Summit Healthcare REIT 10-Q 15 May 24 2024 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2024	May 09, 2024
Document and Entity Information
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2024
Document Transition Report	false
Entity File Number	000-52566
Entity Registrant Name	SUMMIT HEALTHCARE REIT, INC.
Entity Incorporation, State or Country Code	MD
Entity Tax Identification Number	73-1721791
Entity Address, Address Line One	23382 MILL CREEK DRIVE, SUITE 125,
Entity Address, City or Town	LAGUNA HILLS
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	92653
City Area Code	800
Local Phone Number	978-8136
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		23,027,978
Entity Central Index Key	0001310383
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q1
Amendment Flag	false
No Trading Symbol Flag	true

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited) - USD ($)	Mar. 31, 2024	Dec. 31, 2023
ASSETS
Cash and cash equivalents	$ 6,480,000	$ 10,997,000
Restricted cash	3,130,000	3,186,000
Real estate properties, net (Note 14)	58,065,000	156,966,000
Intangible lease assets, net (Note 14)	1,213,000	11,653,000
Tenant and other receivables, net	4,373,000	2,590,000
Other assets, net	1,505,000	1,552,000
Equity-method investments	1,576,000	2,852,000
Contract assets associated with GA8 Properties (Note 14)	126,061,000
Total assets	202,403,000	189,796,000
LIABILITIES AND EQUITY (DEFICIT)
Accounts payable and accrued liabilities	5,242,000	7,038,000
Accrued interest associated with GA8 Properties (Note 14)	2,782,000	1,041,000
Security deposits (Note 14)	837,000	3,705,000
Loans payable, net of debt issuance costs	56,860,000	56,179,000
Loans payable associated with GA8 Properties (Note 14)	123,280,000	123,750,000
Total liabilities	189,001,000	191,713,000
Commitments and contingencies
Stockholders' Equity (Deficit)
Preferred stock, $0.001 par value; 10,000,000 shares authorized; no shares issued or outstanding at March 31, 2024 and December 31, 2023
Common stock, $0.001 par value; 290,000,000 shares authorized; 23,027,978 shares issued and outstanding at March 31, 2024 and December 31, 2023	23,000	23,000
Additional paid-in capital	116,485,000	116,473,000
Accumulated deficit	(103,232,000)	(118,535,000)
Total stockholders' equity (deficit)	13,276,000	(2,039,000)
Noncontrolling interests	126,000	122,000
Total equity (deficit)	13,402,000	(1,917,000)
Total liabilities and equity	$ 202,403,000	$ 189,796,000

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited) (Parenthetical) - $ / shares	Mar. 31, 2024	Dec. 31, 2023
CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited)
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 (Unaudited) - USD ($)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Revenues:
Total rental revenues	$ 3,935,000	$ 5,366,000
Resident fees and services	1,700,000	1,369,000
Asset management fees	96,000	147,000
Total operating revenue	5,731,000	6,882,000
Expenses:
Property operating costs	535,000	806,000
Resident costs	1,378,000	1,211,000
General and administrative	1,132,000	1,104,000
Depreciation and amortization	1,462,000	1,809,000
Total operating expenses	4,507,000	4,930,000
Gain on derecognition associated with GA8 Properties	(17,698,000)
Operating income	18,922,000	1,952,000
Income from equity-method investees	725,000	125,000
Other income	98,000	96,000
Interest expense	(1,014,000)	(1,028,000)
Interest expense associated with GA8 Properties	(3,406,000)	(3,104,000)
Net income (loss)	15,325,000	(1,959,000)
Noncontrolling interests' share in net (income) loss	(22,000)	(17,000)
Net income (loss) applicable to common stockholders	$ 15,303,000	$ (1,976,000)
Basic and diluted:
Basic, Net income (loss) applicable to common stockholders	$ 0.67	$ (0.09)
Diluted, Net income (loss) applicable to common stockholders	$ 0.67	$ (0.09)
Weighted average shares used to calculate earnings per common share:
Basic	23,027,978	23,027,978
Diluted	23,027,978	23,027,978

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF EQUITY (DEFICIT) (Unaudited) - USD ($)	Common Stock	Additional Paid-In Capital	Accumulated Deficit	Total Stockholders' Equity (Deficit)	Noncontrolling Interests	Total
Balance at the beginning at Dec. 31, 2022	$ 23,000	$ 116,432,000	$ (93,734,000)	$ 22,721,000	$ 177,000	$ 22,898,000
Balance at the beginning (in shares) at Dec. 31, 2022	23,027,978
Stock-based compensation	$ 0	7,000	0	7,000	0	7,000
Distributions paid to noncontrolling interests	0	0	0	0	(17,000)	(17,000)
Net (loss) income	0	0	(1,976,000)	(1,976,000)	17,000	(1,959,000)
Balance at the ending at Mar. 31, 2023	$ 23,000	116,439,000	(95,710,000)	20,752,000	177,000	20,929,000
Balance at the ending (in shares) at Mar. 31, 2023	23,027,978
Balance at the beginning at Dec. 31, 2023	$ 23,000	116,473,000	(118,535,000)	(2,039,000)	122,000	(1,917,000)
Balance at the beginning (in shares) at Dec. 31, 2023	23,027,978
Stock-based compensation	$ 0	12,000	0	12,000	0	12,000
Distributions paid to noncontrolling interests	0	0	0	0	(18,000)	(18,000)
Net (loss) income	0	0	15,303,000	15,303,000	22,000	15,325,000
Balance at the ending at Mar. 31, 2024	$ 23,000	$ 116,485,000	$ (103,232,000)	$ 13,276,000	$ 126,000	$ 13,402,000
Balance at the ending (in shares) at Mar. 31, 2024	23,027,978

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Cash flows from operating activities:
Net income (loss)	$ 15,325,000	$ (1,959,000)
Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities:
Amortization of debt issuance costs	187,000	228,000
Depreciation and amortization	1,462,000	1,809,000
Amortization of above-market lease intangible	21,000	16,000
Straight-line rents	(65,000)	(303,000)
Stock-based compensation expense	12,000	7,000
Income from equity-method investees	(725,000)	(125,000)
Gain on derecognition associated with GA8 Properties	(17,698,000)
Change in operating assets and liabilities, net of derecognition of assets:
Tenant and other receivables, net	284,000	251,000
Other assets, net	(22,000)	17,000
Accounts payable and accrued liabilities	796,000	597,000
Security deposits	(280,000)
Net cash (used in) provided by operating activities	(703,000)	538,000
Cash flows from investing activities:
Reduction of cash from derecognition of assets associated with GA8 Properties	(3,084,000)
Additions to real estate and other assets	(2,000)	(145,000)
Investment in equity-method investees		(156,000)
Distributions received from equity-method investees		115,000
Net cash used in investing activities	(3,086,000)	(186,000)
Cash flows from financing activities:
Payments of loans payable	(766,000)	(284,000)
Distributions paid to noncontrolling interests	(18,000)	(17,000)
Deferred financing costs		(4,000)
Net cash used in financing activities	(784,000)	(305,000)
Net (decrease) increase in cash, cash equivalents and restricted cash	(4,573,000)	47,000
Cash, cash equivalents and restricted cash - beginning of period	14,183,000	14,163,000
Cash, cash equivalents and restricted cash - end of period	9,610,000	14,210,000
Supplemental disclosure of cash flow information:
Cash paid for interest	2,928,000	$ 3,795,000
Derecognition of assets associated with GA8 Properties (Note 14)
Real estate properties, net	97,637,000
Intangible lease assets, net	10,250,000
Other assets	12,000
Accounts payable and accrued liabilities	(821,000)
Write off of deferred financing costs	790,000
Security deposits	$ (2,589,000)

Organization

Organization	3 Months Ended
	Mar. 31, 2024
Organization
Organization	1. Organization Summit Healthcare REIT, Inc. (“Summit”) is a real estate investment trust that owns 100% of 14 properties (eight of which were derecognized in March 2024 and are included in contract assets associated with GA8 Properties (see Note 14)), 95.3% of four properties, and four unconsolidated equity-method investments with interests ranging from 10% - 20% that hold an aggregate of 30 properties. As used in these notes, the “Company”, “we”, “us” and “our” refer to Summit and its consolidated subsidiaries, including but not limited to Summit Healthcare Operating Partnership, L.P. (the “Operating Partnership”), except where the context otherwise requires. We conduct substantially all of our operations through 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. Summit and the Operating Partnership are managed and operated as one entity, and Summit has no significant assets other than its investment in the Operating Partnership. Summit, as the general partner of the Operating Partnership, controls the Operating Partnership and consolidates the assets, liabilities, and results of operations of the Operating Partnership. Cornerstone Healthcare Partners LLC – Consolidated Joint Venture We own 95% of Cornerstone Healthcare Partners LLC (“CHP LLC”), which was formed in 2012, and the remaining 5% noncontrolling interest is owned by Cornerstone Healthcare Real Estate Fund, Inc. (“CHREF”), an affiliate of CRA. CHP LLC is consolidated within our condensed consolidated financial statements and owns four properties (the “JV Properties”) with another partially owned subsidiary. As of March 31, 2024 and December 31, 2023, we own a 95.3% interest in the four JV Properties, and CHREF owns a 4.7% interest. 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 March 31, 2024, we have a 10% interest in the SUL JV which owns 14 properties as of March 31, 2024 and as of December 31, 2023, owned 15 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 March 31, 2024 and December 31, 2023, 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 our condensed consolidated financial statements. As of March 31, 2024 and December 31, 2023, we have a 10% interest in the Fantasia III JV which owns eight properties. See Note 15 for further information. 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 our condensed consolidated financial statements. As of March 31, 2024 and December 31, 2023, we have a 10% interest in the FPH JV which owns six properties. Taxable REIT Subsidiaries Summit Healthcare Asset Management, LLC 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 I JV (through July 2, 2023), 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 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. SHOP TRS LLC SHOP TRS LLC (“SHOP TRS”) is our wholly-owned taxable REIT subsidiary that is the sole member for two of our operated properties which are the lessees for our two respective 100% owned real estate properties and the operated properties operations are consolidated in our condensed consolidated financial statements. ​

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2024
Summary of Significant Accounting Policies
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies For more information regarding our significant accounting policies and estimates, please refer to “Summary of Significant Accounting Policies” contained in the consolidated financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2023 filed with the Securities and Exchange Commission (“SEC”) on April 16, 2024. The accompanying condensed consolidated balance sheet at December 31, 2023 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, 2023 consolidated financial statements and contained in our Annual Report on Form 10-K for the year ended December 31, 2023 filed with the SEC on April 16, 2024 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, 2023 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 and its consolidated companies and are prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”). 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 months ended March 31, 2024 are not necessarily indicative of the results that may be expected for the year ending December 31, 2024. Reclassifications Certain line items on the December 31, 2023 condensed consolidated balance sheet for loans payable and accounts payable and accrued liabilities and on condensed consolidated statement of operations for interest expense for the three months ended March 31, 2023 have been reclassified to conform to the current period presentation. See Note 14. Restricted Cash The following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the condensed consolidated balance sheets that sum to the total of the same such amounts shown on the condensed consolidated statements of cash flows. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, ​ December 31, ​ 2024 2023 Cash and cash equivalents ​ $ 6,480,000 ​ $ 10,997,000 Restricted cash ​ 3,130,000 ​ ​ 3,186,000 Total cash, cash equivalents, and restricted cash shown on the condensed consolidated statements of cash flows ​ $ 9,610,000 ​ $ 14,183,000 ​

Investments in Real Estate Prop

Investments in Real Estate Properties	3 Months Ended
	Mar. 31, 2024
Investments in Real Estate Properties
Investments in Real Estate Properties	3. Investments in Real Estate Properties As of March 31, 2024 and December 31, 2023, the table below includes our 10 real estate properties held by our consolidated subsidiaries, 8 of which are 100% leased to the tenants of the related facilities and two are each 100% leased to an affiliated subsidiary. As of March 31, 2024, the table below excludes our eight derecognized real estate properties (see Note 14) and as of March 31, 2024 and December 31, 2023, excludes the 30 and 31 properties, respectively, owned by our unconsolidated Equity-Method Investments. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, ​ December 31, ​ 2024 2023 Land ​ $ 8,530,000 ​ $ 14,905,000 Buildings and improvements ​ 64,266,000 ​ ​ 157,875,000 Less: accumulated depreciation ​ (15,256,000) ​ ​ (20,439,000) Buildings and improvements, net ​ 49,010,000 ​ ​ 137,436,000 Furniture and fixtures ​ 5,103,000 ​ ​ 12,106,000 Less: accumulated depreciation ​ (4,578,000) ​ ​ (7,481,000) Furniture and fixtures, net ​ 525,000 ​ ​ 4,625,000 Real estate properties, net ​ $ 58,065,000 ​ $ 156,966,000 ​ For the three months ended March 31, 2024 and 2023, depreciation expense (excluding lease intangibles amortization and leasing commission amortization) was approximately $1.3 million and $1.6 million, respectively. CA3 Properties In 2021, we acquired three properties located in California (“CA3 Properties”) and we entered into a first priority $15.0 million mortgage loan collateralized by the CA3 Properties with CIBC Bank, USA (“CIBC”). See table in Note 4 listing loans payable for further information. In February 2024, we entered into a Purchase and Sale Agreement (“PSA”), as amended in April and May 2024 to extend the closing date, to sell the CA3 Properties. The transaction is expected to close in the second quarter of 2024. Either party may terminate the agreement for non-satisfaction or failure of a condition to the obligation of either party to consummate the transaction contemplated by this PSA, unless such matter has been satisfied or waived by the date specified in this PSA or by the closing date. Fantasia I JV Transfer of Interest and Sale On July 3, 2023, the majority member of the Fantasia I JV assigned its 65% interest, for no consideration, to Summit. As such, as of July 2023, Summit owned 100% of Fantasia I JV. The Fantasia I JV consisted of the real estate of Summit Citrus Heights, LLC, a wholly-owned subsidiary (“Summit Citrus Heights”) and the operating assets and liabilities of its associated senior housing facility, Sun Oak Assisted Living (“Sun Oak” or “CH TRS”). Summit Citrus Heights was the sole member of CH TRS LLC, the operating company for Sun Oak. On September 29, 2023, we sold the real estate of Summit Citrus Heights, including the Sun Oak facility. Summary of Properties The following table provides summary information regarding our portfolio (excluding the 30 properties owned by our unconsolidated Equity-Method Investments, our 8 derecognized real estate properties (see Note 14) and the $12.75 million loan from Oxford Finance, LLC (“Oxford”) (see Note 14) with Summit Georgia Holdings LLC, our wholly-owned subsidiary,) as of March 31, 2024: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Loans ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Payable, ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Excluding ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Debt ​ ​ ​ ​ ​ ​ ​ ​ Purchase ​ Issuance Property Location Date Purchased Type (1) Price Costs Rivers Edge Rehabilitation and Care (f/k/a Sheridan Care Center) Sheridan, OR ​ August 3, 2012 SNF ​ $ 4,100,000 ​ $ 3,784,000 Fernhill Care Center Portland, OR ​ August 3, 2012 SNF ​ 4,500,000 ​ ​ 3,320,000 Friendship Haven Healthcare and Rehabilitation Center Galveston County, TX ​ September 14, 2012 SNF ​ 15,000,000 ​ ​ 11,054,000 Pacific Health and Rehabilitation Center Tigard, OR ​ December 24, 2012 SNF ​ 8,140,000 ​ ​ 5,534,000 Brookstone of Aledo Aledo, IL ​ July 2, 2013 AL ​ 8,625,000 ​ ​ 6,426,000 Sundial Assisted Living Redding, CA ​ December 18, 2013 AL ​ 3,500,000 ​ ​ 3,612,000 Pennington Gardens Chandler, AZ ​ July 17, 2017 AL/MC ​ 13,400,000 ​ ​ 9,835,000 Yucaipa Hill Post Acute ​ Yucaipa, CA ​ July 2, 2021 ​ SNF ​ ​ 10,715,000 ​ ​ 8,014,000 Creekside Post Acute ​ Yucaipa, CA ​ July 2, 2021 ​ SNF ​ ​ 4,780,000 ​ ​ 3,575,000 University Post Acute ​ Mentone, CA ​ July 2, 2021 ​ SNF ​ ​ 4,560,000 ​ ​ 3,411,000 Total: ​ ​ ​ ​ ​ ​ $ 77,320,000 ​ $ 58,565,000 (1) SNF is an abbreviation for skilled nursing facility. AL is an abbreviation for assisted living facility. MC is an abbreviation for memory care facility. Future Minimum Lease Payments The future minimum lease payments to be received under our existing tenant operating leases (excluding the 30 properties owned by our unconsolidated Equity-Method Investments, our eight derecognized subsidiaries (see Note 14), and the two intercompany leases between our wholly-owned subsidiaries: Summit Chandler LLC and Pennington Gardens, and HP Redding LLC and Sundial) as of March 31, 2024, for the period from April 1, 2024 to December 31, 2024 and for each of the four following years and thereafter ending December 31 are as follows: ​ ​ ​ ​ ​ Years ending ​ ​ April 1, 2024 to December 31, 2024 ​ $ 4,671,000 2025 ​ 6,332,000 2026 ​ 6,447,000 2027 ​ 6,564,000 2028 ​ 5,115,000 Thereafter ​ 28,497,000 ​ ​ $ 57,626,000 ​ Impairment of Real Estate Properties As a result of our ongoing analysis for potential impairment of our investments in real estate, we may be required to adjust the carrying value of certain assets to their estimated fair values, or estimated fair value less selling costs, under certain circumstances. ​ No impairments were recorded during the three months ended March 31, 2024 and 2023.

Loans Payable

Loans Payable	3 Months Ended
	Mar. 31, 2024
Loans Payable
Loans Payable	4. Loans Payable As of March 31, 2024 and December 31, 2023, our loans payable consisted of the following: ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, 2024 December 31, 2023 Loans payable to Lument (formerly ORIX Real Estate Capital, LLC) (insured by HUD) in monthly installments of approximately $183,000, including interest, ranging from a fixed rate of 2.79% to 4.2%, due in September 2039 through April 2055, and collateralized by Sheridan, Fernhill, Pacific Health, Aledo, Sundial and Friendship Haven. ​ $ 33,730,000 ​ $ 33,984,000 ​ ​ ​ ​ ​ ​ ​ 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. ​ ​ 9,835,000 ​ ​ 9,877,000 ​ ​ ​ ​ ​ ​ ​ Loan payable to CIBC Bank, USA in monthly installments of approximately of $147,000 including cash collateral fund payments, variable interest rate (9.4% at March 31, 2024 and December 31, 2023), due in July 2024, and, collateralized by Yucaipa Hill Post Acute, Creekside Post Acute and University Post Acute (“CA3 Properties”). See Note 3 for additional information. ​ ​ 15,000,000 ​ ​ 15,000,000 ​ ​ ​ ​ ​ ​ ​ ​ ​ 58,565,000 ​ ​ 58,861,000 Less debt issuance costs ​ (1,705,000) ​ ​ (2,682,000) Total loans payable ​ $ 56,860,000 ​ $ 56,179,000 ​ As of March 31, 2024, we have total debt obligations of approximately $58.6 million that will mature between 2024 and 2055, in addition to the loans payable associated with GA8 Properties discussed below. 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 March 31, 2024, we were in compliance with all of our debt covenants except for the GA8 Properties (see below and Note 14 for further information). During the three months ended March 31, 2024 and 2023, we incurred approximately $4.2 million and $3.9 million of interest expense, respectively, including interest expense related to the GA8 Properties and excluding debt issuance costs and amortization. In connection with our loans payable, we incurred debt issuance costs. As of March 31, 2024 and December 31, 2023, the unamortized balance of the debt issuance costs was approximately $1.7 million and $2.7 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 each of the three months ended March 31, 2024 and 2023, $0.2 million of debt issuance costs were amortized and included in interest expense in our condensed consolidated statements of operations. The principal payments due on the loans payable (excluding debt issuance costs and loans payable associated with GA8 Properties) for the period from April 1, 2024 to December 31, 2024 and for each of the four following years and thereafter ending December 31 are as follows: ​ ​ ​ ​ ​ ​ ​ ​ Principal ​ Years Ending Amount April 1, 2024 to December 31, 2024 ​ $ 15,905,000 ​ 2025 ​ 1,246,000 ​ 2026 ​ 1,292,000 ​ 2027 ​ 1,341,000 ​ 2028 ​ 1,390,000 ​ Thereafter ​ 37,391,000 ​ ​ ​ $ 58,565,000 ​ ​ GA8 Properties In 2021, through our wholly-owned subsidiary and the parent holding company for the GA8 Properties, Summit Georgia Holdings LLC (“GA Holdco”), we acquired eight skilled nursing facilities located in Georgia (collectively, the “GA8 Properties”). The GA8 Properties were financed with a $91.0 million first priority mortgage loan with CIBC collateralized by those properties, a $20.0 million subordinated term loan with Oxford Financing LLC (“Oxford”) collateralized by those properties and a $12.75 million mezzanine loan with Oxford secured by the equity interests of the GA Holdco. During 2023 and as of March 31, 2024, we have been out of compliance with respect to our debt covenants for our GA8 Properties due to the tenants’ EBITDAR (earnings before interest, taxes, depreciation, amortization and rent) default and from our continuing failure to pay the full and timely interest payments due on the mezzanine loan from October 2023 to April 2024, and for the subordinated term loan from January 2024 through April 2024. Oxford had previously agreed to defer a portion of our interest payments on the mezzanine loan for October and November 2023. As of March 31, 2024 and December 31, 2023, the outstanding interest due on the mezzanine loan is approximately $1.1 million and $0.6 million, respectively. As of March 31, 2024 and December 31, 2023, the outstanding interest due on the subordinated term loan is approximately $1.0 million and $0.3 million, respectively. All interest and principal payments to CIBC have been made timely. On March 13, 2024, we received a notice of default from Oxford, dated March 12, 2024, for the mezzanine loan primarily based on the non-compliance noted above, whereby Oxford exercised certain rights, including, their right to act as attorney-in-fact of GA8 HoldCo, and appointed an independent manager over the GA8 Properties, thereby removing the Company as the manager and removing the Company’s voting rights and rights to receive any distributions with respect to such properties. The Oxford notice of default also constitutes an event of default under the GA8 Properties subordinated term loan with Oxford and the first priority mortgage loan with CIBC. On May 7, 2024, we received a notice of default and reservation of rights letter from CIBC. There were no actions taken by this notice. See Note 14 for further information regarding the derecognition of the GA8 Properties and related debt. ​ As of March 31, 2024 and December 31, 2023, loans payable associated with GA8 Properties consisted of the following: ​ ​ ​ ​ ​ ​ ​ ​ March 31, 2024 December 31, 2023 Loan payable to CIBC Bank, USA in monthly installments of approximately $850,000 (including interest and principal) variable interest rate (8.8% at March 31, 2024 and December 31, 2023), due in December 2024, and collateralized by Calhoun Health Center, Maple Ridge Health Care Center, Chatsworth Health Care Center, East Lake Arbor, Fairburn Health Care Center, Grandview Health Care Center, Rosemont at Stone Mountain, and Willowwood Nursing Center & Rehab (“GA8 Properties”). See Note 14 for additional information. ​ 90,530,000 ​ 91,000,000 ​ ​ ​ ​ ​ ​ ​ Loan payable to Oxford Finance, LLC in monthly installments of approximately $260,000 (interest only through maturity), variable interest rate (16.4% at March 31, 2024 and December 31, 2023, respectively) due in March 2025, collateralized in second position by the GA8 Properties. See Note 14 for additional information. ​ 20,000,000 ​ 20,000,000 ​ ​ ​ ​ ​ ​ ​ Mezzanine Loan payable to Oxford Finance, LLC in monthly installments of approximately $168,000 (interest only through maturity), variable interest rate (16.4% at March 31, 2024 and December 31, 2023, respectively) due in December 2026, secured by the equity interests of our wholly-owned subsidiary, Summit Georgia Holdings LLC, the parent holding company for the GA8 Properties. See Note 14 for additional information. ​ ​ 12,750,000 ​ ​ 12,750,000 ​ ​ ​ ​ ​ ​ ​ Total loans payable associated with GA8 Properties ​ $ 123,280,000 ​ $ 123,750,000 ​ HUD-insured loans We have six properties with HUD-insured loans from Lument Capital (formerly ORIX Real Estate Capital, LLC) and one property with a HUD-insured loan from Capital One Multifamily Finance, LLC. 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. ​ Master Letter of Credit Agreement In June 2023, we entered into $1.0 million Master Letter of Credit Agreement with CIBC. As of March 31, 2024, there are no outstanding letters of credit under this agreement.

Equity-Method Investments

Equity-Method Investments	3 Months Ended
	Mar. 31, 2024
Equity-Method Investments
Equity-Method Investments	5. Equity-Method Investments As of March 31, 2024 and December 31, 2023, the balances of our Equity-Method Investments were approximately $1.6 million and $2.9 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 is distributed monthly, first to the Operating Partnership and Best Years pari passu pari passu For the three months ended March 31, 2024 and 2023, we invested approximately $0 and $156,000, respectively, related to capital calls for the SUL JV. In March 2024, the SUL JV sold one property for a gain of $7.7 million. We recorded our 10% share of the gain of approximately $0.8 million in income from equity-method investees in the condensed consolidated statements of operations for the three months ended March 31, 2024 and recorded distributions receivable from the sale of approximately $1.9 million, which is included in tenant and other receivables in the condensed consolidated balance sheet as of March 31, 2024. Additionally, in April 2024, we received approximately $1.9 million in cash for the distributions receivable. As of March 31, 2024 and December 31, 2023, the balance of our equity-method investment related to the SUL JV was approximately $0.6 million and $1.8 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”). 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 In June 2023, the tenant for the two properties in the Fantasia II JV filed for receivership. The two properties are currently being operated by the receivership estate in conjunction with a third-party manager under a one-year management agreement. As of March 31, 2024, there has been no termination of the tenant leases and the Fantasia II JV is currently communicating with the receiver regarding ongoing lease terms and payments. The Fantasia II JV has not received any rent payments since May 2023. In September 2023, due to the ongoing issues with the receivership, we determined the fair value of our investment in the Fantasia II JV to be impaired and recorded a $0.5 million impairment charge. However, due to our intention to fund a capital call in 2024, we are recording our share of the Fantasia II JV losses. As of March 31, 2024 and December 31, 2023, due to the losses incurred in the Fantasia II JV, the negative balance of our equity-method investment related to the Fantasia II JV was approximately ($0.2) million and ($0.1) 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 is distributed monthly, first to the Operating Partnership and Fantasia pari passu pari passu On May 1, 2024, the Fantasia III JV sold the eight properties and therefore as of May 2, 2024, we no longer have an equity-method investment in the Fantasia III JV. See Note 15 for further information. As of March 31, 2024 and December 31, 2023, the balance of our equity-method investment related to the Fantasia III JV was approximately $1.2 million. 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 is distributed monthly, first to the members pari passu refinancing or another capital event, will be paid to the members pari passu As of March 31, 2024 and December 31, 2023, the balance of our equity-method investment related to the FPH JV was $0. Distributions from Equity-Method Investments As of March 31, 2024 and December 31, 2023, we have distributions receivable, which are included in tenant and other receivables in our condensed consolidated balance sheets, as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, ​ December 31, ​ 2024 2023 SUL JV ​ $ 2,131,000 (1) $ 311,000 Fantasia II JV ​ 30,000 ​ ​ 30,000 Fantasia III JV ​ 111,000 ​ ​ 87,000 FPH JV ​ 64,000 ​ ​ 64,000 Total ​ $ 2,336,000 ​ $ 492,000 (1) Included in the SUL JV distributions receivable are proceeds from the sale of a property in March 2024 for approximately $1.9 million for which the cash was received in April 2024. ​ For the three months ended March 31, 2024 and 2023, 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: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three months Ended March 31, 2024 ​ Three months Ended March 31, 2023 ​ ​ ​ ​ ​ Cash Flow ​ Cash Flow ​ ​ ​ ​ Cash Flow ​ Cash Flow ​ ​ Total Cash ​ from ​ from ​ Total Cash ​ from ​ from ​ ​ Distributions ​ Operating ​ Investing ​ Distributions ​ Operating ​ Investing ​ Received Activities Activities Received Activities Activities SUL JV ​ $ 159,000 ​ $ 159,000 ​ $ — ​ $ 134,000 ​ $ 42,000 ​ $ 92,000 Fantasia II JV ​ — ​ ​ — ​ ​ — ​ ​ 80,000 ​ ​ 57,000 ​ ​ 23,000 Fantasia III JV ​ — ​ ​ — ​ ​ — ​ ​ 12,000 ​ ​ 12,000 ​ ​ — FPH JV ​ — ​ ​ — ​ ​ — ​ ​ — ​ ​ — ​ ​ — Total ​ $ 159,000 ​ $ 159,000 ​ $ — ​ $ 226,000 ​ $ 111,000 ​ $ 115,000 ​ 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 annual asset management fee for managing the properties held by our Equity-Method Investments, as defined in those agreements. For the three months ended March 31, 2024 and 2023, we recorded approximately $0.1 million and $0.2 million, respectively, in asset management fees from our Equity-Method Investments.

Receivables

Receivables	3 Months Ended
	Mar. 31, 2024
Receivables
Receivables	6. Receivables Tenant and Other Receivables, Net Tenant and other receivables, net consists of: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, ​ December 31, ​ 2024 2023 Straight-line rent receivables ​ $ 1,461,000 ​ $ 1,396,000 Distribution receivables from Equity-Method Investments (see Note 5) ​ 2,336,000 ​ ​ 492,000 Asset management fees ​ 230,000 ​ ​ 327,000 Other receivables ​ 346,000 ​ ​ 375,000 Total ​ $ 4,373,000 ​ $ 2,590,000 ​

Related Party Transactions

Related Party Transactions	3 Months Ended
	Mar. 31, 2024
Related Party Transactions
Related Party Transactions	7. Related Party Transactions Equity-Method Investments See Notes 5 and 6 for further discussion of distributions and asset management fees related to our Equity-Method Investments.

Intangible Lease Assets

Intangible Lease Assets	3 Months Ended
	Mar. 31, 2024
Intangible Lease Assets
Intangible Lease Assets	8. Intangible Lease Assets As of March 31, 2024, the table below includes intangible lease assets related to our consolidated real estate properties and excludes our eight derecognized real estate properties (see Note 14). As of December 31, 2023, the table below includes intangible lease assets related to our consolidated real estate properties. Intangible lease assets are as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, December 31, ​ ​ 2024 ​ 2023 In-place leases ​ $ 526,000 ​ $ 12,680,000 Less: accumulated amortization ​ (97,000) ​ ​ (1,831,000) In-place leases, net ​ 429,000 ​ ​ 10,849,000 Above-market leases ​ 959,000 ​ ​ 959,000 Less: accumulated amortization ​ (175,000) ​ ​ (155,000) Above-market leases, net ​ 784,000 ​ ​ 804,000 Total intangible lease assets, net ​ $ 1,213,000 ​ $ 11,653,000 ​ For each of the three months ended March 31, 2024 and 2023, amortization expense for intangible lease assets was approximately $0.2 million of which approximately $0.02 million relates to the amortization of above market leases which is included within rental revenues in the accompanying condensed consolidated statements of operations. Expected future amortization of the intangible lease assets as of March 31, 2024, for the period from April 1, 2024 to December 31, 2024 and for each of the four following years and thereafter ending December 31 are as follows: ​ ​ ​ ​ Years ending December 31, ​ April 1, 2024 to December 31, 2024 ​ $ 75,000 2025 ​ 99,000 2026 ​ 99,000 2027 ​ 99,000 2028 ​ 99,000 Thereafter ​ 742,000 ​ ​ $ 1,213,000 ​

Right of Use (ROU) Asset - Oper

Right of Use (ROU) Asset - Operating	3 Months Ended
	Mar. 31, 2024
Right of Use (ROU) Asset - Operating
Right of Use (ROU) Asset - Operating	9. Right of Use (ROU) Asset - Operating In November 2022, we entered into an operating lease for office space (“Office Lease”) for a period of sixty-six The Office Lease is classified as an operating lease. A “right to use” or “ROU asset” represents the right to use an underlying asset for the lease term and lease liabilities represent the obligation to make lease payments arising from the lease. ROU assets and lease liabilities are recognized at commencement date based on the present value of lease payments over the lease term. The Office Lease did not provide an explicit rate of interest; therefore we used an estimated incremental borrowing rate of 5% based on a fully collateralized and fully amortizing loan with a maturity date of the same length as the lease that is based on information available at the commencement date in determining the present value of lease payments. The Office Lease does not contain material residual value guarantees or material restrictive covenants. Supplemental balance sheet information related to the Office Lease are as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Component Consolidated Balance Sheet Caption March 31, 2024 December 31, 2023 Right of use asset - operating Other assets, net ​ $ 664,000 ​ $ 698,000 Lease liability - operating Accounts payable and accrued liabilities ​ $ 835,000 ​ $ 877,000 ​ Lease expense is presented as part of continuing operations within general and administrative expenses in the condensed consolidated statements of operations. For the three months ended March 31, 2024 and 2023, we recognized approximately $46,000 and $45,000, respectively, in lease expense. The lease payments are classified within operating activities in the consolidated statements of cash flows. As of March 31, 2024 and 2023, we paid approximately $53,000 and $0, respectively, in lease payments and the weighted average remaining lease term is 4.0 years. Lease payments on the Office Lease for the period from April 1, 2024 to December 31, 2024 and for each of the four following years and thereafter ending December 31 are as follows: ​ ​ ​ ​ ​ Year Lease payments April 1, 2024 to December 31, 2024 ​ $ 158,000 2025 ​ 217,000 2026 ​ 224,000 2027 ​ 231,000 2028 ​ 99,000 Total lease payments ​ $ 929,000 Less imputed interest ​ (94,000) Total lease liability ​ $ 835,000 ​

Concentration of Risk

Concentration of Risk	3 Months Ended
	Mar. 31, 2024
Concentration of Risk
Concentration of Risk	10. Concentration of Risk As of March 31, 2024, we owned eight properties in Georgia (see Note 14), four properties in California, three properties in Oregon, one property in Texas, one property in Illinois, and one property in Arizona (excluding the 30 properties held by our Equity-Method Investments). Accordingly, there is a geographic concentration of risk subject to economic conditions in certain states. For the three months ended March 31, 2024, we leased our 16 real estate properties to 14 different tenants under long-term triple net leases, and four of the 14 tenants each represented more than 10% of our rental revenue. For the three months ended March 31, 2023, we leased our 16 real estate properties to 14 different tenants under long-term triple net leases, and three of the 14 tenants each represented more than 10% of our rental revenue. As of March 31, 2024, our GA8 Properties are considered to be a significant asset concentration as the aggregate net assets of the GA8 Properties were greater than 20% of our total assets due to cross-default provisions in the leases. For further information regarding our treatment of the GA8 Properties, see Note 14.

Fair Value Measurements of Fina

Fair Value Measurements of Financial Instruments	3 Months Ended
	Mar. 31, 2024
Fair Value Measurements of Financial Instruments
Fair Value Measurements of Financial Instruments	11. Fair Value Measurements of Financial Instruments Our condensed consolidated balance sheets include the following financial instruments: cash and cash equivalents, restricted cash, tenant and other receivables, certain other assets, accounts payable and accrued liabilities, security deposits and loans payable. With the exception of the loans payable discussed below, we consider the carrying values to approximate fair value (categorized within Level 1 of the fair value hierarchy) for such financial instruments because of the short period of time between origination of the instruments and their expected payment. As of March 31, 2024 and December 31, 2023, the fair value of our HUD-insured loans payable was $36.2 million and $36.4 million, compared to the principal balance (excluding debt discount) of $43.6 million and $43.9 million, respectively. The fair value of loans payable was estimated using lending rates available to us for financial instruments with similar terms and maturities. The fair value of our fixed and variable rate loans payable was estimated by discounting the future cash flows using the current rates at which similar loans would be made to borrowers with similar credit ratings and for the same remaining maturities. As the inputs to our valuation estimate are neither observable in nor supported by market activity, our loans payable are classified as Level 3 liability within the fair value hierarchy. As of March 31, 2024 and December 31, 2023, we believe the carrying amounts of our variable rate loans payable are reasonably estimated at their carrying amounts as there have been minimal changes to the fixed spread portion of interest rates for similar loans observed in the market, and as the variable portion of our interest rates fluctuate with the associated market indices. We believe the fair value of our variable rate mezzanine loan payable, which is currently in default, approximates the carrying amount based on the contractual rights of the mezzanine loan payable holders. As of March 31, 2024 and December 31, 2023, we do not have any significant 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	3 Months Ended
	Mar. 31, 2024
Commitments and Contingencies
Commitments and Contingencies	12. Commitments and Contingencies We inspect our properties under a Phase I assessment for the presence of hazardous or toxic substances. 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 HCRE In September 2015, a bankruptcy petition was filed against Healthcare Real Estate Partners, LLC (“HCRE”) by the investors in Healthcare Real Estate Fund, LLC and Healthcare Real Estate Qualified Purchasers Fund, LLC (collectively, the “Funds”). HCRE did not timely respond to the involuntary petition and the Bankruptcy Court entered an Order of Relief making HCRE a debtor in bankruptcy. As a result, HCRE was removed as manager under the Funds’ operating agreement. Thereafter the Company became the manager of the Funds and purchased the investors’ interests in the Funds for approximately $0.9 million. Following the subsequent dismissal of the involuntary bankruptcy petition filed against it, HCRE filed a motion for attorneys’ fees and damages and a separate complaint for violation of the automatic stay against the petitioning creditors and the Company in the United States Bankruptcy Court of the District of Delaware. The Bankruptcy Court granted a motion to dismiss the complaint for violation of the automatic stay filed jointly by the petitioning creditors and us, and dismissed the complaint with prejudice. HCRE appealed the Bankruptcy Court’s decision to the United States District Court for the District of Delaware which affirmed the Bankruptcy Court’s dismissal of the complaint in a decision dated September 9, 2018. On October 11, 2018, HCRE appealed the District Court’s decision affirming the Bankruptcy Court’s dismissal of the complaint to the United States Court of Appeals for the Third Circuit. On October 22, 2019, the Third Circuit granted HCRE’s appeal, reversing the District Court and holding that HCRE could assert the adversary complaint seeking damages for violation of the automatic stay. The Company filed a Petition for Rehearing on November 5, 2019 asserting that HCRE is not entitled to assert a claim for damages for violation of the automatic stay. This Petition was denied and the mandate was issued sending the matter back to the Bankruptcy Court. The Bankruptcy Court held a status conference on February 4, 2021, and subsequently entered scheduling orders to govern discovery and pretrial matters. The parties filed dispositive motions, including a motion filed by the Company and the petitioning creditors for judgment on the pleadings. On February 4, 2022, the Bankruptcy Court entered an order denying the motion for judgment on the pleadings on the basis that the Bankruptcy Court would consider the points raised therein after trial. The Bankruptcy Court also entered an order denying HCRE’s motion to dismiss certain counterclaims and severing certain other counterclaims asserted by the petitioning creditors and the Company against HCRE on jurisdictional grounds, with the effect that such counterclaims may be pursued in the United States District Court. Trial in the Bankruptcy Court was conducted on January 9 and 10, 2023, with final concluding arguments presented on January 19, 2023. On May 12, 2023, the Court issued an opinion to award the plaintiffs $75,000 for reimbursement of legal fees related to the filing of the involuntary bankruptcy petition plus $517,000 for reimbursement of attorney’s fees related to the stay violation. Several additional motions have been filed and were heard in September 2023. On November 14, 2023, the Bankruptcy Court entered a further Memorandum Opinion, which modified the award for reimbursement of attorneys’ fees for the stay violation from $517,000 to $665,000. The Bankruptcy Court entered an Order and Judgment with respect to the amounts set forth above on May 2, 2024. The Company also filed a notice of appeal with respect to the $664,637 fee award, which appeal remains pending. The Company has also asserted counterclaims against HCRE, which are pending in the Delaware District Court, and which are stayed pending a final determination of the matters addressed in the Bankruptcy Court, including the appeal. Based on the assessment by management, as of March 31, 2024, the Company has accrued $75,000 for the reimbursement of legal fees related to the involuntary petition filing and $0 for the $665,000 in attorney’s fees related to the stay violation as we believe that a loss is currently not probable under Accounting Standards Codification 450, “Contingencies.” Eikanas Dispute On May 15, 2023, the Board of Directors of the Company sent Kent Eikanas, the then-Chief Executive Officer, written notice of various deficiencies in his performance , thereby initiating the 60-day cure period required by Mr. Eikanas’ Amended and Restated Employment Agreement, dated October 19, 2021. On July 14, 2023 (the “Termination Date”), the Board of Directors (the “Board”) of the Company terminated, for cause, Mr. Eikanas from his position as Chief Executive Officer and Secretary of the Company, after Mr. Eikanas was given written notice of and failed to cure various deficiencies in his performance following the expiration of a 60-day cure period. Per the terms of his employment agreement, upon Mr. Eikanas’ termination for cause, Mr. Eikanas is also deemed to have resigned, as of the Termination Date, from all positions with the Company and its subsidiaries, the Board and any boards of directors or managers of any of Company’s subsidiaries and affiliates. On June 5, 2023, Mr. Eikanas filed a lawsuit against the Company in the Superior Court of California for, among other things, wrongful termination and breach of contract, and seeking unspecified monetary damages. On April 8, 2024, Mr. Eikanas amended his Complaint to add additional causes of action and three new defendants – Steven Roush, Board Member; Suzanne Koenig, Board Member; and Elizabeth Pagliarini, Chief Executive Officer and Board Member. Based on the assessment by management, the Company believes that a loss is currently not probable or estimable under ASC 450, “Contingencies”, and as of March 31, 2024, no accrual has been made with regard to the claim. 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. Management of our Equity-Method Investments As the manager of our Equity-Method Investments, we are responsible for day-to-day management. Additionally, we could be subject to a capital call from our Equity-Method Investments (see Note 5 for capital call activity).

Equity

Equity	3 Months Ended
	Mar. 31, 2024
Equity
Equity	13. Equity Share-Based Compensation Plans ​ Upon the grant of stock options, we determine the exercise price by using our estimated per-share value, which is calculated by aggregating the estimated fair value of our investments in real estate and the estimated fair value of our other assets, subtracting the book value of our liabilities, utilizing a discount for the fact that the shares are not currently traded on a national securities exchange and a lack of a control premium, and divided the total by the number of our common shares outstanding at the time the options were granted. ​ The fair value of each grant is estimated on the date of grant using the Black-Scholes option-pricing model. Assumptions required by the model include the risk-free interest rate, the expected life of the options, the expected stock price volatility over the expected life of the options, and the expected distribution yield. Compensation expense for employee stock options is recognized ratably over the vesting term. The expected life of the options was based on the simplified method as we do not have sufficient historical exercise data. The risk-free interest rate was based on the U.S. Treasury yield curve at the date of grant using the expected life of the options at the date of grant. Volatility was based on historical volatility of the stock prices for a sample of publicly traded companies with risk profiles similar to ours. The valuation model applied in this calculation utilizes highly subjective assumptions that could potentially change over time, including the expected stock price volatility and the expected life of an option. ​ The following table summarizes our stock options as of March 31, 2024: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted ​ ​ ​ ​ ​ ​ ​ Weighted ​ Average ​ ​ ​ ​ ​ ​ ​ Average ​ Remaining ​ Aggregate ​ ​ ​ ​ Exercise ​ Contractual ​ Intrinsic ​ Options Price Term Value Options outstanding at January 1, 2024 1,148,063 ​ $ 2.16 ​ ​ ​ ​ ​ Granted — ​ $ — ​ ​ ​ ​ ​ Exercised — ​ ​ ​ ​ ​ ​ ​ ​ Cancelled/forfeited — ​ ​ ​ ​ ​ ​ ​ ​ Options outstanding at March 31, 2024 1,148,063 ​ $ 2.16 ​ 4.54 ​ $ — ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Options exercisable at March 31, 2024 1,063,257 ​ $ 2.16 ​ 4.22 ​ $ — ​ For our outstanding non-vested options as of March 31, 2024, the weighted average grant date fair value per share was $0.91. As of March 31, 2024, we have unrecognized stock-based compensation expense related to unvested stock options which is expected to be recognized as follows: ​ ​ ​ ​ ​ Years Ending December 31, ​ ​ April 1, 2024 to December 31, 2024 ​ $ 37,000 2025 ​ ​ 32,000 2026 ​ 8,000 ​ ​ $ 77,000 ​ The stock-based compensation expense reported for the three months ended March 31, 2024 and 2023 was approximately $12,000 and $7,000, respectively, and is included in general and administrative expense in the condensed consolidated statements of operations.

Derecognition of GA8 Properties

Derecognition of GA8 Properties	3 Months Ended
	Mar. 31, 2024
Derecognition of GA8 Properties
Derecognition of GA8 Properties	14. Derecognition of GA8 Properties As noted in Note 4, on March 13, 2024, we received a notice of default from Oxford, dated March 12, 2024, for events of default under the mezzanine loan, whereby Oxford exercised certain rights as the agent, including, their right to act as attorney-in-fact of Summit Georgia Holdings LLC, and appointed an independent manager over the GA8 Properties, thereby removing Summit as the manager and removing our voting rights and rights to receive any distributions with respect to such properties. As such, the independent manager now has control over all activities of the GA8 Properties and Summit no longer has any control or authority over the properties’ operations or activities. As a result of these actions, Summit derecognized the GA8 Properties as of March 12, 2024, the effective date of when the independent manager took control, and accordingly recognized a gain of $17.7 million which is included in gain on derecognition associated with GA8 Properties in our condensed consolidated statements of operations and recorded a Contract asset of $126.1 million, which represents the liabilities we expect to be released from upon final resolution with the lender in exchange for the transfer of ownership of the GA8 Properties. The loans payable and accrued interest will remain a liability until final resolution with the lender is concluded, and thus, as of March 31, 2024 and 2023, $123.3 million and $123.8 million, respectively, is included in loans payable associated with GA8 Properties and $2.8 million and $1.0 million, respectively, is included in accrued interest associated with GA8 Properties on our condensed consolidated balance sheet. The following assets and property operating liabilities were derecognized from our condensed consolidated balance sheet upon our loss of control of the GA8 Properties: ​ ​ ​ ​ ​ ​ As of March 11, 2024 Real estate properties, net ​ $ 97,637,000 Intangible lease assets, net ​ 10,250,000 Cash and other assets ​ 3,096,000 Property operating liabilities (accrued liabilities, deferred financing costs, and security deposits) ​ (2,620,000) Derecognized assets and liabilities ​ $ 108,363,000 ​ The results of operations included in our condensed consolidated statements of operations from January 1, 2024 through March 11, 2024 (the date of derecognition) and for the three months ended March 31, 2023 are as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ January 1, 2024 For the Three Months Ending ​ ​ through March 11, 2024 March 31, 2023 Total rental revenue ​ $ 2,083,000 ​ $ 3,623,000 Property operating costs ​ $ 75,000 ​ $ 371,000 Depreciation and amortization ​ $ 929,000 ​ $ 1,307,000 Interest expense ​ $ 3,406,000 ​ $ 3,104,000 ​ Subsequent to March 11, 2024, we will continue accruing interest associated with GA8 Properties and adjusting the contract asset through gain on derecognition of assets with the corresponding changes in loan payable and accrued interest associated with the derecognition of GA8 Properties.

Subsequent Events

Subsequent Events	3 Months Ended
	Mar. 31, 2024
Subsequent Events
Subsequent Events	15. Subsequent Events ​ Fantasia III JV In May 2024, the Fantasia III JV sold their eight properties for $60.0 million. We received approximately $2.1 million in cash from the sale resulting in the winding-up of our equity-method investment and as such, as of May 2, 2024, we no longer have an equity-method investment in the Fantasia III JV. As of March 31, 2024, the balance of our equity-method investment related to the Fantasia III JV was approximately $1.2 million.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2024
Summary of Significant Accounting Policies
Principles of Consolidation and Basis of Presentation	Principles of Consolidation and Basis of Presentation The accompanying condensed consolidated financial statements include the accounts of the Company, its wholly-owned subsidiaries, the Operating Partnership and its consolidated companies and are prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”). 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 months ended March 31, 2024 are not necessarily indicative of the results that may be expected for the year ending December 31, 2024.
Reclassifications	Reclassifications Certain line items on the December 31, 2023 condensed consolidated balance sheet for loans payable and accounts payable and accrued liabilities and on condensed consolidated statement of operations for interest expense for the three months ended March 31, 2023 have been reclassified to conform to the current period presentation. See Note 14.
Restricted Cash	Restricted Cash The following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the condensed consolidated balance sheets that sum to the total of the same such amounts shown on the condensed consolidated statements of cash flows. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, ​ December 31, ​ 2024 2023 Cash and cash equivalents ​ $ 6,480,000 ​ $ 10,997,000 Restricted cash ​ 3,130,000 ​ ​ 3,186,000 Total cash, cash equivalents, and restricted cash shown on the condensed consolidated statements of cash flows ​ $ 9,610,000 ​ $ 14,183,000 ​

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	3 Months Ended
	Mar. 31, 2024
Summary of Significant Accounting Policies
Schedule of reconciliation of cash, cash equivalents, and restricted cash	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, ​ December 31, ​ 2024 2023 Cash and cash equivalents ​ $ 6,480,000 ​ $ 10,997,000 Restricted cash ​ 3,130,000 ​ ​ 3,186,000 Total cash, cash equivalents, and restricted cash shown on the condensed consolidated statements of cash flows ​ $ 9,610,000 ​ $ 14,183,000 ​

Investments in Real Estate Pr_2

Investments in Real Estate Properties (Tables)	3 Months Ended
	Mar. 31, 2024
Investments in Real Estate Properties
Schedule of investments in real estate properties	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, ​ December 31, ​ 2024 2023 Land ​ $ 8,530,000 ​ $ 14,905,000 Buildings and improvements ​ 64,266,000 ​ ​ 157,875,000 Less: accumulated depreciation ​ (15,256,000) ​ ​ (20,439,000) Buildings and improvements, net ​ 49,010,000 ​ ​ 137,436,000 Furniture and fixtures ​ 5,103,000 ​ ​ 12,106,000 Less: accumulated depreciation ​ (4,578,000) ​ ​ (7,481,000) Furniture and fixtures, net ​ 525,000 ​ ​ 4,625,000 Real estate properties, net ​ $ 58,065,000 ​ $ 156,966,000
Schedule of real estate properties	The following table provides summary information regarding our portfolio (excluding the 30 properties owned by our unconsolidated Equity-Method Investments, our 8 derecognized real estate properties (see Note 14) and the $12.75 million loan from Oxford Finance, LLC (“Oxford”) (see Note 14) with Summit Georgia Holdings LLC, our wholly-owned subsidiary,) as of March 31, 2024: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Loans ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Payable, ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Excluding ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Debt ​ ​ ​ ​ ​ ​ ​ ​ Purchase ​ Issuance Property Location Date Purchased Type (1) Price Costs Rivers Edge Rehabilitation and Care (f/k/a Sheridan Care Center) Sheridan, OR ​ August 3, 2012 SNF ​ $ 4,100,000 ​ $ 3,784,000 Fernhill Care Center Portland, OR ​ August 3, 2012 SNF ​ 4,500,000 ​ ​ 3,320,000 Friendship Haven Healthcare and Rehabilitation Center Galveston County, TX ​ September 14, 2012 SNF ​ 15,000,000 ​ ​ 11,054,000 Pacific Health and Rehabilitation Center Tigard, OR ​ December 24, 2012 SNF ​ 8,140,000 ​ ​ 5,534,000 Brookstone of Aledo Aledo, IL ​ July 2, 2013 AL ​ 8,625,000 ​ ​ 6,426,000 Sundial Assisted Living Redding, CA ​ December 18, 2013 AL ​ 3,500,000 ​ ​ 3,612,000 Pennington Gardens Chandler, AZ ​ July 17, 2017 AL/MC ​ 13,400,000 ​ ​ 9,835,000 Yucaipa Hill Post Acute ​ Yucaipa, CA ​ July 2, 2021 ​ SNF ​ ​ 10,715,000 ​ ​ 8,014,000 Creekside Post Acute ​ Yucaipa, CA ​ July 2, 2021 ​ SNF ​ ​ 4,780,000 ​ ​ 3,575,000 University Post Acute ​ Mentone, CA ​ July 2, 2021 ​ SNF ​ ​ 4,560,000 ​ ​ 3,411,000 Total: ​ ​ ​ ​ ​ ​ $ 77,320,000 ​ $ 58,565,000 (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 lease payments	​ ​ ​ ​ ​ Years ending ​ ​ April 1, 2024 to December 31, 2024 ​ $ 4,671,000 2025 ​ 6,332,000 2026 ​ 6,447,000 2027 ​ 6,564,000 2028 ​ 5,115,000 Thereafter ​ 28,497,000 ​ ​ $ 57,626,000

Loans Payable (Tables)

Loans Payable (Tables)	3 Months Ended
	Mar. 31, 2024
Debt Instrument [Line Items]
Schedule of loans payable	​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, 2024 December 31, 2023 Loans payable to Lument (formerly ORIX Real Estate Capital, LLC) (insured by HUD) in monthly installments of approximately $183,000, including interest, ranging from a fixed rate of 2.79% to 4.2%, due in September 2039 through April 2055, and collateralized by Sheridan, Fernhill, Pacific Health, Aledo, Sundial and Friendship Haven. ​ $ 33,730,000 ​ $ 33,984,000 ​ ​ ​ ​ ​ ​ ​ 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. ​ ​ 9,835,000 ​ ​ 9,877,000 ​ ​ ​ ​ ​ ​ ​ Loan payable to CIBC Bank, USA in monthly installments of approximately of $147,000 including cash collateral fund payments, variable interest rate (9.4% at March 31, 2024 and December 31, 2023), due in July 2024, and, collateralized by Yucaipa Hill Post Acute, Creekside Post Acute and University Post Acute (“CA3 Properties”). See Note 3 for additional information. ​ ​ 15,000,000 ​ ​ 15,000,000 ​ ​ ​ ​ ​ ​ ​ ​ ​ 58,565,000 ​ ​ 58,861,000 Less debt issuance costs ​ (1,705,000) ​ ​ (2,682,000) Total loans payable ​ $ 56,860,000 ​ $ 56,179,000
Schedule of principal payments due on the loans payable (excluding debt issuance costs)	​ ​ ​ ​ ​ ​ ​ ​ Principal ​ Years Ending Amount April 1, 2024 to December 31, 2024 ​ $ 15,905,000 ​ 2025 ​ 1,246,000 ​ 2026 ​ 1,292,000 ​ 2027 ​ 1,341,000 ​ 2028 ​ 1,390,000 ​ Thereafter ​ 37,391,000 ​ ​ ​ $ 58,565,000 ​
GA8 Properties
Debt Instrument [Line Items]
Schedule of loans payable	As of March 31, 2024 and December 31, 2023, loans payable associated with GA8 Properties consisted of the following: ​ ​ ​ ​ ​ ​ ​ ​ March 31, 2024 December 31, 2023 Loan payable to CIBC Bank, USA in monthly installments of approximately $850,000 (including interest and principal) variable interest rate (8.8% at March 31, 2024 and December 31, 2023), due in December 2024, and collateralized by Calhoun Health Center, Maple Ridge Health Care Center, Chatsworth Health Care Center, East Lake Arbor, Fairburn Health Care Center, Grandview Health Care Center, Rosemont at Stone Mountain, and Willowwood Nursing Center & Rehab (“GA8 Properties”). See Note 14 for additional information. ​ 90,530,000 ​ 91,000,000 ​ ​ ​ ​ ​ ​ ​ Loan payable to Oxford Finance, LLC in monthly installments of approximately $260,000 (interest only through maturity), variable interest rate (16.4% at March 31, 2024 and December 31, 2023, respectively) due in March 2025, collateralized in second position by the GA8 Properties. See Note 14 for additional information. ​ 20,000,000 ​ 20,000,000 ​ ​ ​ ​ ​ ​ ​ Mezzanine Loan payable to Oxford Finance, LLC in monthly installments of approximately $168,000 (interest only through maturity), variable interest rate (16.4% at March 31, 2024 and December 31, 2023, respectively) due in December 2026, secured by the equity interests of our wholly-owned subsidiary, Summit Georgia Holdings LLC, the parent holding company for the GA8 Properties. See Note 14 for additional information. ​ ​ 12,750,000 ​ ​ 12,750,000 ​ ​ ​ ​ ​ ​ ​ Total loans payable associated with GA8 Properties ​ $ 123,280,000 ​ $ 123,750,000

Equity-Method Investments (Tabl

Equity-Method Investments (Tables)	3 Months Ended
	Mar. 31, 2024
Equity-Method Investments
Schedule of distributions receivable	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, ​ December 31, ​ 2024 2023 SUL JV ​ $ 2,131,000 (1) $ 311,000 Fantasia II JV ​ 30,000 ​ ​ 30,000 Fantasia III JV ​ 111,000 ​ ​ 87,000 FPH JV ​ 64,000 ​ ​ 64,000 Total ​ $ 2,336,000 ​ $ 492,000 (1) Included in the SUL JV distributions receivable are proceeds from the sale of a property in March 2024 for approximately $1.9 million for which the cash was received in April 2024.
Schedule of cash distributions	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three months Ended March 31, 2024 ​ Three months Ended March 31, 2023 ​ ​ ​ ​ ​ Cash Flow ​ Cash Flow ​ ​ ​ ​ Cash Flow ​ Cash Flow ​ ​ Total Cash ​ from ​ from ​ Total Cash ​ from ​ from ​ ​ Distributions ​ Operating ​ Investing ​ Distributions ​ Operating ​ Investing ​ Received Activities Activities Received Activities Activities SUL JV ​ $ 159,000 ​ $ 159,000 ​ $ — ​ $ 134,000 ​ $ 42,000 ​ $ 92,000 Fantasia II JV ​ — ​ ​ — ​ ​ — ​ ​ 80,000 ​ ​ 57,000 ​ ​ 23,000 Fantasia III JV ​ — ​ ​ — ​ ​ — ​ ​ 12,000 ​ ​ 12,000 ​ ​ — FPH JV ​ — ​ ​ — ​ ​ — ​ ​ — ​ ​ — ​ ​ — Total ​ $ 159,000 ​ $ 159,000 ​ $ — ​ $ 226,000 ​ $ 111,000 ​ $ 115,000

Receivables (Tables)

Receivables (Tables)	3 Months Ended
	Mar. 31, 2024
Receivables
Schedule of tenant and other receivables	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, ​ December 31, ​ 2024 2023 Straight-line rent receivables ​ $ 1,461,000 ​ $ 1,396,000 Distribution receivables from Equity-Method Investments (see Note 5) ​ 2,336,000 ​ ​ 492,000 Asset management fees ​ 230,000 ​ ​ 327,000 Other receivables ​ 346,000 ​ ​ 375,000 Total ​ $ 4,373,000 ​ $ 2,590,000 ​

Intangible Lease Assets (Tables

Intangible Lease Assets (Tables)	3 Months Ended
	Mar. 31, 2024
Intangible Lease Assets
Schedule of intangible lease assets	​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, December 31, ​ ​ 2024 ​ 2023 In-place leases ​ $ 526,000 ​ $ 12,680,000 Less: accumulated amortization ​ (97,000) ​ ​ (1,831,000) In-place leases, net ​ 429,000 ​ ​ 10,849,000 Above-market leases ​ 959,000 ​ ​ 959,000 Less: accumulated amortization ​ (175,000) ​ ​ (155,000) Above-market leases, net ​ 784,000 ​ ​ 804,000 Total intangible lease assets, net ​ $ 1,213,000 ​ $ 11,653,000 ​
Schedule of expected future amortization of the intangible lease assets	Expected future amortization of the intangible lease assets as of March 31, 2024, for the period from April 1, 2024 to December 31, 2024 and for each of the four following years and thereafter ending December 31 are as follows: ​ ​ ​ ​ Years ending December 31, ​ April 1, 2024 to December 31, 2024 ​ $ 75,000 2025 ​ 99,000 2026 ​ 99,000 2027 ​ 99,000 2028 ​ 99,000 Thereafter ​ 742,000 ​ ​ $ 1,213,000 ​

Right of Use (ROU) Asset - Op_2

Right of Use (ROU) Asset - Operating (Tables)	3 Months Ended
	Mar. 31, 2024
Right of Use (ROU) Asset - Operating
Schedule of supplemental balance sheet information related to the office lease	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Component Consolidated Balance Sheet Caption March 31, 2024 December 31, 2023 Right of use asset - operating Other assets, net ​ $ 664,000 ​ $ 698,000 Lease liability - operating Accounts payable and accrued liabilities ​ $ 835,000 ​ $ 877,000
Schedule of lease payments on the office lease	​ ​ ​ ​ ​ Year Lease payments April 1, 2024 to December 31, 2024 ​ $ 158,000 2025 ​ 217,000 2026 ​ 224,000 2027 ​ 231,000 2028 ​ 99,000 Total lease payments ​ $ 929,000 Less imputed interest ​ (94,000) Total lease liability ​ $ 835,000 ​

Equity (Tables)

Equity (Tables)	3 Months Ended
	Mar. 31, 2024
Equity
Schedule of stock options	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted ​ ​ ​ ​ ​ ​ ​ Weighted ​ Average ​ ​ ​ ​ ​ ​ ​ Average ​ Remaining ​ Aggregate ​ ​ ​ ​ Exercise ​ Contractual ​ Intrinsic ​ Options Price Term Value Options outstanding at January 1, 2024 1,148,063 ​ $ 2.16 ​ ​ ​ ​ ​ Granted — ​ $ — ​ ​ ​ ​ ​ Exercised — ​ ​ ​ ​ ​ ​ ​ ​ Cancelled/forfeited — ​ ​ ​ ​ ​ ​ ​ ​ Options outstanding at March 31, 2024 1,148,063 ​ $ 2.16 ​ 4.54 ​ $ — ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Options exercisable at March 31, 2024 1,063,257 ​ $ 2.16 ​ 4.22 ​ $ —
Schedule of unrecognized stock-based compensation expense	​ ​ ​ ​ ​ Years Ending December 31, ​ ​ April 1, 2024 to December 31, 2024 ​ $ 37,000 2025 ​ ​ 32,000 2026 ​ 8,000 ​ ​ $ 77,000

Derecognition of GA8 Properti_2

Derecognition of GA8 Properties (Tables)	3 Months Ended
	Mar. 31, 2024
Derecognition of GA8 Properties
Schedule of derecognized assets and property operating liabilities of GA8 Properties in condensed consolidated balance sheet	​ ​ ​ ​ ​ ​ As of March 11, 2024 Real estate properties, net ​ $ 97,637,000 Intangible lease assets, net ​ 10,250,000 Cash and other assets ​ 3,096,000 Property operating liabilities (accrued liabilities, deferred financing costs, and security deposits) ​ (2,620,000) Derecognized assets and liabilities ​ $ 108,363,000
Schedule of results of operations included in condensed consolidated statements of operations	​ ​ ​ ​ ​ ​ ​ ​ ​ January 1, 2024 For the Three Months Ending ​ ​ through March 11, 2024 March 31, 2023 Total rental revenue ​ $ 2,083,000 ​ $ 3,623,000 Property operating costs ​ $ 75,000 ​ $ 371,000 Depreciation and amortization ​ $ 929,000 ​ $ 1,307,000 Interest expense ​ $ 3,406,000 ​ $ 3,104,000

Organization (Details)

Organization (Details)	3 Months Ended	12 Months Ended
	Mar. 31, 2024 USD ($) property	Dec. 31, 2023 property	Mar. 31, 2024 property	Mar. 31, 2024 USD ($)	Jul. 31, 2023
Organization
Number of properties derecognized	8
Number of unconsolidated equity method investments | $	4
Number of properties owned by our unconsolidated Equity-Method Investments		30	30	30
Minimum [Member]
Organization
Percentage of interest in unconsolidated equity method investment	10%
Maximum [Member]
Organization
Percentage of interest in unconsolidated equity method investment	20%
Summit Healthcare REIT, Inc
Organization
Percentage of ownership investment	100%
Number of owned properties			14
Summit Healthcare Operating Partnership, L.P
Organization
Limited partnership interest	99.88%
Summit Healthcare Operating Partnership, L.P | Consolidated
Organization
Percentage of ownership investment	100%
Cornerstone Healthcare Partners LLC
Organization
Limited partnership interest	95%
Cornerstone Healthcare Real Estate Fund
Organization
Noncontrolling interest, ownership percentage by noncontrolling owners	5%
JV Properties
Organization
Number of owned properties		4	4
Limited partnership interest	95.30%	95.30%
Noncontrolling interest, ownership percentage by noncontrolling owners	4.70%	4.70%
Summit Union Life Holdings, LLC
Organization
Number of owned properties		15	14
Limited partnership interest	10%
Fantasia III JV
Organization
Number of owned properties		8	8
Limited partnership interest	10%	10%
Summit Fantasy Pearl Holdings, LLC
Organization
Number of owned properties		6	6
Limited partnership interest	10%	10%
Fantasia II JV
Organization
Number of owned properties		2	2
Limited partnership interest	20%	20%
Fantasia JV | Summit Healthcare REIT, Inc
Organization
Percentage of ownership investment					100%
Cornerstone Realty Advisors, LLC
Organization
Limited partnership interest	0.12%

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Restricted Cash (Details) - USD ($)	Mar. 31, 2024	Dec. 31, 2023	Mar. 31, 2023	Dec. 31, 2022
Summary of Significant Accounting Policies
Cash and cash equivalents	$ 6,480,000	$ 10,997,000
Restricted cash	3,130,000	3,186,000
Total cash, cash equivalents, and restricted cash shown on the consolidated statements of cash flows	$ 9,610,000	$ 14,183,000	$ 14,210,000	$ 14,163,000

Investments in Real Estate Pr_3

Investments in Real Estate Properties - Investments in real estate properties (Details) - USD ($)	Mar. 31, 2024	Dec. 31, 2023
Investments in Real Estate Properties
Real estate properties, net	$ 58,065,000	$ 156,966,000
Land
Investments in Real Estate Properties
Real estate properties, net	8,530,000	14,905,000
Buildings and improvements
Investments in Real Estate Properties
Real estate properties, gross	64,266,000	157,875,000
Less: accumulated depreciation	(15,256,000)	(20,439,000)
Real estate properties, net	49,010,000	137,436,000
Furniture and fixtures
Investments in Real Estate Properties
Real estate properties, gross	5,103,000	12,106,000
Less: accumulated depreciation	(4,578,000)	(7,481,000)
Real estate properties, net	$ 525,000	$ 4,625,000

Investments in Real Estate Pr_4

Investments in Real Estate Properties - Summary information regarding portfolio (Details)	3 Months Ended
	Mar. 31, 2024 USD ($)
Investments in Real Estate Properties
Purchase Price	$ 77,320,000
Loans Payable, Excluding Debt Issuance Costs	$ 58,565,000
Rivers Edge Rehabilitation and Care (f/k/a) Sheridan Care Center))
Investments in Real Estate Properties
Location	Sheridan, OR
Date Purchased	Aug. 03, 2012
Type	SNF
Purchase Price	$ 4,100,000
Loans Payable, Excluding Debt Issuance Costs	$ 3,784,000
Fernhill Care Center
Investments in Real Estate Properties
Location	Portland, OR
Date Purchased	Aug. 03, 2012
Type	SNF
Purchase Price	$ 4,500,000
Loans Payable, Excluding Debt Issuance Costs	$ 3,320,000
Friendship Haven Healthcare and Rehabilitation Center
Investments in Real Estate Properties
Location	Galveston County, TX
Date Purchased	Sep. 14, 2012
Type	SNF
Purchase Price	$ 15,000,000
Loans Payable, Excluding Debt Issuance Costs	$ 11,054,000
Pacific Health and Rehabilitation Center
Investments in Real Estate Properties
Location	Tigard, OR
Date Purchased	Dec. 24, 2012
Type	SNF
Purchase Price	$ 8,140,000
Loans Payable, Excluding Debt Issuance Costs	$ 5,534,000
Brookstone of Aledo
Investments in Real Estate Properties
Location	Aledo, IL
Date Purchased	Jul. 02, 2013
Type	AL
Purchase Price	$ 8,625,000
Loans Payable, Excluding Debt Issuance Costs	$ 6,426,000
Sundial Assisted Living
Investments in Real Estate Properties
Location	Redding, CA
Date Purchased	Dec. 18, 2013
Type	AL
Purchase Price	$ 3,500,000
Loans Payable, Excluding Debt Issuance Costs	$ 3,612,000
Pennington Gardens
Investments in Real Estate Properties
Location	Chandler, AZ
Date Purchased	Jul. 17, 2017
Type	AL/MC
Purchase Price	$ 13,400,000
Loans Payable, Excluding Debt Issuance Costs	$ 9,835,000
Yucaipa Hill Post Acute
Investments in Real Estate Properties
Location	Yucaipa, CA
Date Purchased	Jul. 02, 2021
Type	SNF
Purchase Price	$ 10,715,000
Loans Payable, Excluding Debt Issuance Costs	$ 8,014,000
Creekside Post Acute
Investments in Real Estate Properties
Location	Yucaipa, CA
Date Purchased	Jul. 02, 2021
Type	SNF
Purchase Price	$ 4,780,000
Loans Payable, Excluding Debt Issuance Costs	$ 3,575,000
University Post Acute
Investments in Real Estate Properties
Location	Mentone, CA
Date Purchased	Jul. 02, 2021
Type	SNF
Purchase Price	$ 4,560,000
Loans Payable, Excluding Debt Issuance Costs	$ 3,411,000

Investments in Real Estate Pr_5

Investments in Real Estate Properties - Future Minimum Lease Payments (Details)	Mar. 31, 2024 USD ($)
Investments in Real Estate Properties
April 1, 2024 to December 31, 2024	$ 4,671,000
2025	6,332,000
2026	6,447,000
2027	6,564,000
2028	5,115,000
Thereafter	28,497,000
Future minimum lease payments	$ 57,626,000

Investments in Real Estate Pr_6

Investments in Real Estate Properties - Additional information (Details)		3 Months Ended		12 Months Ended
	Jul. 03, 2023 USD ($)	Mar. 31, 2024 USD ($) property	Mar. 31, 2023 USD ($)	Dec. 31, 2023 property USD ($)	Jul. 31, 2023	Dec. 31, 2021 USD ($) property
Investments in Real Estate Properties
Number of properties owned by our unconsolidated Equity-Method Investments		30		30
Depreciation | $		$ 1,300,000	$ 1,600,000
Number of real estate properties | property		10		10
Number of real estate properties leased to related facilities excluding derecognized properties | property		8		8
Percentage of leased to the tenants of the related facilities		100%		100%
Number of real estate properties leased to affiliated subsidiary | $		2		2
Percentage of leased to affiliated subsidiary		100%		100%
Number of properties derecognized | property		8
Number of properties owned by our unconsolidated equity-method investments | property		31		31
Number of properties held by unconsolidated subsidiaries | $		8
Impairments | $		$ 0	$ 0
Summit Healthcare REIT, Inc
Investments in Real Estate Properties
Equity method investment, ownership percentage		100%
Fantasia JV
Investments in Real Estate Properties
Percentage of ownership interest assigned	65%
Consideration for interest assigned | $	$ 0
Fantasia JV | Summit Healthcare REIT, Inc
Investments in Real Estate Properties
Equity method investment, ownership percentage					100%
CA3 Properties | CIBC Bank
Investments in Real Estate Properties
Number of real estate properties acquired | property						3
Principal amount of loan | $						$ 15,000,000
Summit Georgia Holdings LLC
Investments in Real Estate Properties
Number of properties derecognized | property		8
Number of properties owned by our unconsolidated equity-method investments | property		30
Principal amount of loan | $		$ 12,750,000

Loans Payable - Debt (Details)

Loans Payable - Debt (Details) - USD ($)	Mar. 31, 2024	Dec. 31, 2023	Mar. 31, 2023
Loans Payable
Total debt obligations	$ 58,565,000	$ 58,861,000
Less debt issuance costs	(1,705,000)	(2,682,000)
Total loans payable	56,860,000	56,179,000
Loans payable associated with GA8 Properties	123,280,000	123,750,000	$ 123,800,000
Loans payable to Lument (formerly ORIX Real Estate Capital, LLC) due in September 2039 through April 2055
Loans Payable
Total debt obligations	33,730,000	33,984,000
Loans payable to Capital One Multifamily Finance, LLC due in September 2053
Loans Payable
Total debt obligations	9,835,000	9,877,000
Loans payable to CIBC Bank, USA due in July 2024
Loans Payable
Total debt obligations	15,000,000	15,000,000
Loans payable to CIBC Bank, USA due in December 2024
Loans Payable
Loans payable associated with GA8 Properties	90,530,000	91,000,000
Loans payable to Oxford Finance, LLC due in March 2025
Loans Payable
Loans payable associated with GA8 Properties	20,000,000	20,000,000
Loans payable to Oxford Finance, LLC due in December 2026
Loans Payable
Loans payable associated with GA8 Properties	$ 12,750,000	$ 12,750,000

Loans Payable - (Parenthetical)

Loans Payable - (Parenthetical) (Details) - USD ($)	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Loans payable to Lument (formerly ORIX Real Estate Capital, LLC) due in September 2039 through April 2055
Loans Payable
Monthly installments	$ 183,000	$ 183,000
Loans payable to Lument (formerly ORIX Real Estate Capital, LLC) due in September 2039 through April 2055 | Minimum
Loans Payable
Fixed rate of interest (in percent)	2.79%	2.79%
Loans payable to Lument (formerly ORIX Real Estate Capital, LLC) due in September 2039 through April 2055 | Maximum
Loans Payable
Fixed rate of interest (in percent)	4.20%	4.20%
Loans payable to Capital One Multifamily Finance, LLC due in September 2053
Loans Payable
Monthly installments	$ 49,000	$ 49,000
Fixed rate of interest (in percent)	4.23%	4.23%
Loans payable to CIBC Bank, USA due in July 2024
Loans Payable
Monthly installments	$ 147,000	$ 147,000
Variable interest rate (in percent)	9.40%	9.40%
Loans payable to CIBC Bank, USA due in December 2024
Loans Payable
Monthly installments	$ 850,000	$ 850,000
Variable interest rate (in percent)	8.80%	8.80%
Loans payable to Oxford Finance, LLC due in March 2025
Loans Payable
Monthly installments	$ 260,000	$ 260,000
Variable interest rate (in percent)	16.40%	16.40%
Loans payable to Oxford Finance, LLC due in December 2026
Loans Payable
Monthly installments	$ 168,000	$ 168,000
Variable interest rate (in percent)	16.40%	16.40%

Loans Payable - Maturities of l

Loans Payable - Maturities of long term debt (Details) - USD ($)	Mar. 31, 2024	Dec. 31, 2023
Loans Payable
April 1, 2024 to December 31, 2024	$ 15,905,000
2025	1,246,000
2026	1,292,000
2027	1,341,000
2028	1,390,000
Thereafter	37,391,000
Total	58,565,000
Total debt obligations	$ 58,565,000	$ 58,861,000

Loans Payable - Additional info

Loans Payable - Additional information (Details) - USD ($)	3 Months Ended		12 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023	Jun. 30, 2023	Dec. 31, 2021
Loans Payable
Total debt obligations	$ 58,565,000		$ 58,861,000
Interest expense (excluding debt issuance costs, amortization and interest expense related to the Oxford mezzanine loan)	4,200,000	$ 3,900,000
Unamortized balance of the debt issuance costs	1,705,000		2,682,000
Amortization of debt issuance costs	200,000	$ 200,000
Master Letter of Credit Agreement
Loans Payable
Amount outstanding	0			$ 1,000,000
CA3 Properties | CIBC Bank
Loans Payable
Aggregate amount					$ 15,000,000
GA8 Properties | Summit Georgia Holdings LLC
Loans Payable
Aggregate amount					12,750,000
Mezzanine Loan [Member] | GA8 Properties
Loans Payable
Accrued interest	1,100,000		600,000
First priority mortgage loan | GA8 Properties
Loans Payable
Aggregate amount					91,000,000
Second priority mortgage loan | GA8 Properties
Loans Payable
Aggregate amount					$ 20,000,000
Loans payable to Oxford Finance, LLC due in December 2026
Loans Payable
Debt instrument, periodic payment	168,000		168,000
Subordinated term loan | GA8 Properties
Loans Payable
Accrued interest	$ 1,000,000		$ 300,000

Equity-Method Investments - Sum

Equity-Method Investments - Summarized Financial Data for Equity-Method Investments (Details) - USD ($)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Equity-Method Investments
Revenue	$ 5,731,000	$ 6,882,000
Net income	15,303,000	(1,976,000)
Straight-line rent receivables	1,461,000		$ 1,396,000
Income from equity-method investees	725,000	125,000
Equity-method investments	1,576,000		$ 2,852,000
Payments to Acquire Equity Method Investments		156,000
Income (Loss) from Equity Method Investments	725,000	125,000
SUL JV
Equity-Method Investments
Payments to Acquire Equity Method Investments	0	$ 156,000
Loss on sale of real estate	7,700,000
SUL JV
Equity-Method Investments
Income from equity-method investees	$ 800,000
Percentage of interest in annual return	10%
Income (Loss) from Equity Method Investments	$ 800,000

Equity-Method Investments - Dis

Equity-Method Investments - Distributions receivable (Details) - USD ($)	Mar. 31, 2024	Dec. 31, 2023
Equity-Method Investments
Distributions receivable	$ 2,336,000	$ 492,000
SUL JV
Equity-Method Investments
Distributions receivable	2,131,000	311,000
Fantasia II JV
Equity-Method Investments
Distributions receivable	30,000	30,000
Fantasia III JV
Equity-Method Investments
Distributions receivable	111,000	87,000
FPH JV
Equity-Method Investments
Distributions receivable	$ 64,000	$ 64,000

Equity-Method Investments - Cas

Equity-Method Investments - Cash Distributions (Details) - USD ($)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Equity-Method Investments
Total Cash Distributions Received	$ 159,000	$ 226,000
Cash Flow from Operating Activities	159,000	111,000
Cash Flow from Investing Activities		115,000
SUL JV
Equity-Method Investments
Total Cash Distributions Received	159,000	134,000
Cash Flow from Operating Activities	$ 159,000	42,000
Cash Flow from Investing Activities		92,000
Fantasia II JV
Equity-Method Investments
Total Cash Distributions Received		80,000
Cash Flow from Operating Activities		57,000
Cash Flow from Investing Activities		23,000
Fantasia III JV
Equity-Method Investments
Total Cash Distributions Received		12,000
Cash Flow from Operating Activities		$ 12,000

Equity-Method Investments - Add

Equity-Method Investments - Additional information (Details)	1 Months Ended		3 Months Ended
	May 31, 2024 USD ($) property	Apr. 30, 2024 USD ($)	Mar. 31, 2024 USD ($)	Mar. 31, 2023 USD ($)	May 01, 2024 USD ($)	Dec. 31, 2023 USD ($)
Equity-Method Investments
Equity-method investment			$ 1,576,000			$ 2,852,000
Equity method investment, distribution receivable upon sale			1,900,000
Income from equity-method investees			(725,000)	$ (125,000)
Investment in equity-method investees				(156,000)
Total proceeds from the sale			$ 1,900,000
Subsequent events
Equity-Method Investments
Return of capital from the sale		$ 1,900,000
SUL JV
Equity-Method Investments
Minimum percentage of interest in annual return			9%
Percentage of interest in annual return			10%
Income from equity-method investees			$ (800,000)
Summit Fantasia Holdings II, LLC
Equity-Method Investments
Impairment loss of related to equity-method investments			500,000
Summit Fantasia Holdings III, LLC
Equity-Method Investments
Equity-method investment			1,200,000
Summit Fantasia Holdings III, LLC | Subsequent events
Equity-Method Investments
Return of capital from the sale	$ 2,100,000
Summit Fantasia Holdings II, LLC
Equity-Method Investments
Equity-method investment			200,000
Equity Method Investments
Equity-Method Investments
Asset management fees			100,000	$ 200,000
Summit Union Life Holdings, LLC
Equity-Method Investments
Equity-method investment			$ 600,000			1,800,000
Summit Union Life Holdings, LLC | Minimum
Equity-Method Investments
Minimum percentage of interest in annual return			9%
Summit Union Life Holdings, LLC | Maximum
Equity-Method Investments
Percentage of interest in annual return			10%
Summit Union Life Holdings, LLC | Operating Partnership
Equity-Method Investments
Percentage of interest			25%
Percentage of interest in capital proceeds from the sale of properties held			25%
Summit Union Life Holdings, LLC | Best Years Llc
Equity-Method Investments
Percentage of interest			75%
Percentage of interest in capital proceeds from the sale of properties held			75%
Summit Fantasia Holdings II, LLC
Equity-Method Investments
Equity-method investment						(100,000)
Percentage of interest in annual return			8%
Summit Fantasia Holdings II, LLC | Operating Partnership
Equity-Method Investments
Percentage of interest in capital proceeds from the sale of properties held			30%
Summit Fantasia Holdings II, LLC | Fantasia Investment III LLC
Equity-Method Investments
Percentage of interest in capital proceeds from the sale of properties held			70%
Summit Fantasia Holdings III, LLC
Equity-Method Investments
Equity-method investment			$ 1,200,000			1,200,000
Percentage of interest in annual return			9%
Summit Fantasia Holdings III, LLC | Subsequent events
Equity-Method Investments
Number of properties sold	8				8
Total proceeds from the sale	$ 60,000,000
Summit Fantasia Holdings III, LLC | Operating Partnership
Equity-Method Investments
Percentage of interest			25%
Percentage of interest in capital proceeds from the sale of properties held			25%
Summit Fantasia Holdings III, LLC | Fantasia Investment III LLC
Equity-Method Investments
Percentage of interest			75%
Percentage of interest in capital proceeds from the sale of properties held			75%
Summit Fantasy Pearl Holdings, LLC
Equity-Method Investments
Equity-method investment			$ 0			$ 0
Percentage of interest in annual return			9%
Summit Fantasy Pearl Holdings, LLC | Operating Partnership
Equity-Method Investments
Percentage of interest			20%
Percentage of interest in capital proceeds from the sale of properties held			20%
Summit Fantasy Pearl Holdings, LLC | Fantasia Investment III LLC
Equity-Method Investments
Percentage of interest			7.25%
Percentage of interest in capital proceeds from the sale of properties held			7.25%
Summit Fantasy Pearl Holdings, LLC | Summit Fantasy Pearl Holdings, LLC- Equity-Method Investment
Equity-Method Investments
Percentage of interest			65.25%
Percentage of interest in capital proceeds from the sale of properties held			65.25%
Summit Fantasy Pearl Holdings, LLC | Atlantis
Equity-Method Investments
Percentage of interest			7.50%
Percentage of interest in capital proceeds from the sale of properties held			7.50%

Receivables (Details)

Receivables (Details) - USD ($)	Mar. 31, 2024	Dec. 31, 2023
Receivables
Straight-line rent receivables	$ 1,461,000	$ 1,396,000
Distribution receivables from Equity-Method Investments	2,336,000	492,000
Asset management fees	230,000	327,000
Other receivables	346,000	375,000
Total	$ 4,373,000	$ 2,590,000

Intangible Lease Assets (Detail

Intangible Lease Assets (Details)	3 Months Ended
	Mar. 31, 2024 USD ($)	Mar. 31, 2023 USD ($)	Dec. 31, 2023 USD ($)
Intangible Lease Assets
Total intangible lease assets, net	$ 1,213,000		$ 11,653,000
Amortization expense for intangible lease assets	$ 200,000	$ 200,000
Number of properties held by unconsolidated subsidiaries	8
Amortization of above market leases	$ 20,000	$ 20,000
In-place leases
Intangible Lease Assets
Intangible lease assets, gross	526,000		12,680,000
Less: accumulated amortization	(97,000)		(1,831,000)
Total intangible lease assets, net	429,000		10,849,000
Above-market leases
Intangible Lease Assets
Intangible lease assets, gross	959,000		959,000
Less: accumulated amortization	(175,000)		(155,000)
Total intangible lease assets, net	$ 784,000		$ 804,000

Intangible Lease Assets - Expec

Intangible Lease Assets - Expected future amortization (Details) - USD ($)	Mar. 31, 2024	Dec. 31, 2023
Intangible Lease Assets
April 1, 2024 to December 31, 2024	$ 75,000
2025	99,000
2026	99,000
2027	99,000
2028	99,000
Thereafter	742,000
Total intangible lease assets, net	$ 1,213,000	$ 11,653,000

Right of Use (ROU) Asset - Op_3

Right of Use (ROU) Asset - Operating (Details)	1 Months Ended
	Nov. 30, 2022 USD ($)
Right of Use (ROU) Asset - Operating
Estimated incremental borrowing rate	5%
Temporary License
Right of Use (ROU) Asset - Operating
Termination term of lease after substantial completion of certain tenant improvements in office space	5 years
Standard Office Lease
Right of Use (ROU) Asset - Operating
Lease term under three separate triple net leases	66 months
Initial annual base rent	$ 204,399
Increase in initial annual base rent (as a percent)	3%

Right of Use (ROU) Asset - Op_4

Right of Use (ROU) Asset - Operating - Supplemental balance sheet information related to the Office Lease (Details) - USD ($)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Right of Use (ROU) Asset - Operating
Right of use asset - operating	$ 664,000		$ 698,000
Right of use asset - operating, Location	Other Assets		Other Assets
Lease liability - operating	$ 835,000		$ 877,000
Lease liability, location	Accounts Payable and Accrued Liabilities		Accounts Payable and Accrued Liabilities
Operating lease expense	$ 46,000	$ 45,000
Operating lease payments	$ 53,000	$ 0
Weighted average remaining lease term	4 years

Right of Use (ROU) Asset - Op_5

Right of Use (ROU) Asset - Operating - Lease payments (Details) - USD ($)	Mar. 31, 2024	Dec. 31, 2023
Maturity of lease payments
April 1, 2024 to December 31, 2024	$ 158,000
2025	217,000
2026	224,000
2027	231,000
2028	99,000
Total lease payments	929,000
Less imputed interest	(94,000)
Total lease liability	$ 835,000	$ 877,000

Concentration of Risk (Details)

Concentration of Risk (Details)	3 Months Ended
	Mar. 31, 2024 property tenant	Mar. 31, 2023 tenant property
Concentration of Risk
Number of owned properties held by equity method investment	30
Number of real estate properties leased to related facilities	16	16
Number of tenants under long-term triple net leases | tenant	14	14
Number of tenants represents more than 10% of our rental revenue | tenant	4	3
Customer concentration risk | Tenant | Assets, Total
Concentration of Risk
Concentration risk, percentage	20%
Customer concentration risk | Tenant One | Tenant One, Concentration Risk
Concentration of Risk
Concentration risk, percentage	10%	10%
Georgia
Concentration of Risk
Number of owned properties	8
California
Concentration of Risk
Number of owned properties	4
Oregon
Concentration of Risk
Number of owned properties	3
Texas
Concentration of Risk
Number of owned properties	1
Illinois
Concentration of Risk
Number of owned properties	1
Arizona
Concentration of Risk
Number of owned properties	1

Fair Value Measurements of Fi_2

Fair Value Measurements of Financial Instruments (Details) - USD ($)	Mar. 31, 2024	Dec. 31, 2023
Fair Value Measurements of Financial Instruments
Principal balance excluding debt discount	$ 58,565,000	$ 58,861,000
HUD
Fair Value Measurements of Financial Instruments
Fair value of loans payable	36,200,000	36,400,000
Principal balance excluding debt discount	$ 43,600,000	$ 43,900,000

Commitments and Contingencies (

Commitments and Contingencies (Details) - USD ($)						3 Months Ended
	Nov. 14, 2023	Nov. 13, 2023	Jul. 14, 2023	May 15, 2023	May 12, 2023	Mar. 31, 2024
Commitments and Contingencies
Purchased the investors' interests						$ 900,000
Accrued contingencies						0
Cure period of Kent Eikanas			60 days	60 days
Legal fees
Commitments and Contingencies
Amount awarded to the plaintiffs					$ 75,000	75,000
Attorney's fees
Commitments and Contingencies
Amount awarded to the plaintiffs	$ 665,000	$ 517,000			$ 517,000	665,000
Accrued contingencies						0
Fee award
Commitments and Contingencies
Amount awarded to the plaintiffs						$ 664,637

Equity - Stock options (Details

Equity - Stock options (Details)	3 Months Ended
	Mar. 31, 2024 $ / shares shares
Equity
Options outstanding, Beginning Balance	1,148,063
Options outstanding, Exercised	0
Options outstanding, Ending Balance	1,148,063
Options exercisable, Ending Balance	1,063,257
Weighted Average Exercise Price, Outstanding at Beginning Balance | $ / shares	$ 2.16
Weighted Average Exercise Price, Outstanding at Ending Balance | $ / shares	2.16
Weighted Average Exercise Price, Exercisable at Ending Balance | $ / shares	$ 2.16
Options outstanding, Weighted Average Remaining Contractual Term	4 years 6 months 14 days
Options exercisable, Weighted Average Remaining Contractual Term	4 years 2 months 19 days

Equity - Unrecognized stock-bas

Equity - Unrecognized stock-based compensation expense (Details) - USD ($)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Equity
Unrecognized stock-based compensation expense related to unvested stock options, net of forfeitures	$ 77,000
General and administrative expense
Equity
Stock-based compensation expense	12,000	$ 7,000
April 1, 2024 to December 31, 2024
Equity
Unrecognized stock-based compensation expense related to unvested stock options, net of forfeitures	37,000
2025
Equity
Unrecognized stock-based compensation expense related to unvested stock options, net of forfeitures	32,000
2026
Equity
Unrecognized stock-based compensation expense related to unvested stock options, net of forfeitures	$ 8,000

Equity - Additional Information

Equity - Additional Information (Details)	Mar. 31, 2024 $ / shares
Equity
Weighted average grant date fair value (per share)	$ 0.91

Derecognition of GA8 Properti_3

Derecognition of GA8 Properties (Details) - USD ($)		3 Months Ended
	Mar. 12, 2024	Mar. 31, 2024	Dec. 31, 2023	Mar. 31, 2023
Derecognition of GA8 Properties
Gain on derecognition associated with GA8 Properties	$ 17,700,000	$ 17,698,000
Contract assets associated with GA8 Properties (Note 14)	$ 126,100,000	126,061,000
Loans payable associated with GA8 Properties (Note 14)		123,280,000	$ 123,750,000	$ 123,800,000
Accrued interest associated with GA8 Properties (Note 14)		$ 2,782,000	$ 1,041,000	$ 1,000,000

Derecognition of GA8 Properti_4

Derecognition of GA8 Properties - Derecognized assets and property operating liabilities of GA8 Properties in condensed consolidated balance sheet (Details)	Mar. 11, 2024 USD ($)
Derecognition of GA8 Properties
Real estate properties, net	$ 97,637,000
Intangible lease assets, net	10,250,000
Cash and other assets	3,096,000
Property operating liabilities (accrued liabilities, deferred financing costs and security deposits)	(2,620,000)
Derecognized assets and liabilities	$ 108,363,000

Derecognition of GA8 Properti_5

Derecognition of GA8 Properties - Results of operations included in condensed consolidated statements of operations (Details) - USD ($)	2 Months Ended	3 Months Ended
	Mar. 11, 2024	Mar. 31, 2023
Derecognition of GA8 Properties
Total rental revenue	$ 2,083,000	$ 3,623,000
Property operating costs	75,000	371,000
Depreciation and amortization	929,000	1,307,000
Interest expense	$ 3,406,000	$ 3,104,000

Subsequent Events (Details)

Subsequent Events (Details)	1 Months Ended		3 Months Ended
	May 31, 2024 USD ($) property	Apr. 30, 2024 USD ($)	Mar. 31, 2024 USD ($)	May 01, 2024 USD ($)	Dec. 31, 2023 USD ($)
Subsequent Events
Total proceeds from the sale			$ 1,900,000
Equity-method investments			1,576,000		$ 2,852,000
Summit Fantasia Holdings III, LLC
Subsequent Events
Equity-method investments			1,200,000
Summit Fantasia Holdings III, LLC
Subsequent Events
Equity-method investments			$ 1,200,000		$ 1,200,000
Subsequent events
Subsequent Events
Return of capital from the sale		$ 1,900,000
Subsequent events | Summit Fantasia Holdings III, LLC
Subsequent Events
Return of capital from the sale	$ 2,100,000
Subsequent events | Summit Fantasia Holdings III, LLC
Subsequent Events
Number of properties sold	8			8
Total proceeds from the sale	$ 60,000,000

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ 15,303,000	$ (1,976,000)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Mar. 31, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false
Rule10b51ArrModified Flag	false
NonRule10b51ArrModified Flag	false