021
Real Estate [Abstract]  
Summary of Investment in Owned Properties
The following table summarizes the Company’s investment in owned properties at December 31, 2021 and 2020 (dollars in thousands):
 
December 31, 2021December 31, 2020
Land$251,787 $205,356 
Buildings and improvements1,622,019 1,477,849 
Integral equipment, furniture and fixtures104,722 97,836 
Identified intangible assets1,257 2,352 
Real estate investments1,979,785 1,783,393 
Accumulated depreciation and amortization(389,814)(335,294)
Real estate investments, net$1,589,971 $1,448,099 
Schedule of Total Future Contractual Minimum Rental Income As of December 31, 2021, the Company’s total future contractual minimum rental income for all of its tenants, excluding operating expense reimbursements, was (dollars in thousands):
YearAmount
2022$192,897 
2023192,693 
2024191,347 
2025191,319 
2026191,424 
Thereafter1,138,179 
$2,097,859 
Schedule of Tenant Purchase Options
Certain of the Company’s operators hold purchase options allowing them to acquire properties they currently lease from the Company. A summary of these purchase options is presented below (dollars in thousands):
Asset TypePropertiesLease ExpirationNext Option Open Date
Option Type(1)
Current Cash Rent(2)
ALF7October 20341/1/2022
(3)
A$3,383 
SNF11November 20301/1/2022
(3)
C4,944 
SNF1March 20294/1/2022
B / C(4)
779 
SNF / Campus2October 20321/1/2023B1,028 
SNF4November 203412/1/2024B3,796 
ALF2October 20341/1/2026A1,598 
(1) Option type includes:
A - Fixed base price plus a specified share on any appreciation.
B - Fixed base price.
C - Fixed capitalization rate on lease revenue.
(2) Based on annualized cash revenue for contracts in place at December 31, 2021.
(3) Option window is open for six months.
(4) Purchase option reflects two option types.
Schedule of Rental Income
The following table summarizes components of the Company’s rental income (dollars in thousands):
For the Year Ended December 31,
202120202019
Rental Income
Contractual rent due(1)
$190,100 $171,309 $166,056 
Straight-line rent32 77 1,385 
Adjustment for collectibility(2)
— — (11,774)
Recovery of previously reversed rent(3)
— 1,047 — 
Lease termination revenue(3)
63 1,179 — 
Total$190,195 $173,612 $155,667 

(1)Includes initial cash rent and tenant operating expense reimbursements, as adjusted for applicable rental escalators and rent increases due to capital expenditures funded by the Company. For tenants on a cash basis, this represents the lesser of the amount that would be recognized on a straight-line basis or cash that has been received.
(2)During the year ended December 31, 2019, and in accordance with ASC 842, the Company evaluated the collectibility of lease payments through maturity and determined that it was not probable that the Company would collect substantially all of the contractual obligations from five operators through maturity. As such, the Company reversed
$7.8 million of contractual rent, $3.5 million of straight-line rent and $0.5 million of property tax reimbursements during the year ended December 31, 2019.
(3)During the year ended December 31, 2020, the Company recovered $1.0 million in rental income related to affiliates of Metron Integrated Health Systems (“Metron”) that was previously written off. In addition, in connection with the agreement to terminate its lease agreements with Metron and to sell the facilities to a third-party, the Company received certain lease termination payments from Metron. During the years ended December 31, 2021 and 2020, the Company recognized approximately $0.1 million and $1.2 million in lease termination revenue, respectively.
Schedule of Real Estate Acquisitions
The following table summarizes the Company’s acquisitions for the years ended December 31, 2021, 2020 and 2019 (dollar amounts in thousands):
Type of Property
Purchase Price(1)
Initial Annual Cash Rent(2)
Number of Properties
Number of Beds/Units(3)
December 31, 2021
Skilled nursing$57,973 $4,499 (4)4 509 
Multi-service campuses125,708 8,604 (5)4 640 
Assisted living12,395 — (6)2 98 
Total$196,076 $13,103 10 1,247 
December 31, 2020
Skilled nursing$75,545 $6,453 6 715 
Multi-service campuses6,876 555 1 184 
Assisted living7,396 590 1 62 
Total$89,817 $7,598 8 961 
December 31, 2019
Skilled nursing$254,760 $22,909 17 2,099 
Multi-service campuses59,344 5,203 4 762 
Assisted living12,596 1,031 1 96 
Total$326,700 $29,143 22 2,957 
(1)    Purchase price includes capitalized acquisition costs.
(2)    Initial annual cash rent excludes ground lease income.
(3)    The number of beds/units includes operating beds at acquisition date.
(4)    Initial annual cash rent represents initial cash rent for the first twelve months excluding any impact of straight-line rent.
(5)    Initial annual cash rent represents the first twelve months of rent upon commencement of the Company’s long-term net leases, which occurred during the three months ended June 30, 2021, upon the tenant’s receipt of licensing approval and increases to $9.4 million in the second year with CPI-based annual escalators thereafter.
(6)    Initial annual cash rent is zero until transfer of operations upon receipt of licensing approval.
v3.22.0.1
Other Real Estate Investments (Tables)
12 Months Ended
Dec. 31, 2021
Investments, All Other Investments [Abstract]  
Schedule of Loans Receivable and Other Investments
As of December 31, 2021 and 2020, the Company’s loans receivable and other investments consisted of the following (dollar amounts in thousands):
As of December 31, 2021
InvestmentFinancial Statement Line ItemPrincipal Balance as of December 31, 2021Book Value as of December 31, 2021Book Value as of December 31, 2020Weighted Average Contractual Interest RateMaturity Date
Mezzanine loan receivableOther real estate investments$15,000 $15,155 $15,000 12.0 %11/30/2025
Other loans receivablePrepaid expenses and other assets, net3,154 3,161 2,308 8.0 %9/1/2023 - 12/31/2023
Total$18,154 $18,316 $17,308 
Schedule of Interest and Other Income
The following table summarizes the interest and other income recognized during the years ended December 31, 2021, 2020 and 2019 (dollar amounts in thousands):
For Year Ended December 31,
Investment202120202019
Mezzanine loan receivable$1,825 $305 $— 
Mortgage loans receivable(1)
— 2,044 2,838 
Preferred equity investments(1)
— 24 1,343 
Other331 270 164 
Total$2,156 $2,643 $4,345 
(1) As of December 31, 2021 and 2020, the Company had no mortgage loans receivable or preferred equity investments.
v3.22.0.1
Fair Value Measurements (Tables)
12 Months Ended
Dec. 31, 2021
Fair Value Disclosures [Abstract]  
Schedule of Assets and Liabilities Measured at Fair Value on a Recurring Basis The following table presents information about the Company’s assets and liabilities measured at fair value on a recurring basis as of December 31, 2021 and 2020, aggregated by the level in the fair value hierarchy within which those instruments fall (dollars in thousands):
Level 1Level 2Level 3
Balance as of December 31, 2021
Assets:
Mezzanine loan receivable$— $— $15,155 $15,155 
Level 1Level 2Level 3
Balance as of December 31, 2020
Assets:
Mezzanine loan receivable$— $— $15,000 $15,000 
Summary of Fair Value and Carrying Value of Financial Instruments A summary of the face values, carrying amounts and fair values of the Company’s financial instruments as of December 31, 2021 and 2020 using Level 2 inputs for the Notes and the 2025 Notes (each as defined in Note 6, Debt, below) is as follows (dollars in thousands):  
 December 31, 2021December 31, 2020
Face
Value
Carrying
Amount
Fair
Value
Face
Value
Carrying
Amount
Fair
Value
Financial liabilities:
2028 Senior unsecured notes payable$400,000 $394,262 $410,500 $— $— $— 
2025 Senior unsecured notes payable— — — 300,000 296,669 311,430 
v3.22.0.1
Debt (Tables)
12 Months Ended
Dec. 31, 2021
Debt Disclosure [Abstract]  
Schedule of Debt Instruments The following table summarizes the balance of the Company’s indebtedness as of December 31, 2021 and 2020 (in thousands):
December 31, 2021December 31, 2020
PrincipalDeferredCarryingPrincipalDeferredCarrying
AmountLoan FeesAmountAmountLoan FeesAmount
2028 Senior unsecured notes payable$400,000 $(5,738)$394,262 $— $— $— 
2025 Senior unsecured notes payable— — — 300,000 (3,331)296,669 
Senior unsecured term loan200,000 (864)199,136 200,000 (1,075)198,925 
Unsecured revolving credit facility80,000 — 80,000 50,000 — 50,000 
$680,000 $(6,602)$673,398 $550,000 $(4,406)$545,594 
Schedule of Debt Maturities As of December 31, 2021, the Company’s debt maturities were (dollars in thousands):  
Year
Amount
2022$— 
202380,000 
2024— 
2025— 
2026200,000 
Thereafter400,000 
 $680,000 
v3.22.0.1
Equity (Tables)
12 Months Ended
Dec. 31, 2021
Equity [Abstract]  
Summary of the At-The-Market Equity Offering Program The following table summarizes ATM Program activity and predecessor at-the-market equity offering program activity for the years ended December 31, 2021 and 2019 (in thousands, except per share amounts):
For the Year Ended December 31,
20212019
Number of shares990 2,459 
Average sales price per share$23.74 $19.48 
Gross proceeds(1)
$23,505 $47,893 
(1)    Total gross proceeds is before $0.3 million and $0.6 million of commissions paid to the sales agents during the year ended December 31, 2021 and December 31, 2019 under the ATM Program and a predecessor at-the-market equity offering program.
Summary of Dividends on Common Stock The following table summarizes the cash dividends per share of common stock declared by the Company’s Board of Directors for 2021, 2020 and 2019 (dollars in thousands, except per share amounts):
For the Three Months Ended
2021March 31,June 30,September 30,December 31,
Dividends declared$0.265 $0.265 $0.265 $0.265 
Dividends payment dateApril 15, 2021July 15, 2021October 15, 2021January 14, 2022
Dividends payable as of record date$25,633 $25,714 $25,714 $25,755 
Dividends record dateMarch 31, 2021June 30, 2021September 30, 2021December 31, 2021
2020
Dividends declared$0.25 $0.25 $0.25 $0.25 
Dividends payment dateApril 15, 2020July 15, 2020October 15, 2020January 15, 2021
Dividends payable as of record date$23,931 $23,931 $23,934 $23,933 
Dividends record dateMarch 31, 2020June 30, 2020September 30, 2020December 31, 2020
2019
Dividends declared$0.225 $0.225 $0.225 $0.225 
Dividends payment dateApril 15, 2019July 15, 2019October 15, 2019January 15, 2020
Dividends payable as of record date$20,011 $21,508 $21,500 $21,500 
Dividends record dateMarch 29, 2019June 28, 2019September 30, 2019December 31, 2019
v3.22.0.1
Stock-Based Compensation (Tables)
12 Months Ended
Dec. 31, 2021
Share-based Payment Arrangement [Abstract]  
Summary of Restricted Stock Award and Performance Award Activity The following table summarizes the status of the restricted stock award and performance award activity for the year ended December 31, 2021:
SharesWeighted Average Share Price
Unvested balance at December 31, 2020517,686 $18.71 
Granted:
RSAs394,863 21.92 
PSAs108,414 22.48 
Board Awards20,266 24.18 
Vested(147,646)17.43 
Forfeited(2,250)22.38 
Unvested balance at December 31, 2021891,333 $20.91 
Summary of Award Grants
The following table summarizes the Company’s RSA, PSA and Board Award grants during the year ended December 31, 2021 (dollars in thousands, except per share amounts):
GrantsVested
SharesWeighted Average Share PriceGrant Date Fair ValueSharesVest Date Fair Value
During year ended December 31, 2021(1)
RSAs394,863 $21.92 $8,654 89,921 $2,105 
PSAs108,414 22.48 2,437 30,114 707 
Board Awards20,266 24.18 490 27,611 668 
(1) In 2021, the Compensation Committee changed the structure of the grants that resulted in two long-term equity incentive awards being granted to the Company’s named executive officers in 2021. The Compensation Committee also granted annual awards for 2022 in December 2021.
The following table summarizes the Company’s RSA, PSA and Board Award grants during the years ended December 31, 2020 and 2019 (dollars in thousands, except per share amounts):
Grants
SharesWeighted Average Share PriceGrant Date Fair Value
During year ended December 31, 2020
RSAs134,790 19.68 2,653 
PSAs107,790 19.06 2,054 
Board Awards27,611 16.48 455 
During year ended December 31, 2019
RSAs91,440 22.00 2,012 
PSAs71,440 22.00 1,572 
Board Awards17,749 24.23 430 
Schedule of Key Valuation Assumptions Used in Valuation
The fair value of the TSR Awards is estimated on the date of the grant using a Monte Carlo valuation model. The risk-free rate is based on the U.S. Treasury yield curve in effect at the grant date for the expected performance period. Expected volatility is based on historical volatility for the most recent 2.93 year weighted average period ending on the grant date for the Company and the selected TSR peer group, and is calculated on a daily basis. The following table reflects the weighted-average key assumptions used in this valuation for awards granted during the year ended December 31, 2021:
Risk-free interest rate0.60 %
Expected stock price volatility52.42 %
Expected service period2.93 years
Expected dividend yield (assuming full reinvestment)— %
Fair value per share at date of grant$29.10 
Schedule of Stock-Based Compensation Expense The following table summarizes the stock-based compensation expense recognized (dollars in thousands):
 For Year Ended December 31,
 202120202019
Stock-based compensation expense$10,832 $3,790 $4,104 
v3.22.0.1
Earnings Per Common Share (Tables)
12 Months Ended
Dec. 31, 2021
Earnings Per Share [Abstract]  
Reconciliation of Weighted-Average Common Shares Outstanding Used in Calculation of Basic EPS to Diluted EPS
The following table presents the calculation of basic and diluted EPS for the Company’s common stock for the years ended December 31, 2021, 2020 and 2019, and reconciles the weighted-average common shares outstanding used in the calculation of basic EPS to the weighted-average common shares outstanding used in the calculation of diluted EPS for the years ended December 31, 2021, 2020 and 2019 (amounts in thousands, except per share amounts):
 
 Year Ended December 31,
 202120202019
Numerator:
Net income$71,982 $80,867 $46,359 
Less: Net income allocated to participating securities(507)(298)(296)
Numerator for basic and diluted earnings available to common stockholders$71,475 $80,569 $46,063 
Denominator:
Weighted-average basic common shares outstanding96,017 95,200 93,088 
   Dilutive performance stock awards75 7 10 
Weighted-average diluted common shares outstanding96,092 95,207 93,098 
Earnings per common share, basic$0.74 $0.85 $0.49 
Earnings per common share, diluted$0.74 $0.85 $0.49 
Antidilutive unvested restricted stock awards and performance awards excluded from the computation591 296 292 
v3.22.0.1
Concentration of Risk (Tables)
12 Months Ended
Dec. 31, 2021
Risks and Uncertainties [Abstract]  
Schedules of Concentration of Risk
Major operator concentration – The Company has operators from which it derived 10% or more of its rental revenue for the years ended December 31, 2021, 2020 and 2019. The following table sets forth information regarding the Company’s major operators as of December 31, 2021, 2020 and 2019:
 Number of FacilitiesNumber of Beds/Units
Percentage of Total Revenue(1)
Operator(2)
SNFCampusALF/ILFSNFCampusALF/ILF
December 31, 2021
Ensign83 84 8,756 997395 32 %
PMG13 2— 1,742 402— 15 %
December 31, 2020
Ensign77 84 8,129 1,027 390 32 %
PMG13 2— 1,742 403 — 16 %
December 31, 2019
Ensign75 64 7,945 573 390 38 %
PMG13 2— 1,742 403 — 15 %
(1)    The Company’s rental income, exclusive of operating expense reimbursements.
(2)    See Note 3, Real Estate Investments, Net, for further information regarding Ensign and PMG. Ensign is subject to the registration and reporting requirements of the SEC and is required to file with the SEC annual reports containing audited financial information and quarterly reports containing unaudited financial information. Ensign’s financial statements, as filed with the SEC, can be found at http://www.sec.gov. The Company has not verified this information through an independent investigation or otherwise.
Major geographic concentration – The following table provides information regarding the Company’s concentrations with respect to certain states, from which the Company derived 10% or more of its rental revenue for the year ended December 31, 2021:
 Number of FacilitiesNumber of Beds/Units
Percentage of Total Revenue(1)
StateSNFCampusALF/ILFSNFCampusALF/ILF
CA27 85 3,048 1,359 449 25 %
TX37 33 4,694 536242 20 %
(1)    The Company’s rental income, exclusive of operating expense reimbursements.
v3.22.0.1
Organization (Details)
$ in Thousands
12 Months Ended
Dec. 31, 2021
USD ($)
facility
state
bed
Dec. 31, 2020
USD ($)
Real Estate Properties [Line Items]    
Number of facilities 227  
Number of states with properties | state 29  
Other real estate investments | $ $ 15,155 $ 15,000
Skilled nursing, assisted living and independent living facilities    
Real Estate Properties [Line Items]    
Number of facilities 227  
Number of operational beds and units in facilities | bed 23,650  
v3.22.0.1
Summary of Significant Accounting Policies - Narrative (Details)
12 Months Ended
Dec. 31, 2021
USD ($)
segment
Dec. 31, 2020
USD ($)
Dec. 31, 2019
USD ($)
Accounting Policies [Abstract]      
Recovery of previously reserved rent $ 0 $ 1,047,000 $ 0
Adjustment for collectibility of rental income 0 0 11,774,000
Impairment of real estate investments 0 0 16,692,000
Accumulated amortization of deferred financing costs 8,000,000 9,000,000  
Loss on extinguishment of debt (10,827,000) 0 0
Stock-based compensation expense $ 10,832,000 3,790,000 4,104,000
Number of reportable segments | segment 1    
Accounting Policies [Line Items]      
Provision for loan losses $ 0 $ 0 1,076,000
Bridge loan      
Accounting Policies [Line Items]      
Provision for loan losses     $ 1,100,000
v3.22.0.1
Summary of Significant Accounting Policies - Estimated Useful Lives of Assets (Details)
12 Months Ended
Dec. 31, 2021
Building | Minimum  
Property, Plant and Equipment [Line Items]  
Estimated useful life (in years) 25 years
Building | Maximum  
Property, Plant and Equipment [Line Items]  
Estimated useful life (in years) 40 years
Building improvements | Minimum  
Property, Plant and Equipment [Line Items]  
Estimated useful life (in years) 10 years
Building improvements | Maximum  
Property, Plant and Equipment [Line Items]  
Estimated useful life (in years) 25 years
Integral equipment, furniture and fixtures  
Property, Plant and Equipment [Line Items]  
Estimated useful life (in years) 5 years
v3.22.0.1
Real Estate Investments, Net - Investment in Owned Properties (Details) - USD ($)
$ in Thousands
Dec. 31, 2021
Dec. 31, 2020
Real Estate [Abstract]    
Land $ 251,787 $ 205,356
Buildings and improvements 1,622,019 1,477,849
Integral equipment, furniture and fixtures 104,722 97,836
Identified intangible assets 1,257 2,352
Real estate investments 1,979,785 1,783,393
Accumulated depreciation and amortization (389,814) (335,294)
Real estate investments, net $ 1,589,971 $ 1,448,099
v3.22.0.1
Real Estate Investments, Net - Narrative (Details)
$ in Millions
12 Months Ended
Dec. 31, 2021
USD ($)
facility
renewal_option
property
Dec. 31, 2020
facility
property
Dec. 31, 2019
property
Oct. 01, 2019
facility
Real Estate [Line Items]        
Number of facilities 227      
Number of facilities acquired | property 10 8 22  
Short-term lease        
Real Estate [Line Items]        
Number of facilities 2      
Ensign | Minimum        
Real Estate [Line Items]        
Annualized contractual rental income escalation rate (percent) 0.00%      
Ensign | Maximum        
Real Estate [Line Items]        
Annualized contractual rental income escalation rate (percent) 2.50%      
Ensign | Ensign master leases        
Real Estate [Line Items]        
Number of facilities 91     85
Annualized contractual rental income | $ $ 59.7      
Ensign | Other Ensign leases        
Real Estate [Line Items]        
Annualized contractual rental income | $ $ 3.8      
Number of facilities acquired   4    
PMG        
Real Estate [Line Items]        
Number of facilities 15      
Annualized contractual rental income | $ $ 28.9      
Initial lease term (in years) 15 years      
Number of renewal options | renewal_option 2      
Lease renewal term (in years) 5 years      
PMG | Minimum        
Real Estate [Line Items]        
Annualized contractual rental income escalation rate (percent) 0.00%      
PMG | Maximum        
Real Estate [Line Items]        
Annualized contractual rental income escalation rate (percent) 3.00%      
Various other operators        
Real Estate [Line Items]        
Number of facilities 115      
v3.22.0.1
Real Estate Investments, Net - Future Contractual Minimum Rental Income (Details)
$ in Thousands
Dec. 31, 2021
USD ($)
Future Contractual Minimum Rental Income  
2022 $ 192,897
2023 192,693
2024 191,347
2025 191,319
2026 191,424
Thereafter 1,138,179
Total $ 2,097,859
v3.22.0.1
Real Estate Investments, Net - Tenant Purchase Options (Details)
$ in Thousands
Dec. 31, 2021
USD ($)
property
ALF | Lease Expiration October 2034, Next option 2022  
Lessor, Lease, Description [Line Items]  
Properties | property 7
Current Cash Rent | $ $ 3,383
ALF | Lease Expiration October 2034, Next option 2026  
Lessor, Lease, Description [Line Items]  
Properties | property 2
Current Cash Rent | $ $ 1,598
SNF | Lease Expiration November 2030, Next option 2022  
Lessor, Lease, Description [Line Items]  
Properties | property 11
Current Cash Rent | $ $ 4,944
SNF | Lease Expiration March 2029, Next option 2022  
Lessor, Lease, Description [Line Items]  
Properties | property 1
Current Cash Rent | $ $ 779
SNF | Lease Expiration November 2034, Next option 2024  
Lessor, Lease, Description [Line Items]  
Properties | property 4
Current Cash Rent | $ $ 3,796
SNF / Campus | Lease Expiration October 2032, Next option 2023  
Lessor, Lease, Description [Line Items]  
Properties | property 2
Current Cash Rent | $ $ 1,028
v3.22.0.1
Real Estate Investments, Net - Rental Income (Details)
12 Months Ended
Dec. 31, 2021
USD ($)
Dec. 31, 2020
USD ($)
Dec. 31, 2019
USD ($)
operator
Lessor, Lease, Description [Line Items]      
Contractual rent due $ 190,100,000 $ 171,309,000 $ 166,056,000
Straight-line rent 32,000 77,000 1,385,000
Adjustment for collectibility 0 0 (11,774,000)
Recovery of previously reserved rent 0 1,047,000 0
Lease termination revenue 63,000 1,179,000 0
Total 190,195,000 173,612,000 $ 155,667,000
Number of operators for which collectability not probable | operator     5
Contractual rent      
Lessor, Lease, Description [Line Items]      
Adjustment for collectibility     $ (7,800,000)
Straight-line rent      
Lessor, Lease, Description [Line Items]      
Adjustment for collectibility     (3,500,000)
Property taxes      
Lessor, Lease, Description [Line Items]      
Adjustment for collectibility     $ (500,000)
Metron      
Lessor, Lease, Description [Line Items]      
Recovery of previously reserved rent   1,000,000  
Lease termination revenue $ 100,000 $ 1,200,000  
v3.22.0.1
Real Estate Investments, Net - Recent Real Estate Acquisitions (Details)
$ in Thousands
12 Months Ended
Jun. 30, 2023
USD ($)
Dec. 31, 2021
USD ($)
property
unit
Dec. 31, 2020
USD ($)
unit
property
Dec. 31, 2019
USD ($)
unit
property
Business Acquisition [Line Items]        
Purchase Price   $ 196,076 $ 89,817 $ 326,700
Initial Annual Cash Rent   $ 13,103 $ 7,598 $ 29,143
Number of properties | property   10 8 22
Number of Beds/Units | unit   1,247 961 2,957
Skilled nursing        
Business Acquisition [Line Items]        
Purchase Price   $ 57,973 $ 75,545 $ 254,760
Initial Annual Cash Rent   $ 4,499 $ 6,453 $ 22,909
Number of properties | property   4 6 17
Number of Beds/Units | unit   509 715 2,099
Multi-service campuses        
Business Acquisition [Line Items]        
Purchase Price   $ 125,708 $ 6,876 $ 59,344
Initial Annual Cash Rent   $ 8,604 $ 555 $ 5,203
Number of properties | property   4 1 4
Number of Beds/Units | unit   640 184 762
Multi-service campuses | Forecast        
Business Acquisition [Line Items]        
Initial Annual Cash Rent $ 9,400      
Assisted living        
Business Acquisition [Line Items]        
Purchase Price   $ 12,395 $ 7,396 $ 12,596
Initial Annual Cash Rent   $ 0 $ 590 $ 1,031
Number of properties | property   2 1 1
Number of Beds/Units | unit   98 62 96
v3.22.0.1
Real Estate Investments, Net - Lease Amendments (Details)
$ in Thousands
3 Months Ended 12 Months Ended
Sep. 23, 2021
USD ($)
facility
Aug. 01, 2021
USD ($)
extension_option
facility
Jul. 01, 2021
USD ($)
facility
extension_option
Jun. 01, 2021
USD ($)
facility
extension_option
Mar. 10, 2021
USD ($)
Dec. 01, 2020
USD ($)
extension_option
facility
Oct. 01, 2019
USD ($)
facility
extension_option
bed
Sep. 30, 2021
Sep. 30, 2019
USD ($)
Dec. 31, 2021
USD ($)
property
facility
Dec. 31, 2020
USD ($)
property
Dec. 31, 2019
USD ($)
property
Nov. 04, 2019
USD ($)
facility
extension_option
Sep. 01, 2019
USD ($)
property
extension_option
Aug. 16, 2019
property
Jul. 15, 2019
property
Real Estate [Line Items]                                
Number of properties | property                   10 8 22        
Initial annual cash rent                   $ 13,103 $ 7,598 $ 29,143        
Number of facilities | facility                   227            
Accounts and other receivables                                
Real Estate [Line Items]                                
Write-off of accounts and straight-line rent receivable                 $ 3,800              
Noble master leases, amended                                
Real Estate [Line Items]                                
Number of amended leases | facility 2                              
Lease amendment deferral $ 1,800                              
Lease amendment deferral, percentage of contractual base               0.04                
Ensign master lease, amended                                
Real Estate [Line Items]                                
Lease term (in years)   17 years                            
Number of renewal options | extension_option   3                            
Lease renewal term (in years)   5 years                            
Annual cash rent increase under amended lease   $ 2,200                            
GAAP rent increase   $ 2,500                            
Ensign amended triple-net master lease                                
Real Estate [Line Items]                                
Lease term (in years)       15 years                        
Number of renewal options | extension_option       3                        
Lease renewal term (in years)       5 years                        
Initial annual cash rent       $ 2,600                        
Noble VA master lease, amended                                
Real Estate [Line Items]                                
Lease term (in years)     13 years                          
Number of renewal options | extension_option     2                          
Lease renewal term (in years)     5 years                          
Initial annual cash rent     $ 1,000   $ 1,300                      
Noble triple-net master lease                                
Real Estate [Line Items]                                
Lease term (in years)           14 years                    
Number of renewal options | extension_option           2                    
Lease renewal term (in years)           5 years                    
Initial annual cash rent           $ 3,200                    
Skilled nursing facility                                
Real Estate [Line Items]                                
Number of properties | facility   2                            
Rent prepayment   $ 5,000                            
Assisted living                                
Real Estate [Line Items]                                
Number of properties | property                   2 1 1        
Initial annual cash rent                   $ 0 $ 590 $ 1,031        
Skilled nursing properties                                
Real Estate [Line Items]                                
Number of properties | property                   4 6 17        
Initial annual cash rent                   $ 4,499 $ 6,453 $ 22,909        
Noble | Assisted living                                
Real Estate [Line Items]                                
Number of properties | facility 2                              
Ensign | Ensign master leases                                
Real Estate [Line Items]                                
Number of facilities | facility             85     91            
Number of beds in leased facilities | bed             8,908                  
Reduction to contractual annual cash rent as result of spin             $ 7,800                  
Ensign | Skilled nursing facility                                
Real Estate [Line Items]                                
Number of skilled nursing facilities | facility       4                        
Noble VA | Assisted living                                
Real Estate [Line Items]                                
Number of properties transferred | facility     2     5                    
Pennant                                
Real Estate [Line Items]                                
Lease term (in years)             15 years                  
Number of renewal options | extension_option             2                  
Lease renewal term (in years)             5 years                  
Initial annual cash rent             $ 7,800                  
Number of facilities | facility             11                  
Number of beds in leased facilities | bed             1,151                  
Trillium | Iowa                                
Real Estate [Line Items]                                
Properties in terminated master lease | property                               10
Properties covered in new master lease | property                             10  
Trillium | Ohio                                
Real Estate [Line Items]                                
Properties in terminated master lease | property                           7   7
Trillium | Georgia                                
Real Estate [Line Items]                                
Properties in terminated master lease | property                               1
Properties covered in new master lease | property                             1  
Trillium | Skilled nursing properties | Ohio                                
Real Estate [Line Items]                                
Properties in terminated master lease | property                               7
Providence | Triple-net master lease                                
Real Estate [Line Items]                                
Lease term (in years)                           13 years    
Number of renewal options | extension_option                           2    
Lease renewal term (in years)                           5 years    
Annual cash rent increase under amended lease                           $ 2,100    
Providence | Skilled nursing properties | Ohio                                
Real Estate [Line Items]                                
Number of properties transferred | property                           4    
Trio | Trio master lease, amended                                
Real Estate [Line Items]                                
Lease term (in years)                         13 years      
Number of renewal options | extension_option                         2      
Lease renewal term (in years)                         5 years      
Annual cash rent increase under amended lease                         $ 4,700      
Number of facilities | facility                         7      
v3.22.0.1
Real Estate Investments, Net - Impairment of Real Estate Investments, Asset Sales and Assets Held for Sale (Details)
$ in Thousands
1 Months Ended 3 Months Ended 12 Months Ended
Feb. 01, 2021
USD ($)
Nov. 01, 2020
USD ($)
unit
facility
Feb. 14, 2020
USD ($)
facility
Dec. 23, 2019
USD ($)
unit
facility
Jul. 31, 2020
USD ($)
Apr. 30, 2020
USD ($)
Mar. 31, 2020
USD ($)
Sep. 30, 2019
USD ($)
Dec. 31, 2021
USD ($)
facility
Dec. 31, 2020
USD ($)
Dec. 31, 2019
USD ($)
Sep. 01, 2019
USD ($)
property
Jul. 15, 2019
property
Real Estate [Line Items]                          
Loan receivable                 $ 18,316 $ 17,308      
Assets held for sale, net                 4,835 7,226      
Proceeds from sale                 6,958 6,608 $ 3,499    
Gain (loss) on sale of real estate                 77 37 $ (1,777)    
Real estate investments, net                 $ 1,589,971 $ 1,448,099      
Number of facilities | facility                 227        
Trillium | Ohio                          
Real Estate [Line Items]                          
Properties in terminated master lease | property                       7 7
Mortgage loans receivable | CommuniCare                          
Real Estate [Line Items]                          
Facilities utilized to secure mortgage loan | property                       3  
Loan receivable                       $ 26,500  
Mortgage loans receivable | Cascade Capital Group, LLC                          
Real Estate [Line Items]                          
Loan receivable     $ 32,400                    
Loan receivable interest rate (percent)     7.50%                    
Proceeds from settlement of loan         $ 13,900 $ 18,900              
Loan receivable           $ 13,900              
Disposed of by sale                          
Real Estate [Line Items]                          
Number of properties sold | facility     6                    
Disposed of by sale | Trillium skilled nursing facilities                          
Real Estate [Line Items]                          
Number of properties sold | property                       3  
Contract purchase price                       $ 28,000  
Impairment expense to reduce carrying value to fair value less costs to sell               $ 7,800          
Disposed of by sale | Metron skilled nursing facilities                          
Real Estate [Line Items]                          
Contract purchase price     $ 36,000                    
Impairment expense to reduce carrying value to fair value less costs to sell               $ 8,800          
Proceeds from sale     $ 3,500                    
Gain (loss) on sale of real estate             $ 100            
Disposed of by sale | Five Oaks Healthcare LLC                          
Real Estate [Line Items]                          
Proceeds from sale $ 7,000                        
Gain (loss) on sale of real estate 200                        
Real estate investments, net $ 7,200                        
Disposed of by sale | Owned and operated living facilities                          
Real Estate [Line Items]                          
Number of properties sold | facility   1   1                  
Proceeds from sale   $ 4,200   $ 3,300                  
Gain (loss) on sale of real estate   (20)   (1,600)                  
Real estate investments, net   $ 4,200   $ 1,700                  
Number of units available in living facilities | unit   168   38                  
Held for sale                          
Real Estate [Line Items]                          
Number of facilities | facility                 1        
v3.22.0.1
Other Real Estate Investments - Loans Receivable and Other Investments (Details) - USD ($)
$ in Thousands
Dec. 31, 2021
Dec. 31, 2020
Real Estate Properties [Line Items]    
Principal Amount $ 18,154  
Book Value 18,316 $ 17,308
Mezzanine loan receivable    
Real Estate Properties [Line Items]    
Principal Amount 15,000  
Book Value $ 15,155 15,000
Weighted Average Contractual Interest Rate 12.00%  
Other    
Real Estate Properties [Line Items]    
Principal Amount $ 3,154  
Book Value $ 3,161 $ 2,308
Weighted Average Contractual Interest Rate 8.00%  
v3.22.0.1
Other Real Estate Investments - Loans Receivable Narrative (Details)
$ in Thousands
1 Months Ended
Nov. 30, 2020
USD ($)
facility
Dec. 31, 2021
USD ($)
Real Estate Properties [Line Items]    
Loan principal   $ 18,154
Next VA Star Realty Holdings LLC | Mezzanine loan receivable    
Real Estate Properties [Line Items]    
Number of facilities in agreement secured by membership interests | facility 9  
Loan principal $ 15,000  
Loan receivable interest rate (percent) 12.00%  
Period of unpaid interest payments due upon prepayment 24 months  
Next VA Star Realty Holdings LLC | Mezzanine loan receivable | Minimum    
Real Estate Properties [Line Items]    
Loans receivable exit fee (percent) 1.00%  
Next VA Star Realty Holdings LLC | Mezzanine loan receivable | Maximum    
Real Estate Properties [Line Items]    
Loans receivable exit fee (percent) 3.00%  
v3.22.0.1
Other Real Estate Investments - Interest and Other Income (Details) - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Real Estate Properties [Line Items]      
Interest and other income $ 2,156 $ 2,643 $ 4,345
Mezzanine loan receivable      
Real Estate Properties [Line Items]      
Interest and other income 1,825 305 0
Mortgage loans receivable      
Real Estate Properties [Line Items]      
Interest and other income 0 2,044 2,838
Preferred equity investments      
Real Estate Properties [Line Items]      
Interest and other income 0 24 1,343
Other      
Real Estate Properties [Line Items]      
Interest and other income $ 331 $ 270 $ 164
v3.22.0.1
Fair Value Measurements - Assets and Liabilities at Fair Value on Recurring Basis (Details) - Recurring - Mezzanine loan receivable - USD ($)
$ in Thousands
Dec. 31, 2021
Dec. 31, 2020
Assets:    
Mezzanine loan receivable $ 15,155 $ 15,000
Level 1    
Assets:    
Mezzanine loan receivable 0 0
Level 2    
Assets:    
Mezzanine loan receivable 0 0
Level 3    
Assets:    
Mezzanine loan receivable $ 15,155 $ 15,000
v3.22.0.1
Fair Value Measurements - Narrative (Details) - USD ($)
12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Fair Value Disclosures [Abstract]      
Impairment of real estate investments $ 0 $ 0 $ 16,692,000
v3.22.0.1
Fair Value Measurements - Fair Value and Carrying Value of Financial Instruments (Details) - Notes payable - USD ($)
$ in Thousands
Dec. 31, 2021
Jun. 17, 2021
Dec. 31, 2020
May 10, 2017
2028 Senior unsecured notes payable        
Financial liabilities:        
Senior unsecured notes payable, face value $ 400,000 $ 400,000 $ 0  
2025 Senior unsecured notes payable        
Financial liabilities:        
Senior unsecured notes payable, face value 0   300,000 $ 300,000
Carrying Amount | 2028 Senior unsecured notes payable | Level 2        
Financial liabilities:        
Senior unsecured notes payable, fair value 394,262   0  
Carrying Amount | 2025 Senior unsecured notes payable | Level 2        
Financial liabilities:        
Senior unsecured notes payable, fair value 0   296,669  
Fair Value | 2028 Senior unsecured notes payable | Level 2        
Financial liabilities:        
Senior unsecured notes payable, fair value 410,500   0  
Fair Value | 2025 Senior unsecured notes payable | Level 2        
Financial liabilities:        
Senior unsecured notes payable, fair value $ 0   $ 311,430  
v3.22.0.1
Debt - Schedule of Debt (Details) - USD ($)
$ in Thousands
Dec. 31, 2021
Dec. 31, 2020
Debt Instrument [Line Items]    
Principal Amount $ 680,000 $ 550,000
Deferred Loan Fees (6,602) (4,406)
Carrying Amount 673,398 545,594
Unsecured revolving credit facility    
Debt Instrument [Line Items]    
Principal Amount 80,000 50,000
Deferred Loan Fees 0 0
Carrying Amount 80,000 50,000
Notes payable | 2028 Senior unsecured notes payable    
Debt Instrument [Line Items]    
Principal Amount 400,000 0
Deferred Loan Fees (5,738) 0
Carrying Amount 394,262 0
Notes payable | 2025 Senior unsecured notes payable    
Debt Instrument [Line Items]    
Principal Amount 0 300,000
Deferred Loan Fees 0 (3,331)
Carrying Amount 0 296,669
Term loan | Senior unsecured term loan    
Debt Instrument [Line Items]    
Principal Amount 200,000 200,000
Deferred Loan Fees (864) (1,075)
Carrying Amount $ 199,136 $ 198,925
v3.22.0.1
Debt - Senior Unsecured Notes Payable Narrative (Details) - USD ($)
$ in Thousands
12 Months Ended
Jul. 01, 2021
Jun. 17, 2021
May 10, 2017
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Debt Instrument [Line Items]            
Gross proceeds from issuance       $ 0 $ 0 $ 200,000
Loss on extinguishment of debt       10,827 0 $ 0
Notes payable | 3.875% Senior Notes due 2028            
Debt Instrument [Line Items]            
Debt instrument face amount   $ 400,000   400,000 0  
Interest rate (percent)   3.875%        
Gross proceeds from issuance   $ 400,000        
Net proceeds from issuance   $ 393,800        
Redemption price, percentage upon change of control (percent)   101.00%        
Notes payable | 3.875% Senior Notes due 2028 | Period prior to March 30 2028            
Debt Instrument [Line Items]            
Redemption price of notes (percent)   100.00%        
Notes payable | 3.875% Senior Notes due 2028 | Period after March 30 2028            
Debt Instrument [Line Items]            
Redemption price of notes (percent)   100.00%        
Notes payable | 3.875% Senior Notes due 2028 | Period prior to June 30 2024            
Debt Instrument [Line Items]            
Redemption price of notes (percent)   103.875%        
Percentage of principal amount (percent)   40.00%        
Notes payable | 5.25% Senior Notes due 2025            
Debt Instrument [Line Items]            
Debt instrument face amount     $ 300,000 0 $ 300,000  
Interest rate (percent)     5.25%      
Gross proceeds from issuance     $ 300,000      
Net proceeds from issuance     $ 294,000      
Redemption price of notes (percent) 102.625%          
Aggregate principal redeemed $ 300,000          
Loss on extinguishment of debt       10,800    
Prepayment penalty       7,900    
Write-off of deferred financing costs       $ 2,900    
v3.22.0.1
Debt - Unsecured Revolving Credit Facility and Term Loan Narrative (Details)
Feb. 08, 2019
USD ($)
extension_option
Dec. 31, 2021
USD ($)
Dec. 31, 2020
USD ($)
Line of Credit Facility [Line Items]      
Borrowings outstanding   $ 680,000,000 $ 550,000,000
Borrowings outstanding   80,000,000 50,000,000
Revolving credit facility      
Line of Credit Facility [Line Items]      
Credit facility borrowing capacity $ 600,000,000    
Borrowings outstanding   80,000,000 50,000,000
Borrowings outstanding   80,000,000  
Number of extension options | extension_option 2    
Extension option term (in months) 6 months    
Revolving credit facility | Minimum      
Line of Credit Facility [Line Items]      
Facility fee on revolving commitment fees (percent) 0.15%    
Facility fee on revolving commitment fee based on investment grade ratings (percent) 0.125%    
Revolving credit facility | Minimum | Base Rate      
Line of Credit Facility [Line Items]      
Basis spread on variable rate (percent) 0.10%    
Revolving credit facility | Minimum | LIBOR      
Line of Credit Facility [Line Items]      
Basis spread on variable rate (percent) 1.10%    
Revolving credit facility | Maximum      
Line of Credit Facility [Line Items]      
Facility fee on revolving commitment fees (percent) 0.35%    
Facility fee on revolving commitment fee based on investment grade ratings (percent) 0.30%    
Revolving credit facility | Maximum | Base Rate      
Line of Credit Facility [Line Items]      
Basis spread on variable rate (percent) 0.55%    
Revolving credit facility | Maximum | LIBOR      
Line of Credit Facility [Line Items]      
Basis spread on variable rate (percent) 1.55%    
Letter of credit      
Line of Credit Facility [Line Items]      
Subfacility capacity as percentage of available revolving commitments (percent) 10.00%    
Swingline loan      
Line of Credit Facility [Line Items]      
Subfacility capacity as percentage of available revolving commitments (percent) 10.00%    
Term loan | Senior unsecured term loan      
Line of Credit Facility [Line Items]      
Debt instrument face amount $ 200,000,000    
Borrowings outstanding   $ 200,000,000 $ 200,000,000
Term loan | Senior unsecured term loan | Minimum | Base Rate      
Line of Credit Facility [Line Items]      
Basis spread on variable rate (percent) 0.50%    
Term loan | Senior unsecured term loan | Minimum | LIBOR      
Line of Credit Facility [Line Items]      
Basis spread on variable rate (percent) 1.50%    
Term loan | Senior unsecured term loan | Maximum | Base Rate      
Line of Credit Facility [Line Items]      
Basis spread on variable rate (percent) 1.20%    
Term loan | Senior unsecured term loan | Maximum | LIBOR      
Line of Credit Facility [Line Items]      
Basis spread on variable rate (percent) 2.20%    
v3.22.0.1
Debt - Schedule of Debt Maturities (Details) - USD ($)
$ in Thousands
Dec. 31, 2021
Dec. 31, 2020
Debt, Fiscal Year Maturity [Abstract]    
2022 $ 0  
2023 80,000  
2024 0  
2025 0  
2026 200,000  
Thereafter 400,000  
Total debt $ 680,000 $ 550,000
v3.22.0.1
Equity - Narrative (Details) - USD ($)
12 Months Ended
Apr. 15, 2019
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Mar. 20, 2020
Mar. 10, 2020
Class of Stock [Line Items]            
Common stock, par value (usd per share)   $ 0.01 $ 0.01      
Gross proceeds   $ 22,946,000   $ 195,924,000    
Share repurchase program authorization         $ 150,000,000  
Shares repurchased (shares)   0 0      
Underwritten public offering            
Class of Stock [Line Items]            
Issuance of common stock, net (shares) 6,641,250          
Common stock, par value (usd per share) $ 0.01          
Share price to the public (usd per share) $ 23.35          
Gross proceeds $ 149,000,000          
Underwriter option            
Class of Stock [Line Items]            
Issuance of common stock, net (shares) 866,250          
ATM Program            
Class of Stock [Line Items]            
Issuance of common stock, net (shares)     0      
Remaining offering amount available   $ 476,500,000        
Maximum | ATM Program            
Class of Stock [Line Items]            
Authorized aggregate offering price of common stock           $ 500,000,000
v3.22.0.1
Equity - At-The-Market Offering (Details) - USD ($)
$ / shares in Units, $ in Thousands
12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
ATM Program Activity      
Gross proceeds $ 22,946   $ 195,924
Commissions paid on stock issuance   $ 404  
Prior ATM Program      
ATM Program Activity      
Number of shares 990,000   2,459,000
Average sales price per share (usd per share) $ 23.74   $ 19.48
Gross proceeds $ 23,505   $ 47,893
Commissions paid on stock issuance $ 300   $ 600
v3.22.0.1
Equity - Dividends on Common Stock (Details) - USD ($)
$ / shares in Units, $ in Thousands
3 Months Ended 12 Months Ended
Dec. 31, 2021
Sep. 30, 2021
Jun. 30, 2021
Mar. 31, 2021
Dec. 31, 2020
Sep. 30, 2020
Jun. 30, 2020
Mar. 31, 2020
Dec. 31, 2019
Sep. 30, 2019
Jun. 30, 2019
Mar. 31, 2019
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Equity [Abstract]                              
Dividends declared (usd per share) $ 0.265 $ 0.265 $ 0.265 $ 0.265 $ 0.25 $ 0.25 $ 0.25 $ 0.25 $ 0.225 $ 0.225 $ 0.225 $ 0.225 $ 1.06 $ 1.00 $ 0.90
Dividends payment date Jan. 14, 2022 Oct. 15, 2021 Jul. 15, 2021 Apr. 15, 2021 Jan. 15, 2021 Oct. 15, 2020 Jul. 15, 2020 Apr. 15, 2020 Jan. 15, 2020 Oct. 15, 2019 Jul. 15, 2019 Apr. 15, 2019      
Dividends payable as of record date $ 25,755 $ 25,714 $ 25,714 $ 25,633 $ 23,933 $ 23,934 $ 23,931 $ 23,931 $ 21,500 $ 21,500 $ 21,508 $ 20,011 $ 25,755 $ 23,933 $ 21,500
Dividends record date Dec. 31, 2021 Sep. 30, 2021 Jun. 30, 2021 Mar. 31, 2021 Dec. 31, 2020 Sep. 30, 2020 Jun. 30, 2020 Mar. 31, 2020 Dec. 31, 2019 Sep. 30, 2019 Jun. 28, 2019 Mar. 29, 2019      
v3.22.0.1
Stock-Based Compensation - Narrative (Details) - USD ($)
$ in Millions
3 Months Ended 12 Months Ended
Dec. 31, 2021
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Number of shares authorized for awards 5,000,000 5,000,000    
Cumulative out of period adjustment related to stock compensation $ 3.5      
Cumulative adjustment related to quarters of 2021 2.6      
Cumulative adjustment related to prior periods 0.9      
Unamortized stock-based compensation expense $ 11.5 $ 11.5    
RSAs        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Vesting period (in years)   3 years 4 years 4 years
PSAs | Minimum        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Vesting period (in years)   1 year 1 year 1 year
PSAs | Maximum        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Vesting period (in years)   3 years 4 years 4 years
TSR Awards        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Vesting period (in years)   3 years    
Total fair value of awards granted   $ 5.3    
TSR Awards | Minimum        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Performance awards ultimately vesting based on TRS, as percentage of initial grant   0.00%    
TSR Awards | Maximum        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Performance awards ultimately vesting based on TRS, as percentage of initial grant   200.00%    
RSAs and PSAs        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Weighted-average remaining vesting period (in years)   2 years    
v3.22.0.1
Stock-Based Compensation - Restricted Stock and Performance Awards Activity (Details) - $ / shares
12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
RSAs and PSAs      
Shares      
Unvested, beginning balance (shares) 517,686    
Vested (shares) (147,646)    
Forfeited (shares) (2,250)    
Unvested, ending balance (shares) 891,333 517,686  
Weighted Average Share Price      
Unvested, beginning balance (usd per share) $ 18.71    
Vested (usd per share) 17.43    
Forfeited (usd per share) 22.38    
Unvested, ending balance (usd per share) $ 20.91 $ 18.71  
RSAs      
Shares      
Granted (shares) 394,863 134,790 91,440
Vested (shares) (89,921)    
Weighted Average Share Price      
Granted (usd per share) $ 21.92 $ 19.68 $ 22.00
RSAs | Board Awards      
Shares      
Granted (shares) 20,266 27,611 17,749
Vested (shares) (27,611)    
Weighted Average Share Price      
Granted (usd per share) $ 24.18 $ 16.48 $ 24.23
PSAs      
Shares      
Granted (shares) 108,414 107,790 71,440
Vested (shares) (30,114)    
Weighted Average Share Price      
Granted (usd per share) $ 22.48 $ 19.06 $ 22.00
v3.22.0.1
Stock-Based Compensation - Grants During the Period (Details) - USD ($)
$ / shares in Units, $ in Thousands
12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
RSAs      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Granted (shares) 394,863 134,790 91,440
Granted (usd per share) $ 21.92 $ 19.68 $ 22.00
Grant Date Fair Value $ 8,654 $ 2,653 $ 2,012
Vested (shares) 89,921    
Vest Date Fair Value $ 2,105    
RSAs | Board Awards      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Granted (shares) 20,266 27,611 17,749
Granted (usd per share) $ 24.18 $ 16.48 $ 24.23
Grant Date Fair Value $ 490 $ 455 $ 430
Vested (shares) 27,611    
Vest Date Fair Value $ 668    
PSAs      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Granted (shares) 108,414 107,790 71,440
Granted (usd per share) $ 22.48 $ 19.06 $ 22.00
Grant Date Fair Value $ 2,437 $ 2,054 $ 1,572
Vested (shares) 30,114    
Vest Date Fair Value $ 707    
v3.22.0.1
Stock-Based Compensation - Key Assumptions Used in Valuation (Details) - TSR Awards
12 Months Ended
Dec. 31, 2021
$ / shares
Key Assumptions Used in Valuation  
Risk-free interest rate 0.60%
Expected stock price volatility 52.42%
Expected service period 2 years 11 months 4 days
Expected dividend yield (assuming full reinvestment) 0.00%
Fair value per share at date of grant (usd per share) $ 29.10
v3.22.0.1
Stock-Based Compensation - Stock-Based Compensation Expense (Details) - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Share-based Payment Arrangement [Abstract]      
Stock-based compensation expense $ 10,832 $ 3,790 $ 4,104
v3.22.0.1
Earnings Per Common Share (Details) - USD ($)
$ / shares in Units, $ in Thousands
12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Numerator:      
Net income $ 71,982 $ 80,867 $ 46,359
Less: Net income allocated to participating securities (507) (298) (296)
Numerator for basic earnings available to common stockholders 71,475 80,569 46,063
Numerator for diluted earnings available to common stockholders $ 71,475 $ 80,569 $ 46,063
Denominator:      
Weighted-average basic common shares outstanding (shares) 96,017,000 95,200,000 93,088,000
Dilutive performance stock awards (shares) 75,000 7,000 10,000
Weighted-average diluted common shares outstanding (shares) 96,092,000 95,207,000 93,098,000
Earnings per common share, basic (usd per share) $ 0.74 $ 0.85 $ 0.49
Earnings per common share, diluted (usd per share) $ 0.74 $ 0.85 $ 0.49
Antidilutive unvested restricted stock awards and performance awards excluded from the computation 591,000 296,000 292,000
v3.22.0.1
Commitments and Contingencies (Details)
$ in Millions
Dec. 31, 2021
USD ($)
Ensign and Pennant  
Other Commitments [Line Items]  
Aggregate required financing of capital expenditures as percentage of initial investment in property (percent) 20.00%
Expansion, construction and capital improvements at triple-net leased facilities  
Other Commitments [Line Items]  
Funding commitment $ 7.3
Portion of funding commitments subject to rent increase at time of funding $ 6.3
v3.22.0.1
Concentration of Risk (Details)
12 Months Ended
Dec. 31, 2021
facility
beds
Dec. 31, 2020
facility
beds
Dec. 31, 2019
beds
facility
Ensign | SNF      
Concentration Risk [Line Items]      
Number of Facilities | facility 83 77 75
Number of Beds/Units | beds 8,756 8,129 7,945
Ensign | Campus      
Concentration Risk [Line Items]      
Number of Facilities | facility 8 8 6
Number of Beds/Units | beds 997 1,027 573
Ensign | ALF/ILF      
Concentration Risk [Line Items]      
Number of Facilities | facility 4 4 4
Number of Beds/Units | beds 395 390 390
Ensign | Rental revenue | Customer concentration risk      
Concentration Risk [Line Items]      
Concentration risk (percent) 32.00% 32.00% 38.00%
PMG | SNF      
Concentration Risk [Line Items]      
Number of Facilities | facility 13 13 13
Number of Beds/Units | beds 1,742 1,742 1,742
PMG | Campus      
Concentration Risk [Line Items]      
Number of Facilities | facility 2 2 2
Number of Beds/Units | beds 402 403 403
PMG | ALF/ILF      
Concentration Risk [Line Items]      
Number of Facilities | facility 0 0 0
Number of Beds/Units | beds 0 0 0
PMG | Rental revenue | Customer concentration risk      
Concentration Risk [Line Items]      
Concentration risk (percent) 15.00% 16.00% 15.00%
CA | SNF      
Concentration Risk [Line Items]      
Number of Facilities | facility 27    
Number of Beds/Units | beds 3,048    
CA | Campus      
Concentration Risk [Line Items]      
Number of Facilities | facility 8    
Number of Beds/Units | beds 1,359    
CA | ALF/ILF      
Concentration Risk [Line Items]      
Number of Facilities | facility 5    
Number of Beds/Units | beds 449    
CA | Rental revenue | Geographic concentration risk      
Concentration Risk [Line Items]      
Concentration risk (percent) 25.00%    
TX | SNF      
Concentration Risk [Line Items]      
Number of Facilities | facility 37    
Number of Beds/Units | beds 4,694    
TX | Campus      
Concentration Risk [Line Items]      
Number of Facilities | facility 3    
Number of Beds/Units | beds 536    
TX | ALF/ILF      
Concentration Risk [Line Items]      
Number of Facilities | facility 3    
Number of Beds/Units | beds 242    
TX | Rental revenue | Geographic concentration risk      
Concentration Risk [Line Items]      
Concentration risk (percent) 20.00%    
v3.22.0.1
Subsequent Events (Details)
$ in Thousands
1 Months Ended 12 Months Ended
Aug. 01, 2021
facility
Feb. 16, 2022
USD ($)
facility
extension_options
Dec. 31, 2021
USD ($)
property
Dec. 31, 2020
USD ($)
property
Dec. 31, 2019
USD ($)
property
Subsequent Event [Line Items]          
Number of properties | property     10 8 22
Aggregate purchase price     $ 196,076 $ 89,817 $ 326,700
Skilled nursing facility          
Subsequent Event [Line Items]          
Number of properties | facility 2        
Subsequent event | Skilled nursing facility          
Subsequent Event [Line Items]          
Number of properties | facility   1      
Aggregate purchase price   $ 8,900      
Subsequent event | Eduro lease          
Subsequent Event [Line Items]          
Lease term (in years)   12 years      
Number of renewal options | extension_options   2      
Lease renewal term (in years)   5 years      
Annual cash rent increase under amended lease   $ 800      
v3.22.0.1
Schedule III - Real Estate Assets and Accumulated Depreciation - By Property (Details) - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 252,957      
Initial Cost to Company, Buildings and Improvements 1,504,486      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 116,363      
Gross Carrying Value        
Gross Carrying Value, Land 251,787      
Gross Carrying Value, Buildings and Improvements 1,622,019      
Gross Carrying Value, Total 1,873,806 $ 1,683,205 $ 1,605,081 $ 1,368,157
Accumulated Depreciation (304,785) $ (259,803) $ (220,359) $ (185,926)
Aggregate cost of real estate for federal income tax purposes 1,900,000      
Skilled nursing properties        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances 0      
Initial Cost to Company        
Initial Cost to Company, Land 161,032      
Initial Cost to Company, Buildings and Improvements 1,003,798      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 94,187      
Gross Carrying Value        
Gross Carrying Value, Land 159,993      
Gross Carrying Value, Buildings and Improvements 1,099,024      
Gross Carrying Value, Total 1,259,016      
Accumulated Depreciation (225,820)      
Skilled nursing properties | Ensign Highland LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances 0      
Initial Cost to Company        
Initial Cost to Company, Land 257      
Initial Cost to Company, Buildings and Improvements 976      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 926      
Gross Carrying Value        
Gross Carrying Value, Land 257      
Gross Carrying Value, Buildings and Improvements 1,902      
Gross Carrying Value, Total 2,159      
Accumulated Depreciation $ (1,397)      
Construction/Renovation Date 2013      
Acquisition Date 2000      
Skilled nursing properties | Meadowbrook Health Associates LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 425      
Initial Cost to Company, Buildings and Improvements 3,716      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,940      
Gross Carrying Value        
Gross Carrying Value, Land 425      
Gross Carrying Value, Buildings and Improvements 5,656      
Gross Carrying Value, Total 6,081      
Accumulated Depreciation $ (3,308)      
Construction/Renovation Date 2012      
Acquisition Date 2000      
Skilled nursing properties | Terrace Holdings AZ LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 113      
Initial Cost to Company, Buildings and Improvements 504      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 971      
Gross Carrying Value        
Gross Carrying Value, Land 113      
Gross Carrying Value, Buildings and Improvements 1,475      
Gross Carrying Value, Total 1,588      
Accumulated Depreciation $ (945)      
Construction/Renovation Date 2004      
Acquisition Date 2002      
Skilled nursing properties | Rillito Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 471      
Initial Cost to Company, Buildings and Improvements 2,041      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 3,055      
Gross Carrying Value        
Gross Carrying Value, Land 471      
Gross Carrying Value, Buildings and Improvements 5,096      
Gross Carrying Value, Total 5,567      
Accumulated Depreciation $ (3,296)      
Construction/Renovation Date 2013      
Acquisition Date 2003      
Skilled nursing properties | Valley Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 629      
Initial Cost to Company, Buildings and Improvements 5,154      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,519      
Gross Carrying Value        
Gross Carrying Value, Land 629      
Gross Carrying Value, Buildings and Improvements 6,673      
Gross Carrying Value, Total 7,302      
Accumulated Depreciation $ (4,079)      
Construction/Renovation Date 2009      
Acquisition Date 2004      
Skilled nursing properties | Cedar Avenue Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 2,812      
Initial Cost to Company, Buildings and Improvements 3,919      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,994      
Gross Carrying Value        
Gross Carrying Value, Land 2,812      
Gross Carrying Value, Buildings and Improvements 5,913      
Gross Carrying Value, Total 8,725      
Accumulated Depreciation $ (3,672)      
Construction/Renovation Date 2011      
Acquisition Date 2005      
Skilled nursing properties | Granada Investments LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 3,526      
Initial Cost to Company, Buildings and Improvements 2,827      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,522      
Gross Carrying Value        
Gross Carrying Value, Land 3,526      
Gross Carrying Value, Buildings and Improvements 4,349      
Gross Carrying Value, Total 7,875      
Accumulated Depreciation $ (2,780)      
Construction/Renovation Date 2010      
Acquisition Date 2005      
Skilled nursing properties | Plaza Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 450      
Initial Cost to Company, Buildings and Improvements 5,566      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,055      
Gross Carrying Value        
Gross Carrying Value, Land 450      
Gross Carrying Value, Buildings and Improvements 6,621      
Gross Carrying Value, Total 7,071      
Accumulated Depreciation $ (4,143)      
Construction/Renovation Date 2009      
Acquisition Date 2006      
Skilled nursing properties | Mountainview Community Care LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 931      
Initial Cost to Company, Buildings and Improvements 2,612      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 653      
Gross Carrying Value        
Gross Carrying Value, Land 931      
Gross Carrying Value, Buildings and Improvements 3,265      
Gross Carrying Value, Total 4,196      
Accumulated Depreciation $ (2,199)      
Construction/Renovation Date 1963      
Acquisition Date 2006      
Skilled nursing properties | CM Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 3,028      
Initial Cost to Company, Buildings and Improvements 3,119      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 2,071      
Gross Carrying Value        
Gross Carrying Value, Land 3,028      
Gross Carrying Value, Buildings and Improvements 5,190      
Gross Carrying Value, Total 8,218      
Accumulated Depreciation $ (3,184)      
Construction/Renovation Date 2012      
Acquisition Date 2006      
Skilled nursing properties | Polk Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 60      
Initial Cost to Company, Buildings and Improvements 4,391      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,167      
Gross Carrying Value        
Gross Carrying Value, Land 60      
Gross Carrying Value, Buildings and Improvements 5,558      
Gross Carrying Value, Total 5,618      
Accumulated Depreciation $ (3,320)      
Construction/Renovation Date 2009      
Acquisition Date 2006      
Skilled nursing properties | Snohomish Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 741      
Initial Cost to Company, Buildings and Improvements 1,663      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,998      
Gross Carrying Value        
Gross Carrying Value, Land 741      
Gross Carrying Value, Buildings and Improvements 3,661      
Gross Carrying Value, Total 4,402      
Accumulated Depreciation $ (2,714)      
Construction/Renovation Date 2009      
Acquisition Date 2006      
Skilled nursing properties | Cherry Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 171      
Initial Cost to Company, Buildings and Improvements 1,828      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 2,038      
Gross Carrying Value        
Gross Carrying Value, Land 171      
Gross Carrying Value, Buildings and Improvements 3,866      
Gross Carrying Value, Total 4,037      
Accumulated Depreciation $ (2,738)      
Construction/Renovation Date 2010      
Acquisition Date 2006      
Skilled nursing properties | Golfview Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,105      
Initial Cost to Company, Buildings and Improvements 3,110      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,067      
Gross Carrying Value        
Gross Carrying Value, Land 1,105      
Gross Carrying Value, Buildings and Improvements 4,177      
Gross Carrying Value, Total 5,282      
Accumulated Depreciation $ (2,402)      
Construction/Renovation Date 2007      
Acquisition Date 2006      
Skilled nursing properties | Tenth East Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 332      
Initial Cost to Company, Buildings and Improvements 2,426      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 2,507      
Gross Carrying Value        
Gross Carrying Value, Land 332      
Gross Carrying Value, Buildings and Improvements 4,933      
Gross Carrying Value, Total 5,265      
Accumulated Depreciation $ (3,337)      
Construction/Renovation Date 2013      
Acquisition Date 2006      
Skilled nursing properties | Trinity Mill Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 664      
Initial Cost to Company, Buildings and Improvements 2,294      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 902      
Gross Carrying Value        
Gross Carrying Value, Land 664      
Gross Carrying Value, Buildings and Improvements 3,196      
Gross Carrying Value, Total 3,860      
Accumulated Depreciation $ (2,416)      
Construction/Renovation Date 2007      
Acquisition Date 2006      
Skilled nursing properties | Cottonwood Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 965      
Initial Cost to Company, Buildings and Improvements 2,070      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 958      
Gross Carrying Value        
Gross Carrying Value, Land 965      
Gross Carrying Value, Buildings and Improvements 3,028      
Gross Carrying Value, Total 3,993      
Accumulated Depreciation $ (2,428)      
Construction/Renovation Date 2008      
Acquisition Date 2007      
Skilled nursing properties | Verde Villa Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 600      
Initial Cost to Company, Buildings and Improvements 1,890      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 470      
Gross Carrying Value        
Gross Carrying Value, Land 600      
Gross Carrying Value, Buildings and Improvements 2,360      
Gross Carrying Value, Total 2,960      
Accumulated Depreciation $ (1,544)      
Construction/Renovation Date 2011      
Acquisition Date 2007      
Skilled nursing properties | Mesquite Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 470      
Initial Cost to Company, Buildings and Improvements 1,715      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 8,632      
Gross Carrying Value        
Gross Carrying Value, Land 441      
Gross Carrying Value, Buildings and Improvements 10,376      
Gross Carrying Value, Total 10,817      
Accumulated Depreciation $ (7,709)      
Construction/Renovation Date 2012      
Acquisition Date 2007      
Skilled nursing properties | Arrow Tree Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 2,165      
Initial Cost to Company, Buildings and Improvements 1,105      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 324      
Gross Carrying Value        
Gross Carrying Value, Land 2,165      
Gross Carrying Value, Buildings and Improvements 1,429      
Gross Carrying Value, Total 3,594      
Accumulated Depreciation $ (1,080)      
Construction/Renovation Date 1965      
Acquisition Date 2007      
Skilled nursing properties | Fort Street Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 443      
Initial Cost to Company, Buildings and Improvements 2,394      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 759      
Gross Carrying Value        
Gross Carrying Value, Land 443      
Gross Carrying Value, Buildings and Improvements 3,153      
Gross Carrying Value, Total 3,596      
Accumulated Depreciation $ (1,722)      
Construction/Renovation Date 2008      
Acquisition Date 2007      
Skilled nursing properties | Trousdale Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,415      
Initial Cost to Company, Buildings and Improvements 1,841      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,861      
Gross Carrying Value        
Gross Carrying Value, Land 1,415      
Gross Carrying Value, Buildings and Improvements 3,702      
Gross Carrying Value, Total 5,117      
Accumulated Depreciation $ (2,225)      
Construction/Renovation Date 2013      
Acquisition Date 2007      
Skilled nursing properties | Ensign Bellflower LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 937      
Initial Cost to Company, Buildings and Improvements 1,168      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 357      
Gross Carrying Value        
Gross Carrying Value, Land 937      
Gross Carrying Value, Buildings and Improvements 1,525      
Gross Carrying Value, Total 2,462      
Accumulated Depreciation $ (982)      
Construction/Renovation Date 2009      
Acquisition Date 2007      
Skilled nursing properties | RB Heights Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 2,007      
Initial Cost to Company, Buildings and Improvements 2,793      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,762      
Gross Carrying Value        
Gross Carrying Value, Land 2,007      
Gross Carrying Value, Buildings and Improvements 4,555      
Gross Carrying Value, Total 6,562      
Accumulated Depreciation $ (2,714)      
Construction/Renovation Date 2009      
Acquisition Date 2008      
Skilled nursing properties | San Corrine Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 310      
Initial Cost to Company, Buildings and Improvements 2,090      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 719      
Gross Carrying Value        
Gross Carrying Value, Land 310      
Gross Carrying Value, Buildings and Improvements 2,809      
Gross Carrying Value, Total 3,119      
Accumulated Depreciation $ (1,523)      
Construction/Renovation Date 2005      
Acquisition Date 2008      
Skilled nursing properties | Temple Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 529      
Initial Cost to Company, Buildings and Improvements 2,207      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,163      
Gross Carrying Value        
Gross Carrying Value, Land 529      
Gross Carrying Value, Buildings and Improvements 3,370      
Gross Carrying Value, Total 3,899      
Accumulated Depreciation $ (1,932)      
Construction/Renovation Date 2008      
Acquisition Date 2008      
Skilled nursing properties | Anson Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 369      
Initial Cost to Company, Buildings and Improvements 3,220      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,725      
Gross Carrying Value        
Gross Carrying Value, Land 369      
Gross Carrying Value, Buildings and Improvements 4,945      
Gross Carrying Value, Total 5,314      
Accumulated Depreciation $ (2,736)      
Construction/Renovation Date 2012      
Acquisition Date 2008      
Skilled nursing properties | Willits Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 490      
Initial Cost to Company, Buildings and Improvements 1,231      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 500      
Gross Carrying Value        
Gross Carrying Value, Land 490      
Gross Carrying Value, Buildings and Improvements 1,731      
Gross Carrying Value, Total 2,221      
Accumulated Depreciation $ (957)      
Construction/Renovation Date 2011      
Acquisition Date 2008      
Skilled nursing properties | Lufkin Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 467      
Initial Cost to Company, Buildings and Improvements 4,644      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 782      
Gross Carrying Value        
Gross Carrying Value, Land 467      
Gross Carrying Value, Buildings and Improvements 5,426      
Gross Carrying Value, Total 5,893      
Accumulated Depreciation $ (1,782)      
Construction/Renovation Date 1988      
Acquisition Date 2009      
Skilled nursing properties | Lowell Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 217      
Initial Cost to Company, Buildings and Improvements 856      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,735      
Gross Carrying Value        
Gross Carrying Value, Land 217      
Gross Carrying Value, Buildings and Improvements 2,591      
Gross Carrying Value, Total 2,808      
Accumulated Depreciation $ (1,564)      
Construction/Renovation Date 2012      
Acquisition Date 2009      
Skilled nursing properties | Jefferson Ralston Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 280      
Initial Cost to Company, Buildings and Improvements 1,230      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 834      
Gross Carrying Value        
Gross Carrying Value, Land 280      
Gross Carrying Value, Buildings and Improvements 2,064      
Gross Carrying Value, Total 2,344      
Accumulated Depreciation $ (1,003)      
Construction/Renovation Date 2012      
Acquisition Date 2009      
Skilled nursing properties | Lafayette Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,607      
Initial Cost to Company, Buildings and Improvements 4,222      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 6,195      
Gross Carrying Value        
Gross Carrying Value, Land 1,607      
Gross Carrying Value, Buildings and Improvements 10,417      
Gross Carrying Value, Total 12,024      
Accumulated Depreciation $ (5,530)      
Construction/Renovation Date 2012      
Acquisition Date 2009      
Skilled nursing properties | Hillendahl Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 2,133      
Initial Cost to Company, Buildings and Improvements 11,977      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,421      
Gross Carrying Value        
Gross Carrying Value, Land 2,133      
Gross Carrying Value, Buildings and Improvements 13,398      
Gross Carrying Value, Total 15,531      
Accumulated Depreciation $ (6,037)      
Construction/Renovation Date 1984      
Acquisition Date 2009      
Skilled nursing properties | Price Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 193      
Initial Cost to Company, Buildings and Improvements 2,209      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 849      
Gross Carrying Value        
Gross Carrying Value, Land 193      
Gross Carrying Value, Buildings and Improvements 3,058      
Gross Carrying Value, Total 3,251      
Accumulated Depreciation $ (1,209)      
Construction/Renovation Date 2012      
Acquisition Date 2009      
Skilled nursing properties | Silver Lake Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 2,051      
Initial Cost to Company, Buildings and Improvements 8,362      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 2,011      
Gross Carrying Value        
Gross Carrying Value, Land 2,051      
Gross Carrying Value, Buildings and Improvements 10,373      
Gross Carrying Value, Total 12,424      
Accumulated Depreciation $ (3,492)      
Construction/Renovation Date 2011      
Acquisition Date 2009      
Skilled nursing properties | Jordan Health Properties LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 2,671      
Initial Cost to Company, Buildings and Improvements 4,244      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,507      
Gross Carrying Value        
Gross Carrying Value, Land 2,671      
Gross Carrying Value, Buildings and Improvements 5,751      
Gross Carrying Value, Total 8,422      
Accumulated Depreciation $ (2,003)      
Construction/Renovation Date 2013      
Acquisition Date 2009      
Skilled nursing properties | Regal Road Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 767      
Initial Cost to Company, Buildings and Improvements 4,648      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 729      
Gross Carrying Value        
Gross Carrying Value, Land 767      
Gross Carrying Value, Buildings and Improvements 5,377      
Gross Carrying Value, Total 6,144      
Accumulated Depreciation $ (2,250)      
Construction/Renovation Date 2012      
Acquisition Date 2009      
Skilled nursing properties | Paredes Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 373      
Initial Cost to Company, Buildings and Improvements 1,354      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 190      
Gross Carrying Value        
Gross Carrying Value, Land 373      
Gross Carrying Value, Buildings and Improvements 1,544      
Gross Carrying Value, Total 1,917      
Accumulated Depreciation $ (507)      
Construction/Renovation Date 1969      
Acquisition Date 2009      
Skilled nursing properties | Expressway Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 90      
Initial Cost to Company, Buildings and Improvements 675      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 430      
Gross Carrying Value        
Gross Carrying Value, Land 90      
Gross Carrying Value, Buildings and Improvements 1,105      
Gross Carrying Value, Total 1,195      
Accumulated Depreciation $ (503)      
Construction/Renovation Date 2011      
Acquisition Date 2009      
Skilled nursing properties | Rio Grande Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 642      
Initial Cost to Company, Buildings and Improvements 1,085      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 870      
Gross Carrying Value        
Gross Carrying Value, Land 642      
Gross Carrying Value, Buildings and Improvements 1,955      
Gross Carrying Value, Total 2,597      
Accumulated Depreciation $ (1,040)      
Construction/Renovation Date 2012      
Acquisition Date 2009      
Skilled nursing properties | Fifth East Holdings        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 345      
Initial Cost to Company, Buildings and Improvements 2,464      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,065      
Gross Carrying Value        
Gross Carrying Value, Land 345      
Gross Carrying Value, Buildings and Improvements 3,529      
Gross Carrying Value, Total 3,874      
Accumulated Depreciation $ (1,480)      
Construction/Renovation Date 2011      
Acquisition Date 2009      
Skilled nursing properties | Emmett Healthcare Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 591      
Initial Cost to Company, Buildings and Improvements 2,383      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 69      
Gross Carrying Value        
Gross Carrying Value, Land 591      
Gross Carrying Value, Buildings and Improvements 2,452      
Gross Carrying Value, Total 3,043      
Accumulated Depreciation $ (875)      
Construction/Renovation Date 1972      
Acquisition Date 2010      
Skilled nursing properties | Burley Healthcare Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 250      
Initial Cost to Company, Buildings and Improvements 4,004      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 424      
Gross Carrying Value        
Gross Carrying Value, Land 250      
Gross Carrying Value, Buildings and Improvements 4,428      
Gross Carrying Value, Total 4,678      
Accumulated Depreciation $ (1,723)      
Construction/Renovation Date 2011      
Acquisition Date 2010      
Skilled nursing properties | Josey Ranch Healthcare Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,382      
Initial Cost to Company, Buildings and Improvements 2,293      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 478      
Gross Carrying Value        
Gross Carrying Value, Land 1,382      
Gross Carrying Value, Buildings and Improvements 2,771      
Gross Carrying Value, Total 4,153      
Accumulated Depreciation $ (1,026)      
Construction/Renovation Date 1996      
Acquisition Date 2010      
Skilled nursing properties | Everglades Health Holdings        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,847      
Initial Cost to Company, Buildings and Improvements 5,377      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 682      
Gross Carrying Value        
Gross Carrying Value, Land 1,847      
Gross Carrying Value, Buildings and Improvements 6,059      
Gross Carrying Value, Total 7,906      
Accumulated Depreciation $ (1,793)      
Construction/Renovation Date 1990      
Acquisition Date 2011      
Skilled nursing properties | Irving Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 60      
Initial Cost to Company, Buildings and Improvements 2,931      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 245      
Gross Carrying Value        
Gross Carrying Value, Land 60      
Gross Carrying Value, Buildings and Improvements 3,176      
Gross Carrying Value, Total 3,236      
Accumulated Depreciation $ (1,174)      
Construction/Renovation Date 2011      
Acquisition Date 2011      
Skilled nursing properties | Falls City Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 170      
Initial Cost to Company, Buildings and Improvements 2,141      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 82      
Gross Carrying Value        
Gross Carrying Value, Land 170      
Gross Carrying Value, Buildings and Improvements 2,223      
Gross Carrying Value, Total 2,393      
Accumulated Depreciation $ (749)      
Construction/Renovation Date 1972      
Acquisition Date 2011      
Skilled nursing properties | Gillette Park Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 163      
Initial Cost to Company, Buildings and Improvements 1,491      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 12      
Gross Carrying Value        
Gross Carrying Value, Land 163      
Gross Carrying Value, Buildings and Improvements 1,503      
Gross Carrying Value, Total 1,666      
Accumulated Depreciation $ (636)      
Construction/Renovation Date 1967      
Acquisition Date 2011      
Skilled nursing properties | Gazebo Park Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 80      
Initial Cost to Company, Buildings and Improvements 2,541      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 97      
Gross Carrying Value        
Gross Carrying Value, Land 80      
Gross Carrying Value, Buildings and Improvements 2,638      
Gross Carrying Value, Total 2,718      
Accumulated Depreciation $ (1,162)      
Construction/Renovation Date 1978      
Acquisition Date 2011      
Skilled nursing properties | Oleson Park Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 90      
Initial Cost to Company, Buildings and Improvements 2,341      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 759      
Gross Carrying Value        
Gross Carrying Value, Land 90      
Gross Carrying Value, Buildings and Improvements 3,100      
Gross Carrying Value, Total 3,190      
Accumulated Depreciation $ (1,696)      
Construction/Renovation Date 2012      
Acquisition Date 2011      
Skilled nursing properties | Arapahoe Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 158      
Initial Cost to Company, Buildings and Improvements 4,810      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 759      
Gross Carrying Value        
Gross Carrying Value, Land 128      
Gross Carrying Value, Buildings and Improvements 5,599      
Gross Carrying Value, Total 5,727      
Accumulated Depreciation $ (2,248)      
Construction/Renovation Date 2012      
Acquisition Date 2011      
Skilled nursing properties | Dixie Health Holdings        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 487      
Initial Cost to Company, Buildings and Improvements 1,978      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 98      
Gross Carrying Value        
Gross Carrying Value, Land 487      
Gross Carrying Value, Buildings and Improvements 2,076      
Gross Carrying Value, Total 2,563      
Accumulated Depreciation $ (582)      
Construction/Renovation Date 1978      
Acquisition Date 2011      
Skilled nursing properties | Memorial Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 537      
Initial Cost to Company, Buildings and Improvements 2,138      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 698      
Gross Carrying Value        
Gross Carrying Value, Land 537      
Gross Carrying Value, Buildings and Improvements 2,836      
Gross Carrying Value, Total 3,373      
Accumulated Depreciation $ (1,185)      
Construction/Renovation Date 2007      
Acquisition Date 2011      
Skilled nursing properties | Bogardus Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,425      
Initial Cost to Company, Buildings and Improvements 5,307      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,079      
Gross Carrying Value        
Gross Carrying Value, Land 1,425      
Gross Carrying Value, Buildings and Improvements 6,386      
Gross Carrying Value, Total 7,811      
Accumulated Depreciation $ (2,468)      
Construction/Renovation Date 2011      
Acquisition Date 2011      
Skilled nursing properties | South Dora Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 297      
Initial Cost to Company, Buildings and Improvements 2,087      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,621      
Gross Carrying Value        
Gross Carrying Value, Land 297      
Gross Carrying Value, Buildings and Improvements 3,708      
Gross Carrying Value, Total 4,005      
Accumulated Depreciation $ (2,181)      
Construction/Renovation Date 2013      
Acquisition Date 2011      
Skilled nursing properties | Silverada Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,012      
Initial Cost to Company, Buildings and Improvements 3,282      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 103      
Gross Carrying Value        
Gross Carrying Value, Land 1,012      
Gross Carrying Value, Buildings and Improvements 3,385      
Gross Carrying Value, Total 4,397      
Accumulated Depreciation $ (892)      
Construction/Renovation Date 1970      
Acquisition Date 2011      
Skilled nursing properties | Orem Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,689      
Initial Cost to Company, Buildings and Improvements 3,896      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 3,235      
Gross Carrying Value        
Gross Carrying Value, Land 1,689      
Gross Carrying Value, Buildings and Improvements 7,131      
Gross Carrying Value, Total 8,820      
Accumulated Depreciation $ (3,225)      
Construction/Renovation Date 2011      
Acquisition Date 2011      
Skilled nursing properties | Wisteria Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 746      
Initial Cost to Company, Buildings and Improvements 9,903      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 290      
Gross Carrying Value        
Gross Carrying Value, Land 746      
Gross Carrying Value, Buildings and Improvements 10,193      
Gross Carrying Value, Total 10,939      
Accumulated Depreciation $ (2,456)      
Construction/Renovation Date 2008      
Acquisition Date 2011      
Skilled nursing properties | Renne Avenue Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 180      
Initial Cost to Company, Buildings and Improvements 2,481      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 966      
Gross Carrying Value        
Gross Carrying Value, Land 180      
Gross Carrying Value, Buildings and Improvements 3,447      
Gross Carrying Value, Total 3,627      
Accumulated Depreciation $ (1,368)      
Construction/Renovation Date 2013      
Acquisition Date 2012      
Skilled nursing properties | Stillhouse Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 129      
Initial Cost to Company, Buildings and Improvements 7,139      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 6      
Gross Carrying Value        
Gross Carrying Value, Land 129      
Gross Carrying Value, Buildings and Improvements 7,145      
Gross Carrying Value, Total 7,274      
Accumulated Depreciation $ (1,205)      
Construction/Renovation Date 2009      
Acquisition Date 2012      
Skilled nursing properties | Fig Street Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 329      
Initial Cost to Company, Buildings and Improvements 2,653      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,094      
Gross Carrying Value        
Gross Carrying Value, Land 329      
Gross Carrying Value, Buildings and Improvements 3,747      
Gross Carrying Value, Total 4,076      
Accumulated Depreciation $ (1,723)      
Construction/Renovation Date 2007      
Acquisition Date 2012      
Skilled nursing properties | Lowell Lake Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 49      
Initial Cost to Company, Buildings and Improvements 1,554      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 29      
Gross Carrying Value        
Gross Carrying Value, Land 49      
Gross Carrying Value, Buildings and Improvements 1,583      
Gross Carrying Value, Total 1,632      
Accumulated Depreciation $ (350)      
Construction/Renovation Date 1990      
Acquisition Date 2012      
Skilled nursing properties | Queensway Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 999      
Initial Cost to Company, Buildings and Improvements 4,237      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 2,331      
Gross Carrying Value        
Gross Carrying Value, Land 999      
Gross Carrying Value, Buildings and Improvements 6,568      
Gross Carrying Value, Total 7,567      
Accumulated Depreciation $ (2,999)      
Construction/Renovation Date 2008      
Acquisition Date 2012      
Skilled nursing properties | Long Beach Health Associates LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,285      
Initial Cost to Company, Buildings and Improvements 2,343      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 2,172      
Gross Carrying Value        
Gross Carrying Value, Land 1,285      
Gross Carrying Value, Buildings and Improvements 4,515      
Gross Carrying Value, Total 5,800      
Accumulated Depreciation $ (2,101)      
Construction/Renovation Date 2013      
Acquisition Date 2012      
Skilled nursing properties | Kings Court Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 193      
Initial Cost to Company, Buildings and Improvements 2,311      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 318      
Gross Carrying Value        
Gross Carrying Value, Land 193      
Gross Carrying Value, Buildings and Improvements 2,629      
Gross Carrying Value, Total 2,822      
Accumulated Depreciation $ (712)      
Construction/Renovation Date 1965      
Acquisition Date 2012      
Skilled nursing properties | 51st Avenue Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 340      
Initial Cost to Company, Buildings and Improvements 3,925      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 32      
Gross Carrying Value        
Gross Carrying Value, Land 340      
Gross Carrying Value, Buildings and Improvements 3,957      
Gross Carrying Value, Total 4,297      
Accumulated Depreciation $ (1,009)      
Construction/Renovation Date 1970      
Acquisition Date 2013      
Skilled nursing properties | Ives Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 371      
Initial Cost to Company, Buildings and Improvements 2,951      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 274      
Gross Carrying Value        
Gross Carrying Value, Land 371      
Gross Carrying Value, Buildings and Improvements 3,225      
Gross Carrying Value, Total 3,596      
Accumulated Depreciation $ (789)      
Construction/Renovation Date 1972      
Acquisition Date 2013      
Skilled nursing properties | Guadalupe Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 80      
Initial Cost to Company, Buildings and Improvements 2,391      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 15      
Gross Carrying Value        
Gross Carrying Value, Land 80      
Gross Carrying Value, Buildings and Improvements 2,406      
Gross Carrying Value, Total 2,486      
Accumulated Depreciation $ (477)      
Construction/Renovation Date 2013      
Acquisition Date 2013      
Skilled nursing properties | 49th Street Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 129      
Initial Cost to Company, Buildings and Improvements 2,418      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 24      
Gross Carrying Value        
Gross Carrying Value, Land 129      
Gross Carrying Value, Buildings and Improvements 2,442      
Gross Carrying Value, Total 2,571      
Accumulated Depreciation $ (711)      
Construction/Renovation Date 1960      
Acquisition Date 2013      
Skilled nursing properties | Willows Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,388      
Initial Cost to Company, Buildings and Improvements 2,982      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 202      
Gross Carrying Value        
Gross Carrying Value, Land 1,388      
Gross Carrying Value, Buildings and Improvements 3,184      
Gross Carrying Value, Total 4,572      
Accumulated Depreciation $ (1,021)      
Construction/Renovation Date 1970      
Acquisition Date 2013      
Skilled nursing properties | Tulalip Bay Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,722      
Initial Cost to Company, Buildings and Improvements 2,642      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition (980)      
Gross Carrying Value        
Gross Carrying Value, Land 742      
Gross Carrying Value, Buildings and Improvements 2,642      
Gross Carrying Value, Total 3,384      
Accumulated Depreciation $ (748)      
Construction/Renovation Date 1966      
Acquisition Date 2013      
Skilled nursing properties | Sky Holdings AZ LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 228      
Initial Cost to Company, Buildings and Improvements 1,124      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,380      
Gross Carrying Value        
Gross Carrying Value, Land 228      
Gross Carrying Value, Buildings and Improvements 2,504      
Gross Carrying Value, Total 2,731      
Accumulated Depreciation $ (1,830)      
Construction/Renovation Date 2004      
Acquisition Date 2002      
Skilled nursing properties | Lemon River Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 152      
Initial Cost to Company, Buildings and Improvements 357      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,493      
Gross Carrying Value        
Gross Carrying Value, Land 152      
Gross Carrying Value, Buildings and Improvements 1,850      
Gross Carrying Value, Total 2,002      
Accumulated Depreciation $ (1,285)      
Construction/Renovation Date 2012      
Acquisition Date 2009      
Skilled nursing properties | CTR Partnership, L.P. | Bethany Rehabilitation Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,668      
Initial Cost to Company, Buildings and Improvements 15,375      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 56      
Gross Carrying Value        
Gross Carrying Value, Land 1,668      
Gross Carrying Value, Buildings and Improvements 15,431      
Gross Carrying Value, Total 17,099      
Accumulated Depreciation $ (2,671)      
Construction/Renovation Date 1989      
Acquisition Date 2015      
Skilled nursing properties | CTR Partnership, L.P. | Mira Vista Care Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,601      
Initial Cost to Company, Buildings and Improvements 7,425      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 1,601      
Gross Carrying Value, Buildings and Improvements 7,425      
Gross Carrying Value, Total 9,026      
Accumulated Depreciation $ (1,253)      
Construction/Renovation Date 1989      
Acquisition Date 2015      
Skilled nursing properties | CTR Partnership, L.P. | Shoreline Health and Rehabilitation Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,462      
Initial Cost to Company, Buildings and Improvements 5,034      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 1,462      
Gross Carrying Value, Buildings and Improvements 5,034      
Gross Carrying Value, Total 6,496      
Accumulated Depreciation $ (829)      
Construction/Renovation Date 1987      
Acquisition Date 2015      
Skilled nursing properties | CTR Partnership, L.P. | Shamrock Nursing and Rehabilitation Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 251      
Initial Cost to Company, Buildings and Improvements 7,855      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 251      
Gross Carrying Value, Buildings and Improvements 7,855      
Gross Carrying Value, Total 8,106      
Accumulated Depreciation $ (1,276)      
Construction/Renovation Date 2010      
Acquisition Date 2015      
Skilled nursing properties | CTR Partnership, L.P. | BeaverCreek Health and Rehab        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 892      
Initial Cost to Company, Buildings and Improvements 17,159      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 13      
Gross Carrying Value        
Gross Carrying Value, Land 892      
Gross Carrying Value, Buildings and Improvements 17,172      
Gross Carrying Value, Total 18,064      
Accumulated Depreciation $ (2,684)      
Construction/Renovation Date 2014      
Acquisition Date 2015      
Skilled nursing properties | CTR Partnership, L.P. | Premier Estates of Cincinnati-Riverview        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 833      
Initial Cost to Company, Buildings and Improvements 18,086      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 474      
Gross Carrying Value        
Gross Carrying Value, Land 833      
Gross Carrying Value, Buildings and Improvements 18,560      
Gross Carrying Value, Total 19,393      
Accumulated Depreciation $ (2,884)      
Construction/Renovation Date 1992      
Acquisition Date 2015      
Skilled nursing properties | CTR Partnership, L.P. | Englewood Health and Rehab        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,014      
Initial Cost to Company, Buildings and Improvements 18,541      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 88      
Gross Carrying Value        
Gross Carrying Value, Land 1,014      
Gross Carrying Value, Buildings and Improvements 18,629      
Gross Carrying Value, Total 19,643      
Accumulated Depreciation $ (2,937)      
Construction/Renovation Date 1962      
Acquisition Date 2015      
Skilled nursing properties | CTR Partnership, L.P. | Portsmouth Health and Rehab        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 282      
Initial Cost to Company, Buildings and Improvements 9,726      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 428      
Gross Carrying Value        
Gross Carrying Value, Land 282      
Gross Carrying Value, Buildings and Improvements 10,154      
Gross Carrying Value, Total 10,436      
Accumulated Depreciation $ (1,679)      
Construction/Renovation Date 2008      
Acquisition Date 2015      
Skilled nursing properties | CTR Partnership, L.P. | West Cove Care & Rehabilitation Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 93      
Initial Cost to Company, Buildings and Improvements 10,365      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 93      
Gross Carrying Value, Buildings and Improvements 10,365      
Gross Carrying Value, Total 10,458      
Accumulated Depreciation $ (1,619)      
Construction/Renovation Date 2007      
Acquisition Date 2015      
Skilled nursing properties | CTR Partnership, L.P. | BellBrook Health and Rehab        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 214      
Initial Cost to Company, Buildings and Improvements 2,573      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 231      
Gross Carrying Value        
Gross Carrying Value, Land 214      
Gross Carrying Value, Buildings and Improvements 2,804      
Gross Carrying Value, Total 3,018      
Accumulated Depreciation $ (466)      
Construction/Renovation Date 2003      
Acquisition Date 2015      
Skilled nursing properties | CTR Partnership, L.P. | Xenia Health and Rehab        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 205      
Initial Cost to Company, Buildings and Improvements 3,564      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 23      
Gross Carrying Value        
Gross Carrying Value, Land 205      
Gross Carrying Value, Buildings and Improvements 3,587      
Gross Carrying Value, Total 3,792      
Accumulated Depreciation $ (562)      
Construction/Renovation Date 1981      
Acquisition Date 2015      
Skilled nursing properties | CTR Partnership, L.P. | Jamestown Place Health and Rehab        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 266      
Initial Cost to Company, Buildings and Improvements 4,725      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 268      
Gross Carrying Value        
Gross Carrying Value, Land 266      
Gross Carrying Value, Buildings and Improvements 4,993      
Gross Carrying Value, Total 5,259      
Accumulated Depreciation $ (834)      
Construction/Renovation Date 1967      
Acquisition Date 2015      
Skilled nursing properties | CTR Partnership, L.P. | Casa de Paz        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 119      
Initial Cost to Company, Buildings and Improvements 7,727      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 119      
Gross Carrying Value, Buildings and Improvements 7,727      
Gross Carrying Value, Total 7,846      
Accumulated Depreciation $ (1,143)      
Construction/Renovation Date 1974      
Acquisition Date 2016      
Skilled nursing properties | CTR Partnership, L.P. | Denison Care Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 96      
Initial Cost to Company, Buildings and Improvements 2,784      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 96      
Gross Carrying Value, Buildings and Improvements 2,784      
Gross Carrying Value, Total 2,880      
Accumulated Depreciation $ (412)      
Construction/Renovation Date 2015      
Acquisition Date 2016      
Skilled nursing properties | CTR Partnership, L.P. | Garden View Care Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 105      
Initial Cost to Company, Buildings and Improvements 3,179      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 105      
Gross Carrying Value, Buildings and Improvements 3,179      
Gross Carrying Value, Total 3,284      
Accumulated Depreciation $ (470)      
Construction/Renovation Date 2013      
Acquisition Date 2016      
Skilled nursing properties | CTR Partnership, L.P. | Grandview Health Care Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 39      
Initial Cost to Company, Buildings and Improvements 1,167      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 39      
Gross Carrying Value, Buildings and Improvements 1,167      
Gross Carrying Value, Total 1,206      
Accumulated Depreciation $ (173)      
Construction/Renovation Date 2014      
Acquisition Date 2016      
Skilled nursing properties | CTR Partnership, L.P. | Grundy Care Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 65      
Initial Cost to Company, Buildings and Improvements 1,935      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 65      
Gross Carrying Value, Buildings and Improvements 1,935      
Gross Carrying Value, Total 2,000      
Accumulated Depreciation $ (286)      
Construction/Renovation Date 2011      
Acquisition Date 2016      
Skilled nursing properties | CTR Partnership, L.P. | Iowa City Rehab and Health Care Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 522      
Initial Cost to Company, Buildings and Improvements 5,690      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 522      
Gross Carrying Value, Buildings and Improvements 5,690      
Gross Carrying Value, Total 6,212      
Accumulated Depreciation $ (842)      
Construction/Renovation Date 2014      
Acquisition Date 2016      
Skilled nursing properties | CTR Partnership, L.P. | Lenox Care Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 31      
Initial Cost to Company, Buildings and Improvements 1,915      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 31      
Gross Carrying Value, Buildings and Improvements 1,915      
Gross Carrying Value, Total 1,946      
Accumulated Depreciation $ (283)      
Construction/Renovation Date 2012      
Acquisition Date 2016      
Skilled nursing properties | CTR Partnership, L.P. | Osage        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 126      
Initial Cost to Company, Buildings and Improvements 2,255      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 126      
Gross Carrying Value, Buildings and Improvements 2,255      
Gross Carrying Value, Total 2,381      
Accumulated Depreciation $ (334)      
Construction/Renovation Date 2014      
Acquisition Date 2016      
Skilled nursing properties | CTR Partnership, L.P. | Pleasant Acres Care Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 189      
Initial Cost to Company, Buildings and Improvements 2,544      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 189      
Gross Carrying Value, Buildings and Improvements 2,544      
Gross Carrying Value, Total 2,733      
Accumulated Depreciation $ (376)      
Construction/Renovation Date 2014      
Acquisition Date 2016      
Skilled nursing properties | CTR Partnership, L.P. | Cedar Falls Health Care Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 324      
Initial Cost to Company, Buildings and Improvements 4,366      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 324      
Gross Carrying Value, Buildings and Improvements 4,366      
Gross Carrying Value, Total 4,690      
Accumulated Depreciation $ (628)      
Construction/Renovation Date 2015      
Acquisition Date 2016      
Skilled nursing properties | CTR Partnership, L.P. | Premier Estates of Highlands        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 364      
Initial Cost to Company, Buildings and Improvements 2,199      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 439      
Gross Carrying Value        
Gross Carrying Value, Land 364      
Gross Carrying Value, Buildings and Improvements 2,638      
Gross Carrying Value, Total 3,002      
Accumulated Depreciation $ (369)      
Construction/Renovation Date 2012      
Acquisition Date 2016      
Skilled nursing properties | CTR Partnership, L.P. | Shaw Mountain at Cascadia        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,801      
Initial Cost to Company, Buildings and Improvements 6,572      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 395      
Gross Carrying Value        
Gross Carrying Value, Land 1,801      
Gross Carrying Value, Buildings and Improvements 6,967      
Gross Carrying Value, Total 8,768      
Accumulated Depreciation $ (1,112)      
Construction/Renovation Date 1989      
Acquisition Date 2016      
Skilled nursing properties | CTR Partnership, L.P. | The Oaks        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 3,646      
Initial Cost to Company, Buildings and Improvements 2,873      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 110      
Gross Carrying Value        
Gross Carrying Value, Land 3,646      
Gross Carrying Value, Buildings and Improvements 2,983      
Gross Carrying Value, Total 6,629      
Accumulated Depreciation $ (436)      
Construction/Renovation Date 2015      
Acquisition Date 2016      
Skilled nursing properties | CTR Partnership, L.P. | Arbor Nursing Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 768      
Initial Cost to Company, Buildings and Improvements 10,712      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 768      
Gross Carrying Value, Buildings and Improvements 10,712      
Gross Carrying Value, Total 11,480      
Accumulated Depreciation $ (1,451)      
Construction/Renovation Date 1982      
Acquisition Date 2016      
Skilled nursing properties | CTR Partnership, L.P. | Broadmoor Medical Lodge        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,232      
Initial Cost to Company, Buildings and Improvements 22,152      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 1,232      
Gross Carrying Value, Buildings and Improvements 22,152      
Gross Carrying Value, Total 23,384      
Accumulated Depreciation $ (2,816)      
Construction/Renovation Date 1984      
Acquisition Date 2016      
Skilled nursing properties | CTR Partnership, L.P. | Decatur Medical Lodge        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 990      
Initial Cost to Company, Buildings and Improvements 24,909      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 990      
Gross Carrying Value, Buildings and Improvements 24,909      
Gross Carrying Value, Total 25,899      
Accumulated Depreciation $ (3,166)      
Construction/Renovation Date 2013      
Acquisition Date 2016      
Skilled nursing properties | CTR Partnership, L.P. | Royse City Medical Lodge        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 606      
Initial Cost to Company, Buildings and Improvements 14,660      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 606      
Gross Carrying Value, Buildings and Improvements 14,660      
Gross Carrying Value, Total 15,266      
Accumulated Depreciation $ (1,863)      
Construction/Renovation Date 2009      
Acquisition Date 2016      
Skilled nursing properties | CTR Partnership, L.P. | Saline Care Nursing and Rehabilitation Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,022      
Initial Cost to Company, Buildings and Improvements 5,713      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 1,022      
Gross Carrying Value, Buildings and Improvements 5,713      
Gross Carrying Value, Total 6,735      
Accumulated Depreciation $ (690)      
Construction/Renovation Date 2009      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Carrier Mills Nursing and Rehabilitation Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 775      
Initial Cost to Company, Buildings and Improvements 8,377      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 775      
Gross Carrying Value, Buildings and Improvements 8,377      
Gross Carrying Value, Total 9,152      
Accumulated Depreciation $ (1,012)      
Construction/Renovation Date 1968      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | StoneBridge Nursing and Rehabilitation Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 439      
Initial Cost to Company, Buildings and Improvements 3,475      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 439      
Gross Carrying Value, Buildings and Improvements 3,475      
Gross Carrying Value, Total 3,914      
Accumulated Depreciation $ (420)      
Construction/Renovation Date 2014      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | DuQuoin Nursing and Rehabilitation Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 511      
Initial Cost to Company, Buildings and Improvements 3,662      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 511      
Gross Carrying Value, Buildings and Improvements 3,662      
Gross Carrying Value, Total 4,173      
Accumulated Depreciation $ (442)      
Construction/Renovation Date 2014      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Pinckneyville Nursing and Rehabilitation Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 406      
Initial Cost to Company, Buildings and Improvements 3,411      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 406      
Gross Carrying Value, Buildings and Improvements 3,411      
Gross Carrying Value, Total 3,817      
Accumulated Depreciation $ (412)      
Construction/Renovation Date 2014      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Wellspring Health and Rehabilitation Of Cascadia        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 774      
Initial Cost to Company, Buildings and Improvements 5,044      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 111      
Gross Carrying Value        
Gross Carrying Value, Land 774      
Gross Carrying Value, Buildings and Improvements 5,155      
Gross Carrying Value, Total 5,929      
Accumulated Depreciation $ (588)      
Construction/Renovation Date 2011      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | The Rio at Fox Hollow        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,178      
Initial Cost to Company, Buildings and Improvements 12,059      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 1,178      
Gross Carrying Value, Buildings and Improvements 12,059      
Gross Carrying Value, Total 13,237      
Accumulated Depreciation $ (1,382)      
Construction/Renovation Date 2016      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | The Rio at Cabezon        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 2,055      
Initial Cost to Company, Buildings and Improvements 9,749      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 2,055      
Gross Carrying Value, Buildings and Improvements 9,749      
Gross Carrying Value, Total 11,804      
Accumulated Depreciation $ (1,117)      
Construction/Renovation Date 2016      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Eldorado Rehab & Healthcare        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 940      
Initial Cost to Company, Buildings and Improvements 2,093      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 940      
Gross Carrying Value, Buildings and Improvements 2,093      
Gross Carrying Value, Total 3,033      
Accumulated Depreciation $ (235)      
Construction/Renovation Date 1993      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Secora Health and Rehabilitation of Cascadia        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,481      
Initial Cost to Company, Buildings and Improvements 2,216      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 110      
Gross Carrying Value        
Gross Carrying Value, Land 1,481      
Gross Carrying Value, Buildings and Improvements 2,326      
Gross Carrying Value, Total 3,807      
Accumulated Depreciation $ (249)      
Construction/Renovation Date 2012      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Mountain Valley        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 916      
Initial Cost to Company, Buildings and Improvements 7,874      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 916      
Gross Carrying Value, Buildings and Improvements 7,874      
Gross Carrying Value, Total 8,790      
Accumulated Depreciation $ (853)      
Construction/Renovation Date 1971      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Caldwell Care        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 906      
Initial Cost to Company, Buildings and Improvements 7,020      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 516      
Gross Carrying Value        
Gross Carrying Value, Land 906      
Gross Carrying Value, Buildings and Improvements 7,536      
Gross Carrying Value, Total 8,442      
Accumulated Depreciation $ (761)      
Construction/Renovation Date 1947      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Canyon West        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 312      
Initial Cost to Company, Buildings and Improvements 10,410      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 431      
Gross Carrying Value        
Gross Carrying Value, Land 312      
Gross Carrying Value, Buildings and Improvements 10,841      
Gross Carrying Value, Total 11,153      
Accumulated Depreciation $ (1,128)      
Construction/Renovation Date 1969      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Lewiston Health and Rehabilitation        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 625      
Initial Cost to Company, Buildings and Improvements 12,087      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 152      
Gross Carrying Value        
Gross Carrying Value, Land 625      
Gross Carrying Value, Buildings and Improvements 12,239      
Gross Carrying Value, Total 12,864      
Accumulated Depreciation $ (1,284)      
Construction/Renovation Date 1964      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | The Orchards        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 785      
Initial Cost to Company, Buildings and Improvements 8,923      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 47      
Gross Carrying Value        
Gross Carrying Value, Land 785      
Gross Carrying Value, Buildings and Improvements 8,970      
Gross Carrying Value, Total 9,755      
Accumulated Depreciation $ (948)      
Construction/Renovation Date 1958      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Weiser Care        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 80      
Initial Cost to Company, Buildings and Improvements 4,419      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 30      
Gross Carrying Value        
Gross Carrying Value, Land 80      
Gross Carrying Value, Buildings and Improvements 4,449      
Gross Carrying Value, Total 4,529      
Accumulated Depreciation $ (470)      
Construction/Renovation Date 1964      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Aspen Park        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 698      
Initial Cost to Company, Buildings and Improvements 5,092      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 274      
Gross Carrying Value        
Gross Carrying Value, Land 698      
Gross Carrying Value, Buildings and Improvements 5,366      
Gross Carrying Value, Total 6,064      
Accumulated Depreciation $ (584)      
Construction/Renovation Date 1965      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Ridgmar Medical Lodge        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 681      
Initial Cost to Company, Buildings and Improvements 6,587      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,256      
Gross Carrying Value        
Gross Carrying Value, Land 681      
Gross Carrying Value, Buildings and Improvements 7,843      
Gross Carrying Value, Total 8,524      
Accumulated Depreciation $ (950)      
Construction/Renovation Date 2006      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Mansfield Medical Lodge        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 607      
Initial Cost to Company, Buildings and Improvements 4,801      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,073      
Gross Carrying Value        
Gross Carrying Value, Land 607      
Gross Carrying Value, Buildings and Improvements 5,874      
Gross Carrying Value, Total 6,481      
Accumulated Depreciation $ (701)      
Construction/Renovation Date 2006      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Grapevine Medical Lodge        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,602      
Initial Cost to Company, Buildings and Improvements 4,536      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 891      
Gross Carrying Value        
Gross Carrying Value, Land 1,602      
Gross Carrying Value, Buildings and Improvements 5,427      
Gross Carrying Value, Total 7,029      
Accumulated Depreciation $ (659)      
Construction/Renovation Date 2006      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Brookfield Health and Rehab        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 320      
Initial Cost to Company, Buildings and Improvements 500      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 320      
Gross Carrying Value, Buildings and Improvements 500      
Gross Carrying Value, Total 820      
Accumulated Depreciation $ (54)      
Construction/Renovation Date 2012      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | The Oaks at Lakewood        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,000      
Initial Cost to Company, Buildings and Improvements 1,779      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 1,000      
Gross Carrying Value, Buildings and Improvements 1,779      
Gross Carrying Value, Total 2,779      
Accumulated Depreciation $ (189)      
Construction/Renovation Date 1989      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | The Oaks at Timberline        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 445      
Initial Cost to Company, Buildings and Improvements 869      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 445      
Gross Carrying Value, Buildings and Improvements 869      
Gross Carrying Value, Total 1,314      
Accumulated Depreciation $ (92)      
Construction/Renovation Date 1972      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Providence Waterman Nursing Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 3,831      
Initial Cost to Company, Buildings and Improvements 19,791      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 3,831      
Gross Carrying Value, Buildings and Improvements 19,791      
Gross Carrying Value, Total 23,622      
Accumulated Depreciation $ (2,103)      
Construction/Renovation Date 1967      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Providence Orange Tree        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 2,897      
Initial Cost to Company, Buildings and Improvements 14,700      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 345      
Gross Carrying Value        
Gross Carrying Value, Land 2,897      
Gross Carrying Value, Buildings and Improvements 15,045      
Gross Carrying Value, Total 17,942      
Accumulated Depreciation $ (1,585)      
Construction/Renovation Date 1969      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Providence Ontario        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 4,204      
Initial Cost to Company, Buildings and Improvements 21,880      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 4,204      
Gross Carrying Value, Buildings and Improvements 21,880      
Gross Carrying Value, Total 26,084      
Accumulated Depreciation $ (2,325)      
Construction/Renovation Date 1980      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Greenville Nursing and Rehabilitation Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 188      
Initial Cost to Company, Buildings and Improvements 3,972      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 188      
Gross Carrying Value, Buildings and Improvements 3,972      
Gross Carrying Value, Total 4,160      
Accumulated Depreciation $ (484)      
Construction/Renovation Date 1973      
Acquisition Date 2017      
Skilled nursing properties | CTR Partnership, L.P. | Copper Ridge Health and Rehabilitation Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 220      
Initial Cost to Company, Buildings and Improvements 4,974      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 22      
Gross Carrying Value        
Gross Carrying Value, Land 220      
Gross Carrying Value, Buildings and Improvements 4,996      
Gross Carrying Value, Total 5,216      
Accumulated Depreciation $ (536)      
Construction/Renovation Date 2010      
Acquisition Date 2018      
Skilled nursing properties | CTR Partnership, L.P. | Prairie Heights Healthcare Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,372      
Initial Cost to Company, Buildings and Improvements 7,491      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 1,372      
Gross Carrying Value, Buildings and Improvements 7,491      
Gross Carrying Value, Total 8,863      
Accumulated Depreciation $ (718)      
Construction/Renovation Date 1965      
Acquisition Date 2018      
Skilled nursing properties | CTR Partnership, L.P. | The Meadows on University        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 989      
Initial Cost to Company, Buildings and Improvements 3,275      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 989      
Gross Carrying Value, Buildings and Improvements 3,275      
Gross Carrying Value, Total 4,264      
Accumulated Depreciation $ (287)      
Construction/Renovation Date 1966      
Acquisition Date 2018      
Skilled nursing properties | CTR Partnership, L.P. | The Suites - Parker        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,178      
Initial Cost to Company, Buildings and Improvements 17,857      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 1,178      
Gross Carrying Value, Buildings and Improvements 17,857      
Gross Carrying Value, Total 19,035      
Accumulated Depreciation $ (1,408)      
Construction/Renovation Date 2012      
Acquisition Date 2018      
Skilled nursing properties | CTR Partnership, L.P. | Huntington Park Nursing Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 3,131      
Initial Cost to Company, Buildings and Improvements 8,876      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 299      
Gross Carrying Value        
Gross Carrying Value, Land 3,131      
Gross Carrying Value, Buildings and Improvements 9,175      
Gross Carrying Value, Total 12,306      
Accumulated Depreciation $ (720)      
Construction/Renovation Date 1955      
Acquisition Date 2019      
Skilled nursing properties | CTR Partnership, L.P. | Shoreline Care Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,699      
Initial Cost to Company, Buildings and Improvements 9,004      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 1,699      
Gross Carrying Value, Buildings and Improvements 9,004      
Gross Carrying Value, Total 10,703      
Accumulated Depreciation $ (674)      
Construction/Renovation Date 1962      
Acquisition Date 2019      
Skilled nursing properties | CTR Partnership, L.P. | Downey Care Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 2,502      
Initial Cost to Company, Buildings and Improvements 6,141      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 2,502      
Gross Carrying Value, Buildings and Improvements 6,141      
Gross Carrying Value, Total 8,643      
Accumulated Depreciation $ (461)      
Construction/Renovation Date 1967      
Acquisition Date 2019      
Skilled nursing properties | CTR Partnership, L.P. | Courtyard Healthcare Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 2,351      
Initial Cost to Company, Buildings and Improvements 9,256      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 2,351      
Gross Carrying Value, Buildings and Improvements 9,256      
Gross Carrying Value, Total 11,607      
Accumulated Depreciation $ (706)      
Construction/Renovation Date 1969      
Acquisition Date 2019      
Skilled nursing properties | CTR Partnership, L.P. | Cascadia of Nampa        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 880      
Initial Cost to Company, Buildings and Improvements 14,117      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 880      
Gross Carrying Value, Buildings and Improvements 14,117      
Gross Carrying Value, Total 14,997      
Accumulated Depreciation $ (969)      
Construction/Renovation Date 2017      
Acquisition Date 2019      
Skilled nursing properties | CTR Partnership, L.P. | Valley Skilled Nursing        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 798      
Initial Cost to Company, Buildings and Improvements 7,671      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 798      
Gross Carrying Value, Buildings and Improvements 7,671      
Gross Carrying Value, Total 8,469      
Accumulated Depreciation $ (448)      
Construction/Renovation Date 2016      
Acquisition Date 2019      
Skilled nursing properties | CTR Partnership, L.P. | Cascadia of Boise        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,597      
Initial Cost to Company, Buildings and Improvements 15,692      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 1,597      
Gross Carrying Value, Buildings and Improvements 15,692      
Gross Carrying Value, Total 17,289      
Accumulated Depreciation $ (824)      
Construction/Renovation Date 2018      
Acquisition Date 2020      
Skilled nursing properties | CTR Partnership, L.P. | Cooney Healthcare and Rehabilitation        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 867      
Initial Cost to Company, Buildings and Improvements 7,431      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 867      
Gross Carrying Value, Buildings and Improvements 7,431      
Gross Carrying Value, Total 8,298      
Accumulated Depreciation $ (262)      
Construction/Renovation Date 1984      
Acquisition Date 2020      
Skilled nursing properties | CTR Partnership, L.P. | Elkhorn Healthcare and Rehabilitation        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 183      
Initial Cost to Company, Buildings and Improvements 7,380      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 174      
Gross Carrying Value        
Gross Carrying Value, Land 183      
Gross Carrying Value, Buildings and Improvements 7,554      
Gross Carrying Value, Total 7,737      
Accumulated Depreciation $ (264)      
Construction/Renovation Date 1960      
Acquisition Date 2020      
Skilled nursing properties | CTR Partnership, L.P. | Beacon Harbor Healthcare and Rehabilitation        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,295      
Initial Cost to Company, Buildings and Improvements 17,069      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 1,295      
Gross Carrying Value, Buildings and Improvements 17,069      
Gross Carrying Value, Total 18,364      
Accumulated Depreciation $ (533)      
Construction/Renovation Date 1996      
Acquisition Date 2020      
Skilled nursing properties | CTR Partnership, L.P. | Pleasant Manor Healthcare and Rehabilitation        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 629      
Initial Cost to Company, Buildings and Improvements 7,433      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 629      
Gross Carrying Value, Buildings and Improvements 7,433      
Gross Carrying Value, Total 8,062      
Accumulated Depreciation $ (234)      
Construction/Renovation Date 1972      
Acquisition Date 2020      
Skilled nursing properties | CTR Partnership, L.P. | Rowlett Health and Rehabilitation Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,036      
Initial Cost to Company, Buildings and Improvements 10,516      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 1,036      
Gross Carrying Value, Buildings and Improvements 10,516      
Gross Carrying Value, Total 11,552      
Accumulated Depreciation $ (326)      
Construction/Renovation Date 1990      
Acquisition Date 2020      
Skilled nursing properties | CTR Partnership, L.P. | El Centro Post-Acute Care        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,283      
Initial Cost to Company, Buildings and Improvements 8,133      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 76      
Gross Carrying Value        
Gross Carrying Value, Land 1,283      
Gross Carrying Value, Buildings and Improvements 8,209      
Gross Carrying Value, Total 9,492      
Accumulated Depreciation $ (143)      
Construction/Renovation Date 1962      
Acquisition Date 2021      
Skilled nursing properties | CTR Partnership, L.P. | Sedona Trace Health and Wellness        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 3,282      
Initial Cost to Company, Buildings and Improvements 12,763      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 3,282      
Gross Carrying Value, Buildings and Improvements 12,763      
Gross Carrying Value, Total 16,045      
Accumulated Depreciation $ (149)      
Construction/Renovation Date 2017      
Acquisition Date 2021      
Skilled nursing properties | CTR Partnership, L.P. | Cedar Pointe Health and Wellness Suites        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 3,325      
Initial Cost to Company, Buildings and Improvements 11,738      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 3,325      
Gross Carrying Value, Buildings and Improvements 11,738      
Gross Carrying Value, Total 15,063      
Accumulated Depreciation $ (135)      
Construction/Renovation Date 2017      
Acquisition Date 2021      
Skilled nursing properties | 160 North Patterson Avenue, LLC | Buena Vista Care Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 7,987      
Initial Cost to Company, Buildings and Improvements 7,237      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 7,987      
Gross Carrying Value, Buildings and Improvements 7,237      
Gross Carrying Value, Total 15,224      
Accumulated Depreciation $ (160)      
Construction/Renovation Date 1967      
Acquisition Date 2021      
Skilled nursing properties | Gulf Coast Buyer 1 LLC | Alpine Skilled Nursing and Rehabilitation        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 2,688      
Initial Cost to Company, Buildings and Improvements 23,825      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 2,688      
Gross Carrying Value, Buildings and Improvements 23,825      
Gross Carrying Value, Total 26,513      
Accumulated Depreciation $ (1,728)      
Construction/Renovation Date 2014      
Acquisition Date 2019      
Skilled nursing properties | Gulf Coast Buyer 1 LLC | The Bradford Skilled Nursing and Rehabilitation        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 3,758      
Initial Cost to Company, Buildings and Improvements 21,325      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 17      
Gross Carrying Value        
Gross Carrying Value, Land 3,758      
Gross Carrying Value, Buildings and Improvements 21,342      
Gross Carrying Value, Total 25,100      
Accumulated Depreciation $ (1,559)      
Construction/Renovation Date 1980      
Acquisition Date 2019      
Skilled nursing properties | Gulf Coast Buyer 1 LLC | Colonial Oaks Skilled Nursing And Rehabilitation        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,635      
Initial Cost to Company, Buildings and Improvements 21,180      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 1,635      
Gross Carrying Value, Buildings and Improvements 21,180      
Gross Carrying Value, Total 22,815      
Accumulated Depreciation $ (1,500)      
Construction/Renovation Date 2013      
Acquisition Date 2019      
Skilled nursing properties | Gulf Coast Buyer 1 LLC | The Guest House Skilled Nursing And Rehabilitation        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 3,437      
Initial Cost to Company, Buildings and Improvements 20,889      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,226      
Gross Carrying Value        
Gross Carrying Value, Land 3,437      
Gross Carrying Value, Buildings and Improvements 22,115      
Gross Carrying Value, Total 25,552      
Accumulated Depreciation $ (1,550)      
Construction/Renovation Date 2006      
Acquisition Date 2019      
Skilled nursing properties | Gulf Coast Buyer 1 LLC | Pilgrim Manor Skilled Nursing And Rehabilitation        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 2,979      
Initial Cost to Company, Buildings and Improvements 24,617      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 2,979      
Gross Carrying Value, Buildings and Improvements 24,617      
Gross Carrying Value, Total 27,596      
Accumulated Depreciation $ (1,765)      
Construction/Renovation Date 2008      
Acquisition Date 2019      
Skilled nursing properties | Gulf Coast Buyer 1 LLC | Shreveport Manor Skilled Nursing and Rehabilitation        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 676      
Initial Cost to Company, Buildings and Improvements 10,238      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 361      
Gross Carrying Value        
Gross Carrying Value, Land 676      
Gross Carrying Value, Buildings and Improvements 10,599      
Gross Carrying Value, Total 11,275      
Accumulated Depreciation $ (769)      
Construction/Renovation Date 2008      
Acquisition Date 2019      
Skilled nursing properties | Gulf Coast Buyer 1 LLC | Booker T Washington Skilled Nursing and Rehabilitation        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 2,452      
Initial Cost to Company, Buildings and Improvements 9,148      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 113      
Gross Carrying Value        
Gross Carrying Value, Land 2,452      
Gross Carrying Value, Buildings and Improvements 9,261      
Gross Carrying Value, Total 11,713      
Accumulated Depreciation $ (705)      
Construction/Renovation Date 2013      
Acquisition Date 2019      
Skilled nursing properties | Gulf Coast Buyer 1 LLC | Legacy West Rehabilitation and Healthcare        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 120      
Initial Cost to Company, Buildings and Improvements 6,682      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 436      
Gross Carrying Value        
Gross Carrying Value, Land 120      
Gross Carrying Value, Buildings and Improvements 7,118      
Gross Carrying Value, Total 7,238      
Accumulated Depreciation $ (560)      
Construction/Renovation Date 2002      
Acquisition Date 2019      
Skilled nursing properties | Gulf Coast Buyer 1 LLC | Legacy at Jacksonville        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 173      
Initial Cost to Company, Buildings and Improvements 7,481      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 127      
Gross Carrying Value        
Gross Carrying Value, Land 173      
Gross Carrying Value, Buildings and Improvements 7,608      
Gross Carrying Value, Total 7,781      
Accumulated Depreciation $ (588)      
Construction/Renovation Date 2006      
Acquisition Date 2019      
Skilled nursing properties | Gulf Coast Buyer 1 LLC | Pecan Tree Rehabilitation and Healthcare        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 219      
Initial Cost to Company, Buildings and Improvements 10,097      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 255      
Gross Carrying Value        
Gross Carrying Value, Land 219      
Gross Carrying Value, Buildings and Improvements 10,352      
Gross Carrying Value, Total 10,571      
Accumulated Depreciation $ (772)      
Construction/Renovation Date 1990      
Acquisition Date 2019      
Skilled nursing properties | Lakewest SNF Realty LLC | Lakewest Rehabilitation and Skilled Care        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 0      
Initial Cost to Company, Buildings and Improvements 6,905      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 0      
Gross Carrying Value, Buildings and Improvements 6,905      
Gross Carrying Value, Total 6,905      
Accumulated Depreciation $ (515)      
Construction/Renovation Date 2011      
Acquisition Date 2019      
Multi-Service Campus Properties        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 59,450      
Initial Cost to Company, Buildings and Improvements 291,345      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 10,329      
Gross Carrying Value        
Gross Carrying Value, Land 59,319      
Gross Carrying Value, Buildings and Improvements 301,805      
Gross Carrying Value, Total 361,124      
Accumulated Depreciation (35,527)      
Multi-Service Campus Properties | Ensign Southland LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances 0      
Initial Cost to Company        
Initial Cost to Company, Land 966      
Initial Cost to Company, Buildings and Improvements 5,082      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 2,213      
Gross Carrying Value        
Gross Carrying Value, Land 966      
Gross Carrying Value, Buildings and Improvements 7,295      
Gross Carrying Value, Total 8,261      
Accumulated Depreciation $ (5,588)      
Construction/Renovation Date 2011      
Acquisition Date 1999      
Multi-Service Campus Properties | Mission CCRC LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,962      
Initial Cost to Company, Buildings and Improvements 11,035      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 464      
Gross Carrying Value        
Gross Carrying Value, Land 1,962      
Gross Carrying Value, Buildings and Improvements 11,499      
Gross Carrying Value, Total 13,461      
Accumulated Depreciation $ (3,634)      
Construction/Renovation Date 1994      
Acquisition Date 2011      
Multi-Service Campus Properties | Wayne Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 130      
Initial Cost to Company, Buildings and Improvements 3,061      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 122      
Gross Carrying Value        
Gross Carrying Value, Land 130      
Gross Carrying Value, Buildings and Improvements 3,183      
Gross Carrying Value, Total 3,313      
Accumulated Depreciation $ (1,100)      
Construction/Renovation Date 1978      
Acquisition Date 2011      
Multi-Service Campus Properties | 4th Street Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 180      
Initial Cost to Company, Buildings and Improvements 3,352      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 180      
Gross Carrying Value, Buildings and Improvements 3,352      
Gross Carrying Value, Total 3,532      
Accumulated Depreciation $ (1,095)      
Construction/Renovation Date 2006      
Acquisition Date 2011      
Multi-Service Campus Properties | Big Sioux River Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 110      
Initial Cost to Company, Buildings and Improvements 3,522      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 75      
Gross Carrying Value        
Gross Carrying Value, Land 110      
Gross Carrying Value, Buildings and Improvements 3,597      
Gross Carrying Value, Total 3,707      
Accumulated Depreciation $ (1,104)      
Construction/Renovation Date 1974      
Acquisition Date 2011      
Multi-Service Campus Properties | Prairie Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 130      
Initial Cost to Company, Buildings and Improvements 1,571      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 22      
Gross Carrying Value        
Gross Carrying Value, Land 130      
Gross Carrying Value, Buildings and Improvements 1,593      
Gross Carrying Value, Total 1,723      
Accumulated Depreciation $ (838)      
Construction/Renovation Date 2011      
Acquisition Date 2011      
Multi-Service Campus Properties | Salmon River Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 168      
Initial Cost to Company, Buildings and Improvements 2,496      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 168      
Gross Carrying Value, Buildings and Improvements 2,496      
Gross Carrying Value, Total 2,664      
Accumulated Depreciation $ (588)      
Construction/Renovation Date 2012      
Acquisition Date 2012      
Multi-Service Campus Properties | CTR Partnership, L.P. | Centerville Senior Independent Living        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 3,912      
Initial Cost to Company, Buildings and Improvements 22,458      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 117      
Gross Carrying Value        
Gross Carrying Value, Land 3,781      
Gross Carrying Value, Buildings and Improvements 22,706      
Gross Carrying Value, Total 26,487      
Accumulated Depreciation $ (3,605)      
Construction/Renovation Date 2007      
Acquisition Date 2015      
Multi-Service Campus Properties | CTR Partnership, L.P. | Liberty Nursing Center of Willard        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 143      
Initial Cost to Company, Buildings and Improvements 11,097      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 50      
Gross Carrying Value        
Gross Carrying Value, Land 143      
Gross Carrying Value, Buildings and Improvements 11,147      
Gross Carrying Value, Total 11,290      
Accumulated Depreciation $ (1,760)      
Construction/Renovation Date 1985      
Acquisition Date 2015      
Multi-Service Campus Properties | CTR Partnership, L.P. | Premier Estates of Middletown/Premier Retirement Estates of Middletown        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 990      
Initial Cost to Company, Buildings and Improvements 7,484      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 371      
Gross Carrying Value        
Gross Carrying Value, Land 990      
Gross Carrying Value, Buildings and Improvements 7,855      
Gross Carrying Value, Total 8,845      
Accumulated Depreciation $ (1,229)      
Construction/Renovation Date 1985      
Acquisition Date 2015      
Multi-Service Campus Properties | CTR Partnership, L.P. | Premier Estates of Norwood Towers/Premier Retirement Estates of Norwood Towers        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,316      
Initial Cost to Company, Buildings and Improvements 10,071      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 799      
Gross Carrying Value        
Gross Carrying Value, Land 1,316      
Gross Carrying Value, Buildings and Improvements 10,870      
Gross Carrying Value, Total 12,186      
Accumulated Depreciation $ (1,538)      
Construction/Renovation Date 1991      
Acquisition Date 2016      
Multi-Service Campus Properties | CTR Partnership, L.P. | Turlock Nursing and Rehabilitation Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,258      
Initial Cost to Company, Buildings and Improvements 16,526      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 1,258      
Gross Carrying Value, Buildings and Improvements 16,526      
Gross Carrying Value, Total 17,784      
Accumulated Depreciation $ (2,238)      
Construction/Renovation Date 1986      
Acquisition Date 2016      
Multi-Service Campus Properties | CTR Partnership, L.P. | Bridgeport Medical Lodge        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 980      
Initial Cost to Company, Buildings and Improvements 27,917      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 980      
Gross Carrying Value, Buildings and Improvements 27,917      
Gross Carrying Value, Total 28,897      
Accumulated Depreciation $ (3,548)      
Construction/Renovation Date 2014      
Acquisition Date 2016      
Multi-Service Campus Properties | CTR Partnership, L.P. | The Villas at Saratoga        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 8,709      
Initial Cost to Company, Buildings and Improvements 9,736      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,396      
Gross Carrying Value        
Gross Carrying Value, Land 8,709      
Gross Carrying Value, Buildings and Improvements 11,132      
Gross Carrying Value, Total 19,841      
Accumulated Depreciation $ (1,008)      
Construction/Renovation Date 2004      
Acquisition Date 2018      
Multi-Service Campus Properties | CTR Partnership, L.P. | Madison Park Healthcare        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 601      
Initial Cost to Company, Buildings and Improvements 6,385      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 601      
Gross Carrying Value, Buildings and Improvements 6,385      
Gross Carrying Value, Total 6,986      
Accumulated Depreciation $ (525)      
Construction/Renovation Date 1924      
Acquisition Date 2018      
Multi-Service Campus Properties | CTR Partnership, L.P. | Oakview Heights Nursing and Rehabilitation Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 298      
Initial Cost to Company, Buildings and Improvements 8,393      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 298      
Gross Carrying Value, Buildings and Improvements 8,393      
Gross Carrying Value, Total 8,691      
Accumulated Depreciation $ (692)      
Construction/Renovation Date 2004      
Acquisition Date 2019      
Multi-Service Campus Properties | CTR Partnership, L.P. | City Creek Post-Acute and Assisted Living        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 3,980      
Initial Cost to Company, Buildings and Improvements 10,106      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,488      
Gross Carrying Value        
Gross Carrying Value, Land 3,980      
Gross Carrying Value, Buildings and Improvements 11,594      
Gross Carrying Value, Total 15,574      
Accumulated Depreciation $ (655)      
Construction/Renovation Date 1990      
Acquisition Date 2019      
Multi-Service Campus Properties | CTR Partnership, L.P. | Crestwood Health and Rehabilitation Center        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 143      
Initial Cost to Company, Buildings and Improvements 6,075      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 143      
Gross Carrying Value, Buildings and Improvements 6,075      
Gross Carrying Value, Total 6,218      
Accumulated Depreciation $ (198)      
Construction/Renovation Date 1980      
Acquisition Date 2020      
Multi-Service Campus Properties | Gulf Coast Buyer 1 LLC | Spring Lake Skilled Nursing and Rehabilitation        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 3,217      
Initial Cost to Company, Buildings and Improvements 21,195      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 2,730      
Gross Carrying Value        
Gross Carrying Value, Land 3,217      
Gross Carrying Value, Buildings and Improvements 23,925      
Gross Carrying Value, Total 27,142      
Accumulated Depreciation $ (1,666)      
Construction/Renovation Date 2008      
Acquisition Date 2019      
Multi-Service Campus Properties | Gulf Coast Buyer 1 LLC | The Village at Heritage Oaks        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 143      
Initial Cost to Company, Buildings and Improvements 11,429      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 482      
Gross Carrying Value        
Gross Carrying Value, Land 143      
Gross Carrying Value, Buildings and Improvements 11,911      
Gross Carrying Value, Total 12,054      
Accumulated Depreciation $ (913)      
Construction/Renovation Date 2007      
Acquisition Date 2019      
Multi-Service Campus Properties | Northshore Healthcare Holdings LLC | San Juan Capistrano Senior Living        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 11,176      
Initial Cost to Company, Buildings and Improvements 25,298      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 11,176      
Gross Carrying Value, Buildings and Improvements 25,298      
Gross Carrying Value, Total 36,474      
Accumulated Depreciation $ (548)      
Construction/Renovation Date 1999      
Acquisition Date 2021      
Multi-Service Campus Properties | Northshore Healthcare Holdings LLC | Camarillo Senior Living        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 7,516      
Initial Cost to Company, Buildings and Improvements 30,552      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 7,516      
Gross Carrying Value, Buildings and Improvements 30,552      
Gross Carrying Value, Total 38,068      
Accumulated Depreciation $ (655)      
Construction/Renovation Date 2000      
Acquisition Date 2021      
Multi-Service Campus Properties | Northshore Healthcare Holdings LLC | Bayshire Carlsbad        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 7,398      
Initial Cost to Company, Buildings and Improvements 19,714      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 7,398      
Gross Carrying Value, Buildings and Improvements 19,714      
Gross Carrying Value, Total 27,112      
Accumulated Depreciation $ (429)      
Construction/Renovation Date 1999      
Acquisition Date 2021      
Multi-Service Campus Properties | Northshore Healthcare Holdings LLC | Bayshire Rancho Mirage        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 4,024      
Initial Cost to Company, Buildings and Improvements 16,790      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 4,024      
Gross Carrying Value, Buildings and Improvements 16,790      
Gross Carrying Value, Total 20,814      
Accumulated Depreciation $ (373)      
Construction/Renovation Date 2000      
Acquisition Date 2021      
Assisted and Independent Living Properties        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 32,475      
Initial Cost to Company, Buildings and Improvements 209,343      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 11,847      
Gross Carrying Value        
Gross Carrying Value, Land 32,475      
Gross Carrying Value, Buildings and Improvements 221,190      
Gross Carrying Value, Total 253,666      
Accumulated Depreciation (43,438)      
Assisted and Independent Living Properties | Lafayette Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances 0      
Initial Cost to Company        
Initial Cost to Company, Land 420      
Initial Cost to Company, Buildings and Improvements 1,160      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 189      
Gross Carrying Value        
Gross Carrying Value, Land 420      
Gross Carrying Value, Buildings and Improvements 1,349      
Gross Carrying Value, Total 1,769      
Accumulated Depreciation $ (471)      
Construction/Renovation Date 2011      
Acquisition Date 2009      
Assisted and Independent Living Properties | Everglades Health Holdings        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,542      
Initial Cost to Company, Buildings and Improvements 4,012      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 113      
Gross Carrying Value        
Gross Carrying Value, Land 1,542      
Gross Carrying Value, Buildings and Improvements 4,125      
Gross Carrying Value, Total 5,667      
Accumulated Depreciation $ (977)      
Construction/Renovation Date 1990      
Acquisition Date 2011      
Assisted and Independent Living Properties | Wisteria Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 244      
Initial Cost to Company, Buildings and Improvements 3,241      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 81      
Gross Carrying Value        
Gross Carrying Value, Land 244      
Gross Carrying Value, Buildings and Improvements 3,322      
Gross Carrying Value, Total 3,566      
Accumulated Depreciation $ (1,675)      
Construction/Renovation Date 2008      
Acquisition Date 2011      
Assisted and Independent Living Properties | Willows Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 2,835      
Initial Cost to Company, Buildings and Improvements 3,784      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 395      
Gross Carrying Value        
Gross Carrying Value, Land 2,835      
Gross Carrying Value, Buildings and Improvements 4,179      
Gross Carrying Value, Total 7,014      
Accumulated Depreciation $ (1,350)      
Construction/Renovation Date 2013      
Acquisition Date 2013      
Assisted and Independent Living Properties | Sky Holdings AZ LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 61      
Initial Cost to Company, Buildings and Improvements 304      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 372      
Gross Carrying Value        
Gross Carrying Value, Land 61      
Gross Carrying Value, Buildings and Improvements 676      
Gross Carrying Value, Total 738      
Accumulated Depreciation $ (494)      
Construction/Renovation Date 2004      
Acquisition Date 2002      
Assisted and Independent Living Properties | Lemon River Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 342      
Initial Cost to Company, Buildings and Improvements 802      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 3,360      
Gross Carrying Value        
Gross Carrying Value, Land 342      
Gross Carrying Value, Buildings and Improvements 4,162      
Gross Carrying Value, Total 4,504      
Accumulated Depreciation $ (2,892)      
Construction/Renovation Date 2012      
Acquisition Date 2009      
Assisted and Independent Living Properties | Mission CCRC LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 411      
Initial Cost to Company, Buildings and Improvements 2,312      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 258      
Gross Carrying Value        
Gross Carrying Value, Land 411      
Gross Carrying Value, Buildings and Improvements 2,570      
Gross Carrying Value, Total 2,981      
Accumulated Depreciation $ (1,616)      
Construction/Renovation Date 1994      
Acquisition Date 2011      
Assisted and Independent Living Properties | Avenue N Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 124      
Initial Cost to Company, Buildings and Improvements 2,301      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 392      
Gross Carrying Value        
Gross Carrying Value, Land 124      
Gross Carrying Value, Buildings and Improvements 2,693      
Gross Carrying Value, Total 2,817      
Accumulated Depreciation $ (1,453)      
Construction/Renovation Date 2007      
Acquisition Date 2006      
Assisted and Independent Living Properties | Moenium Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,893      
Initial Cost to Company, Buildings and Improvements 5,268      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 1,210      
Gross Carrying Value        
Gross Carrying Value, Land 1,893      
Gross Carrying Value, Buildings and Improvements 6,478      
Gross Carrying Value, Total 8,371      
Accumulated Depreciation $ (3,672)      
Construction/Renovation Date 1986      
Acquisition Date 2007      
Assisted and Independent Living Properties | Expo Park Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 570      
Initial Cost to Company, Buildings and Improvements 1,692      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 248      
Gross Carrying Value        
Gross Carrying Value, Land 570      
Gross Carrying Value, Buildings and Improvements 1,940      
Gross Carrying Value, Total 2,510      
Accumulated Depreciation $ (942)      
Construction/Renovation Date 1986      
Acquisition Date 2010      
Assisted and Independent Living Properties | Flamingo Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 908      
Initial Cost to Company, Buildings and Improvements 4,767      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 281      
Gross Carrying Value        
Gross Carrying Value, Land 908      
Gross Carrying Value, Buildings and Improvements 5,048      
Gross Carrying Value, Total 5,956      
Accumulated Depreciation $ (2,770)      
Construction/Renovation Date 1986      
Acquisition Date 2011      
Assisted and Independent Living Properties | 18th Place Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,011      
Initial Cost to Company, Buildings and Improvements 2,053      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 490      
Gross Carrying Value        
Gross Carrying Value, Land 1,011      
Gross Carrying Value, Buildings and Improvements 2,543      
Gross Carrying Value, Total 3,554      
Accumulated Depreciation $ (1,042)      
Construction/Renovation Date 1974      
Acquisition Date 2011      
Assisted and Independent Living Properties | Boardwalk Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 367      
Initial Cost to Company, Buildings and Improvements 1,633      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 51      
Gross Carrying Value        
Gross Carrying Value, Land 367      
Gross Carrying Value, Buildings and Improvements 1,684      
Gross Carrying Value, Total 2,051      
Accumulated Depreciation $ (568)      
Construction/Renovation Date 1993      
Acquisition Date 2012      
Assisted and Independent Living Properties | Lockwood Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,792      
Initial Cost to Company, Buildings and Improvements 2,253      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 585      
Gross Carrying Value        
Gross Carrying Value, Land 1,792      
Gross Carrying Value, Buildings and Improvements 2,838      
Gross Carrying Value, Total 4,630      
Accumulated Depreciation $ (1,410)      
Construction/Renovation Date 1967      
Acquisition Date 2013      
Assisted and Independent Living Properties | Saratoga Health Holdings LLC        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 444      
Initial Cost to Company, Buildings and Improvements 2,265      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 176      
Gross Carrying Value        
Gross Carrying Value, Land 444      
Gross Carrying Value, Buildings and Improvements 2,441      
Gross Carrying Value, Total 2,885      
Accumulated Depreciation $ (520)      
Construction/Renovation Date 1995      
Acquisition Date 2013      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Prelude Cottages of Woodbury        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 430      
Initial Cost to Company, Buildings and Improvements 6,714      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 76      
Gross Carrying Value        
Gross Carrying Value, Land 430      
Gross Carrying Value, Buildings and Improvements 6,790      
Gross Carrying Value, Total 7,220      
Accumulated Depreciation $ (1,179)      
Construction/Renovation Date 2011      
Acquisition Date 2014      
Assisted and Independent Living Properties | CTR Partnership, L.P. | English Meadows Senior Living Community        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 250      
Initial Cost to Company, Buildings and Improvements 6,114      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 175      
Gross Carrying Value        
Gross Carrying Value, Land 250      
Gross Carrying Value, Buildings and Improvements 6,289      
Gross Carrying Value, Total 6,539      
Accumulated Depreciation $ (1,076)      
Construction/Renovation Date 2011      
Acquisition Date 2014      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Bristol Court Assisted Living        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 645      
Initial Cost to Company, Buildings and Improvements 7,322      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 408      
Gross Carrying Value        
Gross Carrying Value, Land 645      
Gross Carrying Value, Buildings and Improvements 7,730      
Gross Carrying Value, Total 8,375      
Accumulated Depreciation $ (1,198)      
Construction/Renovation Date 2010      
Acquisition Date 2015      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Asbury Place Assisted Living        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 212      
Initial Cost to Company, Buildings and Improvements 4,992      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 222      
Gross Carrying Value        
Gross Carrying Value, Land 212      
Gross Carrying Value, Buildings and Improvements 5,214      
Gross Carrying Value, Total 5,426      
Accumulated Depreciation $ (802)      
Construction/Renovation Date 1997      
Acquisition Date 2015      
Assisted and Independent Living Properties | CTR Partnership, L.P. | New Haven Assisted Living of San Angelo        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 284      
Initial Cost to Company, Buildings and Improvements 4,478      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 284      
Gross Carrying Value, Buildings and Improvements 4,478      
Gross Carrying Value, Total 4,762      
Accumulated Depreciation $ (662)      
Construction/Renovation Date 2012      
Acquisition Date 2016      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Lamplight Inn of Fort Wayne        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 452      
Initial Cost to Company, Buildings and Improvements 8,703      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 304      
Gross Carrying Value        
Gross Carrying Value, Land 452      
Gross Carrying Value, Buildings and Improvements 9,007      
Gross Carrying Value, Total 9,459      
Accumulated Depreciation $ (1,269)      
Construction/Renovation Date 2015      
Acquisition Date 2016      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Lamplight Inn of West Allis        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 97      
Initial Cost to Company, Buildings and Improvements 6,102      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 106      
Gross Carrying Value        
Gross Carrying Value, Land 97      
Gross Carrying Value, Buildings and Improvements 6,208      
Gross Carrying Value, Total 6,305      
Accumulated Depreciation $ (890)      
Construction/Renovation Date 2013      
Acquisition Date 2016      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Fort Myers Assisted Living        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,489      
Initial Cost to Company, Buildings and Improvements 3,531      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 786      
Gross Carrying Value        
Gross Carrying Value, Land 1,489      
Gross Carrying Value, Buildings and Improvements 4,317      
Gross Carrying Value, Total 5,806      
Accumulated Depreciation $ (556)      
Construction/Renovation Date 1980      
Acquisition Date 2016      
Assisted and Independent Living Properties | CTR Partnership, L.P. | English Meadows Elks Home Campus        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 451      
Initial Cost to Company, Buildings and Improvements 9,023      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 287      
Gross Carrying Value        
Gross Carrying Value, Land 451      
Gross Carrying Value, Buildings and Improvements 9,310      
Gross Carrying Value, Total 9,761      
Accumulated Depreciation $ (1,360)      
Construction/Renovation Date 2014      
Acquisition Date 2016      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Croatan Village        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 312      
Initial Cost to Company, Buildings and Improvements 6,919      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 312      
Gross Carrying Value, Buildings and Improvements 6,919      
Gross Carrying Value, Total 7,231      
Accumulated Depreciation $ (980)      
Construction/Renovation Date 2010      
Acquisition Date 2016      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Countryside Village        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 131      
Initial Cost to Company, Buildings and Improvements 4,157      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 131      
Gross Carrying Value, Buildings and Improvements 4,157      
Gross Carrying Value, Total 4,288      
Accumulated Depreciation $ (589)      
Construction/Renovation Date 2011      
Acquisition Date 2016      
Assisted and Independent Living Properties | CTR Partnership, L.P. | The Pines of Clarkston        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 603      
Initial Cost to Company, Buildings and Improvements 9,326      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 603      
Gross Carrying Value, Buildings and Improvements 9,326      
Gross Carrying Value, Total 9,929      
Accumulated Depreciation $ (1,302)      
Construction/Renovation Date 2010      
Acquisition Date 2016      
Assisted and Independent Living Properties | CTR Partnership, L.P. | The Pines of Goodrich        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 241      
Initial Cost to Company, Buildings and Improvements 4,112      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 130      
Gross Carrying Value        
Gross Carrying Value, Land 241      
Gross Carrying Value, Buildings and Improvements 4,242      
Gross Carrying Value, Total 4,483      
Accumulated Depreciation $ (574)      
Construction/Renovation Date 2014      
Acquisition Date 2016      
Assisted and Independent Living Properties | CTR Partnership, L.P. | The Pines of Burton        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 492      
Initial Cost to Company, Buildings and Improvements 9,199      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 492      
Gross Carrying Value, Buildings and Improvements 9,199      
Gross Carrying Value, Total 9,691      
Accumulated Depreciation $ (1,284)      
Construction/Renovation Date 2014      
Acquisition Date 2016      
Assisted and Independent Living Properties | CTR Partnership, L.P. | The Pines of Lapeer        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 302      
Initial Cost to Company, Buildings and Improvements 5,773      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 302      
Gross Carrying Value, Buildings and Improvements 5,773      
Gross Carrying Value, Total 6,075      
Accumulated Depreciation $ (806)      
Construction/Renovation Date 2008      
Acquisition Date 2016      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Arbor Place        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 392      
Initial Cost to Company, Buildings and Improvements 3,605      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 392      
Gross Carrying Value, Buildings and Improvements 3,605      
Gross Carrying Value, Total 3,997      
Accumulated Depreciation $ (488)      
Construction/Renovation Date 1984      
Acquisition Date 2016      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Applewood of Brookfield        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 493      
Initial Cost to Company, Buildings and Improvements 14,002      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 493      
Gross Carrying Value, Buildings and Improvements 14,002      
Gross Carrying Value, Total 14,495      
Accumulated Depreciation $ (1,721)      
Construction/Renovation Date 2013      
Acquisition Date 2017      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Applewood of New Berlin        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 356      
Initial Cost to Company, Buildings and Improvements 10,812      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 13      
Gross Carrying Value        
Gross Carrying Value, Land 356      
Gross Carrying Value, Buildings and Improvements 10,825      
Gross Carrying Value, Total 11,181      
Accumulated Depreciation $ (1,329)      
Construction/Renovation Date 2016      
Acquisition Date 2017      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Tangerine Cove Of Brooksville        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 995      
Initial Cost to Company, Buildings and Improvements 927      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 493      
Gross Carrying Value        
Gross Carrying Value, Land 995      
Gross Carrying Value, Buildings and Improvements 1,420      
Gross Carrying Value, Total 2,415      
Accumulated Depreciation $ (151)      
Construction/Renovation Date 1984      
Acquisition Date 2017      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Memory Care Cottages in White Bear Lake        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,611      
Initial Cost to Company, Buildings and Improvements 5,633      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 1,611      
Gross Carrying Value, Buildings and Improvements 5,633      
Gross Carrying Value, Total 7,244      
Accumulated Depreciation $ (634)      
Construction/Renovation Date 2016      
Acquisition Date 2017      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Culpeper        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 318      
Initial Cost to Company, Buildings and Improvements 3,897      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 197      
Gross Carrying Value        
Gross Carrying Value, Land 318      
Gross Carrying Value, Buildings and Improvements 4,094      
Gross Carrying Value, Total 4,412      
Accumulated Depreciation $ (492)      
Construction/Renovation Date 1997      
Acquisition Date 2017      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Louisa        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 407      
Initial Cost to Company, Buildings and Improvements 4,660      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 240      
Gross Carrying Value        
Gross Carrying Value, Land 407      
Gross Carrying Value, Buildings and Improvements 4,900      
Gross Carrying Value, Total 5,307      
Accumulated Depreciation $ (599)      
Construction/Renovation Date 2002      
Acquisition Date 2017      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Warrenton        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 1,238      
Initial Cost to Company, Buildings and Improvements 7,247      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 194      
Gross Carrying Value        
Gross Carrying Value, Land 1,238      
Gross Carrying Value, Buildings and Improvements 7,441      
Gross Carrying Value, Total 8,679      
Accumulated Depreciation $ (880)      
Construction/Renovation Date 1999      
Acquisition Date 2017      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Vista Del Lago        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 4,362      
Initial Cost to Company, Buildings and Improvements 7,997      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 4,362      
Gross Carrying Value, Buildings and Improvements 7,997      
Gross Carrying Value, Total 12,359      
Accumulated Depreciation $ (489)      
Construction/Renovation Date 2015      
Acquisition Date 2019      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Inn at Barton Creek        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 2,479      
Initial Cost to Company, Buildings and Improvements 4,804      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 15      
Gross Carrying Value        
Gross Carrying Value, Land 2,479      
Gross Carrying Value, Buildings and Improvements 4,819      
Gross Carrying Value, Total 7,298      
Accumulated Depreciation $ (249)      
Construction/Renovation Date 1999      
Acquisition Date 2020      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Bridgeton Essentia Neighborhood        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 245      
Initial Cost to Company, Buildings and Improvements 5,795      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 245      
Gross Carrying Value, Buildings and Improvements 5,795      
Gross Carrying Value, Total 6,040      
Accumulated Depreciation $ (14)      
Construction/Renovation Date 2021      
Acquisition Date 2021      
Assisted and Independent Living Properties | CTR Partnership, L.P. | Rio Grande Essentia Neighborhood        
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]        
Encumbrances $ 0      
Initial Cost to Company        
Initial Cost to Company, Land 224      
Initial Cost to Company, Buildings and Improvements 5,652      
Cost Capitalized Since Acquisition        
Costs Capitalized Since Acquisition 0      
Gross Carrying Value        
Gross Carrying Value, Land 224      
Gross Carrying Value, Buildings and Improvements 5,652      
Gross Carrying Value, Total 5,876      
Accumulated Depreciation $ (13)      
Construction/Renovation Date 2021      
Acquisition Date 2021      
v3.22.0.1
Schedule III - Real Estate Assets and Accumulated Depreciation - Rollforward (Details) - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Real estate:      
Balance at the beginning of the period $ 1,683,205 $ 1,605,081 $ 1,368,157
Acquisitions 190,133 84,630 318,070
Improvements 4,521 7,223 3,103
Impairment 0 0 (21,465)
Sales of real estate (4,053) (13,729) (62,784)
Balance at the end of the period 1,873,806 1,683,205 1,605,081
Accumulated depreciation:      
Balance at the beginning of the period (259,803) (220,359) (185,926)
Depreciation expense (45,498) (41,914) (40,373)
Impairment 0 0 5,220
Sales of real estate 516 2,470 720
Balance at the end of the period $ (304,785) $ (259,803) $ (220,359)
v3.22.0.1
Schedule IV - Mortgage Loans on Real Estate - Mortgage Loan (Details) - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]        
Prior Liens $ 112,278      
Principal Balance 15,000      
Book Value 15,155 $ 15,000 $ 29,500 $ 12,375
Aggregate cost of investments in real estate mortgage loans for federal income tax purposes $ 15,000      
Skilled nursing facility | Next Healthcare Inc - Virginia        
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]        
Contractual Interest Rate 12.00%      
Prior Liens $ 112,278      
Principal Balance 15,000      
Book Value $ 15,155      
v3.22.0.1
Schedule IV - Mortgage Loan on Real Estate - Mortgage Loan Rollforward (Details) - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
SEC Schedule, 12-29, Real Estate Companies, Investment in Movement in Mortgage Loans on Real Estate [Roll Forward]      
Mortgage loans, beginning of period $ 15,000 $ 29,500 $ 12,375
Additions during period:      
New mortgage loans 0 61,258 40,889
Interest income added to principal 155 0 0
Deductions during period:      
Paydowns/Repayments 0 (75,758) (23,764)
Mortgage loans, end of period $ 15,155 $ 15,000 $ 29,500