Summit Healthcare REIT 10-Q 8 Nov 19 2019 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2019	Nov. 05, 2019
Document and Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q3
Entity Registrant Name	Summit Healthcare REIT, Inc
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Central Index Key	0001310383
Current Fiscal Year End Date	--12-31
Entity Filer Category	Non-accelerated Filer
Entity Common Stock, Shares Outstanding		23,027,978
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Small Business	true

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($)	Sep. 30, 2019	Dec. 31, 2018
ASSETS
Cash and cash equivalents	$ 12,729,000	$ 11,463,000
Restricted cash	2,762,000	3,493,000
Real estate properties, net	46,911,000	67,002,000
Notes receivable	660,000	730,000
Tenant and other receivables, net	3,675,000	4,666,000
Deferred leasing commissions, net	624,000	1,133,000
Other assets, net	529,000	319,000
Equity-method investments	13,499,000	9,719,000
Total assets	81,389,000	98,525,000
LIABILITIES AND EQUITY
Accounts payable and accrued liabilities	2,344,000	3,901,000
Security deposits	664,000	1,208,000
Loans payable, net of debt issuance costs	45,748,000	64,050,000
Total liabilities	48,756,000	69,159,000
Commitments and contingencies
Stockholders' Equity
Preferred stock, $0.001 par value; 10,000,000 shares authorized; no shares issued or outstanding at September 30, 2019 and December 31, 2018	0	0
Common stock, $0.001 par value; 290,000,000 shares authorized; 23,027,978 shares issued and outstanding at September 30, 2019 and December 31, 2018	23,000	23,000
Additional paid-in capital	116,142,000	115,950,000
Accumulated deficit	(83,744,000)	(86,956,000)
Total stockholders' equity	32,421,000	29,017,000
Noncontrolling interests	212,000	349,000
Total equity	32,633,000	29,366,000
Total liabilities and equity	$ 81,389,000	$ 98,525,000

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Sep. 30, 2019	Dec. 31, 2018
CONDENSED CONSOLIDATED BALANCE SHEETS
Preferred stock, par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized	290,000,000	290,000,000
Common stock, shares issued	23,027,978	23,027,978
Common stock, shares outstanding	23,027,978	23,027,978

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Revenues:
Total rental revenues	$ 1,594,000	$ 2,343,000	$ 5,268,000	$ 7,039,000
Acquisition and asset management fees	325,000	177,000	861,000	541,000
Interest income from notes receivable	8,000	13,000	21,000	48,000
Total operating revenue	1,927,000	2,533,000	6,150,000	7,628,000
Expenses:
Property operating costs	183,000	281,000	684,000	941,000
General and administrative	764,000	964,000	3,481,000	2,956,000
Depreciation and amortization	416,000	755,000	1,332,000	2,350,000
Total operating expenses	1,363,000	2,000,000	5,497,000	6,247,000
Other operating income:
Gain on sale of real estate properties	22,000	0	4,227,000	0
Operating income	586,000	533,000	4,880,000	1,381,000
Income from equity-method investees	60,000	62,000	90,000	321,000
Other income	52,000	25,000	152,000	63,000
Interest expense	(628,000)	(866,000)	(2,009,000)	(2,784,000)
Gain on note receivable	0	0	0	186,000
Income from continuing operations	70,000	(246,000)	3,113,000	(833,000)
Discontinued operations:
Gain on disposition of Friendswood TRS	0	0	0	109,000
Income from discontinued operations	0	0	0	109,000
Net income (loss)	70,000	(246,000)	3,113,000	(724,000)
Noncontrolling interests' share in net income (loss)	(12,000)	(15,000)	99,000	(32,000)
Net income (loss) applicable to common stockholders	$ 58,000	$ (261,000)	$ 3,212,000	$ (756,000)
Basic:
Income (loss) from continuing operations	$ 0	$ (0.01)	$ 0.14	$ (0.04)
Net income (loss) applicable to common stockholders	0	(0.01)	0.14	(0.04)
Diluted:
Income (loss) from continuing operations	0	(0.01)	0.14	(0.04)
Net income (loss) applicable to common stockholders	$ 0	$ (0.01)	$ 0.14	$ (0.04)
Weighted average shares used to calculate earnings per common share
Basic	23,027,978	23,027,978	23,027,978	23,027,978
Diluted	23,513,331	23,027,978	23,513,331	23,027,978
Rental revenues [Member]
Revenues:
Total rental revenues	$ 1,594,000	$ 2,069,000	$ 5,268,000	$ 6,196,000
Tenant Reimbursements [Member]
Revenues:
Total rental revenues	$ 0	$ 274,000	$ 0	$ 843,000

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF EQUITY - USD ($)	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Deficit [Member]	Total Stockholders' Equity [Member]	Noncontrolling Interests [Member]	Total
Balance at Dec. 31, 2017	$ 23,000	$ 117,349,000	$ (86,040,000)	$ 31,332,000	$ 564,000	$ 31,896,000
Balance (in shares) at Dec. 31, 2017	23,027,978
Stock-based compensation	$ 0	14,000	0	14,000	0	14,000
Distributions paid to noncontrolling interests	0	0	0	0	(97,000)	(97,000)
Net income (loss)	0	0	(288,000)	(288,000)	3,000	(285,000)
Balance at Mar. 31, 2018	$ 23,000	117,363,000	(86,328,000)	31,058,000	470,000	31,528,000
Balance (in shares) at Mar. 31, 2018	23,027,978
Balance at Dec. 31, 2017	$ 23,000	117,349,000	(86,040,000)	31,332,000	564,000	31,896,000
Balance (in shares) at Dec. 31, 2017	23,027,978
Net income (loss)						(724,000)
Balance at Sep. 30, 2018	$ 23,000	117,427,000	(86,796,000)	30,654,000	348,000	31,002,000
Balance (in shares) at Sep. 30, 2018	23,027,978
Balance at Mar. 31, 2018	$ 23,000	117,363,000	(86,328,000)	31,058,000	470,000	31,528,000
Balance (in shares) at Mar. 31, 2018	23,027,978
Stock-based compensation	$ 0	41,000	0	41,000	0	41,000
Distributions paid to noncontrolling interests	0	0	0	0	(132,000)	(132,000)
Net income (loss)	0	0	(207,000)	(207,000)	14,000	(193,000)
Balance at Jun. 30, 2018	$ 23,000	117,404,000	(86,535,000)	30,892,000	352,000	31,244,000
Balance (in shares) at Jun. 30, 2018	23,027,978
Stock-based compensation	$ 0	23,000	0	23,000	0	23,000
Distributions paid to noncontrolling interests	0	0	0	0	(19,000)	(19,000)
Net income (loss)	0	0	(261,000)	(261,000)	15,000	(246,000)
Balance at Sep. 30, 2018	$ 23,000	117,427,000	(86,796,000)	30,654,000	348,000	31,002,000
Balance (in shares) at Sep. 30, 2018	23,027,978
Balance at Dec. 31, 2018	$ 23,000	115,950,000	(86,956,000)	29,017,000	349,000	29,366,000
Balance (in shares) at Dec. 31, 2018	23,027,978
Stock-based compensation	$ 0	68,000	0	68,000	0	68,000
Distributions paid to noncontrolling interests	0	0	0	0	(13,000)	(13,000)
Net income (loss)	0	0	3,923,000	3,923,000	(123,000)	3,800,000
Balance at Mar. 31, 2019	$ 23,000	116,018,000	(83,033,000)	33,008,000	213,000	33,221,000
Balance (in shares) at Mar. 31, 2019	23,027,978
Balance at Dec. 31, 2018	$ 23,000	115,950,000	(86,956,000)	29,017,000	349,000	29,366,000
Balance (in shares) at Dec. 31, 2018	23,027,978
Net income (loss)						3,113,000
Balance at Sep. 30, 2019	$ 23,000	116,142,000	(83,744,000)	32,421,000	212,000	32,633,000
Balance (in shares) at Sep. 30, 2019	23,027,978
Balance at Mar. 31, 2019	$ 23,000	116,018,000	(83,033,000)	33,008,000	213,000	33,221,000
Balance (in shares) at Mar. 31, 2019	23,027,978
Stock-based compensation	$ 0	81,000	0	81,000	0	81,000
Distributions paid to noncontrolling interests	0	0	0	0	(12,000)	(12,000)
Net income (loss)	0	0	(769,000)	(769,000)	12,000	(757,000)
Balance at Jun. 30, 2019	$ 23,000	116,099,000	(83,802,000)	32,320,000	213,000	32,533,000
Balance (in shares) at Jun. 30, 2019	23,027,978
Stock-based compensation	$ 0	43,000	0	43,000	0	43,000
Distributions paid to noncontrolling interests	0	0	0	0	(13,000)	(13,000)
Net income (loss)	0	0	58,000	58,000	12,000	70,000
Balance at Sep. 30, 2019	$ 23,000	$ 116,142,000	$ (83,744,000)	$ 32,421,000	$ 212,000	$ 32,633,000
Balance (in shares) at Sep. 30, 2019	23,027,978

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Cash flows from operating activities:
Net income (loss)	$ 3,113,000	$ (724,000)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Amortization of debt issuance costs	101,000	176,000
Depreciation and amortization	1,332,000	2,350,000
Straight-line rents	(281,000)	(485,000)
Write-off of debt issuance costs	0	94,000
Stock-based compensation expense	192,000	78,000
Gain on sale of real estate properties	(4,227,000)	0
Gain on disposition of Friendswood TRS	0	(109,000)
Gain on notes receivable	0	(186,000)
Income from equity-method investees	(90,000)	(321,000)
Change in operating assets and liabilities:
Tenant and other receivables, net	302,000	505,000
Other assets	0	(9,000)
Accounts payable and accrued liabilities	80,000	231,000
Net cash provided by operating activities	522,000	1,600,000
Cash flows from investing activities:
Proceeds from sale of real estate properties, net of transaction costs	24,805,000	0
Real estate acquisition	0	(715,000)
Real estate additions	0	(75,000)
Investment in equity-method investees	(5,030,000)	(1,313,000)
Distributions received from equity-method investees	822,000	619,000
Issuance of notes receivable	(253,000)	0
Payments from notes receivable	323,000	4,231,000
Net cash provided by investing activities	20,667,000	2,747,000
Cash flows from financing activities:
Proceeds from issuance of loans payable	3,872,000	21,369,000
Payments of loans payable	(22,779,000)	(17,611,000)
Distributions payable	(1,499,000)	0
Distributions paid to noncontrolling interests	(38,000)	(248,000)
Debt issuance costs	(210,000)	(582,000)
Net cash (used in) provided by financing activities	(20,654,000)	2,928,000
Net increase in cash, cash equivalents and restricted cash	535,000	7,275,000
Cash, cash equivalents and restricted cash - beginning of period	14,956,000	7,298,000
Cash, cash equivalents and restricted cash - end of period	15,491,000	14,573,000
Supplemental disclosure of cash flow information:
Cash paid for interest	$ 1,776,000	$ 2,297,000

Organization

Organization	9 Months Ended
	Sep. 30, 2019
Organization
Organization	1. Organization Summit Healthcare REIT, Inc. (“Summit”) is a real estate investment trust that owns 100% of three properties, 95.3% of four properties, a 10% equity interest in an unconsolidated equity-method investment that holds 17 properties, a 35% equity interest in an unconsolidated equity-method investment that holds two properties, a 20% equity interest in an unconsolidated equity-method investment that holds two properties, a 10% equity interest in an unconsolidated equity-method investment that holds nine properties, a 10% equity interest in an unconsolidated equity-method investment that holds six properties and a 15% equity interest in an unconsolidated equity-method investment that holds 14 properties. Summit is a Maryland corporation, formed in 2004 under the General Corporation Law of Maryland for the purpose of investing in and owning real estate. As used in these notes, the “Company”, “we”, “us” and “our” refer to Summit and its consolidated subsidiaries, except where the context otherwise requires. We conduct substantially all of our operations through Summit Healthcare Operating Partnership, L.P. (the “Operating Partnership”), which is a Delaware limited partnership. We own a 99.88% general partner interest in the Operating Partnership, and Cornerstone Realty Advisors, LLC (“CRA”), a former affiliate, owns a 0.12% limited partnership interest. Our financial statements and the financial statements of the Operating Partnership are consolidated in the accompanying condensed consolidated financial statements. Cornerstone Healthcare Partners LLC – Consolidated Joint Venture We own 95% of Cornerstone Healthcare Partners LLC (“CHP LLC”), which was formed in 2012, and the remaining 5% noncontrolling interest is owned by Cornerstone Healthcare Real Estate Fund, Inc. (“CHREF”), an affiliate of CRA. CHP LLC is consolidated with our financial statements and owns four properties (the “JV Properties”) with another partially owned subsidiary. As of September 30, 2019, we own a 95.3% interest in the four JV Properties, and CHREF owns a 4.7% interest. See Note 13 for the disposition of real estate properties which includes one of the JV Properties. Summit Union Life Holdings, LLC – Equity-Method Investment In April 2015, through our Operating Partnership, we entered into a limited liability company agreement with Best Years, LLC (“Best Years”), an unrelated entity and a U.S.-based affiliate of Union Life Insurance Co, Ltd. (a Chinese corporation), and formed Summit Union Life Holdings, LLC (the “SUL JV”). The SUL JV is not consolidated in our condensed consolidated financial statements and is accounted for under the equity-method. As of September 30, 2019 and December 31, 2018, we have a 10% interest in the SUL JV which owns 17 properties. Summit Fantasia Holdings, LLC – Equity-Method Investment In September 2016, through our Operating Partnership, we entered into a limited liability company agreement with Fantasia Investment III LLC (“Fantasia”), an unrelated entity and a U.S.-based affiliate of Fantasia Holdings Group Co., Limited (a Chinese corporation listed on the Stock Exchange of Hong Kong (HKEX)), and formed Summit Fantasia Holdings, LLC (the “Fantasia JV”). The Fantasia JV is not consolidated in our condensed consolidated financial statements and is accounted for under the equity-method. As of September 30, 2019 and December 31, 2018, we have a 35% interest in the Fantasia JV which owns two properties. Summit Fantasia Holdings II, LLC – Equity-Method Investment In December 2016, through our Operating Partnership, we entered into a limited liability company agreement with Fantasia, and formed Summit Fantasia Holdings II, LLC (the “Fantasia II JV”). The Fantasia II JV is not consolidated in our condensed consolidated financial statements and is accounted for under the equity-method. As of September 30, 2019 and December 31, 2018, we have a 20% interest in the Fantasia II JV which owns two properties. Summit Fantasia Holdings III, LLC– Equity-Method Investment In July 2017, through our Operating Partnership, we entered into a limited liability company agreement with Fantasia and formed Summit Fantasia Holdings III, LLC (the “Fantasia III JV”). The Fantasia III JV is not consolidated in our condensed consolidated financial statements and is accounted for under the equity-method. As of September 30, 2019 and December 31, 2018, we have a 10% interest in the Fantasia III JV which owns nine properties. Summit Fantasy Pearl Holdings, LLC– Equity-Method Investment In October 2017, through our Operating Partnership, we entered into a limited liability company agreement with Fantasia, Atlantis Senior Living 9, LLC, a Delaware limited liability company (“Atlantis”), and Fantasy Pearl LLC, a Delaware limited liability company (“Fantasy”), and formed Summit Fantasy Pearl Holdings, LLC (the “FPH JV”). The FPH JV is not consolidated in our condensed consolidated financial statements and is accounted for under the equity-method. As of September 30, 2019 and December 31, 2018, we have a 10% interest in the FPH JV which owns six properties. Indiana JV– Equity-Method Investment In February 2019, through our wholly-owned subsidiary, Summit Indiana, LLC, we formed a new joint venture, a Delaware limited liability company (the “Indiana JV”). On March 13, 2019, we entered into a Limited Liability Company Agreement (the “Indiana JV Agreement”) with two unrelated parties: a real estate holding company and a global institutional asset management firm, both Delaware limited liability companies. The Indiana JV is not consolidated in our condensed consolidated financial statements and is accounted for under the equity-method. As of September 30, 2019, we have a 15% interest in the Indiana JV which owns 14 properties. Summit Healthcare Asset Management, LLC (TRS) Summit Healthcare Asset Management, LLC (“SAM TRS”) is our wholly-owned taxable REIT subsidiary (“TRS”). We serve as the manager of the SUL JV, Fantasia JV, Fantasia II JV, Fantasia III JV, and FPH JV, and as the operating member of the Indiana JV (collectively, our “Equity-Method Investments”), and provide management services in exchange for fees and reimbursements. All acquisition fees and asset management fees earned by us are paid to SAM TRS and expenses incurred by us, as the manager, are reimbursed from SAM TRS. See Notes 5 and 7 for further information.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2019
Summary of Significant Accounting Policies
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies For more information regarding our significant accounting policies and estimates, please refer to “Summary of Significant Accounting Policies” contained in the consolidated financial statements included in our Annual Report on Form 10‑K for the year ended December 31, 2018 filed with the Securities and Exchange Commission (“SEC”) on March 22, 2019. There have been no material changes to our policies since that filing except as noted under Recently Adopted Accounting Pronouncements. The accompanying condensed consolidated balance sheet at December 31, 2018 has been derived from the audited consolidated financial statements at that date. We assume that users of these condensed consolidated financial statements have read or have access to the audited December 31, 2018 consolidated financial statements and Management's Discussion and Analysis of Financial Condition and Results of Operations contained in our Annual Report on Form 10‑K for the year ended December 31, 2018 filed with the SEC on March 22, 2019 and that the adequacy of additional disclosure needed for a fair presentation, except in regard to material contingencies, may be determined in that context. Accordingly, footnotes and other disclosures which would substantially duplicate those contained in our most recent Annual Report on Form 10‑K for the year ended December 31, 2018 have been omitted in this report. Principles of Consolidation and Basis of Presentation The accompanying condensed consolidated financial statements include the accounts of the Company, its wholly-owned subsidiaries, the Operating Partnership (of which the Company owns 99.88%) and CHP LLC (of which the Company owns 95%). All intercompany accounts and transactions have been eliminated in consolidation. The accompanying financial information reflects all adjustments, which are, in the opinion of management, of a normal recurring nature and necessary for a fair presentation of our financial position, results of operations and cash flows for the interim periods. Interim results of operations are not necessarily indicative of the results to be expected for the full year. Operating results for the three and nine months ended September 30, 2019 are not necessarily indicative of the results that may be expected for the year ending December 31, 2019. Restricted Cash The following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the condensed consolidated balance sheets that sum to the total of the same such amounts shown on the condensed consolidated statements of cash flows. September 30, December 31, 2019 2018 Cash and cash equivalents $ 12,729,000 $ 11,463,000 Restricted cash 2,762,000 3,493,000 Total cash, cash equivalents, and restricted cash shown on the condensed consolidated statements of cash flows $ 15,491,000 $ 14,956,000 Recently Adopted Accounting Pronouncements On January 1, 2019, the Company adopted the FASB Accounting Standards Update (“ASU”) 2016‑02, Leases (“Topic 842”), using the modified retrospective approach and have elected the package of practical expedients permitted under the transition guidance within the new standard, which, among other things, permits us to carry forward our prior conclusions for lease classification, the ability not to reassess whether any existing or expired contracts contain leases, lease classifications for existing or expired leases, and initial direct costs on existing leases. We also made an accounting policy election to keep short-term leases less than twelve months off the balance sheet for all classes of underlying assets. The new standard requires a lessor to classify leases as either sales-, finance- or operating-type leases. A lease will be treated as a sales-type lease if it transfers all of the risks and rewards, as well as control of the underlying asset, to the lessee. If risks and rewards are conveyed without the transfer of control, the lease is treated as a financing lease. If the lessor does not convey risks and rewards or control, an operating lease results. After evaluating our tenant leases, we have concluded that these are operating-type leases. Additionally, lessors were provided with the option to elect a practical expedient allowing them to not separate lease and nonlease components in a contract for the purpose of revenue recognition and disclosure. This practical expedient is limited to circumstances in which: (i) the timing and pattern of transfer are the same for the nonlease component and the related lease component and (ii) the lease component, if accounted for separately, would be classified as an operating lease. This practical expedient causes an entity to assess whether a contract is predominantly lease or service based and recognize the entire contract under the relevant accounting guidance (i.e., predominantly lease-based would be accounted for under ASU 2016‑02 and predominantly service-based would be accounted for under the Revenue ASUs). The FASB also issued ASU 2018‑20 "Leases (Topic 842) - Narrow Improvements for Lessors," which provides lessors the ability to make an accounting policy election not to evaluate whether certain sales taxes and other similar taxes imposed by a governmental authority on a specific lease revenue producing transaction are the primary obligation of the lessor as owner of the underlying leased asset. A lessor that makes this election will exclude these taxes from the measurement of lease revenue and the associated expense. Upon adoption of ASC 842, we utilized this practical expedient in cases where real estate taxes were paid directly by our tenants to taxing authorities. For triple-net leasing arrangements in which the tenant remits payment for real estate taxes to us and we pay the taxing authority, we have included the associated revenue and expense in total rental revenues and property operating costs on the condensed consolidated statements of operations. This reporting had no impact on our net income. Additionally, under Topic 842, we must assess if all payments due under the lease are likely to be collected. If tenant lease payments are not likely to be collected, then the revenues will be recognized on a cash basis (or if the answer changes at a later date, the revenues are adjusted to reflect what it would have been on a cash basis) and the adjustments will be recorded through rental revenues, rather than bad debt expense. We did not have any collectability issues for the nine months ended September 30, 2019. As generally accepted accounting principles for lessors remains mostly unchanged, the adoption of Topic 842 did not have a material impact on the total amount of revenues recognized from our leases from our tenants, however, as of January 1, 2019, the presentation of our rental revenues and tenant reimbursements will be combined into one line item on our consolidated statements of operations under lease revenue. All tenant leases prior to January 1, 2019 will be presented under ASC 840. During the three months ended September 30, 2019 and 2018, the Company received $181,000 and $274,000, respectively, from its tenants for reimbursement of property taxes and insurance. During the nine months ended September 30, 2019 and 2018, the Company received $595,000 and $843,000, respectively, from its tenants for reimbursement of property taxes and insurance. Lake Forest Lease We have entered into a lease agreement, as amended, for corporate office space located in Lake Forest, California, which expires in April 2022 (the “LF Lease”). On January 1, 2019, the Company adopted Topic 842 and recorded a right-of-use asset and liability equal to the present value of the remaining lease payments within the consolidated balance sheet. As a result, the Company recognized a right-of-use asset (“ROU”) of $0.3 million and a lease liability of $0.3 million on its consolidated balance sheet as of January 1, 2019. Comparative periods are presented in accordance with ASC Topic 840 and do not include any retrospective adjustments to comparative periods to reflect the adoption of Topic 842. The adoption of this standard did not have any impact on the Company’s condensed consolidated statement of operations or the consolidated statement of cash flows. The LF Lease has fixed lease payments. We make separate payments to the lessor based on the lessor’s property and casualty insurance costs and the property taxes assessed on the property, as well as a portion of the common area maintenance associated with the property. We have elected the practical expedient not to separate lease and nonlease components for our corporate office lease. As of September 30, 2019, the Company had a ROU operating lease asset of $0.2 million recorded in other assets in our condensed consolidated balance sheets and a lease liability of $0.3 million recorded in our condensed consolidated balance sheets in accrued liabilities. The Company will recognize lease expense, calculated as the remaining cost of the lease allocated over the remaining lease term on a straight-line basis. Lease expense will be presented as part of continuing operations within general and administrative expenses in the condensed consolidated statement of operations. For the three and nine months ended September 30, 2019, the Company recognized $25,000 and $75,000, respectively, in lease expense. For the three and nine months ended September 30, 2019, the Company paid $25,000 and $75,000, respectively, in rent relating to the LF Lease. As a payment arising from an operating lease, the $75,000 will be classified within operating activities in the condensed consolidated statements of cash flows. As of September 30, 2019, the remaining lease term for LF Lease is 31 months. Because we do not have access to the discount rate implicit in the lease, we have utilized our estimated incremental borrowing rate as the discount rate. The estimated discount rate associated with our corporate operating lease is 5%. Pursuant to ASC 842, lease payments on the LF Lease for the period from October 1, 2019 to December 31, 2019 and for each of the following years ending December 31 are as follows: Year Lease payments October 1, 2019 to December 31, 2019 25,000 2020 104,000 2021 108,000 2022 36,000 Total lease payments $ 273,000 Less effect of discounting (18,000) Total lease liability 255,000 Pursuant to ASC 840, lease payments on the LF Lease as of December 31, 2018 were as follows: Year Lease payments 2019 100,000 2020 104,000 2021 108,000 2022 36,000 $ 348,000 Recently Issued Accounting Pronouncements In June 2016, the FASB issued ASU No. 2016‑13, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments , which requires that entities use a new forward looking “expected loss” model that generally will result in the earlier recognition of allowance for credit losses. The measurement of expected credit losses is based upon historical experience, current conditions, and reasonable and supportable forecasts that affect the collectability of the reported amount. In November 2018, the FASB issued ASU 2018‑19, Codification Improvements to Topic 326, Financial Instruments—Credit Losses (“ASU 2018‑19”), which amends ASU 2016‑13 to clarify that receivables arising from operating leases are not within the scope of Subtopic 326‑20, and instead, impairment of such receivables should be accounted for in accordance with Topic 842, Leases. ASU 2016‑13 and ASU 2018‑19 are effective for fiscal years and interim periods within those years beginning after December 15, 2019, with early adoption permitted as of the fiscal years beginning after December 15, 2018. An entity will apply the amendments in these updates through a cumulative-effect adjustment to retained earnings as of the beginning of the first reporting period in which the guidance is effective (that is, a modified-retrospective approach). The Company is currently evaluating the impact this guidance will have on its condensed consolidated financial statements when adopted.

Investments in Real Estate Prop

Investments in Real Estate Properties	9 Months Ended
	Sep. 30, 2019
Investments in Real Estate Properties
Investments in Real Estate Properties	3. Investments in Real Estate Properties As of September 30, 2019 and December 31, 2018, our investments in real estate properties including those held by our consolidated subsidiaries (excluding the 50 properties owned by our unconsolidated Equity-Method Investments) are set forth below: September 30, December 31, 2019 2018 Land $ 6,237,000 $ 8,003,000 Buildings and improvements 48,295,000 69,284,000 Less: accumulated depreciation (8,092,000) (11,162,000) Buildings and improvements, net 40,203,000 58,122,000 Furniture and fixtures 4,230,000 6,829,000 Less: accumulated depreciation (3,759,000) (5,952,000) Furniture and fixtures, net 471,000 877,000 Real estate properties, net $ 46,911,000 $ 67,002,000 For the three months ended September 30, 2019 and 2018, depreciation expense (excluding leasing commission amortization) was approximately $0.4 million and $0.7 million, respectively. For the nine months ended September 30, 2019 and 2018, depreciation expense (excluding leasing commission amortization) was approximately $1.3 million and $2.3 million, respectively. As of September 30, 2019, our portfolio consisted of seven real estate properties which were 100% leased to the tenants of the related facilities. See Note 13 for further information regarding the disposition of our four properties located in North Carolina in February 2019. The following table provides summary information regarding our portfolio (excluding the 50 properties owned by our unconsolidated Equity-Method Investments) as of September 30, 2019: Loans Payable, Excluding Debt Number Purchase Issuance of Property Location Date Purchased Type (1) Price Costs Beds Sheridan Care Center Sheridan, OR August 3, 2012 SNF $ 4,100,000 $ 4,523,000 51 Fernhill Care Center Portland, OR August 3, 2012 SNF 4,500,000 3,967,000 63 Friendship Haven Healthcare and Rehabilitation Center Galveston County, TX September 14, 2012 SNF 15,000,000 10,725,000 150 Pacific Health and Rehabilitation Center Tigard, OR December 24, 2012 SNF 8,140,000 6,614,000 73 Brookstone of Aledo Aledo, IL July 2, 2013 AL 8,625,000 7,013,000 66 Sundial Assisted Living Redding, CA December 18, 2013 AL 3,500,000 3,856,000 65 Pennington Gardens Chandler, AZ July 17, 2017 AL/MC 13,400,000 10,508,000 90 Total: $ 57,265,000 $ 47,206,000 558 (1) SNF is an abbreviation for skilled nursing facility. AL is an abbreviation for assisted living facility. MC is an abbreviation for memory care facility. Future Minimum Lease Payments The future minimum lease payments to be received under our existing tenant operating leases (excluding the 50 properties owned by our unconsolidated Equity-Method Investments) as of September 30, 2019, for the period from October 1, 2019 to December 31, 2019 and for each of the four following years and thereafter ending December 31 are as follows: Years ending October 1, 2019 to December 31, 2019 $ 1,330,000 2020 5,400,000 2021 5,511,000 2022 5,626,000 2023 5,742,000 Thereafter 34,331,000 $ 57,940,000 2019 Acquisitions None. 2018 Acquisitions Land Purchase – Redding, CA On March 30, 2018, we purchased the land under the HP Redding facility, Sundial Assisted Living, for $685,000 plus approximately $30,000 in acquisition costs. Additionally, the existing lease agreement for the Sundial Assisted Living tenant was amended to increase the annual rental payment by $36,000. Leasing Commissions As a self-managed REIT, we no longer pay leasing commissions. Leasing commissions are capitalized at cost and amortized on a straight-line basis over the related lease term. As of September 30, 2019 and December 31, 2018, total costs incurred were $1.1 million and $1.9 million, respectively, and the unamortized balance of capitalized leasing commissions was approximately $0.6 million and $1.1 million, respectively. Amortization expense for the three months ended September 30, 2019 and 2018 was approximately $18,000 and $35,000, respectively. Amortization expense for the nine months ended September 30, 2019 and 2018 was approximately $34,000 and $105,000, respectively.

Loans Payable

Loans Payable	9 Months Ended
	Sep. 30, 2019
Loans Payable
Loans Payable	4. Loans Payable As of September 30, 2019 and December 31, 2018, our loans payable consisted of the following: September 30, 2019 December 31, 2018 Loan payable to CIBC Bank USA in monthly installments of approximately $75,000, including cash collateral and interest at LIBOR plus 3.75% (5.82% and 6.12% at September 30, 2019 and December 31, 2018, respectively), due in March 2021, and collateralized by Friendship Haven. $ 10,725,000 $ 10,725,000 Loan payable to Capital One Multifamily Finance, LLC (insured by HUD) in monthly installments of approximately $49,000, including interest at a fixed rate of 4.23%, due in September 2053, and collateralized by Pennington Gardens. $ 10,508,000 $ 10,610,000 Loan payable to Healthcare Financial Solutions, LLC (refinanced with HUD-insured loan in April 2019) was due in monthly installments of approximately $21,000, including cash collateral and interest at LIBOR (floor of 0.50%) plus 4.0% (6.4% at December 31, 2018, respectively), and was collateralized by Sundial Assisted Living. $ — $ 2,800,000 Loans payable to ORIX Real Estate Capital, LLC (formerly Lancaster Pollard) (insured by HUD) in monthly installments of approximately $139,000, including interest, ranging from a fixed rate of 3.70% to 4.2%, due in September 2039 through April 2054, and as of September 30, 2019, collateralized by Sheridan, Fernhill, Pacific Health, Aledo and Sundial Assisted Living. As of December 31, 2018, collateralized by Sheridan, Fernhill, Pacific Health, Shelby, Hamlet, Carteret, Aledo and Danby. $ 25,973,000 $ 41,977,000 47,206,000 66,112,000 Less debt issuance costs (1,458,000) (2,062,000) Total loans payable $ 45,748,000 $ 64,050,000 As of September 30, 2019, we have total debt obligations of approximately $47.2 million that will mature between 2021 and 2054 (see Note 13 for the sale of our four North Carolina properties). See Note 3 for loans payable balance for each property. All of the loans payable have certain financial and non-financial covenants, including ratios and financial statement considerations. As of September 30, 2019, we were in compliance with all of our debt covenants. In connection with our loans payable, we incurred debt issuance costs. As of September 30, 2019 and December 31, 2018, the unamortized balance of the debt issuance costs was approximately $1.5 million and $2.1 million, respectively. These debt issuance costs are being amortized over the life of their respective financing agreements using the straight-line basis which approximates the effective interest rate method. For the three months ended September 30, 2019 and 2018, $44,000 and $63,000, respectively, of debt issuance costs were amortized and included in interest expense in our condensed consolidated statements of operations. For the nine months ended September 30, 2019 and 2018, $0.1 million and $0.3 million, respectively, of debt issuance costs were amortized and included in interest expense in our condensed consolidated statements of operations. During the three months ended September 30, 2019 and 2018, we incurred approximately $0.6 million and $0.8 million, respectively, of interest expense (excluding debt issuance costs amortization) related to our loans payable. During the nine months ended September 30, 2019 and 2018, we incurred approximately $1.9 million and $2.5 million, respectively, of interest expense (excluding debt issuance costs amortization) related to our loans payable. The principal payments due on the loans payable (excluding debt issuance costs) for the period from October 1, 2019 to December 31, 2019 and for each of the four following years and thereafter ending December 31 are as follows: Principal Years Ending Amount October 1, 2019 to December 31, 2019 $ 204,000 2020 836,000 2021 11,594,000 2022 903,000 2023 939,000 Thereafter 32,730,000 $ 47,206,000 The following information describes our loan activity for 2019 and 2018: CIBC Bank USA On March 30, 2018, CHP Friendswood SNF, LLC entered into a $10,725,000, three-year term loan and security agreement with CIBC Bank USA, which is collateralized by the Friendship Haven facility. We incurred approximately $0.2 million in debt issuance costs. The monthly payments, commencing in May 2018, consist of interest plus approximately $18,000 of cash loan guarantee payments, (increasing to $19,000 for year 2 and $20,000 for year 3), which will be held in a cash loan guarantee fund until maturity date. If the loan is refinanced prior to the maturity date, the loan payments in the cash loan guarantee fund will be released to us; otherwise at the maturity date, the loan payments in the cash loan guarantee fund will be released to the lender and applied to the outstanding principal balance. As of September 30, 2019 and December 31, 2018, the total amount in the cash loan guarantee fund was approximately $318,000 and $147,000, respectively, and is included in restricted cash in our condensed consolidated balance sheet. The loan may be prepaid with no penalty if the property is refinanced through a United States Department of Housing and Urban Development (“HUD”)-insured loan; otherwise we will be required to pay a prepayment premium of 2% of the loan balance prior to the first anniversary and 1% thereafter through maturity. See table above listing loans payable for further information. Capital One Multifamily Finance, LLC In September 2018, we refinanced our Capital One loan and entered into a HUD-insured loan with Capital One Multifamily Finance, LLC (“HUD Pennington Loan”) which is collateralized by the Pennington Gardens facility. The note contains a prepayment penalty of 10% in year 1, which reduces each year by 100 basis points, until there is no longer a prepayment penalty beginning in year 11. See table above listing loans payable for further information. Healthcare Financial Solutions, LLC We had an amended loan agreement for the Sundial Assisted Living property located in Redding, California, with Healthcare Financial Solutions, LLC (“HFS”) that was terminated on April 24, 2019 as the loan was refinanced with a HUD-insured loan (“HUD Redding Loan”) through ORIX Real Estate Capital, LLC ) (“ORIX”) (formerly Lancaster Pollard Mortgage Company). See below under ORIX for further information regarding the HUD Redding Loan. See table above listing loans payable for further information as of December 31, 2018. ORIX Real Estate Capital, LLC (formerly Lancaster Pollard Mortgage Company) We have several properties with HUD-insured loans from ORIX. See table above listing loans payable for further information. As noted above, in April 2019, we entered into the HUD Redding Loan, which is collateralized by the Sundial Assisted Living facility. The loan bears interest at a fixed rate of 4.2%, plus 0.65% for mortgage insurance premiums, for the term of the loan. The loan matures in April 2054 and amortizes over 35 years. We incurred approximately $210,000 in debt issuance costs. The note contains a prepayment penalty of 10% in year 1, which reduces each year by 100 basis points, until there is no longer a prepayment penalty beginning in year 11. All of the HUD-insured loans are subject to customary representations, warranties and ongoing covenants and agreements with respect to the operation of the facilities, including the provision for certain maintenance and other reserve accounts for property tax, insurance, and capital expenditures, with respect to the facilities all as described in the HUD agreements. These reserves are included in restricted cash in our condensed consolidated balance sheets.

Equity-Method Investments

Equity-Method Investments	9 Months Ended
	Sep. 30, 2019
Equity-Method Investments
Equity-Method Investments	5. Equity-Method Investments As of September 30, 2019 and December 31, 2018, the balances of our Equity-Method Investments were approximately $13.5 million and $9.7 million, respectively, and are as follows: Summit Union Life Holdings, LLC The SUL JV will exist until an event of dissolution occurs, as defined in the limited liability company agreement of the SUL JV (the “SUL LLC Agreement”). Under the SUL LLC Agreement, net operating cash flow of the SUL JV will be distributed monthly, first to the Operating Partnership and Best Years pari passu up to a 9% to 10% annual return, as defined, and thereafter to Best Years 75% and the Operating Partnership 25%. All capital proceeds from the sale of the properties held by the SUL JV, a refinancing or another capital event will be paid first to the Operating Partnership and Best Years pari passu until each has received an amount equal to its accrued but unpaid 9% to 10% return plus its total contribution, and thereafter to Best Years 75% and the Operating Partnership 25%. In April 2015, the Operating Partnership recorded a receivable for approximately $362,000 for distributions that could not be paid prior to the contribution of the original six properties contributed in April 2015 (“JV 2 Properties”) due to cash restrictions related to the loans payable for the contributed JV 2 Properties. As of September 30, 2019 and December 31, 2018, the receivable balance of $184,000 due from the JV 2 properties is included in tenant and other receivables in our condensed consolidated balance sheets. As of September 30, 2019 and December 31, 2018, we had a receivable balance of $0 and $105,000, respectively, included in tenant and other receivables in our condensed consolidated balance sheets from one of the SUL JV properties related to cash retained by the property to be used for additional capital. In April 2019, approximately $54,000 was converted to capital and the remaining balance was refunded to us in cash. As of September 30, 2019 and December 31, 2018, the balance of our equity-method investment related to the SUL JV was approximately $3.3 million and $3.3 million, respectively. Summit Fantasia Holdings, LLC The Fantasia JV will exist until an event of dissolution occurs, as defined in the limited liability company agreement of the Fantasia JV (the “Fantasia LLC Agreement”). Under the Fantasia LLC Agreement, as amended in April 2018, net operating cash flow of the Fantasia JV will be distributed quarterly, first to the Operating Partnership and Fantasia pari passu until each member has received an amount equal to its accrued, but unpaid 8% return, and thereafter 50% to Fantasia and 50% to the Operating Partnership. All capital proceeds from the sale of the properties held by the Fantasia JV, a refinancing or another capital event, will be paid first to the Operating Partnership and Fantasia pari passu until each has received an amount equal to its accrued but unpaid 8% return plus its total capital contribution, and thereafter 50% to Fantasia and 50% to the Operating Partnership. As of September 30, 2019 and December 31, 2018, the balance of our equity-method investment related to the Fantasia JV was approximately $2.0 million and $2.2 million, respectively. Summit Fantasia Holdings II, LLC The Fantasia II JV will exist until an event of dissolution occurs, as defined in the limited liability company agreement of the Fantasia II JV (the “Fantasia II LLC Agreement”). Under the Fantasia II LLC Agreement, net operating cash flow of the Fantasia JV will be distributed quarterly, first to the Operating Partnership and Fantasia pari passu until each member has received an amount equal to its accrued, but unpaid 8% return, and thereafter 70% to Fantasia and 30% to the Operating Partnership. All capital proceeds from the sale of the properties held by the Fantasia II JV, a refinancing or another capital event, will be paid first to the Operating Partnership and Fantasia pari passu until each has received an amount equal to its accrued but unpaid 8% return plus its total capital contribution, and thereafter 70% to Fantasia and 30% to the Operating Partnership. As of September 30, 2019 and December 31, 2018, the balance of our equity-method investment related to the Fantasia II JV was approximately $1.5 million and $1.6 million, respectively. Summit Fantasia Holdings III, LLC The Fantasia III JV will continue until an event of dissolution occurs, as defined in the limited liability company agreement of the Fantasia III JV (the “Fantasia III LLC Agreement”). Under the Fantasia III LLC Agreement, net operating cash flow of the Fantasia III JV will be distributed quarterly, first to the Operating Partnership and Fantasia pari passu until each member has received an amount equal to its accrued, but unpaid 9% return, and thereafter 75% to Fantasia and 25% to the Operating Partnership. All capital proceeds from the sale of the properties held by the Fantasia III JV, a refinancing or another capital event, will be paid first to the Operating Partnership and Fantasia pari passu until each has received an amount equal to its accrued but unpaid 9% return plus its total capital contribution, and thereafter 75% to Fantasia and 25% to the Operating Partnership. As of September 30, 2019 and December 31, 2018, the balance of our equity-method investment related to the Fantasia III JV was approximately $1.7 million and $1.7 million, respectively. Summit Fantasy Pearl Holdings, LLC The FPH JV will continue until an event of dissolution occurs, as defined in the limited liability company agreement of the FPH JV (the “FPH LLC Agreement”). Under the FPH LLC Agreement, net operating cash flow of the FPH JV will be distributed quarterly, first to the members pari passu until each member has received an amount equal to its accrued, but unpaid 9% return, and thereafter 65.25% to Fantasy, 7.5% to Atlantis, 7.25% to Fantasia and 20% to the Operating Partnership. All capital proceeds from the sale of the properties held by the FPH JV, a refinancing or another capital event, will be paid to the members pari passu until each has received an amount equal to its accrued but unpaid 9% return plus its total capital contribution, and thereafter 65.25% to Fantasy, 7.5% to Atlantis, 7.25% to Fantasia, and 20% to the Operating Partnership. As of September 30, 2019 and December 31, 2018, the balance of our equity-method investment related to the FPH JV was approximately $0.5 million and $0.9 million, respectively. Indiana JV The Indiana JV will continue until an event of dissolution occurs, as defined in the Indiana JV Agreement. Under the Indiana JV Agreement, net operating cash flow of the Indiana JV will be distributed monthly to the members pari passu in accordance with their respective capital percentages, and thereafter as defined in the Indiana JV Agreement. As of September 30, 2019, the balance of our equity-method investment related to the Indiana JV was approximately $4.5 million. Distributions from Equity-Method Investments As of September 30, 2019 and December 31, 2018, we have distributions receivable, which is included in tenant and other receivables in our condensed consolidated balance sheets, as follows: September 30, December 31, 2019 2018 SUL JV $ 129,000 $ 168,000 Fantasia JV 180,000 156,000 Fantasia II JV 42,000 52,000 Fantasia III JV 93,000 90,000 FPH JV 37,000 13,000 Indiana JV 128,000 — Total $ 609,000 $ 479,000 For the nine months ended September 30, 2019 and 2018, we have received cash distributions, which are included in our cash flows from operating activities in tenant and other receivables, and cash flows from investing activities, as follows: Nine Months Ended September 30, 2019 Nine Months Ended September 30, 2018 Cash Flow Cash Flow Cash Flow Cash Flow Total Cash from from Total Cash from from Distributions Operating Investing Distributions Operating Investing Received Activities Activities Received Activities Activities SUL JV $ 401,000 $ 155,000 $ 246,000 $ 379,000 $ 140,000 $ 239,000 Fantasia JV — — — 45,000 8,000 37,000 Fantasia II JV 212,000 138,000 74,000 191,000 45,000 146,000 Fantasia III JV 118,000 93,000 25,000 259,000 106,000 153,000 FPH JV 251,000 — 251,000 66,000 22,000 44,000 Indiana JV 226,000 — 226,000 — — — Total $ 1,208,000 $ 386,000 $ 822,000 $ 940,000 $ 321,000 $ 619,000 Acquisition and Asset Management Fees We serve as the manager or operating member of our Equity-Method Investments and provide management services in exchange for fees and reimbursements. As the manager, we are paid an acquisition fee, as defined in the applicable joint venture agreements. Additionally, as the manager or operating member, we are paid an annual asset management fee for managing the properties held by our Equity-Method Investments, as defined in the agreements. For the three months ended September 30, 2019 and 2018, we recorded approximately $0.3 million and $0.2 million, respectively, in acquisition and asset management fees from our Equity-Method Investments. For the nine months ended September 30, 2019 and 2018, we recorded approximately $0.9 million and $0.5 million, respectively, in acquisition and asset management fees from our Equity-Method Investments.

Receivables

Receivables	9 Months Ended
	Sep. 30, 2019
Receivables
Receivables	6. Receivables Notes Receivable Friendswood TRS Note The Operating Partnership entered into an amended and restated promissory note dated January 1, 2018, with Friendswood TRS for approximately $1.1 million. The note does not bear interest and is due in 48 equal payments of approximately $22,000. We recorded a discount of approximately $95,000 on the note using an imputed interest rate of 4.25%. As of September 30, 2019 and December 31, 2018, the balance on the note was approximately $0.5 million and $0.7 million, respectively. Tenant and Other Receivables, Net Tenant and other receivables, net consists of: September 30, December 31, 2019 2018 Straight-line rent receivables $ 2,469,000 $ 3,675,000 Distributions receivable from Equity-Method Investments 609,000 479,000 Receivable from JV 2 properties 184,000 184,000 Asset management fees 405,000 214,000 Other receivables 8,000 114,000 Total $ 3,675,000 $ 4,666,000

Related Party Transactions

Related Party Transactions	9 Months Ended
	Sep. 30, 2019
Related Party Transactions
Related Party Transactions	7. Related Party Transactions CRA Prior to the termination of our advisory agreement on April 1, 2014 with CRA (our former advisor, a related party), we incurred costs related to fees paid and costs reimbursed for services rendered to us by CRA through September 30, 2014. Some of the fees we had paid to CRA were considered to be in excess of allowed amounts and, therefore, CRA was required to reimburse us for the amount of the excess costs we paid to them. As of September 30, 2019 and December 31, 2018, the receivables from CRA are fully reserved due to the uncertainty of collectability and are included in tenant and other receivables in our condensed consolidated balance sheets (see Note 10). As of September 30, 2019 and December 31, 2018, we had the following receivables and reserves related to CRA: Receivables Reserves Balance Organizational and offering costs $ 738,000 $ (738,000) $ — Asset management fees and expenses 32,000 (32,000) — Operating expenses (direct and indirect) 189,000 (189,000) — Operating expenses (2%/25% Test) 1,717,000 (1,717,000) — Total $ 2,676,000 $ (2,676,000) $ — Equity-Method Investments See Note 5 for further discussion of distributions and acquisition and asset management fees related to our Equity-Method Investments.

Concentration of Risk

Concentration of Risk	9 Months Ended
	Sep. 30, 2019
Concentration of Risk
Concentration of Risk	8. Concentration of Risk Our cash is generally invested in short-term money market instruments. As of September 30, 2019, we had cash and cash equivalent accounts in excess of FDIC-insured limits. However, we do not believe the risk associated with this excess is significant. As of September 30, 2019, we owned one property in California, three properties in Oregon, one property in Texas, one property in Illinois, and one property in Arizona (excluding the 50 properties held by our Equity-Method Investments). Accordingly, there is a geographic concentration of risk subject to economic conditions in certain states. Additionally, for the three months ended September 30, 2019, we leased our seven real estate properties to five different tenants under long-term triple net leases, three of which comprise 35%, 19% and 15% of our tenant rental revenue. For the three months ended September 30, 2018, we leased our 11 real estate properties to five different tenants under long-term triple net leases, three of which comprised 41%, 24% and 14% of our tenant rental revenue. For the nine months ended September 30, 2019, we leased our seven real estate properties to five different tenants under long-term triple net leases, three of which comprise 31%, 18% and 13% of our real estate tenant rental revenue, respectively. For the nine months ended September 30, 2018, we leased our 11 healthcare properties to five different tenants under long-term triple net leases, three of which comprised 41%, 23% and 13% of our healthcare tenant rental revenue, respectively. As of September 30, 2019, we have one tenant that constitutes a significant asset concentration, as the net assets of the tenant are approximately 20% of our total assets. As of December 31, 2018, we had one tenant that constituted a significant asset concentration, however, four of the properties that made up that concentration were sold in February 2019 (see Note 13) and as such, this tenant no longer constitutes a significant asset concentration.

Fair Value Measurements of Fina

Fair Value Measurements of Financial Instruments	9 Months Ended
	Sep. 30, 2019
Fair Value Measurements of Financial Instruments
Fair Value Measurements of Financial Instruments	9. Fair Value Measurements of Financial Instruments Our condensed consolidated balance sheets include the following financial instruments: cash and cash equivalents, restricted cash, notes receivable, tenant and other receivables, certain other assets, accounts payable and accrued liabilities, security deposits and loans payable. With the exception of the Friendswood TRS note receivable (see Note 6) and loans payable discussed below, we consider the carrying values to approximate fair value for such financial instruments because of the short period of time between origination of the instruments and their expected payment. As of September 30, 2019 and December 31, 2018, the fair value of loans payable was $47.6 million and $66.5 million, compared to the principal balance (excluding debt discount) of $47.2 million and $66.1 million, respectively. The fair value of loans payable was estimated using lending rates available to us for financial instruments with similar terms and maturities. To estimate fair value as of September 30, 2019, we utilized discount rates ranging from 4.2% to 6.0% and a weighted average discount rate of 4.6%. As the inputs to our valuation estimate are neither observable in nor supported by market activity, our loans payable are classified as Level 3 assets within the fair value hierarchy. As of September 30, 2019 and December 31, 2018, the fair value of the Friendswood TRS note receivable (see Note 6) was $0.6 million compared to the carrying value of $0.5 million and $0.6 million, respectively. The fair value of the note receivable was estimated based on cash flow analysis at a weighted-average discount rate of 4.6%. As the inputs to our valuation estimate are neither observable in nor supported by market activity, our notes receivable are classified as Level 3 assets within the fair value hierarchy. As a result of our ongoing analysis for potential impairment of our investments in real estate, we may be required to adjust the carrying value of certain assets to their estimated fair values, or estimated fair value less selling costs, under certain circumstances. No impairments were recorded during the three and nine months ended September 30, 2019 and 2018. At September 30, 2019 and December 31, 2018, we do not have any financial assets or financial liabilities that are measured at fair value on a recurring basis in our condensed consolidated financial statements.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2019
Commitments and Contingencies
Commitments and Contingencies	10. Commitments and Contingencies We conduct a Phase I assessment for each of our properties at acquisition to evaluate whether hazardous or toxic substances are present on the properties. While there can be no assurance that a material environmental liability does not exist, we are not currently aware of any environmental liability with respect to the properties that would have a material effect on our consolidated financial condition, results of operations and cash flows. Further, we are not aware of any environmental liability or any unasserted claim or assessment with respect to an environmental liability that we believe would require additional disclosure or the recording of a loss contingency. Our commitments and contingencies include the usual obligations of real estate owners and licensed operators in the normal course of business. In the opinion of management, these matters are not expected to have a material impact on our consolidated financial condition, results of operations and cash flows. We are also subject to contingent losses resulting from litigation against the Company. Legal Proceedings On April 1, 2014, CRA and Cornerstone Ventures, Inc. filed a complaint in the Superior Court of California for the County of Orange-Central Justice Center, Case No. 30‑2014‑00714004‑CU-BT-CJC, naming the Company, its former directors, one of its officers and one of its former officers as defendants, seeking declaratory and injunctive relief and compensatory and punitive damages. On September 17, 2014, we filed a First Amended Cross-Complaint seeking compensatory damages and an accounting pursuant to Sections 10(c)(i) and 17(c)(ii) of the Advisory Agreement and including any monies Plaintiffs and Terry Roussel directly or indirectly received from or paid to the Company. On February 22, 2018, the action was assigned to a different trial judge. On May 29, 2018, the Company filed a motion for terminating and monetary sanctions against CRA, Cornerstone Ventures, Inc. and their counsel, Winget Spadafora & Schwartzberg. On November 30, 2018, the new trial judge vacated the trial date, pending resolution of the Company’s motion for terminating and monetary sanctions against CRA and Cornerstone Ventures, Inc. and denied the Company's motion for sanctions against Winget Spadafora & Schwartzberg. On February 13, 2019, the trial judge held another hearing on the Company’s motion for terminating and monetary sanctions and indicated that it intended to grant the Company’s motion for terminating sanctions and award the Company monetary sanctions. On March 14, 2019, the Court entered an Order and Judgment granting the Company’s motion for terminating sanctions, awarding the Company monetary sanctions in the amount of $588,672, and dismissing CRA and Cornerstone Ventures Inc.’s Complaint with prejudice. On May 21, 2019, CRA and Cornerstone Ventures, Inc. filed a notice of appeal from the Judgment and, on June 3, 2019, the Company filed a notice of cross-appeal from the Judgment. On July 9, 2019, the California Court of Appeal, Fourth District dismissed CRA and Cornerstone Ventures, Inc.'s appeal with prejudice. The Company's appeals against CRA, Cornerstone Ventures, Inc and Winget Spadafora & Schwartzberg are currently pending before the Court of Appeal, Fourth District. In September 2015, a bankruptcy petition was filed against Healthcare Real Estate Partners, LLC (“HCRE”) by the investors in Healthcare Real Estate Fund, LLC and Healthcare Real Estate Qualified Purchasers Fund, LLC (collectively, the “Funds”). HCRE did not timely respond to the involuntary petition and the Bankruptcy Court entered an Order of Relief making HCRE a debtor in bankruptcy. As a result, HCRE was removed as manager under the Funds’ operating agreement. Thereafter the Company became the manager of the Funds and purchased the investors’ interests in the Funds for approximately $0.9 million. Following the subsequent dismissal of the involuntary bankruptcy petition filed against it, HCRE filed a motion for attorneys’ fees and damages and a separate complaint for violation of the automatic stay against the petitioning creditors and the Company in the United States Bankruptcy Court of the District of Delaware. The Bankruptcy Court granted a motion to dismiss the complaint for violation of the automatic stay filed jointly by the petitioning creditors and us, and dismissed the complaint with prejudice. HCRE appealed the Bankruptcy Court’s decision to the United States District Court for the District of Delaware which affirmed the Bankruptcy Court’s dismissal of the complaint in a decision dated September 9, 2018. On October 11, 2018, HCRE appealed the District Court’s decision affirming the Bankruptcy Court’s dismissal of the complaint to the United States Court of Appeals for the Third Circuit. On October 22, 2019, the Third Circuit granted HCRE’s appeal, reversing the District Court and holding that HCRE could assert the adversary complaint seeking damages for violation of the automatic stay. The Company filed a Petition for Rehearing on November 5, 2019 asserting that HCRE is not entitled to assert a claim for damages for violation of the automatic stay. This Petition remains pending. The Bankruptcy Court has stayed all litigation on HCRE’s motion for damages pending resolution of the appeal on the complaint for violation of the automatic stay by the Court of Appeals. We believe that all of HCRE’s remaining alleged claims are without merit and will vigorously defend ourselves. Delbert Freeman and his company, Freescan Ventures, Inc. (collectively, “Freeman”), filed an action against us and Mr. Eikanas, our President, on December 21, 2017 for breach of contract arising out of the sale of the Athens project in Georgia. We originally guaranteed a lease for the development of the Athens project, which was ultimately sold to a third party in June of 2016, thereby releasing us from our obligation. Freeman sued for breach of contract based on an allegation that he was not paid profits he was promised from the proceeds of the project. Freeman is also alleging that he was promised consulting fees of $270,000 from us arising out of an alleged oral agreement to pay consulting fees of $10,000 per month. On May 8, 2019, Freeman agreed to voluntarily dismiss all claims in their complaint, with prejudice. In return, the Company agreed to dismiss its claims with prejudice as well. Accordingly, the Court has dismissed this action in its entirety, with prejudice. Indemnification and Employment Agreements We have entered into indemnification agreements with certain of our executive officers and directors which indemnify them against all judgments, penalties, fines and amounts paid in settlement and all expenses actually and reasonably incurred by him or her in connection with any proceeding. Additionally, effective October 1, 2018, we amended our employment agreements with our executive officers to extend the term of each agreement for an additional three years. These employment agreements include customary terms relating to salary, bonus, position, duties and benefits (including eligibility for equity compensation), as well as a cash payment following a change in control of the Company, as defined in such agreements. Management of our Equity-Method Investments As the manager of our Equity-Method Investments, we are responsible for managing the day-to-day operations and are, thus, subject to contingencies that may arise in the normal course of their operations. Additionally, we could be subject to a capital call from our Equity-Method Investments.

Equity

Equity	9 Months Ended
	Sep. 30, 2019
Equity
Equity	11. Equity Share-Based Compensation Plan Upon the grant of stock options, we determine the exercise price by using our estimated per-share value, which is calculated by aggregating the estimated fair value of our investments in real estate and the estimated fair value of our other assets, subtracting the book value of our liabilities, utilizing a discount for the fact that the shares are not currently traded on a national securities exchange and a lack of a control premium, and divided the total by the number of our common shares outstanding at the time the options were granted. The fair value of each grant is estimated on the date of grant using the Black-Scholes option-pricing model. Assumptions required by the model include the risk-free interest rate, the expected life of the options, the expected stock price volatility over the expected life of the options, and the expected distribution yield. Compensation expense for employee stock options is recognized ratably over the vesting term. The expected life of the options was based on the simplified method as we do not have sufficient historical exercise data. The risk-free interest rate was based on the U.S. Treasury yield curve at the date of grant using the expected life of the options at the date of grant. Volatility was based on historical volatility of the stock prices for a sample of publicly traded companies with risk profiles similar to ours. The valuation model applied in this calculation utilizes highly subjective assumptions that could potentially change over time, including the expected stock price volatility and the expected life of an option. On January 1, 2019, the Compensation Committee of the Board of Directors approved the issuance of 45,000 stock options under our Summit Healthcare REIT, Inc. 2015 Omnibus Incentive Plan (“Incentive Plan”) to our non-executive employees. The stock options vest monthly beginning on February 1, 2019 and continuing over a three-year period through January 1, 2022. The options expire 10 years from the grant date. The weighted-average fair value per share of the stock options granted was $0.61. On March 20, 2019, the Compensation Committee of the Board of Directors approved the issuance of 450,000 stock options under our Incentive Plan, 225,000 to each of our executives. The stock options were granted under the Incentive Plan, with 33% vesting on the grant date and the remaining 67% vesting in equal monthly installments beginning April 1, 2019 and continuing over a two-year period through March 1, 2021. The options expire 10 years from the grant date. The weighted-average fair value per share of the stock options granted was $0.57. On March 20, 2019, the Compensation Committee of the Board of Directors approved the issuance of 110,000 stock options under our Incentive Plan to our directors. The stock options vest monthly beginning on April 1, 2019 and continuing over a three-year period through March 1, 2022. The options expire 10 years from the grant date. The weighted-average fair value per share of the stock options granted was $0.60. The estimated fair value using the Black-Scholes option-pricing model with the following weighted average assumptions: 2019 Stock options granted 605,000 Expected volatility 21.75 % Expected term 5.5 years Risk-free interest rate 2.38 % Dividend yield — % Fair value per share $ 0.58 The following table summarizes our stock options as of September 30, 2019: Weighted Weighted Average Average Remaining Aggregate Exercise Contractual Intrinsic Options Price Term Value Options outstanding at January 1, 2019 1,230,908 $ 1.99 Granted 605,000 2.26 Exercised — Cancelled/forfeited — Options outstanding at September 30, 2019 1,835,908 $ 2.08 8.01 $ 1,374,000 Options exercisable at September 30, 2019 1,361,055 $ 2.02 7.61 $ 1,098,000 For our outstanding non-vested options as of September 30, 2019, the weighted average grant date fair value per share was $0.52. As of September 30, 2019, we have unrecognized stock-based compensation expense related to unvested stock options, net of forfeitures, which is expected to be recognized as follows: Years Ending December 31, October 1, 2019 to December 31, 2019 $ 43,000 2020 144,000 2021 58,000 2022 6,000 $ 251,000 The stock-based compensation expense reported for the three months ended September 30, 2019 and 2018 was approximately $43,000 and $23,000, respectively, and is included in general and administrative expense in the condensed consolidated statements of operations. The stock-based compensation expense reported for the nine months ended September 30, 2019 and 2018 was approximately $192,000 and $78,000, respectively, and is included in general and administrative expense in the condensed consolidated statements of operations.

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 2019
Earnings Per Share
Earnings Per Share	12. Earnings Per Share The following table presents the calculation of basic and diluted earnings per share (“EPS”) for the Company’s common stock for the three and nine months ended September 30, 2019 and 2018, and reconciles the weighted-average common shares outstanding used in the calculation of basic EPS to the weighted-average common shares outstanding used in the calculation of diluted EPS: Three Months Ended Nine Months Ended September 30, September 30, 2019 2018 2019 2018 Numerator: (Loss) income from continuing operations $ 70,000 $ (246,000) $ 3,113,000 $ (833,000) (Loss) income from continuing operations attributable to noncontrolling interest (12,000) (15,000) 99,000 (32,000) (Loss) income applicable to common stockholders, before discontinued operations 58,000 (261,000) (865,000) Income from discontinued operations — — — 109,000 Net (loss) income applicable to common stockholders $ 58,000 $ (261,000) $ 3,212,000 $ (756,000) Denominator: Basic: Denominator for basic EPS - weighted average shares 23,027,978 23,027,978 23,027,978 23,027,978 Effect of dilutive shares: Stock options 485,353 — 485,353 — Denominator for diluted EPS – adjusted weighted average shares 23,513,331 23,027,978 23,513,331 23,027,978 Basic EPS $ — $ (0.01) $ 0.14 $ (0.04) Diluted EPS $ — $ (0.01) $ 0.14 $ (0.04)

Dispositions

Dispositions	9 Months Ended
	Sep. 30, 2019
Dispositions
Dispositions	13. Dispositions Sale of Four North Carolina Properties On February 14, 2019, our wholly-owned subsidiaries HP Shelby, LLC, HP Hamlet, LLC, HP Carteret, LLC, and our 95%-owned subsidiary, HP Winston-Salem, LLC, pursuant to a Purchase and Sale Agreement (the “Agreement”) with Agemark Acquisition, LLC (the “Purchaser”), sold to the Purchaser (the “Sale”) the following four properties located in North Carolina (“NC Properties”): The Shelby House, a 72‑bed assisted living facility located in Shelby, North Carolina; The Hamlet House, a 60‑bed assisted living facility located in Hamlet, North Carolina, The Carteret House, a 64‑bed assisted living facility located in Newport, North Carolina and Danby House, a 100‑bed assisted living and memory care facility located in Winston-Salem, North Carolina. The total consideration received by the Company and its subsidiaries pursuant to the Agreement was $27.0 million in cash. The Company incurred approximately $1.2 million is transaction costs, mainly for the prepayment penalty related to the HUD-insured loans (the “HUD Loans”). On the date of the Sale, the total assets of the NC Properties were approximately $22.1 million, and liabilities were approximately $19.5 million, including approximately $19.4 million of outstanding principal to the HUD Loans. The HUD Loans were paid off in full using the proceeds of the Sale. As a result of the Sale, as of February 15, 2019, the NC Properties will no longer be included in our condensed consolidated financial statements. We recorded a gain of approximately $4.2 million on the sale of the NC Properties. TRS Disposition Friendswood TRS (“Friendswood TRS”) was our wholly-owned TRS, and is the licensed operator and tenant of Friendship Haven Healthcare and Rehabilitation Center (“Friendship Haven”). Effective as of January 1, 2018, we assigned our interest in Friendswood TRS to HMG Park Manor of Friendswood, LLC (“HMG”), the management company of Friendship Haven. Therefore, as of January 1, 2018, Friendswood TRS is no longer consolidated in our condensed consolidated financial statements. In January 2018, we recorded a gain of $109,000 on the disposition of Friendswood TRS, which is recorded in discontinued operations in the condensed consolidated statements of operations.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2019
Summary of Significant Accounting Policies
Principles of Consolidation and Basis of Presentation	Principles of Consolidation and Basis of Presentation The accompanying condensed consolidated financial statements include the accounts of the Company, its wholly-owned subsidiaries, the Operating Partnership (of which the Company owns 99.88%) and CHP LLC (of which the Company owns 95%). All intercompany accounts and transactions have been eliminated in consolidation. The accompanying financial information reflects all adjustments, which are, in the opinion of management, of a normal recurring nature and necessary for a fair presentation of our financial position, results of operations and cash flows for the interim periods. Interim results of operations are not necessarily indicative of the results to be expected for the full year. Operating results for the three and nine months ended September 30, 2019 are not necessarily indicative of the results that may be expected for the year ending December 31, 2019.
Restricted Cash	Restricted Cash The following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the condensed consolidated balance sheets that sum to the total of the same such amounts shown on the condensed consolidated statements of cash flows. September 30, December 31, 2019 2018 Cash and cash equivalents $ 12,729,000 $ 11,463,000 Restricted cash 2,762,000 3,493,000 Total cash, cash equivalents, and restricted cash shown on the condensed consolidated statements of cash flows $ 15,491,000 $ 14,956,000
Recently Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements On January 1, 2019, the Company adopted the FASB Accounting Standards Update (“ASU”) 2016‑02, Leases (“Topic 842”), using the modified retrospective approach and have elected the package of practical expedients permitted under the transition guidance within the new standard, which, among other things, permits us to carry forward our prior conclusions for lease classification, the ability not to reassess whether any existing or expired contracts contain leases, lease classifications for existing or expired leases, and initial direct costs on existing leases. We also made an accounting policy election to keep short-term leases less than twelve months off the balance sheet for all classes of underlying assets. The new standard requires a lessor to classify leases as either sales-, finance- or operating-type leases. A lease will be treated as a sales-type lease if it transfers all of the risks and rewards, as well as control of the underlying asset, to the lessee. If risks and rewards are conveyed without the transfer of control, the lease is treated as a financing lease. If the lessor does not convey risks and rewards or control, an operating lease results. After evaluating our tenant leases, we have concluded that these are operating-type leases. Additionally, lessors were provided with the option to elect a practical expedient allowing them to not separate lease and nonlease components in a contract for the purpose of revenue recognition and disclosure. This practical expedient is limited to circumstances in which: (i) the timing and pattern of transfer are the same for the nonlease component and the related lease component and (ii) the lease component, if accounted for separately, would be classified as an operating lease. This practical expedient causes an entity to assess whether a contract is predominantly lease or service based and recognize the entire contract under the relevant accounting guidance (i.e., predominantly lease-based would be accounted for under ASU 2016‑02 and predominantly service-based would be accounted for under the Revenue ASUs). The FASB also issued ASU 2018‑20 "Leases (Topic 842) - Narrow Improvements for Lessors," which provides lessors the ability to make an accounting policy election not to evaluate whether certain sales taxes and other similar taxes imposed by a governmental authority on a specific lease revenue producing transaction are the primary obligation of the lessor as owner of the underlying leased asset. A lessor that makes this election will exclude these taxes from the measurement of lease revenue and the associated expense. Upon adoption of ASC 842, we utilized this practical expedient in cases where real estate taxes were paid directly by our tenants to taxing authorities. For triple-net leasing arrangements in which the tenant remits payment for real estate taxes to us and we pay the taxing authority, we have included the associated revenue and expense in total rental revenues and property operating costs on the condensed consolidated statements of operations. This reporting had no impact on our net income. Additionally, under Topic 842, we must assess if all payments due under the lease are likely to be collected. If tenant lease payments are not likely to be collected, then the revenues will be recognized on a cash basis (or if the answer changes at a later date, the revenues are adjusted to reflect what it would have been on a cash basis) and the adjustments will be recorded through rental revenues, rather than bad debt expense. We did not have any collectability issues for the nine months ended September 30, 2019. As generally accepted accounting principles for lessors remains mostly unchanged, the adoption of Topic 842 did not have a material impact on the total amount of revenues recognized from our leases from our tenants, however, as of January 1, 2019, the presentation of our rental revenues and tenant reimbursements will be combined into one line item on our consolidated statements of operations under lease revenue. All tenant leases prior to January 1, 2019 will be presented under ASC 840. During the three months ended September 30, 2019 and 2018, the Company received $181,000 and $274,000, respectively, from its tenants for reimbursement of property taxes and insurance. During the nine months ended September 30, 2019 and 2018, the Company received $595,000 and $843,000, respectively, from its tenants for reimbursement of property taxes and insurance.
Lake Forest Lease	Lake Forest Lease We have entered into a lease agreement, as amended, for corporate office space located in Lake Forest, California, which expires in April 2022 (the “LF Lease”). On January 1, 2019, the Company adopted Topic 842 and recorded a right-of-use asset and liability equal to the present value of the remaining lease payments within the consolidated balance sheet. As a result, the Company recognized a right-of-use asset (“ROU”) of $0.3 million and a lease liability of $0.3 million on its consolidated balance sheet as of January 1, 2019. Comparative periods are presented in accordance with ASC Topic 840 and do not include any retrospective adjustments to comparative periods to reflect the adoption of Topic 842. The adoption of this standard did not have any impact on the Company’s condensed consolidated statement of operations or the consolidated statement of cash flows. The LF Lease has fixed lease payments. We make separate payments to the lessor based on the lessor’s property and casualty insurance costs and the property taxes assessed on the property, as well as a portion of the common area maintenance associated with the property. We have elected the practical expedient not to separate lease and nonlease components for our corporate office lease. As of September 30, 2019, the Company had a ROU operating lease asset of $0.2 million recorded in other assets in our condensed consolidated balance sheets and a lease liability of $0.3 million recorded in our condensed consolidated balance sheets in accrued liabilities. The Company will recognize lease expense, calculated as the remaining cost of the lease allocated over the remaining lease term on a straight-line basis. Lease expense will be presented as part of continuing operations within general and administrative expenses in the condensed consolidated statement of operations. For the three and nine months ended September 30, 2019, the Company recognized $25,000 and $75,000, respectively, in lease expense. For the three and nine months ended September 30, 2019, the Company paid $25,000 and $75,000, respectively, in rent relating to the LF Lease. As a payment arising from an operating lease, the $75,000 will be classified within operating activities in the condensed consolidated statements of cash flows. As of September 30, 2019, the remaining lease term for LF Lease is 31 months. Because we do not have access to the discount rate implicit in the lease, we have utilized our estimated incremental borrowing rate as the discount rate. The estimated discount rate associated with our corporate operating lease is 5%. Pursuant to ASC 842, lease payments on the LF Lease for the period from October 1, 2019 to December 31, 2019 and for each of the following years ending December 31 are as follows: Year Lease payments October 1, 2019 to December 31, 2019 25,000 2020 104,000 2021 108,000 2022 36,000 Total lease payments $ 273,000 Less effect of discounting (18,000) Total lease liability 255,000 Pursuant to ASC 840, lease payments on the LF Lease as of December 31, 2018 were as follows: Year Lease payments 2019 100,000 2020 104,000 2021 108,000 2022 36,000 $ 348,000
Recently Issued Accounting Pronouncements	Recently Issued Accounting Pronouncements In June 2016, the FASB issued ASU No. 2016‑13, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments , which requires that entities use a new forward looking “expected loss” model that generally will result in the earlier recognition of allowance for credit losses. The measurement of expected credit losses is based upon historical experience, current conditions, and reasonable and supportable forecasts that affect the collectability of the reported amount. In November 2018, the FASB issued ASU 2018‑19, Codification Improvements to Topic 326, Financial Instruments—Credit Losses (“ASU 2018‑19”), which amends ASU 2016‑13 to clarify that receivables arising from operating leases are not within the scope of Subtopic 326‑20, and instead, impairment of such receivables should be accounted for in accordance with Topic 842, Leases. ASU 2016‑13 and ASU 2018‑19 are effective for fiscal years and interim periods within those years beginning after December 15, 2019, with early adoption permitted as of the fiscal years beginning after December 15, 2018. An entity will apply the amendments in these updates through a cumulative-effect adjustment to retained earnings as of the beginning of the first reporting period in which the guidance is effective (that is, a modified-retrospective approach). The Company is currently evaluating the impact this guidance will have on its condensed consolidated financial statements when adopted.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2019
Summary of Significant Accounting Policies
Schedule of restrictions on Cash and Cash Equivalents	The following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the condensed consolidated balance sheets that sum to the total of the same such amounts shown on the condensed consolidated statements of cash flows. September 30, December 31, 2019 2018 Cash and cash equivalents $ 12,729,000 $ 11,463,000 Restricted cash 2,762,000 3,493,000 Total cash, cash equivalents, and restricted cash shown on the condensed consolidated statements of cash flows $ 15,491,000 $ 14,956,000
Schedule of lease payments on the LF Lease as per 842	Pursuant to ASC 842, lease payments on the LF Lease for the period from October 1, 2019 to December 31, 2019 and for each of the following years ending December 31 are as follows: Year Lease payments October 1, 2019 to December 31, 2019 25,000 2020 104,000 2021 108,000 2022 36,000 Total lease payments $ 273,000 Less effect of discounting (18,000) Total lease liability 255,000
Schedule of lease payments on the LF Lease as per 840	Pursuant to ASC 840, lease payments on the LF Lease as of December 31, 2018 were as follows: Year Lease payments 2019 100,000 2020 104,000 2021 108,000 2022 36,000 $ 348,000

Investments in Real Estate Pr_2

Investments in Real Estate Properties (Tables)	9 Months Ended
	Sep. 30, 2019
Investments in Real Estate Properties.
Schedule of Business Acquisitions, by Acquisition	As of September 30, 2019 and December 31, 2018, our investments in real estate properties including those held by our consolidated subsidiaries (excluding the 50 properties owned by our unconsolidated Equity-Method Investments) are set forth below: September 30, December 31, 2019 2018 Land $ 6,237,000 $ 8,003,000 Buildings and improvements 48,295,000 69,284,000 Less: accumulated depreciation (8,092,000) (11,162,000) Buildings and improvements, net 40,203,000 58,122,000 Furniture and fixtures 4,230,000 6,829,000 Less: accumulated depreciation (3,759,000) (5,952,000) Furniture and fixtures, net 471,000 877,000 Real estate properties, net $ 46,911,000 $ 67,002,000
Schedule of Real Estate Properties	The following table provides summary information regarding our portfolio (excluding the 50 properties owned by our unconsolidated Equity-Method Investments) as of September 30, 2019: Loans Payable, Excluding Debt Number Purchase Issuance of Property Location Date Purchased Type (1) Price Costs Beds Sheridan Care Center Sheridan, OR August 3, 2012 SNF $ 4,100,000 $ 4,523,000 51 Fernhill Care Center Portland, OR August 3, 2012 SNF 4,500,000 3,967,000 63 Friendship Haven Healthcare and Rehabilitation Center Galveston County, TX September 14, 2012 SNF 15,000,000 10,725,000 150 Pacific Health and Rehabilitation Center Tigard, OR December 24, 2012 SNF 8,140,000 6,614,000 73 Brookstone of Aledo Aledo, IL July 2, 2013 AL 8,625,000 7,013,000 66 Sundial Assisted Living Redding, CA December 18, 2013 AL 3,500,000 3,856,000 65 Pennington Gardens Chandler, AZ July 17, 2017 AL/MC 13,400,000 10,508,000 90 Total: $ 57,265,000 $ 47,206,000 558 (1) SNF is an abbreviation for skilled nursing facility. AL is an abbreviation for assisted living facility. MC is an abbreviation for memory care facility.
Schedule of Future Minimum Rental Payments to be received	The future minimum lease payments to be received under our existing tenant operating leases (excluding the 50 properties owned by our unconsolidated Equity-Method Investments) as of September 30, 2019, for the period from October 1, 2019 to December 31, 2019 and for each of the four following years and thereafter ending December 31 are as follows: Years ending October 1, 2019 to December 31, 2019 $ 1,330,000 2020 5,400,000 2021 5,511,000 2022 5,626,000 2023 5,742,000 Thereafter 34,331,000 $ 57,940,000

Loans Payable (Tables)

Loans Payable (Tables)	9 Months Ended
	Sep. 30, 2019
Loans Payable
Schedule of Debt	As of September 30, 2019 and December 31, 2018, our loans payable consisted of the following: September 30, 2019 December 31, 2018 Loan payable to CIBC Bank USA in monthly installments of approximately $75,000, including cash collateral and interest at LIBOR plus 3.75% (5.82% and 6.12% at September 30, 2019 and December 31, 2018, respectively), due in March 2021, and collateralized by Friendship Haven. $ 10,725,000 $ 10,725,000 Loan payable to Capital One Multifamily Finance, LLC (insured by HUD) in monthly installments of approximately $49,000, including interest at a fixed rate of 4.23%, due in September 2053, and collateralized by Pennington Gardens. $ 10,508,000 $ 10,610,000 Loan payable to Healthcare Financial Solutions, LLC (refinanced with HUD-insured loan in April 2019) was due in monthly installments of approximately $21,000, including cash collateral and interest at LIBOR (floor of 0.50%) plus 4.0% (6.4% at December 31, 2018, respectively), and was collateralized by Sundial Assisted Living. $ — $ 2,800,000 Loans payable to ORIX Real Estate Capital, LLC (formerly Lancaster Pollard) (insured by HUD) in monthly installments of approximately $139,000, including interest, ranging from a fixed rate of 3.70% to 4.2%, due in September 2039 through April 2054, and as of September 30, 2019, collateralized by Sheridan, Fernhill, Pacific Health, Aledo and Sundial Assisted Living. As of December 31, 2018, collateralized by Sheridan, Fernhill, Pacific Health, Shelby, Hamlet, Carteret, Aledo and Danby. $ 25,973,000 $ 41,977,000 47,206,000 66,112,000 Less debt issuance costs (1,458,000) (2,062,000) Total loans payable $ 45,748,000 $ 64,050,000
Schedule of Maturities of Long-term Debt	The principal payments due on the loans payable (excluding debt issuance costs) for the period from October 1, 2019 to December 31, 2019 and for each of the four following years and thereafter ending December 31 are as follows: Principal Years Ending Amount October 1, 2019 to December 31, 2019 $ 204,000 2020 836,000 2021 11,594,000 2022 903,000 2023 939,000 Thereafter 32,730,000 $ 47,206,000

Equity-Method Investments (Tabl

Equity-Method Investments (Tables)	9 Months Ended
	Sep. 30, 2019
Equity-Method Investments
Schedule of Distributions receivable	As of September 30, 2019 and December 31, 2018, we have distributions receivable, which is included in tenant and other receivables in our condensed consolidated balance sheets, as follows: September 30, December 31, 2019 2018 SUL JV $ 129,000 $ 168,000 Fantasia JV 180,000 156,000 Fantasia II JV 42,000 52,000 Fantasia III JV 93,000 90,000 FPH JV 37,000 13,000 Indiana JV 128,000 — Total $ 609,000 $ 479,000
Schedule of Cash Distributions	For the nine months ended September 30, 2019 and 2018, we have received cash distributions, which are included in our cash flows from operating activities in tenant and other receivables, and cash flows from investing activities, as follows: Nine Months Ended September 30, 2019 Nine Months Ended September 30, 2018 Cash Flow Cash Flow Cash Flow Cash Flow Total Cash from from Total Cash from from Distributions Operating Investing Distributions Operating Investing Received Activities Activities Received Activities Activities SUL JV $ 401,000 $ 155,000 $ 246,000 $ 379,000 $ 140,000 $ 239,000 Fantasia JV — — — 45,000 8,000 37,000 Fantasia II JV 212,000 138,000 74,000 191,000 45,000 146,000 Fantasia III JV 118,000 93,000 25,000 259,000 106,000 153,000 FPH JV 251,000 — 251,000 66,000 22,000 44,000 Indiana JV 226,000 — 226,000 — — — Total $ 1,208,000 $ 386,000 $ 822,000 $ 940,000 $ 321,000 $ 619,000

Receivables (Tables)

Receivables (Tables)	9 Months Ended
	Sep. 30, 2019
Receivables
Schedule of tenant and other receivables	Tenant and other receivables, net consists of: September 30, December 31, 2019 2018 Straight-line rent receivables $ 2,469,000 $ 3,675,000 Distributions receivable from Equity-Method Investments 609,000 479,000 Receivable from JV 2 properties 184,000 184,000 Asset management fees 405,000 214,000 Other receivables 8,000 114,000 Total $ 3,675,000 $ 4,666,000

Related Party Transactions (Tab

Related Party Transactions (Tables)	9 Months Ended
	Sep. 30, 2019
Related Party Transactions
Schedule of Receivables and reserves related to CRA	As of September 30, 2019 and December 31, 2018, we had the following receivables and reserves related to CRA: Receivables Reserves Balance Organizational and offering costs $ 738,000 $ (738,000) $ — Asset management fees and expenses 32,000 (32,000) — Operating expenses (direct and indirect) 189,000 (189,000) — Operating expenses (2%/25% Test) 1,717,000 (1,717,000) — Total $ 2,676,000 $ (2,676,000) $ —

Equity (Tables)

Equity (Tables)	9 Months Ended
	Sep. 30, 2019
Equity
Schedule of Estimated fair value using assumptions	The estimated fair value using the Black-Scholes option-pricing model with the following weighted average assumptions: 2019 Stock options granted 605,000 Expected volatility 21.75 % Expected term 5.5 years Risk-free interest rate 2.38 % Dividend yield — % Fair value per share $ 0.58
Schedule of Stock options	The following table summarizes our stock options as of September 30, 2019: Weighted Weighted Average Average Remaining Aggregate Exercise Contractual Intrinsic Options Price Term Value Options outstanding at January 1, 2019 1,230,908 $ 1.99 Granted 605,000 2.26 Exercised — Cancelled/forfeited — Options outstanding at September 30, 2019 1,835,908 $ 2.08 8.01 $ 1,374,000 Options exercisable at September 30, 2019 1,361,055 $ 2.02 7.61 $ 1,098,000
Schedule of Unrecognized stock-based compensation expense	For our outstanding non-vested options as of September 30, 2019, the weighted average grant date fair value per share was $0.52. As of September 30, 2019, we have unrecognized stock-based compensation expense related to unvested stock options, net of forfeitures, which is expected to be recognized as follows: Years Ending December 31, October 1, 2019 to December 31, 2019 $ 43,000 2020 144,000 2021 58,000 2022 6,000 $ 251,000

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2019
Earnings Per Share
Schedule of basic and diluted earning per share and reconciliation weighted average common stock outstanding	The following table presents the calculation of basic and diluted earnings per share (“EPS”) for the Company’s common stock for the three and nine months ended September 30, 2019 and 2018, and reconciles the weighted-average common shares outstanding used in the calculation of basic EPS to the weighted-average common shares outstanding used in the calculation of diluted EPS: Three Months Ended Nine Months Ended September 30, September 30, 2019 2018 2019 2018 Numerator: (Loss) income from continuing operations $ 70,000 $ (246,000) $ 3,113,000 $ (833,000) (Loss) income from continuing operations attributable to noncontrolling interest (12,000) (15,000) 99,000 (32,000) (Loss) income applicable to common stockholders, before discontinued operations 58,000 (261,000) (865,000) Income from discontinued operations — — — 109,000 Net (loss) income applicable to common stockholders $ 58,000 $ (261,000) $ 3,212,000 $ (756,000) Denominator: Basic: Denominator for basic EPS - weighted average shares 23,027,978 23,027,978 23,027,978 23,027,978 Effect of dilutive shares: Stock options 485,353 — 485,353 — Denominator for diluted EPS – adjusted weighted average shares 23,513,331 23,027,978 23,513,331 23,027,978 Basic EPS $ — $ (0.01) $ 0.14 $ (0.04) Diluted EPS $ — $ (0.01) $ 0.14 $ (0.04)

Organization (Details)

Organization (Details)	9 Months Ended	12 Months Ended
	Sep. 30, 2019	Dec. 31, 2018
Organization [Line Items]
Equity Method Investment, Ownership Percentage	10.00%
Cornerstone Operating Partnership [Member]
Organization [Line Items]
Limited Liability Company (LLC) or Limited Partnership (LP), Members or Limited Partners, Ownership Interest	99.88%
Cornerstone Operating Partnership [Member] | Cornerstone Realty Advisors, LLC [Member]
Organization [Line Items]
Limited Liability Company (LLC) or Limited Partnership (LP), Members or Limited Partners, Ownership Interest by Affiliates	0.12%
Cornerstone Healthcare Partners [Member]
Organization [Line Items]
Limited Liability Company (LLC) or Limited Partnership (LP), Members or Limited Partners, Ownership Interest	95.00%
Cornerstone Healthcare Real Estate Fund [Member]
Organization [Line Items]
Limited Liability Company (LLC) or Limited Partnership (LP), Members or Limited Partners, Ownership Interest by Affiliates	5.00%
JV Properties [Member]
Organization [Line Items]
Noncontrolling Interest, Ownership Percentage by Noncontrolling Owners	4.70%
Summit Union Life Holding [Member]
Organization [Line Items]
Equity Method Investment, Ownership Percentage	10.00%
Four Jv Properties [Member]
Organization [Line Items]
Limited Liability Company (LLC) or Limited Partnership (LP), Members or Limited Partners, Ownership Interest	95.30%
Fantasia III JV
Organization [Line Items]
Limited Liability Company (LLC) or Limited Partnership (LP), Members or Limited Partners, Ownership Interest by Affiliates	10.00%	10.00%
Fantasia II JV
Organization [Line Items]
Limited Liability Company (LLC) or Limited Partnership (LP), Members or Limited Partners, Ownership Interest by Affiliates	20.00%
Equity Method Investment, Ownership Percentage	20.00%	20.00%
Fantasia JV
Organization [Line Items]
Limited Liability Company (LLC) or Limited Partnership (LP), Members or Limited Partners, Ownership Interest	35.00%
Summit Fantasia Holdings, LLC
Organization [Line Items]
Limited Liability Company (LLC) or Limited Partnership (LP), Members or Limited Partners, Ownership Interest by Affiliates	35.00%	35.00%
Summit Fantasy Pearl Holdings, LLC- Equity-Method Investment
Organization [Line Items]
Limited Liability Company (LLC) or Limited Partnership (LP), Members or Limited Partners, Ownership Interest	10.00%	10.00%
Summit Health Care Four Properties [Member]
Organization [Line Items]
Limited Liability Company (LLC) or Limited Partnership (LP), Members or Limited Partners, Ownership Interest by Affiliates	95.30%
Summit Health Care Three Properties [Member]
Organization [Line Items]
Equity Method Investment, Ownership Percentage	100.00%
Indiana JV
Organization [Line Items]
Limited Liability Company (LLC) or Limited Partnership (LP), Members or Limited Partners, Ownership Interest	15.00%
Equity Method Investment, Ownership Percentage	15.00%

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Restricted Cash (Details) - USD ($)	Sep. 30, 2019	Dec. 31, 2018	Sep. 30, 2018	Dec. 31, 2017
Summary of Significant Accounting Policies
Cash and cash equivalents	$ 12,729,000	$ 11,463,000
Restricted cash	2,762,000	3,493,000
Total cash, cash equivalents, and restricted cash shown on the consolidated statements of cash flows	$ 15,491,000	$ 14,956,000	$ 14,573,000	$ 7,298,000

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Lease liability (Details) - USD ($)	Dec. 31, 2019	Jan. 01, 2019	Dec. 31, 2018
Summary of Significant Accounting Policies
2019	$ 25,000		$ 100,000
2020	104,000		104,000
2021	108,000		108,000
2022	36,000		36,000
Total lease payments	273,000		$ 348,000
Less effect of discounting	(18,000)
Total lease liability	$ 255,000	$ 300,000

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Additional information (Details) - USD ($)	Sep. 30, 2019	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2019	Jan. 01, 2019
Summary of Significant Accounting Policies [Line Items]
Operating Lease, Right-of-Use Asset							$ 300,000
Operating Lease, Liability						$ 255,000	$ 300,000
Additions to Other Assets, Amount				$ 200,000
Accrued Liabilities	$ 300,000	$ 300,000		300,000
Operating Lease, Expense		25,000		75,000
Payments for Rent				75,000
Operating Lease, Payments		$ 25,000		$ 75,000
Operating Lease, Weighted Average Discount Rate, Percent	5.00%	5.00%		5.00%
Operating Remaining lease term	31 months
Tenant reimbursement		$ 181,000	$ 274,000	$ 595,000	$ 843,000
Operating Partnership [Member]
Summary of Significant Accounting Policies [Line Items]
Noncontrolling Interest, Ownership Percentage by Parent	99.88%	99.88%		99.88%
Cornerstone Healthcare Partners [Member]
Summary of Significant Accounting Policies [Line Items]
Noncontrolling Interest, Ownership Percentage by Parent	95.00%	95.00%		95.00%

Investments in Real Estate Pr_3

Investments in Real Estate Properties - Investments in real estate properties (Details) - USD ($)	Sep. 30, 2019	Dec. 31, 2018
Real Estate Properties [Line Items]
Real estate properties, net	$ 46,911,000	$ 67,002,000
Land [Member]
Real Estate Properties [Line Items]
Real estate properties, net	6,237,000	8,003,000
Buildings and improvements [Member]
Real Estate Properties [Line Items]
Investments in real estate	48,295,000	69,284,000
Less: accumulated depreciation	(8,092,000)	(11,162,000)
Real estate properties, net	40,203,000	58,122,000
Furniture and fixtures [Member]
Real Estate Properties [Line Items]
Investments in real estate	4,230,000	6,829,000
Less: accumulated depreciation	(3,759,000)	(5,952,000)
Real estate properties, net	$ 471,000	$ 877,000

Investments in Real Estate Pr_4

Investments in Real Estate Properties - Summary information regarding portfolio (Details)	Sep. 30, 2019USD ($)item
Real Estate Properties [Line Items]
Purchase Price	$ 57,265,000
Loans Payable, Excluding Debt Issuance Costs	$ 47,206,000
Number of Beds | item	558
Sheridan Care Center [Member]
Real Estate Properties [Line Items]
Purchase Price	$ 4,100,000
Loans Payable, Excluding Debt Issuance Costs	$ 4,523,000
Number of Beds | item	51
Fernhill Care Center [Member]
Real Estate Properties [Line Items]
Purchase Price	$ 4,500,000
Loans Payable, Excluding Debt Issuance Costs	$ 3,967,000
Number of Beds | item	63
Friendship Haven Healthcare and Rehabilitation Center [Member]
Real Estate Properties [Line Items]
Purchase Price	$ 15,000,000
Loans Payable, Excluding Debt Issuance Costs	$ 10,725,000
Number of Beds | item	150
Pacific Health and Rehabilitation Center [Member]
Real Estate Properties [Line Items]
Purchase Price	$ 8,140,000
Loans Payable, Excluding Debt Issuance Costs	$ 6,614,000
Number of Beds | item	73
Brookstone of Aledo [Member]
Real Estate Properties [Line Items]
Purchase Price	$ 8,625,000
Loans Payable, Excluding Debt Issuance Costs	$ 7,013,000
Number of Beds | item	66
Sundial Assisted Living [Member]
Real Estate Properties [Line Items]
Purchase Price	$ 3,500,000
Loans Payable, Excluding Debt Issuance Costs	$ 3,856,000
Number of Beds | item	65
Pennington Gardens [Member]
Real Estate Properties [Line Items]
Purchase Price	$ 13,400,000
Loans Payable, Excluding Debt Issuance Costs	$ 10,508,000
Number of Beds | item	90

Investments in Real Estate Pr_5

Investments in Real Estate Properties - Future Minimum Lease Payments (Details)	Sep. 30, 2019USD ($)
Investments in Real Estate Properties
2019	$ 1,330,000
2020	5,400,000
2021	5,511,000
2022	5,626,000
2023	5,742,000
Thereafter	34,331,000
Operating Leases, Future Minimum Payments Receivable	$ 57,940,000

Investments in Real Estate Pr_6

Investments in Real Estate Properties - Additional information (Details) - USD ($)	Mar. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Investments in Real Estate Properties
Percentage of Real Estate Properties				100.00%
Depreciation		$ 400,000	$ 700,000	$ 1,300,000	$ 2,300,000
Payments to Acquire Land	$ 685,000
Acquisition Costs, Period Cost	30,000
Increase In Annual Rental Payments	$ 36,000
Deferred Costs, Leasing, Net		624,000		624,000		$ 1,133,000
Amortization of Deferred Leasing Commissions		18,000	$ 35,000	34,000	$ 105,000
Deferred Costs		$ 1,100,000		$ 1,100,000		$ 1,900,000

Loans Payable - Debt (Details)

Loans Payable - Debt (Details) - USD ($)	Sep. 30, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Long-term Debt, Gross	$ 47,206,000	$ 66,112,000
Less debt issuance costs	(1,458,000)	(2,062,000)
Total loans payable	45,748,000	64,050,000
Cibc Bank [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross	10,725,000	10,725,000
Capital One Multifamily Finance LLC [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross	10,508,000	10,610,000
Healthcare Financial Solutions Llc [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross	0	2,800,000
ORIX Real Estate Capital, LLC [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross	$ 25,973,000	$ 41,977,000

Loans Payable (Details) _Parent

Loans Payable (Details) [Parenthetical] - USD ($)	1 Months Ended	9 Months Ended
	May 31, 2018	Sep. 30, 2019	Dec. 31, 2018
Cibc Bank [Member]
Debt Instrument, Periodic Payment	$ 18,000	$ 75,000
Debt Instrument, Basis Spread on Variable Rate		3.75%
Debt Instrument, Interest Rate, Stated Percentage		5.82%	6.12%
Capital One Multifamily Finance LLC [Member]
Debt Instrument, Periodic Payment		$ 49,000
Debt Instrument, Interest Rate, Stated Percentage		4.23%
Healthcare Financial Solutions Llc [Member]
Debt Instrument, Periodic Payment		$ 21,000
LIBOR floor (as a percentage)		0.50%
Debt Instrument, Description of Variable Rate Basis		4.0%
Debt Instrument, Interest Rate, Stated Percentage			6.40%
ORIX Real Estate Capital, LLC [Member]
Debt Instrument, Periodic Payment		$ 139,000
Debt Instrument, Description of Variable Rate Basis		0.65%
Debt Instrument, Interest Rate, Stated Percentage		4.20%
ORIX Real Estate Capital, LLC [Member] | Minimum [Member]
Debt Instrument, Interest Rate, Stated Percentage		3.70%
ORIX Real Estate Capital, LLC [Member] | Maximum [Member]
Debt Instrument, Interest Rate, Stated Percentage		4.20%

Loans Payable - Maturities of l

Loans Payable - Maturities of long term debt (Details)	Sep. 30, 2019USD ($)
Loans Payable
2019	$ 204,000
2020	836,000
2021	11,594,000
2022	903,000
2023	939,000
Thereafter	32,730,000
Total	$ 47,206,000

Loans Payable - Additional info

Loans Payable - Additional information (Details) - USD ($)	Mar. 30, 2018	May 31, 2018	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	May 31, 2021	May 31, 2020	Dec. 31, 2018
Debt Instrument [Line Items]
Interest Expense, Debt			$ 600,000	$ 800,000	$ 1,900,000	$ 2,500,000
Long-term Debt, Gross			47,206,000		47,206,000				$ 66,112,000
Debt Instrument, Unamortized Discount			1,458,000		1,458,000				$ 2,062,000
Amortization of Debt Discount (Premium)			44,000	$ 63,000	100,000	300,000
Payments of Debt Issuance Costs					210,000	$ 582,000
Healthcare Financial Solutions Llc [Member]
Debt Instrument [Line Items]
Debt Instrument, Periodic Payment					21,000
Debt Instrument, Interest Rate, Stated Percentage									6.40%
Long-term Debt, Gross			$ 0		$ 0				$ 2,800,000
Debt Instrument, Description of Variable Rate Basis					4.0%
Capital One National Association Loan [Member]
Debt Instrument [Line Items]
Debt Extinguishment Percentage					10.00%
Reduction in Prepayment penalty after year 1 (as a percent)					1
Cibc Bank [Member]
Debt Instrument [Line Items]
Debt Instrument, Periodic Payment		$ 18,000			$ 75,000
Debt Instrument, Interest Rate, Stated Percentage			5.82%		5.82%				6.12%
Long-term Debt, Gross			$ 10,725,000		$ 10,725,000				$ 10,725,000
Debt Instrument, Basis Spread on Variable Rate					3.75%
Long-term Debt, Fair Value	$ 10,725,000
Prepayment Premium percentage thereafter					1.00%
Payments of Debt Issuance Costs	$ 200,000
Prepayment Premium percentage Prior to First anniversary					2.00%
Restricted Cash			$ 318,000		$ 318,000				147,000
Cibc Bank [Member] | Scenario, Forecast [Member]
Debt Instrument [Line Items]
Debt Instrument, Periodic Payment							$ 20,000	$ 19,000
ORIX Real Estate Capital, LLC [Member]
Debt Instrument [Line Items]
Debt Instrument, Periodic Payment					$ 139,000
Debt Instrument, Interest Rate, Stated Percentage			4.20%		4.20%
Long-term Debt, Gross			$ 25,973,000		$ 25,973,000				$ 41,977,000
Debt Instrument, Description of Variable Rate Basis					0.65%
Debt Instrument, Term					35 years
Prepayment Premium percentage Prior to First anniversary					10.00%
Reduction in Prepayment penalty after year 1 (as a percent)					1
Debt Issuance Costs, Gross			$ 210,000		$ 210,000

Equity-Method Investments - Dis

Equity-Method Investments - Distributions receivable (Details ) - USD ($)	Sep. 30, 2019	Dec. 31, 2018
Dividends Receivable	$ 609,000	$ 479,000
SUL JV
Dividends Receivable	129,000	168,000
Fantasia JV
Dividends Receivable	180,000	156,000
Fantasia II JV
Dividends Receivable	42,000	52,000
Fantasia III JV
Dividends Receivable	93,000	90,000
FPH JV
Dividends Receivable	37,000	13,000
Indiana JV
Dividends Receivable	$ 128,000	$ 0

Equity-Method Investments - Cas

Equity-Method Investments - Cash Distributions (Details) - USD ($)	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Total Cash Distributions Received	$ 1,208,000	$ 940,000
Cash Flow from Operating Activities	386,000	321,000
Cash Flow from Investing Activities	822,000	619,000
SUL JV
Total Cash Distributions Received	401,000	379,000
Cash Flow from Operating Activities	155,000	140,000
Cash Flow from Investing Activities	246,000	239,000
Fantasia JV
Total Cash Distributions Received	0	45,000
Cash Flow from Operating Activities	0	8,000
Cash Flow from Investing Activities	0	37,000
Fantasia II JV
Total Cash Distributions Received	212,000	191,000
Cash Flow from Operating Activities	138,000	45,000
Cash Flow from Investing Activities	74,000	146,000
Fantasia III JV
Total Cash Distributions Received	118,000	259,000
Cash Flow from Operating Activities	93,000	106,000
Cash Flow from Investing Activities	25,000	153,000
FPH JV
Total Cash Distributions Received	251,000	66,000
Cash Flow from Operating Activities	0	22,000
Cash Flow from Investing Activities	251,000	44,000
Indiana JV
Total Cash Distributions Received	226,000	0
Cash Flow from Operating Activities	0	0
Cash Flow from Investing Activities	$ 226,000	$ 0

Equity-Method Investments - Add

Equity-Method Investments - Additional information (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Apr. 30, 2019	Dec. 31, 2018	Apr. 30, 2015
Equity Method Investment, Ownership Percentage	10.00%		10.00%
Equity Method Investments	$ 13,499,000		$ 13,499,000			$ 9,719,000
Dividends Receivable	609,000		609,000			479,000
Revenue from Contract with Customer, Including Assessed Tax	325,000	$ 177,000	861,000	$ 541,000
SUL JV acquired [Member]
Disposal Group, Including Discontinued Operation, Accounts, Notes and Loans Receivable, Net	0		0			105,000
Additional Paid in Capital					$ 54,000
Indiana JV
Equity Method Investments	4,500,000		$ 4,500,000
Summit Union Life Holdings, LLC [Member]
Minimum percentage of interest in annual return			9.00%
Percentage of interest in annual return			10.00%
Equity Method Investments	3,300,000		$ 3,300,000			3,300,000
Summit Union Life Holdings, LLC [Member] | Best Years Llc [Member]
Net Operating Cash Flows, Percentage of Interest			75.00%
Capital Proceeds, Percentage of Interest			75.00%
Summit Union Life Holdings, LLC [Member] | Operating Partnership [Member]
Net Operating Cash Flows, Percentage of Interest			25.00%
Capital Proceeds, Percentage of Interest			25.00%
Summit Fantasia Holdings Llc [Member]
Percentage of interest in annual return			8.00%
Equity Method Investments	2,000,000		$ 2,000,000			2,200,000
Summit Fantasia Holdings Llc [Member] | Fantasia Investment III LLC [Member]
Net Operating Cash Flows, Percentage of Interest			50.00%
Capital Proceeds, Percentage of Interest			50.00%
Summit Fantasia Holdings Llc [Member] | Operating Partnership [Member]
Net Operating Cash Flows, Percentage of Interest			50.00%
Summit Fantasia ll Holdings LLC [Member]
Percentage of interest in annual return			8.00%
Equity Method Investments	1,500,000		$ 1,500,000			1,600,000
Summit Fantasia ll Holdings LLC [Member] | Fantasia Investment III LLC [Member]
Net Operating Cash Flows, Percentage of Interest			70.00%
Capital Proceeds, Percentage of Interest			70.00%
Summit Fantasia ll Holdings LLC [Member] | Operating Partnership [Member]
Net Operating Cash Flows, Percentage of Interest			30.00%
Capital Proceeds, Percentage of Interest			30.00%
Summit Fantasia Holdings III, LLC [Member]
Percentage of interest in annual return			9.00%
Equity Method Investments	1,700,000		$ 1,700,000			1,700,000
Summit Fantasia Holdings III, LLC [Member] | Fantasia Investment III LLC [Member]
Net Operating Cash Flows, Percentage of Interest			75.00%
Capital Proceeds, Percentage of Interest			75.00%
Summit Fantasia Holdings III, LLC [Member] | Operating Partnership [Member]
Net Operating Cash Flows, Percentage of Interest			25.00%
Capital Proceeds, Percentage of Interest			25.00%
Summit Fantasy Pearl Holdings, LLC [Member]
Percentage of interest in annual return			9.00%
Equity Method Investments	500,000		$ 500,000			900,000
Summit Fantasy Pearl Holdings, LLC [Member] | Fantasia Investment III LLC [Member]
Net Operating Cash Flows, Percentage of Interest			7.25%
Capital Proceeds, Percentage of Interest			7.25%
Summit Fantasy Pearl Holdings, LLC [Member] | Summit Fantasy Pearl Holdings, LLC- Equity-Method Investment
Net Operating Cash Flows, Percentage of Interest			65.25%
Capital Proceeds, Percentage of Interest			65.25%
Summit Fantasy Pearl Holdings, LLC [Member] | Atlantis [Member]
Net Operating Cash Flows, Percentage of Interest			7.50%
Capital Proceeds, Percentage of Interest			7.50%
Summit Fantasy Pearl Holdings, LLC [Member] | Operating Partnership [Member]
Net Operating Cash Flows, Percentage of Interest			20.00%
Capital Proceeds, Percentage of Interest			20.00%
JV 2 Properties [Member]
Dividends Receivable	$ 184,000		$ 184,000			$ 184,000	$ 362,000

Receivables (Details)

Receivables (Details) - USD ($)	Sep. 30, 2019	Dec. 31, 2018
Receivables
Straight-line rent receivables	$ 2,469,000	$ 3,675,000
Distributions receivable from Equity-Method Investments	609,000	479,000
Receivable from JV 2 properties	184,000	184,000
Asset management fees	405,000	214,000
Other receivables	8,000	114,000
Total	$ 3,675,000	$ 4,666,000

Receivables - Additional Inform

Receivables - Additional Information (Details) - USD ($)	Jan. 01, 2018	Sep. 30, 2019	Dec. 31, 2018
Accounts, Notes, Loans and Financing Receivable [Line Items]
Receivable with Imputed Interest, Effective Yield (Interest Rate)		4.25%
Debt Instrument, Frequency of Periodic Payment	22,000
Receivable with Imputed Interest, Face Amount	$ 1,100,000
Accounts and Notes Receivable, Net		$ 500,000	$ 700,000
Friendswood TRS [Member]
Accounts, Notes, Loans and Financing Receivable [Line Items]
Receivable with Imputed Interest, Discount		$ 95,000

Related Party Transactions (Det

Related Party Transactions (Details) - Cornerstone Realty Advisors, LLC [Member]	Sep. 30, 2019USD ($)
Receivables	$ 2,676,000
Reserves	(2,676,000)
Balance	0
Organizational and offering costs [Member]
Receivables	738,000
Reserves	(738,000)
Balance	0
Asset management fees and expenses [Member]
Receivables	32,000
Reserves	(32,000)
Balance	0
Operating expenses (direct and indirect) [Member]
Receivables	189,000
Reserves	(189,000)
Balance	0
Operating expenses (2%/25% Test) [Member]
Receivables	1,717,000
Reserves	(1,717,000)
Balance	$ 0

Concentration of Risk (Details)

Concentration of Risk (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Tenant One, Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	35.00%	41.00%	31.00%	41.00%
Tenant Two, Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	19.00%	24.00%	18.00%	23.00%
Tenant Three, Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	15.00%	14.00%	13.00%	13.00%
Assets, Total [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage			20.00%

Fair Value Measurements of Fi_2

Fair Value Measurements of Financial Instruments (Details) - USD ($)	3 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Loans Payable, Fair Value Disclosure	$ 47,600,000		$ 66,500,000
Long-term Debt, Gross	47,206,000		66,112,000
Asset Impairment Charges	0	$ 0
Friendswood TRS [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Loans Payable, Fair Value Disclosure	600,000
Long-term Debt, Gross	$ 500,000		$ 600,000
Fair Value, Inputs Discount Rate, Loans payable	4.60%
Minimum [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair Value, Inputs Discount Rate, Loans payable	4.20%
Maximum [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair Value, Inputs Discount Rate, Loans payable	6.00%
Weighted Average [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair Value, Inputs Discount Rate, Loans payable	4.60%

Commitments and Contingencies (

Commitments and Contingencies (Details) - USD ($)	Mar. 14, 2019	Dec. 21, 2017	Sep. 30, 2019
consulting fees		$ 270,000
Payments for Repurchase of Equity			$ 900,000
Loss Contingency, Damages Sought, Value	$ 588,672
Alleged agreement [Member]
consulting fees		$ 10,000

Equity - Black-Scholes option-p

Equity - Black-Scholes option-pricing model (Details)	9 Months Ended
	Sep. 30, 2019$ / sharesshares
Equity
Stock options granted | shares	605,000
Expected Volatility	21.75%
Expected term	5 years 6 months
Risk-free interest rate	2.38%
Dividend yield	0.00%
Fair value per share | $ / shares	$ 0.58

Equity - Stock options (Details

Equity - Stock options (Details)	9 Months Ended
	Sep. 30, 2019USD ($)$ / sharesshares
Equity
Options outstanding, Beginning Balance	1,230,908
Granted	605,000
Exercised	0
Options outstanding, Ending Balance	1,835,908
Options exercisable, Ending Balance	1,361,055
Weighted Average Exercise Price, Outstanding at Beginning Balance | $ / shares	$ 1.99
Weighted Average Exercise Price, Granted | $ / shares	2.26
Weighted Average Exercise Price, Outstanding at Ending Balance | $ / shares	2.08
Weighted Average Exercise Price, Exercisable at Ending Balance | $ / shares	$ 2.02
Options outstanding, Weighted Average Remaining Contractual Term	8 years 4 days
Options exercisable, Weighted Average Remaining Contractual Term	7 years 7 months 10 days
Options outstanding, Aggregate Intrinsic Value | $	$ 1,374,000
Options exercisable, Aggregate Intrinsic Value | $	$ 1,098,000

Equity - Unrecognized stock-bas

Equity - Unrecognized stock-based compensation expense (Details)	Sep. 30, 2019USD ($)
Schedule of Equity Method Investments [Line Items]
Unrecognized stock-based compensation expense related to unvested stock options, net of forfeitures	$ 251,000
October 1, 2019 to December 31, 2019 (Member)
Schedule of Equity Method Investments [Line Items]
Unrecognized stock-based compensation expense related to unvested stock options, net of forfeitures	43,000
2020 [Member]
Schedule of Equity Method Investments [Line Items]
Unrecognized stock-based compensation expense related to unvested stock options, net of forfeitures	144,000
2021 [Member]
Schedule of Equity Method Investments [Line Items]
Unrecognized stock-based compensation expense related to unvested stock options, net of forfeitures	58,000
2022 [Member]
Schedule of Equity Method Investments [Line Items]
Unrecognized stock-based compensation expense related to unvested stock options, net of forfeitures	$ 6,000

Equity - Additional information

Equity - Additional information (Details) - USD ($)	Jan. 01, 2019	Apr. 30, 2019	Mar. 20, 2019	Apr. 02, 2018	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Schedule of Equity [Line Items]
Granted							605,000
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Weighted Average Grant Date Fair Value							$ 0.58
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Remaining Contractual Term							8 years 4 days
Share-based Compensation Arrangement by Share-based Payment Award, Options, Nonvested, Weighted Average Exercise Price, Beginning Balance					$ 0.52		$ 0.52
General and Administrative Expense [Member]
Schedule of Equity [Line Items]
Allocated Share-based Compensation Expense					$ 43,000	$ 23,000	$ 192,000	$ 78,000
Executive Officer One Member [Member]
Schedule of Equity [Line Items]
Granted			225,000
Omnibus Incentive Plan [Member]
Schedule of Equity [Line Items]
Granted	45,000		450,000
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Weighted Average Grant Date Fair Value	$ 0.61
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Remaining Contractual Term	10 years
Omnibus Incentive Plan [Member] | Share-based Payment Arrangement, Employee [Member]
Schedule of Equity [Line Items]
Granted			110,000
Omnibus Incentive Plan [Member] | Executive Management [Member]
Schedule of Equity [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Weighted Average Grant Date Fair Value			$ 0.57
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Rights, Percentage			33.00%
Omnibus Incentive Plan [Member] | Executive Management [Member] | Vest in Equal Monthly Installment [Member]
Schedule of Equity [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Rights, Percentage		67.00%
Incentive Plan [Member]
Schedule of Equity [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period				10 years
Incentive Plan [Member] | Director [Member]
Schedule of Equity [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Weighted Average Grant Date Fair Value			$ 0.60
Director Incentive Stock Plan [Member]
Schedule of Equity [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Remaining Contractual Term			10 years

Earnings Per Share (Details)

Earnings Per Share (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Numerator:
(Loss) income from continuing operations	$ 70,000	$ (246,000)	$ 3,113,000	$ (833,000)
(Loss) income from continuing operations attributable to noncontrolling interest	(12,000)	(15,000)	99,000	(32,000)
(Loss) income applicable to common stockholders, before discontinued operations	58,000	(261,000)	321,200	(865,000)
Income from discontinued operations	0	0	0	109,000
Net income (loss) applicable to common stockholders	$ 58,000	$ (261,000)	$ 3,212,000	$ (756,000)
Basic:
Denominator for basic EPS - weighted average shares	23,027,978	23,027,978	23,027,978	23,027,978
Effect of dilutive shares:
Stock options	485,353	0	485,353	0
Denominator for diluted EPS - adjusted weighted average shares	23,513,331	23,027,978	23,513,331	23,027,978
Basic EPS	$ 0	$ (0.01)	$ 0.14	$ (0.04)
Diluted EPS	$ 0	$ (0.01)	$ 0.14	$ (0.04)

Dispositions (Details)

Dispositions (Details) - USD ($)	1 Months Ended		9 Months Ended
	Feb. 14, 2019	Jan. 31, 2018	Sep. 30, 2019	Feb. 15, 2019	Dec. 31, 2018
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain (Loss) on Disposition of Real Estate, Discontinued Operations		$ 109,000
Equity Method Investment, Ownership Percentage			10.00%
Proceeds from Divestiture of Businesses	$ 27,000,000
Transaction Costs Related To Prepayment Penalty	$ 1,200,000
Liabilities			$ 48,756,000		$ 69,159,000
North Carolina Properties [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain (Loss) on Disposition of Real Estate, Discontinued Operations			$ 4,200,000
Property, Plant and Equipment, Net				$ 22,100,000
Liabilities				19,500,000
Loan payable disposition of properties				$ 19,400,000
HPShelby LLC [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Equity Method Investment, Ownership Percentage	95.00%