Audit Information |
12 Months Ended |
|---|---|
Dec. 31, 2023 | |
| Auditor Information [Abstract] | |
| Auditor Firm ID | 34 |
| Auditor Name | Deloitte & Touche LLP |
| Auditor Location | Costa Mesa, California |
CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands |
Dec. 31, 2023 |
Dec. 31, 2022 |
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|---|---|---|---|---|
| ASSETS | ||||
| Real estate investments, net | $ 3,425,438 | $ 3,581,609 | ||
| Debt security investment, net | 86,935 | 83,000 | ||
| Cash and cash equivalents | 43,445 | 65,052 | ||
| Restricted cash | 47,337 | 46,854 | ||
| Accounts and other receivables, net | 185,379 | 137,501 | ||
| Identified intangible assets, net | 180,470 | 236,283 | ||
| Goodwill | 234,942 | 231,611 | ||
| Operating lease right-of-use assets, net | 227,846 | 276,342 | ||
| Other assets, net | 146,141 | 128,446 | ||
| Total assets | 4,577,933 | 4,786,698 | ||
| Liabilities: | ||||
| Mortgage loans payable, net | [1] | 1,302,396 | 1,229,847 | |
| Lines of credit and term loan, net | [1] | 1,223,967 | 1,281,794 | |
| Accounts payable and accrued liabilities | [1] | 242,905 | 243,831 | |
| Identified intangible liabilities, net | 6,095 | 10,837 | ||
| Financing obligations | [1] | 41,756 | 48,406 | |
| Operating lease liabilities | [1] | 225,502 | 273,075 | |
| Security deposits, prepaid rent and other liabilities | [1] | 76,134 | 49,545 | |
| Total liabilities | 3,118,755 | 3,137,335 | ||
| Commitments and Contingencies | ||||
| Redeemable noncontrolling interests | 33,843 | 81,598 | ||
| Stockholders’ equity: | ||||
| Preferred stock, $0.01 par value per share; 200,000,000 shares authorized; none issued and outstanding | 0 | 0 | ||
| Additional paid-in capital | 2,548,307 | 2,540,424 | ||
| Accumulated deficit | (1,276,222) | (1,138,304) | ||
| Accumulated other comprehensive loss | (2,425) | (2,690) | ||
| Total stockholders’ equity | 1,270,321 | 1,400,091 | ||
| Noncontrolling interests | 155,014 | 167,674 | ||
| Total equity | 1,425,335 | 1,567,765 | ||
| Total liabilities, redeemable noncontrolling interests and equity | 4,577,933 | 4,786,698 | ||
| Common Class T | ||||
| Stockholders’ equity: | ||||
| Common stock | 194 | 194 | ||
| Common Class I | ||||
| Stockholders’ equity: | ||||
| Common stock | $ 467 | $ 467 | ||
| ||||
CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands |
Dec. 31, 2023 |
Dec. 31, 2022 |
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|---|---|---|---|---|
| Par value of preferred stock, authorized to be issued (in dollars per share) | $ 0.01 | $ 0.01 | ||
| Preferred stock authorized (in shares) | 200,000,000 | 200,000,000 | ||
| Preferred stock issued (in shares) | 0 | 0 | ||
| Preferred stock outstanding (in shares) | 0 | 0 | ||
| Common stock authorized (in shares) | 1,000,000,000 | 1,000,000,000 | ||
| Lines of credit and term loan | [1] | $ 1,223,967 | $ 1,281,794 | |
| 2022 Corporate Line of Credit | Line of Credit | ||||
| Lines of credit and term loan | $ 914,900 | $ 965,900 | ||
| Common Class T | ||||
| Common stock authorized (in shares) | 200,000,000 | 200,000,000 | ||
| Common stock, par value (in dollars per share) | $ 0.01 | $ 0.01 | ||
| Common stock issued (in shares) | 19,552,856 | 19,535,095 | ||
| Common stock outstanding (in shares) | 19,552,856 | 19,535,095 | ||
| Common Class I | ||||
| Common stock authorized (in shares) | 800,000,000 | 800,000,000 | ||
| Common stock, par value (in dollars per share) | $ 0.01 | $ 0.01 | ||
| Common stock issued (in shares) | 46,673,320 | 46,675,367 | ||
| Common stock outstanding (in shares) | 46,673,320 | 46,675,367 | ||
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CONSOLIDATED STATEMENTS OF EQUITY - USD ($) |
Total |
Total Stockholders' Equity |
Common Stock |
Additional Paid-In Capital |
Accumulated Deficit |
Accumulated Other Comprehensive Loss |
Noncontrolling Interests |
||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Beginning balance, shares at Dec. 31, 2020 | 44,914,588 | ||||||||||||
| Beginning balance Stockholders' Equity at Dec. 31, 2020 | $ 1,034,483,000 | $ 866,108,000 | $ 449,000 | $ 1,731,938,000 | $ (864,271,000) | $ (2,008,000) | $ 168,375,000 | ||||||
| Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||||||||
| Offering costs — common stock | (14,000) | (14,000) | (14,000) | ||||||||||
| Issuance of common stock and purchase of noncontrolling interest in connection with the Merger, shares | [1] | 20,432,815 | |||||||||||
| Issuance of common stock and purchase of noncontrolling interest in connection with the Merger | [1] | 721,945,000 | 765,148,000 | $ 204,000 | 764,944,000 | (43,203,000) | |||||||
| Issuance of operating partnership units to acquire AHI | 112,283,000 | 36,556,000 | 36,449,000 | 107,000 | 75,727,000 | ||||||||
| Issuance of common stock under the DRIP, shares | 207,866 | ||||||||||||
| Issuance of common stock under the DRIP | 7,666,000 | 7,666,000 | $ 2,000 | 7,664,000 | |||||||||
| Issuance of vested and nonvested restricted common stock, shares | 213,091 | ||||||||||||
| Issuance of vested and nonvested restricted common stock, value | 41,000 | 41,000 | $ 3,000 | 38,000 | |||||||||
| Amortization of nonvested common stock compensation | 816,000 | 816,000 | 816,000 | ||||||||||
| Stock based compensation | (14,000) | (14,000) | |||||||||||
| Repurchase of common stock, shares | [2] | (10,356) | |||||||||||
| Repurchase of common stock | [2] | (382,000) | (382,000) | ||||||||||
| Distributions to noncontrolling interests | (15,247,000) | (15,247,000) | |||||||||||
| Reclassification of noncontrolling interests to mezzanine equity | (5,923,000) | (5,923,000) | |||||||||||
| Adjustment to value of redeemable noncontrolling interests | (7,380,000) | (7,549,000) | (7,549,000) | 169,000 | |||||||||
| Distributions declared | (39,238,000) | (39,238,000) | (39,238,000) | ||||||||||
| Net loss | [3] | (52,125,000) | (47,794,000) | (47,794,000) | (4,331,000) | ||||||||
| Other comprehensive income (loss) | (65,000) | (65,000) | (65,000) | ||||||||||
| Ending balance, shares at Dec. 31, 2021 | 65,758,004 | ||||||||||||
| Ending balance Stockholders' Equity at Dec. 31, 2021 | 1,756,846,000 | 1,581,293,000 | $ 658,000 | 2,533,904,000 | (951,303,000) | (1,966,000) | 175,553,000 | ||||||
| Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||||||||
| Offering costs — common stock | (2,000) | (2,000) | (2,000) | ||||||||||
| Issuance of common stock under the DRIP, shares | 992,964 | ||||||||||||
| Issuance of common stock under the DRIP | 36,812,000 | 36,812,000 | $ 8,000 | 36,804,000 | |||||||||
| Issuance of vested and nonvested restricted common stock, shares | 18,689 | ||||||||||||
| Issuance of vested and nonvested restricted common stock, value | 0 | 0 | $ 1,000 | (1,000) | |||||||||
| Amortization of nonvested common stock compensation | 3,935,000 | 3,935,000 | 3,935,000 | ||||||||||
| Stock based compensation | 83,000 | 83,000 | |||||||||||
| Repurchase of common stock | (20,699,000) | (20,699,000) | $ (6,000) | (20,693,000) | |||||||||
| Distributions to noncontrolling interests | (13,985,000) | (13,985,000) | |||||||||||
| Adjustment to noncontrolling interest in connection with the Merger | [1] | (1,173,000) | (1,173,000) | 1,173,000 | |||||||||
| Reclassification of noncontrolling interests to mezzanine equity | (83,000) | (83,000) | |||||||||||
| Adjustment to value of redeemable noncontrolling interests | (16,744,000) | (13,353,000) | (13,353,000) | (3,391,000) | |||||||||
| Purchase of redeemable noncontrolling interest | 1,003,000 | 1,003,000 | 1,003,000 | ||||||||||
| Distributions declared | [3] | (105,699,000) | (105,699,000) | (105,699,000) | |||||||||
| Net loss | [3] | (72,978,000) | (81,302,000) | (81,302,000) | 8,324,000 | ||||||||
| Other comprehensive income (loss) | (724,000) | (724,000) | (724,000) | ||||||||||
| Ending balance, shares at Dec. 31, 2022 | 66,210,462 | ||||||||||||
| Ending balance Stockholders' Equity at Dec. 31, 2022 | 1,567,765,000 | 1,400,091,000 | $ 661,000 | 2,540,424,000 | (1,138,304,000) | (2,690,000) | 167,674,000 | ||||||
| Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||||||||
| Issuance of common stock under the DRIP, shares | 0 | ||||||||||||
| Issuance of common stock under the DRIP | 0 | ||||||||||||
| Issuance of vested and nonvested restricted common stock, shares | 26,156 | ||||||||||||
| Vested restricted stock units (in shares) | 4,120 | ||||||||||||
| Amortization of nonvested common stock compensation | 5,385,000 | 5,385,000 | 5,385,000 | ||||||||||
| Stock based compensation | 83,000 | 83,000 | |||||||||||
| Repurchase of common stock, shares | (14,562) | ||||||||||||
| Repurchase of common stock | (469,000) | (469,000) | (469,000) | ||||||||||
| Distributions to noncontrolling interests | (8,210,000) | (8,210,000) | |||||||||||
| Reclassification of noncontrolling interests to mezzanine equity | (83,000) | (83,000) | |||||||||||
| Adjustment to value of redeemable noncontrolling interests | 2,944,000 | 3,039,000 | 3,039,000 | (95,000) | |||||||||
| Distributions declared | (66,449,000) | (66,449,000) | (66,449,000) | ||||||||||
| Net loss | [3] | (75,824,000) | (71,469,000) | (71,469,000) | (4,355,000) | ||||||||
| Other comprehensive income (loss) | 265,000 | 265,000 | 265,000 | ||||||||||
| Ending balance, shares at Dec. 31, 2023 | 66,226,176 | ||||||||||||
| Ending balance Stockholders' Equity at Dec. 31, 2023 | 1,425,335,000 | 1,270,321,000 | $ 661,000 | 2,548,307,000 | $ (1,276,222,000) | $ (2,425,000) | $ 155,014,000 | ||||||
| Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||||||||
| Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures | $ (72,000) | $ (72,000) | $ (72,000) | ||||||||||
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CONSOLIDATED STATEMENTS OF EQUITY (Parenthetical) - USD ($) $ in Thousands |
12 Months Ended | |||
|---|---|---|---|---|
Oct. 01, 2021 |
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
| Distributions declared (in usd per share) | $ 1.00 | $ 1.60 | $ 0.69 | |
| Net (loss) income attributable to redeemable noncontrolling interests | $ (1,063) | $ (405) | $ (1,144) | |
| Common Stock | ||||
| Stock redeemed (in shares) | 5,148 | |||
| Common Class T | ||||
| Stock redeemed (in shares) | 5,208 | |||
| Griffin-American Healthcare REIT IV, Inc. | ||||
| Joint venture ownership interest | 6.00% | |||
Organization and Description of Business |
12 Months Ended |
|---|---|
Dec. 31, 2023 | |
| Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
| Organization and Description of Business | 1. Organization and Description of Business Overview and Background American Healthcare REIT, Inc., a Maryland corporation, is a self-managed real estate investment trust, or REIT, that acquires, owns and operates a diversified portfolio of clinical healthcare real estate properties, focusing primarily on outpatient medical buildings, senior housing, skilled nursing facilities, or SNFs, and other healthcare-related facilities. We also operate healthcare-related facilities utilizing the structure permitted by the REIT Investment Diversification and Empowerment Act of 2007, which is commonly referred to as a “RIDEA” structure (the provisions of the Internal Revenue Code of 1986, as amended, or the Code, authorizing the RIDEA structure were enacted as part of the Housing and Economic Recovery Act of 2008). Our healthcare facilities operated under a RIDEA structure include our senior housing operating properties, or SHOP, and our integrated senior health campuses. We have originated and acquired secured loans and may also originate and acquire other real estate-related investments on an infrequent and opportunistic basis. We generally seek investments that produce current income; however, we have selectively developed, and may continue to selectively develop, healthcare real estate properties. We have elected to be taxed as a REIT for U.S. federal income tax purposes. We believe that we have been organized and operated, and we intend to continue to operate, in conformity with the requirements for qualification and taxation as a REIT under the Code. On October 1, 2021, Griffin-American Healthcare REIT III, Inc., or GAHR III, merged with and into a wholly-owned subsidiary, or Merger Sub, of Griffin-American Healthcare REIT IV, Inc., or GAHR IV, with Merger Sub being the surviving company, which we refer to as the REIT Merger, and our operating partnership, Griffin-American Healthcare REIT IV Holdings, LP, or GAHR IV Operating Partnership, merged with and into Griffin-American Healthcare REIT III Holdings, LP, or the Surviving Partnership, with the Surviving Partnership being the surviving entity, which we refer to as the Partnership Merger and, together with the REIT Merger, the Merger. Following the Merger on October 1, 2021, our company, or the Combined Company, was renamed American Healthcare REIT, Inc. and the Surviving Partnership was renamed American Healthcare REIT Holdings, LP, or our operating partnership. Also on October 1, 2021, immediately prior to the consummation of the Merger, GAHR III acquired a newly formed entity, American Healthcare Opps Holdings, LLC, or NewCo, which we refer to as the AHI Acquisition, pursuant to a contribution and exchange agreement dated June 23, 2021, or the Contribution Agreement, between GAHR III; our operating partnership; American Healthcare Investors, LLC, or AHI; Griffin Capital Company, LLC, or Griffin Capital; Platform Healthcare Investor T-II, LLC; Flaherty Trust; and Jeffrey T. Hanson, the non-executive Chairman of our board of directors, or our board, Danny Prosky, our Chief Executive Officer, President and director, and Mathieu B. Streiff, one of our directors, or collectively, the AHI Principals. NewCo owned substantially all of the business and operations of AHI, as well as all of the equity interests in (i) Griffin-American Healthcare REIT IV Advisor, LLC, or GAHR IV Advisor, a subsidiary of AHI that served as the external advisor of GAHR IV, and (ii) Griffin-American Healthcare REIT III Advisor, LLC, or GAHR III Advisor, also referred to as our former advisor, a subsidiary of AHI that served as the external advisor of GAHR III. See Note 4, Business Combinations — 2021 Business Combinations, for a further discussion of the Merger and the AHI Acquisition. Operating Partnership We conduct substantially all of our operations through our operating partnership, and we are the sole general partner of our operating partnership. As of both December 31, 2023 and 2022, we owned 95.0% of the operating partnership units, or OP units, in our operating partnership, and the remaining 5.0% limited OP units were owned by the NewCo Sellers, as defined in Note 4, Business Combinations — 2021 Business Combinations. See Note 12, Redeemable Noncontrolling Interests, and Note 13, Equity — Noncontrolling Interests in Total Equity, for a further discussion of the ownership in our operating partnership. Public Offerings As of December 31, 2023, after taking into consideration the Merger and the impact of the reverse stock split as discussed in Note 2, Summary of Significant Accounting Policies, we had issued 65,445,557 shares for a total of $2,737,716,000 of common stock since February 26, 2014 in our initial public offerings and our distribution reinvestment plan, or DRIP, offerings (including historical offering amounts sold by GAHR III and GAHR IV prior to the Merger). On February 9, 2024, pursuant to a Registration Statement filed with the United States Securities and Exchange Commission, or SEC, on Form S-11 (File No. 333-267464), as amended, we closed our underwritten public offering, or the 2024 Offering, through which we issued 64,400,000 shares of common stock, $0.01 par value per share, for a total of $772,800,000 in gross offering proceeds. Such amounts include the exercise in full of the underwriters’ overallotment option to purchase up to an additional 8,400,000 shares of common stock. These shares are listed on New York Stock Exchange, or NYSE, under the trading symbol “AHR” and began trading on February 7, 2024. See Note 13, Equity — Common Stock, and Note 13, Equity — Distribution Reinvestment Plan, for a further discussion of our public offerings. Our Real Estate Investments Portfolio We currently operate through four reportable business segments: integrated senior health campuses, outpatient medical, or OM, (which was formerly known as medical office buildings, or MOBs), triple-net leased properties and SHOP. As of December 31, 2023, we owned and/or operated 296 buildings and integrated senior health campuses including completed development and expansion projects representing approximately 18,822,000 square feet of gross leasable area, or GLA, for an aggregate contract purchase price of $4,473,543,000. In addition, as of December 31, 2023, we also owned a real estate-related debt investment purchased for $60,429,000.
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Summary of Significant Accounting Policies |
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| Accounting Policies [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary of Significant Accounting Policies | 2. Summary of Significant Accounting Policies The summary of significant accounting policies presented below is designed to assist in understanding our accompanying consolidated financial statements. Such consolidated financial statements and the accompanying notes thereto are the representations of our management, who are responsible for their integrity and objectivity. These accounting policies conform to accounting principles generally accepted in the United States of America, or GAAP, in all material respects, and have been consistently applied in preparing our accompanying consolidated financial statements. Basis of Presentation Our accompanying consolidated financial statements include our accounts and those of our operating partnership, the wholly-owned subsidiaries of our operating partnership and all non-wholly owned subsidiaries in which we have control, as well as any VIEs, in which we are the primary beneficiary. The portion of equity in any subsidiary that is not wholly owned by us is presented in our accompanying consolidated financial statements as a noncontrolling interest. We evaluate our ability to control an entity, and whether the entity is a VIE and we are the primary beneficiary, by considering substantive terms of the arrangement and identifying which enterprise has the power to direct the activities of the entity that most significantly impacts the entity’s economic performance. On November 15, 2022, we effected a one-for-four reverse stock split of our common stock and a corresponding reverse split of the OP units, or the Reverse Splits. All numbers of common shares and per share data, as well as the OP units, in our accompanying consolidated financial statements and related notes have been retroactively adjusted for all periods presented to give effect to the Reverse Splits. We operate and intend to continue to operate in an umbrella partnership REIT structure in which our operating partnership, wholly-owned subsidiaries of our operating partnership and all non-wholly owned subsidiaries of which we have control will own substantially all of the interests in properties acquired on our behalf. We are the sole general partner of our operating partnership and as of both December 31, 2023 and 2022, we owned a 95.0% general partnership interest therein, and the remaining 5.0% limited partnership interest was owned by the NewCo Sellers, as defined in Note 4, Business Combinations — 2021 Business Combinations. The accounts of our operating partnership are consolidated in our accompanying consolidated financial statements because we are the sole general partner of our operating partnership and have unilateral control over its management and major operating decisions (even if additional limited partners are admitted to our operating partnership). All intercompany accounts and transactions are eliminated in consolidation. Use of Estimates The preparation of our accompanying consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, as well as the disclosure of contingent assets and liabilities, at the date of our consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Significant items subject to such estimates and assumptions include, but are not limited to, the initial and recurring valuation of certain assets acquired and liabilities assumed through property acquisitions including through business combinations, goodwill and its impairment, revenues and grant income, allowance for credit losses, impairment of long-lived and intangible assets and contingencies. These estimates are made and evaluated on an on-going basis using information that is currently available as well as various other assumptions believed to be reasonable under the circumstances. Actual results could differ from those estimates, perhaps in material adverse ways, and those estimates could be different under different assumptions or conditions. Cash, Cash Equivalents and Restricted Cash Cash and cash equivalents consist of all highly liquid investments with a maturity of three months or less when purchased. Restricted cash primarily comprises lender required accounts for property taxes, tenant improvements, capital improvements and insurance, which are restricted as to use or withdrawal. Leases Lessee: We determine if a contract is a lease upon inception of the lease and maintain a distinction between finance and operating leases. Pursuant to Financial Accounting Standards Board, or FASB, Accounting Standards Codification, or ASC, Topic 842, Leases, or ASC Topic 842, lessees are required to recognize the following for all leases with terms greater than 12 months at the commencement date: (i) a lease liability, which is a lessee’s obligation to make lease payments arising from a lease; and (ii) a right-of-use asset, which is an asset that represents the lessee’s right to use, or control the use of, a specified asset for the lease term. The lease liability is calculated by using either the implicit rate of the lease or the incremental borrowing rate. The accretion of lease liabilities and amortization expense on right-of-use assets for our operating leases are included in rental expenses, property operating expenses or general and administrative expenses in our accompanying consolidated statements of operations and comprehensive loss. Operating lease liabilities are calculated using our incremental borrowing rate based on the information available as of the lease commencement date. For our finance leases, the accretion of lease liabilities are included in interest expense and the amortization expense on right-of-use assets are included in depreciation and amortization in our accompanying consolidated statements of operations and comprehensive loss. Further, finance lease assets are included within real estate investments, net and finance lease liabilities are included within financing obligations in our accompanying consolidated balance sheets. Lessor: Pursuant to ASC Topic 842, lessors bifurcate lease revenues into lease components and non-lease components and separately recognize and disclose non-lease components that are executory in nature. Lease components continue to be recognized on a straight-line basis over the lease term and certain non-lease components may be accounted for under the revenue recognition guidance in ASC Topic 606, Revenue from Contracts with Customers, or ASC Topic 606. See the “Revenue Recognition” section below. ASC Topic 842 also provides for a practical expedient package that permits lessors to not separate non-lease components from the associated lease component if certain conditions are met. In addition, such practical expedient causes an entity to assess whether a contract is predominately lease- or service-based, and recognize the revenue from the entire contract under the relevant accounting guidance. We recognize revenue for our OM buildings and triple-net leased properties segments as real estate revenue. Minimum annual rental revenue is recognized on a straight-line basis over the term of the related lease (including rent holidays). Differences between real estate revenue recognized and cash amounts contractually due from tenants under the lease agreements are recorded to deferred rent receivable, which is included in other assets, net in our accompanying consolidated balance sheets. Tenant reimbursement revenue, which comprises additional amounts recoverable from tenants for common area maintenance expenses and certain other recoverable expenses, are considered non-lease components and variable lease payments. We qualified for and elected the practical expedient as outlined above to combine the non-lease component with the lease component, which is the predominant component, and therefore the non-lease component is recognized as part of real estate revenue. In addition, as lessors, we exclude certain lessor costs (i.e., property taxes and insurance) paid directly by a lessee to third parties on our behalf from our measurement of variable lease revenue and associated expense (i.e., no gross up of revenue and expense for these costs); and include lessor costs that we paid and are reimbursed by the lessee in our measurement of variable lease revenue and associated expense (i.e., gross up revenue and expense for these costs). At our RIDEA facilities, we offer residents room and board (lease component), standard meals and healthcare services (non-lease component) and certain ancillary services that are not contemplated in the lease with each resident (i.e., laundry, guest meals, etc.). For our RIDEA facilities, we recognize revenue under ASC Topic 606 as resident fees and services, based on our predominance assessment from electing the practical expedient outlined above. See the “Revenue Recognition” section below. See Note 17, Leases, for a further discussion of our leases. Revenue Recognition Real Estate Revenue We recognize real estate revenue in accordance with ASC Topic 842. See the “Leases” section above. Resident Fees and Services Revenue We recognize resident fees and services revenue in accordance with ASC Topic 606. A significant portion of resident fees and services revenue represents healthcare service revenue that is reported at the amount that we expect to be entitled to in exchange for providing patient care. These amounts are due from patients, third-party payors (including health insurers and government programs), other healthcare facilities, and others and includes variable consideration for retroactive revenue adjustments due to settlement of audits, reviews, and investigations. Generally, we bill the patients, third-party payors and other healthcare facilities several days after the services are performed. Revenue is recognized as performance obligations are satisfied. Consistent with healthcare industry accounting practices, any changes to these governmental revenue estimates are recorded in the period the change or adjustment becomes known based on final settlement. Any differences between recorded revenues and subsequent adjustments are reflected in operations in the year finalized. Performance obligations are determined based on the nature of the services provided by us. Revenue for performance obligations satisfied over time is recognized based on actual charges incurred in relation to total expected (or actual) charges. This method provides a depiction of the transfer of services over the term of the performance obligation based on the inputs needed to satisfy the obligation. Generally, performance obligations satisfied over time relate to patients receiving long-term healthcare services, including rehabilitation services. We measure the performance obligation from admission into the facility to the point when we are no longer required to provide services to that patient. Revenue for performance obligations satisfied at a point in time is recognized when goods or services are provided and we do not believe we are required to provide additional goods or services to the patient. Generally, performance obligations satisfied at a point in time relate to sales of our pharmaceuticals business or to sales of ancillary supplies. Because all of our performance obligations relate to contracts with a duration of less than one year, we have elected to apply the optional exemption provided in ASC Topic 606 and, therefore, are not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. The performance obligations for these contracts are generally completed within months of the end of the reporting period. We determine the transaction price based on standard charges for goods and services provided, reduced, where applicable, by contractual adjustments provided to third-party payors, implicit price concessions provided to uninsured patients, and estimates of goods to be returned. We also determine the estimates of contractual adjustments based on Medicare and Medicaid pricing tables and historical experience. We determine the estimate of implicit price concessions based on the historical collection experience with each class of payor. Agreements with third-party payors typically provide for payments at amounts less than established charges. The following is a summary of the payment arrangements with major third-party payors: •Medicare: Certain healthcare services are paid at prospectively determined rates based on cost-reimbursement methodologies subject to certain limits. •Medicaid: Reimbursements for Medicaid services are generally paid at prospectively determined rates. In the state of Indiana, we participate in an Upper Payment Limit program, or IGT, with various county hospital partners, which provides supplemental Medicaid payments to SNFs that are licensed to non-state, government-owned entities such as county hospital districts. We have operational responsibility through management agreements for facilities retained by the county hospital districts including this IGT. The licenses and management agreements between the nursing center division and hospital districts are terminable by either party to restore the previous licensed status. •Other: Payment agreements with certain commercial insurance carriers, health maintenance organizations and preferred provider organizations provide for payment using prospectively determined rates per discharge, discounts from established charges and prospectively determined periodic rates. Laws and regulations concerning government programs, including Medicare and Medicaid, are complex and subject to varying interpretation. As a result of investigations by governmental agencies, various healthcare organizations have received requests for information and notices regarding alleged noncompliance with those laws and regulations, which, in some instances, have resulted in organizations entering into significant settlement agreements. Compliance with such laws and regulations may also be subject to future government review and interpretation as well as significant regulatory action, including fines, penalties and potential exclusion from the related programs. There can be no assurance that regulatory authorities will not challenge our compliance with these laws and regulations, and it is not possible to determine the impact such claims or penalties would have upon us, if any. Settlements with third-party payors for retroactive adjustments due to audits, reviews or investigations are considered variable consideration and are included in the determination of the estimated transaction price for providing patient care. These settlements are estimated based on the terms of the payment agreement with the payor, correspondence from the payor and our historical settlement activity, including an assessment to ensure that it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the retroactive adjustment is subsequently resolved. Estimated settlements are adjusted in future periods as adjustments become known (that is, new information becomes available), or as years are settled or are no longer subject to such audits, reviews and investigations. Adjustments arising from a change in the transaction price were not significant for the years ended December 31, 2023, 2022 and 2021. Disaggregation of Resident Fees and Services Revenue We disaggregate revenue from contracts with customers according to lines of business and payor classes. The transfer of goods and services may occur at a point in time or over time; in other words, revenue may be recognized over the course of the underlying contract, or may occur at a single point in time based upon a single transfer of control. This distinction is discussed in further detail below. We determine that disaggregating revenue into these categories achieves the disclosure objective to depict how the nature, amount, timing and uncertainty of revenue and cash flows are affected by economic factors. The following tables disaggregate our resident fees and services revenue by line of business, according to whether such revenue is recognized at a point in time or over time, for the years then ended (in thousands):
The following tables disaggregate our resident fees and services revenue by payor class for the years then ended (in thousands):
___________ (1)Includes fees for basic housing, as well as fees for assisted living or skilled nursing care. We record revenue when services are rendered at amounts billable to individual residents. Residency agreements are generally for a term of 30 days, with resident fees billed monthly in advance. For patients under reimbursement arrangements with Medicaid, revenue is recorded based on contractually agreed-upon amounts or rates on a per resident, daily basis or as services are rendered. Accounts Receivable, Net — Resident Fees and Services Revenue The beginning and ending balances of accounts receivable, net — resident fees and services are as follows (in thousands):
Deferred Revenue — Resident Fees and Services Revenue Deferred revenue is included in security deposits, prepaid rent and other liabilities in our accompanying consolidated balance sheets. The beginning and ending balances of deferred revenue — resident fees and services, almost all of which relates to private and other payors, are as follows (in thousands):
Financing Component We have elected a practical expedient allowed under ASC Topic 606 and, therefore, we do not adjust the promised amount of consideration from patients and third-party payors for the effects of a significant financing component due to our expectation that the period between the time the service is provided to a patient and the time that the patient or a third-party payor pays for that service will be one year or less. Contract Costs We have applied the practical expedient provided by FASB ASC Topic 340, Other Assets and Deferred Costs, and, therefore, all incremental customer contract acquisition costs are expensed as they are incurred since the amortization period of the asset that we otherwise would have recognized is one year or less in duration. Resident and Tenant Receivables and Allowances Resident receivables, which are related to resident fees and services revenue, are carried net of an allowance for credit losses. An allowance is maintained for estimated losses resulting from the inability of residents and payors to meet the contractual obligations under their lease or service agreements. Substantially all of such allowances are recorded as direct reductions of resident fees and services revenue as contractual adjustments provided to third-party payors or implicit price concessions in our accompanying consolidated statements of operations and comprehensive loss. Our determination of the adequacy of these allowances is based primarily upon evaluations of historical loss experience, the residents’ financial condition, security deposits, cash collection patterns by payor and by state, current economic conditions, future expectations in estimating credit losses and other relevant factors. Tenant receivables, which are related to real estate revenue, and unbilled deferred rent receivables are reduced for amounts where collectability is not probable, which are recognized as direct reductions of real estate revenue in our accompanying consolidated statements of operations and comprehensive loss. The following is a summary of our adjustments to allowances for the years ended December 31, 2023 and 2022 (in thousands):
Real Estate Investments Purchase Price Allocation Upon the acquisition of real estate properties or entities owning real estate properties, we determine whether the transaction is a business combination, which requires that the assets acquired and liabilities assumed constitute a business. If the assets acquired and liabilities assumed are not a business, we account for the transaction as an asset acquisition. Under both methods, we recognize the identifiable assets acquired and liabilities assumed; however, for a transaction accounted for as an asset acquisition, we capitalize transaction costs and allocate the purchase price using a relative fair value method allocating all accumulated costs, whereas for a transaction accounted for as a business combination, we immediately expense transaction costs incurred associated with the business combination and allocate the purchase price based on the estimated fair value of each separately identifiable asset and liability. For the years ended December 31, 2023, 2022 and 2021, our investment transactions were accounted for as asset acquisitions or as business combinations, as applicable. See Note 3, Real Estate Investments, Net — Acquisitions of Real Estate Investments, and Note 4, Business Combinations, for a further discussion. We, with assistance from independent valuation specialists, measure the fair value of tangible and identified intangible assets and liabilities, as applicable, based on their respective fair values for acquired properties. Our method for allocating the purchase price to acquired investments in real estate requires us to make subjective assessments for determining fair value of the assets acquired and liabilities assumed. This includes determining the value of the buildings, land, leasehold interests, furniture, fixtures and equipment, above- or below-market rent, in-place leases, master leases, tenant improvements, above- or below-market debt assumed, derivative financial instruments assumed, and noncontrolling interest in the acquiree, if any. These estimates require significant judgment and in some cases involve complex calculations. These allocation assessments directly impact our results of operations, as amounts allocated to certain assets and liabilities have different depreciation or amortization lives. In addition, we amortize the value assigned to above- or below-market rent as a component of revenue, unlike in-place leases and other intangibles, which we include in depreciation and amortization in our accompanying consolidated statements of operations and comprehensive loss. The determination of the fair value of land is based upon comparable sales data. In cases where a leasehold interest in the land is acquired, only the above/below market consideration is necessary where the value of the leasehold interest is determined by discounting the difference between the contract ground lease payments and a market ground lease payment back to a present value as of the acquisition date. The fair value of buildings is based upon our determination of the value under two methods: one, as if it were to be replaced and vacant using cost data and, two, also using a residual technique based on discounted cash flow models, as vacant. Factors considered by us include an estimate of carrying costs during the expected lease-up periods considering current market conditions and costs to execute similar leases. We also recognize the fair value of furniture, fixtures and equipment on the premises, as well as the above- or below-market rent, the value of in-place leases, master leases, above- or below-market debt and derivative financial instruments assumed. The value of the above- or below-market component of the acquired in-place leases is determined based upon the present value (using a discount rate that reflects the risks associated with the acquired leases) of the difference between: (i) the level payment equivalent of the contract rent paid pursuant to the lease; and (ii) our estimate of market rent payments taking into account the expected market rent growth. In the case of leases with options, a case-by-case analysis is performed based on all facts and circumstances of the specific lease to determine whether the option will be assumed to be exercised. The amounts related to above-market leases are included in identified intangible assets, net in our accompanying consolidated balance sheets and are amortized as a decrease to real estate revenue over the remaining non-cancelable lease term of the acquired leases with each property. The amounts related to below-market leases are included in identified intangible liabilities, net in our accompanying consolidated balance sheets and are amortized as an increase to real estate revenue over the remaining non-cancelable lease term plus any below-market renewal options of the acquired leases with each property. The value of in-place lease costs are based on management’s evaluation of the specific characteristics of the tenant’s lease and our overall relationship with the tenants. Characteristics considered by us in allocating these values include the nature and extent of the credit quality and expectations of lease renewals, among other factors. The in-place lease intangible represents the value related to the economic benefit for acquiring a property with in-place leases as opposed to a vacant property, which is evaluated based on a review of comparable leases for a similar property, terms and conditions for marketing and executing new leases, and implied in the difference between the value of the whole property “as is” and “as vacant.” The net amounts related to in-place lease costs are included in identified intangible assets, net in our accompanying consolidated balance sheets and are amortized as an increase to depreciation and amortization expense over the average downtime of the acquired leases with each property. The net amounts related to the value of tenant relationships, if any, are included in identified intangible assets, net in our accompanying consolidated balance sheets and are amortized as an increase to depreciation and amortization expense over the average remaining non-cancelable lease term of the acquired leases plus the market renewal lease term. The value of a master lease, if any, in which a previous owner or a tenant is relieved of specific rental obligations as additional space is leased, is determined by discounting the expected real estate revenue associated with the master lease space over the assumed lease-up period. The value of above- or below-market debt is determined based upon the present value of the difference between the cash flow stream of the assumed mortgage and the cash flow stream of a market rate mortgage at the time of assumption. The net value of above- or below-market debt is included in mortgage loans payable, net in our accompanying consolidated balance sheets and is amortized as an increase or decrease to interest expense, as applicable, over the remaining term of the assumed mortgage. The values of contingent consideration assets and liabilities are analyzed at the time of acquisition. For contingent purchase options, the fair market value of the acquired asset is compared to the specified option price at the exercise date. If the option price is below market, it is assumed to be exercised and the difference between the fair market value and the option price is discounted to the present value at the time of acquisition. The values of the redeemable and nonredeemable noncontrolling interests are estimated by applying the income approach based on a discounted cash flow analysis. The fair value measurement may apply significant inputs that are not observable in the market. See Note 4, Business Combinations — 2021 Business Combinations — Fair Value of Noncontrolling Interests, for a further discussion of our fair value measurement approach and the significant inputs used in the values of redeemable and nonredeemable noncontrolling interests in GAHR IV. Real Estate Investments, Net We carry our operating properties at our historical cost less accumulated depreciation. The cost of operating properties includes the cost of land and completed buildings and related improvements, including those related to financing obligations. Expenditures that increase the service life of properties are capitalized and the cost of maintenance and repairs is charged to expense as incurred. The cost of buildings and capital improvements is depreciated on a straight-line basis over the estimated useful lives of the buildings and capital improvements, up to 39 years, and the cost for tenant improvements is depreciated over the shorter of the lease term or useful life, up to 34 years. The cost of furniture, fixtures and equipment is depreciated over the estimated useful life, up to 28 years. When depreciable property is retired, replaced or disposed of, the related cost and accumulated depreciation is removed from the accounts and any gain or loss is reflected in earnings. As part of the leasing process, we may provide the lessee with an allowance for the construction of leasehold improvements. These leasehold improvements are capitalized and recorded as tenant improvements and depreciated over the shorter of the useful life of the improvements or the lease term. If the allowance represents a payment for a purpose other than funding leasehold improvements, or in the event we are not considered the owner of the improvements, the allowance is considered to be a lease inducement and is included in other assets, net in our accompanying consolidated balance sheets. Lease inducement is amortized over the lease term as a reduction of real estate revenue on a straight-line basis. Factors considered during this evaluation include, among other things, who holds legal title to the improvements as well as other controlling rights provided by the lease agreement and provisions for substantiation of such costs (e.g., unilateral control of the tenant space during the build-out process). Determination of the appropriate accounting for the payment of a tenant allowance is made on a lease-by-lease basis, considering the facts and circumstances of the individual tenant lease. Recognition of lease revenue commences when the lessee is given possession of the leased space upon completion of tenant improvements when we are the owner of the leasehold improvements. However, when the leasehold improvements are owned by the tenant, the lease inception date (and the date on which recognition of lease revenue commences) is the date the tenant obtains possession of the leased space for purposes of constructing its leasehold improvements. Goodwill Goodwill represents the excess of consideration paid over the fair value of underlying identifiable net assets of a business acquired in a business combination. Our goodwill has an indeterminate life and is not amortized, but is tested for impairment on an annual basis, or more frequently if events or changes in circumstances indicate that the asset might be impaired. We take a qualitative approach, as applicable, to consider whether an impairment of goodwill exists prior to quantitatively determining the fair value of the reporting unit in step one of the impairment test. When step one of the impairment test is utilized, we compare the fair value of a reporting unit with its carrying amount. We recognize an impairment loss to the extent the carrying value of goodwill exceeds the implied value in the current period. See Note 4, Business Combinations, for a further discussion of goodwill recognized in connection with our business combinations, and Note 18, Segment Reporting, for a further discussion of goodwill allocation by segment and impairment of goodwill. Impairment of Long-Lived Assets and Intangible Assets We periodically evaluate our long-lived assets, primarily consisting of investments in real estate that we carry at our historical cost less accumulated depreciation, for impairment when events or changes in circumstances indicate that its carrying value may not be recoverable. We consider the following indicators, among others, in our evaluation of impairment: •significant negative industry or economic trends; •a significant underperformance relative to historical or projected future operating results; and •a significant change in the extent or manner in which the asset is used or significant physical change in the asset. If indicators of impairment of our long-lived assets are present, we evaluate the carrying value of the related real estate investments in relation to the future undiscounted cash flows of the underlying operations. In performing this evaluation, we consider market conditions and our current intentions with respect to holding or disposing of the asset. We adjust the net book value of properties we lease to others and other long-lived assets to fair value if the sum of the expected future undiscounted cash flows, including sales proceeds, is less than carrying value. We recognize an impairment loss at the time we make any such determination. We test indefinite-lived intangible assets, other than goodwill, for impairment at least annually, and more frequently if indicators arise. We first assess qualitative factors to determine the likelihood that the fair value of the reporting group is less than its carrying value. If the carrying amount of an indefinite-lived intangible asset exceeds its fair value, an impairment loss is recognized. Fair values of other indefinite-lived intangible assets are usually determined based on discounted cash flows or appraised values, as appropriate. If impairment indicators arise with respect to intangible assets with finite useful lives, we evaluate impairment by comparing the carrying amount of the asset to the estimated future undiscounted net cash flows expected to be generated by the asset. If the estimated future undiscounted net cash flows are less than the carrying amount of the asset, then we estimate the fair value of the asset and compare the estimated fair value to the intangible asset’s carrying value. For all of our reporting units, we recognize any shortfall from carrying value as an impairment loss in the current period. See Note 3, Real Estate Investments, Net — Impairment of Real Estate Investments, for a further discussion of impairment of long-lived assets. See Note 6, Identified Intangible Assets and Liabilities, for a further discussion of impairment of intangible assets. Properties Held for Sale A property or a group of properties is reported in discontinued operations in our consolidated statements of operations and comprehensive loss for current and prior periods if the disposal represents a strategic shift that has (or will have) a major effect on an entity’s operations and financial results when either: (i) the component has been disposed of or (ii) is classified as held for sale. At such time as a property is held for sale, such property is carried at the lower of: (i) its carrying amount or (ii) fair value less costs to sell. In addition, a property being held for sale ceases to be depreciated. We classify operating properties as property held for sale in the period in which all of the following criteria are met: •management, having the authority to approve the action, commits to a plan to sell the asset; •the asset is available for immediate sale in its present condition subject only to terms that are usual and customary for sales of such assets; •an active program to locate a buyer or buyers and other actions required to complete the plan to sell the asset has been initiated; •the sale of the asset is probable and the transfer of the asset is expected to qualify for recognition as a completed sale within one year; •the asset is being actively marketed for sale at a price that is reasonable in relation to its current fair value; and •given the actions required to complete the plan to sell the asset, it is unlikely that significant changes to the plan would be made or that the plan would be withdrawn. Our properties held for sale are included in other assets, net in our accompanying consolidated balance sheets. We did not recognize impairment charges on properties held for sale for the years ended December 31, 2023, 2022 and 2021. For the year ended December 31, 2023, we did not dispose of any held for sale properties. For the year ended December 31, 2022, we disposed of two integrated senior health campuses included in properties held for sale for an aggregate contract sales price of $18,700,000 and recognized an aggregate net gain on sale of $3,421,000. For the year ended December 31, 2021, we disposed of two integrated senior health campuses included in properties held for sale for an aggregate contract sales price of $500,000 and recognized an aggregate net loss on sale of $(114,000). For the year ended December 31, 2021, our former advisor agreed to waive $93,000 in disposition fees that may otherwise have been due to our former advisor pursuant to the Advisory Agreement, as defined in Note 14, Related Party Transactions. Our former advisor did not receive any additional securities, shares of stock or any other form of consideration or any repayment as a result of the waiver of such disposition fees. See Note 3, Real Estate Investments, Net — Dispositions of Real Estate Investments, for a further discussion of our property dispositions, as well as Note 13, Equity — Noncontrolling Interests in Total Equity, for a discussion of the disposition of membership interests in a consolidated limited liability company. Debt Security Investment, Net We classify our marketable debt security investment as held-to-maturity because we have the positive intent and ability to hold the security to maturity, and we have not recorded any unrealized holding gains or losses on such investment. Our held-to-maturity security is recorded at amortized cost and adjusted for the amortization of premiums or discounts through maturity. See Note 5, Debt Security Investment, Net, for a further discussion. Derivative Financial Instruments We are exposed to the effect of interest rate changes in the normal course of business. We seek to mitigate these risks by following established risk management policies and procedures, which include the occasional use of derivatives. Our primary strategy in entering into derivative contracts, such as fixed-rate interest rate swaps and interest rate caps, is to add stability to interest expense and to manage our exposure to interest rate movements by effectively converting a portion of our variable-rate debt to fixed-rate debt. We do not enter into derivative instruments for speculative purposes. Derivatives are recognized as either other assets or other liabilities in our accompanying consolidated balance sheets and are measured at fair value. We do not designate our derivative instruments as hedge instruments as defined by guidance under ASC Topic 815, Derivatives and Hedges, or ASC Topic 815, which allows for gains and losses on derivatives designated as hedges to be offset by the change in value of the hedged items or to be deferred in other comprehensive income (loss). Changes in the fair value of our derivative financial instruments are recorded as a component of interest expense in gain or loss in fair value of derivative financial instruments in our accompanying consolidated statements of operations and comprehensive loss. See Note 10, Derivative Financial Instruments, and Note 15, Fair Value Measurements, for a further discussion of our derivative financial instruments. Fair Value Measurements The fair value of certain assets and liabilities is a market-based measurement, not an entity-specific measurement. Therefore, a fair value measurement should be determined based on the assumptions that market participants would use in pricing the asset or liability. As a basis for considering market participant assumptions in fair value measurements, we follow a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of our reporting entity (observable inputs that are classified within Levels 1 and 2 of the hierarchy) and our reporting entity’s own assumptions about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy). Level 1 inputs are quoted prices (unadjusted) in active markets for identical assets or liabilities that we have the ability to access. An active market is defined as a market in which transactions for the assets or liabilities occur with sufficient frequency and volume to provide pricing information on an ongoing basis. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs that are observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates and yield curves that are observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity’s own assumptions, as there is little, if any, related market activity. 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. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability. See Note 15, Fair Value Measurements, for a further discussion. Other Assets, Net Other assets, net primarily consists of inventory, prepaid expenses and deposits, deferred financing costs related to our lines of credit, deferred rent receivables, deferred tax assets, investments in unconsolidated entities, lease inducements and lease commissions. Inventory consists primarily of pharmaceutical and medical supplies and is stated at the lower of cost (first-in, first-out) or market. Deferred financing costs related to our lines of credit include amounts paid to lenders and others to obtain such financing. Such costs are amortized using the straight-line method over the term of the related loan, which approximates the effective interest rate method. Amortization of deferred financing costs related to our lines of credit is included in interest expense in our accompanying consolidated statements of operations and comprehensive loss. Lease commissions are amortized using the straight-line method over the term of the related lease. Prepaid expenses are amortized over the related contract periods. We report investments in unconsolidated entities using the equity method of accounting when we have the ability to exercise significant influence over the operating and financial policies. Under the equity method, our share of the investee’s earnings or losses is included in our accompanying consolidated statements of operations and comprehensive loss. We generally do not recognize equity method losses when such losses exceed our net equity method investment balance unless we have committed to provide such investee additional financial support or guaranteed its obligations. To the extent that our cost basis is different from the basis reflected at the entity level, the basis difference is generally amortized over the lives of the related assets and liabilities, and such amortization is included in our share of equity in earnings of the entity. The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the entity interest or the estimated fair value of the assets prior to the sale of interests in the entity. We have elected to follow the cumulative earnings approach when classifying distributions received from equity method investments in our consolidated statements of cash flows, whereby any distributions received up to the amount of cumulative equity earnings will be considered a return on investment and classified in operating activities and any excess distributions would be considered a return of investment and classified in investing activities. We evaluate our equity method investments for impairment based upon a comparison of the estimated fair value of the equity method investment to its carrying value. When we determine a decline in the estimated fair value of such an investment below its carrying value is other-than-temporary, an impairment is recorded. See Note 7, Other Assets, Net, for a further discussion. Accounts Payable and Accrued Liabilities As of December 31, 2023 and 2022, accounts payable and accrued liabilities primarily include insurance reserves of $44,548,000 and $39,893,000, respectively, reimbursement of payroll-related costs to the managers of our SHOP and integrated senior health campuses of $42,698,000 and $38,624,000, respectively, accrued developments and capital expenditures to unaffiliated third parties of $24,881,000 and $30,211,000, respectively, accrued property taxes of $23,549,000 and $24,926,000, respectively, and accrued distributions to common stockholders of $16,557,000 and $26,484,000, respectively. Stock Based Compensation We follow ASC Topic 718, Compensation — Stock Compensation, or ASC Topic 718, to account for our stock compensation pursuant to the Second Amended and Restated 2015 Incentive Plan, or the AHR Incentive Plan, using the fair value method, which requires an estimate of fair value of the award at the time of grant and recognition of compensation expense on a straight-line basis over the requisite service period of the awards. Forfeitures of stock based awards are recognized as an adjustment to compensation expense as they occur. Awards granted under the AHR Incentive Plan consist of restricted stock or units issued to our executive officers and employees, in addition to restricted stock issued to our directors. See Note 13, Equity — Equity Compensation Plans, for a further discussion of awards granted under the AHR Incentive Plan. Foreign Currency We have real estate investments in the United Kingdom, or UK, and Isle of Man for which the functional currency is the UK Pound Sterling, or GBP. We translate the results of operations of our foreign real estate investments into United States Dollars, or USD, using the average currency rates of exchange in effect during the period, and we translate assets and liabilities using the currency exchange rate in effect at the end of the period. The resulting foreign currency translation adjustments are included in accumulated other comprehensive loss, a component of stockholders’ equity, in our accompanying consolidated balance sheets. Certain balance sheet items, primarily equity and capital-related accounts, are reflected at the historical currency exchange rates. We also have intercompany notes and payables denominated in GBP with our UK subsidiaries. Gains or losses resulting from remeasuring such intercompany notes and payables into USD at the end of each reporting period are reflected in our accompanying consolidated statements of operations and comprehensive loss. When such intercompany notes and payables are deemed to be of a long-term investment nature, they will be reflected in accumulated other comprehensive loss in our accompanying consolidated balance sheets. Gains or losses resulting from foreign currency transactions are remeasured into USD at the rates of exchange prevailing on the date of the transactions. The effects of transaction gains or losses are included in our accompanying consolidated statements of operations and comprehensive loss. Income Taxes We qualify, and elect to be taxed, as a REIT under the Code, and we intend to continue to qualify to be taxed as a REIT. To maintain our qualification as a REIT, we must meet certain organizational and operational requirements, including a requirement to distribute to our stockholders a minimum of 90.0% of our annual taxable income, excluding net capital gains. We generally will not be subject to U.S. federal income taxes if we distribute 100% of our taxable income each year to our stockholders. If we fail to maintain our qualification as a REIT in any taxable year, we will then be subject to U.S. federal income taxes on our taxable income at regular corporate rates and will not be permitted to qualify for treatment as a REIT for U.S. federal income tax purposes for four years following the year during which qualification is lost unless the Internal Revenue Service grants us relief under certain statutory provisions. Such an event could have a material adverse effect on our net income and net cash available for distribution to our stockholders. We may be subject to certain state and local income taxes on our income, property or net worth in some jurisdictions, and, in certain circumstances, we may also be subject to federal excise taxes on undistributed income. In addition, certain activities that we undertake are conducted by subsidiaries, which we elected to be treated as taxable REIT subsidiaries, or TRS, to allow us to provide services that would otherwise be considered impermissible for REITs. Also, we have real estate investments in the UK and Isle of Man, which do not accord REIT status to United States REITs under their tax laws. Accordingly, we recognize an income tax benefit or expense for the federal, state and local income taxes incurred by our TRS and foreign income taxes on our real estate investments in the UK and Isle of Man. We account for deferred income taxes using the asset and liability method and recognize deferred tax assets and liabilities for the expected future tax consequences of events that have been included in our financial statements or tax returns. Under this method, we determine deferred tax assets and liabilities based on the temporary differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases using enacted tax rates in effect for the year in which the differences are expected to reverse. Deferred tax assets reflect the impact of the future deductibility of operating loss carryforwards. A valuation allowance is provided if we believe it is more likely than not that all or some portion of the deferred tax asset will not be realized. Any increase or decrease in the valuation allowance that results from a change in circumstances, and that causes us to change our judgment about the realizability of the related deferred tax asset, is included in income tax benefit or expense in our accompanying consolidated statements of operations and comprehensive loss when such changes occur. Any increase or decrease in the deferred tax liability that results from a change in circumstances, and that causes us to change our judgment about expected future tax consequences of events, is recorded in income tax benefit or expense in our accompanying consolidated statements of operations and comprehensive loss. Net deferred tax assets are included in other assets, or net deferred tax liabilities are included in security deposits, prepaid rent and other liabilities, in our accompanying consolidated balance sheets. See Note 16, Income Taxes, for a further discussion. Segment Disclosure We segregate our operations into reporting segments in order to assess the performance of our business in the same way that management reviews our performance and makes operating decisions. During the quarter ended December 31, 2023, we modified how we evaluate our business and make resource allocations, and therefore determined that we operate through four reportable business segments; integrated senior health campuses, OM (which was formerly known as MOBs), triple-net leased properties and SHOP. All segment information included in the notes to the accompanying consolidated financial statements has been recast for all periods presented to reflect four reportable business segments and the change in segment name from MOBs to OM. The segment name change from MOBs to OM did not result in any changes to the composition of such segment or information reviewed by management, and therefore, had no impact on the historical results of operations. See Note 18, Segment Reporting, for a further discussion. GLA and Other Measures GLA and other measures used to describe real estate investments included in our accompanying consolidated financial statements are presented on an unaudited basis. Recently Issued Accounting Pronouncements In March 2020, the FASB issued Accounting Standards Update, or ASU, 2020-04, Facilitation of the Effects of Reference Rate Reform of Financial Reporting, or ASU 2020-04, which provides optional expedients and exceptions for applying GAAP to contract modifications, hedging relationships and other transactions, subject to meeting certain criteria. ASU 2020-04 applies to the aforementioned transactions that reference the London Inter-bank Offered Rate, or LIBOR, or another reference rate expected to be discontinued because of the reference rate reform. In January 2021, the FASB issued ASU 2021-01, Reference Rate Reform (Topic 848), or ASU 2021-01, which clarifies that certain optional expedients and exceptions for contract modification and hedge accounting apply to derivative instruments that use an interest rate for margining, discounting, or contract price alignment that is modified as a result of the discontinuation of the use of LIBOR as a benchmark interest rate due to reference rate reform. In December 2022, the FASB issued ASU 2022-06, Reference Rate Reform (Topic 848): Deferral of the Sunset Date of Topic 848, or ASU 2022-06, which extends the period of time entities can utilize the reference rate reform relief guidance under ASU 2020-04 from December 31, 2022 to December 31, 2024. ASU 2020-04, ASU 2021-01 and ASU 2022-06 are effective for fiscal years and interim periods beginning after March 12, 2020 and through the effective date December 31, 2024, as extended by ASU 2022-06. We adopted such accounting pronouncements on January 1, 2023, which has not had a material impact on our consolidated financial statements and disclosures as of December 31, 2023. In July 2023, the FASB issued ASU 2023-03, Presentation of Financial Statements (Topic 205), Income Statement-Reporting Comprehensive Income (Topic 220), Distinguishing Liabilities from Equity (Topic 480), Equity (Topic 505), and Compensation-Stock Compensation (Topic 718): Amendments to SEC Paragraphs Pursuant to SEC Staff Accounting Bulletin No. 120, SEC Staff Announcement at the March 24, 2022 EITF Meeting, and Staff Accounting Bulletin Topic 6.B, Accounting Series Release 280-General Revision of Regulation S-X: Income or Loss Applicable to Common Stock, or ASU 2023-03. ASU 2023-03 amends the Accounting Standards Codification, or ASC, for SEC updates pursuant to SEC Staff Accounting Bulletin No. 120; SEC Staff Announcement at the March 24, 2022 Emerging Issues Task Force Meeting; and Staff Accounting Bulletin Topic 6.B, Accounting Series Release 280 - General Revision of Regulation S-X: Income or Loss Applicable to Common Stock. These updates were immediately effective and did not have a material impact on our consolidated financial statements and disclosures. In August 2023, the FASB issued ASU 2023-05, Business Combinations — Joint Venture Formations (Subtopic 805- 60): Recognition and Initial Measurement, or ASU 2023-05. ASU 2023-05 applies to the initial formation of a “joint venture” or a “corporate joint venture” as defined in the accounting literature and requires a joint venture to apply a new basis of accounting by initially measuring and recognizing all contributions received upon its formation at fair value. In particular, a joint venture will measure its total assets and liabilities upon formation as the fair value of the joint venture as a whole, which would equal the fair value of all of the joint venture’s outstanding equity interests. The new guidance does not change the definition of a joint venture, the accounting by the investors for their investments in a joint venture (e.g., equity method accounting) or the accounting by a joint venture for contributions received after its formation. ASU 2023-05 will be applied prospectively and is effective for all newly-formed joint venture entities with a formation date on or after January 1, 2025. Early adoption is permitted. We do not expect the adoption of ASU 2023-05 on January 1, 2025 to have a material impact to our consolidated financial statements and disclosures. In November 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures, or ASU 2023-07, which is intended to improve reportable segment disclosure requirements, primarily through enhanced disclosures about significant expenses. Such disclosure amendments include the requirement for public entities to disclose significant segment expenses that are regularly provided to the chief operating decision maker and included within each reported measure of segment profit or loss. ASU 2023-07 is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. Early adoption is permitted and should be applied retrospectively to all prior periods presented in the financial statements. We are currently evaluating this guidance to determine the impact to our consolidated financial statements and disclosures. In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures, or ASU 2023-09, which includes amendments that further enhance income tax disclosures, primarily through standardization and disaggregation of rate reconciliation categories and income taxes paid by jurisdiction. ASU 2023-09 is effective for annual periods beginning after December 15, 2024. Early adoption is permitted and should be applied prospectively; however, retrospective application is permitted. We are currently evaluating this guidance to determine the impact to our consolidated financial statements and disclosures. In March 2024, the SEC adopted final rules, The Enhancement and Standardization of Climate-Related Disclosures for Investors. The final rules require a registrant to disclose, among other things: material climate-related risks; activities to mitigate or adapt to such risks, as well as a quantitative and qualitative description of material expenditures incurred and material impacts on financial estimates and assumptions that directly result from such mitigation or adaptation activities; material capitalized costs, expenses and losses incurred as a result of severe weather events and other natural conditions; information about the registrant’s board of directors’ oversight of climate-related risks and management’s role in managing material climate-related risks; and information on any climate-related targets or goals that are material to the registrant’s business, results of operations or financial condition. The rules require registrants to provide such climate-related disclosures in their annual reports, beginning with annual reports for the year ending December 31, 2025, for calendar-year-end large accelerated filers. We are currently evaluating this guidance to determine the impact to our consolidated financial statement disclosures.
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| Real Estate [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Real Estate Investments, Net | 3. Real Estate Investments, Net Our real estate investments, net consisted of the following as of December 31, 2023 and 2022 (in thousands):
Depreciation expense for the years ended December 31, 2023, 2022 and 2021 was $147,587,000, $141,257,000 and $109,036,000, respectively. The following is a summary of our capital expenditures for the years ended December 31, 2023, 2022 and 2021 (in thousands):
Included in the capital expenditure amounts above are costs for the development and expansion of our integrated senior health campuses. For the year ended December 31, 2023, we incurred $4,988,000 to expand three of our existing integrated senior health campuses. For the year ended December 31, 2022, we exercised our right to purchase a leased property that cost $15,462,000 to develop and incurred a total of $7,543,000 to expand three of our existing integrated senior health campuses. For the year ended December 31, 2021, we completed the development of three integrated senior health campuses for an aggregate $50,435,000 and incurred a total $22,720,000 to expand two of our existing integrated senior health campuses. We also exercised our right to purchase a leased property that cost $11,004,000. Acquisitions of Real Estate Investments 2023 Acquisitions of Real Estate Investments For the year ended December 31, 2023, using cash on hand and debt financing, we, through a majority-owned subsidiary of Trilogy Investors, LLC, or Trilogy, of which we owned 74.1%, completed the acquisition of one integrated senior health campus. The following is a summary of such property acquisition (in thousands):
In addition, on June 30, 2023, we, through a majority-owned subsidiary of Trilogy, acquired a land parcel in Ohio for a contract purchase price of $660,000, plus closing costs, for the future expansion of an existing integrated senior health campus. For the year ended December 31, 2023, using cash on hand and debt financing, we, through a majority-owned subsidiary of Trilogy, acquired three previously leased real estate investments located in Indiana and Ohio. The following is a summary of such acquisitions, which are included in our integrated senior health campuses segment (in thousands):
We accounted for our acquisitions of land and real estate investments completed during the year ended December 31, 2023 as asset acquisitions. The following table summarizes the purchase price of such assets acquired at the time of acquisition based on their relative fair values and adjusted for $28,623,000 operating lease right-of-use assets and $30,498,000 operating lease liabilities (in thousands):
2022 Acquisitions of Real Estate Investments For the year ended December 31, 2022, using cash on hand and debt financing, we, through a majority-owned subsidiary of Trilogy, of which we owned 73.1%, exercised purchase options to acquire four previously leased real estate investments located in Indiana and Kentucky for an aggregate contract purchase price of $54,805,000, which investments are included in our integrated senior health campus segment. We financed such acquisitions with cash on hand and a mortgage loan payable with a principal balance of $52,725,000. In addition, for the year ended December 31, 2022, we, through a majority-owned subsidiary of Trilogy, acquired land parcels in Indiana and Kentucky for the future development and expansion of our integrated senior health campuses for an aggregate contract purchase price of $1,020,000, plus closing costs. We accounted for our acquisitions of land and real estate investments completed during the year ended December 31, 2022 as asset acquisitions. For the year ended December 31, 2022, we incurred and capitalized closing costs and direct acquisition related expenses of $303,000. The following table summarizes the purchase price of such assets acquired at the time of acquisition based on their relative fair values and adjusted for $37,464,000 operating lease right-of-use assets and $36,326,000 operating lease liabilities (in thousands):
2021 Acquisitions of Real Estate Investments For the year ended December 31, 2021, using cash on hand and debt financing, we, through a majority-owned subsidiary of Trilogy, of which we owned 72.9%, acquired a portfolio of six previously leased real estate investments located in Indiana and Ohio. The following is a summary of such property acquisitions, which are included in our integrated senior health campuses segment (in thousands):
___________ (1)Our former advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our properties, an acquisition fee of 2.25% of the portion of the contract purchase price of the properties attributed to our ownership interest in the Trilogy subsidiary that acquired the properties. For the year ended December 31, 2021, and prior to the Merger, we, through a majority-owned subsidiary of Trilogy, acquired land parcels in Indiana and Ohio for the future development and expansion of our integrated senior health campuses for an aggregate contract purchase price of $1,459,000 plus closing costs. We paid to our former advisor an acquisition fee of 2.25% of the portion of the contract purchase price of each land parcel attributed to our ownership interest. On October 15, 2021, we, through a majority-owned subsidiary of Trilogy, acquired a land parcel in Ohio for a contract purchase price of $249,000, plus closing costs. We accounted for our acquisitions of land and real estate investments completed during the year ended December 31, 2021 as asset acquisitions. For the year ended December 31, 2021, we incurred and capitalized closing costs and direct acquisition related expenses of $1,855,000. The following table summarizes the purchase price of such assets acquired at the time of acquisition based on their relative fair values and adjusted for $57,647,000 operating lease right-of-use assets and $54,564,000 operating lease liabilities (in thousands):
Dispositions of Real Estate Investments 2023 Dispositions of Real Estate Investments For the year ended December 31, 2023, we disposed of six SHOP and 16 OM buildings. We recognized a total aggregate net gain on such dispositions of $32,717,000. The following is a summary of such dispositions (dollars in thousands):
___________ (1)See Note 12, Redeemable Noncontrolling Interests, for information about the ownership of the Central Florida Senior Housing Portfolio. 2022 Dispositions of Real Estate Investments For the year ended December 31, 2022, we disposed of one OM building in Tennessee and three facilities in Florida within our Central Florida Senior Housing Portfolio. We recognized a total aggregate net gain on such dispositions of $1,370,000. The following is a summary of such dispositions, which were included in our OM and SHOP segments, as applicable (in thousands):
___________ (1)See Note 12, Redeemable Noncontrolling Interests, for information about the ownership of the Central Florida Senior Housing Portfolio. 2021 Disposition of Real Estate Investment In July 2021, we, through a majority-owned subsidiary of Trilogy, sold an integrated senior health campus, or the Sold Property, to an unaffiliated third party, or the Buyer, and leased it back, while retaining control of the Sold Property. This transaction did not meet the criteria for a sale and leaseback under GAAP. The lease agreement includes a finance obligation with a present value of $15,504,000 representing our obligation to purchase the Sold Property between 2028 and 2029. Simultaneously, we, through a majority-owned subsidiary of Trilogy, purchased a previously leased integrated senior health campus, or the Purchased Property, from the Buyer which was in exchange for the Sold Property. No cash consideration was exchanged as part of the transactions explained above. As of the transaction date, the carrying value of the Purchased Property of $14,807,000 was recorded to real estate investments, net, in our accompanying consolidated balance sheet, and the carrying value of the finance obligation of $15,504,000 was recorded to in our accompanying consolidated balance sheet. Sale of Controlling Interests in Developments On February 8, 2022, we sold approximately 74.0% of our ownership interests in several real estate development assets within our integrated senior health campuses segment for an aggregate sales price of $19,622,000, and we recognized an aggregate gain on sale of $$683,000 for the year ended December 31, 2022. At the time of sale, we retained approximately 26.0% ownership interests in such real estate development assets. As of December 31, 2023 and 2022, we own approximately 49.0% and 31.6% ownership interests, respectively, in such real estate development assets, which interests are accounted for as investments in unconsolidated entities within other assets, net in our accompanying consolidated balance sheet as of December 31, 2023 and 2022. For the year ended December 31, 2023 and from February 8, 2022 through December 31, 2022, our interests in the net earnings or losses of such unconsolidated entities were included in income or loss from unconsolidated entities in our accompanying consolidated statements of operations and comprehensive loss. See Note 4, Business Combinations, for a discussion of real estate investment acquisitions accounted for business combinations for the years ended December 31, 2023, 2022 and 2021. Impairment of Real Estate Investments For the year ended December 31, 2023, as we continue to evaluate additional non-strategic properties for sale, we determined that two of our SHOP and one of our OM buildings were impaired and recognized an aggregate impairment charge of $13,899,000, which reduced the total aggregate carrying value of such assets to $20,439,000. The remaining $3,477,000 carrying value of one of the impaired SHOP was reclassified to properties held for sale during the third quarter of 2023, which is included in other assets, net in our accompanying condensed consolidated balance sheet. The fair value of one SHOP was based on its projected sales price from an independent third party letter of intent, and the fair value of such OM was determined by the sales price from an executed purchase and sale agreement with a third-party buyer, which were considered Level 2 measurements within the fair value hierarchy. The fair value of the other SHOP was determined by a third-party appraiser based on the sales comparison approach with the most significant inputs based on a price per unit and price per square foot analysis within the area for similar types of assets. The ranges of these inputs were $190,000 to $200,000 per unit and $250 to $260 per square foot, which were considered Level 3 measurements within the fair value hierarchy. For the year ended December 31, 2022, we determined that 12 facilities within our SHOP segment were impaired and recognized an aggregate impairment charge of $54,579,000, which reduced the total aggregate carrying value of such facilities to $81,149,000. We disposed of three of such impaired facilities during the fourth quarter of 2022, and disposed of five of such impaired facilities during the year of 2023, as discussed in the “Dispositions of Real Estate Investments” section above. The fair value of one of our impaired facilities was determined by the sales price from an executed purchase and sale agreement with a third-party buyer, which was considered a Level 2 measurement within the fair value hierarchy. The fair values of our remaining 11 impaired facilities were based on their projected sales prices, which were considered Level 2 measurements within the fair value hierarchy. For the year ended December 31, 2021, we determined that one OM building was impaired and recognized an impairment charge of $3,335,000, which reduced the carrying value of such asset to $2,880,000. The fair value of such property was determined by the sales price from an executed purchase and sale agreement with a third-party buyer, and adjusted for anticipated selling costs, which was considered a Level 2 measurement within the fair value hierarchy. We disposed of such impaired OM building in July 2021 for a contract sales price of $3,000,000 and recognized a net gain on sale of $346,000.
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Business Combinations |
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| Business Combination and Asset Acquisition [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Business Combinations | 4. Business Combinations 2023 and 2022 Business Combinations On February 15, 2023, we, through a majority-owned subsidiary of Trilogy, acquired from an unaffiliated third party a 60.0% controlling interest in a privately held company, Memory Care Partners, LLC, or MCP, that operated integrated senior health campuses located in Kentucky. The contract purchase price for the acquisition of MCP was $900,000, which was acquired using cash on hand. Prior to such acquisition, we owned a 40.0% interest in MCP, which was accounted for as an equity method investment and was included in investments in unconsolidated entities within other assets, net in our accompanying condensed consolidated balance sheet as of December 31, 2022. In connection with the acquisition of the remaining interest in MCP, we now own a 100% controlling interest in MCP. As a result, we re-measured the fair value of our previously held equity interest in MCP and recognized a gain on re-measurement of $726,000 in our accompanying consolidated statements of operations and comprehensive loss. For the year ended December 31, 2022, we accounted for four acquisitions as business combinations, as discussed below, the first three of which are included within our integrated senior health campuses segment. Based on quantitative and qualitative considerations, such four business combinations were not material to us individually or in the aggregate, and, therefore, pro forma financial information is not provided. On January 3, 2022, we, through a majority-owned subsidiary of Trilogy, acquired an integrated senior health campus in Kentucky from an unaffiliated third party. The contract purchase price for such property acquisition was $27,790,000 plus immaterial transaction costs. We acquired such property using cash on hand and placed a mortgage loan payable of $20,800,000 on the property at the time of acquisition. On April 1, 2022, we, through a majority-owned subsidiary of Trilogy, acquired a 50.0% interest in a pharmaceutical business in Florida from an unaffiliated third party and incurred transaction costs of $938,000. Prior to such pharmaceutical business acquisition, we, through a majority-owned subsidiary of Trilogy, owned the other 50.0% interest in such business, which was accounted for as an equity method investment. Therefore, through March 31, 2022, our 50.0% interest in the net earnings or losses of such unconsolidated entity was included in income or loss from unconsolidated entities in our accompanying consolidated statements of operations and comprehensive loss. On August 1, 2022, we, through a majority-owned subsidiary of Trilogy, acquired a 50.0% controlling interest in a privately held company, RHS Partners, LLC, or RHS, that owns and/or operates 16 integrated senior health campuses located in Indiana, from an unaffiliated third party. The contract purchase price for the acquisition of RHS was $36,661,000 plus immaterial closing costs, which was primarily acquired using cash on hand. Prior to such acquisition, we owned a 50.0% interest in RHS, which was accounted for as an equity method investment and was included in investments in unconsolidated entities within other assets, net in our accompanying consolidated balance sheet as of December 31, 2021. Therefore, through July 31, 2022, our 50.0% equity interest in the net earnings or losses of RHS was included in income or loss from unconsolidated entities in our accompanying consolidated statements of operations and comprehensive loss. In connection with the acquisition of the remaining interest in RHS, we now own a 100% controlling interest in RHS. As a result, we re-measured the fair value of our previously held equity interest in RHS and recognized a gain on re-measurement of $19,567,000 in our accompanying consolidated statements of operations and comprehensive loss. On December 5, 2022, we acquired a portfolio of seven senior housing facilities in Texas from an unaffiliated third party, which facilities are included in our SHOP segment. These facilities are part of the underlying collateral pool of real estate assets securing our debt security investment, as defined and described at Note 5, Debt Security Investment, Net. We acquired the seven facilities by assuming the outstanding principal balance of each related mortgage loan payable from one of the borrowers as such borrower was in default on the required debt payments. The aggregated principal balance of such assumed mortgage loans payable was $110,627,000 at the time of acquisition. No cash consideration was exchanged as part of the transactions; however, we incurred transaction costs of $1,895,000 related to the acquisition of such facilities. See Note 5, Debt Security Investment, Net, for a further discussion. Based on quantitative and qualitative considerations, such business combinations in 2022 and 2023 were not material to us individually or in the aggregate, and, therefore, pro forma financial information is not provided. The fair values of the assets acquired and liabilities assumed were preliminary estimates at acquisition. Any necessary adjustments are finalized within one year from the date of acquisition. The table below summarizes the acquisition date fair values of the assets acquired and liabilities assumed of our business combinations during the years ended December 31, 2023 and 2022 (in thousands):
2021 Business Combinations — Merger and the AHI Acquisition As discussed in Note 1, Organization and Description of Business, on October 1, 2021, pursuant to an Agreement and Plan of Merger dated June 23, 2021, we completed the REIT Merger and Partnership Merger. At the effective time of the REIT Merger and prior to the reverse stock split, each issued and outstanding share of GAHR III’s common stock, $0.01 par value per share, converted into the right to receive 0.9266 shares of GAHR IV’s Class I common stock, $0.01 par value per share. At the effective time of the Partnership Merger and prior to the reverse stock split, (i) each unit of limited partnership interest in our operating partnership outstanding as of immediately prior to the effective time of the Partnership Merger was converted automatically into the right to receive 0.9266 of a Partnership Class I Unit, as defined in the agreement of limited partnership, as amended, of the Surviving Partnership and (ii) each unit of limited partnership interest in GAHR IV Operating Partnership outstanding as of immediately prior to the effective time of the Partnership Merger was converted automatically into the right to receive one unit of limited partnership interest of the Surviving Partnership of like class. Additionally, on October 1, 2021, the AHI Acquisition closed immediately prior to the consummation of the Merger, and pursuant to the Contribution Agreement, AHI contributed substantially all of its business and operations to the Surviving Partnership, including its interest in GAHR III Advisor and GAHR IV Advisor, and Griffin Capital contributed its ownership interest in GAHR III Advisor and GAHR IV Advisor to the Surviving Partnership. In exchange for their contributions, the Surviving Partnership issued limited OP units. The total approximate value of these OP units at the time of consummation of the transactions contemplated by the Contribution Agreement, and prior to the reverse stock split, was approximately $131,674,000, with a reference value for purposes thereof of $8.71 per OP unit, such that the Surviving Partnership issued 15,117,529 OP units as consideration for the transaction. Such OP units were owned by AHI Group Holdings, LLC, or AHI Group Holdings, which is owned and controlled by the AHI Principals, Platform Healthcare Investor T-II, LLC, Flaherty Trust and a wholly-owned subsidiary of Griffin Capital, or collectively, the NewCo Sellers. Further, upon consummation of the AHI Acquisition, we redeemed all 51 limited partnership units that our former advisor held in our operating partnership, as well as all 52 limited partnership units held by GAHR IV Advisor in GAHR IV Operating Partnership. Also, on October 1, 2021 and in connection with the AHI Acquisition, our operating partnership redeemed all 5,148 shares of our common stock owned by our former advisor and all 5,208 shares of our Class T common stock owned by GAHR IV Advisor in GAHR IV. The AHI Acquisition was treated as a business combination for accounting purposes, with GAHR III as both the legal and accounting acquiror of NewCo. While GAHR IV was the legal acquiror of GAHR III in the REIT Merger, GAHR III was determined to be the accounting acquiror in the REIT Merger in accordance with FASB ASC Topic 805, Business Combinations, or ASC Topic 805, after considering the relative share ownership and the composition of the governing body of the Combined Company. Thus, the financial information set forth herein subsequent to the consummation of the Merger and the AHI Acquisition reflects results of the Combined Company, and the financial information set forth herein prior to the Merger and the AHI Acquisition reflects GAHR III’s results. For this reason, period-to-period comparisons may not be meaningful. Purchase Consideration REIT Merger The fair value of the purchase consideration transferred was calculated as follows (in thousands):
(1)Represents the fair value of GAHR III common stock that is deemed to be issued for accounting purposes only. Taking into consideration the impact of the reverse stock split, the fair value of the purchase consideration is calculated based on 22,045,766 shares of common stock deemed to be issued by GAHR III at the fair value per share of $34.84. (2)Represents the fair value of additional interest acquired in GAHR III’s subsidiary, Trilogy REIT Holdings, LLC, or Trilogy REIT Holdings. The acquisition of additional interest in Trilogy is accounted for separately from the REIT Merger in accordance with ASC Topic 810, Consolidation, or ASC Topic 810. See Note 13, Equity — Noncontrolling Interests in Total Equity, for a discussion of the Trilogy transaction. AHI Acquisition The fair value of the purchase consideration transferred was calculated as follows (in thousands):
(1)Taking into consideration the impact of the reverse stock split, the amount represents the estimated fair value of the 3,779,382 Surviving Partnership OP units issued as consideration, with a reference value for purposes thereof of $34.84 per unit. The issuance of Surviving Partnership OP units was accounted for separately from the AHI Acquisition. (2)Represents the estimated fair value of contingent consideration based on the performance of a possible private investment fund under consideration by AHI. We have no definitive plans to establish the investment fund, and, therefore, the fair value of contingent consideration was estimated to be $0. Purchase Price Allocation REIT Merger The following table sets forth the allocation of the purchase consideration to the fair values of identifiable tangible and intangible assets acquired and liabilities assumed recognized at the acquisition date of GAHR IV, as well as the fair value at the acquisition date of the noncontrolling interests in GAHR IV (in thousands):
AHI Acquisition The following table sets forth the allocation of the purchase consideration to the fair values of identifiable tangible and intangible assets acquired and liabilities assumed recognized at the acquisition date (in thousands):
Acquisition-related Costs The Merger and the AHI Acquisition were accounted for as business combinations, and as a result, acquisition-related costs incurred in connection with these transactions of $14,060,000 were expensed and included in business acquisition expenses in our accompanying consolidated statement of operations and comprehensive loss. Acquisition-related costs of $6,753,000 were incurred by GAHR IV in the period before the consummation of the Merger and are therefore not reflected in our accompanying consolidated statements of operations and comprehensive loss for the year ended December 31, 2021 as GAHR III was the accounting acquiror in the Merger under ASC Topic 805, as further explained above. Fair Value of Noncontrolling Interests The fair value of the redeemable and nonredeemable noncontrolling interest in GAHR IV was estimated by applying the income approach based on a discounted cash flow analysis. This fair value measurement is based on significant inputs not observable in the market. The key assumptions applied in the income approach include the estimates of stabilized occupancy, market rents, capitalization rates and discount rates. AHI Acquisition — Goodwill In connection with the AHI Acquisition, we recorded goodwill of $134,589,000 as a result of the consideration exceeding the fair value of the net assets acquired and liabilities assumed. Goodwill represents the estimated future benefits arising from other assets acquired that could not be individually identified and separately recognized. Goodwill recognized in this transaction is not deductible for tax purposes. See Note 18, Segment Reporting, for a further discussion. The table below represents the allocation of goodwill on the acquisition date in connection with the AHI Acquisition to our reporting segments (in thousands):
REIT Merger — Real Estate Investments, Intangible Assets and Intangible Liabilities Real estate investments consist of land, building improvements, site improvements, unamortized tenant improvement allowances and unamortized capital improvements. Intangibles assets consist of in-place leases, above-market leases and certificates of need. We amortize purchased real estate investments and intangible assets on a straight-line basis over their respective useful lives. The following tables present the approximate fair value and the weighted-average depreciation and amortization periods of each major type of asset and liability (dollars in thousands):
The fair values of the assets acquired and liabilities assumed, as well as the fair value of the noncontrolling interests, on October 1, 2021 were estimates determined using the cost approach and direct capitalization method under the income approach and in limited circumstances, the market approach. Any necessary adjustments were finalized within one year from the date of acquisition. Pro Forma Financial Information (Unaudited) The following unaudited pro forma operating information is presented as if the Merger and the AHI Acquisition occurred on January 1, 2020. Such unaudited pro forma information includes a nonrecurring adjustment to present acquisition-related expenses incurred in the year ended December 31, 2021 in the 2020 pro forma results. The pro forma results are not necessarily indicative of the operating results that would have been obtained had the Merger and the AHI Acquisition occurred at the beginning of the periods presented, nor are they necessarily indicative of future operating results. Unaudited pro forma revenue, net loss and net loss attributable to controlling interest would have been as follows (in thousands):
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Debt Security Investment, Net |
12 Months Ended |
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Dec. 31, 2023 | |
| Debt Security Investment [Abstract] | |
| Debt Security Investment, Net | 5. Debt Security Investment, Net Our investment in a commercial mortgage-backed debt security, or debt security, bears an interest rate on the stated principal amount thereof equal to 4.24% per annum, the terms of which security provide for monthly interest-only payments. The debt security has underlying tranches that mature between August 25, 2025 and January 1, 2028 at an aggregate stated amount of $93,433,000, resulting in an anticipated yield-to-maturity of 10.0% per annum. The debt security was issued by an unaffiliated mortgage trust and represents a 10.0% beneficial ownership interest in such mortgage trust. The debt security is subordinate to all other interests in the mortgage trust and is not guaranteed by a government-sponsored entity. On December 5, 2022, we acquired a portfolio of seven senior housing facilities in Texas from an unaffiliated third party, which facilities are included in the underlying collateral pool securing our debt security investment. We acquired the seven facilities by assuming the outstanding principal balance of each related mortgage loan payable from one of the borrowers as such borrower was in default on the required debt payments. We did not grant any concessions to such borrowers, and the carrying value of our debt security investment at the time of acquisition did not exceed the fair value of such facilities. See Note 4, Business Combinations — 2022 and 2023 Business Combinations, for a further discussion of such acquisitions. As of December 31, 2023 and 2022, the carrying amount of the debt security investment was $86,935,000 and $83,000,000, respectively, net of unamortized closing costs of $489,000 and $767,000, respectively. Accretion on the debt security for the years ended December 31, 2023, 2022 and 2021 was $4,213,000, $3,922,000 and $3,665,000, respectively, which is recorded as an increase to real estate revenue in our accompanying consolidated statements of operations and comprehensive loss. Amortization expense of closing costs for the years ended December 31, 2023, 2022 and 2021 was $278,000, $237,000 and $201,000, respectively, which is recorded as a decrease to real estate revenue in our accompanying consolidated statements of operations and comprehensive loss. We evaluated credit quality indicators such as the agency ratings and the underlying collateral of such investment in order to determine expected future credit loss. No credit loss was recorded for the years ended December 31, 2023, 2022 and 2021.
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Identified Intangible Assets and Liabilities |
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| Intangible Assets and Liabilities [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Identified Intangible Assets and Liabilities | 6. Identified Intangible Assets and Liabilities Identified intangible assets, net and identified intangible liabilities, net consisted of the following as of December 31, 2023 and 2022 (dollars in thousands):
Amortization expense on identified intangible assets for the years ended December 31, 2023, 2022 and 2021 was $46,601,000, $28,378,000 and $22,460,000, respectively, which included $14,278,000, $4,444,000 and $1,349,000, respectively, of amortization recorded as a decrease to real estate revenue for above-market leases in our accompanying consolidated statements of operations and comprehensive loss. In March 2023, we transitioned our SNFs within Central Wisconsin Senior Care Portfolio from triple-net leased properties to a RIDEA structure, which resulted in a full amortization of $8,073,000 of above-market leases and $885,000 of in-place leases. In addition, we fully amortized $2,756,000 of above-market leases and $5,750,000 of in-place leases in connection with the transition of our senior housing facilities within Michigan ALF Portfolio from triple-net leased properties to a RIDEA structure in November 2023. For the year ended December 31, 2023, we recognized an impairment loss of approximately $10,520,000 related to the write-off of trade name intangible assets at ancillary business units within Trilogy. For the years ended December 31, 2022 and 2021, we did not recognize any impairment losses with respect to trade name intangible assets. Amortization expense on below-market leases for the years ended December 31, 2023, 2022 and 2021 was $4,534,000, $1,848,000 and $396,000, respectively, which is recorded as an increase to real estate revenue in our accompanying consolidated statements of operations and comprehensive loss. In connection with the transition of our senior housing facilities within Michigan ALF Portfolio to a RIDEA structure in November 2023, we fully amortized $112,000 of below-market leases. The aggregate weighted average remaining life of the identified intangible assets was 7.8 years and 7.7 years as of December 31, 2023 and 2022, respectively. The aggregate weighted average remaining life of the identified intangible liabilities was 7.2 years and 8.4 years as of December 31, 2023 and 2022, respectively. As of December 31, 2023, estimated amortization expense on the identified intangible assets and liabilities for each of the next five years ending December 31 and thereafter was as follows (in thousands):
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Other Assets, Net |
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| Other Assets [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Other Assets, Net | 7. Other Assets, Net Other assets, net consisted of the following as of December 31, 2023 and 2022 (dollars in thousands):
Deferred financing costs included in other assets, net were related to the 2019 Trilogy Credit Facility, as defined in Note 9, and the senior unsecured revolving credit facility portion of the 2022 Credit Facility. See Note 9, Lines of Credit and Term Loan, for a further discussion. Amortization expense on lease inducement for each of the years ended December 31, 2023, 2022 and 2021 was $351,000 and is recorded as a decrease to real estate revenue in our accompanying consolidated statements of operations and comprehensive loss. For the years ended December 31, 2023, 2022 and 2021, we did not incur any impairment losses with respect to our investments in unconsolidated entities.
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Mortgage Loans Payable, Net |
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| Mortgage Loans Payable, Net [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Mortgage Loans Payable, Net | 8. Mortgage Loans Payable, Net Mortgage loans payable, net consisted of the following as of December 31, 2023 and 2022 (dollars in thousands):
Based on interest rates in effect as of December 31, 2023 and 2022, effective interest rates on mortgage loans payable ranged from 2.21% to 8.46% per annum and 2.21% to 7.26% per annum, respectively, with a weighted average effective interest rate of 4.72% and 5.29%, respectively. We are required by the terms of certain loan documents to meet certain reporting requirements and covenants, such as net worth ratios, fixed charge coverage ratios and leverage ratios. The following table reflects the changes in the carrying amount of mortgage loans payable, net for the years ended December 31, 2023 and 2022 (in thousands):
For the year ended December 31, 2023, we incurred a loss on the early extinguishment of a mortgage loan payable of $345,000, which is recorded as an increase to interest expense in our accompanying consolidated statements of operations and comprehensive loss. Such loss was related to the payoff of a mortgage loan payable due to the disposition of the underlying real estate investment in August 2023. For the year ended December 31, 2022, we incurred an aggregate loss on the early extinguishment of mortgage loans payable of $2,005,000. Such aggregate loss was primarily related to the payoff of a mortgage loan payable due to the disposition of a real estate investment in September 2022, the payoff of a construction loan in December 2022 and the write-off of unamortized loan discount related to eight mortgage loans payable that we refinanced on January 1, 2022 that were due to mature in 2044 through 2052. For the year ended December 31, 2021, we incurred an aggregate loss on the extinguishment of mortgage loans payable of $2,425,000. Such loss was primarily related to the write-off of unamortized deferred financing costs of 10 mortgage loans payable that we refinanced on January 29, 2021 and one mortgage loan payable that we refinanced on December 1, 2021 that were due to mature in 2053 and 2049, respectively. As of December 31, 2023, the principal payments due on our mortgage loans payable for each of the next five years ending December 31 and thereafter were as follows (in thousands):
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Lines of Credit and Term Loans |
12 Months Ended |
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Dec. 31, 2023 | |
| Line of Credit Facility [Abstract] | |
| Lines Of Credit and Term Loans | 9. Lines of Credit and Term Loan 2022 Credit Facility On January 19, 2022, we, through our operating partnership, as borrower, and certain of our subsidiaries, or the subsidiary guarantors, collectively as guarantors, entered into an agreement, or the 2022 Credit Agreement, to amend and restate the credit agreement for our existing credit facility with Bank of America, N.A., or Bank of America, KeyBank National Association, Citizens Bank, National Association, and the lenders named therein. The 2022 Credit Agreement provided for a credit facility with an aggregate maximum principal amount up to $1,050,000,000, or the 2022 Credit Facility, which consisted of a senior unsecured revolving credit facility in the initial aggregate amount of $500,000,000 and a senior unsecured term loan facility in the initial aggregate amount of $550,000,000. The proceeds of loans made under the 2022 Credit Facility could have been used for refinancing existing indebtedness and for general corporate purposes including for working capital, capital expenditures and other corporate purposes not inconsistent with obligations under the 2022 Credit Agreement. We could have also obtained up to $25,000,000 in the form of standby letters of credit pursuant to the 2022 Credit Facility. Unless defined herein, all capitalized terms under this “2022 Credit Facility” subsection are defined in the 2022 Credit Agreement. Under the terms of the 2022 Credit Agreement, the revolving loans matured on January 19, 2026, and could have been extended for one 12-month period, subject to the satisfaction of certain conditions, including payment of an extension fee. The term loan would have matured on January 19, 2027, and could not be extended. The maximum principal amount of the 2022 Credit Facility could have been increased by an aggregate incremental amount of $700,000,000, subject to: (i) the terms of the 2022 Credit Agreement; and (ii) at least business days’ prior written notice to Bank of America. The 2022 Credit Facility bore interest at varying rates based upon, at our option, (i) Daily SOFR, plus the Applicable Rate for Daily SOFR Rate Loans or (ii) the Term SOFR, plus the Applicable Rate for Term SOFR Rate Loans. If, under the terms of the 2022 Credit Agreement, there was an inability to determine the Daily SOFR or the Term SOFR then the 2022 Credit Facility bore interest at a rate per annum equal to the Base Rate plus the Applicable Rate for Base Rate Loans. The loans could have been repaid in whole or in part without prepayment premium or penalty, subject to certain conditions. The 2022 Credit Agreement required us to add additional subsidiaries as guarantors in the event the value of the assets owned by the subsidiary guarantors fell below a certain threshold as set forth in the 2022 Credit Agreement. In the event of default, Bank of America had the right to terminate the commitment of each Lender to make Loans and any obligation of the L/C Issuer to make L/C Credit Extensions under the 2022 Credit Agreement, and to accelerate the payment on any unpaid principal amount of all outstanding loans and interest thereon. On March 1, 2023, we entered into an amendment to the 2022 Credit Agreement, or the First Amendment. The material terms of the First Amendment provided for revisions to certain financial covenants for a limited period of time. Except as modified by the terms of the First Amendment, the material terms of the 2022 Credit Agreement remained in full force and effect. As of both December 31, 2023 and 2022, our aggregate borrowing capacity under the 2022 Credit Facility was $1,050,000,000, excluding the $25,000,000 in standby letters of credit described above. As of December 31, 2023 and 2022, borrowings outstanding under the 2022 Credit Facility totaled $914,900,000 ($914,144,000, net of deferred financing costs related to the senior unsecured term loan facility portion of the 2022 Credit Facility) and $965,900,000 ($965,060,000, net of deferred financing costs related to the senior unsecured term loan facility portion of the 2022 Credit Facility), respectively, and the weighted average interest rate on such borrowings outstanding was 7.08% and 6.07% per annum, respectively. As of December 31, 2023, we entered into interest rate swaps to mitigate the risk associated with the entire $550,000,000 outstanding borrowing amount of our term loan. See Note 10, Derivative Financial Instruments, for a further discussion. In January 2022, in connection with the 2022 Credit Agreement, we incurred an aggregate $3,161,000 loss on the extinguishment of a portion of senior unsecured term loan related to former credit facilities. Such loss on extinguishment of debt is recorded as an increase to interest expense in our accompanying condensed consolidated statements of operations and comprehensive loss, and primarily consisted of lender fees we paid to obtain the 2022 Credit Facility. On February 14, 2024, we, through our operating partnership, entered into an agreement, or the 2024 Credit Agreement, that amends, restates, supersedes and replaces the 2022 Credit Agreement. See Note 21, Subsequent Events — 2024 Credit Facility, for a further discussion. 2019 Trilogy Credit Facility We, through Trilogy RER, LLC, are party to an amended and restated loan agreement, or the 2019 Trilogy Credit Agreement, among certain subsidiaries of Trilogy OpCo, LLC, Trilogy RER, LLC, and Trilogy Pro Services, LLC; KeyBank; CIT Bank, N.A.; Regions Bank; KeyBanc Capital Markets, Inc.; Regions Capital Markets; Bank of America; The Huntington National Bank; and a syndicate of other banks, as lenders named therein, with respect to a senior secured revolving credit facility that had an aggregate maximum principal amount of $360,000,000, consisting of: (i) a $325,000,000 secured revolver supported by real estate assets and ancillary business cash flow and (ii) a $35,000,000 accounts receivable revolving credit facility supported by eligible accounts receivable, or the 2019 Trilogy Credit Facility. The proceeds of the 2019 Trilogy Credit Facility may be used for acquisitions, debt repayment and general corporate purposes. The maximum principal amount of the 2019 Trilogy Credit Facility could be increased by up to $140,000,000, for a total principal amount of $500,000,000, subject to certain conditions. Unless defined herein, all capitalized terms under this “2019 Trilogy Credit Facility” subsection are defined in the 2019 Trilogy Credit Agreement, as amended. On December 20, 2022, we entered into an amendment to the 2019 Trilogy Credit Agreement, or the 2019 Trilogy Credit Amendment. The material terms of the 2019 Trilogy Credit Amendment provided for an increase to the secured revolver amount from $325,000,000 to $365,000,000, thereby increasing our aggregate maximum principal amount under the credit facility from $360,000,000 to $400,000,000. In addition, all references to LIBOR were replaced with the Secured Overnight Financing Rate, or SOFR. On March 30, 2023, we further amended the 2019 Trilogy Credit Agreement to update the definition of Implied Debt Service, which is used to calculate the Real Estate Borrowing Base Availability, for interest rate changes and to add an annual interest-only payment calculation option. Except as modified by the terms of the amendments, the material terms of the 2019 Trilogy Credit Agreement remain in full force and effect. The 2019 Trilogy Credit Facility was due to mature on September 5, 2023; however, pursuant to the terms of the 2019 Trilogy Credit Agreement, at such time we extended the maturity date for one 12-month period to mature on September 5, 2024, and paid an extension fee of $600,000. On December 21, 2023, we further amended such agreement to extend the maturity date to June 5, 2025 and paid an extension fee of $745,000. At our option, the 2019 Trilogy Credit Facility bears interest at per annum rates equal to (a) SOFR, plus 2.75% for SOFR Rate Loans and (b) for Base Rate Loans, 1.75% plus the highest of: (i) the fluctuating rate per annum of interest in effect for such day as established from time to time by KeyBank as its prime rate, (ii) 0.50% above the Federal Funds Effective Rate, and (iii) 1.00% above one-month Adjusted Term SOFR. As of both December 31, 2023 and 2022, our aggregate borrowing capacity under the 2019 Trilogy Credit Facility was $400,000,000. As of December 31, 2023 and 2022, borrowings outstanding under the 2019 Trilogy Credit Facility totaled $309,823,000 and $316,734,000, respectively, and the weighted average interest rate on such borrowings outstanding was 8.20% and 7.17% per annum, respectively. On December 21, 2023, we, through Trilogy RER, LLC, entered into an interest rate swap transaction to mitigate the risk with respect to $200,000,000 of our borrowings under the 2019 Trilogy Credit Facility. See Note 10, Derivative Financial Instruments, for a further discussion.
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Derivative Financial Instruments |
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| Derivative Instruments and Hedging Activities Disclosure [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Derivative Financial Instruments | 10. Derivative Financial Instruments We use derivative financial instruments to manage interest rate risk associated with variable-rate debt. We recorded such derivative financial instruments in our accompanying consolidated balance sheets as either an asset or a liability, as applicable, measured at fair value. We did not have any derivative financial instruments as of December 31, 2022. The following table lists the derivative financial instruments held by us as of December 31, 2023, which were included in other assets and other liabilities in our accompanying consolidated balance sheets (dollars in thousands):
As of December 31, 2023, none of our derivative financial instruments were designated as hedges. Derivative financial instruments not designated as hedges are not speculative and are used to manage our exposure to interest rate movements, but do not meet the strict hedge accounting requirements. For the years ended December 31, 2023, 2022 and 2021, we recorded a net (loss) gain in the fair value of derivative financial instruments of $(926,000), $500,000 and $8,200,000, respectively, as a (increase)/decrease to total interest expense in our accompanying consolidated statements of operations and comprehensive loss. Included in the gain in the fair value of derivative instruments recognized for the year ended December 31, 2021 is $823,000 related to the fair value of an interest rate swap entered into by GAHR IV, which matured on November 19, 2021. See Note 15, Fair Value Measurements, for a further discussion of the fair value of our derivative financial instruments.
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Commitments and Contingencies |
12 Months Ended |
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Dec. 31, 2023 | |
| Commitments and Contingencies Disclosure [Abstract] | |
| Commitments and Contingencies | 11. Commitments and Contingencies Litigation We are not presently subject to any material litigation nor, to our knowledge, is any material litigation threatened against us, which, if determined unfavorably to us, would have a material adverse effect on our consolidated financial position, results of operations or cash flows. Environmental Matters We follow a policy of monitoring our properties for the presence of hazardous or toxic substances. While there can be no assurance that a material environmental liability does not exist at our properties, we are not currently aware of any environmental liability with respect to our properties that would have a material adverse effect on our consolidated financial position, results of operations or cash flows. Further, we are not aware of any material environmental liability or any unasserted claim or assessment with respect to an environmental liability that we believe would require additional disclosure or the recording of a loss contingency. Other Our other commitments and contingencies include the usual obligations of real estate owners and operators in the normal course of business, which include calls/puts to sell/acquire properties. In our view, these matters are not expected to have a material adverse effect on our consolidated financial position, results of operations or cash flows.
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Redeemable Noncontrolling Interests |
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| Redeemable Noncontrolling Interest | 12. Redeemable Noncontrolling Interests As of both December 31, 2023 and 2022, we, through our direct and indirect subsidiaries, owned a 95.0% general partnership interest in our operating partnership, and the remaining 5.0% limited partnership interest in our operating partnership was owned by the NewCo Sellers. Some of the limited partnership units outstanding, which account for approximately 1.0% of our total operating partnership units outstanding, have redemption features outside of our control and are accounted for as redeemable noncontrolling interests presented outside of permanent equity in our accompanying consolidated balance sheets. As of December 31, 2023 and 2022, we, through Trilogy REIT Holdings, in which we indirectly hold a 76.0% ownership interest, owned approximately 97.5% and 96.2%, respectively, of the outstanding equity interests of Trilogy. As of December 31, 2023 and 2022, certain members of Trilogy’s management and certain members of an advisory committee to Trilogy’s board of directors owned approximately 2.5% and 3.8%, respectively, of the outstanding equity interests of Trilogy. We account for such equity interests as redeemable noncontrolling interests in our accompanying consolidated balance sheets in accordance with FASB ASC Topic 480-10-S99-3A given certain features associated with such equity interests. For the year ended December 31, 2023, we redeemed a portion of the equity interests owned by a member of Trilogy’s management and a member of Trilogy’s advisory committee for an aggregate of $17,150,000. As of December 31, 2023, we reclassified the balance of the remaining equity interest owned by such member of Trilogy’s advisory committee from redeemable noncontrolling interest to other liabilities in our accompanying consolidated balance sheet, and subsequently redeemed such interest in January 2024 for cash of approximately $25,312,000. In October 2022, we redeemed a portion of the equity interests owned by certain previous or current members of Trilogy’s management and advisory committee for cash of $3,707,000. As of December 31, 2023 and 2022, we own, through our operating partnership, approximately 98.0% of the joint ventures with an affiliate of Meridian Senior Living, LLC, or Meridian, that owned Central Florida Senior Housing Portfolio, Pinnacle Beaumont ALF and Pinnacle Warrenton ALF. The noncontrolling interests held by Meridian have redemption features outside of our control and are accounted for as redeemable noncontrolling interests in our accompanying consolidated balance sheets. See Note 3, Real Estate Investments, Net — Dispositions of Real Estate Investments, for dispositions within our Central Florida Senior Housing Portfolio in 2023 and 2022. We previously owned 90.0% of the joint venture with Avalon Health Care, Inc., or Avalon, that owned Catalina West Haven ALF and Catalina Madera ALF. The noncontrolling interests held by Avalon had redemption features outside of our control and were accounted for as redeemable noncontrolling interests until December 1, 2022, when we exercised our right to purchase the remaining 10.0% of the joint venture with Avalon for a contract purchase price of $295,000. As such, 10.0% of the net earnings of such joint venture were allocated to redeemable noncontrolling interests in our accompanying consolidated statements of operations and comprehensive loss following the Merger and through November 30, 2022. We record the carrying amount of redeemable noncontrolling interests at the greater of: (i) the initial carrying amount, increased or decreased for the noncontrolling interests’ share of net income or loss and distributions or (ii) the redemption value. The changes in the carrying amount of redeemable noncontrolling interests consisted of the following for the years ended December 31, 2023 and 2022 (in thousands):
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Equity |
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| Equity | 13. Equity Preferred Stock Pursuant to our charter, we are authorized to issue 200,000,000 shares of our preferred stock, $0.01 par value per share. As of both December 31, 2023 and 2022, no shares of preferred stock were issued and outstanding. Common Stock Pursuant to our charter, as amended, we are authorized to issue 1,000,000,000 shares of our common stock, $0.01 par value per share, whereby 200,000,000 shares are classified as Class T common stock and 800,000,000 shares were classified as Class I common stock. On January 26, 2024, we further amended our charter to reclassify shares of our Class I common stock such that 200,000,000 shares are classified as Class T common stock, 100,000,000 shares are classified as Class I common stock and 700,000,000 shares are classified as common stock without any designation as to class or series. On October 4, 2021, our board authorized the reinstatement of our distribution reinvestment plan, as amended, or the AHR DRIP, to offer up to $100,000,000 of shares of our common stock pursuant to a Registration Statement on Form S-3 under the Securities Act filed by GAHR IV, or the AHR DRIP Offering. On November 14, 2022, our board suspended the AHR DRIP Offering beginning with the distributions declared, if any, for the quarter ending December 31, 2022. As a result of the suspension of the AHR DRIP, unless and until our board reinstates the AHR DRIP Offering, stockholders who are current participants in the AHR DRIP will be paid future distributions in cash. See Note 1, Organization and Description of Business — Public Offerings, and the “Distribution Reinvestment Plan” section below for a further discussion. We effected a one-for-four reverse split of our common stock on November 15, 2022 and a corresponding reverse split of the partnership units in our operating partnership. As a result of the Reverse Splits, every four shares of our common stock or four partnership units in our operating partnership were automatically combined and converted into one issued and outstanding share of our common stock of like class, or one partnership unit of like class, as applicable, rounded to the nearest 1/100th share or unit. The Reverse Splits impacted all classes of common stock and partnership units proportionately and had no impact on any stockholder’s or partner’s ownership percentage. Neither the number of authorized shares nor the par value of the Class T common stock and Class I common stock were ultimately impacted. All numbers of common shares and per share data, as well as partnership units in our operating partnership, in our accompanying consolidated financial statements and related notes have been retroactively adjusted for all periods presented to give effect to the Reverse Splits. On February 9, 2024, we closed the 2024 Offering and issued 64,400,000 shares of common stock, $0.01 par value per share, for a total of $772,800,000 in gross proceeds, including the exercise in full of the underwriters’ overallotment option to purchase up to an additional 8,400,000 shares of common stock. In conjunction with the 2024 Offering, such shares of common stock were listed on the NYSE and began trading on February 7, 2024. Our Class T common stock and Class I common stock are identical to our common stock, except that such shares are not currently listed on the NYSE or any other national securities exchange. Upon the six month anniversary of the listing of our common stock for trading on the NYSE, which is August 5, 2024, each share of our Class T common stock and Class I common stock will automatically, and without any stockholder action, convert into one share of our listed common stock. Distribution Reinvestment Plan Our DRIP allowed our stockholders to elect to reinvest an amount equal to the distributions declared on their shares of common stock in additional shares of our common stock in lieu of receiving cash distributions. However, on November 14, 2022, our board suspended the DRIP offering beginning with the distributions declared for the quarter ended December 31, 2022. As a result of the suspension of the DRIP offering, unless and until our board reinstates the DRIP offering, stockholders who are current participants in the DRIP were or will be paid distributions in cash. As of both December 31, 2023 and 2022, a total of $91,448,000 in distributions were reinvested that resulted in 2,431,695 shares of common stock being issued pursuant to the AHR DRIP Offering. Since October 5, 2016, our board had approved and established an estimated per share net asset value, or NAV, annually. Commencing with the distribution payment to stockholders paid in the month following such board approval, shares of our common stock issued pursuant to our distribution reinvestment plan were issued at the current estimated per share NAV until such time as our board determined an updated estimated per share NAV. For the year ended December 31, 2023, there were no distributions reinvested and no shares of our common stock were issued pursuant to our DRIP offerings. For the years ended December 31, 2022 and 2021, $36,812,000 and $7,666,000, respectively, in distributions were reinvested and 992,964 and 207,866 shares of our common stock, respectively, were issued pursuant to our DRIP offerings. Share Repurchase Plan Our share repurchase plan allowed for repurchases of shares of our common stock by us when certain criteria are met. Share repurchases were made at the sole discretion of our board. Subject to the availability of the funds for share repurchases and other certain conditions, we generally limited the number of shares of our common stock repurchased during any calendar year to 5.0% of the weighted average number of shares of our common stock outstanding during the prior calendar year; provided however, that shares subject to a repurchase requested upon the death or “qualifying disability,” as defined in our share repurchase plan, of a stockholder were not subject to this cap. Funds for the repurchase of shares of our common stock came from the cumulative proceeds we received from the sale of shares of our common stock pursuant to our DRIP offerings. Pursuant to our share repurchase plan, the repurchase price is equal to the lesser of (i) the amount per share that a stockholder paid for their shares of our common stock, or (ii) the most recent estimated value of one share of our common stock, as determined by our board, except that the repurchase price with respect to repurchases resulting from the death or qualifying disability of stockholders was equal to the most recently published estimated per share NAV. On October 4, 2021, as a result of the Merger, our board authorized the partial reinstatement of our share repurchase plan with respect to requests to repurchase shares resulting from the death or qualifying disability of stockholders, effective with respect to qualifying repurchases for the fiscal quarter ending December 31, 2021. All share repurchase requests other than those requests resulting from the death or qualifying disability of stockholders were rejected. On November 14, 2022, our board suspended our share repurchase plan beginning with share repurchase requests for the quarter ending December 31, 2022. All share repurchase requests, including requests resulting from the death or qualifying disability of stockholders, commencing with the quarter ended December 31, 2022, will not be processed, will be considered canceled in full and will not be considered outstanding repurchase requests. For the years ended December 31, 2023, 2022 and 2021, we repurchased 1,681, 559,195 and 10,356 shares of our common stock, respectively, for an aggregate of $62,000, $20,699,000 and $382,000, respectively, at an average repurchase price of $37.16, $37.02 and $36.88 per share, respectively, pursuant to our share repurchase plan. All shares were repurchased using the cumulative proceeds we received from the sale of shares of our common stock pursuant to our DRIP offerings. Noncontrolling Interests in Total Equity Membership Interest in Trilogy REIT Holdings As of December 31, 2023 and 2022, Trilogy REIT Holdings owned approximately 97.5% and 96.2%, respectively, of Trilogy. Prior to October 1, 2021, we were the indirect owner of a 70.0% interest in Trilogy REIT Holdings pursuant to an amended joint venture agreement with an indirect, wholly-owned subsidiary of NorthStar Healthcare Income, Inc., or NHI, and a wholly-owned subsidiary of GAHR IV Operating Partnership. We serve as the managing member of Trilogy REIT Holdings. In connection with the Merger, the wholly-owned subsidiary of GAHR IV Operating Partnership sold its 6.0% interest in Trilogy REIT Holdings to GAHR III, thereby increasing our indirect ownership in Trilogy REIT Holdings to 76.0%. Through September 30, 2021, 30.0% of the net earnings of Trilogy REIT Holdings were allocated to noncontrolling interests, and since October 1, 2021, 24.0% of the net earnings of Trilogy REIT Holdings were allocated to a noncontrolling interest. On November 3, 2023, we entered into a Membership Interest Purchase Agreement, or the MIPA, with subsidiaries of NHI, which provides us with the option to purchase their 24.0% minority membership interest in Trilogy REIT Holdings. If we exercise this purchase option, we will own 100% of Trilogy REIT Holdings, which (assuming that there are no changes in the equity capitalization of Trilogy prior to consummation of the purchase) will in turn cause us to indirectly own approximately 97.5% of Trilogy. Subject to our first satisfying certain closing conditions, the option is exercisable for a closing before September 30, 2025 assuming that we exercise both extension options described below. If we exercise our purchase option, the all-cash purchase price would be $240,500,000 if we consummate the purchase on or before March 31, 2024, would increase to $247,000,000 if we consummate the purchase from April 1, 2024 to and including December 31, 2024 and would further increase to $260,000,000 if we consummate the purchase on or after January 1, 2025. The MIPA also allows us (at our election), instead of paying all cash, to consummate the purchase transaction by using a combination of cash and the issuance of new Series A Cumulative Convertible Preferred Stock, $0.01 par value per share, or our Convertible Preferred Stock, as purchase price consideration. We must pay at least a minimum amount of the purchase price in cash, in which case we would pay the remaining amount in shares of our Convertible Preferred Stock. The minimum cash amount will be $24,050,000 if we consummate the purchase on or before March 31, 2024, $24,700,000 if we consummate the purchase from April 1, 2024 to and including December 31, 2024, or $26,000,000 if we consummate the purchase on or after January 1, 2025. If issued, our Convertible Preferred Stock will be perpetual, will have a cumulative cash dividend with an initial annual rate of 4.75% (on the liquidation preference per share of $25.00 of our Convertible Preferred Stock) and will be redeemable by us at any time. The annual dividend rate will increase over time, and the redemption price will vary based on the date of redemption. In addition, holders of shares of our Convertible Preferred Stock will have the right, at any time on or after July 1, 2026 and from time to time, to convert some or all of such shares into shares of our common stock, subject to certain customary exceptions. As of December 31, 2023, we did not exercise the MIPA purchase option. Other Noncontrolling Interests In connection with our acquisition and operation of Trilogy, profit interest units in Trilogy, or the Profit Interests, were issued to Trilogy Management Services, LLC and an independent director of Trilogy, both unaffiliated third parties that manage or direct the day-to-day operations of Trilogy. The Profit Interests consisted of time-based or performance-based commitments. The time-based Profit Interests were measured at their grant date fair value and vest in increments of 20.0% on each anniversary of the respective grant date over a five year period. We amortized the time-based Profit Interests on a straight-line basis over the vesting periods, which are recorded to general and administrative in our accompanying consolidated statements of operations and comprehensive loss. The performance-based Profit Interests were subject to a performance commitment and would have vested upon liquidity events as defined in the Profit Interests agreements. The performance-based Profit Interests were measured at their fair value on the adoption date of ASU 2018-07, Improvements to Nonemployee Share-Based Payment Accounting, using a modified retrospective approach. The nonvested awards are presented as noncontrolling interests in total equity in our accompanying consolidated balance sheets, and are re-classified to redeemable noncontrolling interests upon vesting as they had redemption features outside of our control similar to the common stock units held by Trilogy’s management. See Note 12, Redeemable Noncontrolling Interests, for a further discussion. In December 2021, we redeemed a part of the time-based Profit Interests and all of the performance-based Profit Interests that were included in noncontrolling interests in total equity. We redeemed such Profit Interests for $16,517,000, which was paid $8,650,000 in cash and $7,867,000 through the issuance of additional equity interests in Trilogy that are classified as redeemable noncontrolling interests in our consolidated balance sheets. There were no canceled, expired or exercised Profit Interests during the years ended December 31, 2023 and 2022. For the years ended December 31, 2023, 2022 and 2021, we recognized stock compensation expense related to the Profit Interests of $83,000, $83,000 and $8,801,000, respectively. One of our consolidated subsidiaries issued non-voting preferred shares of beneficial interests to qualified investors for total proceeds of $125,000. These preferred shares of beneficial interests are entitled to receive cumulative preferential cash dividends at the rate of 12.5% per annum. We classify the value of the subsidiary’s preferred shares of beneficial interests as noncontrolling interests in our accompanying consolidated balance sheets and the dividends of the preferred shares of beneficial interests in net income or loss attributable to noncontrolling interests in our accompanying consolidated statements of operations and comprehensive loss. As of both December 31, 2023 and 2022, we owned an 86.0% interest in a consolidated limited liability company that owns Lakeview IN Medical Plaza. As such, 14.0% of the net earnings of Lakeview IN Medical Plaza were allocated to noncontrolling interests in our accompanying consolidated statements of operations and comprehensive loss for the years ended December 31, 2023, 2022 and 2021. On February 6, 2024, we purchased the 14.0% membership interest in the consolidated limited liability company that owns Lakeview IN Medical Plaza from an unaffiliated third party for a contract purchase price of $441,000. In connection with such purchase and as of such date, we own a 100% interest in such limited liability company. As of both December 31, 2023 and 2022, we owned a 90.6% membership interest in a consolidated limited liability company that owns Southlake TX Hospital. As such, 9.4% of the net earnings of Southlake TX Hospital were allocated to noncontrolling interests in our accompanying consolidated statements of operations and comprehensive loss for the years ended December 31, 2023, 2022 and 2021. Upon consummation of the Merger, through our operating partnership, we acquired an approximate 90.0% interest in a joint venture that owns the Louisiana Senior Housing Portfolio. As such, 10.0% of the net earnings of the joint venture were allocated to noncontrolling interests in our accompanying consolidated statements of operations and comprehensive loss since October 1, 2021. As discussed in Note 1, Organization and Description of Business, as of both December 31, 2023 and 2022, we, through our direct and indirect subsidiaries, own a 95.0% general partnership interest in our operating partnership, and the remaining 5.0% limited partnership interest in our operating partnership is owned by the NewCo Sellers. As of both December 31, 2023 and 2022, 4.0% of our total operating partnership units outstanding is presented in total equity in our accompanying consolidated balance sheets. See Note 12, Redeemable Noncontrolling Interests, for a further discussion. Equity Compensation Plans GAHR III 2013 Incentive Plan Prior to the REIT Merger, GAHR III adopted the Griffin-American Healthcare REIT III, Inc. Incentive Plan, or the 2013 Incentive Plan, pursuant to which its board, or a committee of its independent directors, could grant options, shares of our common stock, stock purchase rights, stock appreciation rights or other awards to its independent directors, employees and consultants. Under the 2013 Incentive Plan, GAHR III granted an aggregate of 33,750 shares of its restricted common stock, or I RSAs as defined below, which is equal to 31,273 shares of restricted Class I common stock, using the conversion ratio of 0.9266 shares of GAHR IV Class I common stock for each share of GAHR III restricted common stock, as determined in the Merger. Such restricted shares vest as to 20.0% of the shares on the date of grant and on each anniversary thereafter over four years from the date of grant and are subject to continuous service through the vesting dates. As of the Merger date, 4,170 shares such I RSAs remained unvested with a weighted average grant date fair value of $40.38. AHR Incentive Plan Pursuant to the AHR Incentive Plan, our board (with respect to options and restricted shares of common stock granted to independent directors), or our compensation committee (with respect to any other award), may grant options, restricted shares of common stock, stock purchase rights, stock appreciation rights or other awards to our independent directors, officers, employees and consultants. The AHR Incentive Plan terminates on June 15, 2033, and the maximum number of shares of our common stock that may be issued pursuant to such plan is 4,000,000 shares. Restricted common stock Pursuant to the AHR Incentive Plan, through December 31, 2023, we granted an aggregate of 315,459 shares of our restricted common stock, or RSAs, which include restricted Class T common stock and restricted Class I common stock, as defined in the AHR Incentive Plan. RSAs were granted to our independent directors in connection with their initial election or re-election to our board or in consideration of their past services rendered. In addition, certain executive officers and key employees received grants of restricted Class T common stock. In February 2024, we also granted an aggregate of 972,222 RSAs to independent directors, executive officers and certain employees upon completion of the 2024 Offering. RSAs generally have a vesting period ranging from to four years and are subject to continuous service through the vesting dates. Restricted stock units Pursuant to the AHR Incentive Plan, through December 31, 2023, we granted to our executive officers an aggregate 70,751 of performance-based restricted stock units, or PBUs, representing the right to receive shares of our Class T common stock upon vesting. We also granted to our executive officers and certain employees 169,529 time-based restricted stock units, or TBUs, representing the right to receive shares of our Class T common stock upon vesting. PBUs and TBUs are collectively referred to as RSUs. RSUs granted to executive officers and employees, generally have a vesting period of up to three years and are subject to continuous service through the vesting dates and any performance conditions, as applicable. A summary of the status of our nonvested RSAs and RSUs as of December 31, 2023 and 2022 and the changes for the years ended December 31, 2023 and 2022 is presented below:
___________ (1)Amount includes 2,280 shares of common stock that were withheld from issuance to satisfy employee minimum tax withholding requirements associated with the vesting of RSUs during the year ended December 31, 2023. For the years ended December 31, 2023 and 2022, pursuant to the AHR Incentive Plan, we granted 26,156 and 18,689 shares of our restricted common stock, respectively, at a weighted average grant date fair value of $31.83 and $37.16 per share, respectively, to our executives and to our independent directors in connection with their election or re-election to our board. For the years ended December 31, 2023 and 2022, we recognized stock compensation expense related to awards granted pursuant to the AHR Incentive Plan of $5,385,000 and $3,935,000, respectively, based on the grant date fair value, which is equal to the most recently published estimated per share NAV. Stock compensation expense is included in general and administrative expenses in our accompanying consolidated statements of operations and comprehensive loss. As of December 31, 2023 and 2022, there was $6,865,000 and $6,888,000, respectively, of total unrecognized compensation expense, net of estimated forfeitures, related to nonvested RSAs and RSUs. As of December 31, 2023, this expense is expected to be recognized over a remaining weighted average period of 1.6 years.
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Related Party Transactions |
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| Related Party Transactions | 14. Related Party Transactions Fees and Expenses Paid to Affiliates Through September 30, 2021, we were externally advised by our former advisor pursuant to an advisory agreement, as amended, or the Advisory Agreement, between us and our former advisor. Our former advisor, subject to the oversight and review of our board, provided asset management, property management, acquisition, disposition and other advisory services on our behalf consistent with our investment policies and objectives. Until September 30, 2021, all of our executive officers were officers of our former advisor and officers, limited partners and/or members of one of our former co-sponsors and other affiliates of our former advisor. Prior to the Merger and the AHI Acquisition, our former advisor was 75.0% owned and managed by wholly-owned subsidiaries of AHI and 25.0% owned by a wholly-owned subsidiary of Griffin Capital, or collectively, our former cosponsors. Prior to the AHI Acquisition, AHI was 47.1% owned by AHI Group Holdings, 45.1% indirectly owned by DigitalBridge Group, Inc. (NYSE: DBRG), or DigitalBridge, and 7.8% owned by James F. Flaherty III. We were not affiliated with Griffin Capital, DigitalBridge or Mr. Flaherty; however, we were affiliated with our former advisor, AHI and AHI Group Holdings. On December 20, 2021, the Advisory Agreement was assigned to NewCo, and as a result, any fees that would have otherwise been payable to our former advisor are no longer being paid to a third party. Following the consummation of the Merger in October 2021, we became self-managed and as a result we no longer incur any fees or expense reimbursements to our former advisor and its affiliates arising from the Advisory Agreement. We did not incur any fees and expenses to our third-party affiliates for the years ended December 31, 2023 and 2022. Fees and expenses incurred to our former advisor or its affiliates for the year ended December 31, 2021 were as follows (in thousands):
(1)Asset management fees were included in general and administrative expenses in our accompanying consolidated statements of operations and comprehensive loss. (2)Property management fees were included in rental expenses or general and administrative expenses in our accompanying consolidated statements of operations and comprehensive loss, depending on the property type from which the fee was incurred. (3)Acquisition fees in connection with the acquisition of properties accounted for as asset acquisitions or the acquisition of real estate-related investments were capitalized as part of the associated investments in our accompanying consolidated balance sheets. (4)Development fees were capitalized as part of the associated investments in our accompanying consolidated balance sheets. (5)Lease fees were capitalized as costs of entering into new leases and included in other assets, net in our accompanying consolidated balance sheets. (6)We reimbursed our former advisor or its affiliates for operating expenses incurred in rendering services to us, subject to certain limitations. For the 12 months ended December 31, 2021, our operating expenses did not exceed such limitations. Operating expenses were generally included in general and administrative expenses in our accompanying consolidated statements of operations and comprehensive loss. (7)Construction management fees were capitalized as part of the associated asset and included in real estate investments, net in our accompanying consolidated balance sheets. Registration Rights Agreement Upon consummation of the AHI Acquisition, GAHR III and the Surviving Partnership entered into a registration rights agreement, or the Registration Rights Agreement, with Griffin-American Strategic Holdings, LLC, or HoldCo, pursuant to which, subject to certain limitations therein, as promptly as practicable following the later of the expiration of (i) the period commencing on the closing of the AHI Acquisition and ending upon the earliest to occur of (a) the second anniversary date of the issuance of the Surviving Partnership OP units issued in connection with the AHI Acquisition, (b) a change of control of Merger Sub and (c) the listing of shares of our common stock on a national securities exchange, or the Lock-Up Period; and (ii) the date on which we are eligible to file a registration statement (but in any event no later than 180 days after such date), we, as the indirect parent company of the Surviving Partnership, are required to file a shelf registration statement with the SEC under the Securities Act covering the resale of the shares of our Class I common stock issued or issuable in redemption of the Surviving Partnership OP units that the Surviving Partnership issued as consideration in the AHI Acquisition. The Registration Rights Agreement also grants HoldCo (or any successor holder of such shares) demand rights to request additional registration statement filings as well as “piggyback” registration rights, in each case on or after the expiration of the Lock-Up Period. In connection with the Merger, we assumed from GAHR III the Registration Rights Agreement and GAHR III’s obligations thereunder in their entirety. In connection with the 2024 Offering, the Holders (as defined in the Registration Rights Agreement) have agreed that, without the prior written consent of the representatives on behalf of the underwriters of the 2024 Offering, during the period ending 180 days after the date of listing of our common stock for trading on a national securities exchange, they will not, and will not publicly disclose an intention to, directly or indirectly, among others, subject to certain exceptions, exercise their registration rights under the Registration Rights Agreement.
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Fair Value Measurements |
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| Fair Value Disclosures [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Fair Value Measurements | 15. Fair Value Measurements Assets and Liabilities Reported at Fair Value The table below presents our assets and liabilities measured at fair value on a recurring basis as of December 31, 2023, aggregated by the level in the fair value hierarchy within which those measurements fall (in thousands):
We did not have any assets and liabilities measured at fair value on a recurring basis as of December 31, 2022. There were no transfers into and out of fair value measurement levels during the years ended December 31, 2023 and 2022. Warrants As of December 31, 2023, we did not have any warrants outstanding. During the fourth quarter of 2022, we redeemed all the warrants in common units held by certain members of Trilogy’s management for $678,000 in cash, and as a result, we did not have any warrants outstanding as of December 31, 2022. Such warrants had redemption features similar to the common units held by members of Trilogy’s management. See Note 12, Redeemable Noncontrolling Interests, for a further discussion. Derivative Financial Instruments We entered into interest rate swaps to manage interest rate risk associated with variable-rate debt. We also previously used interest rate caps to manage such interest rate risk. The valuation of these instruments was determined using widely accepted valuation techniques including a discounted cash flow analysis on the expected cash flows of each derivative. Such valuation reflected the contractual terms of the derivatives, including the period to maturity, and used observable market-based inputs, including interest rate curves, as well as option volatility. The fair values of our interest rate swaps were determined by netting the discounted future fixed cash payments and the discounted expected variable cash receipts. The variable cash receipts were based on an expectation of future interest rates derived from observable market interest rate curves. We incorporated credit valuation adjustments to appropriately reflect both our own nonperformance risk and the respective counterparty’s nonperformance risk in the fair value measurements. In adjusting the fair value of our derivative contracts for the effect of nonperformance risk, we considered the impact of netting and any applicable credit enhancements, such as collateral postings, thresholds, mutual puts and guarantees. Although we determined that the majority of the inputs used to value our derivative financial instruments fell within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with this instrument utilized Level 3 inputs, such as estimates of current credit spreads, to evaluate the likelihood of default by us and our counterparty. However, as of December 31, 2023, we assessed the significance of the impact of the credit valuation adjustments on the overall valuation of our derivative positions and determined that the credit valuation adjustments were not significant to the overall valuation of our derivatives. As a result, we determined that our derivative valuations in their entirety were classified in Level 2 of the fair value hierarchy. On January 25, 2022, our prior interest rate swap contracts matured and as of December 31, 2022, we did not have any derivative financial instruments. Financial Instruments Disclosed at Fair Value Our accompanying consolidated balance sheets include the following financial instruments: debt security investment, cash and cash equivalents, restricted cash, accounts and other receivables, accounts payable and accrued liabilities, mortgage loans payable and borrowings under our lines of credit and term loan. We consider the carrying values of cash and cash equivalents, restricted cash, accounts and other receivables and accounts payable and accrued liabilities to approximate the fair value for these financial instruments based upon an evaluation of the underlying characteristics and market data, in light of the short period of time between origination of the instruments and their expected realization. The fair values of the other financial instruments are classified in Level 2 of the fair value hierarchy. The fair value of our debt security investment is estimated using a discounted cash flow analysis using interest rates available to us for investments with similar terms and maturities. The fair values of our mortgage loans payable and our lines of credit and term loan are estimated using discounted cash flow analyses using borrowing rates available to us for debt instruments with similar terms and maturities. We have determined that the valuations of our debt security investment, mortgage loans payable and lines of credit and term loan are classified in Level 2 within the fair value hierarchy. The carrying amounts and estimated fair values of such financial instruments as of December 31, 2023 and 2022 were as follows (in thousands):
___________ (1)Carrying amount is net of any discount/premium and unamortized deferred financing costs.
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Income Taxes |
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| Income Tax Disclosure [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Income Taxes | 16. Income Taxes As a REIT, we generally will not be subject to U.S. federal income tax on taxable income that we distribute to our stockholders. We have elected to treat certain of our consolidated subsidiaries as TRS pursuant to the Code. TRS may participate in services that would otherwise be considered impermissible for REITs and are subject to federal and state income tax at regular corporate tax rates. The components of income or loss before taxes for the years ended December 31, 2023, 2022 and 2021, were as follows (in thousands):
The components of income tax benefit or expense for the years ended December 31, 2023, 2022 and 2021 were as follows (in thousands):
Current Income Tax Federal and state income taxes are generally a function of the level of income recognized by our TRS. Foreign income taxes are generally a function of our income on our real estate located in the UK and Isle of Man. Deferred Taxes Deferred income tax is generally a function of the period’s temporary differences (primarily basis differences between tax and financial reporting for real estate assets and equity investments) and generation of tax NOL that may be realized in future periods depending on sufficient taxable income. We recognize the effects of an uncertain tax position on the financial statements, when it is more likely than not, based on the technical merits of the tax position, that such a position will be sustained upon examination by the relevant tax authorities. If the tax benefit meets the “more likely than not” threshold, the measurement of the tax benefit will be based on our estimate of the ultimate tax benefit to be sustained if audited by the taxing authority. As of both December 31, 2023 and 2022, we did not have any tax benefits or liabilities for uncertain tax positions that we believe should be recognized in our accompanying consolidated financial statements. We assess the available positive and negative evidence to estimate if sufficient future taxable income will be generated to use the existing deferred tax assets. A valuation allowance is established if we believe it is more likely than not that all or a portion of the deferred tax assets are not realizable. As of both December 31, 2023 and 2022, our valuation allowance fully reserves the net deferred tax assets due to historical losses and inherent uncertainty of future income. We will continue to monitor industry and economic conditions, and our ability to generate taxable income based on our business plan and available tax planning strategies, which would allow us to utilize the tax benefits of the net deferred tax assets and thereby allow us to reverse all, or a portion of, our valuation allowance in the future. Any increases or decreases to the deferred income tax assets or liabilities are reflected in income tax (expense) benefit in our accompanying consolidated statements of operations and comprehensive loss. The components of deferred tax assets and liabilities as of December 31, 2023 and 2022 were as follows (in thousands):
At December 31, 2023 and 2022, we had a NOL carryforward of $203,320,000 and $196,779,000, respectively, related to our TRS. These amounts can be used to offset future taxable income, if any. The NOL carryforwards incurred before January 1, 2018 will begin to expire starting 2035, and NOL carryforwards incurred after December 31, 2017 will be carried forward indefinitely. Tax Treatment of Distributions (Unaudited) For U.S. federal income tax purposes, distributions to stockholders are characterized as ordinary income, capital gain distributions or nontaxable distributions. Nontaxable distributions will reduce United States stockholders’ basis (but not below zero) in their shares. The income tax treatment for distributions reportable for the years ended December 31, 2023, 2022 and 2021 was as follows (dollars in thousands):
Amounts listed above do not include distributions paid on nonvested RSAs and RSUs, which have been separately reported.
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| Leases [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Leases | 17. Leases Lessor We have operating leases with tenants that expire at various dates through 2050. For the years ended December 31, 2023, 2022 and 2021, we recognized $185,064,000, $200,526,000 and $136,294,000, respectively, of revenues related to operating lease payments, of which $38,415,000 and $39,278,000, $23,340,000, respectively, was for variable lease payments. As of December 31, 2023, the following table sets forth the undiscounted cash flows for future minimum base rents due under operating leases for each of the next five years ending December 31 and thereafter for properties that we wholly own (in thousands):
Lessee We lease certain land, buildings, furniture, fixtures, campus and office equipment and automobiles. We have lease agreements with lease and non-lease components, which are generally accounted for separately. Most leases include one or more options to renew, with renewal terms that generally can extend at various dates through 2107, excluding extension options. The exercise of lease renewal options is at our sole discretion. Certain leases also include options to purchase the leased property. The depreciable life of assets and leasehold improvements are limited by the expected lease term, unless there is a transfer of title or purchase option reasonably certain of exercise. Certain of our lease agreements include rental payments that are adjusted periodically based on the United States Bureau of Labor Statistics’ Consumer Price Index and may also include other variable lease costs (i.e., common area maintenance, property taxes and insurance). Our lease agreements do not contain any material residual value guarantees or material restrictive covenants. The components of lease costs were as follows (in thousands):
___________ (1)Includes short-term leases and variable lease costs, which are immaterial. Additional information related to our leases for the periods presented below was as follows (dollars in thousands):
Operating Leases As of December 31, 2023, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for each of the next five years ending December 31 and thereafter, as well as the reconciliation of those cash flows to operating lease liabilities on our accompanying consolidated balance sheet (in thousands):
Finance Leases As of December 31, 2023, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for each of the next five years ending December 31 and thereafter, as well as a reconciliation of those cash flows to finance lease liabilities (in thousands):
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| Leases | 17. Leases Lessor We have operating leases with tenants that expire at various dates through 2050. For the years ended December 31, 2023, 2022 and 2021, we recognized $185,064,000, $200,526,000 and $136,294,000, respectively, of revenues related to operating lease payments, of which $38,415,000 and $39,278,000, $23,340,000, respectively, was for variable lease payments. As of December 31, 2023, the following table sets forth the undiscounted cash flows for future minimum base rents due under operating leases for each of the next five years ending December 31 and thereafter for properties that we wholly own (in thousands):
Lessee We lease certain land, buildings, furniture, fixtures, campus and office equipment and automobiles. We have lease agreements with lease and non-lease components, which are generally accounted for separately. Most leases include one or more options to renew, with renewal terms that generally can extend at various dates through 2107, excluding extension options. The exercise of lease renewal options is at our sole discretion. Certain leases also include options to purchase the leased property. The depreciable life of assets and leasehold improvements are limited by the expected lease term, unless there is a transfer of title or purchase option reasonably certain of exercise. Certain of our lease agreements include rental payments that are adjusted periodically based on the United States Bureau of Labor Statistics’ Consumer Price Index and may also include other variable lease costs (i.e., common area maintenance, property taxes and insurance). Our lease agreements do not contain any material residual value guarantees or material restrictive covenants. The components of lease costs were as follows (in thousands):
___________ (1)Includes short-term leases and variable lease costs, which are immaterial. Additional information related to our leases for the periods presented below was as follows (dollars in thousands):
Operating Leases As of December 31, 2023, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for each of the next five years ending December 31 and thereafter, as well as the reconciliation of those cash flows to operating lease liabilities on our accompanying consolidated balance sheet (in thousands):
Finance Leases As of December 31, 2023, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for each of the next five years ending December 31 and thereafter, as well as a reconciliation of those cash flows to finance lease liabilities (in thousands):
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| Leases | 17. Leases Lessor We have operating leases with tenants that expire at various dates through 2050. For the years ended December 31, 2023, 2022 and 2021, we recognized $185,064,000, $200,526,000 and $136,294,000, respectively, of revenues related to operating lease payments, of which $38,415,000 and $39,278,000, $23,340,000, respectively, was for variable lease payments. As of December 31, 2023, the following table sets forth the undiscounted cash flows for future minimum base rents due under operating leases for each of the next five years ending December 31 and thereafter for properties that we wholly own (in thousands):
Lessee We lease certain land, buildings, furniture, fixtures, campus and office equipment and automobiles. We have lease agreements with lease and non-lease components, which are generally accounted for separately. Most leases include one or more options to renew, with renewal terms that generally can extend at various dates through 2107, excluding extension options. The exercise of lease renewal options is at our sole discretion. Certain leases also include options to purchase the leased property. The depreciable life of assets and leasehold improvements are limited by the expected lease term, unless there is a transfer of title or purchase option reasonably certain of exercise. Certain of our lease agreements include rental payments that are adjusted periodically based on the United States Bureau of Labor Statistics’ Consumer Price Index and may also include other variable lease costs (i.e., common area maintenance, property taxes and insurance). Our lease agreements do not contain any material residual value guarantees or material restrictive covenants. The components of lease costs were as follows (in thousands):
___________ (1)Includes short-term leases and variable lease costs, which are immaterial. Additional information related to our leases for the periods presented below was as follows (dollars in thousands):
Operating Leases As of December 31, 2023, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for each of the next five years ending December 31 and thereafter, as well as the reconciliation of those cash flows to operating lease liabilities on our accompanying consolidated balance sheet (in thousands):
Finance Leases As of December 31, 2023, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for each of the next five years ending December 31 and thereafter, as well as a reconciliation of those cash flows to finance lease liabilities (in thousands):
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Segment Reporting |
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| Segment Reporting [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Segment Reporting Disclosure | 18. Segment Reporting We evaluate our business and make resource allocations based on four reportable business segments: integrated senior health campuses, or ISHC, OM, triple-net leased properties and SHOP. Our OM buildings are typically leased to multiple tenants under separate leases, thus requiring active management and responsibility for many of the associated operating expenses (much of which are, or can effectively be, passed through to the tenants). Our integrated senior health campuses each provide a range of independent living, assisted living, memory care, skilled nursing services and certain ancillary businesses that are owned and operated utilizing a RIDEA structure. Our triple-net leased properties segment includes senior housing, skilled nursing facilities and hospital investments, which are single-tenant properties for which we lease the facilities to unaffiliated tenants under triple-net and generally master leases that transfer the obligation for all facility operating costs (including maintenance, repairs, taxes, insurance and capital expenditures) to the tenant. In addition, our triple-net leased properties segment includes our debt security investment. Our SHOP segment includes senior housing, which may provide assisted living care, independent living, memory care or skilled nursing services that are owned and operated utilizing a RIDEA structure. While we believe that net income (loss), as defined by GAAP, is the most appropriate earnings measurement, we evaluate our segments’ performance based upon segment net operating income, or NOI. We define segment NOI as total revenues and grant income, less property operating expenses and rental expenses, which excludes depreciation and amortization, general and administrative expenses, business acquisition expenses, interest expense, gain or loss on dispositions of real estate investments, impairment of real estate investments, impairment of intangible assets and goodwill, income or loss from unconsolidated entities, gain on re-measurement of previously held equity interest, foreign currency gain or loss, other income and income tax benefit or expense for each segment. We believe that segment NOI serves as an appropriate supplemental performance measure to net income (loss) because it allows investors and our management to measure unlevered property-level operating results and to compare our operating results to the operating results of other real estate companies and between periods on a consistent basis. Interest expense, depreciation and amortization and other expenses not attributable to individual properties are not allocated to individual segments for purposes of assessing segment performance. Non-segment assets primarily consist of corporate assets, including cash and cash equivalents, other receivables, deferred financing costs and other assets not attributable to individual properties. Summary information for the reportable segments during the years ended December 31, 2023, 2022 and 2021 was as follows (in thousands):
Total assets by reportable segment as of December 31, 2023 and 2022 were as follows (in thousands):
As of and for the years ended December 31, 2023 and 2022, goodwill by reportable segment was as follows (in thousands):
See Note 4, Business Combinations, for a further discussion of goodwill recognized in connection with our business combinations. During the year ended December 31, 2022, we performed the quantitative step one test of the goodwill impairment guidance for each of our reporting units in connection with our annual assessments of goodwill. The fair value of each reporting unit was determined based on various methodologies, including the income approach and the market approach models. For the year ended December 31, 2022, we determined that the fair value of the reporting unit under the SHOP reporting segment compared to its carrying value, including goodwill, was lower than its carrying value. As a result, goodwill pertaining to our SHOP reporting segment was fully impaired and we recognized an impairment loss of $23,277,000 in our accompanying consolidated statements of operations and comprehensive loss for the year ended December 31, 2022. Therefore, as of December 31, 2022, we did not have any remaining goodwill associated with our SHOP reporting segment. Our portfolio of properties and other investments are located in the United States, the UK and Isle of Man. Revenues and grant income and assets are attributed to the country in which the property is physically located. The following is a summary of geographic information for our operations for the periods presented (in thousands):
The following is a summary of real estate investments, net by geographic regions as of December 31, 2023 and 2022 (in thousands):
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Concentration of Credit Risk |
12 Months Ended |
|---|---|
Dec. 31, 2023 | |
| Risks and Uncertainties [Abstract] | |
| Concentration of Credit Risk | 19. Concentration of Credit Risk Financial instruments that potentially subject us to a concentration of credit risk are primarily our debt security investment, cash and cash equivalents, restricted cash and accounts and other receivables. We are exposed to credit risk with respect to our debt security investment, but we believe collection of the outstanding amount is probable. Cash and cash equivalents are generally invested in investment-grade, short-term instruments with a maturity of three months or less when purchased. We have cash and cash equivalents in financial institutions that are insured by the Federal Deposit Insurance Corporation, or FDIC. As of December 31, 2023 and 2022, we had cash and cash equivalents in excess of FDIC insured limits. We believe this risk is not significant. Concentration of credit risk with respect to accounts receivable from tenants and residents is limited. We perform credit evaluations of prospective tenants and security deposits are obtained at the time of property acquisition and upon lease execution. Based on leases as of December 31, 2023, properties in two states in the United States accounted for 10.0% or more of our total consolidated property portfolio’s annualized base rent or annualized NOI, which is based on contractual base rent from leases in effect for our non-RIDEA properties and annualized NOI for our SHOP and integrated senior health campuses as of December 31, 2023. Properties located in Indiana and Michigan accounted for 35.3% and 10.4%, respectively, of our total consolidated property portfolio’s annualized base rent or annualized NOI. Accordingly, there is a geographic concentration of risk subject to fluctuations in each state’s economy. Based on leases as of December 31, 2023, our four reportable business segments, integrated senior health campuses, OM, triple-net leased properties and SHOP accounted for 51.0%, 28.7%, 11.5% and 8.8%, respectively, of our total consolidated property portfolio’s annualized base rent or annualized NOI. As of December 31, 2023, none of our tenants at our properties accounted for 10.0% or more of our total consolidated property portfolio’s annualized base rent or annualized NOI
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Per Share Data |
12 Months Ended |
|---|---|
Dec. 31, 2023 | |
| Earnings Per Share [Abstract] | |
| Per Share Data | 20. Per Share Data Basic earnings (loss) per share for all periods presented are computed by dividing net income (loss) applicable to common stock by the weighted average number of shares of our common stock outstanding during the period. Net income (loss) applicable to common stock is calculated as net income (loss) attributable to controlling interest less distributions allocated to participating securities of $3,803,000, $5,967,000 and $1,440,000, respectively, for the years ended December 31, 2023, 2022 and 2021. Diluted earnings (loss) per share are computed based on the weighted average number of shares of our common stock and all potentially dilutive securities, if any. TBUs, nonvested shares of our RSAs and limited partnership units of our operating partnership are participating securities and give rise to potentially dilutive shares of our common stock. As of December 31, 2023 and 2022, there were 147,044 and 183,240 nonvested shares, respectively, of our RSAs outstanding, but such shares were excluded from the computation of diluted earnings (loss) per share because such shares were anti-dilutive during these periods. As of both December 31, 2023 and 2022, there were 3,501,976 limited partnership units of our operating partnership outstanding, but such units were also excluded from the computation of diluted earnings (loss) per share because such units were anti-dilutive during these periods. As of December 31, 2023 and 2022, there were 157,329 and 19,200 nonvested TBUs outstanding, respectively, but such units were excluded from the computation of diluted earnings (loss) per share because such restricted stock units were anti-dilutive during the period. As of December 31, 2023 and 2022, there were 70,751 and 29,352 nonvested PBUs outstanding, respectively, which were treated as contingently issuable shares pursuant to ASC Topic 718, Compensation — Stock Compensation. Such contingently issuable shares were excluded from the computation of diluted earnings (loss) per share because they were anti-dilutive during the period.
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Subsequent Events |
12 Months Ended |
|---|---|
Dec. 31, 2023 | |
| Subsequent Events [Abstract] | |
| Subsequent Events | 21. Subsequent Events Acquisition of Senior Housing Portfolio On February 1, 2024, we acquired a portfolio of 12 senior housing facilities in Oregon from an unaffiliated third party, which facilities are included in our SHOP segment. These facilities are part of the underlying collateral pool of real estate assets securing our debt security investment. We acquired such 12 facilities by assuming the outstanding principal balance of each related mortgage loan payable from one of the borrowers. The aggregated principal balance of such assumed mortgage loans payable was $94,461,000 at the time of acquisition. 2024 Underwritten Public Offering and Listing On February 9, 2024, pursuant to a Registration Statement filed with the SEC on Form S-11 (File No. 333-267464), as amended, we closed the 2024 Offering, through which we issued 64,400,000 shares of common stock, $0.01 par value per share, for a total of $772,800,000 in gross offering proceeds. Such amounts include the exercise in full of the underwriters’ overallotment option to purchase up to an additional 8,400,000 shares of common stock. These shares are listed on New York Stock Exchange under the trading symbol “AHR” and began trading on February 7, 2024. We received $724,625,000 in net proceeds, which was primarily used to repay $176,145,000 of mortgage loans payable and $545,010,000 on our lines of credit in February 2024. 2024 Credit Facility On February 14, 2024, we, through our operating partnership, as borrower, and certain of our subsidiaries, or the subsidiary guarantors, and our company, collectively as guarantors, entered into an agreement, or the 2024 Credit Agreement, that amends, restates, supersedes and replaces the 2022 Credit Agreement with Bank of America, KeyBank, Citizens Bank and a syndicate of other banks, as lenders, to obtain a credit facility with an aggregate maximum principal amount up to $1,150,000,000, or the 2024 Credit Facility. The 2024 Credit Facility consists of a senior unsecured revolving credit facility in the initial aggregate amount of $600,000,000 and a senior unsecured term loan facility in the initial aggregate amount of $550,000,000. Unless defined herein, all capitalized terms under this “2024 Credit Facility” subsection are defined in the 2024 Credit Agreement. Under the terms of the 2024 Credit Agreement, the Revolving Loans mature on February 14, 2028, and may be extended for one 12-month period, subject to the satisfaction of certain conditions, including payment of an extension fee. The Term Loan matures on January 19, 2027, and may not be extended. The maximum principal amount of the 2024 Credit Facility may be increased by an aggregate incremental amount of $600,000,000, subject to: (i) the terms of the 2024 Credit Agreement; and (ii) at least five business days’ prior written notice to Bank of America. The 2024 Credit Facility bears interest at varying rates based upon, at our option, (i) Daily SOFR, plus the Applicable Rate for Daily SOFR Rate Loans or (ii) Term SOFR, plus the Applicable Rate for Term SOFR Rate Loans. If, under the terms of the 2024 Credit Agreement, there is an inability to determine the Daily SOFR or the Term SOFR, then the 2024 Credit Facility will bear interest at a rate per annum equal to the Base Rate plus the Applicable Rate for Base Rate Loans. The loans may be repaid in whole or in part without prepayment premium or penalty, subject to certain conditions. We are required to pay a fee on the unused portion of the lenders’ commitments under the 2024 Credit Agreement computed at (a) 0.25% per annum if the actual daily Commitment Utilization Percentage for such quarter is less than or equal to 50% and (b) 0.20% per annum if the actual daily Commitment Utilization Percentage for such quarter is greater than 50%, which fee shall be computed on the actual daily amount of the Available Commitments during the period for which payment is made and payable in arrears on a quarterly basis. The 2024 Credit Agreement requires us to add additional subsidiaries as guarantors in the event the value of the assets owned by the subsidiary guarantors falls below a certain threshold as set forth in the 2024 Credit Agreement. In the event of default, Bank of America has the right to terminate the commitment of each Lender to make Loans and any obligation of the L/C Issuer to make L/C Credit Extensions under the 2024 Credit Agreement and to accelerate the payment on any unpaid principal amount of all outstanding loans and all interest accrued and unpaid thereon. The 2024 Credit Facility replaces the 2022 Credit Facility. Distributions Declared On March 13, 2024, our board authorized a quarterly distribution of $0.25 per share to all of our stockholders of record as of the close of business on March 28, 2024. The distribution for the quarter commencing January 1, 2024 to March 31, 2024, which will be paid on or about April 19, 2024, represents an annualized distribution rate of $1.00 per share.
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Schedule III Real Estate and Accumulated Depreciation |
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| SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Schedule III Real Estate and Accumulated Depreciation |
___________ (a)We own 100% of our properties as of December 31, 2023, with the exception of Trilogy, Lakeview IN Medical Plaza, Southlake TX Hospital, Pinnacle Beaumont ALF, Pinnacle Warrenton ALF and Louisiana Senior Housing Portfolio. (b)The cost capitalized subsequent to acquisition is shown net of dispositions and impairments. (c)These properties are used as collateral for the secured revolver portion of the 2019 Trilogy Credit Facility, which had an outstanding balance of $309,823 as of December 31, 2023. See Note 9, Lines of Credit and Term Loan — 2019 Trilogy Credit Facility, for a further discussion. (d)Represents furniture, fixtures, equipment, land and improvements associated with properties under operating leases. (e) The changes in total real estate for the years ended December 31, 2023, 2022 and 2021 are as follows (in thousands):
(f) As of December 31, 2023, the unaudited aggregate cost of our properties was $4,051,405 for U.S. federal income tax purposes. (g) The changes in accumulated depreciation for the years ended December 31, 2023, 2022 and 2021 are as follows (in thousands):
(h) The cost of buildings and capital improvements is depreciated on a straight-line basis over the estimated useful lives of the buildings and capital improvements, up to 39 years, and the cost of tenant improvements is depreciated over the shorter of the lease term or useful life, up to 34 years. The cost of furniture, fixtures and equipment is depreciated over the estimated useful life, up to 28 years.
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Summary of Significant Accounting Policies (Policies) |
12 Months Ended |
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Dec. 31, 2023 | |
| Accounting Policies [Abstract] | |
| Basis of Presentation | Basis of Presentation Our accompanying consolidated financial statements include our accounts and those of our operating partnership, the wholly-owned subsidiaries of our operating partnership and all non-wholly owned subsidiaries in which we have control, as well as any VIEs, in which we are the primary beneficiary. The portion of equity in any subsidiary that is not wholly owned by us is presented in our accompanying consolidated financial statements as a noncontrolling interest. We evaluate our ability to control an entity, and whether the entity is a VIE and we are the primary beneficiary, by considering substantive terms of the arrangement and identifying which enterprise has the power to direct the activities of the entity that most significantly impacts the entity’s economic performance. On November 15, 2022, we effected a one-for-four reverse stock split of our common stock and a corresponding reverse split of the OP units, or the Reverse Splits. All numbers of common shares and per share data, as well as the OP units, in our accompanying consolidated financial statements and related notes have been retroactively adjusted for all periods presented to give effect to the Reverse Splits. We operate and intend to continue to operate in an umbrella partnership REIT structure in which our operating partnership, wholly-owned subsidiaries of our operating partnership and all non-wholly owned subsidiaries of which we have control will own substantially all of the interests in properties acquired on our behalf. The accounts of our operating partnership are consolidated in our accompanying consolidated financial statements because we are the sole general partner of our operating partnership and have unilateral control over its management and major operating decisions (even if additional limited partners are admitted to our operating partnership). All intercompany accounts and transactions are eliminated in consolidation.
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| Use of Estimates | Use of Estimates The preparation of our accompanying consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, as well as the disclosure of contingent assets and liabilities, at the date of our consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Significant items subject to such estimates and assumptions include, but are not limited to, the initial and recurring valuation of certain assets acquired and liabilities assumed through property acquisitions including through business combinations, goodwill and its impairment, revenues and grant income, allowance for credit losses, impairment of long-lived and intangible assets and contingencies. These estimates are made and evaluated on an on-going basis using information that is currently available as well as various other assumptions believed to be reasonable under the circumstances. Actual results could differ from those estimates, perhaps in material adverse ways, and those estimates could be different under different assumptions or conditions.
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| Cash, Cash Equivalents and Restricted Cash | Cash, Cash Equivalents and Restricted Cash Cash and cash equivalents consist of all highly liquid investments with a maturity of three months or less when purchased. Restricted cash primarily comprises lender required accounts for property taxes, tenant improvements, capital improvements and insurance, which are restricted as to use or withdrawal.
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| Lessee, Leases | Leases Lessee: We determine if a contract is a lease upon inception of the lease and maintain a distinction between finance and operating leases. Pursuant to Financial Accounting Standards Board, or FASB, Accounting Standards Codification, or ASC, Topic 842, Leases, or ASC Topic 842, lessees are required to recognize the following for all leases with terms greater than 12 months at the commencement date: (i) a lease liability, which is a lessee’s obligation to make lease payments arising from a lease; and (ii) a right-of-use asset, which is an asset that represents the lessee’s right to use, or control the use of, a specified asset for the lease term. The lease liability is calculated by using either the implicit rate of the lease or the incremental borrowing rate. The accretion of lease liabilities and amortization expense on right-of-use assets for our operating leases are included in rental expenses, property operating expenses or general and administrative expenses in our accompanying consolidated statements of operations and comprehensive loss. Operating lease liabilities are calculated using our incremental borrowing rate based on the information available as of the lease commencement date. For our finance leases, the accretion of lease liabilities are included in interest expense and the amortization expense on right-of-use assets are included in depreciation and amortization in our accompanying consolidated statements of operations and comprehensive loss. Further, finance lease assets are included within real estate investments, net and finance lease liabilities are included within financing obligations in our accompanying consolidated balance sheets.
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| Lessor, Leases | Leases Lessor: Pursuant to ASC Topic 842, lessors bifurcate lease revenues into lease components and non-lease components and separately recognize and disclose non-lease components that are executory in nature. Lease components continue to be recognized on a straight-line basis over the lease term and certain non-lease components may be accounted for under the revenue recognition guidance in ASC Topic 606, Revenue from Contracts with Customers, or ASC Topic 606. See the “Revenue Recognition” section below. ASC Topic 842 also provides for a practical expedient package that permits lessors to not separate non-lease components from the associated lease component if certain conditions are met. In addition, such practical expedient causes an entity to assess whether a contract is predominately lease- or service-based, and recognize the revenue from the entire contract under the relevant accounting guidance. We recognize revenue for our OM buildings and triple-net leased properties segments as real estate revenue. Minimum annual rental revenue is recognized on a straight-line basis over the term of the related lease (including rent holidays). Differences between real estate revenue recognized and cash amounts contractually due from tenants under the lease agreements are recorded to deferred rent receivable, which is included in other assets, net in our accompanying consolidated balance sheets. Tenant reimbursement revenue, which comprises additional amounts recoverable from tenants for common area maintenance expenses and certain other recoverable expenses, are considered non-lease components and variable lease payments. We qualified for and elected the practical expedient as outlined above to combine the non-lease component with the lease component, which is the predominant component, and therefore the non-lease component is recognized as part of real estate revenue. In addition, as lessors, we exclude certain lessor costs (i.e., property taxes and insurance) paid directly by a lessee to third parties on our behalf from our measurement of variable lease revenue and associated expense (i.e., no gross up of revenue and expense for these costs); and include lessor costs that we paid and are reimbursed by the lessee in our measurement of variable lease revenue and associated expense (i.e., gross up revenue and expense for these costs). At our RIDEA facilities, we offer residents room and board (lease component), standard meals and healthcare services (non-lease component) and certain ancillary services that are not contemplated in the lease with each resident (i.e., laundry, guest meals, etc.). For our RIDEA facilities, we recognize revenue under ASC Topic 606 as resident fees and services, based on our predominance assessment from electing the practical expedient outlined above. See the “Revenue Recognition” section below.
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| Revenue Recognition | Revenue Recognition Real Estate Revenue We recognize real estate revenue in accordance with ASC Topic 842. See the “Leases” section above. Resident Fees and Services Revenue We recognize resident fees and services revenue in accordance with ASC Topic 606. A significant portion of resident fees and services revenue represents healthcare service revenue that is reported at the amount that we expect to be entitled to in exchange for providing patient care. These amounts are due from patients, third-party payors (including health insurers and government programs), other healthcare facilities, and others and includes variable consideration for retroactive revenue adjustments due to settlement of audits, reviews, and investigations. Generally, we bill the patients, third-party payors and other healthcare facilities several days after the services are performed. Revenue is recognized as performance obligations are satisfied. Consistent with healthcare industry accounting practices, any changes to these governmental revenue estimates are recorded in the period the change or adjustment becomes known based on final settlement. Any differences between recorded revenues and subsequent adjustments are reflected in operations in the year finalized. Performance obligations are determined based on the nature of the services provided by us. Revenue for performance obligations satisfied over time is recognized based on actual charges incurred in relation to total expected (or actual) charges. This method provides a depiction of the transfer of services over the term of the performance obligation based on the inputs needed to satisfy the obligation. Generally, performance obligations satisfied over time relate to patients receiving long-term healthcare services, including rehabilitation services. We measure the performance obligation from admission into the facility to the point when we are no longer required to provide services to that patient. Revenue for performance obligations satisfied at a point in time is recognized when goods or services are provided and we do not believe we are required to provide additional goods or services to the patient. Generally, performance obligations satisfied at a point in time relate to sales of our pharmaceuticals business or to sales of ancillary supplies. Because all of our performance obligations relate to contracts with a duration of less than one year, we have elected to apply the optional exemption provided in ASC Topic 606 and, therefore, are not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. The performance obligations for these contracts are generally completed within months of the end of the reporting period. We determine the transaction price based on standard charges for goods and services provided, reduced, where applicable, by contractual adjustments provided to third-party payors, implicit price concessions provided to uninsured patients, and estimates of goods to be returned. We also determine the estimates of contractual adjustments based on Medicare and Medicaid pricing tables and historical experience. We determine the estimate of implicit price concessions based on the historical collection experience with each class of payor. Agreements with third-party payors typically provide for payments at amounts less than established charges. The following is a summary of the payment arrangements with major third-party payors: •Medicare: Certain healthcare services are paid at prospectively determined rates based on cost-reimbursement methodologies subject to certain limits. •Medicaid: Reimbursements for Medicaid services are generally paid at prospectively determined rates. In the state of Indiana, we participate in an Upper Payment Limit program, or IGT, with various county hospital partners, which provides supplemental Medicaid payments to SNFs that are licensed to non-state, government-owned entities such as county hospital districts. We have operational responsibility through management agreements for facilities retained by the county hospital districts including this IGT. The licenses and management agreements between the nursing center division and hospital districts are terminable by either party to restore the previous licensed status. •Other: Payment agreements with certain commercial insurance carriers, health maintenance organizations and preferred provider organizations provide for payment using prospectively determined rates per discharge, discounts from established charges and prospectively determined periodic rates. Laws and regulations concerning government programs, including Medicare and Medicaid, are complex and subject to varying interpretation. As a result of investigations by governmental agencies, various healthcare organizations have received requests for information and notices regarding alleged noncompliance with those laws and regulations, which, in some instances, have resulted in organizations entering into significant settlement agreements. Compliance with such laws and regulations may also be subject to future government review and interpretation as well as significant regulatory action, including fines, penalties and potential exclusion from the related programs. There can be no assurance that regulatory authorities will not challenge our compliance with these laws and regulations, and it is not possible to determine the impact such claims or penalties would have upon us, if any. Settlements with third-party payors for retroactive adjustments due to audits, reviews or investigations are considered variable consideration and are included in the determination of the estimated transaction price for providing patient care. These settlements are estimated based on the terms of the payment agreement with the payor, correspondence from the payor and our historical settlement activity, including an assessment to ensure that it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the retroactive adjustment is subsequently resolved. Estimated settlements are adjusted in future periods as adjustments become known (that is, new information becomes available), or as years are settled or are no longer subject to such audits, reviews and investigations. Adjustments arising from a change in the transaction price were not significant for the years ended December 31, 2023, 2022 and 2021. Disaggregation of Resident Fees and Services Revenue We disaggregate revenue from contracts with customers according to lines of business and payor classes. The transfer of goods and services may occur at a point in time or over time; in other words, revenue may be recognized over the course of the underlying contract, or may occur at a single point in time based upon a single transfer of control. This distinction is discussed in further detail below. We determine that disaggregating revenue into these categories achieves the disclosure objective to depict how the nature, amount, timing and uncertainty of revenue and cash flows are affected by economic factors.Financing Component We have elected a practical expedient allowed under ASC Topic 606 and, therefore, we do not adjust the promised amount of consideration from patients and third-party payors for the effects of a significant financing component due to our expectation that the period between the time the service is provided to a patient and the time that the patient or a third-party payor pays for that service will be one year or less. Contract Costs We have applied the practical expedient provided by FASB ASC Topic 340, Other Assets and Deferred Costs, and, therefore, all incremental customer contract acquisition costs are expensed as they are incurred since the amortization period of the asset that we otherwise would have recognized is one year or less in duration.
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| Real Estate Investments Purchase Price Allocation | Real Estate Investments Purchase Price Allocation Upon the acquisition of real estate properties or entities owning real estate properties, we determine whether the transaction is a business combination, which requires that the assets acquired and liabilities assumed constitute a business. If the assets acquired and liabilities assumed are not a business, we account for the transaction as an asset acquisition. Under both methods, we recognize the identifiable assets acquired and liabilities assumed; however, for a transaction accounted for as an asset acquisition, we capitalize transaction costs and allocate the purchase price using a relative fair value method allocating all accumulated costs, whereas for a transaction accounted for as a business combination, we immediately expense transaction costs incurred associated with the business combination and allocate the purchase price based on the estimated fair value of each separately identifiable asset and liability. For the years ended December 31, 2023, 2022 and 2021, our investment transactions were accounted for as asset acquisitions or as business combinations, as applicable. See Note 3, Real Estate Investments, Net — Acquisitions of Real Estate Investments, and Note 4, Business Combinations, for a further discussion. We, with assistance from independent valuation specialists, measure the fair value of tangible and identified intangible assets and liabilities, as applicable, based on their respective fair values for acquired properties. Our method for allocating the purchase price to acquired investments in real estate requires us to make subjective assessments for determining fair value of the assets acquired and liabilities assumed. This includes determining the value of the buildings, land, leasehold interests, furniture, fixtures and equipment, above- or below-market rent, in-place leases, master leases, tenant improvements, above- or below-market debt assumed, derivative financial instruments assumed, and noncontrolling interest in the acquiree, if any. These estimates require significant judgment and in some cases involve complex calculations. These allocation assessments directly impact our results of operations, as amounts allocated to certain assets and liabilities have different depreciation or amortization lives. In addition, we amortize the value assigned to above- or below-market rent as a component of revenue, unlike in-place leases and other intangibles, which we include in depreciation and amortization in our accompanying consolidated statements of operations and comprehensive loss. The determination of the fair value of land is based upon comparable sales data. In cases where a leasehold interest in the land is acquired, only the above/below market consideration is necessary where the value of the leasehold interest is determined by discounting the difference between the contract ground lease payments and a market ground lease payment back to a present value as of the acquisition date. The fair value of buildings is based upon our determination of the value under two methods: one, as if it were to be replaced and vacant using cost data and, two, also using a residual technique based on discounted cash flow models, as vacant. Factors considered by us include an estimate of carrying costs during the expected lease-up periods considering current market conditions and costs to execute similar leases. We also recognize the fair value of furniture, fixtures and equipment on the premises, as well as the above- or below-market rent, the value of in-place leases, master leases, above- or below-market debt and derivative financial instruments assumed. The value of the above- or below-market component of the acquired in-place leases is determined based upon the present value (using a discount rate that reflects the risks associated with the acquired leases) of the difference between: (i) the level payment equivalent of the contract rent paid pursuant to the lease; and (ii) our estimate of market rent payments taking into account the expected market rent growth. In the case of leases with options, a case-by-case analysis is performed based on all facts and circumstances of the specific lease to determine whether the option will be assumed to be exercised. The amounts related to above-market leases are included in identified intangible assets, net in our accompanying consolidated balance sheets and are amortized as a decrease to real estate revenue over the remaining non-cancelable lease term of the acquired leases with each property. The amounts related to below-market leases are included in identified intangible liabilities, net in our accompanying consolidated balance sheets and are amortized as an increase to real estate revenue over the remaining non-cancelable lease term plus any below-market renewal options of the acquired leases with each property. The value of in-place lease costs are based on management’s evaluation of the specific characteristics of the tenant’s lease and our overall relationship with the tenants. Characteristics considered by us in allocating these values include the nature and extent of the credit quality and expectations of lease renewals, among other factors. The in-place lease intangible represents the value related to the economic benefit for acquiring a property with in-place leases as opposed to a vacant property, which is evaluated based on a review of comparable leases for a similar property, terms and conditions for marketing and executing new leases, and implied in the difference between the value of the whole property “as is” and “as vacant.” The net amounts related to in-place lease costs are included in identified intangible assets, net in our accompanying consolidated balance sheets and are amortized as an increase to depreciation and amortization expense over the average downtime of the acquired leases with each property. The net amounts related to the value of tenant relationships, if any, are included in identified intangible assets, net in our accompanying consolidated balance sheets and are amortized as an increase to depreciation and amortization expense over the average remaining non-cancelable lease term of the acquired leases plus the market renewal lease term. The value of a master lease, if any, in which a previous owner or a tenant is relieved of specific rental obligations as additional space is leased, is determined by discounting the expected real estate revenue associated with the master lease space over the assumed lease-up period. The value of above- or below-market debt is determined based upon the present value of the difference between the cash flow stream of the assumed mortgage and the cash flow stream of a market rate mortgage at the time of assumption. The net value of above- or below-market debt is included in mortgage loans payable, net in our accompanying consolidated balance sheets and is amortized as an increase or decrease to interest expense, as applicable, over the remaining term of the assumed mortgage. The values of contingent consideration assets and liabilities are analyzed at the time of acquisition. For contingent purchase options, the fair market value of the acquired asset is compared to the specified option price at the exercise date. If the option price is below market, it is assumed to be exercised and the difference between the fair market value and the option price is discounted to the present value at the time of acquisition. The values of the redeemable and nonredeemable noncontrolling interests are estimated by applying the income approach based on a discounted cash flow analysis. The fair value measurement may apply significant inputs that are not observable in the market. See Note 4, Business Combinations — 2021 Business Combinations — Fair Value of Noncontrolling Interests, for a further discussion of our fair value measurement approach and the significant inputs used in the values of redeemable and nonredeemable noncontrolling interests in GAHR IV.
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| Real Estate Investments, Net | Real Estate Investments, Net We carry our operating properties at our historical cost less accumulated depreciation. The cost of operating properties includes the cost of land and completed buildings and related improvements, including those related to financing obligations. Expenditures that increase the service life of properties are capitalized and the cost of maintenance and repairs is charged to expense as incurred. The cost of buildings and capital improvements is depreciated on a straight-line basis over the estimated useful lives of the buildings and capital improvements, up to 39 years, and the cost for tenant improvements is depreciated over the shorter of the lease term or useful life, up to 34 years. The cost of furniture, fixtures and equipment is depreciated over the estimated useful life, up to 28 years. When depreciable property is retired, replaced or disposed of, the related cost and accumulated depreciation is removed from the accounts and any gain or loss is reflected in earnings. As part of the leasing process, we may provide the lessee with an allowance for the construction of leasehold improvements. These leasehold improvements are capitalized and recorded as tenant improvements and depreciated over the shorter of the useful life of the improvements or the lease term. If the allowance represents a payment for a purpose other than funding leasehold improvements, or in the event we are not considered the owner of the improvements, the allowance is considered to be a lease inducement and is included in other assets, net in our accompanying consolidated balance sheets. Lease inducement is amortized over the lease term as a reduction of real estate revenue on a straight-line basis. Factors considered during this evaluation include, among other things, who holds legal title to the improvements as well as other controlling rights provided by the lease agreement and provisions for substantiation of such costs (e.g., unilateral control of the tenant space during the build-out process). Determination of the appropriate accounting for the payment of a tenant allowance is made on a lease-by-lease basis, considering the facts and circumstances of the individual tenant lease. Recognition of lease revenue commences when the lessee is given possession of the leased space upon completion of tenant improvements when we are the owner of the leasehold improvements. However, when the leasehold improvements are owned by the tenant, the lease inception date (and the date on which recognition of lease revenue commences) is the date the tenant obtains possession of the leased space for purposes of constructing its leasehold improvements.
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| Goodwill | Goodwill Goodwill represents the excess of consideration paid over the fair value of underlying identifiable net assets of a business acquired in a business combination. Our goodwill has an indeterminate life and is not amortized, but is tested for impairment on an annual basis, or more frequently if events or changes in circumstances indicate that the asset might be impaired. We take a qualitative approach, as applicable, to consider whether an impairment of goodwill exists prior to quantitatively determining the fair value of the reporting unit in step one of the impairment test. When step one of the impairment test is utilized, we compare the fair value of a reporting unit with its carrying amount. We recognize an impairment loss to the extent the carrying value of goodwill exceeds the implied value in the current period. See Note 4, Business Combinations, for a further discussion of goodwill recognized in connection with our business combinations, and Note 18, Segment Reporting, for a further discussion of goodwill allocation by segment and impairment of goodwill.
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| Impairment of Long-Lived Assets and Intangible Assets | Impairment of Long-Lived Assets and Intangible Assets We periodically evaluate our long-lived assets, primarily consisting of investments in real estate that we carry at our historical cost less accumulated depreciation, for impairment when events or changes in circumstances indicate that its carrying value may not be recoverable. We consider the following indicators, among others, in our evaluation of impairment: •significant negative industry or economic trends; •a significant underperformance relative to historical or projected future operating results; and •a significant change in the extent or manner in which the asset is used or significant physical change in the asset. If indicators of impairment of our long-lived assets are present, we evaluate the carrying value of the related real estate investments in relation to the future undiscounted cash flows of the underlying operations. In performing this evaluation, we consider market conditions and our current intentions with respect to holding or disposing of the asset. We adjust the net book value of properties we lease to others and other long-lived assets to fair value if the sum of the expected future undiscounted cash flows, including sales proceeds, is less than carrying value. We recognize an impairment loss at the time we make any such determination. We test indefinite-lived intangible assets, other than goodwill, for impairment at least annually, and more frequently if indicators arise. We first assess qualitative factors to determine the likelihood that the fair value of the reporting group is less than its carrying value. If the carrying amount of an indefinite-lived intangible asset exceeds its fair value, an impairment loss is recognized. Fair values of other indefinite-lived intangible assets are usually determined based on discounted cash flows or appraised values, as appropriate. If impairment indicators arise with respect to intangible assets with finite useful lives, we evaluate impairment by comparing the carrying amount of the asset to the estimated future undiscounted net cash flows expected to be generated by the asset. If the estimated future undiscounted net cash flows are less than the carrying amount of the asset, then we estimate the fair value of the asset and compare the estimated fair value to the intangible asset’s carrying value. For all of our reporting units, we recognize any shortfall from carrying value as an impairment loss in the current period.
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| Properties Held for Sale | Properties Held for Sale A property or a group of properties is reported in discontinued operations in our consolidated statements of operations and comprehensive loss for current and prior periods if the disposal represents a strategic shift that has (or will have) a major effect on an entity’s operations and financial results when either: (i) the component has been disposed of or (ii) is classified as held for sale. At such time as a property is held for sale, such property is carried at the lower of: (i) its carrying amount or (ii) fair value less costs to sell. In addition, a property being held for sale ceases to be depreciated. We classify operating properties as property held for sale in the period in which all of the following criteria are met: •management, having the authority to approve the action, commits to a plan to sell the asset; •the asset is available for immediate sale in its present condition subject only to terms that are usual and customary for sales of such assets; •an active program to locate a buyer or buyers and other actions required to complete the plan to sell the asset has been initiated; •the sale of the asset is probable and the transfer of the asset is expected to qualify for recognition as a completed sale within one year; •the asset is being actively marketed for sale at a price that is reasonable in relation to its current fair value; and •given the actions required to complete the plan to sell the asset, it is unlikely that significant changes to the plan would be made or that the plan would be withdrawn. Our properties held for sale are included in other assets, net in our accompanying consolidated balance sheets.
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| Debt Security Investment, Net | Debt Security Investment, Net We classify our marketable debt security investment as held-to-maturity because we have the positive intent and ability to hold the security to maturity, and we have not recorded any unrealized holding gains or losses on such investment. Our held-to-maturity security is recorded at amortized cost and adjusted for the amortization of premiums or discounts through maturity.
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| Derivative Financial Instruments | Derivative Financial Instruments We are exposed to the effect of interest rate changes in the normal course of business. We seek to mitigate these risks by following established risk management policies and procedures, which include the occasional use of derivatives. Our primary strategy in entering into derivative contracts, such as fixed-rate interest rate swaps and interest rate caps, is to add stability to interest expense and to manage our exposure to interest rate movements by effectively converting a portion of our variable-rate debt to fixed-rate debt. We do not enter into derivative instruments for speculative purposes. Derivatives are recognized as either other assets or other liabilities in our accompanying consolidated balance sheets and are measured at fair value. We do not designate our derivative instruments as hedge instruments as defined by guidance under ASC Topic 815, Derivatives and Hedges, or ASC Topic 815, which allows for gains and losses on derivatives designated as hedges to be offset by the change in value of the hedged items or to be deferred in other comprehensive income (loss). Changes in the fair value of our derivative financial instruments are recorded as a component of interest expense in gain or loss in fair value of derivative financial instruments in our accompanying consolidated statements of operations and comprehensive loss.
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| Fair Value Measurements | Fair Value Measurements The fair value of certain assets and liabilities is a market-based measurement, not an entity-specific measurement. Therefore, a fair value measurement should be determined based on the assumptions that market participants would use in pricing the asset or liability. As a basis for considering market participant assumptions in fair value measurements, we follow a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of our reporting entity (observable inputs that are classified within Levels 1 and 2 of the hierarchy) and our reporting entity’s own assumptions about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy). Level 1 inputs are quoted prices (unadjusted) in active markets for identical assets or liabilities that we have the ability to access. An active market is defined as a market in which transactions for the assets or liabilities occur with sufficient frequency and volume to provide pricing information on an ongoing basis. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs that are observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates and yield curves that are observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity’s own assumptions, as there is little, if any, related market activity. 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. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability.
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| Other Assets, Net | Other Assets, Net Other assets, net primarily consists of inventory, prepaid expenses and deposits, deferred financing costs related to our lines of credit, deferred rent receivables, deferred tax assets, investments in unconsolidated entities, lease inducements and lease commissions.
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| Other Assets, Net | Inventory consists primarily of pharmaceutical and medical supplies and is stated at the lower of cost (first-in, first-out) or market. |
| Other Assets, Net | Deferred financing costs related to our lines of credit include amounts paid to lenders and others to obtain such financing. Such costs are amortized using the straight-line method over the term of the related loan, which approximates the effective interest rate method. Amortization of deferred financing costs related to our lines of credit is included in interest expense in our accompanying consolidated statements of operations and comprehensive loss. Lease commissions are amortized using the straight-line method over the term of the related lease. Prepaid expenses are amortized over the related contract periods. |
| Other Assets, Net | We report investments in unconsolidated entities using the equity method of accounting when we have the ability to exercise significant influence over the operating and financial policies. Under the equity method, our share of the investee’s earnings or losses is included in our accompanying consolidated statements of operations and comprehensive loss. We generally do not recognize equity method losses when such losses exceed our net equity method investment balance unless we have committed to provide such investee additional financial support or guaranteed its obligations. To the extent that our cost basis is different from the basis reflected at the entity level, the basis difference is generally amortized over the lives of the related assets and liabilities, and such amortization is included in our share of equity in earnings of the entity. The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the entity interest or the estimated fair value of the assets prior to the sale of interests in the entity. We have elected to follow the cumulative earnings approach when classifying distributions received from equity method investments in our consolidated statements of cash flows, whereby any distributions received up to the amount of cumulative equity earnings will be considered a return on investment and classified in operating activities and any excess distributions would be considered a return of investment and classified in investing activities. We evaluate our equity method investments for impairment based upon a comparison of the estimated fair value of the equity method investment to its carrying value. When we determine a decline in the estimated fair value of such an investment below its carrying value is other-than-temporary, an impairment is recorded.
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| Accounts Payable and Accrued Liabilities | Accounts Payable and Accrued Liabilities As of December 31, 2023 and 2022, accounts payable and accrued liabilities primarily include insurance reserves of $44,548,000 and $39,893,000, respectively, reimbursement of payroll-related costs to the managers of our SHOP and integrated senior health campuses of $42,698,000 and $38,624,000, respectively, accrued developments and capital expenditures to unaffiliated third parties of $24,881,000 and $30,211,000, respectively, accrued property taxes of $23,549,000 and $24,926,000, respectively, and accrued distributions to common stockholders of $16,557,000 and $26,484,000, respectively.
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| Stock Compensation | Stock Based Compensation We follow ASC Topic 718, Compensation — Stock Compensation, or ASC Topic 718, to account for our stock compensation pursuant to the Second Amended and Restated 2015 Incentive Plan, or the AHR Incentive Plan, using the fair value method, which requires an estimate of fair value of the award at the time of grant and recognition of compensation expense on a straight-line basis over the requisite service period of the awards. Forfeitures of stock based awards are recognized as an adjustment to compensation expense as they occur. Awards granted under the AHR Incentive Plan consist of restricted stock or units issued to our executive officers and employees, in addition to restricted stock issued to our directors.
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| Foreign Currency | Foreign Currency We have real estate investments in the United Kingdom, or UK, and Isle of Man for which the functional currency is the UK Pound Sterling, or GBP. We translate the results of operations of our foreign real estate investments into United States Dollars, or USD, using the average currency rates of exchange in effect during the period, and we translate assets and liabilities using the currency exchange rate in effect at the end of the period. The resulting foreign currency translation adjustments are included in accumulated other comprehensive loss, a component of stockholders’ equity, in our accompanying consolidated balance sheets. Certain balance sheet items, primarily equity and capital-related accounts, are reflected at the historical currency exchange rates. We also have intercompany notes and payables denominated in GBP with our UK subsidiaries. Gains or losses resulting from remeasuring such intercompany notes and payables into USD at the end of each reporting period are reflected in our accompanying consolidated statements of operations and comprehensive loss. When such intercompany notes and payables are deemed to be of a long-term investment nature, they will be reflected in accumulated other comprehensive loss in our accompanying consolidated balance sheets. Gains or losses resulting from foreign currency transactions are remeasured into USD at the rates of exchange prevailing on the date of the transactions. The effects of transaction gains or losses are included in our accompanying consolidated statements of operations and comprehensive loss.
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| Income Taxes | Income Taxes We qualify, and elect to be taxed, as a REIT under the Code, and we intend to continue to qualify to be taxed as a REIT. To maintain our qualification as a REIT, we must meet certain organizational and operational requirements, including a requirement to distribute to our stockholders a minimum of 90.0% of our annual taxable income, excluding net capital gains. We generally will not be subject to U.S. federal income taxes if we distribute 100% of our taxable income each year to our stockholders. If we fail to maintain our qualification as a REIT in any taxable year, we will then be subject to U.S. federal income taxes on our taxable income at regular corporate rates and will not be permitted to qualify for treatment as a REIT for U.S. federal income tax purposes for four years following the year during which qualification is lost unless the Internal Revenue Service grants us relief under certain statutory provisions. Such an event could have a material adverse effect on our net income and net cash available for distribution to our stockholders. We may be subject to certain state and local income taxes on our income, property or net worth in some jurisdictions, and, in certain circumstances, we may also be subject to federal excise taxes on undistributed income. In addition, certain activities that we undertake are conducted by subsidiaries, which we elected to be treated as taxable REIT subsidiaries, or TRS, to allow us to provide services that would otherwise be considered impermissible for REITs. Also, we have real estate investments in the UK and Isle of Man, which do not accord REIT status to United States REITs under their tax laws. Accordingly, we recognize an income tax benefit or expense for the federal, state and local income taxes incurred by our TRS and foreign income taxes on our real estate investments in the UK and Isle of Man. We account for deferred income taxes using the asset and liability method and recognize deferred tax assets and liabilities for the expected future tax consequences of events that have been included in our financial statements or tax returns. Under this method, we determine deferred tax assets and liabilities based on the temporary differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases using enacted tax rates in effect for the year in which the differences are expected to reverse. Deferred tax assets reflect the impact of the future deductibility of operating loss carryforwards. A valuation allowance is provided if we believe it is more likely than not that all or some portion of the deferred tax asset will not be realized. Any increase or decrease in the valuation allowance that results from a change in circumstances, and that causes us to change our judgment about the realizability of the related deferred tax asset, is included in income tax benefit or expense in our accompanying consolidated statements of operations and comprehensive loss when such changes occur. Any increase or decrease in the deferred tax liability that results from a change in circumstances, and that causes us to change our judgment about expected future tax consequences of events, is recorded in income tax benefit or expense in our accompanying consolidated statements of operations and comprehensive loss. Net deferred tax assets are included in other assets, or net deferred tax liabilities are included in security deposits, prepaid rent and other liabilities, in our accompanying consolidated balance sheets.
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| Segment Disclosure | Segment Disclosure We segregate our operations into reporting segments in order to assess the performance of our business in the same way that management reviews our performance and makes operating decisions. During the quarter ended December 31, 2023, we modified how we evaluate our business and make resource allocations, and therefore determined that we operate through four reportable business segments; integrated senior health campuses, OM (which was formerly known as MOBs), triple-net leased properties and SHOP. All segment information included in the notes to the accompanying consolidated financial statements has been recast for all periods presented to reflect four reportable business segments and the change in segment name from MOBs to OM. The segment name change from MOBs to OM did not result in any changes to the composition of such segment or information reviewed by management, and therefore, had no impact on the historical results of operations.
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| GLA and Other Measures | GLA and Other Measures GLA and other measures used to describe real estate investments included in our accompanying consolidated financial statements are presented on an unaudited basis.
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| Recently Issued Accounting Pronouncements | Recently Issued Accounting Pronouncements In March 2020, the FASB issued Accounting Standards Update, or ASU, 2020-04, Facilitation of the Effects of Reference Rate Reform of Financial Reporting, or ASU 2020-04, which provides optional expedients and exceptions for applying GAAP to contract modifications, hedging relationships and other transactions, subject to meeting certain criteria. ASU 2020-04 applies to the aforementioned transactions that reference the London Inter-bank Offered Rate, or LIBOR, or another reference rate expected to be discontinued because of the reference rate reform. In January 2021, the FASB issued ASU 2021-01, Reference Rate Reform (Topic 848), or ASU 2021-01, which clarifies that certain optional expedients and exceptions for contract modification and hedge accounting apply to derivative instruments that use an interest rate for margining, discounting, or contract price alignment that is modified as a result of the discontinuation of the use of LIBOR as a benchmark interest rate due to reference rate reform. In December 2022, the FASB issued ASU 2022-06, Reference Rate Reform (Topic 848): Deferral of the Sunset Date of Topic 848, or ASU 2022-06, which extends the period of time entities can utilize the reference rate reform relief guidance under ASU 2020-04 from December 31, 2022 to December 31, 2024. ASU 2020-04, ASU 2021-01 and ASU 2022-06 are effective for fiscal years and interim periods beginning after March 12, 2020 and through the effective date December 31, 2024, as extended by ASU 2022-06. We adopted such accounting pronouncements on January 1, 2023, which has not had a material impact on our consolidated financial statements and disclosures as of December 31, 2023. In July 2023, the FASB issued ASU 2023-03, Presentation of Financial Statements (Topic 205), Income Statement-Reporting Comprehensive Income (Topic 220), Distinguishing Liabilities from Equity (Topic 480), Equity (Topic 505), and Compensation-Stock Compensation (Topic 718): Amendments to SEC Paragraphs Pursuant to SEC Staff Accounting Bulletin No. 120, SEC Staff Announcement at the March 24, 2022 EITF Meeting, and Staff Accounting Bulletin Topic 6.B, Accounting Series Release 280-General Revision of Regulation S-X: Income or Loss Applicable to Common Stock, or ASU 2023-03. ASU 2023-03 amends the Accounting Standards Codification, or ASC, for SEC updates pursuant to SEC Staff Accounting Bulletin No. 120; SEC Staff Announcement at the March 24, 2022 Emerging Issues Task Force Meeting; and Staff Accounting Bulletin Topic 6.B, Accounting Series Release 280 - General Revision of Regulation S-X: Income or Loss Applicable to Common Stock. These updates were immediately effective and did not have a material impact on our consolidated financial statements and disclosures. In August 2023, the FASB issued ASU 2023-05, Business Combinations — Joint Venture Formations (Subtopic 805- 60): Recognition and Initial Measurement, or ASU 2023-05. ASU 2023-05 applies to the initial formation of a “joint venture” or a “corporate joint venture” as defined in the accounting literature and requires a joint venture to apply a new basis of accounting by initially measuring and recognizing all contributions received upon its formation at fair value. In particular, a joint venture will measure its total assets and liabilities upon formation as the fair value of the joint venture as a whole, which would equal the fair value of all of the joint venture’s outstanding equity interests. The new guidance does not change the definition of a joint venture, the accounting by the investors for their investments in a joint venture (e.g., equity method accounting) or the accounting by a joint venture for contributions received after its formation. ASU 2023-05 will be applied prospectively and is effective for all newly-formed joint venture entities with a formation date on or after January 1, 2025. Early adoption is permitted. We do not expect the adoption of ASU 2023-05 on January 1, 2025 to have a material impact to our consolidated financial statements and disclosures. In November 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures, or ASU 2023-07, which is intended to improve reportable segment disclosure requirements, primarily through enhanced disclosures about significant expenses. Such disclosure amendments include the requirement for public entities to disclose significant segment expenses that are regularly provided to the chief operating decision maker and included within each reported measure of segment profit or loss. ASU 2023-07 is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. Early adoption is permitted and should be applied retrospectively to all prior periods presented in the financial statements. We are currently evaluating this guidance to determine the impact to our consolidated financial statements and disclosures. In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures, or ASU 2023-09, which includes amendments that further enhance income tax disclosures, primarily through standardization and disaggregation of rate reconciliation categories and income taxes paid by jurisdiction. ASU 2023-09 is effective for annual periods beginning after December 15, 2024. Early adoption is permitted and should be applied prospectively; however, retrospective application is permitted. We are currently evaluating this guidance to determine the impact to our consolidated financial statements and disclosures. In March 2024, the SEC adopted final rules, The Enhancement and Standardization of Climate-Related Disclosures for Investors. The final rules require a registrant to disclose, among other things: material climate-related risks; activities to mitigate or adapt to such risks, as well as a quantitative and qualitative description of material expenditures incurred and material impacts on financial estimates and assumptions that directly result from such mitigation or adaptation activities; material capitalized costs, expenses and losses incurred as a result of severe weather events and other natural conditions; information about the registrant’s board of directors’ oversight of climate-related risks and management’s role in managing material climate-related risks; and information on any climate-related targets or goals that are material to the registrant’s business, results of operations or financial condition. The rules require registrants to provide such climate-related disclosures in their annual reports, beginning with annual reports for the year ending December 31, 2025, for calendar-year-end large accelerated filers. We are currently evaluating this guidance to determine the impact to our consolidated financial statement disclosures.
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| Credit Loss, Financial Instrument | Resident and Tenant Receivables and Allowances Resident receivables, which are related to resident fees and services revenue, are carried net of an allowance for credit losses. An allowance is maintained for estimated losses resulting from the inability of residents and payors to meet the contractual obligations under their lease or service agreements. Substantially all of such allowances are recorded as direct reductions of resident fees and services revenue as contractual adjustments provided to third-party payors or implicit price concessions in our accompanying consolidated statements of operations and comprehensive loss. Our determination of the adequacy of these allowances is based primarily upon evaluations of historical loss experience, the residents’ financial condition, security deposits, cash collection patterns by payor and by state, current economic conditions, future expectations in estimating credit losses and other relevant factors. Tenant receivables, which are related to real estate revenue, and unbilled deferred rent receivables are reduced for amounts where collectability is not probable, which are recognized as direct reductions of real estate revenue in our accompanying consolidated statements of operations and comprehensive loss.
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Summary of Significant Accounting Policies (Tables) |
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| Accounting Policies [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Disaggregation of Revenue | The following tables disaggregate our resident fees and services revenue by line of business, according to whether such revenue is recognized at a point in time or over time, for the years then ended (in thousands):
The following tables disaggregate our resident fees and services revenue by payor class for the years then ended (in thousands):
___________ (1)Includes fees for basic housing, as well as fees for assisted living or skilled nursing care. We record revenue when services are rendered at amounts billable to individual residents. Residency agreements are generally for a term of 30 days, with resident fees billed monthly in advance. For patients under reimbursement arrangements with Medicaid, revenue is recorded based on contractually agreed-upon amounts or rates on a per resident, daily basis or as services are rendered.
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| Contract with Customer, Asset and Liability | Accounts Receivable, Net — Resident Fees and Services Revenue The beginning and ending balances of accounts receivable, net — resident fees and services are as follows (in thousands):
Deferred Revenue — Resident Fees and Services Revenue Deferred revenue is included in security deposits, prepaid rent and other liabilities in our accompanying consolidated balance sheets. The beginning and ending balances of deferred revenue — resident fees and services, almost all of which relates to private and other payors, are as follows (in thousands):
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| Financing Receivable, Allowance for Credit Loss | The following is a summary of our adjustments to allowances for the years ended December 31, 2023 and 2022 (in thousands):
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Real Estate Investments, Net (Tables) |
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| Real Estate [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Real Estate Investments, Net | Our real estate investments, net consisted of the following as of December 31, 2023 and 2022 (in thousands):
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| Schedule Of Capital Expenditures Incurred | The following is a summary of our capital expenditures for the years ended December 31, 2023, 2022 and 2021 (in thousands):
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| Summary of Assets Acquisitions | The following is a summary of such property acquisition (in thousands):
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The following table summarizes the purchase price of such assets acquired at the time of acquisition based on their relative fair values and adjusted for $37,464,000 operating lease right-of-use assets and $36,326,000 operating lease liabilities (in thousands):
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The following table summarizes the purchase price of such assets acquired at the time of acquisition based on their relative fair values and adjusted for $57,647,000 operating lease right-of-use assets and $54,564,000 operating lease liabilities (in thousands):
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| Summary of Acquisitions of Previously Leased Real Estate Investments | The following is a summary of such acquisitions, which are included in our integrated senior health campuses segment (in thousands):
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The following is a summary of such property acquisitions, which are included in our integrated senior health campuses segment (in thousands):
___________ (1)Our former advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our properties, an acquisition fee of 2.25% of the portion of the contract purchase price of the properties attributed to our ownership interest in the Trilogy subsidiary that acquired the properties.
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| Schedule of Asset Dispositions, by Disposition | The following is a summary of such dispositions (dollars in thousands):
___________ (1)See Note 12, Redeemable Noncontrolling Interests, for information about the ownership of the Central Florida Senior Housing Portfolio.
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The following is a summary of such dispositions, which were included in our OM and SHOP segments, as applicable (in thousands):
___________ (1)See Note 12, Redeemable Noncontrolling Interests, for information about the ownership of the Central Florida Senior Housing Portfolio.
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Business Combinations and Asset Acquisitions (Tables) |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Business Combination and Asset Acquisition [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Schedule of Recognized Identified Assets Acquired and Liabilities Assumed |
REIT Merger The following table sets forth the allocation of the purchase consideration to the fair values of identifiable tangible and intangible assets acquired and liabilities assumed recognized at the acquisition date of GAHR IV, as well as the fair value at the acquisition date of the noncontrolling interests in GAHR IV (in thousands):
AHI Acquisition The following table sets forth the allocation of the purchase consideration to the fair values of identifiable tangible and intangible assets acquired and liabilities assumed recognized at the acquisition date (in thousands):
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| Fair Value of Purchase Consideration | REIT Merger The fair value of the purchase consideration transferred was calculated as follows (in thousands):
(1)Represents the fair value of GAHR III common stock that is deemed to be issued for accounting purposes only. Taking into consideration the impact of the reverse stock split, the fair value of the purchase consideration is calculated based on 22,045,766 shares of common stock deemed to be issued by GAHR III at the fair value per share of $34.84. (2)Represents the fair value of additional interest acquired in GAHR III’s subsidiary, Trilogy REIT Holdings, LLC, or Trilogy REIT Holdings. The acquisition of additional interest in Trilogy is accounted for separately from the REIT Merger in accordance with ASC Topic 810, Consolidation, or ASC Topic 810. See Note 13, Equity — Noncontrolling Interests in Total Equity, for a discussion of the Trilogy transaction. AHI Acquisition The fair value of the purchase consideration transferred was calculated as follows (in thousands):
(1)Taking into consideration the impact of the reverse stock split, the amount represents the estimated fair value of the 3,779,382 Surviving Partnership OP units issued as consideration, with a reference value for purposes thereof of $34.84 per unit. The issuance of Surviving Partnership OP units was accounted for separately from the AHI Acquisition. (2)Represents the estimated fair value of contingent consideration based on the performance of a possible private investment fund under consideration by AHI. We have no definitive plans to establish the investment fund, and, therefore, the fair value of contingent consideration was estimated to be $0.
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| Allocation of Goodwill | The table below represents the allocation of goodwill on the acquisition date in connection with the AHI Acquisition to our reporting segments (in thousands):
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| Real Estate Investments, Intangible Assets and Intangible Liabilities | Real estate investments consist of land, building improvements, site improvements, unamortized tenant improvement allowances and unamortized capital improvements. Intangibles assets consist of in-place leases, above-market leases and certificates of need. We amortize purchased real estate investments and intangible assets on a straight-line basis over their respective useful lives. The following tables present the approximate fair value and the weighted-average depreciation and amortization periods of each major type of asset and liability (dollars in thousands):
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| Pro Forma Financial Information | The following unaudited pro forma operating information is presented as if the Merger and the AHI Acquisition occurred on January 1, 2020. Such unaudited pro forma information includes a nonrecurring adjustment to present acquisition-related expenses incurred in the year ended December 31, 2021 in the 2020 pro forma results. The pro forma results are not necessarily indicative of the operating results that would have been obtained had the Merger and the AHI Acquisition occurred at the beginning of the periods presented, nor are they necessarily indicative of future operating results. Unaudited pro forma revenue, net loss and net loss attributable to controlling interest would have been as follows (in thousands):
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Identified Intangible Assets and Liabilities (Tables) |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Intangible Assets and Liabilities [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Schedule of Intangible Assets and Liabilities | Identified intangible assets, net and identified intangible liabilities, net consisted of the following as of December 31, 2023 and 2022 (dollars in thousands):
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| Amortization Expense on identified Intangible Assets and Liabilities | As of December 31, 2023, estimated amortization expense on the identified intangible assets and liabilities for each of the next five years ending December 31 and thereafter was as follows (in thousands):
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Other Assets, Net (Tables) |
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Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Other Assets [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Other Assets, Net | Other assets, net consisted of the following as of December 31, 2023 and 2022 (dollars in thousands):
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Mortgage Loans Payable, Net (Tables) |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Mortgage Loans Payable, Net [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Mortgage Loans Payable, Net | Mortgage loans payable, net consisted of the following as of December 31, 2023 and 2022 (dollars in thousands):
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| Schedule of Activity Related to Mortgage Loans Payable | The following table reflects the changes in the carrying amount of mortgage loans payable, net for the years ended December 31, 2023 and 2022 (in thousands): For the year ended December 31, 2023, we incurred a loss on the early extinguishment of a mortgage loan payable of $345,000, which is recorded as an increase to interest expense in our accompanying consolidated statements of operations and comprehensive loss. Such loss was related to the payoff of a mortgage loan payable due to the disposition of the underlying real estate investment in August 2023.
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| Principal Payments Due on Mortgage Loans Payable | As of December 31, 2023, the principal payments due on our mortgage loans payable for each of the next five years ending December 31 and thereafter were as follows (in thousands):
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Derivative Financial Instruments (Tables) |
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Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Derivative Instruments and Hedging Activities Disclosure [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Schedule of Derivative Financial Instruments | The following table lists the derivative financial instruments held by us as of December 31, 2023, which were included in other assets and other liabilities in our accompanying consolidated balance sheets (dollars in thousands):
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Redeemable Noncontrolling Interests (Tables) |
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Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Temporary Equity [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Redeemable Noncontrolling Interest | The changes in the carrying amount of redeemable noncontrolling interests consisted of the following for the years ended December 31, 2023 and 2022 (in thousands):
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Equity (Tables) |
12 Months Ended | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Dec. 31, 2023 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Equity [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Schedule of Nonvested RSAs and RSUs | A summary of the status of our nonvested RSAs and RSUs as of December 31, 2023 and 2022 and the changes for the years ended December 31, 2023 and 2022 is presented below:
___________ (1)Amount includes 2,280 shares of common stock that were withheld from issuance to satisfy employee minimum tax withholding requirements associated with the vesting of RSUs during the year ended December 31, 2023.
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Related Party Transactions (Tables) |
12 Months Ended | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Dec. 31, 2023 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Related Party Transactions [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Schedule of Related Party Transactions | Fees and expenses incurred to our former advisor or its affiliates for the year ended December 31, 2021 were as follows (in thousands):
(1)Asset management fees were included in general and administrative expenses in our accompanying consolidated statements of operations and comprehensive loss. (2)Property management fees were included in rental expenses or general and administrative expenses in our accompanying consolidated statements of operations and comprehensive loss, depending on the property type from which the fee was incurred. (3)Acquisition fees in connection with the acquisition of properties accounted for as asset acquisitions or the acquisition of real estate-related investments were capitalized as part of the associated investments in our accompanying consolidated balance sheets. (4)Development fees were capitalized as part of the associated investments in our accompanying consolidated balance sheets. (5)Lease fees were capitalized as costs of entering into new leases and included in other assets, net in our accompanying consolidated balance sheets. (6)We reimbursed our former advisor or its affiliates for operating expenses incurred in rendering services to us, subject to certain limitations. For the 12 months ended December 31, 2021, our operating expenses did not exceed such limitations. Operating expenses were generally included in general and administrative expenses in our accompanying consolidated statements of operations and comprehensive loss. (7)Construction management fees were capitalized as part of the associated asset and included in real estate investments, net in our accompanying consolidated balance sheets.
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Fair Value Measurements (Tables) |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Fair Value Disclosures [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Assets and Liabilities Measured at Fair Value on Recurring Basis | The table below presents our assets and liabilities measured at fair value on a recurring basis as of December 31, 2023, aggregated by the level in the fair value hierarchy within which those measurements fall (in thousands):
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| Fair Value, by Balance Sheet Grouping | The carrying amounts and estimated fair values of such financial instruments as of December 31, 2023 and 2022 were as follows (in thousands):
___________ (1)Carrying amount is net of any discount/premium and unamortized deferred financing costs.
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Income Taxes (Tables) |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Income Tax Disclosure [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Schedule of Income before Income Tax, Domestic and Foreign | The components of income or loss before taxes for the years ended December 31, 2023, 2022 and 2021, were as follows (in thousands):
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| Schedule of Components of Income Tax (Benefit) Expense | The components of income tax benefit or expense for the years ended December 31, 2023, 2022 and 2021 were as follows (in thousands):
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| Schedule of Deferred Tax Assets and Liabilities | The components of deferred tax assets and liabilities as of December 31, 2023 and 2022 were as follows (in thousands):
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| Summary of Tax Treatment of Distributions | The income tax treatment for distributions reportable for the years ended December 31, 2023, 2022 and 2021 was as follows (dollars in thousands):
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Leases (Tables) |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Leases [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Schedule of Lease Payments to be Received | As of December 31, 2023, the following table sets forth the undiscounted cash flows for future minimum base rents due under operating leases for each of the next five years ending December 31 and thereafter for properties that we wholly own (in thousands):
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| Schedule of Lease Cost | The components of lease costs were as follows (in thousands):
___________ (1)Includes short-term leases and variable lease costs, which are immaterial. Additional information related to our leases for the periods presented below was as follows (dollars in thousands):
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| Schedule of Operating Lease Liability | As of December 31, 2023, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for each of the next five years ending December 31 and thereafter, as well as the reconciliation of those cash flows to operating lease liabilities on our accompanying consolidated balance sheet (in thousands):
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| Schedule of Finance Lease Liability | Finance Leases As of December 31, 2023, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for each of the next five years ending December 31 and thereafter, as well as a reconciliation of those cash flows to finance lease liabilities (in thousands):
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Segment Reporting (Tables) |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Segment Reporting [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary Information by Reportable Segment | Summary information for the reportable segments during the years ended December 31, 2023, 2022 and 2021 was as follows (in thousands):
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||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Assets by Reportable Segment | Total assets by reportable segment as of December 31, 2023 and 2022 were as follows (in thousands):
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| Revenues and Grant Income and Real Estate Investments by Geographical Areas | The following is a summary of geographic information for our operations for the periods presented (in thousands):
The following is a summary of real estate investments, net by geographic regions as of December 31, 2023 and 2022 (in thousands):
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| Schedule of Goodwill | As of and for the years ended December 31, 2023 and 2022, goodwill by reportable segment was as follows (in thousands):
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Summary of Significant Accounting Policies (Detail) |
12 Months Ended | ||||||
|---|---|---|---|---|---|---|---|
|
Dec. 31, 2023
USD ($)
segment
|
Dec. 31, 2022
USD ($)
|
Feb. 08, 2022
USD ($)
|
Dec. 31, 2023
USD ($)
segment
|
Dec. 31, 2022
USD ($)
campus
|
Dec. 31, 2021
USD ($)
campus
|
Jan. 01, 2023
USD ($)
|
|
| Resident fees and services | $ 1,668,742,000 | $ 1,412,156,000 | $ 1,123,935,000 | ||||
| Grant income | 7,475,000 | 25,675,000 | 16,951,000 | ||||
| Accounts receivable, allowance for credit loss | $ 17,037,000 | $ 14,071,000 | 17,037,000 | 14,071,000 | 12,378,000 | ||
| Accounts receivable, allowance for credit loss, increase | 20,774,000 | 21,538,000 | |||||
| Increase (decrease) in allowances for collections or adjustments | 9,030,000 | 9,161,000 | |||||
| Receivables written off against the allowance for uncollectible accounts | 8,778,000 | 10,684,000 | |||||
| Asset impairment charges | 10,520,000 | ||||||
| Impairment of real estate held for sale | 0 | 0 | |||||
| Impairment of real estate investments | 13,899,000 | $ 54,579,000 | $ 3,335,000 | ||||
| Number of integrated senior health campuses disposed of | campus | 2 | 2 | |||||
| Contract sales price of dispositions | $ 19,622,000 | 194,640,000 | $ 23,205,000 | ||||
| Gain (loss) on dispositions of real estate investments, net | $ 683,000 | 32,472,000 | 5,481,000 | $ (100,000) | |||
| Disposition fee | 21,113,000 | ||||||
| Other asset impairment charges | 0 | 0 | 0 | ||||
| Payroll related costs | 42,698,000 | 38,624,000 | 42,698,000 | 38,624,000 | |||
| Insurance reserves | 44,548,000 | 39,893,000 | 44,548,000 | 39,893,000 | |||
| Accrued developments and capital expenditures | 24,881,000 | 30,211,000 | 24,881,000 | 30,211,000 | |||
| Accrued property taxes | 23,549,000 | 24,926,000 | 23,549,000 | 24,926,000 | |||
| Distributions declared but not paid to common stockholders | $ 16,557,000 | $ 26,484,000 | $ 16,557,000 | 26,484,000 | 8,768,000 | ||
| Percentage of income required to be distributed as dividends | 90.00% | 90.00% | |||||
| Number of reportable segments | segment | 4 | 4 | |||||
| Disposition Fees Waived | |||||||
| Disposition fee | 93,000 | ||||||
| General Partnership | |||||||
| Percentage of ownership in operating partnership | 95.00% | 95.00% | |||||
| NewCo Sellers | |||||||
| Percentage of limited partnership interest | 5.00% | 5.00% | |||||
| Building and Building Improvements [Member] | |||||||
| Estimated useful life | 39 years | 39 years | |||||
| Leasehold Improvements [Member] | Maximum | |||||||
| Estimated useful life | 34 years | 34 years | |||||
| Furniture, fixtures and equipment | Maximum | |||||||
| Estimated useful life | 28 years | 28 years | |||||
| Integrated Senior Health Campuses | |||||||
| Contract sales price of dispositions | 18,700,000 | 500,000 | |||||
| Gain (loss) on dispositions of real estate investments, net | 3,421,000 | (114,000) | |||||
| Integrated Senior Health Campuses | |||||||
| Resident fees and services | $ 1,481,880,000 | 1,254,665,000 | 1,025,699,000 | ||||
| Grant income | 7,475,000 | 24,820,000 | 13,911,000 | ||||
| SHOP | |||||||
| Resident fees and services | 186,862,000 | 157,491,000 | 98,236,000 | ||||
| Grant income | 0 | 855,000 | 3,040,000 | ||||
| Impairment of real estate investments | 54,579,000 | ||||||
| Resident Fees and Services [Member] | |||||||
| Resident fees and services | 1,668,742,000 | 1,412,156,000 | 1,123,935,000 | ||||
| Accounts receivable, net - resident fees and services, beginning balance | $ 148,277,000 | 148,277,000 | $ 121,985,000 | ||||
| Accounts receivable, net - resident fees and services, ending balance | 148,277,000 | 148,277,000 | 121,985,000 | ||||
| (Decrease) increase in accounts receivable, net - resident fees and services | 26,292,000 | ||||||
| Deferred revenue, net - resident fees and services | 23,372,000 | 23,372,000 | 17,901,000 | ||||
| Increase in deferred revenue, resident fees and services | 5,471,000 | ||||||
| Resident Fees and Services [Member] | Integrated Senior Health Campuses | |||||||
| Resident fees and services | 1,481,880,000 | 1,254,665,000 | 1,025,699,000 | ||||
| Resident Fees and Services [Member] | SHOP | |||||||
| Resident fees and services | 186,862,000 | 157,491,000 | 98,236,000 | ||||
| Resident Fees and Services [Member] | Transferred at Point in Time [Member] | |||||||
| Resident fees and services | 269,895,000 | 238,690,000 | 202,944,000 | ||||
| Resident Fees and Services [Member] | Transferred at Point in Time [Member] | Integrated Senior Health Campuses | |||||||
| Resident fees and services | 265,233,000 | 235,467,000 | 200,708,000 | ||||
| Resident Fees and Services [Member] | Transferred at Point in Time [Member] | SHOP | |||||||
| Resident fees and services | 4,662,000 | 3,223,000 | 2,236,000 | ||||
| Resident Fees and Services [Member] | Transferred over Time [Member] | |||||||
| Resident fees and services | 1,398,847,000 | 1,173,466,000 | 920,991,000 | ||||
| Resident Fees and Services [Member] | Transferred over Time [Member] | Integrated Senior Health Campuses | |||||||
| Resident fees and services | 1,216,647,000 | 1,019,198,000 | 824,991,000 | ||||
| Resident Fees and Services [Member] | Transferred over Time [Member] | SHOP | |||||||
| Resident fees and services | 182,200,000 | 154,268,000 | 96,000,000 | ||||
| Private and Other Payors [Member] | Resident Fees and Services [Member] | |||||||
| Resident fees and services | 870,586,000 | 727,219,000 | 557,501,000 | ||||
| Accounts receivable, net - resident fees and services, beginning balance | 66,218,000 | 66,218,000 | 55,484,000 | ||||
| Accounts receivable, net - resident fees and services, ending balance | 66,218,000 | 66,218,000 | 55,484,000 | ||||
| (Decrease) increase in accounts receivable, net - resident fees and services | 10,734,000 | ||||||
| Private and Other Payors [Member] | Resident Fees and Services [Member] | Integrated Senior Health Campuses | |||||||
| Resident fees and services | 696,147,000 | 582,448,000 | 462,828,000 | ||||
| Private and Other Payors [Member] | Resident Fees and Services [Member] | SHOP | |||||||
| Resident fees and services | 174,439,000 | 144,771,000 | 94,673,000 | ||||
| Medicare [Member] | Resident Fees and Services [Member] | |||||||
| Resident fees and services | 480,146,000 | 429,129,000 | 349,876,000 | ||||
| Accounts receivable, net - resident fees and services, beginning balance | 51,260,000 | 51,260,000 | 45,669,000 | ||||
| Accounts receivable, net - resident fees and services, ending balance | 51,260,000 | 51,260,000 | 45,669,000 | ||||
| (Decrease) increase in accounts receivable, net - resident fees and services | 5,591,000 | ||||||
| Medicare [Member] | Resident Fees and Services [Member] | Integrated Senior Health Campuses | |||||||
| Resident fees and services | 477,338,000 | 429,129,000 | 349,876,000 | ||||
| Medicare [Member] | Resident Fees and Services [Member] | SHOP | |||||||
| Resident fees and services | 2,808,000 | 0 | 0 | ||||
| Medicaid [Member] | Resident Fees and Services [Member] | |||||||
| Resident fees and services | 318,010,000 | 255,808,000 | 216,558,000 | ||||
| Accounts receivable, net - resident fees and services, beginning balance | 30,799,000 | 30,799,000 | 20,832,000 | ||||
| Accounts receivable, net - resident fees and services, ending balance | $ 30,799,000 | 30,799,000 | $ 20,832,000 | ||||
| (Decrease) increase in accounts receivable, net - resident fees and services | 9,967,000 | ||||||
| Medicaid [Member] | Resident Fees and Services [Member] | Integrated Senior Health Campuses | |||||||
| Resident fees and services | 308,395,000 | 243,088,000 | 212,995,000 | ||||
| Medicaid [Member] | Resident Fees and Services [Member] | SHOP | |||||||
| Resident fees and services | $ 9,615,000 | $ 12,720,000 | $ 3,563,000 | ||||
Real Estate Investments, Net - Investments in Consolidated Properties (Detail) - USD ($) $ in Thousands |
Dec. 31, 2023 |
Dec. 31, 2022 |
|---|---|---|
| Real Estate Properties [Line Items] | ||
| Real estate investments, at cost | $ 4,177,595 | $ 4,236,447 |
| Less: accumulated depreciation | (752,157) | (654,838) |
| Real estate investments, net | 3,425,438 | 3,581,609 |
| Building, improvements and construction in process | ||
| Real Estate Properties [Line Items] | ||
| Real estate investments, at cost | 3,604,299 | 3,670,361 |
| Land and improvements | ||
| Real Estate Properties [Line Items] | ||
| Real estate investments, at cost | 335,946 | 344,359 |
| Furniture, fixtures and equipment | ||
| Real Estate Properties [Line Items] | ||
| Real estate investments, at cost | $ 237,350 | $ 221,727 |
Real Estate Investments, Net - Capital Expenditure (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
| Real Estate Properties [Line Items] | |||
| Capital expenditures | $ 100,971 | $ 72,583 | $ 87,771 |
| Integrated Senior Health Campuses | |||
| Real Estate Properties [Line Items] | |||
| Capital expenditures | 64,011 | 30,926 | 62,596 |
| Outpatient Medical | |||
| Real Estate Properties [Line Items] | |||
| Capital expenditures | 24,296 | 32,373 | 21,605 |
| SHOP | |||
| Real Estate Properties [Line Items] | |||
| Capital expenditures | 12,244 | 9,280 | 3,539 |
| Triple-net leased properties | |||
| Real Estate Properties [Line Items] | |||
| Capital expenditures | $ 420 | $ 4 | $ 31 |
Real Estate Investments, Net - Additional Information (Details) |
3 Months Ended | 12 Months Ended | |||||
|---|---|---|---|---|---|---|---|
|
Dec. 05, 2022
campus
|
Feb. 08, 2022
USD ($)
|
Oct. 15, 2021
USD ($)
|
Dec. 31, 2022
USD ($)
facility
|
Dec. 31, 2023
USD ($)
$ / unit
facility
campus
|
Dec. 31, 2022
USD ($)
campus
facility
|
Dec. 31, 2021
USD ($)
Building
campus
|
|
| Real Estate Properties [Line Items] | |||||||
| Depreciation | $ 147,587,000 | $ 141,257,000 | $ 109,036,000 | ||||
| Number of integrated senior health campuses development completed | campus | 3 | ||||||
| Total completed development cost of leased property | $ 11,004,000 | ||||||
| Number of integrated senior health campuses expanded | campus | 3 | 3 | 2 | ||||
| Number of outpatient medical buildings impaired | 1 | 1 | |||||
| Impairment of real estate investments | $ 13,899,000 | $ 54,579,000 | $ 3,335,000 | ||||
| Contract sales price of dispositions | $ 19,622,000 | 194,640,000 | 23,205,000 | ||||
| Gain (loss) on dispositions of real estate investments, net | $ 683,000 | 32,472,000 | 5,481,000 | (100,000) | |||
| Payments to Acquire and Develop Real Estate | $ 45,382,000 | $ 73,229,000 | 80,109,000 | ||||
| Number of SHOP Impaired | facility | 2 | 12 | |||||
| Number Of Real Estate Investment To Be Disposed Of | 22 | ||||||
| Number of impaired facilities, fair value determined by sales price from executed sales agreement | facility | 1 | ||||||
| Number of impaired facilities, fair value based on projected sales price | campus | 11 | ||||||
| Disposal Of Impaired SHOP Facilities, Number Of Facilities | facility | 3 | ||||||
| Number Of SHOP Reclassified To Properties Held For Sale | campus | 1 | ||||||
| Number Of Impaired Facilities, Fair Value Determined By Sales Price From Letters Of Intent | facility | 1 | ||||||
| Asset impairment charges | $ 10,520,000 | ||||||
| Increase (decrease) to right-of-use asset | 57,647,000 | ||||||
| Operating lease liabilities | $ (36,609,000) | $ (24,699,000) | $ (16,793,000) | ||||
| Sale of Ownership Interest in Real Estate, Percent | 74.00% | ||||||
| Ownership Interest in Real Estate, Percent | 26.00% | 31.60% | 49.00% | 31.60% | |||
| Number of properties acquired | campus | 7 | ||||||
| Price Per Square Foot Analysis | Minimum | Measurement Input, Appraised Value | |||||||
| Real Estate Properties [Line Items] | |||||||
| Alternative Investment, Measurement Input | $ / unit | 250 | ||||||
| Price Per Square Foot Analysis | Maximum | Measurement Input, Appraised Value | |||||||
| Real Estate Properties [Line Items] | |||||||
| Alternative Investment, Measurement Input | $ / unit | 260 | ||||||
| Price Per Unit Analysis | Minimum | Measurement Input, Appraised Value | |||||||
| Real Estate Properties [Line Items] | |||||||
| Alternative Investment, Measurement Input | $ / unit | 190,000 | ||||||
| Price Per Unit Analysis | Maximum | Measurement Input, Appraised Value | |||||||
| Real Estate Properties [Line Items] | |||||||
| Alternative Investment, Measurement Input | $ / unit | 200,000 | ||||||
| Integrated Senior Health Campuses | |||||||
| Real Estate Properties [Line Items] | |||||||
| Gain (loss) on dispositions of real estate investments, net | $ 1,370,000 | ||||||
| Outpatient Medical | |||||||
| Real Estate Properties [Line Items] | |||||||
| Number Of Real Estate Investment To Be Disposed Of | campus | 1 | ||||||
| Central Florida Senior Housing Portfolio | |||||||
| Real Estate Properties [Line Items] | |||||||
| Number Of Real Estate Investment To Be Disposed Of | campus | 3 | ||||||
| SHOP | |||||||
| Real Estate Properties [Line Items] | |||||||
| Number Of Real Estate Investment To Be Disposed Of | facility | 5 | ||||||
| Two Thousand Twenty One Acquisitions, Previously Leased | |||||||
| Real Estate Properties [Line Items] | |||||||
| Percentage of contract purchase price paid acquisition fee, in cash | 2.25% | 2.25% | |||||
| Two Thousand Twenty One Acquisitions, Previously Leased | Trilogy Investors, LLC | |||||||
| Real Estate Properties [Line Items] | |||||||
| Property ownership percentage | 72.90% | ||||||
| Number of integrated senior health campuses acquired from unaffiliated parties | campus | 6 | ||||||
| 2021 Acquisition | |||||||
| Real Estate Properties [Line Items] | |||||||
| Acquisition contract purchase price of land acquired | $ 249,000 | ||||||
| Acquisition fees and direct acquisition related expenses | $ 1,855,000 | ||||||
| Two Thousand Twenty Acquisition | |||||||
| Real Estate Properties [Line Items] | |||||||
| Acquisition contract purchase price of land acquired | 1,459,000 | ||||||
| Two Thousand Twenty Two Acquisitions, Previously Leased | |||||||
| Real Estate Properties [Line Items] | |||||||
| Property ownership percentage | 73.10% | ||||||
| Two Thousand Twenty Two Acquisitions | |||||||
| Real Estate Properties [Line Items] | |||||||
| Acquisition contract purchase price of land acquired | $ 1,020,000 | ||||||
| 2022 Acquisitions | |||||||
| Real Estate Properties [Line Items] | |||||||
| Acquisition fees and direct acquisition related expenses | $ 303,000 | 303,000 | |||||
| Increase (decrease) to right-of-use asset | 37,464,000 | ||||||
| Outpatient Medical Building | |||||||
| Real Estate Properties [Line Items] | |||||||
| Impairment of real estate investments | 3,335,000 | ||||||
| Carrying value after impairment | 2,880,000 | ||||||
| Contract sales price of dispositions | 3,000,000 | ||||||
| Gain (loss) on dispositions of real estate investments, net | 346,000 | ||||||
| SHOP | |||||||
| Real Estate Properties [Line Items] | |||||||
| Carrying value after impairment | $ 81,149,000 | $ 20,439,000 | 81,149,000 | ||||
| SHOP | SHOP | |||||||
| Real Estate Properties [Line Items] | |||||||
| Property, Plant and Equipment, Net | 3,477,000 | ||||||
| Integrated Senior Health Campuses | |||||||
| Real Estate Properties [Line Items] | |||||||
| Total completed development cost | 15,462,000 | 50,435,000 | |||||
| Total completed expansion cost | $ 4,988,000 | 7,543,000 | $ 22,720,000 | ||||
| SHOP | |||||||
| Real Estate Properties [Line Items] | |||||||
| Impairment of real estate investments | $ 54,579,000 | ||||||
Real Estate Investments, Net - Acquisitions of Real Estate (Details) $ in Thousands |
12 Months Ended | ||||
|---|---|---|---|---|---|
|
Jul. 13, 2023
USD ($)
|
Feb. 15, 2023
USD ($)
|
Dec. 31, 2023
USD ($)
realEstate
|
Dec. 31, 2022
USD ($)
realEstate
|
Dec. 31, 2021
USD ($)
|
|
| Real Estate Properties [Line Items] | |||||
| Asset acquisition, contract purchase price | $ 32,883 | ||||
| Operating lease liabilities | $ (36,609) | $ (24,699) | $ (16,793) | ||
| Increase (decrease) to right-of-use asset | 57,647 | ||||
| Line of credit | 14,200 | ||||
| Asset Acquisition, Financing Obligation | 16,283 | ||||
| Capital expenditures | 100,971 | 72,583 | 87,771 | ||
| Triple-net leased properties | |||||
| Real Estate Properties [Line Items] | |||||
| Capital expenditures | $ 420 | $ 4 | $ 31 | ||
| Two Thousand Twenty Two Acquisitions, Previously Leased | |||||
| Real Estate Properties [Line Items] | |||||
| Property ownership percentage | 73.10% | ||||
| Number of previously leased real estate investments purchased | realEstate | 4 | ||||
| Loans payable | $ 52,725 | ||||
| Asset acquisition, contract purchase price | 54,805 | ||||
| 2022 Acquisitions | |||||
| Real Estate Properties [Line Items] | |||||
| Increase (decrease) to right-of-use asset | 37,464 | ||||
| Increase (decrease) to operating lease liability | $ 36,326 | ||||
| Two Thousand Twenty One Acquisitions, Previously Leased | |||||
| Real Estate Properties [Line Items] | |||||
| Percentage of contract purchase price paid acquisition fee, in cash | 2.25% | 2.25% | |||
| Two Thousand Twenty One Acquisitions | |||||
| Real Estate Properties [Line Items] | |||||
| Operating lease liabilities | $ 54,564 | ||||
| Two Thousand Twenty Three Acquisitions | |||||
| Real Estate Properties [Line Items] | |||||
| Number of previously leased real estate investments purchased | realEstate | 3 | ||||
| Asset acquisition, contract purchase price | $ 660 | ||||
| Acquisition ownership percentage | 74.10% | ||||
| Kendallville, IN; and Delphos, Lima, Springfield, Sylvania and Union Township, OH | Two Thousand Twenty One Acquisitions, Previously Leased | |||||
| Real Estate Properties [Line Items] | |||||
| Date of acquisition of property | Jan. 19, 2021 | ||||
| Contract purchase price | $ 76,549 | ||||
| Line of credit | 78,587 | ||||
| Acquisition fees | $ 1,164 | ||||
| Louisville, KY | Two Thousand Twenty Three Acquisitions | |||||
| Real Estate Properties [Line Items] | |||||
| Asset acquisition, contract purchase price | $ 11,000 | ||||
| Line of credit | $ 7,700 | ||||
| Washington, IN | Two Thousand Twenty Three Acquisitions | |||||
| Real Estate Properties [Line Items] | |||||
| Asset acquisition, contract purchase price | 14,200 | ||||
| Line of credit | 12,212 | ||||
| Asset Acquisition, Financing Obligation | 0 | ||||
| Tell City, IN | Two Thousand Twenty Three Acquisitions | |||||
| Real Estate Properties [Line Items] | |||||
| Asset acquisition, contract purchase price | 2,400 | ||||
| Line of credit | 1,988 | ||||
| Asset Acquisition, Financing Obligation | 0 | ||||
| New Albany, OH | Two Thousand Twenty Three Acquisitions | |||||
| Real Estate Properties [Line Items] | |||||
| Asset acquisition, contract purchase price | 16,283 | ||||
| Line of credit | 0 | ||||
| Asset Acquisition, Financing Obligation | $ 16,283 | ||||
Real Estate Investments, Net - Dispositions of Real Estate Investments (Details) |
1 Months Ended | 12 Months Ended | |||
|---|---|---|---|---|---|
|
Feb. 08, 2022
USD ($)
|
Jul. 31, 2021
USD ($)
|
Dec. 31, 2023
USD ($)
$ / unit
campus
|
Dec. 31, 2022
USD ($)
|
Dec. 31, 2021
USD ($)
|
|
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 19,622,000 | $ 194,640,000 | $ 23,205,000 | ||
| Number Of Real Estate Investment To Be Disposed Of | 22 | ||||
| Present value of finance lease liabilities | $ 100,000 | ||||
| Asset Acquisition, Carrying Value | $ 14,807,000 | ||||
| Payments to Acquire Productive Assets | 0 | ||||
| Finance Lease, Liability, Statement of Financial Position [Extensible Enumeration] | Security deposits, prepaid rent and other liabilities | Security deposits, prepaid rent and other liabilities | |||
| Finance Lease, Liability, Noncurrent | $ 15,504,000 | ||||
| Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration] | Financing obligations | ||||
| (Gain) loss on dispositions of real estate investments, net | $ (683,000) | $ (32,472,000) | $ (5,481,000) | $ 100,000 | |
| Price Per Square Foot Analysis | Minimum | Measurement Input, Appraised Value | |||||
| Real Estate Properties [Line Items] | |||||
| Alternative Investment, Measurement Input | $ / unit | 250 | ||||
| Price Per Square Foot Analysis | Maximum | Measurement Input, Appraised Value | |||||
| Real Estate Properties [Line Items] | |||||
| Alternative Investment, Measurement Input | $ / unit | 260 | ||||
| Brooksville, FL | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 7,800,000 | 2,640,000 | |||
| Number Of Real Estate Investment To Be Disposed Of | 1 | ||||
| Sanford, FL | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | 3,750,000 | ||||
| Memphis, TN | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | 9,600,000 | ||||
| Bradenton, FL | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 7,215,000 | ||||
| Longview, TX | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 1,500,000 | ||||
| Number Of Real Estate Investment To Be Disposed Of | 1 | ||||
| Pinellas Park, FL | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 7,730,000 | ||||
| Number Of Real Estate Investment To Be Disposed Of | 1 | ||||
| Olympia Fields, IL | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 3,750,000 | ||||
| Number Of Real Estate Investment To Be Disposed Of | 1 | ||||
| Auburn, CA | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 7,050,000 | ||||
| Number Of Real Estate Investment To Be Disposed Of | 1 | ||||
| Pottsville, PA | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 6,000,000 | ||||
| Number Of Real Estate Investment To Be Disposed Of | 1 | ||||
| New London, CT | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 4,200,000 | ||||
| Number Of Real Estate Investment To Be Disposed Of | 1 | ||||
| Stratford, CT | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 4,800,000 | ||||
| Number Of Real Estate Investment To Be Disposed Of | 1 | ||||
| Westbrook, CT | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 7,250,000 | ||||
| Number Of Real Estate Investment To Be Disposed Of | 1 | ||||
| Lakeland, FL | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 7,080,000 | ||||
| Number Of Real Estate Investment To Be Disposed Of | 1 | ||||
| Winter Haven, FL | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 17,500,000 | ||||
| Number Of Real Estate Investment To Be Disposed Of | 1 | ||||
| Acworth, GA | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 8,775,000 | ||||
| Number Of Real Estate Investment To Be Disposed Of | 3 | ||||
| Lithonia, GA [Member] | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 3,445,000 | ||||
| Number Of Real Estate Investment To Be Disposed Of | 1 | ||||
| Stockbridge, GA [Member] | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 2,430,000 | ||||
| Number Of Real Estate Investment To Be Disposed Of | 1 | ||||
| Lake Placid, FL | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 5,620,000 | ||||
| Number Of Real Estate Investment To Be Disposed Of | 1 | ||||
| Spring Hill, FL | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 7,800,000 | ||||
| Number Of Real Estate Investment To Be Disposed Of | 1 | ||||
| Morristown, NJ [Member] | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 62,210,000 | ||||
| Number Of Real Estate Investment To Be Disposed Of | 1 | ||||
| Evendale, OH | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 11,900,000 | ||||
| Number Of Real Estate Investment To Be Disposed Of | 1 | ||||
| Naperville, IL Two | |||||
| Real Estate Properties [Line Items] | |||||
| Contract sales price of dispositions | $ 17,800,000 | ||||
| Number Of Real Estate Investment To Be Disposed Of | 2 | ||||
| SHOP | |||||
| Real Estate Properties [Line Items] | |||||
| Number Of Real Estate Investment To Be Disposed Of | campus | 6 | ||||
| Outpatient Medical | |||||
| Real Estate Properties [Line Items] | |||||
| Number Of Real Estate Investment To Be Disposed Of | campus | 16 | ||||
| SHOP and OMs | |||||
| Real Estate Properties [Line Items] | |||||
| (Gain) loss on dispositions of real estate investments, net | $ (32,717,000) | ||||
Real Estate Investments, Net - Purchase Price of Assets (Details) - USD ($) $ in Thousands |
12 Months Ended | ||||
|---|---|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|||
| Real Estate Properties [Line Items] | |||||
| Increase (decrease) to right-of-use asset | $ 57,647 | ||||
| Operating lease right-of-use assets, net | $ 227,846 | $ 276,342 | |||
| Operating lease liabilities | [1] | 225,502 | 273,075 | ||
| Operating lease liabilities | (36,609) | (24,699) | (16,793) | ||
| Two Thousand Twenty Two Acquisitions | |||||
| Real Estate Properties [Line Items] | |||||
| Building and improvements | 49,645 | ||||
| Land | 8,885 | ||||
| Total assets acquired | $ 58,530 | ||||
| Two Thousand Twenty One Acquisitions | |||||
| Real Estate Properties [Line Items] | |||||
| Building and improvements | 66,167 | ||||
| Land | 17,612 | ||||
| Total assets acquired | 83,779 | ||||
| Operating lease liabilities | $ 54,564 | ||||
| Two Thousand Twenty Three Acquisitions | |||||
| Real Estate Properties [Line Items] | |||||
| Building and improvements | 38,517 | ||||
| Land | 4,917 | ||||
| Total assets acquired | 43,434 | ||||
| Operating lease right-of-use assets, net | 28,623 | ||||
| Operating lease liabilities | $ 30,498 | ||||
| |||||
Business Combinations - Narrative (Details) |
1 Months Ended | 12 Months Ended | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
Jul. 13, 2023
USD ($)
|
Feb. 15, 2023
USD ($)
|
Dec. 05, 2022
USD ($)
campus
|
Oct. 01, 2021
USD ($)
$ / shares
shares
|
Aug. 31, 2022
USD ($)
|
Dec. 31, 2023
USD ($)
$ / shares
shares
|
Dec. 31, 2022
USD ($)
campus
$ / shares
|
Dec. 31, 2021
USD ($)
|
Feb. 14, 2023 |
Aug. 01, 2022
campus
|
Apr. 01, 2022
USD ($)
|
|||
| Business Acquisitions [Line Items] | |||||||||||||
| Gain on re-measurement of previously held equity interests | $ (726,000) | $ (19,567,000) | $ 0 | ||||||||||
| Acquisition-related costs | $ 1,895,000 | $ 14,060,000 | |||||||||||
| Goodwill | 234,942,000 | $ 231,611,000 | 209,898,000 | ||||||||||
| Business Combination, Number | campus | 4 | ||||||||||||
| Number of properties acquired | campus | 7 | ||||||||||||
| Post-closing cash payment to NewCo Sellers related to net working capital adjustments | $ 0 | ||||||||||||
| Line of credit | $ 14,200,000 | ||||||||||||
| Issuance of common stock and purchase of noncontrolling interest in connection with the Merger | [1] | 721,945,000 | |||||||||||
| Security deposits | (331,000) | $ (777,000) | 95,000 | ||||||||||
| Integrated Senior Health Campuses | |||||||||||||
| Business Acquisitions [Line Items] | |||||||||||||
| Goodwill | $ 168,177,000 | $ 164,846,000 | $ 119,856,000 | ||||||||||
| Business Combination, Number | campus | 3 | ||||||||||||
| Texas Ranger Portfolio | Two Thousand Twenty Two Acquisitions | |||||||||||||
| Business Acquisitions [Line Items] | |||||||||||||
| Contract purchase price | $ 110,627,000 | ||||||||||||
| AHI | |||||||||||||
| Business Acquisitions [Line Items] | |||||||||||||
| Goodwill | 134,589,000 | ||||||||||||
| Total purchase consideration | 131,747,000 | ||||||||||||
| Post-closing cash payment to NewCo Sellers related to net working capital adjustments | 73,000 | ||||||||||||
| April 1, 2022 Acquisition | |||||||||||||
| Business Acquisitions [Line Items] | |||||||||||||
| Business Combination, Step Acquisition, Equity Interest in Acquiree, Percentage | 50.00% | ||||||||||||
| Acquisition-related costs | $ 938,000 | ||||||||||||
| RHS | |||||||||||||
| Business Acquisitions [Line Items] | |||||||||||||
| Gain on re-measurement of previously held equity interests | $ (19,567,000) | ||||||||||||
| Business Combination, Step Acquisition, Equity Interest in Acquiree, Percentage | 100.00% | 50.00% | 50.00% | ||||||||||
| Total purchase consideration | $ 36,661,000 | ||||||||||||
| January 3, 2022 Acquisition | |||||||||||||
| Business Acquisitions [Line Items] | |||||||||||||
| Total purchase consideration | $ 27,790,000 | ||||||||||||
| Line of credit | $ 20,800,000 | ||||||||||||
| Memory Care Partners, LLC | |||||||||||||
| Business Acquisitions [Line Items] | |||||||||||||
| Gain on re-measurement of previously held equity interests | $ (726,000) | ||||||||||||
| Business Combination, Step Acquisition, Equity Interest in Acquiree, Percentage | 60.00% | 40.00% | |||||||||||
| Total purchase consideration | $ 900,000 | ||||||||||||
| Business Acquisition, Percentage of Voting Interests Acquired | 100.00% | ||||||||||||
| OP Units | AHI | |||||||||||||
| Business Acquisitions [Line Items] | |||||||||||||
| Issuance of common stock and purchase of noncontrolling interest in connection with the Merger | $ 131,674,000 | ||||||||||||
| Stock purchased (shares) | shares | 15,117,529 | ||||||||||||
| Issuance of stock (in dollars per share) | $ / shares | $ 8.71 | ||||||||||||
| Common Class I | |||||||||||||
| Business Acquisitions [Line Items] | |||||||||||||
| Common stock, par value (in dollars per share) | $ / shares | $ 0.01 | $ 0.01 | |||||||||||
| Conversion ratio (in shares) | shares | 0.9266 | ||||||||||||
| Griffin-American Healthcare REIT III | |||||||||||||
| Business Acquisitions [Line Items] | |||||||||||||
| Common stock, par value (in dollars per share) | $ / shares | $ 0.01 | ||||||||||||
| Griffin-American Healthcare REIT III | Partnership Class I Unit | |||||||||||||
| Business Acquisitions [Line Items] | |||||||||||||
| Conversion ratio (in shares) | shares | 0.9266 | ||||||||||||
| Griffin-American Healthcare REIT III | Common Class I | |||||||||||||
| Business Acquisitions [Line Items] | |||||||||||||
| Conversion ratio (in shares) | shares | 0.9266 | ||||||||||||
| Griffin-American Healthcare REIT IV, Inc. | |||||||||||||
| Business Acquisitions [Line Items] | |||||||||||||
| Acquisition-related costs | $ 6,753,000 | ||||||||||||
| Griffin-American Healthcare REIT IV, Inc. | Common Class I | |||||||||||||
| Business Acquisitions [Line Items] | |||||||||||||
| Common stock, par value (in dollars per share) | $ / shares | $ 0.01 | ||||||||||||
| RHS | |||||||||||||
| Business Acquisitions [Line Items] | |||||||||||||
| Number Of Senior Health Campuses Owns | campus | 16 | ||||||||||||
| |||||||||||||
Business Combinations - Fair Value of Purchase Consideration (Details) - USD ($) $ / shares in Units, $ in Thousands |
Dec. 05, 2022 |
Oct. 01, 2021 |
|---|---|---|
| Business Acquisitions [Line Items] | ||
| Post-closing cash payment to NewCo Sellers related to net working capital adjustments | $ 0 | |
| REIT Merger | ||
| Business Acquisitions [Line Items] | ||
| Equity consideration | $ 768,075 | |
| Consideration for acquisition of noncontrolling interest | (53,300) | |
| Repurchase of GAHR IV Class T common stock | 192 | |
| Total purchase consideration | $ 714,967 | |
| REIT Merger | Griffin-American Healthcare REIT III | ||
| Business Acquisitions [Line Items] | ||
| Number of shares issued (in shares) | 22,045,766 | |
| Share price (in dollars per share) | $ 34.84 | |
| AHI | ||
| Business Acquisitions [Line Items] | ||
| Equity consideration | $ 131,674 | |
| Post-closing cash payment to NewCo Sellers related to net working capital adjustments | 73 | |
| Contingent consideration | 0 | |
| Total purchase consideration | 131,747 | |
| Contingent consideration obligation | $ 0 | |
| AHI | OP Units | ||
| Business Acquisitions [Line Items] | ||
| Number of shares issued (in shares) | 3,779,382 | |
| Share price (in dollars per share) | $ 34.84 | |
| Issuance of stock (in dollars per share) | $ 8.71 |
Business Combinations - Purchase Price Allocation (Details) - USD ($) $ in Thousands |
Oct. 01, 2021 |
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|---|---|---|---|---|
| Business Acquisitions [Line Items] | ||||
| Goodwill | $ 234,942 | $ 231,611 | $ 209,898 | |
| REIT Merger | ||||
| Business Acquisitions [Line Items] | ||||
| Real estate investments | $ 1,126,641 | |||
| Cash and cash equivalents | 16,163 | |||
| Accounts and other receivables, net | 2,086 | |||
| Restricted cash | 986 | |||
| Identified intangible assets | 115,824 | |||
| Operating lease right-of-use assets | 11,939 | |||
| Other assets | 3,938 | |||
| Total assets | 1,277,577 | |||
| Mortgage loans payable (including debt premium of $311) | (18,602) | |||
| Lines of credit and term loans | (488,900) | |||
| Accounts payable and accrued liabilities | (21,882) | |||
| Accounts payable due to affiliates | (324) | |||
| Identified intangible liabilities | (12,927) | |||
| Operating lease liabilities | (7,568) | |||
| Security deposits, prepaid rent and other liabilities | (8,354) | |||
| Total liabilities | (558,557) | |||
| Net identifiable assets acquired | 719,020 | |||
| Redeemable noncontrolling interests | (2,525) | |||
| Noncontrolling interest in total equity | (1,528) | |||
| Total purchase consideration | 714,967 | |||
| Add: premium | 311 | |||
| AHI | ||||
| Business Acquisitions [Line Items] | ||||
| Cash and cash equivalents | 706 | |||
| Operating lease right-of-use assets | 3,526 | |||
| Other assets | 362 | |||
| Total assets | 4,594 | |||
| Accounts payable and accrued liabilities | (3,910) | |||
| Operating lease liabilities | (3,526) | |||
| Total liabilities | (7,436) | |||
| Net identifiable assets acquired | (2,842) | |||
| Goodwill | 134,589 | |||
| Total purchase consideration | $ 131,747 | |||
| 2022 Acquisitions | ||||
| Business Acquisitions [Line Items] | ||||
| Cash and cash equivalents | 12,331 | |||
| Accounts and other receivables, net | 19,472 | |||
| Operating lease right-of-use assets | 153,777 | |||
| Total assets | 440,385 | |||
| Total liabilities | (343,053) | |||
| Net identifiable assets acquired | 97,332 | |||
| Goodwill | $ 44,990 |
Business Combinations - Allocation of Goodwill (Details) - USD ($) $ in Thousands |
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
Oct. 01, 2021 |
|---|---|---|---|---|
| Business Acquisitions [Line Items] | ||||
| Goodwill | $ 234,942 | $ 231,611 | $ 209,898 | |
| AHI | ||||
| Business Acquisitions [Line Items] | ||||
| Goodwill | $ 134,589 | |||
| AHI | Outpatient Medical | ||||
| Business Acquisitions [Line Items] | ||||
| Goodwill | 47,812 | |||
| AHI | Integrated Senior Health Campuses | ||||
| Business Acquisitions [Line Items] | ||||
| Goodwill | 44,547 | |||
| AHI | SHOP | ||||
| Business Acquisitions [Line Items] | ||||
| Goodwill | 23,277 | |||
| AHI | Skilled Nursing Facilities | ||||
| Business Acquisitions [Line Items] | ||||
| Goodwill | 4,389 | |||
| AHI | Senior Housing | ||||
| Business Acquisitions [Line Items] | ||||
| Goodwill | 8,640 | |||
| AHI | Hospitals | ||||
| Business Acquisitions [Line Items] | ||||
| Goodwill | $ 5,924 |
Business Combinations - Real Estate Investments (Details) - REIT Merger $ in Thousands |
Oct. 01, 2021
USD ($)
|
|---|---|
| Business Acquisitions [Line Items] | |
| Approximate Fair Value | $ 1,126,641 |
| Land | |
| Business Acquisitions [Line Items] | |
| Approximate Fair Value | 114,525 |
| Building Improvements | |
| Business Acquisitions [Line Items] | |
| Approximate Fair Value | $ 930,700 |
| Estimated Useful Lives (in years) | 39 years |
| Site Improvements | |
| Business Acquisitions [Line Items] | |
| Approximate Fair Value | $ 33,644 |
| Estimated Useful Lives (in years) | 7 years |
| Tenant Improvement Allowances | |
| Business Acquisitions [Line Items] | |
| Approximate Fair Value | $ 42,407 |
| Estimated Useful Lives (in years) | 6 years |
| Capital Improvements | |
| Business Acquisitions [Line Items] | |
| Approximate Fair Value | $ 5,365 |
| Estimated Useful Lives (in years) | 11 years |
Business Combinations - Intangible Assets and Intangible Liabilities (Details) - REIT Merger $ in Thousands |
Oct. 01, 2021
USD ($)
|
|---|---|
| Business Acquisitions [Line Items] | |
| Approximate Fair Value | $ 115,824 |
| Below-market leases | $ 12,927 |
| Below Market Lease, Gross, Weighted Average Useful Life | 10 years |
| In-Place Leases | |
| Business Acquisitions [Line Items] | |
| Approximate Fair Value | $ 79,887 |
| Estimated Useful Lives (in years) | 6 years |
| Above-Market Leases | |
| Business Acquisitions [Line Items] | |
| Approximate Fair Value | $ 35,606 |
| Estimated Useful Lives (in years) | 10 years |
| Certificates Of Need | |
| Business Acquisitions [Line Items] | |
| Approximate Fair Value | $ 331 |
Business Combinations - Pro Forma Financial Information (Details) - REIT Merger - USD ($) $ in Thousands |
12 Months Ended | |
|---|---|---|
Dec. 31, 2021 |
Dec. 31, 2020 |
|
| Business Acquisitions [Line Items] | ||
| Revenue | $ 1,392,884 | $ 1,397,261 |
| Net loss | (45,253) | (17,116) |
| Net loss attributable to controlling interest | $ 35,140 | $ 20,642 |
Business Combinations - Schedule of Recognized Identified Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Thousands |
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|---|---|---|---|
| Asset Acquisition [Line Items] | |||
| Goodwill | $ 234,942 | $ 231,611 | $ 209,898 |
| Business Acquisitions [Line Items] | |||
| Goodwill | 234,942 | 231,611 | $ 209,898 |
| 2022 Acquisitions | |||
| Asset Acquisition [Line Items] | |||
| Operating lease right-of-use assets | 153,777 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Buildings | 163,166 | ||
| Goodwill | 44,990 | ||
| Accounts and other receivables, net | 19,472 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, In-Place Leases | 18,834 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Land | 20,514 | ||
| Cash and cash equivalents | 12,331 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Certificates of Need | 3,567 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Equipment | 1,936 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Assets, Prepaid Expense and Other Assets | 1,798 | ||
| Total assets | 440,385 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed,, Operating Lease Liabilities | (161,121) | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Noncurrent Liabilities, Long-Term Debt | (149,861) | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Security Deposits | (15,994) | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities | (16,012) | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Financing Obligations | (65) | ||
| Liabilities assumed | (343,053) | ||
| Net identifiable assets acquired | 97,332 | ||
| Business Acquisitions [Line Items] | |||
| Operating lease right-of-use assets | 153,777 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Buildings | 163,166 | ||
| Goodwill | 44,990 | ||
| Accounts and other receivables, net | 19,472 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, In-Place Leases | 18,834 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Land | 20,514 | ||
| Cash and cash equivalents | 12,331 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Certificates of Need | 3,567 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Equipment | 1,936 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Assets, Prepaid Expense and Other Assets | 1,798 | ||
| Total assets | 440,385 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed,, Operating Lease Liabilities | 161,121 | ||
| Debt Instrument, Unamortized Discount | 6,066 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Noncurrent Liabilities, Long-Term Debt | 149,861 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Security Deposits | 15,994 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities | 16,012 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Financing Obligations | 65 | ||
| Liabilities assumed | 343,053 | ||
| Net identifiable assets acquired | $ 97,332 | ||
| 2023 Acquisitions | |||
| Asset Acquisition [Line Items] | |||
| Operating lease right-of-use assets | 0 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Buildings | 0 | ||
| Goodwill | 3,331 | ||
| Accounts and other receivables, net | 0 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, In-Place Leases | 0 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Land | 0 | ||
| Cash and cash equivalents | 565 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Certificates of Need | 0 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Equipment | 39 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Assets, Prepaid Expense and Other Assets | 66 | ||
| Total assets | 4,001 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed,, Operating Lease Liabilities | 0 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities | (1,676) | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Financing Obligations | (12) | ||
| Liabilities assumed | (2,500) | ||
| Net identifiable assets acquired | 1,501 | ||
| Business Acquisitions [Line Items] | |||
| Operating lease right-of-use assets | 0 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Buildings | 0 | ||
| Goodwill | 3,331 | ||
| Accounts and other receivables, net | 0 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, In-Place Leases | 0 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Land | 0 | ||
| Cash and cash equivalents | 565 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Certificates of Need | 0 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Equipment | 39 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Assets, Prepaid Expense and Other Assets | 66 | ||
| Total assets | 4,001 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed,, Operating Lease Liabilities | 0 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities | 1,676 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Financing Obligations | 12 | ||
| Liabilities assumed | 2,500 | ||
| Net identifiable assets acquired | 1,501 | ||
| Business Combination, Recognized Identifiable Assets Acquired And Liabilities Assumed, Mortgage Loans Payable | 0 | ||
| Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Security Deposits and Other Liabilities | $ (812) |
Debt Security Investmen, Net - Additional Information (Details) - USD ($) $ in Thousands |
12 Months Ended | |||
|---|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
Oct. 15, 2015 |
|
| Debt Security Investment, Net | ||||
| Debt security investment, net | $ 86,935 | $ 83,000 | ||
| Held-to-Maturity, debt securities, unamortized closing costs | 489 | 767 | ||
| Accretion on debt security | 4,213 | 3,922 | $ 3,665 | |
| Amortization of closing costs | $ 278 | $ 237 | $ 201 | |
| Debt security investment [Member] | ||||
| Debt Security Investment, Net | ||||
| Stated interest rate | 4.24% | |||
| Stated amount after maturity | $ 93,433 | |||
| Yield to maturity interest rate | 10.00% | |||
| Beneficial ownership interest in mortgage trust | 10.00% | |||
Identified Intangible Assets and Liabilities - Summary of Intangible Assets and Liabilities (Details) - USD ($) $ in Thousands |
12 Months Ended | |
|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
|
| Finite-Lived Intangible Assets [Line Items] | ||
| Identified intangible assets, net | $ 180,470 | $ 236,283 |
| Identified intangible liabilities, net | 6,095 | $ 10,837 |
| Amortized intangible assets | ||
| Amortized intangible assets | $ 60,426 | |
| Weighted average remaining life | 7 years 9 months 18 days | 7 years 8 months 12 days |
| Amortized intangible liabilities | ||
| Total identified intangible liabilities, net | $ 6,095 | $ 10,837 |
| Below-Market Lease | ||
| Finite-Lived Intangible Assets [Line Items] | ||
| Identified intangible liabilities, net | 6,095 | 10,837 |
| Amortized intangible liabilities | ||
| Intangible liabilities accumulated amortization | $ (2,831) | $ 2,508 |
| Weighted average remaining life | 7 years 2 months 12 days | 8 years 4 months 24 days |
| Certificates Of Need | ||
| Unamortized intangible assets | ||
| Unamortized intangible assets | $ 99,777 | $ 97,667 |
| Trade Names | ||
| Unamortized intangible assets | ||
| Unamortized intangible assets | 20,267 | 30,787 |
| In-Place Leases | ||
| Amortized intangible assets | ||
| Amortized intangible assets | 42,615 | 75,580 |
| Intangible assets accumulated amortization | $ 35,437 | $ 38,930 |
| Weighted average remaining life | 7 years 8 months 12 days | 7 years |
| Customer Relationships | ||
| Amortized intangible assets | ||
| Amortized intangible assets | $ 1,906 | $ 2,055 |
| Intangible assets accumulated amortization | $ 934 | $ 785 |
| Weighted average remaining life | 12 years 8 months 12 days | 13 years 8 months 12 days |
| Above-Market Leases | ||
| Amortized intangible assets | ||
| Amortized intangible assets | $ 15,905 | $ 30,194 |
| Intangible assets accumulated amortization | $ 7,079 | $ 6,360 |
| Weighted average remaining life | 7 years 6 months | 9 years |
Identified Intangible Assets and Liabilities - Additional Information (Details) - USD ($) $ in Thousands |
3 Months Ended | 12 Months Ended | |||
|---|---|---|---|---|---|
Mar. 01, 2023 |
Dec. 31, 2023 |
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
| Finite-Lived Intangible Assets [Line Items] | |||||
| Amortization expense | $ 46,601 | $ 28,378 | $ 22,460 | ||
| Asset impairment charges | $ 10,520 | ||||
| Weighted average remaining life | 7 years 9 months 18 days | 7 years 9 months 18 days | 7 years 8 months 12 days | ||
| Below-Market Lease | |||||
| Finite-Lived Intangible Assets [Line Items] | |||||
| Amortization expense | $ 4,534 | $ 1,848 | 396 | ||
| Weighted average remaining life | 7 years 2 months 12 days | 8 years 4 months 24 days | |||
| Above-Market Leases | |||||
| Finite-Lived Intangible Assets [Line Items] | |||||
| Amortization expense | $ 14,278 | $ 4,444 | $ 1,349 | ||
| Write-Off Of Amortization Of Intangible Assets | $ 8,073 | $ 2,756 | |||
| In-Place Leases | |||||
| Finite-Lived Intangible Assets [Line Items] | |||||
| Write-Off Of Amortization Of Intangible Assets | $ 885 | 5,750 | |||
| Below-Market Lease | |||||
| Finite-Lived Intangible Assets [Line Items] | |||||
| Write-Off Of Amortization Of Intangible Assets | $ 112 | ||||
Identified Intangible Assets and Liabilities - Summary of Amortization Expense on Identified Intangible Assets and Liabilities, Net (Details) - USD ($) $ in Thousands |
Dec. 31, 2023 |
Dec. 31, 2022 |
|---|---|---|
| Intangible Assets | ||
| 2024 | $ 11,618 | |
| 2025 | 8,797 | |
| 2026 | 7,729 | |
| 2027 | 7,205 | |
| 2028 | 6,152 | |
| Thereafter | 18,925 | |
| Finite-lived intangible assets, gross | 60,426 | |
| Intangible Liabilities | ||
| 2024 | (1,073) | |
| 2025 | (956) | |
| 2026 | (840) | |
| 2027 | (825) | |
| 2028 | (709) | |
| Thereafter | (1,692) | |
| Finite-lived intangible liabilities, gross | $ (6,095) | $ (10,837) |
Other Assets, Net - Schedule of Other Assets, Net (Details) - USD ($) $ in Thousands |
12 Months Ended | |
|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
|
| Other Assets [Abstract] | ||
| Deferred rent receivables | $ 47,540 | $ 46,867 |
| Prepaid expenses, deposits, other assets and deferred tax assets, net | 33,204 | 25,866 |
| Inventory — finished goods | 19,472 | 19,775 |
| Lease commissions, net of accumulated amortization of $7,231 and $6,260 as of December 31, 2023 and 2022, respectively | 17,565 | 19,217 |
| Equity Method Investments | 20,611 | 9,580 |
| Debt Issuance Costs, Net | 3,830 | 4,334 |
| Incentive to Lessee | 2,456 | 2,807 |
| Other Assets, net | 146,141 | 128,446 |
| Accumulated amortization, lease commissions | 7,231 | 6,260 |
| Accumulated amortization, deferred financing costs | 8,494 | 5,704 |
| Accumulated amortization, lease inducements | $ 2,544 | $ 2,193 |
| Lease inducements, weighted average remaining life | 6 years 10 months 24 days | 7 years 10 months 24 days |
| Derivative Asset, Statement of Financial Position [Extensible Enumeration] | Other Assets, net | Other Assets, net |
| Derivative Asset | $ 1,463 | $ 0 |
Other Assets, Net - Narrative (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
| Other Assets [Abstract] | |||
| Amortization of deferred lease inducements | $ 351 | $ 351 | $ 351 |
Mortgage Loans Payable, Net - Narrative (Details) $ in Thousands |
12 Months Ended | ||||||
|---|---|---|---|---|---|---|---|
|
Dec. 31, 2023
USD ($)
MortgageLoan
|
Dec. 31, 2022
USD ($)
MortgageLoan
|
Dec. 31, 2021
USD ($)
campus
|
|||||
| Debt Instrument [Line Items] | |||||||
| Mortgage loans payable, gross | $ 1,326,313 | ||||||
| Mortgage loans payable, net | $ 1,302,396 | [1] | $ 1,229,847 | [1] | $ 1,095,594 | ||
| Number of fixed-rate mortgage loans payable | MortgageLoan | 76 | 68 | |||||
| Number of variable-rate mortgage loans payable | MortgageLoan | 13 | 11 | |||||
| Loss on extinguishments of debt | $ 345 | $ 5,166 | $ 2,655 | ||||
| Number of debt instruments extinguished | campus | 10 | ||||||
| Secured Debt | |||||||
| Debt Instrument [Line Items] | |||||||
| Loss on extinguishments of debt | 345 | 2,005 | $ 2,425 | ||||
| Mortgage Loans Payable, Net | |||||||
| Debt Instrument [Line Items] | |||||||
| Mortgage loans payable, gross | 1,326,313 | 1,254,479 | |||||
| Mortgage loans payable, net | $ 1,302,396 | $ 1,229,847 | |||||
| Debt, weighted average interest rate (as a percent) | 4.72% | 5.29% | |||||
| Minimum | |||||||
| Debt Instrument [Line Items] | |||||||
| Effective interest rate (as a percent) | 2.21% | 2.21% | |||||
| Maximum | |||||||
| Debt Instrument [Line Items] | |||||||
| Effective interest rate (as a percent) | 8.46% | 7.26% | |||||
| |||||||
Mortgage Loans Payable, Net - Mortgage Loans Payable, Net (Details) - USD ($) $ in Thousands |
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
||||
|---|---|---|---|---|---|---|---|
| Debt Instrument [Line Items] | |||||||
| Mortgage loans payable, gross | $ 1,326,313 | ||||||
| Mortgage loans payable, net | 1,302,396 | [1] | $ 1,229,847 | [1] | $ 1,095,594 | ||
| Fixed Rate Debt | |||||||
| Debt Instrument [Line Items] | |||||||
| Mortgage loans payable, gross | 990,325 | 885,892 | |||||
| Variable Rate Debt | |||||||
| Debt Instrument [Line Items] | |||||||
| Mortgage loans payable, gross | 335,988 | 368,587 | |||||
| Mortgage Loans Payable, Net | |||||||
| Debt Instrument [Line Items] | |||||||
| Mortgage loans payable, gross | 1,326,313 | 1,254,479 | |||||
| Less: deferred financing costs, net | (9,713) | (8,845) | |||||
| Add: premium | 167 | 237 | |||||
| Less: discount | (14,371) | (16,024) | |||||
| Mortgage loans payable, net | $ 1,302,396 | $ 1,229,847 | |||||
| |||||||
Mortgage Loans Payable, Net - Changes in Carrying Amount of Mortgage Loans Payable, Net (Details) $ in Thousands |
12 Months Ended | ||||
|---|---|---|---|---|---|
|
Dec. 31, 2023
USD ($)
MortgageLoan
|
Dec. 31, 2022
USD ($)
MortgageLoan
|
||||
| Mortgage Loan Activities [Roll Forward] | |||||
| Beginning balance | $ 1,229,847 | [1] | $ 1,095,594 | ||
| Borrowings under mortgage loans payable | 160,442 | 186,227 | |||
| Assumption of mortgage loans payable, net | 10,884 | 149,861 | |||
| Amortization of deferred financing costs | 2,284 | 2,332 | |||
| Amortization of discount/premium on mortgage loans payable, net | 3,549 | 2,242 | |||
| Scheduled principal payments on mortgage loans payable | (64,792) | (104,384) | |||
| Early payoff of mortgage loans payable | 9,809 | 90,871 | |||
| Payoff of a mortgage loans payable due to disposition of real estate investments | (26,856) | (8,637) | |||
| Deferred financing costs | (3,153) | (2,517) | |||
| Ending balance | [1] | $ 1,302,396 | $ 1,229,847 | ||
| Number of fixed-rate mortgage loans payable | MortgageLoan | 76 | 68 | |||
| Mortgage loans payable, gross | $ 1,326,313 | ||||
| Minimum | |||||
| Mortgage Loan Activities [Roll Forward] | |||||
| Effective interest rate (as a percent) | 2.21% | 2.21% | |||
| Maximum | |||||
| Mortgage Loan Activities [Roll Forward] | |||||
| Effective interest rate (as a percent) | 8.46% | 7.26% | |||
| Mortgage Loans Payable, Net | |||||
| Mortgage Loan Activities [Roll Forward] | |||||
| Beginning balance | $ 1,229,847 | ||||
| Ending balance | 1,302,396 | $ 1,229,847 | |||
| Mortgage loans payable, gross | $ 1,326,313 | $ 1,254,479 | |||
| Debt, weighted average interest rate (as a percent) | 4.72% | 5.29% | |||
| |||||
Mortgage Loans Payable, Net - Schedule of Principal Payments Due on Mortgage Loans Payable (Details) $ in Thousands |
Dec. 31, 2023
USD ($)
|
|---|---|
| Mortgage Loans Payable, Net [Abstract] | |
| 2024 | $ 311,445 |
| 2025 | 166,853 |
| 2026 | 171,432 |
| 2027 | 50,175 |
| 2028 | 16,421 |
| Thereafter | 609,987 |
| Total | $ 1,326,313 |
Lines of Credit and Term Loans (Details) |
1 Months Ended | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
|
Dec. 31, 2023
USD ($)
|
Aug. 30, 2023
USD ($)
|
Jan. 19, 2022
USD ($)
|
Sep. 05, 2019
Extension
|
Jan. 31, 2022
USD ($)
|
Dec. 31, 2022
USD ($)
|
Dec. 20, 2022
USD ($)
|
Oct. 01, 2021
USD ($)
|
|||
| Debt Instrument [Line Items] | ||||||||||
| Lines of credit and term loan | [1] | $ 1,223,967,000 | $ 1,281,794,000 | |||||||
| 2019 Trilogy Credit Facility [Member] | Line of Credit | Alternate Base Rate | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Variable interest rate (as a percent) | 1.75% | |||||||||
| 2019 Trilogy Credit Facility [Member] | Line of Credit | LIBOR | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Variable interest rate (as a percent) | 2.75% | |||||||||
| 2019 Trilogy Credit Facility [Member] | Line of Credit | Federal Funds Effective Rate | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Variable interest rate (as a percent) | 0.50% | |||||||||
| 2019 Trilogy Credit Facility [Member] | Line of Credit | One-Month LIBOR | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Variable interest rate (as a percent) | 1.00% | |||||||||
| 2022 Corporate Line of Credit | Line of Credit | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Line of credit facility, maximum borrowing capacity | 1,050,000,000 | $ 1,050,000,000 | 1,050,000,000 | |||||||
| Revolving Credit Facility | 2022 Corporate Line of Credit | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Number of extensions | Extension | 1 | |||||||||
| Extension term | 12 months | |||||||||
| 2022 Credit Agreement | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Number of business days | 5 days | |||||||||
| Revolving Credit Facility | 2019 Trilogy Credit Facility [Member] | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Lines of credit and term loan | $ 309,823,000 | $ 316,734,000 | ||||||||
| Debt, weighted average interest rate (as a percent) | 8.20% | 7.17% | ||||||||
| Current borrowing capacity | $ 400,000,000 | |||||||||
| Revolving Credit Facility | 2019 Trilogy Credit Facility [Member] | Real Estate Assets and Ancillary Business Cash Flow | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Line of credit facility, maximum borrowing capacity | $ 365,000,000 | $ 325,000,000 | ||||||||
| Revolving Credit Facility | 2019 Trilogy Credit Facility [Member] | Eligible Accounts Receivable | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Line of credit facility, maximum borrowing capacity | 35,000,000 | |||||||||
| Revolving Credit Facility | 2019 Trilogy Credit Facility [Member] | Line of Credit | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Line of credit facility, maximum borrowing capacity | $ 400,000,000 | 360,000,000 | ||||||||
| Potential maximum borrowing capacity | 500,000,000 | |||||||||
| Increase to maximum borrowing capacity | $ 140,000,000 | |||||||||
| Revolving Credit Facility | 2022 Corporate Line of Credit | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Line of credit facility, maximum borrowing capacity | $ 500,000,000 | |||||||||
| Lines of credit and term loan | $ 914,144,000 | |||||||||
| Revolving Credit Facility | 2022 Credit Agreement | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Debt, weighted average interest rate (as a percent) | 7.08% | 607.00% | ||||||||
| Long-Term Debt | $ 965,060,000 | |||||||||
| Revolving Credit Facility | 2019 Trilogy Credit Facility 1 | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Current borrowing capacity | $ 200,000,000 | |||||||||
| Line of Credit | 2022 Corporate Line of Credit | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Lines of credit and term loan | 914,900,000 | 965,900,000 | ||||||||
| Term Loan | 2022 Corporate Line of Credit | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Line of credit facility, maximum borrowing capacity | 550,000,000 | 550,000,000 | ||||||||
| Increase in maximum borrowing capacity | 700,000,000 | |||||||||
| Term Loan | 2022 Credit Agreement | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Write off of unamortized deferred financing fees | $ 3,161,000 | |||||||||
| Standby Letters of Credit [Member] | 2022 Corporate Line of Credit | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Line of credit facility, maximum borrowing capacity | 25,000,000 | $ 25,000,000 | $ 25,000,000 | |||||||
| 2019 Trilogy Credit Facility [Member] | ||||||||||
| Debt Instrument [Line Items] | ||||||||||
| Extension fee | $ 745,000 | $ 600,000 | ||||||||
| ||||||||||
Derivative Financial Instruments (Detail) $ in Thousands |
12 Months Ended |
|---|---|
|
Dec. 31, 2023
USD ($)
| |
| Derivative [Line Items] | |
| Notional Amount | $ 750,000 |
| Not Designated as Hedging Instrument | |
| Derivative [Line Items] | |
| Fair Value | $ (926) |
| Not Designated as Hedging Instrument | Swap, 2.10% Interest Rate | |
| Derivative [Line Items] | |
| Instrument | Swap |
| Notional Amount | $ 275,000 |
| Index | one month Term SOFR |
| Interest Rate | 3.74% |
| Maturity Date | Jan. 19, 2026 |
| Fair Value | $ 1,463 |
| Not Designated as Hedging Instrument | Swap, 1.98% Interest Rate | |
| Derivative [Line Items] | |
| Instrument | Swap |
| Notional Amount | $ 275,000 |
| Index | one month Term SOFR |
| Interest Rate | 4.41% |
| Maturity Date | Jan. 19, 2026 |
| Fair Value | $ (2,178) |
| Not Designated as Hedging Instrument | Swap, 0.20% Interest Rate | |
| Derivative [Line Items] | |
| Instrument | Swap |
| Notional Amount | $ 200,000 |
| Index | one month Term SOFR |
| Interest Rate | 4.40% |
| Maturity Date | Jun. 05, 2025 |
| Fair Value | $ (211) |
Derivative Financial Instruments - Additional Information (Details) $ in Thousands |
12 Months Ended | ||
|---|---|---|---|
|
Dec. 31, 2023
USD ($)
instrument
|
Dec. 31, 2022
USD ($)
instrument
|
Dec. 31, 2021
USD ($)
|
|
| (Loss) gain in fair value of derivative financial instruments | $ (926) | $ 500 | $ 8,200 |
| Interest Rate Swap | |||
| (Loss) gain in fair value of derivative financial instruments | $ 823 | ||
| Not Designated as Hedging Instrument | |||
| Number of derivative financial instruments | instrument | 0 | 0 | |
Redeemable Noncontrolling Interests - Additional Information (Details) - USD ($) $ in Thousands |
1 Months Ended | 12 Months Ended | 15 Months Ended | 24 Months Ended | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 01, 2022 |
Oct. 06, 2022 |
Dec. 31, 2021 |
Oct. 01, 2021 |
Jan. 31, 2024 |
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
Dec. 31, 2022 |
Dec. 31, 2022 |
Sep. 30, 2021 |
|
| Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items] | |||||||||||||
| Percent of partnership units outstanding with redemption features | 1.00% | ||||||||||||
| Adjustment to redemption value | $ (2,944) | $ 16,744 | $ 7,380 | ||||||||||
| Contributions from redeemable noncontrolling interests | $ 0 | $ 273 | $ 152 | ||||||||||
| Trilogy REIT Holdings, LLC | |||||||||||||
| Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items] | |||||||||||||
| Joint venture ownership interest | 76.00% | 76.00% | 70.00% | ||||||||||
| Trilogy Investors, LLC | |||||||||||||
| Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items] | |||||||||||||
| Ownership percentage equity interest | 97.50% | 96.20% | 97.50% | 96.20% | 96.20% | 96.20% | |||||||
| Contributions from redeemable noncontrolling interests | $ 3,707 | $ 17,150 | |||||||||||
| Trilogy Investors, LLC | Subsequent Event | |||||||||||||
| Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items] | |||||||||||||
| Contributions from redeemable noncontrolling interests | $ 25,312 | ||||||||||||
| General Partnership | |||||||||||||
| Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items] | |||||||||||||
| Percentage of ownership in operating partnership | 95.00% | 95.00% | |||||||||||
| NewCo Sellers | |||||||||||||
| Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items] | |||||||||||||
| Percentage of limited partnership interest | 5.00% | 5.00% | |||||||||||
| Trilogy Investors, LLC | |||||||||||||
| Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items] | |||||||||||||
| Noncontrolling interest, ownership percentage by noncontrolling owners | 2.50% | 3.80% | 2.50% | 3.80% | 3.80% | 3.80% | |||||||
| Meridan | |||||||||||||
| Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items] | |||||||||||||
| Joint venture acquired (as a percent) | 98.00% | ||||||||||||
| Avalon | |||||||||||||
| Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items] | |||||||||||||
| Joint venture acquired (as a percent) | 10.00% | 90.00% | |||||||||||
| Payments to Acquire Interest in Joint Venture | $ 295 | ||||||||||||
| Redeemable Noncontrolling Interest, Percent Of Earnings | 10.00% | ||||||||||||
Redeemable Noncontrolling Interests Redeemable Noncontrolling Interests - Changes in Carrying Amount (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
| Changes in carrying amount of redeemable noncontrolling interest [Roll Forward] | |||
| Beginning balance | $ 81,598 | $ 72,725 | |
| Additional redeemable noncontrolling interest | 0 | 273 | |
| Reclassification from equity | 83 | 83 | $ 5,923 |
| Reclassification to other liabilities | (25,312) | 0 | |
| Distributions | (1,369) | (2,817) | |
| Repurchase of redeemable noncontrolling interests | (17,150) | (4,034) | |
| Adjustment to redemption value | (2,944) | 15,773 | |
| Net loss attributable to redeemable noncontrolling interests | (1,063) | (405) | (1,144) |
| Ending balance | $ 33,843 | $ 81,598 | $ 72,725 |
Equity - Preferred Stock and Common Stock (Details) |
12 Months Ended | 118 Months Ended | |||||||
|---|---|---|---|---|---|---|---|---|---|
|
Feb. 09, 2024
USD ($)
$ / shares
shares
|
Nov. 03, 2023
$ / shares
|
Nov. 15, 2022 |
Oct. 01, 2021
$ / shares
shares
|
Dec. 31, 2023
$ / shares
Rate
shares
|
Dec. 31, 2022
$ / shares
shares
|
Dec. 31, 2023
USD ($)
$ / shares
shares
|
Jan. 26, 2024
shares
|
Jan. 18, 2019
USD ($)
|
|
| Class of Stock [Line Items] | |||||||||
| Number of shares of preferred stock, authorized to be issued | 200,000,000 | 200,000,000 | 200,000,000 | ||||||
| Par value of preferred stock, authorized to be issued (in dollars per share) | $ / shares | $ 0.01 | $ 0.01 | $ 0.01 | ||||||
| Preferred stock outstanding (in shares) | 0 | 0 | 0 | ||||||
| Preferred stock issued (in shares) | 0 | 0 | 0 | ||||||
| Common stock authorized (in shares) | 1,000,000,000 | 1,000,000,000 | 1,000,000,000 | ||||||
| Dividend rate of preferred stock (as a percent) | Rate | 12.50% | ||||||||
| Subsequent Event | |||||||||
| Class of Stock [Line Items] | |||||||||
| Common stock, par value (in dollars per share) | $ / shares | $ 0.01 | ||||||||
| Common stock authorized (in shares) | 64,400,000 | ||||||||
| Common stock issued (in shares) | 64,400,000 | ||||||||
| Proceeds from Issuance or Sale of Equity | $ | $ 772,800,000 | ||||||||
| Subsequent Event | Over-Allotment Option | |||||||||
| Class of Stock [Line Items] | |||||||||
| Common stock issued (in shares) | 8,400,000 | ||||||||
| DRIP S-3 Public Offering | |||||||||
| Class of Stock [Line Items] | |||||||||
| Maximum dollar amount of common stock issuable under public offering | $ | $ 100,000,000 | ||||||||
| Issuance of common stock under the DRIP, shares | 2,431,695 | 2,431,695 | |||||||
| Common Stock | |||||||||
| Class of Stock [Line Items] | |||||||||
| Common stock issued (in shares) | 65,445,557 | 65,445,557 | |||||||
| Proceeds from Issuance or Sale of Equity | $ | $ 2,737,716,000 | ||||||||
| Common Class I | |||||||||
| Class of Stock [Line Items] | |||||||||
| Common stock, par value (in dollars per share) | $ / shares | $ 0.01 | $ 0.01 | $ 0.01 | ||||||
| Common stock authorized (in shares) | 800,000,000 | 800,000,000 | 800,000,000 | ||||||
| Common stock issued (in shares) | 46,673,320 | 46,675,367 | 46,673,320 | ||||||
| Common Class I | Subsequent Event | |||||||||
| Class of Stock [Line Items] | |||||||||
| Shares Reclassified | 100,000,000 | ||||||||
| Common Class T | |||||||||
| Class of Stock [Line Items] | |||||||||
| Common stock, par value (in dollars per share) | $ / shares | $ 0.01 | $ 0.01 | $ 0.01 | ||||||
| Stock redeemed (in shares) | 5,208 | ||||||||
| Common stock authorized (in shares) | 200,000,000 | 200,000,000 | 200,000,000 | ||||||
| Common stock issued (in shares) | 19,552,856 | 19,535,095 | 19,552,856 | ||||||
| Common Class T | Subsequent Event | |||||||||
| Class of Stock [Line Items] | |||||||||
| Shares Reclassified | 200,000,000 | ||||||||
| Common Stock | |||||||||
| Class of Stock [Line Items] | |||||||||
| Stock redeemed (in shares) | 5,148 | ||||||||
| Reverse stock split ratio | 0.25 | ||||||||
| Common Stock | Subsequent Event | |||||||||
| Class of Stock [Line Items] | |||||||||
| Shares Reclassified | 700,000,000 | ||||||||
| Operating Partnership Units | |||||||||
| Class of Stock [Line Items] | |||||||||
| Reverse stock split ratio | 0.25 | ||||||||
| Series A Preferred Stock | |||||||||
| Class of Stock [Line Items] | |||||||||
| Par value of preferred stock, authorized to be issued (in dollars per share) | $ / shares | $ 0.01 | ||||||||
| Dividend rate of preferred stock (as a percent) | 4.75% | ||||||||
| Griffin-American Healthcare REIT III | |||||||||
| Class of Stock [Line Items] | |||||||||
| Common stock, par value (in dollars per share) | $ / shares | $ 0.01 | ||||||||
Equity - Distribution Reinvestment Plan (Details) - USD ($) |
12 Months Ended | |||||
|---|---|---|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
Jan. 18, 2019 |
|||
| Class of Stock [Line Items] | ||||||
| Issuance of common stock under the DRIP | $ 36,812,000 | $ 7,666,000 | ||||
| Total Stockholders' Equity | ||||||
| Class of Stock [Line Items] | ||||||
| Issuance of common stock under the DRIP | $ 0 | 36,812,000 | $ 7,666,000 | |||
| Common Stock | ||||||
| Class of Stock [Line Items] | ||||||
| Issuance of common stock and purchase of noncontrolling interest in connection with the Merger, shares | [1] | 20,432,815 | ||||
| Issuance of common stock under the DRIP | $ 8,000 | $ 2,000 | ||||
| Issuance of common stock under the DRIP, shares | 0 | 992,964 | 207,866 | |||
| DRIP S-3 Public Offering | ||||||
| Class of Stock [Line Items] | ||||||
| Maximum dollar amount of common stock issuable under public offering | $ 100,000,000 | |||||
| Issuance of common stock under the DRIP | $ 91,448,000 | $ 91,448,000 | ||||
| Issuance of common stock under the DRIP, shares | 2,431,695 | 2,431,695 | ||||
| ||||||
Equity - Share Repurchase Plan (Details) - USD ($) $ / shares in Units, $ in Thousands |
1 Months Ended | 12 Months Ended | 118 Months Ended | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
Oct. 01, 2021 |
Feb. 26, 2014 |
Feb. 29, 2024 |
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
Dec. 31, 2023 |
||||
| Class of Stock [Line Items] | ||||||||||
| Maximum percentage of common stock repurchased during the period | 5.00% | |||||||||
| Repurchase of common stock | $ (469) | $ (20,699) | $ (382) | [1] | ||||||
| Stock acquired average cost per share | $ 37.16 | $ 37.02 | $ 36.88 | |||||||
| Stock based compensation | $ 5,468 | $ 3,909 | $ 9,658 | |||||||
| Share Repurchase Plan | ||||||||||
| Class of Stock [Line Items] | ||||||||||
| Repurchase of common stock, shares | 1,681 | 559,195 | 10,356 | |||||||
| Repurchase of common stock | $ (62) | $ (20,699) | $ (382) | [1] | ||||||
| Restricted Stock | ||||||||||
| Class of Stock [Line Items] | ||||||||||
| Granted (shares) | 26,156 | 18,689 | ||||||||
| Granted (usd per share) | $ 31.83 | $ 37.16 | ||||||||
| Number of unnvested units (in shares) | 147,044 | 183,240 | 222,886 | 147,044 | ||||||
| Restricted Stock | Griffin-American Healthcare REIT III | ||||||||||
| Class of Stock [Line Items] | ||||||||||
| Granted (shares) | 33,750 | |||||||||
| Common Class I | ||||||||||
| Class of Stock [Line Items] | ||||||||||
| Conversion ratio (in shares) | 0.9266 | |||||||||
| Common Class I | Griffin-American Healthcare REIT III | ||||||||||
| Class of Stock [Line Items] | ||||||||||
| Conversion ratio (in shares) | 0.9266 | |||||||||
| Common Class I | Restricted Stock | Griffin-American Healthcare REIT III | ||||||||||
| Class of Stock [Line Items] | ||||||||||
| Granted (shares) | 31,273 | |||||||||
| Two Thousand Thirteen Incentive Plan | Restricted Stock | Independent Directors | ||||||||||
| Class of Stock [Line Items] | ||||||||||
| Number of unnvested units (in shares) | 4,170 | |||||||||
| Two Thousand Fifteen Incentive Plan | Restricted Stock | ||||||||||
| Class of Stock [Line Items] | ||||||||||
| Granted (shares) | 315,459 | |||||||||
| Stock based compensation | $ 5,385 | $ 3,935 | ||||||||
| Subsequent Event | Two Thousand Fifteen Incentive Plan | Restricted Stock | ||||||||||
| Class of Stock [Line Items] | ||||||||||
| Granted (shares) | 972,222 | |||||||||
| ||||||||||
Equity - Noncontrolling Interest in Total Equity (Details) - USD ($) |
1 Months Ended | 5 Months Ended | 9 Months Ended | 12 Months Ended | 15 Months Ended | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Jan. 01, 2025 |
Feb. 06, 2024 |
Dec. 31, 2023 |
Nov. 03, 2023 |
Dec. 31, 2022 |
Sep. 30, 2021 |
Dec. 01, 2015 |
Dec. 31, 2021 |
Mar. 31, 2024 |
Dec. 31, 2024 |
Dec. 31, 2020 |
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
Dec. 31, 2022 |
Oct. 01, 2021 |
Jan. 06, 2016 |
|
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Stock based compensation | $ 5,468,000 | $ 3,909,000 | $ 9,658,000 | ||||||||||||||
| Preferred stock, value, subscriptions | $ 125,000 | ||||||||||||||||
| Dividend rate of preferred stock (as a percent) | 12.50% | ||||||||||||||||
| Operating partnership units outstanding presented in total equity (as a percent) | 4.00% | 4.00% | |||||||||||||||
| Preferred Stock, Par or Stated Value Per Share | $ 0.01 | $ 0.01 | $ 0.01 | $ 0.01 | $ 0.01 | ||||||||||||
| Payments to Acquire Businesses, Net of Cash Acquired | $ 335,000 | $ 13,714,000 | $ 0 | ||||||||||||||
| Series A Preferred Stock | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Dividend rate of preferred stock (as a percent) | 4.75% | ||||||||||||||||
| Preferred Stock, Liquidation Preference Per Share | $ 25.00 | $ 25.00 | |||||||||||||||
| Preferred Stock, Par or Stated Value Per Share | $ 0.01 | ||||||||||||||||
| Lakeview IN Medical Plaza | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Joint venture ownership interest | 86.00% | 86.00% | 86.00% | 86.00% | 86.00% | ||||||||||||
| Net earning of joint venture allocated to noncontrolling interest | 14.00% | 14.00% | 14.00% | ||||||||||||||
| Lakeview IN Medical Plaza | Subsequent Event | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Joint venture ownership interest | 100.00% | ||||||||||||||||
| Payments to Acquire Businesses, Net of Cash Acquired | $ 441,000 | ||||||||||||||||
| MetSL Property Investor, LLC | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Joint venture ownership interest | 90.60% | 90.60% | 90.60% | 90.60% | 90.60% | ||||||||||||
| Net earning of joint venture allocated to noncontrolling interest | 9.40% | ||||||||||||||||
| Louisiana Senior Housing Portfolio | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Joint venture ownership interest | 90.00% | ||||||||||||||||
| Net earning of joint venture allocated to noncontrolling interest | 10.00% | ||||||||||||||||
| Profits Interests | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Forfeited (shares) | 0 | 0 | |||||||||||||||
| Exercised (shares) | 0 | 0 | |||||||||||||||
| Profits Interests | Trilogy Joint Venture | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Vesting percentage | 20.00% | ||||||||||||||||
| Vesting period | 5 years | ||||||||||||||||
| Stock based compensation | $ 83,000 | $ 83,000 | $ 8,801,000 | ||||||||||||||
| Redemption of award | $ 16,517,000 | ||||||||||||||||
| Payments for redemption of award | 8,650,000 | ||||||||||||||||
| Issuance of additional equity interests | $ 7,867,000 | ||||||||||||||||
| General Partnership | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Percentage of ownership in operating partnership | 95.00% | 95.00% | |||||||||||||||
| NewCo Sellers | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Percentage of limited partnership interest | 5.00% | 5.00% | |||||||||||||||
| Trilogy Investors, LLC | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Subsidiary, Ownership Percentage, Parent | 97.50% | ||||||||||||||||
| Noncontrolling interest, ownership percentage by noncontrolling owners | 2.50% | 3.80% | 2.50% | 3.80% | 3.80% | ||||||||||||
| Trilogy REIT Holdings, LLC | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Subsidiary, Ownership Percentage, Parent | 100.00% | 100.00% | |||||||||||||||
| Trilogy REIT Holdings, LLC | Forecast [Member] | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Payments to Acquire Businesses, Net of Cash Acquired | $ 260,000,000 | $ 240,500,000 | $ 247,000,000 | ||||||||||||||
| Trilogy REIT Holdings, LLC | Forecast [Member] | Minimum | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Payments to Acquire Businesses, Net of Cash Acquired | $ 26,000,000 | $ 24,050,000 | $ 24,700,000 | ||||||||||||||
| Lakeview IN Medical Plaza | Lakeview IN Medical Plaza | Subsequent Event | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Percentage of ownership in operating partnership | 14.00% | ||||||||||||||||
| Trilogy Investors, LLC | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Ownership percentage equity interest | 97.50% | 96.20% | 97.50% | 96.20% | 96.20% | ||||||||||||
| Trilogy REIT Holdings, LLC | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Joint venture ownership interest | 76.00% | 70.00% | 76.00% | ||||||||||||||
| Net earning of joint venture allocated to noncontrolling interest | 30.00% | ||||||||||||||||
| Trilogy REIT Holdings, LLC | Griffin-American Healthcare REIT IV, Inc. | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Joint venture ownership interest | 6.00% | 6.00% | 6.00% | 6.00% | 6.00% | ||||||||||||
| Trilogy REIT Holdings, LLC | NorthStar Healthcare Income, Inc. | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Joint venture ownership interest | 24.00% | 24.00% | |||||||||||||||
| NHI | Trilogy REIT Holdings, LLC | |||||||||||||||||
| Noncontrolling Interest [Line Items] | |||||||||||||||||
| Noncontrolling interest, ownership percentage by noncontrolling owners | 24.00% | ||||||||||||||||
Equity - Equity Compensation Plans (Details) - USD ($) $ / shares in Units, $ in Thousands |
1 Months Ended | 12 Months Ended | 118 Months Ended | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
Oct. 01, 2021 |
Feb. 29, 2024 |
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
Dec. 31, 2023 |
Jun. 15, 2023 |
||||
| Weighted Average Grant Date Fair Value | ||||||||||
| Stock based compensation | $ 5,468 | $ 3,909 | $ 9,658 | |||||||
| Unrecognized compensation expense | $ 6,865 | 6,888 | $ 6,865 | |||||||
| Unrecognized compensation expense, period of recognition | 1 year 7 months 6 days | |||||||||
| Repurchase of common stock, value | $ 469 | $ 20,699 | $ 382 | [1] | ||||||
| Stock acquired average cost per share | $ 37.16 | $ 37.02 | $ 36.88 | |||||||
| Common Class I | ||||||||||
| Weighted Average Grant Date Fair Value | ||||||||||
| Conversion ratio (in shares) | 0.9266 | |||||||||
| Common Class I | Griffin-American Healthcare REIT III | ||||||||||
| Weighted Average Grant Date Fair Value | ||||||||||
| Conversion ratio (in shares) | 0.9266 | |||||||||
| Two Thousand Fifteen Incentive Plan | Common Stock | ||||||||||
| Weighted Average Grant Date Fair Value | ||||||||||
| Share-based compensation arrangement by share-based payment award, number of shares authorized | 4,000,000 | |||||||||
| Restricted Stock | ||||||||||
| Number of Nonvested Shares of our Restricted Common Stock | ||||||||||
| Number of Nonvested Units, beginning balance (in shares) | 183,240 | 222,886 | ||||||||
| Granted (shares) | 26,156 | 18,689 | ||||||||
| Vested (in shares) | (62,352) | (58,335) | ||||||||
| Forfeited (shares) | 0 | 0 | ||||||||
| Number of Nonvested Units, ending balance (in shares) | 147,044 | 183,240 | 222,886 | 147,044 | ||||||
| Weighted Average Grant Date Fair Value | ||||||||||
| Nonvested, Weighted Average Grant Date Fair Value, beginning balance (in usd per share) | $ 36.97 | $ 36.99 | ||||||||
| Granted, Weighted Average Grant Date Fair Value (in usd per share) | 31.83 | 37.16 | ||||||||
| Vested, Weighted Average Grant Date Fair Value (in usd per share) | 37.11 | 37.14 | ||||||||
| Forfeited, Weighted average Grant Date Fair Value (in usd per share) | 0 | 0 | ||||||||
| Nonvested, Weighted Average Grant Date Fair Value, ending balance (in usd per share) | $ 35.99 | $ 36.97 | $ 36.99 | $ 35.99 | ||||||
| Restricted Stock | Griffin-American Healthcare REIT III | ||||||||||
| Number of Nonvested Shares of our Restricted Common Stock | ||||||||||
| Granted (shares) | 33,750 | |||||||||
| Restricted Stock | Common Class I | Griffin-American Healthcare REIT III | ||||||||||
| Number of Nonvested Shares of our Restricted Common Stock | ||||||||||
| Granted (shares) | 31,273 | |||||||||
| Weighted Average Grant Date Fair Value | ||||||||||
| Vesting percentage | 20.00% | |||||||||
| Vesting period | four year | |||||||||
| Restricted Stock | Two Thousand Thirteen Incentive Plan | Independent Directors | ||||||||||
| Number of Nonvested Shares of our Restricted Common Stock | ||||||||||
| Number of Nonvested Units, ending balance (in shares) | 4,170 | |||||||||
| Weighted Average Grant Date Fair Value | ||||||||||
| Nonvested, Weighted Average Grant Date Fair Value, ending balance (in usd per share) | $ 40.38 | |||||||||
| Restricted Stock | Two Thousand Fifteen Incentive Plan | ||||||||||
| Number of Nonvested Shares of our Restricted Common Stock | ||||||||||
| Granted (shares) | 315,459 | |||||||||
| Weighted Average Grant Date Fair Value | ||||||||||
| Stock based compensation | $ 5,385 | $ 3,935 | ||||||||
| Restricted Stock | Two Thousand Fifteen Incentive Plan | Subsequent Event | ||||||||||
| Number of Nonvested Shares of our Restricted Common Stock | ||||||||||
| Granted (shares) | 972,222 | |||||||||
| Restricted Stock | Two Thousand Fifteen Incentive Plan | Minimum | ||||||||||
| Weighted Average Grant Date Fair Value | ||||||||||
| Vesting period | 1 year | |||||||||
| Restricted Stock | Two Thousand Fifteen Incentive Plan | Maximum | ||||||||||
| Weighted Average Grant Date Fair Value | ||||||||||
| Vesting period | 4 years | |||||||||
| Restricted Stock Units (RSUs) | ||||||||||
| Number of Nonvested Shares of our Restricted Common Stock | ||||||||||
| Number of Nonvested Units, beginning balance (in shares) | 48,553 | 0 | ||||||||
| Granted (shares) | 191,728 | 60,077 | ||||||||
| Vested (in shares) | (6,400) | 0 | ||||||||
| Forfeited (shares) | (5,800) | (11,524) | ||||||||
| Number of Nonvested Units, ending balance (in shares) | 228,081 | 48,553 | 0 | 228,081 | ||||||
| Weighted Average Grant Date Fair Value | ||||||||||
| Nonvested, Weighted Average Grant Date Fair Value, beginning balance (in usd per share) | $ 37.16 | $ 0 | ||||||||
| Granted, Weighted Average Grant Date Fair Value (in usd per share) | 31.40 | 37.16 | ||||||||
| Vested, Weighted Average Grant Date Fair Value (in usd per share) | 37.16 | 0 | ||||||||
| Forfeited, Weighted average Grant Date Fair Value (in usd per share) | 32.57 | 37.16 | ||||||||
| Nonvested, Weighted Average Grant Date Fair Value, ending balance (in usd per share) | $ 32.43 | $ 37.16 | $ 0 | $ 32.43 | ||||||
| Share-Based Payment Arrangement, Shares Withheld for Tax Withholding Obligation | 2,280 | |||||||||
| Restricted Stock Units (RSUs) | Two Thousand Fifteen Incentive Plan | Maximum | ||||||||||
| Weighted Average Grant Date Fair Value | ||||||||||
| Vesting period | 3 years | |||||||||
| Performance Based Unit | Two Thousand Fifteen Incentive Plan | ||||||||||
| Number of Nonvested Shares of our Restricted Common Stock | ||||||||||
| Granted (shares) | 70,751 | |||||||||
| Time Based Unit | Two Thousand Fifteen Incentive Plan | ||||||||||
| Number of Nonvested Shares of our Restricted Common Stock | ||||||||||
| Granted (shares) | 169,529 | |||||||||
| ||||||||||
Related Party Transactions - Additional Information (Details) |
Sep. 30, 2021 |
|---|---|
| Griffin Capital Company | |
| Related Party Transaction [Line Items] | |
| Ownership percentage in affiliate | 2500.00% |
| American Healthcare Investors | |
| Related Party Transaction [Line Items] | |
| Ownership percentage in affiliate | 7500.00% |
Related Party Transactions - Schedule of Amounts Outstanding to Affiliates (Detail) $ in Thousands |
12 Months Ended |
|---|---|
|
Dec. 31, 2021
USD ($)
| |
| Related Party Transaction [Line Items] | |
| Related Party Transaction, Amounts of Transaction | $ 21,113 |
| Asset Management | |
| Related Party Transaction [Line Items] | |
| Related Party Transaction, Amounts of Transaction | 16,187 |
| Property Management Fee | |
| Related Party Transaction [Line Items] | |
| Related Party Transaction, Amounts of Transaction | 1,993 |
| Development Fees | |
| Related Party Transaction [Line Items] | |
| Related Party Transaction, Amounts of Transaction | 1,363 |
| Operating Expense | |
| Related Party Transaction [Line Items] | |
| Related Party Transaction, Amounts of Transaction | 856 |
| Construction Management Fee | |
| Related Party Transaction [Line Items] | |
| Related Party Transaction, Amounts of Transaction | 410 |
| Lease Commissions | |
| Related Party Transaction [Line Items] | |
| Related Party Transaction, Amounts of Transaction | 160 |
| Acquistion Fees | |
| Related Party Transaction [Line Items] | |
| Related Party Transaction, Amounts of Transaction | $ 144 |
Fair Value Measurements - Schedule of Assets and Liabilities Measured at Fair Value on Recurring Basis (Details) - Fair Value, Recurring $ in Thousands |
Dec. 31, 2023
USD ($)
|
|---|---|
| Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |
| Derivative financial instrument | $ 1,463 |
| Total assets at fair value | 1,463 |
| Liabilities: | |
| Derivative financial instruments | 2,389 |
| Total liabilities at fair value | 2,389 |
| Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) | |
| Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |
| Derivative financial instrument | 0 |
| Total assets at fair value | 0 |
| Liabilities: | |
| Derivative financial instruments | 0 |
| Total liabilities at fair value | 0 |
| Significant Other Observable Inputs (Level 2) | |
| Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |
| Derivative financial instrument | 1,463 |
| Total assets at fair value | 1,463 |
| Liabilities: | |
| Derivative financial instruments | 2,389 |
| Total liabilities at fair value | 2,389 |
| Significant Unobservable Inputs (Level 3) | |
| Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |
| Derivative financial instrument | 0 |
| Total assets at fair value | 0 |
| Liabilities: | |
| Derivative financial instruments | 0 |
| Total liabilities at fair value | $ 0 |
Fair Value Measurements - Narrative (Details) $ in Thousands |
3 Months Ended |
|---|---|
|
Dec. 31, 2022
USD ($)
| |
| Business Acquisitions [Line Items] | |
| Warrants redeemed | $ 678 |
Fair Value Measurements Fair Value by Balance Sheet Grouping (Details) - USD ($) $ in Thousands |
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
||||
|---|---|---|---|---|---|---|---|
| Financial Instruments, Financial Assets, Balance Sheet Groupings [Abstract] | |||||||
| Debt security investment, net | $ 86,935 | $ 83,000 | |||||
| Debt security investment, fair value | 93,304 | 93,230 | |||||
| Financial Instruments, Financial Liabilities, Balance Sheet Groupings [Abstract] | |||||||
| Mortgage loans payable, net | 1,302,396 | [1] | 1,229,847 | [1] | $ 1,095,594 | ||
| Mortgage loans payable, net fair value | 1,185,260 | 1,091,667 | |||||
| Lines of credit and term loan, net | 1,220,137 | 1,277,460 | |||||
| Lines of credit and term loan, net fair value | $ 1,225,890 | $ 1,285,205 | |||||
| |||||||
Income Taxes - Income Before Income Tax (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
| Income Tax Disclosure [Abstract] | |||
| Domestic | $ (75,843) | $ (72,510) | $ (52,001) |
| Foreign | (381) | (287) | (312) |
| Loss before income taxes | $ (76,224) | $ (72,797) | $ (52,313) |
Income Taxes - Income Tax (Benefit) Expense (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
| Income Tax Disclosure [Abstract] | |||
| Federal deferred | $ (655) | $ (8,176) | $ (12,033) |
| State deferred | 210 | (2,099) | (2,908) |
| Federal current | 10 | 0 | 0 |
| State current | (3) | 0 | 329 |
| Foreign current | 656 | 586 | 627 |
| Valuation allowances | 445 | 10,275 | 14,941 |
| Total income tax expense | $ 663 | $ 586 | $ 956 |
Income Taxes - Deferred Taxes (Details) - USD ($) $ in Thousands |
Dec. 31, 2023 |
Dec. 31, 2022 |
|---|---|---|
| Income Tax Disclosure [Abstract] | ||
| Fixed assets and intangibles | $ 7,297 | $ 8,271 |
| Expense accruals and other | 10,535 | 18,189 |
| Net operating loss and other carry forwards | 57,011 | 50,101 |
| Reserves and accruals | 8,119 | 7,487 |
| Allowances for accounts receivable | 2,878 | 2,224 |
| Investments in unconsolidated entities | 75 | 0 |
| Total deferred income tax assets | 85,915 | 86,272 |
| Fixed assets and intangibles | (12,892) | (13,626) |
| Other — temporary differences | (2,608) | (2,676) |
| Total deferred income tax liabilities | (15,500) | (16,302) |
| Net deferred income tax assets before valuation allowance | 70,415 | 69,970 |
| Valuation allowances | (70,415) | (69,970) |
| Net deferred income tax assets (liabilities) | $ 0 | $ 0 |
Income Taxes - Additional Information (Details) - USD ($) $ in Thousands |
Dec. 31, 2023 |
Dec. 31, 2022 |
|---|---|---|
| Income Tax Disclosure [Abstract] | ||
| NOL carryforwards | $ 203,320 | $ 196,779 |
Income Taxes - Tax Treatment of Distributions (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
| Income Tax Disclosure [Abstract] | |||
| Ordinary income | $ 2,208 | $ 40,745 | $ 7,989 |
| Capital gain | 0 | 0 | 0 |
| Return of capital | 73,614 | 46,890 | 22,406 |
| Distributions reportable | $ 75,822 | $ 87,635 | $ 30,395 |
| Ordinary income (as a percent) | 2.90% | 46.50% | 26.30% |
| Capital gain (as a percent) | 0.00% | 0.00% | 0.00% |
| Return of capital (as a percent) | 97.10% | 53.50% | 73.70% |
| Percentage distribution reportable (as a percent) | 100.00% | 100.00% | 100.00% |
Leases Additional Information (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
| Lessee, Lease, Description [Line Items] | |||
| Operating lease revenue | $ 185,064 | $ 200,526 | $ 136,294 |
| Variable lease payments | $ 38,415 | $ 39,278 | $ 23,340 |
Leases Lessor, Future Minimum Rents Due (Details) $ in Thousands |
Dec. 31, 2023
USD ($)
|
|---|---|
| Future Minimum Rent [Abstract] | |
| 2024 | $ 134,438 |
| 2025 | 125,035 |
| 2026 | 115,544 |
| 2027 | 109,950 |
| 2028 | 98,546 |
| Thereafter | 466,484 |
| Total | $ 1,049,997 |
Leases Components of Lease Cost (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
| Leases [Abstract] | |||
| Operating Lease, Cost | $ 44,141 | $ 30,566 | $ 23,774 |
| Amortization of leased assets | 1,360 | 1,249 | 1,447 |
| Interest on lease liabilities | 353 | 261 | 384 |
| Sublease income | (572) | (693) | (210) |
| Total lease cost | $ 45,282 | $ 31,383 | $ 25,395 |
Leases Lease Term and Discount Rate (Details) |
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|---|---|---|---|
| Leases [Abstract] | |||
| Operating leases, weighted average remaining lease term | 12 years 2 months 12 days | 12 years 9 months 18 days | 16 years 10 months 24 days |
| Finance leases, weighted average remaining lease term | 1 year 6 months | 2 years 3 months 18 days | 3 years 7 months 6 days |
| Operating leases, weighted average discount rate | 5.76% | 5.69% | 5.52% |
| Finance leases, weighted average discount rate | 7.78% | 7.66% | 7.68% |
Leases Supplemental Disclosure of Cash Flows Information (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
| Leases [Abstract] | |||
| Operating cash outflows related to finance leases | $ 353 | $ 262 | $ 384 |
| Financing cash outflows related to finance leases | 62 | 54 | 170 |
| Right-of-use assets obtained in exchange for operating lease liabilities | $ 6,153 | $ 173,832 | $ 29,523 |
Leases Future Minimum Rent Payments, Operating Leases (Details) - USD ($) $ in Thousands |
Dec. 31, 2023 |
Dec. 31, 2022 |
||
|---|---|---|---|---|
| Lessee, Operating Lease, Description [Abstract] | ||||
| 2024 | $ 35,834 | |||
| 2025 | 35,153 | |||
| 2026 | 35,073 | |||
| 2027 | 35,618 | |||
| 2028 | 35,707 | |||
| Thereafter | 166,313 | |||
| Total undiscounted operating lease payments | 343,698 | |||
| Less: interest | 118,196 | |||
| Present value of operating lease liabilities | [1] | $ 225,502 | $ 273,075 | |
| ||||
Leases Future Minimum Rent Payments, Finance Leases (Details) - USD ($) $ in Thousands |
Dec. 31, 2023 |
Dec. 31, 2022 |
|---|---|---|
| Lessee, Finance Lease, Description [Abstract] | ||
| 2024 | $ 76 | |
| 2025 | 31 | |
| 2026 | 0 | |
| 2027 | 0 | |
| 2028 | 0 | |
| Thereafter | 0 | |
| Total undiscounted finance lease payments | 107 | |
| Less: interest | 7 | |
| Present value of finance lease liabilities | $ 100 | |
| Finance Lease, Liability, Statement of Financial Position [Extensible Enumeration] | Security deposits, prepaid rent and other liabilities | Security deposits, prepaid rent and other liabilities |
Segment Reporting - Summary Information for Reportable Segments (Details) $ in Thousands |
12 Months Ended | |||||
|---|---|---|---|---|---|---|
|
Dec. 31, 2023
USD ($)
segment
|
Dec. 05, 2022
campus
|
Feb. 08, 2022
USD ($)
|
Dec. 31, 2023
USD ($)
segment
|
Dec. 31, 2022
USD ($)
|
Dec. 31, 2021
USD ($)
|
|
| Segment Reporting [Line Items] | ||||||
| Number of reportable segments | segment | 4 | 4 | ||||
| Number of properties acquired | campus | 7 | |||||
| Goodwill | $ 234,942 | $ 234,942 | $ 231,611 | $ 209,898 | ||
| Revenues and grant income: | ||||||
| Resident fees and services | 1,668,742 | 1,412,156 | 1,123,935 | |||
| Real estate revenue | 190,401 | 205,344 | 141,368 | |||
| Grant income | 7,475 | 25,675 | 16,951 | |||
| Total revenues and grant income | 1,866,618 | 1,643,175 | 1,282,254 | |||
| Expenses: | ||||||
| Property operating expenses | 1,502,310 | 1,281,526 | 1,030,193 | |||
| Rental expenses | 57,475 | 59,684 | 38,725 | |||
| Segment net operating income | 306,833 | 301,965 | 213,336 | |||
| Expenses: | ||||||
| General and administrative | 47,510 | 43,418 | 43,199 | |||
| Business acquisition expenses | 5,795 | 4,388 | 13,022 | |||
| Depreciation and amortization | 182,604 | 167,957 | 133,191 | |||
| Gain on re-measurement of previously held equity interests | 726 | 19,567 | 0 | |||
| Other income (expense): | ||||||
| Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments) | (163,191) | (105,956) | (80,937) | |||
| (Loss) gain in fair value of derivative financial instruments | (926) | 500 | 8,200 | |||
| Gain (loss) on dispositions of real estate investments, net | $ 683 | 32,472 | 5,481 | (100) | ||
| Impairment of real estate investments | (13,899) | (54,579) | (3,335) | |||
| Impairment loss | (10,520) | (23,277) | 0 | |||
| (Loss) income from unconsolidated entities | (1,718) | 1,407 | (1,355) | |||
| Foreign currency gain (loss) | 2,307 | (5,206) | (564) | |||
| Other income | 7,601 | 3,064 | 1,854 | |||
| Total net other expense | (147,148) | (158,999) | (76,237) | |||
| Income before income taxes | (76,224) | (72,797) | (52,313) | |||
| Income tax expense | (663) | (586) | (956) | |||
| Net loss | (76,887) | (73,383) | (53,269) | |||
| Integrated Senior Health Campuses | ||||||
| Segment Reporting [Line Items] | ||||||
| Goodwill | 168,177 | 168,177 | 164,846 | 119,856 | ||
| Revenues and grant income: | ||||||
| Resident fees and services | 1,481,880 | 1,254,665 | 1,025,699 | |||
| Real estate revenue | 0 | 0 | 0 | |||
| Grant income | 7,475 | 24,820 | 13,911 | |||
| Total revenues and grant income | 1,489,355 | 1,279,485 | 1,039,610 | |||
| Expenses: | ||||||
| Property operating expenses | 1,335,817 | 1,133,480 | 943,743 | |||
| Rental expenses | 0 | 0 | 0 | |||
| Segment net operating income | 153,538 | 146,005 | 95,867 | |||
| Other income (expense): | ||||||
| Impairment loss | 0 | |||||
| SHOP | ||||||
| Segment Reporting [Line Items] | ||||||
| Goodwill | 0 | 0 | 0 | 23,277 | ||
| Revenues and grant income: | ||||||
| Resident fees and services | 186,862 | 157,491 | 98,236 | |||
| Real estate revenue | 0 | 0 | 0 | |||
| Grant income | 0 | 855 | 3,040 | |||
| Total revenues and grant income | 186,862 | 158,346 | 101,276 | |||
| Expenses: | ||||||
| Property operating expenses | 166,493 | 148,046 | 86,450 | |||
| Rental expenses | 0 | 0 | 0 | |||
| Segment net operating income | 20,369 | 10,300 | 14,826 | |||
| Other income (expense): | ||||||
| Impairment of real estate investments | (54,579) | |||||
| Impairment loss | (23,277) | |||||
| Outpatient Medical | ||||||
| Segment Reporting [Line Items] | ||||||
| Goodwill | 47,812 | 47,812 | 47,812 | 47,812 | ||
| Revenues and grant income: | ||||||
| Resident fees and services | 0 | 0 | 0 | |||
| Real estate revenue | 146,068 | 148,717 | 97,297 | |||
| Grant income | 0 | 0 | 0 | |||
| Total revenues and grant income | 146,068 | 148,717 | 97,297 | |||
| Expenses: | ||||||
| Property operating expenses | 0 | 0 | 0 | |||
| Rental expenses | 54,457 | 56,390 | 36,375 | |||
| Segment net operating income | 91,611 | 92,327 | 60,922 | |||
| Other income (expense): | ||||||
| Impairment loss | 0 | |||||
| Triple-net leased properties | ||||||
| Segment Reporting [Line Items] | ||||||
| Goodwill | $ 18,953 | 18,953 | 18,953 | 18,953 | ||
| Revenues and grant income: | ||||||
| Resident fees and services | 0 | 0 | 0 | |||
| Real estate revenue | 44,333 | 56,627 | 44,071 | |||
| Grant income | 0 | 0 | 0 | |||
| Total revenues and grant income | 44,333 | 56,627 | 44,071 | |||
| Expenses: | ||||||
| Property operating expenses | 0 | 0 | 0 | |||
| Rental expenses | 3,018 | 3,294 | 2,350 | |||
| Segment net operating income | $ 41,315 | 53,333 | $ 41,721 | |||
| Other income (expense): | ||||||
| Impairment loss | $ 0 | |||||
Segment Reporting - Assets by Reportable Segment (Details) - USD ($) $ in Thousands |
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
Oct. 01, 2021 |
|---|---|---|---|---|
| Segment Reporting [Line Items] | ||||
| Total assets | $ 4,577,933 | $ 4,786,698 | ||
| Goodwill | 234,942 | 231,611 | $ 209,898 | |
| AHI | ||||
| Segment Reporting [Line Items] | ||||
| Goodwill | $ 134,589 | |||
| AHI | Outpatient Medical | ||||
| Segment Reporting [Line Items] | ||||
| Goodwill | 47,812 | |||
| AHI | Skilled Nursing Facilities | ||||
| Segment Reporting [Line Items] | ||||
| Goodwill | 4,389 | |||
| AHI | Hospitals | ||||
| Segment Reporting [Line Items] | ||||
| Goodwill | 5,924 | |||
| AHI | SHOP | ||||
| Segment Reporting [Line Items] | ||||
| Goodwill | 23,277 | |||
| AHI | Senior Housing | ||||
| Segment Reporting [Line Items] | ||||
| Goodwill | 8,640 | |||
| AHI | Integrated Senior Health Campuses | ||||
| Segment Reporting [Line Items] | ||||
| Goodwill | $ 44,547 | |||
| Integrated Senior Health Campuses | ||||
| Segment Reporting [Line Items] | ||||
| Total assets | 2,197,762 | 2,157,748 | ||
| Goodwill | 168,177 | 164,846 | 119,856 | |
| Outpatient Medical | ||||
| Segment Reporting [Line Items] | ||||
| Total assets | 1,232,310 | 1,379,502 | ||
| Goodwill | 47,812 | 47,812 | 47,812 | |
| SHOP | ||||
| Segment Reporting [Line Items] | ||||
| Total assets | 630,373 | 635,190 | ||
| Goodwill | 0 | 0 | 23,277 | |
| Triple-net leased properties | ||||
| Segment Reporting [Line Items] | ||||
| Total assets | 502,836 | 601,360 | ||
| Goodwill | 18,953 | 18,953 | $ 18,953 | |
| Other | ||||
| Segment Reporting [Line Items] | ||||
| Total assets | $ 14,652 | $ 12,898 |
Segment Reporting - Goodwill by Segment (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
| Goodwill [Roll Forward] | |||
| Goodwill, beginning balance | $ 231,611 | $ 209,898 | |
| Goodwill acquired | 3,331 | 44,990 | |
| Impairment loss | (10,520) | (23,277) | $ 0 |
| Goodwill, ending balance | 234,942 | 231,611 | 209,898 |
| Integrated Senior Health Campuses | |||
| Goodwill [Roll Forward] | |||
| Goodwill, beginning balance | 164,846 | 119,856 | |
| Goodwill acquired | 3,331 | 44,990 | |
| Impairment loss | 0 | ||
| Goodwill, ending balance | 168,177 | 164,846 | 119,856 |
| Outpatient Medical | |||
| Goodwill [Roll Forward] | |||
| Goodwill, beginning balance | 47,812 | 47,812 | |
| Goodwill acquired | 0 | 0 | |
| Impairment loss | 0 | ||
| Goodwill, ending balance | 47,812 | 47,812 | 47,812 |
| SHOP | |||
| Goodwill [Roll Forward] | |||
| Goodwill, beginning balance | 0 | 23,277 | |
| Goodwill acquired | 0 | 0 | |
| Impairment loss | (23,277) | ||
| Goodwill, ending balance | 0 | 0 | 23,277 |
| Triple-net leased properties | |||
| Goodwill [Roll Forward] | |||
| Goodwill, beginning balance | 18,953 | 18,953 | |
| Goodwill acquired | 0 | 0 | |
| Impairment loss | 0 | ||
| Goodwill, ending balance | $ 18,953 | $ 18,953 | $ 18,953 |
Segment Reporting - Segment Information by Geographic Region (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
| Segment Reporting [Line Items] | |||
| Total revenues and grant income | $ 1,866,618 | $ 1,643,175 | $ 1,282,254 |
| Real estate investments, net | 3,425,438 | 3,581,609 | |
| United States | |||
| Segment Reporting [Line Items] | |||
| Total revenues and grant income | 1,861,954 | 1,638,557 | 1,277,095 |
| Real estate investments, net | 3,382,115 | 3,539,453 | |
| International | |||
| Segment Reporting [Line Items] | |||
| Total revenues and grant income | 4,664 | 4,618 | $ 5,159 |
| Real estate investments, net | $ 43,323 | $ 42,156 | |
Concentration of Credit Risk (Details) |
12 Months Ended | |
|---|---|---|
|
Dec. 31, 2023
segment
tenant
State
|
Dec. 31, 2023
segment
tenant
State
|
|
| Concentration of Credit Risk | ||
| Number of states that generated at least 10% of annualized base rent | State | 2 | 2 |
| Minimum percent share of each state annualized base rent that company owned | 10.00% | 10.00% |
| Number of reportable segments | segment | 4 | 4 |
| Number of tenants with more than ten percent of annual base rent | tenant | 0 | 0 |
| Minimum percent share of annualized base rent accounted by tenants | 10.00% | 10.00% |
| Outpatient Medical | ||
| Concentration of Credit Risk | ||
| Percentage of annual base rent | 28.70% | 28.70% |
| Integrated Senior Health Campuses | ||
| Concentration of Credit Risk | ||
| Percentage of annual base rent | 51.00% | 51.00% |
| Triple-net leased properties | ||
| Concentration of Credit Risk | ||
| Percentage of annual base rent | 11.50% | 11.50% |
| SHOP | ||
| Concentration of Credit Risk | ||
| Percentage of annual base rent | 8.80% | 8.80% |
| Indiana | ||
| Concentration of Credit Risk | ||
| Percentage of annual base rent | 35.30% | 35.30% |
| MICHIGAN | ||
| Concentration of Credit Risk | ||
| Percentage of annual base rent | 10.40% | 10.40% |
Per Share Data (Detail) - USD ($) $ in Thousands |
12 Months Ended | ||
|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
| Anti-dilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | |||
| Participating securities, distributed and undistributed earnings (loss), basic | $ 3,803 | $ 5,967 | $ 1,440 |
| Restricted Common Stock | |||
| Anti-dilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | |||
| Anti-dilutive securities excluded from computation of earnings per share | 147,044 | 183,240 | |
| Limited Partnership Units | |||
| Anti-dilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | |||
| Anti-dilutive securities excluded from computation of earnings per share | 3,501,976 | 3,501,976 | |
| Restricted Stock Units (RSUs) | Time Based Unit | |||
| Anti-dilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | |||
| Anti-dilutive securities excluded from computation of earnings per share | 157,329 | 19,200 | |
| Restricted Stock Units (RSUs) | Performance Based Unit | |||
| Anti-dilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | |||
| Anti-dilutive securities excluded from computation of earnings per share | 70,751 | 29,352 | |
Subsequent Events (Details) |
12 Months Ended | ||||||
|---|---|---|---|---|---|---|---|
|
Mar. 13, 2024
$ / shares
|
Feb. 09, 2024
USD ($)
$ / shares
shares
|
Dec. 31, 2023
USD ($)
$ / shares
shares
|
Dec. 31, 2022
USD ($)
$ / shares
shares
|
Dec. 31, 2021
USD ($)
$ / shares
|
Feb. 14, 2024
USD ($)
|
Feb. 01, 2024
USD ($)
facility
|
|
| Subsequent Events [Line Items] | |||||||
| Common stock authorized (in shares) | shares | 1,000,000,000 | 1,000,000,000 | |||||
| Repayments of Lines of Credit | $ 459,361,000 | $ 1,104,400,000 | $ 157,000,000 | ||||
| Distributions declared (in usd per share) | $ / shares | $ 1.00 | $ 1.60 | $ 0.69 | ||||
| Subsequent Event | |||||||
| Subsequent Events [Line Items] | |||||||
| Common stock authorized (in shares) | shares | 64,400,000 | ||||||
| Common stock, par value (in dollars per share) | $ / shares | $ 0.01 | ||||||
| Proceeds from Issuance of Common Stock | $ 772,800,000 | ||||||
| Sale of Stock, Consideration Received on Transaction | 724,625,000 | ||||||
| Repayments of Long-Term Debt | 176,145,000 | ||||||
| Repayments of Lines of Credit | $ 545,010,000 | ||||||
| Subsequent Event | Over-Allotment Option | |||||||
| Subsequent Events [Line Items] | |||||||
| Sale of Stock, Number of Shares Issued in Transaction | shares | 8,400,000 | ||||||
| Subsequent Event | Senior Housing Facility | |||||||
| Subsequent Events [Line Items] | |||||||
| Number of Housing Facilities Acquired | facility | 12 | ||||||
| Liabilities assumed | $ 94,461,000 | ||||||
| Subsequent Event | Quarterly Dividend | |||||||
| Subsequent Events [Line Items] | |||||||
| Distributions declared (in usd per share) | $ / shares | $ 0.25 | ||||||
| Subsequent Event | Annual Dividend | |||||||
| Subsequent Events [Line Items] | |||||||
| Distributions declared (in usd per share) | $ / shares | $ 1.00 | ||||||
| Subsequent Event | Commitment Utilization Scenario 1 | Minimum | |||||||
| Subsequent Events [Line Items] | |||||||
| Commitment Utilization Percentage used for fee calculation | 0.25% | ||||||
| Subsequent Event | Commitment Utilization Scenario 1 | Maximum | |||||||
| Subsequent Events [Line Items] | |||||||
| Commitment Utilization Percentage used for fee calculation | 50.00% | ||||||
| Subsequent Event | Commitment Utilization Scenario 2 | Minimum | |||||||
| Subsequent Events [Line Items] | |||||||
| Commitment Utilization Percentage used for fee calculation | 0.20% | ||||||
| Subsequent Event | Commitment Utilization Scenario 2 | Maximum | |||||||
| Subsequent Events [Line Items] | |||||||
| Commitment Utilization Percentage used for fee calculation | 50.00% | ||||||
| Subsequent Event | Revolving Credit Facility | |||||||
| Subsequent Events [Line Items] | |||||||
| Line of credit facility, maximum borrowing capacity | $ 1,150,000,000 | ||||||
| Subsequent Event | Senior Unsecured Revolving Credit Facility | |||||||
| Subsequent Events [Line Items] | |||||||
| Line of credit facility, maximum borrowing capacity | 600,000,000 | ||||||
| Subsequent Event | Senior Unsecured Term Loan Facility | |||||||
| Subsequent Events [Line Items] | |||||||
| Line of credit facility, maximum borrowing capacity | $ 550,000,000 | ||||||
Schedule III Real Estate and Accumulated Depreciation (Details) - USD ($) |
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
Dec. 31, 2020 |
|---|---|---|---|---|
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | $ 1,326,313,000 | |||
| Initial cost to company, land | 327,467,000 | |||
| Initial cost to company, buildings and improvements | 3,328,973,000 | |||
| Cost capitalized subsequent to acquisition | 521,155,000 | |||
| Gross amount of which carried at close of period, land | 335,946,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 3,841,649,000 | |||
| Gross amount of which carried at close of period, total | 4,177,595,000 | $ 4,236,447,000 | $ 4,038,572,000 | $ 2,762,272,000 |
| Gross amount of which carried at close of period, accumulated deprecation | (752,157,000) | $ (654,838,000) | $ (523,886,000) | $ (425,272,000) |
| Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 1,312,019,000 | |||
| Initial cost to company, land | 325,412,000 | |||
| Initial cost to company, buildings and improvements | 3,228,159,000 | |||
| Cost capitalized subsequent to acquisition | 355,820,000 | |||
| Gross amount of which carried at close of period, land | 332,402,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 3,576,989,000 | |||
| Gross amount of which carried at close of period, total | 3,909,391,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (627,189,000) | |||
| Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,130,000 | |||
| Initial cost to company, buildings and improvements | 84,944,000 | |||
| Cost capitalized subsequent to acquisition | 157,431,000 | |||
| Gross amount of which carried at close of period, land | 2,051,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 241,454,000 | |||
| Gross amount of which carried at close of period, total | 243,505,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (123,997,000) | |||
| Construction in Progress [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 14,294,000 | |||
| Initial cost to company, land | 925,000 | |||
| Initial cost to company, buildings and improvements | 15,870,000 | |||
| Cost capitalized subsequent to acquisition | 7,904,000 | |||
| Gross amount of which carried at close of period, land | 1,493,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 23,206,000 | |||
| Gross amount of which carried at close of period, total | 24,699,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (971,000) | |||
| Wichita KS OM [Member] | Wichita, KS [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 943,000 | |||
| Initial cost to company, buildings and improvements | 6,288,000 | |||
| Cost capitalized subsequent to acquisition | 812,000 | |||
| Gross amount of which carried at close of period, land | 943,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 7,100,000 | |||
| Gross amount of which carried at close of period, total | 8,043,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,316,000) | |||
| Delta Valley ALF Portfolio [Member] | Batesville, MS [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 331,000 | |||
| Initial cost to company, buildings and improvements | 5,103,000 | |||
| Cost capitalized subsequent to acquisition | (335,000) | |||
| Gross amount of which carried at close of period, land | 331,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 4,768,000 | |||
| Gross amount of which carried at close of period, total | 5,099,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,295,000) | |||
| Delta Valley ALF Portfolio [Member] | Cleveland, MS [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 348,000 | |||
| Initial cost to company, buildings and improvements | 6,369,000 | |||
| Cost capitalized subsequent to acquisition | (921,000) | |||
| Gross amount of which carried at close of period, land | 355,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 5,441,000 | |||
| Gross amount of which carried at close of period, total | 5,796,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,460,000) | |||
| Delta Valley ALF Portfolio [Member] | Springdale, AR [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 891,000 | |||
| Initial cost to company, buildings and improvements | 6,538,000 | |||
| Cost capitalized subsequent to acquisition | (705,000) | |||
| Gross amount of which carried at close of period, land | 891,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 5,833,000 | |||
| Gross amount of which carried at close of period, total | 6,724,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,502,000) | |||
| Lee's Summit MO OM [Member] | Lee's Summit, MO [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,045,000 | |||
| Initial cost to company, buildings and improvements | 5,068,000 | |||
| Cost capitalized subsequent to acquisition | 1,530,000 | |||
| Gross amount of which carried at close of period, land | 1,045,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 6,598,000 | |||
| Gross amount of which carried at close of period, total | 7,643,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,190,000) | |||
| Carolina Commons OM [Member] | Indian Land, SC [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,028,000 | |||
| Initial cost to company, buildings and improvements | 9,430,000 | |||
| Cost capitalized subsequent to acquisition | 4,931,000 | |||
| Gross amount of which carried at close of period, land | 1,028,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 14,361,000 | |||
| Gross amount of which carried at close of period, total | 15,389,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (4,378,000) | |||
| Mount Olympia OM Portflio [Member] | Mount Dora, FL [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 393,000 | |||
| Initial cost to company, buildings and improvements | 5,633,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 393,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 5,633,000 | |||
| Gross amount of which carried at close of period, total | 6,026,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,576,000) | |||
| Southlake TX Hospital [Member] | Southlake, TX [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 91,601,000 | |||
| Initial cost to company, land | 5,089,000 | |||
| Initial cost to company, buildings and improvements | 108,517,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 5,089,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 108,517,000 | |||
| Gross amount of which carried at close of period, total | 113,606,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (26,425,000) | |||
| East Texas OM Portfolio [Member] | Longview, TX One [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 0 | |||
| Initial cost to company, buildings and improvements | 19,942,000 | |||
| Cost capitalized subsequent to acquisition | 9,079,000 | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 29,021,000 | |||
| Gross amount of which carried at close of period, total | 29,021,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (6,397,000) | |||
| East Texas OM Portfolio [Member] | Longview, TX Three [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 759,000 | |||
| Initial cost to company, buildings and improvements | 1,696,000 | |||
| Cost capitalized subsequent to acquisition | 140,000 | |||
| Gross amount of which carried at close of period, land | 759,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 1,836,000 | |||
| Gross amount of which carried at close of period, total | 2,595,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (912,000) | |||
| East Texas OM Portfolio [Member] | Longview, TX Four [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 0 | |||
| Initial cost to company, buildings and improvements | 8,027,000 | |||
| Cost capitalized subsequent to acquisition | 1,000 | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 8,028,000 | |||
| Gross amount of which carried at close of period, total | 8,028,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,489,000) | |||
| East Texas OM Portfolio [Member] | Longview, TX Five [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 0 | |||
| Initial cost to company, buildings and improvements | 696,000 | |||
| Cost capitalized subsequent to acquisition | 41,000 | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 737,000 | |||
| Gross amount of which carried at close of period, total | 737,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (335,000) | |||
| East Texas OM Portfolio [Member] | Longview, TX Six [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 0 | |||
| Initial cost to company, buildings and improvements | 27,601,000 | |||
| Cost capitalized subsequent to acquisition | 5,494,000 | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 33,095,000 | |||
| Gross amount of which carried at close of period, total | 33,095,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (10,359,000) | |||
| East Texas OM Portfolio [Member] | Marshall, TX [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 368,000 | |||
| Initial cost to company, buildings and improvements | 1,711,000 | |||
| Cost capitalized subsequent to acquisition | 110,000 | |||
| Gross amount of which carried at close of period, land | 368,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 1,821,000 | |||
| Gross amount of which carried at close of period, total | 2,189,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (856,000) | |||
| Premier OM [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 644,000 | |||
| Initial cost to company, buildings and improvements | 10,420,000 | |||
| Cost capitalized subsequent to acquisition | 2,031,000 | |||
| Gross amount of which carried at close of period, land | 644,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,451,000 | |||
| Gross amount of which carried at close of period, total | 13,095,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,808,000) | |||
| Premier OM [Member] | Novi, MI [Domain] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Independence OM Portfolio [Member] | Southgate, KY [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 411,000 | |||
| Initial cost to company, buildings and improvements | 11,005,000 | |||
| Cost capitalized subsequent to acquisition | 2,530,000 | |||
| Gross amount of which carried at close of period, land | 411,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,535,000 | |||
| Gross amount of which carried at close of period, total | 13,946,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (4,112,000) | |||
| Independence OM Portfolio [Member] | Somerville, MA [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 28,474,000 | |||
| Initial cost to company, land | 1,509,000 | |||
| Initial cost to company, buildings and improvements | 46,775,000 | |||
| Cost capitalized subsequent to acquisition | 6,500,000 | |||
| Gross amount of which carried at close of period, land | 1,509,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 53,275,000 | |||
| Gross amount of which carried at close of period, total | 54,784,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (12,866,000) | |||
| Independence OM Portfolio [Member] | Verona, NJ [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,683,000 | |||
| Initial cost to company, buildings and improvements | 9,405,000 | |||
| Cost capitalized subsequent to acquisition | 2,409,000 | |||
| Gross amount of which carried at close of period, land | 1,683,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,814,000 | |||
| Gross amount of which carried at close of period, total | 13,497,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,175,000) | |||
| Independence OM Portfolio [Member] | Bronx, NY [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 0 | |||
| Initial cost to company, buildings and improvements | 19,593,000 | |||
| Cost capitalized subsequent to acquisition | 3,403,000 | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 22,996,000 | |||
| Gross amount of which carried at close of period, total | 22,996,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (6,098,000) | |||
| King of Prussia PA OM [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 3,427,000 | |||
| Initial cost to company, buildings and improvements | 13,849,000 | |||
| Cost capitalized subsequent to acquisition | 6,305,000 | |||
| Gross amount of which carried at close of period, land | 3,427,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 20,154,000 | |||
| Gross amount of which carried at close of period, total | 23,581,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (6,232,000) | |||
| North Carolina ALF Portfolio | Clemmons, NC [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 596,000 | |||
| Initial cost to company, buildings and improvements | 13,237,000 | |||
| Cost capitalized subsequent to acquisition | (412,000) | |||
| Gross amount of which carried at close of period, land | 596,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,825,000 | |||
| Gross amount of which carried at close of period, total | 13,421,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,296,000) | |||
| North Carolina ALF Portfolio | Garner, NC [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,723,000 | |||
| Initial cost to company, buildings and improvements | 11,517,000 | |||
| Cost capitalized subsequent to acquisition | 196,000 | |||
| Gross amount of which carried at close of period, land | 1,723,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,713,000 | |||
| Gross amount of which carried at close of period, total | 13,436,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,988,000) | |||
| North Carolina ALF Portfolio | Huntersville, NC [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 2,033,000 | |||
| Initial cost to company, buildings and improvements | 11,494,000 | |||
| Cost capitalized subsequent to acquisition | 95,000 | |||
| Gross amount of which carried at close of period, land | 2,033,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,589,000 | |||
| Gross amount of which carried at close of period, total | 13,622,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,573,000) | |||
| North Carolina ALF Portfolio | Matthews, NC [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 949,000 | |||
| Initial cost to company, buildings and improvements | 12,537,000 | |||
| Cost capitalized subsequent to acquisition | (5,000) | |||
| Gross amount of which carried at close of period, land | 949,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,532,000 | |||
| Gross amount of which carried at close of period, total | 13,481,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,248,000) | |||
| North Carolina ALF Portfolio | Mooresville, NC [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 835,000 | |||
| Initial cost to company, buildings and improvements | 15,894,000 | |||
| Cost capitalized subsequent to acquisition | (350,000) | |||
| Gross amount of which carried at close of period, land | 835,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 15,544,000 | |||
| Gross amount of which carried at close of period, total | 16,379,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,945,000) | |||
| North Carolina ALF Portfolio | Raleigh, NC [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,069,000 | |||
| Initial cost to company, buildings and improvements | 21,235,000 | |||
| Cost capitalized subsequent to acquisition | (429,000) | |||
| Gross amount of which carried at close of period, land | 1,069,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 20,806,000 | |||
| Gross amount of which carried at close of period, total | 21,875,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (5,036,000) | |||
| North Carolina ALF Portfolio | Wake Forest, NC [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 772,000 | |||
| Initial cost to company, buildings and improvements | 13,596,000 | |||
| Cost capitalized subsequent to acquisition | (432,000) | |||
| Gross amount of which carried at close of period, land | 772,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,164,000 | |||
| Gross amount of which carried at close of period, total | 13,936,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,144,000) | |||
| Orange Star Medical Portfolio [Member] | Durango, CO One [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 623,000 | |||
| Initial cost to company, buildings and improvements | 14,166,000 | |||
| Cost capitalized subsequent to acquisition | 483,000 | |||
| Gross amount of which carried at close of period, land | 623,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 14,649,000 | |||
| Gross amount of which carried at close of period, total | 15,272,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,664,000) | |||
| Orange Star Medical Portfolio [Member] | Durango, CO Two [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 788,000 | |||
| Initial cost to company, buildings and improvements | 10,467,000 | |||
| Cost capitalized subsequent to acquisition | 1,242,000 | |||
| Gross amount of which carried at close of period, land | 788,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,709,000 | |||
| Gross amount of which carried at close of period, total | 12,497,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,059,000) | |||
| Orange Star Medical Portfolio [Member] | Friendswood, TX [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 500,000 | |||
| Initial cost to company, buildings and improvements | 7,664,000 | |||
| Cost capitalized subsequent to acquisition | 1,114,000 | |||
| Gross amount of which carried at close of period, land | 500,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 8,778,000 | |||
| Gross amount of which carried at close of period, total | 9,278,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,338,000) | |||
| Orange Star Medical Portfolio [Member] | Keller, TX [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,604,000 | |||
| Initial cost to company, buildings and improvements | 7,912,000 | |||
| Cost capitalized subsequent to acquisition | 873,000 | |||
| Gross amount of which carried at close of period, land | 1,604,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 8,785,000 | |||
| Gross amount of which carried at close of period, total | 10,389,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,453,000) | |||
| Orange Star Medical Portfolio [Member] | Wharton, TX [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 259,000 | |||
| Initial cost to company, buildings and improvements | 10,590,000 | |||
| Cost capitalized subsequent to acquisition | 3,543,000 | |||
| Gross amount of which carried at close of period, land | 259,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 14,133,000 | |||
| Gross amount of which carried at close of period, total | 14,392,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,978,000) | |||
| Kingwood OM Portfolio [Member] | Kingwood, TX One [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 820,000 | |||
| Initial cost to company, buildings and improvements | 8,589,000 | |||
| Cost capitalized subsequent to acquisition | 526,000 | |||
| Gross amount of which carried at close of period, land | 820,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 9,115,000 | |||
| Gross amount of which carried at close of period, total | 9,935,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,475,000) | |||
| Kingwood OM Portfolio [Member] | Kingwood, TX Two [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 781,000 | |||
| Initial cost to company, buildings and improvements | 3,943,000 | |||
| Cost capitalized subsequent to acquisition | 64,000 | |||
| Gross amount of which carried at close of period, land | 781,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 4,007,000 | |||
| Gross amount of which carried at close of period, total | 4,788,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,137,000) | |||
| Mt. Juliet TN OM [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,188,000 | |||
| Initial cost to company, buildings and improvements | 10,720,000 | |||
| Cost capitalized subsequent to acquisition | 516,000 | |||
| Gross amount of which carried at close of period, land | 1,188,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,236,000 | |||
| Gross amount of which carried at close of period, total | 12,424,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,893,000) | |||
| Homewood AL OM [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 405,000 | |||
| Initial cost to company, buildings and improvements | 6,590,000 | |||
| Cost capitalized subsequent to acquisition | (665,000) | |||
| Gross amount of which carried at close of period, land | 405,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 5,925,000 | |||
| Gross amount of which carried at close of period, total | 6,330,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,961,000) | |||
| Paoli PA Medical Plaza [Member] | Paoli, PA One [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 2,313,000 | |||
| Initial cost to company, buildings and improvements | 12,447,000 | |||
| Cost capitalized subsequent to acquisition | 8,809,000 | |||
| Gross amount of which carried at close of period, land | 2,313,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 21,256,000 | |||
| Gross amount of which carried at close of period, total | 23,569,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (6,149,000) | |||
| Paoli PA Medical Plaza [Member] | Paoli, PA Two [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,668,000 | |||
| Initial cost to company, buildings and improvements | 7,357,000 | |||
| Cost capitalized subsequent to acquisition | 2,193,000 | |||
| Gross amount of which carried at close of period, land | 1,668,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 9,550,000 | |||
| Gross amount of which carried at close of period, total | 11,218,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,123,000) | |||
| Glen Burnie MD OM [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 2,692,000 | |||
| Initial cost to company, buildings and improvements | 14,095,000 | |||
| Cost capitalized subsequent to acquisition | 4,289,000 | |||
| Gross amount of which carried at close of period, land | 2,692,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 18,384,000 | |||
| Gross amount of which carried at close of period, total | 21,076,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (5,666,000) | |||
| Marietta GA OM [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,347,000 | |||
| Initial cost to company, buildings and improvements | 10,947,000 | |||
| Cost capitalized subsequent to acquisition | 749,000 | |||
| Gross amount of which carried at close of period, land | 1,347,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,696,000 | |||
| Gross amount of which carried at close of period, total | 13,043,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,992,000) | |||
| Mountain Crest Senior Housing Portfolio [Member] | Elkhart, IN One [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 793,000 | |||
| Initial cost to company, buildings and improvements | 6,009,000 | |||
| Cost capitalized subsequent to acquisition | 682,000 | |||
| Gross amount of which carried at close of period, land | 793,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 6,691,000 | |||
| Gross amount of which carried at close of period, total | 7,484,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,960,000) | |||
| Mountain Crest Senior Housing Portfolio [Member] | Elkhart, IN Two [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 782,000 | |||
| Initial cost to company, buildings and improvements | 6,760,000 | |||
| Cost capitalized subsequent to acquisition | 819,000 | |||
| Gross amount of which carried at close of period, land | 782,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 7,579,000 | |||
| Gross amount of which carried at close of period, total | 8,361,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,346,000) | |||
| Mountain Crest Senior Housing Portfolio [Member] | Hobart, IN [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 604,000 | |||
| Initial cost to company, buildings and improvements | 11,529,000 | |||
| Cost capitalized subsequent to acquisition | (799,000) | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,334,000 | |||
| Gross amount of which carried at close of period, total | 11,334,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,180,000) | |||
| Mountain Crest Senior Housing Portfolio [Member] | LaPorte, IN [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 392,000 | |||
| Initial cost to company, buildings and improvements | 14,894,000 | |||
| Cost capitalized subsequent to acquisition | (6,101,000) | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 9,185,000 | |||
| Gross amount of which carried at close of period, total | 9,185,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (4,057,000) | |||
| Mountain Crest Senior Housing Portfolio [Member] | Mishawaka, IN [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 3,670,000 | |||
| Initial cost to company, buildings and improvements | 14,416,000 | |||
| Cost capitalized subsequent to acquisition | 1,382,000 | |||
| Gross amount of which carried at close of period, land | 3,670,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 15,798,000 | |||
| Gross amount of which carried at close of period, total | 19,468,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (4,375,000) | |||
| Mountain Crest Senior Housing Portfolio [Member] | Niles, MI [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 404,000 | |||
| Initial cost to company, buildings and improvements | 5,050,000 | |||
| Cost capitalized subsequent to acquisition | 802,000 | |||
| Gross amount of which carried at close of period, land | 404,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 5,852,000 | |||
| Gross amount of which carried at close of period, total | 6,256,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,775,000) | |||
| Nebraska Senior Housing Portfolio [Member] | Bennington, NE [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 981,000 | |||
| Initial cost to company, buildings and improvements | 20,427,000 | |||
| Cost capitalized subsequent to acquisition | 1,418,000 | |||
| Gross amount of which carried at close of period, land | 981,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 21,845,000 | |||
| Gross amount of which carried at close of period, total | 22,826,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (5,422,000) | |||
| Nebraska Senior Housing Portfolio [Member] | Omaha, NE [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,274,000 | |||
| Initial cost to company, buildings and improvements | 38,619,000 | |||
| Cost capitalized subsequent to acquisition | 1,865,000 | |||
| Gross amount of which carried at close of period, land | 1,274,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 40,484,000 | |||
| Gross amount of which carried at close of period, total | 41,758,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (9,569,000) | |||
| Pennsylvania Senior Housing Portfolio [Member] | Bethlehem, PA [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,542,000 | |||
| Initial cost to company, buildings and improvements | 22,249,000 | |||
| Cost capitalized subsequent to acquisition | 1,012,000 | |||
| Gross amount of which carried at close of period, land | 1,542,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 23,261,000 | |||
| Gross amount of which carried at close of period, total | 24,803,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (6,340,000) | |||
| Pennsylvania Senior Housing Portfolio [Member] | Boyertown, PA [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 22,932,000 | |||
| Initial cost to company, land | 480,000 | |||
| Initial cost to company, buildings and improvements | 25,544,000 | |||
| Cost capitalized subsequent to acquisition | 814,000 | |||
| Gross amount of which carried at close of period, land | 480,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 26,358,000 | |||
| Gross amount of which carried at close of period, total | 26,838,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (6,513,000) | |||
| Pennsylvania Senior Housing Portfolio [Member] | York, PA [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 12,432,000 | |||
| Initial cost to company, land | 972,000 | |||
| Initial cost to company, buildings and improvements | 29,860,000 | |||
| Cost capitalized subsequent to acquisition | 1,560,000 | |||
| Gross amount of which carried at close of period, land | 972,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 31,420,000 | |||
| Gross amount of which carried at close of period, total | 32,392,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (7,417,000) | |||
| Southern Illinois OM Portfolio [Member] | Waterloo, IL One [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 94,000 | |||
| Initial cost to company, buildings and improvements | 1,977,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 94,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 1,977,000 | |||
| Gross amount of which carried at close of period, total | 2,071,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (595,000) | |||
| Southern Illinois OM Portfolio [Member] | Waterloo, IL Two [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 738,000 | |||
| Initial cost to company, buildings and improvements | 6,332,000 | |||
| Cost capitalized subsequent to acquisition | 588,000 | |||
| Gross amount of which carried at close of period, land | 738,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 6,920,000 | |||
| Gross amount of which carried at close of period, total | 7,658,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,010,000) | |||
| Southern Illinois OM Portfolio [Member] | Waterloo, IL Three [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 200,000 | |||
| Initial cost to company, buildings and improvements | 2,648,000 | |||
| Cost capitalized subsequent to acquisition | (69,000) | |||
| Gross amount of which carried at close of period, land | 200,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 2,579,000 | |||
| Gross amount of which carried at close of period, total | 2,779,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (707,000) | |||
| Napa Medical Center [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,176,000 | |||
| Initial cost to company, buildings and improvements | 13,328,000 | |||
| Cost capitalized subsequent to acquisition | 2,223,000 | |||
| Gross amount of which carried at close of period, land | 1,176,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 15,551,000 | |||
| Gross amount of which carried at close of period, total | 16,727,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (4,695,000) | |||
| Chesterfield Corporate Plaza [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 8,030,000 | |||
| Initial cost to company, buildings and improvements | 24,533,000 | |||
| Cost capitalized subsequent to acquisition | 3,617,000 | |||
| Gross amount of which carried at close of period, land | 8,030,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 28,150,000 | |||
| Gross amount of which carried at close of period, total | 36,180,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (9,020,000) | |||
| Richmond VA ALF Senior Housing Portfolio [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 2,146,000 | |||
| Initial cost to company, buildings and improvements | 56,671,000 | |||
| Cost capitalized subsequent to acquisition | 1,237,000 | |||
| Gross amount of which carried at close of period, land | 2,146,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 57,908,000 | |||
| Gross amount of which carried at close of period, total | 60,054,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (12,955,000) | |||
| Crown Senior Care Portfolio - Peel, Isle of Man [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,164,000 | |||
| Initial cost to company, buildings and improvements | 6,952,000 | |||
| Cost capitalized subsequent to acquisition | 82,000 | |||
| Gross amount of which carried at close of period, land | 1,164,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 7,034,000 | |||
| Gross amount of which carried at close of period, total | 8,198,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,736,000) | |||
| Crown Senior Care Portfolio - St. Albans [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,174,000 | |||
| Initial cost to company, buildings and improvements | 12,344,000 | |||
| Cost capitalized subsequent to acquisition | 681,000 | |||
| Gross amount of which carried at close of period, land | 1,174,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,025,000 | |||
| Gross amount of which carried at close of period, total | 14,199,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,224,000) | |||
| Crown Senior Care Portfolio - Salisbury [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,248,000 | |||
| Initial cost to company, buildings and improvements | 11,986,000 | |||
| Cost capitalized subsequent to acquisition | 55,000 | |||
| Gross amount of which carried at close of period, land | 1,248,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,041,000 | |||
| Gross amount of which carried at close of period, total | 13,289,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,961,000) | |||
| Crown Senior Care Portfolio - Aberdeen [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 2,025,000 | |||
| Initial cost to company, buildings and improvements | 6,037,000 | |||
| Cost capitalized subsequent to acquisition | 337,000 | |||
| Gross amount of which carried at close of period, land | 2,025,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 6,374,000 | |||
| Gross amount of which carried at close of period, total | 8,399,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,266,000) | |||
| Crown Senior Care Portfolio - Felixstowe One [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 704,000 | |||
| Initial cost to company, buildings and improvements | 5,800,000 | |||
| Cost capitalized subsequent to acquisition | 514,000 | |||
| Gross amount of which carried at close of period, land | 704,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 6,314,000 | |||
| Gross amount of which carried at close of period, total | 7,018,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,328,000) | |||
| Crown Senior Care Portfolio - Felixstowe Two [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 531,000 | |||
| Initial cost to company, buildings and improvements | 2,542,000 | |||
| Cost capitalized subsequent to acquisition | 343,000 | |||
| Gross amount of which carried at close of period, land | 531,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 2,885,000 | |||
| Gross amount of which carried at close of period, total | 3,416,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (681,000) | |||
| Washington DC SNF [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 60,100,000 | |||
| Initial cost to company, land | 1,194,000 | |||
| Initial cost to company, buildings and improvements | 34,200,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 1,194,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 34,200,000 | |||
| Gross amount of which carried at close of period, total | 35,394,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (9,056,000) | |||
| Stockbridge GA OM II [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 499,000 | |||
| Initial cost to company, buildings and improvements | 8,353,000 | |||
| Cost capitalized subsequent to acquisition | 1,623,000 | |||
| Gross amount of which carried at close of period, land | 485,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 9,990,000 | |||
| Gross amount of which carried at close of period, total | 10,475,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,396,000) | |||
| Marietta GA OM II [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 661,000 | |||
| Initial cost to company, buildings and improvements | 4,783,000 | |||
| Cost capitalized subsequent to acquisition | 309,000 | |||
| Gross amount of which carried at close of period, land | 661,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 5,092,000 | |||
| Gross amount of which carried at close of period, total | 5,753,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,298,000) | |||
| Lakeview IN Medical Plaza | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 20,155,000 | |||
| Initial cost to company, land | 2,375,000 | |||
| Initial cost to company, buildings and improvements | 15,911,000 | |||
| Cost capitalized subsequent to acquisition | 9,762,000 | |||
| Gross amount of which carried at close of period, land | 2,375,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 25,673,000 | |||
| Gross amount of which carried at close of period, total | 28,048,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (7,326,000) | |||
| Pennsylvania Senior Housing Portfolio II [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 19,114,000 | |||
| Initial cost to company, land | 835,000 | |||
| Initial cost to company, buildings and improvements | 24,424,000 | |||
| Cost capitalized subsequent to acquisition | 703,000 | |||
| Gross amount of which carried at close of period, land | 835,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 25,127,000 | |||
| Gross amount of which carried at close of period, total | 25,962,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (6,528,000) | |||
| Snellville GA OM [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 332,000 | |||
| Initial cost to company, buildings and improvements | 7,781,000 | |||
| Cost capitalized subsequent to acquisition | 2,329,000 | |||
| Gross amount of which carried at close of period, land | 332,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,110,000 | |||
| Gross amount of which carried at close of period, total | 10,442,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,285,000) | |||
| Stockbridge GA OM III [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 606,000 | |||
| Initial cost to company, buildings and improvements | 7,924,000 | |||
| Cost capitalized subsequent to acquisition | 1,946,000 | |||
| Gross amount of which carried at close of period, land | 606,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 9,870,000 | |||
| Gross amount of which carried at close of period, total | 10,476,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,453,000) | |||
| Joplin MO OM [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,245,000 | |||
| Initial cost to company, buildings and improvements | 9,860,000 | |||
| Cost capitalized subsequent to acquisition | 200,000 | |||
| Gross amount of which carried at close of period, land | 1,245,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,060,000 | |||
| Gross amount of which carried at close of period, total | 11,305,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,727,000) | |||
| Austell GA OM [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 663,000 | |||
| Initial cost to company, buildings and improvements | 10,547,000 | |||
| Cost capitalized subsequent to acquisition | 224,000 | |||
| Gross amount of which carried at close of period, land | 663,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,771,000 | |||
| Gross amount of which carried at close of period, total | 11,434,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,467,000) | |||
| Middletown OH OM [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 0 | |||
| Initial cost to company, buildings and improvements | 17,389,000 | |||
| Cost capitalized subsequent to acquisition | 3,242,000 | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 20,631,000 | |||
| Gross amount of which carried at close of period, total | 20,631,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (4,206,000) | |||
| Fox Grape SNF Portfolio - Braintree, MA [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,844,000 | |||
| Initial cost to company, buildings and improvements | 10,847,000 | |||
| Cost capitalized subsequent to acquisition | 31,000 | |||
| Gross amount of which carried at close of period, land | 1,844,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,878,000 | |||
| Gross amount of which carried at close of period, total | 12,722,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,327,000) | |||
| Fox Grape SNF Portfolio - Brighton, MA [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 779,000 | |||
| Initial cost to company, buildings and improvements | 2,661,000 | |||
| Cost capitalized subsequent to acquisition | 475,000 | |||
| Gross amount of which carried at close of period, land | 779,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 3,136,000 | |||
| Gross amount of which carried at close of period, total | 3,915,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (702,000) | |||
| Fox Grape SNF Portfolio - Duxbury, MA [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 2,921,000 | |||
| Initial cost to company, buildings and improvements | 11,244,000 | |||
| Cost capitalized subsequent to acquisition | 1,933,000 | |||
| Gross amount of which carried at close of period, land | 2,921,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,177,000 | |||
| Gross amount of which carried at close of period, total | 16,098,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,155,000) | |||
| Fox Grape SNF Portfolio - Hingham, MA [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 2,316,000 | |||
| Initial cost to company, buildings and improvements | 17,390,000 | |||
| Cost capitalized subsequent to acquisition | (166,000) | |||
| Gross amount of which carried at close of period, land | 2,316,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 17,224,000 | |||
| Gross amount of which carried at close of period, total | 19,540,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,670,000) | |||
| Fox Grape SNF Portfolio - Quincy, MA [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 13,329,000 | |||
| Initial cost to company, land | 3,537,000 | |||
| Initial cost to company, buildings and improvements | 13,697,000 | |||
| Cost capitalized subsequent to acquisition | 459,000 | |||
| Gross amount of which carried at close of period, land | 3,537,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 14,156,000 | |||
| Gross amount of which carried at close of period, total | 17,693,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,930,000) | |||
| Voorhees NJ OM [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,727,000 | |||
| Initial cost to company, buildings and improvements | 8,451,000 | |||
| Cost capitalized subsequent to acquisition | 2,655,000 | |||
| Gross amount of which carried at close of period, land | 1,727,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,106,000 | |||
| Gross amount of which carried at close of period, total | 12,833,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,845,000) | |||
| Norwich CT OM Portfolio [Member] | Norwich, CT One [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 403,000 | |||
| Initial cost to company, buildings and improvements | 1,601,000 | |||
| Cost capitalized subsequent to acquisition | 1,234,000 | |||
| Gross amount of which carried at close of period, land | 403,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 2,835,000 | |||
| Gross amount of which carried at close of period, total | 3,238,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,050,000) | |||
| Norwich CT OM Portfolio [Member] | Norwich, CT Two [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 804,000 | |||
| Initial cost to company, buildings and improvements | 12,094,000 | |||
| Cost capitalized subsequent to acquisition | 1,265,000 | |||
| Gross amount of which carried at close of period, land | 804,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,359,000 | |||
| Gross amount of which carried at close of period, total | 14,163,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,882,000) | |||
| Middletown OH OM II [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 0 | |||
| Initial cost to company, buildings and improvements | 3,949,000 | |||
| Cost capitalized subsequent to acquisition | 683,000 | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 4,632,000 | |||
| Gross amount of which carried at close of period, total | 4,632,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (791,000) | |||
| Homewood Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 8,354,000 | |||
| Initial cost to company, land | 973,000 | |||
| Initial cost to company, buildings and improvements | 9,702,000 | |||
| Cost capitalized subsequent to acquisition | 2,467,000 | |||
| Gross amount of which carried at close of period, land | 1,100,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,042,000 | |||
| Gross amount of which carried at close of period, total | 13,142,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,334,000) | |||
| Ashford Place Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 5,663,000 | |||
| Initial cost to company, land | 664,000 | |||
| Initial cost to company, buildings and improvements | 12,662,000 | |||
| Cost capitalized subsequent to acquisition | 1,412,000 | |||
| Gross amount of which carried at close of period, land | 857,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,881,000 | |||
| Gross amount of which carried at close of period, total | 14,738,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,100,000) | |||
| Mill Pond Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 6,701,000 | |||
| Initial cost to company, land | 1,576,000 | |||
| Initial cost to company, buildings and improvements | 8,124,000 | |||
| Cost capitalized subsequent to acquisition | 727,000 | |||
| Gross amount of which carried at close of period, land | 1,629,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 8,798,000 | |||
| Gross amount of which carried at close of period, total | 10,427,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,905,000) | |||
| St. Andrews Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 4,228,000 | |||
| Initial cost to company, land | 552,000 | |||
| Initial cost to company, buildings and improvements | 8,213,000 | |||
| Cost capitalized subsequent to acquisition | 705,000 | |||
| Gross amount of which carried at close of period, land | 772,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 8,698,000 | |||
| Gross amount of which carried at close of period, total | 9,470,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,964,000) | |||
| Hampton Oaks Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 5,952,000 | |||
| Initial cost to company, land | 720,000 | |||
| Initial cost to company, buildings and improvements | 8,145,000 | |||
| Cost capitalized subsequent to acquisition | 824,000 | |||
| Gross amount of which carried at close of period, land | 845,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 8,844,000 | |||
| Gross amount of which carried at close of period, total | 9,689,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,023,000) | |||
| Forest Park Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 6,500,000 | |||
| Initial cost to company, land | 535,000 | |||
| Initial cost to company, buildings and improvements | 9,399,000 | |||
| Cost capitalized subsequent to acquisition | 893,000 | |||
| Gross amount of which carried at close of period, land | 647,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,180,000 | |||
| Gross amount of which carried at close of period, total | 10,827,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,281,000) | |||
| The Maples at Waterford Crossing [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 5,533,000 | |||
| Initial cost to company, land | 344,000 | |||
| Initial cost to company, buildings and improvements | 8,027,000 | |||
| Cost capitalized subsequent to acquisition | 1,989,000 | |||
| Gross amount of which carried at close of period, land | 363,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 9,997,000 | |||
| Gross amount of which carried at close of period, total | 10,360,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,753,000) | |||
| Morrison Woods Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 26,888,000 | |||
| Initial cost to company, land | 1,903,000 | |||
| Initial cost to company, buildings and improvements | 21,806,000 | |||
| Cost capitalized subsequent to acquisition | 1,414,000 | |||
| Gross amount of which carried at close of period, land | 1,922,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 23,201,000 | |||
| Gross amount of which carried at close of period, total | 25,123,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (4,039,000) | |||
| Woodbridge Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 7,910,000 | |||
| Initial cost to company, land | 228,000 | |||
| Initial cost to company, buildings and improvements | 11,812,000 | |||
| Cost capitalized subsequent to acquisition | 536,000 | |||
| Gross amount of which carried at close of period, land | 262,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,314,000 | |||
| Gross amount of which carried at close of period, total | 12,576,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,687,000) | |||
| Bridgepointe Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 6,775,000 | |||
| Initial cost to company, land | 747,000 | |||
| Initial cost to company, buildings and improvements | 7,469,000 | |||
| Cost capitalized subsequent to acquisition | 2,004,000 | |||
| Gross amount of which carried at close of period, land | 909,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 9,311,000 | |||
| Gross amount of which carried at close of period, total | 10,220,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,892,000) | |||
| Greenleaf Living Center [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 10,851,000 | |||
| Initial cost to company, land | 492,000 | |||
| Initial cost to company, buildings and improvements | 12,157,000 | |||
| Cost capitalized subsequent to acquisition | 1,234,000 | |||
| Gross amount of which carried at close of period, land | 521,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,362,000 | |||
| Gross amount of which carried at close of period, total | 13,883,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,854,000) | |||
| Forest Glen Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 9,056,000 | |||
| Initial cost to company, land | 846,000 | |||
| Initial cost to company, buildings and improvements | 12,754,000 | |||
| Cost capitalized subsequent to acquisition | 1,195,000 | |||
| Gross amount of which carried at close of period, land | 1,055,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,740,000 | |||
| Gross amount of which carried at close of period, total | 14,795,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,062,000) | |||
| The Meadows of Kalida Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 7,492,000 | |||
| Initial cost to company, land | 298,000 | |||
| Initial cost to company, buildings and improvements | 7,628,000 | |||
| Cost capitalized subsequent to acquisition | 598,000 | |||
| Gross amount of which carried at close of period, land | 394,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 8,130,000 | |||
| Gross amount of which carried at close of period, total | 8,524,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,726,000) | |||
| The Heritage [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 12,311,000 | |||
| Initial cost to company, land | 1,312,000 | |||
| Initial cost to company, buildings and improvements | 13,475,000 | |||
| Cost capitalized subsequent to acquisition | 730,000 | |||
| Gross amount of which carried at close of period, land | 1,434,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 14,083,000 | |||
| Gross amount of which carried at close of period, total | 15,517,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,105,000) | |||
| Genoa Retirement Village [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 7,911,000 | |||
| Initial cost to company, land | 881,000 | |||
| Initial cost to company, buildings and improvements | 8,113,000 | |||
| Cost capitalized subsequent to acquisition | 1,728,000 | |||
| Gross amount of which carried at close of period, land | 1,054,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 9,668,000 | |||
| Gross amount of which carried at close of period, total | 10,722,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,059,000) | |||
| Waterford Crossing [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 7,581,000 | |||
| Initial cost to company, land | 344,000 | |||
| Initial cost to company, buildings and improvements | 4,381,000 | |||
| Cost capitalized subsequent to acquisition | 1,001,000 | |||
| Gross amount of which carried at close of period, land | 349,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 5,377,000 | |||
| Gross amount of which carried at close of period, total | 5,726,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,197,000) | |||
| St. Elizabeth Healthcare [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 8,351,000 | |||
| Initial cost to company, land | 522,000 | |||
| Initial cost to company, buildings and improvements | 5,463,000 | |||
| Cost capitalized subsequent to acquisition | 5,490,000 | |||
| Gross amount of which carried at close of period, land | 643,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,832,000 | |||
| Gross amount of which carried at close of period, total | 11,475,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,255,000) | |||
| Cumberland Pointe [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 8,846,000 | |||
| Initial cost to company, land | 1,645,000 | |||
| Initial cost to company, buildings and improvements | 13,696,000 | |||
| Cost capitalized subsequent to acquisition | 818,000 | |||
| Gross amount of which carried at close of period, land | 1,905,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 14,254,000 | |||
| Gross amount of which carried at close of period, total | 16,159,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,480,000) | |||
| Franciscan Healthcare Center [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 9,922,000 | |||
| Initial cost to company, land | 808,000 | |||
| Initial cost to company, buildings and improvements | 8,439,000 | |||
| Cost capitalized subsequent to acquisition | 3,218,000 | |||
| Gross amount of which carried at close of period, land | 915,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,550,000 | |||
| Gross amount of which carried at close of period, total | 12,465,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,535,000) | |||
| Blair Ridge Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 7,311,000 | |||
| Initial cost to company, land | 734,000 | |||
| Initial cost to company, buildings and improvements | 11,648,000 | |||
| Cost capitalized subsequent to acquisition | 1,041,000 | |||
| Gross amount of which carried at close of period, land | 789,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,634,000 | |||
| Gross amount of which carried at close of period, total | 13,423,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,119,000) | |||
| Glen Oaks Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 4,855,000 | |||
| Initial cost to company, land | 384,000 | |||
| Initial cost to company, buildings and improvements | 8,189,000 | |||
| Cost capitalized subsequent to acquisition | 504,000 | |||
| Gross amount of which carried at close of period, land | 419,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 8,658,000 | |||
| Gross amount of which carried at close of period, total | 9,077,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,756,000) | |||
| Covered Bridge Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 386,000 | |||
| Initial cost to company, buildings and improvements | 9,699,000 | |||
| Cost capitalized subsequent to acquisition | 927,000 | |||
| Gross amount of which carried at close of period, land | 45,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,967,000 | |||
| Gross amount of which carried at close of period, total | 11,012,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,407,000) | |||
| Stonebridge Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 9,409,000 | |||
| Initial cost to company, land | 1,087,000 | |||
| Initial cost to company, buildings and improvements | 7,965,000 | |||
| Cost capitalized subsequent to acquisition | 2,223,000 | |||
| Gross amount of which carried at close of period, land | 1,144,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,131,000 | |||
| Gross amount of which carried at close of period, total | 11,275,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,958,000) | |||
| RiverOaks Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 14,018,000 | |||
| Initial cost to company, land | 440,000 | |||
| Initial cost to company, buildings and improvements | 8,953,000 | |||
| Cost capitalized subsequent to acquisition | 2,557,000 | |||
| Gross amount of which carried at close of period, land | 764,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,186,000 | |||
| Gross amount of which carried at close of period, total | 11,950,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,187,000) | |||
| Park Terrace Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 2,177,000 | |||
| Initial cost to company, buildings and improvements | 7,626,000 | |||
| Cost capitalized subsequent to acquisition | 1,749,000 | |||
| Gross amount of which carried at close of period, land | 2,177,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 9,375,000 | |||
| Gross amount of which carried at close of period, total | 11,552,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,152,000) | |||
| Cobblestone Crossing [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 1,462,000 | |||
| Initial cost to company, buildings and improvements | 13,860,000 | |||
| Cost capitalized subsequent to acquisition | 5,892,000 | |||
| Gross amount of which carried at close of period, land | 1,564,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 19,650,000 | |||
| Gross amount of which carried at close of period, total | 21,214,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (4,160,000) | |||
| Creasy Springs Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 15,531,000 | |||
| Initial cost to company, land | 2,111,000 | |||
| Initial cost to company, buildings and improvements | 14,337,000 | |||
| Cost capitalized subsequent to acquisition | 6,223,000 | |||
| Gross amount of which carried at close of period, land | 2,512,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 20,159,000 | |||
| Gross amount of which carried at close of period, total | 22,671,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (4,286,000) | |||
| Avalon Springs Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 16,894,000 | |||
| Initial cost to company, land | 1,542,000 | |||
| Initial cost to company, buildings and improvements | 14,107,000 | |||
| Cost capitalized subsequent to acquisition | 277,000 | |||
| Gross amount of which carried at close of period, land | 1,607,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 14,319,000 | |||
| Gross amount of which carried at close of period, total | 15,926,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,092,000) | |||
| Prairie Lakes Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 8,525,000 | |||
| Initial cost to company, land | 2,204,000 | |||
| Initial cost to company, buildings and improvements | 13,227,000 | |||
| Cost capitalized subsequent to acquisition | 623,000 | |||
| Gross amount of which carried at close of period, land | 2,342,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,712,000 | |||
| Gross amount of which carried at close of period, total | 16,054,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,937,000) | |||
| RidgeWood Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 13,278,000 | |||
| Initial cost to company, land | 1,240,000 | |||
| Initial cost to company, buildings and improvements | 16,118,000 | |||
| Cost capitalized subsequent to acquisition | 437,000 | |||
| Gross amount of which carried at close of period, land | 1,268,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 16,527,000 | |||
| Gross amount of which carried at close of period, total | 17,795,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,483,000) | |||
| Westport Place Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 1,245,000 | |||
| Initial cost to company, buildings and improvements | 9,946,000 | |||
| Cost capitalized subsequent to acquisition | 1,299,000 | |||
| Gross amount of which carried at close of period, land | 1,262,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,228,000 | |||
| Gross amount of which carried at close of period, total | 12,490,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,229,000) | |||
| Paddock Springs [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 13,195,000 | |||
| Initial cost to company, land | 488,000 | |||
| Initial cost to company, buildings and improvements | 0 | |||
| Cost capitalized subsequent to acquisition | 10,638,000 | |||
| Gross amount of which carried at close of period, land | 660,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,466,000 | |||
| Gross amount of which carried at close of period, total | 11,126,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,437,000) | |||
| Amber Manor Care Center [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 5,390,000 | |||
| Initial cost to company, land | 446,000 | |||
| Initial cost to company, buildings and improvements | 6,063,000 | |||
| Cost capitalized subsequent to acquisition | 538,000 | |||
| Gross amount of which carried at close of period, land | 515,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 6,532,000 | |||
| Gross amount of which carried at close of period, total | 7,047,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,506,000) | |||
| The Meadows of Leipsic Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 1,242,000 | |||
| Initial cost to company, buildings and improvements | 6,988,000 | |||
| Cost capitalized subsequent to acquisition | 967,000 | |||
| Gross amount of which carried at close of period, land | 1,428,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 7,769,000 | |||
| Gross amount of which carried at close of period, total | 9,197,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,803,000) | |||
| Springview Manor [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 260,000 | |||
| Initial cost to company, buildings and improvements | 3,968,000 | |||
| Cost capitalized subsequent to acquisition | 649,000 | |||
| Gross amount of which carried at close of period, land | 408,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 4,469,000 | |||
| Gross amount of which carried at close of period, total | 4,877,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (986,000) | |||
| Willows at Bellevue [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 15,821,000 | |||
| Initial cost to company, land | 587,000 | |||
| Initial cost to company, buildings and improvements | 15,575,000 | |||
| Cost capitalized subsequent to acquisition | 1,530,000 | |||
| Gross amount of which carried at close of period, land | 790,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 16,902,000 | |||
| Gross amount of which carried at close of period, total | 17,692,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,726,000) | |||
| Briar Hill Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 673,000 | |||
| Initial cost to company, buildings and improvements | 2,688,000 | |||
| Cost capitalized subsequent to acquisition | 569,000 | |||
| Gross amount of which carried at close of period, land | 756,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 3,174,000 | |||
| Gross amount of which carried at close of period, total | 3,930,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (793,000) | |||
| Cypress Pointe Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 921,000 | |||
| Initial cost to company, buildings and improvements | 10,291,000 | |||
| Cost capitalized subsequent to acquisition | 11,066,000 | |||
| Gross amount of which carried at close of period, land | 1,850,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 20,428,000 | |||
| Gross amount of which carried at close of period, total | 22,278,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,277,000) | |||
| The Oaks at NorthPointe Woods [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 567,000 | |||
| Initial cost to company, buildings and improvements | 12,716,000 | |||
| Cost capitalized subsequent to acquisition | 240,000 | |||
| Gross amount of which carried at close of period, land | 571,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,952,000 | |||
| Gross amount of which carried at close of period, total | 13,523,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,741,000) | |||
| Westlake Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 13,809,000 | |||
| Initial cost to company, land | 815,000 | |||
| Initial cost to company, buildings and improvements | 13,502,000 | |||
| Cost capitalized subsequent to acquisition | 202,000 | |||
| Gross amount of which carried at close of period, land | 547,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,972,000 | |||
| Gross amount of which carried at close of period, total | 14,519,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,953,000) | |||
| Springhurst Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 19,200,000 | |||
| Initial cost to company, land | 931,000 | |||
| Initial cost to company, buildings and improvements | 14,114,000 | |||
| Cost capitalized subsequent to acquisition | 4,170,000 | |||
| Gross amount of which carried at close of period, land | 2,330,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 16,885,000 | |||
| Gross amount of which carried at close of period, total | 19,215,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (4,357,000) | |||
| Glen Ridge Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 1,208,000 | |||
| Initial cost to company, buildings and improvements | 9,771,000 | |||
| Cost capitalized subsequent to acquisition | 2,569,000 | |||
| Gross amount of which carried at close of period, land | 1,402,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,146,000 | |||
| Gross amount of which carried at close of period, total | 13,548,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,769,000) | |||
| St. Mary Healthcare [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 5,058,000 | |||
| Initial cost to company, land | 348,000 | |||
| Initial cost to company, buildings and improvements | 2,710,000 | |||
| Cost capitalized subsequent to acquisition | 344,000 | |||
| Gross amount of which carried at close of period, land | 393,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 3,009,000 | |||
| Gross amount of which carried at close of period, total | 3,402,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (694,000) | |||
| The Oaks at Woodfield [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 14,880,000 | |||
| Initial cost to company, land | 897,000 | |||
| Initial cost to company, buildings and improvements | 12,270,000 | |||
| Cost capitalized subsequent to acquisition | 676,000 | |||
| Gross amount of which carried at close of period, land | 1,130,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,713,000 | |||
| Gross amount of which carried at close of period, total | 13,843,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,790,000) | |||
| Stonegate Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 10,976,000 | |||
| Initial cost to company, land | 538,000 | |||
| Initial cost to company, buildings and improvements | 13,159,000 | |||
| Cost capitalized subsequent to acquisition | 406,000 | |||
| Gross amount of which carried at close of period, land | 717,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,386,000 | |||
| Gross amount of which carried at close of period, total | 14,103,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,930,000) | |||
| Senior Living at Forest Ridge [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 204,000 | |||
| Initial cost to company, buildings and improvements | 5,470,000 | |||
| Cost capitalized subsequent to acquisition | 363,000 | |||
| Gross amount of which carried at close of period, land | 325,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 5,712,000 | |||
| Gross amount of which carried at close of period, total | 6,037,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,255,000) | |||
| River Terrace Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 0 | |||
| Initial cost to company, buildings and improvements | 13,378,000 | |||
| Cost capitalized subsequent to acquisition | 4,346,000 | |||
| Gross amount of which carried at close of period, land | 76,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 17,648,000 | |||
| Gross amount of which carried at close of period, total | 17,724,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,966,000) | |||
| St. Charles Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 11,053,000 | |||
| Initial cost to company, land | 467,000 | |||
| Initial cost to company, buildings and improvements | 14,532,000 | |||
| Cost capitalized subsequent to acquisition | 2,404,000 | |||
| Gross amount of which carried at close of period, land | 558,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 16,845,000 | |||
| Gross amount of which carried at close of period, total | 17,403,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,690,000) | |||
| Bethany Pointe Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 18,945,000 | |||
| Initial cost to company, land | 2,337,000 | |||
| Initial cost to company, buildings and improvements | 26,524,000 | |||
| Cost capitalized subsequent to acquisition | 2,812,000 | |||
| Gross amount of which carried at close of period, land | 2,550,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 29,123,000 | |||
| Gross amount of which carried at close of period, total | 31,673,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (6,509,000) | |||
| River Pointe Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 13,606,000 | |||
| Initial cost to company, land | 1,118,000 | |||
| Initial cost to company, buildings and improvements | 14,736,000 | |||
| Cost capitalized subsequent to acquisition | 1,998,000 | |||
| Gross amount of which carried at close of period, land | 1,204,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 16,648,000 | |||
| Gross amount of which carried at close of period, total | 17,852,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,802,000) | |||
| Waterford Place Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 14,404,000 | |||
| Initial cost to company, land | 1,219,000 | |||
| Initial cost to company, buildings and improvements | 18,557,000 | |||
| Cost capitalized subsequent to acquisition | 6,653,000 | |||
| Gross amount of which carried at close of period, land | 1,805,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 24,624,000 | |||
| Gross amount of which carried at close of period, total | 26,429,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (4,680,000) | |||
| Autumn Woods Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 1,016,000 | |||
| Initial cost to company, buildings and improvements | 13,414,000 | |||
| Cost capitalized subsequent to acquisition | 1,850,000 | |||
| Gross amount of which carried at close of period, land | 1,048,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 15,232,000 | |||
| Gross amount of which carried at close of period, total | 16,280,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,710,000) | |||
| Oakwood Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 8,842,000 | |||
| Initial cost to company, land | 783,000 | |||
| Initial cost to company, buildings and improvements | 11,880,000 | |||
| Cost capitalized subsequent to acquisition | 1,396,000 | |||
| Gross amount of which carried at close of period, land | 868,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,191,000 | |||
| Gross amount of which carried at close of period, total | 14,059,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,191,000) | |||
| Cedar Ridge Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 102,000 | |||
| Initial cost to company, buildings and improvements | 8,435,000 | |||
| Cost capitalized subsequent to acquisition | 3,745,000 | |||
| Gross amount of which carried at close of period, land | 205,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,077,000 | |||
| Gross amount of which carried at close of period, total | 12,282,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,276,000) | |||
| Aspen Place Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 9,188,000 | |||
| Initial cost to company, land | 980,000 | |||
| Initial cost to company, buildings and improvements | 10,970,000 | |||
| Cost capitalized subsequent to acquisition | 963,000 | |||
| Gross amount of which carried at close of period, land | 1,212,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,701,000 | |||
| Gross amount of which carried at close of period, total | 12,913,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,669,000) | |||
| The WIllows at East Lansing [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 15,878,000 | |||
| Initial cost to company, land | 1,449,000 | |||
| Initial cost to company, buildings and improvements | 15,161,000 | |||
| Cost capitalized subsequent to acquisition | 1,681,000 | |||
| Gross amount of which carried at close of period, land | 1,496,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 16,795,000 | |||
| Gross amount of which carried at close of period, total | 18,291,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,940,000) | |||
| The Willows at Howell [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 1,051,000 | |||
| Initial cost to company, buildings and improvements | 12,099,000 | |||
| Cost capitalized subsequent to acquisition | 6,763,000 | |||
| Gross amount of which carried at close of period, land | 1,158,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 18,755,000 | |||
| Gross amount of which carried at close of period, total | 19,913,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,429,000) | |||
| The Willows at Okemos [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 7,277,000 | |||
| Initial cost to company, land | 1,171,000 | |||
| Initial cost to company, buildings and improvements | 12,326,000 | |||
| Cost capitalized subsequent to acquisition | 1,045,000 | |||
| Gross amount of which carried at close of period, land | 1,229,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,313,000 | |||
| Gross amount of which carried at close of period, total | 14,542,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,139,000) | |||
| Shelby Crossing Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 16,686,000 | |||
| Initial cost to company, land | 2,533,000 | |||
| Initial cost to company, buildings and improvements | 18,440,000 | |||
| Cost capitalized subsequent to acquisition | 2,404,000 | |||
| Gross amount of which carried at close of period, land | 2,620,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 20,757,000 | |||
| Gross amount of which carried at close of period, total | 23,377,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (5,154,000) | |||
| Village Green Healthcare Center [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 6,763,000 | |||
| Initial cost to company, land | 355,000 | |||
| Initial cost to company, buildings and improvements | 9,696,000 | |||
| Cost capitalized subsequent to acquisition | 1,175,000 | |||
| Gross amount of which carried at close of period, land | 448,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,778,000 | |||
| Gross amount of which carried at close of period, total | 11,226,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,314,000) | |||
| The Oaks at Northpointe [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 624,000 | |||
| Initial cost to company, buildings and improvements | 11,665,000 | |||
| Cost capitalized subsequent to acquisition | 1,106,000 | |||
| Gross amount of which carried at close of period, land | 722,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,673,000 | |||
| Gross amount of which carried at close of period, total | 13,395,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,973,000) | |||
| The Oaks at Bethesda [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 4,417,000 | |||
| Initial cost to company, land | 714,000 | |||
| Initial cost to company, buildings and improvements | 10,791,000 | |||
| Cost capitalized subsequent to acquisition | 949,000 | |||
| Gross amount of which carried at close of period, land | 812,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,642,000 | |||
| Gross amount of which carried at close of period, total | 12,454,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,635,000) | |||
| White Oak Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 20,088,000 | |||
| Initial cost to company, land | 1,005,000 | |||
| Initial cost to company, buildings and improvements | 13,207,000 | |||
| Cost capitalized subsequent to acquisition | 208,000 | |||
| Gross amount of which carried at close of period, land | 1,005,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,415,000 | |||
| Gross amount of which carried at close of period, total | 14,420,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,173,000) | |||
| Woodmont Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 7,584,000 | |||
| Initial cost to company, land | 790,000 | |||
| Initial cost to company, buildings and improvements | 9,633,000 | |||
| Cost capitalized subsequent to acquisition | 1,236,000 | |||
| Gross amount of which carried at close of period, land | 1,010,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,649,000 | |||
| Gross amount of which carried at close of period, total | 11,659,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,547,000) | |||
| Silver Oaks Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 1,776,000 | |||
| Initial cost to company, buildings and improvements | 21,420,000 | |||
| Cost capitalized subsequent to acquisition | 1,499,000 | |||
| Gross amount of which carried at close of period, land | 8,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 24,687,000 | |||
| Gross amount of which carried at close of period, total | 24,695,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (5,513,000) | |||
| Thornton Terrace Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 5,375,000 | |||
| Initial cost to company, land | 764,000 | |||
| Initial cost to company, buildings and improvements | 9,209,000 | |||
| Cost capitalized subsequent to acquisition | 1,601,000 | |||
| Gross amount of which carried at close of period, land | 873,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,701,000 | |||
| Gross amount of which carried at close of period, total | 11,574,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,386,000) | |||
| The Willows at Hamburg [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 11,192,000 | |||
| Initial cost to company, land | 1,740,000 | |||
| Initial cost to company, buildings and improvements | 13,422,000 | |||
| Cost capitalized subsequent to acquisition | 1,676,000 | |||
| Gross amount of which carried at close of period, land | 1,810,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 15,028,000 | |||
| Gross amount of which carried at close of period, total | 16,838,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,912,000) | |||
| The Lakes at Monclova [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 19,130,000 | |||
| Initial cost to company, land | 2,869,000 | |||
| Initial cost to company, buildings and improvements | 12,855,000 | |||
| Cost capitalized subsequent to acquisition | 10,302,000 | |||
| Gross amount of which carried at close of period, land | 3,186,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 22,840,000 | |||
| Gross amount of which carried at close of period, total | 26,026,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,884,000) | |||
| The Willows at Willard [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 610,000 | |||
| Initial cost to company, buildings and improvements | 12,256,000 | |||
| Cost capitalized subsequent to acquisition | 10,003,000 | |||
| Gross amount of which carried at close of period, land | 223,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 22,646,000 | |||
| Gross amount of which carried at close of period, total | 22,869,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (4,267,000) | |||
| Westlake Health Campus - Commerce Villa [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 261,000 | |||
| Initial cost to company, buildings and improvements | 6,610,000 | |||
| Cost capitalized subsequent to acquisition | 1,270,000 | |||
| Gross amount of which carried at close of period, land | 553,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 7,588,000 | |||
| Gross amount of which carried at close of period, total | 8,141,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,458,000) | |||
| Orchard Grove Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 27,515,000 | |||
| Initial cost to company, land | 2,065,000 | |||
| Initial cost to company, buildings and improvements | 11,510,000 | |||
| Cost capitalized subsequent to acquisition | 18,156,000 | |||
| Gross amount of which carried at close of period, land | 3,515,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 28,216,000 | |||
| Gross amount of which carried at close of period, total | 31,731,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (3,902,000) | |||
| The Meadows of Ottawa [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 695,000 | |||
| Initial cost to company, buildings and improvements | 7,752,000 | |||
| Cost capitalized subsequent to acquisition | 1,168,000 | |||
| Gross amount of which carried at close of period, land | 728,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 8,887,000 | |||
| Gross amount of which carried at close of period, total | 9,615,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,729,000) | |||
| Valley View Healthcare Center [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 10,237,000 | |||
| Initial cost to company, land | 930,000 | |||
| Initial cost to company, buildings and improvements | 7,635,000 | |||
| Cost capitalized subsequent to acquisition | 1,546,000 | |||
| Gross amount of which carried at close of period, land | 1,107,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 9,004,000 | |||
| Gross amount of which carried at close of period, total | 10,111,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,353,000) | |||
| Novi Lakes Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 12,154,000 | |||
| Initial cost to company, land | 1,654,000 | |||
| Initial cost to company, buildings and improvements | 7,494,000 | |||
| Cost capitalized subsequent to acquisition | 2,770,000 | |||
| Gross amount of which carried at close of period, land | 1,702,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,216,000 | |||
| Gross amount of which carried at close of period, total | 11,918,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,420,000) | |||
| The Willows at Fritz Farm [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 8,918,000 | |||
| Initial cost to company, land | 1,538,000 | |||
| Initial cost to company, buildings and improvements | 8,637,000 | |||
| Cost capitalized subsequent to acquisition | 455,000 | |||
| Gross amount of which carried at close of period, land | 1,563,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 9,067,000 | |||
| Gross amount of which carried at close of period, total | 10,630,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,316,000) | |||
| Trilogy Real Estate Gahanna, LLC [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 1,146,000 | |||
| Initial cost to company, buildings and improvements | 0 | |||
| Cost capitalized subsequent to acquisition | 16,745,000 | |||
| Gross amount of which carried at close of period, land | 1,218,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 16,673,000 | |||
| Gross amount of which carried at close of period, total | 17,891,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,361,000) | |||
| Oaks at Byron Center [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 14,264,000 | |||
| Initial cost to company, land | 2,000,000 | |||
| Initial cost to company, buildings and improvements | 0 | |||
| Cost capitalized subsequent to acquisition | 15,932,000 | |||
| Gross amount of which carried at close of period, land | 2,193,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 15,739,000 | |||
| Gross amount of which carried at close of period, total | 17,932,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,517,000) | |||
| Harrison Springs Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 2,017,000 | |||
| Initial cost to company, buildings and improvements | 11,487,000 | |||
| Cost capitalized subsequent to acquisition | 5,933,000 | |||
| Gross amount of which carried at close of period, land | 2,305,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 17,132,000 | |||
| Gross amount of which carried at close of period, total | 19,437,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,775,000) | |||
| The Cloister at Silvercrest | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 139,000 | |||
| Initial cost to company, buildings and improvements | 634,000 | |||
| Cost capitalized subsequent to acquisition | 6,000 | |||
| Gross amount of which carried at close of period, land | 139,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 640,000 | |||
| Gross amount of which carried at close of period, total | 779,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (70,000) | |||
| Trilogy Healthcare of Ferdinand II, LLC [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 16,805,000 | |||
| Initial cost to company, land | 0 | |||
| Initial cost to company, buildings and improvements | 0 | |||
| Cost capitalized subsequent to acquisition | 14,619,000 | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 14,619,000 | |||
| Gross amount of which carried at close of period, total | 14,619,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,541,000) | |||
| Forest Springs Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 964,000 | |||
| Initial cost to company, buildings and improvements | 16,691,000 | |||
| Cost capitalized subsequent to acquisition | 363,000 | |||
| Gross amount of which carried at close of period, land | 1,000,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 17,018,000 | |||
| Gross amount of which carried at close of period, total | 18,018,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,654,000) | |||
| Gateway Springs Health Campus [Member] | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 11,505,000 | |||
| Initial cost to company, land | 1,277,000 | |||
| Initial cost to company, buildings and improvements | 10,923,000 | |||
| Cost capitalized subsequent to acquisition | 1,615,000 | |||
| Gross amount of which carried at close of period, land | 1,431,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,384,000 | |||
| Gross amount of which carried at close of period, total | 13,815,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,016,000) | |||
| The Meadows of Delphos | Kendallville, IN | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Gross amount of which carried at close of period, accumulated deprecation | (1,003,000) | |||
| The Meadows of Delphos | Delphos, OH | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 9,330,000 | |||
| Initial cost to company, land | 2,345,000 | |||
| Initial cost to company, buildings and improvements | 8,150,000 | |||
| Cost capitalized subsequent to acquisition | 98,000 | |||
| Gross amount of which carried at close of period, land | 2,382,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 8,211,000 | |||
| Gross amount of which carried at close of period, total | 10,593,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,140,000) | |||
| Harrison Trail Health Campus | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 15,632,000 | |||
| Initial cost to company, land | 1,750,000 | |||
| Initial cost to company, buildings and improvements | 17,114,000 | |||
| Cost capitalized subsequent to acquisition | 86,000 | |||
| Gross amount of which carried at close of period, land | 2,048,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 16,902,000 | |||
| Gross amount of which carried at close of period, total | 18,950,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,266,000) | |||
| Charlottesville OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 4,902,000 | |||
| Initial cost to company, buildings and improvements | 19,741,000 | |||
| Cost capitalized subsequent to acquisition | 785,000 | |||
| Gross amount of which carried at close of period, land | 4,902,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 20,526,000 | |||
| Gross amount of which carried at close of period, total | 25,428,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,652,000) | |||
| Rochester Hills OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 1,813,000 | |||
| Initial cost to company, land | 2,218,000 | |||
| Initial cost to company, buildings and improvements | 8,380,000 | |||
| Cost capitalized subsequent to acquisition | 947,000 | |||
| Gross amount of which carried at close of period, land | 2,218,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 9,327,000 | |||
| Gross amount of which carried at close of period, total | 11,545,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (918,000) | |||
| Cullman OM III | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 0 | |||
| Initial cost to company, buildings and improvements | 19,224,000 | |||
| Cost capitalized subsequent to acquisition | (587,000) | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 18,637,000 | |||
| Gross amount of which carried at close of period, total | 18,637,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,080,000) | |||
| Iron OM Portfolio | Iron OM Portfolio One | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 0 | |||
| Initial cost to company, buildings and improvements | 14,799,000 | |||
| Cost capitalized subsequent to acquisition | 1,382,000 | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 16,181,000 | |||
| Gross amount of which carried at close of period, total | 16,181,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,552,000) | |||
| Iron OM Portfolio | Iron OM Portfolio Two | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 0 | |||
| Initial cost to company, buildings and improvements | 12,287,000 | |||
| Cost capitalized subsequent to acquisition | 438,000 | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,725,000 | |||
| Gross amount of which carried at close of period, total | 12,725,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,071,000) | |||
| Iron OM Portfolio | Iron OM Portfolio Three | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 0 | |||
| Initial cost to company, buildings and improvements | 11,273,000 | |||
| Cost capitalized subsequent to acquisition | 2,161,000 | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,434,000 | |||
| Gross amount of which carried at close of period, total | 13,434,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (976,000) | |||
| Mint Hill OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 0 | |||
| Initial cost to company, buildings and improvements | 24,110,000 | |||
| Cost capitalized subsequent to acquisition | (26,000) | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 24,084,000 | |||
| Gross amount of which carried at close of period, total | 24,084,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,981,000) | |||
| Lafayette Assisted Living Portfolio | Lafayette Assisted Living Portfolio One | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,206,000 | |||
| Initial cost to company, buildings and improvements | 9,076,000 | |||
| Cost capitalized subsequent to acquisition | 697,000 | |||
| Gross amount of which carried at close of period, land | 1,206,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 9,773,000 | |||
| Gross amount of which carried at close of period, total | 10,979,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (569,000) | |||
| Lafayette Assisted Living Portfolio | Lafayette Assisted Living Portfolio Two | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,039,000 | |||
| Initial cost to company, buildings and improvements | 4,684,000 | |||
| Cost capitalized subsequent to acquisition | 255,000 | |||
| Gross amount of which carried at close of period, land | 1,039,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 4,939,000 | |||
| Gross amount of which carried at close of period, total | 5,978,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (316,000) | |||
| Battle Creek OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,156,000 | |||
| Initial cost to company, buildings and improvements | 7,910,000 | |||
| Cost capitalized subsequent to acquisition | 10,000 | |||
| Gross amount of which carried at close of period, land | 1,156,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 7,920,000 | |||
| Gross amount of which carried at close of period, total | 9,076,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (855,000) | |||
| Reno OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 0 | |||
| Initial cost to company, buildings and improvements | 82,515,000 | |||
| Cost capitalized subsequent to acquisition | 735,000 | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 83,250,000 | |||
| Gross amount of which carried at close of period, total | 83,250,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (6,090,000) | |||
| Athens OM | Athens OM Portfolio One | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 860,000 | |||
| Initial cost to company, buildings and improvements | 7,989,000 | |||
| Cost capitalized subsequent to acquisition | 120,000 | |||
| Gross amount of which carried at close of period, land | 860,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 8,109,000 | |||
| Gross amount of which carried at close of period, total | 8,969,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (689,000) | |||
| Athens OM | Athens OM Portfolio Two | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,106,000 | |||
| Initial cost to company, buildings and improvements | 11,531,000 | |||
| Cost capitalized subsequent to acquisition | 456,000 | |||
| Gross amount of which carried at close of period, land | 1,106,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,987,000 | |||
| Gross amount of which carried at close of period, total | 13,093,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (962,000) | |||
| SW Illinois Senior Housing Portfolio | SW Illinois Senior Housing Portfolio One | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,117,000 | |||
| Initial cost to company, buildings and improvements | 9,700,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 1,117,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 9,700,000 | |||
| Gross amount of which carried at close of period, total | 10,817,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (640,000) | |||
| SW Illinois Senior Housing Portfolio | SW Illinois Senior Housing Portfolio Two | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 147,000 | |||
| Initial cost to company, buildings and improvements | 2,106,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 147,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 2,106,000 | |||
| Gross amount of which carried at close of period, total | 2,253,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (135,000) | |||
| SW Illinois Senior Housing Portfolio | SW Illinois Senior Housing Portfolio Three | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 259,000 | |||
| Initial cost to company, buildings and improvements | 3,980,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 259,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 3,980,000 | |||
| Gross amount of which carried at close of period, total | 4,239,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (256,000) | |||
| SW Illinois Senior Housing Portfolio | SW Illinois Senior Housing Portfolio Four | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 690,000 | |||
| Initial cost to company, buildings and improvements | 5,175,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 690,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 5,175,000 | |||
| Gross amount of which carried at close of period, total | 5,865,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (332,000) | |||
| SW Illinois Senior Housing Portfolio | SW Illinois Senior Housing Portfolio Five | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 934,000 | |||
| Initial cost to company, buildings and improvements | 8,932,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 934,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 8,932,000 | |||
| Gross amount of which carried at close of period, total | 9,866,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (576,000) | |||
| Lawrenceville OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,663,000 | |||
| Initial cost to company, buildings and improvements | 12,019,000 | |||
| Cost capitalized subsequent to acquisition | 250,000 | |||
| Gross amount of which carried at close of period, land | 1,663,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,269,000 | |||
| Gross amount of which carried at close of period, total | 13,932,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,019,000) | |||
| Northern California Senior Housing Portfolio | Northern California Senior Housing Portfolio One | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 10,491,000 | |||
| Initial cost to company, buildings and improvements | 9,650,000 | |||
| Cost capitalized subsequent to acquisition | (6,971,000) | |||
| Gross amount of which carried at close of period, land | 10,491,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 2,679,000 | |||
| Gross amount of which carried at close of period, total | 13,170,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (624,000) | |||
| Northern California Senior Housing Portfolio | Northern California Senior Housing Portfolio Three | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 3,730,000 | |||
| Initial cost to company, buildings and improvements | 3,018,000 | |||
| Cost capitalized subsequent to acquisition | (6,741,000) | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 7,000 | |||
| Gross amount of which carried at close of period, total | 7,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | 0 | |||
| Roseburg OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 0 | |||
| Initial cost to company, buildings and improvements | 28,140,000 | |||
| Cost capitalized subsequent to acquisition | 134,000 | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 28,274,000 | |||
| Gross amount of which carried at close of period, total | 28,274,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,180,000) | |||
| Fairfield County OM | Fairfield County OM Portfolio Two | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 2,797,000 | |||
| Initial cost to company, buildings and improvements | 10,400,000 | |||
| Cost capitalized subsequent to acquisition | 274,000 | |||
| Gross amount of which carried at close of period, land | 2,797,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,674,000 | |||
| Gross amount of which carried at close of period, total | 13,471,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,137,000) | |||
| Central Wisconsin Senior Care Portfolio | Central Wisconsin Senior Care Portfolio One | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 543,000 | |||
| Initial cost to company, buildings and improvements | 2,587,000 | |||
| Cost capitalized subsequent to acquisition | 70,000 | |||
| Gross amount of which carried at close of period, land | 543,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 2,657,000 | |||
| Gross amount of which carried at close of period, total | 3,200,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (202,000) | |||
| Central Wisconsin Senior Care Portfolio | Central Wisconsin Senior Care Portfolio Two | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 2,171,000 | |||
| Initial cost to company, buildings and improvements | 10,198,000 | |||
| Cost capitalized subsequent to acquisition | 423,000 | |||
| Gross amount of which carried at close of period, land | 2,171,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,621,000 | |||
| Gross amount of which carried at close of period, total | 12,792,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (796,000) | |||
| Sauk Prairie OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 2,044,000 | |||
| Initial cost to company, buildings and improvements | 19,669,000 | |||
| Cost capitalized subsequent to acquisition | 401,000 | |||
| Gross amount of which carried at close of period, land | 2,044,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 20,070,000 | |||
| Gross amount of which carried at close of period, total | 22,114,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,558,000) | |||
| Surprise OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,827,000 | |||
| Initial cost to company, buildings and improvements | 10,968,000 | |||
| Cost capitalized subsequent to acquisition | 443,000 | |||
| Gross amount of which carried at close of period, land | 1,827,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,411,000 | |||
| Gross amount of which carried at close of period, total | 13,238,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (881,000) | |||
| Southfield OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 5,408,000 | |||
| Initial cost to company, land | 1,634,000 | |||
| Initial cost to company, buildings and improvements | 16,550,000 | |||
| Cost capitalized subsequent to acquisition | 1,187,000 | |||
| Gross amount of which carried at close of period, land | 1,634,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 17,737,000 | |||
| Gross amount of which carried at close of period, total | 19,371,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,824,000) | |||
| Pinnacle Beaumont ALF | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,775,000 | |||
| Initial cost to company, buildings and improvements | 17,541,000 | |||
| Cost capitalized subsequent to acquisition | 39,000 | |||
| Gross amount of which carried at close of period, land | 1,775,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 17,580,000 | |||
| Gross amount of which carried at close of period, total | 19,355,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,062,000) | |||
| Grand Junction OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 2,460,000 | |||
| Initial cost to company, buildings and improvements | 34,188,000 | |||
| Cost capitalized subsequent to acquisition | 42,000 | |||
| Gross amount of which carried at close of period, land | 2,460,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 34,230,000 | |||
| Gross amount of which carried at close of period, total | 36,690,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (2,749,000) | |||
| Edmonds OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 4,523,000 | |||
| Initial cost to company, buildings and improvements | 22,414,000 | |||
| Cost capitalized subsequent to acquisition | 338,000 | |||
| Gross amount of which carried at close of period, land | 4,523,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 22,752,000 | |||
| Gross amount of which carried at close of period, total | 27,275,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,826,000) | |||
| Pinnacle Warrenton ALF | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 514,000 | |||
| Initial cost to company, buildings and improvements | 7,059,000 | |||
| Cost capitalized subsequent to acquisition | (2,240,000) | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 5,333,000 | |||
| Gross amount of which carried at close of period, total | 5,333,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (462,000) | |||
| Glendale OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 665,000 | |||
| Initial cost to company, buildings and improvements | 6,782,000 | |||
| Cost capitalized subsequent to acquisition | 410,000 | |||
| Gross amount of which carried at close of period, land | 665,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 7,192,000 | |||
| Gross amount of which carried at close of period, total | 7,857,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (701,000) | |||
| Missouri Skilled Nursing Facility Portfolio | Missouri SNF Portfolio One | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 800,000 | |||
| Initial cost to company, buildings and improvements | 10,363,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 800,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,363,000 | |||
| Gross amount of which carried at close of period, total | 11,163,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (692,000) | |||
| Missouri Skilled Nursing Facility Portfolio | Missouri SNF Portfolio Two | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 2,090,000 | |||
| Initial cost to company, buildings and improvements | 10,527,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 2,090,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,527,000 | |||
| Gross amount of which carried at close of period, total | 12,617,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (821,000) | |||
| Missouri Skilled Nursing Facility Portfolio | Missouri SNF Portfolio Three | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 493,000 | |||
| Initial cost to company, buildings and improvements | 7,057,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 493,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 7,057,000 | |||
| Gross amount of which carried at close of period, total | 7,550,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (464,000) | |||
| Missouri Skilled Nursing Facility Portfolio | Missouri SNF Portfolio Four | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 729,000 | |||
| Initial cost to company, buildings and improvements | 10,187,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 729,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,187,000 | |||
| Gross amount of which carried at close of period, total | 10,916,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (658,000) | |||
| Missouri Skilled Nursing Facility Portfolio | Missouri SNF Portfolio Five | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 515,000 | |||
| Initial cost to company, buildings and improvements | 8,852,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 515,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 8,852,000 | |||
| Gross amount of which carried at close of period, total | 9,367,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (584,000) | |||
| Missouri Skilled Nursing Facility Portfolio | Missouri SNF Portfolio Six | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 631,000 | |||
| Initial cost to company, buildings and improvements | 24,172,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 631,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 24,172,000 | |||
| Gross amount of which carried at close of period, total | 24,803,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,466,000) | |||
| Missouri Skilled Nursing Facility Portfolio | Missouri SNF Portfolio Seven | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 437,000 | |||
| Initial cost to company, buildings and improvements | 4,561,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 437,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 4,561,000 | |||
| Gross amount of which carried at close of period, total | 4,998,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (307,000) | |||
| Missouri Skilled Nursing Facility Portfolio | Missouri SNF Portfolio Eight | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 310,000 | |||
| Initial cost to company, buildings and improvements | 4,875,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 310,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 4,875,000 | |||
| Gross amount of which carried at close of period, total | 5,185,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (316,000) | |||
| Flemington OM | Flemington OM Portfolio One | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,419,000 | |||
| Initial cost to company, buildings and improvements | 11,110,000 | |||
| Cost capitalized subsequent to acquisition | 553,000 | |||
| Gross amount of which carried at close of period, land | 1,419,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,663,000 | |||
| Gross amount of which carried at close of period, total | 13,082,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,107,000) | |||
| Flemington OM | Flemington OM Portfolio Two | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 578,000 | |||
| Initial cost to company, buildings and improvements | 3,340,000 | |||
| Cost capitalized subsequent to acquisition | 297,000 | |||
| Gross amount of which carried at close of period, land | 578,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 3,637,000 | |||
| Gross amount of which carried at close of period, total | 4,215,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (370,000) | |||
| Lawrenceville OM II | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,058,000 | |||
| Initial cost to company, buildings and improvements | 9,709,000 | |||
| Cost capitalized subsequent to acquisition | 1,718,000 | |||
| Gross amount of which carried at close of period, land | 1,058,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,427,000 | |||
| Gross amount of which carried at close of period, total | 12,485,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (994,000) | |||
| Mill Creek OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,344,000 | |||
| Initial cost to company, buildings and improvements | 7,516,000 | |||
| Cost capitalized subsequent to acquisition | 535,000 | |||
| Gross amount of which carried at close of period, land | 1,344,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 8,051,000 | |||
| Gross amount of which carried at close of period, total | 9,395,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (610,000) | |||
| Modesto OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 0 | |||
| Initial cost to company, buildings and improvements | 16,065,000 | |||
| Cost capitalized subsequent to acquisition | 479,000 | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 16,544,000 | |||
| Gross amount of which carried at close of period, total | 16,544,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,310,000) | |||
| Michigan ALF Portfolio | Michigan ALF Portfolio One | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,196,000 | |||
| Initial cost to company, buildings and improvements | 8,955,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 1,196,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 8,955,000 | |||
| Gross amount of which carried at close of period, total | 10,151,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (619,000) | |||
| Michigan ALF Portfolio | Michigan ALF Portfolio Two | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 9,608,000 | |||
| Initial cost to company, land | 1,291,000 | |||
| Initial cost to company, buildings and improvements | 11,308,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 1,291,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,308,000 | |||
| Gross amount of which carried at close of period, total | 12,599,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (779,000) | |||
| Michigan ALF Portfolio | Michigan ALF Portfolio Three | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 716,000 | |||
| Initial cost to company, buildings and improvements | 6,534,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 716,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 6,534,000 | |||
| Gross amount of which carried at close of period, total | 7,250,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (518,000) | |||
| Michigan ALF Portfolio | Michigan ALF Portfolio Four | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 836,000 | |||
| Initial cost to company, buildings and improvements | 4,202,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 836,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 4,202,000 | |||
| Gross amount of which carried at close of period, total | 5,038,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (290,000) | |||
| Michigan ALF Portfolio | Michigan ALF Portfolio Five | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,300,000 | |||
| Initial cost to company, buildings and improvements | 11,629,000 | |||
| Cost capitalized subsequent to acquisition | 3,000 | |||
| Gross amount of which carried at close of period, land | 1,300,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,632,000 | |||
| Gross amount of which carried at close of period, total | 12,932,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (767,000) | |||
| Michigan ALF Portfolio | Michigan ALF Portfolio Six | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,343,000 | |||
| Initial cost to company, buildings and improvements | 13,347,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 1,343,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,347,000 | |||
| Gross amount of which carried at close of period, total | 14,690,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (881,000) | |||
| Lithonia OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,676,000 | |||
| Initial cost to company, buildings and improvements | 10,871,000 | |||
| Cost capitalized subsequent to acquisition | 895,000 | |||
| Gross amount of which carried at close of period, land | 1,676,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,766,000 | |||
| Gross amount of which carried at close of period, total | 13,442,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,015,000) | |||
| West Des Moines SNF | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 509,000 | |||
| Initial cost to company, buildings and improvements | 3,813,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 509,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 3,813,000 | |||
| Gross amount of which carried at close of period, total | 4,322,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (260,000) | |||
| Great Nord OM Portfolio | Great Nord OM Portfolio One | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 0 | |||
| Initial cost to company, buildings and improvements | 15,423,000 | |||
| Cost capitalized subsequent to acquisition | 945,000 | |||
| Gross amount of which carried at close of period, land | 0 | |||
| Gross amount of which carried at close of period, buildings and improvements | 16,368,000 | |||
| Gross amount of which carried at close of period, total | 16,368,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,491,000) | |||
| Great Nord OM Portfolio | Great Nord OM Portfolio Two | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 743,000 | |||
| Initial cost to company, buildings and improvements | 9,070,000 | |||
| Cost capitalized subsequent to acquisition | 260,000 | |||
| Gross amount of which carried at close of period, land | 743,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 9,330,000 | |||
| Gross amount of which carried at close of period, total | 10,073,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (912,000) | |||
| Great Nord OM Portfolio | Great Nord OM Portfolio Three | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 265,000 | |||
| Initial cost to company, buildings and improvements | 5,467,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 265,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 5,467,000 | |||
| Gross amount of which carried at close of period, total | 5,732,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (451,000) | |||
| Great Nord OM Portfolio | Great Nord OM Portfolio Four | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,491,000 | |||
| Initial cost to company, buildings and improvements | 12,994,000 | |||
| Cost capitalized subsequent to acquisition | 68,000 | |||
| Gross amount of which carried at close of period, land | 1,491,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,062,000 | |||
| Gross amount of which carried at close of period, total | 14,553,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,106,000) | |||
| Overland Park OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 2,803,000 | |||
| Initial cost to company, buildings and improvements | 23,639,000 | |||
| Cost capitalized subsequent to acquisition | 640,000 | |||
| Gross amount of which carried at close of period, land | 2,803,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 24,279,000 | |||
| Gross amount of which carried at close of period, total | 27,082,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,942,000) | |||
| Blue Badger OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,518,000 | |||
| Initial cost to company, buildings and improvements | 12,543,000 | |||
| Cost capitalized subsequent to acquisition | 28,000 | |||
| Gross amount of which carried at close of period, land | 1,518,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,571,000 | |||
| Gross amount of which carried at close of period, total | 14,089,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (948,000) | |||
| Bloomington OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 2,114,000 | |||
| Initial cost to company, buildings and improvements | 17,363,000 | |||
| Cost capitalized subsequent to acquisition | 0 | |||
| Gross amount of which carried at close of period, land | 2,114,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 17,363,000 | |||
| Gross amount of which carried at close of period, total | 19,477,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,102,000) | |||
| Haverhill OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,393,000 | |||
| Initial cost to company, buildings and improvements | 15,477,000 | |||
| Cost capitalized subsequent to acquisition | 96,000 | |||
| Gross amount of which carried at close of period, land | 1,393,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 15,573,000 | |||
| Gross amount of which carried at close of period, total | 16,966,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,493,000) | |||
| Fresno OM | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,536,000 | |||
| Initial cost to company, buildings and improvements | 8,964,000 | |||
| Cost capitalized subsequent to acquisition | 291,000 | |||
| Gross amount of which carried at close of period, land | 1,536,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 9,255,000 | |||
| Gross amount of which carried at close of period, total | 10,791,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (850,000) | |||
| Colorado Foothills OM Portfolio | Colorado Foothills OM Portfolio One | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 695,000 | |||
| Initial cost to company, buildings and improvements | 6,369,000 | |||
| Cost capitalized subsequent to acquisition | 292,000 | |||
| Gross amount of which carried at close of period, land | 695,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 6,661,000 | |||
| Gross amount of which carried at close of period, total | 7,356,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (786,000) | |||
| Colorado Foothills OM Portfolio | Colorado Foothills OM Portfolio Two | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 873,000 | |||
| Initial cost to company, buildings and improvements | 11,233,000 | |||
| Cost capitalized subsequent to acquisition | 346,000 | |||
| Gross amount of which carried at close of period, land | 873,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,579,000 | |||
| Gross amount of which carried at close of period, total | 12,452,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,037,000) | |||
| Colorado Foothills OM Portfolio | Colorado Foothills OM Portfolio Three | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 2,225,000 | |||
| Initial cost to company, buildings and improvements | 12,520,000 | |||
| Cost capitalized subsequent to acquisition | 1,007,000 | |||
| Gross amount of which carried at close of period, land | 2,225,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,527,000 | |||
| Gross amount of which carried at close of period, total | 15,752,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,052,000) | |||
| Catalina West Haven ALF | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,936,000 | |||
| Initial cost to company, buildings and improvements | 10,415,000 | |||
| Cost capitalized subsequent to acquisition | 253,000 | |||
| Gross amount of which carried at close of period, land | 1,936,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,668,000 | |||
| Gross amount of which carried at close of period, total | 12,604,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (697,000) | |||
| Louisiana Senior Housing Portfolio | Louisiana Senior Housing Portfolio One | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,123,000 | |||
| Initial cost to company, buildings and improvements | 5,668,000 | |||
| Cost capitalized subsequent to acquisition | 142,000 | |||
| Gross amount of which carried at close of period, land | 1,123,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 5,810,000 | |||
| Gross amount of which carried at close of period, total | 6,933,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (404,000) | |||
| Louisiana Senior Housing Portfolio | Louisiana Senior Housing Portfolio Two | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 834,000 | |||
| Initial cost to company, buildings and improvements | 4,037,000 | |||
| Cost capitalized subsequent to acquisition | 393,000 | |||
| Gross amount of which carried at close of period, land | 834,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 4,430,000 | |||
| Gross amount of which carried at close of period, total | 5,264,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (268,000) | |||
| Louisiana Senior Housing Portfolio | Louisiana Senior Housing Portfolio Three | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 952,000 | |||
| Initial cost to company, buildings and improvements | 5,257,000 | |||
| Cost capitalized subsequent to acquisition | 54,000 | |||
| Gross amount of which carried at close of period, land | 952,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 5,311,000 | |||
| Gross amount of which carried at close of period, total | 6,263,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (357,000) | |||
| Louisiana Senior Housing Portfolio | Louisiana Senior Housing Portfolio Four | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,177,000 | |||
| Initial cost to company, buildings and improvements | 6,810,000 | |||
| Cost capitalized subsequent to acquisition | 54,000 | |||
| Gross amount of which carried at close of period, land | 1,177,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 6,864,000 | |||
| Gross amount of which carried at close of period, total | 8,041,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (437,000) | |||
| Louisiana Senior Housing Portfolio | Louisiana Senior Housing Portfolio Five | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 801,000 | |||
| Initial cost to company, buildings and improvements | 4,348,000 | |||
| Cost capitalized subsequent to acquisition | 194,000 | |||
| Gross amount of which carried at close of period, land | 801,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 4,542,000 | |||
| Gross amount of which carried at close of period, total | 5,343,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (320,000) | |||
| Catalina Madera ALF | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,312,000 | |||
| Initial cost to company, buildings and improvements | 15,299,000 | |||
| Cost capitalized subsequent to acquisition | 375,000 | |||
| Gross amount of which carried at close of period, land | 1,312,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 15,674,000 | |||
| Gross amount of which carried at close of period, total | 16,986,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,008,000) | |||
| Cedar Creek Health Campus | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 2,326,000 | |||
| Initial cost to company, buildings and improvements | 12,650,000 | |||
| Cost capitalized subsequent to acquisition | 770,000 | |||
| Gross amount of which carried at close of period, land | 2,864,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,882,000 | |||
| Gross amount of which carried at close of period, total | 15,746,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (833,000) | |||
| The Oaks of Belmont | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 14,795,000 | |||
| Initial cost to company, land | 767,000 | |||
| Initial cost to company, buildings and improvements | 17,043,000 | |||
| Cost capitalized subsequent to acquisition | 192,000 | |||
| Gross amount of which carried at close of period, land | 1,068,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 16,934,000 | |||
| Gross amount of which carried at close of period, total | 18,002,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,349,000) | |||
| The Willows at Springhurst (ISHC) | Louisville, KY One | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 20,800,000 | |||
| Initial cost to company, land | 1,876,000 | |||
| Initial cost to company, buildings and improvements | 12,595,000 | |||
| Cost capitalized subsequent to acquisition | (547,000) | |||
| Gross amount of which carried at close of period, land | 1,952,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,972,000 | |||
| Gross amount of which carried at close of period, total | 13,924,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (702,000) | |||
| The Willows at Springhurst (ISHC) | Louisville, KY Two | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,184,000 | |||
| Initial cost to company, buildings and improvements | 6,483,000 | |||
| Cost capitalized subsequent to acquisition | (34,000) | |||
| Gross amount of which carried at close of period, land | 1,184,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 6,449,000 | |||
| Gross amount of which carried at close of period, total | 7,633,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (375,000) | |||
| The Willows at Harrodsburg (ISHC) | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 7,125,000 | |||
| Initial cost to company, land | 918,000 | |||
| Initial cost to company, buildings and improvements | 10,181,000 | |||
| Cost capitalized subsequent to acquisition | 1,396,000 | |||
| Gross amount of which carried at close of period, land | 1,594,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,901,000 | |||
| Gross amount of which carried at close of period, total | 12,495,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (567,000) | |||
| North River Health Campus (ISHC) | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 17,100,000 | |||
| Initial cost to company, land | 2,614,000 | |||
| Initial cost to company, buildings and improvements | 15,031,000 | |||
| Cost capitalized subsequent to acquisition | 94,000 | |||
| Gross amount of which carried at close of period, land | 2,631,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 15,108,000 | |||
| Gross amount of which carried at close of period, total | 17,739,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (874,000) | |||
| Trilogy Healthcare of Jefferson III, LLC (ISHC) | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 14,175,000 | |||
| Initial cost to company, land | 2,265,000 | |||
| Initial cost to company, buildings and improvements | 14,077,000 | |||
| Cost capitalized subsequent to acquisition | 356,000 | |||
| Gross amount of which carried at close of period, land | 2,265,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 14,433,000 | |||
| Gross amount of which carried at close of period, total | 16,698,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (722,000) | |||
| Pickerington Health Campus (ISHC) | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 13,050,000 | |||
| Initial cost to company, land | 860,000 | |||
| Initial cost to company, buildings and improvements | 15,575,000 | |||
| Cost capitalized subsequent to acquisition | 30,000 | |||
| Gross amount of which carried at close of period, land | 880,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 15,585,000 | |||
| Gross amount of which carried at close of period, total | 16,465,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,712,000) | |||
| Mt. Washington Development Project (ISHC) | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 14,325,000 | |||
| Initial cost to company, land | 2,054,000 | |||
| Initial cost to company, buildings and improvements | 10,225,000 | |||
| Cost capitalized subsequent to acquisition | 24,000 | |||
| Gross amount of which carried at close of period, land | 2,054,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,249,000 | |||
| Gross amount of which carried at close of period, total | 12,303,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (578,000) | |||
| Silvercrest Health Center (ISHC) | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 20,259,000 | |||
| Initial cost to company, land | 1,920,000 | |||
| Initial cost to company, buildings and improvements | 24,965,000 | |||
| Cost capitalized subsequent to acquisition | 352,000 | |||
| Gross amount of which carried at close of period, land | 1,920,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 25,317,000 | |||
| Gross amount of which carried at close of period, total | 27,237,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,018,000) | |||
| The Springs of Mooresville (ISHC) | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 13,853,000 | |||
| Initial cost to company, land | 1,460,000 | |||
| Initial cost to company, buildings and improvements | 12,617,000 | |||
| Cost capitalized subsequent to acquisition | 99,000 | |||
| Gross amount of which carried at close of period, land | 1,460,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,716,000 | |||
| Gross amount of which carried at close of period, total | 14,176,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (510,000) | |||
| Hearthstone Health Campus (ISHC) | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 19,008,000 | |||
| Initial cost to company, land | 2,140,000 | |||
| Initial cost to company, buildings and improvements | 16,928,000 | |||
| Cost capitalized subsequent to acquisition | 202,000 | |||
| Gross amount of which carried at close of period, land | 2,160,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 17,110,000 | |||
| Gross amount of which carried at close of period, total | 19,270,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (732,000) | |||
| AHR Texas ALF Portfolio (SHOP) | Temple, TX | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 14,561,000 | |||
| Initial cost to company, land | 1,819,000 | |||
| Initial cost to company, buildings and improvements | 11,090,000 | |||
| Cost capitalized subsequent to acquisition | 217,000 | |||
| Gross amount of which carried at close of period, land | 1,819,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,307,000 | |||
| Gross amount of which carried at close of period, total | 13,126,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (416,000) | |||
| AHR Texas ALF Portfolio (SHOP) | Cedar Park, TX | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 5,744,000 | |||
| Initial cost to company, land | 1,347,000 | |||
| Initial cost to company, buildings and improvements | 5,250,000 | |||
| Cost capitalized subsequent to acquisition | 114,000 | |||
| Gross amount of which carried at close of period, land | 1,347,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 5,364,000 | |||
| Gross amount of which carried at close of period, total | 6,711,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (206,000) | |||
| AHR Texas ALF Portfolio (SHOP) | Corpus Christi, TX | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 14,174,000 | |||
| Initial cost to company, land | 1,229,000 | |||
| Initial cost to company, buildings and improvements | 12,663,000 | |||
| Cost capitalized subsequent to acquisition | 98,000 | |||
| Gross amount of which carried at close of period, land | 1,229,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,761,000 | |||
| Gross amount of which carried at close of period, total | 13,990,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (465,000) | |||
| AHR Texas ALF Portfolio (SHOP) | League City, TX | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 15,537,000 | |||
| Initial cost to company, land | 1,435,000 | |||
| Initial cost to company, buildings and improvements | 15,475,000 | |||
| Cost capitalized subsequent to acquisition | 125,000 | |||
| Gross amount of which carried at close of period, land | 1,435,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 15,600,000 | |||
| Gross amount of which carried at close of period, total | 17,035,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (512,000) | |||
| AHR Texas ALF Portfolio (SHOP) | Round Rock, TX | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 21,123,000 | |||
| Initial cost to company, land | 2,124,000 | |||
| Initial cost to company, buildings and improvements | 14,895,000 | |||
| Cost capitalized subsequent to acquisition | 383,000 | |||
| Gross amount of which carried at close of period, land | 2,124,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 15,278,000 | |||
| Gross amount of which carried at close of period, total | 17,402,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (502,000) | |||
| AHR Texas ALF Portfolio (SHOP) | Sugarland, TX | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 27,780,000 | |||
| Initial cost to company, land | 2,674,000 | |||
| Initial cost to company, buildings and improvements | 12,751,000 | |||
| Cost capitalized subsequent to acquisition | 155,000 | |||
| Gross amount of which carried at close of period, land | 2,674,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,906,000 | |||
| Gross amount of which carried at close of period, total | 15,580,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (450,000) | |||
| AHR Texas ALF Portfolio (SHOP) | Tyler, TX | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 9,667,000 | |||
| Initial cost to company, land | 1,131,000 | |||
| Initial cost to company, buildings and improvements | 10,510,000 | |||
| Cost capitalized subsequent to acquisition | 103,000 | |||
| Gross amount of which carried at close of period, land | 1,131,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,613,000 | |||
| Gross amount of which carried at close of period, total | 11,744,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (384,000) | |||
| Orchard Pointe Health Campus | Kendallville, IN | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 10,176,000 | |||
| Initial cost to company, land | 1,806,000 | |||
| Initial cost to company, buildings and improvements | 9,243,000 | |||
| Cost capitalized subsequent to acquisition | 15,000 | |||
| Gross amount of which carried at close of period, land | 1,806,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 9,258,000 | |||
| Gross amount of which carried at close of period, total | 11,064,000 | |||
| The Springs of Lima | Lima, OH | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 10,765,000 | |||
| Initial cost to company, land | 2,397,000 | |||
| Initial cost to company, buildings and improvements | 9,638,000 | |||
| Cost capitalized subsequent to acquisition | 50,000 | |||
| Gross amount of which carried at close of period, land | 2,403,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 9,682,000 | |||
| Gross amount of which carried at close of period, total | 12,085,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,216,000) | |||
| Wooded Glen | Springfield, OH | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 14,450,000 | |||
| Initial cost to company, land | 2,803,000 | |||
| Initial cost to company, buildings and improvements | 11,928,000 | |||
| Cost capitalized subsequent to acquisition | 15,000 | |||
| Gross amount of which carried at close of period, land | 2,803,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 11,943,000 | |||
| Gross amount of which carried at close of period, total | 14,746,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,436,000) | |||
| The Lake of Sylvania | Sylvania, OH | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 19,493,000 | |||
| Initial cost to company, land | 3,208,000 | |||
| Initial cost to company, buildings and improvements | 15,059,000 | |||
| Cost capitalized subsequent to acquisition | 232,000 | |||
| Gross amount of which carried at close of period, land | 3,265,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 15,234,000 | |||
| Gross amount of which carried at close of period, total | 18,499,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,869,000) | |||
| The Glen | Union Township, OH | Property, Excluding Leased Property [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 14,741,000 | |||
| Initial cost to company, land | 2,789,000 | |||
| Initial cost to company, buildings and improvements | 12,343,000 | |||
| Cost capitalized subsequent to acquisition | 35,000 | |||
| Gross amount of which carried at close of period, land | 2,789,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 12,378,000 | |||
| Gross amount of which carried at close of period, total | 15,167,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (1,431,000) | |||
| The Legacy at English Station | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Initial cost to company, land | 912,000 | |||
| Initial cost to company, buildings and improvements | 10,139,000 | |||
| Cost capitalized subsequent to acquisition | 56,000 | |||
| Gross amount of which carried at close of period, land | 912,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 10,195,000 | |||
| Gross amount of which carried at close of period, total | 11,107,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (255,000) | |||
| The Legacy at English Station | Louisville, KY | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 7,700,000 | |||
| The Village at Oak Ridge | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 12,901,000 | |||
| Initial cost to company, land | 1,483,000 | |||
| Initial cost to company, buildings and improvements | 11,551,000 | |||
| Cost capitalized subsequent to acquisition | 1,799,000 | |||
| Gross amount of which carried at close of period, land | 1,483,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 13,350,000 | |||
| Gross amount of which carried at close of period, total | 14,833,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (174,000) | |||
| Smith's Mill Health Campus | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 0 | |||
| Initial cost to company, land | 1,323,000 | |||
| Initial cost to company, buildings and improvements | 15,271,000 | |||
| Cost capitalized subsequent to acquisition | 46,000 | |||
| Gross amount of which carried at close of period, land | 1,323,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 15,317,000 | |||
| Gross amount of which carried at close of period, total | 16,640,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | (255,000) | |||
| Oakwood Health Center Villas | Property, Excluding Construction in Progress | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Encumbrances | 1,988,000 | |||
| Initial cost to company, land | 535,000 | |||
| Initial cost to company, buildings and improvements | 1,555,000 | |||
| Cost capitalized subsequent to acquisition | 131,000 | |||
| Gross amount of which carried at close of period, land | 541,000 | |||
| Gross amount of which carried at close of period, buildings and improvements | 1,680,000 | |||
| Gross amount of which carried at close of period, total | 2,221,000 | |||
| Gross amount of which carried at close of period, accumulated deprecation | $ (47,000) |
Schedule III Real Estate and Accumulated Depreciation (Details 2) - USD ($) $ in Thousands |
12 Months Ended | |||
|---|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
|||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Ownership percentage, excluding joint venture, properties | 100.00% | |||
| Lines of credit and term loan | [1] | $ 1,223,967 | $ 1,281,794 | |
| Aggregate cost of properties for federal income tax purposes | $ 4,051,405 | |||
| Building and Building Improvements [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Estimated useful life | 39 years | |||
| Leasehold Improvements [Member] | Maximum | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Estimated useful life | 34 years | |||
| Furniture, fixtures and equipment | Maximum | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Estimated useful life | 28 years | |||
| Revolving Credit Facility | 2019 Trilogy Credit Facility [Member] | ||||
| Real Estate and Accumulated Depreciation [Line Items] | ||||
| Lines of credit and term loan | $ 309,823 | $ 316,734 | ||
| ||||
Schedule III Real Estate and Accumulated Depreciation (Changes in Total Real Estate Assets) (Detail) - USD ($) $ in Thousands |
12 Months Ended | ||
|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
| Reconciliation of Carrying Amount of Real Estate Investments [Roll Forward] | |||
| Beginning balance | $ 4,236,447 | $ 4,038,572 | $ 2,762,272 |
| Acquisitions | 55,658 | 254,947 | 1,225,626 |
| Additions | 97,667 | 72,802 | 87,909 |
| Dispositions and impairments | (214,906) | (123,841) | (36,645) |
| Foreign currency translation adjustment | 2,729 | (6,033) | (590) |
| Ending balance | 4,177,595 | $ 4,236,447 | $ 4,038,572 |
| Aggregate cost of properties for federal income tax purposes | $ 4,051,405 | ||
Schedule III Real Estate and Accumulated Depreciation (Changes in Accumulated Depreciation) (Detail) - USD ($) $ in Thousands |
12 Months Ended | ||
|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
| Reconciliation of Real Estate Accumulated Depreciation [Roll Forward] | |||
| Beginning balance | $ 654,838 | $ 523,886 | $ 425,272 |
| Additions | 147,587 | 141,257 | 109,036 |
| Dispositions and impairments | (50,790) | (9,355) | (10,320) |
| Foreign currency translation adjustment | 522 | (950) | (102) |
| Ending balance | $ 752,157 | $ 654,838 | $ 523,886 |