NorthStar Healthcare Income (NHHS) 10-K 22 Mar 24 2023 FY Annual report Financial data

Cover Page

Cover Page - USD ($)	12 Months Ended
	Dec. 31, 2023	Mar. 21, 2024	Jun. 30, 2023
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2023
Document Transition Report	false
Entity File Number	000-55190
Entity Registrant Name	NORTHSTAR HEALTHCARE INCOME, INC.
Entity Incorporation, State or Country Code	MD
Entity Tax Identification Number	27-3663988
Entity Address, Address Line One	16 East 34th Street,
Entity Address, Address Line Two	18th Floor
Entity Address, City or Town	New York
Entity Address, State or Province	NY
Entity Address, Postal Zip Code	10016
City Area Code	929
Local Phone Number	777-3125
Title of 12(b) Security	Common stock, par value $0.01 per share
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	false
Document Financial Statement Error Correction [Flag]	false
Entity Shell Company	false
Entity Public Float			$ 0
Entity Common Stock, Shares Outstanding		185,712,103
Documents Incorporated by Reference	DOCUMENTS INCORPORATED BY REFERENCE Certain portions of the definitive proxy statement related to the registrant’s 2024 Annual Meeting of Stockholders to be filed hereafter are incorporated by reference into Part III (Items 10, 11, 12, 13 and 14) of this Annual Report on Form 10-K
Entity Central Index Key	0001503707
Current Fiscal Year End Date	--12-31
Amendment Flag	false
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY

Audit Information

Audit Information	12 Months Ended
	Dec. 31, 2023
Audit Information [Abstract]
Auditor Firm ID	248
Auditor Name	GRANT THORNTON LLP
Auditor Location	New York, New York

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands		Dec. 31, 2023	Dec. 31, 2022
Assets
Cash and cash equivalents		$ 85,037	$ 103,926
Restricted cash		7,906	11,734
Operating real estate, net		821,270	933,002
Investments in unconsolidated ventures ($142 held at fair value as of December 31, 2023)		122,949	176,502
Assets held for sale		11,611	0
Receivables, net		1,558	2,815
Intangible assets, net		1,916	2,253
Other assets		7,172	7,603
Total assets	[1]	1,059,419	1,237,835
Liabilities
Mortgage notes payable, net		898,154	912,248
Escrow deposits payable		507	993
Accounts payable and accrued expenses		27,502	21,034
Total liabilities	[1]	927,739	936,763
Commitments and contingencies (Note 12)
NorthStar Healthcare Income, Inc. Stockholders’ Equity
Preferred stock, $0.01 par value, 50,000,000 shares authorized, no shares issued and outstanding as of December 31, 2023 and December 31, 2022		0	0
Common stock, $0.01 par value, 400,000,000 shares authorized, 185,712,103 and 195,421,656 shares issued and outstanding as of December 31, 2023 and December 31, 2022, respectively		1,857	1,954
Additional paid-in capital		1,716,757	1,729,589
Retained earnings (accumulated deficit)		(1,585,725)	(1,428,840)
Accumulated other comprehensive income (loss)		0	(3,679)
Total NorthStar Healthcare Income, Inc. stockholders’ equity		132,889	299,024
Non-controlling interests		(1,209)	2,048
Total equity		131,680	301,072
Total liabilities and equity		1,059,419	1,237,835
Related Party
Liabilities
Due to related party		121	469
Other liabilities		121	469
Nonrelated Party
Liabilities
Due to related party		1,455	2,019
Other liabilities		$ 1,455	$ 2,019
[1] Includes $121.1 million and $183.8 million of assets and liabilities, respectively, of certain VIEs that are consolidated by the Operating Partnership. Refer to Note 2, “Summary of Significant Accounting Policies.”

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parentheticals) - USD ($) $ in Thousands		Dec. 31, 2023	Dec. 31, 2022
Equity method investment, fair value		$ 142
Preferred stock, par value (in dollars per share)		$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)		50,000,000	50,000,000
Preferred stock, shares issued (in shares)		0	0
Preferred stock, shares outstanding (in shares)		0	0
Common stock, par value (in dollars per share)		$ 0.01	$ 0.01
Common stock, shares authorized (in shares)		400,000,000	400,000,000
Common stock, shares issued (in shares)		185,712,103	195,421,656
Common stock, shares outstanding (in shares)		185,712,103	195,421,656
Total assets	[1]	$ 1,059,419	$ 1,237,835
Liabilities	[1]	927,739	$ 936,763
Northstar Healthcare Income Operating Partnership, LP | Primary Beneficiary
Total assets		121,100
Liabilities		$ 183,800
[1] Includes $121.1 million and $183.8 million of assets and liabilities, respectively, of certain VIEs that are consolidated by the Operating Partnership. Refer to Note 2, “Summary of Significant Accounting Policies.”

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Property and other revenues
Resident fee income		$ 47,591	$ 44,274	$ 105,955
Rental income		153,544	139,841	137,322
Other revenue		3,843	1,021	0
Total property and other revenues		204,978	185,136	243,277
Interest income
Interest income on debt investments		0	0	4,667
Expenses
Property operating expenses		140,612	137,578	177,936
Interest expense		50,028	43,278	61,620
Transaction costs		683	1,569	54
Asset management fees - related party		0	8,058	11,105
General and administrative expenses		13,817	13,938	12,691
Depreciation and amortization		38,511	38,587	54,836
Impairment loss		49,423	45,299	5,386
Total expenses		293,074	288,307	323,628
Other income (loss)
Other income, net		194	77	7,278
Gain (loss) on investments and other		(64,001)	1,029	79,477
Income (loss) before equity in earnings (losses) of unconsolidated ventures and income tax expense		(151,903)	(102,065)	11,071
Equity in earnings (losses) of unconsolidated ventures		(8,272)	47,625	15,843
Income tax expense		(74)	(61)	(99)
Net income (loss)		(160,249)	(54,501)	26,815
Net (income) loss attributable to non-controlling interests		3,364	401	(1,748)
Net income (loss) attributable to NorthStar Healthcare Income, Inc. common stockholders		(156,885)	(54,100)	25,067
Net income (loss) attributable to NorthStar Healthcare Income, Inc. common stockholders		$ (156,885)	$ (54,100)	$ 25,067
Net income (loss) per share of common stock, basic (in dollars per share)	[1]	$ (0.83)	$ (0.28)	$ 0.13
Net income (loss) per share of common stock, diluted (in dollars per share)	[1]	$ (0.83)	$ (0.28)	$ 0.13
Weighted average number of shares of common stock outstanding, basic (in shares)	[1]	189,941,744	194,343,635	191,629,613
Weighted average number of shares of common stock outstanding, diluted (in shares)	[1]	189,941,744	194,343,635	191,629,613
Distributions declared per share of common stock (in dollars per share)		$ 0	$ 0.50	$ 0
[1]The Company had issued 203,742, 116,712 and 66,840 restricted stock units as of December 31, 2023, 2022 and 2021, respectively. The restricted stock units have been excluded from the diluted earnings per share calculation as their impact is anti-dilutive due to the net loss generated during the years ended December 31, 2023 and 2022. During the year ended December 31, 2021, the impact of the restricted stock units on the diluted earnings per share calculation was de minimis.

CONSOLIDATED STATEMENTS OF OP_2

CONSOLIDATED STATEMENTS OF OPERATIONS (Parenthetical) - shares	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Statement [Abstract]
Number of restricted stock units issued (in shares)	203,742	116,712	66,840

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Statement of Comprehensive Income [Abstract]
Net income (loss)	$ (160,249)	$ (54,501)	$ 26,815
Other comprehensive income (loss)
Foreign currency translation adjustments related to investment in unconsolidated venture	3,679	(3,193)	(953)
Total other comprehensive income (loss)	3,679	(3,193)	(953)
Comprehensive income (loss)	(156,570)	(57,694)	25,862
Comprehensive (income) loss attributable to non-controlling interests	3,364	401	(1,748)
Comprehensive income (loss) attributable to NorthStar Healthcare Income, Inc. common stockholders	$ (153,206)	$ (57,293)	$ 24,114

CONSOLIDATED STATEMENTS OF EQUI

CONSOLIDATED STATEMENTS OF EQUITY - USD ($) $ in Thousands		Total	Total Company’s Stockholders’ Equity	Common Stock	Additional Paid-in Capital	Retained Earnings (Accumulated Deficit)	Accumulated Other Comprehensive Income (Loss)	Non-controlling Interests
Beginning Balance (in shares) at Dec. 31, 2020				190,409,000
Beginning Balance at Dec. 31, 2020		$ 412,062	$ 409,639	$ 1,904	$ 1,710,023	$ (1,302,755)	$ 467	$ 2,423
Increase (Decrease) in Stockholder's Equity
Share-based payment of advisor assets management fees (in shares)				2,712,000
Share-based payment of advisor asset management fees		10,557	10,557	$ 26	10,531
Amortization of equity-based compensation		165	165		165
Non-controlling interests - contributions		724						724
Non-controlling interests - distributions		(2,552)						(2,552)
Other comprehensive income (loss)		(953)	(953)				(953)
Net income (loss)		26,815	25,067			25,067		1,748
Ending Balance (in shares) at Dec. 31, 2021				193,121,000
Ending Balance at Dec. 31, 2021		446,818	444,475	$ 1,930	1,720,719	(1,277,688)	(486)	2,343
Increase (Decrease) in Stockholder's Equity
Share-based payment of advisor assets management fees (in shares)				2,301,000
Share-based payment of advisor asset management fees		8,866	8,866	$ 24	8,842
Amortization of equity-based compensation		28	28		28
Non-controlling interests - contributions		330						330
Non-controlling interests - distributions		(224)						(224)
Distributions declared		(97,052)	(97,052)			(97,052)
Other comprehensive income (loss)		(3,193)	(3,193)				(3,193)
Net income (loss)		$ (54,501)	(54,100)			(54,100)		(401)
Ending Balance (in shares) at Dec. 31, 2022		195,421,656		195,422,000
Ending Balance at Dec. 31, 2022		$ 301,072	299,024	$ 1,954	1,729,589	(1,428,840)	(3,679)	2,048
Beginning Balance (in shares) at Dec. 31, 2022		195,421,656		195,422,000
Beginning Balance at Dec. 31, 2022		$ 301,072	299,024	$ 1,954	1,729,589	(1,428,840)	(3,679)	2,048
Increase (Decrease) in Stockholder's Equity
Amortization of equity-based compensation		470	470		470
Non-controlling interests - contributions		322						322
Non-controlling interests - distributions		(215)						215
Retirement of common stock (in shares)				(9,710,000)
Retirement of common stock (Note 8)		(13,399)	(13,399)	$ (97)	(13,302)
Other comprehensive income (loss)		3,679
Other comprehensive income (loss)		404	404				404
Reclassification of accumulated other comprehensive loss	[1]	3,275	3,275				3,275
Net income (loss)		$ (160,249)	(156,885)			(156,885)		(3,364)
Ending Balance (in shares) at Dec. 31, 2023		185,712,103		185,712,000
Ending Balance at Dec. 31, 2023		$ 131,680	$ 132,889	$ 1,857	$ 1,716,757	$ (1,585,725)	$ 0	$ (1,209)
[1]The Company reclassified the accumulated other comprehensive loss related to foreign currency adjustments for an unconsolidated venture ownership interest that was sold during the three months ended June 30, 2023. The accumulated balance was reclassified to gain (loss) on investments and other on the consolidated statements of operations.

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Cash flows from operating activities:
Net income (loss)	$ (160,249)	$ (54,501)	$ 26,815
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Equity in (earnings) losses of unconsolidated ventures	8,272	(47,625)	(15,843)
Depreciation and amortization	38,511	38,587	54,836
Impairment loss	49,423	45,299	5,386
Amortization of below market debt	3,326	3,247	3,169
Straight-line rental (income) loss, net	0	0	7,803
Amortization of discount/accretion of premium on investments	0	0	(697)
Amortization of deferred financing costs	1,120	637	1,662
Amortization of equity-based compensation	226	207	165
Paid-in-kind interest on real estate debt investment	0	0	(194)
(Gain) loss on investments and other	64,001	(1,029)	(79,477)
Change in allowance for uncollectible accounts	433	519	176
Issuance of common stock as payment for asset management fees	0	8,058	10,557
Distributions from unconsolidated ventures	10,640	22,291	0
Changes in assets and liabilities:
Receivables	626	332	1,756
Other assets	(3,140)	3,644	(1,287)
Due to related party	(348)	(5,928)	(985)
Escrow deposits payable	(296)	(90)	(2,680)
Accounts payable and accrued expenses	6,629	(5,222)	(17,346)
Other liabilities	(112)	(602)	(254)
Net cash provided by (used in) operating activities	19,062	7,824	(6,438)
Cash flows from investing activities:
Capital expenditures for operating real estate	(38,422)	(29,304)	(27,773)
Sales of real estate	136	0	596,414
Properties placed into a receivership	(994)	0	0
Repayment of real estate debt investment	0	0	74,376
Investments in unconsolidated ventures	0	0	(400)
Distributions from unconsolidated ventures	16,873	44,842	18,110
Real estate debt investment modification fee	0	0	686
Sales of other assets	523	0	413
Net cash provided by (used in) investing activities	(21,884)	15,538	661,826
Cash flows from financing activities:
Borrowings from mortgage notes	0	0	26,000
Repayments of mortgage notes	(18,492)	(21,212)	(517,618)
Repayment of borrowings from line of credit - related party	0	0	(35,000)
Payment of deferred financing costs	(48)	(36)	(708)
Debt extinguishment costs	0	0	(8,288)
Payments under finance leases	(147)	(480)	(578)
Acquisition and retirement of common stock	(1,315)	0	0
Distributions paid on common stock	0	(97,018)	0
Contributions from non-controlling interests	322	330	724
Distributions to non-controlling interests	(215)	(224)	(2,552)
Net cash provided by (used in) financing activities	(19,895)	(118,640)	(538,020)
Net increase (decrease) in cash, cash equivalents and restricted cash	(22,717)	(95,278)	117,368
Cash, cash equivalents and restricted cash-beginning of period	115,660	210,938	93,570
Cash, cash equivalents and restricted cash-end of period	92,943	115,660	210,938
Supplemental disclosure of cash flow information:
Cash paid for interest	38,269	38,836	65,828
Cash paid for income taxes	86	53	100
Supplemental disclosure of non-cash investing and financing activities:
Accrued capital expenditures	824	1,227	3,624
Exchange of ownership interests in unconsolidated ventures for common stock	13,399	0	0
Assets acquired under finance leases	0	0	144
Assets acquired under capital lease obligations	25	0	100
Reclassification of assets held for sale	11,966	0	0
Derecognition of operating real estate placed into a receivership	$ 58,953	$ 0	$ 0

Business and Organization

Business and Organization	12 Months Ended
	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Business and Organization	Business and Organization NorthStar Healthcare Income, Inc., together with its consolidated subsidiaries (the “Company”), owns a diversified portfolio of seniors housing properties, including independent living facilities (“ILF”), assisted living (“ALF”) and memory care facilities (“MCF”) located throughout the United States. In addition, the Company has an investment through a non-controlling interest in a joint venture that invests in integrated senior health campuses, which provide services associated with ILFs, ALFs, MCFs and skilled nursing facilities (“SNF”), across the Midwest region of the United States. The Company was formed in October 2010 as a Maryland corporation and commenced operations in February 2013. The Company elected to be taxed as a real estate investment trust (“REIT”) under the Internal Revenue Code of 1986, as amended (the “Internal Revenue Code”), commencing with the taxable year ended December 31, 2013. The Company has conducted its operations, and intends to do so in the future, so as to continue to qualify as a REIT for U.S. federal income tax purposes. Substantially all of the Company’s business is conducted through NorthStar Healthcare Income Operating Partnership, LP (the “Operating Partnership”). The Company is the sole general partner of the Operating Partnership. The limited partners of the Operating Partnership are NorthStar Healthcare Income Advisor, LLC and NorthStar Healthcare Income OP Holdings, LLC (the “Special Unit Holder”), which became indirect subsidiaries of the Company on June 9, 2023. NorthStar Healthcare Income Advisor, LLC invested $1,000 in the Operating Partnership in exchange for common units and the Special Unit Holder invested $1,000 in the Operating Partnership and was issued a separate class of limited partnership units (the “Special Units”), which were collectively recorded as non-controlling interests on the accompanying consolidated balance sheets prior to June 9, 2023. As the Company issued shares, it contributed substantially all of the proceeds from its continuous, public offerings to the Operating Partnership as a capital contribution. As of December 31, 2023, the Company’s limited partnership interest in the Operating Partnership, directly or indirectly, was 100%. The Company’s charter authorizes the issuance of up to 400.0 million shares of common stock with a par value of $0.01 per share and up to 50.0 million shares of preferred stock with a par value of $0.01 per share. The board of directors of the Company is authorized to amend its charter, without the approval of the stockholders, to increase the aggregate number of authorized shares of capital stock or the number of shares of any class or series that the Company has authority to issue. The Company raised $2.0 billion in total gross proceeds from the sale of shares of common stock in its continuous, public offerings (the “Offering”), including $232.6 million pursuant to its distribution reinvestment plan (the “DRP”). The Internalization

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies Basis of Accounting The accompanying consolidated financial statements and related notes of the Company have been prepared in accordance with accounting principles generally accepted in the United States (“U.S. GAAP”). Principles of Consolidation The consolidated financial statements include the accounts of the Company, the Operating Partnership and their consolidated subsidiaries. The Company consolidates entities in which it has a controlling financial interest by first considering if an entity meets the definition of a variable interest entity (“VIE”) for which the Company is deemed to be the primary beneficiary or if the Company has the power to control an entity through majority voting interest or other arrangements. All significant intercompany balances are eliminated in consolidation. Variable Interest Entities A VIE is an entity that lacks one or more of the characteristics of a voting interest entity. A VIE is defined as an entity in which equity investors do not have the characteristics of a controlling financial interest or do not have sufficient equity at risk for the entity to finance its activities without additional subordinated financial support from other parties. The determination of whether an entity is a VIE includes both a qualitative and quantitative analysis. The Company bases its qualitative analysis on its review of the design of the entity, its organizational structure including decision-making ability and relevant financial agreements and the quantitative analysis on the forecasted cash flow of the entity. The Company reassesses its initial evaluation of an entity as a VIE upon the occurrence of certain reconsideration events. A VIE must be consolidated only by its primary beneficiary, which is defined as the party who, along with its affiliates and agents, has both the: (i) power to direct the activities that most significantly impact the VIE’s economic performance; and (ii) obligation to absorb the losses of the VIE or the right to receive the benefits from the VIE, which could be significant to the VIE. The Company determines whether it is the primary beneficiary of a VIE by considering qualitative and quantitative factors, including, but not limited to: which activities most significantly impact the VIE’s economic performance and which party controls such activities; the amount and characteristics of its investment; the obligation or likelihood for the Company or other interests to provide financial support; consideration of the VIE’s purpose and design, including the risks the VIE was designed to create and pass through to its variable interest holders and the similarity with and significance to the business activities of the Company and the other interests. The Company reassesses its determination of whether it is the primary beneficiary of a VIE each reporting period. Judgments related to these determinations include estimates about the current and future fair value and performance of investments held by these VIEs and general market conditions. The Company evaluates its investments and financings, including investments in unconsolidated ventures to determine whether each investment or financing is a VIE. The Company analyzes new investments, as well as reconsideration events for existing investments, which vary depending on the type of investment. As of December 31, 2023, the Company has identified certain consolidated and unconsolidated VIEs. Assets of each of the VIEs may only be used to settle obligations of the respective VIE. Creditors of each of the VIEs have no recourse to the general credit of the Company. Consolidated VIEs The most significant VIEs of the Company are certain entities that are consolidated by the Operating Partnership. These entities are VIEs because of non-controlling interests owned by third parties, which do not have substantive kick-out or participating rights. Included in operating real estate, net, assets held for sale and mortgage notes payable, net on the Company’s consolidated balance sheet as of December 31, 2023 is $101.3 million, $11.6 million and $171.8 million, respectively, related to such consolidated VIEs. Unconsolidated VIEs As of December 31, 2023, the Company identified unconsolidated VIEs related to its investments in unconsolidated ventures with a carrying value of $122.9 million. The Company’s maximum exposure to loss as of December 31, 2023 would not exceed the carrying value of its investment in the VIEs. The Company determined that it is not the primary beneficiary of these VIEs and, accordingly, they are not consolidated in the Company’s financial statements as of December 31, 2023. The Company did not provide financial support to its unconsolidated VIEs during the year ended December 31, 2023. As of December 31, 2023, there were no explicit arrangements or implicit variable interests that could require the Company to provide financial support to its unconsolidated VIEs. Voting Interest Entities A voting interest entity is an entity in which the total equity investment at risk is sufficient to enable it to finance its activities independently and the equity holders have the power to direct the activities of the entity that most significantly impact its economic performance, the obligation to absorb the losses of the entity and the right to receive the residual returns of the entity. The usual condition for a controlling financial interest in a voting interest entity is ownership of a majority voting interest. If the Company has a majority voting interest in a voting interest entity, the entity will generally be consolidated. The Company does not consolidate a voting interest entity if there are substantive participating rights by other parties and/or kick-out rights by a single party or through a simple majority vote. The Company performs on-going reassessments of whether entities previously evaluated under the voting interest framework have become VIEs, based on certain events, and therefore subject to the VIE consolidation framework. Investments in Unconsolidated Ventures A non-controlling, unconsolidated ownership interest in an entity may be accounted for using the equity method or the Company may elect the fair value option. The Company will account for an investment under the equity method of accounting if it has the ability to exercise significant influence over the operating and financial policies of an entity, but does not have a controlling financial interest. Under the equity method, the investment is adjusted each period for capital contributions and distributions and its share of the entity’s net income (loss). Capital contributions, distributions and net income (loss) of such entities are recorded in accordance with the terms of the governing documents. An allocation of net income (loss) may differ from the stated ownership percentage interest in such entity as a result of preferred returns and allocation formulas, if any, as described in such governing documents. Equity method investments are recognized using a cost accumulation model, in which the investment is recognized based on the cost to the investor, which includes acquisition fees. The Company records as an expense certain acquisition costs and fees associated with consolidated investments deemed to be business combinations and capitalizes these costs for investments deemed to be acquisitions of an asset, including an equity method investment. The Company may elect the fair value option of accounting for an investment that would otherwise be accounted for under the equity method. The fair value option election allows an entity to make an irrevocable election of fair value for certain financial assets and liabilities on an instrument-by-instrument basis at the initial or subsequent measurement. The decision to elect the fair value option must be applied to an entire instrument and is irrevocable once elected. Under the fair value option, the Company records its share of the changes to fair value of the investment and any unrealized gains and losses. On June 30, 2023, the Company elected the fair value option method to account for its investment in the Espresso joint venture, which is included in investments in unconsolidated ventures on the consolidated balance sheets. The fair value election was made based on the Company’s assessment that the expected return of investment was lower than the Company’s carrying value of its investment in the Espresso joint venture, which resulted in an impairment of $4.7 million and reduced the carrying value of its investment to recoverable fair value of $3.1 million as of June 30, 2023. The Company’s assessment for the recoverability of its investment took into consideration the joint venture’s remaining assets and estimated future cash distributions, less transaction and wind down costs. The Company will record any changes to its investment’s fair value in gain (loss) on investments and other in the consolidated statements of operations. From the date of the election of fair value through December 31, 2023, the Company did not record any changes to the fair value of its investment in the Espresso joint venture. Refer to Note 4 “Investment in Unconsolidated Ventures” and Note 10 “Fair Value” for further discussion. Non-controlling Interests A non-controlling interest in a consolidated subsidiary is defined as the portion of the equity (net assets) in a subsidiary not attributable, directly or indirectly, to the Company. A non-controlling interest is required to be presented as a separate component of equity on the consolidated balance sheets and presented separately as net income (loss) and comprehensive income (loss) attributable to controlling and non-controlling interests. An allocation to a non-controlling interest may differ from the stated ownership percentage interest in such entity as a result of a preferred return and allocation formula, if any, as described in such governing documents. Estimates The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that could affect the amounts reported in the consolidated financial statements and accompanying notes. Actual results could materially differ from those estimates and assumptions. Any estimates of the effects of the COVID-19 pandemic, inflation, rising interest rates, risk of recession and other economic conditions as reflected and/or discussed in these financial statements are based upon the Company's best estimates using information known to the Company as of the date of this Annual Report on Form 10-K. Such estimates may change and the impact of which could be material. Cash, Cash Equivalents and Restricted Cash The Company considers all highly-liquid investments with an original maturity date of three months or less to be cash equivalents. Cash, including amounts restricted, may at times exceed the Federal Deposit Insurance Corporation deposit insurance limit of $250,000 per institution. The Company mitigates credit risk by placing cash and cash equivalents with major financial institutions and money market funds invested in short-term U.S. government securities. To date, the Company has not experienced any losses on cash and cash equivalents. Restricted cash consists of amounts related to operating real estate (escrows for taxes, insurance, capital expenditures, security deposits received from residents and payments required under certain lease agreements) and other escrows required by lenders of the Company’s borrowings. The following table provides a reconciliation of cash, cash equivalents, and restricted cash as reported on the consolidated balance sheets to the total of such amounts as reported on the consolidated statements of cash flows (dollars in thousands): December 31, 2023 2022 2021 Cash and cash equivalents $ 85,037 $ 103,926 $ 200,473 Restricted cash 7,906 11,734 10,465 Total cash, cash equivalents and restricted cash $ 92,943 $ 115,660 $ 210,938 Operating Real Estate Operating real estate is carried at historical cost less accumulated depreciation. Major replacements and betterments which improve or extend the life of the asset are capitalized and depreciated over their useful life. Ordinary repairs and maintenance are expensed as incurred. Operating real estate is depreciated using the straight-line method over the estimated useful life of the assets, summarized as follows: Category: Term: Building 39 to 49 years Building improvements Lesser of the useful life or remaining life of the building Land improvements 9 to 15 years Tenant improvements Lesser of the useful life or remaining term of the lease Furniture, fixtures and equipment 5 to 14 years Construction costs incurred in connection with the Company’s investments are capitalized and included in operating real estate, net on the consolidated balance sheets. Construction in progress is not depreciated until the asset is available for its intended use. Lessee Accounting A leasing arrangement, a right to control the use of an identified asset for a period of time in exchange for consideration, is classified by the lessee either as a finance lease, which represents a financed purchase of the leased asset, or as an operating lease. For leases with terms greater than 12 months, a lease asset and a lease liability are recognized on the balance sheet at commencement date based on the present value of lease payments over the lease term. Lease renewal or termination options are included in the lease asset and lease liability only if it is reasonably certain that the option to extend would be exercised or the option to terminate would not be exercised. As the implicit rate in most leases are not readily determinable, the Company’s incremental borrowing rate for each lease at commencement date is used to determine the present value of lease payments. Consideration is given to the Company’s recent debt financing transactions, as well as publicly available data for instruments with similar characteristics, adjusted for the respective lease term, when estimating incremental borrowing rates. Lease expense is recognized over the lease term based on an effective interest method for finance leases and on a straight-line basis for operating leases. Right of Use (“ROU”) - Finance Assets The Company has entered into finance leases for equipment which are included in operating real estate, net The following table presents the future minimum lease payments under finance leases and the present value of the minimum lease payments, which are included in other liabilities Years Ending December 31: 2024 $ 38 2025 38 2026 33 2027 18 2028 10 Thereafter — Total minimum lease payments $ 137 Less: Amount representing interest (23) Present value of minimum lease payments $ 114 The weighted average interest rate related to the finance lease obligations is 6.5% with a weighted average lease term of 3.8 years. As of December 31, 2023, there were no leases that had yet to commence which would create significant rights and obligations to the Company as lessee. Assets Held For Sale The Company classifies certain long-lived assets as held for sale once the criteria, as defined by U.S. GAAP, have been met and are expected to sell within one year. Long-lived assets to be disposed of are reported at the lower of their carrying amount or fair value minus cost to sell, with any write-down recorded to impairment loss on the consolidated statements of operations. Depreciation and amortization is not recorded for assets classified as held for sale. In November 2023, the Company entered into an agreement to sell a property within the Rochester portfolio for $12.0 million, and as of December 31, 2023, has classified the property as held for sale on its consolidated balance sheets. At the time of the reclassification to held for sale, the Company recorded an impairment loss of $0.4 million. The sale was completed in February 2024. As of December 31, 2022, the Company did not have any assets classified as held for sale. Intangible Assets and Deferred Costs Deferred Costs Deferred costs consist of deferred financing costs. Deferred financing costs represent commitment fees, legal and other third-party costs associated with obtaining financing. These costs are recorded against the carrying value of such financing and are amortized to interest expense over the term of the financing using the effective interest method. Unamortized deferred financing costs are expensed to gain (loss) on investments and other, when the associated borrowing is repaid before maturity. Costs incurred in seeking financing transactions which do not close are expensed in the period in which it is determined that the financing will not occur. Identified Intangibles The Company records acquired identified intangibles, such as the value of in-place leases and other intangibles, based on estimated fair value at the acquisition date. The value allocated to the identified intangibles is amortized over the remaining lease term. In-place leases are amortized into depreciation and amortization expense. Impairment analysis for identified intangible assets is performed in connection with the impairment assessment of the related operating real estate. An impairment establishes a new basis for the identified intangible asset and any impairment loss recognized is not subject to subsequent reversal. Refer to “—Impairment on Operating Real Estate and Investments in Unconsolidated Ventures” for additional information. Identified intangible assets are recorded in intangible assets, net on the consolidated balance sheets. Intangible assets relate to the Company’s in-place lease values for the Company’s four net lease properties. The following table presents intangible assets, net (dollars in thousands): December 31, 2023 December 31, 2022 In-place lease value $ 120,149 $ 120,149 Less: Accumulated amortization (118,233) (117,896) Intangible assets, net $ 1,916 $ 2,253 The Company recorded $0.3 million of amortization expense for in-place leases for the years ended December 31, 2023 and 2022 and $1.4 million of amortization expense for in-place leases for the year ended December 2021. The following table presents future amortization of in-place lease value (dollars in thousands): Years Ending December 31: 2024 $ 337 2025 337 2026 337 2027 337 2028 337 Thereafter 231 Total $ 1,916 Derivative Instruments The Company uses derivative instruments to manage its interest rate risk. The Company’s derivative instruments are recorded at fair value. The accounting for changes in fair value of derivatives depends upon whether or not the Company has elected to designate the derivative in a hedging relationship and the derivative qualifies for hedge accounting. Under hedge accounting, changes in fair value for derivatives are recorded through other comprehensive income. When hedge accounting is not elected, changes in fair value for derivatives are recorded through the income statement. The Company has interest rate caps that have not been designated for hedge accounting. The fair value of the Company's interest rate caps totaled $0.4 million and $0.7 million as of December 31, 2023 and 2022, respectively, and are included in other assets on the consolidated balance sheets. Changes in fair value of derivatives Revenue Recognition Operating Real Estate Rental income from operating real estate is derived from leasing of space to operators and residents, including rent received from the Company’s net lease properties and rent, ancillary service fees and other related revenue earned from ILF residents. Rental income recognition commences when the operator takes legal possession of the leased space and the leased space is substantially ready for its intended use. The leases are for fixed terms of varying length and generally provide for rentals and expense reimbursements to be paid in monthly installments. Rental income from leases, which includes community and move-in fees, is recognized over the term of the respective leases. ILF resident agreements are generally short-term in nature and may allow for termination with 30 days’ notice. The Company also generates revenue from operating healthcare properties. Revenue related to operating healthcare properties includes resident room and care charges, ancillary fees and other resident service charges. Rent is charged and revenue is recognized when such services are provided, generally defined per the resident agreement as of the date upon which a resident occupies a room or uses the services. Resident agreements are generally short-term in nature and may allow for termination with 30 days’ notice. Revenue derived from our ALFs and MCFs is recorded in resident fee income in the consolidated statements of operations. Revenue from operators and residents is recognized at lease commencement only to the extent collection is expected to be probable. This assessment is based on several qualitative and quantitative factors, including and as appropriate, the payment history, ability to satisfy its lease obligations, the value of the underlying collateral or deposit, if any, and current economic conditions. If collection is assessed to not be probable, thereafter lease income recognized is limited to amounts collected, with the reversal of any revenue recognized to date in excess of amounts received. If collection is subsequently reassessed to be probable, revenue is adjusted to reflect the amount that would have been recognized had collection always been assessed as probable. The operator of the Company’s four net lease properties failed to remit contractual monthly rent obligations and the Company deemed it not probable that these obligations will be satisfied in the foreseeable future. On March 27, 2023, the Company entered into a lease forbearance and modification agreement (the “Forbearance Agreement”) with the existing operator, pursuant to which, among other things, the Company will be entitled to receive all cash flow in excess of permitted expenses, and be required to fund any operating deficits, through 2025, subject to the terms and conditions thereof. For the years ended December 31, 2023, 2022 and 2021 remittances from the operator totaled $1.7 million, $1.6 million, and $3.4 million, respectively, which the Company recorded as rental income. For the years ended December 31, 2023, 2022 and 2021, total property and other revenue includes variable lease revenue of $14.1 million, $11.2 million and $13.1 million, respectively. Variable lease revenue includes ancillary services provided to residents, as well as non-recurring services and fees at the Company’s operating facilities. Impairment on Operating Real Estate and Investments in Unconsolidated Ventures Operating Real Estate and Assets Held for Sale The Company’s real estate portfolio is reviewed on a quarterly basis, or more frequently as necessary, to assess whether there are any indicators that the value of its operating real estate may be impaired or that its carrying value may not be recoverable. A property’s value is considered impaired if the Company’s estimate of the aggregate expected future undiscounted cash flow generated by the property is less than the carrying value. In conducting this review, the Company considers U.S. macroeconomic factors, real estate and healthcare sector conditions, together with asset specific and other factors. To the extent an impairment has occurred, the loss is measured as the excess of the carrying value of the property over the estimated fair value and recorded in impairment loss in the consolidated statements of operations. Real estate held for sale is stated at the lower of its carrying amount or estimated fair value less disposal cost, with any write-down to disposal cost recorded as an impairment loss. For any increase in fair value less disposal cost subsequent to classification as held for sale, the impairment may be reversed, but only up to the amount of cumulative loss previously recognized. The Company considered the potential impact of the lasting effects of inflation, rising interest rates, risk of recession and other economic conditions on the future net operating income of its healthcare real estate held for investment as an indicator of impairment. Fair values were estimated based upon the income capitalization approach, using net operating income for each property and applying indicative capitalization rates. During the year ended December 31, 2023, the Company recorded impairment losses on its operating real estate totaling $44.7 million, which includes impairment losses of $38.6 million for five facilities within the Rochester portfolio as a result of revised holding period assumptions, $5.6 million for a facility within its Arbors portfolio as a result of lower estimated future cash flows and estimated market value, $0.4 million to reflect net realizable value for a facility within the Rochester portfolio designated as held for sale and $0.1 million for a land parcel within the Rochester portfolio as a result of lower estimated market value. During the year ended December 31, 2022, the Company recorded impairment losses on its operating real estate totaling $31.9 million. The Company recorded impairment losses of $18.5 million, $8.5 million, and $3.9 million for facilities in its Arbors, Winterfell and Rochester portfolios, respectively, as a result of declining operating margins and lower projected future cash flows. In addition, the Company recorded impairment losses totaling $0.8 million and $0.2 million for property damage sustained by facilities in its Winterfell portfolio and a facility in its Avamere portfolio, respectively. Investments in Unconsolidated Ventures The Company reviews its investments in unconsolidated ventures on a quarterly basis, or more frequently as necessary, to assess whether there are any indicators that the value may be impaired or that its carrying value may not be recoverable. An investment is considered impaired if the projected net recoverable amount over the expected holding period is less than the carrying value. In conducting this review, the Company considers global macroeconomic factors, including real estate sector conditions, together with investment specific and other factors. To the extent an impairment has occurred on the Company’s investment in unconsolidated ventures, and is considered to be other than temporary, the loss is measured as the excess of the carrying value of the investment over the estimated fair value and recorded in impairment loss in the consolidated statements of operations. In June 2023, the Company impaired its investment in the Espresso joint venture by $4.7 million, which reduced the carrying value of its investment to $3.1 million as of June 30, 2023. The Company’s assessment for the fair value of its investment took into consideration the joint venture’s remaining assets and estimated future cash distributions, less transaction and wind down costs. Upon impairing its investment, the Company elected the fair value option method to account for its investment in the Espresso joint venture on June 30, 2023. During the year ended December 31, 2022, the Company impaired its investment in the Diversified US/UK joint venture by $13.4 million, which reduced the carrying value of its investment to $28.4 million. Refer to Note 10, “Fair Value” for further discussion. Further, the joint ventures underlying the Company’s unconsolidated ventures assess and record impairment and reserves on their respective real estate portfolios, goodwill, and other assets, and the Company recognizes its proportionate share through equity in earnings (losses). In May 2023, prior to the Sale of Minority Interests (as defined in Note 4, “Investments in Unconsolidated Ventures”), the Diversified US/UK joint venture recorded impairment losses on its remaining properties, 48 care homes located in the United Kingdom (the “UK Portfolio”), due to, among other things, the extended period contemplated for the UK Portfolio to reach stabilization. The Company’s proportionate share of the impairment losses recorded by the Diversified US/UK portfolio totaled $11.4 million. Additionally, the Trilogy joint venture recorded impairment losses on its trade name intangible assets during the year ended December 31, 2023, of which the Company’s proportionate share totaled $2.4 million. During the year ended December 31, 2022, the Company’s proportionate share of impairment and reserves recognized by the underlying joint ventures of its unconsolidated ventures was $25.1 million. Credit Losses on Receivables The current expected credit loss model, in estimating expected credit losses over the life of a financial instrument at the time of origination or acquisition, considers historical loss experiences, current conditions and the effects of reasonable and supportable expectations of changes in future macroeconomic conditions. The Company assesses the estimate of expected credit losses on a quarterly basis or more frequently as necessary. The Company considers historical credit loss information that is adjusted for current conditions and reasonable and supportable forecasts. The Company measures expected credit losses of receivables on a collective basis when similar risk characteristics exist. If the Company determines that a particular receivable does not share risk characteristics with its other receivables, the Company evaluates the receivable for expected credit losses on an individual basis. When developing an estimate of expected credit losses on receivables, the Company considers available information relevant to assessing the collectability of cash flows. This information may include internal information, external information, or a combination of both relating to past events, current conditions, and reasonable and supportable forecasts. The Company considers relevant qualitative and quantitative factors that relate to the environment in which the Company operates and are specific to the borrower. Further, the fair value of the collateral, less estimated costs to sell, may be used when determining the allowance for credit losses for a receivable for which the repayment is expected to be provided substantially through the sale of the collateral when the borrower is experiencing financial difficulty. As of December 31, 2023, the Company has not recorded an allowance for credit losses on its receivables. Acquisition Fees and Expenses The Company recorded an expense for certain acquisition costs and fees associated with transactions deemed to be business combinations in which it consolidated the asset and capitalized these costs for transactions deemed to be acquisitions of an asset, including an equity investment. Equity-Based Compensation The Company accounts for equity-based compensation awards using the fair value method, which requires an estimate of fair value of the award at the time of grant. All fixed equity-based awards to directors, which have no vesting conditions other than time of service, are amortized to compensation expense over the awards’ vesting period on a straight-line basis. Equity-based compensation is classified within general and administrative expenses in the consolidated statements of operations. Income Taxes The Company elected to be taxed as a REIT and to comply with the related provisions of the Internal Revenue Code beginning in its taxable year ended December 31, 2013. Accordingly, the Company will generally not be subject to U.S. federal income tax to the extent of its distributions to stockholders as long as certain asset, gross income and share ownership tests are met. To maintain its qualification as a REIT, the Company must annually distribute dividends equal to at least 90.0% of its REIT taxable income (with certain adjustments) to its stockholders and meet certain other requirements. The Company believes that all of the criteria to maintain the Company’s REIT qualification have been met for the applicable periods. For the taxable year ended December 31, 2023, the Company anticipates that its REIT taxable income, if any, will be offset by its net operating loss carry-forward and as such, the Company will not be subject to the distribution requirements. The Company’s most recently filed tax return is for the year ended December 31, 2022 and includes a net operating loss carry-forward of $248.5 million. If the Company were to fail to meet these requirements, it would be subject to U.S. federal income tax and potential interest and penalties, which could have a material adverse impact on its r

Operating Real Estate

Operating Real Estate	12 Months Ended
	Dec. 31, 2023
Real Estate [Abstract]
Operating Real Estate	Operating Real Estate The following table presents operating real estate, net (dollars in thousands): December 31, 2023 December 31, 2022 Land $ 115,758 $ 121,518 Land improvements 12,705 18,945 Buildings and improvements 861,452 957,924 Tenant improvements 372 372 Construction in progress 5,493 6,736 Furniture, fixtures and equipment 93,373 91,058 Subtotal $ 1,089,153 $ 1,196,553 Less: Accumulated depreciation (267,883) (263,551) Operating real estate, net $ 821,270 $ 933,002 For the years ended December 31, 2023, 2022 and 2021, depreciation expense was $38.2 million, $38.3 million and $53.5 million, respectively. Within the table above, operating real estate has been reduced by accumulated impairment losses of $162.9 million and $181.5 million as of December 31, 2023 and December 31, 2022, respectively. Impairment losses on the Company’s operating real estate and properties held for sale totaled $44.7 million, $31.9 million and $5.4 million for the years ended December 31, 2023, 2022 and 2021, respectively, and are recorded in impairment losses on the consolidated statements of operations. Refer to Note 2, “Summary of Significant Accounting Policies” for further discussion. The following table presents the operators and managers of the Company’s operating real estate (dollars in thousands): As of December 31, 2023 Year Ended December 31, 2023 Operator / Manager Properties Under Management Units Under Management (1) Property and Other Revenues (2) % of Total Property and Other Revenues Solstice Senior Living (3) 32 3,969 $ 127,765 62.3 % Watermark Retirement Communities (4) 6 723 45,001 22.0 % Avamere Health Services 5 453 21,780 10.6 % Integral Senior Living 1 40 4,880 2.4 % Arcadia Management 4 564 1,709 0.8 % Other (5) — — 3,843 1.9 % Total 48 5,749 $ 204,978 100.0 % ______________________________________ (1) Represents rooms for ALFs, ILFs and MCFs. (2) Includes rental income received from the Company’s net lease properties, rental income, ancillary service fees and other related revenue earned from ILF residents and resident fee income derived from the Company’s ALFs and MCFs, which includes resident room and care charges, ancillary fees and other resident service charges. (3) Solstice is a joint venture of which affiliates of ISL own 80%. (4) Property count and units exclude one property within the Rochester portfolio designated as held for sale and the properties within the Rochester Sub-Portfolio, which were placed into a receivership in October 2023. (5) Consists primarily of interest income earned on corporate-level cash and cash equivalents. Rochester Sub-Portfolio As a result of the mortgage loan payment defaults in July 2023, on October 30, 2023, the Rochester Sub-Portfolio (as defined in Note 5, “Borrowings”) was placed into a receivership. The receiver now has effective control of the properties and the Company is working with the lender and the receiver to facilitate an orderly transition of the operations, and eventually ownership, of the properties. As a result of the loss of control, the Company discontinued recognizing revenues and expenses related to the Rochester Sub-Portfolio as of October 30, 2023 and derecognized the properties and related assets from the Company’s financial statements, which resulted in a $59.0 million loss recognized in accordance with ASC 610-20, “Gains and Losses from the Derecognition of Nonfinancial Assets.” Net Lease Rental Income Net lease properties owned as of December 31, 2023 have current lease expirations of 2029, with certain operator renewal rights. These net lease arrangements require the operator to pay rent and substantially all the expenses of the leased property including maintenance, taxes, utilities and insurance. The Company’s net lease agreements provide for periodic rental increases based on the greater of certain percentages or increase in the consumer price index. Beginning in February 2021, the operator of the Company’s net lease properties failed to remit contractual monthly rent obligations and the Company deemed it not probable that these obligations will be satisfied in the future. As a result, during the year ended December 31, 2023, the Company recorded rental income to the extent rental payments were received. The following table presents the future contractual rent obligations for the operator of the Company’s net lease properties over the next five years and thereafter as of December 31, 2023 (dollars in thousands): Years Ending December 31: 2024 $ 11,192 2025 11,472 2026 11,759 2027 12,053 2028 12,354 Thereafter 9,438 Total $ 68,268

Investments in Unconsolidated V

Investments in Unconsolidated Ventures	12 Months Ended
	Dec. 31, 2023
Equity Method Investments and Joint Ventures [Abstract]
Investments in Unconsolidated Ventures	Investments in Unconsolidated Ventures The Company’s investments in unconsolidated ventures are accounted for under the equity method or fair value option. The following table presents the Company’s investments in unconsolidated ventures (dollars in thousands): Carrying Value Portfolio Acquisition Date Ownership December 31, 2023 December 31, 2022 Trilogy Dec-2015 23.4 % $ 122,339 $ 128,884 Solstice Jul-2017 20.0 % 468 323 Espresso Jul-2015 36.7 % 142 18,019 Investments sold — 29,276 Investments in Unconsolidated Ventures $ 122,949 $ 176,502 Trilogy Option Agreement On November 3, 2023, the Company entered into an agreement to sell all of its ownership interests in Trilogy REIT Holdings, LLC (the “Trilogy Joint Venture”), which indirectly owns 125 integrated senior health campuses, to American Healthcare REIT, Inc. or its affiliates (“AHR”), the majority partner of the Trilogy Joint Venture. Under the agreement, AHR has the right to purchase the Company’s ownership interests in the Trilogy Joint Venture at any time prior to September 30, 2025, assuming AHR exercises all of its extension options and subject to satisfaction of certain closing conditions, for a purchase price ranging from $240.5 million to up to $260 million depending upon the purchase price consideration, timing of the closing and certain additional fees that AHR may pay to the Company in the interim. A minimum of 10% of the purchase price consideration must be paid in cash, with the balance payable in either cash or new Series A Cumulative Convertible Preferred Stock to be issued by AHR in connection with the closing. The portion of the purchase price consideration paid in cash may be subject to a 7.5% or 5% discount, respectively, if the transaction closes prior to March 31, 2024 or December 31, 2024, respectively. In addition, the Company may be entitled to a supplemental cash payment of $25,600 per day for the period between July 1, 2023 until the closing date, for up to approximately $21 million, if the Trilogy Joint Venture does not distribute an equivalent amount to the Company during the interim period. AHR may terminate the agreement at any time, subject to payment of a termination fee equal to: (i) if terminated prior to the initial outside date, September 30, 2024, $7.8 million, (ii) if extended and terminated prior March 31, 2025, $11.7 million and (iii) if further extended and terminated prior to September 30, 2025, $15.6 million. There can be no assurance that AHR will consummate the purchase of the Company’s interests on these terms or at all. Solstice Solstice Senior Living, LLC (“Solstice”), the manager of the Winterfell portfolio, is a joint venture between affiliates of Integral Senior Living, LLC (“ISL”), a management company of ILF, ALF and MCF founded in 2000, which owns 80.0%, and the Company, which owns 20.0% . Espresso During the year ended December 31, 2023, the Espresso joint venture completed the sale of its remaining sub-portfolios and distributed the net proceeds generated, of which the Company's proportionate share totaled $17.3 million. In June 2023, the Company recorded an impairment of $4.7 million to reflect the fair value of its investment in the Espresso joint venture, based on the estimated cash distributions to be received from the joint venture. The Company’s elected the fair value option method to account for its investment in the Espresso joint venture on June 30, 2023. Investments Sold In June 2023, the Company sold its 14% interest in Healthcare GA Holdings, General Partnership, which indirectly owned 48 care homes across the United Kingdom (the “Diversified US/UK Portfolio”), and its 6% interest in Eclipse Health, General Partnership, which indirectly owned 34 seniors housing facilities (the “Eclipse Portfolio”), together with $1.1 million in cash, to its Former Sponsor, who is affiliated with the majority partner of each joint venture, for all of the Company’s equity securities held by the Former Sponsor and its affiliates, including 9,709,553 shares of common stock of the Company, 100 common units in the Operating Partnership and 100 special units in the Operating Partnership (the “Sale of Minority Interests”). The following table presents the results of the Company’s investment in unconsolidated ventures (dollars in thousands): Year Ended December 31, 2023 2022 2021 Portfolio Equity in Earnings (Losses) Cash Distribution Equity in Earnings (Losses) Cash Distribution Equity in Earnings (Losses) Cash Distribution Trilogy (1) $ (1,409) $ 5,136 $ 11,652 $ 9,134 $ (2,891) $ 4,638 Solstice 145 — 2 — (79) — Espresso (2) 9,228 22,377 72,427 54,654 19,619 5,500 Envoy — — — 66 740 817 Investments sold (3) (16,236) — (36,456) 3,279 (1,546) 7,155 Total $ (8,272) $ 27,513 $ 47,625 $ 67,133 $ 15,843 $ 18,110 _______________________________________ (1) The Trilogy joint venture recognized impairment losses on its intangible assets, of which the Company’s proportionate share totaled $2.4 million and is included in equity in earnings (losses) for the year ended December 31, 2023. (2) The Espresso joint venture recognized net gains related to sub-portfolio sales, of which the Company’s proportionate share totaled $9.2 million and $70.6 million for the years ended December 31, 2023 and 2022, respectively. The Company was distributed its proportionate share of the net proceeds generated from the sales during the years ended December 31, 2023 and 2022, totaling $17.3 million and $49.7 million, respectively. In addition, the Company elected to account for the joint venture under the fair value option on June 30, 2023, which resulted in no earnings recorded from the date of election through December 31, 2023. (3) Prior to the sale of the Diversified US/UK joint venture, the joint venture recognized impairment, of which the Company’s proportionate share totaled $11.4 million and $22.9 million is included in equity in earnings (losses) for the years ended December 31, 2023, and 2022, respectively. Summarized Financial Data The following table presents a summary of the combined balance sheets and combined statements of operations of the Espresso and Solstice joint ventures (dollars in thousands): December 31, 2023 December 31, 2022 Years Ended December 31, 2023 2022 2021 Assets Operating real estate, net $ — $ 76,087 Total revenues $ 17,766 $ 40,445 $ 67,206 All other assets 10,530 34,842 Net income (loss) $ 52,224 $ 197,734 $ 53,167 Total assets $ 10,530 $ 110,929 Liabilities and equity Total liabilities $ 7,457 $ 97,826 Equity 3,073 13,103 Total liabilities and equity $ 10,530 $ 110,929 On June 9 2023, the Company sold its ownership interest in the Diversified US/UK and Eclipse joint ventures. The following table presents a summary of the combined balance sheets and combined statements of operations of the Diversified US/UK and Eclipse joint ventures (dollars in thousands): June 9, 2023 December 31, 2022 Period Ended June 9, 2023 Years Ended December 31, 2022 2021 Assets Operating real estate, net $ 615,335 $ 2,325,802 Total revenues $ 115,068 $ 352,098 $ 386,354 All other assets 45,069 232,202 Net income (loss) $ (198,793) $ (288,881) $ 12,087 Total assets $ 660,404 $ 2,558,004 Liabilities and equity Total liabilities $ 573,185 $ 2,341,223 Equity 87,219 216,781 Total liabilities and equity $ 660,404 $ 2,558,004 Trilogy Joint Venture Financials SEC Rule 3-09 of Regulation S-X requires that a company include audited financial statements for equity method investees when such investees are individually significant for a company’s fiscal year. For the year ended December 31, 2023, the Company’s investment in the Trilogy joint venture was determined to not be significant, however, for the year ended December 31, 2022, the income from the Company’s investment in the Trilogy joint venture was determined to be significant. As a result, Trilogy’s financial data has been excluded from the summarized financial information above and the joint venture’s unaudited financial statements for the year ended December 31, 2023 and audited financial statements for the year ended December 31, 2022 were included as Exhibit 99.1 in this Annual Report on Form 10-K.

Borrowings

Borrowings	12 Months Ended
	Dec. 31, 2023
Debt Disclosure [Abstract]
Borrowings	Borrowings The following table presents the Company’s mortgage notes payable (dollars in thousands): December 31, 2023 December 31, 2022 Recourse vs. Non-Recourse (1) Initial Contractual Interest Rate (2) Principal Amount (3) Carrying Value (3) Principal (3) Carrying (3) Aqua Portfolio Frisco, TX (4) Non-recourse Feb 2026 3.0% $ 26,000 $ 25,694 $ 26,000 $ 25,560 Milford, OH Non-recourse Sep 2026 SOFR + 2.79% 18,173 18,015 18,336 18,126 Rochester Portfolio Rochester, NY Non-recourse Feb 2025 4.25% 17,470 17,448 18,206 18,165 Rochester, NY (5) Non-recourse Jul 2023 SOFR + 2.45% 99,786 99,786 100,651 100,042 Rochester, NY (6) Non-recourse Aug 2024 SOFR + 2.93% 10,874 10,853 11,336 11,315 Arbors Portfolio (7) Various locations Non-recourse Feb 2025 3.99% 81,397 81,209 83,423 83,051 Winterfell Portfolio (8) Various locations Non-recourse Jun 2025 4.17% 583,471 578,694 596,408 588,306 Avamere Portfolio (9) Various locations Non-recourse Feb 2027 4.66% 66,691 66,455 67,995 67,683 Mortgage notes payable, net $ 903,862 $ 898,154 $ 922,355 $ 912,248 _______________________________________ (1) Subject to non-recourse carve-outs. (2) Floating-rate borrowings total $128.8 million of principal outstanding and reference one-month of the Secured Overnight Financing Rate (“SOFR”) as of December 31, 2023. (3) The difference between principal amount and carrying value of mortgage notes payable is attributable to deferred financing costs, net for all borrowings, other than the Winterfell portfolio which is attributable to below market debt intangibles. (4) The mortgage note carries a fixed interest rate of 3.0% through February 2024, followed by one-month adjusted SOFR, plus 2.80% through the initial maturity date of February 2026. (5) Composed of seven individual mortgage notes payable secured by the Rochester Sub-Portfolio (as defined below), cross-collateralized and subject to cross-default. (6) In February 2024, the Company sold the property which served as collateral for the mortgage note payable. In conjunction with the sale, the mortgage note payable was repaid. Refer to Note 13, “Subsequent Events” for further discussion. (7) Composed of four individual mortgage notes payable secured by four healthcare real estate properties, cross-collateralized and subject to cross-default. (8) Composed of 32 individual mortgage notes payable secured by 32 healthcare real estate properties, cross-collateralized and subject to cross-default. (9) Composed of five individual mortgage notes payable secured by five healthcare real estate properties, cross-collateralized and subject to cross-default. The following table presents future scheduled principal payments on mortgage notes payable based on initial maturity as of December 31, 2023 (dollars in thousands): Years Ending December 31: 2024 1 $ 128,574 2025 667,741 2026 45,151 2027 62,396 Total $ 903,862 _______________________________________ (1) Includes the outstanding principal as of December 31, 2023 of the Rochester Sub-Portfolio Loan (as defined below), which is in default. Rochester Sub-Portfolio Loan In July 2023, the Company elected not to use cash reserves to pay July debt service on seven cross-defaulted and cross-collateralized mortgage notes with an aggregate principal amount outstanding of $99.8 million (the “Rochester Sub-Portfolio Loan") secured by seven healthcare real estate properties (the “Rochester Sub-Portfolio") that did not generate sufficient cash flow to pay debt service in full. The Rochester Sub-Portfolio Loan is non-recourse to the Company, subject to limited customary exceptions. As a result of the payment default, on October 25, 2023, the lender filed a complaint seeking the appointment of a receiver and foreclosure on the underlying properties and to enforce its rights in its collateral under the loan documents and, on October 30, 2023, the Rochester Sub-Portfolio was placed into a receivership to facilitate an orderly transition of the operations, and eventually ownership, of the properties. Once legal ownership of the Rochester Sub-Portfolio transfers and the obligations under the Rochester Sub-Portfolio Loan are extinguished, the Company expects to recognize a gain related to the debt extinguishment in accordance with ASC 470, “Debt”. However, until the extinguishment occurs, default interest expense and any other expenses related to the Rochester Sub-Portfolio Loan will continue to accrue. As of December 31, 2023, $99.8 million of outstanding mortgage debt and $7.9 million of accrued interest expense were included on the Company's consolidated balance sheets related to the Rochester Sub-Portfolio Loan. Arbors Portfolio

Related Party Arrangements

Related Party Arrangements	12 Months Ended
	Dec. 31, 2023
Related Party Transactions [Abstract]
Related Party Arrangements	Related Party Arrangements Former Advisor In connection with the Internalization, on October 21, 2022, the advisory agreement was terminated and, along with the Operating Partnership and the Former Advisor, the Company entered into a Transition Services Agreement (the “TSA”) to facilitate an orderly transition of the Company’s management of its operations. As of December 31, 2023, the TSA was effectively terminated. Prior to the Internalization, the Former Advisor was responsible for managing the Company’s affairs on a day-to-day basis and for identifying, acquiring, originating and asset managing investments on behalf of the Company. For such services, to the extent permitted by law and regulations, the Former Advisor received fees and reimbursements from the Company. Pursuant to the advisory agreement, the Former Advisor could defer or waive fees in its discretion. Summary of Reimbursements The following table presents the costs incurred and paid to the Former Advisor under the TSA (dollars in thousands): Due to Related Party as of December 31, 2022 Year Ended December 31, 2023 Due to Related Party as of December 31, 2023 Financial Statement Location Incurred Paid General and administrative expenses/ Transaction costs $ 469 $ 562 $ (910) $ 121 Incentive Fee The Special Unit Holder, formerly an affiliate of the Former Advisor, was entitled to receive distributions equal to 15.0% of net cash flows of the Company, whether from continuing operations, repayment of loans, disposition of assets or otherwise, but only after stockholders have received, in the aggregate, cumulative distributions equal to their invested capital plus a 6.75% cumulative, non-compounded annual pre-tax return on such invested capital. From inception through the date of the Sale of Minority Interests, the Special Unit Holder did not receive any incentive fees from the Company. In connection with the Sale of Minority Interests, as of June 9, 2023, the Special Unit Holder became an indirect subsidiary of the Company, though the Special Unit Holder continues to have a contractual obligation to pay any such incentive fees to affiliates of the Former Sponsor, if ever earned. Investments in Joint Ventures Solstice, the manager of the Winterfell portfolio, is a joint venture between affiliates of ISL, which owns 80.0%, and the Company, which owns 20.0%. For the year ended December 31, 2023, the Company recognized property management fee expense of $6.9 million payable to Solstice related to the Winterfell portfolio. In June 2023, the Company completed the Sale of Minority Interests, involving the sale of its minority interests in the Diversified US/UK and Eclipse Portfolios, together with $1.1 million in cash, to its Former Sponsor, who is affiliated with the majority partner of each joint venture, for all of the Company’s equity securities held by the Former Sponsor and its affiliates. Refer to Note 4, “Investments in Unconsolidated Ventures” for further discussion of the Sale of Minority Interests .

Equity-Based Compensation

Equity-Based Compensation	12 Months Ended
	Dec. 31, 2023
Share-Based Payment Arrangement [Abstract]
Equity-Based Compensation	Equity-Based Compensation The Company adopted a long-term incentive plan, as amended (the “Plan”), which it may use to attract and retain qualified officers, directors, employees and consultants, as well as an independent directors compensation plan, which is a component of the Plan. Under the Plan, 2.0 million shares of restricted common stock were eligible to be issued for any equity-based awards granted under the Plan. Pursuant to the Plan, as of December 31, 2023, the Company’s independent directors were granted a total of 159,932 shares of restricted common stock and 203,742 restricted stock units totaling $1.3 million and $0.7 million, respectively, based on the share price on the date of each grant. The restricted common stock and restricted stock units granted generally vest quarterly over two years in equal installments and will become fully vested on the earlier occurrence of: (i) the termination of the independent director’s service as a director due to his or her death or disability; or (ii) a change in control of the Company. The restricted stock units are convertible, on a one-for-one basis, into shares of the Company’s common stock upon the earlier occurrence of: (i) the termination of the independent director’s service as a director; or (ii) a change in control of the Company. The Company recognized equity-based compensation expense of $226,250, $206,917 and $230,083 for the years ended December 31, 2023, 2022 and 2021, respectively. Equity-based compensation expense is recorded in general and administrative expenses in the consolidated statements of operations.

Stockholders' Equity

Stockholders' Equity	12 Months Ended
	Dec. 31, 2023
Equity [Abstract]
Stockholders' Equity	Stockholders’ Equity Common Stock The Company stopped accepting subscriptions for its Offering on December 17, 2015 and all of the shares initially registered for its Offering were issued on or before January 19, 2016. The Company issued 173.4 million shares of common stock generating gross proceeds of $1.7 billion, excluding proceeds from the DRP. Distribution Reinvestment Plan The Company adopted the DRP through which common stockholders were able to elect to reinvest an amount equal to the distributions declared on their shares in additional shares of the Company’s common stock in lieu of receiving cash distributions. Since inception, the Company issued 25.7 million shares of common stock, generating gross offering proceeds of $232.6 million pursuant to the DRP. No selling commissions or dealer manager fees were paid on shares issued pursuant to the DRP. In April 2022, the Company’s board of directors elected to end the DRP, effective April 30, 2022. Distributions Effective February 1, 2019, the Company’s board of directors determined to stop recurring distributions in order to preserve capital and liquidity. On April 20, 2022, the Company’s board of directors declared a special distribution of $0.50 per share (the “Special Distribution”) for each stockholder of record on May 2, 2022 totaling approximately $97.0 million. Share Repurchase Program The Company adopted the share repurchase program (the “Share Repurchase Program”) that enabled stockholders to sell their shares to the Company in limited circumstances and could be amended, suspended, or terminated at any time. The Company previously funded repurchase requests with cash on hand, borrowings or other available capital. In April 2020, the Company’s board of directors determined to suspend all repurchases under the Share Repurchase Program effective April 30, 2020 in order to preserve capital and liquidity and does not currently anticipate resuming the Share Repurchase Program. Retirement of Shares In connection with the Sale of Minority Interests, the Company acquired 9.7 million shares of its common stock in exchange for its minority interests in the Diversified US/UK and Eclipse Portfolios from its Former Sponsor, who is affiliated with the majority partner of each joint venture. Upon completion of the Sale of Minority Interests, the Company retired all of the shares of common stock acquired. To account for the acquisition and retirement of the common stock, the Company estimated the value of its minority interests in the Diversified US/UK and Eclipse Portfolios based on a variety of factors, including historical and projected revenues, market lease rates, the partners’ respective rights under the joint venture agreements, independent third-party appraisals obtained by the joint ventures and other factors deemed relevant. The Company determined the estimated value of minority interests to be approximately $12.5 million at the time of transaction. The estimated value, together with the $1.1 million of cash consideration, net of closing costs, is presented on the consolidated statements of equity as retirement of common stock.

Non-controlling Interests

Non-controlling Interests	12 Months Ended
	Dec. 31, 2023
Noncontrolling Interest [Abstract]
Non-controlling Interests	Non-controlling Interests Operating Partnership Non-controlling interests included the aggregate limited partnership interests in the Operating Partnership held by limited partners, other than the Company. Income (loss) attributable to the non-controlling interests was based on the limited partners’ ownership percentage of the Operating Partnership. As a result of the Sale of Minority Interests, the Company’s limited partnership interest in the Operating Partnership, directly or indirectly, is 100% as of December 31, 2023. Income (loss) allocated to the Operating Partnership non-controlling interests for the period prior to June 9, 2023 were de minimis. Other

Fair Value

Fair Value	12 Months Ended
	Dec. 31, 2023
Fair Value Disclosures [Abstract]
Fair Value	Fair Value Fair Value Measurement The fair value of financial instruments is categorized based on the priority of the inputs to the valuation technique and categorized into a three-level fair value hierarchy. The fair value hierarchy gives the highest priority to quoted prices in active markets for identical assets or liabilities (Level 1) and the lowest priority to unobservable inputs (Level 3). If the inputs used to measure the financial instruments fall within different levels of the hierarchy, the categorization is based on the lowest level input that is significant to the fair value measurement of the instrument. Financial assets and liabilities recorded at fair value on the consolidated balance sheets are categorized based on the inputs to the valuation techniques as follows: Level 1. Quoted prices for identical assets or liabilities in an active market. Level 2. Financial assets and liabilities whose values are based on the following: a) Quoted prices for similar assets or liabilities in active markets. b) Quoted prices for identical or similar assets or liabilities in non-active markets. c) Pricing models whose inputs are observable for substantially the full term of the asset or liability. d) Pricing models whose inputs are derived principally from or corroborated by observable market data for substantially the full term of the asset or liability. Level 3. Prices or valuation techniques based on inputs that are both unobservable and significant to the overall fair value measurement. Derivative Instruments Derivative instruments consist of interest rate contracts and foreign exchange contracts that are generally traded over-the-counter, and are valued using a third-party service provider. Quotations on over-the-counter derivatives are not adjusted and are generally valued using observable inputs such as contractual cash flows, yield curve, foreign currency rates and credit spreads, and are classified as Level 2 of the fair value hierarchy. Although credit valuation adjustments, such as the risk of default, rely on Level 3 inputs, these inputs are not significant to the overall valuation of its derivatives. As a result, derivative valuations in their entirety are classified as Level 2 of the fair value hierarchy. Fair Value Hierarchy Financial assets recorded at fair value on a recurring basis are classified in their entirety based on the lowest level of input that is significant to the fair value measurement. The following table presents financial assets that were accounted for at fair value on a recurring basis as of December 31, 2023 and December 31, 2022 by level within the fair value hierarchy (dollars in thousands): December 31, 2023 December 31, 2022 Level 1 Level 2 Level 3 Level 1 Level 2 Level 3 Financial assets: Derivative assets - interest rate caps $ — $ 433 $ — $ — $ 652 $ — Investment in Espresso joint venture (1) — — 142 — — — _______________________________________ (1) The Company elected the fair value option method to account for its investment in the Espresso joint venture on June 30, 2023. As of December 31, 2022, the investment was accounted for under the equity method. Derivative Assets - Interest Rate Caps The Company’s interest rate caps fair values are determined using models developed by the respective counterparty that use the market standard methodology of discounting the future expected cash receipts that would occur if variable interest rates rise above the strike rate of the caps. The floating interest rates used in the calculation of projected receipts on the caps are based on an expectation of future interest rates derived from observable market interest rate curves and volatilities. Investment in Espresso Joint Venture The Company’s assessment of fair value for its unconsolidated investment in the Espresso joint venture took into consideration the net proceeds that are estimated to be realized from the sales, under contract, of the remaining real estate owned by the joint venture as well as forecasted distributions of available cash, less and wind down and other expenses. Fair Value of Financial Instruments U.S. GAAP requires disclosure of fair value about all financial instruments. The following disclosure of estimated fair value of financial instruments was determined by the Company using available market information and appropriate valuation methodologies. Considerable judgment is necessary to interpret market data and develop estimated fair value. Accordingly, the estimates presented herein are not necessarily indicative of the amounts the Company could realize on disposition of the financial instruments. The use of different market assumptions and/or estimation methodologies may have a material effect on estimated fair value. The following table presents the principal amount, carrying value and fair value of certain financial assets and liabilities (dollars in thousands): December 31, 2023 December 31, 2022 Principal Amount Carrying Value Fair Value Principal Amount Carrying Value Fair Value Financial liabilities: (1) Mortgage notes payable, net $ 903,862 $ 898,154 $ 842,559 $ 922,355 $ 912,248 $ 882,754 _______________________________________ (1) The fair value of other financial instruments not included in this table is estimated to approximate their carrying value. Disclosure about fair value of financial instruments is based on pertinent information available to management as of the reporting date. Although management is not aware of any factors that would significantly affect fair value, such amounts have not been comprehensively revalued for purposes of these consolidated financial statements since that date and current estimates of fair value may differ significantly from the amounts presented herein. Mortgage Notes Payable The Company primarily uses rates currently available with similar terms and remaining maturities to estimate fair value. These measurements are determined using comparable U.S. Treasury and SOFR rates as of the end of the reporting period. These fair value measurements are based on observable inputs, and as such, are classified as Level 2 of the fair value hierarchy. Nonrecurring Fair Values The Company measures fair value of certain assets on a nonrecurring basis when events or changes in circumstances indicate that the carrying value of the assets may not be recoverable. Adjustments to fair value generally result from the application of lower of amortized cost or fair value accounting for assets held for sale or otherwise, write-down of asset values due to impairment. The following table summarizes the fair value and impairment losses of Level 3 assets which have been measured at fair value on a nonrecurring basis at the time of impairment during the periods presented (dollars in thousands): Year Ended December 31, 2023 2022 2021 Fair Value Impairment Losses (1) Fair Value Impairment Losses (1) Fair Value Impairment Losses (1) Operating real estate, net $ 56,718 $ 44,294 $ 80,931 $ 30,900 $ 11,793 $ 5,386 Investments in unconsolidated ventures 3,075 4,728 28,442 13,419 — — Assets held for sale 11,611 355 — — — — _______________________________________ (1) Excludes impairment losses for property damage sustained by facilities. Operating Real Estate, Net Operating real estate that is impaired is carried at fair value at the time of impairment. Impairment was driven by various factors that impacted undiscounted future net cash flows, including declines in operating performance, market growth assumptions and expected margins to be generated by the properties. Fair value of impaired operating real estate was estimated based upon various approaches including discounted cash flow analysis using terminal capitalization rates ranging from 6.25% to 8.50% and discount rates ranging from 7.75% to 10.50%, third party appraisals and offer prices. Investments in Unconsolidated Ventures In June 2023, the Company impaired its investment in the Espresso joint venture by $4.7 million, which reduced the carrying value of its investment to $3.1 million as of June 30, 2023. The Company’s assessment of fair value for its investment took into consideration the net proceeds that are estimated to be realized from the sales, under contract, of the remaining real estate owned by the joint venture as well as forecasted distributions of available cash, less and wind down and other expenses. Upon impairing its investment, the Company elected the fair value option method to account for its investment in the Espresso joint venture on June 30, 2023. In December 2022, the Company impaired its investment in the Diversified US/UK joint venture by $13.4 million, which reduced the carrying value of its investment to $28.4 million as of December 31, 2022. The Company’s assessment for the recoverability of its investment took into consideration the joint venture’s post-COVID-19 underperformance, rising interest rates and the joint venture’s ability to continue to service debt collateralized by substantially all of its domestically-located healthcare real estate. Fair value of the joint venture’s underlying operating real estate was estimated based upon various approaches including discounted cash flow analysis, using terminal capitalization rates ranging from 6.6% to 12.5% and discount rates ranging from 8.8% to 16.0%, and offer prices. Assets Held For Sale Assets held for sale are carried at the lower of amortized cost or fair value. Assets held for sale that were written down to fair value were generally valued using either broker opinions of value, or a combination of market information, including third-party appraisals and indicative sale prices, adjusted as deemed appropriate by management to account for the inherent risk associated with specific properties. In all cases, the fair value of assets held for sale is reduced for estimated selling costs. As of December 31, 2023, the Company classified one operating real estate property within the Rochester portfolio as held for sale. As of December 31, 2022 and December 31, 2021, the Company did not have any assets classified as held for sale.

Segment Reporting

Segment Reporting	12 Months Ended
	Dec. 31, 2023
Segment Reporting [Abstract]
Segment Reporting	Segment Reporting The Company conducts its business through the following segments, which are based on how management reviews and manages its business. • Direct Operating Investments - Properties operated pursuant to management agreements with healthcare managers. • Direct Net Lease Investments - Properties operated under net leases with an operator. • Unconsolidated Investments - Joint venture investments, in which the Company owns a minority, non-controlling interest. Our chief operating decision maker (“CODM”) evaluates performance of each reportable business segment and determines how to allocate resources to those segments, in significant part, based on net operating income (“NOI”) and related measures for each segment. The Company defines NOI as property and other revenues, less property operating expenses. While the Company believes that net income (loss), as defined by GAAP, is the most appropriate earnings measurement, the Company believes that NOI provides useful information to stockholders and provides management with a performance measure to compare the Company's operating results to the operating results of other healthcare real estate companies between periods on a consistent basis. The following tables present the NOI of the Company’s direct investments segments and the Company's proportionate share of the NOI generated by the joint ventures of its unconsolidated investments segment (dollars in thousands): Direct Investments Year Ended December 31, 2023 Net Lease Operating Unconsolidated Investments (2) Non-Segment (3) Adjustments (4) Total (5) Property and other revenues (1) $ 1,709 $ 199,426 $ 361,005 $ 3,843 $ (361,005) $ 204,978 Property operating expenses — (140,612) (316,357) — 316,357 (140,612) Net operating income $ 1,709 $ 58,814 $ 44,648 $ 3,843 $ (44,648) $ 64,366 Interest expense (50,028) Transaction costs (683) General and administrative expenses (13,817) Depreciation and amortization (38,511) Impairment loss (49,423) Other income, net 194 Gain (loss) on investments and other (64,001) Equity in earnings (losses) of unconsolidated ventures (8,272) Income tax expense (74) Net income (loss) $ (160,249) _______________________________________ (1) Includes rental income received from net lease properties as well as resident room and care charges, ancillary service fees and other related revenue earned from operating properties. (2) Includes the Company's proportionate share of revenues and expenses of the Diversified US/UK and Eclipse Portfolios prior to the Sale of Minority Interests in June 2023. (3) Primarily consists of interest income earned on corporate cash and equivalents. (4) Represents adjustments to eliminate the NOI presented for the unconsolidated investments segment, in order to reconcile to the Company's net income (loss) prepared in accordance with GAAP. The Company records its proportionate share of the net income of its unconsolidated investments through equity in earnings (losses) of unconsolidated ventures as presented on its consolidated statements of operations. (5) Non-NOI items are not allocated to individual segments for purposes of assessing segment performance. Direct Investments Year Ended December 31, 2022 Net Lease Operating Unconsolidated Investments Non-Segment (2) Adjustments (3) Total (4) Property and other revenues (1) $ 1,596 $ 182,519 $ 343,575 $ 1,021 $ (343,575) $ 185,136 Property operating expenses (39) (137,539) (285,291) — 285,291 (137,578) Net operating income $ 1,557 $ 44,980 $ 58,284 $ 1,021 $ (58,284) $ 47,558 Interest expense (43,278) Transaction costs (1,569) Asset management fees - related party (8,058) General and administrative expenses (13,938) Depreciation and amortization (38,587) Impairment loss (45,299) Other income, net 77 Realized gain (loss) on investments and other 1,029 Equity in earnings (losses) of unconsolidated ventures 47,625 Income tax expense (61) Net income (loss) $ (54,501) _______________________________________ (1) Includes rental income received from net lease properties as well as resident room and care charges, ancillary service fees and other related revenue earned from operating properties. (2) Primarily consists of interest income earned on corporate cash and equivalents. (3) Represents adjustments to eliminate the NOI presented for the unconsolidated investments segment, in order to reconcile to the Company's net income (loss) prepared in accordance with GAAP. The Company records its proportionate share of the net income of its unconsolidated investments through equity in earnings (losses) of unconsolidated ventures as presented on its consolidated statements of operations. (4) Non-NOI items are not allocated to individual segments for purposes of assessing segment performance. Direct Investments Year Ended December 31, 2021 Net Lease Operating Unconsolidated Investments Non-Segment Adjustments (2) Total (3) Property and other revenues (1) $ 14,708 $ 228,569 $ 301,320 $ — $ (301,320) $ 243,277 Property operating expenses (29) (177,907) (240,784) — 240,784 (177,936) Net operating income $ 14,679 $ 50,662 $ 60,536 $ — $ (60,536) $ 65,341 Interest income on debt investments 4,667 Interest expense (61,620) Transaction costs (54) Asset management fees - related party (11,105) General and administrative expenses (12,691) Depreciation and amortization (54,836) Impairment loss (5,386) Other income, net 7,278 Realized gain (loss) on investments and other 79,477 Equity in earnings (losses) of unconsolidated ventures 15,843 Income tax expense (99) Net income (loss) $ 26,815 _______________________________________ (1) Includes rental income received from net lease properties as well as resident room and care charges, ancillary service fees and other related revenue earned from operating properties. (2) Represents adjustments to eliminate the NOI presented for the unconsolidated investments segment, in order to reconcile to the Company's net income (loss) prepared in accordance with GAAP. The Company records its proportionate share of the net income of its unconsolidated investments through equity in earnings (losses) of unconsolidated ventures as presented on its consolidated statements of operations. (3) Non-NOI items are not allocated to individual segments for purposes of assessing segment performance. The following table presents total assets by segment (dollars in thousands): Direct Investments Total Assets: Net Lease Operating Unconsolidated Investments Non-Segment (1) Total December 31, 2023 $ 74,655 $ 787,925 $ 122,949 $ 73,890 $ 1,059,419 December 31, 2022 83,435 884,137 176,502 93,761 1,237,835 ______________________________________ (1) Represents primarily corporate cash and cash equivalents balances. The following table presents capital expenditures made by the Company for each of its reportable segments (dollars in thousands): Direct Investments Total Capital Expenditures for the Year Ended: Net Lease Operating Unconsolidated Investments Non-Segment Total December 31, 2023 $ — $ 38,422 $ — $ — $ 38,422 December 31, 2022 372 28,932 — — 29,304

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies As of December 31, 2023, the Company believes there are no material unrecorded contingencies that would affect its results of operations, cash flows or financial position. Litigation and Claims The Company may be involved in various litigation matters arising in the ordinary course of its business. Although the Company is unable to predict with certainty the eventual outcome of any litigation, any current legal proceedings are not expected to have a material adverse effect on its financial position or results of operations. The Company’s operators and managers may be involved in various litigation matters arising in the ordinary course of their business. The unfavorable resolution of any such actions, investigations or claims could, individually or in the aggregate, materially adversely affect such operators’ or managers’ liquidity, financial condition or results of operations and their ability to satisfy their respective obligations to the Company, which, in turn, could have a material adverse effect on the Company. As of December 31, 2023, the Company has an accrued reserve of $0.6 million, inclusive of legal fees, relating to a resolution of claims against a manager of one of the Company’s direct operating investments, for which the Company has indemnification obligations under the management agreement. Environmental Matters The Company follows a policy of monitoring its properties for the presence of hazardous or toxic substances. While there can be no assurance that a material environmental liability does not exist at its properties, the Company is not currently aware of any environmental liability with respect to its properties that would have a material effect on its consolidated financial position, results of operations or cash flows. Further, the Company is not aware of any material environmental liability or any unasserted claim or assessment with respect to an environmental liability that it believes would require additional disclosure or the recording of a loss contingency. General Uninsured Losses The Company obtains various types of insurance to mitigate the impact of professional liability, property, business interruption, liability, flood, windstorm, earthquake, environmental and terrorism related losses. The Company attempts to obtain appropriate policy terms, conditions, limits and deductibles considering the relative risk of loss, the cost of such coverage and current industry practice. Disruptions in insurance markets may increase the costs of coverage and result in the Company retaining more risk, to the extent it is more commercially reasonable to do so. In addition, there are also certain types of extraordinary losses, such as those due to acts of war or other events, that may be either uninsurable or not economically insurable. Other

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2023
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events The following is a discussion of material events which have occurred subsequent to December 31, 2023 through the issuance of the consolidated financial statements. Dispositions In February 2024, the Company executed the sale of a property within the Rochester portfolio for $12.0 million. The sale generated net proceeds of approximately $0.7 million, after the repayment of outstanding mortgage principal balance of $10.9 million and transaction costs. As of December 31, 2023, the property was classified as held for sale, as presented on the Company’s consolidated balance sheet.

Schedule III - Real Estate and

Schedule III - Real Estate and Accumulated Depreciation	12 Months Ended
	Dec. 31, 2023
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]
Schedule III - Real Estate and Accumulated Depreciation	Initial Cost Gross Amount Carried at Close of Period (2) Location City, State Encumbrances Land Building & Improvements Capitalized Subsequent to Acquisition (1) Land Building & Improvements Total Accumulated Depreciation Net Book Value Date Acquired Life on Which Depreciation is Computed Direct Operating Investments Milford, OH $ 18,173 $ 1,160 $ 14,440 $ 4,646 $ 1,160 $ 19,086 $ 20,246 $ 5,704 $ 14,542 Dec-13 40 years Milford, OH — 700 — 5,658 696 5,662 6,358 933 5,425 Jul-17 40 years Frisco, TX (3) 26,000 3,100 35,874 5,199 3,100 41,073 44,173 11,179 32,994 Feb-14 40 years Apple Valley, CA 19,668 1,168 24,625 (4,636) 1,168 19,989 21,157 5,889 15,268 Mar-16 40 years Auburn, CA 22,220 1,694 18,438 3,429 1,694 21,867 23,561 5,679 17,882 Mar-16 40 years Austin, TX 24,465 4,020 19,417 3,155 4,020 22,572 26,592 6,569 20,023 Mar-16 40 years Bakersfield, CA 15,526 1,831 21,006 3,260 1,831 24,266 26,097 6,285 19,812 Mar-16 40 years Bangor, ME 19801 2,463 23,205 3,395 2,463 26,600 29,063 6,262 22,801 Mar-16 40 years Bellingham, WA 21,986 2,242 18,807 3,841 2,242 22,648 24,890 5,561 19,329 Mar-16 40 years Clovis, CA 17,303 1,821 21,721 3,140 1,821 24,861 26,682 5,992 20,690 Mar-16 40 years Columbia, MO 20,935 1,621 23,521 (4,656) 1,621 18,865 20,486 6,057 14,429 Mar-16 40 years Corpus Christi, TX 17,155 2,263 20,142 (2,362) 2,263 17,780 20,043 5,463 14,580 Mar-16 40 years East Amherst, NY 17,087 2,873 18,279 3,320 2,873 21,599 24,472 5,130 19,342 Mar-16 40 years El Cajon, CA 19,356 2,357 14,733 1,902 2,357 16,635 18,992 4,488 14,504 Mar-16 40 years El Paso, TX 11,261 1,610 14,103 2,685 1,610 16,788 18,398 4,454 13,944 Mar-16 40 years Fairport, NY 15,237 1,452 19,427 3,256 1,452 22,683 24,135 5,202 18,933 Mar-16 40 years Fenton, MO 22,643 2,410 22,216 3,017 2,410 25,233 27,643 6,225 21,418 Mar-16 40 years Grand Junction, CO 17,971 2,525 26,446 3,718 2,525 30,164 32,689 6,980 25,709 Mar-16 40 years Grand Junction, CO 9,208 1,147 12,523 2,604 1,147 15,127 16,274 3,746 12,528 Mar-16 40 years Grapevine, TX 20,598 1,852 18,143 (7,817) 1,852 10,326 12,178 4,436 7,742 Mar-16 40 years Groton, CT 16,228 3,673 21,879 (5,623) 3,673 16,256 19,929 5,851 14,078 Mar-16 40 years Guilford, CT 22,409 6,725 27,488 (19,288) 6,725 8,200 14,925 5,318 9,607 Mar-16 40 years Joliet, IL 13,752 1,473 23,427 (3,626) 1,473 19,801 21,274 5,374 15,900 Mar-16 40 years Kennewick, WA 7,079 1,168 18,933 3,233 1,168 22,166 23,334 5,394 17,940 Mar-16 40 years Las Cruces, NM 10,316 1,568 15,091 4,341 1,568 19,432 21,000 4,930 16,070 Mar-16 40 years Lee’s Summit, MO 25,073 1,263 20,500 3,346 1,263 23,846 25,109 5,975 19,134 Mar-16 40 years Lodi, CA 18,547 2,863 21,152 2,290 2,863 23,442 26,305 6,083 20,222 Mar-16 40 years Normandy Park, WA 14,967 2,031 16,407 (1,600) 2,031 14,807 16,838 4,591 12,247 Mar-16 40 years Palatine, IL 18,546 1,221 26,993 (9,917) 1,221 17,076 18,297 6,852 11,445 Mar-16 40 years Plano, TX 14,839 2,200 14,860 (4,555) 2,200 10,305 12,505 4,427 8,078 Mar-16 40 years Renton, WA 17,564 2,642 20,469 3,597 2,642 24,066 26,708 6,036 20,672 Mar-16 40 years Sandy, UT 14,569 2,810 19,132 (4,189) 2,810 14,943 17,753 4,727 13,026 Mar-16 40 years Santa Rosa, CA 25,771 5,409 26,183 3,166 5,409 29,349 34,758 7,469 27,289 Mar-16 40 years Sun City West, AZ 23,679 2,684 29,056 (3,462) 2,684 25,594 28,278 7,635 20,643 Mar-16 40 years Tacoma, WA 27,712 7,974 32,435 4,922 7,974 37,357 45,331 9,987 35,344 Mar-16 40 years Frisco, TX (3) — 1,130 — 12,652 1,130 12,652 13,782 2,790 10,992 Oct-16 40 years Albany, OR 8,190 958 6,625 (3,406) 758 3,419 4,177 1,647 2,530 Feb-17 40 years Port Townsend, WA 15,660 1,613 21,460 1,543 996 23,620 24,616 5,607 19,009 Feb-17 40 years Roseburg, OR 11,587 699 11,589 1,040 459 12,869 13,328 3,094 10,234 Feb-17 40 years Sandy, OR 13,216 1,611 16,697 1,409 1,233 18,484 19,717 4,132 15,585 Feb-17 40 years Santa Barbara, CA — 2,408 15,674 637 2,408 16,311 18,719 3,286 15,433 Feb-17 40 years Wenatchee, WA 18,038 2,540 28,971 1,284 1,534 31,261 32,795 6,592 26,203 Feb-17 40 years Greece, NY — 534 18,158 (10,999) 534 7,159 7,693 1,878 5,815 Aug-17 49 years Rochester, NY 17,470 2,426 31,861 4,267 2,426 36,128 38,554 8,046 30,508 Aug-17 39 years Undeveloped Land Rochester, NY — 544 — (94) 450 — 450 — 450 Aug-17 (4) Penfield, NY — 534 — — 534 — 534 — 534 Aug-17 (4) Direct Net Lease Investments Bohemia, NY 21,659 4,258 27,805 (9,539) 4,258 18,266 22,524 7,302 15,222 Sep-14 40 years Hauppauge, NY 13,141 2,086 18,495 (149) 2,086 18,346 20,432 5,675 14,757 Sep-14 40 years Islandia, NY 32,290 8,437 37,198 (12,238) 8,437 24,960 33,397 9,801 23,596 Sep-14 40 years Westbury, NY 14,307 2,506 19,163 293 2,506 19,456 21,962 5,150 16,812 Sep-14 40 years Subtotal $ 793,202 $ 118,297 $ 974,767 $ (3,911) $ 115,758 $ 973,395 $ 1,089,153 $ 267,883 $ 821,270 Initial Cost Gross Amount Carried at Close of Period (2) Location City, State Encumbrances Land Building & Improvements Capitalized Subsequent to Acquisition (1) Land Building & Improvements Total Accumulated Depreciation Net Book Value Date Acquired Life on Which Depreciation is Computed Held for Sale Victor, NY 10,874 557 13,570 (2,516) — 11,611 11,611 — 11,611 Nov-17 (4) Properties in Receivership 99,786 — — — — — — — — Aug-17 (5) Total $ 903,862 $ 118,854 $ 988,337 $ (6,427) $ 115,758 $ 985,006 $ 1,100,764 $ 267,883 $ 832,881 ______________________________________ (1) Negative amount represents impairment of operating real estate. (2) The aggregate cost for federal income tax purposes, is approximately $1.4 billion. (3) Both properties located in Frisco, Texas serve as collateral for a $26.0 million mortgage note payable. (4) Depreciation is not recorded on land or assets held for sale. (5) The Rochester-Sub Portfolio was placed into a receivership in October 2023. Refer to Note 3, “Operating Real Estate” and Note 5, “Borrowings” for additional information. The following table presents changes in the Company’s operating real estate portfolio for the years ended December 31, 2023, 2022 and 2021 (dollars in thousands): Year Ended December 31, 2023 2022 2021 Balance at beginning of year $ 1,196,553 $ 1,197,900 $ 1,774,971 Dispositions (88,100) — (603,082) Improvements 39,246 30,531 31,397 Impairment (44,695) (31,878) (5,386) Subtotal 1,103,004 1,196,553 1,197,900 Classified as held for sale (1) (13,851) — — Balance at end of year (2) $ 1,089,153 $ 1,196,553 $ 1,197,900 _____________________________ (1) Amounts classified as held for sale during the year and remained as held for sale at the end of the year. (2) The aggregate cost of the properties is approximately $344.3 million higher for federal income tax purposes as of December 31, 2023. The following table presents changes in accumulated depreciation for the years ended December 31, 2023, 2022 and 2021 (dollars in thousands): Year Ended December 31, 2023 2022 2021 Balance at beginning of year $ 263,551 $ 225,301 $ 291,041 Depreciation expense 38,174 38,250 53,476 Property dispositions (31,602) — (119,216) Subtotal 270,123 263,551 225,301 Classified as held for sale (2,240) — — Balance at end of year $ 267,883 $ 263,551 $ 225,301

Schedule IV - Mortgage Loans on

Schedule IV - Mortgage Loans on Real Estate	12 Months Ended
	Dec. 31, 2023
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Abstract]
Schedule IV - Mortgage Loans on Real Estate	The Company’s mezzanine loan debt investment was repaid in full in August 2021. The following table presents changes in the Company’s real estate debt investments for the years ended December 31, 2023, 2022 and 2021 (dollars in thousands): Years Ended December 31, 2023 2022 2021 Balance at beginning of year $ — $ — $ 55,864 Additions: Capitalized payment-in-kind interest — — 194 Loan modification fees — — (687) Deductions: Reclassification (1) — — 18,307 Repayment of principal — — (74,376) Amortization of acquisition costs, fees, premiums and discounts — — 698 Balance at end of year $ — $ — $ — _______________________________________ (1) As a result of impairments and other non-cash reserves recorded by the joint venture, the Company’s carrying value of its Espresso unconsolidated investment was reduced to zero as of December 31, 2018. The Company has recorded the excess equity in losses related to its unconsolidated venture as a reduction to the carrying value of its mezzanine loan, which was originated to a subsidiary of the Espresso joint venture and was repaid in full in August 2021. During the year ended December 31, 2021, the Company received distributions from the joint venture greater than the Company’s carrying value of its unconsolidated investment, which resulted in the Company recording a gain on the distribution and a carrying value of zero as of December 31, 2021.

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Dec. 31, 2023
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

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Basis of Accounting	Basis of Accounting The accompanying consolidated financial statements and related notes of the Company have been prepared in accordance with accounting principles generally accepted in the United States (“U.S. GAAP”).
Principles of Consolidation	Principles of Consolidation The consolidated financial statements include the accounts of the Company, the Operating Partnership and their consolidated subsidiaries. The Company consolidates entities in which it has a controlling financial interest by first considering if an entity meets the definition of a variable interest entity (“VIE”) for which the Company is deemed to be the primary beneficiary or if the Company has the power to control an entity through majority voting interest or other arrangements. All significant intercompany balances are eliminated in consolidation.
Variable Interest Entities	Variable Interest Entities A VIE is an entity that lacks one or more of the characteristics of a voting interest entity. A VIE is defined as an entity in which equity investors do not have the characteristics of a controlling financial interest or do not have sufficient equity at risk for the entity to finance its activities without additional subordinated financial support from other parties. The determination of whether an entity is a VIE includes both a qualitative and quantitative analysis. The Company bases its qualitative analysis on its review of the design of the entity, its organizational structure including decision-making ability and relevant financial agreements and the quantitative analysis on the forecasted cash flow of the entity. The Company reassesses its initial evaluation of an entity as a VIE upon the occurrence of certain reconsideration events. A VIE must be consolidated only by its primary beneficiary, which is defined as the party who, along with its affiliates and agents, has both the: (i) power to direct the activities that most significantly impact the VIE’s economic performance; and (ii) obligation to absorb the losses of the VIE or the right to receive the benefits from the VIE, which could be significant to the VIE. The Company determines whether it is the primary beneficiary of a VIE by considering qualitative and quantitative factors, including, but not limited to: which activities most significantly impact the VIE’s economic performance and which party controls such activities; the amount and characteristics of its investment; the obligation or likelihood for the Company or other interests to provide financial support; consideration of the VIE’s purpose and design, including the risks the VIE was designed to create and pass through to its variable interest holders and the similarity with and significance to the business activities of the Company and the other interests. The Company reassesses its determination of whether it is the primary beneficiary of a VIE each reporting period. Judgments related to these determinations include estimates about the current and future fair value and performance of investments held by these VIEs and general market conditions. The Company evaluates its investments and financings, including investments in unconsolidated ventures to determine whether each investment or financing is a VIE. The Company analyzes new investments, as well as reconsideration events for existing investments, which vary depending on the type of investment. As of December 31, 2023, the Company has identified certain consolidated and unconsolidated VIEs. Assets of each of the VIEs may only be used to settle obligations of the respective VIE. Creditors of each of the VIEs have no recourse to the general credit of the Company. Consolidated VIEs The most significant VIEs of the Company are certain entities that are consolidated by the Operating Partnership. These entities are VIEs because of non-controlling interests owned by third parties, which do not have substantive kick-out or participating rights. Included in operating real estate, net, assets held for sale and mortgage notes payable, net on the Company’s consolidated balance sheet as of December 31, 2023 is $101.3 million, $11.6 million and $171.8 million, respectively, related to such consolidated VIEs. Unconsolidated VIEs
Voting Interest Entities	Voting Interest Entities A voting interest entity is an entity in which the total equity investment at risk is sufficient to enable it to finance its activities independently and the equity holders have the power to direct the activities of the entity that most significantly impact its economic performance, the obligation to absorb the losses of the entity and the right to receive the residual returns of the entity. The usual condition for a controlling financial interest in a voting interest entity is ownership of a majority voting interest. If the Company has a majority voting interest in a voting interest entity, the entity will generally be consolidated. The Company does not consolidate a voting interest entity if there are substantive participating rights by other parties and/or kick-out rights by a single party or through a simple majority vote. The Company performs on-going reassessments of whether entities previously evaluated under the voting interest framework have become VIEs, based on certain events, and therefore subject to the VIE consolidation framework.
Investments in Unconsolidated Ventures	Investments in Unconsolidated Ventures A non-controlling, unconsolidated ownership interest in an entity may be accounted for using the equity method or the Company may elect the fair value option. The Company will account for an investment under the equity method of accounting if it has the ability to exercise significant influence over the operating and financial policies of an entity, but does not have a controlling financial interest. Under the equity method, the investment is adjusted each period for capital contributions and distributions and its share of the entity’s net income (loss). Capital contributions, distributions and net income (loss) of such entities are recorded in accordance with the terms of the governing documents. An allocation of net income (loss) may differ from the stated ownership percentage interest in such entity as a result of preferred returns and allocation formulas, if any, as described in such governing documents. Equity method investments are recognized using a cost accumulation model, in which the investment is recognized based on the cost to the investor, which includes acquisition fees. The Company records as an expense certain acquisition costs and fees associated with consolidated investments deemed to be business combinations and capitalizes these costs for investments deemed to be acquisitions of an asset, including an equity method investment. The Company may elect the fair value option of accounting for an investment that would otherwise be accounted for under the equity method. The fair value option election allows an entity to make an irrevocable election of fair value for certain financial assets and liabilities on an instrument-by-instrument basis at the initial or subsequent measurement. The decision to elect the fair value option must be applied to an entire instrument and is irrevocable once elected. Under the fair value option, the Company records its share of the changes to fair value of the investment and any unrealized gains and losses. On June 30, 2023, the Company elected the fair value option method to account for its investment in the Espresso joint venture, which is included in investments in unconsolidated ventures on the consolidated balance sheets. The fair value election was made based on the Company’s assessment that the expected return of investment was lower than the Company’s carrying value of its investment in the Espresso joint venture, which resulted in an impairment of $4.7 million and reduced the carrying value of its investment to recoverable fair value of $3.1 million as of June 30, 2023. The Company’s assessment for the recoverability of its investment took into consideration the joint venture’s remaining assets and estimated future cash distributions, less transaction and wind down costs. The Company will record any changes to its investment’s fair value in gain (loss) on investments and other in the consolidated statements of operations. From the date of the election of fair value through December 31, 2023, the Company did not record any changes to the fair value of its investment in the Espresso joint venture. Refer to Note 4 “Investment in Unconsolidated Ventures” and Note 10 “Fair Value” for further discussion.
Non-controlling Interests	Non-controlling Interests A non-controlling interest in a consolidated subsidiary is defined as the portion of the equity (net assets) in a subsidiary not attributable, directly or indirectly, to the Company. A non-controlling interest is required to be presented as a separate component of equity on the consolidated balance sheets and presented separately as net income (loss) and comprehensive income (loss) attributable to controlling and non-controlling interests. An allocation to a non-controlling interest may differ from the stated ownership percentage interest in such entity as a result of a preferred return and allocation formula, if any, as described in such governing documents.
Estimates	Estimates The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that could affect the amounts reported in the consolidated financial statements and accompanying notes. Actual results could materially differ from those estimates and assumptions. Any estimates of the effects of the COVID-19 pandemic, inflation, rising interest rates, risk of recession and other economic conditions as reflected and/or discussed in these financial statements are based upon the Company's best estimates using information known to the Company as of the date of this Annual Report on Form 10-K. Such estimates may change and the impact of which could be material.
Cash, Cash Equivalents and Restricted Cash	Cash, Cash Equivalents and Restricted Cash The Company considers all highly-liquid investments with an original maturity date of three months or less to be cash equivalents. Cash, including amounts restricted, may at times exceed the Federal Deposit Insurance Corporation deposit insurance limit of $250,000 per institution. The Company mitigates credit risk by placing cash and cash equivalents with major financial institutions and money market funds invested in short-term U.S. government securities. To date, the Company has not experienced any losses on cash and cash equivalents.
Operating Real Estate	Operating Real Estate Operating real estate is carried at historical cost less accumulated depreciation. Major replacements and betterments which improve or extend the life of the asset are capitalized and depreciated over their useful life. Ordinary repairs and maintenance are expensed as incurred. Operating real estate is depreciated using the straight-line method over the estimated useful life of the assets, summarized as follows: Category: Term: Building 39 to 49 years Building improvements Lesser of the useful life or remaining life of the building Land improvements 9 to 15 years Tenant improvements Lesser of the useful life or remaining term of the lease Furniture, fixtures and equipment 5 to 14 years
Lessee Accounting	Lessee Accounting A leasing arrangement, a right to control the use of an identified asset for a period of time in exchange for consideration, is classified by the lessee either as a finance lease, which represents a financed purchase of the leased asset, or as an operating lease. For leases with terms greater than 12 months, a lease asset and a lease liability are recognized on the balance sheet at commencement date based on the present value of lease payments over the lease term. Lease renewal or termination options are included in the lease asset and lease liability only if it is reasonably certain that the option to extend would be exercised or the option to terminate would not be exercised. As the implicit rate in most leases are not readily determinable, the Company’s incremental borrowing rate for each lease at commencement date is used to determine the present value of lease payments. Consideration is given to the Company’s recent debt financing transactions, as well as publicly available data for instruments with similar characteristics, adjusted for the respective lease term, when estimating incremental borrowing rates. Lease expense is recognized over the lease term based on an effective interest method for finance leases and on a straight-line basis for operating leases. Right of Use (“ROU”) - Finance Assets operating real estate, net
Assets Held For Sale	The Company classifies certain long-lived assets as held for sale once the criteria, as defined by U.S. GAAP, have been met and are expected to sell within one year. Long-lived assets to be disposed of are reported at the lower of their carrying amount or fair value minus cost to sell, with any write-down recorded to impairment loss on the consolidated statements of operations. Depreciation and amortization is not recorded for assets classified as held for sale.
Deferred Costs	Deferred Costs Deferred costs consist of deferred financing costs. Deferred financing costs represent commitment fees, legal and other third-party costs associated with obtaining financing. These costs are recorded against the carrying value of such financing and are amortized to interest expense over the term of the financing using the effective interest method. Unamortized deferred financing costs are expensed to gain (loss) on investments and other, when the associated borrowing is repaid before maturity. Costs incurred in seeking financing transactions which do not close are expensed in the period in which it is determined that the financing will not occur.
Identified Intangibles	Identified Intangibles The Company records acquired identified intangibles, such as the value of in-place leases and other intangibles, based on estimated fair value at the acquisition date. The value allocated to the identified intangibles is amortized over the remaining lease term. In-place leases are amortized into depreciation and amortization expense. Impairment analysis for identified intangible assets is performed in connection with the impairment assessment of the related operating real estate. An impairment establishes a new basis for the identified intangible asset and any impairment loss recognized is not subject to subsequent reversal. Refer to “—Impairment on Operating Real Estate and Investments in Unconsolidated Ventures” for additional information.
Derivative Instruments	Derivative Instruments
Revenue Recognition	Revenue Recognition Operating Real Estate Rental income from operating real estate is derived from leasing of space to operators and residents, including rent received from the Company’s net lease properties and rent, ancillary service fees and other related revenue earned from ILF residents. Rental income recognition commences when the operator takes legal possession of the leased space and the leased space is substantially ready for its intended use. The leases are for fixed terms of varying length and generally provide for rentals and expense reimbursements to be paid in monthly installments. Rental income from leases, which includes community and move-in fees, is recognized over the term of the respective leases. ILF resident agreements are generally short-term in nature and may allow for termination with 30 days’ notice. The Company also generates revenue from operating healthcare properties. Revenue related to operating healthcare properties includes resident room and care charges, ancillary fees and other resident service charges. Rent is charged and revenue is recognized when such services are provided, generally defined per the resident agreement as of the date upon which a resident occupies a room or uses the services. Resident agreements are generally short-term in nature and may allow for termination with 30 days’ notice. Revenue derived from our ALFs and MCFs is recorded in resident fee income in the consolidated statements of operations. Revenue from operators and residents is recognized at lease commencement only to the extent collection is expected to be probable. This assessment is based on several qualitative and quantitative factors, including and as appropriate, the payment history, ability to satisfy its lease obligations, the value of the underlying collateral or deposit, if any, and current economic conditions. If collection is assessed to not be probable, thereafter lease income recognized is limited to amounts collected, with the reversal of any revenue recognized to date in excess of amounts received. If collection is subsequently reassessed to be probable, revenue is adjusted to reflect the amount that would have been recognized had collection always been assessed as probable. The operator of the Company’s four net lease properties failed to remit contractual monthly rent obligations and the Company deemed it not probable that these obligations will be satisfied in the foreseeable future. On March 27, 2023, the Company entered into a lease forbearance and modification agreement (the “Forbearance Agreement”) with the existing operator, pursuant to which, among other things, the Company will be entitled to receive all cash flow in excess of permitted expenses, and be required to fund any operating deficits, through 2025, subject to the terms and conditions thereof. For the years ended December 31, 2023, 2022 and 2021 remittances from the operator totaled $1.7 million, $1.6 million, and $3.4 million, respectively, which the Company recorded as rental income. For the years ended December 31, 2023, 2022 and 2021, total property and other revenue includes variable lease revenue of $14.1 million, $11.2 million and $13.1 million, respectively. Variable lease revenue includes ancillary services provided to residents, as well as non-recurring services and fees at the Company’s operating facilities.
Impairment on Operating Real Estate and Investments in Unconsolidated Ventures	Impairment on Operating Real Estate and Investments in Unconsolidated Ventures Operating Real Estate and Assets Held for Sale The Company’s real estate portfolio is reviewed on a quarterly basis, or more frequently as necessary, to assess whether there are any indicators that the value of its operating real estate may be impaired or that its carrying value may not be recoverable. A property’s value is considered impaired if the Company’s estimate of the aggregate expected future undiscounted cash flow generated by the property is less than the carrying value. In conducting this review, the Company considers U.S. macroeconomic factors, real estate and healthcare sector conditions, together with asset specific and other factors. To the extent an impairment has occurred, the loss is measured as the excess of the carrying value of the property over the estimated fair value and recorded in impairment loss in the consolidated statements of operations. Real estate held for sale is stated at the lower of its carrying amount or estimated fair value less disposal cost, with any write-down to disposal cost recorded as an impairment loss. For any increase in fair value less disposal cost subsequent to classification as held for sale, the impairment may be reversed, but only up to the amount of cumulative loss previously recognized. The Company considered the potential impact of the lasting effects of inflation, rising interest rates, risk of recession and other economic conditions on the future net operating income of its healthcare real estate held for investment as an indicator of impairment. Fair values were estimated based upon the income capitalization approach, using net operating income for each property and applying indicative capitalization rates. Investments in Unconsolidated Ventures The Company reviews its investments in unconsolidated ventures on a quarterly basis, or more frequently as necessary, to assess whether there are any indicators that the value may be impaired or that its carrying value may not be recoverable. An investment is considered impaired if the projected net recoverable amount over the expected holding period is less than the carrying value. In conducting this review, the Company considers global macroeconomic factors, including real estate sector conditions, together with investment specific and other factors. To the extent an impairment has occurred on the Company’s investment in unconsolidated ventures, and is considered to be other than temporary, the loss is measured as the excess of the carrying value of the investment over the estimated fair value and recorded in impairment loss in the consolidated statements of operations.
Credit Losses on Receivables	Credit Losses on Receivables The current expected credit loss model, in estimating expected credit losses over the life of a financial instrument at the time of origination or acquisition, considers historical loss experiences, current conditions and the effects of reasonable and supportable expectations of changes in future macroeconomic conditions. The Company assesses the estimate of expected credit losses on a quarterly basis or more frequently as necessary. The Company considers historical credit loss information that is adjusted for current conditions and reasonable and supportable forecasts. The Company measures expected credit losses of receivables on a collective basis when similar risk characteristics exist. If the Company determines that a particular receivable does not share risk characteristics with its other receivables, the Company evaluates the receivable for expected credit losses on an individual basis. When developing an estimate of expected credit losses on receivables, the Company considers available information relevant to assessing the collectability of cash flows. This information may include internal information, external information, or a combination of both relating to past events, current conditions, and reasonable and supportable forecasts. The Company considers relevant qualitative and quantitative factors that relate to the environment in which the Company operates and are specific to the borrower.
Acquisition Fees and Expenses	Acquisition Fees and Expenses
Equity-Based Compensation	Equity-Based Compensation The Company accounts for equity-based compensation awards using the fair value method, which requires an estimate of fair value of the award at the time of grant. All fixed equity-based awards to directors, which have no vesting conditions other than time of service, are amortized to compensation expense over the awards’ vesting period on a straight-line basis. Equity-based compensation is classified within general and administrative expenses in the consolidated statements of operations.
Income Taxes	Income Taxes The Company elected to be taxed as a REIT and to comply with the related provisions of the Internal Revenue Code beginning in its taxable year ended December 31, 2013. Accordingly, the Company will generally not be subject to U.S. federal income tax to the extent of its distributions to stockholders as long as certain asset, gross income and share ownership tests are met. To maintain its qualification as a REIT, the Company must annually distribute dividends equal to at least 90.0% of its REIT taxable income (with certain adjustments) to its stockholders and meet certain other requirements. The Company believes that all of the criteria to maintain the Company’s REIT qualification have been met for the applicable periods. For the taxable year ended December 31, 2023, the Company anticipates that its REIT taxable income, if any, will be offset by its net operating loss carry-forward and as such, the Company will not be subject to the distribution requirements. The Company’s most recently filed tax return is for the year ended December 31, 2022 and includes a net operating loss carry-forward of $248.5 million. If the Company were to fail to meet these requirements, it would be subject to U.S. federal income tax and potential interest and penalties, which could have a material adverse impact on its results of operations and amounts available for distributions to its stockholders. The Company’s accounting policy with respect to interest and penalties is to classify these amounts as a component of income tax expense, where applicable. The Company has assessed its tax positions for all open tax years, which include 2019 to 2023, and concluded there were no material uncertainties to be recognized. The Company may also be subject to certain state, local and franchise taxes. Under certain circumstances, federal income and excise taxes may be due on its undistributed taxable income. The Company made a joint election to treat certain subsidiaries as taxable REIT subsidiaries (“TRS”) which may be subject to U.S. federal, state and local income taxes. In general, a TRS of the Company may perform services for managers/operators/residents of the Company, hold assets that the Company cannot hold directly and may engage in any real estate or non-real estate related business. Certain subsidiaries of the Company are subject to taxation by federal and state authorities for the periods presented. Income taxes are accounted for by the asset/liability approach in accordance with U.S. GAAP. Deferred taxes, if any, represent the expected future tax consequences when the reported amounts of assets and liabilities are recovered or paid. Such amounts arise from differences between the financial reporting and tax bases of assets and liabilities and are adjusted for changes in tax laws and tax rates in the period which such changes are enacted. A provision for income tax represents the total of income taxes paid or payable for the current period, plus the change in deferred taxes. Current and deferred taxes are provided on the portion of earnings (losses) recognized by the Company with respect to its interest in the TRS. A reconciliation of income taxes, which is computed by applying the federal corporate tax rate for the years ended December 31, 2023, 2022 and 2021, to the taxable income is as follows (in thousands): For the Years Ended December 31, 2023 2022 2021 Tax (benefit) at statutory rate for taxable entities (21%) $ (1,098) $ (2,112) $ 4,956 State income tax (benefit), net of federal benefits (48) (91) 304 Change in valuation allowance 1,216 2,145 (5,102) Other differences 4 119 (59) Income tax expense (benefit) $ 74 $ 61 $ 99 Deferred income tax assets and liabilities are calculated based on temporary differences between the Company’s U.S. GAAP consolidated financial statements and the federal and state income tax basis of assets and liabilities as of the consolidated balance sheet date. The Company evaluates the realizability of its deferred tax assets (e.g., net operating loss and capital loss carryforwards) and recognizes a valuation allowance if, based on the available evidence, it is more likely than not that some portion or all of its deferred tax assets will not be realized. When evaluating the realizability of its deferred tax assets, the Company considers estimates of expected future taxable income, existing and projected book/tax differences, tax planning strategies available and the general and industry specific economic outlook. This realizability analysis is inherently subjective, as it requires the Company to forecast its business and general economic environment in future periods. Changes in estimate of deferred tax asset realizability, if any, are included in provision for income tax expense in the consolidated statements of operations. The Company has a deferred tax asset and continues to have a full valuation allowance recognized, as there are no changes in the facts and circumstances to indicate that the Company should release the valuation allowance.
Comprehensive Income (Loss)	Comprehensive Income (Loss)
Foreign Currency	Foreign Currency Assets and liabilities denominated in a foreign currency for which the functional currency is a foreign currency are translated using the currency exchange rate in effect at the end of the period presented and the results of operations for such entities are translated into U.S. dollars using the average currency exchange rate in effect during the period. The resulting foreign currency translation adjustment is recorded as a component of accumulated OCI in the consolidated statements of equity. Assets and liabilities denominated in a foreign currency for which the functional currency is the U.S. dollar are remeasured using the currency exchange rate in effect at the end of the period presented and the results of operations for such entities are remeasured into U.S. dollars using the average currency exchange rate in effect during the period.
Recent Accounting Pronouncements	Recent Accounting Pronouncements Accounting Standards Adopted in 2023 In March 2020, the FASB issued an amendment to the reference rate reform standard, which provides the option for a limited period of time to ease the potential burden in accounting for, or recognizing the effects of, reference rate reform on contract modifications and hedge accounting. An example of such reform is the market transition from the London Interbank Offered Rate (“LIBOR”) to alternative reference rates. Entities that make this optional expedient election would not have to remeasure the contracts at the modification date or reassess the accounting treatment if certain criteria are met and would continue applying hedge accounting for relationships affected by reference rate reform. In December 2022, the FASB extended the date for which this guidance can be applied from December 31, 2022 to December 31, 2024. The Company did not make the optional election of the aforementioned accounting standards. Future Application of Accounting Standards In November 2023, the FASB issued ASU No. 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures , which requires disclosure of incremental segment information on an annual and interim basis, primarily through enhanced disclosures of significant segment expenses. ASU No. 2023-07 is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024 and requires retrospective application to all periods presented upon adoption. Early adoption is permitted. The Company does not anticipate the application of the accounting standards will have a material impact on the Company’s financial statements. In December 2023, the FASB issued ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures , which requires disclosure of incremental income tax information within the rate reconciliation and expanded disclosures of income taxes paid, among other disclosure requirements. ASU No. 2023-09 is effective for fiscal years beginning after December 15, 2024. Early adoption is permitted. The Company does not anticipate the application of the accounting standards will have a material impact on the Company’s financial statements.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Reconciliation of Cash, Cash Equivalents and Restricted Cash	The following table provides a reconciliation of cash, cash equivalents, and restricted cash as reported on the consolidated balance sheets to the total of such amounts as reported on the consolidated statements of cash flows (dollars in thousands): December 31, 2023 2022 2021 Cash and cash equivalents $ 85,037 $ 103,926 $ 200,473 Restricted cash 7,906 11,734 10,465 Total cash, cash equivalents and restricted cash $ 92,943 $ 115,660 $ 210,938
Reconciliation of Cash, Cash Equivalents and Restricted Cash	The following table provides a reconciliation of cash, cash equivalents, and restricted cash as reported on the consolidated balance sheets to the total of such amounts as reported on the consolidated statements of cash flows (dollars in thousands): December 31, 2023 2022 2021 Cash and cash equivalents $ 85,037 $ 103,926 $ 200,473 Restricted cash 7,906 11,734 10,465 Total cash, cash equivalents and restricted cash $ 92,943 $ 115,660 $ 210,938
Schedule of Operating Real Estate Estimated Useful Life	Operating real estate is depreciated using the straight-line method over the estimated useful life of the assets, summarized as follows: Category: Term: Building 39 to 49 years Building improvements Lesser of the useful life or remaining life of the building Land improvements 9 to 15 years Tenant improvements Lesser of the useful life or remaining term of the lease Furniture, fixtures and equipment 5 to 14 years
Schedule of Future Minimum Lease Payments for Capital Leases	The following table presents the future minimum lease payments under finance leases and the present value of the minimum lease payments, which are included in other liabilities Years Ending December 31: 2024 $ 38 2025 38 2026 33 2027 18 2028 10 Thereafter — Total minimum lease payments $ 137 Less: Amount representing interest (23) Present value of minimum lease payments $ 114
Schedule of Intangible Assets, Net	The following table presents intangible assets, net (dollars in thousands): December 31, 2023 December 31, 2022 In-place lease value $ 120,149 $ 120,149 Less: Accumulated amortization (118,233) (117,896) Intangible assets, net $ 1,916 $ 2,253
Schedule of Deferred Costs and Intangible Assets, Future Amortization Expense	The following table presents future amortization of in-place lease value (dollars in thousands): Years Ending December 31: 2024 $ 337 2025 337 2026 337 2027 337 2028 337 Thereafter 231 Total $ 1,916
Schedule of Effective Income Tax Rate Reconciliation	A reconciliation of income taxes, which is computed by applying the federal corporate tax rate for the years ended December 31, 2023, 2022 and 2021, to the taxable income is as follows (in thousands): For the Years Ended December 31, 2023 2022 2021 Tax (benefit) at statutory rate for taxable entities (21%) $ (1,098) $ (2,112) $ 4,956 State income tax (benefit), net of federal benefits (48) (91) 304 Change in valuation allowance 1,216 2,145 (5,102) Other differences 4 119 (59) Income tax expense (benefit) $ 74 $ 61 $ 99
Schedule of Deferred Tax Assets and Liabilities	The components of the Company’s deferred tax assets as of December 31, 2023 and 2022 is as follows (in thousands): As of December 31, 2023 2022 Fixed assets and other $ 656 $ 586 Net operating losses 15,827 14,681 Total deferred tax assets $ 16,483 $ 15,267 Valuation allowance (16,483) (15,267) Net deferred income tax assets $ — $ —

Operating Real Estate (Tables)

Operating Real Estate (Tables)	12 Months Ended
	Dec. 31, 2023
Real Estate [Abstract]
Schedule of Operating Real Estate	The following table presents operating real estate, net (dollars in thousands): December 31, 2023 December 31, 2022 Land $ 115,758 $ 121,518 Land improvements 12,705 18,945 Buildings and improvements 861,452 957,924 Tenant improvements 372 372 Construction in progress 5,493 6,736 Furniture, fixtures and equipment 93,373 91,058 Subtotal $ 1,089,153 $ 1,196,553 Less: Accumulated depreciation (267,883) (263,551) Operating real estate, net $ 821,270 $ 933,002
Schedule of Real Estate Properties	The following table presents the operators and managers of the Company’s operating real estate (dollars in thousands): As of December 31, 2023 Year Ended December 31, 2023 Operator / Manager Properties Under Management Units Under Management (1) Property and Other Revenues (2) % of Total Property and Other Revenues Solstice Senior Living (3) 32 3,969 $ 127,765 62.3 % Watermark Retirement Communities (4) 6 723 45,001 22.0 % Avamere Health Services 5 453 21,780 10.6 % Integral Senior Living 1 40 4,880 2.4 % Arcadia Management 4 564 1,709 0.8 % Other (5) — — 3,843 1.9 % Total 48 5,749 $ 204,978 100.0 % ______________________________________ (1) Represents rooms for ALFs, ILFs and MCFs. (2) Includes rental income received from the Company’s net lease properties, rental income, ancillary service fees and other related revenue earned from ILF residents and resident fee income derived from the Company’s ALFs and MCFs, which includes resident room and care charges, ancillary fees and other resident service charges. (3) Solstice is a joint venture of which affiliates of ISL own 80%. (4) Property count and units exclude one property within the Rochester portfolio designated as held for sale and the properties within the Rochester Sub-Portfolio, which were placed into a receivership in October 2023. (5) Consists primarily of interest income earned on corporate-level cash and cash equivalents.
Schedule of Future Contractual Rent Obligations	The following table presents the future contractual rent obligations for the operator of the Company’s net lease properties over the next five years and thereafter as of December 31, 2023 (dollars in thousands): Years Ending December 31: 2024 $ 11,192 2025 11,472 2026 11,759 2027 12,053 2028 12,354 Thereafter 9,438 Total $ 68,268

Investments in Unconsolidated_2

Investments in Unconsolidated Ventures (Tables)	12 Months Ended
	Dec. 31, 2023
Equity Method Investments and Joint Ventures [Abstract]
Equity Method Investments	The following table presents the Company’s investments in unconsolidated ventures (dollars in thousands): Carrying Value Portfolio Acquisition Date Ownership December 31, 2023 December 31, 2022 Trilogy Dec-2015 23.4 % $ 122,339 $ 128,884 Solstice Jul-2017 20.0 % 468 323 Espresso Jul-2015 36.7 % 142 18,019 Investments sold — 29,276 Investments in Unconsolidated Ventures $ 122,949 $ 176,502 The following table presents the results of the Company’s investment in unconsolidated ventures (dollars in thousands): Year Ended December 31, 2023 2022 2021 Portfolio Equity in Earnings (Losses) Cash Distribution Equity in Earnings (Losses) Cash Distribution Equity in Earnings (Losses) Cash Distribution Trilogy (1) $ (1,409) $ 5,136 $ 11,652 $ 9,134 $ (2,891) $ 4,638 Solstice 145 — 2 — (79) — Espresso (2) 9,228 22,377 72,427 54,654 19,619 5,500 Envoy — — — 66 740 817 Investments sold (3) (16,236) — (36,456) 3,279 (1,546) 7,155 Total $ (8,272) $ 27,513 $ 47,625 $ 67,133 $ 15,843 $ 18,110 _______________________________________ (1) The Trilogy joint venture recognized impairment losses on its intangible assets, of which the Company’s proportionate share totaled $2.4 million and is included in equity in earnings (losses) for the year ended December 31, 2023. (2) The Espresso joint venture recognized net gains related to sub-portfolio sales, of which the Company’s proportionate share totaled $9.2 million and $70.6 million for the years ended December 31, 2023 and 2022, respectively. The Company was distributed its proportionate share of the net proceeds generated from the sales during the years ended December 31, 2023 and 2022, totaling $17.3 million and $49.7 million, respectively. In addition, the Company elected to account for the joint venture under the fair value option on June 30, 2023, which resulted in no earnings recorded from the date of election through December 31, 2023. (3) Prior to the sale of the Diversified US/UK joint venture, the joint venture recognized impairment, of which the Company’s proportionate share totaled $11.4 million and $22.9 million is included in equity in earnings (losses) for the years ended December 31, 2023, and 2022, respectively. The following table presents a summary of the combined balance sheets and combined statements of operations of the Espresso and Solstice joint ventures (dollars in thousands): December 31, 2023 December 31, 2022 Years Ended December 31, 2023 2022 2021 Assets Operating real estate, net $ — $ 76,087 Total revenues $ 17,766 $ 40,445 $ 67,206 All other assets 10,530 34,842 Net income (loss) $ 52,224 $ 197,734 $ 53,167 Total assets $ 10,530 $ 110,929 Liabilities and equity Total liabilities $ 7,457 $ 97,826 Equity 3,073 13,103 Total liabilities and equity $ 10,530 $ 110,929 On June 9 2023, the Company sold its ownership interest in the Diversified US/UK and Eclipse joint ventures. The following table presents a summary of the combined balance sheets and combined statements of operations of the Diversified US/UK and Eclipse joint ventures (dollars in thousands): June 9, 2023 December 31, 2022 Period Ended June 9, 2023 Years Ended December 31, 2022 2021 Assets Operating real estate, net $ 615,335 $ 2,325,802 Total revenues $ 115,068 $ 352,098 $ 386,354 All other assets 45,069 232,202 Net income (loss) $ (198,793) $ (288,881) $ 12,087 Total assets $ 660,404 $ 2,558,004 Liabilities and equity Total liabilities $ 573,185 $ 2,341,223 Equity 87,219 216,781 Total liabilities and equity $ 660,404 $ 2,558,004

Borrowings (Tables)

Borrowings (Tables)	12 Months Ended
	Dec. 31, 2023
Debt Disclosure [Abstract]
Summary of Borrowings	The following table presents the Company’s mortgage notes payable (dollars in thousands): December 31, 2023 December 31, 2022 Recourse vs. Non-Recourse (1) Initial Contractual Interest Rate (2) Principal Amount (3) Carrying Value (3) Principal (3) Carrying (3) Aqua Portfolio Frisco, TX (4) Non-recourse Feb 2026 3.0% $ 26,000 $ 25,694 $ 26,000 $ 25,560 Milford, OH Non-recourse Sep 2026 SOFR + 2.79% 18,173 18,015 18,336 18,126 Rochester Portfolio Rochester, NY Non-recourse Feb 2025 4.25% 17,470 17,448 18,206 18,165 Rochester, NY (5) Non-recourse Jul 2023 SOFR + 2.45% 99,786 99,786 100,651 100,042 Rochester, NY (6) Non-recourse Aug 2024 SOFR + 2.93% 10,874 10,853 11,336 11,315 Arbors Portfolio (7) Various locations Non-recourse Feb 2025 3.99% 81,397 81,209 83,423 83,051 Winterfell Portfolio (8) Various locations Non-recourse Jun 2025 4.17% 583,471 578,694 596,408 588,306 Avamere Portfolio (9) Various locations Non-recourse Feb 2027 4.66% 66,691 66,455 67,995 67,683 Mortgage notes payable, net $ 903,862 $ 898,154 $ 922,355 $ 912,248 _______________________________________ (1) Subject to non-recourse carve-outs. (2) Floating-rate borrowings total $128.8 million of principal outstanding and reference one-month of the Secured Overnight Financing Rate (“SOFR”) as of December 31, 2023. (3) The difference between principal amount and carrying value of mortgage notes payable is attributable to deferred financing costs, net for all borrowings, other than the Winterfell portfolio which is attributable to below market debt intangibles. (4) The mortgage note carries a fixed interest rate of 3.0% through February 2024, followed by one-month adjusted SOFR, plus 2.80% through the initial maturity date of February 2026. (5) Composed of seven individual mortgage notes payable secured by the Rochester Sub-Portfolio (as defined below), cross-collateralized and subject to cross-default. (6) In February 2024, the Company sold the property which served as collateral for the mortgage note payable. In conjunction with the sale, the mortgage note payable was repaid. Refer to Note 13, “Subsequent Events” for further discussion. (7) Composed of four individual mortgage notes payable secured by four healthcare real estate properties, cross-collateralized and subject to cross-default. (8) Composed of 32 individual mortgage notes payable secured by 32 healthcare real estate properties, cross-collateralized and subject to cross-default. (9) Composed of five individual mortgage notes payable secured by five healthcare real estate properties, cross-collateralized and subject to cross-default.
Schedule of Principal on Borrowings based on Final Maturity	The following table presents future scheduled principal payments on mortgage notes payable based on initial maturity as of December 31, 2023 (dollars in thousands): Years Ending December 31: 2024 1 $ 128,574 2025 667,741 2026 45,151 2027 62,396 Total $ 903,862 _______________________________________ (1) Includes the outstanding principal as of December 31, 2023 of the Rochester Sub-Portfolio Loan (as defined below), which is in default.

Related Party Arrangements (Tab

Related Party Arrangements (Tables)	12 Months Ended
	Dec. 31, 2023
Related Party Transactions [Abstract]
Schedule of the Fees and Reimbursements Incurred to the Advisor and Dealer Manager	The following table presents the costs incurred and paid to the Former Advisor under the TSA (dollars in thousands): Due to Related Party as of December 31, 2022 Year Ended December 31, 2023 Due to Related Party as of December 31, 2023 Financial Statement Location Incurred Paid General and administrative expenses/ Transaction costs $ 469 $ 562 $ (910) $ 121

Fair Value (Tables)

Fair Value (Tables)	12 Months Ended
	Dec. 31, 2023
Fair Value Disclosures [Abstract]
Schedule of the Principal Amount, Carrying Value and Fair Value of Certain Financial Assets and Liabilities	The following table presents financial assets that were accounted for at fair value on a recurring basis as of December 31, 2023 and December 31, 2022 by level within the fair value hierarchy (dollars in thousands): December 31, 2023 December 31, 2022 Level 1 Level 2 Level 3 Level 1 Level 2 Level 3 Financial assets: Derivative assets - interest rate caps $ — $ 433 $ — $ — $ 652 $ — Investment in Espresso joint venture (1) — — 142 — — — _______________________________________ (1) The Company elected the fair value option method to account for its investment in the Espresso joint venture on June 30, 2023. As of December 31, 2022, the investment was accounted for under the equity method. The following table presents the principal amount, carrying value and fair value of certain financial assets and liabilities (dollars in thousands): December 31, 2023 December 31, 2022 Principal Amount Carrying Value Fair Value Principal Amount Carrying Value Fair Value Financial liabilities: (1) Mortgage notes payable, net $ 903,862 $ 898,154 $ 842,559 $ 922,355 $ 912,248 $ 882,754 _______________________________________ (1) The fair value of other financial instruments not included in this table is estimated to approximate their carrying value. The following table summarizes the fair value and impairment losses of Level 3 assets which have been measured at fair value on a nonrecurring basis at the time of impairment during the periods presented (dollars in thousands): Year Ended December 31, 2023 2022 2021 Fair Value Impairment Losses (1) Fair Value Impairment Losses (1) Fair Value Impairment Losses (1) Operating real estate, net $ 56,718 $ 44,294 $ 80,931 $ 30,900 $ 11,793 $ 5,386 Investments in unconsolidated ventures 3,075 4,728 28,442 13,419 — — Assets held for sale 11,611 355 — — — — _______________________________________ (1) Excludes impairment losses for property damage sustained by facilities.

Segment Reporting (Tables)

Segment Reporting (Tables)	12 Months Ended
	Dec. 31, 2023
Segment Reporting [Abstract]
Summary of Segment Reporting	The following tables present the NOI of the Company’s direct investments segments and the Company's proportionate share of the NOI generated by the joint ventures of its unconsolidated investments segment (dollars in thousands): Direct Investments Year Ended December 31, 2023 Net Lease Operating Unconsolidated Investments (2) Non-Segment (3) Adjustments (4) Total (5) Property and other revenues (1) $ 1,709 $ 199,426 $ 361,005 $ 3,843 $ (361,005) $ 204,978 Property operating expenses — (140,612) (316,357) — 316,357 (140,612) Net operating income $ 1,709 $ 58,814 $ 44,648 $ 3,843 $ (44,648) $ 64,366 Interest expense (50,028) Transaction costs (683) General and administrative expenses (13,817) Depreciation and amortization (38,511) Impairment loss (49,423) Other income, net 194 Gain (loss) on investments and other (64,001) Equity in earnings (losses) of unconsolidated ventures (8,272) Income tax expense (74) Net income (loss) $ (160,249) _______________________________________ (1) Includes rental income received from net lease properties as well as resident room and care charges, ancillary service fees and other related revenue earned from operating properties. (2) Includes the Company's proportionate share of revenues and expenses of the Diversified US/UK and Eclipse Portfolios prior to the Sale of Minority Interests in June 2023. (3) Primarily consists of interest income earned on corporate cash and equivalents. (4) Represents adjustments to eliminate the NOI presented for the unconsolidated investments segment, in order to reconcile to the Company's net income (loss) prepared in accordance with GAAP. The Company records its proportionate share of the net income of its unconsolidated investments through equity in earnings (losses) of unconsolidated ventures as presented on its consolidated statements of operations. (5) Non-NOI items are not allocated to individual segments for purposes of assessing segment performance. Direct Investments Year Ended December 31, 2022 Net Lease Operating Unconsolidated Investments Non-Segment (2) Adjustments (3) Total (4) Property and other revenues (1) $ 1,596 $ 182,519 $ 343,575 $ 1,021 $ (343,575) $ 185,136 Property operating expenses (39) (137,539) (285,291) — 285,291 (137,578) Net operating income $ 1,557 $ 44,980 $ 58,284 $ 1,021 $ (58,284) $ 47,558 Interest expense (43,278) Transaction costs (1,569) Asset management fees - related party (8,058) General and administrative expenses (13,938) Depreciation and amortization (38,587) Impairment loss (45,299) Other income, net 77 Realized gain (loss) on investments and other 1,029 Equity in earnings (losses) of unconsolidated ventures 47,625 Income tax expense (61) Net income (loss) $ (54,501) _______________________________________ (1) Includes rental income received from net lease properties as well as resident room and care charges, ancillary service fees and other related revenue earned from operating properties. (2) Primarily consists of interest income earned on corporate cash and equivalents. (3) Represents adjustments to eliminate the NOI presented for the unconsolidated investments segment, in order to reconcile to the Company's net income (loss) prepared in accordance with GAAP. The Company records its proportionate share of the net income of its unconsolidated investments through equity in earnings (losses) of unconsolidated ventures as presented on its consolidated statements of operations. (4) Non-NOI items are not allocated to individual segments for purposes of assessing segment performance. Direct Investments Year Ended December 31, 2021 Net Lease Operating Unconsolidated Investments Non-Segment Adjustments (2) Total (3) Property and other revenues (1) $ 14,708 $ 228,569 $ 301,320 $ — $ (301,320) $ 243,277 Property operating expenses (29) (177,907) (240,784) — 240,784 (177,936) Net operating income $ 14,679 $ 50,662 $ 60,536 $ — $ (60,536) $ 65,341 Interest income on debt investments 4,667 Interest expense (61,620) Transaction costs (54) Asset management fees - related party (11,105) General and administrative expenses (12,691) Depreciation and amortization (54,836) Impairment loss (5,386) Other income, net 7,278 Realized gain (loss) on investments and other 79,477 Equity in earnings (losses) of unconsolidated ventures 15,843 Income tax expense (99) Net income (loss) $ 26,815 _______________________________________ (1) Includes rental income received from net lease properties as well as resident room and care charges, ancillary service fees and other related revenue earned from operating properties. (2) Represents adjustments to eliminate the NOI presented for the unconsolidated investments segment, in order to reconcile to the Company's net income (loss) prepared in accordance with GAAP. The Company records its proportionate share of the net income of its unconsolidated investments through equity in earnings (losses) of unconsolidated ventures as presented on its consolidated statements of operations. (3) Non-NOI items are not allocated to individual segments for purposes of assessing segment performance. The following table presents capital expenditures made by the Company for each of its reportable segments (dollars in thousands): Direct Investments Total Capital Expenditures for the Year Ended: Net Lease Operating Unconsolidated Investments Non-Segment Total December 31, 2023 $ — $ 38,422 $ — $ — $ 38,422 December 31, 2022 372 28,932 — — 29,304
Summary of Assets by Segment	The following table presents total assets by segment (dollars in thousands): Direct Investments Total Assets: Net Lease Operating Unconsolidated Investments Non-Segment (1) Total December 31, 2023 $ 74,655 $ 787,925 $ 122,949 $ 73,890 $ 1,059,419 December 31, 2022 83,435 884,137 176,502 93,761 1,237,835 ______________________________________ (1)

Business and Organization (Deta

Business and Organization (Details) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Class of Stock [Line Items]
Common stock, shares authorized (in shares)	400,000,000	400,000,000
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	50,000,000	50,000,000
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Net proceeds from issuance of common stock	$ 2,000,000,000
Dividend Reinvestment Plan
Class of Stock [Line Items]
Net proceeds from issuance of common stock	$ 232,600,000
Primary Beneficiary | Northstar Healthcare Income Operating Partnership, LP
Class of Stock [Line Items]
Limited partnership interest in operating partnership	100%
Advisor
Class of Stock [Line Items]
Non-controlling interest investment in operating partnership	$ 1,000
Special Unit Holder
Class of Stock [Line Items]
Non-controlling interest investment in operating partnership	$ 1,000

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Narrative (Details)		1 Months Ended		6 Months Ended		12 Months Ended
		Jun. 30, 2023 USD ($) home	May 31, 2023 home	Dec. 31, 2023 USD ($) day property	Jun. 30, 2023 USD ($)	Dec. 31, 2023 USD ($) facility day property	Dec. 31, 2022 USD ($) property	Dec. 31, 2021 USD ($) property	Dec. 31, 2018 USD ($)
Variable Interest Entities
Operating real estate, net				$ 821,270,000		$ 821,270,000	$ 933,002,000
Assets held for sale				11,611,000		11,611,000	0
Mortgage notes payable, net				898,154,000		898,154,000	912,248,000
Investments in unconsolidated ventures ($142 held at fair value as of December 31, 2023)				$ 122,949,000		$ 122,949,000	$ 176,502,000
Finance Lease Liability
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]				Operating real estate, net		Operating real estate, net	Operating real estate, net
Finance leases for equipment				$ 200,000		$ 200,000
Payments of finance lease obligations						$ 100,000	$ 500,000
Finance Lease, Liability, Statement of Financial Position [Extensible Enumeration]				Other liabilities		Other liabilities	Other liabilities
Weighted average interest rate (percent)				6.50%		6.50%
Remaining lease term (years)				3 years 9 months 18 days		3 years 9 months 18 days
Number of properties classified as held-for-sale | property				1		1	0	0
Identified Intangibles
Number of triple net lease portfolios | property				4		4
Amortization expense for in-place leases and deferred costs						$ 300,000	$ 300,000	$ 1,400,000
Derivative
Derivative, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]						Gain (loss) on investments and other	Gain (loss) on investments and other
Derivative, gain (loss) on derivative, net						$ (900,000)	$ 500,000	0
Revenue Recognition
Days notice required for lease termination | day				30		30
Proceeds from rents received						$ 1,700,000	1,600,000	3,400,000
Variable lease revenues						$ 14,100,000	11,200,000	13,100,000
Impairment on Operating Real Estate and Investments in Unconsolidated Ventures
Number of facilities impaired | facility						5
Investments in unconsolidated ventures ($142 held at fair value as of December 31, 2023)				$ 122,949,000		$ 122,949,000	176,502,000
Financing Receivable, after Allowance for Credit Loss
Allowance for credit losses on receivables				0		0
Income Taxes
Operating loss carryforwards							248,500,000
Foreign Currency
Reclassification of accumulated other comprehensive loss	[1]					3,275,000
Espresso
Variable Interest Entities
Investments in unconsolidated ventures ($142 held at fair value as of December 31, 2023)		$ 3,100,000		142,000	$ 3,100,000	142,000	18,019,000	0	$ 0
Impairment recognized		4,700,000		0	4,700,000
Impairment on Operating Real Estate and Investments in Unconsolidated Ventures
Impairment recognized		4,700,000		0	4,700,000
Investments in unconsolidated ventures ($142 held at fair value as of December 31, 2023)		$ 3,100,000		142,000	$ 3,100,000	142,000	18,019,000	0	$ 0
Diversified US/UK
Variable Interest Entities
Impairment recognized							13,400,000
Impairment on Operating Real Estate and Investments in Unconsolidated Ventures
Impairment losses							13,400,000
Impairment recognized							13,400,000
Capitalized acquisition costs							28,400,000
Number of senior care homes owned | home		48	48
Trilogy
Variable Interest Entities
Investments in unconsolidated ventures ($142 held at fair value as of December 31, 2023)				122,339,000		122,339,000	128,884,000
Impairment recognized						2,400,000	25,100,000
Impairment on Operating Real Estate and Investments in Unconsolidated Ventures
Impairment recognized						2,400,000	25,100,000
Investments in unconsolidated ventures ($142 held at fair value as of December 31, 2023)				122,339,000		122,339,000	128,884,000
Arbors Portfolio
Impairment on Operating Real Estate and Investments in Unconsolidated Ventures
Impairment losses							18,500,000
Arbors Portfolio | Facility
Impairment on Operating Real Estate and Investments in Unconsolidated Ventures
Impairment losses						5,600,000
Winterfell Portfolio
Impairment on Operating Real Estate and Investments in Unconsolidated Ventures
Impairment losses							8,500,000
Tangible asset impairment charges							800,000
Rochester Portfolio
Impairment on Operating Real Estate and Investments in Unconsolidated Ventures
Impairment losses							3,900,000
Impairment of real estate held for sale						400,000
Rochester Portfolio | Facility
Impairment on Operating Real Estate and Investments in Unconsolidated Ventures
Impairment losses						38,600,000
Rochester Portfolio | Land Parcel
Impairment on Operating Real Estate and Investments in Unconsolidated Ventures
Impairment losses						100,000
Avamere Portfolio
Impairment on Operating Real Estate and Investments in Unconsolidated Ventures
Tangible asset impairment charges							200,000
Operating real estate, net
Impairment on Operating Real Estate and Investments in Unconsolidated Ventures
Impairment losses						44,700,000	31,900,000	$ 5,400,000
Primary Beneficiary
Variable Interest Entities
Operating real estate, net				101,300,000		101,300,000
Assets held for sale				11,600,000		11,600,000
Mortgage notes payable, net				171,800,000		171,800,000
Interest Rate Cap
Derivative
Derivative asset				$ 400,000		$ 400,000	$ 700,000
[1]The Company reclassified the accumulated other comprehensive loss related to foreign currency adjustments for an unconsolidated venture ownership interest that was sold during the three months ended June 30, 2023. The accumulated balance was reclassified to gain (loss) on investments and other on the consolidated statements of operations.

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Reconciliation of Cash, Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Accounting Policies [Abstract]
Cash and cash equivalents	$ 85,037	$ 103,926	$ 200,473
Restricted cash	7,906	11,734	10,465
Total cash, cash equivalents and restricted cash	$ 92,943	$ 115,660	$ 210,938	$ 93,570

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Estimated Useful Lives (Details)	Dec. 31, 2023
Building | Minimum
Property, Plant and Equipment [Line Items]
Estimated useful life (in years)	39 years
Building | Maximum
Property, Plant and Equipment [Line Items]
Estimated useful life (in years)	49 years
Land improvements | Minimum
Property, Plant and Equipment [Line Items]
Estimated useful life (in years)	9 years
Land improvements | Maximum
Property, Plant and Equipment [Line Items]
Estimated useful life (in years)	15 years
Furniture, fixtures and equipment | Minimum
Property, Plant and Equipment [Line Items]
Estimated useful life (in years)	5 years
Furniture, fixtures and equipment | Maximum
Property, Plant and Equipment [Line Items]
Estimated useful life (in years)	14 years

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Future Minimum Lease Payments from Capital Leases (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Accounting Policies [Abstract]
2024	$ 38
2025	38
2026	33
2027	18
2028	10
Thereafter	0
Total minimum lease payments	137
Less: Amount representing interest	(23)
Present value of minimum lease payments	$ 114

Summary of Significant Accoun_8

Summary of Significant Accounting Policies - Deferred Costs and Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Less: Accumulated amortization	$ (118,233)	$ (117,896)
Intangible assets, net	1,916	2,253
In-place lease value
Finite-Lived Intangible Assets [Line Items]
In-place lease value	$ 120,149	$ 120,149

Summary of Significant Accoun_9

Summary of Significant Accounting Policies - Schedule of Future Amortization Expense (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Accounting Policies [Abstract]
2024	$ 337
2025	337
2026	337
2027	337
2028	337
Thereafter	231
Total	$ 1,916

Summary of Significant Accou_10

Summary of Significant Accounting Policies - Reconciliation of Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Accounting Policies [Abstract]
Tax (benefit) at statutory rate for taxable entities (21%)	$ (1,098)	$ (2,112)	$ 4,956
State income tax (benefit), net of federal benefits	(48)	(91)	304
Change in valuation allowance	1,216	2,145	(5,102)
Other differences	4	119	(59)
Income tax expense (benefit)	$ 74	$ 61	$ 99

Summary of Significant Accou_11

Summary of Significant Accounting Policies - Schedule of Deferred Tax Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Accounting Policies [Abstract]
Fixed assets and other	$ 656	$ 586
Net operating losses	15,827	14,681
Total deferred tax assets	16,483	15,267
Valuation allowance	(16,483)	(15,267)
Net deferred income tax assets	$ 0	$ 0

Operating Real Estate - Identif

Operating Real Estate - Identifiable Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Real Estate [Abstract]
Land	$ 115,758	$ 121,518
Land improvements	12,705	18,945
Buildings and improvements	861,452	957,924
Tenant improvements	372	372
Construction in progress	5,493	6,736
Furniture, fixtures and equipment	93,373	91,058
Subtotal	1,089,153	1,196,553
Less: Accumulated depreciation	(267,883)	(263,551)
Operating real estate, net	$ 821,270	$ 933,002

Operating Real Estate - Narrati

Operating Real Estate - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Real Estate [Line Items]
Depreciation	$ 38,200	$ 38,300	$ 53,500
Derecognition of operating real estate placed into a receivership	(58,953)	0	0
Operating real estate, net
Real Estate [Line Items]
Impairment losses	44,700	31,900	$ 5,400
Building and Building Improvements
Real Estate [Line Items]
Accumulated impairment	$ (162,900)	$ (181,500)

Operating Real Estate - Schedul

Operating Real Estate - Schedule of Properties (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($) unit property
Real Estate Properties [Line Items]
Number of properties held-for-sale	1
Total Properties [Member]
Real Estate Properties [Line Items]
Properties Under Management	48
Units Under Management | unit	5,749
Property and Other Revenues | $	$ 204,978
Total Properties [Member] | Revenue | Customer Concentration Risk
Real Estate Properties [Line Items]
% of Total Property and Other Revenues	100%
Solstice Senior Living
Real Estate Properties [Line Items]
Properties Under Management	32
Units Under Management | unit	3,969
Property and Other Revenues | $	$ 127,765
Solstice Senior Living | Revenue | Customer Concentration Risk
Real Estate Properties [Line Items]
% of Total Property and Other Revenues	62.30%
Watermark Retirement Communities
Real Estate Properties [Line Items]
Properties Under Management	6
Units Under Management | unit	723
Property and Other Revenues | $	$ 45,001
Watermark Retirement Communities | Revenue | Customer Concentration Risk
Real Estate Properties [Line Items]
% of Total Property and Other Revenues	22%
Avamere Health Services
Real Estate Properties [Line Items]
Properties Under Management	5
Units Under Management | unit	453
Property and Other Revenues | $	$ 21,780
Avamere Health Services | Revenue | Customer Concentration Risk
Real Estate Properties [Line Items]
% of Total Property and Other Revenues	10.60%
Integral Senior Living
Real Estate Properties [Line Items]
Properties Under Management	1
Units Under Management | unit	40
Property and Other Revenues | $	$ 4,880
Integral Senior Living | Revenue | Customer Concentration Risk
Real Estate Properties [Line Items]
% of Total Property and Other Revenues	2.40%
Arcadia Management
Real Estate Properties [Line Items]
Properties Under Management	4
Units Under Management | unit	564
Property and Other Revenues | $	$ 1,709
Arcadia Management | Revenue | Customer Concentration Risk
Real Estate Properties [Line Items]
% of Total Property and Other Revenues	0.80%
Other
Real Estate Properties [Line Items]
Properties Under Management	0
Units Under Management | unit	0
Property and Other Revenues | $	$ 3,843
Other | Revenue | Customer Concentration Risk
Real Estate Properties [Line Items]
% of Total Property and Other Revenues	1.90%
Solstice Senior Living
Real Estate Properties [Line Items]
Noncontrolling interest, ownership percentage by parent (as a percentage)	80%

Operating Real Estate - Future

Operating Real Estate - Future Contractual Rent Obligations (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Real Estate [Abstract]
2024	$ 11,192
2025	11,472
2026	11,759
2027	12,053
2028	12,354
Thereafter	9,438
Total	$ 68,268

Investments in Unconsolidated_3

Investments in Unconsolidated Ventures - Changes in Carrying Value (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Jun. 30, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2018
Schedule of Equity Method Investments [Line Items]
Carrying value	$ 122,949		$ 176,502
Trilogy, Espresso, Solstice
Schedule of Equity Method Investments [Line Items]
Carrying value	$ 0		29,276
Trilogy
Schedule of Equity Method Investments [Line Items]
Ownership interest (as a percentage)	23.40%
Carrying value	$ 122,339		128,884
Solstice
Schedule of Equity Method Investments [Line Items]
Ownership interest (as a percentage)	20%
Carrying value	$ 468		323
Espresso
Schedule of Equity Method Investments [Line Items]
Ownership interest (as a percentage)	36.70%
Carrying value	$ 142	$ 3,100	$ 18,019	$ 0	$ 0

Investments in Unconsolidated_4

Investments in Unconsolidated Ventures - Narrative (Details)	1 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2023 USD ($) facility home shares	May 31, 2023 home	Dec. 31, 2023 USD ($) shares	Jun. 30, 2023 USD ($) shares	Dec. 31, 2024 USD ($) campus uSDollarsPerDay	Dec. 31, 2023 USD ($) shares	Dec. 31, 2022 USD ($) shares	Dec. 31, 2021 USD ($)
Schedule of Equity Method Investments [Line Items]
Distributions from unconsolidated ventures						$ 10,640,000	$ 22,291,000	$ 0
Common stock, shares outstanding (in shares) | shares			185,712,103			185,712,103	195,421,656
Preferred stock, shares outstanding (in shares) | shares			0			0	0
Solstice
Schedule of Equity Method Investments [Line Items]
Noncontrolling interest, ownership percentage by parent (as a percentage)			80%			80%
Winterfell Portfolio | Solstice
Schedule of Equity Method Investments [Line Items]
Noncontrolling interest, ownership percentage by parent (as a percentage)			80%			80%
Forecast | Disposal Group, Disposed of by Sale, Not Discontinued Operations | Trilogy
Schedule of Equity Method Investments [Line Items]
Number of senior care homes owned | campus					125
Disposal group, not discontinued operation, percentage of consideration paid in cash					10%
Proceeds from divestiture of equity method investment, supplemental cash payment | uSDollarsPerDay					25,600
Proceeds from divestiture of equity method investment, supplemental cash payment, maximum					$ 21,000,000
Forecast | Disposal Group, Disposed of by Sale, Not Discontinued Operations | Trilogy | Qualifying IPO Has Occurred
Schedule of Equity Method Investments [Line Items]
Disposal group, not discontinued operation, termination fee					7,800,000
Forecast | Disposal Group, Disposed of by Sale, Not Discontinued Operations | Trilogy | Terminated Prior To March 31, 2025
Schedule of Equity Method Investments [Line Items]
Disposal group, not discontinued operation, termination fee					11,700,000
Forecast | Disposal Group, Disposed of by Sale, Not Discontinued Operations | Trilogy | Terminated Prior To September 30, 2025
Schedule of Equity Method Investments [Line Items]
Disposal group, not discontinued operation, termination fee					$ 15,600,000
Forecast | Disposal Group, Disposed of by Sale, Not Discontinued Operations | Trilogy | March 31, 2024
Schedule of Equity Method Investments [Line Items]
Disposal group, not discontinued operation, discount on purchase consideration paid in cash					7.50%
Forecast | Disposal Group, Disposed of by Sale, Not Discontinued Operations | Trilogy | December 31, 2024
Schedule of Equity Method Investments [Line Items]
Disposal group, not discontinued operation, discount on purchase consideration paid in cash					5%
Minimum | Forecast | Disposal Group, Disposed of by Sale, Not Discontinued Operations | Trilogy
Schedule of Equity Method Investments [Line Items]
Consideration received					$ 240,500,000
Maximum | Forecast | Disposal Group, Disposed of by Sale, Not Discontinued Operations | Trilogy
Schedule of Equity Method Investments [Line Items]
Consideration received					$ 260,000,000
Former Sponsor and Affiliates
Schedule of Equity Method Investments [Line Items]
Payments for divestiture of interest in joint venture	$ 1,100,000
Common stock, shares outstanding (in shares) | shares	9,709,553			9,709,553
Common unit, outstanding (in shares) | shares	100			100
Preferred stock, shares outstanding (in shares) | shares	100			100
Eclipse
Schedule of Equity Method Investments [Line Items]
Number of senior care homes owned | facility	34
Ownership interest (as a percentage)	6%			6%
Diversified US/UK
Schedule of Equity Method Investments [Line Items]
Number of senior care homes owned | home	48	48
Ownership interest (as a percentage)	14%			14%
Impairment recognized							$ 13,400,000
Solstice
Schedule of Equity Method Investments [Line Items]
Ownership interest (as a percentage)			20%			20%
Solstice | Winterfell Portfolio
Schedule of Equity Method Investments [Line Items]
Ownership interest (as a percentage)			20%			20%
Espresso
Schedule of Equity Method Investments [Line Items]
Ownership interest (as a percentage)			36.70%			36.70%
Distributions from unconsolidated ventures						$ 17,300,000	$ 49,700,000
Impairment recognized	$ 4,700,000		$ 0	$ 4,700,000

Investments in Unconsolidated_5

Investments in Unconsolidated Ventures - Summary of Investments in Unconsolidated Ventures (Details) - USD ($)	1 Months Ended	6 Months Ended		12 Months Ended
	Jun. 30, 2023	Dec. 31, 2023	Jun. 30, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Schedule of Equity Method Investments [Line Items]
Equity in earnings (losses) of unconsolidated ventures				$ (8,272,000)	$ 47,625,000	$ 15,843,000
Cash Distribution				27,513,000	67,133,000	18,110,000
Distributions from unconsolidated ventures				10,640,000	22,291,000	0
Trilogy
Schedule of Equity Method Investments [Line Items]
Equity in earnings (losses) of unconsolidated ventures				(1,409,000)	11,652,000	(2,891,000)
Cash Distribution				5,136,000	9,134,000	4,638,000
Impairment recognized				2,400,000	25,100,000
Solstice
Schedule of Equity Method Investments [Line Items]
Equity in earnings (losses) of unconsolidated ventures				145,000	2,000	(79,000)
Cash Distribution				0	0	0
Espresso
Schedule of Equity Method Investments [Line Items]
Equity in earnings (losses) of unconsolidated ventures				9,228,000	72,427,000	19,619,000
Cash Distribution				22,377,000	54,654,000	5,500,000
Impairment recognized	$ 4,700,000	$ 0	$ 4,700,000
Equity method investment, realized gain on disposal				9,200,000	70,600,000
Distributions from unconsolidated ventures				17,300,000	49,700,000
Envoy
Schedule of Equity Method Investments [Line Items]
Equity in earnings (losses) of unconsolidated ventures				0	0	740,000
Cash Distribution				0	66,000	817,000
Investments Sold
Schedule of Equity Method Investments [Line Items]
Equity in earnings (losses) of unconsolidated ventures				(16,236,000)	(36,456,000)	(1,546,000)
Cash Distribution				0	3,279,000	$ 7,155,000
Diversified US/UK
Schedule of Equity Method Investments [Line Items]
Impairment recognized					13,400,000
Equity method investment, impairment				$ 11,400,000	$ 22,900,000

Investments in Unconsolidated_6

Investments in Unconsolidated Ventures - Assets and Liabilities (Details) - USD ($) $ in Thousands		5 Months Ended	12 Months Ended
		Jun. 09, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Schedule of Equity Method Investments [Line Items]
Operating real estate, net			$ 821,270	$ 933,002
Other assets			7,172	7,603
Total assets	[1]		1,059,419	1,237,835
Total liabilities	[1]		927,739	936,763
Equity			131,680	301,072	$ 446,818	$ 412,062
Total liabilities and equity			1,059,419	1,237,835
Total revenues			204,978	185,136	243,277
Net income (loss)			(160,249)	(54,501)	26,815
Espresso and Solstice
Schedule of Equity Method Investments [Line Items]
Operating real estate, net			0	76,087
Other assets			10,530	34,842
Total assets			10,530	110,929
Total liabilities			7,457	97,826
Equity			3,073	13,103
Total liabilities and equity			10,530	110,929
Total revenues			17,766	40,445	67,206
Net income (loss)			$ 52,224	197,734	53,167
Diversified US/UK and Eclipse
Schedule of Equity Method Investments [Line Items]
Operating real estate, net		$ 615,335		2,325,802
Other assets		45,069		232,202
Total assets		660,404		2,558,004
Total liabilities		573,185		2,341,223
Equity		87,219		216,781
Total liabilities and equity		660,404		2,558,004
Total revenues		115,068		352,098	386,354
Net income (loss)		$ (198,793)		$ (288,881)	$ 12,087
[1] Includes $121.1 million and $183.8 million of assets and liabilities, respectively, of certain VIEs that are consolidated by the Operating Partnership. Refer to Note 2, “Summary of Significant Accounting Policies.”

Borrowings - Schedule of Borrow

Borrowings - Schedule of Borrowings (Details) $ in Thousands	1 Months Ended		12 Months Ended
	Jul. 31, 2023 USD ($) debt_instrument property	Feb. 28, 2021 property debt_instrument	Dec. 31, 2023 USD ($) property debt_instrument	Dec. 31, 2022 USD ($)
Debt Instrument [Line Items]
Carrying Value			$ 903,862
Winterfell Portfolio
Debt Instrument [Line Items]
Number of healthcare real estate properties | property			32
Mortgages and other notes payable
Debt Instrument [Line Items]
Principal Amount			$ 903,862	$ 922,355
Carrying Value			898,154	912,248
Mortgages
Debt Instrument [Line Items]
Principal Amount			$ 903,862	922,355
Mortgages | Rochester, NY
Debt Instrument [Line Items]
Number of debt instruments | debt_instrument	7		7
Number of healthcare real estate properties | property	7
Mortgages | Arbors Portfolio
Debt Instrument [Line Items]
Number of debt instruments | debt_instrument		4	4
Number of healthcare real estate properties | property		4	4
Mortgages | Winterfell Portfolio
Debt Instrument [Line Items]
Number of debt instruments | debt_instrument			32
Mortgages | Avamere Portfolio
Debt Instrument [Line Items]
Number of debt instruments | debt_instrument			5
Number of healthcare real estate properties | property			5
Mortgages | Frisco, TX Non-recourse, February 2026 | Frisco, TX
Debt Instrument [Line Items]
Fixed interest rate			3%
Principal Amount			$ 26,000	26,000
Carrying Value			$ 25,694	25,560
Mortgages | Frisco, TX Non-recourse, February 2026 | Frisco, TX | Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Basis spread on variable interest rate			2.80%
Mortgages | Milford, OH Non-recourse, September 2026 | Milford, OH
Debt Instrument [Line Items]
Principal Amount			$ 18,173	18,336
Carrying Value			$ 18,015	18,126
Mortgages | Milford, OH Non-recourse, September 2026 | Milford, OH | Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Basis spread on variable interest rate			2.79%
Mortgages | Rochester, NY Non-recourse, February 2025 | Rochester, NY
Debt Instrument [Line Items]
Fixed interest rate			4.25%
Principal Amount			$ 17,470	18,206
Carrying Value			17,448	18,165
Mortgages | Rochester, NY Non-recourse, July 2023 | Rochester, NY
Debt Instrument [Line Items]
Principal Amount	$ 99,800		99,786	100,651
Carrying Value			$ 99,786	100,042
Mortgages | Rochester, NY Non-recourse, July 2023 | Rochester, NY | Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Basis spread on variable interest rate			2.45%
Mortgages | Rochester NY Nonrecourse August 2024 | Rochester, NY
Debt Instrument [Line Items]
Principal Amount			$ 10,874	11,336
Carrying Value			$ 10,853	11,315
Mortgages | Rochester NY Nonrecourse August 2024 | Rochester, NY | Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Basis spread on variable interest rate			2.93%
Mortgages | Non-Recourse | Arbors Portfolio
Debt Instrument [Line Items]
Fixed interest rate			3.99%
Principal Amount			$ 81,397	83,423
Carrying Value			$ 81,209	83,051
Mortgages | Non-Recourse | Winterfell Portfolio
Debt Instrument [Line Items]
Fixed interest rate			4.17%
Principal Amount			$ 583,471	596,408
Carrying Value			$ 578,694	588,306
Mortgages | Non-Recourse | Avamere Portfolio
Debt Instrument [Line Items]
Fixed interest rate			4.66%
Principal Amount			$ 66,691	67,995
Carrying Value			66,455	$ 67,683
Mortgages | One-Month LIBOR
Debt Instrument [Line Items]
Principal Amount			$ 128,800

Borrowings - Maturity Schedule

Borrowings - Maturity Schedule (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Debt Disclosure [Abstract]
2024	$ 128,574
2025	667,741
2026	45,151
2027	62,396
Total	$ 903,862

Borrowings - Narrative (Details

Borrowings - Narrative (Details) $ in Thousands	1 Months Ended		12 Months Ended
	Jul. 31, 2023 USD ($) debt_instrument property	Feb. 28, 2021 property debt_instrument	Dec. 31, 2023 USD ($) property debt_instrument	Dec. 31, 2022 USD ($)
Mortgages
Debt Instrument [Line Items]
Principal Amount			$ 903,862	$ 922,355
Rochester, NY | Mortgages
Debt Instrument [Line Items]
Number of debt instruments | debt_instrument	7		7
Number of healthcare real estate properties | property	7
Rochester, NY | Rochester, NY Non-recourse, July 2023
Debt Instrument [Line Items]
Interest payable			$ 7,900
Rochester, NY | Rochester, NY Non-recourse, July 2023 | Mortgages
Debt Instrument [Line Items]
Principal Amount	$ 99,800		$ 99,786	$ 100,651
Arbors Portfolio | Mortgages
Debt Instrument [Line Items]
Number of debt instruments | debt_instrument		4	4
Number of healthcare real estate properties | property		4	4
Repayments of long-term debt			$ 3,300

Related Party Arrangements - Su

Related Party Arrangements - Summary of Fees and Reimbursements (Details) - Advisor - General and administrative expenses/ Transaction costs $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($)
Related Party Transaction, Due to Related Parties [Roll Forward]
Due to related party, beginning balance	$ 469
Due to related party, ending balance	121
Incurred
Related Party Transaction, Due to Related Parties [Roll Forward]
Related party transaction, amounts of transaction	562
Paid
Related Party Transaction, Due to Related Parties [Roll Forward]
Related party transaction, amounts of transaction	$ (910)

Related Party Arrangements - In

Related Party Arrangements - Incentive Fee (Details) - Related Party - Incentive Fee	12 Months Ended
	Dec. 31, 2023
Related Party Transaction [Line Items]
Incentive fee distributions, percent of net cash flows	15%
Incentive fee distributions, minimum non-compounded annual pre-tax return on invested capital	6.75%

Related Party Arrangements - _2

Related Party Arrangements - Investments in Joint Ventures (Details) - USD ($) $ in Millions	1 Months Ended	12 Months Ended
	Jun. 30, 2023	Dec. 31, 2023
Former Sponsor and Affiliates
Related Party Transaction [Line Items]
Payments for divestiture of interest in joint venture	$ 1.1
Solstice
Related Party Transaction [Line Items]
Noncontrolling interest, ownership percentage by parent (as a percentage)		80%
Solstice | Winterfell Portfolio
Related Party Transaction [Line Items]
Noncontrolling interest, ownership percentage by parent (as a percentage)		80%
Solstice
Related Party Transaction [Line Items]
Ownership interest (as a percentage)		20%
Solstice | Winterfell Portfolio
Related Party Transaction [Line Items]
Ownership interest (as a percentage)		20%
Winterfell Portfolio | Solstice
Related Party Transaction [Line Items]
Ownership interest (as a percentage)		20%
Related party transaction, amounts of transaction		$ 6.9

Equity-Based Compensation (Deta

Equity-Based Compensation (Details) - USD ($)				12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Equity-based compensation
Number of shares granted to independent directors (in shares)	203,742	116,712	66,840
Equity-based compensation expense				$ 226,250	$ 206,917	$ 230,083
Unrecognized equity-based compensation	$ 240,000	$ 211,250		$ 240,000	$ 211,250
Restricted stock
Equity-based compensation
Number of shares authorized (in shares)	2,000,000			2,000,000
Restricted common shares grant vesting period				2 years
Restricted Stock Units (RSUs)
Equity-based compensation
Restricted common shares grant vesting period				2 years
Share-based compensation arrangement by share-based payment award shares issued per award exercised (in shares)	1			1
Unvested shares (in shares)	77,741	54,114		77,741	54,114
Independent Directors | Restricted stock
Equity-based compensation
Number of shares granted to independent directors (in shares)				159,932
Aggregate value for restricted common shares granted to independent directors	$ 1,300,000			$ 1,300,000
Independent Directors | Restricted Stock Units (RSUs)
Equity-based compensation
Number of shares granted to independent directors (in shares)				203,742
Aggregate value for restricted common shares granted to independent directors	$ 700,000			$ 700,000

Stockholders' Equity - Common S

Stockholders' Equity - Common Stock and Distribution Reinvestment Plan (Details) - USD ($) shares in Millions	1 Months Ended	12 Months Ended	76 Months Ended
	Jan. 19, 2016	Dec. 31, 2023	Apr. 30, 2022
Class of Stock [Line Items]
Value of common stock issued		$ 2,000,000,000
Dividend Reinvestment Plan
Class of Stock [Line Items]
Selling commissions or dealer manager fees paid			$ 0
Common Stock
Class of Stock [Line Items]
Number of shares issued (in shares)	173.4
Value of common stock issued	$ 1,700,000,000
Common Stock | Dividend Reinvestment Plan
Class of Stock [Line Items]
Number of shares issued (in shares)			25.7
Value of common stock issued			$ 232,600,000

Stockholders' Equity - Distribu

Stockholders' Equity - Distributions (Details) $ / shares in Units, $ in Millions	May 02, 2022 USD ($) $ / shares
Equity [Abstract]
Special distribution (dollars per share) | $ / shares	$ 0.50
Dividends payable | $	$ 97

Stockholders' Equity - Retireme

Stockholders' Equity - Retirement of Shares (Details) - USD ($) $ in Thousands, shares in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Schedule of Equity Method Investments [Line Items]
Shares repurchased during period (in shares)	9.7
Investments in unconsolidated ventures ($142 held at fair value as of December 31, 2023)	$ 122,949	$ 176,502
Diversified US/UK and Eclipse
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated ventures ($142 held at fair value as of December 31, 2023)	12,500
Equity method investee, cash consideration	$ 1,100

Non-controlling Interests (Deta

Non-controlling Interests (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Noncontrolling Interest [Line Items]
Net income (loss) attributable to non-controlling interests	$ (3,364)	$ (401)	$ 1,748
Primary Beneficiary | Northstar Healthcare Income Operating Partnership, LP
Noncontrolling Interest [Line Items]
Ownership interest in operating partnership	100%

Fair Value - Schedule of the Pr

Fair Value - Schedule of the Principal Amount, Carrying Value and Fair Value of Certain Financial Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Jun. 30, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2018
Financial assets:
Investment in Espresso joint venture	$ 122,949		$ 176,502
Financial liabilities
Carrying Value	898,154		912,248
Espresso
Financial assets:
Investment in Espresso joint venture	142	$ 3,100	18,019	$ 0	$ 0
Interest Rate Cap
Financial assets:
Derivative asset - interest rate caps	400		700
Level 1 | Espresso
Financial assets:
Investment in Espresso joint venture	0		0
Level 1 | Interest Rate Cap
Financial assets:
Derivative asset - interest rate caps	0		0
Level 2 | Espresso
Financial assets:
Investment in Espresso joint venture	0		0
Level 2 | Interest Rate Cap
Financial assets:
Derivative asset - interest rate caps	433		652
Level 3 | Espresso
Financial assets:
Investment in Espresso joint venture	142		0
Level 3 | Interest Rate Cap
Financial assets:
Derivative asset - interest rate caps	0		0
Mortgage notes payable, net
Financial liabilities
Principal Amount	903,862		922,355
Carrying Value	898,154		912,248
Fair Value	$ 842,559		$ 882,754

Fair Value - Nonrecurring Fair

Fair Value - Nonrecurring Fair Value (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Operating real estate, net	$ 821,270	$ 933,002
Assets held for sale	11,611	0
Operating real estate, net
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment losses	44,700	31,900	$ 5,400
Nonrecurring | Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Operating real estate, net	56,718	80,931	11,793
Investments in unconsolidated ventures	3,075	28,442	0
Assets held for sale	11,611	0	0
Nonrecurring | Level 3 | Operating real estate, net
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment losses	44,294	30,900	5,386
Nonrecurring | Level 3 | Investments in unconsolidated ventures
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment losses	4,728	13,419	0
Nonrecurring | Level 3 | Assets held for sale
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment losses	$ 355	$ 0	$ 0

Fair Value - Narrative (Details

Fair Value - Narrative (Details)	1 Months Ended	6 Months Ended		12 Months Ended
	Jun. 30, 2023 USD ($)	Dec. 31, 2023 USD ($) property	Jun. 30, 2023 USD ($)	Dec. 31, 2022 USD ($) property	Dec. 31, 2021 USD ($) property	Dec. 31, 2018 USD ($)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments in unconsolidated ventures ($142 held at fair value as of December 31, 2023)		$ 122,949,000		$ 176,502,000
Number of properties classified as held-for-sale | property		1		0	0
Espresso
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment recognized	$ 4,700,000	$ 0	$ 4,700,000
Investments in unconsolidated ventures ($142 held at fair value as of December 31, 2023)	$ 3,100,000	$ 142,000	$ 3,100,000	$ 18,019,000	$ 0	$ 0
Diversified US/UK
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment recognized				13,400,000
Impairment losses				13,400,000
Capitalized acquisition costs				$ 28,400,000
Discounted cash flow method | Minimum | Real Estate Investment | Terminal capitalization rate | Nonrecurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement input (percentage)		6.25%
Discounted cash flow method | Minimum | Real Estate Investment | Discount rate | Nonrecurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement input (percentage)		7.75%
Discounted cash flow method | Minimum | Investments in unconsolidated ventures | Terminal capitalization rate | Nonrecurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement input (percentage)		6.60%
Discounted cash flow method | Minimum | Investments in unconsolidated ventures | Discount rate | Nonrecurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement input (percentage)		8.80%
Discounted cash flow method | Maximum | Real Estate Investment | Terminal capitalization rate | Nonrecurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement input (percentage)		8.50%
Discounted cash flow method | Maximum | Real Estate Investment | Discount rate | Nonrecurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement input (percentage)		10.50%
Discounted cash flow method | Maximum | Investments in unconsolidated ventures | Terminal capitalization rate | Nonrecurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement input (percentage)		12.50%
Discounted cash flow method | Maximum | Investments in unconsolidated ventures | Discount rate | Nonrecurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement input (percentage)		16%

Segment Reporting - Segment Sta

Segment Reporting - Segment Statement of Operations (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Segment Reporting Information [Line Items]
Property and other revenues	$ 204,978	$ 185,136	$ 243,277
Property operating expenses	(140,612)	(137,578)	(177,936)
Net operating income	64,366	47,558	65,341
Interest income on debt investments			4,667
Interest expense	(50,028)	(43,278)	(61,620)
Transaction costs	(683)	(1,569)	(54)
Asset management fees - related party	0	(8,058)	(11,105)
General and administrative expenses	(13,817)	(13,938)	(12,691)
Depreciation and amortization	(38,511)	(38,587)	(54,836)
Impairment loss	(49,423)	(45,299)	(5,386)
Other income, net	194	77	7,278
Gain (loss) on investments and other	(64,001)	1,029	79,477
Equity in earnings (losses) of unconsolidated ventures	(8,272)	47,625	15,843
Income tax expense	(74)	(61)	(99)
Net income (loss)	(160,249)	(54,501)	26,815
Non-Segment
Segment Reporting Information [Line Items]
Property and other revenues	3,843	1,021	0
Property operating expenses	0	0	0
Net operating income	3,843	1,021	0
Adjustments
Segment Reporting Information [Line Items]
Property and other revenues	(361,005)	(343,575)	(301,320)
Property operating expenses	316,357	285,291	240,784
Net operating income	(44,648)	(58,284)	(60,536)
Net Lease | Operating Segments
Segment Reporting Information [Line Items]
Property and other revenues	1,709	1,596	14,708
Property operating expenses	0	(39)	(29)
Net operating income	1,709	1,557	14,679
Operating | Operating Segments
Segment Reporting Information [Line Items]
Property and other revenues	199,426	182,519	228,569
Property operating expenses	(140,612)	(137,539)	(177,907)
Net operating income	58,814	44,980	50,662
Unconsolidated Investments | Operating Segments
Segment Reporting Information [Line Items]
Property and other revenues	361,005	343,575	301,320
Property operating expenses	(316,357)	(285,291)	(240,784)
Net operating income	$ 44,648	$ 58,284	$ 60,536

Segment Reporting - Summary of

Segment Reporting - Summary of Assets by Segment (Details) - USD ($) $ in Thousands		Dec. 31, 2023	Dec. 31, 2022
Segment Reporting Information [Line Items]
Total assets	[1]	$ 1,059,419	$ 1,237,835
Non-Segment
Segment Reporting Information [Line Items]
Total assets		73,890	93,761
Net Lease | Operating Segments
Segment Reporting Information [Line Items]
Total assets		74,655	83,435
Operating | Operating Segments
Segment Reporting Information [Line Items]
Total assets		787,925	884,137
Unconsolidated Investments | Operating Segments
Segment Reporting Information [Line Items]
Total assets		$ 122,949	$ 176,502
[1] Includes $121.1 million and $183.8 million of assets and liabilities, respectively, of certain VIEs that are consolidated by the Operating Partnership. Refer to Note 2, “Summary of Significant Accounting Policies.”

Segment Reporting - Summary o_2

Segment Reporting - Summary of Capital Expenditures by Segment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Segment Reporting Information [Line Items]
Payments to improve real estate	$ 38,422	$ 29,304
Operating Segments | Net Lease
Segment Reporting Information [Line Items]
Payments to improve real estate	0	372
Operating Segments | Operating
Segment Reporting Information [Line Items]
Payments to improve real estate	38,422	28,932
Operating Segments | Unconsolidated Investments
Segment Reporting Information [Line Items]
Payments to improve real estate	0	0
Non-Segment
Segment Reporting Information [Line Items]
Payments to improve real estate	$ 0	$ 0

Commitments and Contingencies -

Commitments and Contingencies - Narrative (Details) $ in Millions	Dec. 31, 2023 USD ($)
Commitments and Contingencies Disclosure [Abstract]
Loss contingency accrual	$ 0.6

Subsequent Events - Narrative (

Subsequent Events - Narrative (Details) - USD ($) $ in Thousands	1 Months Ended	12 Months Ended
	Feb. 29, 2024	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Nov. 30, 2023
Subsequent Event [Line Items]
Repayments of notes payable		$ 18,492	$ 21,212	$ 517,618
Rochester Portfolio Property | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Subsequent Event [Line Items]
Consideration received					$ 12,000
Subsequent event | Rochester Portfolio Property | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Subsequent Event [Line Items]
Consideration received	$ 12,000
Proceeds from sale of held-for-sale property	700
Repayments of notes payable	$ 10,900

Schedule III - Real Estate an_2

Schedule III - Real Estate and Accumulated Depreciation - Schedule of Real Estate Properties (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 903,862
Initial cost of land	118,854
Initial cost of buildings and improvements	988,337
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(6,427)
Gross amount carried at close of period, land	115,758
Gross amount carried at close of period, buildings and improvements	985,006
Gross amount carried at close of period, total	1,100,764	$ 1,196,553	$ 1,197,900	$ 1,774,971
Accumulated depreciation	267,883	263,551	225,301	$ 291,041
Total	832,881
Federal income tax basis over cost basis	1,400,000
Mortgages
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Principal Amount	903,862	922,355
Frisco [Member] | Frisco, TX Non-recourse, February 2026 | Mortgages
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Principal Amount	26,000	26,000
Direct Investment - Operating and Net Lease
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	793,202
Initial cost of land	118,297
Initial cost of buildings and improvements	974,767
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(3,911)
Gross amount carried at close of period, land	115,758
Gross amount carried at close of period, buildings and improvements	973,395
Gross amount carried at close of period, total	1,089,153	$ 1,196,553	$ 1,197,900
Accumulated depreciation	267,883
Total	821,270
Operating | Milford, OH
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	18,173
Initial cost of land	1,160
Initial cost of buildings and improvements	14,440
Costs capitalized subsequent to acquisition, land, buildings, and improvements	4,646
Gross amount carried at close of period, land	1,160
Gross amount carried at close of period, buildings and improvements	19,086
Gross amount carried at close of period, total	20,246
Accumulated depreciation	5,704
Total	$ 14,542
Life on which depreciation is computed (in years)	40 years
Operating | Milford, OH
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost of land	700
Initial cost of buildings and improvements	0
Costs capitalized subsequent to acquisition, land, buildings, and improvements	5,658
Gross amount carried at close of period, land	696
Gross amount carried at close of period, buildings and improvements	5,662
Gross amount carried at close of period, total	6,358
Accumulated depreciation	933
Total	$ 5,425
Life on which depreciation is computed (in years)	40 years
Operating | Frisco, TX
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 26,000
Initial cost of land	3,100
Initial cost of buildings and improvements	35,874
Costs capitalized subsequent to acquisition, land, buildings, and improvements	5,199
Gross amount carried at close of period, land	3,100
Gross amount carried at close of period, buildings and improvements	41,073
Gross amount carried at close of period, total	44,173
Accumulated depreciation	11,179
Total	$ 32,994
Life on which depreciation is computed (in years)	40 years
Operating | Apple Valley, CA
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 19,668
Initial cost of land	1,168
Initial cost of buildings and improvements	24,625
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(4,636)
Gross amount carried at close of period, land	1,168
Gross amount carried at close of period, buildings and improvements	19,989
Gross amount carried at close of period, total	21,157
Accumulated depreciation	5,889
Total	$ 15,268
Life on which depreciation is computed (in years)	40 years
Operating | Auburn, CA
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 22,220
Initial cost of land	1,694
Initial cost of buildings and improvements	18,438
Costs capitalized subsequent to acquisition, land, buildings, and improvements	3,429
Gross amount carried at close of period, land	1,694
Gross amount carried at close of period, buildings and improvements	21,867
Gross amount carried at close of period, total	23,561
Accumulated depreciation	5,679
Total	$ 17,882
Life on which depreciation is computed (in years)	40 years
Operating | Austin, TX
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 24,465
Initial cost of land	4,020
Initial cost of buildings and improvements	19,417
Costs capitalized subsequent to acquisition, land, buildings, and improvements	3,155
Gross amount carried at close of period, land	4,020
Gross amount carried at close of period, buildings and improvements	22,572
Gross amount carried at close of period, total	26,592
Accumulated depreciation	6,569
Total	$ 20,023
Life on which depreciation is computed (in years)	40 years
Operating | Bakersfield, CA
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 15,526
Initial cost of land	1,831
Initial cost of buildings and improvements	21,006
Costs capitalized subsequent to acquisition, land, buildings, and improvements	3,260
Gross amount carried at close of period, land	1,831
Gross amount carried at close of period, buildings and improvements	24,266
Gross amount carried at close of period, total	26,097
Accumulated depreciation	6,285
Total	$ 19,812
Life on which depreciation is computed (in years)	40 years
Operating | Bangor, ME
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 19,801
Initial cost of land	2,463
Initial cost of buildings and improvements	23,205
Costs capitalized subsequent to acquisition, land, buildings, and improvements	3,395
Gross amount carried at close of period, land	2,463
Gross amount carried at close of period, buildings and improvements	26,600
Gross amount carried at close of period, total	29,063
Accumulated depreciation	6,262
Total	$ 22,801
Life on which depreciation is computed (in years)	40 years
Operating | Bellingham, WA
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 21,986
Initial cost of land	2,242
Initial cost of buildings and improvements	18,807
Costs capitalized subsequent to acquisition, land, buildings, and improvements	3,841
Gross amount carried at close of period, land	2,242
Gross amount carried at close of period, buildings and improvements	22,648
Gross amount carried at close of period, total	24,890
Accumulated depreciation	5,561
Total	$ 19,329
Life on which depreciation is computed (in years)	40 years
Operating | Clovis, CA
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 17,303
Initial cost of land	1,821
Initial cost of buildings and improvements	21,721
Costs capitalized subsequent to acquisition, land, buildings, and improvements	3,140
Gross amount carried at close of period, land	1,821
Gross amount carried at close of period, buildings and improvements	24,861
Gross amount carried at close of period, total	26,682
Accumulated depreciation	5,992
Total	$ 20,690
Life on which depreciation is computed (in years)	40 years
Operating | Columbia, MO
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 20,935
Initial cost of land	1,621
Initial cost of buildings and improvements	23,521
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(4,656)
Gross amount carried at close of period, land	1,621
Gross amount carried at close of period, buildings and improvements	18,865
Gross amount carried at close of period, total	20,486
Accumulated depreciation	6,057
Total	$ 14,429
Life on which depreciation is computed (in years)	40 years
Operating | Corpus Christi, TX
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 17,155
Initial cost of land	2,263
Initial cost of buildings and improvements	20,142
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(2,362)
Gross amount carried at close of period, land	2,263
Gross amount carried at close of period, buildings and improvements	17,780
Gross amount carried at close of period, total	20,043
Accumulated depreciation	5,463
Total	$ 14,580
Life on which depreciation is computed (in years)	40 years
Operating | East Amherst, NY
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 17,087
Initial cost of land	2,873
Initial cost of buildings and improvements	18,279
Costs capitalized subsequent to acquisition, land, buildings, and improvements	3,320
Gross amount carried at close of period, land	2,873
Gross amount carried at close of period, buildings and improvements	21,599
Gross amount carried at close of period, total	24,472
Accumulated depreciation	5,130
Total	$ 19,342
Life on which depreciation is computed (in years)	40 years
Operating | El Cajon, CA
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 19,356
Initial cost of land	2,357
Initial cost of buildings and improvements	14,733
Costs capitalized subsequent to acquisition, land, buildings, and improvements	1,902
Gross amount carried at close of period, land	2,357
Gross amount carried at close of period, buildings and improvements	16,635
Gross amount carried at close of period, total	18,992
Accumulated depreciation	4,488
Total	$ 14,504
Life on which depreciation is computed (in years)	40 years
Operating | El Paso, TX
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 11,261
Initial cost of land	1,610
Initial cost of buildings and improvements	14,103
Costs capitalized subsequent to acquisition, land, buildings, and improvements	2,685
Gross amount carried at close of period, land	1,610
Gross amount carried at close of period, buildings and improvements	16,788
Gross amount carried at close of period, total	18,398
Accumulated depreciation	4,454
Total	$ 13,944
Life on which depreciation is computed (in years)	40 years
Operating | Fairport, NY
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 15,237
Initial cost of land	1,452
Initial cost of buildings and improvements	19,427
Costs capitalized subsequent to acquisition, land, buildings, and improvements	3,256
Gross amount carried at close of period, land	1,452
Gross amount carried at close of period, buildings and improvements	22,683
Gross amount carried at close of period, total	24,135
Accumulated depreciation	5,202
Total	$ 18,933
Life on which depreciation is computed (in years)	40 years
Operating | Fenton, MO
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 22,643
Initial cost of land	2,410
Initial cost of buildings and improvements	22,216
Costs capitalized subsequent to acquisition, land, buildings, and improvements	3,017
Gross amount carried at close of period, land	2,410
Gross amount carried at close of period, buildings and improvements	25,233
Gross amount carried at close of period, total	27,643
Accumulated depreciation	6,225
Total	$ 21,418
Life on which depreciation is computed (in years)	40 years
Operating | Grand Junction, CO
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 17,971
Initial cost of land	2,525
Initial cost of buildings and improvements	26,446
Costs capitalized subsequent to acquisition, land, buildings, and improvements	3,718
Gross amount carried at close of period, land	2,525
Gross amount carried at close of period, buildings and improvements	30,164
Gross amount carried at close of period, total	32,689
Accumulated depreciation	6,980
Total	$ 25,709
Life on which depreciation is computed (in years)	40 years
Operating | Grand Junction, CO
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 9,208
Initial cost of land	1,147
Initial cost of buildings and improvements	12,523
Costs capitalized subsequent to acquisition, land, buildings, and improvements	2,604
Gross amount carried at close of period, land	1,147
Gross amount carried at close of period, buildings and improvements	15,127
Gross amount carried at close of period, total	16,274
Accumulated depreciation	3,746
Total	$ 12,528
Life on which depreciation is computed (in years)	40 years
Operating | Grapevine, TX
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 20,598
Initial cost of land	1,852
Initial cost of buildings and improvements	18,143
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(7,817)
Gross amount carried at close of period, land	1,852
Gross amount carried at close of period, buildings and improvements	10,326
Gross amount carried at close of period, total	12,178
Accumulated depreciation	4,436
Total	$ 7,742
Life on which depreciation is computed (in years)	40 years
Operating | Groton, CT
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 16,228
Initial cost of land	3,673
Initial cost of buildings and improvements	21,879
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(5,623)
Gross amount carried at close of period, land	3,673
Gross amount carried at close of period, buildings and improvements	16,256
Gross amount carried at close of period, total	19,929
Accumulated depreciation	5,851
Total	$ 14,078
Life on which depreciation is computed (in years)	40 years
Operating | Guilford, CT
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 22,409
Initial cost of land	6,725
Initial cost of buildings and improvements	27,488
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(19,288)
Gross amount carried at close of period, land	6,725
Gross amount carried at close of period, buildings and improvements	8,200
Gross amount carried at close of period, total	14,925
Accumulated depreciation	5,318
Total	$ 9,607
Life on which depreciation is computed (in years)	40 years
Operating | Joliet, IL
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 13,752
Initial cost of land	1,473
Initial cost of buildings and improvements	23,427
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(3,626)
Gross amount carried at close of period, land	1,473
Gross amount carried at close of period, buildings and improvements	19,801
Gross amount carried at close of period, total	21,274
Accumulated depreciation	5,374
Total	$ 15,900
Life on which depreciation is computed (in years)	40 years
Operating | Kennewick, WA
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 7,079
Initial cost of land	1,168
Initial cost of buildings and improvements	18,933
Costs capitalized subsequent to acquisition, land, buildings, and improvements	3,233
Gross amount carried at close of period, land	1,168
Gross amount carried at close of period, buildings and improvements	22,166
Gross amount carried at close of period, total	23,334
Accumulated depreciation	5,394
Total	$ 17,940
Life on which depreciation is computed (in years)	40 years
Operating | Las Cruces, NM
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 10,316
Initial cost of land	1,568
Initial cost of buildings and improvements	15,091
Costs capitalized subsequent to acquisition, land, buildings, and improvements	4,341
Gross amount carried at close of period, land	1,568
Gross amount carried at close of period, buildings and improvements	19,432
Gross amount carried at close of period, total	21,000
Accumulated depreciation	4,930
Total	$ 16,070
Life on which depreciation is computed (in years)	40 years
Operating | Lee’s Summit, MO
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 25,073
Initial cost of land	1,263
Initial cost of buildings and improvements	20,500
Costs capitalized subsequent to acquisition, land, buildings, and improvements	3,346
Gross amount carried at close of period, land	1,263
Gross amount carried at close of period, buildings and improvements	23,846
Gross amount carried at close of period, total	25,109
Accumulated depreciation	5,975
Total	$ 19,134
Life on which depreciation is computed (in years)	40 years
Operating | Lodi, CA
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 18,547
Initial cost of land	2,863
Initial cost of buildings and improvements	21,152
Costs capitalized subsequent to acquisition, land, buildings, and improvements	2,290
Gross amount carried at close of period, land	2,863
Gross amount carried at close of period, buildings and improvements	23,442
Gross amount carried at close of period, total	26,305
Accumulated depreciation	6,083
Total	$ 20,222
Life on which depreciation is computed (in years)	40 years
Operating | Normandy Park, WA
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 14,967
Initial cost of land	2,031
Initial cost of buildings and improvements	16,407
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(1,600)
Gross amount carried at close of period, land	2,031
Gross amount carried at close of period, buildings and improvements	14,807
Gross amount carried at close of period, total	16,838
Accumulated depreciation	4,591
Total	$ 12,247
Life on which depreciation is computed (in years)	40 years
Operating | Palatine, IL
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 18,546
Initial cost of land	1,221
Initial cost of buildings and improvements	26,993
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(9,917)
Gross amount carried at close of period, land	1,221
Gross amount carried at close of period, buildings and improvements	17,076
Gross amount carried at close of period, total	18,297
Accumulated depreciation	6,852
Total	$ 11,445
Life on which depreciation is computed (in years)	40 years
Operating | Plano, TX
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 14,839
Initial cost of land	2,200
Initial cost of buildings and improvements	14,860
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(4,555)
Gross amount carried at close of period, land	2,200
Gross amount carried at close of period, buildings and improvements	10,305
Gross amount carried at close of period, total	12,505
Accumulated depreciation	4,427
Total	$ 8,078
Life on which depreciation is computed (in years)	40 years
Operating | Renton, WA
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 17,564
Initial cost of land	2,642
Initial cost of buildings and improvements	20,469
Costs capitalized subsequent to acquisition, land, buildings, and improvements	3,597
Gross amount carried at close of period, land	2,642
Gross amount carried at close of period, buildings and improvements	24,066
Gross amount carried at close of period, total	26,708
Accumulated depreciation	6,036
Total	$ 20,672
Life on which depreciation is computed (in years)	40 years
Operating | Sandy, UT
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 14,569
Initial cost of land	2,810
Initial cost of buildings and improvements	19,132
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(4,189)
Gross amount carried at close of period, land	2,810
Gross amount carried at close of period, buildings and improvements	14,943
Gross amount carried at close of period, total	17,753
Accumulated depreciation	4,727
Total	$ 13,026
Life on which depreciation is computed (in years)	40 years
Operating | Santa Rosa, CA
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 25,771
Initial cost of land	5,409
Initial cost of buildings and improvements	26,183
Costs capitalized subsequent to acquisition, land, buildings, and improvements	3,166
Gross amount carried at close of period, land	5,409
Gross amount carried at close of period, buildings and improvements	29,349
Gross amount carried at close of period, total	34,758
Accumulated depreciation	7,469
Total	$ 27,289
Life on which depreciation is computed (in years)	40 years
Operating | Sun City West, AZ
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 23,679
Initial cost of land	2,684
Initial cost of buildings and improvements	29,056
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(3,462)
Gross amount carried at close of period, land	2,684
Gross amount carried at close of period, buildings and improvements	25,594
Gross amount carried at close of period, total	28,278
Accumulated depreciation	7,635
Total	$ 20,643
Life on which depreciation is computed (in years)	40 years
Operating | Tacoma, WA
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 27,712
Initial cost of land	7,974
Initial cost of buildings and improvements	32,435
Costs capitalized subsequent to acquisition, land, buildings, and improvements	4,922
Gross amount carried at close of period, land	7,974
Gross amount carried at close of period, buildings and improvements	37,357
Gross amount carried at close of period, total	45,331
Accumulated depreciation	9,987
Total	$ 35,344
Life on which depreciation is computed (in years)	40 years
Operating | Frisco, TX(3)
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost of land	1,130
Initial cost of buildings and improvements	0
Costs capitalized subsequent to acquisition, land, buildings, and improvements	12,652
Gross amount carried at close of period, land	1,130
Gross amount carried at close of period, buildings and improvements	12,652
Gross amount carried at close of period, total	13,782
Accumulated depreciation	2,790
Total	$ 10,992
Life on which depreciation is computed (in years)	40 years
Operating | Albany, OR
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 8,190
Initial cost of land	958
Initial cost of buildings and improvements	6,625
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(3,406)
Gross amount carried at close of period, land	758
Gross amount carried at close of period, buildings and improvements	3,419
Gross amount carried at close of period, total	4,177
Accumulated depreciation	1,647
Total	$ 2,530
Life on which depreciation is computed (in years)	40 years
Operating | Port Townsend, WA
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 15,660
Initial cost of land	1,613
Initial cost of buildings and improvements	21,460
Costs capitalized subsequent to acquisition, land, buildings, and improvements	1,543
Gross amount carried at close of period, land	996
Gross amount carried at close of period, buildings and improvements	23,620
Gross amount carried at close of period, total	24,616
Accumulated depreciation	5,607
Total	$ 19,009
Life on which depreciation is computed (in years)	40 years
Operating | Roseburg, OR
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 11,587
Initial cost of land	699
Initial cost of buildings and improvements	11,589
Costs capitalized subsequent to acquisition, land, buildings, and improvements	1,040
Gross amount carried at close of period, land	459
Gross amount carried at close of period, buildings and improvements	12,869
Gross amount carried at close of period, total	13,328
Accumulated depreciation	3,094
Total	$ 10,234
Life on which depreciation is computed (in years)	40 years
Operating | Sandy, OR
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 13,216
Initial cost of land	1,611
Initial cost of buildings and improvements	16,697
Costs capitalized subsequent to acquisition, land, buildings, and improvements	1,409
Gross amount carried at close of period, land	1,233
Gross amount carried at close of period, buildings and improvements	18,484
Gross amount carried at close of period, total	19,717
Accumulated depreciation	4,132
Total	$ 15,585
Life on which depreciation is computed (in years)	40 years
Operating | Santa Barbara, CA
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost of land	2,408
Initial cost of buildings and improvements	15,674
Costs capitalized subsequent to acquisition, land, buildings, and improvements	637
Gross amount carried at close of period, land	2,408
Gross amount carried at close of period, buildings and improvements	16,311
Gross amount carried at close of period, total	18,719
Accumulated depreciation	3,286
Total	$ 15,433
Life on which depreciation is computed (in years)	40 years
Operating | Wenatchee, WA
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 18,038
Initial cost of land	2,540
Initial cost of buildings and improvements	28,971
Costs capitalized subsequent to acquisition, land, buildings, and improvements	1,284
Gross amount carried at close of period, land	1,534
Gross amount carried at close of period, buildings and improvements	31,261
Gross amount carried at close of period, total	32,795
Accumulated depreciation	6,592
Total	$ 26,203
Life on which depreciation is computed (in years)	40 years
Operating | Greece, NY
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost of land	534
Initial cost of buildings and improvements	18,158
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(10,999)
Gross amount carried at close of period, land	534
Gross amount carried at close of period, buildings and improvements	7,159
Gross amount carried at close of period, total	7,693
Accumulated depreciation	1,878
Total	$ 5,815
Life on which depreciation is computed (in years)	49 years
Operating | Rochester, NY
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 17,470
Initial cost of land	2,426
Initial cost of buildings and improvements	31,861
Costs capitalized subsequent to acquisition, land, buildings, and improvements	4,267
Gross amount carried at close of period, land	2,426
Gross amount carried at close of period, buildings and improvements	36,128
Gross amount carried at close of period, total	38,554
Accumulated depreciation	8,046
Total	$ 30,508
Life on which depreciation is computed (in years)	39 years
Undeveloped Land | Rochester, NY
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost of land	544
Initial cost of buildings and improvements	0
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(94)
Gross amount carried at close of period, land	450
Gross amount carried at close of period, buildings and improvements	0
Gross amount carried at close of period, total	450
Total	450
Undeveloped Land | Penfield, NY
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost of land	534
Initial cost of buildings and improvements	0
Costs capitalized subsequent to acquisition, land, buildings, and improvements	0
Gross amount carried at close of period, land	534
Gross amount carried at close of period, buildings and improvements	0
Gross amount carried at close of period, total	534
Total	534
Net Lease | Bohemia, NY
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	21,659
Initial cost of land	4,258
Initial cost of buildings and improvements	27,805
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(9,539)
Gross amount carried at close of period, land	4,258
Gross amount carried at close of period, buildings and improvements	18,266
Gross amount carried at close of period, total	22,524
Accumulated depreciation	7,302
Total	$ 15,222
Life on which depreciation is computed (in years)	40 years
Net Lease | Hauppauge, NY
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 13,141
Initial cost of land	2,086
Initial cost of buildings and improvements	18,495
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(149)
Gross amount carried at close of period, land	2,086
Gross amount carried at close of period, buildings and improvements	18,346
Gross amount carried at close of period, total	20,432
Accumulated depreciation	5,675
Total	$ 14,757
Life on which depreciation is computed (in years)	40 years
Net Lease | Islandia, NY
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 32,290
Initial cost of land	8,437
Initial cost of buildings and improvements	37,198
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(12,238)
Gross amount carried at close of period, land	8,437
Gross amount carried at close of period, buildings and improvements	24,960
Gross amount carried at close of period, total	33,397
Accumulated depreciation	9,801
Total	$ 23,596
Life on which depreciation is computed (in years)	40 years
Net Lease | Westbury, NY
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 14,307
Initial cost of land	2,506
Initial cost of buildings and improvements	19,163
Costs capitalized subsequent to acquisition, land, buildings, and improvements	293
Gross amount carried at close of period, land	2,506
Gross amount carried at close of period, buildings and improvements	19,456
Gross amount carried at close of period, total	21,962
Accumulated depreciation	5,150
Total	$ 16,812
Life on which depreciation is computed (in years)	40 years
Held for Sale | Victor, NY
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 10,874
Initial cost of land	557
Initial cost of buildings and improvements	13,570
Costs capitalized subsequent to acquisition, land, buildings, and improvements	(2,516)
Gross amount carried at close of period, land	0
Gross amount carried at close of period, buildings and improvements	11,611
Gross amount carried at close of period, total	11,611
Accumulated depreciation	0
Total	11,611
Properties in Receivership
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	99,786
Initial cost of land	0
Initial cost of buildings and improvements	0
Costs capitalized subsequent to acquisition, land, buildings, and improvements	0
Gross amount carried at close of period, land	0
Gross amount carried at close of period, buildings and improvements	0
Gross amount carried at close of period, total	0
Accumulated depreciation	0
Total	$ 0

Schedule III - Real Estate an_3

Schedule III - Real Estate and Accumulated Depreciation - Schedule of Real Estate and Accumulated Depreciation Rollforward (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate [Roll Forward]
Balance at beginning of year	$ 1,196,553	$ 1,197,900	$ 1,774,971
Dispositions	(88,100)	0	(603,082)
Improvements	39,246	30,531	31,397
Impairment	(44,695)	(31,878)	(5,386)
Subtotal	1,103,004	1,196,553	1,197,900
Classified as held for sale	(13,851)	0	0
Balance at end of year	1,100,764	1,196,553	1,197,900
Amount of federal income tax basis over cost basis	344,300
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate, Accumulated Depreciation [Roll Forward]
Balance at beginning of year	263,551	225,301	291,041
Depreciation expense	38,174	38,250	53,476
Property dispositions	(31,602)	0	(119,216)
Subtotal	270,123	263,551	225,301
Classified as held for sale	(2,240)	0	0
Balance at end of year	$ 267,883	$ 263,551	$ 225,301

Schedule IV - Mortgage Loans _2

Schedule IV - Mortgage Loans on Real Estate - Real Estate Rollforward (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Jun. 30, 2023	Dec. 31, 2018
SEC Schedule, 12-29, Real Estate Companies, Investment in Movement in Mortgage Loans on Real Estate [Roll Forward]
Balance at beginning of year	$ 0	$ 0	$ 55,864
Additions to Mortgage Loans on Real Estate [Abstract]
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate, New Mortgage Loan, Capitalized Payment In-Kind Interest	0	0	194
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate, Loan Modification Fees	0	0	(687)
Deductions:
Reclassification	0	0	18,307
Repayment of principal	0	0	(74,376)
Amortization of acquisition costs, fees, premiums and discounts	0	0	698
Balance at end of year	0	0	0
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Carrying value	122,949	176,502
Espresso
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Carrying value	$ 142	$ 18,019	$ 0	$ 3,100	$ 0