Table of Contents

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

FORM 10-Q


(Mark One)
xQUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended September 30, 2017March 31, 2022
or
¨TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from                    to                     
Commission File Number: 000-55775

GRIFFIN-AMERICANAMERICAN HEALTHCARE REIT, IV, INC.
(Exact name of registrant as specified in its charter)
Maryland47-2887436
(State or other jurisdiction of

incorporation or organization)
(I.R.S. Employer

Identification No.)
18191 Von Karman Avenue, Suite 300
Irvine, California
92612
(Address of principal executive offices)(Zip Code)


(949) 270-9200
(Registrant’s telephone number, including area code)


Not Applicable
(Former name, former address and former fiscal year, if changed since last report)


Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
NoneNoneNone
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Sections 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.x     ☒  Yes    ¨  No
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).    x  Yes    ¨  No
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated fileroAccelerated filero
Non-accelerated filerxSmaller reporting companyo
Emerging growth companyx
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. x
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). ¨  Yes   x  No
As of November 3, 2017,May 13, 2022, there were 36,675,85077,678,544 shares of Class T common stock and 2,028,989186,233,584 shares of Class I common stock of Griffin-AmericanAmerican Healthcare REIT, IV, Inc. outstanding.



Table of Contents

GRIFFIN-AMERICANAMERICAN HEALTHCARE REIT, IV, INC.
(A Maryland Corporation)
TABLE OF CONTENTS

Page



2

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PART I — FINANCIAL INFORMATION
Item 1. Financial Statements.
GRIFFIN-AMERICANAMERICAN HEALTHCARE REIT, IV, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
As of September 30, 2017March 31, 2022 and December 31, 20162021
(Unaudited)

March 31,
2022
December 31,
2021
ASSETS
Real estate investments, net$3,475,635,000 $3,514,686,000 
Debt security investment, net80,239,000 79,315,000 
Cash and cash equivalents75,115,000 81,597,000 
Restricted cash44,055,000 43,889,000 
Accounts and other receivables, net130,872,000 122,778,000 
Identified intangible assets, net241,140,000 248,871,000 
Goodwill211,724,000 209,898,000 
Operating lease right-of-use assets, net154,619,000 158,157,000 
Other assets, net142,786,000 121,148,000 
Total assets$4,556,185,000 $4,580,339,000 
LIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND EQUITY
Liabilities:
Mortgage loans payable, net(1)$1,103,006,000 $1,095,594,000 
Lines of credit and term loans, net(1)1,238,147,000 1,226,634,000 
Accounts payable and accrued liabilities(1)170,757,000 187,254,000 
Accounts payable due to affiliates(1)— 866,000 
Identified intangible liabilities, net12,077,000 12,715,000 
Financing obligations(1)32,921,000 33,653,000 
Operating lease liabilities(1)142,615,000 145,485,000 
Security deposits, prepaid rent and other liabilities(1)50,574,000 48,567,000 
Total liabilities2,750,097,000 2,750,768,000 
Commitments and contingencies (Note 12)00
Redeemable noncontrolling interests (Note 13)75,267,000 72,725,000 
Equity:
Stockholders’ equity:
Preferred stock, $0.01 par value per share; 200,000,000 shares authorized; none issued and outstanding— — 
Class T common stock, $0.01 par value per share; 200,000,000 shares authorized; 77,504,480 and 77,176,406 shares issued and outstanding as of March 31, 2022 and December 31, 2021, respectively766,000 763,000 
Class I common stock, $0.01 par value per share; 800,000,000 shares authorized; 186,305,249 and 185,855,625 shares issued and outstanding as of March 31, 2022 and December 31, 2021, respectively1,863,000 1,859,000 
Additional paid-in capital2,536,811,000 2,531,940,000 
Accumulated deficit(980,613,000)(951,303,000)
Accumulated other comprehensive loss(2,160,000)(1,966,000)
Total stockholders’ equity1,556,667,000 1,581,293,000 
Noncontrolling interests (Note 14)174,154,000 175,553,000 
Total equity1,730,821,000 1,756,846,000 
Total liabilities, redeemable noncontrolling interests and equity$4,556,185,000 $4,580,339,000 
 September 30, 2017 December 31, 2016
ASSETS
Real estate investments, net$318,942,000
 $117,942,000
Cash and cash equivalents4,397,000
 2,237,000
Accounts and other receivables, net1,359,000
 1,299,000
Restricted cash16,000
 
Real estate deposits5,021,000
 200,000
Identified intangible assets, net37,635,000
 19,673,000
Other assets, net4,142,000
 1,407,000
Total assets$371,512,000
 $142,758,000
    
LIABILITIES, REDEEMABLE NONCONTROLLING INTEREST AND STOCKHOLDERS’ EQUITY
Liabilities:   
Mortgage loans payable, net(1)$11,639,000
 $3,965,000
Line of Credit(1)26,000,000
 33,900,000
Accounts payable and accrued liabilities(1)17,053,000
 5,426,000
Accounts payable due to affiliates(1)8,065,000
 5,531,000
Identified intangible liabilities, net1,822,000
 1,063,000
Security deposits, prepaid rent and other liabilities(1)786,000
 616,000
Total liabilities65,365,000
 50,501,000
    
Commitments and contingencies (Note 9)
 
    
Redeemable noncontrolling interest (Note 10)2,000
 2,000
    
Stockholders’ equity:   
Preferred stock, $0.01 par value per share; 200,000,000 shares authorized; none issued and outstanding
 
Class T common stock, $0.01 par value per share; 900,000,000 shares authorized; 34,346,388 and 11,000,433 shares issued and outstanding as of September 30, 2017 and December 31, 2016, respectively343,000
 110,000
Class I common stock, $0.01 par value per share; 100,000,000 shares authorized; 1,884,007 and 377,006 shares issued and outstanding as of September 30, 2017 and December 31, 2016, respectively19,000
 4,000
Additional paid-in capital322,549,000
 99,492,000
Accumulated deficit(16,766,000) (7,351,000)
Total stockholders’ equity306,145,000
 92,255,000
Total liabilities, redeemable noncontrolling interest and stockholders’ equity$371,512,000
 $142,758,000
___________


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GRIFFIN-AMERICAN
AMERICAN HEALTHCARE REIT, IV, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS — (Continued)
As of September 30, 2017March 31, 2022 and December 31, 20162021
(Unaudited)

___________

(1)Such liabilities of Griffin-American Healthcare REIT IV, Inc. as of September 30, 2017 and December 31, 2016 represented liabilities of Griffin-American Healthcare REIT IV Holdings, LP, a variable interest entity and consolidated subsidiary of Griffin-American Healthcare REIT IV, Inc. The creditors of Griffin-American Healthcare REIT IV Holdings, LP do not have recourse against Griffin-American Healthcare REIT IV, Inc., except for the Line of Credit, as defined in Note 7, held by Griffin-American Healthcare REIT IV Holdings, LP in the amount of $26,000,000 and $33,900,000 as of September 30, 2017 and December 31, 2016, respectively, which is guaranteed by Griffin-American Healthcare REIT IV, Inc.

(1)Such liabilities of American Healthcare REIT, Inc. represented liabilities of American Healthcare REIT Holdings, LP or its consolidated subsidiaries as of March 31, 2022 and December 31, 2021. American Healthcare REIT Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of American Healthcare REIT, Inc. The creditors of American Healthcare REIT Holdings, LP or its consolidated subsidiaries do not have recourse against American Healthcare REIT, Inc., except for the 2022 Credit Facility, as defined in Note 9, held by American Healthcare REIT Holdings, LP in the amount of $934,400,000 as of March 31, 2022 and the 2018 Credit Facility and 2019 Credit Facility, each as defined in Note 9, held by American Healthcare REIT Holdings, LP in the amount of $441,900,000 and $480,000,000, respectively, as of December 31, 2021, which were guaranteed by American Healthcare REIT, Inc.
The accompanying notes are an integral part of these condensed consolidated financial statements.


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GRIFFIN-AMERICANAMERICAN HEALTHCARE REIT, IV, INC.
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS
For the Three and Nine Months Ended September 30, 2017March 31, 2022 and 20162021
(Unaudited)

 Three Months Ended September 30, Nine Months Ended September 30,
 2017 2016 2017 2016
Revenue:       
Real estate revenue$8,488,000
 $312,000
 $18,738,000
 $338,000
Expenses:       
Rental expenses2,095,000
 98,000
 4,893,000
 121,000
General and administrative1,296,000
 329,000
 2,996,000
 725,000
Acquisition related expenses121,000
 1,857,000
 334,000
 2,227,000
Depreciation and amortization3,442,000
 64,000
 7,619,000
 64,000
Total expenses6,954,000

2,348,000
 15,842,000
 3,137,000
Other income (expense):       
Interest expense (including amortization of deferred financing costs and debt premium)(780,000) (56,000) (1,607,000) (56,000)
Interest income
 
 1,000
 
Net income (loss)754,000
 (2,092,000) 1,290,000
 (2,855,000)
Less: net income (loss) attributable to redeemable noncontrolling interest
 
 
 
Net income (loss) attributable to controlling interest$754,000
 $(2,092,000) $1,290,000
 $(2,855,000)
Net income (loss) per Class T and Class I common share attributable to controlling interest — basic and diluted$0.02
 $(0.62) $0.05
 $(2.12)
Weighted average number of Class T and Class I common shares outstanding — basic and diluted32,593,321
 3,357,979
 23,827,175
 1,345,578
Distributions declared per Class T and Class I common share$0.15
 $0.15
 $0.45
 $0.25

Three Months Ended March 31,
20222021
Revenues and grant income:
Resident fees and services$318,974,000 $253,026,000 
Real estate revenue51,943,000 30,023,000 
Grant income5,214,000 8,229,000 
Total revenues and grant income376,131,000 291,278,000 
Expenses:
Property operating expenses287,160,000 245,142,000 
Rental expenses15,287,000 8,055,000 
General and administrative11,119,000 7,257,000 
Business acquisition expenses173,000 1,248,000 
Depreciation and amortization42,311,000 25,723,000 
Total expenses356,050,000 287,425,000 
Other income (expense):
Interest expense:
Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments)(23,325,000)(20,365,000)
Gain in fair value of derivative financial instruments500,000 1,821,000 
Gain (loss) on dispositions of real estate investments756,000 (335,000)
Income (loss) from unconsolidated entities1,386,000 (1,771,000)
Foreign currency (loss) gain(1,387,000)415,000 
Other income1,260,000 272,000 
Total net other expense(20,810,000)(19,963,000)
Loss before income taxes(729,000)(16,110,000)
Income tax expense(168,000)(163,000)
Net loss(897,000)(16,273,000)
Net (income) loss attributable to noncontrolling interests(2,059,000)4,426,000 
Net loss attributable to controlling interest$(2,956,000)$(11,847,000)
Net loss per Class T and Class I common share attributable to controlling interest — basic and diluted$(0.01)$(0.07)
Weighted average number of Class T and Class I common shares outstanding — basic and diluted262,516,815 179,627,778 
Net loss$(897,000)$(16,273,000)
Other comprehensive (loss) income:
Foreign currency translation adjustments(194,000)69,000 
Total other comprehensive (loss) income(194,000)69,000 
Comprehensive loss(1,091,000)(16,204,000)
Comprehensive (income) loss attributable to noncontrolling interests(2,059,000)4,426,000 
Comprehensive loss attributable to controlling interest$(3,150,000)$(11,778,000)
The accompanying notes are an integral part of these condensed consolidated financial statements.

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GRIFFIN-AMERICANAMERICAN HEALTHCARE REIT, IV, INC.
CONDENSED CONSOLIDATED STATEMENTS OF EQUITY
For the NineThree Months Ended September 30, 2017March 31, 2022 and 20162021
(Unaudited)


 Class T and Class I Common Stock      
 
Number
of Shares
 Amount 
Additional
Paid-In Capital
 
Accumulated
Deficit
 
Total
Stockholders’
Equity
BALANCE — December 31, 201611,377,439
 $114,000
 $99,492,000
 $(7,351,000) $92,255,000
Issuance of common stock24,264,521
 242,000
 241,193,000
 
 241,435,000
Offering costs — common stock
 
 (23,544,000) 
 (23,544,000)
Issuance of common stock under the DRIP584,318
 6,000
 5,486,000
 
 5,492,000
Issuance of vested and nonvested restricted common stock22,500
 
 45,000
 
 45,000
Amortization of nonvested common stock compensation
 
 55,000
 
 55,000
Repurchase of common stock(18,383) 
 (178,000) 
 (178,000)
Distributions declared
 
 
 (10,705,000) (10,705,000)
Net income
 
 
 1,290,000
 1,290,000
BALANCE — September 30, 201736,230,395
 $362,000
 $322,549,000
 $(16,766,000) $306,145,000


Stockholders’ Equity
 Common Stock  
Number
of
Shares
AmountAdditional
Paid-In
Capital
Accumulated
Deficit
Accumulated
Other
Comprehensive
Loss
Total
Stockholders’
Equity
Noncontrolling
Interests
Total Equity
BALANCE — December 31, 2021263,032,031 $2,622,000 $2,531,940,000 $(951,303,000)$(1,966,000)$1,581,293,000 $175,553,000 $1,756,846,000 
Offering costs — common stock— — (3,000)— — (3,000)— (3,000)
Issuance of common stock under the DRIP1,226,073 12,000 11,292,000 — — 11,304,000 — 11,304,000 
Amortization of nonvested common stock compensation— — 811,000 — — 811,000 — 811,000 
Stock based compensation— — — — — — 21,000 21,000 
Repurchase of common stock(448,375)(5,000)(4,129,000)— — (4,134,000)— (4,134,000)
Distributions to noncontrolling interests— — — — — — (3,515,000)(3,515,000)
Adjustment to noncontrolling interest in connection with the Merger— — (1,173,000)— — (1,173,000)1,173,000 — 
Reclassification of noncontrolling interests to mezzanine equity— — — — — — (21,000)(21,000)
Adjustment to value of redeemable noncontrolling interests— — (1,927,000)— — (1,927,000)(929,000)(2,856,000)
Distributions declared ($0.10 per share)— — — (26,354,000)— (26,354,000)— (26,354,000)
Net (loss) income— — — (2,956,000)— (2,956,000)1,872,000 (1,084,000)(1)
Other comprehensive loss— — — — (194,000)(194,000)— (194,000)
BALANCE — March 31, 2022263,809,729 $2,629,000 $2,536,811,000 $(980,613,000)$(2,160,000)$1,556,667,000 $174,154,000 $1,730,821,000 

 Stockholders’ Equity    
 Class T and Class I Common Stock          
 
Number
of Shares
 Amount 
Additional
Paid-In Capital
 
Accumulated
Deficit
 
Total
Stockholders’
Equity
 
Noncontrolling
Interest
 Total Equity
BALANCE — December 31, 201520,833
 $
 $200,000
 $
 $200,000
 $2,000
 $202,000
Issuance of common stock5,374,861
 54,000
 53,449,000
 
 53,503,000
 
 53,503,000
Offering costs — common stock
 
 (7,584,000) 
 (7,584,000) 
 (7,584,000)
Issuance of common stock under the DRIP23,379
 
 222,000
 
 222,000
 
 222,000
Issuance of vested and nonvested restricted common stock15,000
 
 30,000
 
 30,000
 
 30,000
Amortization of nonvested common stock compensation
 
 36,000
 
 36,000
 
 36,000
Reclassification of noncontrolling interest to mezzanine equity
 
 
 
 
 (2,000) (2,000)
Distributions declared
 
 
 (598,000) (598,000) 
 (598,000)
Net loss
 
 
 (2,855,000) (2,855,000) 
 (2,855,000)
BALANCE — September 30, 20165,434,073
 $54,000
 $46,353,000
 $(3,453,000) $42,954,000
 $
 $42,954,000
Stockholders’ Equity
 Common Stock  
Number
of
Shares
AmountAdditional
Paid-In
Capital
Accumulated
Deficit
Accumulated
Other
Comprehensive
Loss
Total
Stockholders’
Equity
Noncontrolling
Interests
Total Equity
BALANCE — December 31, 2020179,658,367 $1,798,000 $1,730,589,000 $(864,271,000)$(2,008,000)$866,108,000 $168,375,000 $1,034,483,000 
Offering costs — common stock— — (1,000)— — (1,000)— (1,000)
Amortization of nonvested common stock compensation— — 27,000 — — 27,000 — 27,000 
Stock based compensation— — — — — — (14,000)(14,000)
Distributions to noncontrolling interests— — — — — — (176,000)(176,000)
Adjustment to value of redeemable noncontrolling interests— — (378,000)— — (378,000)(148,000)(526,000)
Net loss— — — (11,847,000)— (11,847,000)(3,942,000)(15,789,000)(1)
Other comprehensive income— — — — 69,000 69,000 — 69,000 
BALANCE — March 31, 2021179,658,367 $1,798,000 $1,730,237,000 $(876,118,000)$(1,939,000)$853,978,000 $164,095,000 $1,018,073,000 

___________
(1)For the three months ended March 31, 2022 and 2021, amounts exclude $187,000 and $(484,000), respectively, of net income (loss) attributable to redeemable noncontrolling interests. See Note 13, Redeemable Noncontrolling Interests, for a further discussion.
The accompanying notes are an integral part of these condensed consolidated financial statements.

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GRIFFIN-AMERICANAMERICAN HEALTHCARE REIT, IV, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
For the NineThree Months Ended September 30, 2017March 31, 2022 and 20162021
(Unaudited)

Three Months Ended March 31,
20222021
CASH FLOWS FROM OPERATING ACTIVITIES
Net loss$(897,000)$(16,273,000)
Adjustments to reconcile net loss to net cash provided by (used in) operating activities:
Depreciation and amortization42,311,000 25,723,000 
Other amortization6,166,000 5,955,000 
Deferred rent(1,695,000)(1,023,000)
Stock based compensation(32,000)(14,000)
Stock based compensation — nonvested restricted common stock811,000 27,000 
(Gain) loss from unconsolidated entities(1,386,000)1,771,000 
(Gain) loss on dispositions of real estate investments(756,000)335,000 
Foreign currency loss (gain)1,335,000 (416,000)
Loss on extinguishments of debt4,591,000 2,288,000 
Change in fair value of derivative financial instruments(500,000)(1,821,000)
Changes in operating assets and liabilities:
Accounts and other receivables(8,300,000)3,203,000 
Other assets(1,432,000)(4,440,000)
Accounts payable and accrued liabilities(7,878,000)(10,891,000)
Accounts payable due to affiliates(184,000)(5,160,000)
Operating lease liabilities(4,602,000)(4,358,000)
Security deposits, prepaid rent and other liabilities(5,192,000)(161,000)
Net cash provided by (used in) operating activities22,360,000 (5,255,000)
CASH FLOWS FROM INVESTING ACTIVITIES
Developments and capital expenditures(20,856,000)(29,196,000)
Acquisitions of real estate investments(19,878,000)(78,542,000)
Proceeds from dispositions of real estate investments14,074,000 1,248,000 
Investments in unconsolidated entities(200,000)(325,000)
Real estate and other deposits(507,000)(26,000)
Net cash used in investing activities(27,367,000)(106,841,000)
CASH FLOWS FROM FINANCING ACTIVITIES
Borrowings under mortgage loans payable22,489,000 104,092,000 
Payments on mortgage loans payable(4,538,000)(3,480,000)
Borrowings under the lines of credit and term loan941,400,000 16,600,000 
Payments on the lines of credit and term loan(928,900,000)(18,000,000)
Deferred financing costs(4,796,000)(799,000)
Debt extinguishment costs(2,790,000)(125,000)
Payments on financing obligations(787,000)(8,481,000)
Distributions paid to common stockholders(15,010,000)— 
Repurchase of common stock(4,134,000)— 
Distributions to noncontrolling interests in total equity(3,511,000)(172,000)
Contribution from redeemable noncontrolling interest173,000 — 
Distributions to redeemable noncontrolling interests(695,000)— 
Security deposits and other(208,000)(30,000)
Net cash (used in) provided by financing activities(1,307,000)89,605,000 
 Nine Months Ended September 30,
 2017 2016
CASH FLOWS FROM OPERATING ACTIVITIES   
Net income (loss)$1,290,000
 $(2,855,000)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:   
Depreciation and amortization7,619,000
 64,000
Other amortization (including deferred financing costs, above/below-market leases, leasehold interests, above-market leasehold interests and debt premium)251,000
 27,000
Deferred rent(1,124,000) (33,000)
Stock based compensation100,000
 66,000
Share discounts3,000
 49,000
Bad debt expense94,000
 
Changes in operating assets and liabilities:   
Accounts and other receivables(362,000) (80,000)
Other assets(305,000) (105,000)
Accounts payable and accrued liabilities1,394,000
 449,000
Accounts payable due to affiliates169,000
 33,000
Security deposits, prepaid rent and other liabilities(280,000) (6,000)
Net cash provided by (used in) operating activities8,849,000
 (2,391,000)
CASH FLOWS FROM INVESTING ACTIVITIES   
Acquisition of real estate investments(215,738,000) (55,619,000)
Capital expenditures(845,000) (18,000)
Restricted cash(16,000) 
Real estate deposits(4,821,000) (1,000,000)
Pre-acquisition expenses(698,000) 
Net cash used in investing activities(222,118,000)
(56,637,000)
CASH FLOWS FROM FINANCING ACTIVITIES   
Payments on mortgage loan payable(189,000) (19,000)
Borrowings under the Line of Credit192,600,000
 12,000,000
Payments on the Line of Credit(200,500,000) 
Proceeds from issuance of common stock241,647,000
 52,484,000
Deferred financing costs(175,000) (1,027,000)
Repurchase of common stock(178,000) 
Payment of offering costs(13,673,000) (1,889,000)
Security deposits(97,000) 
Distributions paid(4,006,000) (148,000)
Net cash provided by financing activities215,429,000
 61,401,000
NET CHANGE IN CASH AND CASH EQUIVALENTS2,160,000
 2,373,000
CASH AND CASH EQUIVALENTS — Beginning of period2,237,000
 202,000
CASH AND CASH EQUIVALENTS — End of period$4,397,000
 $2,575,000
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION   
Cash paid for:   
Interest$1,356,000
 $1,000
Income taxes$7,000
 $

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GRIFFIN-AMERICANAMERICAN HEALTHCARE REIT, IV, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS — (Continued)
For the NineThree Months Ended September 30, 2017March 31, 2022 and 20162021
(Unaudited)

 Nine Months Ended September 30,
 2017 2016
SUPPLEMENTAL DISCLOSURE OF NONCASH ACTIVITIES   
Investing Activities:   
Accrued capital expenditures$931,000
 $
Accrued pre-acquisition expenses$601,000
 $
The following represents the increase in certain assets and liabilities in connection with our acquisitions of real estate investments:   
Other assets$213,000
 $144,000
Mortgage loans payable$8,000,000
 $3,968,000
Accounts payable and accrued liabilities$803,000
 $75,000
Security deposits and prepaid rent$545,000
 $106,000
Financing Activities:   
Issuance of common stock under the DRIP$5,492,000
 $222,000
Distributions declared but not paid$1,739,000
 $228,000
Accrued Contingent Advisor Payment$7,759,000
 $3,802,000
Accrued stockholder servicing fee$11,496,000
 $1,847,000
Reclassification of noncontrolling interest to mezzanine equity$
 $2,000
Accrued deferred financing costs$22,000
 $72,000
Receivable from transfer agent$807,000
 $926,000

Three Months Ended March 31,
20222021
NET CHANGE IN CASH, CASH EQUIVALENTS AND RESTRICTED CASH$(6,314,000)$(22,491,000)
EFFECT OF FOREIGN CURRENCY TRANSLATION ON CASH, CASH EQUIVALENTS AND RESTRICTED CASH(2,000)7,000 
CASH, CASH EQUIVALENTS AND RESTRICTED CASH — Beginning of period125,486,000 152,190,000 
CASH, CASH EQUIVALENTS AND RESTRICTED CASH — End of period$119,170,000 $129,706,000 
RECONCILIATION OF CASH, CASH EQUIVALENTS AND RESTRICTED CASH
Beginning of period:
Cash and cash equivalents$81,597,000 $113,212,000 
Restricted cash43,889,000 38,978,000 
Cash, cash equivalents and restricted cash$125,486,000 $152,190,000 
End of period:
Cash and cash equivalents$75,115,000 $89,995,000 
Restricted cash44,055,000 39,711,000 
Cash, cash equivalents and restricted cash$119,170,000 $129,706,000 
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION
Cash paid for:
Interest$18,916,000 $16,079,000 
Income taxes$191,000 $169,000 
SUPPLEMENTAL DISCLOSURE OF NONCASH INVESTING AND FINANCING ACTIVITIES
Accrued developments and capital expenditures$14,750,000 $16,020,000 
Tenant improvement overage$223,000 $41,000 
Issuance of common stock under the DRIP$11,304,000 $— 
Distributions declared but not paid — common stockholders$8,794,000 $— 
Distributions declared but not paid — limited partnership units$467,000 $— 
Capital expenditures from financing obligations$— $136,000 
The following represents the net (decrease) increase in certain assets and liabilities in connection with our acquisitions and dispositions of real estate investments:
Accounts and other receivables$(173,000)$4,000 
Other assets, net$5,023,000 $(190,000)
Mortgage loan payable, net$(12,059,000)$— 
Accounts payable and accrued liabilities$(21,000)$— 
Financing obligations$56,000 $— 
Security deposits$7,746,000 $— 
The accompanying notes are an integral part of these condensed consolidated financial statements.

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GRIFFIN-AMERICANAMERICAN HEALTHCARE REIT, IV, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited)
For the Three and Nine Months Ended September 30, 2017March 31, 2022 and 20162021

The use of the words “we,” “us” or “our” refers to Griffin-American Healthcare REIT IV,III, Inc., or GAHR III, and its subsidiaries, including Griffin-American Healthcare REIT IVIII Holdings, LP, for periods prior to the Merger, as defined below, and American Healthcare REIT, Inc. (formerly known as Griffin-American Healthcare REIT IV, Inc., or GAHR IV) and its subsidiaries, including American Healthcare REIT Holdings, LP (formerly known as Griffin-American Healthcare REIT III Holdings, LP), for periods following the Merger, except where the context otherwise requires.noted. Certain historical information of GAHR IV is included for background purposes.
1. Organization and Description of Business
Griffin-AmericanOverview and Background
American Healthcare REIT, IV, Inc., a Maryland corporation, was incorporated on January 23, 2015 and therefore we consider that our date of inception. We were initially capitalized on February 6, 2015. We invest inowns a diversified portfolio of clinical healthcare real estate properties, focusing primarily on medical office buildings, hospitals, skilled nursing facilities, senior housing, hospitals 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 (formerly known as senior housing — RIDEA), and our integrated senior health campuses. We have originated and acquired secured loans and may also originate and acquire secured loans andother real estate-related investments on an infrequent and opportunistic basis. We generally seek investments that produce current income.income; however, we have selectively developed, and may continue to selectively develop, healthcare real estate properties. We qualified to be taxed as a real estate investment trust, or REIT, under the Internal Revenue Code of 1986, as amended, or the Code for federal income tax purposes, beginning with our taxable year ended December 31, 2016, and we intend to continue to qualify to be taxed as a REIT.
Merger of Griffin-American Healthcare REIT III, Inc. and Griffin-American Healthcare REIT IV, Inc.
On February 16, 2016, we commenced our initial public offering,October 1, 2021, pursuant to an Agreement and Plan of Merger dated June 23, 2021, or the Merger Agreement, GAHR III merged with and into Continental Merger Sub, LLC, a Maryland limited liability company and newly formed wholly owned subsidiary of GAHR IV, or Merger Sub, with Merger Sub being the surviving company, or the REIT Merger. On October 1, 2021, also pursuant to the Merger Agreement, Griffin-American Healthcare REIT IV Holdings, LP, a Delaware limited partnership and subsidiary and operating partnership of GAHR IV, or GAHR IV Operating Partnership, merged with and into Griffin-American Healthcare REIT III Holdings, LP, a Delaware limited partnership, or our offering, in which we were offeringoperating partnership, with our operating partnership being the surviving entity, or the Partnership Merger. We collectively refer to the public upREIT Merger and the Partnership Merger as the Merger. Following the Merger on October 1, 2021, our company, or the Combined Company, was renamed American Healthcare REIT, Inc. and our operating partnership, also referred to $3,150,000,000 inas the surviving partnership, was renamed American Healthcare REIT Holdings, LP. The REIT Merger qualified as a reorganization under, and within the meaning of, Section 368(a) of the Code. As a result of and at the effective time of the Merger, the separate corporate existence of GAHR III and GAHR IV Operating Partnership ceased.
At the effective time of the REIT Merger, 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 our Class T common stock, consisting of up to $3,000,000,000 in shares of our Class T common stock at a price of $10.00 per share in our primary offering and up to $150,000,000 in shares of our Class T common stock for $9.50 per share pursuant to our distribution reinvestment plan, as amended, or the DRIP. Effective June 17, 2016, we reallocated certain of the unsold shares of Class T common stock being offered and began offering shares ofGAHR IV’s Class I common stock, such that we are currently offering up$0.01 par value per share. At the effective time of the Partnership Merger, (i) each unit of limited partnership interest in our operating partnership outstanding as of immediately prior to approximately $2,800,000,000 in sharesthe effective time of Class T common stock and $200,000,000 in sharesthe Partnership Merger was converted automatically into the right to receive 0.9266 of a Partnership Class I common stockUnit, as defined in our primary offering,the agreement of limited partnership, as amended, of the surviving partnership and up(ii) each unit of limited partnership interest in GAHR IV Operating Partnership outstanding as of immediately prior to an aggregatethe effective time of $150,000,000 in sharesthe Partnership Merger was converted automatically into the right to receive one unit of our Class T and Class I common stocklimited partnership interest of the surviving partnership of like class.
AHI Acquisition
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 DRIP, aggregating up to $3,150,000,000. The sharesContribution 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, our former Chief Executive Officer and current Executive Chairman of the Board of Directors, Danny Prosky, our Class T common stockformer Chief Operating Officer and current Chief Executive Officer and President, and Mathieu B. Streiff, our former Executive Vice President, General Counsel and current Chief
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AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
Operating Officer, 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 our primary offering are being offered at a price of $10.00 per share. The shares of our Class I common stock in our primary offering were being offered at a price of $9.30 per share prior to March 1, 2017, and are being offered at a price of $9.21 per share for all shares issued effective March 1, 2017. The shares of our Class T and Class I common stock issued pursuant to the DRIP were sold at a price of $9.50 per share prior to January 1, 2017, and are sold at a price of $9.40 per share for all shares issued pursuant to the DRIP effective January 1, 2017. After our board of directors determines an estimated net asset value, or NAV, per share of our common stock, share prices are expected to be adjusted to reflect the estimated NAV per share and, in the case of shares offered pursuant to our primary offering, up-front selling commissions and dealer manager fees other than those funded by(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 “Operating Partnership and Former Advisor” below for a further discussion.
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 then-current ownership interest in GAHR III Advisor and GAHR IV Advisor to the surviving partnership. In exchange for these contributions, the surviving partnership issued limited partnership units, or our advisor. We reservesurviving partnership OP units. Subject to working capital and other customary adjustments, the right to reallocatetotal approximate value of these surviving partnership OP units at the sharestime of common stock we are offering betweenconsummation of the primary offeringtransactions contemplated by the Contribution Agreement was approximately $131,674,000, with a reference value for purposes thereof of $8.71 per unit, such that the surviving partnership issued 15,117,529 surviving partnership OP units as consideration, or the Closing Date Consideration. Following the consummation of the Merger and the DRIP, and among classes of stock.AHI Acquisition, the Combined Company became self-managed. As of September 30, 2017, we had receivedMarch 31, 2022 and accepted subscriptionsDecember 31, 2021, such surviving partnership OP units are 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.
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 our offering for 35,522,410 aggregate sharesthe REIT Merger, GAHR III was determined to be the accounting acquiror in the REIT Merger in accordance with Financial Accounting Standards Board Accounting Standards Codification Topic 805, Business Combinations, after considering the relative share ownership and the composition of our Class T and Class I common stock, or approximately $353,510,000, excluding sharesthe governing body of our common stock issued pursuantthe Combined Company. Thus, the financial information set forth herein subsequent to the DRIP.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.
Operating Partnership and Former Advisor
We conduct substantially all of our operations through Griffin-American Healthcare REIT IV Holdings, LP, or our operating partnership. We areThrough 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. The Advisory Agreement was effective as of February 16, 2016 and had a one-year term, subject to successive one-year renewals upon the mutual consent of the parties. The Advisory Agreement was renewed pursuant to the mutual consent of the parties on February 13, 2017 and expires on February 16, 2018. Our former advisor usesused its best efforts, subject to the oversight and review of our board of directors, or our board, to, among other things, research, identify, reviewprovide asset management, property management, acquisition, disposition and make investments in and dispositions of properties and securitiesother advisory services on our behalf consistent with our investment policies and objectives. OurFollowing the Merger and the AHI Acquisition, we became self-managed and are no longer externally advised. As a result, any fees that would have otherwise been payable to our former advisor performs its dutiesare no longer being paid. Also, on October 1, 2021 and responsibilities underin connection with the Advisory Agreement asAHI Acquisition, our fiduciary. Ouroperating partnership redeemed all 22,222 shares of our common stock owned by our former advisor isand the 20,833 shares of our Class T common stock owned by GAHR IV Advisor in GAHR IV.
Prior to the Merger and the AHI Acquisition, our former advisor was 75.0% owned and managed by American Healthcare Investors, LLC, or American Healthcare Investors,wholly owned subsidiaries of AHI, and 25.0% owned by a wholly owned subsidiary of Griffin Capital, Company, LLC, or Griffin Capital (formerly known as Griffin Capital Corporation), or collectively, our former co-sponsors. American Healthcare Investors isPrior to the AHI Acquisition, AHI was 47.1% owned by AHI Group Holdings, LLC, or AHI Group Holdings, 45.1% indirectly owned by Colony NorthStar,Digital Bridge Group, Inc. (NYSE: CLNS)DBRG), or Colony NorthStar (formerly known as NorthStar Asset Management Group Inc. prior to its merger with Colony Capital, Inc. and NorthStar Realty Finance Corp. on January 10, 2017),Digital Bridge, and 7.8% owned by James F. Flaherty III, a former partner of Colony NorthStar.III. We arewere not affiliated with Griffin Capital, Griffin Capital Securities, LLC, or our dealer manager, Colony NorthStarDigital Bridge or Mr. Flaherty; however, we arewere affiliated with our former advisor, AHI and AHI Group Holdings. Please see the “Merger of Griffin-American Healthcare REIT III, Inc. and Griffin-American Healthcare REIT IV, Advisor, American Healthcare InvestorsInc.” and AHI Group Holdings.“AHI Acquisition” sections above for a further discussion of our operations effective October 1, 2021. See Note 13, Redeemable Noncontrolling Interests, and Note 14, Equity — Noncontrolling Interests in Total Equity, for a further discussion of the ownership in our operating partnership.
Public Offering
Prior to the Merger, we raised $1,842,618,000 through a best efforts initial public offering that commenced on February 26, 2014, or the GAHR III initial offering, and issued 184,930,598 shares of our common stock. In addition, during the GAHR III initial offering, we issued 1,948,563 shares of our common stock pursuant to our initial distribution reinvestment plan, or the Initial DRIP, for a total of $18,511,000 in distributions reinvested. Following the deregistration of the GAHR III initial offering on April 22, 2015, we continued issuing shares of our common stock pursuant to subsequent distribution reinvestment plan offerings.
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AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
See Note 14, Equity — Common Stock, and Note 14, Equity — Distribution Reinvestment Plan, for a further discussion of our public offerings.
Our Real Estate Investments Portfolio
We currently operate through two6 reportable business segments —segments: medical office buildings, integrated senior health campuses, skilled nursing facilities, SHOP, senior housing and senior housing.hospitals. As of September 30, 2017, we had completed 17 real estate acquisitions wherebyMarch 31, 2022, we owned 29and/or operated 182 properties, comprising 30191 buildings, and 122 integrated senior health campuses including completed development projects, or approximately 1,418,00019,461,000 square feet of gross leasable area, or GLA, for an aggregate contract purchase price of $356,640,000.$4,299,872,000, including the fair value of the properties acquired in the Merger. In addition, as of March 31, 2022, we also owned a real estate-related debt investment purchased for $60,429,000.

COVID-19
9

Our residents, tenants, operating partners and managers, our industry and the U.S. economy continue to be disrupted by the COVID-19 pandemic and related supply chain disruptions and labor shortages. The timing and extent of the economic recovery from the COVID-19 pandemic is dependent upon many factors, including the rate of vaccination, the emergence and severity of COVID-19 variants, the continued effectiveness of the vaccines against those variants, the frequency of booster vaccinations and the duration and implications of continued restrictions and safety measures. As the COVID-19 pandemic is still impacting the healthcare system to a certain extent, it continues to present challenges for us as an owner and operator of healthcare facilities, making it difficult to ascertain the long-term impact the COVID-19 pandemic will have on real estate markets in which we own and/or operate properties and our portfolio of investments.
TableWe have evaluated the impacts of Contentsthe COVID-19 pandemic on our business thus far and incorporated information concerning such impacts into our assessments of liquidity, impairment and collectability from tenants and residents as of March 31, 2022. We will continue to monitor such impacts and will adjust our estimates and assumptions based on the best available information.

GRIFFIN-AMERICAN HEALTHCARE REIT IV, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)

2. Summary of Significant Accounting Policies
The summary of significant accounting policies presented below is designed to assist in understanding our accompanying condensed consolidated financial statements. Such condensed 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 condensed consolidated financial statements.
Basis of Presentation
Our accompanying condensed consolidated financial statements include our accounts and those of our operating partnership, and the wholly owned subsidiaries of our operating partnership and all non-wholly owned subsidiaries in which we have control, as well as any variable interest entities, or 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 condensed 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 as defined in Financial Accounting Standards Board, or FASB, Accounting Standards Codification, or ASC, Topic 810, Consolidation, or ASC Topic 810.performance.
We operate and intend to continue to operate in an umbrella partnership REIT structure in which our operating partnership, or 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 ourour operating partnership and as of September 30, 2017March 31, 2022 and December 31, 2016,2021, we owned an approximately 95.0% and 94.9% general partnership interest therein, respectively, and the remaining 5.0% and 5.1%, respectively, was owned by the NewCo Sellers. Prior to the Merger on October 1, 2021, we owned greater than a 99.99% general partnership interest therein. Ourin our operating partnership and our former advisor iswas a limited partner and as of September 30, 2017 and December 31, 2016,that owned less than a 0.01% noncontrolling limited partnership interest in our operating partnership. On October 1, 2021, in connection with the AHI Acquisition, we repurchased our former advisor’s 222 limited partnership units in our operating partnership.
Because
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AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
The accounts of our operating partnership are consolidated in our accompanying condensed 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), the accounts of our operating partnership are consolidated in our condensed consolidated financial statements.. All intercompany accounts and transactions are eliminated in consolidation.
Interim Unaudited Financial Data
Our accompanying condensed consolidated financial statements have been prepared by us in accordance with GAAP in conjunction with the rules and regulations of the United States Securities and Exchange Commission, or SEC. Certain information and footnote disclosures required for annual financial statements have been condensed or excluded pursuant to SECthe SEC’s rules and regulations. Accordingly, our accompanying condensed consolidated financial statements do not include all of the information and footnotes required by GAAP for complete financial statements. Our accompanying condensed consolidated financial statements reflect all adjustments which are, in our view, of a normal recurring nature and necessary for a fair presentation of our financial position, results of operations and cash flows for the interim period. Interim results of operations are not necessarily indicative of the results to be expected for the full year; such full year results may be less favorable.
In preparing our accompanying condensed consolidated financial statements, management has evaluated subsequent events through the financial statement issuance date. We believe that although the disclosures contained herein are adequate to prevent the information presented from being misleading, our accompanying condensed consolidated financial statements should be read in conjunction with our audited consolidated financial statements and the notes thereto included in our 20162021 Annual Report on Form 10-K, as filed with the SEC on March 1, 2017.25, 2022.
Use of Estimates
The preparation of our accompanying condensed 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 condensed 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.

Revenue Recognition Resident Fees and Services Revenue
Disaggregation of Resident Fees and Services 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:
Three Months Ended March 31,
20222021
Integrated
Senior Health
Campuses
SHOP(1)TotalIntegrated
Senior Health
Campuses
SHOP(1)Total
Over time$230,534,000 $37,216,000 $267,750,000 $188,258,000 $19,459,000 $207,717,000 
Point in time50,478,000 746,000 51,224,000 44,968,000 341,000 45,309,000 
Total resident fees and services$281,012,000 $37,962,000 $318,974,000 $233,226,000 $19,800,000 $253,026,000 
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GRIFFIN-AMERICANAMERICAN HEALTHCARE REIT, IV, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)

The following tables disaggregate our resident fees and services revenue by payor class:
Allowance
Three Months Ended March 31,
20222021
Integrated
Senior Health
Campuses
SHOP(1)TotalIntegrated
Senior Health
Campuses
SHOP(1)Total
Private and other payors$131,803,000 $35,037,000 $166,840,000 $106,110,000 $19,419,000 $125,529,000 
Medicare94,517,000 — 94,517,000 84,283,000 — 84,283,000 
Medicaid54,692,000 2,925,000 57,617,000 42,833,000 381,000 43,214,000 
Total resident fees and services$281,012,000 $37,962,000 $318,974,000 $233,226,000 $19,800,000 $253,026,000 
___________
(1)Includes fees for Uncollectible basic housing and assisted living 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, netresident fees and services are as follows:
Private
and
Other Payors
MedicareMedicaidTotal
Beginning balanceJanuary 1, 2022
$42,056,000 $35,953,000 $16,922,000 $94,931,000 
Ending balanceMarch 31, 2022
44,032,000 39,469,000 18,448,000 101,949,000 
Increase$1,976,000 $3,516,000 $1,526,000 $7,018,000 
Deferred Revenue Resident Fees and Services Revenue
The beginning and ending balances of deferred revenueresident fees and services, almost all of which relates to private and other payors, are as follows:
Total
Beginning balanceJanuary 1, 2022
$14,673,000 
Ending balanceMarch 31, 2022
16,087,000 
Increase$1,414,000 
In addition to the deferred revenue above, as of March 31, 2022, we had approximately $2,069,000 remaining in Medicare advance payments that were received during 2020 through an expanded program of the Centers for Medicare & Medicaid Services. Such amounts were deferred and included in security deposits, prepaid rent and other liabilities in our accompanying condensed consolidated balance sheets, and are applied to future Medicare claims. Our recoupment period commenced in the second quarter of 2021, and for the three months ended March 31, 2022, we recognized $10,899,000 of resident fees and services revenue pertaining to such Medicare advance payments.
Tenant and Resident Receivables and Allowances
Resident receivables, which are related to resident fees and unbilled deferred rent receivablesservices, are carried net of an allowance for uncollectible amounts.credit losses. An allowance is maintained for estimated losses resulting from the inability of certain tenantsresidents and payors to meet the contractual obligations under their lease or service agreements. We also maintain an allowance for deferred rent receivables arising from the straight line recognitionSubstantially all of rents. Suchsuch allowances are chargedrecorded as direct reductions of resident fees and services revenue as contractual adjustments provided to bad debt expense, which is included in general and administrativethird-party payors or implicit price concessions in our accompanying condensed consolidated statements of operations.operations and comprehensive loss. Our determination of the adequacy of these allowances is based primarily upon evaluations of historical loss experience, the tenant’sresidents’ financial condition, security deposits, letters of credit, lease guarantees,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 uncollectible amounts, which are recognized as direct reductions of real estate revenue in our accompanying condensed consolidated statements of operations and comprehensive loss.
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AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
As of September 30, 2017March 31, 2022 and December 31, 2016,2021, we had $94,000$13,872,000 and $0,$12,378,000, respectively, in allowance for uncollectible accounts,allowances, which waswere determined necessary to reduce receivables toby our estimate of the amount recoverable.expected future credit losses. For the three and nine months ended September 30, 2017March 31, 2022 and 2016,2021, we did not write off anyincreased allowances by $5,223,000 and $2,478,000, respectively, and reduced allowances for collections or adjustments by $2,099,000 and $1,505,000, respectively. For the three months ended March 31, 2022 and 2021, $1,630,000 and $1,606,000, respectively, of our receivables directlywere written off against the related allowances.
Accounts Payable and Accrued Liabilities
As of March 31, 2022 and December 31, 2021, accounts payable and accrued liabilities primarily include reimbursement of payroll-related costs to bad debt expense. the managers of our SHOP and integrated senior health campuses of $28,456,000 and $31,101,000, respectively, insurance reserves of $35,294,000 and $36,440,000, respectively, accrued property taxes of $21,654,000 and $22,102,000, respectively, accrued developments and capital expenditures to unaffiliated third parties of $14,750,000 and $22,852,000, respectively, and accrued distributions to common stockholders of $8,794,000 and $8,768,000, respectively.
Statement of Cash Flows
For the three and nine months ended September 30, 2017March 31, 2021, amounts totaling $101,734,000 have been removed from borrowings under mortgage loans payable and 2016, we did not write off any receivables againstearly payoff of mortgage loans payable to properly reflect only actual cash flows resulting from borrowings and payments of mortgage loans compared to amounts previously presented. There was no net change in previously disclosed net cash provided by financing activities.
3. Real Estate Investments, Net
Our real estate investments, net consisted of the allowance for uncollectible accounts.
Asfollowing as of September 30, 2017March 31, 2022 and December 31, 2016, we did not have any allowance2021:
 
March 31,
2022
December 31,
2021
Building, improvements and construction in process$3,495,979,000 $3,505,786,000 
Land and improvements332,486,000 334,562,000 
Furniture, fixtures and equipment202,965,000 198,224,000 
4,031,430,000 4,038,572,000 
Less: accumulated depreciation(555,795,000)(523,886,000)
$3,475,635,000 $3,514,686,000 
Depreciation expense for uncollectible accounts for deferred rent receivables.the three months ended March 31, 2022 and 2021 was $34,422,000 and $24,190,000, respectively. For the three and nine months ended September 30, 2017, $0March 31, 2022, we incurred capital expenditures of $8,248,000 for our integrated senior health campuses, $2,434,000 for our medical office buildings and $2,000, respectively,$1,454,000 for our SHOP. We did not incur any capital expenditures for our skilled nursing facilities, senior housing facilities or hospitals for the three months ended March 31, 2022.
Acquisition of our deferred rent receivables were directly written off to bad debt expense. Real Estate Investment
For the three and nine months ended September 30, 2016,March 31, 2022, we, did not write off anythrough a majority-owned subsidiary of our deferred rent receivables directly to bad debt expense.
Property Acquisitions
In accordance with ASC Topic 805, Trilogy Investors, LLC, or Trilogy, of which we owned 72.9% at the time of acquisition, acquired an integrated senior health campus located in Kentucky. See Note 4, Business Combinations, and Accounting Standards Update, or ASU, 2017-01, Clarifying the Definition ofCombination, for a Business, or ASU 2017-01, we determine whether a transactionfurther discussion. The following 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 accountsummary of such property acquisition for the transaction asthree months ended March 31, 2022:
LocationDate
Acquired
Contract
Purchase Price
Mortgage
Loan Payable(1)
Louisville, KY01/03/22$27,790,000 $20,800,000 
___________
(1)Represents the principal balance of the mortgage loan payable placed on the campus at the time of acquisition.
Sale of Controlling Interests in Real Estate Investments
On February 8, 2022, we sold approximately 77.0% ownership interests in several real estate assets for development within our integrated senior health campuses segment for an asset acquisition. Under both methods, we recognize the identifiableaggregate sales price of $19,622,000 and a gain on sale of $756,000. We retained approximately 23.0% ownership interests in such real estate development assets, acquired and liabilities assumed; however, for a transaction which interests are
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accounted for as investments in unconsolidated entities within other assets, net in our accompanying condensed consolidated balance sheet as of March 31, 2022. From February 8, 2022 through March 31, 2022, 23.0% interest in the net earnings or losses of such unconsolidated entities were included in net loss from unconsolidated entities in our accompanying condensed consolidated statements of operations and comprehensive loss.
4. Business Combination
For the three months ended March 31, 2022, using cash on hand and debt financing, we completed the acquisition of an asset acquisition, we allocate theintegrated senior healthcare campus, which was accounted for as a business combination. The contract purchase price to the identifiable assets acquired and liabilities assumed based on their relative fair values. We immediately expensefor such property acquisition related expenses associated with a business combination and capitalize acquisition related expenses directly associated with an asset acquisition. As a result of our early adoption of ASU 2017-01 on January 1, 2017, we accounted for the eight property acquisitions we completed for the nine months ended September 30, 2017 as asset acquisitions rather than business combinations.was $27,790,000 plus immaterial transaction costs. See Note 3, Real Estate Investments, Net, for a further discussion. For the nine months ended September 30, 2016, we completed fiveBased on quantitative and qualitative considerations, such business combination was not material to us and, therefore, pro forma financial information is not provided. We did not complete any property acquisitions which we accounted for as business combinations. See Note 14, Business Combinations,combinations for a further discussion.the three months ended March 31, 2021.
Real Estate Deposits
Real estate deposits include refundableThe fair values of the assets acquired and non-refundable funds held by escrow agents and others toliabilities assumed during 2022 were preliminary estimates. Any necessary adjustments will be applied towardsfinalized within one year from the date of acquisition. The following table summarizes the acquisition date fair values of the assets acquired and liabilities assumed of our 2022 property acquisition.
2022
Acquisition
Building and improvements$17,235,000 
Land3,060,000 
In-place leases3,420,000 
Goodwill1,827,000 
Furniture, fixtures and equipment1,558,000 
Certificates of need690,000 
Cash588,000 
Total assets acquired28,378,000 
Security deposits(7,747,000)
Accounts payable and accrued liabilities(109,000)
Financing obligations(56,000)
Total liabilities assumed(7,912,000)
Net assets acquired$20,466,000 
5. Debt Security Investment, Net
On October 15, 2015, we acquired a commercial mortgage-backed debt security, or debt security, from an unaffiliated third party. The 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 matures on August 25, 2025 at a 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.
As of March 31, 2022 and December 31, 2021, the carrying amount of the debt security investment was $80,239,000 and $79,315,000, respectively, net of unamortized closing costs of $948,000 and $1,004,000, respectively. Accretion on the debt security for the three months ended March 31, 2022 and 2021 was $980,000 and $881,000, respectively, which is recorded as an increase to real estate investments,revenue in our accompanying condensed consolidated statements of operations and such future investments are subjectcomprehensive loss. Amortization expense of closing costs for the three months ended March 31, 2022 and 2021 was $56,000 and $47,000, respectively, which is recorded as a decrease to substantial conditions to closing. As of September 30, 2017, we had $5,000,000 of non-refundable real estate deposits heldrevenue in escrow to be applied towardsour accompanying condensed consolidated statements of operations and comprehensive loss. We evaluated credit quality indicators such as the acquisition of a senior housing portfolio from unaffiliated third parties. The acquisitionagency ratings and the underlying collateral of such senior housing portfolioinvestment in order to determine expected future credit loss. No credit loss was completed on November 1, 2017recorded for the three months ended March 31, 2022 and the real estate deposits held in escrow were applied towards the purchase price. See Note 18, Subsequent Events — Property Acquisition, for a further discussion.
Recently Issued or Adopted Accounting Pronouncements
In May 2014, the FASB issued ASU 2014-09, Revenue from Contracts with Customers, as codified in ASC Topic 606, which replaces the existing accounting standards for revenue recognition. ASC Topic 606 provides a five-step framework to recognize revenue to depict the transfer of goods or services to customers in an amount that reflects the consideration expected to be received in exchange for those goods or services. ASC Topic 606 is effective for interim and annual reporting periods beginning after December 15, 2017. Currently, our primary source of revenue is generated through leasing arrangements, which are excluded from ASC Topic 606; however, we expect that the adoption of ASC Topic 606 on January 1, 2018 will impact the recognition of common area maintenance from our current leasing arrangements and certain elements of resident fees (including revenues that are ancillary to the contractual rights of residents) for any healthcare-related facilities we may acquire and operate in the future 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 Code authorizing the RIDEA structure were enacted as part of the Housing and Economic Recovery Act of 2008). We will not apply the principles of ASC Topic 606 to our common area maintenance revenues and certain elements of resident fees to the extent they qualified as lease revenues until

2021.
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January 1, 2019, when we adopt ASU 2016-02, Leases, or ASU 2016-02. We have not yet selected a transition method and we expect to complete our evaluation of the impact of the adoption of ASC Topic 606 and its amendments on our consolidated financial statements during the fourth quarter of 2017.
In January 2016, the FASB issued ASU 2016-01, Recognition and Measurement of Financial Assets and Financial Liabilities, or ASU 2016-01, which amends the classification and measurement of financial instruments. ASU 2016-01 revises the accounting related to: (i) the classification and measurement of investments in equity securities; and (ii) the presentation of certain fair value changes for financial liabilities measured at fair value. ASU 2016-01 also amends certain disclosure requirements associated with the fair value of financial instruments. ASU 2016-01 is effective for interim and annual reporting periods beginning after December 15, 2017. Early adoption is permitted, with respect to only certain of the amendments in ASU 2016-01, for financial statements that have not yet been made available for issuance. ASU 2016-01 requires the application of the amendments by means of a cumulative-effect adjustment to the balance sheet as of the beginning of the fiscal year of adoption, with certain exceptions. We do not expect the adoption of ASU 2016-01 on January 1, 2018 to have a material impact on our consolidated financial statements.
In February 2016, the FASB issued ASU 2016-02, which amends the guidance on accounting for leases, including extensive amendments to the disclosure requirements. Under ASU 2016-02, lessees will be required to recognize the following for all leases (with the exception of short-term leases) 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. Under ASU 2016-02 from a lessor perspective, the guidance will require bifurcation of lease revenues into lease components and non-lease components and to separately recognize and disclose non-lease components that are executory in nature. Lease components will continue to be recognized on a straight-line basis over the lease term and certain non-lease components will be accounted for under the new revenue recognition guidance in ASC Topic 606. The disaggregated disclosure of lease and executory non-lease components (e.g., maintenance) will be required upon the adoption of ASU 2016-02. ASU 2016-02 is effective for fiscal years and interim periods beginning after December 15, 2018. Early adoption is permitted for financial statements that have not yet been made available for issuance. ASU 2016-02 requires a modified retrospective transition approach for leases existing at, or entered into after, the beginning of the earliest comparative period presented in the financial statements with a few optional practical expedients. As a result of the adoption of ASU 2016-02 on January 1, 2019, we will recognize all of our operating leases for which we are the lessee, including facilities leases and ground leases, on our consolidated balance sheets and will capitalize fewer legal costs related to the drafting and execution of our lease agreements. We are still evaluating the transition method including the practical expedient offered in ASU 2016-02. We are also evaluating the complete impact of the adoption of ASU 2016-02 on January 1, 2019 to our consolidated financial statements and disclosures.
In June 2016, the FASB issued ASU 2016-13, Measurement of Credit Losses on Financial Instruments, or ASU 2016-13, which introduces a new approach to estimate credit losses on certain types of financial instruments based on expected losses. It also modifies the impairment model for available-for-sale debt securities and provides for a simplified accounting model for purchased financial assets with credit deterioration since their origination. ASU 2016-13 is effective for fiscal years and interim periods beginning after December 15, 2019. Early adoption is permitted after December 15, 2018. We do not expect the adoption of ASU 2016-13 on January 1, 2020 to have a material impact on our consolidated financial statements.
In August 2016, the FASB issued ASU 2016-15, Classification of Certain Cash Receipts and Cash Payments, or ASU 2016-15, which intends to reduce diversity in practice in how certain transactions are classified in the statement of cash flows. ASU 2016-15 is effective for fiscal years and interim periods beginning after December 15, 2017. Early adoption is permitted, including adoption in an interim period. We do not expect the adoption of ASU 2016-15 on January 1, 2018 to have a material impact on our consolidated financial statements.
In October 2016, the FASB issued ASU 2016-16, Intra-Entity Transfers of Assets Other Than Inventory, or ASU 2016-16, which removes the prohibition in ASC 740, Income Taxes, against the immediate recognition of the current and deferred income tax effects of intra-entity transfers of assets other than inventory. ASU 2016-16 is effective for fiscal years and interim periods beginning after December 15, 2017. Early adoption is permitted, including adoption in an interim period. We do not expect the adoption of ASU 2016-16 on January 1, 2018 to have a material impact on our consolidated financial statements.
In January 2017, the FASB issued ASU 2017-04, Simplifying the Test for Goodwill Impairment, or ASU 2017-04, which eliminates Step 2 from the goodwill impairment test and allows an entity to perform its goodwill impairment test by comparing the fair value of a reporting segment with its carrying amount. ASU 2017-04 is effective for fiscal years and interim periods beginning after December 15, 2019. Early adoption is permitted, including adoption in an interim period. We early adopted ASU 2017-04 on January 1, 2017, which did not have an impact on our consolidated financial statements.

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In May 2017, the FASB issued ASU 2017-09, Scope of Modification Accounting, or ASU 2017-09, which clarifies when changes to the terms or conditions of a share-based payment award must be accounted for as modifications. Modification accounting is only applied if the value, the vesting conditions or the classification of the award (or equity or liability) changes as a result of the change in terms or conditions. ASU 2017-09 is effective for fiscal years and interim periods beginning after December 15, 2017. Early adoption is permitted. We do not expect the adoption of ASU 2017-09 on January 1, 2018 to have a material impact on our consolidated financial statements.
3. Real Estate Investments, Net
Our real estate investments, net consisted of the following as of September 30, 2017 and December 31, 2016:
 
September 30,
2017
 
December 31,
2016
Building and improvements$285,481,000
 $106,442,000
Land39,386,000
 12,322,000
 324,867,000
 118,764,000
Less: accumulated depreciation(5,925,000) (822,000)
 $318,942,000
 $117,942,000
Depreciation expense for the three and nine months ended September 30, 2017 was $2,305,000 and $5,110,000, respectively. Depreciation expense for the three and nine months ended September 30, 2016 was $40,000. 
For the three months ended September 30, 2017, we incurred capital expenditures of $324,000 on our medical office buildings and $700,000 on our senior housing facilities. In addition to the acquisitions discussed below, for the nine months ended September 30, 2017, we incurred capital expenditures of $1,076,000 on our medical office buildings and $700,000 on our senior housing facilities.
We reimburse our advisor or its affiliates for acquisition expenses related to selecting, evaluating and acquiring assets. The reimbursement of acquisition expenses, acquisition fees, total development costs and real estate commissions and other fees paid to unaffiliated third parties will not exceed, in the aggregate, 6.0% of the contract purchase price of our property acquisitions, unless fees in excess of such limits are approved by a majority of our directors, including a majority of our independent directors. For the three and nine months ended September 30, 2017 and 2016, such fees and expenses paid did not exceed 6.0% of the contract purchase price of our property acquisitions, except with respect to our acquisitions of Auburn MOB, Pottsville MOB and Lafayette Assisted Living Portfolio. Our directors, including a majority of our independent directors, not otherwise interested in the transactions, approved the reimbursement of fees and expenses to our advisor or its affiliates for the acquisitions of Auburn MOB, Pottsville MOB and Lafayette Assisted Living Portfolio in excess of the 6.0% limit and determined that such fees and expenses were commercially fair and reasonable to us.

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Acquisitions in 2017
For the nine months ended September 30, 2017, using net proceeds from our offering and debt financing, we completed eight property acquisitions comprising 18 buildings from unaffiliated third parties. The aggregate contract purchase price of these properties was $217,820,000 and we incurred $9,802,000 in total acquisition fees to our advisor in connection with these property acquisitions. The following is a summary of our property acquisitions for the nine months ended September 30, 2017:
Acquisition(1) Location Type Date Acquired Contract Purchase Price Mortgage Loan Payable(2) Line of Credit(3) Total Acquisition Fee(4)
Battle Creek MOB Battle Creek, MI Medical Office 03/10/17 $7,300,000
 $
 $
 $328,000
Reno MOB Reno, NV Medical Office 03/13/17 66,250,000
 
 60,000,000
 2,982,000
Athens MOB Portfolio Athens, GA Medical Office 05/18/17 16,800,000
 
 7,800,000
 756,000
SW Illinois Senior Housing Portfolio Columbia, Millstadt, Red Bud and Waterloo, IL Senior Housing 05/22/17 31,800,000
 
 31,700,000
 1,431,000
Lawrenceville MOB Lawrenceville, GA Medical Office 06/12/17 11,275,000
 8,000,000
 3,000,000
 507,000
Northern California Senior Housing Portfolio Belmont, Fairfield, Menlo Park and Sacramento, CA Senior Housing 06/28/17 45,800,000
 
 21,600,000
 2,061,000
Roseburg MOB Roseburg, OR Medical Office 06/29/17 23,200,000
 
 23,000,000
 1,044,000
Fairfield County MOB Portfolio Stratford and Trumbull, CT Medical Office 09/29/17 15,395,000
 
 15,500,000
 693,000
Total       $217,820,000
 $8,000,000
 $162,600,000
 $9,802,000
___________
(1)We own 100% of our properties acquired in 2017.
(2)Represents the principal balance of the mortgage loan payable assumed by us at the time of acquisition.
(3)Represents a borrowing under the Line of Credit, as defined in Note 7, Line of Credit, at the time of acquisition.
(4)Our advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our properties, a base acquisition fee of 2.25% of the aggregate contract purchase price upon the closing of the acquisition. In addition, the total acquisition fee includes a Contingent Advisor Payment, as defined in Note 12, Related Party Transactions, in the amount of 2.25% of the aggregate contract purchase price of the property acquired, which shall be paid by us to our advisor, subject to the satisfaction of certain conditions. See Note 12, Related Party Transactions — Acquisition and Development Stage — Acquisition Fee, for a further discussion.

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We accounted for the eight property acquisitions we completed for the nine months ended September 30, 2017 as asset acquisitions. We incurred base acquisition fees and direct acquisition related expenses of $6,999,000, which were capitalized in accordance with our early adoption of ASU 2017-01. In addition, we incurred Contingent Advisor Payments of $4,901,000 to our advisor for these property acquisitions. The following table summarizes the purchase price of the assets acquired and liabilities assumed at the time of acquisition from our eight property acquisitions in 2017 based on their relative fair values:
  
2017
Acquisitions
Building and improvements $177,270,000
Land 27,064,000
In-place leases 20,518,000
Above-market leases 127,000
Total assets acquired 224,979,000
Mortgage loan payable (8,000,000)
Below-market leases (571,000)
Above-market leasehold interests (395,000)
Total liabilities assumed (8,966,000)
Net assets acquired $216,013,000
4.6. Identified Intangible Assets, Net
Identified intangible assets, net consisted of the following as of September 30, 2017March 31, 2022 and December 31, 2016:
2021:
 
September 30,
2017
 
December 31,
2016
In-place leases, net of accumulated amortization of $2,936,000 and $430,000 as of September 30, 2017 and December 31, 2016, respectively (with a weighted average remaining life of 9.3 years and 8.1 years as of September 30, 2017 and December 31, 2016, respectively)$30,517,000
 $12,504,000
Leasehold interests, net of accumulated amortization of $95,000 and $22,000 as of September 30, 2017 and December 31, 2016, respectively (with a weighted average remaining life of 70.8 years and 71.5 years as of September 30, 2017 and December 31, 2016, respectively)6,317,000
 6,390,000
Above-market leases, net of accumulated amortization of $135,000 and $31,000 as of September 30, 2017 and December 31, 2016, respectively (with a weighted average remaining life of 5.8 years and 6.3 years as of September 30, 2017 and December 31, 2016, respectively)801,000
 779,000
 $37,635,000
 $19,673,000
March 31,
2022
December 31,
2021
Intangible assets subject to amortization:
In-place leases, net of accumulated amortization of $28,703,000 and $28,120,000 as of March 31, 2022 and December 31, 2021, respectively (with a weighted average remaining life of 8.1 years and 8.2 years as of March 31, 2022 and December 31, 2021, respectively)$77,597,000 $81,538,000 
Above-market leases, net of accumulated amortization of $3,193,000 and $2,082,000 as of March 31, 2022 and December 31, 2021, respectively (with a weighted average remaining life of 9.6 years and 9.7 years as of March 31, 2022 and December 31, 2021, respectively)33,962,000 35,106,000 
Customer relationships, net of accumulated amortization of $673,000 and $635,000 as of March 31, 2022 and December 31, 2021, respectively (with a weighted average remaining life of 14.4 years and 14.7 years as of March 31, 2022 and December 31, 2021, respectively)2,167,000 2,205,000 
Internally developed technology and software, net of accumulated amortization of $423,000 and $399,000 as of March 31, 2022 and December 31, 2021, respectively (with a weighted average remaining life of 0.4 years and 0.7 years as of March 31, 2022 and December 31, 2021, respectively)47,000 70,000 
Intangible assets not subject to amortization:
Certificates of need96,580,000 99,165,000 
Trade names30,787,000 30,787,000 
$241,140,000 $248,871,000 
Amortization expense on identified intangible assets for the three and nine months ended September 30, 2017March 31, 2022 and 2021 was $1,196,000$8,239,000 and $2,683,000,$1,196,000, respectively, which included $38,000$1,114,000 and $104,000,$83,000, respectively, of amortization recorded againstas a decrease to real estate revenue for above-market leases and $24,000 and $73,000, respectively, of amortization recorded to rental expenses for leasehold interests in our accompanying condensed consolidated statements of operations. Amortization expense on identified intangible assets for the threeoperations and nine months ended September 30, 2016 was $24,000, which related to in-place leases.

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comprehensive loss.
The aggregate weighted average remaining life of the identified intangible assets was 19.68.7 years and 28.68.8 years as of September 30, 2017March 31, 2022 and December 31, 2016,2021, respectively. As of September 30, 2017,March 31, 2022, estimated amortization expense on the identified intangible assets for the threenine months ending December 31, 20172022 and for each of the next four years ending December 31 and thereafter was as follows:
YearAmount
2022$16,985,000 
202317,202,000 
202413,673,000 
202511,034,000 
20269,864,000 
Thereafter45,015,000 
$113,773,000 
Year Amount
2017 $1,310,000
2018 4,863,000
2019 4,400,000
2020 3,862,000
2021 3,466,000
Thereafter 19,734,000
  $37,635,000
5. Other Assets, Net
Other assets, net consisted of the following as of September 30, 2017 and December 31, 2016:
 
September 30,
2017
 
December 31,
2016
Prepaid expenses and deposits$1,968,000
 $257,000
Deferred rent receivables1,330,000
 207,000
Deferred financing costs, net of accumulated amortization of $379,000 and $112,000 as of September 30, 2017 and December 31, 2016, respectively(1)710,000
 943,000
Lease commissions, net of accumulated amortization of $3,000 and $0 as of September 30, 2017 and December 31, 2016, respectively134,000
 
 $4,142,000
 $1,407,000
___________
(1)
In accordance with ASU 2015-03, Simplifying the Presentation of Debt Issuance Costs, or ASU 2015-03, and ASU 2015-15, Presentation and Subsequent Measurement of Debt Issuance Costs Associated with Line-of-Credit Arrangements, or ASU 2015-15, deferred financing costs only include costs related to the Line of Credit, as defined in Note 7, Line of Credit.
Amortization expense on deferred financing costs of the Line of Credit for the three and nine months ended September 30, 2017 was $90,000 and $267,000, respectively. Amortization expense on deferred financing costs of the Line of Credit for the three and nine months ended September 30, 2016 was $27,000. Amortization expense on deferred financing costs of the Line of Credit is recorded to interest expense in our accompanying condensed consolidated statements of operations. Amortization expense on lease commissions for the three and nine months ended September 30, 2017 was $3,000. For the three and nine months ended September 30, 2016, we did not incur any amortization expense on lease commissions. 
6. Mortgage Loans Payable, Net
Mortgage loans payable were $11,718,000 ($11,639,000, including premium and deferred financing costs, net) and $3,908,000 ($3,965,000, including premium and deferred financing costs, net) as of September 30, 2017 and December 31, 2016, respectively. As of September 30, 2017, we had two fixed-rate mortgage loans with interest rates ranging from 4.77% to 5.25% per annum, maturity dates ranging from April 1, 2020 to August 1, 2029 and a weighted average effective interest rate of 4.92%. As of December 31, 2016, we had one fixed-rate mortgage loan with an interest rate of 5.25% per annum and a maturity date of August 1, 2029.


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7. Other Assets, Net
Other assets, net consisted of the following as of March 31, 2022 and December 31, 2021:
 
March 31,
2022
December 31,
2021
Deferred rent receivables$42,672,000 $41,061,000 
Prepaid expenses, deposits, other assets and deferred tax assets, net33,818,000 22,484,000 
Investments in unconsolidated entities22,726,000 15,615,000 
Inventory18,087,000 18,929,000 
Lease commissions, net of accumulated amortization of $5,100,000 and $4,911,000 as of March 31, 2022 and December 31, 2021, respectively16,283,000 16,120,000 
Deferred financing costs, net of accumulated amortization of $3,668,000 and $8,469,000 as of March 31, 2022 and December 31, 2021, respectively6,130,000 3,781,000 
Lease inducement, net of accumulated amortization of $1,930,000 and $1,842,000 as of March 31, 2022 and December 31, 2021, respectively (with a weighted average remaining life of 8.7 years and 8.9 years as of March 31, 2022 and December 31, 2021, respectively)3,070,000 3,158,000 
$142,786,000 $121,148,000 
Deferred financing costs included in other assets were related to the 2019 Trilogy Credit Facility and the senior unsecured revolving credit facility portion of the 2022 Credit Facility, each as defined at Note 9, Lines of Credit and Term Loans. Amortization expense on lease inducement for both the three months ended March 31, 2022 and 2021 was $88,000, and is recorded as a decrease to real estate revenue in our accompanying condensed consolidated statements of operations and comprehensive loss.
8. Mortgage Loans Payable, Net
As of March 31, 2022 and December 31, 2021, mortgage loans payable were $1,121,901,000 ($1,103,006,000, net of discount/premium and deferred financing costs) and $1,116,216,000 ($1,095,594,000, net of discount/premium and deferred financing costs), respectively. As of March 31, 2022, we had 67 fixed-rate mortgage loans payable and 11 variable-rate mortgage loans payable with effective interest rates ranging from 2.21% to 5.25% per annum based on interest rates in effect as of March 31, 2022 and a weighted average effective interest rate of 3.16%. As of December 31, 2021, we had 66 fixed-rate mortgage loans payable and 12 variable-rate mortgage loans payable with effective interest rates ranging from 2.21% to 5.25% per annum based on interest rates in effect as of December 31, 2021 and a weighted average effective interest rate of 3.21%. 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.
Mortgage loans payable, net consisted of the following as of March 31, 2022 and December 31, 2021:
March 31,
2022
December 31,
2021
Total fixed-rate debt$862,480,000 $845,504,000 
Total variable-rate debt259,421,000 270,712,000 
Total fixed- and variable-rate debt1,121,901,000 1,116,216,000 
Less: deferred financing costs, net(8,314,000)(8,680,000)
Add: premium356,000 397,000 
Less: discount(10,937,000)(12,339,000)
Mortgage loans payable, net$1,103,006,000 $1,095,594,000 
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NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
The following table reflects the changes in the carrying amount of mortgage loans payable, net consisted of the following for the ninethree months ended September 30, 2017March 31, 2022 and 2016:
2021:
 Nine Months Ended September 30,
 2017 2016
Beginning balance$3,965,000
 $
Additions:   
Assumptions of mortgage loans payable8,000,000
 3,968,000
Amortization of deferred financing costs(1)23,000
 
Deductions:   
Deferred financing costs(1)(151,000) (102,000)
Scheduled principal payments on mortgage loan payable(189,000) (19,000)
Amortization of premium on mortgage loan payable(9,000) 
Ending balance$11,639,000
 $3,847,000
Three Months Ended March 31,
20222021
Beginning balance$1,095,594,000 $810,478,000 
Additions:
Borrowings under mortgage loans payable88,659,000 205,826,000 
Amortization of deferred financing costs2,078,000 2,627,000 
Deductions:
Scheduled principal payments on mortgage loans payable(4,538,000)(3,480,000)
Early payoff of mortgage loans payable(78,437,000)(101,734,000)
Deferred financing costs(333,000)(1,037,000)
Amortization of discount/premium on mortgage loans payable, net(17,000)203,000 
Ending balance$1,103,006,000 $912,883,000 
___________For the three months ended March 31, 2022, we incurred an aggregate loss on the extinguishment of mortgage loans payable of $1,430,000, which is recorded as an increase to interest expense in our accompanying condensed consolidated statements of operations and comprehensive loss. Such loss was primarily related to the write-off of unamortized loan discount related to 8 mortgage loans payable that we refinanced on January 1, 2022 that were due to mature in 2044 through 2052.
(1)In accordance with ASU 2015-03 and ASU 2015-15, deferred financing costs only include costs related to our mortgage loans payable.
For the three months ended March 31, 2021, we incurred an aggregate loss on the extinguishment of mortgage loans payable of $2,288,000, which is recorded as an increase to interest expense in our accompanying condensed consolidated statements of operations and comprehensive loss. 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 that were due to mature in 2053.
As of September 30, 2017,March 31, 2022, the principal payments due on our mortgage loans payable for the threenine months ending December 31, 20172022 and for each of the next four years ending December 31 and thereafter were as follows:
YearAmount
2022$121,952,000 
2023121,130,000 
2024163,974,000 
202529,571,000 
2026155,402,000 
Thereafter529,872,000 
$1,121,901,000 
Some of our mortgage loan agreements include a standard loan term requiring lender approval for a change of control event, which was triggered upon the closing of the Merger. All of our mortgage lenders and loan servicers approved such event as of March 31, 2022, except for the servicers of 2 of our mortgage loans with an aggregate principal balance of $14,137,000, for which approvals were received in April 2022.
Year Amount
2017 $84,000
2018 386,000
2019 407,000
2020 8,035,000
2021 314,000
Thereafter 2,492,000
  $11,718,000
7. Line9. Lines of Credit and Term Loans
On August 25, 2016,2018 Credit Facility
In order to accommodate the Merger, we through ouramended GAHR IV and its operating partnership,partnership's credit agreement, as borrower, and certain of our subsidiaries,amended, or the subsidiary guarantors, and us, collectively as guarantors, entered into a credit agreement, or the2018 Credit Agreement, with Bank of America, N.A., or Bank of America, as administrative agent, swing line lender and letters of credit issuer; andAmerica; KeyBank, National Association, or KeyBank, as syndication agentKeyBank; Citizens Bank, National Association, or Citizens Bank; Merrill Lynch, Pierce, Fenner & Smith Incorporated; KeyBanc Capital Markets, Inc., or KeyBanc Capital Markets; and letters ofthe lenders named therein, for a credit issuer, to obtain a revolving line of creditfacility with an aggregate maximum principal amount of $100,000,000,$530,000,000, or the Line2018 Credit Facility. The 2018 Credit Facility, which was further amended on October 1, 2021 to provide for updates regarding the Combined Company subsequent to the Merger, consisted of Credit, subject to certain terms and conditions.
On August 25, 2016, we also entered into separatea senior unsecured revolving notes, orcredit facility in the Revolving Notes, with each of Bank of America and KeyBank, whereby we promised to pay the principal amount of each revolving$235,000,000 and senior unsecured term loan and accrued interest to the respective lender or its registered assigns, in accordance with the terms and conditions of the Credit Agreement. The proceeds of loans made under the Line of Credit may be used for general working capital (including acquisitions), capital expenditures and other general corporate purposes not inconsistent with obligations under the Credit Agreement. We may obtain up to $20,000,000facilities in the form of standby letters of credit and up to $25,000,000 in the form of swing line loans. The Line of Credit matures on August 25, 2019, and may be extended for one 12-month period during the term of the Credit Agreement subject to satisfaction of certain conditions, including payment of an extension fee.
The maximum principalaggregate amount of $295,000,000. At our option, the 2018 Credit Agreement may be increased by upFacility bore interest at per annum rates equal to $100,000,000, for a total principal amount of $200,000,000, subject to: (a)(i) the terms of the Credit Agreement; and (ii) at least five business days’ prior written notice to Bank of America. On October 31, 2017, we increased the aggregate maximum principal amount of the Line of Credit to $200,000,000. See Note 18, Subsequent Events — Amendment to the Credit Agreement with Bank of America and KeyBank, for a further discussion.

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Eurodollar Rate, as defined in the 2018 Credit Agreement, plus (ii) a margin ranging from 1.70% to 2.20% based on our Consolidated Leverage Ratio, as defined in the 2018 Credit Agreement, or (b)(i) the greater of: (1) the prime rate publicly announced by Bank of America, (2) the Federal Funds Rate, as defined in the 2018 Credit Agreement, plus 0.50%, (3) the one-month Eurodollar Rate plus 1.00%, and (4) 0.00%, plus (ii) a margin ranging from 0.70% to 1.20% based on our Consolidated Leverage Ratio.
The 2018 Credit Facility was due to mature on November 19, 2021; however, pursuant to the terms of the 2018 Credit Agreement, at such time we extended the maturity date for an additional 12 months and paid an extension fee of $795,000. As of December 31, 2021, borrowings outstanding totaled $441,900,000 and the weighted average interest rate on such borrowings outstanding was 2.27% per annum. On January 19, 2022, we terminated the 2018 Credit Agreement and entered into the 2022 Credit Agreement, as defined and discussed below under “2022 Credit Facility.”
2019 Credit Facility
On October 1, 2021, upon consummation of the Merger, we, through the surviving partnership, were subject to GAHR III’s credit agreement, as amended, or the 2019 Corporate Credit Agreement, with Bank of America; KeyBank; Citizens Bank; and a syndicate of other banks, as lenders, for a credit facility with an aggregate maximum principal amount of $630,000,000, or the 2019 Credit Facility. The 2019 Credit Facility consisted of a senior unsecured revolving credit facility in an aggregate amount of $150,000,000 and a senior unsecured term loan facility in an aggregate amount of $480,000,000. On October 1, 2021, upon consummation of the Merger, the previously available $150,000,000 senior unsecured revolving credit facility was cancelled and a ratable amendment to certain financial covenants was made to account for the Combined Company.
At our option, the Line of2019 Credit bearsFacility bore interest at per annum rates equal to (a) (i) the Eurodollar Rate, (asas defined in the 2019 Corporate Credit Agreement)Agreement, plus (ii) a margin ranging from 1.75%1.85% to 2.25%2.80% based on our Consolidated Leverage Ratio, (asas defined in the 2019 Corporate Credit Agreement),Agreement, or (b) (i) the greater of: (1) the prime rate publicly announced by Bank of America, (2) the Federal Funds Rate, (asas defined in the 2019 Corporate Credit Agreement)Agreement, plus 0.50%, (3) the one-month Eurodollar Rate plus 1.00%, and (4) 0.00%, plus (ii) a margin ranging from 0.55%0.85% to 1.05%1.80% based on our Consolidated Leverage Ratio. Accrued
As of December 31, 2021, borrowings outstanding under the 2019 Credit Facility totaled $480,000,000 and the weighted average interest rate on such borrowings outstanding was 2.60% per annum. The 2019 Corporate Credit Agreement was due to mature on January 25, 2022. On January 19, 2022, we, through our operating partnership, entered into an agreement that amended and restated the Line2019 Corporate Credit Agreement in its entirety, or the 2022 Credit Agreement. See below for a further discussion.
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 the 2022 Credit Agreement that amended, restated, superseded and replaced the 2019 Corporate Credit Agreement and the 2018 Credit Agreement for a credit facility with an aggregate maximum principal amount up to $1,050,000,000, or the 2022 Credit Facility. The 2022 Credit Facility consists 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 may be 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 may also obtain 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 mature on January 19, 2026, and may be extended for 1 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 2022 Credit Facility may be increased by an aggregate incremental amount of $700,000,000, subject to: (i) the terms of the 2022 Credit Agreement; and (ii) at least five business days’ prior written notice to Bank of America.
The 2022 Credit Facility bears interest at varying rates based upon, at our option, (i) the Daily Simple Secured Overnight Financing Rate, or Daily SOFR, plus the Applicable Rate for Daily SOFR Rate Loans or (ii) the Term Secured Overnight Financing Rate, or the Term SOFR, plus the Applicable Rate for Term SOFR Rate Loans. If, under the terms of the 2022 Credit Agreement, there is payable monthly.an inability to determine the Daily SOFR or the Term SOFR then the 2022 Credit Facility will
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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 theThe 2022 Credit Agreement at a per annum rate equal to 0.20% if the average daily used amount is greater than 50.0% of the commitments and 0.25% if the average daily used amount is less than or equal to 50.0% of the commitments, which fee shall be measured and payable on a quarterly basis.
The Credit Agreement contains various affirmative and negative covenants that are customary for credit facilities and transactions of this type, including limitations on the incurrence of debt by our operating partnership and its subsidiaries. The Credit Agreement also imposes certain financial covenants based on the following criteria, which are specifically defined in the Credit Agreement: (a) Consolidated Leverage Ratio; (b) Consolidated Secured Leverage Ratio; (c) Consolidated Tangible Net Worth; (d) Consolidated Fixed Charge Coverage Ratio; (e) Unencumbered Indebtedness Yield; (f) Consolidated Unencumbered Leverage Ratio; (g) Consolidated Unencumbered Interest Coverage Ratio; (h) Secured Recourse Indebtedness; and (i) Consolidated Unsecured Indebtedness.
The Credit Agreement permitsrequires us to add additional subsidiaries as guarantors.guarantors in the event the value of the assets owned by the subsidiary guarantors falls below a certain threshold as set forth in the 2022 Credit Agreement. In the event of default, Bank of America has the right to terminate its obligationsthe 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, including the funding of future loans, and to accelerate the payment on any unpaid principal amount of all outstanding loans and interest thereon. Additionally, in connection with the Credit Agreement, we also entered into a Pledge Agreement on August 25, 2016, pursuant to which we pledged the capital stock of our subsidiaries which own the real property to be included in the Unencumbered Property Pool, as such term is defined in the Credit Agreement. The pledged collateral will be released upon achieving a consolidated total asset value of at least $750,000,000.
As of September 30, 2017 and DecemberMarch 31, 2016,2022, our aggregate borrowing capacity under the Line2022 Credit Facility was $1,050,000,000, excluding the $25,000,000 in standby letters of Credit was $100,000,000.credit described above. As of September 30, 2017 and DecemberMarch 31, 2016,2022, borrowings outstanding totaled $26,000,000 and $33,900,000, respectively, and $74,000,000 and $66,100,000, respectively, remained available under the Line2022 Credit Facility totaled $934,400,000 ($933,413,000, net of Credit. Asdeferred financing costs related to the senior unsecured term loan facility portion of September 30, 2017the 2022 Credit Facility) and December 31, 2016, the weighted average interest rate on such borrowings outstanding was 3.72% and 4.30%2.04% per annum, respectively.annum.
8. Identified Intangible Liabilities, Net
Identified intangible liabilities, net consistedFor the three months ended March 31, 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 loans which formed part of the following2018 Credit Facility and the 2019 Credit Facility. Such loss on extinguishment of debt is recorded as of September 30, 2017 and December 31, 2016:
 
September 30,
2017
 
December 31,
2016
Below-market leases, net of accumulated amortization of $263,000 and $60,000 as of September 30, 2017 and December 31, 2016, respectively (with a weighted average remaining life of 6.6 years and 5.4 years as of September 30, 2017 and December 31, 2016, respectively)$1,431,000
 $1,063,000
Above-market leasehold interests, net of accumulated amortization of $4,000 and $0 as of September 30, 2017 and December 31, 2016, respectively (with a weighted average remaining life of 52.4 years and 0 years as of September 30, 2017 and December 31, 2016, respectively)391,000
 
 $1,822,000
 $1,063,000
Amortizationan increase to interest expense on identified intangible liabilities for the three and nine months ended September 30, 2017 was $70,000 and $207,000, respectively, which included $68,000 and $203,000, respectively, of amortization recorded to real estate revenue for below-market leases and $2,000 and $4,000, respectively, of amortization recorded against rental expenses for above-market leasehold interests in our accompanying condensed consolidated statements of operations. We did not incur any amortization expenseoperations and comprehensive loss, and primarily consisted of lender fees we paid to obtain the 2022 Credit Facility.
2019 Trilogy Credit Facility
On October 1, 2021, upon consummation of the Merger, through Trilogy RER, LLC, we are subject 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 with 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 may be increased by up to $140,000,000, for a total principal amount of $500,000,000, subject to certain conditions. The 2019 Trilogy Credit Facility matures on identified intangible liabilitiesSeptember 5, 2023 and may be extended for 1 12-month period during the threeterm of the 2019 Trilogy Credit Agreement, subject to the satisfaction of certain conditions, including payment of an extension fee.
At our option, the 2019 Trilogy Credit Facility bears interest at per annum rates equal to (a) the London Inter-bank Offered Rate, or LIBOR, plus 2.75% for LIBOR Rate Loans, as defined in the 2019 Trilogy Credit Agreement, and nine months ended September 30, 2016.(b) for Base Rate Loans, as defined in the 2019 Trilogy Credit Agreement, 1.75% plus the greater of: (i) the fluctuating annual rate of interest announced from time to time by KeyBank as its prime rate, (ii) 0.50% above the Federal Funds Effective Rate, as defined in the 2019 Trilogy Credit Agreement, and (iii) 1.00% above the one-month LIBOR.

As of both March 31, 2022 and December 31, 2021, our aggregate borrowing capacity under the 2019 Trilogy Credit Facility was $360,000,000. As of both March 31, 2022 and December 31, 2021, borrowings outstanding under the 2019 Trilogy Credit Facility totaled $304,734,000, and the weighted average interest rate on such borrowings outstanding was 3.20% and 2.85% per annum, respectively.
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10. Derivative Financial Instruments
We have used derivative financial instruments to manage interest rate risk associated with variable-rate debt. We recorded such derivative financial instruments in our accompanying condensed consolidated balance sheets as either an asset or a liability measured at fair value. We did not have any derivative financial instruments as of March 31, 2022. The aggregatefollowing table lists the derivative financial instruments held by us as of December 31, 2021, which were included in security deposits, prepaid rent and other liabilities in our accompanying condensed consolidated balance sheets:
InstrumentNotional AmountIndexInterest RateMaturity DateFair Value
December 31, 2021
Swap$250,000,000 one month LIBOR2.10%01/25/22$332,000 
Swap$130,000,000 one month LIBOR1.98%01/25/22162,000 
Swap$100,000,000 one month LIBOR0.20%01/25/226,000 
$500,000 
As of December 31, 2021, 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 three months ended March 31, 2022 and 2021, we recorded $500,000 and $1,821,000, respectively, as a decrease to interest expense in our accompanying condensed consolidated statements of operations and comprehensive loss related to the change in the fair value of our derivative financial instruments.
See Note 16, Fair Value Measurements, for a further discussion of the fair value of our derivative financial instruments.
11. Identified Intangible Liabilities, Net
As of March 31, 2022 and December 31, 2021, identified intangible liabilities, net consisted of below-market leases of $12,077,000 and $12,715,000, respectively, net of accumulated amortization of $1,335,000 and $1,047,000, respectively. Amortization expense on below-market leases for the three months ended March 31, 2022 and 2021 was $609,000 and $47,000, respectively, which is recorded as an increase to real estate revenue in our accompanying condensed consolidated statements of operations and comprehensive loss.
The weighted average remaining life of the identified intangible liabilitiesbelow-market leases was 16.49.0 years and 5.49.1 years as of September 30, 2017March 31, 2022 and December 31, 2016,2021, respectively. As of September 30, 2017,March 31, 2022, estimated amortization expense on identified intangible liabilitiesbelow-market leases for the threenine months ending December 31, 20172022 and for each of the next four years ending December 31 and thereafter was as follows:
YearAmount
2022$1,239,000 
20231,596,000 
20241,475,000 
20251,347,000 
20261,198,000 
Thereafter5,222,000 
$12,077,000 
Year Amount
2017 $85,000
2018 338,000
2019 310,000
2020 147,000
2021 125,000
Thereafter 817,000
  $1,822,000
9.12. 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 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
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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.
10.13. Redeemable Noncontrolling InterestInterests
As a result of September 30, 2017the Merger and the AHI Acquisition, as of March 31, 2022 and December 31, 2016,2021, we, owned greater than a 99.99%through our direct and indirect subsidiaries, own an approximately 95.0% and 94.9% general partnership interest, respectively, in our operating partnership and our advisor owned less than a 0.01%the remaining approximate 5.0% and 5.1% limited partnership interest, in our operating partnership. The noncontrolling interest of our advisorrespectively, in our operating partnership is owned by the NewCo Sellers. Some of the limited partnership units outstanding, which hasaccount for approximately 1.0% of our total operating partnership units outstanding, have redemption features outside of our control isand are accounted for as a redeemable noncontrolling interest and isinterests presented outside of permanent equity in our accompanying condensed consolidated balance sheets. See Note 11, Equity — Noncontrolling Interest
As of Limited Partnerboth March 31, 2022 and December 31, 2021, we, through Trilogy REIT Holdings LLC, or Trilogy REIT Holdings, in Operating Partnership, forwhich we indirectly hold a further discussion. In addition, see Note 12, Related Party Transactions — Liquidity Stage — Subordinated Participation Interest — Subordinated Distribution Upon Listing, and Note 12, Related Party Transactions — Subordinated Distribution Upon Termination, for a further discussion76.0% ownership interest, owned 95.9% of the outstanding equity interests of Trilogy. As of both March 31, 2022 and December 31, 2021, certain members of Trilogy’s management and certain members of an advisory committee to Trilogy’s board of directors owned approximately 4.1% of the outstanding equity interests of Trilogy. The noncontrolling interests held by such members have redemption features outside of our control and are accounted for as redeemable noncontrolling interests in our accompanying condensed consolidated balance sheets.
As a result of the limitedMerger and through our operating partnership, units.

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March 31, 2022 and December 31, 2021, we own approximately 98.0% of the joint ventures with an affiliate of Meridian Senior Living, LLC, or Meridian, that own Central Florida Senior Housing Portfolio, Pinnacle Beaumont ALF and Pinnacle Warrenton ALF. Also as a result of the Merger, as of March 31, 2022 and December 31, 2021, we also own approximately 90.0% of the joint venture with Avalon Health Care, Inc., or Avalon, that owns Catalina West Haven ALF and Catalina Madera ALF. The noncontrolling interests held by Meridian and Avalon have redemption features outside of our control and are accounted for as redeemable noncontrolling interests in our accompanying condensed consolidated balance sheets. Both of our joint ventures with an affiliate of Meridian and with Avalon described above were acquired on October 1, 2021, upon consummation of the Merger.
We record the carrying amount of redeemable noncontrolling interestinterests at the greater of: (i) the initial carrying amount, increased or decreased for the noncontrolling interest’sinterests’ share of net income or loss and distributions;distributions or (ii) the redemption value. The changes in the carrying amount of redeemable noncontrolling interestinterests consisted of the following for the nine monthsyears ended September 30, 2017March 31, 2022 and 2016:2021:
Three Months Ended March 31,
20222021
Beginning balance$72,725,000 $40,340,000 
Additional redeemable noncontrolling interest173,000 — 
Reclassification from equity21,000 — 
Distributions(695,000)— 
Adjustment to redemption value2,856,000 526,000 
Net income (loss) attributable to redeemable noncontrolling interests187,000 (484,000)
Ending balance$75,267,000 $40,382,000 
22
  Nine Months Ended September 30,
  2017 2016
Beginning balance $2,000
 $
Reclassification from equity 
 2,000
Net income (loss) attributable to redeemable noncontrolling interest 
 
Ending balance $2,000
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11.AMERICAN HEALTHCARE REIT, INC.
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14. Equity
Preferred Stock
OurPursuant to our charter, authorizes uswe are authorized to issue 200,000,000 shares of our preferred stock, par value $0.01$0.01 per share. As of September 30, 2017both March 31, 2022 and December 31, 2016,2021, no shares of preferred stock were issued and outstanding.
Common Stock
OurOn March 12, 2015, we terminated the primary portion of our initial public offering. We continued to offer shares of our common stock in the GAHR III initial offering pursuant to the Initial DRIP, until the termination of the distribution reinvestment plan portion of the GAHR III initial offering and deregistration of the GAHR III initial offering on April 22, 2015. On March 25, 2015, we filed a Registration Statement on Form S-3 under the Securities Act of 1933, as amended, or the Securities Act, to register a maximum of $250,000,000 of additional shares of our common stock pursuant to the Initial DRIP through a subsequent offering, or the 2015 GAHR III DRIP Offering, and we commenced offering shares following the deregistration of the GAHR III initial offering until the termination and deregistration of the 2015 GAHR III DRIP Offering on March 29, 2019. Effective October 5, 2016, we amended and restated the Initial DRIP, or the GAHR III Amended and Restated DRIP, to amend the price at which shares of our common stock were issued pursuant to the 2015 GAHR III DRIP Offering.
On January 30, 2019, we filed a Registration Statement on Form S-3 under the Securities Act to register a maximum of $200,000,000 of additional shares of our common stock to be issued pursuant to the GAHR III Amended and Restated DRIP, or the 2019 GAHR III DRIP Offering, which we commenced offering on April 1, 2019, following the deregistration of the 2015 GAHR III DRIP Offering. On May 29, 2020, our board authorized the suspension of the 2019 GAHR III DRIP Offering, and consequently, ceased issuing shares pursuant to such offering following the distributions paid in June 2020 to stockholders of record on or prior to the close of business on May 31, 2020. As a result of the Merger, we deregistered the 2019 GAHR III DRIP Offering on October 4, 2021. Further, on October 4, 2021, our board authorized the reinstatement of our distribution reinvestment plan, as amended, or the AHR DRIP. We continue to offer up to $100,000,000 of shares of our common stock to be issued pursuant to the AHR DRIP under an existing Registration Statement on Form S-3 under the Securities Act filed by GAHR IV, or the AHR DRIP Offering. We collectively refer to the Initial DRIP portion of the GAHR III initial offering, the 2015 GAHR III DRIP Offering, the 2019 GAHR III DRIP Offering and the AHR DRIP Offering as our DRIP Offerings. See Note 1, Organization and Description of Business — Public Offering and the “Distribution Reinvestment Plan” section below for a further discussion.
At the effective time of the REIT Merger, on October 1, 2021, each issued and outstanding share of GAHR III’s common stock, $0.01 par value per share, was converted into the right to receive 0.9266 shares of GAHR IV’s Class I common stock, $0.01 par value per share, resulting in the issuance of 179,637,776 shares of Class I common stock to GAHR III’s stockholders. Also, on October 1, 2021, we filed the Fourth Articles of Amendment and Restatement to our charter, authorizesor the Charter Amendment, which among other things, amended the common stock we are authorized to issue. The Charter Amendment authorized us to issue 1,000,000,000 shares of our common stock, par value $0.01 per share. We commenced our public offering of shares of our common stock on February 16, 2016, and as of such date we were offering to the public up to $3,150,000,000 in shares of our Class T common stock, consisting of up to $3,000,000,000 in shares of our Class T common stock at a price of $10.00 per share, in our primary offering and up to $150,000,000 in shares of our Class T common stock for $9.50 per share pursuant to the DRIP. Effective June 17, 2016, we reallocated certain of the unsold shares of our Class T common stock being offered and began offering shares of our Class I common stock, such that we are currently offering up to approximately $2,800,000,000 in shares of Class T common stock and $200,000,000 in shares of Class I common stock in our primary offering, and up to an aggregate of $150,000,000 in shares of our Class T and Class I common stock pursuant to the DRIP. Subsequent to the reallocation, of the 1,000,000,000 shares of common stock authorized, 900,000,000whereby 200,000,000 shares are classified as Class T common stock and 100,000,000800,000,000 shares are classified as Class I common stock. We reserve
Distribution Reinvestment Plan
Following the rightderegistration of the Initial DRIP on April 22, 2015, we continued to reallocateoffer shares of our common stock pursuant to the 2015 GAHR III DRIP Offering and 2019 GAHR III DRIP Offering which resulted in a total of $308,501,000 in distributions being reinvested that resulted in 33,110,893 shares of common stock being issued.
As a result of the Merger, we are offering betweenderegistered the primary offering2019 GAHR III DRIP Offering on October 4, 2021. Further, on October 4, 2021, our board reinstated distributions and authorized the reinstatement of the AHR DRIP and among classesOffering. We continue to offer up to $100,000,000 of stock.
The shares of our Class T common stock to be issued pursuant to the AHR DRIP under the AHR DRIP Offering. As a result, beginning with the October 2021 distribution, which was paid in November 2021, stockholders who previously enrolled as participants in the primary offering are being offered at a price of $10.00 per share. TheAHR DRIP received or will receive distributions in shares of our Class I common stock pursuant to the terms of the AHR DRIP, instead of cash distributions. As of March 31, 2022, a total of $65,941,000 in distributions were reinvested that resulted in 6,981,086 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 NAV annually. Commencing with the distribution payment to stockholders paid in the primary offering were being offered at a price of $9.30 per share prior to March 1, 2017, and are being offered at a price of $9.21 per share for all shares issued effective March 1, 2017. Themonth following such board approval, shares of our Class T and Class I common stock issued pursuant to our distribution reinvestment plan are issued at the DRIP were sold at a price of $9.50current estimated per share prior to January 1, 2017, and are sold at a price of $9.40NAV until such time as our board determined an updated estimated per share for all shares issued pursuant to the DRIP effective January 1, 2017. After our board of directors determines an estimated NAV per share of our common stock, share prices are expected to be adjusted to reflect the estimated NAV per share and, in the case of shares offered pursuant to our primary offering, up-front selling commissions and dealer manager fees other than those funded by our advisor.
Each share of our common stock, regardless of class, will be entitled to one vote per share on matters presented to the common stockholders for approval; provided, however, that stockholders of one share class shall have exclusive voting rights on any amendment to our charter that would alter only the contract rights of that share class, and no stockholders of another share class shall be entitled to vote thereon.
On February 6, 2015, our advisor acquired shares of our Class T common stock for total cash consideration of $200,000 and was admitted as our initial stockholder. We used the proceeds from the sale of shares of our Class T common stock to our advisor to make an initial capital contribution to our operating partnership. As of September 30, 2017 and December 31, 2016, our advisor owned 20,833 shares of our Class T common stock.
Through September 30, 2017, we had issued 35,522,410 aggregate shares of our Class T and Class I common stock in connection with the primary portion of our offering and 668,035 aggregate shares of our Class T and Class I common stock pursuant to the DRIP. We also granted an aggregate of 37,500 shares of our restricted Class T common stock to our independent directors and repurchased 18,383 shares of our common stock under our share repurchase plan through September 30, 2017. As of September 30, 2017 and December 31, 2016, we had 36,230,395 and 11,377,439 aggregate shares of our Class T and Class I common stock, respectively, issued and outstanding.

NAV.
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AsThe following is a summary of September 30, 2017, we had a receivable of $807,000 for offering proceeds, net of selling commissions and dealer manager fees, from our transfer agent, which was received in October 2017.
Distribution Reinvestment Plan
We have registered and reserved $150,000,000 in shares of our common stock for sale pursuant to the DRIP in our offering. The DRIP allows stockholders to purchase additional Class T shares and Class I shares of our common stock through the reinvestment of distributions during our offering. Prior to January 1, 2017, we issued both Class T shares and Class I shares pursuant to the DRIP at a price of $9.50 per share. Effective January 1, 2017, shares of both Class T shares and Class I shares issued pursuant to the DRIP are issued at a price of $9.40historical estimated per share until our board of directors determines an estimated NAV per share of our common stock. After our board of directors determines an estimated NAV per share of our common stock, participants infor GAHR III and the DRIP will receive Class T shares and Class I shares,Combined Company, as applicable, at the most recently published estimated NAV per share of our common stock. Pursuant to the DRIP, distributions with respect to Class T shares are reinvested in Class T shares and distributions with respect to Class I shares are reinvested in Class I shares.applicable:
Approval Date by our BoardEstimated Per Share NAV
(Unaudited)
10/03/19$9.40 
03/18/21$8.55 
03/24/22$9.29 
For the three and nine months ended September 30, 2017, $2,618,000March 31, 2022, and $5,492,000,2021, $11,304,000 and $0, respectively, in distributions were reinvested and 278,5201,226,073 and 584,3180 shares of our common stock, respectively, were issued pursuant to the DRIP. For the three and nine months ended September 30, 2016, $203,000 and $222,000, respectively, in distributions were reinvested and 21,376 and 23,379 shares of our common stock, respectively, were issued pursuant to the DRIP. As of September 30, 2017 and December 31, 2016, a total of $6,288,000 and $796,000, respectively, in distributions were reinvested that resulted in 668,035 and 83,717 shares of our common stock, respectively, being issued pursuant to the DRIP.DRIP Offerings.
Share Repurchase Plan
In February 2016, our board of directors approved a share repurchase plan. TheOur share repurchase plan allows for repurchases of shares of our common stock by us when certain criteria are met. Share repurchases will beare made at the sole discretion of our board of directors.board. Subject to the availability of the funds for share repurchases and other certain conditions, we willgenerally limit 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 willare not be subject to this cap. Funds for the repurchase of shares of our common stock will come exclusively from the cumulative proceeds we receive from the sale of shares of our common stock pursuant to the DRIP.our DRIP Offerings.
All repurchases will be subjectPursuant to a one-year holding period, except for repurchases made in connection with a stockholder’s death or “qualifying disability,” as defined in our share repurchase plan. Further, all share repurchases will be repurchased following a one-year holding period at a price between 92.5% to 100% of each stockholder’s repurchase amount depending on the period of time their shares have been held. During our offering, the repurchase amount for shares repurchased under our share repurchase plan, shall bethe 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 is equal to the most recently published estimated per share offering price inNAV. On October 4, 2021, as a result of the Merger, our offering. If we are no longer engaged in an offering,board authorized the repurchase amount for shares repurchased underpartial reinstatement of our share repurchase plan will be determined by our board of directors. However, ifwith respect to requests to repurchase shares of our common stock are repurchased in connection with a stockholder’sresulting from the death or qualifying disability of stockholders, effective with respect to qualifying repurchases for the repurchase price will be no less than 100% of the price paid to acquire the shares of our common stock from us. Furthermore, ourfiscal quarter ending December 31, 2021. All share repurchase plan provides that if there are insufficient funds to honor all repurchase requests pendingother than those requests willresulting from the death or qualifying disability of stockholders were and shall be honored among all requests for repurchase in any given repurchase period, as follows: first, pro rata as to repurchases sought upon a stockholder’s death; next, pro rata as to repurchases sought by stockholders with a qualifying disability; and, finally, pro rata as to other repurchase requests.rejected.
For the three and nine months ended September 30, 2017,March 31, 2022, we received share repurchase requests and repurchased 11,209 and 18,383 shares of our common stock, respectively, for an aggregate of $109,000 and $178,000, respectively, at an average repurchase price of $9.69 and $9.68 per share, respectively. No share repurchases were requested or made for the three and nine months ended September 30, 2016.
As of September 30, 2017, we received share repurchase requests and repurchased 18,383448,375 shares of our common stock, for an aggregate of $178,000$4,134,000, at an averagea repurchase price of $9.68$9.22 per share. For the three months ended March 31, 2021, we did not repurchase any shares of common stock. In April 2022, we repurchased 699,460 shares of our common stock, for an aggregate of $6,449,000, at a repurchase price of $9.22 per share. All shares were repurchased using the cumulative proceeds we received from the sale of shares of our common stock pursuant to the DRIP. our DRIP Offerings.
Noncontrolling Interests in Total Equity
As of both March 31, 2022 and December 31, 2016, no share repurchases2021, Trilogy REIT Holdings owned approximately 95.9% of Trilogy. Prior to October 1, 2021, we were requestedthe 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 made.NHI, and a wholly owned subsidiary of GAHR IV Operating Partnership. We serve as the managing member of Trilogy REIT Holdings. As part of the Merger on October 1, 2021, 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.

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 condensed 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 Accounting Standards Update 2018-07, Improvements to Nonemployee Share-Based Payment Accounting, using a modified retrospective approach. The nonvested awards were presented as noncontrolling interests in total equity in our accompanying condensed consolidated balance sheets, and were re-classified to
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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 13, 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 in cash and 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 three months ended March 31, 2022 and 2021. For the three months ended March 31, 2022 and 2021, we recognized stock compensation expense related to the Profit Interests of $21,000 and $(14,000), 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 condensed 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 condensed consolidated statements of operations and comprehensive loss.
As of both March 31, 2022 and December 31, 2021, we owned an 86.0% interest in a consolidated limited liability company that owns Lakeview IN Medical Plaza, which we acquired on January 21, 2016. As such, 14.0% of the net earnings of Lakeview IN Medical Plaza were allocated to noncontrolling interests for the three months ended March 31, 2022 and 2021.
On April 7, 2020, we sold a 9.4% membership interest in a consolidated limited liability company that owns Southlake TX Hospital to an unaffiliated third party for a contract purchase price of $11,000,000 and therefore as of both March 31, 2022 and December 31, 2021, we owned a 90.6% membership interest in such consolidated limited liability company. For the three months ended March 31, 2022 and 2021, 9.4% of the net earnings of Southlake TX Hospital were allocated to noncontrolling interests in our accompanying condensed consolidated statements of operations and comprehensive loss.
On October 1, 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 condensed consolidated statements of operations and comprehensive loss during the three months ended March 31, 2022.
As discussed in Note 1, Organization and Description of Business, as a result of the Merger and the AHI Acquisition, as of March 31, 2022 and December 31, 2021, we, through our direct and indirect subsidiaries, own an approximately 95.0% and 94.9% general partnership interest, respectively, in our operating partnership and the remaining approximately 5.0% and 5.1% limited partnership interest, respectively, in our operating partnership is owned by the NewCo Sellers. As of March 31, 2022 and December 31, 2021, approximately 4.0% and 4.1% of our total operating partnership units outstanding, respectively, is presented in total equity in our accompanying condensed consolidated balance sheet. See Note 13, Redeemable Noncontrolling Interests, for a further discussion.
2015 Incentive Plan
In February 2016,Upon consummation of the Merger, we adopted the 2015 Incentive Plan, as amended and restated, or our incentive plan, pursuant to which our board (with respect to options and restricted shares of directorscommon stock granted to independent directors), or aour compensation committee of our independent directors(with respect to any other award), may make grants of options, restricted shares of common stock, stock purchase rights, stock appreciation rights or other awards to our independent directors, officers, employees and consultants. The maximum number of shares of our common stock that may be issued pursuant to our incentive plan is 4,000,000 shares.
Through September 30, 2017,March 31, 2022, we granted an aggregate of 22,5001,082,455 shares of our restricted common stock under our incentive plan. Such amount includes: (i) 160,314 shares of our restricted Class T common stock, as defined in our incentive plan,at a weighted average grant date fair value of $9.61 per share, to our independent directors in connection with their initial election or re-election to our board of directors, of which 20.0% immediately vested on the grant date and 20.0% will vest on each of the first four anniversaries of the grant date. In addition, through September 30, 2017, we granted an aggregate of 15,000directors; (ii) 477,901 time-based shares of our restricted Class T common stock, at a grant date fair value of $9.22 per share, to our independent directors in consideration for their past services rendered. These shares of restricted Class T common stock vest under the same period described above. Shares of our restricted common stock may not be sold, transferred, exchanged, assigned, pledged, hypothecated or otherwise encumbered. Such restrictions expire upon vesting. Shares of our restricted common stock will have full voting rightscertain executive officers and rights to distributions.
From the applicable service inception dates to the applicable grant dates, we recognized compensation expense related to thekey employees; and (iii) 319,149 shares of our restricted Class T common stock, based on the reportingat a grant date fair value which was estimated at $10.00of $9.22 per share, to certain of our key employees. Also, through March 31, 2022, we granted 159,301 performance-based restricted units under our incentive plan to certain executive officers representing the price paidright to acquire one sharereceive shares of our Class T common stock in our offering. Beginning onupon vesting. Prior to the applicable grant dates, compensation cost relatedMerger, GAHR III granted an aggregate of 135,000 shares of its restricted common stock, which is equal to the125,091 shares of our restricted Class TI common stock, is measured based onusing the applicable grant date fair value, which was estimated at $10.00 perconversion 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 price paidMerger.
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On April 1, 2022, we granted 76,800 time-based restricted units under our incentive plan to acquire one sharecertain employees representing the right to receive shares of our Class T common stock upon vesting. Such time-based restricted units vest in our offering. Stock compensation expense is recognized from the applicable service inception date to the applicable vesting date for each vesting tranche (i.e.,three equal annual installments on a tranche-by-tranche basis) using the accelerated attribution method.April 1, 2023, April 1, 2024 and April 1, 2025.
ASC Topic 718, Compensation — Stock Compensation, requires forfeitures to be estimated at the time of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates. For the three and nine months ended September 30, 2017 and 2016, we did not assume any forfeitures. For the three months ended September 30, 2017March 31, 2022 and 2016, we recognized compensation expense of $61,000 and $14,000, respectively, and for the nine months ended September 30, 2017 and 2016,2021, we recognized stock compensation expense related to the restricted stock grants to our independent directors, executive officers and key employees of $100,000$811,000 and $66,000, respectively, which$27,000, respectively. Such stock compensation expense is included in general and administrative in our accompanying consolidated statements of operations and comprehensive loss.
15. Related Party Transactions
Fees and Expenses Paid to Affiliates
Prior to the closing of the AHI Acquisition on October 1, 2021, our former advisor used its best efforts, subject to the oversight and review of our board, to, among other things, provide asset management, property management, acquisition, disposition and other advisory services on our behalf consistent with our investment policies and objectives. Our former advisor performed its duties and responsibilities under the Advisory Agreement as our fiduciary. 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.
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 now eliminated in consolidation. Following the consummation of the Merger, we became self-managed and as a result, we no longer incur to our former advisor and its affiliates any fees or expense reimbursements arising from the Advisory Agreement.
Fees and expenses incurred to our former advisor or its affiliates for the three months ended March 31, 2021 were as follows:
Three Months Ended
 March 31, 2021
Asset management fees(1)$5,362,000 
Acquisition fees(2)1,334,000 
Property management fees(3)654,000 
Development fees(4)283,000 
Lease fees(5)265,000 
Operating expenses(6)63,000 
Construction management fees(7)12,000 
$7,973,000 
___________
(1)Asset management fees were included in general and administrative in our accompanying condensed consolidated statements of operations.operations and comprehensive loss.
As of September 30, 2017 and December 31, 2016, there was $195,000 and $70,000, respectively, of total unrecognized compensation expense, net of estimated forfeitures, related to nonvested shares of our restricted Class T common stock. As of September 30, 2017, this expense is expected to be recognized over a remaining weighted average period of 2.00 years.
As of September 30, 2017 and December 31, 2016, the weighted average grant date fair value of the nonvested shares of our restricted Class T common stock was $270,000 and $120,000, respectively. A summary of the status of the nonvested shares of our restricted Class T common stock as of September 30, 2017 and December 31, 2016 and the changes for the nine months ended September 30, 2017 is presented below:
 
Number of Nonvested
Shares of Our
Restricted Common Stock
 
Weighted
Average Grant
Date Fair Value
Balance — December 31, 201612,000
 $10.00
Granted22,500
 $10.00
Vested(7,500) $10.00
Forfeited
 $
Balance — September 30, 201727,000
 $10.00
Expected to vest — September 30, 201727,000
 $10.00
Offering Costs
Selling Commissions
Generally, we pay our dealer manager selling commissions of up to 3.0% of the gross offering proceeds from the sale of Class T shares of our common stock pursuant to our primary offering. To the extent that selling commissions are less than 3.0% of the gross offering proceeds for any Class T shares sold, such reduction in selling commissions will be accompanied by a corresponding reduction in the applicable per share purchase price for purchases of such shares. No selling commissions are

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payable on Class I shares or shares of our common stock sold pursuant to the DRIP. Our dealer manager may re-allow all or a portion of these(2)Acquisition fees to participating broker-dealers. For the three months ended September 30, 2017 and 2016, we incurred $2,059,000 and $1,012,000, respectively, in selling commissions to our dealer manager. For the nine months ended September 30, 2017 and 2016, we incurred $6,763,000 and $1,392,000, respectively, in selling commissions to our dealer manager. Such commissions were charged to stockholders’ equity as such amounts were paid to our dealer manager from the gross proceeds of our offering.
Dealer Manager Fee
With respect to shares of our Class T common stock, our dealer manager generally receives a dealer manager fee of up to 3.0% of the gross offering proceeds from the sale of Class T shares of our common stock pursuant to our primary offering, of which 1.0% of the gross offering proceeds is funded by us and up to an amount equal to 2.0% of the gross offering proceeds is funded by our advisor. With respect to shares of our Class I common stock, prior to March 1, 2017, our dealer manager generally received a dealer manager fee up to 3.0% of the gross offering proceeds from the sale of Class I shares of our common stock pursuant to our primary offering, of which 1.0% of the gross offering proceeds was funded by us and an amount equal to 2.0% of the gross offering proceeds was funded by our advisor. Effective March 1, 2017, our dealer manager generally receives a dealer manager fee up to an amount equal to 1.5% of the gross offering proceeds from the sale of Class I shares pursuant to our primary offering, all of which is funded by our advisor. Our dealer manager may enter into participating dealer agreements with participating dealers that provide for a reduction or waiver of dealer manager fees. To the extent that the dealer manager fee is less than 3.0% of the gross offering proceeds for any Class T shares sold and less than 1.5% of the gross offering proceeds for any Class I shares sold, such reduction will be applied first to the portion of the dealer manager fee funded by our advisor. To the extent that any reduction in dealer manager fee exceeds the portion of the dealer manager fee funded by our advisor, such excess reduction will be accompanied by a corresponding reduction in the applicable per share purchase price for purchases of such shares. No dealer manager fee is payable on shares of our common stock sold pursuant to the DRIP. Our dealer manager may re-allow all or a portion of these fees to participating broker-dealers.
For the three months ended September 30, 2017 and 2016, we incurred $689,000 and $370,000, respectively, in dealer manager fees to our dealer manager. For the nine months ended September 30, 2017 and 2016, we incurred $2,311,000 and $521,000, respectively, in dealer manager fees to our dealer manager. Such fees were charged to stockholders’ equity as such amounts were paid to our dealer manager or its affiliates from the gross proceeds of our offering. See Note 12, Related Party Transactions — Offering Stage — Dealer Manager Fee, for a further discussion of the dealer manager fee funded by our advisor.
Stockholder Servicing Fee
We pay our dealer manager a quarterly stockholder servicing fee with respect to our Class T shares sold as additional compensation to the dealer manager and participating broker-dealers. No stockholder servicing fee shall be paid with respect to Class I shares or shares of our common stock sold pursuant to the DRIP. The stockholder servicing fee accrues daily in an amount equal to 1/365th of 1.0% of the purchase price per share of our Class T shares sold in our primary offering and, in the aggregate will not exceed an amount equal to 4.0% of the gross proceeds from the sale of Class T shares in our primary offering. We will cease paying the stockholder servicing fee with respect to our Class T shares sold in our offering upon the occurrence of certain defined events. Our dealer manager may re-allow to participating broker-dealers all or a portion of the stockholder servicing fee for services that such participating broker-dealers perform in connection with the shares of our Class T common stock. By agreement with participating broker-dealers, such stockholder servicing fee may be reduced or limited.
For the three months ended September 30, 2017 and 2016, we incurred $2,430,000 and $1,349,000, respectively, in stockholder servicing fees to our dealer manager. For the nine months ended September 30, 2017 and 2016, we incurred $8,568,000 and $1,856,000, respectively, in stockholder servicing fees to our dealer manager. As of September 30, 2017 and December 31, 2016, we accrued $11,496,000 and $3,973,000, respectively, in connection with the stockholder servicing fee payable, which is included in accounts payable and accrued liabilities with a corresponding offset to stockholders’ equity in our accompanying condensed consolidated balance sheets.
Noncontrolling Interest of Limited Partner in Operating Partnership
On February 6, 2015, our advisor made an initial capital contribution of $2,000 to our operating partnership in exchange for Class T partnership units. Upon the effectiveness of the Advisory Agreement on February 16, 2016, Griffin-American Healthcare REIT IV Advisor became our advisor. As our advisor, Griffin-American Healthcare REIT IV Advisor is entitled to redemption rights of its limited partnership units. Therefore, as of February 16, 2016, such limited partnership units no longer

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meet the criteria for classification within the equity section of our accompanying condensed consolidated balance sheets, and as such, were reclassified outside of permanent equity, as a mezzanine item, in our accompanying condensed consolidated balance sheets. See Note 10, Redeemable Noncontrolling Interest, for a further discussion. As of September 30, 2017 and December 31, 2016, our advisor owned all of our 208 Class T partnership units outstanding.
12. Related Party Transactions
Fees and Expenses Paid to Affiliates
All of our executive officers and one of our non-independent directors are also executive officers and employees and/or holders of a direct or indirect interest in our advisor, one of our co-sponsors or other affiliated entities. We are affiliated with our advisor, American Healthcare Investors and AHI Group Holdings; however, we are not affiliated with Griffin Capital, our dealer manager, Colony NorthStar or Mr. Flaherty. We entered into the Advisory Agreement, which entitles our advisor and its affiliates to specified compensation for certain services, as well as reimbursement of certain expenses. For the three months ended September 30, 2017 and 2016, we incurred $2,856,000 and $2,331,000, respectively, and for the nine months ended September 30, 2017 and 2016, we incurred $12,633,000 and $5,500,000, respectively, in fees and expenses to our affiliates as detailed below.
Offering Stage
Dealer Manager Fee
With respect to shares of our Class T common stock, our dealer manager generally receives a dealer manager fee of up to 3.0% of the gross offering proceeds from the sale of Class T shares of our common stock pursuant to our primary offering, of which 1.0% of the gross offering proceeds is funded by us and up to an amount equal to 2.0% of the gross offering proceeds is funded by our advisor. With respect to shares of our Class I common stock, prior to March 1, 2017, our dealer manager generally received a dealer manager fee up to 3.0% of the gross offering proceeds from the sale of Class I shares of our common stock pursuant to our primary offering, of which 1.0% of the gross offering proceeds was funded by us and an amount equal to 2.0% of the gross offering proceeds was funded by our advisor. Effective March 1, 2017, our dealer manager generally receives a dealer manager fee up to an amount equal to 1.5% of the gross offering proceeds from the sale of Class I shares pursuant to our primary offering, all of which is funded by our advisor. Our dealer manager may enter into participating dealer agreements with participating dealers that provide for a reduction or waiver of dealer manager fees. To the extent that the dealer manager fee is less than 3.0% of the gross offering proceeds for any Class T shares sold and less than 1.5% of the gross offering proceeds for any Class I shares sold, such reduction will be applied first to the portion of the dealer manager fee funded by our advisor. To the extent that any reduction in dealer manager fee exceeds the portion of the dealer manager fee funded by our advisor, such excess reduction will be accompanied by a corresponding reduction in the applicable per share purchase price for purchases of such shares. No dealer manager fee is payable on shares of our common stock sold pursuant to the DRIP. Our advisor intends to recoup the portion of the dealer manager fee it funds through the receipt of the Contingent Advisor Payment from us, as described below, through the payment of acquisition fees.
For the three months ended September 30, 2017 and 2016, we incurred $1,414,000 and $741,000, respectively, payable to our advisor as part of the Contingent Advisor Payment in connection with the dealer manager fee that our advisor had incurred. For the nine months ended September 30, 2017 and 2016, we incurred $4,751,000 and $1,043,000, respectively, payable to our advisor as part of the Contingent Advisor Payment in connection with the dealer manager fee that our advisor had incurred. Such fee was charged to stockholders' equity as incurred with a corresponding offset to accounts payable due to affiliates in our accompanying condensed consolidated balance sheets. See Note 11, Equity — Offering Costs — Dealer Manager Fee, for a further discussion of the dealer manager fee funded by us.
Other Organizational and Offering Expenses
Our other organizational and offering expenses in connection with our offering (other than selling commissions, the dealer manager fee and the stockholder servicing fee) are funded by our advisor. Our advisor intends to recoup such expenses it funds through the receipt of the Contingent Advisor Payment from us, as described below, through the payment of acquisition fees. We anticipate that our other organizational and offering expenses will not exceed 1.0% of the gross offering proceeds for shares of our common stock sold pursuant to our primary offering. No other organizational and offering expenses will be paid with respect to shares of our common stock sold pursuant to the DRIP.
For the three months ended September 30, 2017 and 2016, we incurred $259,000 and $344,000, respectively, payable to our advisor as part of the Contingent Advisor Payment in connection with the other organizational and offering expenses that

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our advisor had incurred. For the nine months ended September 30, 2017 and 2016, we incurred $1,151,000 and $2,759,000, respectively, payable to our advisor as part of the Contingent Advisor Payment in connection with the other organizational and offering expenses that our advisor had incurred. Such expenses were charged to stockholders' equity as incurred with a corresponding offset to accounts payable due to affiliates in our accompanying condensed consolidated balance sheets.
Acquisition and Development Stage
Acquisition Fee
We pay our advisor an acquisition fee of up to 4.50% of the contract purchase price, including any contingent or earn-out payments that may be paid, of each property we acquire or, with respect to any real estate-related investment we originate or acquire, up to 4.25% of the origination or acquisition price, including any contingent or earn-out payments that may be paid. The 4.50% or 4.25% acquisition fees consist of a 2.25% or 2.00% base acquisition fee, or the base acquisition fee, for real estate and real estate-related acquisitions, respectively, and an additional 2.25% contingent advisor payment, or the Contingent Advisor Payment. The Contingent Advisor Payment allows our advisor to recoup the portion of the dealer manager fee and other organizational and offering expenses funded by our advisor. Therefore, the amount of the Contingent Advisor Payment paid upon the closing of an acquisition shall not exceed the then outstanding amounts paid by our advisor for dealer manager fees and other organizational and offering expenses at the time of such closing. For these purposes, the amounts paid by our advisor and considered as “outstanding” are reduced by the amount of the Contingent Advisor Payment previously paid. Notwithstanding the foregoing, the initial $7,500,000 of amounts paid by our advisor to fund the dealer manager fee and other organizational and offering expenses, or the Contingent Advisor Payment Holdback, shall be retained by us until the later of the termination of our last public offering or the third anniversary of the commencement date of our initial public offering, at which time such amount shall be paid to our advisor or its affiliates. In connection with any subsequent public offering of shares of our common stock, the Contingent Advisor Payment Holdback may increase, based upon the maximum offering amount in such subsequent public offering and the amount sold in prior offerings. Our advisor or its affiliates will be entitled to receive these acquisition fees for properties and real estate-related investments acquired with funds raised in our offering, including acquisitions completed after the termination of the Advisory Agreement (including imputed leverage of 50.0% on funds raised in our offering), or funded with net proceeds from the sale of a property or real estate-related investment, subject to certain conditions. Our advisor may waive or defer all or a portion of the acquisition fee at any time and from time to time, in our advisor’s sole discretion.
The base acquisition fee in connection with the acquisition of properties accounted for as business combinations is expensed as incurred and included in acquisition related expenses in our accompanying condensed consolidated statements of operations. The base acquisition fee in connection with the acquisition of properties accounted for as asset acquisitions or the acquisition of real estate-related investments iswere capitalized as part of the associated investmentinvestments in our accompanying condensed consolidated balance sheets. For
(3)Property management fees were included in rental expenses or general and administrative expenses in our accompanying condensed consolidated statements of operations and comprehensive loss, depending on the three months ended September 30, 2017 and 2016, we paid base acquisitionproperty type from which the fee was incurred.
(4)Development fees of $347,000 and $1,220,000, respectively, to our advisor. For the nine months ended September 30, 2017 and 2016, we paid base acquisition fees of $4,901,000 and $1,343,000, respectively, to our advisor. As of September 30, 2017 and December 31, 2016, we recorded $7,759,000 and $5,404,000, respectively,were capitalized as part of the Contingent Advisor Payment, which is included in accounts payable due to affiliates with a corresponding offset to stockholders’ equityassociated investments in our accompanying condensed consolidated balance sheets. As
(5)Lease fees were capitalized as costs of September 30, 2017, we have paid $3,548,000entering into new leases and included in Contingent Advisor Payments toother assets, net in our advisor. For a further discussion of amounts paid in connection with the Contingent Advisor Payment, see Dealer Manager Fee and Other Organizational and Offering Expenses, above. In addition, see Note 3, Real Estate Investments, Net, for a further discussion.accompanying condensed consolidated balance sheets.
Development Fee
In the event(6)We reimbursed our advisor or its affiliates provide development-related services, we pay our advisor or its affiliates a development fee in an amount that is usual and customary for comparable services rendered for similar projects in the geographic market where the services are provided; however, we will not pay a development fee to our advisor or its affiliates if our advisor or its affiliates elect to receive an acquisition fee based on the cost of such development.
For the three and nine months ended September 30, 2017 and 2016, we did not incur any development fees to our advisor or its affiliates.
Reimbursement of Acquisition Expenses
We reimburse ourformer advisor or its affiliates for acquisitionoperating expenses relatedincurred in rendering services to selecting, evaluating and acquiring assets, which are reimbursed regardless of whether an asset is acquired. The reimbursement of acquisitionus, subject to certain limitations. For the 12 months ended March 31, 2021, our operating expenses acquisition fees, total development costs and real estate commissions paid to unaffiliated third parties willdid not exceed in the aggregate, 6.0% of

such limitations.
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the contract purchase price of the property or real estate-related investments, unless fees in excess of such limits are approved by a majority of our directors, including a majority of our independent directors, not otherwise interested in the transaction. For the three and nine months ended September 30, 2017 and 2016, such fees andOperating expenses paid did not exceed 6.0% of the contract purchase price of our property acquisitions, except with respect to our acquisitions of Auburn MOB, Pottsville MOB and Lafayette Assisted Living Portfolio. For a further discussion, see Note 3, Real Estate Investments, Net.
Reimbursements of acquisition expenses in connection with the acquisition of properties accounted for as business combinations are expensed as incurred and included in acquisition related expenses in our accompanying condensed consolidated statements of operations. Reimbursements of acquisition expenses in connection with the acquisition of properties accounted for as asset acquisitions or the acquisition of real estate-related investments are capitalized as part of the associated investment in our accompanying condensed consolidated balance sheets. For the three and nine months ended September 30, 2017, we incurred $0 and $2,000, respectively, in acquisition expenses to our advisor or its affiliates. We did not incur any acquisition expenses to our advisor or its affiliates for the three and nine months ended September 30, 2016.
Operational Stage
Asset Management Fee
We pay our advisor or its affiliates a monthly fee for services rendered in connection with the management of our assets equal to one-twelfth of 0.80% of average invested assets. For such purposes, average invested assets means the average of the aggregate book value of our assets invested in real estate properties and real estate-related investments, before deducting depreciation, amortization, bad debt and other similar non-cash reserves, computed by taking the average of such values at the end of each month during the period of calculation.
For the three and nine months ended September 30, 2017, we incurred $700,000 and $1,505,000, respectively, in asset management fees to our advisor. We did not incur any asset management fees to our advisor or its affiliates for the three and nine months ended September 30, 2016 as a result of our advisor waiving $29,000 and $31,000, respectively, in asset management fees. Our advisor agreed to waive certain asset management fees that may otherwise have been due to our advisor pursuant to the Advisory Agreement until such time as the amount of such waived asset management fees was equal to the amount of distributions payable to our stockholders for the period beginning on May 1, 2016 and ending on the date of the acquisition of our first property or real estate-related investment, as such terms are defined in the Advisory Agreement. We purchased our first property in June 2016. As such, the asset management fees of $31,000 that would have been incurred through September 2016 were waived by our advisor and an additional $49,000 in asset management fees was waived during the remainder for 2016. Our advisor did not receive any additional securities, shares of our stock, or any other form of consideration or any repayment as a result of the waiver of such asset management fees. Asset management fees aregenerally included in general and administrative in our accompanying condensed consolidated statements of operations.operations and comprehensive loss.
Property Management Fee
American Healthcare Investors or its designated personnel may provide property management services with respect to our properties or may sub-contract these duties to any third party and provide oversight of such third-party property manager. We pay American Healthcare Investors a monthly management fee equal to a percentage of the gross monthly cash receipts of such property as follows: (i) a property management oversight fee of 1.0% of the gross monthly cash receipts of any stand-alone, single-tenant, net leased property, except for such properties operated utilizing a RIDEA structure, for which we pay a property management oversight fee of 1.5% of the gross monthly cash receipts with respect to such property; (ii) a property management oversight fee of 1.5% of the gross monthly cash receipts of any property that is not a stand-alone, single-tenant, net leased property and for which American Healthcare Investors or its designated personnel provide oversight of a third party that performs the duties of a property manager with respect to such property; or (iii) a fair and reasonable property management fee that is approved by a majority of our directors, including a majority of our independent directors, that is not less favorable to us than terms available from unaffiliated third parties for any property that is not a stand-alone, single-tenant, net leased property and for which American Healthcare Investors or its designated personnel directly serve as the property manager without sub-contracting such duties to a third party.
Property management fees are included in rental expenses in our accompanying condensed consolidated statements of operations. For the three months ended September 30, 2017 and 2016, we incurred property management fees of $103,000 and $5,000, respectively, to American Healthcare Investors. For the nine months ended September 30, 2017 and 2016, we incurred property management fees of $249,000 and $5,000, respectively, to American Healthcare Investors.

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Lease Fees
We may pay our advisor or its affiliates a separate fee for any leasing activities in an amount not to exceed the fee customarily charged in arm’s-length transactions by others rendering similar services in the same geographic area for similar properties as determined by a survey of brokers and agents in such area. Such fee is generally expected to range from 3.0% to 6.0% of the gross revenues generated during the initial term of the lease.
Lease fees are capitalized as lease commissions, which are included in other assets, net in our accompanying condensed consolidated balance sheets, and amortized over the term of the lease. For the three and nine months ended September 30, 2017, we incurred lease fees of $12,000. For the three and nine months ended September 30, 2016, we did not incur any lease fees to our advisor or its affiliates.
Construction Management Fee
In the event that our advisor or its affiliates assist with planning and coordinating the construction of any capital or tenant improvements, we pay our advisor or its affiliates a construction management fee of up to 5.0% of the cost of such improvements. (7)Construction management fees arewere capitalized as part of the associated asset and included in real estate investments, net in our accompanying condensed consolidated balance sheets or are expensedsheets.
Accounts Payable Due to Affiliates
We did not have any amounts outstanding to our affiliates as of March 31, 2022. The following amounts were outstanding to our affiliates as of December 31, 2021:
FeeDecember 31, 2021
Lease commissions$245,000 
Development fees229,000 
Construction management fees152,000 
Operating expenses100,000 
Asset and property management fees83,000 
Acquisition fees57,000 
$866,000 
16. Fair Value Measurements
Assets and Liabilities Reported at Fair Value
The table below presents our assets and liabilities measured at fair value on a recurring basis as of March 31, 2022, aggregated by the level in the fair value hierarchy within which those measurements fall:
Quoted Prices in
Active Markets for
Identical Assets
and Liabilities
(Level 1)
Significant Other
Observable Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
Total
Liabilities:
Warrants$— $— $733,000 $733,000 
Total liabilities at fair value$— $— $733,000 $733,000 
The table below presents our assets and liabilities measured at fair value on a recurring basis as of December 31, 2021, aggregated by the level in the fair value hierarchy within which those measurements fall.
Quoted Prices in
Active Markets for
Identical Assets
and Liabilities
(Level 1)
Significant Other
Observable Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
Total
Liabilities:
Derivative financial instruments$— $500,000 $— $500,000 
Warrants— — 786,000 786,000 
Total liabilities at fair value$— $500,000 $786,000 $1,286,000 
There were no transfers into and out of fair value measurement levels during the three months ended March 31, 2022 and 2021.
Warrants
As of March 31, 2022 and December 31, 2021, we have recorded $733,000 and $786,000, respectively, related to warrants in Trilogy common units held by certain members of Trilogy’s management, which is included in security deposits, prepaid rent and other liabilities in our accompanying condensed consolidated statements of operations, as applicable. For the three and nine months ended September 30, 2017 and 2016, we did not incur any construction management fees to our advisor or its affiliates.
Operating Expenses
We reimburse our advisor or its affiliates for operating expenses incurred in rendering services to us, subject to certain limitations. However, we will not reimburse our advisor or its affiliates at the end of any fiscal quarter for total operating expenses that, in the four consecutive fiscal quarters then ended, exceed the greater of: (i) 2.0% of our average invested assets, as defined in the Advisory Agreement; or (ii) 25.0% of our net income, as defined in the Advisory Agreement, unless our independent directors determined that such excess expenses were justified based on unusual and nonrecurring factors which they deem sufficient.
Our operating expenses as a percentage of average invested assets and as a percentage of net income were 1.4% and 40.9%, respectively, for the 12 months ended September 30, 2017; however, we did not exceed the aforementioned limitation as 2.0% of our average invested assets was greater than 25.0% of our net income.
For the three months ended September 30, 2017 and 2016, our advisor incurred operating expenses on our behalf of $21,000, and for the nine months ended September 30, 2017 and 2016, our advisor incurred operating expenses on our behalf of $62,000 and $350,000, respectively. Operating expenses are generally included in general and administrative in our accompanying condensed consolidated statements of operations.
Compensation for Additional Services
We pay our advisor and its affiliates for services performed for us other than those required to be rendered by our advisor or its affiliates under the Advisory Agreement. The rate of compensation forbalance sheets. Once exercised, these services has to be approved by a majority of our board of directors, including a majority of our independent directors, and cannot exceed an amount that would be paid to unaffiliated third parties forwarrants have redemption features similar services. For the three and nine months ended September 30, 2017 and 2016, our advisor and its affiliates were not compensated for any additional services.
Liquidity Stage
Disposition Fees
For services relating to the salecommon units held by members of one or more properties, we pay our advisor or its affiliates a disposition fee up to the lesser of 2.0% of the contract sales price or 50.0% of a customary competitive real estate commission given the circumstances surrounding the sale, in each case as determined by our board of directors, including a majority of our independent directors, upon the provision of a substantial amount of the services in the sales effort. The amount of disposition fees paid, when added to the real estate commissions paid to unaffiliated third parties, will not exceed the lesser of the customary competitive real estate commission or an amount equal to 6.0% of the contract sales price. For the three and nine months ended September 30, 2017 and 2016, we did not incur any disposition fees to our advisor or its affiliates.Trilogy’s management.See Note 13, Redeemable

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Noncontrolling Interests, for a further discussion. As of March 31, 2022 and December 31, 2021, the carrying value is a reasonable estimate of fair value.
Subordinated Participation InterestDerivative Financial Instruments
Subordinated DistributionWe used interest rate swaps and interest rate caps to manage interest rate risk associated with variable-rate debt. The valuation of Net Sales Proceeds
Inthese instruments was determined using widely accepted valuation techniques including a discounted cash flow analysis on the eventexpected cash flows of liquidation, we will pay our advisor a subordinated distribution of net sales proceeds. The distribution will be equal to 15.0%each derivative. This analysis reflected the contractual terms of the remaining net proceedsderivatives, including the period to maturity, and used observable market-based inputs, including interest rate curves, as well as option volatility. The fair values of 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 sales of properties, after distributions to our stockholders,respective counterparty’s nonperformance risk in the aggregate, of: (i) a full return of capital raised from stockholders (less amounts paid to repurchase sharesfair value measurements. In adjusting the fair value of our common stock pursuantderivative 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 share repurchase plan); plus (ii) an annual 6.0% cumulative, non-compounded returnderivative financial instruments fell within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with these instruments 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, 2021, we assessed the significance of the impact of the credit valuation adjustments on the gross proceeds from the sale of sharesoverall valuation of our common stock, as adjusted for distributionsderivative positions and determined that the credit valuation adjustments were not significant to the overall valuation of net sales proceeds. Actual amounts to be received depend onour derivatives. As a result, we determined that our derivative valuations in their entirety were classified in Level 2 of the sale pricesfair value hierarchy. As of properties upon liquidation. For the three and nine months ended September 30, 2017 and 2016,March 31, 2022, we did not payhave any such distributions to our advisor.
Subordinated Distribution Upon Listing
Upon the listing of shares of our common stock on a national securities exchange, in redemption of our advisor’s limited partnership units, we will pay our advisor a distribution equal to 15.0% of the amount by which: (i) the market value of our outstanding common stock at listing plus distributions paid prior to listing exceeds (ii) the sum of the total amount of capital raised from stockholders (less amounts paid to repurchase shares of our common stock pursuant to our share repurchase plan) and the amount of cash that, if distributed to stockholders as of the date of listing, would have provided them an annual 6.0% cumulative, non-compounded return on the gross proceeds from the sale of shares of our common stock through the date of listing. Actual amounts to be received depend upon the market value of our outstanding stock at the time of listing, among other factors. For the three and nine months ended September 30, 2017 and 2016, we did not pay any such distributions to our advisor.
Subordinated Distribution Upon Termination
Pursuant to the Agreement of Limited Partnership, as amended, of our operating partnership upon termination or non-renewal of the Advisory Agreement, our advisor will also be entitled to a subordinated distribution in redemption of its limited partnership units from our operating partnership equal to 15.0% of the amount, if any, by which: (i) the appraised value of our assets on the termination date, less any indebtedness secured by such assets, plus total distributions paid through the termination date, exceeds (ii) the sum of the total amount of capital raised from stockholders (less amounts paid to repurchase shares of our common stock pursuant to our share repurchase plan) and the total amount of cash equal to an annual 6.0% cumulative, non-compounded return on the gross proceeds from the sale of shares of our common stock through the termination date. In addition, our advisor may elect to defer its right to receive a subordinated distribution upon termination until either a listing or other liquidity event, including a liquidation, sale of substantially all of our assets or merger in which our stockholders receive in exchange for their shares of our common stock, shares of a company that are traded on a national securities exchange.
As of September 30, 2017 and December 31, 2016, we had not recorded any charges to earnings related to the subordinated distribution upon termination.
Stock Purchase Plans
On February 29, 2016, our Chief Executive Officer and Chairman of the Board of Directors, Jeffrey T. Hanson, our President and Chief Operating Officer, Danny Prosky, and our Executive Vice President and General Counsel, Mathieu B. Streiff, each executed stock purchase plans, or the 2016 Stock Purchase Plans, whereby they each irrevocably agreed to invest 100% of their net after-tax base salary and cash bonus compensation earned as employees of American Healthcare Investors directly into our company by purchasing shares of our Class T common stock. In addition, on February 29, 2016, three Executive Vice Presidents of American Healthcare Investors during 2016, including our Executive Vice President of Acquisitions, Stefan K.L. Oh, each executed similar 2016 Stock Purchase Plans whereby they each irrevocably agreed to invest a portion of their net after-tax base salary or a portion of their net after-tax base salary and cash bonus compensation, ranging from 10.0% to 15.0%, earned as employees of American Healthcare Investors directly into our company by purchasing shares of our Class T common stock. The 2016 Stock Purchase Plans terminated on December 31, 2016.
Purchases of shares of our Class T common stock pursuant to the 2016 Stock Purchase Plans commenced after the initial release from escrow of the minimum offering amount, beginning with the officers’ regularly scheduled payroll payment on April 13, 2016. The shares of Class T common stock were purchased at a price of $9.60 per share, reflecting the purchase price of the Class T shares in our offering, exclusive of selling commissions and the portion of the dealer manager fee funded by us.

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On December 30, 2016, Messrs. Hanson, Prosky and Streiff each executed stock purchase plans for the purchase of shares of our Class I common stock, or the 2017 Stock Purchase Plans, on terms similar to their 2016 Stock Purchase Plans. In addition, on December 30, 2016, Mr. Oh, as well as Wendie Newman and Christopher M. Belford, both of whom were appointed as our Vice Presidents of Asset Management as of June 2017, each executed similar 2017 Stock Purchase Plans whereby they each irrevocably agreed to invest a portion of their net after-tax base salary or a portion of their net after-tax base salary and cash bonus compensation, ranging from 5.0% to 15.0%, earned as employees of American Healthcare Investors directly into our company by purchasing shares of our Class I common stock. The 2017 Stock Purchase Plans terminate on December 31, 2017 or earlier upon the occurrence of certain events, such as any earlier termination of our public offering of securities, unless otherwise renewed or extended.
Purchases of shares of our Class I common stock pursuant to the 2017 Stock Purchase Plans commenced beginning with the officers’ regularly scheduled payroll payment on January 23, 2017. The shares of Class I common stock are purchased pursuant to the 2017 Stock Purchase Plans at a price of $9.21 per share, reflecting the purchase price of the Class I shares in our offering. No selling commissions, dealer manager fees (including the portion of such dealer manager fees funded by our advisor) or stockholder servicing fees will be paid with respect to such sales of our Class I common stock.
For the three and nine months ended September 30, 2017 and 2016, our officers invested the following amounts and we issued the following shares of our Class T and Class I common stock pursuant to the applicable stock purchase plan:
    Three Months Ended September 30, Nine Months Ended September 30,
    2017 2016 2017 2016
Officer’s Name Title Amount Shares Amount Shares Amount Shares Amount Shares
Jeffrey T. Hanson Chief Executive Officer and Chairman of the Board of Directors $70,000
 7,553
 $64,000
 6,653
 $193,000
 20,910
 $115,000
 11,936
Danny Prosky President and Chief Operating Officer 72,000
 7,825
 72,000
 7,463
 199,000
 21,571
 133,000
 13,810
Mathieu B. Streiff Executive Vice President and General Counsel 67,000
 7,293
 69,000
 7,194
 194,000
 21,065
 127,000
 13,259
Stefan K.L. Oh Executive Vice President of Acquisitions 8,000
 857
 8,000
 875
 24,000
 2,558
 15,000
 1,605
Christopher M. Belford Vice President of Asset Management 6,000
 653
 6,000
 642
 59,000
 6,361
 11,000
 1,194
Wendie Newman Vice President of Asset Management 2,000
 221
 
 
 6,000
 607
 
 
    $225,000
 24,402
 $219,000
 22,827
 $675,000
 73,072
 $401,000
 41,804
Accounts Payable Due to Affiliates
The following amounts were outstanding to our affiliates as of September 30, 2017 and December 31, 2016:
Fee 
September 30,
2017
 
December 31,
2016
Contingent Advisor Payment $7,759,000
 $5,404,000
Asset management fees 237,000
 83,000
Property management fees 37,000
 24,000
Operating expenses 22,000
 20,000
Lease commissions 10,000
 
  $8,065,000
 $5,531,000
13. Fair Value Measurementsderivative financial instruments.
Financial Instruments Disclosed at Fair Value
ASC Topic 825, Financial Instruments, requires disclosure of the fair value of financial instruments, whether or not recognized on the face of the balance sheet. Fair value is defined under ASC Topic 820, Fair Value Measurements and Disclosures.

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Our accompanying condensed consolidated balance sheets include the following financial instruments: debt security investment, cash and cash equivalents, restricted cash, accounts and other receivables, restricted cash, real estate deposits, accounts payable and accrued liabilities, accounts payable due to affiliates, mortgage loans payable and borrowings under the Lineour lines of Credit.credit and term loans.
We consider the carrying values of cash and cash equivalents, restricted cash, accounts and other receivables restricted cash, real estate deposits and accounts payable and accrued liabilities to approximate the fair valuesvalue for these financial instruments based upon an evaluation of the underlying characteristics, market data and because of the short period of time between origination of the instruments and their expected realization. The fair value of cash and cash equivalents is classified in Level 1 of the fair value hierarchy. The fair value of accounts payable due to affiliates is not determinable due to the related party nature of the accounts payable. The fair valuevalues of the other financial instruments isare classified in Level 2 of the fair value hierarchy.
The fair value of our mortgage loans payable and the Line of Creditdebt 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 loans are estimated using discounted cash flow analyses using borrowing rates available to us for debt instruments with similar terms and maturities. As of September 30, 2017 and December 31, 2016, the fair value of our mortgage loans payable was $11,950,000 and $4,131,000, respectively, compared to the carrying value of $11,639,000 and $3,965,000, respectively. As of September 30, 2017 and December 31, 2016, the fair value of the Line of Credit was $25,998,000 and $33,899,000, respectively, compared to the carrying value of $25,290,000 and $32,957,000, respectively. We have determined that the valuations of our debt security investment, mortgage loans payable and the Linelines of Creditcredit and term loans are classified in Level 2 within the fair value hierarchy. The carrying amounts and estimated fair values of such financial instruments as of March 31, 2022 and December 31, 2021 were as follows:
March 31,
2022
December 31,
2021
 Carrying
Amount(1)
Fair
Value
Carrying
Amount(1)
Fair
Value
Financial Assets:
Debt security investment$80,239,000 $93,859,000 $79,315,000 $93,920,000 
Financial Liabilities:
Mortgage loans payable$1,103,006,000 $1,039,112,000 $1,095,594,000 $1,075,729,000 
Lines of credit and term loans$1,232,017,000 $1,243,616,000 $1,222,853,000 $1,226,636,000 
14. Business Combinations___________
For the nine months ended September 30, 2017, none(1)Carrying amount is net of our property acquisitions were accounted for as business combinations. See Note 3, Real Estate Investments, Net, for a discussion of our 2017 property acquisitions accounted for as asset acquisitions. For the nine months ended September 30, 2016, using net proceeds from our offeringany discount/premium and debt financing, we completed five property acquisitions comprising five buildings, which were accounted for as business combinations. The aggregate contract purchase price for these property acquisitions was $59,670,000, plus closing costs and base acquisition fees of $2,005,000, which are included in acquisition related expenses in our accompanying condensed consolidated statements of operations. In addition, we incurred Contingent Advisor Payments of $1,342,000 to our advisor for these property acquisitions. See See Note 12, Related Party Transactions, for a further discussion of the Contingent Advisor Payment.unamortized costs.
Results of operations for these property acquisitions during the nine months ended September 30, 2016 are reflected in our accompanying condensed consolidated statements of operations for the period from the date of acquisition of each property through September 30, 2016. For the period from the acquisition date through September 30, 2016, we recognized the following amounts of revenue and net income for the property acquisitions:
28
Acquisition Revenue Net Income
Auburn MOB $239,000
 $74,000
Pottsville MOB $42,000
 $33,000
Charlottesville MOB $47,000
 $37,000
Rochester Hills MOB $6,000
 $4,000
Cullman MOB III $4,000
 $4,000

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17. Income Taxes
TheAs a REIT, we generally will not be subject to federal income tax on taxable income that we distribute to our stockholders. We have elected to treat certain of our consolidated subsidiaries as taxable REIT subsidiaries, or 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.
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 United Kingdom, or 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 net operating loss that may be realized in future periods depending on sufficient taxable income.
We recognize the financial statement effects of an uncertain tax position 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 March 31, 2022 and December 31, 2021, we did not have any tax benefits or liabilities for uncertain tax positions that we believe should be recognized in our accompanying condensed 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 March 31, 2022 and December 31, 2021, 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.
18. Leases
Lessor
We have operating leases with tenants that expire at various dates through 2050. For the three months ended March 31, 2022 and 2021, we recognized $50,731,000 and $28,667,000, respectively, of revenues related to operating lease payments, of which $10,413,000 and $4,350,000, respectively, was for variable lease payments. As of March 31, 2022, the following table summarizessets forth the acquisition date fair valuesundiscounted cash flows for future minimum base rents due under operating leases for the nine months ending December 31, 2022 and for each of the next four years ending December 31 and thereafter for properties that we wholly own:
YearAmount
2022$111,923,000 
2023143,369,000 
2024132,178,000 
2025119,475,000 
2026109,477,000 
Thereafter612,203,000 
Total$1,228,625,000 
Lessee
We lease certain land, buildings, furniture, fixtures, campus equipment, 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
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AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
leased property. As of March 31, 2022, we had future lease payments of $27,229,000 for an operating lease that had not yet commenced. Such operating lease will commence in fiscal year 2022 with a lease term of 15 years.
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 fivelease 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 acquisitions in 2016:
taxes and insurance). Our lease agreements do not contain any material residual value guarantees or material restrictive covenants.
 Auburn MOB Pottsville MOB Charlottesville MOB Rochester Hills MOB Cullman MOB III
Building and improvements$4,600,000
 $7,050,000
 $13,330,000
 $5,640,000
 $13,989,000
Land406,000
 1,493,000
 4,768,000
 1,702,000
 
In-place leases386,000
 740,000
 2,030,000
 1,073,000
 1,249,000
Leasehold interests
 
 
 
 1,412,000
Total assets acquired5,392,000
 9,283,000
 20,128,000
 8,415,000
 16,650,000
Mortgage loan payable
 
 
 3,968,000
 
Below-market leases
 133,000
 
 115,000
 
Total liabilities assumed
 133,000
 
 4,083,000
 
Net assets acquired$5,392,000
 $9,150,000
 $20,128,000
 $4,332,000
 $16,650,000
Assuming the property acquisitions in 2016 discussed above had occurred on January 23, 2015 (DateThe components of Inception), for the three and nine months ended September 30, 2016, unaudited pro forma revenue, net income, net income attributable to controlling interest and net income per Class T and Class I common share attributable to controlling interest — basic and diluted would have beenlease costs were as follows:
Three Months Ended March 31,
Lease CostClassification20222021
Operating lease cost(1)Property operating expenses, rental expenses or general and administrative expenses$6,356,000 $6,337,000 
Finance lease cost
Amortization of leased assetsDepreciation and amortization312,000 412,000 
Interest on lease liabilitiesInterest expense74,000 118,000 
Sublease incomeResident fees and services revenue or other income(147,000)— 
Total lease cost$6,595,000 $6,867,000 
 
Three Months Ended
 September 30, 2016
 
Nine Months Ended
 September 30, 2016
  
Revenue$1,632,000
 $4,849,000
Net income$45,000
 $536,000
Net income attributable to controlling interest$45,000
 $536,000
Net income per Class T and Class I common share attributable to controlling interest — basic and diluted$
 $0.07
___________
The unaudited pro forma adjustments assume that the offering proceeds, at a price of $10.00 per share, net of offering(1)Includes short-term leases and variable lease costs, were raised as of January 23, 2015 (Date of Inception). In addition, acquisitionwhich are immaterial.
Additional information related expenses associated withto our five property acquisitions have been excluded from the pro forma results in 2016. The pro forma results are not necessarily indicative of the operating results that would have been obtained had the acquisitions occurred at the beginning ofleases for the periods presented nor are they necessarily indicativebelow was as follows:
Lease Term and Discount Rate
March 31,
2022
December 31,
2021
Weighted average remaining lease term (in years)
Operating leases16.916.9
Finance leases4.43.6
Weighted average discount rate
Operating leases5.53 %5.52 %
Finance leases7.57 %7.68 %
Three Months Ended March 31,
Supplemental Disclosure of Cash Flows Information20222021
Operating cash outflows related to finance leases$74,000 $118,000 
Financing cash outflows related to finance leases$13,000 $60,000 
Leased assets obtained in exchange for finance lease liabilities$56,000 $138,000 
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15. Segment ReportingAMERICAN HEALTHCARE REIT, INC.
ASC Topic 280, Segment Reporting, establishes standards for reporting financial and descriptive information about a public entity’s reportable segments. We segregate our operations into reporting segments in order to assessNOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
Operating Leases
As of March 31, 2022, the performancefollowing table sets forth the undiscounted cash flows of our business inscheduled obligations for future minimum payments for the same way that management reviewsnine months ending December 31, 2022 and for each of the next four years ending December 31 and thereafter, as well as the reconciliation of those cash flows to operating lease liabilities on our performance and makes operating decisions. Accordingly, when we acquired our first medical office building in June 2016 and senior housing facility in December 2016, we established a new reportable segment at each such time. accompanying condensed consolidated balance sheet:
YearAmount
2022$14,522,000 
202319,275,000 
202418,245,000 
202517,190,000 
202616,851,000 
Thereafter163,815,000 
Total undiscounted operating lease payments249,898,000 
Less: interest107,283,000 
Present value of operating lease liabilities$142,615,000 
Finance Leases
As of September 30, 2017,March 31, 2022, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for the nine months ending December 31, 2022 and for each of the next four years ending December 31 and thereafter, as well as a reconciliation of those cash flows to finance lease liabilities:
YearAmount
2022$51,000 
202361,000 
202475,000 
202531,000 
2026— 
Thereafter— 
Total undiscounted finance lease payments218,000 
Less: interest27,000 
Present value of finance lease liabilities$191,000 
19. Segment Reporting
As of March 31, 2022, we evaluated our business and made resource allocations based on two6 reportable business segments —segments: medical office buildings, integrated senior health campuses, skilled nursing facilities, SHOP, senior housing and senior housing.hospitals. Our medical office buildings are typically leased to multiple tenants under separate leases, in each building, thus requiring active management and responsibility for many of the associated operating expenses (although many(much of thesewhich are, or can effectively be, passed through to the tenants). Our integrated senior health campuses include a range of assisted living, memory care, independent living, skilled nursing services and certain ancillary businesses that are owned and operated utilizing a RIDEA structure. Our skilled nursing and senior housing facilities are primarily single-tenant properties for which we lease the facilities to unaffiliated tenants under “triple-net”triple-net and generally “master”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 senior housing segment includes our debt security investment. Our SHOP include senior housing facilities that are owned and operated utilizing a RIDEA structure. Our hospital investments are similarly structured to our skilled nursing and senior housing facilities.
We evaluate performance based upon segment net operating income. We define segment net operating income as total revenues, less rental expenses, which excludes depreciation and amortization, general and administrative expenses, acquisition related expenses, interest expense and interest income for each segment. WeWhile we believe that net income (loss), as defined by GAAP, is the most appropriate earnings measurement. However,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, income or loss from unconsolidated entities, foreign currency
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NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
gain or loss, other income and income tax benefit or expense for each segment. We believe that segment net operating incomeNOI 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.

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NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)

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, real estate depositsdeferred financing costs and other assets not attributable to individual properties.
Summary information forOn October 1, 2021, as part of the reportableMerger, we acquired 87 properties, comprising 92 buildings, or approximately 4,799,000 square feet of GLA, which expanded our portfolio of real estate properties and SHOP within the segments during the three and nine months ended September 30, 2017 and 2016 was as follows:


Medical Office Buildings
Senior Housing
Three Months Ended
September 30, 2017
Revenue:





Real estate revenue
$6,330,000

$2,158,000

$8,488,000
Expenses:





Rental expenses
1,857,000

238,000

2,095,000
Segment net operating income
$4,473,000

$1,920,000

$6,393,000
Expenses:





General and administrative




$1,296,000
Acquisition related expenses




121,000
Depreciation and amortization




3,442,000
Other income (expense):





Interest expense (including amortization of deferred financing costs and debt premium)




(780,000)
Net income




$754,000
outlined above.


Medical Office Buildings
Senior Housing
Three Months Ended
September 30, 2016
Revenue:





Real estate revenue
$312,000

$

$312,000
Expenses:





Rental expenses
98,000



98,000
Segment net operating income
$214,000

$

$214,000
Expenses:      
General and administrative




$329,000
Acquisition related expenses




1,857,000
Depreciation and amortization     64,000
Other income (expense):      
Interest expense (including amortization of deferred financing costs)     (56,000)
Net loss




$(2,092,000)

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GRIFFIN-AMERICANAMERICAN HEALTHCARE REIT, IV, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)

Summary information for the reportable segments during the three months ended March 31, 2022 and 2021 was as follows:
Integrated
Senior Health
Campuses
SHOPMedical
Office
Buildings
Senior
Housing
Skilled
Nursing
Facilities
Hospitals
Three Months
Ended
March 31, 2022
Revenues and grant income:
Resident fees and services$281,012,000 $37,962,000 $— $— $— $— $318,974,000 
Real estate revenue— — 37,837,000 5,298,000 6,393,000 2,415,000 51,943,000 
Grant income5,096,000 118,000 — — — — 5,214,000 
Total revenues and grant income286,108,000 38,080,000 37,837,000 5,298,000 6,393,000 2,415,000 376,131,000 
Expenses:
Property operating expenses253,150,000 34,010,000 — — — — 287,160,000 
Rental expenses— — 14,313,000 179,000 686,000 109,000 15,287,000 
Segment net operating income$32,958,000 $4,070,000 $23,524,000 $5,119,000 $5,707,000 $2,306,000 $73,684,000 
Expenses:
General and administrative$11,119,000 
Business acquisition expenses173,000 
Depreciation and amortization42,311,000 
Other income (expense):
Interest expense:
Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments)(23,325,000)
Gain in fair value of derivative financial instruments500,000 
Gain on dispositions of real estate investments756,000 
Income from unconsolidated entities1,386,000 
Foreign currency loss(1,387,000)
Other income1,260,000 
Total net other expense(20,810,000)
Loss before income taxes(729,000)
Income tax expense(168,000)
Net loss$(897,000)
  Medical Office Buildings Senior Housing 
Nine Months Ended
September 30, 2017
Revenue:      
Real estate revenue $15,456,000
 $3,282,000
 $18,738,000
Expenses:      
Rental expenses 4,543,000
 350,000
 4,893,000
Segment net operating income $10,913,000
 $2,932,000
 $13,845,000
Expenses:      
General and administrative     $2,996,000
Acquisition related expenses     334,000
Depreciation and amortization     7,619,000
Other income (expense):      
Interest expense (including amortization of deferred financing costs and debt premium)     (1,607,000)
Interest income     1,000
Net income     $1,290,000
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  Medical Office Buildings Senior Housing 
Nine Months Ended
September 30, 2016
Revenue:      
Real estate revenue $338,000
 $
 $338,000
Expenses:      
Rental expenses 121,000
 
 121,000
Segment net operating income $217,000
 $
 $217,000
Expenses:      
General and administrative     $725,000
Acquisition related expenses     2,227,000
Depreciation and amortization     64,000
Other income (expense):      
Interest expense (including amortization of deferred financing costs)     (56,000)
Net loss     $(2,855,000)

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
Assets
Integrated
Senior Health
Campuses
SHOPMedical
Office
Buildings
Senior
Housing
Skilled
Nursing
Facilities
Hospitals
Three Months
Ended
March 31, 2021
Revenues and grant income:
Resident fees and services$233,226,000 $19,800,000 $— $— $— $— $253,026,000 
Real estate revenue— — 20,023,000 3,570,000 3,667,000 2,763,000 30,023,000 
Grant income8,229,000 — — — — — 8,229,000 
Total revenues and grant income241,455,000 19,800,000 20,023,000 3,570,000 3,667,000 2,763,000 291,278,000 
Expenses:
Property operating expenses228,639,000 16,503,000 — — — — 245,142,000 
Rental expenses— — 7,537,000 15,000 369,000 134,000 8,055,000 
Segment net operating income$12,816,000 $3,297,000 $12,486,000 $3,555,000 $3,298,000 $2,629,000 $38,081,000 
Expenses:
General and administrative$7,257,000 
Business acquisition expenses1,248,000 
Depreciation and amortization25,723,000 
Other income (expense):
Interest expense:
Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishment)(20,365,000)
Gain in fair value of derivative financial instruments1,821,000 
Loss on disposition of real estate investment(335,000)
Loss from unconsolidated entities(1,771,000)
Foreign currency gain415,000 
Other income272,000 
Total net other expense(19,963,000)
Loss before income taxes(16,110,000)
Income tax expense(163,000)
Net loss$(16,273,000)
Total assets by reportable segment as of September 30, 2017March 31, 2022 and December 31, 20162021 were as follows:
March 31,
2022
December 31,
2021
Integrated senior health campuses$1,898,886,000 $1,896,608,000 
Medical office buildings1,396,556,000 1,412,247,000 
SHOP621,835,000 625,164,000 
Senior housing253,850,000 255,555,000 
Skilled nursing facilities251,058,000 252,869,000 
Hospitals108,602,000 109,834,000 
Other25,398,000 28,062,000 
Total assets$4,556,185,000 $4,580,339,000 
In connection with the AHI Acquisition, we recorded goodwill of $134,589,000, which was allocated across our reporting segments. As discussed in Note 4, Business Combination, in connection with the acquisition of Springhurst, we recorded goodwill of $1,827,000, which was allocated to our integrated senior health campuses segment. As of March 31, 2022, goodwill of $47,812,000, $8,640,000, $4,389,000, $23,277,000, $5,924,000 and $121,684,000 was allocated to our medical office buildings, skilled nursing facilities, hospitals, SHOP, senior housing facilities and integrated senior health campuses,
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NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
 
September 30,
2017
 
December 31,
2016
Medical office buildings$263,970,000
 $123,223,000
Senior housing98,836,000
 16,758,000
Other8,706,000
 2,777,000
Total assets$371,512,000
 $142,758,000
respectively. As of December 31, 2021, goodwill of $47,812,000, $8,640,000, $4,389,000, $23,277,000, $5,924,000 and $119,856,000 was allocated to our medical office buildings, skilled nursing facilities, hospitals, SHOP, senior housing facilities and integrated senior health campuses, respectively.
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:
16.
Three Months Ended March 31,
 20222021
Revenues and grant income:
United States$374,879,000 $289,986,000 
International1,252,000 1,292,000 
$376,131,000 $291,278,000 
The following is a summary of real estate investments, net by geographic regions as of March 31, 2022 and December 31, 2021:
 
March 31,
2022
December 31,
2021
Real estate investments, net:
United States$3,428,705,000 $3,466,019,000 
International46,930,000 48,667,000 
$3,475,635,000 $3,514,686,000 
20. 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, restricted cash and real estate deposits.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 September 30, 2017March 31, 2022 and December 31, 2016,2021, we had cash and cash equivalents in excess of FDIC insured limits. We believe

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NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)

this risk is not significant. Concentration of credit risk with respect to accounts receivable from tenants is limited. In general, weWe perform credit evaluations of prospective tenants and security deposits are obtained at the time of property acquisition and upon lease execution.
Based on leases in effect as of September 30, 2017, three statesMarch 31, 2022, properties in 1 state in the United States accounted for 10.0% or more of our total property portfolio’s annualized base rent or annualized NOI. Properties located in Indiana accounted for 31.4% of our total property portfolio. Our properties located in Nevada, Alabama and California accounted for approximately 17.2%, 15.3% and 12.6%, respectively, of theportfolio’s annualized base rent of our total property portfolio.or annualized NOI. Accordingly, there is a geographic concentration of risk subject to fluctuations in eachsuch state’s economy.
Based on leases in effect as of March 31, 2022, our 6 reportable business segments, medical office buildings, integrated senior health campuses, skilled nursing facilities, SHOP, senior housing and hospitals accounted for 39.3%, 39.1%, 8.4%, 5.7%, 4.3% and 3.2%, respectively, of our total property portfolio’s annualized base rent or annualized NOI. As of September 30, 2017, we had twoMarch 31, 2022, none of our tenants thatat our properties accounted for 10.0% or more of our total 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 operations as follows:of March 31, 2022.
Tenant Annualized
Base Rent(1)
 
Percentage of
Annualized Base Rent
 Acquisition Reportable Segment GLA
(Sq Ft)
 Lease Expiration
Date
Colonial Oaks Master Tenant, LLC $4,108,000
 15.1% Lafayette Assisted Living Portfolio and Northern California Senior Housing Portfolio Senior Housing 215,000
 06/30/32
Prime Healthcare Services – Reno $3,817,000
 14.0% Reno MOB Medical Office 146,000
 Multiple
35
___________
(1)Annualized base rent is based on contractual base rent from the leases in effect as of September 30, 2017. The loss of these tenants or their inability to pay rent could have a material adverse effect on our business and results of operations.
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AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
21. Per Share Data
We report earnings (loss) per share pursuant to ASC Topic 260, Earnings per Share. 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 $4,000$1,490,000 and $2,000$0, respectively, for the three months ended September 30, 2017March 31, 2022 and 2016, respectively. Net income (loss) applicable to common stock is calculated as net income (loss) attributable to controlling interest less distributions allocated to participating securities of $8,000 and $3,000 for the nine months ended September 30, 2017 and 2016, respectively.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. Nonvested shares of our restricted common stock and redeemable limited partnership units of our operating partnership are participating securities and give rise to potentially dilutive shares of our common stock.
As of September 30, 2017March 31, 2022 and 2016,2021, there were 27,000891,543 and 12,00033,000 nonvested shares, respectively, of our restricted Class T common stock 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 September 30, 2017March 31, 2022 and 2016,2021, there were 208 units of redeemable14,007,903 and 222 limited partnership units, respectively, of our operating partnership outstanding, but such units were also excluded from the computation of diluted earnings per share because such units were anti-dilutive during these periods.
18. Subsequent Events
Status of Our Offering
As of November 3, 2017, we had received and accepted subscriptions in our offering for 37,774,078 aggregate shares of our Class T and Class I common stock, or $375,913,000, excluding shares of our common stock issued pursuant to the DRIP.
Amendment to the Credit Agreement with Bank of America and KeyBank
On October 31, 2017, we entered into an amendment to the Credit Agreement, or the Amendment, with Bank of America, as administrative agent, and the subsidiary guarantors and lenders named therein. The material terms of the Amendment provide for: (i) a $50,000,000 increase in the Line of Credit from an aggregate principal amount of $100,000,000 to $150,000,000; (ii) a term loan with an aggregate maximum principal amount of $50,000,000, or the Term Loan Credit Facility, that matures on August 25, 2019, and may be extended for one 12-month period during the term of the Credit Agreement subject to satisfaction of certain conditions, including payment of an extension fee; (iii) our right, upon at least five business days’ prior written notice to Bank of America, to increase the Line of Credit or Term Loan Credit Facility, provided that the aggregate principal amount of all such increases and additions shall not exceed $300,000,000; (iv) a revision to the definition of Threshold Amount, as defined in the Credit Agreement, to reflect an increase in such amount for any Recourse

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Indebtedness, as defined in the Credit Agreement, to $20,000,000, and an increase in such amount for any Non-Recourse Indebtedness, as defined in the Credit Agreement, to $50,000,000; (v) the revision of certain Unencumbered Property Pool Criteria, as defined and set forth in the Credit Agreement; and (vii) an increase in the maximum Consolidated Secured Leverage Ratio, as defined in the Credit Agreement, to be equal to or less than 40.0%. The aggregate borrowing capacity under the credit facilities was $200,000,000 as of October 31, 2017.
Property Acquisition
Subsequent to September 30, 2017, we completed one property acquisition comprising ten buildings from unaffiliated third parties and established a new reportable segment, senior housing — RIDEA, at such time. The following is a summary of our property acquisition subsequent to September 30, 2017:
Acquisition(1) Location Type Date Acquired Contract Purchase Price Line of Credit(2) Total Acquisition Fee(3)
Central Florida Senior Housing Portfolio Bradenton, Brooksville, Lake Placid, Lakeland, Pinellas Park, Sanford, Spring Hill and Winter Haven, FL Senior Housing — RIDEA 11/01/17 $109,500,000
 $112,000,000
 $4,882,000
___________
(1)On November 1, 2017, we completed the acquisition of Central Florida Senior Housing Portfolio, pursuant to a joint venture with an affiliate of Meridian Senior Living, LLC, an unaffiliated third party. Our effective ownership of the joint venture is approximately 98.0%.
(2)Represents borrowings under the Line of Credit, as amended, at the time of acquisition.
(3)Our advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of Central Florida Senior Housing Portfolio, a base acquisition fee upon the closing of the acquisition of 2.25% of the portion of the aggregate contract purchase price paid by us. In addition, the total acquisition fee includes a Contingent Advisor Payment in the amount of 2.25% of the portion of the aggregate contract purchase price paid by us, which shall be paid by us to our advisor, subject to the satisfaction of certain conditions. See Note 12, Related Party Transactions — Acquisition and Development Stage — Acquisition Fee, for a further discussion.


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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations.
The use of the words “we,” “us” or “our” refers to Griffin-American Healthcare REIT IV,III, Inc., or GAHR III, and its subsidiaries, including Griffin-American Healthcare REIT IVIII Holdings, LP, for periods prior to the Merger, as defined below, and American Healthcare REIT, Inc. (formerly known as Griffin-American Healthcare REIT IV, Inc., or GAHR IV) and its subsidiaries, including American Healthcare REIT Holdings, LP (formerly known as Griffin-American Healthcare REIT III Holdings, LP), for periods following the Merger, except where the context otherwise requires.noted. Certain historical information of GAHR IV is included for background purposes.
The following Management's Discussion and Analysis of Financial Condition and Results of Operations is intended to promote understanding of our results of operations and financial condition. The following discussion is provided as a supplement to, and should be read in conjunction with our accompanying condensed consolidated financial statements and notes thereto appearing elsewhere in this Quarterly Report on Form 10-Q and in our 20162021 Annual Report on Form 10-K, as filed with the United States Securities and Exchange Commission, or the SEC, on March 1, 2017.25, 2022. Such condensed consolidated financial statements and information have been prepared to reflect our financial position as of September 30, 2017March 31, 2022 and December 31, 2016,2021, together with our results of operations for the three and nine months ended September 30, 2017 and 2016 and cash flows for the ninethree months ended September 30, 2017March 31, 2022 and 2016.2021.
In connection with the Merger as discussed and defined below, GAHR IV was the legal acquiror of GAHR III, whereas GAHR III was the accounting acquiror of GAHR IV in accordance with accounting principles generally accepted in the United States of America, or GAAP, and as discussed in Note 1, Organization and Description of Business, to our accompanying condensed consolidated financial statements. Thus, the financial information set forth herein subsequent to the Merger reflects results of the Combined Company (as defined below), and the financial information set forth herein prior to the Merger reflects GAHR III’s results. For this reason, period to period comparisons may not be meaningful.
Forward-Looking Statements
Historical results and trends should not be taken as indicative of future operations. Our statements contained in this report that are not historical facts are forward-looking. Actual results may differ materially from those included in the forward-looking statements. Forward-looking statements, which are based on certain assumptions and describe future plans, strategies and expectations, are generally identifiable by use of the words “expect,” “project,” “may,” “will,” “should,” “could,” “would,” “intend,” “plan,” “anticipate,” “estimate,” “believe,” “continue,” “opinion,” “predict,” “potential”“potential,” “seek” and any other comparable and derivative terms or the negative of such terms and other comparable terminology.negatives thereof. Our ability to predict results or the actual effect of future plans orand strategies is inherently uncertain. Factors which could have a material adverse effect on our operations and future investments on a consolidated basis include, but are not limited to: changes in economic conditions generally and the real estate market specifically; the company’s ability to recover from the continuing adverse effects of the coronavirus, or COVID-19, pandemic, including its effects on the healthcare industry, senior housing and skilled nursing facilities and the economy in general; legislative and regulatory changes, including changes to laws governing the taxation of real estate investment trusts, or REITs; the availability of capital; changes in interest rates;rates and foreign currency risk; uncertainty from the discontinuance of the London Inter-bank Offered Rate, or LIBOR, and the transition to the Secured Overnight Financing Rate, or SOFR; competition in the real estate industry; the supply and demand for operating properties in our proposed market areas; changes in accounting principles generally accepted in the United States of America, or GAAP policies and guidelines applicable to REITs; the success of our best efforts initial public offering; the availability of properties to acquire;investment strategy; the availability of financing; our ability to retain our executives and our ongoing relationship with American Healthcare Investors, LLC, or American Healthcare Investors,key employees; and Griffin Capital Company, LLC, or Griffin Capital (formerly known as Griffin Capital Corporation),unexpected labor costs and their affiliates.inflationary pressures. These risks and uncertainties should be considered in evaluating forward-looking statements and undue reliance should not be placed on such statements. Forward-looking statements in this Quarterly Report on Form 10-Q speak only as of the date on which such statements are made, and undue reliance should not be placed on such statements. We undertake no obligation to update any such statements that may become untrue because of subsequent events. Additional information concerning us and our business, including additional factors that could materially affect our financial results, is included herein and in our other filings with the SEC.
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Overview and Background
Griffin-AmericanAmerican Healthcare REIT, IV, Inc., a Maryland corporation, was incorporated on January 23, 2015 and therefore we consider that our date of inception. We were initially capitalized on February 6, 2015. We invest inowns a diversified portfolio of clinical healthcare real estate properties, focusing primarily on medical office buildings, hospitals, skilled nursing facilities, senior housing, hospitals 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 (formerly known as senior housing — RIDEA), and our integrated senior health campuses. We have originated and acquired secured loans and may also originate and acquire secured loans andother real estate-related investments on an infrequent and opportunistic basis. We generally seek investments that produce current income.income; however, we have selectively developed, and may continue to selectively develop, healthcare real estate properties. We qualified to be taxed as a real estate investment trust, or REIT, under the Internal Revenue Code of 1986, as amended, or the Code for federal income tax purposes, beginning with our taxable year ended December 31, 2016, and we intend to continue to qualify to be taxed as a REIT.
Merger of Griffin-American Healthcare REIT III, Inc. and Griffin-American Healthcare REIT IV, Inc.
On February 16, 2016, we commenced our initial public offering,October 1, 2021, pursuant to an Agreement and Plan of Merger dated June 23, 2021, or the Merger Agreement, GAHR III merged with and into Continental Merger Sub, LLC, a Maryland limited liability company and newly formed wholly owned subsidiary of GAHR IV, or Merger Sub, with Merger Sub being the surviving company, or the REIT Merger. On October 1, 2021, also pursuant to the Merger Agreement, Griffin-American Healthcare REIT IV Holdings, LP, a Delaware limited partnership and subsidiary and operating partnership of GAHR IV, or GAHR IV Operating Partnership, merged with and into Griffin-American Healthcare REIT III Holdings, LP, a Delaware limited partnership, or our offering, in which we were offeringoperating partnership, with our operating partnership being the surviving entity, or the Partnership Merger. We collectively refer to the public upREIT Merger and the Partnership Merger as the Merger. Following the Merger on October 1, 2021, our company, or the Combined Company, was renamed American Healthcare REIT, Inc. and our operating partnership, also referred to $3,150,000,000 inas the surviving partnership, was renamed American Healthcare REIT Holdings, LP. The REIT Merger qualified as a reorganization under, and within the meaning of, Section 368(a) of the Code. As a result of and at the effective time of the Merger, the separate corporate existence of GAHR III and GAHR IV Operating Partnership ceased.
At the effective time of the REIT Merger, 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 our Class T common stock, consisting of up to $3,000,000,000 in shares of our Class T common stock at a price of $10.00 per share in our primary offering and up to $150,000,000 in shares of our Class T common stock for $9.50 per share pursuant to our distribution reinvestment plan, as amended, or the DRIP. Effective June 17, 2016, we reallocated certain of the unsold shares of Class T common stock being offered and began offering shares ofGAHR IV’s Class I common stock, such that we are currently offering up$0.01 par value per share. Further, at the effective time of the Partnership Merger, (i) each unit of limited partnership interest in the surviving partnership outstanding as of immediately prior to approximately $2,800,000,000 in sharesthe effective time of Class T common stock and $200,000,000 in sharesthe Partnership Merger was converted automatically into the right to receive 0.9266 of a Partnership Class I common stockUnit, as defined in our primary offering,the agreement of limited partnership, as amended, of the surviving partnership, and up(ii) each unit of limited partnership interest in GAHR IV Operating Partnership outstanding as of immediately prior to an aggregatethe effective time of $150,000,000 in sharesthe Partnership Merger was converted automatically into the right to receive one unit of our Class T and Class I common stocklimited partnership interest of the surviving partnership of like class.
AHI Acquisition
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 DRIP, aggregating up to $3,150,000,000. The sharesContribution 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, our former Chief Executive Officer and current Executive Chairman of the Board of Directors, Danny Prosky, our Class T common stockformer Chief Operating Officer and current Chief Executive Officer and President, and Mathieu B. Streiff, our former Executive Vice President, General Counsel and current Chief Operating Officer, 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 our primary offering are being offered at a price of $10.00 per share. The shares of our Class I common stock in our primary offering were being offered at a price of $9.30 per share prior to March 1, 2017, and are being offered at a price of $9.21 per share for all shares issued effective March 1, 2017. The shares of our Class T and Class I common stock issued pursuant to the DRIP were sold at a price of $9.50 per share prior to January 1, 2017, and are sold at a price of $9.40 per share for all shares issued pursuant to the DRIP effective January 1, 2017. After our board of directors determines an estimated net asset value, or NAV, per share of our common stock, share prices are expected to be adjusted to reflect the estimated NAV per share and, in the case of shares offered pursuant to our primary offering, up-front selling commissions and dealer manager fees other than those funded by(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 “Operating Partnership and Former Advisor” below for a further discussion.
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 then-current ownership interest in GAHR III Advisor and GAHR IV Advisor to the surviving partnership. In exchange for these contributions, the surviving partnership issued limited partnership units, or our advisor. We reservesurviving partnership OP units. Subject to working capital and other customary adjustments, the right to reallocatetotal approximate value of these surviving partnership OP units at the sharestime of common stock we are offering betweenconsummation of the primary offering andtransactions contemplated by the DRIP, and among classesContribution Agreement was approximately $131,674,000, with a reference value for purposes thereof of stock. As of September 30, 2017, we had received and accepted subscriptions in our offering for 35,522,410 aggregate shares of our Class T and Class I common stock, or approximately $353,510,000,

$8.71 per unit, such that the surviving partnership issued 15,117,529 surviving
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partnership OP units as consideration, or the Closing Date Consideration. Following the consummation of the Merger and the AHI Acquisition, the Combined Company became self-managed. As of March 31, 2022 and December 31, 2021, such surviving partnership OP units are 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.
excluding sharesThe AHI Acquisition was treated as a business combination for accounting purposes, with GAHR III as both the legal and accounting acquiror of our common stock issued pursuantNewCo. 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 Financial Accounting Standards Board, Accounting Standards Codification, Topic 805, Business Combinations, 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 DRIP.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.
Operating Partnership and Former Advisor
We conduct substantially all of our operations through Griffin-American Healthcare REIT IV Holdings, LP, or our operating partnership. We areThrough 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. The Advisory Agreement was effective as of February 16, 2016 and had a one-year term, subject to successive one-year renewals upon the mutual consent of the parties. The Advisory Agreement was renewed pursuant to the mutual consent of the parties on February 13, 2017 and expires on February 16, 2018. Our former advisor usesused its best efforts, subject to the oversight and review of our board of directors, or our board, to, among other things, research, identify, reviewprovide asset management, property management, acquisition, disposition and make investments in and dispositions of properties and securitiesother advisory services on our behalf consistent with our investment policies and objectives. OurFollowing the Merger and the AHI Acquisition, we became self-managed and are no longer externally advised. As a result, any fees that would have otherwise been payable to our former advisor performs its dutiesare no longer being paid. Also, on October 1, 2021 and responsibilities underin connection with the Advisory Agreement asAHI Acquisition, our fiduciary. Ouroperating partnership redeemed all 22,222 shares of our common stock owned by our former advisor isand the 20,833 shares of our Class T common stock owned by GAHR IV Advisor in GAHR IV.
Prior to the Merger and the AHI Acquisition, our former advisor was 75.0% owned and managed by American Healthcare Investorswholly owned subsidiaries of AHI, and 25.0% owned by a wholly owned subsidiary of Griffin Capital, or collectively, our former co-sponsors. American Healthcare Investors isPrior to the AHI Acquisition, AHI was 47.1% owned by AHI Group Holdings, LLC, or AHI Group Holdings, 45.1% indirectly owned by Colony NorthStar,Digital Bridge Group, Inc. (NYSE: CLNS)DBRG), or Colony NorthStar (formerly known as NorthStar Asset Management Group Inc. prior to its merger with Colony Capital, Inc. and NorthStar Realty Finance Corp. on January 10, 2017),Digital Bridge, and 7.8% owned by James F. Flaherty III, a former partner of Colony NorthStar.III. We arewere not affiliated with Griffin Capital, Griffin Capital Securities, LLC, or our dealer manager, Colony NorthStarDigital Bridge or Mr. Flaherty; however, we arewere affiliated with our former advisor, AHI and AHI Group Holdings. Please see the “Merger of Griffin-American Healthcare REIT III, Inc. and Griffin-American Healthcare REIT IV, Advisor, American Healthcare InvestorsInc.” and AHI Group Holdings.“AHI Acquisition” sections above for a further discussion of our operations effective October 1, 2021. See Note 13, Redeemable Noncontrolling Interests, and Note 14, Equity — Noncontrolling Interests in Total Equity, to our accompanying condensed consolidated financial statements for a further discussion of the ownership in our operating partnership.
Public Offering
GAHR IV raised $754,118,000 through a best efforts initial public offering, or the initial offering, and issued 75,639,681 aggregate shares of its Class T and Class I common stock. In addition, during the initial offering, GAHR IV issued 3,253,535 aggregate shares of its Class T and Class I common stock pursuant to GAHR IV’s distribution reinvestment plan, as amended, or the DRIP, for a total of $31,021,000 in distributions reinvested. Following the deregistration of the initial offering, GAHR IV continued issuing shares of its common stock pursuant to the DRIP through a subsequent offering, or the 2019 GAHR IV DRIP Offering. GAHR IV commenced offering shares pursuant to the 2019 GAHR IV DRIP Offering on March 1, 2019, following the termination of the initial offering on February 15, 2019. On March 18, 2021, the GAHR IV board of directors authorized the suspension of the DRIP, effective as of April 1, 2021.
On October 4, 2021, our board authorized the reinstatement of the DRIP, as amended, or the AHR DRIP. We continue to offer up to $100,000,000 of shares of our common stock to be issued pursuant to the AHR DRIP under an existing Registration Statement on Form S-3 under the Securities Act of 1933, as amended, or the Securities Act, previously filed by GAHR IV. As of March 31, 2022, a total of $65,941,000 in distributions were reinvested that resulted in 6,981,086 shares of common stock being issued pursuant to the AHR DRIP. See Note 14, Equity — Distribution Reinvestment Plan, to our accompanying condensed consolidated financial statements for a further discussion.
On March 24, 2022, our board, at the recommendation of the audit committee of our board, comprised solely of independent directors, unanimously approved and established an updated estimated per share net asset value, or NAV, of our common stock of $9.29. We provide this updated estimated per share NAV annually to assist broker-dealers in connection with their obligations under Financial Industry Regulatory Authority, or FINRA, Rule 2231 with respect to customer account statements. The updated estimated per share NAV is based on the estimated value of our assets less the estimated value of our liabilities, divided by the number of shares outstanding on a fully diluted basis, calculated as of December 31, 2021. The
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valuation was performed in accordance with the methodology provided in Practice Guideline 2013-01, Valuations of Publicly Registered Non-Listed REITs, issued by the Institute for Portfolio Alternatives, or the IPA, in April 2013, in addition to guidance from the SEC. See our Current Report on Form 8-K filed with the SEC on March 25, 2022 for more information on the methodologies and assumptions used to determine, and the limitations and risks of, our updated estimated per share NAV.
Our Real Estate Investments Portfolio
We currently operate through twosix reportable business segments —segments: medical office buildings, integrated senior health campuses, skilled nursing facilities, SHOP, senior housing and senior housing.hospitals. As of September 30, 2017, we had completed 17 real estate acquisitions wherebyMarch 31, 2022, we owned 29and/or operated 182 properties, comprising 30191 buildings, and 122 integrated senior health campuses including completed development projects, or approximately 1,418,00019,461,000 square feet of gross leasable area, or GLA, for an aggregate contract purchase price of $356,640,000. As of September 30, 2017, our portfolio capitalization rate was approximately 6.9%, which estimate was based upon total property portfolio net operating income from each property’s forward looking pro forma projections for$4,299,872,000, including the expected year one property performance, including any contractual rent increases contained in such leases for year one, divided by the contract purchase pricefair value of the total property portfolio, exclusiveproperties acquired in the Merger. In addition, as of any acquisition fees and expenses paid.March 31, 2022, we also owned a real estate-related debt investment purchased for $60,429,000.
Critical Accounting PoliciesEstimates
The complete listing of our Critical Accounting PoliciesEstimates was previously disclosed in our 20162021 Annual Report on Form 10-K, as filed with the SEC on March 1, 2017,25, 2022, and there have been no material changes to our Critical Accounting PoliciesEstimates as disclosed therein, except as noted below.below or included within Note 2, Summary of Significant Accounting Policies, to our accompanying condensed consolidated financial statements.
Interim Unaudited Financial Data
Our accompanying condensed consolidatedFor a discussion of interim unaudited financial statements have been prepared by us in accordance with GAAP in conjunction with the rules and regulationsdata, see Note 2, Summary of the SEC. Certain information and footnote disclosures required for annual financial statements have been condensed or excluded pursuantSignificant Accounting Policies — Interim Unaudited Financial Data, to SEC rules and regulations. Accordingly, our accompanying condensed consolidated financial statements do not include all of the information and footnotes required by GAAP for complete financial statements. Our accompanying condensed consolidated financial statements reflect all adjustments, which are, in our view, of a normal recurring nature and necessary for a fair presentation of our financial position, results of operations and cash flows for the interim period. Interim results of operations are not necessarily indicative of the results to be expected for the full year; such full year results may be less favorable. Our accompanying condensed consolidated financial statements should be read in conjunction with our audited consolidated financial statements and the notes thereto included in our 20162021 Annual Report on Form 10-K, as filed with the SEC on March 1, 2017.25, 2022.
Property Acquisitions
In accordance with Accounting Standards Codification Topic 805, Business Combinations,Acquisition and Accounting Standards Update, or ASU, 2017-01, Clarifying the Definition of a Business, or ASU 2017-01, we determine whether a 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 allocate the purchase price to the identifiable assets acquired and liabilities assumed based on their relative fair values. We immediately expense acquisition related expenses associated with a business combination and capitalize acquisition related expenses directly associated with an asset acquisition. As a result of our early adoption of ASU 2017-01 on January 1, 2017, we accounted for the eight property acquisitions we completed for the nine months ended September 30, 2017 as asset acquisitions rather than business combinations.

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Recently Issued or Adopted Accounting Pronouncements
For a discussion of recently issued or adopted accounting pronouncements, see Note 2, Summary of Significant Accounting Policies — Recently Issued or Adopted Accounting Pronouncements, to our accompanying condensed consolidated financial statements.
AcquisitionsDispositions in 20172022
For a discussion of our property acquisitionsacquisition and dispositions of investments in 2017,2022, see Note 3, Real Estate Investments, Net, and Note 18, Subsequent Events — Property Acquisition,4, Business Combination, to our accompanying condensed consolidated financial statements.
Factors Which May Influence Results of Operations
WeIn connection with the Merger, GAHR IV was the legal acquiror and GAHR III was the accounting acquiror for financial reporting purposes, as discussed in Note 1, Organization and Description of Business, to our accompanying condensed consolidated financial statements. Thus, the financial information set forth herein subsequent to the Merger reflects results of the Combined Company, and the financial information set forth herein prior to the Merger reflects GAHR III’s results. Furthermore, as a result of the closing of the AHI Acquisition on October 1, 2021, and following the Merger, our company is now self-managed and employs all the employees necessary to operate as a self-managed company. The impact of being a self-managed company on our results of operations is predominantly an increase in general and administrative costs related to employing the workforce necessary to operate as a self-managed company and cost savings associated with no longer paying advisory fees to our former advisor. For these reasons, period to period comparisons may not be meaningful.
Other than the effects of the Merger and the AHI Acquisition discussed above, and the COVID-19 pandemic discussed below, as well as other national economic conditions affecting real estate generally, we are not aware of any material trends or uncertainties other than national economic conditions affecting real estate generally, that may reasonably be expected to have a material impact, favorable or unfavorable, on revenues or income from the acquisition, disposition, management and operation of propertiesour properties. For a further discussion of these and other than those listed infactors that could impact our future results or performance, see Part II,I, Item 1A. Risk Factors, of this Quarterly Report on Form 10-Q and those1A, Risk Factors, previously disclosed in our 20162021 Annual Report on Form 10-K, as filed with the SEC on March 1, 2017.25, 2022.
Real Estate RevenueCOVID-19
Our residents, tenants, operating partners and managers, our industry and the U.S. economy continue to be disrupted by the COVID-19 pandemic and related supply chain disruptions and labor shortages. The timing and extent of the economic recovery from the COVID-19 pandemic is dependent upon many factors, including the rate of vaccination, the emergence and severity of COVID-19 variants, the continued effectiveness of the vaccines against those variants, the frequency of booster vaccinations and the duration and implications of continued restrictions and safety measures. As the COVID-19 pandemic is still impacting the healthcare system to a certain extent, it continues to present challenges for us as an owner and operator of healthcare facilities, making it difficult to ascertain the long-term impact the COVID-19 pandemic will have on real estate markets in which we own and/or operate properties and our portfolio of investments. COVID-19 is particularly dangerous among the senior population and results in heightened risk to our senior housing and skilled nursing facilities, and we continue
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to work diligently to maintain aggressive protocols at such facilities as well as actively collaborate with our tenants, operating partners and managers to respond and take action to mitigate the impact of the COVID-19 pandemic.
We have evaluated the impacts of the COVID-19 pandemic on our business thus far and incorporated information concerning such impacts into our assessments of liquidity, impairment and collectability from tenants and residents as of March 31, 2022. We will continue to monitor such impacts and will adjust our estimates and assumptions based on the best available information.
Since March 2020, we have taken actions to strengthen our balance sheet and preserve liquidity in response to the COVID-19 pandemic, including reducing the stockholder distribution rate and temporarily suspending our share repurchase plan. We believe that the long-term stability of our portfolio of investments will return once the virus has been controlled. Each type of real estate asset we own has been impacted by the COVID-19 pandemic to varying degrees.
The amount of revenue generated by our properties depends principally on our ability to maintain the occupancy rates of leased space and to lease available space and space available from lease terminations at the then existing rental rates. Negative trends in one or more of these factors could adversely affect our revenue in the future.
Offering Proceeds
If we fail to raise significant additional proceeds in our offering, we will not have enough proceeds to investCOVID-19 pandemic has resulted in a diversified real estate portfolio. Our real estatesignificant decline in resident occupancies at our senior housing facilities, SHOP, integrated senior health campuses and skilled nursing facilities, and an increase in COVID-19 related operating expenses with more costly short-term hires due to the shortage of healthcare personnel. Therefore, our focus at such properties continues to be on resident occupancy recovery and operating expense management. While resident occupancies at our integrated senior health campuses and skilled nursing facilities have gradually improved to near pre-pandemic levels, our SHOP have been slower to recover. Based on information available to management as of April 29, 2022, resident occupancy at our SHOP has declined by approximately 11.5% since February 2020, prior to COVID-19 shutdowns.
To date, the impacts of the COVID-19 pandemic have been significant, rapidly evolving and may continue into the future. The information in this Quarterly Report on Form 10-Q is based on data currently available to us and will likely change as the COVID-19 pandemic progresses. Future actions that may be taken by state and local governments to mitigate the impact of COVID-19 variants that may emerge could disrupt our business, activities and operations, the extent to which are highly uncertain. We continue to closely monitor COVID-19 developments and are continuously assessing the implications to our business, residents, tenants, operating partners, managers and our portfolio wouldof investments. We cannot predict with reasonable certainty when demand for healthcare services at our senior housing and skilled nursing facility segments will return to pre-COVID-19 pandemic levels.
The lasting effect of the COVID-19 pandemic over the next 12 months could be concentrated in a small numbersignificant and will largely depend on future developments, including COVID-19 vaccination and booster rates; the long term efficacy of properties, resulting in increased exposure to localCOVID-19 vaccinations and regional economic downturnsboosters; and the poor performancepotential emergence of onenew, more transmissible or moresevere variants, which cannot be predicted with confidence at this time. See the “Results of our propertiesOperations” and therefore, expose our stockholders to increased risk. In addition, many of our expenses are fixed regardless of the size of our real estate portfolio. Therefore, depending on the amount of proceeds we raise from our offering, we would expend“Liquidity and Capital Resources” sections below, for a larger portion of our income on operating expenses. This would reduce our profitability and, in turn, the amount of net income available for distribution to our stockholders.further discussion.
Scheduled Lease Expirations
AsExcluding our SHOP and integrated senior health campuses, as of September 30, 2017,March 31, 2022, our properties were 95.7%92.7% leased and during the remainder of 2017, 1.7%2022, 6.5% of the leased GLA is scheduled to expire. Our leasing strategy focuses on negotiating renewals for leases scheduled to expire during the next 12twelve months. In the future, if we are unable to negotiate renewals, we will try to identify new tenants or collaborate with existing tenants who are seeking additional space to occupy.
As of September 30, 2017,March 31, 2022, our remaining weighted average lease term was 8.5 years.7.1 years, excluding our SHOP and integrated senior health campuses.
Our combined SHOP and integrated senior health campuses were 77.8% leased as of March 31, 2022. Substantially all of our leases with residents at such properties are for a term of one year or less.
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Results of Operations
Comparison of the Three and Nine Months Ended September 30, 2017March 31, 2022 and 20162021
We were incorporated on January 23, 2015,Our operating results are primarily comprised of income derived from our portfolio of properties and expenses in connection with the acquisition and operation of such properties. Our primary sources of revenue include rent generated by our leased, non-RIDEA properties, and resident fees and services revenue from our RIDEA properties. Our primary expenses include property operating expenses and rental expenses. In addition, beginning in the fourth quarter of 2021, following the AHI Acquisition that resulted in our company being self managed, general and administrative expenses include payroll and other corporate operating expenses but we did not commence material operations until the commencement ofno longer include advisory fees to our offering on February 16, 2016. We purchased our first property in June 2016. Accordingly, our results of operations for the three and nine months ended September 30, 2017 and 2016 are not comparable.former advisor. In general, and under a normal operating environment without the disruption of the COVID-19 pandemic, we expect all amounts related to our portfolio of operating properties to increase in the future baseddue to fixed annual rent escalations on a full yearour portfolio of operations as well as increased activity as we acquire additionalproperties. The ability to compare one period to another is also impacted by the closing of the AHI Acquisition and the increase in size of our real estate or real estate-related investments. Our resultsportfolio as a result of operations are not indicativethe Merger. See Note 1, Organization and Description of those expected in future periods.Business, to our accompanying condensed consolidated financial statements for a further discussion.
As of September 30, 2017, we operated through two reportable business segments — medical office buildings and senior housing. 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. Accordingly, whenAs of March 31, 2022, we acquired our firstoperated through six reportable business segments: medical office building in June 2016 andbuildings, integrated senior health campuses, skilled nursing facilities, SHOP, senior housing facility in December 2016, we established a new reportable segment at each such time.and hospitals.

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Except where otherwise noted, the changes in our consolidated results of operations for 2022 as compared to 2021 are primarily due to owning 30the acquisition of GAHR IV’s portfolio of 87 properties, comprising 92 buildings, or approximately 4,799,000 square feet of GLA, as a result of September 30, 2017,the Merger on October 1, 2021, the disruption to our normal operations as compared to owning five buildings asa result of September 30, 2016.the COVID-19 pandemic and grant income received. As of September 30, 2017March 31, 2022 and 2016,2021, we owned and/or operated the following types of properties:
March 31,
 20222021
 Number of
Buildings/
Campuses
Aggregate
Contract
Purchase Price
Leased
%
Number of
Buildings/
Campuses
Aggregate
Contract
Purchase Price
Leased
%
Integrated senior health campuses122 $1,795,199,000 (1)120 $1,732,058,000 (1)
Medical office buildings105 1,249,658,000 89.7 %63 657,885,000 89.1 %
SHOP47 708,050,000 (2)20 433,891,000 (2)
Senior housing20 169,885,000 100 %89,535,000 100 %
Skilled nursing facilities17 237,300,000 100 %119,500,000 100 %
Hospitals139,780,000 100 %139,780,000 100 %
Total/weighted average(3)313 $4,299,872,000 92.7 %220 $3,172,649,000 91.7 %
___________
(1)The leased percentage for the resident units of our integrated senior health campuses was 80.0% and 70.7% as of March 31, 2022 and 2021, respectively.
(2)The leased percentage for the resident units of our SHOP was 71.9% and 70.3% as of March 31, 2022 and 2021, respectively.
(3)Leased percentage excludes our SHOP and integrated senior health campuses.
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 September 30,
 2017 2016
 
Number of
Buildings
 
Aggregate Contract
Purchase Price
 Leased % 
Number of
Buildings
 
Aggregate Contract
Purchase Price
 Leased %
Medical office buildings18
 $262,290,000
 94.0% 5
 $59,670,000
 100%
Senior housing12
 94,350,000
 100% 
 
 %
Total/weighted average30
 $356,640,000
 95.7% 5
 $59,670,000
 100%
Revenues and Grant Income
Real Estate RevenueOur primary sources of revenue include rent generated by our leased, non-RIDEA properties, and resident fees and services revenue from our RIDEA properties. The amount of revenues generated by our properties depends principally on our ability to maintain the occupancy rates of currently leased space and to lease available space at the then existing rental rates. We also receive grant income. Revenues and grant income by reportable segment consisted of the following for the periods then ended:
Three Months Ended March 31,
 20222021
Resident Fees and Services Revenue
Integrated senior health campuses$281,012,000 $233,226,000 
SHOP37,962,000 19,800,000 
Total resident fees and services revenue318,974,000 253,026,000 
Real Estate Revenue
Medical office buildings37,837,000 20,023,000 
Skilled nursing facilities6,393,000 3,667,000 
Senior housing5,298,000 3,570,000 
Hospitals2,415,000 2,763,000 
Total real estate revenue51,943,000 30,023,000 
Grant Income
Integrated senior health campuses5,096,000 8,229,000 
SHOP118,000 — 
Total grant income5,214,000 8,229,000 
Total revenues and grant income$376,131,000 $291,278,000 
For the three months ended September 30, 2017March 31, 2022 and 2016,2021, resident fees and services revenue primarily consisted of rental fees related to resident leases, extended health care fees and other ancillary services, and real estate revenue primarily consisted of base rent and expense recoveries. For the three months ended March 31, 2022, $14,113,000 in resident fees and services revenue for our SHOP was due to the increase in the size of our portfolio as a result of the Merger. The remaining increase in resident fees and services revenue was primarily attributable to improved occupancy and higher reimbursement rates from both Medicare and Medicaid programs for our integrated senior health campuses and SHOP. In addition, for the three months ended March 31, 2022, $22,332,000 of real estate revenue was $8,488,000 and $312,000, respectively, and was primarily compriseddue to the increase in the size of base rentour portfolio as a result of $6,295,000 and $191,000, respectively, and expense recoveries of $1,579,000 and $88,000, respectively.the Merger.
For the ninethree months ended September 30, 2017March 31, 2022 and 2016,2021, we recognized $5,214,000 and $8,229,000, respectively, of grant income at our integrated senior health campuses and SHOP related to government grants received through the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, economic stimulus programs.
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Property Operating Expenses and Rental Expenses
Property operating expenses and property operating expenses as a percentage of resident fees and services revenue and grant income, as well as rental expenses and rental expenses as a percentage of real estate revenue was $18,738,000 and $338,000, respectively, and was primarily comprised of base rent of $13,894,000 and $194,000, respectively, and expense recoveries of $3,586,000 and $111,000, respectively. Real estate revenue, by reportable segment consisted of the following for the periods then ended:
Three Months Ended March 31,
Three Months Ended September 30, Nine Months Ended September 30, 20222021
Property Operating ExpensesProperty Operating Expenses
Integrated senior health campusesIntegrated senior health campuses$253,150,000 88.5 %$228,639,000 94.7 %
SHOPSHOP34,010,000 89.3 %16,503,000 83.3 %
Total property operating expensesTotal property operating expenses$287,160,000 88.6 %$245,142,000 93.8 %
2017 2016 2017 2016
Rental ExpensesRental Expenses
Medical office buildings$6,330,000
 $312,000
 $15,456,000
 $338,000
Medical office buildings$14,313,000 37.8 %$7,537,000 37.6 %
Skilled nursing facilitiesSkilled nursing facilities686,000 10.7 %369,000 10.1 %
HospitalsHospitals109,000 4.5 %134,000 4.8 %
Senior housing2,158,000
 
 3,282,000
 
Senior housing179,000 3.4 %15,000 0.4 %
Total$8,488,000
 $312,000
 $18,738,000
 $338,000
Total rental expensesTotal rental expenses$15,287,000 29.4 %$8,055,000 26.8 %
Rental Expenses
Integrated senior health campuses and SHOP typically have a higher percentage of direct operating expenses to revenue than medical office buildings, hospitals, and leased senior housing and skilled nursing facilities due to the nature of RIDEA — type facilities where we conduct day-to-day operations. For the three months ended September 30, 2017 and 2016,March 31, 2022, as compared to the three months ended March 31, 2021, rental expenses were $2,095,000increased by $6,542,000 and $98,000, respectively. property operating expenses increased by $14,460,000 for our SHOP due to the increase in the size of our portfolio as a result of the Merger. Further, the remaining increase in total property operating expenses was due to an increase in labor costs at our SHOP and integrated senior health campuses.
General and Administrative
For the ninethree months ended September 30, 2017March 31, 2022, general and 2016, rentaladministrative expenses were $4,893,000$11,119,000 compared to $7,257,000 for the three months ended March 31, 2021. The increase in general and $121,000,administrative expenses of $3,862,000 was primarily the result of an increase of: (i) $6,468,000 in payroll and compensation costs for the acquired employees as a result of the AHI Acquisition; (ii) $1,319,000 in professional and legal fees; and (iii) $958,000 in corporate operating expenses. Such increases were partially offset by a decrease in our asset management and property management oversight fees of $5,678,000 as a result of the AHI Acquisition.
Business Acquisition Expenses
For the three months ended March 31, 2022 and 2021, we recorded business acquisition expense of $173,000 and $1,248,000, respectively. RentalThe decrease in such expenses primarily related to a $1,195,000 decrease in third-party advisory costs and fees to our special committee related to the Merger and the AHI Acquisition.
Depreciation and Amortization
For the three months ended March 31, 2022 and 2021, depreciation and amortization was $42,311,000 and $25,723,000, respectively, which primarily consisted of depreciation on our operating properties of $34,422,000 and $24,190,000, respectively, and amortization of our identified intangible assets of $7,125,000 and $1,113,000, respectively. The increase in depreciation and amortization of $16,588,000 was primarily the result of the increase in depreciable assets in our portfolio as a result of the Merger resulting in depreciation and amortization expense of $14,954,000.

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Interest Expense
Interest expense, including gain or loss in fair value of derivative financial instruments, consisted of the following for the periods then ended:
presented:
 Three Months Ended September 30, Nine Months Ended September 30,
 2017 2016 2017 2016
Real estate taxes$651,000
 $24,000
 $1,278,000
 $39,000
Utilities552,000
 29,000
 1,267,000
 36,000
Building maintenance467,000
 28,000
 1,327,000
 28,000
Property management fees — third party127,000
 6,000
 320,000
 6,000
Property management fees — affiliates103,000
 5,000
 249,000
 5,000
Administration91,000
 
 212,000
 
Insurance23,000
 
 56,000
 
Amortization of leasehold interests22,000
 
 69,000
 
Other59,000
 6,000
 115,000
 7,000
Total$2,095,000
 $98,000
 $4,893,000
 $121,000

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Rental expenses and rental expenses as a percentage of total revenue by reportable segment consisted of the following for the periods then ended:
 Three Months Ended September 30, Nine Months Ended September 30,
 2017 2016 2017 2016
Medical office buildings$1,857,000
 29.3% $98,000
 31.4% $4,543,000
 29.4% $121,000
 35.8%
Senior housing238,000
 11.0% 
 % 350,000
 10.7% 
 %
Total/weighted average$2,095,000
 24.7% $98,000
 31.4% $4,893,000
 26.1% $121,000
 35.8%
Multi-tenant medical office buildings typically have a higher percentage of rental expenses to revenue than senior housing facilities. We anticipate that the percentage of rental expenses to revenue will fluctuate based on the types of property we acquire in the future.
General and Administrative
General and administrative expenses consisted of the following for the periods then ended:
 Three Months Ended September 30, Nine Months Ended September 30,
 2017 2016 2017 2016
Asset management fees — affiliates$700,000
 $
 $1,505,000
 $
Professional and legal fees310,000
 141,000
 646,000
 260,000
Restricted stock compensation61,000
 14,000
 100,000
 66,000
Transfer agent services57,000
 40,000
 141,000
 42,000
Board of directors fees53,000
 58,000
 163,000
 141,000
Directors’ and officers’ liability insurance53,000
 59,000
 161,000
 147,000
Franchise taxes31,000
 
 121,000
 
Bad debt expense25,000
 
 94,000
 
Other6,000
 17,000
 65,000
 69,000
Total$1,296,000
 $329,000
 $2,996,000
 $725,000
The increase in general and administrative expenses for the three and nine months ended September 30, 2017 as compared to the three and nine months ended September 30, 2016 was primarily due to the purchase of additional properties in 2016 and 2017 and thus incurring asset management fees to our advisor or its affiliates and higher professional and legal fees. We did not incur any asset management fees for the three and nine months ended September 30, 2016 as a result of our advisor waiving $31,000 in asset management fees through September 2016. See Note 12, Related Party Transactions — Operational Stage — Asset Management Fee, for a further discussion of the waiver. In addition, we incurred higher transfer agent service fees for the three and nine months ended September 30, 2017 as compared to the three and nine months ended September 30, 2016 due to an increase in the number of investors in connection with the increased equity raise pursuant to our offering throughout 2016 and 2017. We expect general and administrative expenses to continue to increase in 2017 as we acquire additional properties.
Acquisition Related Expenses
 Three Months Ended March 31,
 20222021
Interest expense:
Lines of credit and term loans and derivative financial instruments$7,549,000 $7,594,000 
Mortgage loans payable9,544,000 8,585,000 
Amortization of deferred financing costs:
Lines of credit and term loans809,000 1,075,000 
Mortgage loans payable441,000 339,000 
Amortization of debt discount/premium, net(17,000)203,000 
Gain in fair value of derivative financial instruments(500,000)(1,821,000)
Loss on extinguishments of debt4,591,000 2,288,000 
Interest on finance lease liabilities74,000 118,000 
Interest expense on financing obligations and other liabilities334,000 163,000 
Total$22,825,000 $18,544,000 
For the three and nine months ended September 30, 2017, acquisition related expenses were $121,000 and $334,000, respectively, and were related primarily to expenses incurred in pursuit of properties that did not result in an acquisition.
For the three and nine months ended September 30, 2016, acquisition related expenses of $1,857,000 and $2,227,000, respectively, were related primarily to expenses associated with our four and five property acquisitions, respectively, including base acquisition fees of $1,220,000 and $1,343,000, respectively, incurred to our advisor.
Depreciation and Amortization
For the three and nine months ended September 30, 2017, depreciation and amortization was $3,442,000 and $7,619,000, respectively, and consisted primarily of depreciation on our operating properties of $2,305,000 and $5,110,000, respectively, and amortization on our identified intangible assets of $1,134,000 and $2,506,000, respectively. For the three and nine months ended September 30, 2016, depreciation and amortization was $64,000 and consisted primarily of depreciation on our operating properties of $40,000 and amortization on our identified intangible assets of $24,000.

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Interest Expense
For the three and nine months ended September 30, 2017,March 31, 2022, interest expense was $780,000 and $1,607,000, respectively, and related primarily$22,825,000 compared to interest expense on our revolving line of credit with Bank of America, N.A., or Bank of America, and KeyBank, National Association, or KeyBank, or the Line of Credit, of $531,000 and $1,059,000, respectively, interest expense on our mortgage loans payable of $146,000 and $267,000, respectively, and amortization of deferred financing costs of $90,000 and $267,000, respectively, on the Line of Credit. For$18,544,000 for the three and nine months ended September 30, 2016,March 31, 2021. The increase in interest expense was $56,000primarily related to a decrease in the gain in fair value recognized on our derivative financial instruments of $1,321,000 and related primarily to the unused feean increase in loss on debt extinguishment of $26,000 and amortization of deferred financing costs of $27,000 on the Line of Credit.$2,303,000. See Note 6,8, Mortgage Loans Payable, Net, and Note 7, Line9, Lines of Credit to our accompanying condensed consolidated financial statements, for a further discussion.
Liquidity and Capital Resources
Our sources of funds will primarily be the net proceeds of our offering, operating cash flows and borrowings. We believe that these resources will be sufficient to satisfy our cash requirements for the foreseeable future, and we do not anticipate a need to raise funds from other sources within the next 12 months.
We are dependent upon the net proceeds to be received from our offering to conduct our proposed activities. Our ability to raise funds through our offering is dependent on general economic conditions, general market conditions for REITs and our operating performance. We expect a relative increase in liquidity as additional subscriptions for shares of our common stock are received and a relative decrease in liquidity as net offering proceeds are expended in connection with the acquisition, management and operation of our investments in real estate and real estate-related investments.
Our principal demands for funds are for acquisitions of real estate and real estate-related investments, payment of operating expenses and interest on our current and future indebtedness and payment of distributions to our stockholders. We estimate that we will require approximately $388,000 to pay interest on our outstanding indebtedness in the remainder of 2017, based on interest rates in effect as of September 30, 2017, and that we will require $84,000 to pay principal on our outstanding indebtedness in the remainder of 2017. In addition, we require resources to make certain payments to our advisor and our dealer manager, which during our offering will include payments to our dealer manager and its affiliates for selling commissions, the dealer manager fee and the stockholder servicing fee. See Note 11, Equity — Offering Costs, and Note 12, Related Party Transactions,Term Loans, to our accompanying condensed consolidated financial statements for a further discussion on debt extinguishments.
Liquidity and Capital Resources
In the normal course of business, our payments tomaterial cash requirements consist of payment of operating expenses, capital improvement expenditures, interest on our advisor and our dealer manager.
Generally, cash needs for items other than acquisitions of real estate and real estate-related investments will be met from operations, borrowings and the net proceeds of our offering, including the proceeds raised through the DRIP. However, there may be a delay between the sale of our shares of common stock and our investments in real estate and real estate-related investments, which could result in a delay in the benefitsindebtedness, distributions to our stockholders if any, of returns generated from our investments.
Our advisor evaluates potential investments and engages in negotiations with real estate sellers, developers, brokers, investment managers, lenders and others on our behalf. Investors should be aware that after a purchase contract for a property is executed that contains specific terms, the property will not be purchased until the successful completion of due diligence, which includes review of the title insurance commitment, market evaluation, review of leases, review of financing options and an environmental analysis. In some instances, the proposed acquisition will require the negotiation of final binding agreements, which may include financing documents. Until we invest the proceeds of our offering in real estate and real estate-related investments, we may invest in short-term, highly liquid or other authorized investments. Such short-term investments will not earn significant returns, and we cannot predict how long it will take to fully invest the proceeds in real estate and real estate related-investments. The number of properties we may acquire and other investments we will make will depend upon the number of sharesrepurchases of our common stock sold. Our sources of funds primarily consist of operating cash flows and the resulting amount of the net proceeds availableborrowings.
Absent our requirements to make distributions to maintain our REIT qualification, we do not have any material off-balance sheet arrangements that we expect would materially affect our liquidity and capital resources.
Material Cash Requirements
Capital Improvement Expenditures
A capital plan for each investment from our offering as well as our ability to arrange debt financing.
When we acquire a property, our advisor prepares a capital planis established upon acquisition that contemplates the estimated capital needs of that investment. In addition to operating expenses, capital needs may also includeinvestment, including costs of refurbishment, tenant improvements or other major capital expenditures. The capital plan will also setsets forth the anticipated sources of the necessary capital, which may include operating cash generated by the investment, capital reserves, a line of credit or other loan established with respect to the investment, other borrowings operating cash generated by the investment,or additional equity investments from us orand joint venture partners or, when necessary, capital reserves. Any capital reserve would be established from the net proceeds of our offering, proceeds from sales of other investments, operating cash generated by other investments or other cash on hand. In some cases, a lender may require us to establish capital reserves for a particular investment.partners. The capital plan for each investment will beis adjusted through ongoing, regular reviews of our portfolio or as necessary to respond to unanticipated additional capital needs.
As of March 31, 2022, we had $16,673,000 of restricted cash in loan impounds and reserve accounts to fund a portion of such capital expenditures. Based on the budget for the properties we own as of September 30, 2017,March 31, 2022, we estimate that our discretionary expenditures for capital and tenant improvements willcould require up to $1,246,000$96,038,000 for the remaining threenine months of 2017. As of September 30, 2017, we had $16,000 of restricted

2022.
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Contractual Obligations
The following table provides information with respect to: (i) the maturity and scheduled principal repayment of our secured mortgage loans payable and our lines of credit and term loans; (ii) interest payments on our mortgage loans payable, lines of credit and term loans; (iii) ground and other lease obligations; and (iv) financing obligations as of March 31, 2022:
 Payments Due by Period
 20222023-20242025-2026ThereafterTotal
Principal payments — fixed-rate debt$61,521,000 $106,157,000 $184,034,000 $510,768,000 $862,480,000 
Interest payments — fixed-rate debt19,960,000 46,823,000 38,564,000 202,140,000 307,487,000 
Principal payments — variable-rate debt60,431,000 483,681,000 385,339,000 569,104,000 1,498,555,000 
Interest payments — variable-rate debt (based on rates in effect as of March 31, 2022)27,483,000 50,914,000 32,030,000 2,561,000 112,988,000 
Ground and other lease obligations14,522,000 37,520,000 34,041,000 163,815,000 249,898,000 
Financing obligations13,837,000 5,366,000 3,048,000 16,241,000 38,492,000 
Total$197,754,000 $730,461,000 $677,056,000 $1,464,629,000 $3,069,900,000 
Distributions and Share Repurchases
For information on distributions, see the “Distributions” section below. For information on our share repurchase plan, see Note 14, Equity Share Repurchase Plan, to our accompanying condensed consolidated financial statements.
Credit Facilities
On January 19, 2022, we terminated our credit agreement, as amended, for our line of credit and term loans with an aggregate maximum principal amount of $530,000,000, or the 2018 Credit Facility, and, through our operating partnership, entered into an agreement that superseded and replaced our amended credit facility with a maximum principal amount of $480,000,000, or the 2019 Credit Facility, with a credit facility with an aggregate maximum principal amount of up to $1,050,000,000, or the 2022 Credit Facility. See Note 9, Lines of Credit and Term Loans, to our accompanying condensed consolidated financial statements for a further discussion. In addition, we are subject to an amended and restated loan agreement regarding a senior secured revolving credit facility with an aggregate maximum principal amount of $360,000,000, or the 2019 Trilogy Credit Facility. Our total capacity to pay operating expenses, capital improvement expenditures, interest, distributions and repurchases is a function of our current cash in reserve accounts for such capital expenditures. We cannot provide assurance, however,position, our borrowing capacity on our lines of credit and term loans, as well as any future indebtedness that we may incur.
As of March 31, 2022, our aggregate borrowing capacity under the 2022 Credit Facility and the 2019 Trilogy Credit Facility was $1,410,000,000. As of March 31, 2022, our aggregate borrowings outstanding under our credit facilities was $1,239,134,000 and we had an aggregate of $170,866,000 available on such facilities. We believe that the resources described above will not exceed these estimated expenditure and distribution levels or be ablesufficient to obtain additional sources of financing on commercially favorable terms or at all.
Other Liquidity Needs
Insatisfy our cash requirements for the event that there is a shortfall in net cash available due to various factors, including, without limitation, the timing of distributions or the timing of the collection of receivables, we may seek to obtain capital to pay distributions by means of secured or unsecured debt financing through one or more third parties, or our advisor or its affiliates. There are currently no limits or restrictions on the use of proceeds from our advisor or its affiliates which would prohibit us from making the proceeds available for distribution. We may also pay distributions from cash from capital transactions, including, without limitation, the sale of one or more of our properties.
If we experience lower occupancy levels, reduced rental rates, reduced revenues as a result of asset sales, or increased capital expenditures and leasing costs compared to historical levels due to competitive market conditions for new and renewed leases, the effect would be a reduction of net cash provided by operating activities. If such a reduction of net cash provided by operating activities is realized, we may have a cash flow deficit in subsequent periods. Our estimate of net cash available is based on various assumptions which are difficult to predict, including the levels of leasing activity and related leasing costs. Any changes in these assumptions could impact our financial results and our ability to fund working capital and unanticipated cash needs.foreseeable future.
Cash Flows
The following table sets forth changes in cash flows:
 Nine Months Ended September 30,
 2017 2016
Cash and cash equivalents — beginning of period$2,237,000
 $202,000
Net cash provided by (used in) operating activities8,849,000
 (2,391,000)
Net cash used in investing activities(222,118,000) (56,637,000)
Net cash provided by financing activities215,429,000
 61,401,000
Cash and cash equivalents — end of period$4,397,000
 $2,575,000
Three Months Ended March 31,
 20222021
Cash, cash equivalents and restricted cash — beginning of period$125,486,000 $152,190,000 
Net cash provided by (used in) operating activities22,360,000 (5,255,000)
Net cash used in investing activities(27,367,000)(106,841,000)
Net cash (used in) provided by financing activities(1,307,000)89,605,000 
Effect of foreign currency translation on cash, cash equivalents and restricted cash(2,000)7,000 
Cash, cash equivalents and restricted cash — end of period$119,170,000 $129,706,000 
The following summary discussion of our changes in our cash flows is based on our accompanying condensed consolidated statements of cash flows and is not meant to be an all-inclusive discussion of the changes in our cash flows for the periods presented below.
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Operating Activities
For the nine months ended September 30, 2017 and 2016,The change from net cash flowsused in operating activities to net cash provided by operating activities of $27,615,000 was primarily relateddue to the cash flows provided byincrease in the size of our property operations, offset byportfolio as a result of the payment ofMerger on October 1, 2021, thereby increasing our net operating income during the three months ended March 31, 2022, as compared to the prior year period. In general, and administrative expenses. See Results of Operations above for a further discussion. We anticipate cash flows from operating activities to increase in 2017 as we acquire additional properties.is affected by the timing of cash receipts and payments. See the “Results of Operations” section above for a further discussion.
Investing Activities
For the nine months ended September 30, 2017,The decrease in net cash flows used in investing activities relatedof $79,474,000 was primarily due to our eighta $58,664,000 decrease in property acquisitions, a $12,826,000 increase in proceeds from dispositions of real estate and an $8,340,000 decrease in developments and capital expenditures during the amount of $215,738,000. For the ninethree months ended September 30, 2016, cash flows used in investing activities related primarilyMarch 31, 2022 as compared to the acquisition of five medical office buildings in the amount of $55,619,000 and the payment of $1,000,000 for real estate deposits. Cash flows used in investing activities are heavily dependent upon the investment of our net offering proceeds in real estate investments. We anticipate cash flows used in investing activities to increase as we acquire additional properties and real estate-related investments.prior year period.
Financing Activities
For the nine months ended September 30, 2017,The change from net cash flows provided by financing activities relatedto net cash used in financing activities of $90,912,000 was primarily due to funds raised from investorsa decrease in net borrowings under our offering inmortgage loans payable of $82,661,000 during the amount of $241,647,000, partially offset bythree months ended March 31, 2022 as compared to the prior year period, as well as the $15,010,000 payment of offering costs of $13,673,000 in connection with our offering, net payments on the Line of Credit of $7,900,000 and distributions to our common stockholders of $4,006,000. Forand $4,134,000 payment to repurchase our common stock for the ninethree months ended September 30, 2016, cash flows provided by financing activities related primarily to funds raised from investors in our offering in the amount of $52,484,000 and borrowings under the Line of Credit of $12,000,000,March 31, 2022. Such amounts were partially offset by a decrease in net borrowings under our lines of credit and term loans of $13,900,000 during the payment of offering costs of $1,889,000three months ended March 31, 2022 as compared to the prior year period. The change in connection with our offering, the payment of deferred financing costs of $1,027,000 in connection with the Line of Credit and mortgage loan

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payable and distributions paid to our common stockholders was due to the suspension of $148,000. We anticipate cash flowsall stockholder distributions on May 29, 2020 in response to the impact of the COVID-19 pandemic, which the board of directors of GAHR III subsequently reinstated in June 2021. The change in share repurchases was due to the suspension of the GAHR III share repurchase plan from financing activities to increase inMay 31, 2020 through October 4, 2021, when the future as we raise additional funds from investors and incur debt to purchase properties.partial reinstatement of our share repurchase plan was approved by our board.
Distributions
On April 13, 2016, ourThe following information represents distributions of GAHR IV for the period before the consummation of the Merger between GAHR III and GAHR IV on October 1, 2021. Since October 1, 2021, the information included below represents the distributions of the Combined Company.
Prior to March 31, 2020, the GAHR IV board of directors authorized a daily distribution to our Class T stockholders of record as of the close of business on each day of the period from May 1, 2016 through June 30, 2016. Our advisor agreed to waive certain asset management fees that may otherwise have been due to our advisor pursuant to the Advisory Agreement until such time as the amount of such waived asset management fees was equal to the amount of distributions payable to our stockholders for the period beginningcommencing on May 1, 2016 and ending on the date of the acquisition of our first property or real estate-related investment, as such terms are defined in the Advisory Agreement. Having raised the minimum offering in April 2016, the distributions declared for each record date in the May 2016 and June 2016 periods were paid in June 2016 and July 2016, respectively, from legally available funds.March 31, 2020. The daily distributions were calculated based on 365 days in the calendar year and were equal to $0.001643836 per share of our Class T and Class I common stock.stock, which was equal to an annualized distribution rate of $0.60 per share. These distributions were aggregated and paid in cash or shares of our common stock pursuant to the DRIP on a monthly basis, in arrears. We acquired our first property on June 28, 2016, and as such, our advisor waived $80,000 in asset management fees equalarrears, only from legally available funds.
In response to the amount of distributions paid from May 1, 2016 through June 27, 2016. Our advisor did not receive any additional securities, shares ofCOVID-19 pandemic and its effects to our stock, or any other form of consideration or any repayment as a resultbusiness and operations, at the end of the waiverfirst quarter of such asset management fees.
On June 28, 2016,2020, the GAHR IV board decided to take steps to protect our capital and maximize our liquidity in an effort to strengthen our long-term financial prospects by reducing our distribution payments to stockholders. Consequently, the GAHR IV board of directors authorized a daily distribution to our Class T stockholders of record as of the close of business on each day of the period commencing on JulyApril 1, 20162020 and ending on September 30, 2016August 31, 2021, which was calculated based on 365 days in the calendar year and was equal to $0.001095890 per share of our Class I stockholders of record as of the close of business on each day of the period commencing on the date that the firstT and Class I sharecommon stock. Such daily distribution was soldequal to an annualized distribution rate of $0.40 per share. The distributions were aggregated and endingpaid in cash or shares of our common stock pursuant to the DRIP on September 30, 2016. Subsequently, oura monthly basis, in arrears, only from legally available funds.
The GAHR IV board of directors also authorized on a quarterly basis a daily distributiondistributions to our Class T and Class I stockholders of record as of the close of business on each day of the quarterly periods commencing on October 1, 2016 and ending on December 31, 2017. The daily distributions were or will be calculated based on 365 days in the calendar year and areSeptember 17, 2021, equal to $0.001643836$0.0328767 per share of our common stock, which was equal to an annualized distribution of $0.40 per share. Further, our board authorized record date distributions to our Class T and Class I stockholders of record as of each monthly record date from October 2021 through June 2022, equal to $0.033333333 per share of our common stock, which is equal to an annualized distribution rate of $0.60$0.40 per share. TheseThe distributions were or will be aggregated and paid in cash or shares of our common stock pursuant to the DRIP. Beginning with the third quarter of 2022, distributions, if any, shall be authorized by our board on a quarterly basis, in such amounts as our board shall determine, and each quarterly record date for purposes of such distributions shall be determined and declared by our board in the last month of each calendar quarter until such time as our board changes such policy. Stockholders who have elected to participate in our DRIP monthlywill continue to have their distributions reinvested to purchase additional shares of our common stock, but on a quarterly basis beginning with any third quarter 2022 distribution declared.
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On March 18, 2021, in arrears, only from legally available funds.connection with the GAHR IV special committee's strategic alternative review process, the GAHR IV board of directors authorized the suspension of the DRIP, effective as of April 1, 2021. As a result, beginning with the April 2021 distributions, which were paid in May 2021, there were no further issuances of shares pursuant to the DRIP, and stockholders who were participants in the DRIP received cash distributions instead. On October 4, 2021, our board authorized the reinstatement of the DRIP and as a result, beginning with the October 2021 distribution, which was paid in November 2021, stockholders who previously enrolled as participants in the DRIP (including former GAHR III stockholders who participated in the GAHR III distribution reinvestment plan) received distributions in shares of our common stock pursuant to the terms of the DRIP, instead of cash distributions.
The amount of the distributions paid to our common stockholders iswas determined quarterly or monthly, as applicable, by our board of directors and iswas dependent on a number of factors, including funds available for payment of distributions, our financial condition, capital expenditure requirements and annual distribution requirements needed to maintain our qualification as a REIT under the Code. We have not established any limit on the amount of offering proceedsborrowings that may be used to fund distributions, except that, in accordance with our organizational documents and Maryland law, we may not make distributions that would: (i) cause us to be unable to pay our debts as they become due in the usual course of business;business or (ii) cause our total assets to be less than the sum of our total liabilities plus senior liquidation preferences.
GAHR III did not pay any distributions for the three months ended March 31, 2021. The distributions paid for the ninethree months ended September 30, 2017 and 2016,March 31, 2022, along with the amount of distributions reinvested pursuant to the AHR DRIP, and the sources of our distributions as compared to cash flows from operations were as follows:
Nine Months Ended September 30,
2017 2016
Three Months Ended
March 31, 2022
Distributions paid in cash$4,006,000
   $148,000
  Distributions paid in cash$15,010,000 
Distributions reinvested5,492,000
   222,000
  Distributions reinvested11,304,000 
$9,498,000
   $370,000
  $26,314,000 
Sources of distributions:       Sources of distributions:
Cash flows from operations$8,849,000
 93.2% $
 %Cash flows from operations$22,360,000 85.0 %
Offering proceeds649,000
 6.8
 370,000
 100
Proceeds from borrowingsProceeds from borrowings3,954,000 15.0 
$9,498,000
 100% $370,000
 100%
$26,314,000 100 %
Under GAAP, certain acquisition related expenses, such as expenses incurred in connection with property acquisitions accounted for as business combinations, are expensed, and therefore, subtracted from cash flows from operations. However, these expenses may be paid from offering proceeds or debt.
OurAs of March 31, 2022, any distributions of amounts in excess of our current and accumulated earnings and profits have resulted in a return of capital to our stockholders, and all or any portion of a distribution to our stockholders may behave been paid from offering proceeds. The payment ofborrowings.
GAHR III did not pay any distributions from our offering proceeds could reduce the amount of capital we ultimately invest in assets and negatively impact the amount of income available for future distributions.

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As of September 30, 2017, we had an amount payable of $8,065,000 to our advisor or its affiliates primarily for the Contingent Advisor Payment and asset management fees, which will be paid from cash flows from operations in the future as it becomes due and payable by us in the ordinary course of business consistent with our past practice. See Note 12, Related Party Transactions — Acquisition and Development Stage — Acquisition Fee, to our accompanying condensed consolidated financial statements, for a further discussion.
As of September 30, 2017, no amounts due to our advisor or its affiliates had been deferred, waived or forgiven other than the $80,000 in asset management fees waived by our advisor discussed above. Other than the waiver of asset management fees by our advisor to provide us with additional funds to pay initial distributions to our stockholders through June 27, 2016, our advisor and its affiliates, including our co-sponsors, have no obligation to defer or forgive fees owed by us to our advisor or its affiliates or to advance any funds to us. In the future, if our advisor or its affiliates do not defer or continue to defer, waive or forgive amounts due to them, this would negatively affect our cash flows from operations, which could result in us paying distributions, or a portion thereof, using borrowed funds. As a result, the amount of proceeds available for investment and operations would be reduced, or we may incur additional interest expense as a result of borrowed funds.
three months ended March 31, 2021. The distributions paid for the ninethree months ended September 30, 2017 and 2016,March 31, 2022, along with the amount of distributions reinvested pursuant to the AHR DRIP, and the sources of our distributions as compared to funds from operations attributable to controlling interest, or FFO, a non-GAAP financial measure, were as follows:
Nine Months Ended September 30,
2017 2016
Three Months Ended
March 31, 2022
Distributions paid in cash$4,006,000
   $148,000
  Distributions paid in cash$15,010,000 
Distributions reinvested5,492,000
   222,000
  Distributions reinvested11,304,000 
$9,498,000
   $370,000
  $26,314,000 
Sources of distributions:       Sources of distributions:
FFO attributable to controlling interest$8,909,000
 93.8% $
 %FFO attributable to controlling interest$26,314,000 100 %
Offering proceeds589,000
 6.2
 370,000
 100
Proceeds from borrowingsProceeds from borrowings— — 
$9,498,000
 100% $370,000
 100%
$26,314,000 100 %
The payment of distributions from sources other than FFO may reduce the amount of proceeds available for investment and operations or cause us to incur additional interest expense as a result of borrowed funds. For a further discussion of FFO, a non-GAAP financial measure, including a reconciliation of our GAAP net income (loss)loss to FFO, see Funds“Funds from Operations and Modified Funds from Operations,Operations” below.
Financing
We intend to continue to finance a portion of the purchase price of our investments in real estate and real estate-related investments by borrowing funds. We anticipate that after an initial phase of our operations (prior to the investment of all of the net proceeds of our offering) when we may employ greater amounts of leverage to enable us to purchase properties more quickly and therefore generate distributions for our stockholders sooner, our overall leverage will not exceed 50.0% of the combined fair market value of all of our properties, and other real estate-related investments, as determined at the end of each calendar year beginning with our first full year of operations.year. For these purposes, the fair market value of each asset will be equal to the contract purchase price paid for the asset or, if the asset was appraised subsequent to the date of purchase, then the fair market value will be equal to the value reported in the most recent independent appraisal of the asset. Our
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policies do not limit the amount we may borrow with respect to any individual investment. As of September 30, 2017,March 31, 2022, our aggregate borrowings were 10.6%46.9% of the combined market value of all of our real estate investments.
Under our charter, we have a limitation on borrowing that precludes us from borrowing in excess of 300% of our net assets without the approval of a majority of our independent directors. Net assets for purposes of this calculation are defined to be our total assets (other than intangibles), valued at cost prior to deducting depreciation, amortization, bad debt and other non-cash reserves, less total liabilities. Generally, the preceding calculation is expected to approximate 75.0% of the aggregate cost of our real estate and real estate-related investments before depreciation, amortization, bad debt and other similar non-cash reserves. In addition, we may incur mortgage debt and pledge some or all of our real properties as security for that debt to obtain funds to acquire additional real estate or for working capital. We may also borrow funds to satisfy the REIT tax qualification requirement that we distribute at least 90.0% of our annual taxable income, excluding net capital gains, to our stockholders. Furthermore, we may borrow if we otherwise deem it necessary or advisable to ensure that we maintain our qualification as a REIT for federal income tax purposes. As of November 9, 2017 and September 30, 2017, our leverage did not exceed 300% of the value of our net assets.

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investments.
Mortgage Loans Payable, Net
For a discussion of our mortgage loans payable, net, see Note 6,8, Mortgage Loans Payable, Net, to our accompanying condensed consolidated financial statements.
LineLines of Credit and Term Loans
For a discussion of the Lineour lines of credit and term loans, see Note 9, Lines of Credit see Note 7, Line of Credit,and Term Loans, to our accompanying condensed consolidated financial statements.
REIT Requirements
In order to maintain our qualification as a REIT for federal income tax purposes, we are required to make distributionsdistribute to our stockholders a minimum of at least 90.0% of our annual taxable income, excluding net capital gains.Existing Internal Revenue Service, or IRS, guidance includes a safe harbor pursuant to which publicly offered REITs can satisfy the distribution requirement by distributing a combination of cash and stock to stockholders. In general, to qualify under the safe harbor, each stockholder must elect to receive either cash or stock, and the aggregate cash component of the distribution to stockholders must represent at least 20.0% of the total distribution. In the event that there is a shortfall in net cash available due to factors including, without limitation, the timing of such distributions or the timing of the collection of receivables, we may seek to obtain capital to pay distributions by means of secured and unsecured debt financing through one or more unaffiliated third parties. We may also pay distributions from cash from capital transactions including, without limitation, the sale of one or more of our properties or from the proceeds of our offering.properties.
Commitments and Contingencies
For a discussion of our commitments and contingencies, see Note 9,12, Commitments and Contingencies, to our accompanying condensed consolidated financial statements.
Debt Service Requirements
Typically, aA significant liquidity need is the payment of principal and interest on our outstanding indebtedness. As of September 30, 2017,March 31, 2022, we had $11,718,000 ($11,639,000, including premium$1,121,901,000 of fixed-rate and deferred financing costs, net) of fixed-ratevariable-rate mortgage loans payable outstanding secured by our properties. As of September 30, 2017,March 31, 2022, we had $26,000,000$1,239,134,000 outstanding and $74,000,000$170,866,000 remained available under the Lineour lines of Credit.credit. The weighted average effective interest rate on our outstanding debt was 2.72% per annum as of March 31, 2022. See Note 6,8, Mortgage Loans Payable, Net and Note 7, Line9, Lines of Credit and Term Loans, to our accompanying condensed consolidated financial statements.
We are required by the terms of certain loan documents to meet certainvarious financial and non-financial covenants, such as leverage ratios, net worth ratios, debt service coverage ratios and fixed charge coverage ratios and reporting requirements. Asratios. Except as explained below, as of September 30, 2017,March 31, 2022, we were in compliance with all such covenants and requirements on our mortgage loans payable and our lines of credit and term loans. While the Lineextent and severity of Credit. As of September 30, 2017, the weighted average effective interest rateCOVID-19 pandemic on our outstandingbusiness is subsiding, any potential future deterioration of operations in excess of management's projections as a result of COVID-19 could impact future compliance with these covenants. If any future covenants are violated, we anticipate seeking a waiver or amending the debt was 4.09% per annum.
Contractual Obligations
The following table provides informationcovenants with respect to: (i) the maturitylenders when and scheduled principal repaymentif such event should occur. However, there can be no assurances that management will be able to effectively achieve such plans. Some of our secured mortgage loans payableloan agreements include a standard loan term requiring lender approval for a change of control event, which was triggered upon the closing of the Merger. All of our mortgage lenders and loan servicers approved such event, except for the Lineservicers of Credit; (ii) interest payments ontwo of our mortgage loans payable and the Linewith an aggregate principal balance of Credit; and (iii) ground and other lease obligations as of September 30, 2017:
 Payments Due by Period
 2017 2018-2019 2020-2021 Thereafter Total
Principal payments — fixed-rate debt$84,000
  $793,000
 $8,349,000
 $2,492,000
 $11,718,000
Interest payments — fixed-rate debt145,000
  1,117,000
 421,000
 455,000
 2,138,000
Principal payments — variable-rate debt
 26,000,000
 
 
 26,000,000
Interest payments — variable-rate debt (based on rates in effect as of September 30, 2017)243,000
 1,621,000
 
 
 1,864,000
Ground and other lease obligations24,000
  491,000
 492,000
 11,466,000
 12,473,000
Total$496,000
  $30,022,000
 $9,262,000
 $14,413,000
 $54,193,000
Off-Balance Sheet Arrangements
As of September 30, 2017, we had no off-balance sheet transactions, nor do we currently have any such arrangements or obligations.$14,137,000, for which approvals were received in April 2022.
Inflation
During the ninethree months ended September 30, 2017March 31, 2022 and 2016,2021, inflation has not significantly affected our operations; however, the annual rate of inflation in the United States reached 8.3% in April 2022, the highest rate in more than four decades, as measured by the Consumer Price Index, and while we believe inflation has not significantly impacted our operations, becausewe have experienced, and continue to experience, increases in the cost of the moderate inflation rate; however, we expect to be exposed to inflation risk as income fromlabor, services and personal protective equipment and therefore continued inflationary pressures could impact our profitability in future long-term

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leases will be the primary source of our cash flows from operations.periods. There are provisions in the majority of our tenant leases that will protect us from the impact of inflation. These provisions will include negotiated rental increases, reimbursement billings for operating expense pass-through charges and real estate tax and insurance reimbursements on a per square foot allowance.reimbursements. However, due to the long-term nature of the anticipated leases, among other factors, the leases may not re-setreset frequently enough to cover inflation.
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Related Party Transactions
For a discussionsummary of related party transactions, see Note 12,15, Related Party Transactions, to our accompanying condensed consolidated financial statements.statements, and Note 15, Related Party Transactions, to the consolidated financial statements that are a part of our 2021 Annual Report on Form 10-K, as filed with the SEC on March 25, 2022.
Funds from Operations and Modified Funds from Operations
Due to certain unique operating characteristics of real estate companies, the National Association of Real Estate Investment Trusts, or NAREIT, an industry trade group, has promulgated a measure known as funds from operations, a non-GAAP measure, which we believe to be an appropriate supplemental performance measure to reflect the operating performance of a REIT. The use of funds from operations is recommended by the REIT industry as a supplemental performance measure, and our management uses FFO to evaluate our performance over time. FFO is not equivalent to our net income (loss) as determined under GAAP.
We define FFO, a non-GAAP measure, consistent with the standards established by the White Paper on funds from operations approved by the Board of Governors of NAREIT, as revised in February 2004, or the White Paper. The White Paper defines funds from operations as net income (loss) computed in accordance with GAAP, excluding gains or losses from sales of propertycertain real estate assets and asset impairment writedowns of certain real estate assets and investments, plus depreciation and amortization related to real estate, and after adjustments for unconsolidated partnerships and joint ventures. While impairment charges are excluded from the calculation of FFO as described above, investors are cautioned that impairments are based on estimated future undiscounted cash flows. Adjustments for unconsolidated partnerships and joint ventures are calculated to reflect funds from operations. Our FFO calculation complies with NAREIT’s policy described above.
The historical accounting convention used for real estate assets requires straight-line depreciation of buildings and improvements, which implies that the value of real estate assets diminishes predictably over time, which is the case if such assets are not adequately maintained or repaired and renovated as required by relevant circumstances and/or as requested or required by lessees for operational purposes in order to maintain the value disclosed. We believe that, since real estate values historically rise and fall with market conditions, including inflation, interest rates, the business cycle, unemployment and consumer spending, presentations of operating results for a REIT using historical accounting for depreciation may be less informative. In addition, we believe it is appropriate to exclude impairment charges, as this is a fair value adjustment that is largely based on market fluctuations and assessments regarding general market conditions, which can change over time. Testing for an impairment of an asset is a continuous process and is analyzed on a quarterly basis. If certain impairment indications exist in an asset, and if the asset’s carrying, or book value, exceeds the total estimated undiscounted future cash flows (including net rental and lease revenues, net proceeds on the sale of the property and any other ancillary cash flows at a property or group level under GAAP) from such asset, an impairment charge would be recognized. Investors should note, however, that determinations of whether impairment charges have been incurred are based partly on anticipated operating performance, because estimated undiscounted future cash flows from a property, including estimated future net rental and lease revenues, net proceeds on the sale of the property and certain other ancillary cash flows, are taken into account in determining whether an impairment charge has been incurred. While impairment charges are excluded from the calculation of FFO as described above, investors are cautioned that due to the fact that impairments are based on estimated future undiscounted cash flows and that we intend to have a relatively limited term of our operations, it could be difficult to recover any impairment charges through the eventual sale of the property.
Historical accounting for real estate involves the use of GAAP. Any other method of accounting for real estate such as the fair value method cannot be construed to be any more accurate or relevant than the comparable methodologies of real estate valuation found in GAAP. Nevertheless, we believe that the use of FFO, which excludes the impact of real estate-related depreciation and amortization and impairments, provides a further understanding of our performance to investors and to our management, and when compared year over year, reflects the impact on our operations from trends in occupancy rates, rental rates, operating costs, general and administrative expenses and interest costs, which may not be immediately apparent from net income (loss).
However, FFO and modified funds from operations attributable to controlling interest, or MFFO, as described below, should not be construed to be more relevant or accurate than the current GAAP methodology in calculating net income (loss) or in its applicability in evaluating our operating performance. The method utilized to evaluate the value and performance of real estate under GAAP should be construed as a more relevant measure of operational performance and considered more prominently than the non-GAAP FFO and MFFO measures and the adjustments to GAAP in calculating FFO and MFFO.

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Changes in the accounting and reporting rules under GAAP that were put into effect and other changes to GAAP accounting for real estate subsequent to the establishment of NAREIT’s definition of FFO have prompted an increase in cash-settled expenses, specifically acquisition fees and expenses, as items that are expensed as operating expenses under GAAP. We believe these fees and expenses do not affect our overall long-term operating performance. Publicly registered, non-listed REITs typically have a significant amount of acquisition activity and are substantially more dynamic during their initial years of investment and operation. While other start up entities may also experience significant acquisition activity during their initial years, we believe that publicly registered, non-listed REITs are unique in that they have a limited life with targeted exit strategies within a relatively limited time frame after the acquisition activity ceases. We will use the proceeds raised in our offering to acquire properties, and we intend to begin the process of achieving a liquidity event (i.e., listing of our shares of common stock on a national securities exchange, a merger or sale, the sale of all or substantially all of our assets, or another similar transaction) within five years after the completion of our offering stage, which is generally comparable to other publicly registered, non-listed REITs. Thus, we do not intend to continuously purchase assets and intend to have a limited life. Due to the above factors and other unique features of publicly registered, non-listed REITs, the Investment Program Association, or theThe IPA, an industry trade group, has standardized a measure known as modified funds from operations, which the IPA has recommended as a supplemental performance measure for publicly registered, non-listed REITs and which we believe to be another appropriate supplemental performance measure to reflect the operating performance of a publicly registered, non-listed REIT having the characteristics described above. MFFO is not equivalent to our net income (loss) as determined under GAAP, and MFFO may not be a useful measure of the impact of long-term operating performance on value if we do not continue to operate with a limited life and targeted exit strategy, as currently intended. We believe that, because MFFO excludes expensed acquisition fees and expenses that affect our operations only in periods in which properties are acquired and that we consider more reflective of investing activities, as well as other non-operating items included in FFO, MFFO can provide, on a going forward basis, an indication of the sustainability (that is, the capacity to continue to be maintained) of our operating performance after the period in which we are acquiring our properties and once our portfolio is in place. By providing MFFO, we believe we are presenting useful information that assists investors and analysts to better assess the sustainability of our operating performance after ourthe initial offering stage has been completed and our properties have been acquired. We also believe that MFFO is a recognized measure of sustainable operating performance by the publicly registered, non-listed REIT industry. Further, we believe MFFO is useful in comparing the sustainability of our operating performance after our offering stage and acquisitions are completed with the sustainability of the operating performance of other real estate companies that are not as involved in acquisition activities. Investors are cautioned that MFFO should only be used to assess the sustainability of our operating performance after ourthe initial offering stage has been completed and properties have been acquired, as it excludes expensed acquisition fees and expenses that have a negative effect on our initial operating performance during the periods in which properties are acquired.
We define MFFO, a non-GAAP measure, consistent with the IPA’sPractice Guideline 2010-01, Supplemental Performance Measure for Publicly Registered, Non-Listed REITs: Modified Funds from Operations, or the Practice Guideline, issued by the IPA in November 2010. The Practice Guideline defines modified funds from operations as funds from operations further
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adjusted for the following items included in the determination of GAAP net income (loss): expensed acquisition fees and expenses;costs; amounts relating to deferred rent receivables and amortization of above- and below-market leases and liabilities (which are adjusted in order to reflect such payments from a GAAP accrual basis to closer to an expected to be received cash basis of disclosing the rent and lease payments); accretion of discounts and amortization of premiums on debt investments; mark-to-market adjustments included in net income (loss); gains or losses included in net income (loss) from the extinguishment or sale of debt, hedges, foreign exchange, derivatives or securities holdings where trading of such holdings is not a fundamental attribute of the business plan; unrealized gains or losses resulting from consolidation from, or deconsolidation to, equity accounting; and after adjustments for consolidated and unconsolidated partnerships and joint ventures, with such adjustments calculated to reflect modified funds from operations on the same basis. The accretion of discounts and amortization of premiums on debt investments, unrealized gains and losses on hedges, foreign exchange, derivatives or securities holdings, unrealized gains and losses resulting from consolidations, as well as other listed cash flow adjustments are adjustments made to net income (loss) in calculating cash flows from operations and, in some cases, reflect gains or losses which are unrealized and may not ultimately be realized. We are responsible for managing interest rate, hedge and foreign exchange risk, and we do not rely on another party to manage such risk. In as much as interest rate hedges will not be a fundamental part of our operations, we believe it is appropriate to exclude such gains and losses in calculating MFFO, as such gains and losses are based on market fluctuations and may not be directly related or attributable to our operations.
Our MFFO calculation complies with the IPA’s Practice Guideline described above. In calculating MFFO, we exclude acquisition related expenses, amortization of above- and below-market leases, change in deferred rent receivables and the adjustments of such items related to redeemable noncontrolling interest. The other adjustments included in the IPA’s Practice Guideline are not applicable to us for the three and nine months ended September 30, 2017 and 2016. Acquisition fees and expenses are paid in cash by us, and we have not set aside or put into escrow any specific amount of proceeds from our offering to be used to fund acquisition fees and expenses. The purchase of real estate and real estate-related investments, and the

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corresponding expenses associated with that process, is a key operational feature of our business plan in order to generate operating revenues and cash flows to make distributions to our stockholders. However, we do not intend to fund acquisition fees and expenses in the future from operating revenues and cash flows, nor from the sale of properties and subsequent redeployment of capital and concurrent incurring of acquisition fees and expenses. Acquisition fees and expenses include payments to our advisor or its affiliates and third parties. Such fees and expenses are not reimbursed by our advisor or its affiliates and third parties, and therefore if there is no further cash on hand from the proceeds from the sale of shares of our common stock to fund future acquisition fees and expenses, such fees and expenses will need to be paid from either additional debt, operational earnings or cash flows, net proceeds from the sale of properties or from ancillary cash flows. Certain acquisition related expenses under GAAP, such as expenses incurred in connection with property acquisitions accounted for as business combinations, are considered operating expenses and as expenses included in the determination of net income (loss), which is a performance measure under GAAP. All paid and accrued acquisition fees and expenses will have negative effects on returns to investors, the potential for future distributions and cash flows generated by us, unless earnings from operations or net sales proceeds from the disposition of other properties are generated to cover the purchase price of the property, these fees and expenses and other costs related to such property. In the future, we may pay acquisition fees or reimburse acquisition expenses due to our advisor and its affiliates, or a portion thereof, with net proceeds from borrowed funds, operational earnings or cash flows, net proceeds from the sale of properties or ancillary cash flows. As a result, the amount of proceeds from borrowings available for investment and operations would be reduced, or we may incur additional interest expense as a result of borrowed funds. Nevertheless, our advisor or its affiliates will not accrue any claim on our assets if acquisition fees and expenses are not paid from the proceeds of our offering.
Further, under GAAP, certain contemplated non-cash fair value and other non-cash adjustments are considered operating non-cash adjustments to net income (loss) in determining cash flows from operations. In addition, we view fair value adjustments of derivatives and gains and losses from dispositions of assets as items which are unrealized and may not ultimately be realized or as items which are not reflective of on-going operations and are therefore typically adjusted for when assessing operating performance.
Our management uses MFFO and the adjustments used to calculate it in order to evaluate our performance against other publicly registered, non-listed REITs which intend to have limited lives with short and defined acquisition periods and targeted exit strategies shortly thereafter. As noted above, MFFO may not be a useful measure of the impact of long-term operating performance if we do not continue to operate in this manner. We believe that our use of MFFO and the adjustments used to calculate it allow us to present our performance in a manner that reflects certain characteristics that are unique to publicly registered, non-listed REITs, such as their limited life, limited and defined acquisition period and targeted exit strategy, and hence, that the use of such measures may be useful to investors. For example, acquisition fees and expenses are intended to be funded from the proceeds of our offering and other financing sources and not from operations. By excluding expensed acquisition fees and expenses, the use of MFFO provides information consistent with management’s analysis of the operating performance of the properties. Additionally, fair value adjustments, which are based on the impact of current market fluctuations and underlying assessments of general market conditions, but can also result from operational factors such as rental and occupancy rates, may not be directly related or attributable to our current operating performance. By excluding such charges that may reflect anticipated and unrealized gains or losses, we believe MFFO provides useful supplemental information.
Presentation of this information is intended to provide useful information to investors as they compare the operating performance of different REITs, although it should be noted that not all REITs calculate funds from operations and modified funds from operations the same way, so comparisons with other REITs may not be meaningful. Furthermore, FFO and MFFO are not necessarily indicative of cash flow available to fund cash needs and should not be considered as an alternative to net income (loss) as an indication of our performance, as an alternative to cash flows from operations, which is an indication of our liquidity, or indicative of funds available to fund our cash needs including our ability to make distributions to our stockholders. FFO and MFFO should be reviewed in conjunction with other measurements as an indication of our performance. MFFO has limitations as a performance measure in offerings such as ours where the price of a share of common stock is a stated value and there is no net asset value determination during the offering stage and for a period thereafter. MFFO may be useful in assisting management and investors in assessing the sustainability of operating performance in future operating periods, and in particular, after the offering and acquisition stages are complete and net asset value is disclosed.complete. FFO and MFFO are not useful measures in evaluating net asset value because impairments are taken into account in determining net asset value but not in determining FFO and MFFO.
Neither the SEC, NAREIT nor any other regulatory body has passed judgment on the acceptability of the adjustments that we use to calculate FFO or MFFO. In the future, the SEC, NAREIT or another regulatory body may decide to standardize the allowable adjustments across the publicly registered, non-listed REIT industry and we would have to adjust our calculation and characterization of FFO or MFFO.

For the three months ended March 31, 2022 and 2021, we recognized government grants as grant income or as a reduction of property operating expenses, as applicable, and within loss from unconsolidated entities. Such amounts were granted through federal and state government programs, such as through the CARES Act, and which were established for eligible healthcare providers to preserve liquidity in response to the COVID-19 pandemic. See the “Results of Operations” section above for a further discussion. The government grants helped mitigate some of the negative impact that the COVID-19 pandemic had on our financial condition and results of operations. Without such relief funds, the COVID-19 pandemic would have had a material adverse impact to our FFO and MFFO. For the three months ended March 31, 2022 and 2021, FFO would have been approximately $28,244,000 and $4,458,000, respectively, excluding government grants recognized. For the three months ended March 31, 2022 and 2021, MFFO would have been approximately $32,722,000 and $4,707,000, respectively, excluding government grants recognized.
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The following is a reconciliation of net income (loss),or loss, which is the most directly comparable GAAP financial measure, to FFO and MFFO for the three and nine months ended September 30, 2017 and 2016:periods presented below:
 Three Months Ended September 30, Nine Months Ended September 30,
 2017 2016 2017 2016
Net income (loss)$754,000
 $(2,092,000) $1,290,000
 $(2,855,000)
Add:       
Depreciation and amortization — consolidated properties3,442,000
 64,000
 7,619,000
 64,000
Less:       
Net income (loss) attributable to redeemable noncontrolling interest
 
 
 
FFO attributable to controlling interest$4,196,000
 $(2,028,000) $8,909,000
 $(2,791,000)
        
Acquisition related expenses(1)$121,000
 $1,857,000
 $334,000
 $2,227,000
Amortization of above- and below-market leases(2)(30,000) (33,000) (99,000) (33,000)
Change in deferred rent receivables(3)(569,000) 
 (1,124,000) 
Adjustments for redeemable noncontrolling interest(4)
 
 
 
MFFO attributable to controlling interest$3,718,000

$(204,000) $8,020,000

$(597,000)
Weighted average Class T and Class I common shares outstanding — basic and diluted32,593,321
 3,357,979
 23,827,175
 1,345,578
Net income (loss) per Class T and Class I common share — basic and diluted$0.02
 $(0.62) $0.05
 $(2.12)
FFO attributable to controlling interest per Class T and Class I common share — basic and diluted$0.13
 $(0.60) $0.37
 $(2.07)
MFFO attributable to controlling interest per Class T and Class I common share — basic and diluted$0.11
 $(0.06) $0.34
 $(0.44)
Three Months Ended March 31,
 20222021
Net loss$(897,000)$(16,273,000)
Add:
Depreciation and amortization related to real estate ��� consolidated properties42,311,000 25,723,000 
Depreciation and amortization related to real estate — unconsolidated entities426,000 806,000 
Less:
(Gain) loss on dispositions of real estate investments — consolidated properties(756,000)335,000 
Net (income) loss attributable to noncontrolling interests(2,059,000)4,426,000 
Depreciation, amortization and gain/loss on dispositions — noncontrolling interests(6,409,000)(4,765,000)
FFO attributable to controlling interest$32,616,000 $10,252,000 
Business acquisition expenses(1)$173,000 $1,248,000 
Amortization of above- and below-market leases(2)505,000 36,000 
Amortization of closing costs(3)56,000 47,000 
Change in deferred rent(4)(1,026,000)(334,000)
Loss on debt extinguishments(5)4,591,000 2,288,000 
Gain in fair value of derivative financial instruments(6)(500,000)(1,821,000)
Foreign currency loss (gain)(7)1,387,000 (415,000)
Adjustments for unconsolidated entities(8)105,000 171,000 
Adjustments for noncontrolling interests(8)(813,000)(971,000)
MFFO attributable to controlling interest$37,094,000 $10,501,000 
Weighted average common shares outstanding — basic and diluted262,516,815 179,627,778 
Net loss per common share — basic and diluted$— $(0.09)
FFO attributable to controlling interest per common share — basic and diluted$0.12 $0.06 
MFFO attributable to controlling interest per common share — basic and diluted$0.14 $0.06 
___________
(1)In evaluating investments in real estate, we differentiate the costs to acquire the investment from the operations derived from the investment. Such information would be comparable only for publicly registered, non-listed REITs that have completed their acquisition activity and have other similar operating characteristics. By excluding expensed acquisition related expenses, we believe MFFO provides useful supplemental information that is comparable for each type of real estate investment and is consistent with management’s analysis of the investing and operating performance of our properties. Acquisition fees and expenses include payments to our advisor or its affiliates and third parties. Certain acquisition related expenses under GAAP, such as expenses incurred in connection with property acquisitions accounted for as business combinations, are considered operating expenses and as expenses included in the determination of net income (loss), which is a performance measure under GAAP. All paid and accrued acquisition fees and expenses will have negative effects on returns to investors, the potential for future distributions, and cash flows generated by us, unless earnings from operations or net sales proceeds from the disposition of other properties are generated to cover the purchase price of the property, these fees and expenses and other costs related to such property.
(2)Under GAAP, above- and below-market leases are assumed to diminish predictably in value over time and amortized, similar to depreciation and amortization of other real estate-related assets that are excluded from FFO. However, because real estate values and market lease rates historically rise or fall with market conditions, including inflation, interest rates, the business cycle, unemployment and consumer spending, we believe that by excluding charges relating to the amortization of above- and below-market leases, MFFO may provide useful supplemental information on the performance of the real estate.
(3)Under GAAP, rental revenue or rental expense is recognized on a straight-line basis over the terms of the related lease (including rent holidays). This may result in income or expense recognition that is significantly different than the underlying contract terms. By adjusting for the change in deferred rent receivables, MFFO may provide useful supplemental information on the realized economic impact of lease terms, providing insight on the expected contractual cash flows of such lease terms, and aligns results with our analysis of operating performance.
(4)Includes all adjustments to eliminate the redeemable noncontrolling interest’s share of the adjustments described in notes (1) – (3) above to convert our FFO to MFFO.

(1)In evaluating investments in real estate, we differentiate the costs to acquire the investment from the operations derived from the investment. Such information would be comparable only for publicly registered, non-listed REITs that have completed their acquisition activity and have other similar operating characteristics. By excluding business acquisition expenses that have been deducted as expenses in the determination of GAAP net income or loss, we believe MFFO provides useful supplemental information that is comparable for each type of real estate investment and is consistent with management’s analysis of the investing and operating performance of our properties. Business acquisition expenses include payments to our former advisor or its affiliates and third parties.
(2)Under GAAP, above- and below-market leases are assumed to diminish predictably in value over time and amortized, similar to depreciation and amortization of other real estate related assets that are excluded from FFO. However, because real estate values and market lease rates historically rise or fall with market conditions, including inflation, interest rates, the business cycle, unemployment and consumer spending, we believe that by excluding charges relating to the amortization of above- and below-market leases, MFFO may provide useful supplemental information on the performance of the real estate.
(3)Under GAAP, closing costs are amortized over the term of our debt security investment as an adjustment to the yield on our debt security investment. This may result in income recognition that is different than the contractual cash flows under our debt security investment. By adjusting for the amortization of the closing costs, MFFO may provide useful supplemental information on the realized economic impact of our debt security investment, providing insight on the expected contractual cash flows of such investment, and aligns results with management’s analysis of operating performance.
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(4)Under GAAP, as a lessor, rental revenue is recognized on a straight-line basis over the terms of the related lease (including rent holidays). As a lessee, we record amortization of right-of-use assets and accretion of lease liabilities for our operating leases. This may result in income or expense recognition that is significantly different than the underlying contract terms. By adjusting such amounts, MFFO may provide useful supplemental information on the realized economic impact of lease terms, providing insight on the expected contractual cash flows of such lease terms, and aligns results with management’s analysis of operating performance.
(5)The loss associated with the early extinguishment of debt primarily relates to the write-off of unamortized deferred financing fees, write-off of unamortized debt discount or premium, penalties, or other fees incurred. We believe that adjusting for such non-recurring losses provides useful supplemental information because such charges (or losses) may not be reflective of on-going business transactions and operations and is consistent with management’s analysis of our operating performance.
(6)Under GAAP, we are required to include changes in fair value of our derivative financial instruments in the determination of net income or loss. We believe that adjusting for the change in fair value of our derivative financial instruments to arrive at MFFO is appropriate because such adjustments may not be reflective of on-going operations and reflect unrealized impacts on value based only on then current market conditions, although they may be based upon general market conditions. The need to reflect the change in fair value of our derivative financial instruments is a continuous process and is analyzed on a quarterly basis in accordance with GAAP.
(7)We believe that adjusting for the change in foreign currency exchange rates provides useful information because such adjustments may not be reflective of on-going operations.
(8)Includes all adjustments to eliminate the unconsolidated entities’ share or noncontrolling interests’ share, as applicable, of the adjustments described in notes (1) – (7) above to convert our FFO to MFFO.
Net Operating Income
Net operating income, or NOI, is a non-GAAP financial measure that is defined as net income (loss), computed in accordance with GAAP, generated from properties before general and administrative expenses, business acquisition related expenses, depreciation and amortization, interest expense, and interest income. Acquisition fees and expenses are paid in cash by us, and we have not set asidegain or put into escrow any specific amount of proceeds from our offering to be used to fund acquisition fees and expenses. The purchaseloss on dispositions, impairment of real estate investments, income or loss from unconsolidated entities, foreign currency gain or loss, other income and real estate-related investments, and the corresponding expenses associated with that process, is a key operational feature of our business plan in order to generate operating revenues and cash flows to make distributions to our stockholders. However, we do not intend to fund acquisition fees and expenses in the future from operating revenues and cash flows, nor from the sale of properties and subsequent redeployment of capital and concurrent incurring of acquisition fees and expenses. Acquisition fees and expenses include payments to our advisorincome tax benefit or its affiliates and third parties. Such fees and expenses are not reimbursed by our advisor or its affiliates and third parties, and therefore, if there is no further cash on hand from the proceeds from the sale of shares of our common stock to fund future acquisition fees and expenses, such fees and expenses will need to be paid from either additional debt, operational earnings or cash flows, net proceeds from the sale of properties or from ancillary cash flows. As a result, the amount of proceeds available for investment, operations and non-operating expenses would be reduced, or we may incur additional interest expense as a result of borrowed funds. Nevertheless, our advisor or its affiliates will not accrue any claim on our assets if acquisition fees and expenses are not paid from the proceeds of our offering. Certain acquisition related expenses under GAAP, such as expenses incurred in connection with property acquisitions accounted for as business combinations, are considered operating expenses and as expenses included in the determination of net income (loss), which is a performance measure under GAAP. All paid and accrued acquisition fees and expenses have negative effects on returns to investors, the potential for future distributions and cash flows generated by us, unless earnings from operations or net sales proceeds from the disposition of other properties are generated to cover the purchase price of the property, these fees and expenses and other costs related to such property.expense.
NOI is not equivalent to our net income (loss) as determined under GAAP and may not be a useful measure in measuring operational income or cash flows. Furthermore, NOI is not necessarily indicative of cash flow available to fund cash needs and should not be considered as an alternative to net income (loss) as an indication of our performance, as an alternative to cash flows from operations, as an indication of our liquidity, or indicative of fundscash flow available to fund our cash needs including our ability to make distributions to our stockholders. NOI should not be construed to be more relevant or accurate than the current GAAP methodology in calculating net income (loss) or in its applicability in evaluating our operating performance. Investors are also cautioned that NOI should only be used to assess our operational performance in periods in which we have not incurred or accrued any business acquisition related expenses.
We believe that NOI is an appropriate supplemental performance measure to reflect the operating performance of our operating assets because NOI excludes certain items that are not associated with the managementoperations of the properties. We believe that NOI is a widely accepted measure of comparative operating performance in the real estate community. However, our use of the term NOI may not be comparable to that of other real estate companies as they may have different methodologies for computing this amount.
For the three months ended March 31, 2022 and 2021, we recognized government grants as grant income or as a reduction of property operating expenses, as applicable. The government grants helped mitigate some of the negative impact that the COVID-19 pandemic had on our financial condition and results of operations. Without such relief funds, the COVID-19 pandemic would have had a material adverse impact to our NOI. For the three months ended March 31, 2022 and 2021, NOI would have been approximately $68,470,000 and $29,852,000, respectively, excluding government grants recognized.
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To facilitate understanding of this financial measure, the following is a reconciliation of net income (loss),or loss, which is the most directly comparable GAAP financial measure, to NOI for the three and nine months ended September 30, 2017 and 2016:periods presented below:
 Three Months Ended March 31,
20222021
Net loss$(897,000)$(16,273,000)
General and administrative11,119,000 7,257,000 
Business acquisition expenses173,000 1,248,000 
Depreciation and amortization42,311,000 25,723,000 
Interest expense22,825,000 18,544,000 
(Gain) loss on dispositions of real estate investments(756,000)335,000 
(Income) loss from unconsolidated entities(1,386,000)1,771,000 
Foreign currency loss (gain)1,387,000 (415,000)
Other income(1,260,000)(272,000)
Income tax expense168,000 163,000 
Net operating income$73,684,000 $38,081,000 
 Three Months Ended September 30, Nine Months Ended September 30,
 2017 2016 2017 2016
Net income (loss)$754,000
 $(2,092,000) $1,290,000
 $(2,855,000)
General and administrative1,296,000
 329,000
 2,996,000
 725,000
Acquisition related expenses121,000
 1,857,000
 334,000
 2,227,000
Depreciation and amortization3,442,000
 64,000
 7,619,000
 64,000
Interest expense780,000
 56,000
 1,607,000
 56,000
Interest income
 
 (1,000) 
Net operating income$6,393,000

$214,000
 $13,845,000
 $217,000
Subsequent Events
For a discussion of our subsequent events, see Note 18, Subsequent Events, to our accompanying condensed consolidated financial statements.

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Item 3. Quantitative and Qualitative Disclosures About Market Risk.
Market risk includes risks that arise from changes in interest rates, foreign currency exchange rates, commodity prices, equity prices and other market changes that affect market sensitive instruments. In pursuing our business plan, we expect that the primary market risk to which we will be exposed is interest rate risk. There were no material changes in our market risk exposures, or in the methods we use to manage market risk, from those that were provided for in our 20162021 Annual Report on Form 10-K, as filed with the SEC on March 1, 2017.25, 2022.
Interest Rate Risk
We are exposed to the effects of interest rate changes primarily as a result of long-term debt used to acquire properties and make loansdevelop properties and other permitted investments. Our interest rate risk is monitored using a variety of techniques. Our interest rate risk management objectives are to limit the impact of interest rate changesincreases on earnings, prepayment penalties and cash flows and to lower overall borrowing costs while taking into account variable interest rate risk. To achieve our objectives, we may borrow or lend at fixed or variable rates.
We entered into, and may alsocontinue to enter into, derivative financial instruments such as interest rate swaps and interest rate caps in order to mitigate our interest rate risk on a related financial instrument.instrument, and for which we have not and may not elect hedge accounting treatment. We willdid not elect to apply hedge accounting treatment to these derivatives; therefore, changes in the fair value of interest rate derivative financial instruments were recorded as a component of interest expense in gain or loss in fair value of derivative financial instruments in our accompanying condensed consolidated statements of operations and comprehensive income (loss). As of March 31, 2022, we did not have any derivative financial instruments. We do not enter into derivatives or interest ratederivative transactions for speculative purposes.
In July 2017, the Financial Conduct Authority, or FCA, that regulates LIBOR announced its intention to stop compelling banks to submit rates for the calculation of LIBOR after 2021. As a result, the Federal Reserve Board and the Federal Reserve Bank of New York organized the Alternative Reference Rates Committee, which identified SOFR as its preferred alternative to United States dollar LIBOR in derivatives and other financial contracts. The FCA ceased publishing one-week and two-month LIBOR after December 31, 2021 and intends to cease publishing all remaining LIBOR after June 30, 2023. On January 19, 2022, we entered into the 2022 Credit Agreement that bears interest at varying rates based upon SOFR. Please see Note 9, Lines of Credit and Term Loans — 2022 Credit Facility, to our accompanying condensed consolidated financial statements for a further discussion.
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We have variable rate debt outstanding and maturing on various dates from 2022 to 2031 that are indexed to LIBOR. As such, we are monitoring and evaluating the related risks of the discontinuation of LIBOR, which include possible changes to the interest on loans or amounts received and paid on derivative instruments we may enter into in the future. These risks arise in connection with transitioning contracts to a new alternative rate, including any resulting value transfer that may occur. The value of loans or derivative instruments tied to LIBOR could also be impacted by the discontinuation of LIBOR. For some instruments, the method of transitioning to an alternative rate may be challenging, as they may require negotiation with the respective counterparty. If a contract is not transitioned to an alternative rate, upon LIBOR’s discontinuation the impact on our contracts is likely to vary. Currently we cannot estimate the overall impact of the phase-out of LIBOR on our current debt agreements, although it is possible that an alternative variable rate could raise our borrowing costs. It is not possible to predict whether LIBOR will continue to be viewed as an acceptable market “benchmark” prior to June 30, 2023, and it is possible that LIBOR will become unavailable prior to that point. This could result, for example, if a sufficient number of banks decline to make submissions to the LIBOR administrator. In that case, the risks associated with the transition to an alternative reference rate will be accelerated and magnified.
As of September 30, 2017,March 31, 2022, the table below presents the principal amounts and weighted average interest rates by year of expected maturity to evaluate the expected cash flows and sensitivity to interest rate changes.
Expected Maturity Date
Expected Maturity Date 20222023202420252026ThereafterTotalFair Value
2017 2018 2019 2020 2021 Thereafter Total Fair Value
AssetsAssets
Debt security held-to-maturityDebt security held-to-maturity$— $— $— $93,433,000 $— $— $93,433,000 $93,859,000 
Weighted average interest rate on maturing fixed-rate debt securityWeighted average interest rate on maturing fixed-rate debt security— %— %— %4.24 %— %— %4.24 %— 
LiabilitiesLiabilities
Fixed-rate debt — principal payments$84,000
 $386,000
 $407,000
 $8,035,000
 $314,000
 $2,492,000
 $11,718,000
 $11,950,000
Fixed-rate debt — principal payments$61,521,000 $34,521,000 $71,636,000 $29,107,000 $154,927,000 $510,768,000 $862,480,000 $777,535,000 
Weighted average interest rate on maturing fixed-rate debt5.14% 5.10% 5.10% 4.79% 5.25% 5.25% 4.92% 
Weighted average interest rate on maturing fixed-rate debt4.05 %3.78 %3.53 %3.35 %2.98 %3.01 %3.16 %— 
Variable-rate debt — principal payments$
 $
 $26,000,000
 $
 $
 $
 $26,000,000
 $25,998,000
Variable-rate debt — principal payments$60,431,000 $391,343,000 $92,338,000 $464,000 $384,875,000 $569,104,000 $1,498,555,000 $1,505,193,000 
Weighted average interest rate on maturing variable-rate debt (based on rates in effect as of September 30, 2017)% % 3.72% % % % 3.72% 
Weighted average interest rate on maturing variable-rate debt (based on rates in effect as of March 31, 2022)Weighted average interest rate on maturing variable-rate debt (based on rates in effect as of March 31, 2022)2.33 %3.20 %3.76 %2.33 %2.07 %2.03 %2.46 %— 
Debt Security Investment, Net
As of March 31, 2022, the net carrying value of our debt security investment was $80,239,000. As we expect to hold our debt security investment to maturity and the amounts due under such debt security investment would be limited to the outstanding principal balance and any accrued and unpaid interest, we do not expect that fluctuations in interest rates, and the resulting change in fair value of our debt security investment, would have a significant impact on our operations. See Note 16, Fair Value Measurements, to our accompanying condensed consolidated financial statements, for a discussion of the fair value of our investment in a held-to-maturity debt security. The effective interest rate on our debt security investment was 4.24% per annum as of March 31, 2022.
Mortgage Loans Payable, Net and LineLines of Credit and Term Loans
Mortgage loans payable were $11,718,000 ($11,639,000, including premium and deferred financing costs, net)$1,121,901,000 as of September 30, 2017.March 31, 2022. As of September 30, 2017,March 31, 2022, we had two67 fixed-rate mortgage loans payable and 11 variable-rate mortgage loans payable with effective interest rates ranging from 4.77%2.21% to 5.25% per annum.annum and a weighted average effective interest rate of 3.16%. In addition, as of September 30, 2017,March 31, 2022, we had $26,000,000$1,239,134,000 outstanding under the Lineour lines of Creditcredit and term loans, at a weighted average interest rate of 3.72%2.32% per annum.
As of September 30, 2017,March 31, 2022, the weighted average effective interest rate on our outstanding debt was 4.09%2.72% per annum. An increase in the variable interest rate on our variable-rate Linemortgage loans payable and lines of Creditcredit and term loans constitutes a market risk. As of September 30, 2017,March 31, 2022, a 0.50% increase in the market rates of interest would have increased our overall annualized interest expense on all of our other variable-rate Linemortgage loans payable and lines of Creditcredit and term loans by $132,000,$7,597,000, or 7.45%11.7% of total annualized interest expense on our mortgage loans payable and the Linelines of Credit.credit and term loans. See Note 6,8, Mortgage Loans Payable, Net and Note 7, Line9, Lines of Credit and Term Loans, to our accompanying condensed consolidated financial statements, for a further discussion.statements.
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Other Market Risk
In addition to changes in interest rates and foreign currency exchange rates, the value of our future investments is subject to fluctuations based on changes in local and regional economic conditions and changes in the creditworthiness of tenants, which may affect our ability to refinance our debt if necessary.
Item 4. Controls and Procedures.
(a) Evaluation of disclosure controls and procedures. We maintain disclosure controls and procedures that are designed to ensure that information required to be disclosed in our reports under the Securities Exchange Act of 1934, as amended, or the Exchange Act, is recorded, processed, summarized and reported within the time periods specified in the rules and forms, and that such information is accumulated and communicated to us, including our chief executive officerChief Executive Officer and chief financial officer,Chief Financial Officer, as appropriate, to allow timely decisions regarding required disclosure. In designing and evaluating the disclosure controls and procedures, we recognize that any controls and procedures, no matter how well designed and operated, can provide only

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reasonable assurance of achieving the desired control objectives, as ours are designed to do, and we necessarily wereare required to apply our judgment in evaluating whether the benefits of the controls and procedures that we adopt outweigh their costs.
As required by Rules 13a-15(b) and 15d-15(b) of the Exchange Act, an evaluation as of September 30, 2017March 31, 2022 was conducted under the supervision and with the participation of our management, including our chief executive officerChief Executive Officer and chief financial officer,Chief Financial Officer, of the effectiveness of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Exchange Act). Based on this evaluation, our chief executive officerChief Executive Officer and chief financial officerChief Financial Officer concluded that our disclosure controls and procedures, as of September 30, 2017,March 31, 2022, were effective at the reasonable assurance level.
(b) Changes in internal control over financial reporting. There were no changes in internal control over financial reporting that occurred during the fiscal quarter ended September 30, 2017March 31, 2022 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

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PART II — OTHER INFORMATION
Item 1. Legal Proceedings.
None.For a discussion of our legal proceedings, see Note 12, Commitments and Contingencies — Litigation, to our accompanying condensed consolidated financial statements.
Item 1A. Risk Factors.
There were no material changes from the risk factors previously disclosed in our 20162021 Annual Report on Form 10-K, as filed with the SEC on March 1, 2017, except as noted below.25, 2022.
We have not had sufficient cash available from operations to pay distributions, and therefore, we have paid a portion of distributions from the net proceeds of our offering, and in the future, may pay distributions from borrowings in anticipation of future cash flows or from other sources. Any such distributions may reduce the amount of capital we ultimately invest in assets, may negatively impact the value of our stockholders’ investment and may cause subsequent investors to experience dilution.
Distributions payable to our stockholders may include a return of capital, rather than a return on capital, and it is likely that we will use offering proceeds to fund a majority of our initial distributions. We have not established any limit on the amount of proceeds from our offering that may be used to fund distributions, except that, in accordance with our organizational documents and Maryland law, we may not make distributions that would: (i) cause us to be unable to pay our debts as they become due in the usual course of business; or (ii) cause our total assets to be less than the sum of our total liabilities plus senior liquidation preferences. The actual amount and timing of distributions will be determined by our board of directors in its sole discretion and typically will depend on the amount of funds available for distribution, which will depend on items such as our financial condition, current and projected capital expenditure requirements, tax considerations and annual distribution requirements needed to qualify as a REIT. As a result, our distribution rate and payment frequency vary from time to time.
We have used the net proceeds from our offering and our advisor has waived certain fees payable to it as discussed below, and in the future, may use the net proceeds from our offering, borrowed funds, or other sources, to pay cash distributions to our stockholders in order to maintain our qualification as a REIT, which may reduce the amount of proceeds available for investment and operations, cause us to incur additional interest expense as a result of borrowed funds or cause subsequent investors to experience dilution. Further, if the aggregate amount of cash distributed in any given year exceeds the amount of our current and accumulated earnings and profits, the excess amount will be deemed a return of capital.
On April 13, 2016, our board of directors authorized a daily distribution to our Class T stockholders of record as of the close of business on each day of the period from May 1, 2016 through June 30, 2016. Our advisor agreed to waive certain asset management fees that may otherwise have been due to our advisor pursuant to the Advisory Agreement until such time as the amount of such waived asset management fees was equal to the amount of distributions payable to our stockholders for the period beginning on May 1, 2016 and ending on the date of the acquisition of our first property or real estate-related investment, as such terms are defined in the Advisory Agreement. Having raised the minimum offering in April 2016, the distributions declared for each record date in the May 2016 and June 2016 periods were paid in June 2016 and July 2016, respectively, from legally available funds. The daily distributions were calculated based on 365 days in the calendar year and were equal to $0.001643836 per share of our Class T common stock. These distributions were aggregated and paid in cash or shares of our common stock pursuant to the DRIP monthly in arrears. We acquired our first property on June 28, 2016, and as such, our advisor waived $80,000 in asset management fees equal to the amount of distributions paid from May 1, 2016 through June 27, 2016. Our advisor did not receive any additional securities, shares of our stock, or any other form of consideration or any repayment as a result of the waiver of such asset management fees.
On June 28, 2016, our board of directors authorized a daily distribution to our Class T stockholders of record as of the close of business on each day of the period commencing on July 1, 2016 and ending on September 30, 2016 and to our Class I stockholders of record as of the close of business on each day of the period commencing on the date that the first Class I share was sold and ending on September 30, 2016. Subsequently, our board of directors authorized on a quarterly basis a daily distribution to our Class T and Class I stockholders of record as of the close of business on each day of the quarterly periods commencing on October 1, 2016 and ending on December 31, 2017. The daily distributions were or will be calculated based on 365 days in the calendar year and are equal to $0.001643836 per share of our Class T and Class I common stock, which is equal to an annualized distribution of $0.60 per share. These distributions were or will be aggregated and paid in cash or shares of our common stock pursuant to the DRIP monthly in arrears, only from legally available funds.
The amount of distributions paid to our stockholders is determined quarterly by our board of directors and is dependent on a number of factors, including funds available for payment of distributions, our financial condition, capital expenditure requirements and annual distribution requirements needed to maintain our qualification as a REIT under the Code. We have not established any limit on the amount of offering proceeds that may be used to fund distributions, except that, in accordance with

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our organizational documents and Maryland law, we may not make distributions that would: (i) cause us to be unable to pay our debts as they become due in the usual course of business; or (ii) cause our total assets to be less than the sum of our total liabilities plus senior liquidation preferences.
The distributions paid for the nine months ended September 30, 2017 and 2016, along with the amount of distributions reinvested pursuant to the DRIP and the sources of distributions as compared to cash flows from operations were as follows:
 Nine Months Ended September 30,
 2017 2016
Distributions paid in cash$4,006,000
   $148,000
  
Distributions reinvested5,492,000
   222,000
  
 $9,498,000
   $370,000
  
Sources of distributions:       
Cash flows from operations$8,849,000
 93.2% $
 %
Offering proceeds649,000
 6.8
 370,000
 100
 $9,498,000
 100% $370,000
 100%
Under GAAP, certain acquisition related expenses, such as expenses incurred in connection with property acquisitions accounted for as business combinations, are expensed, and therefore, subtracted from cash flows from operations. However, these expenses may be paid from offering proceeds or debt.
Our distributions of amounts in excess of our current and accumulated earnings and profits have resulted in a return of capital to our stockholders, and all or any portion of a distribution to our stockholders may be paid from offering proceeds. The payment of distributions from our offering proceeds could reduce the amount of capital we ultimately invest in assets and negatively impact the amount of income available for future distributions.
As of September 30, 2017, we had an amount payable of $8,065,000 to our advisor or its affiliates primarily for the Contingent Advisor Payment and asset management fees, which will be paid from cash flows from operations in the future as it becomes due and payable by us in the ordinary course of business consistent with our past practice.
As of September 30, 2017, no amounts due to our advisor or its affiliates had been deferred, waived or forgiven other than the $80,000 in asset management fees waived by our advisor discussed above. Other than the waiver of asset management fees by our advisor to provide us with additional funds to pay initial distributions to our stockholders through June 27, 2016, our advisor and its affiliates, including our co-sponsors, have no obligation to defer or forgive fees owed by us to our advisor or its affiliates or to advance any funds to us. In the future, if our advisor or its affiliates do not defer or continue to defer, waive or forgive amounts due to them, this would negatively affect our cash flows from operations, which could result in us paying distributions, or a portion thereof, using borrowed funds. As a result, the amount of proceeds available for investment and operations would be reduced, or we may incur additional interest expense as a result of borrowed funds.
The distributions paid for the nine months ended September 30, 2017 and 2016, along with the amount of distributions reinvested pursuant to the DRIP and the sources of our distributions as compared to FFO were as follows:
 Nine Months Ended September 30,
 2017 2016
Distributions paid in cash$4,006,000
   $148,000
  
Distributions reinvested5,492,000
   222,000
  
 $9,498,000
   $370,000
  
Sources of distributions:       
FFO attributable to controlling interest$8,909,000
 93.8% $
 %
Offering proceeds589,000
 6.2
 370,000
 100
 $9,498,000
 100% $370,000
 100%


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The payment of distributions from sources other than FFO may reduce the amount of proceeds available for investment and operations or cause us to incur additional interest expense as a result of borrowed funds. For a further discussion of FFO, a non-GAAP financial measure, including a reconciliation of our GAAP net income (loss) to FFO, see Part I, Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations — Funds from Operations and Modified Funds from Operations.
A high concentration of our properties in a particular geographic area would magnify the effects of downturns in that geographic area.
To the extent that we have a concentration of properties in any particular geographic area, any adverse situation that disproportionately effects that geographic area would have a magnified adverse effect on our portfolio. As of November 9, 2017, our properties located in Florida, Nevada and Alabama accounted for approximately 20.4%, 13.7% and 12.2%, respectively, of the annualized base rent of our total property portfolio. Accordingly, there is a geographic concentration of risk subject to fluctuations in each state’s economy.
A significant portion of our annual base rent may be concentrated in a small number of tenants. Therefore, non-renewals, terminations or lease defaults by any of these significant tenants could reduce our net income and have a negative effect on our ability to pay distributions to our stockholders.
As of November 9, 2017, rental payments by two of our tenants, Colonial Oaks Master Tenant, LLC and Prime Healthcare Services – Reno, accounted for approximately 12.0% and 11.1%, respectively, of our annualized base rent. The success of our investments materially depends upon the financial stability of the tenants leasing the properties we own. Therefore, a non-renewal after the expiration of a lease term, termination, default or other failure to meet rental obligations by significant tenants, such as Colonial Oaks Master Tenant, LLC and Prime Healthcare Services – Reno, would significantly lower our net income. These events could cause us to reduce the amount of distributions to our stockholders.
Reductions in reimbursement from third-party payers, including Medicare and Medicaid, could adversely affect the profitability of our tenants and hinder their ability to make rent payments to us.
Sources of revenue for our tenants may include the federal Medicare program, state Medicaid programs, private insurance carriers and health maintenance organizations, among others. Efforts by such payers to reduce healthcare costs will likely continue, which may result in reductions or slower growth in reimbursement for certain services provided by some of our tenants. In addition, the healthcare billing rules and regulations are complex, and the failure of any of our tenants to comply with various laws and regulations could jeopardize their ability to continue participating in Medicare, Medicaid and other government sponsored payment programs. Moreover, the state and federal governmental healthcare programs are subject to reductions by state and federal legislative actions. The American Taxpayer Relief Act of 2012 prevented the reduction in physician reimbursement of Medicare from being implemented in 2013. The Protecting Access to Medicare Act of 2014 prevented the reduction of 24.4% in the physician fee schedule by replacing the scheduled reduction with a 0.5% increase to the physician fee schedule through December 31, 2014, and a 0% increase for January 1, 2015 through March 31, 2015. The potential 21.0% cut in reimbursement that was to be effective April 1, 2015 was removed by the Medicare Access & CHIP Reauthorization Act of 2015, or MACRA, and replaced with two new methodologies that will focus upon payment based upon quality outcomes. The first model is the Merit-Based Incentive Payment System, or MIPS, which combines the Physician Quality Reporting System, or PQRS, and Meaningful Use program with the Value Based Modifier program to provide for one payment model based upon (i) quality, (ii) resource use, (iii) clinical practice improvement and (iv) advancing care information through the use of certified Electronic Health Record, or EHR, technology. The second model is the Advanced Alternative Payment Models, or APM, which requires the physician to participate in a risk share arrangement for reimbursement related to his or her patients while utilizing a certified health record and reporting on specific quality metrics. There are a number of physicians that will not qualify for the APM payment method. Therefore, this change in reimbursement models may impact our tenants’ payments and create uncertainty in the tenants’ financial condition.
The healthcare industry continues to face various challenges, including increased government and private payer pressure on healthcare providers to control or reduce costs. It is possible that our tenants will continue to experience a shift in payer mix away from fee-for-service payers, resulting in an increase in the percentage of revenues attributable to reimbursement based upon value based principles and quality driven managed care programs, and general industry trends that include pressures to control healthcare costs. The federal government’s goal is to move approximately 90.0% of its reimbursement for providers to be based upon quality outcome models. Pressures to control healthcare costs and a shift away from traditional health insurance reimbursement to payments based upon quality outcomes have increased the uncertainty of payments.
In 2014, state insurance exchanges were implemented which provide a new mechanism for individuals to obtain insurance. At this time, the number of payers that are participating in the state insurance exchanges varies, and in some regions there are very limited insurance plans available for individuals to choose from when purchasing insurance. In addition, not all healthcare providers will maintain participation agreements with the payers that are participating in the state health insurance

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exchange. Therefore, it is possible that our tenants may incur a change in their reimbursement if the tenant does not have a participation agreement with the state insurance exchange payers and a large number of individuals elect to purchase insurance from the state insurance exchange. Further, the rates of reimbursement from the state insurance exchange payers to healthcare providers will vary greatly. The rates of reimbursement will be subject to negotiation between the healthcare provider and the payer, which may vary based upon the market, the healthcare provider’s quality metrics, the number of providers participating in the area and the patient population, among other factors. Therefore, it is uncertain whether healthcare providers will incur a decrease in reimbursement from the state insurance exchange, which may impact a tenant’s ability to pay rent.
On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act of 2010, or the Patient Protection and Affordable Care Act, and on March 30, 2010, President Obama signed into law the Health Care and Education Reconciliation Act of 2010, or the Reconciliation Act, which in part modified the Patient Protection and Affordable Care Act. Together, the two acts serve as the primary vehicle for comprehensive healthcare reform in the U.S., or collectively the Healthcare Reform Act. The insurance plans that participated on the health insurance exchanges created by the Healthcare Reform Act were expecting to receive risk corridor payments to address the high risk claims that they paid through the exchange product. However, the federal government currently owes the insurance companies approximately $8.3 billion under the risk corridor payment program that is currently disputed by the federal government. The federal government is currently defending several lawsuits from the insurance plans that participate on the health insurance exchange. If the insurance companies do not receive the payments, the insurance companies may cease to participate on the insurance exchange which limits insurance options for patients. If patients do not have access to insurance coverage, it may adversely impact the tenants’ revenues and the tenants’ ability to pay rent.
In addition, the healthcare legislation passed in 2010 included new payment models with new shared savings programs and demonstration programs that include bundled payment models and payments contingent upon reporting on satisfaction of quality benchmarks. The new payment models will likely change how physicians are paid for services. These changes could have a material adverse effect on the financial condition of some or all of our tenants. The financial impact on our tenants could restrict their ability to make rent payments to us, which would have a material adverse effect on our business, financial condition and results of operations and our ability to pay distributions to our stockholders. 
Furthermore, beginning in 2016, the Centers for Medicare and Medicaid Services has applied a negative payment adjustment to individual eligible professionals, Comprehensive Primary Care practice sites, and group practices participating in the PQRS group practice reporting option (including Accountable Care Organizations) that do not satisfactorily report PQRS in 2014. Program participation during a calendar year will affect payments two years later. Providers can appeal the determination, but if the provider is not successful, the provider’s reimbursement may be adversely impacted, which would adversely impact a tenant’s ability to make rent payments to us.
Moreover, President Trump signed an Executive Order on January 20, 2017 to “ease the burden of Obamacare.” On May 4, 2017, members of the House of Representatives approved legislation to repeal portions of the Healthcare Reform Act, which legislation was submitted to the Senate for approval. On July 25, 2017, the Senate rejected a complete repeal and, further, on July 27, 2017, the Senate rejected a repeal on the Healthcare Reform Act’s individual and employer mandates and a temporary repeal on the medical device tax. Furthermore, on October 12, 2017, President Trump signed an Executive Order the purpose of which was to, among other things, (i) cut healthcare cost-sharing reduction subsidies, (ii) allow more small businesses to join together to purchase insurance coverage, (iii) extend short-term coverage policies, and (iv) expand employers’ ability to provide workers cash to buy coverage elsewhere. The Executive Order required the government agencies to draft regulations for consideration related to Associated Health Plans, short-term limited duration insurance and health reimbursement arrangements. At this time, the proposed legislation has not been drafted. The Trump Administration also ceased to provide the cost-share subsidies to the insurance companies that offered the silver plan benefits on the Health Information Exchange. The termination of the cost-share subsidies would impact the subsidy payments due in 2017 and will likely adversely impact the insurance companies, causing an increase in the premium payments for the individual beneficiaries in 2018. 19 State Attorney Generals filed suit to force the Trump Administration to reinstate the cost-share subsidy payments. On October 25, 2017, a California judge ruled in favor of the Trump Administration and found that the federal government was not required to immediately reinstate payment for the cost-share subsidy. The injunction sought by the Attorney Generals’ lawsuit was denied. Therefore, our tenants will likely see an increase in individuals who are self-pay or have a lower health benefit plan due to the increase in the premium payments. Our tenants’ collections and revenues may be adversely impacted by the change in the payor mix of their patients and it may adversely impact the tenants’ ability to make rent payments.
On October 17, 2017, Senate health committee leaders unveiled a new, bipartisan deal to stabilize Healthcare Reform Act markets. This new deal aims to guarantee cost-sharing subsidies for two years and restore the Healthcare Reform Act’s outreach funding cut off by the Trump administration in exchange for allowing states to pursue alternative regulations without critically gutting the Healthcare Reform Act’s basic mandated benefits and framework. Therefore, at this time, it is uncertain

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whether any healthcare reform legislation will ultimately become law. If our tenants’ patients do not have insurance, it could adversely impact the tenants’ ability to pay rent and operate a practice.
In addition, the Trump administration has commented on the possibility that it may seek to cease the additional subsidies to the qualified health plans that provide coverage for beneficiaries on the health insurance exchange. There are also multiple lawsuits in several judicial districts brought by qualified health plans to recover the prior risk corridor payments that were anticipated to be paid as part of the health insurance exchange program. The multiple lawsuits are moving through the judicial process. Further, there is a current lawsuit, United States House of Representatives vs. Price, which alleges that the Executive Branch of the United States of America exceeded its authority in implementing the risk corridor payments under the Healthcare Reform Act and therefore the payments should not be made. At this time, the case is pending. If the Trump administration or the court system determines that risk corridor or risk share payments are not required to be paid to the qualified health plans offering insurance coverage on the health insurance exchange program, the insurance companies may cease participation, causing millions of beneficiaries to lose insurance coverage. Therefore, our tenants may have an increase of self-pay patients and collections may decline, adversely impacting the tenants’ ability to pay rent.
Comprehensive healthcare reform legislation, the effects of which are not yet known, could materially adversely affect our business, financial condition and results of operations and our ability to pay distributions to our stockholders.
The Healthcare Reform Act is intended to reduce the number of individuals in the U.S. without health insurance and effect significant other changes to the ways in which healthcare is organized, delivered and reimbursed. Included within the legislation is a limitation on physician-owned hospitals from expanding, unless the facility satisfies very narrow federal exceptions to this limitation. Therefore, if our tenants are physicians that own and refer to a hospital, the hospital would be limited in its operations and expansion potential, which may limit the hospital’s services and resulting revenues and may impact the owner’s ability to make rental payments. The legislation will become effective through a phased approach, having begun in 2010 and concluding in 2018. On June 28, 2012, the United States Supreme Court upheld the individual mandate under the Healthcare Reform Act, although substantially limiting its expansion of Medicaid. At this time, the effects of healthcare reform and its impact on our properties are not yet known but could materially adversely affect our business, financial condition, results of operations and ability to pay distributions to our stockholders.
On May 4, 2017, members of the House of Representatives approved legislation to repeal portions of the Healthcare Reform Act, which legislation was submitted to the Senate for approval. On July 25, 2017, the Senate rejected a complete repeal and, further, on July 27, 2017, the Senate rejected a repeal on the Healthcare Reform Act’s individual and employer mandates and a temporary repeal on the medical device tax. Furthermore, on October 12, 2017, President Trump signed an Executive Order the purpose of which was to, among other things, (i) cut healthcare cost-sharing reduction subsidies, (ii) allow more small businesses to join together to purchase insurance coverage, (iii) extend short-term coverage policies, and (iv) expand employers’ ability to provide workers cash to buy coverage elsewhere. On October 17, 2017, Senate health committee leaders unveiled a new, bipartisan deal to stabilize Healthcare Reform Act markets. This new deal aims to guarantee cost-sharing subsidies for two years and restore the Healthcare Reform Act’s outreach funding cut off by the Trump administration in exchange for allowing states to pursue alternative regulations without critically gutting the Healthcare Reform Act’s basic mandated benefits and framework. However, while President Trump initially praised the new proposed deal, by October 18, 2017, he criticized the deal as an insurance company bailout because of the subsidy funding. Therefore, at this time, it is uncertain whether any healthcare reform legislation will ultimately become law. If our tenants’ patients do not have insurance, it could adversely impact the tenants’ ability to pay rent and operate a practice.
Although the Healthcare Reform Act has not been replaced or repealed, the Trump administration has commented on the possibility that it may seek to cease subsidies to the qualified health plans that provide coverage for beneficiaries on the health insurance exchange. There are also multiple lawsuits in several judicial districts brought by qualified health plans to recover the prior risk corridor payments that were anticipated to be paid as part of the health insurance exchange program. The multiple lawsuits are moving through the judicial process. Further, there is a current lawsuit, United States House of Representatives vs. Price, which alleges that the Executive Branch of the United States of America exceeded its authority in implementing the risk corridor payments under the Healthcare Reform Act and therefore the payments should not be made. At this time, the case is pending. If the Trump administration or the court system determines that risk corridor or risk share payments are not required to be paid to the qualified health plans offering insurance coverage on the health insurance exchange program, the insurance companies may cease participation, causing millions of beneficiaries to lose insurance coverage. Therefore, our tenants may have an increase of self-pay patients and collections may decline, adversely impacting the tenants’ ability to pay rent.
The U.S. Department of Labor has issued a final regulation revising the definition of “fiduciary” and the scope of “investment advice” under ERISA, which may have a negative impact on our ability to raise capital.
On April 8, 2016, the U.S. Department of Labor, or DOL, issued a final regulation relating to the definition of a fiduciary under ERISA and Section 4975 of the Code. The final regulation broadens the definition of fiduciary by expanding the range of

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activities that would be considered to be fiduciary investment advice under ERISA and is accompanied by new and revised prohibited transaction exemptions relating to investments by employee benefit plans subject to Title I of ERISA or retirement plans or accounts subject to Section 4975 of the Code (including IRAs). Under the final regulation, a person is deemed to be providing investment advice if that person renders advice as to the advisability of investing in our shares, and that person regularly provides investment advice to the plan pursuant to a mutual agreement or understanding that such advice will serve as the primary basis for investment decisions, and that the advice will be individualized for the plan based on its particular needs. The final regulation and the related exemptions were expected to become applicable for investment transactions on and after April 10, 2017, but generally should not apply to purchases of our shares before the final regulation becomes applicable. However, on February 3, 2017, the President asked for additional review of this regulation; the results of such review are unknown. In response, on March 2, 2017, the DOL published a notice seeking public comments on, among other things, a proposal to adopt a 60-day delay of the April 10 applicability date of the final regulation. On April 7, 2017, the DOL published a final rule extending for 60 days the applicability date of the final regulation, to June 9, 2017. However, certain requirements and exemptions under the regulation are implemented through a phased-in approach. Therefore, certain requirements and exemptions will not take effect until January 1, 2018 and other key requirements and exemptions will not take effect until July 1, 2019.
The final regulation and the accompanying exemptions are complex, and plan fiduciaries and the beneficial owners of IRAs are urged to consult with their own advisors regarding this development. The final regulation could have negative implications on our ability to raise capital from potential investors, including those investing through IRAs.
We, our future tenants and our operators for our skilled nursing, senior housing and integrated senior health campuses may be subject to various government reviews, audits and investigations that could adversely affect our business, including an obligation to refund amounts previously paid to us, potential criminal charges, the imposition of fines, and/or the loss of the right to participate in Medicare and Medicaid programs.
As a result of our future tenants’ participation in the Medicaid and Medicare programs, we, our future tenants and our operators for our skilled nursing, senior housing and integrated senior health campuses are subject to various governmental reviews, audits and investigations to verify compliance with these programs and applicable laws and regulations. We, our future tenants and our operators for our skilled nursing, senior housing and integrated senior health campuses are also subject to audits under various government programs, including Recovery Audit Contractors, Zone Program Integrity Contractors, Program Safeguard Contractors and Medicaid Integrity Contractors programs, in which third party firms engaged by Centers for Medicare & Medicaid Services, or CMS, conduct extensive reviews of claims data and medical and other records to identify potential improper payments under the Medicare and Medicaid programs. Private pay sources also reserve the right to conduct audits. Billing and reimbursement errors and disagreements occur in the healthcare industry. We, our future tenants and our operators for our skilled nursing, senior housing and integrated senior health campuses may be engaged in reviews, audits and appeals of claims for reimbursement due to the subjectivities inherent in the process related to patient diagnosis and care, record keeping, claims processing and other aspects of the patient service and reimbursement processes, and the errors and disagreements those subjectivities can produce. An adverse review, audit or investigation could result in:
an obligation to refund amounts previously paid to us, our future tenants or our operators pursuant to the Medicare or Medicaid programs or from private payors, in amounts that could be material to our business;
state or federal agencies imposing fines, penalties and other sanctions on us, our tenants or our operators;
loss of our right, our tenants’ right or our operators’ right to participate in the Medicare or Medicaid programs or one or more private payor networks;
an increase in private litigation against us, our tenants or our operators; and
damage to our reputation in various markets.
While we, our future tenants and our operators for our skilled nursing, senior housing and integrated senior health campuses have always been subject to post-payment audits and reviews, more intensive “probe reviews” appear to be a permanent procedure with our fiscal intermediaries. Generally, findings of overpayment from CMS contractors are eligible for appeal through the CMS defined continuum, but there may be rare instances that are not eligible for appeal. We, our future tenants and our operators for our skilled nursing, senior housing and integrated senior health campuses utilize all defenses at our disposal to demonstrate that the services provided meet all clinical and regulatory requirements for reimbursement.
If the government or a court were to conclude that such errors, deficiencies or disagreements constituted criminal violations, or were to conclude that such errors, deficiencies or disagreements resulted in the submission of false claims to federal healthcare programs, or if the government were to discover other problems in addition to the ones identified by the probe reviews that rose to actionable levels, we and certain of our officers, and our future tenants and operators for our skilled nursing, senior housing and integrated senior health campuses and certain of their officers, might face potential criminal

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charges and/or civil claims, administrative sanctions and penalties for amounts that could be material to our business, results of operations and financial condition. In addition, we and/or some of the key personnel of our operating subsidiaries, or those of our future tenants and operators for our skilled nursing, senior housing and integrated senior health campuses, could be temporarily or permanently excluded from future participation in state and federal healthcare reimbursement programs such as Medicaid and Medicare. In any event, it is likely that a governmental investigation alone, regardless of its outcome, would divert material time, resources and attention from our management team and our staff, or those of our future tenants and our operators for our skilled nursing, senior housing and integrated senior health campuses and could have a materially detrimental impact on our results of operations during and after any such investigation or proceedings.
In cases where claim and documentation review by any CMS contractor results in repeated poor performance, a facility can be subjected to protracted oversight. This oversight may include repeat education and re-probe, extended pre-payment review, referral to recovery audit or integrity contractors, or extrapolation of an error rate to other reimbursement outside of specifically reviewed claims. Sustained failure to demonstrate improvement towards meeting all claim filing and documentation requirements could ultimately lead to Medicare and Medicaid decertification, which could have a materially detrimental impact on our results of operations. Adverse actions by CMS may also cause third party payer or licensure authorities to audit our tenants. These additional audits could result in termination of third party payer agreements or licensure of the facility, which would also adversely impact our operations.
Item 2. Unregistered Sales of Equity Securities and Use of Proceeds.
Recent Sales of Unregistered Securities
On July 1, 2017, we issued 15,000 shares of restricted Class T common stock to our independent directors. These shares of restricted Class T common stock were issued pursuant to our incentive plan in a private transaction exempt from registration pursuant to Section 4(2) of the Securities Act of 1933, as amended, or the Securities Act. The restricted Class T common stock awards vested 20.0% on the grant date and 20.0% will vest on each of the first four anniversaries of the grant date.
Use of Public Offering Proceeds
Our Registration Statement on Form S-11 (File No. 333-205960), registering a public offering of up to $3,150,000,000 in shares of our common stock, was declared effective under the Securities Act on February 16, 2016. Griffin Capital Securities, LLC is the dealer manager of our offering. Commencing on February 16, 2016, we offered to the public up to $3,150,000,000 in shares of our Class T common stock consisting of up to $3,000,000,000 in shares of our Class T common stock at a price of $10.00 per share in our primary offering and up to $150,000,000 in shares of our Class T common stock for $9.50 per share pursuant to the DRIP. Effective June 17, 2016, we reallocated certain of the unsold shares of Class T common stock being offered and began offering shares of Class I common stock, such that we are currently offering up to approximately $2,800,000,000 in shares of Class T common stock and $200,000,000 in shares of Class I common stock in our primary offering, and up to an aggregate of $150,000,000 in shares of our Class T and Class I common stock pursuant to the DRIP, aggregating up to $3,150,000,000. The shares of our Class T common stock in our primary offering are being offered at a price of $10.00 per share. The shares of our Class I common stock in our primary offering were being offered at a price of $9.30 per share prior to March 1, 2017 and are being offered at a price of $9.21 per share for all shares issued effective March 1, 2017. The shares of our Class T and Class I common stock issued pursuant to the DRIP were sold at a price of $9.50 per share prior to January 1, 2017 and are sold at a price of $9.40 per share for all shares issued pursuant to the DRIP effective January 1, 2017. After our board of directors determines an estimated NAV per share of our common stock, share prices are expected to be adjusted to reflect the estimated NAV per share and, in the case of shares offered pursuant to our primary offering, up-front selling commissions and dealer manager fees other than those funded by our advisor, and participants in the DRIP will receive Class T shares and Class I shares, as applicable, at the most recently published estimated NAV per share of our common stock. We reserve the right to reallocate the shares of common stock we are offering between the primary offering and the DRIP, and among classes of stock.
As of September 30, 2017, we had received and accepted subscriptions in our offering for 33,658,771 shares of Class T common stock and 1,863,639 shares of Class I common stock, or approximately $336,280,000 and $17,230,000, respectively, excluding shares of our common stock issued pursuant to the DRIP. As of September 30, 2017, a total of $6,096,000 in Class T distributions and $192,000 in Class I distributions were reinvested pursuant to the DRIP and 647,666 shares of Class T common stock and 20,369 shares of Class I common stock were issued pursuant to the DRIP.

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Our equity raise as of September 30, 2017 resulted in the following:
 Amount
Gross offering proceeds — Class T and Class I common stock$353,510,000
Gross offering proceeds from Class T and Class I shares issued pursuant to the DRIP6,288,000
Total gross offering proceeds359,798,000
Less public offering expenses: 
Selling commissions9,807,000
Dealer manager fees10,380,000
Advisor funding of dealer manager fees(6,963,000)
Other organizational and offering expenses4,343,000
Advisor funding of other organizational and offering expenses(4,343,000)
Net proceeds from our offering$346,574,000
The cost of raising funds in our offering as a percentage of gross proceeds received in our primary offering was 3.7% as of September 30, 2017. As of September 30, 2017, we had used $307,938,000 in proceeds from our offering to purchase properties from unaffiliated third parties, $11,575,000 to pay acquisition fees and acquisition related expenses to affiliated parties, $5,021,000 to pay real estate deposits for proposed future acquisitions, $4,651,000 to pay acquisition related expenses to unaffiliated third parties and $1,321,000 to pay deferred financing costs on our mortgage loans payable and the Line of Credit.None.
Purchase of Equity Securities by the Issuer and Affiliated Purchasers
Our share repurchase plan allows for repurchases of shares of our common stock by us when certain criteria are met. Share repurchases will be made at the sole discretion of our board of directors. All repurchases are subject to a one-year holding period, except for repurchases made in connection with a stockholder’s death or “qualifying disability,” as defined in our share repurchase plan.board. Funds for the repurchase of shares of our common stock will come exclusively from the cumulative proceeds we receive from the sale of shares of our common stock pursuant to the AHR DRIP.
The prices perOn October 4, 2021, our board approved our amended and restated share at which we will repurchase shares of our common stock will range, depending onplan that included a change in the length of timerepurchase price with respect to repurchases resulting from the stockholder held such shares, from 92.5% to 100% of the price paid per share to acquire such shares from us. However, if shares of our common stock are to be repurchased in connection with a stockholder’s death or qualifying disability (as such term is defined in our share repurchase plan) of stockholders, to the repurchase price will be no less than 100% ofmost recently published estimated per share NAV. In addition, on October 4, 2021, our board authorized the price paid to acquire the sharespartial reinstatement of our common stockshare repurchase plan with respect to requests to repurchase shares resulting from us.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 and shall be rejected.
During the three months ended September 30, 2017,March 31, 2022, we repurchased shares of our common stock as follows:
Period 

Total Number of
Shares Purchased
 

Average Price
Paid per Share
 

Total Number of Shares
Purchased As Part of
Publicly Announced
Plan or Program
 
Maximum Approximate
Dollar Value
of Shares that May
Yet Be Purchased
Under the
Plans or Programs
July 1, 2017 to July 31, 2017 
 $
 
 (1)
August 1, 2017 to August 31, 2017 
 $
 
 (1)
September 1, 2017 to September 30, 2017 11,209
 $9.69
 11,209
 (1)
Total 11,209
 $9.69
 11,209
  
Period
Total Number of
Shares Purchased

Average Price
Paid per Share

Total Number of Shares
Purchased As Part of
Publicly Announced
Plan or Program
Maximum Approximate
Dollar Value
of Shares that May
Yet Be Purchased
Under the
Plans or Programs
January 1, 2022 to January 31, 2022448,375 $9.22 448,375 (1)
February 1, 2022 to February 28, 2022— $— — (1)
March 1, 2022 to March 31, 2022— $— — (1)
Total448,375 $9.22 448,375 
___________
(1)Subject to funds being available, we will limit 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, shares of our common stock subject to a repurchase requested upon the death of a stockholder will not be subject to this cap.
(1)A description of the maximum number of shares that may be purchased under our share repurchase plan is included in Note 14, Equity — Share Repurchase Plan, to our accompanying condensed consolidated financial statements.
Item 3. Defaults Upon Senior Securities.
None.
Item 4. Mine Safety Disclosures.
Not applicable.

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Item 5. Other Information.
None.
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Item 6. Exhibits.
The following exhibits are included, or incorporated by reference, in this Quarterly Report on Form 10-Q for the period ended September 30, 2017March 31, 2022 (and are numbered in accordance with Item 601 of Regulation S-K).

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101.INS*Inline XBRL Instance Document – the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL Document
101.SCH*Inline XBRL Taxonomy Extension Schema Document
101.CAL*Inline XBRL Taxonomy Extension Calculation Linkbase Document
101.LAB*101.DEF*Inline XBRL Taxonomy Extension Definition Linkbase Document
101.LAB*Inline XBRL Taxonomy Extension Label Linkbase Document
101.PRE*Inline XBRL Taxonomy Extension Presentation Linkbase Document
101.DEF*XBRL Taxonomy Extension Definition Linkbase Document
___________
*104*Filed herewith.Cover Page Interactive Data File (formatted as Inline XBRL and contained in Exhibit 101)
___________
*Filed herewith.
**Furnished herewith. In accordance with Item 601(b)(32) of Regulation S-K, this Exhibit is not deemed “filed” for purposes of Section 18 of the Exchange Act or otherwise subject to the liabilities of that section. Such certifications will not be deemed incorporated by reference into any filing under the Securities Act of 1933, as amended, or the Securities Exchange Act of 1934, as amended, except to the extent that the registrant specifically incorporates it by reference.

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SIGNATURES
Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.

American Healthcare REIT, Inc.
(Registrant)
May 16, 2022By:
/s/ DANNY PROSKY
DateDanny Prosky
Chief Executive Officer, President and Director
(Principal Executive Officer)
May 16, 2022By:
Griffin-American Healthcare REIT IV, Inc./s/ BRIAN S. PEAY
(Registrant)
Date
November 9, 2017By:
/s/ JEFFREYT. HANSON
DateJeffrey T. Hanson
Chief Executive Officer and Chairman of the Board of Directors
(Principal Executive Officer)
November 9, 2017By:
/s/ BRIAN S. PEAY
DateBrian S. Peay
Chief Financial Officer
(Principal Financial Officer and Principal Accounting Officer)




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