Table of Contents
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q

(Mark One)
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended September 30, 2021March 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
AMERICAN HEALTHCARE REIT, INC.
(Exact name of registrant as specified in its charter)
Maryland 47-2887436
(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)

Griffin-American Healthcare REIT IV, Inc.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.     ☒  Yes    ☐  No
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted 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 such files).    ☒  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 filerAccelerated filer
Non-accelerated filerSmaller reporting company
Emerging growth company
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. ☒ 
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). ☐  Yes   ☒  No
As of November 12, 2021,May 13, 2022, there were 77,005,83377,678,544 shares of Class T common stock and 185,578,806186,233,584 shares of Class I common stock of American Healthcare REIT, Inc. outstanding.


Table of Contents

AMERICAN HEALTHCARE REIT, INC.
(A Maryland Corporation)
TABLE OF CONTENTS
 Page

2

Table of Contents
PART I — FINANCIAL INFORMATION
Item 1. Financial Statements.
AMERICAN HEALTHCARE REIT, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
As of September 30, 2021March 31, 2022 and December 31, 20202021
(Unaudited)
September 30, 2021December 31, 2020March 31,
2022
December 31,
2021
ASSETSASSETSASSETS
Real estate investments, netReal estate investments, net$907,103,000 $921,580,000 Real estate investments, net$3,475,635,000 $3,514,686,000 
Debt security investment, netDebt security investment, net80,239,000 79,315,000 
Cash and cash equivalentsCash and cash equivalents16,183,000 17,411,000 Cash and cash equivalents75,115,000 81,597,000 
Restricted cashRestricted cash986,000 714,000 Restricted cash44,055,000 43,889,000 
Accounts and other receivables, netAccounts and other receivables, net2,086,000 2,635,000 Accounts and other receivables, net130,872,000 122,778,000 
Identified intangible assets, netIdentified intangible assets, net54,752,000 64,101,000 Identified intangible assets, net241,140,000 248,871,000 
GoodwillGoodwill211,724,000 209,898,000 
Operating lease right-of-use assets, netOperating lease right-of-use assets, net14,043,000 14,133,000 Operating lease right-of-use assets, net154,619,000 158,157,000 
Other assets, netOther assets, net68,743,000 72,199,000 Other assets, net142,786,000 121,148,000 
Total assetsTotal assets$1,063,896,000 $1,092,773,000 Total assets$4,556,185,000 $4,580,339,000 
LIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND EQUITYLIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND EQUITYLIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND EQUITY
Liabilities:Liabilities:Liabilities:
Mortgage loans payable, net(1)Mortgage loans payable, net(1)$17,409,000 $17,827,000 Mortgage loans payable, net(1)$1,103,006,000 $1,095,594,000 
Line of credit and term loans(1)488,900,000 476,900,000 
Lines of credit and term loans, net(1)Lines of credit and term loans, net(1)1,238,147,000 1,226,634,000 
Accounts payable and accrued liabilities(1)Accounts payable and accrued liabilities(1)21,897,000 23,057,000 Accounts payable and accrued liabilities(1)170,757,000 187,254,000 
Accounts payable due to affiliates(1)Accounts payable due to affiliates(1)324,000 1,046,000 Accounts payable due to affiliates(1)— 866,000 
Identified intangible liabilities, netIdentified intangible liabilities, net1,115,000 1,295,000 Identified intangible liabilities, net12,077,000 12,715,000 
Financing obligations(1)Financing obligations(1)32,921,000 33,653,000 
Operating lease liabilities(1)Operating lease liabilities(1)10,021,000 9,904,000 Operating lease liabilities(1)142,615,000 145,485,000 
Security deposits, prepaid rent and other liabilities(1)Security deposits, prepaid rent and other liabilities(1)6,300,000 10,387,000 Security deposits, prepaid rent and other liabilities(1)50,574,000 48,567,000 
Total liabilitiesTotal liabilities545,966,000 540,416,000 Total liabilities2,750,097,000 2,750,768,000 
Commitments and contingencies (Note 10)00
Commitments and contingencies (Note 12)Commitments and contingencies (Note 12)00
Redeemable noncontrolling interests (Note 11)2,592,000 2,618,000 
Redeemable noncontrolling interests (Note 13)Redeemable noncontrolling interests (Note 13)75,267,000 72,725,000 
Equity:Equity:Equity:
Stockholders’ equity:Stockholders’ equity:Stockholders’ equity:
Preferred stock, $0.01 par value per share; 200,000,000 shares authorized; none issued and outstandingPreferred stock, $0.01 par value per share; 200,000,000 shares authorized; none issued and outstanding— — 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; 76,069,129 and 75,690,838 shares issued and outstanding as of September 30, 2021 and December 31, 2020, respectively760,000 756,000 
Class I common stock, $0.01 par value per share; 100,000,000 shares authorized; 5,662,132 and 5,648,499 shares issued and outstanding as of September 30, 2021 and December 31, 2020, respectively57,000 57,000 
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, respectivelyClass 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, respectivelyClass 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 capitalAdditional paid-in capital736,756,000 733,192,000 Additional paid-in capital2,536,811,000 2,531,940,000 
Accumulated deficitAccumulated deficit(222,775,000)(185,047,000)Accumulated deficit(980,613,000)(951,303,000)
Accumulated other comprehensive lossAccumulated other comprehensive loss(2,160,000)(1,966,000)
Total stockholders’ equityTotal stockholders’ equity514,798,000 548,958,000 Total stockholders’ equity1,556,667,000 1,581,293,000 
Noncontrolling interest (Note 12)540,000 781,000 
Noncontrolling interests (Note 14)Noncontrolling interests (Note 14)174,154,000 175,553,000 
Total equityTotal equity515,338,000 549,739,000 Total equity1,730,821,000 1,756,846,000 
Total liabilities, redeemable noncontrolling interests and equityTotal liabilities, redeemable noncontrolling interests and equity$1,063,896,000 $1,092,773,000 Total liabilities, redeemable noncontrolling interests and equity$4,556,185,000 $4,580,339,000 
3

Table of Contents




AMERICAN HEALTHCARE REIT, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS — (Continued)
As of September 30, 2021March 31, 2022 and December 31, 20202021
(Unaudited)
___________
(1)Such liabilities of American Healthcare REIT, Inc., (formerly known as Griffin-American Healthcare REIT IV, Inc.), as of September 30, 2021 and December 31, 2020 represented liabilities of Griffin-AmericanAmerican Healthcare REIT IV Holdings, LP or its consolidated subsidiaries. Griffin-Americansubsidiaries as of March 31, 2022 and December 31, 2021. American Healthcare REIT IV Holdings, LP wasis a variable interest entity, or VIE, and a consolidated subsidiary of American Healthcare REIT, Inc. The creditors of Griffin-AmericanAmerican Healthcare REIT IV Holdings, LP or its consolidated subsidiaries do not have recourse against American Healthcare REIT, Inc., except for the 20182022 Credit Facility, as defined in Note 7,9, held by Griffin-AmericanAmerican Healthcare REIT IV Holdings, LP in the amount of $488,900,000$934,400,000 as of March 31, 2022 and $476,900,000the 2018 Credit Facility and 2019 Credit Facility, each as defined in Note 9, held by American Healthcare REIT Holdings, LP in the amount of September 30, 2021$441,900,000 and $480,000,000, respectively, as of December 31, 2020, respectively,2021, which iswere guaranteed by American Healthcare REIT, Inc.

The accompanying notes are an integral part of these condensed consolidated financial statements.

4

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS
For the Three and Nine Months Ended September 30,March 31, 2022 and 2021 and 2020
(Unaudited)
Three Months Ended September 30,Nine Months Ended September 30,
2021202020212020
Revenues and grant income:
Real estate revenue$22,120,000 $21,519,000 $66,054,000 $64,824,000 
Resident fees and services15,090,000 18,948,000 46,179,000 51,863,000 
Grant income— 864,000 — 864,000 
Total revenues and grant income37,210,000 41,331,000 112,233,000 117,551,000 
Expenses:
Rental expenses6,389,000 5,905,000 18,542,000 17,723,000 
Property operating expenses14,540,000 17,397,000 44,179,000 44,856,000 
General and administrative4,304,000 3,672,000 11,710,000 11,960,000 
Business acquisition expenses3,800,000 57,000 6,552,000 74,000 
Depreciation and amortization10,746,000 12,669,000 33,745,000 37,919,000 
Total expenses39,779,000 39,700,000 114,728,000 112,532,000 
Other income (expense):
Interest expense:
Interest expense (including amortization of deferred financing costs and debt discount/premium)(4,961,000)(4,839,000)(14,556,000)(15,123,000)
Gain (loss) in fair value of derivative financial instruments1,514,000 1,450,000 4,431,000 (2,302,000)
Impairment of real estate investments— (3,064,000)— (3,064,000)
Gain (loss) on disposition of real estate investments15,000 — (184,000)— 
Income (loss) from unconsolidated entity70,000 (377,000)(1,027,000)952,000 
Other income33,000 8,000 49,000 278,000 
Total net other expense(3,329,000)(6,822,000)(11,287,000)(19,259,000)
Loss before income taxes(5,898,000)(5,191,000)(13,782,000)(14,240,000)
Income tax benefit— 39,000 — — 
Net loss(5,898,000)(5,152,000)(13,782,000)(14,240,000)
Less: net loss attributable to noncontrolling interests121,000 232,000 489,000 608,000 
Net loss attributable to controlling interest$(5,777,000)$(4,920,000)$(13,293,000)$(13,632,000)
Net loss per Class T and Class I common share attributable to controlling interest — basic and diluted$(0.07)$(0.06)$(0.16)$(0.17)
Weighted average number of Class T and Class I common shares outstanding — basic and diluted81,704,261 80,788,359 81,635,053 80,498,693 

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.
5

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
CONDENSED CONSOLIDATED STATEMENTS OF EQUITY
For the Three and Nine Months Ended September 30,March 31, 2022 and 2021 and 2020
(Unaudited)
Three Months Ended September 30, 2021
Stockholders’ Equity
 Class T and Class I Common Stock  
Number
of Shares
AmountAdditional
Paid-In Capital
Accumulated
Deficit
Total
Stockholders’
Equity
Noncontrolling
Interest
Total Equity
BALANCE — June 30, 202181,731,261 $817,000 $736,827,000 $(208,759,000)$528,885,000 $577,000 $529,462,000 
Amortization of nonvested common stock compensation— — 21,000 — 21,000 — 21,000 
Distributions to noncontrolling interest— — — — — (7,000)(7,000)
Adjustment to value of redeemable noncontrolling interests— — (92,000)— (92,000)— (92,000)
Distributions declared ($0.10 per share)— — — (8,239,000)(8,239,000)— (8,239,000)
Net loss— — — (5,777,000)(5,777,000)(30,000)(5,807,000)(1)
BALANCE — September 30, 202181,731,261 $817,000 $736,756,000 $(222,775,000)$514,798,000 $540,000 $515,338,000 

Three Months Ended September 30, 2020
Stockholders’ Equity
 Class T and Class I Common Stock  
Number
of Shares
AmountAdditional
Paid-In Capital
Accumulated
Deficit
Total
Stockholders’
Equity
Noncontrolling
Interest
Total Equity
BALANCE — June 30, 202080,599,306 $805,000 $726,516,000 $(159,366,000)$567,955,000 $1,047,000 $569,002,000 
Offering costs — common stock— — 5,000 — 5,000 — 5,000 
Issuance of common stock under the DRIP445,239 4,000 4,243,000 — 4,247,000 — 4,247,000 
Issuance of vested and nonvested restricted common stock15,000 — 29,000 — 29,000 — 29,000 
Amortization of nonvested common stock compensation— — 44,000 — 44,000 — 44,000 
Repurchase of common stock(71,551)— (706,000)— (706,000)— (706,000)
Distributions to noncontrolling interest— — — — — (22,000)(22,000)
Adjustment to value of redeemable noncontrolling interests— — (208,000)— (208,000)— (208,000)
Distributions declared ($0.10 per share)— — — (8,150,000)(8,150,000)— (8,150,000)
Net loss— — — (4,920,000)(4,920,000)(105,000)(5,025,000)(1)
BALANCE — September 30, 202080,987,994 $809,000 $729,923,000 $(172,436,000)$558,296,000 $920,000 $559,216,000 





6

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
CONDENSED CONSOLIDATED STATEMENTS OF EQUITY — (Continued)
For the Three and Nine Months Ended September 30, 2021 and 2020
(Unaudited)

Nine Months Ended September 30, 2021
Stockholders’ Equity
 Class T and Class I Common Stock  
Number
of Shares
AmountAdditional
Paid-In Capital
Accumulated
Deficit
Total
Stockholders’
Equity
Noncontrolling
Interest
Total Equity
BALANCE — December 31, 202081,339,337 $813,000 $733,192,000 $(185,047,000)$548,958,000 $781,000 $549,739,000 
Offering costs — common stock— — 5,000 — 5,000 — 5,000 
Issuance of common stock under the DRIP581,491 6,000 5,493,000 — 5,499,000 — 5,499,000 
Amortization of nonvested common stock compensation— — 105,000 — 105,000 — 105,000 
Repurchase of common stock(189,567)(2,000)(1,872,000)— (1,874,000)— (1,874,000)
Distributions to noncontrolling interest— — — — — (62,000)(62,000)
Adjustment to value of redeemable noncontrolling interests— — (167,000)— (167,000)— (167,000)
Distributions declared ($0.30 per share)— — — (24,435,000)(24,435,000)— (24,435,000)
Net loss— — — (13,293,000)(13,293,000)(179,000)(13,472,000)(1)
BALANCE — September 30, 202181,731,261 $817,000 $736,756,000 $(222,775,000)$514,798,000 $540,000 $515,338,000 

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 

Nine Months Ended September 30, 2020
Stockholders’ Equity
 Class T and Class I Common Stock  
Number
of Shares
AmountAdditional
Paid-In Capital
Accumulated
Deficit
Total
Stockholders’
Equity
Noncontrolling
Interest
Total Equity
BALANCE — December 31, 201979,899,874 $798,000 $719,894,000 $(130,613,000)$590,079,000 $— $590,079,000 
Offering costs — common stock— — 67,000 — 67,000 — 67,000 
Issuance of common stock under the DRIP1,643,731 16,000 15,665,000 — 15,681,000 — 15,681,000 
Issuance of vested and nonvested restricted common stock22,500 — 43,000 — 43,000 — 43,000 
Amortization of nonvested common stock compensation— — 128,000 — 128,000 — 128,000 
Repurchase of common stock(578,111)(5,000)(5,344,000)— (5,349,000)— (5,349,000)
Contribution from noncontrolling interest— — — — — 1,250,000 1,250,000 
Distributions to noncontrolling interest— — — — — (54,000)(54,000)
Adjustment to value of redeemable noncontrolling interests— — (530,000)— (530,000)— (530,000)
Distributions declared ($0.35 per share)— — — (28,191,000)(28,191,000)— (28,191,000)
Net loss— — — (13,632,000)(13,632,000)(276,000)(13,908,000)(1)
BALANCE — September 30, 202080,987,994 $809,000 $729,923,000 $(172,436,000)$558,296,000 $920,000 $559,216,000 
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)Amount excludes $91,000 and $127,000 forFor the three months ended September 30,March 31, 2022 and 2021, amounts exclude $187,000 and 2020, respectively, and $310,000 and $332,000 for the nine months ended September 30, 2021 and 2020,$(484,000), respectively, of net lossincome (loss) attributable to redeemable noncontrolling interests. See Note 11,13, Redeemable Noncontrolling Interests, for a further discussion.

The accompanying notes are an integral part of these condensed consolidated financial statements.
76

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
For the NineThree Months Ended September 30,March 31, 2022 and 2021 and 2020
(Unaudited)
Nine Months Ended September 30,Three Months Ended March 31,
2021202020222021
CASH FLOWS FROM OPERATING ACTIVITIESCASH FLOWS FROM OPERATING ACTIVITIESCASH FLOWS FROM OPERATING ACTIVITIES
Net lossNet loss$(13,782,000)$(14,240,000)Net loss$(897,000)$(16,273,000)
Adjustments to reconcile net loss to net cash provided by operating activities:
Adjustments to reconcile net loss to net cash provided by (used in) operating activities:Adjustments to reconcile net loss to net cash provided by (used in) operating activities:
Depreciation and amortizationDepreciation and amortization33,745,000 37,919,000 Depreciation and amortization42,311,000 25,723,000 
Other amortizationOther amortization2,099,000 2,084,000 Other amortization6,166,000 5,955,000 
Deferred rentDeferred rent(2,707,000)(3,440,000)Deferred rent(1,695,000)(1,023,000)
Stock based compensationStock based compensation105,000 171,000 Stock based compensation(32,000)(14,000)
Loss on disposition of real estate investments184,000 — 
Loss (income) from unconsolidated entity1,027,000 (952,000)
Stock based compensation — nonvested restricted common stockStock based compensation — nonvested restricted common stock811,000 27,000 
(Gain) loss from unconsolidated entities(Gain) loss from unconsolidated entities(1,386,000)1,771,000 
(Gain) loss on dispositions of real estate investments(Gain) loss on dispositions of real estate investments(756,000)335,000 
Foreign currency loss (gain)Foreign currency loss (gain)1,335,000 (416,000)
Loss on extinguishments of debtLoss on extinguishments of debt4,591,000 2,288,000 
Change in fair value of derivative financial instrumentsChange in fair value of derivative financial instruments(4,431,000)2,302,000 Change in fair value of derivative financial instruments(500,000)(1,821,000)
Impairment of real estate investments— 3,064,000 
Changes in operating assets and liabilities:Changes in operating assets and liabilities:Changes in operating assets and liabilities:
Accounts and other receivablesAccounts and other receivables533,000 1,347,000 Accounts and other receivables(8,300,000)3,203,000 
Other assetsOther assets(2,829,000)(1,654,000)Other assets(1,432,000)(4,440,000)
Accounts payable and accrued liabilitiesAccounts payable and accrued liabilities3,805,000 3,436,000 Accounts payable and accrued liabilities(7,878,000)(10,891,000)
Accounts payable due to affiliatesAccounts payable due to affiliates(921,000)27,000 Accounts payable due to affiliates(184,000)(5,160,000)
Operating lease liabilitiesOperating lease liabilities(309,000)(306,000)Operating lease liabilities(4,602,000)(4,358,000)
Security deposits, prepaid rent and other liabilitiesSecurity deposits, prepaid rent and other liabilities37,000 185,000 Security deposits, prepaid rent and other liabilities(5,192,000)(161,000)
Net cash provided by operating activities16,556,000 29,943,000 
Net cash provided by (used in) operating activitiesNet cash provided by (used in) operating activities22,360,000 (5,255,000)
CASH FLOWS FROM INVESTING ACTIVITIESCASH FLOWS FROM INVESTING ACTIVITIESCASH FLOWS FROM INVESTING ACTIVITIES
Developments and capital expendituresDevelopments and capital expenditures(20,856,000)(29,196,000)
Acquisitions of real estate investmentsAcquisitions of real estate investments(3,385,000)(68,032,000)Acquisitions of real estate investments(19,878,000)(78,542,000)
Proceeds from disposition of real estate investments6,196,000 — 
Capital expenditures(4,384,000)(6,729,000)
Proceeds from dispositions of real estate investmentsProceeds from dispositions of real estate investments14,074,000 1,248,000 
Investments in unconsolidated entitiesInvestments in unconsolidated entities(200,000)(325,000)
Real estate and other depositsReal estate and other deposits(507,000)(26,000)
Net cash used in investing activitiesNet cash used in investing activities(1,573,000)(74,761,000)Net cash used in investing activities(27,367,000)(106,841,000)
CASH FLOWS FROM FINANCING ACTIVITIESCASH FLOWS FROM FINANCING ACTIVITIESCASH FLOWS FROM FINANCING ACTIVITIES
Borrowings under mortgage loans payableBorrowings under mortgage loans payable22,489,000 104,092,000 
Payments on mortgage loans payablePayments on mortgage loans payable(475,000)(8,166,000)Payments on mortgage loans payable(4,538,000)(3,480,000)
Borrowings under the line of credit and term loans17,000,000 140,800,000 
Payments on the line of credit and term loans(5,000,000)(58,100,000)
Borrowings under the lines of credit and term loanBorrowings under the lines of credit and term loan941,400,000 16,600,000 
Payments on the lines of credit and term loanPayments on the lines of credit and term loan(928,900,000)(18,000,000)
Deferred financing costsDeferred financing costs— (43,000)Deferred financing costs(4,796,000)(799,000)
Payment of offering costs(3,940,000)(4,876,000)
Debt extinguishment costsDebt extinguishment costs(2,790,000)(125,000)
Payments on financing obligationsPayments on financing obligations(787,000)(8,481,000)
Distributions paid to common stockholdersDistributions paid to common stockholders(21,700,000)(13,932,000)Distributions paid to common stockholders(15,010,000)— 
Repurchase of common stockRepurchase of common stock(1,874,000)(5,349,000)Repurchase of common stock(4,134,000)— 
Contribution from noncontrolling interest— 1,250,000 
Distributions to noncontrolling interest(62,000)(54,000)
Contributions from redeemable noncontrolling interest125,000 1,118,000 
Distributions to noncontrolling interests in total equityDistributions to noncontrolling interests in total equity(3,511,000)(172,000)
Contribution from redeemable noncontrolling interestContribution from redeemable noncontrolling interest173,000 — 
Distributions to redeemable noncontrolling interestsDistributions to redeemable noncontrolling interests(8,000)(81,000)Distributions to redeemable noncontrolling interests(695,000)— 
Security deposits(5,000)(199,000)
Security deposits and otherSecurity deposits and other(208,000)(30,000)
Net cash (used in) provided by financing activitiesNet cash (used in) provided by financing activities(15,939,000)52,368,000 Net cash (used in) provided by financing activities(1,307,000)89,605,000 
NET CHANGE IN CASH, CASH EQUIVALENTS AND RESTRICTED CASH(956,000)7,550,000 
CASH, CASH EQUIVALENTS AND RESTRICTED CASH — Beginning of period18,125,000 15,846,000 
CASH, CASH EQUIVALENTS AND RESTRICTED CASH — End of period$17,169,000 $23,396,000 
87

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS — (Continued)
For the NineThree Months Ended September 30,March 31, 2022 and 2021 and 2020
(Unaudited)
Nine Months Ended September 30,
20212020
RECONCILIATION OF CASH, CASH EQUIVALENTS AND RESTRICTED CASH
Beginning of period:
Cash and cash equivalents$17,411,000 $15,290,000 
Restricted cash714,000 556,000 
Cash, cash equivalents and restricted cash$18,125,000 $15,846,000 
End of period:
Cash and cash equivalents$16,183,000 $22,690,000 
Restricted cash986,000 706,000 
Cash, cash equivalents and restricted cash$17,169,000 $23,396,000 
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION
Cash paid for:
Interest$13,116,000 $13,777,000 
Income taxes$51,000 $88,000 
SUPPLEMENTAL DISCLOSURE OF NONCASH ACTIVITIES
Investing Activities:
Accrued capital expenditures$3,720,000 $2,182,000 
Tenant improvement overage$303,000 $636,000 
The following represents the increase (decrease) in certain assets and liabilities in connection with our acquisitions and disposition of real estate investments:
Other assets$(16,000)$196,000 
Accounts payable and accrued liabilities$(50,000)$201,000 
Prepaid rent$10,000 $11,000 
Financing Activities:
Issuance of common stock under the DRIP$5,499,000 $15,681,000 
Distributions declared but not paid to common stockholders$— $2,664,000 
Accrued stockholder servicing fee$2,157,000 $7,667,000 

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.
98

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited)
For the Three and Nine Months Ended September 30,March 31, 2022 and 2021 and 2020

The use of the words “we,” “us” or “our” refers to Griffin-American Healthcare REIT III, Inc., or GAHR III, and its subsidiaries, including Griffin-American Healthcare REIT III 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 IVIII Holdings, LP,LP), for periods following the Merger, except where otherwise noted. Certain historical information of GAHR IV is included for background purposes.
1. Organization and Description of Business
Overview and Background
American Healthcare REIT, Inc. (formerly known as Griffin-American Healthcare REIT IV, Inc.), a Maryland corporation, invests inowns a diversified portfolio of clinical healthcare real estate properties, focusing primarily on medical office buildings, skilled nursing facilities, and senior housing, facilities that produce current income.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 other real estate-related investments on an infrequent and opportunistic basis. We generally seek investments that produce current income; however, we have selectively developed, and may continue to selectively develop, healthcare real estate properties. We qualified to be taxed as a real estate investment trust, or REIT, under 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.
We raised $754,118,000 through a best efforts initial public offering, or our initial offering, that commenced on February 16, 2016,Merger of Griffin-American Healthcare REIT III, Inc. and issued 75,639,681 aggregate shares of our Class T and Class I common stock. In addition, during our initial offering, we issued 3,253,535 aggregate shares of our Class T and Class I common stockGriffin-American Healthcare REIT IV, Inc.
On October 1, 2021, pursuant to our distribution reinvestment plan, as amended,an Agreement and Plan of Merger dated June 23, 2021, or the DRIP, forMerger Agreement, GAHR III merged with and into Continental Merger Sub, LLC, a totalMaryland limited liability company and newly formed wholly owned subsidiary of $31,021,000 in distributions reinvested. FollowingGAHR IV, or Merger Sub, with Merger Sub being the termination of our initial offering on February 15, 2019, we continued issuing shares of our common stocksurviving company, or the REIT Merger. On October 1, 2021, also pursuant to the DRIP through a subsequent offering, or the 2019 DRIP Offering, which commenced on March 1, 2019. On March 18, 2021, our board of directors, or our board, authorized the suspension of the DRIP, effective as of April 1, 2021. As of September 30, 2021, a total of $46,970,000 in distributions were reinvested that resulted in 4,923,550 shares of our common stock being issued pursuant to the 2019 DRIP Offering. We collectively refer to the DRIP portion of our initial offering and the 2019 DRIP Offering as our DRIP Offerings. See Note 12, Equity — Distribution Reinvestment Plan, for a further discussion. On October 4, 2021, our board authorized the reinstatement of the DRIP. See Note 20, Subsequent Events —Reinstatement of the DRIP, for a further discussion.
Until October 1, 2021, we conducted substantially all of our operations throughMerger 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 operating partnership. Through September 30, 2021, we were externally advised by Griffin-American Healthcare REIT IV Advisor, LLC, or our advisor, pursuant to an advisory agreement, as amended, or the Advisory Agreement, between us,partnership, with our operating partnership being the surviving entity, or the Partnership Merger. We collectively refer to the REIT 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 advisor.operating partnership, also referred to as the surviving partnership, was renamed American Healthcare REIT Holdings, LP. The Advisory Agreement wasREIT 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 GAHR IV’s Class I common stock, $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 February 16, 2016 and had a one-year initial term, subjectimmediately prior to successive one-year renewals upon the mutual consenteffective time of the parties. The Advisory AgreementPartnership Merger was last renewedconverted automatically into the right to receive 0.9266 of a Partnership Class I Unit, as defined in the agreement of limited partnership, as amended, of the surviving partnership and (ii) each unit of limited partnership interest in GAHR IV Operating Partnership outstanding as of immediately prior to the effective time of the Partnership Merger was converted automatically into the right to receive one unit of limited partnership interest of the surviving partnership of like class.
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 the mutual consent of the parties on February 11, 2021. Ona contribution and exchange agreement dated June 23, 2021, in anticipation ofor the Merger, as defined and discussed below, we entered into an amendment to the AdvisoryContribution Agreement, whereby it was agreed that any acquisition fee due tobetween GAHR III; our advisor is to be waived in connection with the REIT Merger, as defined and discussed below. Except as set forth in such amendment to the Advisory Agreement, the terms of the Advisory Agreement continued in full force and effect. Our 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 advisor performed its duties and responsibilities under the Advisory Agreement as our fiduciary. Prior to the Merger, our advisor was 75.0% owned and managed by wholly owned subsidiaries ofoperating partnership; American Healthcare Investors, LLC, or American Healthcare Investors, and 25.0% owned by a wholly owned subsidiary ofAHI; Griffin Capital Company, LLC, or Griffin Capital, or collectively,Capital; Platform Healthcare Investor T-II, LLC; Flaherty Trust; and Jeffrey T. Hanson, our co-sponsors. American Healthcare Investors was 47.1% owned by AHI Group Holdings, LLC, or AHI Group Holdings, 45.1% indirectly owned by Digital Bridge Group, Inc. (NYSE: DBRG) (formerly known as Colony Capital, Inc.), or Digital Bridge,former Chief Executive Officer and 7.8% owned by James F. Flaherty III, acurrent Executive Chairman of the Board of Directors, Danny Prosky, our former partner of Colony Capital, Inc. We were not affiliated with Griffin Capital, Griffin Capital Securities, LLC, orChief Operating Officer and current Chief Executive Officer and President, and Mathieu B. Streiff, our dealer manager, Digital Bridge or Mr. Flaherty; however, we were affiliated with our advisor, American Healthcare Investorsformer Executive Vice President, General Counsel and AHI Group Holdings. Please see the “Merger with Griffin-American Healthcare REIT III, Inc.” and “AHI Acquisition” sections below for a further discussion of our operations effective October 1, 2021.
We operate through 4 reportable business segments: medical office buildings, senior housing, senior housing — RIDEA and skilled nursing facilities. As of September 30, 2021, we owned 87 properties, comprising 92 buildings, or approximately 4,799,000 square feet of gross leasable area, or GLA, for an aggregate contract purchase price of $1,080,381,000. As of September 30, 2021, we also owned a 6.0% interest in a joint venture which owned a portfolio of integrated senior health campuses and ancillary businesses.
Due to the ongoing coronavirus, or COVID-19, pandemic in the United States and globally, since March 2020, our residents, tenants, operating partners and managers have been materially impacted, and the prolonged economic impact remainscurrent Chief
109

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
uncertain. As the COVID-19 pandemic is still impacting the healthcare system to a degree, it continues to present challenges for us as an owner and operator of healthcare facilities. Since its outset, the impacts of the COVID-19 pandemic have been significant, rapidly and continuously evolving and may continue into the future, especially due to the emergence of the Delta variant which has caused COVID-19 cases and deaths to increase significantly in recent months, 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. We have evaluated the impacts of the COVID-19 pandemic on our business thus far and incorporated information concerning the impact of COVID-19 into our assessments of liquidity, impairment and collectability from tenants and residents as of September 30, 2021. We will continue to monitor such impacts and will adjust our estimates and assumptions based on the best available information.
Merger with Griffin-American Healthcare REIT III, Inc.
On June 23, 2021, we, our operating partnership, our wholly owned subsidiary, Continental Merger Sub, LLC, or merger sub, Griffin-American Healthcare REIT III, Inc., or GAHR III, and American Healthcare REIT Holdings, LP (formerly known as Griffin-American Healthcare REIT III Holdings, LP), or the surviving partnership, entered into an Agreement and Plan of Merger, or the Merger Agreement. On October 1, 2021, pursuant to the Merger Agreement, (i) GAHR III merged with and into merger sub, with merger sub being the surviving company, or the REIT Merger, and (ii) our operating partnership merged with and into the surviving partnership, with the surviving partnership being the surviving entity and being renamed American Healthcare REIT Holdings, LP, or the Partnership Merger, and, together with the REIT Merger, the Merger. As a result of and at the effective time of the Merger, the separate corporate existence of GAHR III and our operating partnership ceased.
Following the Merger, our company, combined with GAHR III, or the Combined Company, was renamed “American Healthcare REIT, Inc.” The REIT Merger is intended to qualify as a “reorganization” under, and within the meaning of, Section 368(a) of the Code.
AHI Acquisition
Also on June 23, 2021, the surviving partnership, our co-sponsors, Platform Healthcare Investor T-II, LLC, Flaherty Trust, Jeffrey T. Hanson, our former Chief Executive Officer and Chairman of the Board of Directors, Danny Prosky, our President and former Chief Operating Officer, and Mathieu B. Streiff, our former Executive Vice President, General Counsel, entered into a contribution and exchange agreement, or the Contribution Agreement, pursuant to which, among other things, the surviving partnership agreed to acquire a newly formed entity, or NewCo, which we refer to ascollectively, the AHI Acquisition, thatPrincipals. NewCo owned substantially all of the business and operations of one of our co-sponsors, American Healthcare Investors,AHI, as well as all of the equity interests in (i) Griffin-American Healthcare REIT IIIIV Advisor, LLC, or GAHR IIIIV Advisor, a subsidiary of American Healthcare InvestorsAHI that served as the external advisor of GAHR III,IV, and (ii) Griffin-American Healthcare REIT III Advisor, LLC, or GAHR III Advisor, also referred to as our advisor. On October 1, 2021,former advisor, a subsidiary of AHI that served as the AHI Acquisition closed immediately priorexternal 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 surviving partnership OP units. Subject to working capital and other customary adjustments, the total approximate value of these surviving partnership OP units at the time of consummation of the Merger.transactions 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 AHI Acquisition, the Combined Company has becomebecame 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 self-managed company.wholly owned subsidiary of Griffin Capital, or collectively, the NewCo Sellers.
The AHI Acquisition will bewas treated as a business combination for accounting purposes, with GAHR III as both the legal and accounting acquiror of NewCo. While we areGAHR 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 transaction 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. As a result ofThus, the completionfinancial information set forth herein subsequent to the consummation of the Merger and the AHI Acquisition reflects results of the historical information regarding our company’s structure, agreementsCombined Company, and the financial information presented withinset forth herein prior to the Merger and the AHI Acquisition reflects GAHR III’s results. For this Note 1reason, period to period comparisons may not be meaningful.
Operating Partnership and throughout the restFormer Advisor
We conduct substantially all of the Notes to Condensed Consolidated Financial Statements has materially changed; however, such information did apply to us as ofour operations through our operating partnership. Through September 30, 2021. See Note 20, Subsequent Events —2021, we were externally advised by our former advisor pursuant to an advisory agreement, as amended, or the Advisory Agreement, between us and our former advisor. Our former advisor used its best efforts, subject to the oversight and review of our board of directors, or 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.Following 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 are no longer being paid. Also, on October 1, 2021 and in connection with the AHI Acquisition, our operating partnership redeemed all 22,222 shares of our common stock owned by our former advisor and 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 wholly owned subsidiaries of AHI, and 25.0% owned by a wholly owned subsidiary of Griffin Capital, or collectively, our former co-sponsors. Prior to the AHI Acquisition, AHI was 47.1% owned by AHI Group Holdings, 45.1% indirectly owned by Digital Bridge Group, Inc. (NYSE: DBRG), or Digital Bridge, and 7.8% owned by James F. Flaherty III. We were not affiliated with Griffin Capital, Digital Bridge or Mr. Flaherty; however, we were affiliated with our former advisor, AHI and AHI Group Holdings. Please see the “Merger of Griffin-American Healthcare REIT III, Inc. and AHI Acquisition,Griffin-American Healthcare REIT IV, Inc.” and “AHI Acquisition” sections above for a further discussion aboutof 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.
10

Table of Contents

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 6 reportable business segments: medical office buildings, integrated senior health campuses, skilled nursing facilities, SHOP, senior housing and hospitals. As of March 31, 2022, we owned and/or operated 182 properties, comprising 191 buildings, and 122 integrated senior health campuses including completed development projects, or approximately 19,461,000 square feet of gross leasable area, or GLA, for an aggregate contract purchase price of $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
Our residents, tenants, operating partners and managers, our industry and the AHI Acquisition.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.
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.
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, the wholly owned subsidiaries of our operating partnership and all non-wholly owned subsidiaries in which we have control, as well as any VIEs, in which we are the primary beneficiary. The portion of equity in any subsidiary that is not
11

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
wholly-owned 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.
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 areare the sole general partner of our operating partnership and as of both September 30, 2021March 31, 2022 and December 31, 2020,2021, 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 was a limited partner and as of both September 30, 2021 and December 31, 2020,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.
11

Table of Contents
Because
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 accompanying 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 the SEC. Certain information and footnote disclosures required for annual financial statements have been condensed or excluded pursuant to the 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 that mayto 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 20202021 Annual Report on Form 10-K, as filed with the SEC on March 26, 2021.25, 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 September 30,
20212020
Point in TimeOver TimeTotalPoint in TimeOver TimeTotal
Senior housing — RIDEA$150,000 $14,940,000 $15,090,000 $174,000 $18,774,000 $18,948,000 
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 
12

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
Nine Months Ended September 30,
20212020
Point in TimeOver TimeTotalPoint in TimeOver TimeTotal
Senior housing — RIDEA$473,000 $45,706,000 $46,179,000 $746,000 $51,117,000 $51,863,000 
The following tables disaggregate our resident fees and services revenue by payor class:
Three Months Ended March 31,
Three Months Ended September 30,Nine Months Ended September 30,20222021
2021202020212020Integrated
Senior Health
Campuses
SHOP(1)TotalIntegrated
Senior Health
Campuses
SHOP(1)Total
Private and other payorsPrivate and other payors$13,556,000 $17,300,000 $41,326,000 $46,766,000 Private and other payors$131,803,000 $35,037,000 $166,840,000 $106,110,000 $19,419,000 $125,529,000 
MedicareMedicare94,517,000 — 94,517,000 84,283,000 — 84,283,000 
MedicaidMedicaid1,534,000 1,648,000 4,853,000 5,097,000 Medicaid54,692,000 2,925,000 57,617,000 42,833,000 381,000 43,214,000 
Total resident fees and servicesTotal resident fees and services$15,090,000 $18,948,000 $46,179,000 $51,863,000 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 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, net resident 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 
MedicaidPrivate
and
Other Payors
Total
Beginning balanceJanuary 1, 2021
$1,123,000 $358,000 $1,481,000 
Ending balanceSeptember 30, 2021
257,000 900,000 1,157,000 
(Decrease)/increase$(866,000)$542,000 $(324,000)
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 services, are carried net of an allowance for credit losses. An allowance is maintained for estimated losses resulting from the inability of residents and payors to meet the contractual obligations under their lease or service agreements. Substantially all of such allowances are recorded as direct reductions of resident fees and services revenue as contractual adjustments provided to third-party payors or implicit price concessions in our accompanying 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 residents’ financial condition, security deposits, cash collection patterns by payor and by state, current economic conditions, future expectations in estimating credit losses and other relevant factors. Tenant receivables, which are related to real estate revenue, and unbilled deferred rent receivables are reduced for uncollectible amounts, which are recognized as direct reductions of real estate revenue in our accompanying condensed consolidated statements of operations.
As of September 30, 2021operations and December 31, 2020, we had $2,219,000 and $2,086,000, respectively, in allowances, which were determined necessary to reduce receivables by our expected future credit losses. For the nine months ended September 30, 2021 and 2020, we increased allowances by $839,000 and $937,000, respectively, and reduced allowances for collections or adjustments by $350,000 and $126,000, respectively. For the nine months ended September 30, 2021 and 2020, $356,000 and $60,000, respectively, of our receivables were written off against the related allowances.
3. Real Estate Investments, Net
Our real estate investments, net consisted of the following as of September 30, 2021 and December 31, 2020:
 September 30,
2021
December 31,
2020
Building and improvements$892,743,000 $884,816,000 
Land109,771,000 109,444,000 
Furniture, fixtures and equipment9,315,000 8,599,000 
1,011,829,000 1,002,859,000 
Less: accumulated depreciation(104,726,000)(81,279,000)
Total$907,103,000 $921,580,000 
comprehensive loss.
13

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
As of March 31, 2022 and December 31, 2021, we had $13,872,000 and $12,378,000, respectively, in allowances, which were determined necessary to reduce receivables by our expected future credit losses. For the three months ended March 31, 2022 and 2021, we increased 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 were 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 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 months ended March 31, 2021, amounts totaling $101,734,000 have been removed from borrowings under mortgage loans payable and early 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 following as of March 31, 2022 and December 31, 2021:
 
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 the three months ended September 30,March 31, 2022 and 2021 was $34,422,000 and 2020 was $8,181,000 and $7,966,000, respectively, and for the nine months ended September 30, 2021 and 2020 was $24,025,000 and $23,698,000,$24,190,000, respectively. For the three and nine months ended September 30, 2021,March 31, 2022, we incurred capital expenditures of $1,959,000 and $4,875,000, respectively,$8,248,000 for our integrated senior health campuses, $2,434,000 for our medical office buildings $827,000 and $1,885,000, respectively,$1,454,000 for our senior housing — RIDEA facilities and $31,000 and $31,000, respectively, for our skilled nursing facilities.SHOP. We did not incur any capital expenditures for our skilled nursing facilities, senior housing facilities duringor hospitals for the three and nine months ended September 30, 2021.March 31, 2022.
On February 12, 2021, we acquired a previously unowned unit within oneAcquisition of our buildings at our existing Athens MOB Portfolio, originally purchased in May 2017, for a contract purchase price of $2,950,000. Our advisor was paid, as compensation for services rendered in connection withReal Estate Investment
For the investigation, selection and acquisition of such unit, a base acquisition fee of 2.25% of the contract purchase price paid by us, or $66,000. We acquired such unit using cash on hand and borrowed $2,000,000 under the 2018 Credit Facility, as defined in Note 7, Line of Credit and Term Loans, at the time of acquisition.
We accounted for our acquisition completed during the ninethree months ended September 30, 2021 as an asset acquisition. We incurred and capitalized the base acquisition fee and direct acquisition related expensesMarch 31, 2022, we, through a majority-owned subsidiary of $94,000. The following table summarizes the purchase priceTrilogy Investors, LLC, or Trilogy, of the assets acquiredwhich we owned 72.9% at the time of acquisition, based on their relative fair values:
2021
Acquisition
Building and improvements$2,429,000 
Land327,000 
In-place lease288,000 
Total assets acquired$3,044,000 
On April 1, 2021, we disposed of twoacquired an integrated senior housing facilitieshealth campus located in Fairfield and Sacramento, CaliforniaKentucky. See Note 4, Business Combination, for a contract sales price of $6,800,000. Such facilities were part of our existing Northern California Senior Housing Portfolio and were included within our senior housing – RIDEA reporting segment. We recognizedfurther discussion. The following is a total net loss on such disposition of $184,000. Our advisor agreed to waive the $136,000 disposition fee and any expense reimbursements for such disposition that may otherwise have been due to our advisor pursuant to the Advisory Agreement. 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 waiversummary of such disposition fee and expense reimbursements.
4. Identified Intangible Assets, Net
Identified intangible assets, net consisted of the following as of September 30, 2021 and December 31, 2020:
September 30,
2021
December 31,
2020
Amortized intangible assets:
In-place leases, net of accumulated amortization of $30,663,000 and $32,134,000 as of September 30, 2021 and December 31, 2020, respectively (with a weighted average remaining life of 8.8 years as of both September 30, 2021 and December 31, 2020)$52,112,000 $61,166,000 
Above-market leases, net of accumulated amortization of $1,252,000 and $1,009,000 as of September 30, 2021 and December 31, 2020, respectively (with a weighted average remaining life of 8.5 years and 9.1 years as of September 30, 2021 and December 31, 2020, respectively)2,292,000 2,587,000 
Unamortized intangible assets:
Certificates of need348,000 348,000 
Total$54,752,000 $64,101,000 
Amortization expense on identified intangible assetsproperty acquisition for the three months ended September 30, 2021 and 2020 was $2,358,000 and $4,728,000, respectively, which included $97,000 and $109,000, respectively,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 amortization recorded as a decrease tothe 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 revenue for above-market leases in our accompanying condensed consolidated statements of operations. Amortization expense on identified intangible assets for the nine months ended September 30, 2021development within our integrated senior health campuses segment for an aggregate sales price of $19,622,000 and 2020 was $9,495,000 and $14,361,000, respectively, which included $296,000 and $329,000, respectively,a gain on sale of amortization recorded as a decrease to$756,000. We retained approximately 23.0% ownership interests in such real estate revenue for above-market leases in our accompanying condensed consolidated statements of operations.development assets, which interests are
14

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
The aggregate weighted average remaining life of the identified intangibleaccounted for as investments in unconsolidated entities within other assets, was 8.8 yearsnet in our accompanying condensed consolidated balance sheet as of both September 30, 2021 and DecemberMarch 31, 2020. As2022. From February 8, 2022 through March 31, 2022, 23.0% interest in the net earnings or losses of September 30, 2021, estimated amortization expense on the identified intangible assets for the three months ending December 31, 2021 and for each of the next four years ending December 31 and thereafter was as follows:
YearAmount
2021$2,396,000 
20228,647,000 
20237,390,000 
20246,195,000 
20255,017,000 
Thereafter24,759,000 
Total$54,404,000 
5. Other Assets, Net
Other assets,such unconsolidated entities were included in net consisted of the following as of September 30, 2021 and December 31, 2020:
 September 30,
2021
December 31,
2020
Investment in unconsolidated entity$45,627,000 $46,653,000 
Deferred rent receivables15,101,000 12,395,000 
Prepaid expenses, deposits and other assets3,939,000 9,028,000 
Lease commissions, net of accumulated amortization of $687,000 and $426,000 as of September 30, 2021 and December 31, 2020, respectively3,763,000 2,399,000 
Deferred financing costs, net of accumulated amortization of $4,808,000 and $3,397,000 as of September 30, 2021 and December 31, 2020, respectively(1)313,000 1,724,000 
Total$68,743,000 $72,199,000 
___________
(1)Deferred financing costs only include costs related to our line of credit and term loans. Amortization expense on deferred financing costs of our line of credit and term loans for the three months ended September 30, 2021 and 2020 was $470,000 and $471,000, respectively, and for the nine months ended September 30, 2021 and 2020 was $1,411,000 and $1,410,000, respectively, which is recorded to interest expenseloss from unconsolidated entities in our accompanying condensed consolidated statements of operations.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 integrated senior healthcare campus, which was accounted for as a business combination. The contract purchase price for such property acquisition was $27,790,000 plus immaterial transaction costs. See Note 7, Line of Credit and Term Loans,3, Real Estate Investments, Net, for a further discussion. Based 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 accounted for as business combinations for the three months ended March 31, 2021.
The fair values of the assets acquired and liabilities assumed during 2022 were preliminary estimates. Any necessary adjustments will be finalized 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 unconsolidated entityan anticipated yield-to-maturity of 10.0% per annum. The debt security was issued by an unaffiliated mortgage trust and represents oura 10.0% beneficial ownership interest in Trilogy REIT Holdings, LLC, or Trilogy, pursuantsuch mortgage trust. The debt security is subordinate to an amended joint venture agreement with an indirect, wholly-owned subsidiary of NorthStar Healthcare Income, Inc.all other interests in the mortgage trust and is not guaranteed by a wholly-owned subsidiary of the surviving partnership. Trilogy owns a portfolio of integrated senior health campuses and ancillary businesses. government-sponsored entity.
As of September 30, 2021March 31, 2022 and December 31, 2020, we owned a 6.0% interest in such joint venture and2021, the unamortized basis difference of our investment in Trilogy of $16,448,000 and $16,791,000, respectively, was primarily attributable to the difference between thecarrying amount for which we purchased our interest in such joint venture, including transaction costs, and the historical carrying value of the debt security investment was $80,239,000 and $79,315,000, respectively, net assets of such joint venture. This differenceunamortized 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 being amortized over the remaining useful life of the related assets$980,000 and included in income or loss from unconsolidated entity$881,000, respectively, which is recorded as an increase to real estate revenue in our accompanying condensed consolidated statements of operations.operations and comprehensive 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 real estate revenue in our accompanying condensed consolidated statements of operations and comprehensive loss. We evaluated credit quality indicators such as the agency ratings and the underlying collateral of such investment in order to determine expected future credit loss. No credit loss was recorded for the three months ended March 31, 2022 and 2021.
15

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
6. Mortgage Loans Payable,Identified Intangible Assets, Net
AsIdentified intangible assets, net consisted of September 30, 2021the following as of March 31, 2022 and December 31, 2020, mortgage loans payable were $18,291,000 ($17,409,000, net2021:
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 months ended March 31, 2022 and 2021 was $8,239,000 and $1,196,000, respectively, which included $1,114,000 and $83,000, respectively, of discount/premiumamortization recorded as a decrease to real estate revenue for above-market leases in our accompanying condensed consolidated statements of operations and deferred financing costs)comprehensive loss.
The aggregate weighted average remaining life of the identified intangible assets was 8.7 years and $18,766,000 ($17,827,000, net8.8 years as of discount/premiumMarch 31, 2022 and deferred financing costs),December 31, 2021, respectively. As of September 30, 2021, we had 3 fixed-rate mortgage loans with interest rates ranging from 3.67% to 5.25% per annum, maturity dates ranging from April 1, 2025 to February 1, 2051 and a weighted average effective interest rate of 3.91%. As of DecemberMarch 31, 2020, we had 3 fixed-rate mortgage loans with interest rates ranging from 3.67% to 5.25% per annum, maturity dates ranging from April 1, 2025 to February 1, 2051 and a weighted average effective interest rate of 3.93%.
In January 2020, we paid off a mortgage loan payable with a principal balance of $7,738,000, which had an original maturity date of April 1, 2020. We did not incur any prepayment penalties or fees in connection with such payoff. The following table reflects2022, estimated amortization expense on the changes in the carrying amount of mortgage loans payable, netidentified intangible assets for the nine months ended September 30, 2021 and 2020:
Nine Months Ended September 30,
20212020
Beginning balance$17,827,000 $26,070,000 
Additions:
Amortization of deferred financing costs20,000 33,000 
Amortization of discount/premium on mortgage loans payable37,000 37,000 
Deductions:
Scheduled principal payments on mortgage loans payable(475,000)(8,166,000)
Ending balance$17,409,000 $17,974,000 
As of September 30, 2021, the principal payments due on our mortgage loans payable for the three months ending December 31, 20212022 and for each of the next four years ending December 31 and thereafter werewas as follows:
YearYearAmountYearAmount
2021$132,000 
20222022651,000 2022$16,985,000 
20232023680,000 202317,202,000 
20242024711,000 202413,673,000 
202520255,878,000 202511,034,000 
202620269,864,000 
ThereafterThereafter10,239,000 Thereafter45,015,000 
Total$18,291,000 
$113,773,000 
16

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
7. LineOther Assets, Net
Other assets, net consisted of Creditthe following as of March 31, 2022 and Term LoansDecember 31, 2021:
We, through our operating partnership, as borrower, entered into a credit agreement, or
 
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 2018 Credit Agreement, as amended, with Bank of America, N.A., or Bank of America; KeyBank, National Association, or KeyBank; Citizens Bank, National Association; Merrill Lynch, Pierce, Fenner & Smith Incorporated; KeyBanc Capital Markets, Inc., or KeyBanc Capital Markets; and the lenders named therein, to obtain a credit facility with an aggregate maximum principal amount of $530,000,000, or the 2018 Credit Facility. The 20182019 Trilogy Credit Facility consists of aand the senior unsecured revolving credit facility in the amount of $235,000,000 and senior unsecured term loan facilities in the aggregate amount of $295,000,000. The maximum principal amountportion of the 20182022 Credit Facility, may be increased by upeach 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 $120,000,000, forreal 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 total principal amountweighted average effective interest rate of $650,000,000, subject3.16%. 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 certain conditions. The 2018 Credit Facility matures5.25% per annum based on November 19,interest rates in effect as of December 31, 2021 and we intend to extend the maturity for 1 12-month period pursuant toa 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 2018 Credit Agreement,following as amended, subject to the satisfaction of certain conditions, including payment of an extension fee.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 
1617

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
The following table reflects the changes in the carrying amount of mortgage loans payable, net for the three months ended March 31, 2022 and 2021:
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.
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 March 31, 2022, the principal payments due on our mortgage loans payable for the nine months ending December 31, 2022 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.
9. Lines of Credit and Term Loans
2018 Credit Facility
In order to accommodate the Merger, we amended GAHR IV and its operating partnership's credit agreement, as amended, or the 2018 Credit Agreement, with Bank of America, N.A., or Bank of America; KeyBank, National Association, or KeyBank; Citizens Bank, National Association, or Citizens Bank; Merrill Lynch, Pierce, Fenner & Smith Incorporated; KeyBanc Capital Markets, Inc., or KeyBanc Capital Markets; and the lenders named therein, for a credit facility with an aggregate maximum principal amount of $530,000,000, or the 2018 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 a senior unsecured revolving credit facility in the amount of $235,000,000 and senior unsecured term loan facilities in the aggregate amount of $295,000,000. At our option, the 2018 Credit Facility bearsbore interest at per annum rates equal to (a)(i) the
18

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
Eurodollar Rate, as defined in the 2018 Credit Agreement, as amended, plus (ii) a margin ranging from 1.70% to 2.20% based on our Consolidated Leverage Ratio, as defined in the 2018 Credit Agreement, as amended, 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, as amended, 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.
As of both September 30, 2021 and December 31, 2020, our aggregate borrowing capacity under theThe 2018 Credit Facility was $530,000,000.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 September 30, 2021 and December 31, 2020,2021, borrowings outstanding totaled $488,900,000 and $476,900,000, respectively,$441,900,000 and the weighted average interest rate on such borrowings outstanding was 2.05%2.27% per annum. On January 19, 2022, we terminated the 2018 Credit Agreement and 2.12%, respectively, per annum.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 2019 Credit Facility bore interest at per annum rates equal to (a) (i) the Eurodollar Rate, as defined in the 2019 Corporate Credit Agreement, plus (ii) a margin ranging from 1.85% to 2.80% based on our Consolidated Leverage Ratio, as defined in the 2019 Corporate 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 2019 Corporate Credit Agreement, plus 0.50%, (3) the one-month Eurodollar Rate plus 1.00%, and (4) 0.00%, plus (ii) a margin ranging from 0.85% to 1.80% based on our Consolidated Leverage Ratio.
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 2019 Corporate Credit Agreement in its entirety, or the 2022 Credit Agreement. See below for a Second Amendment tofurther 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 Amendment. See Note 20, Subsequent Events — Lines of2022 Credit and Term Loans — Amendment to 2018Facility. 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 a further discussion.
8. Derivative Financial Instruments
We use derivative financial instruments to manage interest rate risk associated with our variable-rate term loansrefinancing existing indebtedness and we record such derivative financial instruments in our accompanying condensed consolidated balance sheets as either an asset or a liability measured at fair value. The following table lists the derivative financial instruments held by us as of September 30, 2021 and December 31, 2020, which are included in security deposits, prepaid rentfor general corporate purposes including for working capital, capital expenditures and other liabilitiescorporate purposes not inconsistent with obligations under the 2022 Credit Agreement. We may also obtain up to $25,000,000 in our accompanying condensed consolidated balance sheets:
Fair Value
InstrumentNotional AmountIndexInterest RateMaturity DateSeptember 30,
2021
December 31,
2020
Swap$139,500,000 one month LIBOR2.49%11/19/21$(455,000)$(2,915,000)
Swap58,800,000 one month LIBOR2.49%11/19/21(192,000)(1,229,000)
Swap45,000,000 one month LIBOR0.20%11/19/21(7,000)(27,000)
Swap36,700,000 one month LIBOR2.49%11/19/21(120,000)(766,000)
Swap15,000,000 one month LIBOR2.53%11/19/21(50,000)(318,000)
$295,000,000 $(824,000)$(5,255,000)
Asthe form of both September 30, 2021 and December 31, 2020, nonestandby letters of our derivative financial instruments were designated as hedges. For the three months ended September 30, 2021 and 2020, we recorded $1,514,000 and $1,450,000, respectively, and for the nine months ended September 30, 2021 and 2020, we recorded $4,431,000 and $(2,302,000), respectively, as a decrease (increase) to interest expense in our accompanying condensed consolidated statements of operations relatedcredit pursuant to the change2022 Credit Facility. Unless defined herein, all capitalized terms under this “2022 Credit Facility” subsection are defined in the fair value of our derivative financial instruments.2022 Credit Agreement.
See Note 14, Fair Value Measurements, for a further discussionUnder the terms of the fair value2022 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 derivative financial instruments.
9. Identified Intangible Liabilities, Net
Asoption, (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 September 30, 2021 and December 31, 2020, identified intangible liabilities, net consisted of below-market leases of $1,115,000 and $1,295,000, respectively, net of accumulated amortization of $730,000 and $608,000, respectively. Amortization expense on below-market leases for the three months ended September 30, 2021 and 2020 was $59,000 and $78,000, respectively, and for2022 Credit Agreement, there is an inability to determine the nine months ended September 30, 2021 and 2020 was $181,000 and $239,000, respectively, which was recorded as an increase to real estate revenue in our accompanying condensed consolidated statements of operations.Daily SOFR or the Term SOFR then the 2022 Credit Facility will
1719

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
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.
The 2022 Credit Agreement requires us to add additional subsidiaries as guarantors in the event the value of the assets owned by the subsidiary guarantors falls below a certain threshold as set forth in the 2022 Credit Agreement. In the event of default, Bank of America has the right to terminate the commitment of each Lender to make Loans and any obligation of the L/C Issuer to make L/C Credit Extensions under the 2022 Credit Agreement, and to accelerate the payment on any unpaid principal amount of all outstanding loans and interest thereon.
As of March 31, 2022, our aggregate borrowing capacity under the 2022 Credit Facility was $1,050,000,000, excluding the $25,000,000 in standby letters of credit described above. As of March 31, 2022, borrowings outstanding under the 2022 Credit Facility totaled $934,400,000 ($933,413,000, net of deferred financing costs related to the senior unsecured term loan facility portion of the 2022 Credit Facility) and the weighted average interest rate on such borrowings outstanding was 2.04% per annum.
For 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 2018 Credit Facility and the 2019 Credit Facility. Such loss on extinguishment of debt is recorded as an increase to interest expense in our accompanying condensed consolidated statements of operations and comprehensive loss, and primarily consisted of lender fees we paid to obtain the 2022 Credit Facility.
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 September 5, 2023 and may be extended for 1 12-month period during the term 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 (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.
20

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
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 following 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 below-market leases was 12.09.0 years and 11.69.1 years as of September 30, 2021March 31, 2022 and December 31, 2020,2021, respectively. As of September 30, 2021,March 31, 2022, estimated amortization expense on below-market leases for the threenine months ending December 31, 20212022 and for each of the next four years ending December 31 and thereafter was as follows:
YearYearAmountYearAmount
2021$55,000 
20222022217,000 2022$1,239,000 
20232023207,000 20231,596,000 
20242024161,000 20241,475,000 
20252025123,000 20251,347,000 
202620261,198,000 
ThereafterThereafter352,000 Thereafter5,222,000 
Total$1,115,000 
$12,077,000 
10.12. 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
21

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
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.
11.13. Redeemable Noncontrolling Interests
As a result of both September 30, 2021the Merger and the AHI Acquisition, as of March 31, 2022 and December 31, 2020,2021, we, through our advisor owned all of the 208 limited partnership units outstanding in our operating partnership. As of both September 30, 2021direct and December 31, 2020, we owned greater than a 99.99%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. Our advisor was entitled to special redemption rights of its limited partnership units. The noncontrolling interest of our advisorrespectively, in our operating partnership is owned by the NewCo Sellers. Some of the limited partnership units outstanding, which hadaccount for approximately 1.0% of our total operating partnership units outstanding, have redemption features outside of our control wasand are accounted for as a redeemable noncontrolling interest and wasinterests presented outside of permanent equity in our accompanying condensed consolidated balance sheets assheets.
As of both September 30, 2021March 31, 2022 and December 31, 2020. In connection with2021, we, through Trilogy REIT Holdings LLC, or Trilogy REIT Holdings, in which we indirectly hold a 76.0% ownership interest, owned 95.9% of the AHI Acquisition, on October 1,outstanding equity interests of Trilogy. As of both March 31, 2022 and December 31, 2021, GAHR III redeemed all 208 limited partnership unitscertain 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 Merger and through our operating partnership, owned by our advisor for approximately $2,000.
In connection with our acquisitionsas of Central Florida Senior Housing Portfolio, Pinnacle Beaumont ALFMarch 31, 2022 and Pinnacle Warrenton ALF,December 31, 2021, we own approximately 98.0% of the joint ventures with an affiliate of Meridian Senior Living, LLC, or Meridian. In connection with our acquisitions of Catalina West HavenMeridian, that own Central Florida Senior Housing Portfolio, Pinnacle Beaumont ALF and Catalina Madera ALF,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.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.
18

Table Both of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
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 interests at the greater of: (i) the initial carrying amount, increased or decreased for the noncontrolling interests’ share of net income or loss and distributions;distributions or (ii) the redemption value. The changes in the carrying amount of redeemable noncontrolling interests consisted of the following for the nine monthsyears ended September 30, 2021March 31, 2022 and 2020:2021:
Nine Months Ended September 30,Three Months Ended March 31,
2021202020222021
Beginning balanceBeginning balance$2,618,000 $1,462,000 Beginning balance$72,725,000 $40,340,000 
Additions125,000 1,118,000 
Additional redeemable noncontrolling interestAdditional redeemable noncontrolling interest173,000 — 
Reclassification from equityReclassification from equity21,000 — 
DistributionsDistributions(8,000)(81,000)Distributions(695,000)— 
Adjustment to redemption valueAdjustment to redemption value167,000 530,000 Adjustment to redemption value2,856,000 526,000 
Net loss attributable to redeemable noncontrolling interests(310,000)(332,000)
Net income (loss) attributable to redeemable noncontrolling interestsNet income (loss) attributable to redeemable noncontrolling interests187,000 (484,000)
Ending balanceEnding balance$2,592,000 $2,697,000 Ending balance$75,267,000 $40,382,000 
22

12.
Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
14. Equity
Preferred Stock
As of September 30, 2021, pursuantPursuant to our Third Articles of Amendment and Restatement, as supplemented, or our charter, we wereare authorized to issue 200,000,000 shares of our preferred stock, par value $0.01 per share. As of both September 30, 2021March 31, 2022 and December 31, 2020,2021, no shares of our preferred stock were issued and outstanding.
Common Stock
On 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 September 30,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, or 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, whereby 900,000,000200,000,000 shares wereare classified as Class T common stock and 100,000,000800,000,000 shares wereare classified as Class I common stock. See Note 20, Subsequent Events — Amendments to Articles
Distribution Reinvestment Plan
Following the deregistration of Incorporation, for a discussion of an amendment to our charter filedthe Initial DRIP on October 1, 2021. 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. As of both September 30, 2021 and December 31, 2020, our advisor owned 20,833 shares of our Class T common stock. In connection with the AHI Acquisition, on October 1, 2021, GAHR III redeemed all 20,833 shares of our Class T common stock owned by our advisor for approximately $192,000.
On February 15, 2019, we terminated our initial offering andApril 22, 2015, we continued to offer shares of our common stock pursuant to the 2015 GAHR III DRIP Offering and 2019 GAHR III DRIP Offering. On March 18, 2021, our board authorized the suspensionOffering 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 deregistered the 2019 GAHR III DRIP effective with distributions declared for the month of April 2021; however,Offering on October 4, 2021. Further, on October 4, 2021, our board reinstated distributions and authorized the DRIP. Seereinstatement of the “Distribution Reinvestment Plan” section below for a further discussion. Through September 30, 2021, we had issued 75,639,681 aggregate sharesAHR DRIP Offering. We continue to offer up to $100,000,000 of our Class T and Class I common stock in connection with the primary portion of our initial offering and 8,177,085 aggregate shares of our Class T and Class I common stock pursuant to our DRIP Offerings. We also granted an aggregate of 105,000 shares of our restricted Class T common stock to our independent directors and repurchased 2,211,338 shares of our common stock under our share repurchase plan through September 30, 2021. As of September 30, 2021 and December 31, 2020, we had 81,731,261 and 81,339,337 aggregate shares of our Class T and Class I common stock, respectively,to be issued and outstanding.
Distribution Reinvestment Plan
We had registered and reserved $150,000,000 in shares of our common stock for sale pursuant to the AHR DRIP under the AHR DRIP Offering. As a result, beginning with the October 2021 distribution, which was paid in our initial offering. TheNovember 2021, stockholders who previously enrolled as participants in the AHR DRIP allowed stockholders to purchase additional Class T shares and Class I shares of our common stock through the reinvestment ofreceived or will receive distributions during our initial offering. Pursuant to the DRIP, distributions with respect to Class T shares were reinvested in Class T shares and distributions with respect to Class I shares were reinvested in Class I shares. On February 15, 2019, we terminated our initial offering and continued to offer up to $100,000,000 in shares of our common stock pursuant to the 2019 DRIP Offering. In connection with our special committee’s strategic alternative review process and in order to facilitate a strategic transaction, on March 18, 2021, our board authorized the suspensionterms of the AHR DRIP, effective asinstead of April 1, 2021.cash distributions. As of March 31, 2022, a consequencetotal of the suspension$65,941,000 in distributions were reinvested that resulted in 6,981,086 shares of the DRIP, beginning with the April 2021 distributions, which were paid in May 2021, there were no further issuances of sharescommon 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 who are participantspaid in the DRIP received or will receive cash distributions instead. On October 4, 2021,month following such board approval, shares of our common stock issued pursuant to our distribution reinvestment plan are issued at the current estimated per share NAV until such time as our board authorized the reinstatement of the DRIP. See Note 20, Subsequent Events — Reinstatement of the DRIP, for a further discussion.determined an updated estimated per share NAV.
1923

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
Since April 6, 2018, our board has approved and established an estimated per share net asset value, or NAV, on at least an annual basis. Commencing withThe following is a summary of the distribution payment to stockholders paid in the month following such board approval, shares of our common stock issued pursuant the DRIP were or will be issued at the currenthistorical estimated per share NAV until such timefor GAHR III and the Combined Company, as our board determines an updated estimated per share NAV.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 months ended September 30,March 31, 2022, and 2021, there were no distributions reinvested or shares issued due to the suspension of the DRIP. For the three months ended September 30, 2020, $4,247,000 in distributions were reinvested$11,304,000 and 445,239 shares of our common stock were issued pursuant to our DRIP Offerings. For the nine months ended September 30, 2021 and 2020, $5,499,000 and $15,681,000,$0, respectively, in distributions were reinvested and 581,4911,226,073 and 1,643,7310 shares of our common stock, respectively, were issued pursuant to our DRIP Offerings. As of September 30, 2021 and December 31, 2020, a total of $77,991,000 and $72,492,000, respectively, in distributions were cumulatively reinvested that resulted in 8,177,085 and 7,595,594 shares of our common stock, respectively, being issued pursuant to our DRIP Offerings.
Share Repurchase Plan
Due to the impact the COVID-19 pandemic has had on the United States and globally, and the ongoing uncertainty of the severity and duration of the COVID-19 pandemic and its effects, beginning in March 2020, our board decided to take steps to protect our capital and maximize our liquidity in an effort to strengthen our long-term financial prospects. As a result, on March 31, 2020, our board suspended our share repurchase plan with respect to all repurchase requests other than repurchases resulting from the death or qualifying disability of stockholders, beginning with share repurchase requests submitted for repurchase during the second quarter of 2020. Repurchase requests resulting from the death or qualifying disability of stockholders were not suspended, but remained subject to all terms and conditions of our share repurchase plan, including our board’s discretion to determine whether we have sufficient funds available to repurchase any shares. In connection with our special committee’s strategic alternative review process and in order to facilitate a strategic transaction, on March 18, 2021, our board approved the suspension of our share repurchase plan with respect to all repurchase requests received by us after February 28, 2021, including repurchases resulting from the death or qualifying disability of stockholders. On October 4, 2021, our board authorized the partial reinstatement of our share repurchase plan. See Note 20, Subsequent Events — Amendments to and Partial Reinstatement of Share Repurchase Plan, for a further discussion.
Our 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. 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 are not subject to this cap. Funds for the repurchase of shares of our common stock come exclusively from the cumulative proceeds we receive from the sale of shares of our common stock pursuant to our DRIP Offerings.
During our initial offering and with respectPursuant to shares repurchased for the quarter ended March 31, 2019, the repurchase amount for shares repurchased under our share repurchase plan, wasthe 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 per share offering price in our initial offering. Commencing with shares repurchased for the quarter ended June 30, 2019, the repurchase amount for shares repurchased under our share repurchase plan is the lesser of (i) the amount per share the stockholder paid for their shares of our common stock, or (ii) the most recent estimated value of one share of the applicable class ofour common stock, as determined by our board. However, if shares of our common stock were repurchased in connection with a stockholder’s death or qualifying disability, the repurchase price was no less than 100% of the price paid to acquire the shares of our common stock from us. On October 4, 2021, we amended and restated our share repurchase plan to changeboard, except that the repurchase price with respect to repurchases resulting from the death or qualifying disability of stockholders. See Note 20, Subsequent Events — Amendmentsstockholders is equal to the most recently published estimated per share NAV. On October 4, 2021, as a result of the Merger, our board authorized the partial reinstatement of our share repurchase plan with respect to requests to repurchase shares resulting from the death or qualifying disability of stockholders, effective with respect to qualifying repurchases for the fiscal quarter ending December 31, 2021. All share repurchase requests other than those requests resulting from the death or qualifying disability of stockholders were and Partial Reinstatement of Share Repurchase Plan, for a further discussion.shall be rejected.
For the three months ended September 30, 2021, we did not repurchase any shares of our common stock due to the suspension of our share repurchase plan. For the three months ended September 30, 2020,March 31, 2022, we repurchased 71,551448,375 shares of our common stock, for an aggregate of $706,000$4,134,000, at an averagea repurchase price of $9.87$9.22 per share. For the ninethree months ended September 30,March 31, 2021, and 2020,we did not repurchase any shares of common stock. In April 2022, we repurchased 189,567 and 578,111699,460 shares of our common stock, respectively, for an aggregate of $1,874,000 and $5,349,000, respectively,$6,449,000, at an averagea repurchase price of $9.88 and $9.25$9.22 per share, respectively. As of September 30, 2021 and December 31, 2020, we cumulatively repurchased 2,211,338 and 2,021,771 shares of our common stock, respectively, for an aggregate of $20,744,000 and $18,870,000, respectively, at an average repurchase price of $9.38 and $9.33 per share, respectively.share. All shares were repurchased using the cumulative proceeds we received from the sale of shares of our common stock pursuant to our DRIP Offerings.
Noncontrolling Interests in Total Equity
As of both March 31, 2022 and December 31, 2021, Trilogy REIT Holdings owned approximately 95.9% of Trilogy. Prior to October 1, 2021, we were the indirect owner of a 70.0% interest in Trilogy REIT Holdings pursuant to an amended joint venture agreement with an indirect, wholly owned subsidiary of NorthStar Healthcare Income, Inc., or NHI, and a wholly owned subsidiary of GAHR IV Operating Partnership. We serve as the managing member of Trilogy REIT Holdings. 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, Offerings.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
2024

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
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 InterestInterests, for a further discussion.
In connection withDecember 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 acquisitionconsolidated 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 Louisiana Senior Housing Portfolio$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 3,21, 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 September 30, 2021March 31, 2022 and December 31, 2020,2021, 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 our consolidateda joint venture that owns such properties.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 forand comprehensive loss during the three and nine months ended September 30, 2021March 31, 2022.
As discussed in Note 1, Organization and forDescription of Business, as a result of the period from January 3, 2020 through September 30, 2020,Merger and the carrying amountAHI Acquisition, as of such noncontrollingMarch 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 sheetssheet. See Note 13, Redeemable Noncontrolling Interests, for a further discussion.
2015 Incentive Plan
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 September 30,common stock granted to independent directors), or our compensation committee (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 March 31, 2022, we granted an aggregate of 1,082,455 shares of our restricted common stock under our incentive plan. Such amount includes: (i) 160,314 shares of our restricted Class T common stock, at a weighted average grant date fair value of $9.61 per share, to our independent directors; (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 certain executive officers and key employees; and (iii) 319,149 shares of our restricted Class T common stock, at a grant date fair value of $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 right to receive shares of our Class T common stock upon vesting. Prior to the Merger, GAHR III granted an aggregate of 135,000 shares of its restricted common stock, which is equal to 125,091 shares of our restricted Class I common stock, using the conversion ratio of 0.9266 shares of GAHR IV Class I common stock for each share of GAHR III restricted common stock, as determined in the Merger.
25

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
On April 1, 2022, we granted 76,800 time-based restricted units under our incentive plan to certain employees representing the right to receive shares of our Class T common stock upon vesting. Such time-based restricted units vest in three equal annual installments on April 1, 2023, April 1, 2024 and April 1, 2025.
For the three months ended March 31, 2022 and 2021, we recognized stock compensation expense related to the restricted stock grants to our independent directors, executive officers and December 31, 2020.key employees of $811,000 and $27,000, respectively. Such stock compensation expense is included in general and administrative in our accompanying consolidated statements of operations and comprehensive loss.
13.15. Related Party Transactions
Fees and Expenses Paid to Affiliates
AsPrior 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 non-independent directors were also executive officersformer co-sponsors and employees and/or holders of a direct or indirect interest in our advisor, oneother affiliates of our co-sponsors or other affiliated entities. We were affiliated with our advisor, American Healthcare Investors and AHI Group Holdings; however, we were not affiliated with Griffin Capital, our dealer manager, Digital Bridge or Mr. Flaherty. We entered intoformer advisor.
On December 20, 2021, the Advisory Agreement was assigned to NewCo and as amended, which entitleda 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 to specified compensation for certain services, as well as reimbursement of certain expenses. Our board, including a majority of our independent directors, reviewedany fees or expense reimbursements arising from the material transactions between our affiliates and us during the nine months ended September 30, 2021. We believe that we have executed all of the transactions set forth below on terms that are fair and reasonable to us and on terms no less favorable to us than those available from unaffiliated third parties.Advisory Agreement.
Fees and expenses incurred to our former advisor or its affiliates incurred for the three and nine months ended September 30,March 31, 2021 and 2020 were as follows:
Three Months Ended September 30,Nine Months Ended September 30,
 2021202020212020
Asset management fees(1)$2,454,000 $2,446,000 $7,359,000 $7,292,000 
Property management fees(2)383,000 376,000 1,124,000 1,100,000 
Lease fees(3)211,000 117,000 632,000 254,000 
Construction management fees(4)36,000 12,000 98,000 76,000 
Operating expenses(5)24,000 37,000 103,000 122,000 
Development fees(6)19,000 22,000 74,000 24,000 
Base acquisition fees and reimbursement of acquisition expenses(7)2,000 35,000 184,000 1,476,000 
Total$3,129,000 $3,045,000 $9,574,000 $10,344,000 
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.
(2)Acquisition fees in connection with the acquisition of properties accounted for as asset acquisitions or the acquisition of real estate-related investments were capitalized as part of the associated investments in our accompanying condensed consolidated balance sheets.
(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 property type from which the fee was incurred.
(3)(4)Development fees were capitalized as part of the associated investments in our accompanying condensed consolidated balance sheets.
(5)Lease fees were capitalized as costs of entering into new leases and included in other assets, net in our accompanying condensed consolidated balance sheets, and amortized over the term of the lease.sheets.
(4)(6)We reimbursed our former advisor or its affiliates for operating expenses incurred in rendering services to us, subject to certain limitations. For the 12 months ended March 31, 2021, our operating expenses did not exceed such limitations.
26

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
Operating expenses were generally included in general and administrative in our accompanying condensed consolidated statements of operations and comprehensive loss.
(7)Construction management fees were capitalized as part of the associated asset and included in real estate investments, net in our accompanying condensed consolidated balance sheets.
(5)Accounts Payable Due to Affiliates
We reimburseddid not have any amounts outstanding to our advisor or its affiliates for operating expenses incurredas 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 
$866,000 
16. Fair Value Measurements
Assets and Liabilities Reported at Fair Value
The table below presents our assets and liabilities measured at fair value on a recurring basis as of March 31, 2022, aggregated by the level in rendering services to us, subject to certain limitations. For the 12fair value hierarchy within which those measurements fall:
Quoted Prices in
Active Markets for
Identical Assets
and Liabilities
(Level 1)
Significant Other
Observable Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
Total
Liabilities:
Warrants$— $— $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 September 30,March 31, 2022 and 2021.
Warrants
As of March 31, 2022 and December 31, 2021, we have recorded $733,000 and 2020,$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 operating expenses did not exceed suchaccompanying condensed consolidated balance sheets. Once exercised, these warrants have redemption features similar to the common units held by members of Trilogy’s management.See Note 13, Redeemable
2127

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
limitations. Operating expenses were generally included in general and administrative in our accompanying condensed consolidated statementsNoncontrolling Interests, for a further discussion. As of operations.
(6)Development fees were expensed as incurred and included in business acquisition expenses in our accompanying condensed consolidated statements of operations.
(7)Such amounts were capitalized as part of the associated asset and included in real estate investments, net in our accompanying condensed consolidated balance sheets or were expensed as incurred and included in business acquisition expenses in our accompanying condensed consolidated statements of operations, as applicable.
Accounts Payable Due to Affiliates
The following amounts were outstanding to our affiliates as of September 30, 2021March 31, 2022 and December 31, 2020:
FeeSeptember 30,
2021
December 31,
2020
Lease commissions$210,000 $8,000 
Operating expenses34,000 10,000 
Property management fees32,000 117,000 
Construction management fees31,000 33,000 
Development fees16,000 64,000 
Asset management fees1,000 814,000 
Total$324,000 $1,046,000 
14. Fair Value Measurements
Assets and Liabilities Reported at Fair Value
The table below presents our assets and liabilities measured at fair2021, the carrying value onis a recurring basis as of September 30, 2021, aggregated by the level in the fair value hierarchy within which those measurements fall:
Quoted Prices in
Active Markets for
Identical Assets
and Liabilities
(Level 1)
Significant Other
Observable Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
Total
Liabilities:
Derivative financial instruments$— $824,000 $— $824,000 
The table below presents our assets and liabilities measured at fair value on a recurring basis as of December 31, 2020, aggregated by the level in the fair value hierarchy within which those measurements fall:
Quoted Prices in
Active Markets for
Identical Assets
and Liabilities
(Level 1)
Significant Other
Observable Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
Total
Liabilities:
Derivative financial instruments$— $5,255,000 $— $5,255,000 
There were no transfers into or outreasonable estimate of fair value measurement levels during the nine months ended September 30, 2021 and 2020.value.
Derivative Financial Instruments
We useused interest rate swaps and interest rate caps to manage interest rate risk associated with variable-rate debt. The valuation of these instruments iswas determined using widely accepted valuation techniques including a discounted cash flow analysis on the expected cash flows of each derivative. This analysis reflectsreflected the contractual terms of the derivatives, including the period to maturity, and usesused observable market-based inputs, including interest rate curves, as well as option volatility. The fair values of interest rate swaps arewere determined by netting the discounted future fixed cash payments and the discounted expected variable
22

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
cash receipts. The variable cash receipts arewere based on an expectation of future interest rates derived from observable market interest rate curves.
We incorporateincorporated credit valuation adjustments to appropriately reflect both our own nonperformance risk and the respective counterparty’s nonperformance risk in the fair value measurements. In adjusting the fair value of our derivative contracts for the effect of nonperformance risk, we have considered the impact of netting and any applicable credit enhancements, such as collateral postings, thresholds, mutual puts and guarantees.
Although we have determined that the majority of the inputs used to value our derivative financial instruments fallfell within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with these instruments utilizeutilized Level 3 inputs, such as estimates of current credit spreads, to evaluate the likelihood of default by us and our counterparty. However, as of September 30,December 31, 2021, we have assessed the significance of the impact of the credit valuation adjustments on the overall valuation of our derivative positions and have determined that the credit valuation adjustments arewere not significant to the overall valuation of our derivatives. As a result, we have determined that our derivative valuations in their entirety arewere classified in Level 2 of the fair value hierarchy. As of March 31, 2022, we did not have any derivative financial instruments.
Financial Instruments Disclosed at Fair Value
Our accompanying condensed consolidated balance sheets include the following financial instruments: debt security investment, cash and cash equivalents, restricted cash, accounts and other receivables, accounts payable and accrued liabilities, accounts payable due to affiliates, mortgage loans payable and borrowings under the 2018 Credit Facility.our lines of credit and term loans.
We consider the carrying values of cash and cash equivalents, restricted cash, accounts and other receivables and accounts payable and accrued liabilities to approximate the fair 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 accounts payable due to affiliates is not determinable due to the related party nature of the accounts payable. TheseThe fair values of the other financial assets and liabilities are measured at fair value on a recurring basis based on quoted prices in active markets for identical assets and liabilities, and thereforeinstruments are classified asin Level 1 in2 of the fair value hierarchy.
The fair value of our debt security investment is estimated using a discounted cash flow analysis using interest rates available to us for investments with similar terms and maturities. The fair values of our mortgage loans payable and the 2018 Credit Facilityour 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. We have determined that the valuations of our debt security investment, mortgage loans payable and the 2018 Credit Facilitylines of credit and term loans are classified in Level 2 within the fair value hierarchy as reliance is placed on inputs other than quoted prices that are observable, such as interest rates and yield curves.hierarchy. The carrying amounts and estimated fair values of such financial instruments as of September 30, 2021March 31, 2022 and December 31, 20202021 were as follows:
September 30, 2021December 31, 2020
March 31,
2022
December 31,
2021
Carrying
Amount(1)
Fair
Value
Carrying
Amount(1)
Fair
Value
Carrying
Amount(1)
Fair
Value
Carrying
Amount(1)
Fair
Value
Financial Assets:Financial Assets:
Debt security investmentDebt security investment$80,239,000 $93,859,000 $79,315,000 $93,920,000 
Financial Liabilities:Financial Liabilities:Financial Liabilities:
Mortgage loans payableMortgage loans payable$17,409,000 $20,891,000 $17,827,000 $22,052,000 Mortgage loans payable$1,103,006,000 $1,039,112,000 $1,095,594,000 $1,075,729,000 
Line of credit and term loans$488,587,000 $488,995,000 $475,176,000 $477,651,000 
Lines of credit and term loansLines of credit and term loans$1,232,017,000 $1,243,616,000 $1,222,853,000 $1,226,636,000 
___________
(1)Carrying amount is net of any discount/premium and deferred financingunamortized costs.
28
15.

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
17. Income Taxes
As 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.
23

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
The components of income tax benefit or expense for the three and nine months ended September 30, 2021 and 2020 were as follows:
Three Months Ended September 30,Nine Months Ended September 30,
2021202020212020
Federal deferred$(914,000)$(863,000)$(2,717,000)$(2,134,000)
State deferred(232,000)(327,000)(791,000)(721,000)
Federal current— (37,000)— — 
State current— (2,000)— — 
Valuation allowance1,146,000 1,190,000 3,508,000 2,855,000 
Total income tax benefit$— $(39,000)$— $— 
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 lossesloss 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 September 30, 2021March 31, 2022 and December 31, 2020,2021, 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 both September 30, 2021March 31, 2022 and December 31, 2020,2021, our valuation allowance fully reserves the net deferred tax assetassets 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 sets forth the undiscounted 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
24
29

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
16. Leases
Lessor
We have operating leases with tenants that expire at various dates through 2040. For the three months ended September 30, 2021 and 2020,leased property. As of March 31, 2022, we recognized $22,120,000 and $21,519,000 of real estate revenue, respectively, related to operatinghad future lease payments of which $5,013,000 and $4,592,000, respectively, was$27,229,000 for variable lease payments. For the nine months ended September 30, 2021 and 2020, we recognized $66,054,000 and $64,824,000 of real estate revenue, respectively, related toan operating lease payments,that had not yet commenced. Such operating lease will commence in fiscal year 2022 with a lease term of which $14,817,00015 years.
The depreciable life of assets and $13,861,000, respectively, was for variableleasehold improvements are limited by the expected lease payments. Asterm, unless there is a transfer of September 30, 2021, the following table sets forth the undiscounted cash flows for future minimum base rents due under operating leases for the three months ending December 31, 2021 and for eachtitle or purchase option reasonably certain of the next four years ending December 31 and thereafter for the properties that we wholly own:
YearAmount
2021$16,361,000 
202264,121,000 
202360,213,000 
202454,662,000 
202549,138,000 
Thereafter283,142,000 
Total$527,637,000 
Lessee
We have ground lease obligations that generally require fixed annual rental payments and may also include escalation clauses and renewal options. These leases expire at various dates through 2107, excluding extension options.exercise. Certain of our lease agreements include rental payments that are adjusted periodically based on the United States Bureau of Labor Statistics’ Consumer Price Index, and may also include other variable lease costs (i.e., common area maintenance, property taxes and insurance). Our lease agreements do not contain any material residual value guarantees or material restrictive covenants.
For the three months ended September 30, 2021 and 2020, operatingThe components of lease costs were $226,000as 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 
___________
(1)Includes short-term leases and $206,000, respectively, and for the nine months ended September 30, 2021 and 2020, operating lease costs were $644,000 and $643,000, respectively, which are included in rental expenses in our accompanying condensed consolidated statements of operations. Such costs also include variable lease costs, which are immaterial.
Additional information related to our operating leases for the periods presented below was as follows:
September 30,
 2021
December 31,
2020
Lease Term and Discount RateLease Term and Discount Rate
March 31,
2022
December 31,
2021
Weighted average remaining lease term (in years)Weighted average remaining lease term (in years)78.779.5Weighted average remaining lease term (in years)
Operating leasesOperating leases16.916.9
Finance leasesFinance leases4.43.6
Weighted average discount rateWeighted average discount rate5.74 %5.74 %Weighted average discount rate
Operating leasesOperating leases5.53 %5.52 %
Finance leasesFinance 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 
2530

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
Operating Leases
As of September 30, 2021,March 31, 2022, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for the threenine months ending December 31, 20212022 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 accompanying condensed consolidated balance sheet:
YearYearAmountYearAmount
2021$213,000 
20222022526,000 2022$14,522,000 
20232023530,000 202319,275,000 
20242024534,000 202418,245,000 
20252025538,000 202517,190,000 
2026202616,851,000 
ThereafterThereafter46,565,000 Thereafter163,815,000 
Total undiscounted operating lease paymentsTotal undiscounted operating lease payments48,906,000 Total undiscounted operating lease payments249,898,000 
Less: interestLess: interest38,885,000 Less: interest107,283,000 
Present value of operating lease liabilitiesPresent value of operating lease liabilities$10,021,000 Present value of operating lease liabilities$142,615,000 
Finance Leases
As of 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 
17.19. Segment Reporting
As of September 30, 2021,March 31, 2022, we evaluated our business and made resource allocations based on 46 reportable business segments —segments: medical office buildings, integrated senior health campuses, skilled nursing facilities, SHOP, senior housing senior housing — RIDEA and skilled nursing facilities.hospitals. Our medical office buildings are typically leased to multiple tenants under separate leases, thus requiring active management and responsibility for many of the associated operating expenses (much of which are, or can effectively be, passed through to the tenants). Our integrated senior health campuses 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 and skilled nursing facilities are primarily single-tenant properties for which we lease the facilities to unaffiliated tenants under triple-net and generally master leases that transfer the obligation for all facility operating costs (including maintenance, repairs, taxes, insurance and capital expenditures) to the tenant. OurIn addition, our senior housing — RIDEA propertiessegment 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.
While we believe that net income (loss), as defined by GAAP, is the most appropriate earnings measurement, we evaluate our segments’ performance based upon segment net operating income, or NOI. We define segment NOI as total revenues and grant income, less rentalproperty operating expenses and property operatingrental expenses, which excludes depreciation and amortization, general and administrative expenses, business acquisition expenses, interest expense, gain or loss on dispositiondispositions of real estate investments, impairment of real estate investments, income or loss from unconsolidated entity,entities, foreign currency
31

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
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 NOI serves as an appropriate supplemental performance measure to net income (loss) because it allows investors and our management to measure unlevered property-level operating results and to compare our operating results to the operating results of other real estate companies and between periods on a consistent basis.
Interest expense, depreciation and amortization and other expenses not attributable to individual properties are not allocated to individual segments for purposes of assessing segment performance. Non-segment assets primarily consist of corporate assets including our joint venture investment in an unconsolidated entity, cash and cash equivalents, other receivables, deferred financing costs and other assets not attributable to individual properties.
On October 1, 2021, as part of the Merger, 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 as outlined above.
26
32

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
Summary information for the reportable segments during the three and nine months ended September 30,March 31, 2022 and 2021 and 2020 was as follows:
Medical
Office
Buildings
Senior
Housing —
RIDEA
Skilled
Nursing
Facilities
Senior
Housing
Three Months
Ended
September 30, 2021
Integrated
Senior Health
Campuses
SHOPMedical
Office
Buildings
Senior
Housing
Skilled
Nursing
Facilities
Hospitals
Three Months
Ended
March 31, 2022
Revenues:
Revenues and grant income:Revenues and grant income:
Resident fees and servicesResident fees and services$281,012,000 $37,962,000 $— $— $— $— $318,974,000 
Real estate revenueReal estate revenue$16,921,000 $— $2,996,000 $2,203,000 $22,120,000 Real estate revenue— — 37,837,000 5,298,000 6,393,000 2,415,000 51,943,000 
Resident fees and services— 15,090,000 — — 15,090,000 
Total revenues16,921,000 15,090,000 2,996,000 2,203,000 37,210,000 
Grant incomeGrant income5,096,000 118,000 — — — — 5,214,000 
Total revenues and grant incomeTotal 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:Expenses:Expenses:
Property operating expensesProperty operating expenses253,150,000 34,010,000 — — — — 287,160,000 
Rental expensesRental expenses6,072,000 — 145,000 172,000 6,389,000 Rental expenses— — 14,313,000 179,000 686,000 109,000 15,287,000 
Property operating expenses— 14,540,000 — — 14,540,000 
Segment net operating incomeSegment net operating income$10,849,000 $550,000 $2,851,000 $2,031,000 $16,281,000 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:Expenses:Expenses:
General and administrativeGeneral and administrative$4,304,000 General and administrative$11,119,000 
Business acquisition expensesBusiness acquisition expenses3,800,000 Business acquisition expenses173,000 
Depreciation and amortizationDepreciation and amortization10,746,000 Depreciation and amortization42,311,000 
Other income (expense):Other income (expense):Other income (expense):
Interest expense:Interest expense:Interest expense:
Interest expense (including amortization of deferred financing costs and debt discount/premium)(4,961,000)
Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments)Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments)(23,325,000)
Gain in fair value of derivative financial instrumentsGain in fair value of derivative financial instruments1,514,000 Gain in fair value of derivative financial instruments500,000 
Gain on disposition of real estate investments15,000 
Income from unconsolidated entity70,000 
Gain on dispositions of real estate investmentsGain on dispositions of real estate investments756,000 
Income from unconsolidated entitiesIncome from unconsolidated entities1,386,000 
Foreign currency lossForeign currency loss(1,387,000)
Other incomeOther income33,000 Other income1,260,000 
Total net other expenseTotal net other expense(3,329,000)Total net other expense(20,810,000)
Loss before income taxesLoss before income taxes(729,000)
Income tax expenseIncome tax expense(168,000)
Net lossNet loss$(5,898,000)Net loss$(897,000)
2733

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
Medical
Office
Buildings
Senior
Housing —
RIDEA
Skilled
Nursing
Facilities
Senior
Housing
Three Months
Ended
September 30, 2020
Integrated
Senior Health
Campuses
SHOPMedical
Office
Buildings
Senior
Housing
Skilled
Nursing
Facilities
Hospitals
Three Months
Ended
March 31, 2021
Revenues and grant income:Revenues and grant income:Revenues and grant income:
Resident fees and servicesResident fees and services$233,226,000 $19,800,000 $— $— $— $— $253,026,000 
Real estate revenueReal estate revenue$16,338,000 $— $2,979,000 $2,202,000 $21,519,000 Real estate revenue— — 20,023,000 3,570,000 3,667,000 2,763,000 30,023,000 
Resident fees and services— 18,948,000 — — 18,948,000 
Grant incomeGrant income— 864,000 — — 864,000 Grant income8,229,000 — — — — — 8,229,000 
Total revenues and grant incomeTotal revenues and grant income16,338,000 19,812,000 2,979,000 2,202,000 41,331,000 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:Expenses:Expenses:
Property operating expensesProperty operating expenses228,639,000 16,503,000 — — — — 245,142,000 
Rental expensesRental expenses5,607,000 — 125,000 173,000 5,905,000 Rental expenses— — 7,537,000 15,000 369,000 134,000 8,055,000 
Property operating expenses— 17,397,000 — — 17,397,000 
Segment net operating incomeSegment net operating income$10,731,000 $2,415,000 $2,854,000 $2,029,000 $18,029,000 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:Expenses:Expenses:
General and administrativeGeneral and administrative$3,672,000 General and administrative$7,257,000 
Business acquisition expensesBusiness acquisition expenses57,000 Business acquisition expenses1,248,000 
Depreciation and amortizationDepreciation and amortization12,669,000 Depreciation and amortization25,723,000 
Other income (expense):Other income (expense):Other income (expense):
Interest expense:Interest expense:Interest expense:
Interest expense (including amortization of deferred financing costs and debt discount/premium)(4,839,000)
Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishment)Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishment)(20,365,000)
Gain in fair value of derivative financial instrumentsGain in fair value of derivative financial instruments1,450,000 Gain in fair value of derivative financial instruments1,821,000 
Impairment of real estate investments(3,064,000)
Loss from unconsolidated entity(377,000)
Loss on disposition of real estate investmentLoss on disposition of real estate investment(335,000)
Loss from unconsolidated entitiesLoss from unconsolidated entities(1,771,000)
Foreign currency gainForeign currency gain415,000 
Other incomeOther income8,000 Other income272,000 
Total net other expenseTotal net other expense(6,822,000)Total net other expense(19,963,000)
Loss before income taxesLoss before income taxes(5,191,000)Loss before income taxes(16,110,000)
Income tax benefit39,000 
Income tax expenseIncome tax expense(163,000)
Net lossNet loss$(5,152,000)Net loss$(16,273,000)
Total assets by reportable segment as of March 31, 2022 and December 31, 2021 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,
2834

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
Medical
Office
Buildings
Senior
Housing —
RIDEA
Skilled
Nursing
Facilities
Senior
Housing
Nine Months
Ended
September 30, 2021
Revenues:
Real estate revenue$50,478,000 $— $8,987,000 $6,589,000 $66,054,000 
Resident fees and services— 46,179,000 — — 46,179,000 
Total revenues50,478,000 46,179,000 8,987,000 6,589,000 112,233,000 
Expenses:
Rental expenses17,503,000 — 470,000 569,000 18,542,000 
Property operating expenses— 44,179,000 — — 44,179,000 
Segment net operating income$32,975,000 $2,000,000 $8,517,000 $6,020,000 $49,512,000 
Expenses:
General and administrative$11,710,000 
Business acquisition expenses6,552,000 
Depreciation and amortization33,745,000 
Other income (expense):
Interest expense:
Interest expense (including amortization of deferred financing costs and debt discount/premium)(14,556,000)
Gain in fair value of derivative financial instruments4,431,000 
Loss on disposition of real estate investments(184,000)
Loss from unconsolidated entity(1,027,000)
Other income49,000 
Total net other expense(11,287,000)
Net loss$(13,782,000)
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.
29

TableOur portfolio of Contentsproperties 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:

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 
AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
Medical
Office
Buildings
Senior
Housing —
RIDEA
Skilled
Nursing
Facilities
Senior
Housing
Nine Months
Ended
September 30, 2020
Revenues and grant income:
Real estate revenue$49,184,000 $— $8,984,000 $6,656,000 $64,824,000 
Resident fees and services— 51,863,000 — — 51,863,000 
Grant income— 864,000 — — 864,000 
Total revenues and grant income49,184,000 52,727,000 8,984,000 6,656,000 117,551,000 
Expenses:
Rental expenses16,616,000 — 459,000 648,000 17,723,000 
Property operating expenses— 44,856,000 — — 44,856,000 
Segment net operating income$32,568,000 $7,871,000 $8,525,000 $6,008,000 $54,972,000 
Expenses:
General and administrative$11,960,000 
Business acquisition expenses74,000 
Depreciation and amortization37,919,000 
Other income (expense):
Interest expense:
Interest expense (including amortization of deferred financing costs and debt discount/premium)(15,123,000)
Loss in fair value of derivative financial instruments(2,302,000)
Impairment of real estate investments(3,064,000)
Income from unconsolidated entity952,000 
Other income278,000 
Total net other expense(19,259,000)
Net loss$(14,240,000)
AssetsThe following is a summary of real estate investments, net by reportable segmentgeographic regions as of September 30, 2021March 31, 2022 and December 31, 2020 were as follows:2021:
 September 30,
2021
December 31,
2020
Medical office buildings$570,415,000 $583,131,000 
Senior housing — RIDEA227,978,000 238,910,000 
Skilled nursing facilities115,565,000 119,247,000 
Senior housing97,243,000 100,370,000 
Other52,695,000 51,115,000 
Total assets$1,063,896,000 $1,092,773,000 
30
 
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 

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
18.20. 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. 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, 2021March 31, 2022 and December 31, 2020,2021, we had cash and cash equivalents in excess of FDIC insured limits. We believe this risk is not significant. Concentration of credit risk with respect to accounts receivable from tenants 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, 2021, 2 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. Our propertiesProperties located in Missouri and MichiganIndiana accounted for approximately 12.4% and 10.6%, respectively,31.4% of our total property portfolio’s annualized base rent 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 September 30, 2021,March 31, 2022, our 46 reportable business segments, medical office buildings, integrated senior health campuses, skilled nursing facilities, SHOP, senior housing and senior housing — RIDEA,hospitals accounted for 68.9%39.3%, 14.9%39.1%, 10.7%8.4%, 5.7%, 4.3% and 5.5%3.2%, respectively, of our total property portfolio’s annualized base rent or annualized NOI.
As of September 30, 2021, we had 1 tenant thatMarch 31, 2022, none of our tenants at our properties accounted for 10.0% or more of our total property portfolio’s annualized base rent or annualized NOI, as follows:
TenantAnnualized
Base Rent/
NOI(1)
Percentage of
Annualized
Base Rent/NOI
Real Estate InvestmentReportable
Segment
GLA
(Sq Ft)
Lease Expiration
Date
RC Tier Properties, LLC$7,937,000 11.3%Missouri SNF PortfolioSkilled Nursing385,00009/30/33
___________
(1)Amountwhich is based on contractual base rent from leases in effect as of September 30, 2021 for our non–RIDEAnon-RIDEA properties and annualized NOI for our SHOP and integrated senior housing — RIDEA facilities. The losshealth campuses operations as of this tenant or its inability to pay rent could have a material adverse effect on our business and resultsMarch 31, 2022.
35

Table of operations.Contents

19.AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
21. Per Share Data
Basic earnings (loss) per share for all periods presented are computed by dividing net income (loss) applicable to common stock by the weighted average number of shares of our common stock outstanding during the period. Net income (loss) applicable to common stock is calculated as net income (loss) attributable to controlling interest less distributions allocated to participating securities of $3,000$1,490,000 and $4,000,$0, respectively, for the three months ended September 30, 2021March 31, 2022 and 2020 and $12,000 and $15,000, respectively, for the nine months ended September 30, 2021 and 2020.2021. 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,March 31, 2022 and 2021, and 2020, there were 27,000891,543 and 45,00033,000 nonvested shares, respectively, of our restricted common stock outstanding, but such shares were excluded from the computation of diluted earnings per share because such shares were anti-dilutive during these periods. As of both September 30,March 31, 2022 and 2021, and 2020, there were 208 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.
3136

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
20. Subsequent Events
Merger with Griffin-American Healthcare REIT III, Inc. and AHI Acquisition
As discussed in Note 1, Organization and Description of Business, on October 1, 2021, we completed the REIT Merger pursuant to the Merger Agreement with GAHR III. 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 I common stock, $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 the effective time of the Partnership Merger was converted automatically into the right to receive 0.9266 of a Partnership Class I Unit, as defined in the agreement of limited partnership, as amended, of the surviving partnership and (ii) each unit of limited partnership interest in our operating partnership outstanding as of immediately prior to the effective time of the Partnership Merger was converted automatically into the right to receive one unit of limited partnership interest of the surviving partnership of like class.
Also on October 1, 2021, the AHI Acquisition closed immediately prior to the consummation of the Merger and pursuant to the Contribution Agreement, American Healthcare Investors contributed substantially all of its business and operations to the surviving partnership, including its interest in GAHR III Advisor and our advisor, and Griffin Capital contributed its current ownership interest in GAHR III Advisor and our advisor to the surviving partnership. In exchange for these contributions, the surviving partnership issued limited partnership units, or Surviving Partnership OP Units. Subject to working capital and other customary adjustments, the total approximate value of these Surviving Partnership OP Units at the time of consummation of the transactions 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. The Combined Company following the Merger has become self-managed and was named “American Healthcare REIT, Inc.”
In addition to the Closing Date Consideration, we may in the future pay cash “earnout” consideration to American Healthcare Investors based on the fees that we may earn from our potential sponsorship of, and investment advisory services rendered to, American Healthcare RE Fund, L.P., a healthcare-related, real-estate-focused, private investment fund currently under consideration by American Healthcare Investors, or the Earnout Consideration. The Earnout Consideration is uncapped in amount and, if ever payable by us to American Healthcare Investors, will be due on the seventh anniversary of the closing of the AHI Acquisition (subject to acceleration in certain events, including if we achieve certain fee-generation milestones from our sponsorship of the private investment fund). American Healthcare Investors’ ability to receive the Earnout Consideration is also subject to vesting conditions relating to the private investment fund’s deployed equity capital and the continuous employment of at least two of its principals throughout the vesting period.
Amendments to Articles of Incorporation
On October 1, 2021, we filed the Fourth Articles of Amendment and Restatement to our charter, or the Charter Amendment, with the State Department of Assessments and Taxation of Maryland, and the Charter Amendment became effective upon filing. The changes to the Charter Amendment include, among other things, the following: (i) the removal of certain limitations relating to (a) suitability of stockholders and (b) collection of an internalization fee; (ii) the removal or revision of certain limitations required by the North American Securities Administrators Association and making other conforming and ministerial changes; (iii) revisions in order to bring our charter more in line with those of publicly-listed companies; and (iv) the change in common stock we are authorized to issue from 900,000,000 shares classified as Class T common stock and 100,000,000 shares classified as Class I common stock to 200,000,000 shares classified as Class T common stock and 800,000,000 shares classified as Class I common stock.
Second Amended and Restated Agreement of Limited Partnership
On October 1, 2021, in connection with the Partnership Merger, merger sub entered into the Second Amended and Restated Agreement of Limited Partnership of American Healthcare REIT, Inc., which amends and supersedes the Amended and Restated Agreement of Limited Partnership of the surviving partnership, or the Operating Partnership Agreement. The Operating Partnership Agreement reflects, among other things, the following: (i) the change of the surviving partnership’s name to “American Healthcare REIT Holdings, LP,” (ii) the change of the general partner of the surviving partnership to merger sub, (iii) the conversion of units of partnership interest in the surviving partnership outstanding as of immediately prior to the effective time of the Partnership Merger into “Partnership Class I Units” pursuant to the Partnership Merger, (iv) the conversion of units of partnership interest in our operating partnership outstanding as of immediately prior to the effective time of the Partnership Merger into units of limited partnership interest of the surviving partnership of like class, and (v) to make other updates to reflect the effects of the mergers consummated pursuant to the Merger Agreement.
32

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
Lines of Credit and Term Loans
Amendment to 2018 Credit Facility
On October 1, 2021, we entered into the Amendment, which provide for, among other things, the following: (i) revisions to financial covenant calculations to exclude the assets, liabilities and operating performance of Trilogy or any subsidiary thereof; (ii) our operating partnership to pledge the equity interests in each direct and indirect subsidiary that owns an unencumbered asset; (iii) updates regarding restrictions and limitations on certain investments during the remainder of the term of the 2018 Credit Facility; and (iv) updates to the certain financial covenants to reflect the Combined Company subsequent to the Merger.
Assumption of Obligations Under GAHR III 2019 Corporate Line of Credit
On October 1, 2021, upon consummation of the Merger, we assumed GAHR III’s obligations, through the surviving partnership, under the 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, with respect to a credit facility with a maximum principal amount of $480,000,000, or the 2019 Corporate Line of Credit. The 2019 Corporate Line of Credit consists of a senior unsecured term loan facility in an amount of $480,000,000. The maximum principal amount of term loans under the 2019 Corporate Line of Credit may be increased by up to $370,000,000, for a total principal amount of $850,000,000, subject to certain conditions. The 2019 Corporate Line of Credit matures on January 25, 2022 and may be extended for 1 12-month period during the term of the 2019 Corporate Credit Agreement, subject to satisfaction of certain conditions, including payment of an extension fee. Upon consummation of the Merger, a previously available $150,000,000 senior unsecured revolving credit facility was cancelled, and a ratable amendment to certain financial covenants to account for the Combined Company was made.
At our option, the 2019 Corporate Line of Credit bears interest at per annum rates equal to (a) (i) the Eurodollar Rate, as defined in the 2019 Corporate Credit Agreement, plus (ii) a margin ranging from 1.85% to 2.80% based on the Consolidated Leverage Ratio, as defined in the 2019 Corporate 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 2019 Corporate Credit Agreement, plus 0.50%, (3) the one-month Eurodollar Rate plus 1.00%, and (4) 0.00%, plus (ii) a margin ranging from 0.85% to 1.80% based on the Consolidated Leverage Ratio. Accrued interest on the 2019 Corporate Line of Credit is payable monthly. The loans may be repaid in whole or in part without prepayment premium or penalty, subject to certain conditions.
Assumption of GAHR III Obligations Under 2019 Trilogy Credit Facility
On October 1, 2021, upon consummation of the Merger, we assumed GAHR III’s obligations under the amended and restated loan agreement, or the 2019 Trilogy Credit Agreement, with KeyBank; CIT Bank, N.A.; Regions Bank; KeyBanc Capital Markets; Regions Capital Markets; Bank of America; The Huntington National Bank; and a syndicate of other banks, as lenders named therein, regarding 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. We may obtain up to $35,000,000 in the form of swing line loans and up to $15,000,000 in the form of standby letters of credit under 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 September 5, 2023 and may be extended for 1 12-month period during the term 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 Offer Rate, or LIBOR, plus 2.75% for LIBOR Rate Loans, as defined in the 2019 Trilogy Credit Agreement, and (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. Accrued interest on the 2019 Trilogy Credit Facility is payable monthly. The 2019 Trilogy Credit Facility may be repaid in whole or in part without prepayment fees or penalty, subject to certain conditions. We are required to pay fees on the unused portion of the lenders’ commitments under the 2019 Trilogy Credit Facility, with respect to any day during a calendar quarter, at a per annum rate equal to (a) 0.15% if the sum of the Aggregate Real Estate Revolving Credit Obligations, as defined in the 2019 Trilogy Credit Agreement, outstanding on such day is greater than 50.00% of the commitments or 0.20% if the sum of the Aggregate Real Estate Revolving Credit Obligations on such day is less than or equal to 50.00% of the commitments, and (b) 0.15% if the sum of the Aggregate A/R Revolving Credit Obligations, as defined in the 2019 Trilogy Credit Agreement, outstanding on such day is greater than 50.00% of the commitments or 0.20% if the sum of the Aggregate A/R Revolving Credit Obligations on such day is less than or equal to 50.00% of the commitments, which fees shall be measured and payable on a quarterly basis.
33

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
Reinstatement of the DRIP
On October 4, 2021, our board reinstated 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 or will receive distributions in shares of our common stock pursuant to the terms of the DRIP, instead of cash distributions.
Amendments to and Partial Reinstatement of Share Repurchase Plan
On October 4, 2021, our board authorized our amended and restated share repurchase plan that included the change in the repurchase price with respect to repurchases resulting from the death or qualifying disability (as such term is defined in the share repurchase plan) of stockholders from 100% of the price paid by the stockholder to acquire shares of our Class T common stock or Class I common stock, as applicable, to the most recently published estimated NAV per share. In addition, on October 4, 2021, our board authorized the partial reinstatement of our share repurchase plan with respect to requests to repurchase shares resulting from the death or qualifying disability of stockholders, effective with respect to qualifying repurchases for the fiscal quarter ending December 31, 2021, which will be paid on or about January 1, 2022. All share repurchase requests other than those requests resulting from the death or qualifying disability of stockholders, shall be rejected.
Distributions Declared
Our board authorized a daily distribution to our Class T and Class I stockholders of record as of the close of business on October 27, 2021. This distribution for the month of October 2021 was equal to $0.033333333 per share of our common stock, which is equal to an annualized distribution rate of $0.40 per share. The distribution was paid in cash or shares of our common stock pursuant to the DRIP. The distribution was paid in November 2021, only from legally available funds.
Director Appointments and Resignation
On October 1, 2021, immediately following the effective time of the REIT Merger, our board was increased from 5 members to 9 members. Our board appointed Harold H. Greene, J. Grayson Sanders and Gerald W. Robinson to our board as independent directors. Messrs. Greene, Sanders and Robinson were independent directors on GAHR III’s board of directors immediately prior to the effective time of the REIT Merger. Our board also appointed Mr. Prosky and Mr. Streiff as directors. On October 1, 2021, Richard S. Welch resigned from our board and no longer serves as our director.
Messrs. Greene, Sanders and Robinson satisfy the independent director standards applicable to us and, as independent directors, are entitled to receive the same compensation and reimbursement of expenses that we pay to each of our independent directors; Messrs. Prosky and Streiff also serve as our executive officers and therefore will not receive compensation for services rendered as directors. We also issued 5,000 shares of restricted Class T common stock to each of Messrs. Greene, Sanders and Robinson in connection with their appointment to our board.
Officer Transitions and Appointments
Effective October 1, 2021, Jeffrey T. Hanson was appointed as our Executive Chairman of the Board of Directors and thereby no longer serves as our Chief Executive Officer. In addition, effective October 1, 2021, Danny Prosky was appointed Chief Executive Officer and thereby no longer serves as our Chief Operating Officer but continues in the role of President, and Mathieu B. Streiff was appointed as our Chief Operating Officer and thereby no longer serves as our Executive Vice President, General Counsel. Also effective October 1, 2021, Gabriel M. Willhite was appointed as our Executive Vice President, General Counsel, filling the vacancy created by Mr. Streiff’s resignation from such position.
Employment Agreements
On October 1, 2021, immediately prior to the closing of the AHI Acquisition, GAHR III (through a wholly owned subsidiary) entered into offer letters with each of Mr. Hanson, Mr. Prosky, Mr. Streiff and Brian S. Peay, GAHR III’s chief financial officer, relating to their employment with GAHR III following the closing of the AHI Acquisition and relating to their employment with us following the consummation of the REIT Merger. Upon the closing of the REIT Merger, we indirectly assumed (by virtue of the REIT Merger and our acquisition of GAHR III’s wholly owned subsidiary that is party to the offer letters) GAHR III’s obligations under these offer letters.
Issuance of Restricted Stock Awards to Key Executives and Employees
As a result of the REIT Merger, under our incentive plan, as amended, or our 2015 Incentive Plan, certain of our key executives received initial grants of 477,901 time-based restricted stock and 159,301 performance-based restricted units representing the right to receive shares of our Class T common stock upon vesting. The time-based restricted stock vest in three equal annual installments on October 1, 2022, October 1, 2023 and October 1, 2024 (subject to continuous employment through
34

Table of Contents

AMERICAN HEALTHCARE REIT, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited) — (Continued)
each vesting date). The performance-based restricted stock will cliff vest in the first quarter of 2025 (subject to continuous employment through that vesting date) with the amount vesting depending on meeting certain key performance criteria as further described in the 2015 Incentive Plan.
Also in connection with the Merger, on October 4, 2021, certain of our key employees were granted 319,149 of restricted Class T common stock under our 2015 Incentive Plan, which will cliff vest on October 4, 2024 (subject to continuous employment through that vesting date).
Registration Rights Agreement
On October 1, 2021, at the consummation of the AHI Acquisition, GAHR III and the surviving partnership entered into a registration rights agreement, or the Registration Rights Agreement, with Griffin-American Strategic Holdings, LLC, or HoldCo, pursuant to which, subject to certain limitations therein, as promptly as practicable following the later of the expiration of (i) the period commencing on the closing of the AHI Acquisition and ending upon the earliest to occur of (a) the second anniversary date of the issuance of the Surviving Partnership OP Units issued in connection with the AHI Acquisition, (b) a change of control of Merger Sub, and (c) the listing of shares of our common stock on a national securities exchange, or the Lock-Up Period; and (ii) the date on which we are eligible to file a registration statement (but in any event no later than 180 days after such date), we, as the indirect parent company of the surviving partnership, are required to file a shelf registration statement with the SEC under the Securities Act of 1933, as amended, covering the resale of the shares of our Class I common stock issued or issuable in redemption of the Surviving Partnership OP Units that the surviving partnership issued as consideration in the AHI Acquisition. The Registration Rights Agreement also grants HoldCo (or any successor holder of such shares) demand rights to request additional registration statement filings as well as “piggyback” registration rights, in each case on or after the expiration of the Lock-Up Period. In connection with the Merger, we assumed from GAHR III the Registration Rights Agreement and GAHR III’s obligations thereunder in their entirety.
35

Table of Contents
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 III, Inc., or GAHR III, and its subsidiaries, including Griffin-American Healthcare REIT III 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 IVIII Holdings, LP,LP), for periods following the Merger, except where otherwise noted. Capitalized terms related to the merger with Griffin-American Healthcare REIT III, Inc., orCertain historical information of GAHR III, are defined and further discussed below in the “Overview and Background” section.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 20202021 Annual Report on Form 10-K, as filed with the United States Securities and Exchange Commission, or the SEC, on March 26, 2021.25, 2022. Such condensed consolidated financial statements and information have been prepared to reflect our financial position as of September 30, 2021March 31, 2022 and December 31, 2020,2021, together with our results of operations for the three and nine months ended September 30, 2021 and 2020 and cash flows for the ninethree months ended September 30, 2021March 31, 2022 and 2020.2021.
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,” “seek” and any other comparable and derivative terms or the negatives thereof. Our ability to predict results or the actual effect of future plans and strategies is inherently uncertain. Factors which could have a material adverse effect on our operations 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; risks related to disruption of management’s attention from the ongoing business operations due to the Merger;rates and foreign currency risk; uncertainty from the expected discontinuance of the London Inter-bank Offered Rate, or LIBOR, and the transition to any other interest rate benchmark;the Secured Overnight Financing Rate, or SOFR; competition in the real estate industry; changes in accounting principles generally accepted in the United States of America, or GAAP policies and guidelines applicable to REITs; the success of our investment strategy; and the availability of financing.financing; our ability to retain our executives and key employees; and unexpected labor costs and 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.
37

Table of Contents
Overview and Background
American Healthcare REIT, Inc. (formerly known as Griffin-American Healthcare REIT IV, Inc.), a Maryland corporation, invests inowns a diversified portfolio of clinical healthcare real estate properties, focusing primarily on medical office buildings, skilled nursing facilities, and senior housing, facilities that produce current income.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 other real estate-related investments on an infrequent and opportunistic basis. We generally seek investments that produce current income; however, we have selectively developed, and may continue to selectively develop, healthcare real estate properties. We qualified to be taxed as a real estate investment trust, or REIT, under 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.
We raised $754,118,000 through a best efforts initial public offering, or our initial offering, that commenced on February 16, 2016,Merger of Griffin-American Healthcare REIT III, Inc. and issued 75,639,681 aggregate shares of our Class T and Class I common stock. In addition, during our initial offering, we issued 3,253,535 aggregate shares of our Class T and Class I common stock pursuant to our distribution reinvestment plan, as amended, or the DRIP, for a total of $31,021,000 in distributions reinvested. Following the termination of our initial offering on February 15, 2019, we continued issuing shares of our common stock pursuant to the DRIP through a subsequent offering, or the 2019 DRIP Offering, which commenced on March 1, 2019. On March 18, 2021, our board of directors, or our board, authorized the suspension of the DRIP, effective as of April 1, 2021. As of September 30, 2021, a total of $46,970,000 in distributions were reinvested that resulted in 4,923,550 shares of our common stock being issued pursuant to the 2019 DRIP Offering. We collectively refer to the DRIP portion of our initial offering and the 2019 DRIP Offering as our DRIP Offerings. See Note 20, Subsequent Events — Reinstatement of the DRIP, to our accompanying condensed consolidated financial statements.
36

Table of Contents
Until October 2021, we conducted substantially all of our operations through Griffin-American Healthcare REIT IV, Holdings, LP, or our operating partnership. Through September 30, 2021, we were externally advised by Griffin-American Healthcare REIT IV Advisor, LLC, or our advisor, pursuant to an advisory agreement, as amended, or the Advisory Agreement, between us, our operating partnership and our advisor. The Advisory Agreement was effective as of February 16, 2016 and had a one-year initial term, subject to successive one-year renewals upon the mutual consent of the parties. The Advisory Agreement was last renewed pursuant to the mutual consent of the parties on February 11, 2021. Inc.
On June 23, 2021, in anticipation of the Merger, as defined and discussed below, we entered into an amendment to the Advisory Agreement, whereby it was agreed that any acquisition fee due to our advisor is to be waived in connection with the REIT Merger, as defined and discussed below. Except as set forth in such amendment to the Advisory Agreement, the terms of the Advisory Agreement continued in full force and effect. Our 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 advisor performed its duties and responsibilities under the Advisory Agreement as our fiduciary. Prior to the Merger, our advisor was 75.0% owned and managed by wholly owned subsidiaries of American Healthcare Investors, LLC, or American Healthcare Investors, and 25.0% owned by a wholly owned subsidiary of Griffin Capital Company, LLC, or Griffin Capital, or collectively, our co-sponsors. American Healthcare Investors was 47.1% owned by AHI Group Holdings, LLC, or AHI Group Holdings, 45.1% indirectly owned by Digital Bridge Group, Inc. (NYSE: DBRG) (formerly known as Colony Capital, Inc.), or Digital Bridge, and 7.8% owned by James F. Flaherty III, a former partner of Colony Capital, Inc. We were not affiliated with Griffin Capital, Griffin Capital Securities, LLC, or our dealer manager, Digital Bridge or Mr. Flaherty; however, we were affiliated with our advisor, American Healthcare Investors and AHI Group Holdings. Please see the “Merger with Griffin-American Healthcare REIT III, Inc.” and “AHI Acquisition” sections below for a further discussion of our operations effective October 1, 2021.
We operate through four reportable business segments: medical office buildings, senior housing, senior housing — RIDEA and skilled nursing facilities. As of September 30, 2021, we owned 87 properties, comprising 92 buildings, or approximately 4,799,000 square feet of gross leasable area, or GLA, for an aggregate contract purchase price of $1,080,381,000. As of September 30, 2021, we also owned a 6.0% interest in a joint venture which owned a portfolio of integrated senior health campuses and ancillary businesses.
On March 18, 2021, 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 $9.22 calculated as of September 30, 2020. We provide this updated estimated per share NAVpursuant 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 of Class T and Class I common stock outstanding on a fully diluted basis. The valuation was performed in accordance with the methodology provided in Practice Guideline 2013-01, Valuations of Publicly Registered Non-Listed REITs, or the Practice Guideline, issued by the Institute for Portfolio Alternatives, or the IPA, in April 2013, in addition to guidance from the SEC. On April 2, 2020, the board previously determined an estimated per share NAV of our common stock of $9.54 calculated as of December 31, 2019. See our Current Report on Form 8-K filed with the SEC on March 19, 2021 for more information on the methodologies and assumptions used to determine, and the limitations and risks of, our updated estimated per share NAV.
Merger with Griffin-American Healthcare REIT III, Inc.
On June 23, 2021, we, our operating partnership, our wholly owned subsidiary, Continental Merger Sub, LLC, or merger sub, Griffin-American Healthcare REIT III, Inc., or GAHR III, and American Healthcare REIT Holdings, LP (formerly known as Griffin-American Healthcare REIT III Holdings, LP), or the surviving partnership, entered into an Agreement and Plan of Merger dated June 23, 2021, or the Merger Agreement. On October 1, 2021, pursuant to the Merger Agreement, (i) GAHR III merged with and into merger sub,Continental Merger Sub, LLC, a Maryland limited liability company and newly formed wholly owned subsidiary of GAHR IV, or Merger Sub, with merger subMerger 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 (ii) oursubsidiary and operating partnership of GAHR IV, or GAHR IV Operating Partnership, merged with and into the survivingGriffin-American Healthcare REIT III Holdings, LP, a Delaware limited partnership, or our operating partnership, with the survivingour operating partnership being the surviving entity, or the Partnership Merger. We collectively refer to the REIT Merger and beingthe 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 as the surviving partnership, was renamed American Healthcare REIT Holdings, LP, or the Partnership Merger, and, together with theLP. The REIT Merger qualified as a reorganization under, and within the Merger.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 our operating partnershipGAHR 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 ourGAHR IV’s Class I common stock, $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 the effective time of the Partnership Merger was converted automatically into the right to receive 0.9266 of a Partnership Class I Unit, as defined in the agreement of limited partnership, as amended, of the surviving partnership, and (ii) each unit of limited partnership interest in our operating partnershipGAHR IV Operating Partnership outstanding as of immediately prior to the effective time of the Partnership Merger was converted automatically into the right to receive one unit of limited partnership interest of the surviving partnership of like class.
37

Table of Contents
Following the Merger, our company, combined with GAHR III, or the Combined Company, was renamed “American Healthcare REIT, Inc.” The REIT Merger is intended to qualify as a “reorganization” under, and within the meaning of, Section 368(a) of the Code. Based on data as of September 30, 2021, the Combined Company has a healthcare real estate portfolio consisting of 311 buildings and campuses in 36 states (as well as the United Kingdom & Isle of Man). On a pro forma basis, the Combined Company portfolio would have a leased percentage rate as of September 30, 2021 of approximately 94.1% for its leased, non-RIDEA assets, 78.1% for its senior housing-RIDEA assets and 77.8% for its integrated senior health campuses.
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 surviving partnership,Contribution Agreement, between GAHR III; our co-sponsors,operating partnership; American Healthcare Investors, LLC, or AHI; Griffin Capital Company, LLC, or Griffin Capital; Platform Healthcare Investor T-II, LLC,LLC; Flaherty Trust,Trust; and Jeffrey T. Hanson, our former Chief Executive Officer and current Executive Chairman of the Board of Directors, Danny Prosky, our President and former Chief Operating Officer and current Chief Executive Officer and President, and Mathieu B. Streiff, our former Executive Vice President, General Counsel entered into a contribution and exchange agreement,current Chief Operating Officer, or the Contribution Agreement, pursuant to which, among other things, the surviving partnership agreed to acquire a newly formed entity, or NewCo, which we refer to ascollectively, the AHI Acquisition, thatPrincipals. NewCo owned substantially all of the business and operations of one of our co-sponsors, American Healthcare Investors,AHI, as well as all of the equity interests in (i) Griffin-American Healthcare REIT IIIIV Advisor, LLC, or GAHR IIIIV Advisor, a subsidiary of American Healthcare InvestorsAHI that served as the external advisor of GAHR III,IV, and (ii) Griffin-American Healthcare REIT III Advisor, LLC, or GAHR III Advisor, also referred to as our advisor. On October 1, 2021,former advisor, a subsidiary of AHI that served as the AHI Acquisition closed immediately priorexternal 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 surviving partnership OP units. Subject to working capital and other customary adjustments, the total approximate value of these surviving partnership OP units at the time of consummation of the Merger.transactions 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
38

Table of Contents
partnership OP units as consideration, or the Closing Date Consideration. Following the consummation of the Merger and the AHI Acquisition, the Combined Company has becomebecame 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 self-managed company.wholly owned subsidiary of Griffin Capital, or collectively, the NewCo Sellers.
The AHI Acquisition will bewas treated as a business combination for accounting purposes, with GAHR III as both the legal and accounting acquiror of NewCo. While we areGAHR 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 transaction 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. As a result ofThus, the completionfinancial information set forth herein subsequent to the consummation of the Merger and the AHI Acquisition reflects results of the historical information regarding our company’s structure, agreementsCombined Company, and the financial information presented withinset forth herein prior to the Merger and the AHI Acquisition reflects GAHR III’s results. For this Item 2 has materially changed; however, such information did applyreason, period to us asperiod comparisons may not be meaningful.
Operating Partnership and Former Advisor
We conduct substantially all of our operations through our operating partnership. Through September 30, 2021. See Note 20, Subsequent Events —2021, we were externally advised by our former advisor pursuant to an advisory agreement, as amended, or the Advisory Agreement, between us and our former advisor. Our former advisor used its best efforts, subject to the oversight and review of our board of directors, or 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.Following 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 are no longer being paid. Also, on October 1, 2021 and in connection with the AHI Acquisition, our operating partnership redeemed all 22,222 shares of our common stock owned by our former advisor and 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 wholly owned subsidiaries of AHI, and 25.0% owned by a wholly owned subsidiary of Griffin Capital, or collectively, our former co-sponsors. Prior to the AHI Acquisition, AHI was 47.1% owned by AHI Group Holdings, 45.1% indirectly owned by Digital Bridge Group, Inc. (NYSE: DBRG), or Digital Bridge, and 7.8% owned by James F. Flaherty III. We were not affiliated with Griffin Capital, Digital Bridge or Mr. Flaherty; however, we were affiliated with our former advisor, AHI and AHI Group Holdings. Please see the “Merger of Griffin-American Healthcare REIT III, Inc. and AHI Acquisition,Griffin-American Healthcare REIT IV, Inc.” and “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
39

Table of Contents
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 October 1, 2021,March 25, 2022 for additionalmore information regardingon the Mergermethodologies and assumptions used to determine, and the AHI Acquisition.limitations and risks of, our updated estimated per share NAV.
Our Real Estate Investments Portfolio
We currently operate through six reportable business segments: medical office buildings, integrated senior health campuses, skilled nursing facilities, SHOP, senior housing and hospitals. As of March 31, 2022, we owned and/or operated 182 properties, comprising 191 buildings, and 122 integrated senior health campuses including completed development projects, or approximately 19,461,000 square feet of gross leasable area, or GLA, for an aggregate contract purchase price of $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.
Critical Accounting PoliciesEstimates
The complete listing of our Critical Accounting PoliciesEstimates was previously disclosed in our 20202021 Annual Report on Form 10-K, as filed with the SEC on March 26, 2021,25, 2022, and there have been no material changes to our Critical Accounting PoliciesEstimates as disclosed therein, except as noted below or included within Note 2, Summary of Significant Accounting Policies, to our accompanying condensed consolidated financial statements.
Interim Unaudited Financial Data
For a discussion of interim unaudited financial data, see Note 2, Summary of Significant Accounting Policies — Interim Unaudited Financial Data, to our accompanying condensed consolidated financial statements. Our accompanying condensed consolidated financial statements should be read in conjunction with our audited consolidated financial statements and the notes thereto included in our 20202021 Annual Report on Form 10-K, as filed with the SEC on March 26, 2021.25, 2022.
Acquisition and DispositionDispositions in 20212022
For a discussion of our acquisition and dispositiondispositions of investments in 2021, See2022, see Note 3, Real Estate Investments, Net, and Note 4, Business Combination, to our accompanying condensed consolidated financial statements.
Factors Which May Influence Results of Operations
In 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 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 our properties. In addition,For a further discussion of these and other factors 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 those Risk Factors, previously disclosed in our 20202021 Annual Report on Form 10-K, as filed with the SEC on March 26, 2021.25, 2022.
Ongoing Impact of the COVID-19 Pandemic
Due to the ongoing COVID-19 pandemic in the United States and globally, since March 2020, ourOur residents, tenants, operating partners and managers, have been materially impacted,our industry and the prolongedU.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 impact remains uncertain.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 degree,certain extent, it continues to present challenges for us as an owner and operator of healthcare facilities. Since its outset, the impacts of the COVID-19 pandemic have been significant, rapidly and continuously evolving and may continue into the future, especially due to the emergence of the Delta variant which has caused
38

Table of Contents
COVID-19 cases and deaths to increase significantly in the third quarter of 2021,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
40

Table of Contents
to work diligently to implement and 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 the impact of COVID-19such impacts into our assessments of liquidity, impairment and collectability from tenants and residents as of September 30, 2021.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.
In the early months of the pandemic, the businesses of our medical office tenants were negatively impacted when many of the states had implemented “stay at home” orders, thereby creating unprecedented revenue pressure on such tenants and their ability to pay rent on a timely basis. Substantially all of our physician practices and other medical service providers of non-essential and elective services in our medical office buildings are now open and as a result, our medical office building segment rebounded quickly from the initial shock of the pandemic and has demonstrated remarkable resilience. This trend has continued despite the emergence of the Delta variant.
The COVID-19 pandemic has resulted in a significant decline in the resident occupancies ofat our senior housing facilities, SHOP, integrated senior health campuses and skilled nursing facilities, and an increase in COVID-19 related operating expenses especially in our skilled nursing segment where personal protective equipment, or PPE, costs andwith more costly short-term hires due to the shortage of healthcare personnel resulting in more costly short-term hires, present ongoing challenges.personnel. Therefore, our immediate focus at such properties continues to be on resident occupancy recovery and operating expense management. While we experienced steady recovery in early 2021, the emergence of the Delta variant has slowed the recovery inresident occupancies at our integrated senior housinghealth campuses and skilled nursing segments as we are seeing case counts reachfacilities have gradually improved to near pre-pandemic levels, not seen since January 2021. In addition, since the fourth quarter of 2020, COVID-19 vaccinesour SHOP have becomebeen slower to recover. Based on information available to certain partsmanagement 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 population, which we believe will be important to a rebound in our resident occupancy levels over time. As of November 1, 2021, based on information provided by our operators, the majority of our residentsCOVID-19 pandemic have been fully vaccinated.
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. Despite improving macroeconomic conditionsFuture actions that may be taken by state and local governments to mitigate the emergenceimpact of vaccines, surges in COVID-19 cases, including variants ofthat may emerge could disrupt our business, activities and operations, the strain, such as those experienced in Europe and the U.S., could slow down the recovery of the U.S. and the global economy.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 of investments. We believe that the government-imposed or self-imposed lockdowns and restrictions have created pent-up demand for doctors’ visits and move-ins into senior housing facilities; however, we cannot predict with reasonable certainty when such demand for healthcare services at our senior housing and skilled nursing facility segments will return to pre-COVID-19 pandemic levels.
The medical community understands COVID-19 far better today than it did at the onset of the pandemic, and we are now equipped with greater therapeutics and other treatments to mitigate its impact. Likewise, we are optimistic about the favorable reports regarding the efficacy of vaccines. The COVID-19 pandemic has had, and may continue to have, an adverselasting effect on the operations of our business, and therefore, we are unable to predict the full extent or nature of the future impact to our financial condition and results of operations at this time. We expect the trends discussed above with respect to the impact of the COVID-19 pandemic to continue. Thus, the lasting impact of the COVID-19 pandemic over the next 12 months could be significant and will largely depend on future developments, including COVID-19 vaccination and booster rates; the durationlong term efficacy of the crisisCOVID-19 vaccinations and boosters; and the successpotential emergence of efforts to containnew, more transmissible or treat COVID-19 and itssevere variants, such as the use of effective vaccines and availability of vaccine boosters, which cannot be predicted with confidence at this time. See the “Results of Operations” and “Liquidity and Capital Resources” sections below, for a further discussion.
Scheduled Lease Expirations
Excluding our SHOP and integrated senior housing — RIDEA facilities,health campuses, as of September 30, 2021,March 31, 2022, our properties were 95.7%92.7% leased and during the remainder of 2021, 1.5%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, 2021,March 31, 2022, our remaining weighted average lease term was 7.87.1 years, excluding our SHOP and integrated senior housing — RIDEA facilities.health campuses.
For the threeOur combined SHOP and nine months ended September 30, 2021, ourintegrated senior housing — RIDEA facilitieshealth campuses were 71.1% and 69.7%77.8% leased respectively.as of March 31, 2022. Substantially all of our leases with residents at such properties are for a term of one year or less.
3941

Table of Contents
Results of Operations
Comparison of the Three and Nine Months Ended September 30,March 31, 2022 and 2021 and 2020
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 no longer include advisory fees to our former advisor. In general, and under a normal operating environment without the disruption of the COVID-19 pandemic, we expect amounts related to our portfolio of operating properties to increase in the future due to fixed annual rent escalations on our portfolio of properties. 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 portfolio as a result of the Merger. See Note 1, Organization and Description of Business, to our accompanying condensed consolidated financial statements for a further discussion.
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. As of September 30, 2021,March 31, 2022, we operated through foursix reportable business segments, with activities related to investing insegments: medical office buildings, integrated senior housing, senior housing — RIDEA andhealth campuses, skilled nursing facilities.
The COVID-19 pandemic has had a significant adverse impact on the operations of our real estate portfolio. Although we have experienced some delays in receiving rent payments from our tenants, as of September 30, 2021, we have collected 100% of contractual rent from our leased, non-RIDEAfacilities, SHOP, senior housing and skilled nursing facility tenants. Most of our skilled nursing facilities provide behavioral health services with resident occupancies that are less impacted by either the COVID-19 pandemic or restrictions on elective surgeries than traditional skilled nursing facilities. In addition, substantially all of the contractual rent through September 2021 from our medical office building tenants has been received. However, given the significant ongoing uncertainty of the impact of the COVID-19 pandemic over the next 12 months, we are unable to predict the impact it will have on such tenants’ continued ability to pay rent.hospitals.
Except where otherwise noted, the changes in our condensed consolidated results of operations for 20212022 as compared to 20202021 are primarily due to the 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 the Merger on October 1, 2021, the disruption to our normal operations as a result of the COVID-19 pandemic and grant income received and costs incurred related to the Merger.received. As of September 30,March 31, 2022 and 2021, and 2020, we owned and/or operated the following types of properties:
September 30,March 31,
20212020 20222021
Number
of
Buildings
Aggregate
Contract
Purchase Price
Leased %Number
of
Buildings
Aggregate
Contract
Purchase Price
Leased % Number of
Buildings/
Campuses
Aggregate
Contract
Purchase Price
Leased
%
Number of
Buildings/
Campuses
Aggregate
Contract
Purchase Price
Leased
%
Integrated senior health campusesIntegrated senior health campuses122 $1,795,199,000 (1)120 $1,732,058,000 (1)
Medical office buildingsMedical office buildings43 $608,072,000 93.2 %43 $605,122,000 93.0 %Medical office buildings105 1,249,658,000 89.7 %63 657,885,000 89.1 %
Senior housing — RIDEA24 252,709,000 (1)26 264,349,000 (1)
SHOPSHOP47 708,050,000 (2)20 433,891,000 (2)
Senior housingSenior housing14 101,800,000 100 %14 101,800,000 100 %Senior housing20 169,885,000 100 %89,535,000 100 %
Skilled nursing facilitiesSkilled nursing facilities11 117,800,000 100 %11 117,800,000 100 %Skilled nursing facilities17 237,300,000 100 %119,500,000 100 %
Total/weighted average(2)92 $1,080,381,000 95.7 %94 $1,089,071,000 95.4 %
HospitalsHospitals139,780,000 100 %139,780,000 100 %
Total/weighted average(3)Total/weighted average(3)313 $4,299,872,000 92.7 %220 $3,172,649,000 91.7 %
___________
(1)For the three months ended September 30, 2021 and 2020, theThe leased percentage for the resident units of our integrated senior housing — RIDEA facilitieshealth campuses was 71.1%80.0% and 71.6%, respectively,70.7% as of March 31, 2022 and for the nine months ended September 30, 2021, and 2020, therespectively.
(2)The leased percentage for the resident units of our senior housing — RIDEA facilitiesSHOP was 69.7%71.9% and 77.2%, respectively, based on daily average occupancy70.3% as of licensed beds or units.March 31, 2022 and 2021, respectively.
(2)(3)Leased percentage excludes our SHOP and integrated senior housing — RIDEA facilities.health campuses.
4042

Table of Contents
Revenues and Grant Income
Our primary sources of revenue include rent generated by our leased, non – RIDEAnon-RIDEA properties, and resident fees and services revenue from our RIDEA properties. The amount of revenuerevenues generated by our properties depends principally on our ability to maintain the occupancy rates of currently leased space and to lease available space at marketthe then existing rental rates. We also receive grant income. Revenues and grant income by reportable segment consisted of the following for the periods presented:
Three Months Ended September 30,Nine Months Ended September 30,
2021202020212020
Real Estate Revenue
Medical office buildings$16,921,000 $16,338,000 $50,478,000 $49,184,000 
Skilled nursing facilities2,996,000 2,979,000 8,987,000 8,984,000 
Senior housing2,203,000 2,202,000 6,589,000 6,656,000 
Total real estate revenue22,120,000 21,519,000 66,054,000 64,824,000 
Resident Fees and Services Revenue
Senior housing — RIDEA15,090,000 18,948,000 46,179,000 51,863,000 
Total resident fees and services15,090,000 18,948,000 46,179,000 51,863,000 
Grant Income
Senior housing — RIDEA— 864,000 — 864,000 
Total grant income— 864,000 — 864,000 
Total revenues and grant income$37,210,000 $41,331,000 $112,233,000 $117,551,000 
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,March 31, 2022 and 2021, and 2020, real estate revenue was primarily comprised of base rent of $16,520,000 and $15,847,000, respectively, and expense recoveries of $4,963,000 and $4,575,000, respectively. For the nine months ended September 30, 2021 and 2020, real estate revenue was primarily comprised of base rent of $48,581,000 and $47,544,000, respectively, and expense recoveries of $14,566,000 and $13,697,000, respectively. For the three and nine months ended September 30, 2021 and 2020, resident fees and services revenue primarily consisted of rental fees related to resident leases, and extended health care fees.
The decreasefees 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 both the three and nine months ended September 30, 2021, compared to the three and nine months ended September 30, 2020, is primarily related to lower occupancy rates in our facilitiesSHOP was due to the prolonged operational disruptionincrease in the size of our portfolio as a result of the COVID-19 pandemic.Merger. The decreaseremaining 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 ninethree months ended September 30, 2021, comparedMarch 31, 2022, $22,332,000 of real estate revenue was primarily due to the nineincrease in the size of our portfolio as a result of the Merger.
For the three months ended September 30, 2020 was partially offset by the impact of the transition of five senior housing facilities within Northern California Senior Housing Portfolio to a RIDEA structure in March 2020 resulting in higher resident fees31, 2022 and services in the comparable period.
For both the three and nine months ended September 30, 2021, we did not recognize any government grants. For both the threerecognized $5,214,000 and nine months ended September 30, 2020, we recognized $864,000$8,229,000, respectively, of grant income at our integrated senior housing — RIDEA facilitieshealth campuses and SHOP related to government grants received through the Coronavirus Aid, Relief, and Economic Security Act, or the CARES Act, economic stimulus programs.
4143

Table of Contents
RentalProperty Operating Expenses and Property OperatingRental Expenses
Rental expenses and rental expenses as a percentage of real estate revenue, as well as propertyProperty 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, by reportable segment consisted of the following for the periods presented:then ended:
Three Months Ended September 30,Nine Months Ended September 30, Three Months Ended March 31,
2021202020212020 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 %
Rental ExpensesRental ExpensesRental Expenses
Medical office buildingsMedical office buildings$6,072,000 35.9 %$5,607,000 34.3 %$17,503,000 34.7 %$16,616,000 33.8 %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 housingSenior housing172,000 7.8 %173,000 7.9 %569,000 8.6 %648,000 9.7 %Senior housing179,000 3.4 %15,000 0.4 %
Skilled nursing facilities145,000 4.8 %125,000 4.2 %470,000 5.2 %459,000 5.1 %
Total rental expensesTotal rental expenses$6,389,000 28.9 %$5,905,000 27.4 %$18,542,000 28.1 %$17,723,000 27.3 %Total rental expenses$15,287,000 29.4 %$8,055,000 26.8 %
Property Operating Expenses
Senior housing — RIDEA$14,540,000 96.4 %$17,397,000 87.8 %$44,179,000 95.7 %$44,856,000 85.1 %
Total property operating expenses$14,540,000 96.4 %$17,397,000 87.8 %$44,179,000 95.7 %$44,856,000 85.1 %
For the three months ended September 30, 2021Integrated senior health campuses and 2020, property operating expenses primarily consisted of administration and benefits expense of $10,921,000 and $8,634,000, respectively, and for the nine months ended September 30, 2021 and 2020, property operating expenses primarily consisted of administration and benefits expense of $33,320,000 and $23,683,000, respectively. The decrease in property operating expenses for the three months ended September 30, 2021, compared to the three months ended September 30, 2020, is primarily because we experienced a significant increase in labor costs, as well as the costs of COVID-19 testing of employees and residents in our facilities and the costs of PPE and other supplies required as a result of the COVID-19 pandemic in the prior year, which decreased in the current year in line with the normalization of such costs and with the decline in COVID-19 case counts and increase in vaccination rates. Senior housing — RIDEA facilitiesSHOP typically have a higher percentage of direct operating expenses to revenue than medical office buildings, skilled nursing facilitieshospitals, and leased non-RIDEA 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 March 31, 2022, as compared to the three months ended March 31, 2021, rental expenses increased by $6,542,000 and 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
GeneralFor the three months ended March 31, 2022, general and administrative expenses consisted of the followingwere $11,119,000 compared to $7,257,000 for the periods presented:
Three Months Ended September 30,Nine Months Ended September 30,
 2021202020212020
Asset management and property management oversight fees — affiliates$2,540,000 $2,529,000 $7,616,000 $7,539,000 
Professional and legal fees1,278,000 566,000 2,433,000 2,664,000 
Bank charges175,000 183,000 534,000 501,000 
Transfer agent services118,000 119,000 362,000 368,000 
Directors’ and officers’ liability insurance89,000 65,000 254,000 194,000 
Board of directors fees64,000 64,000 194,000 206,000 
Restricted stock compensation21,000 73,000 105,000 171,000 
Franchise taxes15,000 54,000 125,000 170,000 
Other4,000 19,000 87,000 147,000 
Total$4,304,000 $3,672,000 $11,710,000 $11,960,000 
three months ended March 31, 2021. The increase in general and 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 three months ended September 30, 2021, compared toacquired employees as a result of the three months ended September 30, 2020, is primarily due to an increaseAHI 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 from transitioningof $5,678,000 as a result of the operator at Central Florida Senior Housing Portfolio in September 2021.AHI Acquisition.
Business Acquisition Expenses
For the three months ended September 30,March 31, 2022 and 2021, and 2020,we recorded business acquisition expenses were $3,800,000expense of $173,000 and $57,000, respectively, and for the nine months ended September 30, 2021 and 2020, business acquisition expenses were $6,552,000 and $74,000,$1,248,000, respectively. The increasedecrease in such expenses for the nine months ended September 30, 2021, comparedprimarily related to the nine
42

Table of Contents
months ended September 30, 2020, was primarily due to $6,753,000a $1,195,000 decrease in third-party legaladvisory costs and professional services fees incurredto our special committee related to the Merger. Such increase was partially offset byMerger and the recovery of costs of $400,000 during the nine months ended September 30, 2021 that were incurred in prior periods in the pursuit of a portfolio of properties that did not result in an acquisition.AHI Acquisition.
Depreciation and Amortization
For the three months ended September 30,March 31, 2022 and 2021, and 2020, depreciation and amortization was $10,746,000$42,311,000 and $12,669,000,$25,723,000, respectively, andwhich primarily consisted primarily of depreciation on our operating properties of $8,181,000$34,422,000 and $7,966,000,$24,190,000, respectively, and amortization onof our identified intangible assets of $2,261,000$7,125,000 and $4,619,000,$1,113,000, respectively. For the nine months ended September 30, 2021 and 2020,The increase in depreciation and amortization of $16,588,000 was $33,745,000 and $37,919,000, respectively, and consisted primarily the result of depreciation onthe increase in depreciable assets in our operating propertiesportfolio as a result of $24,025,000 and $23,698,000, respectively,the Merger resulting in depreciation and amortization on our identified intangible assetsexpense of $9,199,000 and $14,032,000, respectively. Approximately $3,333,000$14,954,000.

44

Table of the decrease in amortization expense on our identified intangible assets for the nine months ended September 30, 2021 as compared to the nine months ended September 30, 2020 is related to in-place leases recognized in January 2020 and totaling $8,974,000 that were fully amortized during the nine months ended September 30, 2021.Contents
Interest Expense
Interest expense, including gain or loss in fair value of derivative financial instruments, consisted of the following for the periods presented:
Three Months Ended September 30,Nine Months Ended September 30, Three Months Ended March 31,
2021202020212020 20222021
Interest expense:Interest expense:Interest expense:
Line of credit and term loans and derivative financial instruments$4,274,000 $4,145,000 $12,492,000 $13,053,000 
Lines of credit and term loans and derivative financial instrumentsLines of credit and term loans and derivative financial instruments$7,549,000 $7,594,000 
Mortgage loans payableMortgage loans payable198,000 204,000 596,000 590,000 Mortgage loans payable9,544,000 8,585,000 
Amortization of deferred financing costs:Amortization of deferred financing costs:Amortization of deferred financing costs:
Line of credit and term loans470,000 471,000 1,411,000 1,410,000 
Lines of credit and term loansLines of credit and term loans809,000 1,075,000 
Mortgage loans payableMortgage loans payable7,000 7,000 20,000 33,000 Mortgage loans payable441,000 339,000 
(Gain) loss in fair value of derivative financial instruments(1,514,000)(1,450,000)(4,431,000)2,302,000 
Amortization of debt discount/premium12,000 12,000 37,000 37,000 
Amortization of debt discount/premium, netAmortization of debt discount/premium, net(17,000)203,000 
Gain in fair value of derivative financial instrumentsGain in fair value of derivative financial instruments(500,000)(1,821,000)
Loss on extinguishments of debtLoss on extinguishments of debt4,591,000 2,288,000 
Interest on finance lease liabilitiesInterest on finance lease liabilities74,000 118,000 
Interest expense on financing obligations and other liabilitiesInterest expense on financing obligations and other liabilities334,000 163,000 
TotalTotal$3,447,000 $3,389,000 $10,125,000 $17,425,000 Total$22,825,000 $18,544,000 
For the three months ended March 31, 2022, interest expense was $22,825,000 compared to $18,544,000 for the three months ended March 31, 2021. The decreaseincrease in interest expense for the nine months ended September 30, 2021, compared to the nine months ended September 30, 2020, iswas primarily related to a change to adecrease in the gain in fair value recognized on our derivative financial instruments from aof $1,321,000 and an increase in loss in fair value recognized on our derivative financial instruments, respectively, as such instruments approach maturity in November 2021, as well as a decline in interest rates on our linedebt extinguishment of credit and term loans.$2,303,000. See Note 6,8, Mortgage Loans Payable, Net, and Note 7, Line9, Lines of Credit and Term Loans, and Note 8, Derivative Financial Instruments, to our accompanying condensed consolidated financial statements for a further discussion.discussion on debt extinguishments.
Liquidity and Capital Resources
Our sources of funds primarily consist of operating cash flows and borrowings. In the normal course of business, our principal demands for funds are formaterial cash requirements consist of payment of operating expenses, capital improvement expenditures, interest on our indebtedness, distributions to our stockholders and repurchases of our common stock. Upon consummationstock. Our sources of the Merger, on October 1, 2021,funds primarily consist of operating cash flows and borrowings.
Absent our requirements to make distributions to maintain our REIT qualification, we assumed GAHR III's obligations, through the surviving partnership, with respect to a credit facility with a maximum principal amount of $480,000,000, or the 2019 Corporate Line of Credit. In addition, on October 1, 2021, upon consummation of the Merger, we assumed GAHR III's obligations under 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. We also entered into an amendment to our credit agreement for our line of credit and term loans, as amended, or the 2018 Credit Facility. We refer to the 2019 Corporate Line of Credit, 2019 Trilogy Credit Facility and the 2018 Credit Facility as the Credit Facilities. See Note 20, Subsequent Events — Lines of Credit and Term Loans, to our accompanying condensed consolidated financial statements, for a further discussion, and our Current Report on Form 8-K filed with the SEC on October 5, 2021 for more information on the amendments to or assumption of the Credit Facilities. Our total capacity to pay operating expenses, capital improvement expenditures, interest, distributions and repurchases is a function of our current cash position, our borrowing capacity on our Credit Facilities, as well asdo not have any future indebtednessmaterial off-balance sheet arrangements that we may incur.
43

Table of Contents
As of October 31, 2021, the Combined Company’s aggregate borrowing capacity under the Credit Facilities was $1,370,000,000. As of October 31, 2021, the Combined Company’s aggregate borrowings outstanding under the Credit Facilities was $1,205,634,000. The 2018 Credit Facility is scheduled to mature on November 19, 2021. We intend to extend the maturity date of the 2018 Credit Facility for an additional 12 months pursuant to the terms of the 2018 Credit Agreement, as amended, and expect to pay an extension fee of approximately $795,000. The 2019 Corporate Line of Credit is scheduled to mature on January 25, 2022; however, we intend to combine our 2019 Corporate Line of Credit and the 2018 Credit Facility into one joint credit facility and pay any related fees. As of October 31, 2021, we had an aggregate of $164,366,000 available on the Credit Facilities. We believe that these resources will be sufficient to satisfy our cash requirements for the foreseeable future.
Due to the impact the COVID-19 pandemic has had on the United States and globally, and the uncertainty of the severity and duration of the COVID-19 pandemic and its effects, beginning in March 2020, our board decided to take steps to protect our capital and maximizewould materially affect our liquidity in an effort to strengthen our long-term financial prospects by decreasing our distributions to stockholders and temporarily suspending our share repurchase plan. Consequently, our board approved a reduced distribution rate for April 2020 through October 2021 for our Class T and Class I common stock, which is equal to an annualized distribution rate of $0.40 per share, a decrease from the annualized rate of $0.60 per share previously paid by us. See the “Distributions” section below for a further discussion. In addition, on March 31, 2020, our board suspended our share repurchase plan with respect to all repurchase requests other than repurchases resulting from the death or qualifying disability of stockholders, beginning with share repurchase requests submitted for repurchase during the second quarter of 2020. Furthermore, in connection with our special committee’s strategic alternative review process and in order to facilitate a strategic transaction, on March 18, 2021, our board authorized the suspension of the DRIP, effective as of April 1, 2021, and also approved the suspension of our share repurchase plan with respect to all repurchase requests received by us after February 28, 2021, including repurchases resulting from the death or qualifying disability of stockholders. For a further discussion, see our Current Report on Form 8-K filed with the SEC on March 19, 2021. On October 4, 2021, our board authorized the reinstatement of the DRIP and a partial reinstatement of our share repurchase plan with respect to repurchase requests resulting from the death or qualifying disability of stockholders. See Note 20, Subsequent Events — Reinstatement of the DRIP and — Amendments to and Partial Reinstatement of Share Repurchase Plan, to our accompanying condensed consolidated financial statements for a further discussion, and our Current Report on Form 8-K filed with the SEC on October 5, 2021 for more information on the reinstatement of the DRIP and partial reinstatement of our share repurchase plan.capital resources.
Material Cash Requirements
Capital Improvement Expenditures
A capital plan for each investment is established upon acquisition that contemplates the estimated capital needs of that investment, including costs of refurbishment, tenant improvements or other major capital expenditures. The capital plan also sets 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 or additional equity investments from us orand joint venture partners. The capital plan for each investment is 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 the Combined Company,March 31, 2022, we estimate that our discretionary expenditures for capital and tenant improvements could require up to $33,809,000$96,038,000 for the remaining threenine months of 2021.2022.
Other Liquidity Needs
45

Table of Contents
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 event that there2019 Trilogy Credit Facility. Our total capacity to pay operating expenses, capital improvement expenditures, interest, distributions and repurchases is a shortfall in netfunction of our current cash available due to various factors, including, without limitation, the timingposition, our borrowing capacity on our lines of distributions or the collection of receivables,credit and term loans, as well as any future indebtedness that we may seekincur.
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 be sufficient to obtain capital to pay distributions by means of secured or unsecured debt financing through one or more third parties, orsatisfy our advisor or its affiliates. There are currently no limits or restrictions oncash requirements for 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.foreseeable future.
Cash Flows
The following table sets forth changes in cash flows:
Nine Months Ended September 30,
 20212020
Cash, cash equivalents and restricted cash — beginning of period$18,125,000 $15,846,000 
Net cash provided by operating activities16,556,000 29,943,000 
Net cash used in investing activities(1,573,000)(74,761,000)
Net cash (used in) provided by financing activities(15,939,000)52,368,000 
Cash, cash equivalents and restricted cash — end of period$17,169,000 $23,396,000 
44

Table of Contents
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.
46

Table of Contents
Operating Activities
For the nine months ended September 30, 2021,The change from net cash flows provided byused in operating activities was $16,556,000, compared to cash flows provided by operating activities of $29,943,000 for the nine months ended September 30, 2020. The decrease innet cash provided by operating activities of $13,387,000$27,615,000 was primarily due to paymentsthe increase in the size of general and administrative expenses, interest paymentsour portfolio as a result of the Merger on October 1, 2021, thereby increasing our outstanding indebtedness and payment of costs relatednet operating income during the three months ended March 31, 2022, as compared to the Merger of $6,753,000 during the nine months ended September 30, 2021, as well as grant income of $864,000 recognized during the nine months ended September 30, 2020.
Investing Activities
For the nine months ended September 30, 2021 and 2020,prior year period. In general, cash flows used in investingfrom operating activities related to our property acquisitions in the amount of $3,385,000 and $68,032,000, respectively, and the payment of $4,384,000 and $6,729,000, respectively, for capital expenditures. For the nine months ended September 30, 2021, cash flows used in investing activities were offset by $6,196,000 in net proceeds from the sale of two senior housing facilities, which were part of the Northern California Senior Housing Portfolio. We anticipate that cash flows used in investing activities will primarily beis affected by the timing of cash receipts and payments. See the “Results of Operations” section above for a further discussion.
Investing Activities
The decrease in net cash used in investing activities of $79,474,000 was primarily due to a $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 and generally will decreaseduring the three months ended March 31, 2022 as compared to the prior years as we have substantially completed the acquisition phase of our real estate investment strategy.year period.
Financing Activities
For the nine months ended September 30, 2021, cash flows used in financing activities was $15,939,000, compared to cash flows provided by financing activities of $52,368,000 for the nine months ended September 30, 2020. The $68,307,000 change from net cash provided by financing activities to net cash used in financing activities of $90,912,000 was primarily due to thea decrease in net borrowing proceeds onborrowings under our 2018 Credit Facilitymortgage loans payable of $70,700,000$82,661,000 during the three months ended March 31, 2022 as compared to the prior year period, as well as the $15,010,000 payment of distributions to our common stockholders and an increase$4,134,000 payment to repurchase our common stock for the three months ended March 31, 2022. Such amounts were partially offset by a decrease in net borrowings under our lines of $7,768,000credit and term loans of $13,900,000 during the three months ended March 31, 2022 as compared to the prior year period. The change in distributions paid to our common stockholders partially offset by the January 2020 payoff of one mortgage loan payable with a principal balance of $7,738,000 and a decrease in share repurchases of $3,475,000. The increase in distributions paid in cash for the nine months ended September 30, 2021 compared to the nine months ended September 30, 2020 was primarily due to the suspension of the DRIP by our boardall stockholder distributions on March 18, 2021, resulting in no further issuances of shares pursuant to the DRIP, and stockholders who were participants in the DRIP received cash distributions instead beginning with the May 2021 payment date. The decrease in share repurchases paid in the nine months ended September 30, 2021 compared to the nine months ended September 30,29, 2020 was primarily related to the partial suspension of our share repurchase plan in March 2020 by our board to protect our capital and maximize our liquidity in response to the impact of the COVID-19 pandemic. See Note 12, Equity, and Note 20, Subsequent Events — Reinstatementpandemic, 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 DRIP and — Amendments to and Partial ReinstatementGAHR III share repurchase plan from May 31, 2020 through October 4, 2021, when the partial reinstatement of Share Repurchase Plan, to our accompanying condensed consolidated financial statements, for a further discussion regarding our share repurchase plan and DRIP distributions. Overall, we anticipate cash flows from financing activities to decrease in the future.was approved by our board.
Distributions
The 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, ourthe GAHR IV board authorized a daily distribution to our stockholders of record as of the close of business on each day of the period commencing on May 1, 2016 and ending on 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, which was equal to an annualized distribution rate of $0.60 per share. These distributions were aggregated and paid monthly in arrears in cash or shares of our common stock pursuant to ourthe DRIP Offerings,on a monthly basis, in arrears, only from legally available funds.
In response to the COVID-19 pandemic and its effects to our business and operations, at the end of the first quarter of 2020, ourthe 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, ourthe GAHR IV board authorized a daily distribution to our stockholders of record as of the close of business on each day of the period commencing on April 1, 2020 and ending on August 31, 2021, which was calculated based on 365 days in the calendar year and was equal to $0.001095890 per share of our Class T and Class I common stock. Such daily distribution was equal to an annualized distribution rate of $0.40 per share. The distributions were aggregated and paid in cash or shares of our common stock pursuant to the DRIP on a monthly basis, in arrears, only from legally available funds.
OurThe GAHR IV board of directors also authorized distributions to our Class T and Class I stockholders of record as of the close of business on September 17, 2021, and October 27, 2021. The distributions were equal to $0.0328767 and $0.033333333 per share of our common stock, for the months of September 2021 and October 2021, respectively, 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 $0.40 per share. The distributions were or will be 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 September 2021such amounts as our board shall determine, and November 2021, respectively, only from legally available funds.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 will 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.
4547

Table of Contents
As discussed above,On March 18, 2021, in connection with ourthe GAHR IV special committee’scommittee's strategic alternative review process, on March 18, 2021, ourthe 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 arewere participants in the DRIP received or will receive cash distributions instead. As also discussed above, onOn October 4, 2021, our board authorized the reinstatement of the DRIP and as a result, beginning with the October 2021 distribution, which werewas 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. See Note 20, Subsequent Events — Reinstatement of the DRIP, to our accompanying condensed consolidated financial statements, for a further discussion, and our Current Report on Form 8-K filed with the SEC on October 5, 2021 for more information on the reinstatement of the DRIP and the declaration of October 2021 distribution.
The amount of the distributions paid to our common stockholders iswas determined quarterly or monthly, as applicable, by our board 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 borrowings 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, 2021 and 2020,March 31, 2022, along with the amount of distributions reinvested pursuant to ourthe AHR DRIP, Offerings and the sources of our distributions as compared to cash flows from operations were as follows:
Nine Months Ended September 30,
20212020
Three Months Ended
March 31, 2022
Distributions paid in cashDistributions paid in cash$21,700,000 $13,932,000 Distributions paid in cash$15,010,000 
Distributions reinvestedDistributions reinvested5,499,000 15,681,000 Distributions reinvested11,304,000 
$27,199,000 $29,613,000 $26,314,000 
Sources of distributions:Sources of distributions:Sources of distributions:
Cash flows from operationsCash flows from operations$16,556,000 60.9 %$29,613,000 100 %Cash flows from operations$22,360,000 85.0 %
Proceeds from borrowingsProceeds from borrowings10,643,000 39.1 — — Proceeds from borrowings3,954,000 15.0 
$27,199,000 100 %$29,613,000 100 %
$26,314,000 100 %
As of September 30, 2021,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 have been paid from net offering proceeds and borrowings. The payment of
GAHR III did not pay any distributions from our net offering proceeds and borrowings have reducedfor the amount of capital we ultimately invested in assets and negatively impacted the amount of income available for future distributions.
three months ended March 31, 2021. The distributions paid for the ninethree months ended September 30, 2021 and 2020,March 31, 2022, along with the amount of distributions reinvested pursuant to ourthe AHR DRIP, Offerings 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,
20212020
Three Months Ended
March 31, 2022
Distributions paid in cashDistributions paid in cash$21,700,000 $13,932,000 Distributions paid in cash$15,010,000 
Distributions reinvestedDistributions reinvested5,499,000 15,681,000 Distributions reinvested11,304,000 
$27,199,000 $29,613,000 $26,314,000 
Sources of distributions:Sources of distributions:Sources of distributions:
FFO attributable to controlling interestFFO attributable to controlling interest$23,126,000 85.0 %$29,361,000 99.1 %FFO attributable to controlling interest$26,314,000 100 %
Proceeds from borrowingsProceeds from borrowings4,073,000 15.0 252,000 0.9 Proceeds from borrowings— — 
$27,199,000 100 %$29,613,000 100 %
$26,314,000 100 %
46

Table of Contents
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 the “Funds from Operations and Modified Funds from Operations” section below.
Financing
We anticipate that our overall leverage will not exceed 50.0% of the combined fair market value of all of our properties, including the properties acquired as part of the Merger, and other real estate-related investments, as determined at the end of each calendar 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
48

Table of Contents
policies do not limit the amount we may borrow with respect to any individual investment. As of September 30, 2021,March 31, 2022, our aggregate borrowings were 40.5%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. 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 September 30, 2021, our leverage did not exceed 300% of the value of our net assets.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.
Lines of Credit and Term Loans
For a discussion of our linelines of credit and term loans, see Note 7, Line of Credit and Term Loans and Note 20, Subsequent Events —9, Lines 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 distribute to our stockholders a minimum of 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.
Commitments and Contingencies
For a discussion of our commitments and contingencies, see Note 10,12, Commitments and Contingencies, to our accompanying condensed consolidated financial statements.
Debt Service Requirements
A significant liquidity need is the payment of principal and interest on our outstanding indebtedness. As of September 30, 2021,March 31, 2022, we had $18,291,000 ($17,409,000, net$1,121,901,000 of discount/premiumfixed-rate and deferred financing costs) of fixed-ratevariable-rate mortgage loans payable outstanding secured by our properties. As of September 30, 2021,March 31, 2022, we had $488,900,000$1,239,134,000 outstanding and $41,100,000$170,866,000 remained available under the 2018 Credit Facility.our lines of 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 certain reporting requirementsvarious financial and non-financial covenants, such as leverage ratios, net worth ratios, debt service coverage ratios and fixed charge coverage ratios. AsExcept as explained below, as of September 30, 2021,March 31, 2022, we
47

Table of Contents
were in compliance with all such covenants and requirements on our Combined Company mortgage loans payable and our lines of credit and term loans. While the Credit Facilities. Asextent and severity of September 30, 2021, 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 factoring in our fixed-rate interest rate swaps, was 3.32% 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 2018 Credit Facility; (ii) interest payments onservicers of two of our mortgage loans payable and the 2018 Credit Facility; and (iii) ground lease obligations aswith an aggregate principal balance of September 30, 2021:
 Payments Due by Period
 20212022-20232024-2025ThereafterTotal
Principal payments — fixed-rate debt$132,000 $1,331,000 $6,589,000 $10,239,000 $18,291,000 
Interest payments — fixed-rate debt179,000 1,370,000 1,113,000 4,970,000 7,632,000 
Principal payments — variable-rate debt488,900,000 — — — 488,900,000 
Interest payments — variable-rate debt (based on rates in effect as of September 30, 2021)1,691,000 — — — 1,691,000 
Ground lease obligations213,000 1,056,000 1,072,000 46,565,000 48,906,000 
Total$491,115,000 $3,757,000 $8,774,000 $61,774,000 $565,420,000 
Off-Balance Sheet Arrangements
As of September 30, 2021, 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,March 31, 2022 and 2021, and 2020, 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 tenant 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 include negotiated rental increases, reimbursement billings for operating expense pass-through charges and real estate tax and insurance 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.
49

Table of Contents
Related Party Transactions
For a summary of related party transactions, see Note 13,15, Related Party Transactions, to our accompanying condensed consolidated financial statements, and Note 13,15, Related Party Transactions, to the consolidated financial statements that are a part of our 20202021 Annual Report on Form 10-K, as filed with the SEC on March 26, 2021.25, 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, 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 certain real estate assets and 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.
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
48

Table of Contents
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.
The 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 initial 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 Practice Guideline 2010-01, Supplemental Performance Measure for Publicly Registered, Non-Listed REITs: Modified Funds from Operations, or the Practice Guideline, issued by the IPA.IPA in November 2010. The Practice Guideline defines modified funds from operations as funds from operations further
50

Table of Contents
adjusted for the following items included in the determination of GAAP net income (loss): expensed acquisition fees and costs; amounts relating to deferred rent 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. Our MFFO calculation complies with the IPA’s Practice Guideline described above.
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.
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 may be useful in assisting management and investors in assessing the sustainability of operating performance in future operating
49

Table of Contents
periods, and in particular, after the offering and acquisition stages are 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 both the three and nine months ended September 30, 2020,March 31, 2022 and 2021, we recognized government grants through economic stimulus programs of the CARES Act as grant income or as a reduction of property operating expenses, as applicable, and within income or loss from an unconsolidated entity.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 impact would have had a material adverse impact to our FFO and MFFO. For the three months ended September 30,March 31, 2022 and 2021, and 2020, FFO would have been approximately $5,809,000$28,244,000 and $10,662,000, respectively, and for the nine months ended September 30, 2021 and 2020, FFO would have been approximately $22,522,000 and $26,563,000,$4,458,000, respectively, excluding government grants recognized. For the three months ended September 30,March 31, 2022 and 2021, and 2020, MFFO would have been approximately $7,659,000$32,722,000 and $8,200,000, respectively, and for the nine months ended September 30, 2021 and 2020, MFFO would have been approximately $22,531,000 and $26,028,000,$4,707,000, respectively, excluding government grants recognized.
5051

Table of Contents
The following is a reconciliation of net income or loss, which is the most directly comparable GAAP financial measure, to FFO and MFFO for the periods presented below:
 Three Months Ended September 30,Nine Months Ended September 30,
 2021202020212020
Net loss$(5,898,000)$(5,152,000)$(13,782,000)$(14,240,000)
Add:
Depreciation and amortization related to real estate — consolidated properties10,746,000 12,669,000 33,745,000 37,919,000 
Depreciation and amortization related to real estate — unconsolidated entity977,000 880,000 2,889,000 2,640,000 
Impairment of real estate investments — consolidated properties— 3,064,000 — 3,064,000 
(Gain) loss on disposition of real estate investments — consolidated properties(15,000)— 184,000 — 
Impairments and gain or loss on disposition of real estate investments, net — unconsolidated entity4,000 99,000 7,000 99,000 
Net loss attributable to noncontrolling interests121,000 232,000 489,000 608,000 
Less:
Depreciation, amortization and loss on disposition — noncontrolling interests(72,000)(250,000)(406,000)(729,000)
FFO attributable to controlling interest$5,863,000 $11,542,000 $23,126,000 $29,361,000 
Business acquisition expenses(1)$3,800,000 $57,000 $6,552,000 $74,000 
Amortization of above- and below-market leases(2)38,000 31,000 115,000 90,000 
Change in deferred rent(3)(523,000)(1,009,000)(2,500,000)(3,232,000)
(Gain) loss in fair value of derivative financial instruments(4)(1,514,000)(1,450,000)(4,431,000)2,302,000 
Adjustments for unconsolidated entity(5)49,000 (91,000)273,000 237,000 
Adjustments for noncontrolling interests(5)— — — (6,000)
MFFO attributable to controlling interest$7,713,000 $9,080,000 $23,135,000 $28,826,000 
Weighted average Class T and Class I common shares outstanding — basic and diluted81,704,261 80,788,359 81,635,053 80,498,693 
Net loss per Class T and Class I common share — basic and diluted$(0.07)$(0.06)$(0.17)$(0.18)
FFO attributable to controlling interest per Class T and Class I common share — basic and diluted$0.07 $0.14 $0.28 $0.36 
MFFO attributable to controlling interest per Class T and Class I common share — basic and diluted$0.09 $0.11 $0.28 $0.36 
Three Months Ended March 31,
 20222021
Net loss$(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 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-relatedestate 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.
52

Table of Contents
(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
51

Table of Contents
our operating leases. This may result in income or expense recognition that is significantly different than the underlying contract terms. By adjusting for 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.
(4)(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.
(5)(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 entity’sentities’ share or noncontrolling interests’ share, as applicable, of the adjustments described in notes (1) – (4)(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 expenses, depreciation and amortization, interest expense, gain or loss on dispositiondispositions, impairment of real estate investments, income or loss from unconsolidated entity,entities, foreign currency gain or loss, other income and income tax benefit or 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 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 cash 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 expenses.
We believe that NOI is an appropriate supplemental performance measure to reflect the performance of our operating assets because NOI excludes certain items that are not associated with the operations 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 both the three and nine months ended September 30,March 31, 2022 and 2021, we did not recognize any government grants. For both the three and nine months ended September 30, 2020, we recognized government grants through economic stimulus programs of the CARES Act as grant income.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.condition and results of operations. Without such relief proceeds, the negative impact offunds, the COVID-19 pandemic would have had a material adverse impact to our NOI. For the three and nine months ended September 30, 2020,March 31, 2022 and 2021, NOI would have been approximately $17,165,000$68,470,000 and $54,108,000,$29,852,000, respectively, excluding government grants recognized.
53

Table of Contents
To facilitate understanding of this financial measure, the following is a reconciliation of net income or loss, which is the most directly comparable GAAP financial measure, to NOI for the periods presented below:
 Three Months Ended September 30,Nine Months Ended September 30,
 2021202020212020
Net loss$(5,898,000)$(5,152,000)$(13,782,000)$(14,240,000)
General and administrative4,304,000 3,672,000 11,710,000 11,960,000 
Business acquisition expenses3,800,000 57,000 6,552,000 74,000 
Depreciation and amortization10,746,000 12,669,000 33,745,000 37,919,000 
Interest expense3,447,000 3,389,000 10,125,000 17,425,000 
Impairment of real estate investments— 3,064,000 — 3,064,000 
(Gain) loss on disposition of real estate investments(15,000)— 184,000 — 
(Income) loss from unconsolidated entity(70,000)377,000 1,027,000 (952,000)
Other income(33,000)(8,000)(49,000)(278,000)
Income tax benefit— (39,000)— — 
Net operating income$16,281,000 $18,029,000 $49,512,000 $54,972,000 
52

Table of Contents
Subsequent Events
For a discussion of subsequent events, see Note 20, Subsequent Events, to our accompanying condensed consolidated financial statements.
 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 
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 20202021 Annual Report on Form 10-K, as filed with the SEC on March 26, 2021.25, 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 and develop 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 have entered into, and may continue 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 dodid not elect to apply hedge accounting treatment to these derivatives; therefore, changes in the fair value of interest rate derivative financial instruments arewere 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.operations and comprehensive income (loss). As of September 30, 2021, our interest rate swap liabilities are recorded in our accompanying condensed consolidated balance sheets at their aggregate fair value of $824,000.March 31, 2022, we did not have any derivative financial instruments. We willdo 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 the Secured Overnight Financing Rate, or SOFR as its preferred alternative to United States dollar LIBOR in derivatives and other financial contracts. In March 2021, theThe FCA confirmed its intention to ceaseceased publishing one-week and two-month LIBOR after December 31, 2021 and intends to cease publishing all remaining LIBOR after June 30, 2023. At this time, it is not known whether or when SOFR or other alternative referenceOn January 19, 2022, we entered into the 2022 Credit Agreement that bears interest at varying rates will attain market traction as replacementsbased upon SOFR. Please see Note 9, Lines of Credit and Term Loans — 2022 Credit Facility, to our accompanying condensed consolidated financial statements for LIBOR.a further discussion.
As
54

Table of September 30, 2021, weContents
We have variable rate debt outstanding under our credit facilities and derivative financial instruments maturing on November 19, 2021various dates from 2022 to 2031 that are indexed to LIBOR. We intend to extend the maturity date of such variable rate credit facilities for an additional 12 months pursuant to the terms of the 2018 Credit Agreement, as amended. 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 if LIBOR is discontinued.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, and LIBOR is discontinued,upon LIBOR’s discontinuation the impact on our contracts is likely to vary. If LIBOR is discontinued, interest rates on our current or future indebtedness may be adversely affected. 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.
53

Table of Contents
As of September 30, 2021,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
20212022202320242025ThereafterTotalFair Value 20222023202420252026ThereafterTotalFair 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 paymentsFixed-rate debt — principal payments$132,000 $651,000 $680,000 $711,000 $5,878,000 $10,239,000 $18,291,000 $20,891,000 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 debtWeighted average interest rate on maturing fixed-rate debt4.36 %4.49 %4.49 %4.50 %3.85 %3.83 %3.92 %— 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 paymentsVariable-rate debt — principal payments$488,900,000 $— $— $— $— $— $488,900,000 $488,995,000 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, 2021)2.05 %— %— %— %— %— %2.05 %— 
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 was $18,291,000 ($17,409,000, net of discount/premium and deferred financing costs)were $1,121,901,000 as of September 30, 2021.March 31, 2022. As of September 30, 2021,March 31, 2022, we had three67 fixed-rate mortgage loans payable and 11 variable-rate mortgage loans payable with effective interest rates ranging from 3.67%2.21% to 5.25% per annum.annum and a weighted average effective interest rate of 3.16%. In addition, as of September 30, 2021,March 31, 2022, we had $488,900,000$1,239,134,000 outstanding under our linelines of credit and term loans, at a weighted average interest rate of 2.05%2.32% per annum.
As of September 30, 2021,March 31, 2022, the weighted average effective interest rate on our outstanding debt factoring in our fixed-rate interest rate swaps, was 3.32%2.72% per annum. An increase in the variable interest rate on our variable-rate linemortgage loans payable and lines of credit and term loans constitutes a market risk. As of September 30, 2021,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 credit and term loans by $983,000,$7,597,000, or 5.63%11.7% of total annualized interest expense on our mortgage loans payable and our linelines of 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.
55

Table of Contents
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 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, 2021March 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, 2021,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, 2021March 31, 2022 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
5456

Table of Contents
PART II — OTHER INFORMATION
Item 1. Legal Proceedings.
For a discussion of our legal proceedings, see Note 10,12, Commitments and Contingencies — Litigation, to our accompanying condensed consolidated financial statements.
Item 1A. Risk Factors.
The use of the words “we,” “us” or “our” refers to American Healthcare REIT, Inc. and its subsidiaries, including Griffin-American Healthcare REIT IV Holdings, LP, except where otherwise noted.
There were no material changes from the risk factors previously disclosed in our 20202021 Annual Report on Form 10-K, as filed with the SEC on March 26, 2021, except as noted below.
Risks Related to Our Business
The COVID-19 pandemic has adversely impacted, and will likely continue to adversely impact, our business and financial results, and the ultimate impact will depend on future developments, which are highly uncertain and cannot be predicted, including the scope and duration of the pandemic and actions taken by governmental authorities in response to the pandemic.
In December 2019, COVID-19 was identified in Wuhan, China. This virus continues to spread globally including in the United States. As a result of the COVID-19 pandemic and related shelter-in-place, business re-opening and quarantine restrictions, our property values, NOI and revenues may decline, and our tenants, operating partners and managers have been, and may continue to be, limited in their ability to generate income, service patients and residents and/or properly manage our properties. In addition, based on preliminary information available to management as of October 29, 2021, we have experienced an approximate 14.9% and 4.5% decline in resident occupancies since February 2020, as well as a significant increase in costs to care for residents, at our senior housing — RIDEA facilities and our integrated senior health campuses, respectively. Our leased, non-RIDEA senior housing and skilled nursing facility tenants have also experienced, and may continue to experience, similar pressures related to occupancy declines and expense increases, which may impact their ability to pay rent and have an adverse effect on our operations. However, through October 2021, substantially all rents have been collected from such leased, non-RIDEA senior housing and skilled nursing facility tenants. Given the significant uncertainty of the impact of the COVID-19 pandemic, we are unable to predict the impact it will have on such tenants’ continued ability to pay rent. Therefore, information provided regarding prior rent collections should not serve as an indication of expected future rent collections. As such, our immediate focus continues to be on resident occupancy recovery and operating expense management.
The emergence of the Delta variant and other new variants may put additional pressure on our operations. Additionally, the public perception of a risk of a pandemic or media coverage of the COVID-19 pandemic and related deaths or confirmed cases, or public perception of health risks linked to perceived regional healthcare safety in our senior housing or SNFs, particularly if focused on regions in which our properties are located, may adversely affect our business operations by reducing occupancy demand at our facilities. We have also held discussions with our tenants, operating partners and managers and they have expressed that the ultimate impact of the COVID-19 pandemic on their business operations is uncertain.
Although vaccines for COVID-19 that have been approved for use are generally effective, vaccine boosters may be necessary and there can be no assurance that efforts to vaccinate the public will be successful in ending the pandemic or that vaccines will be effective against variants such as the Delta variant. The rapid development and fluidity of this situation continues to preclude any prediction as to the ultimate adverse impact of the COVID-19 pandemic on economic and market conditions, and, as a result, present material uncertainty and risk with respect to us and the performance of our investments. The full extent of the impact and effects of the COVID-19 pandemic will depend on future developments, including, among other factors, the success of efforts to contain or treat COVID-19 and its variants, the use and distribution of effective vaccines and availability of such vaccines and vaccine boosters, potential resurgences of COVID-19, along with the related travel advisories, quarantines and business restrictions, the recovery time of the disrupted supply chains and industries, the impact of the labor market interruptions, the impact of government interventions, and the performance or valuation outlook for healthcare REIT markets and certain property types. The COVID-19 pandemic and the current financial, economic and capital markets environment, and future developments in these and other areas present uncertainty and risk and have had an adverse effect on us and may have a material adverse effect on us in the future.
55

Table of Contents
The integrated senior health campuses managed by Trilogy Management Services, LLC, or TMS, account for a significant portion of our revenues and/or operating income. Adverse developments in TMS’s business or financial condition could have a material adverse effect on us.
As of November 15, 2021, TMS managed all of the day-to-day operations for our integrated senior health campuses pursuant to long-term management agreements. These integrated senior health campuses represent a substantial portion of our portfolio, based on their gross book value, and account for a significant portion of our revenues and/or NOI. Although we have various rights as the owner of these integrated senior health campuses under our management agreements, we rely on TMS’s personnel, expertise, technical resources and information systems, proprietary information, good faith and judgment to manage our integrated senior health campuses operations efficiently and effectively, and to identify and manage development opportunities for new integrated senior health campuses. We also rely on TMS to provide accurate campus-level financial results for our integrated senior health campuses in a timely manner and to otherwise operate our integrated senior health campuses in compliance with the terms of our management agreements and all applicable laws and regulations. We depend on TMS’s ability to attract and retain skilled personnel to provide these services. A shortage of nurses or other trained personnel or general inflationary pressures may force TMS to enhance its pay and benefits package to compete effectively for such personnel, but it may not be able to offset these added costs by increasing the rates charged to residents. As such, any adverse developments in TMS’s business or financial condition, including its ability to retain key personnel, could impair its ability to manage our integrated senior health campuses efficiently and effectively and could have a material adverse effect on us. In addition, if TMS experiences any significant financial, legal, accounting or regulatory difficulties due to a weak economy, industry downturn or otherwise, such difficulties could result in, among other adverse events, acceleration of its indebtedness, impairment of its continued access to capital, the enforcement of default remedies by its counterparties, or the commencement of insolvency proceedings by or against it under the United States Bankruptcy Code. Any one or a combination of these risks could have a material adverse effect on us.
In the event that our management agreements with TMS are terminated or not renewed, we may be unable to replace TMS with another suitable manager, or, if we were successful in locating such a manager, that it would manage the integrated senior health campuses effectively or that any such transition would be completed timely, which may have a material adverse effect on us.
We continually monitor and assess our contractual rights and remedies under our management agreements with TMS. When determining whether to pursue any existing or future rights or remedies under those agreements, including termination rights, we consider numerous factors, including legal, contractual, regulatory, business and other relevant considerations. In the event that we exercise our rights to terminate management agreements with TMS for any reason or such agreements are not renewed upon expiration of their terms, we would attempt to reposition the affected integrated senior health campuses with another manager. Although we believe that many qualified national and regional operators would be interested in managing our integrated senior health campuses, we cannot provide any assurance that we would be able to locate another suitable manager or, if we were successful in locating such a manager, that it would manage the integrated senior health campuses effectively or that any such transition would be completed timely. Any such transition would likely result in disruption of the operation of such facilities, including matters relating to staffing and reporting. Moreover, the transition to a replacement manager may require approval by the applicable regulatory authorities and, in most cases, one or more of our lenders including the mortgage lenders for the integrated senior health campuses, and we cannot provide any assurance that such approvals would be granted on a timely basis, if at all. Any inability to replace, or delay in replacing TMS as the manager of integrated senior health campuses could have a material adverse effect on us.
Risks Related to Investments in Real Estate
A high concentration of our properties in a particular geographic area would magnify the effects of downturns in that geographic area.
We have a concentration of properties in particular geographic areas; therefore, any adverse situation that disproportionately effects one of those areas would have a magnified adverse effect on our portfolio. As of November 15, 2021, our properties located in Indiana accounted for approximately 30.7% of our total property portfolio’s annualized base rent or annualized NOI. Accordingly, there is a geographic concentration of risk subject to fluctuations in such state’s economy.
Most of our costs, such as operating and general and administrative expenses, interest expense, and real estate acquisition and construction costs, are subject to inflation.
A significant portion of our operating expenses is sensitive to inflation. These include expenses for property-related costs such as insurance, utilities and repairs and maintenance. Property taxes are also impacted by inflationary changes as taxes are typically regularly reassessed in most states based on changes in the fair value of our properties. We also have ground lease expenses in certain of our properties. Ground lease costs are contractual, but in some cases, lease payments reset every few years based on changes on consumer price indexes.
56

Table of Contents
Operating expenses on our non-RIDEA properties, with the exception of ground lease rental expenses, are typically recoverable through our lease arrangements, which allow us to pass through substantially all expenses associated with property taxes, insurance, utilities, repairs and maintenance, and other operating expenses (including increases thereto) to our tenants. As of September 30, 2021, the majority of our existing leases were either triple net leases or leases that allow us to recover operating expenses, and also provided for the recapture of capital expenditures. Our remaining leases are generally gross leases, which provide for recoveries of operating expenses above the operating expenses from the initial year within each lease. During inflationary periods, we expect to recover increases in operating expenses from our triple net leases and our gross leases. As a result, we do not believe that inflation would result in a significant adverse effect on our net operating income, results of operations, and operating cash flows at the property level. For our RIDEA properties, increases in operating expenses, including labor, that are caused by inflationary pressures will generally be passed through to the us and may adversely impact our net operating income, results of operations and operating cash flows.
Effective upon the Merger and the AHI Acquisition on October 1, 2021, our general and administrative expenses consist primarily of compensation costs, as well as professional and legal fees. Annually, our employee compensation is adjusted to reflect merit increases; however, to maintain our ability to successfully compete for the best talent, rising inflation rates may require us to provide compensation increases beyond historical annual merit increases, which may significantly increase our compensation costs. Similarly, professional and legal fees are also subject to the impact of inflation and expected to increase proportionately with increasing market prices for such services. Consequently, inflation is expected to increase our general and administrative expenses over time and may adversely impact our results of operations and operating cash flows.
Also, during inflationary periods, interest rates have historically increased, which would have a direct effect on the interest expense of our borrowings. Our exposure to increases in interest rates is limited to our variable-rate borrowings, which consist of borrowings under the Credit Facilities and variable-rate mortgage loans payable. As of September 30, 2021, our outstanding debt and GAHR III outstanding debt aggregated $2.4 billion, of which 31.2% was unhedged variable-rate debt. Therefore, a significant increase in inflation rates would have a material adverse impact on our financing costs and interest expense.
We have long term lease agreements with our tenants that contain effective annual rent escalations that were either fixed or indexed based on a consumer price index or other index. We believe our annual lease expirations allow us to reset these leases to market rents upon renewal or re-leasing and that annual rent escalations within our long-term leases are generally sufficient to offset the effect of inflation on non-recoverable costs, such as general and administrative expenses and interest expense. However, it is possible that during higher inflationary periods the impact of inflation will not be adequately offset by the resetting of rents from our renewal and re-leasing activities or our annual rent escalations. As a result, during inflationary periods in which the inflation rate exceeds the annual rent escalation percentages within our lease contracts, we may not adequately mitigate the impact of inflation, which may adversely affect to our business, financial condition, results of operations, and cash flows.
Additionally, inflationary pricing may have a negative effect on the real estate acquisitions and construction costs necessary to complete our development and redevelopment projects, including, but not limited to, costs of construction materials, labor, and services from third-party contractors and suppliers. Higher acquisition and construction costs could adversely impact our net investments in real estate and expected yields in our development and redevelopment projects, which may make otherwise lucrative investment opportunities less profitable to us. As a result, our financial condition, results of operations, and cash flows, we well as our ability to pay dividends, could be adversely affected over time.
Risks Related to Debt Financing
Changes in banks’ inter-bank lending rate reporting practices or the method pursuant to which LIBOR is determined may adversely affect the value of the financial obligations to be held or issued by us that are linked to LIBOR.
LIBOR and other indices which are deemed “benchmarks” are the subject of recent national, international and other regulatory guidance and proposals for reform. Some of these reforms are already effective while others are still to be implemented. These reforms may cause such “benchmarks” to perform differently than in the past, or have other consequences which cannot be predicted. As published by the Federal Reserve Bank of New York, it currently appears that, over time, United States dollar LIBOR may be replaced by SOFR. In March 2021, the FCA confirmed its intention to cease publishing one-week and two-month LIBOR after December 31, 2021 and all remaining LIBOR after June 30, 2023. At this time, it is not known whether or when SOFR or other alternative reference rates will attain market traction as replacements for LIBOR. Market participants are still considering how various types of financial instruments and securitization vehicles should react to a discontinuation of LIBOR. It is possible that not all of our assets and liabilities will transition away from LIBOR at the same time, or to the same alternative reference rate, in each case increasing the difficulty of hedging. The process of transition involves operational risks. It is also possible that no transition will occur for many financial instruments. At this time, it is not possible to predict the effect of any such changes, any establishment of alternative reference rates or any other reforms to
57

Table of Contents
LIBOR that may be implemented. Uncertainty as to the nature of such potential changes, alternative reference rates or other reforms may adversely affect the market for or value of any securities on which the interest or dividend is determined by reference to LIBOR, loans, derivatives and other financial obligations or on our overall financial condition or results of operations. More generally, any of the above changes or any other consequential changes to LIBOR or any other “benchmark” as a result of international, national or other proposals for reform or other initiatives, or any further uncertainty in relation to the timing and manner of implementation of such changes, could have a material adverse effect on the value of financial assets and liabilities based on or linked to a “benchmark.”
Risks Related to the Merger
The ownership position of our stockholders and the stockholders of GAHR III is diluted by the REIT Merger.
The REIT Merger diluted the ownership percentage of our stockholders and resulted in GAHR III stockholders having an ownership stake in the Combined Company that is smaller than their prior stake in GAHR III. Based on the number of shares of our common stock and GAHR III common stock outstanding on September 30, 2021, our stockholders, on the one hand, and former GAHR III stockholders, on the other hand, owned approximately 31.3% and 68.7%, respectively, of the issued and outstanding shares of our common stock following the REIT Merger on October 1, 2021. Consequently, each of our stockholders and each GAHR III stockholder, as a general matter, has less influence over the management and policies of the Combined Company following the Merger than previously exercisable over our management and policies and the management and policies of GAHR III, as applicable.
If and when the Combined Company completes a liquidity event, the market value ascribed to the shares of common stock of the Combined Company upon the liquidity event may be significantly lower than the current estimated per share NAV after the consummation of the Merger.
The estimated per share NAV of our common stock was not immediately determined following the consummation of the Merger. In the event that the Combined Company completes a liquidity event after consummation of the Merger, such as a listing of its shares on a national securities exchange, a merger in which stockholders of the Combined Company receive securities that are listed on a national securities exchange, or a sale of the Combined Company for cash, the market value of the shares of the Combined Company upon consummation of such liquidity event may be significantly lower than the current estimated per share NAV of our common stock that may be reflected on the account statements of stockholders of the Combined Company after consummation of the Merger. For example, if the shares of the Combined Company are listed on a national securities exchange at some point after the consummation of the Merger, the trading price of the shares may be significantly lower than the most recent estimated per share NAV of our common stock of $9.22 as of September 30, 2020.
As a result of the AHI Acquisition, the Combined Company is newly self-managed.
As a result of the AHI Acquisition and the Merger, the Combined Company is a self-managed REIT. The Combined Company will no longer bear the costs of the various fees and expense reimbursements previously paid to the former external advisors of GAHR III and our company and their affiliates; however, the Combined Company’s expenses will include the compensation and benefits of the Combined Company’s officers, employees and consultants, as well as overhead previously paid by the former external advisors of GAHR III and our company and their affiliates. The Combined Company’s employees will provide services historically provided by the external advisors and their affiliates. The Combined Company will be subject to potential liabilities that are commonly faced by employers, such as workers’ disability and compensation claims, potential labor disputes, and other employee-related liabilities and grievances, and the Combined Company will bear the cost of the establishment and maintenance of any employee compensation plans. In addition, the Combined Company has not previously operated as a self-managed REIT and may encounter unforeseen costs, expenses and difficulties associated with providing these services on a self-advised basis. If the Combined Company incurs unexpected expenses as a result of its self-management, its results of operations could be lower than they otherwise would have been.
If the REIT Merger does not qualify as a tax-free reorganization, there may be adverse tax consequences.
The REIT Merger is intended to qualify as a tax-free reorganization within the meaning of Section 368(a) of the Code. The closing of the REIT Merger was conditioned on the receipt by us and GAHR III of an opinion of counsel to the effect that the REIT Merger will qualify as a tax-free reorganization within the meaning of Section 368(a) of the Code. However, these legal opinions will not be binding on the IRS or on the courts. If, for any reason, the REIT Merger were to fail to qualify as a tax-free reorganization, then each GAHR III stockholder generally would recognize gain or loss, as applicable, equal to the difference between (1) the merger consideration (i.e. the fair market value of the shares of our Class I common stock) received by such GAHR III stockholder in the REIT Merger; and (2) such GAHR III stockholder’s adjusted tax basis in its GAHR III common stock.
58
25, 2022.

Table of Contents
Item 2. Unregistered Sales of Equity Securities and Use of Proceeds.
NoneRecent Sales of Unregistered Securities
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. 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.
On October 4, 2021, our board approved our amended and restated share repurchase plan that included a change in the repurchase price with respect to repurchases resulting from the death or qualifying disability (as such term is defined in our share repurchase plan) of stockholders, to the most recently published estimated per share NAV. In addition, on October 4, 2021, our board authorized the partial reinstatement of our share repurchase plan with respect to requests to repurchase shares resulting from the death or qualifying disability of stockholders, effective with respect to qualifying repurchases for the fiscal quarter ending December 31, 2021. All share repurchase requests other than those requests resulting from the death or qualifying disability of stockholders were and shall be rejected.
During the three months ended 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
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)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.
Item 5. Other Information.
None.
5957

Table of Contents
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, 2021March 31, 2022 (and are numbered in accordance with Item 601 of Regulation S-K).
60

Table of Contents
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.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
104*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.

6158

Table of Contents
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. (f/k/a Griffin-American Healthcare REIT IV, Inc.)
(Registrant)
November 15, 2021May 16, 2022By:
/s/ DANNY PROSKY
DateDanny Prosky
Chief Executive Officer, President and PresidentDirector
(Principal Executive Officer)
November 15, 2021May 16, 2022By:
/s/ BRIAN S. PEAY
DateBrian S. Peay
Chief Financial Officer
(Principal Financial Officer and Principal Accounting Officer)


6259