Summit Healthcare REIT 10-Q 8 Nov 18 2018 Q3 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	9 Months Ended
	Sep. 30, 2018	Nov. 05, 2018
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q3
Entity Registrant Name	Summit Healthcare REIT, Inc
Entity Central Index Key	1,310,383
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 Small Business	true

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($)	Sep. 30, 2018	Dec. 31, 2017
ASSETS
Cash and cash equivalents	$ 11,014,000	$ 3,851,000
Restricted cash	3,559,000	3,447,000
Real estate properties, net	67,615,000	69,063,000
Notes receivable	781,000	3,854,000
Tenant and other receivables, net	4,479,000	4,106,000
Deferred leasing commissions, net	1,168,000	1,273,000
Other assets, net	235,000	234,000
Equity-method investments	9,865,000	9,241,000
Assets of Friendswood TRS held for sale	0	1,762,000
Total assets	98,716,000	96,831,000
LIABILITIES AND EQUITY
Accounts payable and accrued liabilities	2,188,000	1,902,000
Accrued salaries and benefits	41,000	96,000
Security deposits	1,208,000	1,208,000
Loans payable, net of debt issuance costs	64,277,000	60,831,000
Liabilities of Friendswood TRS held for sale	0	898,000
Total liabilities	67,714,000	64,935,000
Commitments and contingencies
Stockholders' Equity
Preferred stock, $0.001 par value; 10,000,000 shares authorized; no shares issued or outstanding at September 30, 2018 and December 31, 2017	0	0
Common stock, $0.001 par value; 290,000,000 shares authorized; 23,027,978 shares issued and outstanding at September 30, 2018 and December 31, 2017	23,000	23,000
Additional paid-in capital	117,427,000	117,349,000
Accumulated deficit	(86,796,000)	(86,040,000)
Total stockholders' equity	30,654,000	31,332,000
Noncontrolling interests	348,000	564,000
Total equity	31,002,000	31,896,000
Total liabilities and equity	$ 98,716,000	$ 96,831,000

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Sep. 30, 2018	Dec. 31, 2017
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, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Revenues:
Tenant reimbursements	$ 274,000	$ 219,000	$ 843,000	$ 588,000
Interest income from notes receivable	13,000	44,000	48,000	132,000
Revenues, Total	2,533,000	2,200,000	7,628,000	5,802,000
Expenses:
Property operating costs	281,000	238,000	941,000	745,000
General and administrative	964,000	1,670,000	2,956,000	3,950,000
Depreciation and amortization	755,000	809,000	2,350,000	2,266,000
Costs and Expenses, Total	2,000,000	2,717,000	6,247,000	6,961,000
Operating income (loss)	533,000	(517,000)	1,381,000	(1,159,000)
Income from equity-method investee	62,000	73,000	321,000	251,000
Other income	25,000	5,000	63,000	37,000
Interest expense	(866,000)	(806,000)	(2,784,000)	(2,173,000)
Gain on note receivable	0	0	186,000	0
Loss from continuing operations	(246,000)	(1,245,000)	(833,000)	(3,044,000)
Discontinued operations:
Gain on disposition of Friendswood TRS	0	0	109,000	0
Income from Friendswood TRS	0	571,000	0	1,383,000
Income from discontinued operations	0	571,000	109,000	1,383,000
Net loss	(246,000)	(674,000)	(724,000)	(1,661,000)
Noncontrolling interests' share in net income	(15,000)	(15,000)	(32,000)	(40,000)
Net loss applicable to common stockholders	$ (261,000)	$ (689,000)	$ (756,000)	$ (1,701,000)
Basic and diluted loss per common share:
Continuing operations	$ (0.01)	$ (0.05)	$ (0.04)	$ (0.13)
Discontinued operations	0	0.02	0	0.06
Net loss applicable to common stockholders	$ (0.01)	$ (0.03)	$ (0.04)	$ (0.07)
Weighted average shares used to calculate basic and diluted net loss per common share	23,027,978	23,027,978	23,027,978	23,027,978
Real Estate [Member]
Revenues:
Operating Leases, Income Statement, Lease Revenue	$ 2,069,000	$ 1,644,000	$ 6,196,000	$ 4,488,000
Financial Service, Other [Member]
Revenues:
Revenue from Contract with Customer, Including Assessed Tax	$ 177,000	$ 293,000	$ 541,000	$ 594,000

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENT OF EQUITY - 9 months ended Sep. 30, 2018 - USD ($)	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Deficit [Member]	Total Stockholders' Equity [Member]	Noncontrolling Interests [Member]
Balance at Dec. 31, 2017	$ 31,896,000	$ 23,000	$ 117,349,000	$ (86,040,000)	$ 31,332,000	$ 564,000
Balance (in shares) at Dec. 31, 2017		23,027,978
Stock-based compensation	78,000	$ 0	78,000	0	78,000	0
Distributions paid to noncontrolling interests	(248,000)	0	0	0	0	(248,000)
Net (loss) income	(724,000)	0	0	(756,000)	(756,000)	32,000
Balance at Sep. 30, 2018	$ 31,002,000	$ 23,000	$ 117,427,000	$ (86,796,000)	$ 30,654,000	$ 348,000
Balance (in shares) at Sep. 30, 2018		23,027,978

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
Cash flows from operating activities:
Net loss	$ (724,000)	$ (1,661,000)
Adjustments to reconcile net loss to net cash provided by operating activities:
Amortization of debt issuance costs	176,000	136,000
Depreciation and amortization	2,350,000	2,307,000
Straight-line rents	(485,000)	(337,000)
Bad debt expense	0	148,000
Write-off of debt issuance costs	94,000	0
Stock-based compensation expense	78,000	83,000
Gain on disposition of Friendswood TRS	(109,000)	0
Gain on note receivable	(186,000)	0
Income from equity-method investees	(321,000)	(251,000)
Change in operating assets and liabilities:
Tenant and other receivables, net	505,000	398,000
Other assets	(9,000)	62,000
Accounts payable and accrued liabilities	286,000	459,000
Accrued salaries and benefits	(55,000)	(46,000)
Net cash provided by operating activities	1,600,000	1,298,000
Cash flows from investing activities:
Deferred costs and deposits	0	(482,000)
Real estate acquisition	(715,000)	(13,452,000)
Real estate additions	(75,000)	(122,000)
Investment in equity-method investees	(1,313,000)	(3,694,000)
Distributions received from equity-method investees	619,000	608,000
Payments from notes receivable	4,231,000	25,000
Net cash provided by (used in) investing activities	2,747,000	(17,117,000)
Cash flows from financing activities:
Proceeds from issuance notes payable	21,369,000	10,050,000
Payments of loans payable	(17,611,000)	(729,000)
Distributions paid to noncontrolling interests	(248,000)	(83,000)
Debt issuance costs	(582,000)	(172,000)
Net cash, cash equivalents and restricted cash provided by financing activities	2,928,000	9,066,000
Net increase (decrease) in cash, cash equivalents and restricted cash	7,275,000	(6,753,000)
Cash, cash equivalents and restricted cash – beginning of period	7,298,000	14,563,000
Cash, cash equivalents and restricted cash – end of period (including cash of Friendswood TRS)	14,573,000	7,810,000
Cash of Friendswood TRS held for sale – end of period (see Note 12)	0	(597,000)
Cash, cash equivalents and restricted cash – end of period	14,573,000	7,213,000
Supplemental disclosure of cash flow information:
Cash paid for interest	$ 2,297,000	$ 1,800,000

Organization

Organization	9 Months Ended
	Sep. 30, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization, Consolidation and Presentation of Financial Statements Disclosure [Text Block]	1. Organization Summit Healthcare REIT, Inc. (“Summit”) is a real estate investment trust that owns 100% of six properties, 95.3% of four properties, 95% of one property, 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 and a 10% equity interest in an unconsolidated equity-method investment that holds six 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% non-controlling 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 five properties (the “JV Properties”). As of September 30, 2018, we own a 95.3% interest in four of the JV Properties, and CHREF owns a 4.7% interest. We continue to own a 95% interest in the fifth JV Property, and CHREF owns a 5% interest in the fifth JV Property. 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 in our condensed consolidated financial statements. As of September 30, 2018 and December 31, 2017, 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 in our condensed consolidated financial statements. In April 2018, we made an additional capital contribution of $1.25 million to the Fantasia JV. As a result of this capital contribution, the Operating Partnership has a 35% equity investment (see Note 5) as of April 27, 2018. As of September 30, 2018 and December 31, 2017, we have a 35% and 20% interest, respectively, 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 in our condensed consolidated financial statements. As of September 30, 2018 and December 31, 2017, 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 in the Company’s condensed consolidated financial statements. As of September 30, 2018 and December 31, 2017, 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 in the Company’s condensed consolidated financial statements. As of September 30, 2018 and December 31, 2017, we have a 10% interest in the FPH JV which owns six 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 (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. Friendswood TRS 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. See Note 12 for further information regarding the transaction and the classification of assets, liabilities and operations for Friendswood TRS as of December 31, 2017 and for the three and nine months ended September 30, 2017.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2018
Accounting Policies [Abstract]
Significant Accounting Policies [Text Block]	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 our Annual Report on Form 10-K for the year ended December 31, 2017 filed with the Securities and Exchange Commission (“SEC”) on March 16, 2018. 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, 2017 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, 2017 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, 2017 filed with the SEC on March 16, 2018 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, 2017 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, 2018 are not necessarily indicative of the results that may be expected for the year ending December 31, 2018. Recently Adopted Accounting Pronouncements Restricted Cash On January 1, 2018, the Company adopted the Financial Accounting Standards Board (“FASB”) Accounting Standards Update (“ASU”) No. 2016-18, Statement of Cash Flows (Topic 230): Restricted Cash. The amendments in this ASU require that a statement of cash flows explain the change during the period in the total of cash, cash equivalents and amounts generally described as restricted cash or restricted cash equivalents. As a result, amounts generally described as restricted cash and restricted cash equivalents should be included with cash and cash equivalents when reconciling the beginning-of-period and end-of-period total amounts shown on the statement of cash flows. Our restricted cash consists of escrows from our tenants for property taxes, insurance and capital improvements required by and held by our lenders. The Company’s statements of cash flows for the nine months ended September 30, 2017 has been retroactively restated for the effect of adopting this ASU, adding approximately $3.8 million to the beginning of the period cash, cash equivalents and restricted cash and approximately $3.6 million to the end of the period cash, cash equivalents and restricted cash. This reclassification resulted in an increase to cash, cash equivalents and restricted cash provided by operating activities by $108,000 (related to the change in restricted cash held for operating activities) and a decrease to cash, cash equivalents and restricted cash used in investing activities by $339,000 (related to the change in restricted cash held for capital improvements). 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, 2018 December 31, 2017 Cash and cash equivalents $ 11,014,000 $ 3,851,000 Restricted cash 3,559,000 3,447,000 Total cash, cash equivalents, and restricted cash shown on the condensed consolidated statements of cash flows $ 14,573,000 $ 7,298,000 Revenue Recognition On January 1, 2018, the Company adopted Revenue from Contracts with Customers (Topic 606) . Our adoption of this new revenue recognition standard did not have a significant impact on our condensed consolidated financial statements as our rental revenue relates to triple net leases and related tenant reimbursements, which are excluded from this standard. Additionally, interest income from our notes receivable is excluded from this standard. Acquisition fees arise from contractual agreements with our joint venture partners and are earned and paid at the time we close an acquisition, therefore, satisfying our performance obligations at that time. We earn our asset management fees based on a percentage of the purchase price or equity raised. As the manager, our duty is to manage the day-to-day operations of the special-purpose entities which own the properties. Asset management fees are recognized as a single performance obligation (managing the properties) comprised of a series of distinct services (handling issues with our tenants, etc.). We believe that the overall service of asset management is substantially the same each day and has the same pattern of performance over the term of the agreement. As a result, each day of service represents a performance obligation satisfied at that point in time. These fees are recognized at the end of each period for services performed during that period, billed monthly and paid quarterly. Revenue recognition for acquisition and asset management fees did not change under the new standard. The Company elected the modified retrospective transition method, however, no adjustments were required. Recently Issued Accounting Pronouncements In February 2016, the FASB issued ASU No. 2016-02, Leases Leases - Targeted Improvements We continue to evaluate the impact of our adoption of this new standard in 2019 and we estimate the effect on our condensed consolidated financial statements could be approximately $0.3 million, as we have an operating lease that will be added to the assets and liabilities of our condensed consolidated balance sheet. As generally accepted accounting principles for lessors remains mostly unchanged, we do not expect it to have an impact on our leases from our tenants. Reclassifications Certain amounts related to the assets, liabilities and operations of Friendswood TRS have been reclassified in the Company’s condensed consolidated balance sheets and condensed consolidated statements of operations for prior year due to the classification of Friendswood TRS as held for sale (see Note 12). These reclassifications had no effect on total assets or liabilities or cash flows from operating activities. The reclassifications as of and for the three months ended September 30, 2017 increased our loss from continuing operations by $571,000, but did not change our net loss of $(674,000) or our net loss applicable to common stockholders of $(689,000). The reclassifications for the nine months ended September 30, 2017 increased our loss from continuing operations by $1,383,000, but did not change our net loss of $(1,661,000) or our net loss applicable to common stockholders of $(1,701,000). See above under Recently Adopted Accounting Pronouncements for reclassifications due to the adoption of ASU No. 2016-18, Statement of Cash Flows (Topic 230): Restricted Cash.

Investments in Real Estate Prop

Investments in Real Estate Properties	9 Months Ended
	Sep. 30, 2018
Real Estate [Abstract]
Real Estate Disclosure [Text Block]	3. Investments in Real Estate Properties As of September 30, 2018 and December 31, 2017, our investments in real estate properties including those held by our consolidated subsidiaries are set forth below: September 30, 2018 December 31, 2017 Land $ 8,003,000 $ 7,318,000 Buildings and improvements 69,285,000 69,254,000 Less: accumulated depreciation (10,643,000 ) (9,012,000 ) Buildings and improvements, net 58,642,000 60,242,000 Furniture and fixtures 6,829,000 6,755,000 Less: accumulated depreciation (5,859,000 ) (5,252,000 ) Furniture and fixtures, net 970,000 1,503,000 Real estate properties, net $ 67,615,000 $ 69,063,000 For the three months ended September 30, 2018 and 2017, depreciation expense (excluding leasing commission amortization) was approximately $0.7 million and $0.8 million, respectively. For the nine months ended September 30, 2018 and 2017, depreciation expense (excluding leasing commission amortization) was approximately $2.3 million and $2.2 million, respectively. As of September 30, 2018, our portfolio consisted of 11 real estate properties which were 100% leased to the tenants of the related facilities. The following table provides summary information regarding our portfolio (excluding the 36 properties owned by our unconsolidated Equity-Method Investments) as of September 30, 2018: Property Location Date Purchased Type (1) Purchase Price Loans Payable, Excluding Debt Issuance Costs Number of Beds Sheridan Care Center Sheridan, OR August 3, 2012 SNF $ 4,100,000 $ 4,670,000 51 Fernhill Care Center Portland, OR August 3, 2012 SNF 4,500,000 4,097,000 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 6,830,000 73 Danby House Winston-Salem, NC January 31, 2013 AL/MC 9,700,000 7,553,000 100 Brookstone of Aledo Aledo, IL July 2, 2013 AL 8,625,000 7,130,000 66 The Shelby House Shelby, NC October 4, 2013 AL 4,500,000 4,664,000 72 The Hamlet House Hamlet, NC October 4, 2013 AL 6,500,000 3,940,000 60 The Carteret House Newport, NC October 4, 2013 AL 4,300,000 3,324,000 64 Sundial Assisted Living Redding, CA December 18, 2013 AL 3,500,000 2,800,000 65 Pennington Gardens Chandler, AZ July 17, 2017 AL/MC 13,400,000 10,644,000 90 Total: $ 82,265,000 $ 66,377,000 854 (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 existing operating leases owned as of September 30, 2018, for the period from October 1, 2018 to December 31, 2018 and for each of the four following years and thereafter ending December 31 are as follows: Years ending October 1, 2018 to December 31, 2018 $ 1,915,000 2019 7,740,000 2020 7,902,000 2021 8,068,000 2022 8,237,000 Thereafter 60,988,000 $ 94,850,000 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. 2017 Acquisition - Chandler, AZ On July 17, 2017, we acquired a 100% interest in Pennington Gardens, a 90-bed assisted living/memory care facility located in Chandler, Arizona (“Pennington Gardens”), for a purchase price of $13.4 million plus approximately $52,000 in acquisition costs (allocated values were approximately $1.8 million to land, $10.9 million to building and improvements and $750,000 to furniture and fixtures), which was funded through cash on hand plus a collateralized loan (see Note 4). Pennington Gardens is leased pursuant to a 15-year triple net lease with two five-year renewal options, and per the lease agreement, we received a letter of credit in lieu of a cash security deposit. 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, 2018 and December 31, 2017, total costs incurred were $1.9 million and the unamortized balance of capitalized leasing commissions was approximately $1.2 million and $1.3 million, respectively. Amortization expense for the three months ended September 30, 2018 and 2017 was approximately $35,000. Amortization expense for the nine months ended September 30, 2018 and 2017 was approximately $105,000.

Loans Payable

Loans Payable	9 Months Ended
	Sep. 30, 2018
Debt Disclosure [Abstract]
Debt Disclosure [Text Block]	4. Loans Payable As of September 30, 2018 and December 31, 2017, our loans payable consisted of the following: September 30, 2018 December 31, 2017 Loan payable to CIBC Bank USA in monthly installments of approximately $60,000, including cash collateral and interest at LIBOR plus 3.75% (5.86% at September 30, 2018), due in March 2021, and collateralized by Friendship Haven. $ 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. $ 10,644,000 $ - Loan payable to Capital One, National Association in monthly installments of approximately $36,000, including interest at LIBOR plus 2.95% (4.3% at December 31, 2017), was terminated in September 2018 and was collateralized by Pennington Gardens. $ - $ 10,050,000 Loan payable to Healthcare Financial Solutions, LLC in monthly installments of approximately $18,000, including cash collateral and interest at LIBOR (floor of 0.50%) plus 4.0% (6.3% at September 30, 2018 and 5.3% at December 31, 2017, respectively), due in January 2019 and collateralized by Sundial Assisted Living. $ 2,800,000 $ 2,800,000 Loan payable to Oxford Finance, LLC in monthly installments of approximately $53,000, including interest at LIBOR (floor of 0.75%) plus 6.50% (8.1% as of December 31, 2017), was terminated in March 2018 and was collateralized by Friendship Haven as of December 31, 2017. $ - $ 6,880,000 Loans payable to Lancaster Pollard (insured by HUD) in monthly installments of approximately $209,000, including interest, ranging from a fixed rate of 3.70% to 3.78%, due in September 2039 through January 2051, and collateralized by Sheridan, Fernhill, Pacific Health, Shelby, Hamlet, Carteret, Aledo and Danby. $ 42,208,000 $ 42,889,000 66,377,000 62,619,000 Less debt issuance costs (2,100,000 ) (1,788,000 ) Total loans payable $ 64,277,000 $ 60,831,000 As of September 30, 2018, we have total debt obligations of approximately $66.4 million that will mature between 2019 and 2053. 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, 2018, 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, 2018 and December 31, 2017, the unamortized balance of the debt issuance costs was approximately $2.1 million and $1.8 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, 2018 and 2017, $63,000 and $69,000, 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, 2018 and 2017, $0.3 million and $0.1 million, respectively, of debt issuance costs were amortized and included in interest expense in our condensed consolidated statements of operations. See below under Oxford Finance, LLC regarding the additional expense of approximately $79,000 due to the termination of that loan in March 2018 and under Capital One regarding the additional expense of approximately $15,000 due to the termination of that loan in September 2018. During the three months ended September 30, 2018 and 2017, we incurred approximately $0.8 million and $0.7 million, respectively, of interest expense (excluding debt issuance costs amortization) related to our loans payable. During the nine months ended September 30, 2018 and 2017, we incurred approximately $2.5 million and $2.0 million, respectively, of interest expense (excluding debt issuance costs amortization) related to our loans payable (see below under Oxford Finance, LLC regarding the additional expense of $167,000 due to the termination of that loan). The principal payments due on the loans payable (excluding debt issuance costs) for the period from October 1, 2018 to December 31, 2018 and for each of the four following years and thereafter ending December 31 are as follows: Years Ending Principal Amount October 1, 2018 to December 31, 2018 $ 320,000 2019 4,115,000 2020 1,367,000 2021 11,378,000 2022 1,219,000 Thereafter 47,978,000 $ 66,377,000 The following information describes our loan activity: 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 received approximately $9.0 million on March 30, 2018 and the remaining $1.7 million on April 16, 2018. The loan bears interest at One Month LIBOR (London Interbank Offered Rate) plus 3.75%, and matures on March 30, 2021. 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. The loan may be prepaid with no penalty if the property is refinanced through United States Department of Housing and Urban Development (“HUD”); 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. We incurred approximately $0.2 million in debt issuance costs. See table above listing loans payable for further information. Capital One We had a secured term loan agreement with Capital One, National Association collateralized by the Pennington Gardens facility that was terminated on September 27, 2018 as the loan was refinanced with Capital One Multifamily Finance, LLC and insured by HUD (“HUD Pennington Loan”). We expensed the unamortized balance of approximately $15,000 of debt issuance costs related to the original Capital One loan, which is included in interest expense in our condensed consolidated statements of operations. The HUD Pennington Loan is insured by HUD and collateralized by the Pennington Gardens facility. The loan bears interest at a fixed rate of 4.23%, plus 0.65% for mortgage insurance premiums, for the term of the loan. The loan matures in September 2053 and amortizes over 35 years. We incurred approximately $0.3 million 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. As of September 30, 2018, the outstanding balance of the HUD Pennington Loan was approximately $10.6 million. See table above listing loans payable for further information. Healthcare Financial Solutions, LLC (a.k.a. Capital One) We have an amended loan agreement for the Sundial Assisted Living property located in Redding, California, with Healthcare Financial Solutions, LLC (“HFS”). See table above listing loans payable for further information. The loan was interest-only through January 2017 and commencing in February 2017, payments of approximately $5,000 per month are being held in a cash collateral fund until maturity date. As of September 30, 2018, the total monthly payment is approximately $18,000, including cash collateral and interest. If the loan is refinanced prior to the maturity date, the loan payments in the cash collateral fund will be released to us; otherwise at the maturity date, the loan payments in the cash collateral fund will be released to the lender and applied to the outstanding principal balance. Additionally, the loan is collateralized by the property and cross-guaranteed with several properties owned by the SUL JV, which will be released from the guarantee when the property is refinanced with a HUD-insured loan or upon repayment at the maturity date. We are currently in negotiations to refinance this loan with a HUD-insured loan through Lancaster Pollard and the maturity date has been extended to January 2019. Oxford Finance, LLC On March 30, 2018, we terminated our secured term loan agreement with Oxford Finance, LLC, which was collateralized by the Friendship Haven facility. See table above listing loans payable for further information. As we prepaid the loan prior to the maturity date of October 2019, we paid an exit fee of $87,500, a prepayment penalty of approximately $69,000 and $10,000 in other costs. Additionally, we expensed the unamortized balance of approximately $79,000 of debt issuance costs related to this loan. These payments were expensed to interest expense in our condensed consolidated statements of operations in March 2018. Lancaster Pollard Mortgage Company, LLC We have several properties with HUD-insured loans from the Lancaster Pollard Mortgage Company, LLC (“Lancaster Pollard”). See table above listing loans payable for further information. 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, 2018
Equity Method Investments and Joint Ventures [Abstract]
Equity Method Investments and Joint Ventures Disclosure [Text Block]	5. Equity-Method Investments As of September 30, 2018 and December 31, 2017, the balances of our Equity-Method Investments were approximately $9.9 million and $9.2 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. In April 2017, we received approximately $122,000 to pay down the distribution receivable from one of the JV 2 properties. In December 2017, we received approximately $56,000 to pay down the distribution receivable from two of the JV 2 properties. As of September 30, 2018 and December 31, 2017, the receivable of $184,000, due from the JV 2 properties is included in tenant and other receivables on our condensed consolidated balance sheets. In April 2017, one of the JV 2 properties that owed Summit approximately $110,000 in distributions payable was able to repay the funds; however, the cash was retained by the property to fund future capital calls. Through September 30, 2018, we applied approximately $5,000 of this as additional capital. As of September 30, 2018 and December 31, 2017, the remaining balance of $105,000 is included in tenant and other receivables in our condensed consolidated balance sheets. As of September 30, 2018 and December 31, 2017, the balance of our equity-method investment related to the SUL JV was approximately $3.5 million and $3.6 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”). In April 2018, we made an additional capital contribution of $1.25 million to the Fantasia JV. As a result of this capital contribution, as of April 27, 2018, the Operating Partnership has a 35% equity investment and each member will receive a distribution of net operating cash flow and capital proceeds of 50% (instead of 70% for Fantasia and 30% for the Operating Partnership) after the Operating Partnership and Fantasia receive their accrued, but unpaid, returns. 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, 2018 and December 31, 2017, the balance of our equity-method investment related to the Fantasia JV was approximately $2.2 million and $1.1 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, 2018 and December 31, 2017, the balance of our equity-method investment related to the Fantasia II JV was approximately $1.6 million and $1.8 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, 2018 and December 31, 2017, the balance of our equity-method investment related to the Fantasia III JV was approximately $1.7 million and $1.8 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, 2018 and December 31, 2017, the balance of our equity-method investment related to the FPH JV was approximately $0.9 million. Distributions from Equity-Method Investments As of September 30, 2018 and December 31, 2017, we have distributions receivable, which is included in tenant and other receivables in our condensed consolidated balance sheets, as follows: September 30, 2018 December 31, 2017 SUL JV $ 163,000 $ 169,000 Fantasia JV 124,000 30,000 Fantasia II JV 50,000 58,000 Fantasia III JV 92,000 97,000 FPH JV 13,000 17,000 Total $ 442,000 $ 371,000 For the nine months ended September 30, 2018 and 2017, 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, 2018 Nine Months Ended September 30, 2017 Total Cash Distributions Received Cash Flow from Operating Activities Cash Flow from Investing Activities Total Cash Distributions Received Cash Flow from Operating Activities Cash Flow from Investing Activities SUL JV $ 379,000 $ 140,000 $ 239,000 $ 556,000 $ 117,000 $ 439,000 Fantasia JV 45,000 8,000 37,000 136,000 19,000 117,000 Fantasia II JV 191,000 45,000 146,000 148,000 96,000 52,000 Fantasia III JV 259,000 106,000 153,000 - - - FPH JV 66,000 22,000 44,000 - - - Total $ 940,000 $ 321,000 $ 619,000 $ 840,000 $ 232,000 $ 608,000 Acquisition and Asset Management Fees We serve as the manager 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 agreements. Additionally, 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, 2018 and 2017, we recorded approximately $0.2 million and $0.3 million, respectively, in acquisition and asset management fees from our Equity-Method Investments. For the nine months ended September 30, 2018 and 2017, we recorded approximately $0.5 million and $0.6 million, respectively, in acquisition and asset management fees from our Equity-Method Investments.

Receivables

Receivables	9 Months Ended
	Sep. 30, 2018
Receivables [Abstract]
Loans, Notes, Trade and Other Receivables Disclosure [Text Block]	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, 2018, the balance on the note was approximately $0.8 million. Fernhill Note In September 2014, we loaned approximately $140,000 to the operator of the Fernhill facility for certain property improvements at a fixed rate of interest of 6% payable in monthly installments through January 2019. As of September 30, 2018 and December 31, 2017, the balance on the note was approximately $12,000 and $38,000, respectively. Nantucket Note In 2015, through our Operating Partnership, we sold Sherburne Commons to The Residences at Sherburne Commons, Inc. (“Sherburne Buyer”), an unaffiliated Massachusetts non-profit corporation, in exchange for $5.0 million, as evidenced by a purchase money note from Sherburne Buyer to us as the lender. In December 2017, we collected approximately $0.9 million related to the principal on the note and in January 2018, we received approximately $4.0 million in full payoff of the note and recorded a gain of approximately $0.2 million. For the three months ended September 30, 2018 and 2017, we received interest payments from the note of approximately $0 and $43,000, respectively, which is recorded as interest income from notes receivable in our condensed consolidated statements of operations. For the nine months ended September 30, 2018 and 2017, we received interest payments from the note of approximately $18,000 and $129,000, which is recorded as interest income from notes receivable in our condensed consolidated statements of operations. Tenant and Other Receivables, Net Tenant and other receivables, net consists of: September 30, 2018 December 31, 2017 Straight-line rent receivables $ 3,531,000 $ 3,046,000 Distribution receivables from Equity-Method Investments 442,000 371,000 Receivable from JV 2 properties 184,000 184,000 Asset management fees 201,000 170,000 Other receivables 121,000 335,000 Total $ 4,479,000 $ 4,106,000

Related Party Transactions

Related Party Transactions	9 Months Ended
	Sep. 30, 2018
Related Party Transactions [Abstract]
Related Party Transactions Disclosure [Text Block]	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, 2018 and December 31, 2017, 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, 2018 and December 31, 2017, we had the following receivables and reserves: 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, 2018
Risks and Uncertainties [Abstract]
Concentration Risk Disclosure [Text Block]	8. Concentration of Risk Our cash is generally invested in short-term money market instruments. As of September 30, 2018, 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, 2018, we owned one property in California, three properties in Oregon, four properties in North Carolina, one property in Texas, one property in Illinois, and one property in Arizona (excluding the 36 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, 2018, we leased our 11 real estate properties to five different tenants under long-term triple net leases, three of which comprise 41%, 24% and 14% of our tenant rental revenue. For the three months ended September 30, 2017, we leased our 11 healthcare properties to four different tenants under long-term triple net leases, three of which comprised 50%, 30% and 19% of our tenant rental revenue. 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 comprise 41%, 23% and 13% of our tenant rental revenue. For the nine months ended September 30, 2017, we leased our 11 healthcare properties to five different tenants under long-term triple net leases, three of which comprise 55%, 33%, and 11% of our tenant rental revenue. As of September 30, 2018 and December 31, 2017, we have one tenant that constitutes a significant asset concentration, as the net assets of the tenant are approximately 32% and 33%, respectively, of our total assets.

Fair Value Measurements of Fina

Fair Value Measurements of Financial Instruments	9 Months Ended
	Sep. 30, 2018
Fair Value Disclosures [Abstract]
Fair Value Disclosures [Text Block]	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, deposits, tenant and other receivables, certain other assets, accounts payable and accrued liabilities, accrued salaries and benefits, security deposits and loans payable. With the exception of the Nantucket 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, 2018 and December 31, 2017, the fair value of our loans payable was approximately $66.8 million and $63.3 million, respectively, compared to the carrying value of approximately $66.4 million and $62.6 million, respectively. The fair value of our loans payable is estimated using lending rates available to us for financial instruments with similar terms and maturities. To estimate fair value as of September 30, 2018, we utilized a discount rate ranging from 4.4% to 6.3% and a weighted-average discount rate of 4.7%. 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, 2018, the fair value of the Friendswood TRS note receivable (see Note 6) was $0.8 million compared to the carrying value of $0.8 million. The fair value of the note receivable was estimated based on cash flow analysis at a weighted-average discount rate of 4.7%. 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 nine months ended September 30, 2018 and 2017. At September 30, 2018 and December 31, 2017, 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, 2018
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies Disclosure [Text Block]	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 and two of its officers (one current and one former) 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. At this time, no trial date has been scheduled. A status conference is currently scheduled for November 30, 2018. We continue to believe that all of plaintiffs’ claims are without merit and will continue to vigorously defend ourselves. An involuntary 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. 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 (the “Complaint”) 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. The District Court affirmed the Bankruptcy Court’s decision dismissing the Complaint. HCRE appealed the District Court’s decision affirming the Bankruptcy Court’s order dismissing the Complaint to the United States Court of Appeals for the Third Circuit, where the matter awaits a briefing schedule and ruling. The Bankruptcy Court has stayed all litigation on HCRE’s motion for damages pending resolution of all appeals relative to the dismissal of the Complaint. 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 agreement to pay consulting fees of $10,000 per month. We believe that his claims are without merit and are vigorously defending them. 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, 2018
Equity [Abstract]
Stockholders' Equity Note Disclosure [Text Block]	11. Equity 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 estimated fair value of our liabilities, which approximate book value, utilizing a discount for the fact that the shares are not currently traded on a national securities exchange and a control premium, and divided by 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 evaluations of expected future exercise behavior. The risk-free interest rate was based on the U.S. Treasury yield curve at the date of grant with maturity dates approximating the expected term 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, 2018, the Compensation Committee of the Board of Directors approved the issuance of 41,500 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, 2018 and continuing over a three-year period through January 1, 2021. The options expire 10 years from the grant date. The weighted-average fair value per share of the stock options granted was $0.40. On April 1, 2018, the Compensation Committee of the Board of Directors approved the issuance of 200,000 stock options under our Incentive Plan to executive management related to their performance goals for 2017. 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 May 1, 2018 and continuing over a two-year period through May 1, 2020. The options expire 10 years from the grant date. The weighted-average fair value per share of the stock options granted was $0.32. On April 1, 2018, the Compensation Committee of the Board of Directors approved the issuance of 100,000 stock options under our Incentive Plan to our directors. The stock options vest monthly beginning on May 1, 2018 and continuing over a three-year period through May 1, 2021. The options expire 10 years from the grant date. The weighted-average fair value per share of the stock options granted was $0.42. The estimated fair value using the Black-Scholes option-pricing model with the following weighted average assumptions: 2018 Stock options granted 341,500 Expected Volatility 21.97 % Expected lives 2.4 years Risk-free interest rate 2.27 % Dividends 0 % Fair value per share $ 0.36 The following table summarizes our stock options as of September 30, 2018: Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term Aggregate Intrinsic Value Options outstanding at January 1, 2018 895,408 $ 1.90 Granted 341,500 2.24 Exercised — Cancelled/forfeited (3,668 ) Options outstanding at September 30, 2018 1,233,240 $ 1.99 8.31 $ 993,000 Options exercisable at September 30, 2018 903,187 $ 1.93 8.00 $ 790,000 For our outstanding non-vested options as of September 30, 2018, the weighted average grant date fair value per share was $0.35. As of September 30, 2018, 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, July 1, 2018 to December 31, 2018 $ 23,000 2019 62,000 2020 27,000 2021 5,000 $ 117,000 The stock-based compensation expense reported for the three months ended September 30, 2018 and 2017 was approximately $23,000 and $18,000, 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, 2018 and 2017 was approximately $78,000 and $83,000, respectively, and is included in general and administrative expense in the condensed consolidated statements of operations.

Dispositions

Dispositions	9 Months Ended
	Sep. 30, 2018
Discontinued Operations and Disposal Groups [Abstract]
Disposal Groups, Including Discontinued Operations, Disclosure [Text Block]	12. Dispositions In accordance with ASC 360, Property, Plant & Equipment , we report results of operations from real estate assets that meet the definition of a component of an entity that have been sold, or meet the criteria to be classified as held for sale, as discontinued operations. Friendswood TRS Effective January 1, 2018, we assigned our interest in Friendswood TRS, the licensed operator and tenant of Friendship Haven, to HMG, the management company of Friendship Haven. Therefore, as of January 1, 2018, Friendswood TRS is no longer consolidated in our consolidated financial statements. The consolidated statement of operations for the three months ended September 30, 2017 has been restated to present the operations of Friendswood TRS as a discontinued operation. We made the decision to dispose of Friendswood TRS primarily because we are not in the business of operating facilities; we are in the business of acquiring senior housing facilities and leasing them to independent third party operators under triple-net leases. Friendswood TRS recorded the operations of Friendship Haven as resident services and fee income and resident services costs in their financial statements, which were then consolidated in our consolidated balance sheets and consolidated statements of operations and cash flows. The disposition represented a strategic shift to divest ourselves of being a tenant and licensed operator of our facilities, and had a material effect on the Company’s operations and financial results as we will no longer record resident services and fee income and resident services costs. Prior to January 1, 2018, HMG provided management services to Friendship Haven pursuant to a management agreement with Friendswood TRS. We do not have any continuing obligations under the management agreement as of January 1, 2018. Effective January 1, 2018, the new owners of Friendswood TRS entered into an Amended and Restated 10-year triple-net lease with two five-year renewal options, with CHP Friendswood SNF, LLC, our majority-owned consolidated subsidiary. Additionally, the Operating Partnership entered into an amended and restated promissory note 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%. The income from discontinued operations presented in the consolidated statements of operations related to Friendswood TRS consisted of the following for the three and nine months ended September 30, 2017: Three Months Ended September 30, 2017 Nine Months Ended September 30, 2017 Revenues: Resident services and fee income $ 2,413,000 $ 6,829,000 Other revenues 5,000 8,000 2,418,000 6,837,000 Expenses: Property operating costs 157,000 442,000 Resident services costs 1,658,000 4,917,000 General and administrative 18,000 54,000 Depreciation and amortization 14,000 41,000 1,847,000 5,454,000 Income from discontinued operations $ 571,000 $ 1,383,000 The assets and liabilities of the discontinued operations are presented separately under the captions “Assets of Friendswood TRS held for sale” and “Liabilities of Friendswood TRS held for sale,” respectively, in the accompanying condensed consolidated balance sheets at December 31, 2017 and consist of the following: December 31, 2017 ASSETS: Cash and cash equivalents $ 459,000 Real estate properties, net 320,000 Tenant and other receivables, net 947,000 Other assets 36,000 Total assets $ 1,762,000 LIABILITIES: Accounts payable and accrued liabilities 821,000 Accrued salaries and benefits 77,000 Total liabilities of property held for sale $ 898,000 For the nine months ended September 30, 2017, total cash flows of the discontinued operations provided by operating activities was $758,000 and cash flows used in investing activities was $163,000.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2018
Accounting Policies [Abstract]
Basis of Accounting, Policy [Policy Text Block]	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, 2018 are not necessarily indicative of the results that may be expected for the year ending December 31, 2018.
Cash and Cash Equivalents, Restricted Cash and Cash Equivalents, Policy [Policy Text Block]	Recently Adopted Accounting Pronouncements Restricted Cash On January 1, 2018, the Company adopted the Financial Accounting Standards Board (“FASB”) Accounting Standards Update (“ASU”) No. 2016-18, Statement of Cash Flows (Topic 230): Restricted Cash. The amendments in this ASU require that a statement of cash flows explain the change during the period in the total of cash, cash equivalents and amounts generally described as restricted cash or restricted cash equivalents. As a result, amounts generally described as restricted cash and restricted cash equivalents should be included with cash and cash equivalents when reconciling the beginning-of-period and end-of-period total amounts shown on the statement of cash flows. Our restricted cash consists of escrows from our tenants for property taxes, insurance and capital improvements required by and held by our lenders. The Company’s statements of cash flows for the nine months ended September 30, 2017 has been retroactively restated for the effect of adopting this ASU, adding approximately $3.8 million to the beginning of the period cash, cash equivalents and restricted cash and approximately $3.6 million to the end of the period cash, cash equivalents and restricted cash. This reclassification resulted in an increase to cash, cash equivalents and restricted cash provided by operating activities by $108,000 (related to the change in restricted cash held for operating activities) and a decrease to cash, cash equivalents and restricted cash used in investing activities by $339,000 (related to the change in restricted cash held for capital improvements). 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, 2018 December 31, 2017 Cash and cash equivalents $ 11,014,000 $ 3,851,000 Restricted cash 3,559,000 3,447,000 Total cash, cash equivalents, and restricted cash shown on the condensed consolidated statements of cash flows $ 14,573,000 $ 7,298,000
Revenue Recognition, Policy [Policy Text Block]	Revenue Recognition On January 1, 2018, the Company adopted Revenue from Contracts with Customers (Topic 606) . Our adoption of this new revenue recognition standard did not have a significant impact on our condensed consolidated financial statements as our rental revenue relates to triple net leases and related tenant reimbursements, which are excluded from this standard. Additionally, interest income from our notes receivable is excluded from this standard. Acquisition fees arise from contractual agreements with our joint venture partners and are earned and paid at the time we close an acquisition, therefore, satisfying our performance obligations at that time. We earn our asset management fees based on a percentage of the purchase price or equity raised. As the manager, our duty is to manage the day-to-day operations of the special-purpose entities which own the properties. Asset management fees are recognized as a single performance obligation (managing the properties) comprised of a series of distinct services (handling issues with our tenants, etc.). We believe that the overall service of asset management is substantially the same each day and has the same pattern of performance over the term of the agreement. As a result, each day of service represents a performance obligation satisfied at that point in time. These fees are recognized at the end of each period for services performed during that period, billed monthly and paid quarterly. Revenue recognition for acquisition and asset management fees did not change under the new standard. The Company elected the modified retrospective transition method, however, no adjustments were required.
New Accounting Pronouncements, Policy [Policy Text Block]	Recently Issued Accounting Pronouncements In February 2016, the FASB issued ASU No. 2016-02, Leases Leases - Targeted Improvements We continue to evaluate the impact of our adoption of this new standard in 2019 and we estimate the effect on our condensed consolidated financial statements could be approximately $0.3 million, as we have an operating lease that will be added to the assets and liabilities of our condensed consolidated balance sheet. As generally accepted accounting principles for lessors remains mostly unchanged, we do not expect it to have an impact on our leases from our tenants.
Reclassification, Policy [Policy Text Block]	Reclassifications Certain amounts related to the assets, liabilities and operations of Friendswood TRS have been reclassified in the Company’s condensed consolidated balance sheets and condensed consolidated statements of operations for prior year due to the classification of Friendswood TRS as held for sale (see Note 12). These reclassifications had no effect on total assets or liabilities or cash flows from operating activities. The reclassifications as of and for the three months ended September 30, 2017 increased our loss from continuing operations by $571,000, but did not change our net loss of $(674,000) or our net loss applicable to common stockholders of $(689,000). The reclassifications for the nine months ended September 30, 2017 increased our loss from continuing operations by $1,383,000, but did not change our net loss of $(1,661,000) or our net loss applicable to common stockholders of $(1,701,000). See above under Recently Adopted Accounting Pronouncements for reclassifications due to the adoption of ASU No. 2016-18, Statement of Cash Flows (Topic 230): Restricted Cash.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2018
Accounting Policies [Abstract]
Restrictions on Cash and Cash Equivalents [Table Text Block]	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, 2018 December 31, 2017 Cash and cash equivalents $ 11,014,000 $ 3,851,000 Restricted cash 3,559,000 3,447,000 Total cash, cash equivalents, and restricted cash shown on the condensed consolidated statements of cash flows $ 14,573,000 $ 7,298,000

Investments in Real Estate Pr_2

Investments in Real Estate Properties (Tables)	9 Months Ended
	Sep. 30, 2018
Business Combinations [Abstract]
Schedule of Business Acquisitions, by Acquisition [Table Text Block]	As of September 30, 2018 and December 31, 2017, our investments in real estate properties including those held by our consolidated subsidiaries are set forth below: September 30, 2018 December 31, 2017 Land $ 8,003,000 $ 7,318,000 Buildings and improvements 69,285,000 69,254,000 Less: accumulated depreciation (10,643,000 ) (9,012,000 ) Buildings and improvements, net 58,642,000 60,242,000 Furniture and fixtures 6,829,000 6,755,000 Less: accumulated depreciation (5,859,000 ) (5,252,000 ) Furniture and fixtures, net 970,000 1,503,000 Real estate properties, net $ 67,615,000 $ 69,063,000
Schedule of Real Estate Properties [Table Text Block]	The following table provides summary information regarding our portfolio (excluding the 36 properties owned by our unconsolidated Equity-Method Investments) as of September 30, 2018: Property Location Date Purchased Type (1) Purchase Loans Number Sheridan Care Center Sheridan, OR August 3, 2012 SNF $ 4,100,000 $ 4,670,000 51 Fernhill Care Center Portland, OR August 3, 2012 SNF 4,500,000 4,097,000 63 Friendship Haven Healthcare and Rehabilitation Center Galveston County, 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 6,830,000 73 Danby House Winston-Salem, January 31, 2013 AL/MC 9,700,000 7,553,000 100 Brookstone of Aledo Aledo, IL July 2, 2013 AL 8,625,000 7,130,000 66 The Shelby House Shelby, NC October 4, 2013 AL 4,500,000 4,664,000 72 The Hamlet House Hamlet, NC October 4, 2013 AL 6,500,000 3,940,000 60 The Carteret House Newport, NC October 4, 2013 AL 4,300,000 3,324,000 64 Sundial Assisted Living Redding, CA December 18, 2013 AL 3,500,000 2,800,000 65 Pennington Gardens Chandler, AZ July 17, 2017 AL/MC 13,400,000 10,644,000 90 Total: $ 82,265,000 $ 66,377,000 854 (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 for Operating Leases [Table Text Block]	The future minimum lease payments to be received under existing operating leases owned as of September 30, 2018, for the period from October 1, 2018 to December 31, 2018 and for each of the four following years and thereafter ending December 31 are as follows: Years ending October 1, 2018 to December 31, 2018 $ 1,915,000 2019 7,740,000 2020 7,902,000 2021 8,068,000 2022 8,237,000 Thereafter 60,988,000 $ 94,850,000

Loans Payable (Tables)

Loans Payable (Tables)	9 Months Ended
	Sep. 30, 2018
Debt Disclosure [Abstract]
Schedule of Debt [Table Text Block]	As of September 30, 2018 and December 31, 2017, our loans payable consisted of the following: September 30, 2018 December 31, 2017 Loan payable to CIBC Bank USA in monthly installments of approximately $60,000, including cash collateral and interest at LIBOR plus 3.75% (5.86% at September 30, 2018), due in March 2021, and collateralized by Friendship Haven. $ 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. $ 10,644,000 $ - Loan payable to Capital One, National Association in monthly installments of approximately $36,000, including interest at LIBOR plus 2.95% (4.3% at December 31, 2017), was terminated in September 2018 and was collateralized by Pennington Gardens. $ - $ 10,050,000 Loan payable to Healthcare Financial Solutions, LLC in monthly installments of approximately $18,000, including cash collateral and interest at LIBOR (floor of 0.50%) plus 4.0% (6.3% at September 30, 2018 and 5.3% at December 31, 2017, respectively), due in January 2019 and collateralized by Sundial Assisted Living. $ 2,800,000 $ 2,800,000 Loan payable to Oxford Finance, LLC in monthly installments of approximately $53,000, including interest at LIBOR (floor of 0.75%) plus 6.50% (8.1% as of December 31, 2017), was terminated in March 2018 and was collateralized by Friendship Haven as of December 31, 2017. $ - $ 6,880,000 Loans payable to Lancaster Pollard (insured by HUD) in monthly installments of approximately $209,000, including interest, ranging from a fixed rate of 3.70% to 3.78%, due in September 2039 through January 2051, and collateralized by Sheridan, Fernhill, Pacific Health, Shelby, Hamlet, Carteret, Aledo and Danby. $ 42,208,000 $ 42,889,000 66,377,000 62,619,000 Less debt issuance costs (2,100,000 ) (1,788,000 ) Total loans payable $ 64,277,000 $ 60,831,000
Schedule of Maturities of Long-term Debt [Table Text Block]	The principal payments due on the loans payable (excluding debt issuance costs) for the period from October 1, 2018 to December 31, 2018 and for each of the four following years and thereafter ending December 31 are as follows: Years Ending Principal Amount October 1, 2018 to December 31, 2018 $ 320,000 2019 4,115,000 2020 1,367,000 2021 11,378,000 2022 1,219,000 Thereafter 47,978,000 $ 66,377,000

Equity-Method Investments (Tabl

Equity-Method Investments (Tables)	9 Months Ended
	Sep. 30, 2018
Equity Method Investments and Joint Ventures [Abstract]
Schedule Of Distribution From Equity Method Investments [Table Text Block]	As of September 30, 2018 and December 31, 2017, we have distributions receivable, which is included in tenant and other receivables in our condensed consolidated balance sheets, as follows: September 30, 2018 December 31, 2017 SUL JV $ 163,000 $ 169,000 Fantasia JV 124,000 30,000 Fantasia II JV 50,000 58,000 Fantasia III JV 92,000 97,000 FPH JV 13,000 17,000 Total $ 442,000 $ 371,000
Schedule Of Cash Distributions Included In Cash Flows From Operating And Investing Activities [Table Text Block]	For the nine months ended September 30, 2018 and 2017, 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, 2018 Nine Months Ended September 30, 2017 Total Cash Distributions Received Cash Flow from Operating Activities Cash Flow from Investing Activities Total Cash Distributions Received Cash Flow from Operating Activities Cash Flow from Investing Activities SUL JV $ 379,000 $ 140,000 $ 239,000 $ 556,000 $ 117,000 $ 439,000 Fantasia JV 45,000 8,000 37,000 136,000 19,000 117,000 Fantasia II JV 191,000 45,000 146,000 148,000 96,000 52,000 Fantasia III JV 259,000 106,000 153,000 - - - FPH JV 66,000 22,000 44,000 - - - Total $ 940,000 $ 321,000 $ 619,000 $ 840,000 $ 232,000 $ 608,000

Receivables (Tables)

Receivables (Tables)	9 Months Ended
	Sep. 30, 2018
Receivables [Abstract]
Schedule of Accounts, Notes, Loans and Financing Receivable [Table Text Block]	Tenant and other receivables, net consists of: September 30, 2018 December 31, 2017 Straight-line rent receivables $ 3,531,000 $ 3,046,000 Distribution receivables from Equity-Method Investments 442,000 371,000 Receivable from JV 2 properties 184,000 184,000 Asset management fees 201,000 170,000 Other receivables 121,000 335,000 Total $ 4,479,000 $ 4,106,000

Related Party Transactions (Tab

Related Party Transactions (Tables)	9 Months Ended
	Sep. 30, 2018
Related Party Transactions [Abstract]
Schedule of Related Party Transactions [Table Text Block]	As of September 30, 2018 and December 31, 2017, we had the following receivables and reserves: 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, 2018
Equity [Abstract]
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]	The estimated fair value using the Black-Scholes option-pricing model with the following weighted average assumptions: 2018 Stock options granted 341,500 Expected Volatility 21.97 % Expected lives 2.4 years Risk-free interest rate 2.27 % Dividends 0 % Fair value per share $ 0.36
Share-based Compensation, Stock Options, Activity [Table Text Block]	The following table summarizes our stock options as of September 30, 2018: Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term Aggregate Intrinsic Value Options outstanding at January 1, 2018 895,408 $ 1.90 Granted 341,500 2.24 Exercised — Cancelled/forfeited (3,668 ) Options outstanding at September 30, 2018 1,233,240 $ 1.99 8.31 $ 993,000 Options exercisable at September 30, 2018 903,187 $ 1.93 8.00 $ 790,000
Schedule of Unrecognized Compensation Cost, Nonvested Awards [Table Text Block]	For our outstanding non-vested options as of September 30, 2018, the weighted average grant date fair value per share was $0.35. As of September 30, 2018, 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, July 1, 2018 to December 31, 2018 $ 23,000 2019 62,000 2020 27,000 2021 5,000 $ 117,000

Dispositions (Tables)

Dispositions (Tables)	9 Months Ended
	Sep. 30, 2018
Discontinued Operations and Disposal Groups [Abstract]
Disposal Groups, Including Discontinued Operations [Table Text Block]	The income from discontinued operations presented in the consolidated statements of operations related to Friendswood TRS consisted of the following for the three and nine months ended September 30, 2017: Three Months Ended September 30, 2017 Nine Months Ended September 30, 2017 Revenues: Resident services and fee income $ 2,413,000 $ 6,829,000 Other revenues 5,000 8,000 2,418,000 6,837,000 Expenses: Property operating costs 157,000 442,000 Resident services costs 1,658,000 4,917,000 General and administrative 18,000 54,000 Depreciation and amortization 14,000 41,000 1,847,000 5,454,000 Income from discontinued operations $ 571,000 $ 1,383,000 The assets and liabilities of the discontinued operations are presented separately under the captions “Assets of Friendswood TRS held for sale” and “Liabilities of Friendswood TRS held for sale,” respectively, in the accompanying condensed consolidated balance sheets at December 31, 2017 and consist of the following: December 31, 2017 ASSETS: Cash and cash equivalents $ 459,000 Real estate properties, net 320,000 Tenant and other receivables, net 947,000 Other assets 36,000 Total assets $ 1,762,000 LIABILITIES: Accounts payable and accrued liabilities 821,000 Accrued salaries and benefits 77,000 Total liabilities of property held for sale $ 898,000

Organization (Details Textual)

Organization (Details Textual) - USD ($)	1 Months Ended	9 Months Ended		12 Months Ended
	Apr. 02, 2018	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2017
Organization [Line Items]
Equity Method Investment, Ownership Percentage		10.00%
Payments to Acquire Equity Method Investments		$ 1,313,000	$ 3,694,000
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 LLC [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]
Limited Liability Company (LLC) or Limited Partnership (LP), Members or Limited Partners, Ownership Interest		10.00%
Summit Healthcare Five Properties One [Member]
Organization [Line Items]
Equity Method Investment, Ownership Percentage		100.00%
Summit Healthcare Five Properties Two [Member]
Organization [Line Items]
Real Estate Investment Trust Owne Percentage		95.00%
Five Jv Propertie [Member] | Chref One [Member]
Organization [Line Items]
Limited Liability Company (LLC) or Limited Partnership (LP), Members or Limited Partners, Ownership Interest		95.00%
Five Jv Propertie [Member] | Chref Two [Member]
Organization [Line Items]
Noncontrolling Interest, Ownership Percentage by Noncontrolling Owners		5.00%
Four Jv Propertie [Member]
Organization [Line Items]
Limited Liability Company (LLC) or Limited Partnership (LP), Members or Limited Partners, Ownership Interest		95.30%
Summit Fantasia Holdings Llc [Member]
Organization [Line Items]
Limited Liability Company (LLC) or Limited Partnership (LP), Members or Limited Partners, Ownership Interest by Affiliates		35.00%		20.00%
Equity Method Investment, Ownership Percentage	35.00%	35.00%		20.00%
Payments to Acquire Equity Method Investments	$ 1,250,000
Summit Fantasia Holdings III, LLC
Organization [Line Items]
Limited Liability Company (LLC) or Limited Partnership (LP), Members or Limited Partners, Ownership Interest		10.00%		10.00%
Limited Liability Company (LLC) or Limited Partnership (LP), Members or Limited Partners, Ownership Interest by Affiliates		10.00%		10.00%
Summit Union Life Holdings, LLC
Organization [Line Items]
Equity Method Investment, Ownership Percentage		10.00%		10.00%
Summit Fantasia Holdings, LLC
Organization [Line Items]
Equity Method Investment, Ownership Percentage		35.00%		20.00%

Summary of Significant Accoun_4

Summary of Significant Accounting Policies (Details) - USD ($)	Sep. 30, 2018	Dec. 31, 2017	Sep. 30, 2017
Cash and cash equivalents	$ 11,014,000	$ 3,851,000
Restricted cash	3,559,000	3,447,000
Total cash, cash equivalents, and restricted cash shown on the condensed consolidated statements of cash flows	$ 14,573,000	$ 7,298,000	$ 7,213,000

Summary of Significant Accoun_5

Summary of Significant Accounting Policies (Details Textual) - USD ($)	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2016
Summary of Significant Accounting Policies [Line Items]
Income (Loss) from Discontinued Operations, Net of Tax, Including Portion Attributable to Noncontrolling Interest	$ 0	$ 571,000	$ 109,000	$ 1,383,000
Net Income (Loss) Available to Common Stockholders, Basic		(689,000)		(1,701,000)
Net Income (Loss), Including Portion Attributable to Noncontrolling Interest	$ (246,000)	$ (674,000)	(724,000)	(1,661,000)
New Accounting Pronouncement or Change in Accounting Principle Decrease In Cash, Cash Equivalents And Restricted Cash Operating Activity				108,000
New Accounting Pronouncement or Change in Accounting Principle Decrease in Cash, Cash Equivalents and Restricted Cash Investing Activities				339,000
New Accounting Pronouncement or Change in Accounting Principle, Effect of Adoption, Quantification			$ 300,000
Adjustments for New Accounting Pronouncement [Member]
Summary of Significant Accounting Policies [Line Items]
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents, Period Increase (Decrease), Including Exchange Rate Effect				$ 3,600,000	$ 3,800,000
Operating Partnership [Member]
Summary of Significant Accounting Policies [Line Items]
Noncontrolling Interest, Ownership Percentage by Parent	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%

Investments in Real Estate Pr_3

Investments in Real Estate Properties (Details) - USD ($)	Sep. 30, 2018	Dec. 31, 2017
Real Estate Properties [Line Items]
Real estate properties, net	$ 67,615,000	$ 69,063,000
Land [Member]
Real Estate Properties [Line Items]
Real estate properties, net	8,003,000	7,318,000
Buildings and improvements [Member]
Real Estate Properties [Line Items]
Investments in real estate	69,285,000	69,254,000
Less: accumulated depreciation	(10,643,000)	(9,012,000)
Real estate properties, net	58,642,000	60,242,000
Furniture and Fixture [Member]
Real Estate Properties [Line Items]
Investments in real estate	6,829,000	6,755,000
Less: accumulated depreciation	(5,859,000)	(5,252,000)
Real estate properties, net	$ 970,000	$ 1,503,000

Investments in Real Estate Pr_4

Investments in Real Estate Properties (Details 1)	9 Months Ended
	Sep. 30, 2018USD ($)
Real Estate Properties [Line Items]
Purchase Price	$ 82,265,000
Loans Payable, Excluding Debt Issuance Costs	$ 66,377,000
Number of Beds	854
Sheridan Care Center [Member]
Real Estate Properties [Line Items]
Location	Sheridan, OR
Date Purchased	Aug. 3, 2012
Type Of property	SNF	[1]
Purchase Price	$ 4,100,000
Loans Payable, Excluding Debt Issuance Costs	$ 4,670,000
Number of Beds	51
Fernhill Care Center [Member]
Real Estate Properties [Line Items]
Location	Portland, OR
Date Purchased	Aug. 3, 2012
Type Of property	SNF	[1]
Purchase Price	$ 4,500,000
Loans Payable, Excluding Debt Issuance Costs	$ 4,097,000
Number of Beds	63
Friendship Haven Healthcare and Rehabilitation Center [Member]
Real Estate Properties [Line Items]
Location	Galveston County,
Date Purchased	Sep. 14, 2012
Type Of property	SNF	[1]
Purchase Price	$ 15,000,000
Loans Payable, Excluding Debt Issuance Costs	$ 10,725,000
Number of Beds	150
Pacific Health and Rehabilitation Center [Member]
Real Estate Properties [Line Items]
Location	Tigard, OR
Date Purchased	Dec. 24, 2012
Type Of property	SNF	[1]
Purchase Price	$ 8,140,000
Loans Payable, Excluding Debt Issuance Costs	$ 6,830,000
Number of Beds	73
Danby House [Member]
Real Estate Properties [Line Items]
Location	Winston-Salem,
Date Purchased	Jan. 31, 2013
Type Of property	AL/MC	[1]
Purchase Price	$ 9,700,000
Loans Payable, Excluding Debt Issuance Costs	$ 7,553,000
Number of Beds	100
Brookstone of Aledo [Member]
Real Estate Properties [Line Items]
Location	Aledo, IL
Date Purchased	Jul. 2, 2013
Type Of property	AL	[1]
Purchase Price	$ 8,625,000
Loans Payable, Excluding Debt Issuance Costs	$ 7,130,000
Number of Beds	66
The Shelby House [Member]
Real Estate Properties [Line Items]
Location	Shelby, NC
Date Purchased	Oct. 4, 2013
Type Of property	AL	[1]
Purchase Price	$ 4,500,000
Loans Payable, Excluding Debt Issuance Costs	$ 4,664,000
Number of Beds	72
The Hamlet House [Member]
Real Estate Properties [Line Items]
Location	Hamlet, NC
Date Purchased	Oct. 4, 2013
Type Of property	AL	[1]
Purchase Price	$ 6,500,000
Loans Payable, Excluding Debt Issuance Costs	$ 3,940,000
Number of Beds	60
The Carteret House [Member]
Real Estate Properties [Line Items]
Location	Newport, NC
Date Purchased	Oct. 4, 2013
Type Of property	AL	[1]
Purchase Price	$ 4,300,000
Loans Payable, Excluding Debt Issuance Costs	$ 3,324,000
Number of Beds	64
Sundial Assisted Living [Member]
Real Estate Properties [Line Items]
Location	Redding, CA
Date Purchased	Dec. 18, 2013
Type Of property	AL	[1]
Purchase Price	$ 3,500,000
Loans Payable, Excluding Debt Issuance Costs	$ 2,800,000
Number of Beds	65
Pennington Gardens [Member]
Real Estate Properties [Line Items]
Location	Chandler, AZ
Date Purchased	Jul. 17, 2017
Type Of property	AL/MC	[1]
Purchase Price	$ 13,400,000
Loans Payable, Excluding Debt Issuance Costs	$ 10,644,000
Number of Beds	90
[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.

Investments in Real Estate Pr_5

Investments in Real Estate Properties (Details 2)	Sep. 30, 2018USD ($)
Real Estate Properties [Line Items]
October 1, 2018 to December 31, 2018	$ 1,915,000
2,019	7,740,000
2,020	7,902,000
2,021	8,068,000
2,022	8,237,000
Thereafter	60,988,000
Operating Leases, Future Minimum Payments Receivable	$ 94,850,000

Investments in Real Estate Pr_6

Investments in Real Estate Properties (Details Textual)	1 Months Ended		3 Months Ended		9 Months Ended
	Mar. 30, 2018USD ($)	Jul. 17, 2017USD ($)	Sep. 30, 2018USD ($)	Sep. 30, 2017USD ($)	Sep. 30, 2018USD ($)	Sep. 30, 2017USD ($)	Dec. 31, 2017USD ($)
Real Estate Properties [Line Items]
Number of Real Estate Properties			11		11
Percentage of Real Estate Properties					100.00%
Depreciation			$ 700,000	$ 800,000	$ 2,300,000	$ 2,200,000
Business Combination, Consideration Transferred		$ 13,400,000
Business Combination, Acquisition Related Costs		52,000
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Land		1,800,000
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Buildings		$ 10,900,000
Payments to Acquire Land	$ 685,000
Acquisition Costs, Period Cost	30,000
Increase In Annual Rental Payments	$ 36,000
Deferred Costs, Leasing, Net			1,168,000		1,168,000		$ 1,273,000
Amortization of Deferred Leasing Commissions			35,000	$ 35,000	105,000	$ 105,000
Deferred Costs			$ 1,900,000		$ 1,900,000		$ 1,900,000
Pennington Gardens [Member]
Real Estate Properties [Line Items]
Lessee, Finance Lease, Term of Contract		15 years
Business Acquisition, Percentage of Voting Interests Acquired		100.00%
Furniture and Fixtures [Member] | Pennington Gardens [Member]
Real Estate Properties [Line Items]
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Property, Plant, and Equipment		$ 750,000

Loans Payable (Details)

Loans Payable (Details) - USD ($)	Sep. 30, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Long-term Debt, Gross	$ 66,377,000	$ 62,619,000
Less debt issuance costs	(2,100,000)	(1,788,000)
Total loans payable	64,277,000	60,831,000
General Electric Capital Corporation [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross	0	10,050,000
Lancaster Pollard Mortgage Company, LLC [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross	42,208,000	42,889,000
Healthcare Financial Solutions, LLC [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross	2,800,000	2,800,000
Housing and Healthcare Finance [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross	0	6,880,000
Cibc Bank [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross	10,725,000	0
Capital One Multifamily Finance LLC [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross	$ 10,644,000	$ 0

Loans Payable (Details) _Parent

Loans Payable (Details) [Parenthetical] - USD ($)	9 Months Ended
	Sep. 30, 2018	Dec. 31, 2017
Debt Instrument, Periodic Payment	$ 209,000
Debt Instrument, Interest Rate, Stated Percentage	4.23%	6.30%
Debt Instrument, Maturity Date, Description	35 Years
Minimum [Member]
Debt Instrument, Interest Rate, Stated Percentage	3.70%
Maximum [Member]
Debt Instrument, Interest Rate, Stated Percentage	3.78%
Cibc Bank [Member]
Debt Instrument, Periodic Payment	$ 60,000
Debt Instrument, Description of Variable Rate Basis	LIBOR plus 3.75%
Debt Instrument, Interest Rate, Stated Percentage	5.86%
Debt Instrument, Maturity Date, Description	due in March 2021
Capital One National Association Loan [Member]
Debt Instrument, Periodic Payment	$ 36,000
Debt Instrument, Description of Variable Rate Basis	LIBOR plus 2.95%
Debt Instrument, Interest Rate, Stated Percentage	4.30%
Healthcare Financial Solutions Llc [Member]
Debt Instrument, Periodic Payment	$ 18,000
Debt Instrument, Description of Variable Rate Basis	LIBOR (floor of 0.50%) plus 4.0%
Debt Instrument, Interest Rate, Stated Percentage		5.30%
Oxford Finance, LLC [Member]
Debt Instrument, Periodic Payment	$ 53,000
Debt Instrument, Description of Variable Rate Basis	LIBOR (floor of 0.75%) plus 6.50%
Debt Instrument, Interest Rate, Stated Percentage		8.10%
Lancaster Pollard Mortgage Company, LLC Sheridan Loan [Member]
Debt Instrument, Maturity Date, Description	due in September 2039 through January 2051
Capital One Multifamily Finance LLC [Member]
Debt Instrument, Periodic Payment	$ 49,000
Debt Instrument, Maturity Date, Description	due in September 2053

Loans Payable (Details 1)

Loans Payable (Details 1)	Sep. 30, 2018USD ($)
Debt Instrument [Line Items]
July 1, 2018 to December 31, 2018	$ 320,000
2,019	4,115,000
2,020	1,367,000
2,021	11,378,000
2,022	1,219,000
Thereafter	47,978,000
Total	$ 66,377,000

Loans Payable (Details Textual)

Loans Payable (Details Textual) - USD ($)	1 Months Ended			3 Months Ended			9 Months Ended		12 Months Ended		36 Months Ended
	Apr. 16, 2018	Mar. 30, 2018	Jul. 31, 2017	Sep. 30, 2018	Mar. 31, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Mar. 30, 2020	Mar. 30, 2019	Mar. 30, 2021	Sep. 27, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Debt Instrument, Periodic Payment							$ 209,000
Debt Instrument, Interest Rate, Stated Percentage				4.23%			4.23%						6.30%
Amortization of Debt Issuance Costs							$ 176,000	$ 136,000
Interest Expense, Debt				$ 800,000		$ 700,000	2,500,000	2,000,000
Long-term Debt, Gross				66,377,000			66,377,000						$ 62,619,000
Debt Instrument, Unamortized Discount				2,100,000			2,100,000						1,788,000
Amortization of Debt Discount (Premium)				$ 63,000		$ 69,000	300,000	100,000
Proceeds from Notes Payable							$ 21,369,000	10,050,000
Debt Instrument, Redemption, Description							prepayment penalty of 10% in year 1, which reduces each year by 100 basis points
Prepaid Penalty							$ 69,000
Prepaid Penalty One							10,000
Payments of Debt Issuance Costs							$ 582,000	$ 172,000
Debt Instrument, Maturity Date, Description							35 Years
Hfs Formerly Ge Capital [Member]
Debt Instrument [Line Items]
Debt Instrument, Periodic Payment							$ 5,000
Capital One National Association Loan [Member]
Debt Instrument [Line Items]
Debt Instrument, Periodic Payment							$ 36,000
Debt Instrument, Interest Rate, Stated Percentage				4.30%			4.30%
Amortization of Debt Issuance Costs							$ 15,000
Debt Instrument, Maturity Date			Jan. 17, 2019
Long-term Debt, Gross				$ 10.6			$ 10.6
Debt Extinguishment Percentage							10.00%
Payments of Debt Issuance Costs							$ 300,000
Debt Instrument, Term							35 years
Debt Issuance Costs, Gross												$ 15,000
Cibc Bank [Member]
Debt Instrument [Line Items]
Debt Instrument, Periodic Payment							$ 60,000
Debt Instrument, Interest Rate, Stated Percentage				5.86%			5.86%
Debt Instrument, Maturity Date		Mar. 30, 2021
Long-term Debt, Gross				$ 10,725,000			$ 10,725,000						$ 0
Debt Instrument, Basis Spread on Variable Rate		3.75%
Long-term Debt, Fair Value					$ 10,725,000
Proceeds from Notes Payable	$ 1,700,000	$ 9,000,000
Debt Instrument, Redemption, Description							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
Payments of Debt Issuance Costs					$ 200,000
Debt Instrument, Maturity Date, Description							due in March 2021
Cibc Bank [Member] | Scenario, Forecast [Member]
Debt Instrument [Line Items]
Debt Instrument, Periodic Payment									$ 19,000	$ 18,000	$ 20,000
Oxford Finance [Member]
Debt Instrument [Line Items]
Amortization of Debt Issuance Costs							$ 79,000
Interest Expense, Debt							167,000
Payment for Debt Extinguishment or Debt Prepayment Cost							$ 87,500
HUD Pennington Loan [Member]
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage				4.23%			4.23%
Debt Instrument Mortgage Insurance Premium percentage							0.65%

Equity-Method Investments (Deta

Equity-Method Investments (Details) - USD ($)	Sep. 30, 2018	Dec. 31, 2017
Dividends Receivable	$ 442,000	$ 371,000
SUL JV
Dividends Receivable	163,000	169,000
Fantasia JV
Dividends Receivable	124,000	30,000
Fantasia II JV
Dividends Receivable	50,000	58,000
Fantasia III JV
Dividends Receivable	92,000	97,000
FPH JV
Dividends Receivable	$ 13,000	$ 17,000

Equity-Method Investments (De_2

Equity-Method Investments (Details 1) - USD ($)	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
Total Cash Distributions Received	$ 940,000	$ 840,000
Cash Flow from Operating	321,000	232,000
Cash Flow from Investing	619,000	608,000
SUL JV
Total Cash Distributions Received	379,000	556,000
Cash Flow from Operating	140,000	117,000
Cash Flow from Investing	239,000	439,000
Fantasia JV
Total Cash Distributions Received	45,000	136,000
Cash Flow from Operating	8,000	19,000
Cash Flow from Investing	37,000	117,000
Fantasia II JV
Total Cash Distributions Received	191,000	148,000
Cash Flow from Operating	45,000	96,000
Cash Flow from Investing	146,000	52,000
Fantasia III JV
Total Cash Distributions Received	259,000	0
Cash Flow from Operating	106,000	0
Cash Flow from Investing	153,000	0
FPH JV
Total Cash Distributions Received	66,000	0
Cash Flow from Operating	22,000	0
Cash Flow from Investing	$ 44,000	$ 0

Equity-Method Investments (De_3

Equity-Method Investments (Details Textual) - USD ($)	1 Months Ended		3 Months Ended		9 Months Ended		12 Months Ended
	Apr. 02, 2018	Apr. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2017	Apr. 30, 2018	Apr. 30, 2015
Equity Method Investment, Ownership Percentage			10.00%		10.00%
Equity Method Investments			$ 9,865,000		$ 9,865,000		$ 9,241,000
Dividends Receivable			442,000		442,000		371,000
Proceeds from Dividends Received					$ 321,000	$ 232,000
Disposal Group, Including Discontinued Operation, Accounts, Notes and Loans Receivable, Net							947,000
Summit Fantasia Holdings III, LLC [Member]
Limited Liability Company or Limited Partnership, Managing Member or General Partner, Compensation					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.
Equity Method Investments			1,700,000		$ 1,700,000		1,800,000
SUL JV acquired [Member]
Proceeds from Dividends Received		$ 122,000
Disposal Group, Including Discontinued Operation, Accounts, Notes and Loans Receivable, Net			105,000		$ 105,000		105,000
Summit Fantasia ll Holdings LLC [Member]
Limited Liability Company or Limited Partnership, Managing Member or General Partner, Compensation					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.
Equity Method Investments			1,600,000		$ 1,600,000		1,800,000
Summit Fantasia ll Holdings LLC [Member] | Asset Management [Member]
Revenue from Contract with Customer, Including Assessed Tax			200,000	$ 300,000	$ 500,000	$ 600,000
Summit Fantasia Holdings Llc [Member]
Limited Liability Company or Limited Partnership, Managing Member or General Partner, Compensation	As a result of this capital contribution, as of April 27, 2018, the Operating Partnership will have a 35% equity investment and each member will each receive a distribution of net operating cash flow and capital proceeds after the pari passu of 50% instead of 70% for Fantasia and 30% for the Operating Partnership				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.
Equity Method Investments			2,200,000		$ 2,200,000		1,100,000
Additional Paid in Capital								$ 1,250,000
Summit Fantasy Pearl Holdings, LLC [Member]
Limited Liability Company or Limited Partnership, Managing Member or General Partner, Compensation					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.
Equity Method Investments			900,000		$ 900,000		900,000
Summit Union Life Holdings, LLC [Member]
Limited Liability Company or Limited Partnership, Managing Member or General Partner, Compensation					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%.
Equity Method Investments			$ 3,500,000		$ 3,500,000		3,600,000
Best Years Llc [Member] | Minimum [Member]
Equity Method Investment, Ownership Percentage			9.00%		9.00%
Best Years Llc [Member] | Maximum [Member]
Equity Method Investment, Ownership Percentage			10.00%		10.00%
JV 2 Properties [Member]
Dividends Receivable		$ 110,000	$ 184,000		$ 184,000		184,000		$ 362,000
Proceeds from Dividends Received							$ 56,000
Adjustment To Additional Paid In Capital Increase From Cash Addition					$ 5,000

Receivables (Details)

Receivables (Details) - USD ($)	Sep. 30, 2018	Dec. 31, 2017
Straight-line rent receivables	$ 3,531,000	$ 3,046,000
Distribution receivables from Equity-Method Investments	442,000	371,000
Receivable from JV 2 properties	184,000	184,000
Asset management fees	201,000	170,000
Other receivables	121,000	335,000
Total	$ 4,479,000	$ 4,106,000

Receivables (Details Textual)

Receivables (Details Textual) - USD ($)	1 Months Ended		3 Months Ended		9 Months Ended
	Jan. 31, 2018	Dec. 31, 2017	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2015	Sep. 30, 2014
Accounts, Notes, Loans and Financing Receivable [Line Items]
Interest Income Note Receivable			$ 0	$ 43,000	$ 18,000	$ 129,000
Financing Receivable, Net		$ 3,854,000	$ 781,000		$ 781,000
Receivable with Imputed Interest, Effective Yield (Interest Rate)					4.25%
Debt Instrument, Interest Rate, Stated Percentage		6.30%	4.23%		4.23%
Debt Instrument, Frequency of Periodic Payment					22,000
Receivable with Imputed Interest, Face Amount			$ 1,100,000		$ 1,100,000
Proceeds from Sale of Notes Receivable					4,231,000	25,000
Gain (Loss) on Sale of Notes Receivable			0	$ 0	186,000	$ 0
Receivable with Imputed Interest, Discount			95,000		95,000
Nantucket Note [Member]
Accounts, Notes, Loans and Financing Receivable [Line Items]
Proceeds from Sale of Notes Receivable	$ 4,000,000
Gain (Loss) on Sale of Notes Receivable	$ 200,000
Friendswood TRS [Member]
Accounts, Notes, Loans and Financing Receivable [Line Items]
Financing Receivable, Net			800,000		$ 800,000
Receivable with Imputed Interest, Due Date					Dec. 31, 2021
Sherburne Commons, Inc., Money Note [Member]
Accounts, Notes, Loans and Financing Receivable [Line Items]
Receivable with Imputed Interest, Face Amount							$ 5,000,000
Proceeds from Sale of Notes Receivable		$ 900,000
Operator [Member]
Accounts, Notes, Loans and Financing Receivable [Line Items]
Financing Receivable, Net		$ 38,000	$ 12,000		$ 12,000			$ 140,000
Debt Instrument, Interest Rate, Stated Percentage			6.00%		6.00%

Related Party Transactions (Det

Related Party Transactions (Details) - Cornerstone Realty Advisors, LLC [Member]	Sep. 30, 2018USD ($)
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

Related Party Transactions (D_2

Related Party Transactions (Details Textual)	9 Months Ended
	Sep. 30, 2018
Minimum [Member]
Related Party Transaction [Line Items]
Percentage Of Restricted Operating Expenses	2.00%
Maximum [Member]
Related Party Transaction [Line Items]
Percentage Of Restricted Operating Expenses	25.00%

Concentration of Risk (Details

Concentration of Risk (Details Textual)	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2017
Tenant One, Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	41.00%	50.00%	41.00%	55.00%
Tenant Two, Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	24.00%	30.00%	23.00%	33.00%
Tenant Three, Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	14.00%	19.00%	13.00%	11.00%
Assets, Total [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage			32.00%		33.00%

Fair Value Measurements of Fi_2

Fair Value Measurements of Financial Instruments (Details Textual) - USD ($)	Sep. 30, 2018	Dec. 31, 2017
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Loans Payable, Fair Value Disclosure	$ 66,800,000	$ 63,300,000
Long-term Debt, Gross	66,377,000	$ 62,619,000
Friendswood TRS [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Loans Payable, Fair Value Disclosure	800,000
Long-term Debt, Gross	$ 800,000
Fair Value, Inputs Discount Rate, Loans payable	4.70%
Minimum [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair Value, Inputs Discount Rate, Loans payable	4.40%
Maximum [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair Value, Inputs Discount Rate, Loans payable	6.30%
Weighted Average [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair Value, Inputs Discount Rate, Loans payable	4.70%

Commitments and Contingencies (

Commitments and Contingencies (Details Textual)	Dec. 21, 2017USD ($)
consulting fees	$ 270,000
Alleged agreement [Member]
consulting fees	$ 10,000

Equity (Details)

Equity (Details)	9 Months Ended
	Sep. 30, 2018$ / sharesshares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options granted | shares	341,500
Expected Volatility	21.97%
Expected lives	2 years 4 months 24 days
Risk-free interest rate	2.27%
Dividends	0.00%
Fair value per share | $ / shares	$ 0.36

Equity (Details 1)

Equity (Details 1)	9 Months Ended
	Sep. 30, 2018USD ($)$ / sharesshares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options outstanding, Beginning Balance	895,408
Options, Granted	341,500
Options, Exercised	0
Options, Cancelled/forfeited	(3,668)
Options outstanding, Ending Balance	1,233,240
Options exercisable, Ending Balance	903,187
Weighted Average Exercise Price, Outstanding at Beginning Balance | $ / shares	$ 1.90
Weighted Average Exercise Price, Granted | $ / shares	2.24
Weighted Average Exercise Price, Outstanding at Ending Balance | $ / shares	1.99
Weighted Average Exercise Price, Exercisable at Ending Balance | $ / shares	$ 1.93
Options outstanding, Weighted Average Remaining Contractual Term	8 years 3 months 22 days
Options exercisable, Weighted Average Remaining Contractual Term	8 years
Options outstanding, Aggregate Intrinsic Value | $	$ 993,000
Options exercisable, Aggregate Intrinsic Value | $	$ 790,000

Equity (Details 2)

Equity (Details 2)	Sep. 30, 2018USD ($)
Schedule of Equity Method Investments [Line Items]
Unrecognized stock-based compensation expense related to unvested stock options, net of forfeitures	$ 117,000
July 1, 2018 to December 31, 2018[Member]
Schedule of Equity Method Investments [Line Items]
Unrecognized stock-based compensation expense related to unvested stock options, net of forfeitures	23,000
2019 [Member]
Schedule of Equity Method Investments [Line Items]
Unrecognized stock-based compensation expense related to unvested stock options, net of forfeitures	62,000
2020 [Member]
Schedule of Equity Method Investments [Line Items]
Unrecognized stock-based compensation expense related to unvested stock options, net of forfeitures	27,000
2021 [Member]
Schedule of Equity Method Investments [Line Items]
Unrecognized stock-based compensation expense related to unvested stock options, net of forfeitures	$ 5,000

Equity (Details Textual)

Equity (Details Textual) - USD ($)	Jan. 02, 2018	May 31, 2018	Apr. 02, 2018	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Schedule of Equity [Line Items]
Options, Granted						341,500
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Weighted Average Grant Date Fair Value						$ 0.36
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Remaining Contractual Term						8 years 3 months 22 days
Share-based Compensation Arrangement by Share-based Payment Award, Options, Nonvested, Weighted Average Exercise Price				$ 0.35		$ 0.35
General and Administrative Expense [Member]
Schedule of Equity [Line Items]
Allocated Share-based Compensation Expense				$ 23,000	$ 18,000	$ 78,000	$ 83,000
Omnibus Incentive Plan [Member]
Schedule of Equity [Line Items]
Options, Granted	41,500		200,000
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Weighted Average Grant Date Fair Value	$ 0.40
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Remaining Contractual Term	10 years
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			$ 0.32
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			$ 0.42
Incentive Plan [Member] | Employee [Member]
Schedule of Equity [Line Items]
Options, Granted			100,000
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

Dispositions (Details)

Dispositions (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Revenues:
Resident services and fee income		$ 2,413,000		$ 6,829,000
Other revenues		5,000		8,000
Disposal Group, Including Discontinued Operation, Revenue		2,418,000		6,837,000
Expenses:
Property operating costs		157,000		442,000
Resident services costs		1,658,000		4,917,000
General and administrative		18,000		54,000
Depreciation and amortization		14,000		41,000
Disposal Group, Including Discontinued Operation, Total Expenses		1,847,000		5,454,000
Income from discontinued operations	$ 0	$ 571,000	$ 109,000	$ 1,383,000

Dispositions (Details 1)

Dispositions (Details 1) - USD ($)	Sep. 30, 2018	Dec. 31, 2017	Sep. 30, 2017
ASSETS:
Cash and cash equivalents	$ 0	$ 459,000	$ 597,000
Real estate properties, net		320,000
Tenant and other receivables, net		947,000
Other assets		36,000
Total assets	0	1,762,000
LIABILITIES:
Accounts payable and accrued liabilities		821,000
Accrued salaries and benefits		77,000
Total liabilities of property held for sale	$ 0	$ 898,000

Dispositions (Details Textual)

Dispositions (Details Textual) - USD ($)	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Receivable with Imputed Interest, Face Amount	$ 1,100,000
Receivable with Imputed Interest, Periodic payment	$ 22,000
Receivable with Imputed Interest, Effective Yield (Interest Rate)	4.25%
Cash Provided by (Used in) Operating Activities, Discontinued Operations		$ 758,000
Cash Provided by (Used in) Investing Activities, Discontinued Operations		$ 163,000
Receivable with Imputed Interest, Discount	$ 95,000