Griffin-American Healthcare REIT III (GRAH) 10-K 25 Mar 21 2020 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Mar. 12, 2021	Jun. 30, 2020
Document and Entity Information [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2020
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	000-55434
Entity Registrant Name	GRIFFIN-AMERICAN HEALTHCARE REIT III, INC.
Entity Incorporation, State or Country Code	MD
Entity Tax Identification Number	46-1749436
Entity Address, Address Line One	18191 Von Karman Avenue
Entity Address, Address Line Two	Suite 300
Entity Address, City or Town	Irvine
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	92612
City Area Code	949
Local Phone Number	270-9200
Title of 12(g) Security	Common Stock, $0.01 par value 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
Entity Shell Company	false
Entity Public Float			$ 1,818,857
Entity Common Stock, Shares Outstanding		193,889,872
Documents Incorporated by Reference	None.
Amendment Flag	false
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	FY
Entity Central Index Key	0001566912

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands		Dec. 31, 2020	Dec. 31, 2019
ASSETS
Real estate investments, net		$ 2,330,000	$ 2,270,421
Debt security investment, net		75,851	72,717
Cash and cash equivalents		113,212	53,149
Accounts and other receivables, net		124,556	144,130
Restricted cash		38,978	36,731
Identified intangible assets, net		154,687	160,247
Goodwill		75,309	75,309
Operating lease right-of-use assets, net		203,988	219,187
Other assets, net		118,356	140,398
Total assets		3,234,937	3,172,289
Liabilities:
Mortgage loans payable, net	[1]	810,478	792,870
Lines of credit and term loans	[1]	843,634	815,879
Accounts payable and accrued liabilities	[1]	186,651	171,394
Accounts payable due to affiliates	[1]	8,026	2,321
Identified intangible liabilities, net		367	663
Financing obligations	[1]	28,425	30,918
Operating lease liabilities	[1]	193,634	207,371
Security deposits, prepaid rent and other liabilities	[1]	88,899	48,105
Total liabilities		2,160,114	2,069,521
Commitments and Contingencies
Redeemable noncontrolling interests		40,340	44,105
Stockholders’ equity:
Preferred stock, $0.01 par value per share; 200,000,000 shares authorized; none issued and outstanding		0	0
Common stock, $0.01 par value per share; 1,000,000,000 shares authorized; 193,889,872 and 193,967,474 shares issued and outstanding as of December 31, 2020 and 2019, respectively		1,939	1,939
Additional paid-in capital		1,730,448	1,728,421
Accumulated deficit		(864,271)	(827,550)
Accumulated other comprehensive loss		(2,008)	(2,255)
Total stockholders’ equity		866,108	900,555
Noncontrolling interests		168,375	158,108
Total equity		1,034,483	1,058,663
Total liabilities, redeemable noncontrolling interests and equity		$ 3,234,937	$ 3,172,289
[1]	Such liabilities of Griffin-American Healthcare REIT III, Inc. as of December 31, 2020 and 2019 represented liabilities of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries. Griffin-American Healthcare REIT III Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of Griffin-American Healthcare REIT III, Inc. The creditors of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries do not have recourse against Griffin-American Healthcare REIT III, Inc., except for the 2019 Corporate Line of Credit, as defined in Note 8, held by Griffin-American Healthcare REIT III Holdings, LP in the amount of $556,500,000 and $557,000,000 as of December 31, 2020 and 2019, respectively, which is guaranteed by Griffin-American Healthcare REIT III, Inc.

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands		Dec. 31, 2020	Dec. 31, 2019
Par value of preferred stock, authorized to be issued		$ 0.01	$ 0.01
Preferred stock, shares authorized		200,000,000	200,000,000
Preferred stock, shares issued		0	0
Preferred stock, shares outstanding		0	0
Common stock, par value (usd per share)		$ 0.01	$ 0.01
Common stock, shares authorized		1,000,000,000	1,000,000,000
Common stock, shares issued		193,889,872	193,967,474
Common stock, shares outstanding		193,889,872	193,967,474
Lines of credit and term loans	[1]	$ 843,634	$ 815,879
2019 Corporate Line of Credit [Member] | Line of Credit [Member]
Lines of credit and term loans		$ 556,500	$ 557,000
[1]	Such liabilities of Griffin-American Healthcare REIT III, Inc. as of December 31, 2020 and 2019 represented liabilities of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries. Griffin-American Healthcare REIT III Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of Griffin-American Healthcare REIT III, Inc. The creditors of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries do not have recourse against Griffin-American Healthcare REIT III, Inc., except for the 2019 Corporate Line of Credit, as defined in Note 8, held by Griffin-American Healthcare REIT III Holdings, LP in the amount of $556,500,000 and $557,000,000 as of December 31, 2020 and 2019, respectively, which is guaranteed by Griffin-American Healthcare REIT III, Inc.

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE INCOME (LOSS) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Revenues [Abstract]
Resident fees and services	$ 1,069,073	$ 1,099,078	$ 1,005,691
Real estate revenue	120,047	124,038	129,569
Grant income	55,181	0	0
Total revenues and grant income	1,244,301	1,223,116	1,135,260
Expenses:
Property operating expenses	993,727	967,860	889,071
Rental expenses	32,298	33,859	34,823
General and administrative	27,007	29,749	28,770
Acquisition related expenses	290	(161)	(2,913)
Depreciation and amortization	98,858	111,412	95,678
Total expenses	1,152,180	1,142,719	1,045,429
Other income (expense):
Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishment)	(71,278)	(78,553)	(66,281)
Loss in fair value of derivative financial instruments	(3,906)	(4,541)	(1,949)
Gain on dispositions of real estate investments	1,395	0	0
Impairment of real estate investments	(11,069)	0	(2,542)
Loss from unconsolidated entities	(4,517)	(2,097)	(3,877)
Foreign currency gain (loss)	1,469	1,730	(2,690)
Other income	1,570	3,736	1,248
Income before income taxes	5,785	672	13,740
Income tax benefit (expense)	3,078	(1,524)	797
Net income (loss)	8,863	(852)	14,537
Less: net income attributable to noncontrolling interests	(6,700)	(4,113)	(1,240)
Net income (loss) attributable to controlling interest	$ 2,163	$ (4,965)	$ 13,297
Net income (loss) per common share attributable to controlling interest — basic and diluted	$ 0.01	$ (0.03)	$ 0.07
Weighted average number of common shares outstanding — basic and diluted	194,168,833	196,342,873	199,953,936
Other comprehensive income (loss):
Foreign currency translation adjustments	$ 247	$ 305	$ (589)
Total other comprehensive income (loss)	247	305	(589)
Comprehensive income (loss)	9,110	(547)	13,948
Less: comprehensive income attributable to noncontrolling interests	(6,700)	(4,113)	(1,240)
Comprehensive income (loss) attributable to controlling interest	$ 2,410	$ (4,660)	$ 12,708

CONSOLIDATED STATEMENTS OF EQUI

CONSOLIDATED STATEMENTS OF EQUITY - USD ($) $ in Thousands	Total		Total Stockholders' Equity	Common Stock	Additional Paid-In Capital	Accumulated Deficit	Accumulated Other Comprehensive Loss	Noncontrolling Interests
Beginning balance, shares at Dec. 31, 2017				199,343,234
Beginning balance Stockholders' Equity at Dec. 31, 2017	$ 1,346,575		$ 1,187,850	$ 1,993	$ 1,785,872	$ (598,044)	$ (1,971)	$ 158,725
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Offering costs — common stock	(7)		(7)		(7)
Issuance of common stock under the DRIP, shares				6,464,432
Issuance of common stock under the DRIP	60,030		60,030	$ 65	59,965
Issuance of vested and nonvested restricted common stock, shares				22,500
Issuance of vested and nonvested restricted common stock	41		41		41
Amortization of nonvested common stock compensation	174		174		174
Stock based compensation	$ 2,898							2,898
Repurchase of common stock, shares	(8,272,789)			(8,272,789)
Repurchase of common stock	$ (76,577)		(76,577)	$ (83)	(76,494)
Contributions from noncontrolling interests	4,470							4,470
Distributions to noncontrolling interests	(6,701)							(6,701)
Reclassification of noncontrolling interests to mezzanine equity	(780)							(780)
Adjustment to value of redeemable noncontrolling interests	(5,301)		(3,711)		(3,711)			(1,590)
Distributions declared	(120,001)		(120,001)			(120,001)
Net income (loss)	14,403	[1]	13,297			13,297		1,106
Other comprehensive income (loss)	(589)		(589)				(589)
Ending balance, shares at Dec. 31, 2018				197,557,377
Ending balance Stockholders' Equity at Dec. 31, 2018	1,218,635		1,060,507	$ 1,975	1,765,840	(704,748)	(2,560)	158,128
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Offering costs — common stock	(91)		(91)		(91)
Issuance of common stock under the DRIP, shares				5,913,684
Issuance of common stock under the DRIP	55,440		55,440	$ 59	55,381
Issuance of vested and nonvested restricted common stock, shares				22,500
Issuance of vested and nonvested restricted common stock	42		42		42
Amortization of nonvested common stock compensation	173		173		173
Stock based compensation	$ 2,698							2,698
Repurchase of common stock, shares	(9,526,087)			(9,526,087)
Repurchase of common stock	$ (89,888)		(89,888)	$ (95)	(89,793)
Contributions from noncontrolling interests	3,000							3,000
Distributions to noncontrolling interests	(7,272)							(7,272)
Reclassification of noncontrolling interests to mezzanine equity	(780)							(780)
Adjustment to value of redeemable noncontrolling interests	(4,473)		(3,131)		(3,131)			(1,342)
Distributions declared	(117,837)		(117,837)			(117,837)
Net income (loss)	(1,289)	[1]	(4,965)			(4,965)		3,676
Other comprehensive income (loss)	305		305				305
Ending balance, shares at Dec. 31, 2019				193,967,474
Ending balance Stockholders' Equity at Dec. 31, 2019	1,058,663		900,555	$ 1,939	1,728,421	(827,550)	(2,255)	158,108
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Offering costs — common stock	(8)		(8)		(8)
Issuance of common stock under the DRIP, shares				2,325,762
Issuance of common stock under the DRIP	21,861		21,861	$ 24	21,837
Issuance of vested and nonvested restricted common stock, shares				7,500
Issuance of vested and nonvested restricted common stock	14		14		14
Amortization of nonvested common stock compensation	141		141		141
Stock based compensation	$ (1,188)							(1,188)
Repurchase of common stock, shares	(2,410,864)			(2,410,864)
Repurchase of common stock	$ (23,107)		(23,107)	$ (24)	(23,083)
Issuance of noncontrolling interest	11,000		515		515			10,485
Distributions to noncontrolling interests	(5,463)							(5,463)
Reclassification of noncontrolling interests to mezzanine equity	(715)							(715)
Adjustment to value of redeemable noncontrolling interests	3,714		2,611		2,611			1,103
Distributions declared	(38,884)		(38,884)			(38,884)
Net income (loss)	8,208	[1]	2,163			2,163		6,045
Other comprehensive income (loss)	247		247				247
Ending balance, shares at Dec. 31, 2020				193,889,872
Ending balance Stockholders' Equity at Dec. 31, 2020	$ 1,034,483		$ 866,108	$ 1,939	$ 1,730,448	$ (864,271)	$ (2,008)	$ 168,375
[1]	For the years ended December 31, 2020, 2019 and 2018, amounts exclude $655,000, $437,000 and $134,000, respectively, of net income attributable to redeemable noncontrolling interests. See Note 12, Redeemable Noncontrolling Interests, for a further discussion.

CONSOLIDATED STATEMENTS OF EQ_2

CONSOLIDATED STATEMENTS OF EQUITY (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Statement of Stockholders' Equity [Abstract]
Distributions declared (in usd per share)	$ 0.20	$ 0.60	$ 0.60
Net income attributable to redeemable noncontrolling interests	$ 655	$ 437	$ 134

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
CASH FLOWS FROM OPERATING ACTIVITIES
Net income (loss)	$ 8,863	$ (852)	$ 14,537
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization	98,858	111,412	95,678
Other amortization	30,789	29,740	4,918
Deferred rent	(5,606)	(3,264)	(4,841)
Stock based compensation	(1,342)	2,744	3,026
Stock based compensation — nonvested restricted common stock	155	215	215
Loss from unconsolidated entities	4,517	2,097	3,877
Gain on dispositions of real estate investments	(1,395)	0	0
Foreign currency (gain) loss	(1,522)	(1,731)	2,658
Loss on extinguishment of debt	0	2,968	0
Deferred income taxes	(3,329)	964	(1,854)
Contingent consideration related to acquisition of real estate	0	0	(93)
Change in fair value of contingent consideration	0	(681)	(2,843)
Change in fair value of derivative financial instruments	3,906	4,541	1,949
Impairment of real estate investments	11,069	0	2,542
Changes in operating assets and liabilities:
Accounts and other receivables	20,318	(22,435)	(6,731)
Other assets	(7,357)	(6,537)	(15,317)
Accounts payable and accrued liabilities	30,290	18,103	8,187
Accounts payable due to affiliates	5,162	121	(26)
Security deposits, prepaid rent, operating lease and other liabilities	25,780	(19,951)	932
Net cash provided by operating activities	219,156	117,454	106,814
CASH FLOWS FROM INVESTING ACTIVITIES
Developments and capital expenditures	(128,302)	(92,836)	(66,907)
Acquisitions of real estate and other investments	(30,552)	(37,863)	(67,285)
Proceeds from dispositions of real estate and other investments	12,525	1,227	1,000
Investments in unconsolidated entities	(960)	(1,640)	(2,050)
Real estate and other deposits	(656)	(650)	(2,329)
Principal repayments on real estate notes receivable	0	28,650	1,799
Net cash used in investing activities	(147,945)	(103,112)	(135,772)
CASH FLOWS FROM FINANCING ACTIVITIES
Borrowings under mortgage loans payable	92,399	191,246	181,594
Payments on mortgage loans payable	(71,990)	(74,037)	(10,444)
Early payoff of mortgage loans payable	(2,601)	(14,022)	(94,449)
Borrowings under the lines of credit and term loans	121,755	1,030,653	273,639
Payments on the lines of credit and term loans	(94,000)	(952,822)	(159,716)
Deferred financing costs	(4,890)	(12,945)	(4,177)
Debt extinguishment costs	0	(870)	0
Borrowing under financing obligation	1,907	0	0
Payments on financing and other obligations	(5,453)	(7,850)	(8,055)
Distributions paid	(26,997)	(62,612)	(59,974)
Repurchase of common stock	(23,107)	(89,888)	(76,577)
Issuance of noncontrolling interest	11,000	0	0
Contributions from noncontrolling interests	0	3,000	4,470
Distributions to noncontrolling interests	(5,463)	(7,272)	(6,701)
Distributions to redeemable noncontrolling interests	(1,271)	(1,430)	(711)
Repurchase of stock warrants and redeemable noncontrolling interests	(150)	(475)	(306)
Purchase of derivative financial instruments	0	0	(153)
Contingent consideration related to acquisition of real estate	0	0	(1,490)
Contributions from redeemable noncontrolling interests	0	2,000	535
Security deposits and other	50	12	112
Net cash (used in) provided by financing activities	(8,811)	2,688	37,597
NET CHANGE IN CASH, CASH EQUIVALENTS AND RESTRICTED CASH	62,400	17,030	8,639
EFFECT OF FOREIGN CURRENCY TRANSLATION ON CASH, CASH EQUIVALENTS AND RESTRICTED CASH	(90)	145	(77)
CASH, CASH EQUIVALENTS AND RESTRICTED CASH — Beginning of period	89,880	72,705	64,143
CASH, CASH EQUIVALENTS AND RESTRICTED CASH — End of period	152,190	89,880	72,705
Cash and cash equivalents at beginning of period	53,149	35,132	33,656
Restricted cash at beginning of period	36,731	37,573	30,487
Cash and cash equivalents at end of period	113,212	53,149	35,132
Restricted cash at end of period	38,978	36,731	37,573
Cash paid for:
Interest	65,771	68,654	59,365
Income taxes	753	921	1,647
Investing Activities:
Accrued developments and capital expenditures	22,342	25,194	12,616
Capital expenditures from financing obligations	1,053	11,821	16,809
Tenant improvement overage	4,482	1,216	1,373
Investments in unconsolidated entity	0	5,276	0
The following represents the (decrease) increase in certain assets and liabilities in connection with our acquisitions and dispositions of real estate investments:
Accounts and other receivables	(11)	0	0
Other assets, net	(253)	0	(1,587)
Accounts payable and accrued liabilities	(110)	46	58
Security deposits, prepaid rent and other liabilities	(459)	105	223
Financing Activities:
Issuance of common stock under the DRIP	21,861	55,440	60,030
Distributions declared but not paid	0	9,974	10,189
Reclassification of noncontrolling interests to mezzanine equity	$ 715	$ 780	$ 780

Organization and Description of

Organization and Description of Business	12 Months Ended
	Dec. 31, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Description of Business	1. Organization and Description of Business Griffin-American Healthcare REIT III, Inc., a Maryland corporation, invests in a diversified portfolio of real estate properties, focusing primarily on medical office buildings, hospitals, skilled nursing facilities, senior housing and other healthcare-related facilities. We also operate healthcare-related facilities utilizing the structure permitted by the REIT Investment Diversification and Empowerment Act of 2007, which is commonly referred to as a “RIDEA” structure (the provisions of the Internal Revenue Code of 1986, as amended, or the Code, authorizing the RIDEA structure were enacted as part of the Housing and Economic Recovery Act of 2008). We have originated and acquired secured loans and may also originate and acquire other real estate-related investments on an infrequent and opportunistic basis. We generally seek investments that produce current income; however, we have selectively developed, and may continue to selectively develop, real estate properties. We qualified to be taxed as a real estate investment trust, or REIT, under the Code for federal income tax purposes beginning with our taxable year ended December 31, 2014, and we intend to continue to qualify to be taxed as a REIT. We raised $1,842,618,000 through a best efforts initial public offering, or our initial offering, and issued 184,930,598 shares of our common stock. In additional, during our initial offering, we issued 1,948,563 shares of our common stock pursuant to our initial distribution reinvestment plan, or the Initial DRIP, for a total of $18,511,000 in distributions reinvested. Following the deregistration of our initial offering, we continued issuing shares of our common stock pursuant to the Initial DRIP through a subsequent offering, or the 2015 DRIP Offering. Effective October 5, 2016, we amended and restated the Initial DRIP, or the Amended and Restated DRIP, to amend the price at which shares of our common stock were issued pursuant to the 2015 DRIP Offering. A total of $245,396,000 in distributions were reinvested that resulted in 26,386,545 shares of common stock being issued pursuant to the 2015 DRIP Offering. On January 30, 2019, we filed a Registration Statement on Form S-3 under the Securities Act of 1933, as amended, or the Securities Act, to register a maximum of $200,000,000 of additional shares of our common stock to be issued pursuant to the Amended and Restated DRIP, or the 2019 DRIP Offering. We commenced offering shares pursuant to the 2019 DRIP Offering on April 1, 2019, following the deregistration of the 2015 DRIP Offering. On May 29, 2020, in consideration of the impact the coronavirus, or COVID-19, pandemic has had on the United States, globally and our business operations, our board of directors, or our board, authorized the suspension of the Amended and Restated DRIP until such time, if any, as our board determines to authorize new distributions and to reinstate such plan. Such suspension was effective upon the completion of all shares issued with respect to distributions payable to stockholders of record on or prior to the close of business on May 31, 2020. See Note 13, Equity, for a further discussion. As of December 31, 2020, a total of $63,105,000 in distributions were reinvested that resulted in 6,724,348 shares of common stock being issued pursuant to the 2019 DRIP Offering. We collectively refer to the Initial DRIP portion of our initial offering, the 2015 DRIP Offering and the 2019 DRIP Offering as our DRIP Offerings. We conduct substantially all of our operations through Griffin-American Healthcare REIT III Holdings, LP, or our operating partnership. We are externally advised by Griffin-American Healthcare REIT III Advisor, LLC, or our advisor, pursuant to an advisory agreement between us and our advisor that was effective as of February 26, 2014 and had a one-year initial term, subject to successive one-year renewals upon the mutual consent of the parties. The advisory agreement, as amended to clarify certain indemnification provisions and last renewed on February 22, 2021, or the Advisory Agreement, expires on February 26, 2022. Our advisor uses its best efforts, subject to the oversight, review and approval of our board, to, among other things, research, identify, review and make investments in and dispositions of properties and securities on our behalf consistent with our investment policies and objectives. Our advisor performs its duties and responsibilities under the Advisory Agreement as our fiduciary. Our advisor is 75.0% owned and managed by wholly owned subsidiaries of American Healthcare Investors, LLC, or American Healthcare Investors, and 25.0% owned by a wholly owned subsidiary of Griffin Capital Company, LLC, or Griffin Capital, or collectively, our co-sponsors. American Healthcare Investors is 47.1% owned by AHI Group Holdings, LLC, or AHI Group Holdings, 45.1% indirectly owned by Colony Capital, Inc. (NYSE: CLNY), or Colony Capital, and 7.8% owned by James F. Flaherty III, a former partner of Colony Capital. We are not affiliated with Griffin Capital, Griffin Capital Securities, LLC, the dealer manager for our initial offering, or our dealer manager, Colony Capital or Mr. Flaherty; however, we are affiliated with our advisor, American Healthcare Investors and AHI Group Holdings. In October 2020, our board established a special committee of our board, which consists of all of our independent directors, to investigate and analyze strategic alternatives, including but not limited to, the sale of our assets, a listing of our shares on a national securities exchange, or a merger with another entity, including a merger with another unlisted entity that we expect would enhance our value. We currently operate through six reportable business segments: medical office buildings, hospitals, skilled nursing facilities, senior housing, senior housing — RIDEA and integrated senior health campuses. As of December 31, 2020, we owned and/or operated 97 properties, comprising 101 buildings, and 119 integrated senior health campuses including completed development projects, or approximately 14,110,000 square feet of gross leasable area, or GLA, for an aggregate contract purchase price of $3,076,041,000. In addition, as of December 31, 2020, we also owned a real estate-related investment purchased for $60,429,000.

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2020
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies The summary of significant accounting policies presented below is designed to assist in understanding our accompanying consolidated financial statements. Such consolidated financial statements and the accompanying notes thereto are the representations of our management, who are responsible for their integrity and objectivity. These accounting policies conform to accounting principles generally accepted in the United States of America, or GAAP, in all material respects, and have been consistently applied in preparing our accompanying consolidated financial statements. Basis of Presentation Our accompanying consolidated financial statements include our accounts and those of our operating partnership, the wholly owned subsidiaries of our operating partnership and all non-wholly owned subsidiaries in which we have control, as well as any VIEs, in which we are the primary beneficiary. We evaluate our ability to control an entity, and whether the entity is a VIE and we are the primary beneficiary, by considering substantive terms of the arrangement and identifying which enterprise has the power to direct the activities of the entity that most significantly impacts the entity’s economic performance. We operate and intend to continue to operate in an umbrella partnership REIT structure in which our operating partnership, or wholly owned subsidiaries of our operating partnership and all non-wholly owned subsidiaries of which we have control, will own substantially all of the interests in properties acquired on our behalf. We are the sole general partner of our operating partnership, and as of both December 31, 2020 and 2019, we owned greater than a 99.99% general partnership interest therein. Our advisor is a limited partner, and as of both December 31, 2020 and 2019, owned less than a 0.01% noncontrolling limited partnership interest in our operating partnership. Because we are the sole general partner of our operating partnership and have unilateral control over its management and major operating decisions (even if additional limited partners are admitted to our operating partnership), the accounts of our operating partnership are consolidated in our accompanying consolidated financial statements. All intercompany accounts and transactions are eliminated in consolidation. Use of Estimates The preparation of our accompanying consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, as well as the disclosure of contingent assets and liabilities, at the date of our consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Significant items subject to such estimates and assumptions include, but are not limited to, the initial and recurring valuation of certain assets acquired and liabilities assumed through property acquisitions, revenues and grant income, allowance for credit losses, impairment of long-lived and intangible assets and contingencies. These estimates are made and evaluated on an on-going basis using information that is currently available as well as various other assumptions believed to be reasonable under the circumstances. Actual results could differ from those estimates, perhaps in material adverse ways, and those estimates could be different under different assumptions or conditions. Cash, Cash Equivalents and Restricted Cash Cash and cash equivalents consist of all highly liquid investments with a maturity of three months or less when purchased. Restricted cash primarily comprises lender required accounts for property taxes, tenant improvements, capital improvements and insurance, which are restricted as to use or withdrawal. Leases On January 1, 2019, we adopted Financial Accounting Standards Board, or FASB, Accounting Standards Codification, or ASC, Topic 842, Leases , or ASC Topic 842. ASC Topic 842 supersedes ASC Topic 840, Leases , or ASC Topic 840. We adopted ASC Topic 842 using the modified retrospective approach whereby the cumulative effect of adoption was recognized on the adoption date and prior periods were not restated. There was no net cumulative effect adjustment to retained earnings as of January 1, 2019 as a result of this adoption. Therefore, with respect to our leases as both lessees and lessors, information is presented under ASC Topic 842 for the years ended December 31, 2020 and 2019 and under ASC Topic 840 for the year ended December 31, 2018. We determine if a contract is a lease upon inception of the lease. We maintain a distinction between finance and operating leases, which is substantially similar to the classification criteria for distinguishing between capital leases and operating leases in the previous lease guidance. Lessee : Pursuant to ASC Topic 842, lessees are required to recognize the following for all leases with terms greater than 12 months at the commencement date: (i) a lease liability, which is a lessee’s obligation to make lease payments arising from a lease; and (ii) a right-of-use asset, which is an asset that represents the lessee’s right to use, or control the use of, a specified asset for the lease term. The lease liability is calculated by using either the implicit rate of the lease or the incremental borrowing rate. As a result of the adoption of ASC Topic 842 on January 1, 2019, we recognized an initial amount of operating lease liabilities of $198,453,000 in our consolidated balance sheet for all of our operating leases for which we are the lessee, including facilities leases and ground leases. In addition, we recorded corresponding right-of-use assets of $211,679,000, which represent the lease liabilities, net of the existing prepaid rent asset and accrued straight-line rent liabilities and adjusted for unamortized above/below market ground lease intangibles. The accretion of lease liabilities and amortization expense on right-of-use assets for our operating leases are included in rental expenses and property operating expenses in our accompanying consolidated statements of operations and comprehensive income (loss). Operating lease liabilities are calculated using our incremental borrowing rate based on the information available as of the lease commencement date. The accounting for our existing capital (finance) leases upon adoption of ASC Topic 842 remains substantially unchanged. For our finance leases, the accretion of lease liabilities are included in interest expense and the amortization expense on right-of-use assets are included in depreciation and amortization in our accompanying consolidated statements of operations and comprehensive income (loss). Further, finance lease assets are included within real estate investments, net and finance lease liabilities are included within financing obligations in our accompanying consolidated balance sheets. Lessor : Pursuant to ASC Topic 842, lessors bifurcate lease revenues into lease components and non-lease components and separately recognize and disclose non-lease components that are executory in nature. Lease components continue to be recognized on a straight-line basis over the lease term and certain non-lease components may be accounted for under the revenue recognition guidance in ASC Topic 606, Revenue from Contracts with Customers, or ASC Topic 606. See the “Revenue Recognition” section below. ASC Topic 842 also provides for a practical expedient package that permits lessors to not separate non-lease components from the associated lease component if certain conditions are met. In addition, such practical expedient causes an entity to assess whether a contract is predominately lease or service based, and recognize the revenue from the entire contract under the relevant accounting guidance. Effective upon our adoption of ASC Topic 842 on January 1, 2019, we continued to recognize revenue for our medical office buildings, senior housing, skilled nursing facilities and hospitals segments as real estate revenue. Minimum annual rental revenue is recognized on a straight-line basis over the term of the related lease (including rent holidays). Differences between real estate revenue recognized and cash amounts contractually due from tenants under the lease agreements are recorded to deferred rent receivable, which is included in other assets, net in our accompanying consolidated balance sheets. Tenant reimbursement revenue, which comprises additional amounts recoverable from tenants for common area maintenance expenses and certain other recoverable expenses, are considered non-lease components and variable lease payments. We qualified for and elected the practical expedient as outlined above to combine the non-lease component with the lease component, which is the predominant component, and therefore the non-lease component is recognized as part of real estate revenue. In addition, as lessors, we exclude certain lessor costs (i.e., property taxes and insurance) paid directly by a lessee to third parties on our behalf from our measurement of variable lease revenue and associated expense (i.e., no gross up of revenue and expense for these costs); and include lessor costs that we paid and are reimbursed by the lessee in our measurement of variable lease revenue and associated expense (i.e., gross up revenue and expense for these costs). Therefore, we no longer record revenue or expense when the lessee pays the property taxes and insurance directly to a third party. Our senior housing — RIDEA facilities offer residents room and board (lease component), standard meals and healthcare services (non-lease component) and certain ancillary services that are not contemplated in the lease with each resident (i.e., laundry, guest meals, etc.). For our senior housing — RIDEA facilities, we recognize revenue under ASC Topic 606 as resident fees and services, based on our predominance assessment from electing the practical expedient outlined above. See the “Revenue Recognition” section below. See Note 17, Leases, for a further discussion. Revenue Recognition Real Estate Revenue Prior to January 1, 2019, minimum annual rental revenue was recognized on a straight-line basis over the term of the related lease (including rent holidays) in accordance with ASC Topic 840. Differences between real estate revenue recognized and cash amounts contractually due from tenants under the lease agreements were recorded to deferred rent receivable. Tenant reimbursement revenue was recognized as revenue in the period in which the related expenses were incurred. Tenant reimbursements were recognized and presented in accordance with ASC Subtopic 606-10-55-36, Revenue Recognition — Principal Versus Agent Consideration, or ASC Subtopic 606. ASC Subtopic 606 requires that these reimbursements be recorded on a gross basis as we are generally primarily responsible to fulfill the promise to provide specified goods and services. We recognized lease termination fees at such time when there was a signed termination letter agreement, all of the conditions of such agreement had been met and the tenant was no longer occupying the property. Effective January 1, 2019, we recognize real estate revenue in accordance with ASC Topic 842. See the “Leases” section above. Resident Fees and Services Revenue We recognize resident fees and services revenue in accordance with ASC Topic 606. A significant portion of resident fees and services revenue represents healthcare service revenue that is reported at the amount that we expect to be entitled to in exchange for providing patient care. These amounts are due from patients, third-party payors (including health insurers and government programs), other healthcare facilities, and others and includes variable consideration for retroactive revenue adjustments due to settlement of audits, reviews, and investigations. Generally, we bill the patients, third-party payors and other healthcare facilities several days after the services are performed. Revenue is recognized as performance obligations are satisfied. Performance obligations are determined based on the nature of the services provided by us. Revenue for performance obligations satisfied over time is recognized based on actual charges incurred in relation to total expected (or actual) charges. This method provides a depiction of the transfer of services over the term of the performance obligation based on the inputs needed to satisfy the obligation. Generally, performance obligations satisfied over time relate to patients receiving long-term healthcare services, including rehabilitation services. We measure the performance obligation from admission into the facility to the point when we are no longer required to provide services to that patient. Revenue for performance obligations satisfied at a point in time is recognized when goods or services are provided and we do not believe we are required to provide additional goods or services to the patient. Generally, performance obligations satisfied at a point in time relate to sales of our pharmaceuticals business or to sales of ancillary supplies. Because all of its performance obligations relate to contracts with a duration of less than one year, we have elected to apply the optional exemption provided in ASC Topic 606 and, therefore, are not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. The performance obligations for these contracts are generally completed within months of the end of the reporting period. We determine the transaction price based on standard charges for goods and services provided, reduced, where applicable, by contractual adjustments provided to third-party payors, implicit price concessions provided to uninsured patients, and estimates of goods to be returned. We also determine the estimates of contractual adjustments based on Medicare and Medicaid pricing tables and historical experience. We determine the estimate of implicit price concessions based on the historical collection experience with each class of payor. Agreements with third-party payors typically provide for payments at amounts less than established charges. A summary of the payment arrangements with major third-party payors follows: • Medicare: Certain healthcare services are paid at prospectively determined rates based on cost-reimbursement methodologies subject to certain limits. • Medicaid: Reimbursements for Medicaid services are generally paid at prospectively determined rates. In the state of Indiana, we participate in an Upper Payment Limit program, or IGT, with various county hospital partners, which provides supplemental Medicaid payments to skilled nursing facilities that are licensed to non-state, government-owned entities such as county hospital districts. We have operational responsibility through management agreements for facilities retained by the county hospital districts including this IGT. • Other: Payment agreements with certain commercial insurance carriers, health maintenance organizations and preferred provider organizations provide for payment using prospectively determined rates per discharge, discounts from established charges and prospectively determined periodic rates. Laws and regulations concerning government programs, including Medicare and Medicaid, are complex and subject to varying interpretation. As a result of investigations by governmental agencies, various healthcare organizations have received requests for information and notices regarding alleged noncompliance with those laws and regulations, which, in some instances, have resulted in organizations entering into significant settlement agreements. Compliance with such laws and regulations may also be subject to future government review and interpretation as well as significant regulatory action, including fines, penalties and potential exclusion from the related programs. There can be no assurance that regulatory authorities will not challenge our compliance with these laws and regulations, and it is not possible to determine the impact (if any) such claims or penalties would have upon us. Settlements with third-party payors for retroactive adjustments due to audits, reviews or investigations are considered variable consideration and are included in the determination of the estimated transaction price for providing patient care. These settlements are estimated based on the terms of the payment agreement with the payor, correspondence from the payor and our historical settlement activity, including an assessment to ensure that it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the retroactive adjustment is subsequently resolved. Estimated settlements are adjusted in future periods as adjustments become known (that is, new information becomes available), or as years are settled or are no longer subject to such audits, reviews and investigations. Adjustments arising from a change in the transaction price were not significant for the years ended December 31, 2020, 2019 and 2018. Disaggregation of Resident Fees and Services Revenue We disaggregate revenue from contracts with customers according to lines of business and payor classes. The transfer of goods and services may occur at a point in time or over time; in other words, revenue may be recognized over the course of the underlying contract, or may occur at a single point in time based upon a single transfer of control. This distinction is discussed in further detail below. We determine that disaggregating revenue into these categories achieves the disclosure objective to depict how the nature, amount, timing and uncertainty of revenue and cash flows are affected by economic factors. The following table disaggregates our resident fees and services revenue by line of business, according to whether such revenue is recognized at a point in time or over time, for the years then ended: Integrated Senior Total 2020: Point in time $ 196,053,000 $ 2,861,000 $ 198,914,000 Over time 787,116,000 83,043,000 870,159,000 Total resident fees and services $ 983,169,000 $ 85,904,000 $ 1,069,073,000 2019: Point in time $ 214,650,000 $ 2,944,000 $ 217,594,000 Over time 816,284,000 65,200,000 881,484,000 Total resident fees and services $ 1,030,934,000 $ 68,144,000 $ 1,099,078,000 2018: Point in time $ 185,273,000 $ 3,079,000 $ 188,352,000 Over time 755,343,000 61,996,000 817,339,000 Total resident fees and services $ 940,616,000 $ 65,075,000 $ 1,005,691,000 The following table disaggregates our resident fees and services revenue by payor class for the years then ended: Integrated Senior Total 2020: Private and other payors $ 437,133,000 $ 84,308,000 $ 521,441,000 Medicare 356,350,000 — 356,350,000 Medicaid 189,686,000 1,596,000 191,282,000 Total resident fees and services $ 983,169,000 $ 85,904,000 $ 1,069,073,000 2019: Private and other payors $ 499,693,000 $ 67,930,000 $ 567,623,000 Medicare 338,466,000 — 338,466,000 Medicaid 192,775,000 214,000 192,989,000 Total resident fees and services $ 1,030,934,000 $ 68,144,000 $ 1,099,078,000 2018: Private and other payors $ 437,100,000 $ 65,032,000 $ 502,132,000 Medicare 332,852,000 — 332,852,000 Medicaid 170,664,000 43,000 170,707,000 Total resident fees and services $ 940,616,000 $ 65,075,000 $ 1,005,691,000 ___________ (1) Includes fees for basic housing and assisted living care. We record revenue when services are rendered at amounts billable to individual residents. Residency agreements are generally for a term of 30 days, with resident fees billed monthly in advance. For patients under reimbursement arrangements with Medicaid, revenue is recorded based on contractually agreed-upon amounts or rates on a per resident, daily basis or as services are rendered. Accounts Receivable, Net — Resident Fees and Services Revenue The beginning and ending balances of accounts receivable, net — resident fees and services are as follows: Private Medicare Medicaid Total Beginning balance — January 1, 2020 $ 46,543,000 $ 32,127,000 $ 26,366,000 $ 105,036,000 Ending balance — December 31, 2020 36,125,000 36,479,000 14,473,000 87,077,000 (Decrease)/increase $ (10,418,000) $ 4,352,000 $ (11,893,000) $ (17,959,000) Deferred Revenue — Resident Fees and Services Revenue The beginning and ending balances of deferred revenue — resident fees and services, almost all of which relates to private and other payors, are as follows: Total Beginning balance — January 1, 2020 $ 13,518,000 Ending balance — December 31, 2020 10,597,000 Decrease $ (2,921,000) In addition to the deferred revenue above, we received approximately $52,322,000 of Medicare advance payments through an expanded program of the Centers for Medicare & Medicaid Services, or CMS. Such amounts will be recognized once our recoupment period commences in 2021. See Note 11, Commitments and Contingencies — Impact of the COVID-19 Pandemic, for a further discussion. Financing Component We have elected a practical expedient allowed under ASC Topic 606 and, therefore, we do not adjust the promised amount of consideration from patients and third-party payors for the effects of a significant financing component due to our expectation that the period between the time the service is provided to a patient and the time that the patient or a third-party payor pays for that service will be one year or less. Contract Costs We have applied the practical expedient provided by FASB ASC Topic 340, Other Assets and Deferred Costs , and, therefore, all incremental customer contract acquisition costs are expensed as they are incurred since the amortization period of the asset that we otherwise would have recognized is one year or less in duration. Government Grants We have been granted stimulus funds through various federal and state government programs, such as through the Coronavirus Aid, Relief, and Economic Security Act, or the CARES Act, passed by the federal government on March 27, 2020, which were established for eligible healthcare providers to preserve liquidity in response to lost revenues and/or increased healthcare expenses (as such terms are defined in the applicable regulatory guidance) associated with the COVID-19 pandemic. Such grants are not loans and, as such, are not required to be repaid, subject to certain conditions. We recognize government grants as grant income or as a reduction of property operating expenses, as applicable, in our accompanying consolidated statements of operations and comprehensive income (loss) when there is reasonable assurance that the grants will be received and all conditions to retain the funds will be met. We adjust our estimates and assumptions based on the applicable guidance provided by the government and the best available information that we have. Any stimulus or other relief funds received that are not expected to be used in accordance with such terms and conditions will be returned to the government, and any related deferred income will not be recognized. For the year ended December 31, 2020, we recognized government grants of $55,181,000 as grant income and $519,000 as a reduction of property operating expenses. As of December 31, 2020, we deferred approximately $2,635,000 of grant income until such time as it is earned. Such deferred amounts are included in security deposits, prepaid rent and other liabilities in our accompanying consolidated balance sheet. As of and for the years ended December 31, 2019 and 2018, we did not recognize any government grants. Tenant and Resident Receivables and Allowances On January 1, 2020, we adopted ASC Topic 326, Financial Instruments Credit Losses , or ASC Topic 326. We adopted ASC Topic 326 using the modified retrospective approach whereby the cumulative effect of adoption was recognized on the adoption date and prior periods were not restated. There was no net cumulative effect adjustment to retained earnings as of January 1, 2020. Resident receivables are carried net of an allowance for credit losses. An allowance is maintained for estimated losses resulting from the inability of residents and payors to meet the contractual obligations under their lease or service agreements. Substantially all of such allowances are recorded as direct reductions of resident fees and services revenue as contractual adjustments provided to third-party payors or implicit price concessions in our accompanying consolidated statements of operations and comprehensive income (loss). Our determination of the adequacy of these allowances is based primarily upon evaluations of historical loss experience, the residents’ financial condition, security deposits, cash collection patterns by payor and by state, current economic conditions, future expectations in estimating credit losses and other relevant factors. Prior to our adoption of ASC Topic 326 on January 1, 2020, resident receivables were carried net of an allowance for uncollectible amounts. Tenant receivables and unbilled deferred rent receivables are reduced for uncollectible amounts, which are recognized as direct reductions of real estate revenue in our accompanying consolidated statements of operations and comprehensive income (loss). Prior to our adoption of ASC Topic 842 on January 1, 2019, tenant receivables and unbilled deferred rent receivables were reduced for uncollectible amounts. Such amounts were charged to bad debt expense, which was included in general and administrative in our accompanying consolidated statements of operations and comprehensive income (loss). As of December 31, 2020 and 2019, we had $9,466,000 and $11,435,000, respectively, in allowances, which were determined necessary to reduce receivables by our expected future credit losses. For the years ended December 31, 2020, 2019 and 2018, we increased allowances by $12,494,000, $13,087,000 and $8,520,000, respectively, and reduced allowances for collections or adjustments by $7,697,000, $6,094,000 and $1,437,000, respectively. For the years ended December 31, 2020, 2019 and 2018, $6,766,000, $6,774,000 and $6,405,000, respectively, of our receivables were written off against the related allowances. Property Acquisitions We determine whether a transaction is a business combination, which requires that the assets acquired and liabilities assumed constitute a business. If the assets acquired and liabilities assumed are not a business, we account for the transaction as an asset acquisition. Under both methods, we recognize the identifiable assets acquired and liabilities assumed; however, for a transaction accounted for as an asset acquisition, we allocate the purchase price to the identifiable assets acquired and liabilities assumed based on their relative fair values. We immediately expense acquisition related expenses associated with a business combination and capitalize acquisition related expenses directly associated with an asset acquisition. We, with assistance from independent valuation specialists, measure the fair value of tangible and identified intangible assets and liabilities, as applicable, based on their respective fair values for acquired properties. Our method for allocating the purchase price to acquired investments in real estate requires us to make subjective assessments for determining fair value of the assets acquired and liabilities assumed. This includes determining the value of the buildings, land, leasehold interests, furniture, fixtures and equipment, above- or below-market rent, in-place leases, master leases, above- or below-market debt assumed and derivative financial instruments assumed. These estimates require significant judgment and in some cases involve complex calculations. These allocation assessments directly impact our results of operations, as amounts allocated to certain assets and liabilities have different depreciation or amortization lives. In addition, we amortize the value assigned to above- or below-market rent as a component of revenue, unlike in-place leases and other intangibles, which we include in depreciation and amortization in our accompanying consolidated statements of operations and comprehensive income (loss). The determination of the fair value of land is based upon comparable sales data. In cases where a leasehold interest in the land is acquired, only the above/below market consideration is necessary where the value of the leasehold interest is determined by discounting the difference between the contract ground lease payments and a market ground lease payment back to a present value as of the acquisition date. The fair value of buildings is based upon our determination of the value under two methods: one, as if it were to be replaced and vacant using cost data and, two, also using a residual technique based on discounted cash flow models, as vacant. Factors considered by us include an estimate of carrying costs during the expected lease-up periods considering current market conditions and costs to execute similar leases. We also recognize the fair value of furniture, fixtures and equipment on the premises, as well as the above- or below-market rent, the value of in-place leases, master leases, above- or below-market debt and derivative financial instruments assumed. The value of the above- or below-market component of the acquired in-place leases is determined based upon the present value (using a discount rate that reflects the risks associated with the acquired leases) of the difference between: (i) the level payment equivalent of the contract rent paid pursuant to the lease; and (ii) our estimate of market rent payments taking into account rent steps throughout the lease. In the case of leases with options, a case-by-case analysis is performed based on all facts and circumstances of the specific lease to determine whether the option will be assumed to be exercised. The amounts related to above-market leases are included in identified intangible assets, net in our accompanying consolidated balance sheets and are amortized against real estate revenue over the remaining non-cancelable lease term of the acquired leases with each property. The amounts related to below-market leases are included in identified intangible liabilities, net in our accompanying consolidated balance sheets and are amortized to real estate revenue over the remaining non-cancelable lease term plus any below-market renewal options of the acquired leases with each property. The value of in-place lease costs are based on management’s evaluation of the specific characteristics of the tenant’s lease and our overall relationship with the tenants. Characteristics considered by us in allocating these values include the nature and extent of the credit quality and expectations of lease renewals, among other factors. The in-place lease intangible represents the value related to the economic benefit for acquiring a property with in-place leases as opposed to a vacant property, which is evaluated based on a review of comparable leases for a similar property, terms and conditions for marketing and executing new leases, and implied in the difference between the value of the whole property “as is” and “as vacant.” The net amounts related to in-place lease costs are included in identified intangible assets, net in our accompanying consolidated balance sheets and are amortized to depreciation and amortization expense over the average downtime of the acquired leases with each property. The net amounts related to the value of tenant relationships, if any, are included in identified intangible assets, net in our accompanying consolidated balance sheets and are amortized to depreciation and amortization expense over the average remaining non-cancelable lease term of the acquired leases plus the market renewal lease term. The value of a master lease, if any, in which a previous owner or a tenant is relieved of specific rental obligations as additional space is leased, is determined by discounting the expected real estate revenue associated with the master lease space over the assumed lease-up period. The value of above- or below-market debt is determined based upon the present value of the difference between the cash flow stream of the assumed mortgage and the cash flow stream of a market rate mortgage at the time of assumption. The net value of above- or below-market debt is included in mortgage loans payable, net in our accompanying consolidated balance sheets and is amortized to interest expense over the remaining term of the

Real Estate Investments, Net

Real Estate Investments, Net	12 Months Ended
	Dec. 31, 2020
Real Estate [Abstract]
Real Estate Investments, Net	3. Real Estate Investments, Net Our real estate investments, net consisted of the following as of December 31, 2020 and 2019: December 31, 2020 2019 Building, improvements and construction in process $ 2,379,337,000 $ 2,262,320,000 Land and improvements 200,319,000 195,491,000 Furniture, fixtures and equipment 174,994,000 150,508,000 2,754,650,000 2,608,319,000 Less: accumulated depreciation (424,650,000) (337,898,000) $ 2,330,000,000 $ 2,270,421,000 Depreciation expense for the years ended December 31, 2020, 2019 and 2018 was $90,997,000, $90,914,000 and $83,309,000, respectively. In addition to the acquisitions discussed below, for the years ended December 31, 2020, 2019 and 2018, we incurred capital expenditures of $111,286,000, $93,485,000 and $76,330,000, respectively, for our integrated senior health campuses, $17,854,000, $16,571,000 and $8,426,000, respectively, for our medical office buildings, $1,232,000, $2,015,000 and $1,711,000, respectively, for our senior housing — RIDEA facilities, $0, $1,954,000 and $463,000, respectively, for our skilled nursing facilities and $47,000, $53,000 and $131,000, respectively, for our hospitals. We did not incur any capital expenditures for our senior housing facilities for the years ended December 31, 2020, 2019 and 2018. Included in the capital expenditure amounts above are costs for the development and expansion of our integrated senior health campuses. For the year ended December 31, 2020, we completed the development of six integrated senior health campuses for $64,782,000 and incurred $2,573,000 to expand two of our existing integrated senior health campuses. For the year ended December 31, 2019, we completed the development of two integrated senior health campuses for $25,087,000. For the year ended December 31, 2018, we incurred $8,309,000 to expand three of our existing integrated senior health campuses. For the year ended December 31, 2020, we determined that one skilled nursing facility and one medical office building were impaired and recognized an aggregate impairment charge of $8,350,000, which reduced the total aggregate carrying value of such assets to $4,256,000. The fair values of such properties were determined by the sales price from executed purchase and sales agreements with third-party buyers, and adjusted for anticipated selling costs, which were considered Level 2 measurements within the fair value hierarchy. We disposed of such impaired medical office building in July 2020 for a contract sales price of $3,500,000 and recognized a net gain on sale of $15,000. As of December 31, 2020, the carrying value of such skilled nursing facility is classified in properties held for sale, which is included in other assets, net in our accompanying consolidated balance sheets. No impairment charges were recognized for the year ended December 31, 2019. For the year ended December 31, 2018, we determined that one of our medical office buildings was impaired and recognized an impairment charge of $2,542,000, which reduced the total carrying value of such investment to $7,387,000. The fair value of such medical office building was based upon a discounted cash flow analysis where the most significant inputs were considered Level 3 measurements within the fair value hierarchy. See Note 15, Fair Value Measurements — Assets and Liabilities Reported at Fair Value — Real Estate Investment, for a further discussion. For the years ended December 31, 2019 and 2018, we did not dispose of any long-lived assets. Acquisitions of Real Estate Investments 2020 Acquisitions of Previously Leased Real Estate Investments For the year ended December 31, 2020, we, through a majority-owned subsidiary of Trilogy Investors, LLC, or Trilogy, of which we owned 67.6% at the time of property acquisition, acquired two previously leased real estate investments located in Indiana and Kentucky. The following is a summary of such property acquisitions, which are included in our integrated senior health campuses segment: Location Date Contract Line of Credit(1) Acquisition Monticello, IN 07/30/20 $ 10,600,000 $ 13,200,000 $ 161,000 Louisville, KY 07/30/20 16,719,000 15,055,000 254,000 Total $ 27,319,000 $ 28,255,000 $ 415,000 ___________ (1) Represents borrowings under the 2019 Trilogy Credit Facility, as defined in Note 8, Lines of Credit and Term Loans, at the time of acquisition. (2) Our advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our properties, an acquisition fee of 2.25% of the portion of the contract purchase price of the properties attributed to our ownership interest in the Trilogy subsidiary that acquired the properties. In addition to the property acquisitions discussed above, for the year ended December 31, 2020, we, through a majority-owned subsidiary of Trilogy, acquired land in Ohio for an aggregate contract purchase price of $2,833,000 plus closing costs and paid to our advisor an acquisition fee of 2.25% of the portion of the contract purchase price of each land parcel attributed to our ownership interest. For the year ended December 31, 2020, we accounted for our property acquisitions as asset acquisitions. We incurred and capitalized closing costs and direct acquisition related expenses of $709,000 for such acquisitions. The following table summarizes the purchase price of the assets acquired at the time of acquisition, adjusted for $14,281,000 of operating lease right-of-use assets and $15,530,000 of operating lease liabilities, and based on their relative fair values: 2020 Building and improvements $ 26,311,000 Land 4,563,000 Total assets acquired $ 30,874,000 2019 Acquisitions of Real Estate Investments For the year ended December 31, 2019, using cash on hand and debt financing, we completed the acquisition of two buildings from unaffiliated third parties. The following is a summary of such property acquisitions: Acquisition Location Type Date Contract Line of Credit Acquisition North Carolina ALF Portfolio(1) Garner, NC Senior Housing 03/27/19 $ 15,000,000 $ 15,000,000 $ 338,000 The Cloister at Silvercrest(2) New Albany, IN Integrated Senior Health Campus 10/01/19 750,000 — 11,000 Total $ 15,750,000 $ 15,000,000 $ 349,000 ___________ (1) We own 100% of such property acquired, which we added to our existing North Carolina ALF Portfolio. The other six buildings in North Carolina ALF Portfolio were acquired between January 2015 and August 2018. We borrowed under the 2019 Corporate Line of Credit, as defined in Note 8, Lines of Credit and Term Loans, at the time of acquisition. Our advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our property, an acquisition fee of 2.25% of the contract purchase price of such property. (2) We, through a majority-owned subsidiary of Trilogy, of which we owned 67.7% at the time of such property acquisition, acquired such property using cash on hand. Our advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our property, an acquisition fee of 2.25% of the portion of the contract purchase price of the property attributed to our ownership interest in the Trilogy subsidiary that acquired the property. In addition to the property acquisitions discussed above, for the year ended December 31, 2019, we, through a majority-owned subsidiary of Trilogy, acquired land in Michigan and Ohio for an aggregate contract purchase price of $4,806,000 plus closing costs and paid to our advisor an acquisition fee of 2.25% of the portion of the contract purchase price of each land parcel attributed to our ownership interest at the time of acquisition. 2019 Acquisition of Previously Leased Real Estate Investment For the year ended December 31, 2019, we, through a majority-owned subsidiary of Trilogy, of which we owned 67.6% at the time of property acquisition, acquired one previously leased real estate investment located in Indiana. The following is a summary of such property acquisition, which is included in our integrated senior health campuses segment: Location Date Contract Line of Credit(1) Acquisition Corydon, IN 09/05/19 $ 14,082,000 $ 14,114,000 $ 215,000 ___________ (1) Represents a borrowing under the 2019 Trilogy Credit Facility, at the time of acquisition. (2) Our advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our property, an acquisition fee of 2.25% of the portion of the contract purchase price of the property attributed to our ownership interest at the time of acquisition in the Trilogy subsidiary that acquired the property. For the year ended December 31, 2019, we accounted for our property acquisitions, including our acquisition of previously leased real estate investments, as asset acquisitions. We incurred and capitalized closing costs and direct acquisition related expenses of $836,000 for such property acquisitions. The following table summarizes the purchase price of the assets acquired at the time of acquisition, adjusted for $13,052,000 of operating lease right-of-use assets and $12,599,000 of operating lease liabilities, based on their relative fair values: 2019 Building and improvements $ 23,834,000 Land 8,496,000 In-place leases 3,596,000 Total assets acquired $ 35,926,000 2018 Acquisitions of Real Estate Investments For the year ended December 31, 2018, using cash on hand and debt financing, we completed the acquisition of one building from an unaffiliated third party, which was added to our existing North Carolina ALF Portfolio. The other five buildings in North Carolina ALF Portfolio were acquired in January 2015, June 2015 and January 2017. On December 1, 2019, we transitioned the operations of North Carolina ALF Portfolio to a RIDEA structure. The following is a summary of our property acquisition for the year ended December 31, 2018: Acquisition(1) Location Type Date Contract Line of Credit(2) Acquisition North Carolina ALF Portfolio Matthews, NC Senior Housing — RIDEA 08/30/18 $ 15,000,000 $ 13,500,000 $ 338,000 ___________ (1) We own 100% of our property acquired in 2018. (2) Represents a borrowing under the 2016 Corporate Line of Credit, as defined in Note 8, Lines of Credit and Term Loans, at the time of acquisition. (3) Our advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our property, an acquisition fee of 2.25% of the contract purchase price of such property. In addition to the property acquisition discussed above, for the year ended December 31, 2018, we purchased land as part of our existing Southern Illinois MOB Portfolio for a contract purchase price of $300,000, plus closing costs and paid to our advisor an acquisition fee of 2.25% of such contract purchase price. We, through a majority-owned subsidiary of Trilogy, also acquired land in Ohio and Michigan for an aggregate contract purchase price of $3,146,000 plus closing costs and paid to our advisor an acquisition fee of 2.25% of the portion of the contract purchase price of each land parcel attributed to our ownership interest at the time of acquisition. 2018 Acquisition of Previously Leased Real Estate Investments For the year ended December 31, 2018, we, through a majority-owned subsidiary of Trilogy, of which we owned 67.7% at the time of property acquisition, acquired a portfolio of four previously leased real estate investments located in Kentucky, Michigan and Ohio. The following is a summary of such acquisition, which is included in our integrated senior health campuses segment: Locations Date Contract Mortgage Loan Acquisition Lexington, KY; Novi and Romeo, MI; and Fremont, OH 07/20/18 $ 47,455,000 $ 47,500,000 $ 723,000 ___________ (1) Represents the principal balance of the mortgage loan payable placed on the properties at the time of acquisition. (2) Our advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our properties, an acquisition fee of 2.25% of the portion of the contract purchase price of the properties attributed to our ownership interest at the time of acquisition in the Trilogy subsidiary that acquired the properties. For the year ended December 31, 2018, we accounted for our property acquisitions, including our acquisition of previously leased real estate investments, as asset acquisitions. We incurred and capitalized closing costs and direct acquisition related expenses of $3,044,000 for such property acquisitions. The following table summarizes the purchase price of the assets acquired at the time of acquisition based on their relative fair values: 2018 Building and improvements $ 49,757,000 Land 10,980,000 In-place leases 6,894,000 Certificates of need 1,313,000 Total assets acquired $ 68,944,000

Debt Security Investment, Net

Debt Security Investment, Net	12 Months Ended
	Dec. 31, 2020
Debt Security Investment [Abstract]
Debt Security Investment, Net	4. Debt Security Investment, Net On October 15, 2015, we acquired a commercial mortgage-backed debt security, or debt security, from an unaffiliated third party. The debt security bears an interest rate on the stated principal amount thereof equal to 4.24% per annum, the terms of which security provide for monthly interest-only payments. The debt security matures on August 25, 2025 at a stated amount of $93,433,000, resulting in an anticipated yield-to-maturity of 10.0% per annum. The debt security was issued by an unaffiliated mortgage trust and represents a 10.0% beneficial ownership interest in such mortgage trust. The debt security is subordinate to all other interests in the mortgage trust and is not guaranteed by a government-sponsored entity. As of December 31, 2020 and 2019, the carrying amount of the debt security investment was $75,851,000 and $72,717,000, respectively, net of unamortized closing costs of $1,205,000 and $1,375,000, respectively. Accretion on the debt security for the years ended December 31, 2020, 2019 and 2018 was $3,304,000, $2,987,000 and $2,717,000, respectively, which is recorded to real estate revenue in our accompanying consolidated statements of operations and comprehensive income (loss). Amortization expense of closing costs for the years ended December 31, 2020, 2019 and 2018 was $170,000, $143,000 and $119,000, respectively, which is recorded against real estate revenue in our accompanying consolidated statements of operations and comprehensive income (loss). In accordance with ASC Topic 326, we evaluated credit quality indicators such as

Identified Intangible Assets, N

Identified Intangible Assets, Net	12 Months Ended
	Dec. 31, 2020
Finite-Lived Intangible Assets, Net [Abstract]
Identified Intangible Assets, Net	5. Identified Intangible Assets, Net Identified intangible assets, net consisted of the following as of December 31, 2020 and 2019: December 31, 2020 2019 Amortized intangible assets: In-place leases, net of accumulated amortization of $22,019,000 and $21,029,000 as of December 31, 2020 and 2019, respectively (with a weighted average remaining life of 9.4 years as of both December 31, 2020 and 2019) $ 23,760,000 $ 30,407,000 Customer relationships, net of accumulated amortization of $486,000 and $336,000 as of December 31, 2020 and 2019, respectively (with a weighted average remaining life of 15.7 years and 16.8 years as of December 31, 2020 and 2019, respectively) 2,354,000 2,504,000 Above-market leases, net of accumulated amortization of $1,975,000 and $2,057,000 as of December 31, 2020 and 2019, respectively (with a weighted average remaining life of 4.6 years and 5.0 years as of December 31, 2020 and 2019, respectively) 1,032,000 1,452,000 Internally developed technology and software, net of accumulated amortization of $305,000 and $211,000 as of December 31, 2020 and 2019, respectively (with a weighted average remaining life of 1.7 years and 2.8 years as of December 31, 2020 and 2019, respectively) 165,000 259,000 Unamortized intangible assets: Certificates of need 96,589,000 94,838,000 Trade names 30,787,000 30,787,000 $ 154,687,000 $ 160,247,000 Amortization expense for the years ended December 31, 2020, 2019 and 2018 was $6,678,000, $19,973,000 and $12,736,000, respectively, which included $420,000, $607,000 and $967,000, respectively, of amortization recorded against real estate revenue for above-market leases in our accompanying consolidated statements of operations and comprehensive income (loss). The aggregate weighted average remaining life of the identified intangible assets was 9.7 years as of both December 31, 2020 and 2019. As of December 31, 2020, estimated amortization expense on the identified intangible assets for each of the next five years ending December 31 and thereafter was as follows: Year Amount 2021 $ 4,639,000 2022 3,909,000 2023 3,140,000 2024 2,723,000 2025 2,210,000 Thereafter 10,690,000 $ 27,311,000

Other Assets, Net

Other Assets, Net	12 Months Ended
	Dec. 31, 2020
Other Assets [Abstract]
Other Assets, Net	6. Other Assets, Net Other assets, net consisted of the following as of December 31, 2020 and 2019: December 31, 2020 2019 Deferred rent receivables $ 38,918,000 $ 33,205,000 Prepaid expenses, deposits, other assets and deferred tax assets, net 16,618,000 40,354,000 Inventory 24,669,000 23,872,000 Investments in unconsolidated entities 16,469,000 20,176,000 Lease commissions, net of accumulated amortization of $3,413,000 and $2,201,000 as of December 31, 2020 and 2019, respectively 11,309,000 10,794,000 Deferred financing costs, net of accumulated amortization of $5,700,000 and $2,138,000 as of December 31, 2020 and 2019, respectively(1) 6,864,000 8,137,000 Lease inducement, net of accumulated amortization of $1,491,000 and $1,140,000 as of December 31, 2020 and 2019, respectively (with a weighted average remaining life of 9.9 years and 10.9 years as of December 31, 2020 and 2019, respectively) 3,509,000 3,860,000 $ 118,356,000 $ 140,398,000 ___________ (1) Deferred financing costs only include costs related to our lines of credit and term loans. See Note 8, Lines of Credit and Term Loans. Amortization expense on deferred financing costs of our lines of credit and term loans for the years ended December 31, 2020, 2019 and 2018 was $3,559,000, $3,664,000 and $4,637,000, respectively, and is recorded to interest expense in our accompanying consolidated statements of operations and comprehensive income (loss). Amortization expense on lease inducement for the years ended December 31, 2020, 2019 and 2018 was $351,000, $351,000 and $350,000, respectively, and is recorded against real estate revenue in our accompanying consolidated statements of operations and comprehensive income (loss).

Mortgage Loans Payable, Net

Mortgage Loans Payable, Net	12 Months Ended
	Dec. 31, 2020
Mortgage Loans Payable, Net [Abstract]
Mortgage Loans Payable, Net	7. Mortgage Loans Payable, Net As of December 31, 2020 and 2019, mortgage loans payable were $834,026,000 ($810,478,000, net of discount/premium and deferred financing costs) and $816,217,000 ($792,870,000, net of discount/premium and deferred financing costs), respectively. As of December 31, 2020, we had 62 fixed-rate mortgage loans payable and 10 variable-rate mortgage loans payable with effective interest rates ranging from 2.21% to 5.23% per annum based on interest rates in effect as of December 31, 2020 and a weighted average effective interest rate of 3.58%. As of December 31, 2019, we had 58 fixed-rate mortgage loans payable and seven variable-rate mortgage loans payable with effective interest rates ranging from 2.45% to 6.21% per annum based on interest rates in effect as of December 31, 2019 and a weighted average effective interest rate of 3.85%. We are required by the terms of certain loan documents to meet certain reporting requirements and covenants, such as net worth ratios, fixed charge coverage ratios and leverage ratios. Mortgage loans payable, net consisted of the following as of December 31, 2020 and 2019: December 31, 2020 2019 Total fixed-rate debt $ 742,686,000 $ 714,786,000 Total variable-rate debt 91,340,000 101,431,000 Total fixed- and variable-rate debt 834,026,000 816,217,000 Less: deferred financing costs, net (10,389,000) (9,362,000) Add: premium 204,000 304,000 Less: discount (13,363,000) (14,289,000) Mortgage loans payable, net $ 810,478,000 $ 792,870,000 The following table reflects the changes in the carrying amount of mortgage loans payable, net for the years ended December 31, 2020 and 2019: Years Ended December 31, 2020 2019 Beginning balance $ 792,870,000 $ 688,262,000 Additions: Borrowings under mortgage loans payable 92,399,000 191,246,000 Amortization of deferred financing costs 796,000 1,544,000 Amortization of discount/premium on mortgage loans payable 826,000 647,000 Deductions: Scheduled principal payments on mortgage loans payable (71,990,000) (74,037,000) Early payoff of mortgage loans payable (2,601,000) (14,022,000) Deferred financing costs (1,822,000) (770,000) Ending balance $ 810,478,000 $ 792,870,000 For the year ended December 31, 2020, we did not incur a gain or loss on the extinguishment of mortgage loans payable in 2020. For the year ended December 31, 2019, we incurred an aggregate loss on the extinguishment of mortgage loans payable of $2,182,000, which is recorded to interest expense in our accompanying consolidated statements of operations and comprehensive income (loss). Such losses were primarily related to the write-off of unamortized debt discounts and prepayment penalties on two mortgage loans payable that were due to mature in November 2047 and April 2049. The source of funds for the payoffs was the 2019 Trilogy Credit Facility. As of December 31, 2020, the principal payments due on our mortgage loans payable for each of the next five years ending December 31 and thereafter were as follows: Year Amount 2021 $ 54,169,000 2022 62,985,000 2023 67,651,000 2024 80,451,000 2025 15,324,000 Thereafter 553,446,000 $ 834,026,000

Lines of Credit and Term Loans

Lines of Credit and Term Loans	12 Months Ended
	Dec. 31, 2020
Line of Credit Facility [Abstract]
Lines Of Credit and Term Loans	8. Lines of Credit and Term Loans 2016 Corporate Line of Credit On February 3, 2016, we, through certain of our subsidiaries, entered into a credit agreement, or the 2016 Corporate Credit Agreement, with Bank of America, N.A., or Bank of America, as administrative agent, a swing line lender and a letter of credit issuer; KeyBank, National Association, or KeyBank, as syndication agent, a swing line lender and a letter of credit issuer; and a syndicate of other banks, as lenders, to obtain a revolving line of credit with an aggregate maximum principal amount of $300,000,000, or the 2016 Corporate Revolving Credit Facility, and a term loan credit facility in the amount of $200,000,000, or the 2016 Corporate Term Loan Facility, and together with the 2016 Corporate Revolving Credit Facility, the 2016 Corporate Line of Credit. On February 3, 2016, we also entered into separate revolving notes, or the 2016 Corporate Revolving Notes, and separate term notes with each of Bank of America, KeyBank and a syndicate of other banks. The 2016 Corporate Line of Credit would have matured on February 3, 2019. On each of August 3, 2017 and December 20, 2018, we amended the 2016 Corporate Credit Agreement. The material terms of such amendments designated the Bank of the West as an additional lender and increased both the 2016 Corporate Revolving Credit Facility and the 2016 Corporate Term Loan Facility, which resulted in an aggregate borrowing capacity under the 2016 Corporate Line of Credit of $575,000,000. On January 25, 2019, we terminated the 2016 Corporate Credit Agreement, as amended, and the 2016 Corporate Revolving Notes and entered into the 2019 Corporate Line of Credit as described below. We currently do not have any obligations under the 2016 Corporate Credit Agreement, as amended, or the 2016 Corporate Revolving Notes. 2019 Corporate Line of Credit On January 25, 2019, we, through our operating partnership and certain of our subsidiaries, entered into a credit agreement, or the 2019 Corporate Credit Agreement, with Bank of America, as administrative agent, a swing line lender and a letter of credit issuer; KeyBank, as syndication agent, a swing line lender and a letter of credit issuer; Citizens Bank, National Association, or Citizens Bank, as a syndication agent, a swing line lender, a letter of credit issuer, a joint lead arranger and joint bookrunner; and a syndicate of other banks, as lenders, to obtain a credit facility with an aggregate maximum principal amount of $630,000,000, or the 2019 Corporate Line of Credit. The 2019 Corporate Line of Credit consists of a senior unsecured revolving credit facility in an aggregate amount of $150,000,000 and a senior unsecured term loan facility in an aggregate amount of $480,000,000. We may obtain up to $25,000,000 in the form of standby letters of credit and up to $25,000,000 in the form of swing line loans pursuant to the 2019 Corporate Line of Credit. On July 28, 2020, we entered into a First Amendment to the 2019 Corporate Credit Agreement, or the Credit Agreement Amendment, with Bank of America; KeyBank; Citizens Bank; and a syndicate of other banks, as lenders. The material terms of the Credit Agreement Amendment provide for, including among other things, the following, with capitalized terms having the meaning as defined in the 2019 Corporate Credit Agreement, unless otherwise defined herein: (i) revisions to financial covenant calculations to exclude the assets, liabilities and operating performance of our indirect, majority-owned subsidiary Trilogy REIT Holdings, LLC, or Trilogy REIT Holdings, or any subsidiary thereof; (ii) the inclusion of a covenant modification period beginning on June 30, 2020 continuing through the earlier of (a) June 30, 2021, or (b) the date we deliver written notice to end the covenant modification period, subject to certain conditions, or the First Amendment Period; (iii) an increased Consolidated Leverage Ratio equal to or less than 65.0% during the First Amendment Period; (iv) changes to the applicable interest rate based on revisions to the Consolidated Leverage Ratio pricing grid; (v) an increased Consolidated Unencumbered Leverage Ratio equal to or less than 65.0% during the First Amendment Period; (vi) revisions to the Consolidated Tangible Net Worth and EBITDAR coverage requirements; (vii) the inclusion of a LIBOR floor, provided that the Term Loan Hedged Portion of the Term Loans shall not be subject to such floor; (viii) our operating partnership to pledge the equity interests in each direct and indirect subsidiary that owns an unencumbered asset; (ix) the removal of swing line loans; (x) updates regarding restrictions and limitations on certain investments during the remainder of the term of the 2019 Corporate Line of Credit; (xi) clarifications regarding events triggering a Fundamental Change; (xii) a restriction on the payment of distributions and share repurchases during the First Amendment Period; and (xiii) a lender fee. Notwithstanding the foregoing, the Credit Agreement Amendment provides that we can opt out of these modifications based on our written irrevocable election to end the First Amendment Period. Except as modified by the Credit Agreement Amendment, the material terms of the 2019 Corporate Credit Agreement, as amended, remain in full force and effect. The maximum principal amount of the 2019 Corporate Line of Credit may be increased by up to $370,000,000, for a total principal amount of $1,000,000,000, subject to: (i) the terms of the 2019 Corporate Credit Agreement, as amended; and (ii) at least five At our option, the 2019 Corporate Line of Credit bears interest at per annum rates equal to (a) (i) the Eurodollar Rate, as defined in the 2019 Corporate Credit Agreement, as amended, plus (ii) a margin ranging from 1.85% to 2.80% based on our Consolidated Leverage Ratio, as defined in the 2019 Corporate Credit Agreement, as amended, or (b) (i) the greater of: (1) the prime rate publicly announced by Bank of America, (2) the Federal Funds Rate, as defined in the 2019 Corporate Credit Agreement, as amended, plus 0.50%, (3) the one-month Eurodollar Rate plus 1.00%, and (4) 0.00%, plus (ii) a margin ranging from 0.85% to 1.80% based on our Consolidated Leverage Ratio. Accrued interest on the 2019 Corporate Line of Credit is payable monthly. The loans may be repaid in whole or in part without prepayment premium or penalty, subject to certain conditions. We are required to pay a fee on the unused portion of the lenders’ commitments under the 2019 Corporate Credit Agreement, as amended, at a per annum rate equal to 0.20% if the average daily used amount is greater than 50.00% of the commitments and 0.25% if the average daily used amount is less than or equal to 50.00% of the commitments, which fee shall be measured and payable on a quarterly basis. As of both December 31, 2020 and 2019, our aggregate borrowing capacity under the 2019 Corporate Line of Credit was $630,000,000. As of December 31, 2020 and 2019, borrowings outstanding under the 2019 Corporate Line of Credit totaled $556,500,000 and $557,000,000, respectively, and the weighted average interest rate on such borrowings outstanding was 2.70% and 3.83% per annum, respectively. Trilogy PropCo Line of Credit In connection with our acquisition of Trilogy, on December 1, 2015, we, through Trilogy PropCo Finance, LLC, a Delaware limited liability company and an indirect subsidiary of Trilogy, or Trilogy PropCo Parent, and certain of its subsidiaries, or the Trilogy PropCo Co-Borrowers, and, together with Trilogy PropCo Parent, the Trilogy PropCo Borrowers, entered into a loan agreement, or the Trilogy PropCo Credit Agreement, with KeyBank, as administrative agent; Regions Bank, as syndication agent; and a syndicate of other banks, as lenders, to obtain a line of credit with an aggregate maximum principal amount of $300,000,000, or the Trilogy PropCo Line of Credit. On December 1, 2015, we also entered into separate revolving notes with each of KeyBank and Regions Bank, whereby we promised to pay the principal amount of each revolving loan and accrued interest to the respective lender or its registered assigns, in accordance with the terms and conditions of the Trilogy PropCo Credit Agreement. The Trilogy PropCo Line of Credit would have matured on December 1, 2019. On October 27, 2017, we entered into an amendment to the Trilogy PropCo Credit Agreement, or the Trilogy PropCo Amendment, with KeyBank, as administrative agent, and a syndicate of other banks, as lenders, to amend the terms of the Trilogy PropCo Credit Agreement. The material terms of the Trilogy PropCo Amendment included a reduction of the total commitment under the Trilogy PropCo Line of Credit from $300,000,000 to $250,000,000. On September 5, 2019, we entered into an amended and restated loan agreement, or the 2019 Trilogy Credit Agreement, to further amend the Trilogy PropCo Credit Agreement and to replace the terms of the Trilogy PropCo Line of Credit with the 2019 Trilogy Credit Facility, as further discussed below in the “2019 Trilogy Credit Facility” section. Trilogy OpCo Line of Credit On March 21, 2016, we, through Trilogy Healthcare Holdings, Inc., a direct subsidiary of Trilogy, and certain of its subsidiaries, or the Trilogy OpCo Borrowers, entered into a credit agreement, or the Trilogy OpCo Credit Agreement, with Wells Fargo Bank, National Association, as administrative agent and lender; and a syndicate of other banks, as lenders, to obtain a $42,000,000 secured revolving credit facility, or the Trilogy OpCo Line of Credit. On April 1, 2016, we entered into an amendment to the Trilogy OpCo Credit Agreement to increase the aggregate maximum principal amount of the Trilogy OpCo Line of Credit to $60,000,000. In April 2018, we further amended the Trilogy OpCo Credit Agreement to provide for: (i) a reduction in the aggregate maximum principal amount from $60,000,000 to $25,000,000; and (ii) an updated maturity date of April 27, 2021. On September 5, 2019, we paid off and terminated the Trilogy OpCo Line of Credit, as amended, and replaced it with the 2019 Trilogy Credit Facility, as described below. As a result of such termination, we incurred a loss on extinguishment of $786,000, which is recorded to interest expense in our accompanying consolidated statements of operations and comprehensive income (loss) and was primarily related to the write-off of unamortized deferred financing fees. The source of funds for the payoff was from the 2019 Trilogy Credit Facility. We currently do not have any obligations under the Trilogy OpCo Credit Agreement, as amended. 2019 Trilogy Credit Facility On September 5, 2019, we, through Trilogy RER, LLC and certain subsidiaries of Trilogy OpCo, LLC, Trilogy RER, LLC, and Trilogy Pro Services, LLC, or the 2019 Trilogy Co-Borrowers, entered into an amended and restated loan agreement, or the 2019 Trilogy Credit Agreement, with KeyBank, as administrative agent; CIT Bank, N.A., as revolving agent; Regions Bank, as syndication agent; KeyBanc Capital Markets, Inc., as co-lead arranger and co-book runner; Regions Capital Markets, as co-lead arranger and co-book runner; Bank of America, as co-documentation agent; The Huntington National Bank, as co-documentation agent; and a syndicate of other banks, as lenders named therein, to amend and restate the terms of the Trilogy PropCo Credit Agreement in order to obtain a senior secured revolving credit facility with an aggregate maximum principal amount of $360,000,000, consisting of: (i) a $325,000,000 secured revolver supported by real estate assets and ancillary business cash flow and (ii) a $35,000,000 accounts receivable revolving credit facility supported by eligible accounts receivable, or the 2019 Trilogy Credit Facility. We may obtain up to $35,000,000 in the form of swing line loans and up to $15,000,000 in the form of standby letters of credit under the 2019 Trilogy Credit Facility. The proceeds of the 2019 Trilogy Credit Facility may be used for acquisitions, debt repayment and general corporate purposes. The maximum principal amount of the 2019 Trilogy Credit Facility may be increased by up to $140,000,000, for a total principal amount of $500,000,000, subject to: (i) the terms of the 2019 Trilogy Credit Agreement and (ii) at least 10 business days’ prior written notice to KeyBank. The 2019 Trilogy Credit Facility matures on September 5, 2023 and may be extended for one 12-month period during the term of the 2019 Trilogy Credit Agreement subject to the satisfaction of certain conditions, including payment of an extension fee. At our option, the 2019 Trilogy Credit Facility bears interest at per annum rates equal to (a) LIBOR plus 2.75% for LIBOR Rate Loans, as defined in the 2019 Trilogy Credit Agreement, and (b) for Base Rate Loans, as defined in the 2019 Trilogy Credit Agreement, 1.75% plus the greater of: (i) the fluctuating annual rate of interest announced from time to time by KeyBank as its prime rate, (ii) 0.50% above the Federal Funds Effective Rate, as defined in the 2019 Trilogy Credit Agreement, and (iii) 1.00% above the one-month LIBOR. Accrued interest on the 2019 Trilogy Credit Facility is payable monthly. The loans may be repaid in whole or in part without prepayment fees or penalty, subject to certain conditions. We are required to pay fees on the unused portion of the lenders’ commitments under the 2019 Trilogy Credit Facility, with respect to any day during a calendar quarter, at a per annum rate equal to (a) 0.15% if the sum of the Aggregate Real Estate Revolving Credit Obligations, as defined in the 2019 Trilogy Credit Agreement, outstanding on such day is greater than 50.00% of the commitments or 0.20% if the sum of the Aggregate Real Estate Revolving Credit Obligations on such day is less than or equal to 50.00% of the commitments, and (b) 0.15% if the sum of the Aggregate A/R Revolving Credit Obligations, as defined in the 2019 Trilogy Credit Agreement, outstanding on such day is greater than 50.00% of the commitments or 0.20% if the sum of the Aggregate A/R Revolving Credit Obligations on such day is less than or equal to 50.00% of the commitments, which fees shall be measured and payable on a quarterly basis. As of both December 31, 2020 and 2019, our aggregate borrowing capacity under the 2019 Trilogy Credit Facility was $360,000,000. As of December 31, 2020 and 2019, borrowings outstanding under the 2019 Trilogy Credit Facility totaled $287,134,000 and $258,879,000, respectively, and the weighted average interest rate on such borrowings outstanding was 2.94% and 4.52% per annum, respectively. Both the 2019 Corporate Credit Agreement, as amended, and the 2019 Trilogy Credit Agreement contain various financial covenants. We were in compliance with such covenants as of December 31, 2020.

Derivative Financial Instrument

Derivative Financial Instruments	12 Months Ended
	Dec. 31, 2020
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative Financial Instruments	9. Derivative Financial Instruments We record derivative financial instruments in our accompanying consolidated balance sheets as either an asset or a liability measured at fair value. The following table lists the derivative financial instruments held by us as of December 31, 2020 and 2019, which are included in other assets, net, or security deposits, prepaid rent and other liabilities in our accompanying consolidated balance sheets: Fair Value December 31, Instrument Notional Amount Index Interest Rate Maturity Date 2020 2019 Cap $ 20,000,000 one month LIBOR 3.00% 09/23/21 $ — $ — Swap 250,000,000 one month LIBOR 2.10% 01/25/22 (5,245,000) (2,821,000) Swap 130,000,000 one month LIBOR 1.98% 01/25/22 (2,561,000) (1,150,000) Swap 100,000,000 one month LIBOR 0.20% 01/25/22 (71,000) — $ (7,877,000) $ (3,971,000) As of December 31, 2020 and 2019, none of our derivative financial instruments were designated as hedges as defined by guidance under ASC Topic 815. Derivative financial instruments not designated as hedges are not speculative and are used to manage our exposure to interest rate movements, but do not meet the strict hedge accounting requirements. For the years ended December 31, 2020, 2019 and 2018, we recorded $(3,906,000), $(4,541,000) and $(1,949,000), respectively, as an increase to interest expense in our accompanying consolidated statements of operations and comprehensive income (loss) related to the change in the fair value of our derivative financial instruments. See Note 15, Fair Value Measurements, for a further discussion of the fair value of our derivative financial instruments.

Identified Intangible Liabiliti

Identified Intangible Liabilities, Net	12 Months Ended
	Dec. 31, 2020
Identified Intangible Liabilities [Abstract]
Identified Intangible Liabilities, Net	10. Identified Intangible Liabilities, Net As of December 31, 2020 and 2019, identified intangible liabilities, net consisted of below-market leases of $367,000 and $663,000, respectively, net of accumulated amortization of $834,000 and $1,342,000, respectively. Amortization expense on below-market leases for the years ended December 31, 2020, 2019 and 2018 was $296,000, $388,000 and $517,000, respectively, which is recorded to real estate revenue in our accompanying consolidated statements of operations and comprehensive income (loss). The weighted average remaining life of below-market leases was 2.6 years and 4.3 years as of December 31, 2020 and 2019, respectively. As of December 31, 2020, estimated amortization expense on below-market leases for each of the next five years ending December 31 and thereafter was as follows: Year Amount 2021 $ 180,000 2022 89,000 2023 71,000 2024 27,000 2025 — Thereafter — $ 367,000

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2020
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	11. Commitments and Contingencies Litigation We are not presently subject to any material litigation nor, to our knowledge, is any material litigation threatened against us, which if determined unfavorably to us, would have a material adverse effect on our consolidated financial position, results of operations or cash flows. Environmental Matters We follow a policy of monitoring our properties for the presence of hazardous or toxic substances. While there can be no assurance that a material environmental liability does not exist at our properties, we are not currently aware of any environmental liability with respect to our properties that would have a material effect on our consolidated financial position, results of operations or cash flows. Further, we are not aware of any material environmental liability or any unasserted claim or assessment with respect to an environmental liability that we believe would require additional disclosure or the recording of a loss contingency. Other Our other commitments and contingencies include the usual obligations of real estate owners and operators in the normal course of business, which include calls/puts to sell/acquire properties. In our view, these matters are not expected to have a material adverse effect on our consolidated financial position, results of operations or cash flows. Impact of the COVID-19 Pandemic Since March 2020, the COVID-19 pandemic has been dramatically impacting the United States, which has resulted in an aggressive worldwide effort to contain the spread of the virus. These efforts have significantly and adversely disrupted economic markets and impacted commercial activity worldwide, including markets in which we own and/or operate properties, and the prolonged economic impact remains uncertain. In addition, the continuously evolving nature of the COVID-19 pandemic makes it difficult to ascertain the long-term impact it will have on real estate markets and our portfolio of investments. Considerable uncertainty still surrounds the COVID-19 pandemic and its effects on the population, as well as the effectiveness of any responses taken on an international, national and local level by government and public health authorities and businesses to contain and combat the outbreak and spread of the virus, including the widespread availability and use of effective vaccines. In particular, government-imposed business closures and re-opening restrictions, as well as self-imposed restrictions on discretionary activities, have dramatically impacted the operations of our real estate investments and our tenants across the country, such as creating significant declines in resident occupancy. Further, our senior housing — RIDEA facilities and integrated senior health campuses have also experienced dramatic increases, and may continue to experience increases, in costs to care for residents, particularly increased labor costs to maintain staffing levels to care for the aged population during this crisis, costs of COVID-19 testing of employees and residents and costs to procure the volume of personal protective equipment and other supplies required. We have taken actions to strengthen our balance sheet and preserve liquidity in response to the COVID-19 pandemic. From March to December 2020, we postponed non-essential capital expenditures. In addition, in March 2020, we reduced stockholder distributions and partially suspended our share repurchase plan with respect to all repurchase requests other than repurchases resulting from the death or qualifying disability of stockholders. In response to the continued uncertainty and adverse effects of the COVID-19 pandemic on our operations, in May 2020 we suspended all distribution payments, the Amended and Restated DRIP and our share repurchase plan for all stockholders. In addition, in an effort to further increase our liquidity, our advisor deferred 50.0% of the asset management fees that it would otherwise have been entitled to receive for services performed by our advisor or its affiliates from June 1, 2020 to November 30, 2020. See Note 14, Related Party Transactions, for a further discussion. We are continuously monitoring the impact of the COVID-19 pandemic on our business, residents, tenants, operating partners, managers, portfolio of investments and on the United States and global economies. The prolonged duration and impact of the COVID-19 pandemic has materially disrupted, and may continue to materially disrupt, our business operations and impact our financial performance. In addition to the government grants we recognized as of December 31, 2020 as discussed at Note 2, Summary of Significant Accounting Policies — Government Grants, we received approximately $52,322,000 of Medicare advance payments during the second quarter of 2020 through an expanded program of the CMS that was intended to expedite cash flow to qualified healthcare providers. Such advance payments were based upon a qualified healthcare provider’s estimate of Medicare services to be performed for up to three months in the future and are recovered by CMS from future Medicare claims submitted by the qualified healthcare provider at any time. However, any remaining unpaid balance is required to be recouped in accordance with CMS guidance issued in October 2020 such that recoupment will commence one year after the Medicare advance payments were issued. After the first year, Medicare will automatically recoup 25.0% of Medicare payments otherwise owed to the provider for 11 months. Thereafter, recoupment will increase to 50.0% for another six months. Any amounts of unutilized Medicare advance payments, which reflect funds received that are not applied to actual billings for Medicare services performed, will be repaid to CMS by the end of 2022. The amount of Medicare advance payments received as of December 31, 2020 is included in security deposits, prepaid rent and other liabilities in our accompanying consolidated balance sheets as we cannot currently estimate the future services to be performed and the amount of funds we will retain and/or return. Once our recoupment period commences in 2021, any Medicare advance payments retained for actual services performed and Medicare claims billed will be recognized in resident fees and services revenue in our accompanying consolidated statements of operations and comprehensive income (loss).

Redeemable Noncontrolling Inter

Redeemable Noncontrolling Interests	12 Months Ended
	Dec. 31, 2020
Temporary Equity [Abstract]
Redeemable Noncontrolling Interest	12. Redeemable Noncontrolling Interests As of both December 31, 2020 and 2019, our advisor owned all of the 222 limited partnership units outstanding in our operating partnership. As of both December 31, 2020 and 2019, we owned greater than a 99.99% general partnership interest in our operating partnership, and our advisor owned less than a 0.01% limited partnership interest in our operating partnership. Our advisor is entitled to special redemption rights of its limited partnership units. The noncontrolling interest of our advisor in our operating partnership that has redemption features outside of our control is accounted for as a redeemable noncontrolling interest and is presented outside of permanent equity in our accompanying consolidated balance sheets. See Note 14, Related Party Transactions — Liquidity Stage — Subordinated Participation Interest — Subordinated Distribution Upon Listing, and Note 14, Related Party Transactions — Subordinated Distribution Upon Termination, for a further discussion of the redemption features of the limited partnership units. As of both December 31, 2020 and 2019, we, through Trilogy REIT Holdings, in which we indirectly hold a 70.0% ownership interest, owned 96.6% of the outstanding equity interests of Trilogy. As of both December 31, 2020 and 2019, certain members of Trilogy’s management and certain members of an advisory committee to Trilogy’s board of directors owned approximately 3.4% of the outstanding equity interests of Trilogy. The noncontrolling interests held by such members have redemption features outside of our control and are accounted for as redeemable noncontrolling interests in our accompanying consolidated balance sheets. We record the carrying amount of redeemable noncontrolling interests at the greater of: (i) the initial carrying amount, increased or decreased for the noncontrolling interests’ share of net income or loss and distributions or (ii) the redemption value. The changes in the carrying amount of redeemable noncontrolling interests consisted of the following for the years ended December 31, 2020 and 2019: December 31, 2020 2019 Beginning balance $ 44,105,000 $ 38,245,000 Additions — 2,000,000 Reclassification from equity 715,000 780,000 Distributions (1,271,000) (1,430,000) Repurchase of redeemable noncontrolling interests (150,000) (400,000) Adjustment to redemption value (3,714,000) 4,473,000 Net income attributable to redeemable noncontrolling interests 655,000 437,000 Ending balance $ 40,340,000 $ 44,105,000

Equity

Equity	12 Months Ended
	Dec. 31, 2020
Equity [Abstract]
Equity	13. Equity Preferred Stock Our charter authorizes us to issue 200,000,000 shares of our preferred stock, par value $0.01 per share. As of both December 31, 2020 and 2019, no shares of preferred stock were issued and outstanding. Common Stock Our charter authorizes us to issue 1,000,000,000 shares of our common stock, par value $0.01 per share. As of both December 31, 2020 and 2019, our advisor owned 22,222 shares of our common stock. On March 12, 2015, we terminated the primary portion of our initial public offering. We continued to offer shares of our common stock in our initial offering pursuant to the Initial DRIP, until the termination of the DRIP portion of our initial offering and deregistration of our initial offering on April 22, 2015. On March 25, 2015, we filed a Registration Statement on Form S-3 under the Securities Act to register a maximum of $250,000,000 of additional shares of our common stock pursuant to the 2015 DRIP Offering. We commenced offering shares pursuant to the 2015 DRIP Offering following the deregistration of our initial offering. We continued to offer shares of our common stock pursuant to the 2015 DRIP Offering until the termination and deregistration of the 2015 DRIP Offering on March 29, 2019. On January 30, 2019, we filed a Registration Statement on Form S-3 under the Securities Act to register a maximum of $200,000,000 of additional shares of our common stock to be issued pursuant to the 2019 DRIP Offering. We commenced offering shares pursuant to the 2019 DRIP Offering on April 1, 2019, following the deregistration of the 2015 DRIP Offering. On May 29, 2020, our board authorized the suspension of the Amended and Restated DRIP, and consequently, we ceased issuing shares pursuant to the 2019 DRIP Offering following the distributions paid in June 2020 to stockholders of record on or prior to the close of business on May 31, 2020. See the “Distribution Reinvestment Plan” section below for a further discussion. Through December 31, 2020, we had issued 184,930,598 shares of our common stock in connection with the primary portion of our initial public offering and 35,059,456 shares of our common stock pursuant to our DRIP Offerings. We also repurchased 26,257,404 shares of our common stock under our share repurchase plan and granted an aggregate of 135,000 shares of our restricted common stock to our independent directors through December 31, 2020. As of December 31, 2020 and 2019, we had 193,889,872 and 193,967,474 shares of our common stock issued and outstanding, respectively. Accumulated Other Comprehensive Loss The changes in accumulated other comprehensive loss, net of noncontrolling interests, by component consisted of the following for the years ended December 31, 2020 and 2019: December 31, 2020 2019 Beginning balance — foreign currency translation adjustments $ (2,255,000) $ (2,560,000) Net change in current period 247,000 305,000 Ending balance — foreign currency translation adjustments $ (2,008,000) $ (2,255,000) Noncontrolling Interests As of both December 31, 2020 and 2019, Trilogy REIT Holdings owned approximately 96.6% of Trilogy. We are the indirect owner of a 70.0% interest in Trilogy REIT Holdings pursuant to an amended joint venture agreement with an indirect, wholly-owned subsidiary of NorthStar Healthcare Income, Inc., or NHI, and a wholly-owned subsidiary of the operating partnership of Griffin-American Healthcare REIT IV, Inc., or GA Healthcare REIT IV. Both GA Healthcare REIT IV and us are sponsored by American Healthcare Investors. We serve as the managing member of Trilogy REIT Holdings. As of both December 31, 2020 and 2019, NHI and GA Healthcare REIT IV indirectly owned a 24.0% and 6.0% membership interest in Trilogy REIT Holdings, respectively. As of both December 31, 2020 and 2019, 30.0% of the net earnings of Trilogy REIT Holdings were allocated to noncontrolling interests. In connection with our acquisition and operation of Trilogy, profit interest units in Trilogy, or the Profit Interests, were issued to Trilogy Management Services, LLC and an independent director of Trilogy, both unaffiliated third parties that manage or direct the day-to-day operations of Trilogy. The Profit Interests consist of time-based or performance-based commitments. The time-based Profit Interests were measured at their grant date fair value and vest in increments of 20.0% on each anniversary of the respective grant date over a five year period. We amortize the time-based Profit Interests on a straight-line basis over the vesting periods, which are recorded to general and administrative in our accompanying consolidated statements of operations and comprehensive income (loss). The performance-based Profit Interests are subject to a performance commitment and vest upon liquidity events as defined in the Profit Interests agreements. The performance-based Profit Interests were measured at their fair value on the adoption date of ASU 2018-07 using a modified retrospective approach. For the years ended December 31, 2020, 2019 and 2018, we recognized stock compensation expense related to the Profit Interests of $(1,342,000), $2,744,000 and $2,898,000, respectively. There were no canceled, expired or exercised Profit Interests during the years ended December 31, 2020, 2019 and 2018. The nonvested awards are presented as noncontrolling interests and are re-classified to redeemable noncontrolling interests upon vesting as they have redemption features outside of our control similar to the common stock units held by Trilogy’s management. See Note 12, Redeemable Noncontrolling Interests, for a further discussion. On January 6, 2016, one of our consolidated subsidiaries issued non-voting preferred shares of beneficial interests to qualified investors for total proceeds of $125,000. These preferred shares of beneficial interests are entitled to receive cumulative preferential cash dividends at the rate of 12.5% per annum. We classify the value of the subsidiary’s preferred shares of beneficial interests as noncontrolling interests in our accompanying consolidated balance sheets and the dividends of the preferred shares of beneficial interests in net income or loss attributable to noncontrolling interests in our accompanying consolidated statements of operations and comprehensive income (loss). As of both December 31, 2020 and 2019, we owned an 86.0% interest in a consolidated limited liability company that owns Lakeview IN Medical Plaza, which we acquired on January 21, 2016. As such, 14.0% of the net earnings of Lakeview IN Medical Plaza were allocated to noncontrolling interests for the years ended December 31, 2020, 2019 and 2018. On April 7, 2020, we sold a 9.4% membership interest in a consolidated limited liability company that owns Southlake TX Hospital to an unaffiliated third party for a contract purchase price of $11,000,000. For the period from April 7, 2020 through December 31, 2020, 9.4% of the net earnings of Southlake TX Hospital were allocated to noncontrolling interests in our accompanying consolidated statements of operations and comprehensive income (loss), and the carrying amount of such noncontrolling interest is presented in total equity in our accompanying consolidated balance sheet as of December 31, 2020. Distribution Reinvestment Plan We had registered and reserved $35,000,000 in shares of our common stock for sale pursuant to the Initial DRIP in our initial offering, which we deregistered on April 22, 2015. We continued to offer shares of our common stock pursuant to the 2015 DRIP Offering, which commenced following the deregistration of our initial offering, until the deregistration of the 2015 DRIP Offering on March 29, 2019. We continue to offer up to $200,000,000 of additional shares of our common stock pursuant to the 2019 DRIP Offering, which commenced offering shares on April 1, 2019, following the deregistration of the 2015 DRIP Offering. Effective October 5, 2016, we amended and restated the Initial DRIP to amend the price at which shares of our common stock were issued pursuant to such distribution reinvestment plan. Pursuant to the Amended and Restated DRIP, shares are issued at a price equal to the most recently estimated net asset value, or NAV, of one share of our common stock, as approved and established by our board. The Amended and Restated DRIP became effective with the distribution payments to stockholders paid in the month of November 2016. In all other material respects, the terms of the 2015 DRIP Offering remained unchanged by the Amended and Restated DRIP. On May 29, 2020, in consideration of the impact the COVID-19 pandemic has had on the United States, globally and our business operations, our board authorized the suspension of all stockholder distributions upon the completion of the payment of distributions payable to stockholders of record on or prior to the close of business on May 31, 2020. As a result, our board also approved the suspension of the Amended and Restated DRIP until such time, if any, as our board determines to authorize new distributions and to reinstate such plan. Such suspension was effective upon the completion of all shares issued with respect to distributions payable to stockholders of record on or prior to the close of business on May 31, 2020. Since October 5, 2016, our board had approved and established an estimated per share NAV annually. Commencing with the distribution payment to stockholders paid in the month following such board approval, shares of our common stock issued pursuant to the Amended and Restated DRIP were issued at the current estimated per share NAV until such time as our board determined an updated estimated per share NAV. The following is a summary of our historical estimated per share NAV: Approval Date by our Board Estimated Per Share NAV 10/05/16 $ 9.01 10/04/17 $ 9.27 10/03/18 $ 9.37 10/03/19 $ 9.40 For the years ended December 31, 2020, 2019 and 2018, $21,861,000, $55,440,000 and $60,030,000, respectively, in distributions were reinvested and 2,325,762, 5,913,684 and 6,464,432 shares of our common stock, respectively, were issued pursuant to our DRIP Offerings. As of December 31, 2020 and 2019, a total of $327,012,000 and $305,151,000, respectively, in distributions were cumulatively reinvested that resulted in 35,059,456 and 32,733,694 shares of our common stock, respectively, being issued pursuant to our DRIP Offerings. Share Repurchase Plan As discussed above, in response to the effects of the COVID-19 pandemic and to protect our capital and maximize our liquidity in an effort to strengthen our long-term financial prospects, on March 31, 2020, our board partially suspended our share repurchase plan with respect to all repurchase requests other than repurchases resulting from the death or qualifying disability of stockholders, beginning with share repurchase requests submitted for repurchase during the second quarter of 2020. Repurchase requests that resulted from the death or qualifying disability of stockholders were not suspended, but remained subject to all terms and conditions of our share repurchase plan, including our board’s discretion to determine whether we had sufficient funds available to repurchase any shares. Subsequently, on May 29, 2020, our board suspended our share repurchase plan with respect to all share repurchase requests received after May 31, 2020, including repurchases resulting from the death or qualifying disability of stockholders. On July 1, 2020, we repurchased the final share repurchase requests presented prior to the suspension of our share repurchase plan. Our board shall determine if and when it is in the best interest of our company and stockholders to reinstate our share repurchase plan. Prior to the suspension of the share repurchase plan, our share repurchase plan, as amended, allowed for repurchases of shares of our common stock by us when certain criteria were met. Share repurchases were made at the sole discretion of our board. Subject to the availability of the funds for share repurchases, we generally limited the number of shares of our common stock repurchased during any calendar year to 5.0% of the weighted average number of shares of our common stock outstanding during the prior calendar year. Additionally, effective with respect to share repurchase requests submitted for repurchase during the second quarter of 2019, the number of shares that were repurchased during any fiscal quarter was limited to an amount equal to the net proceeds that we received from the sale of shares issued pursuant to our DRIP Offerings during the immediately preceding completed fiscal quarter; provided however, that shares subject to a repurchase requested upon the death or “qualifying disability,” as defined in our share repurchase plan, of a stockholder were not subject to this quarterly cap or to our existing cap on repurchases of 5.0% of the weighted average number of shares outstanding during the calendar year prior to the repurchase date. Funds for the repurchase of shares of our common stock came from the cumulative proceeds we received from the sale of shares of our common stock pursuant to our DRIP Offerings. Furthermore, our share repurchase plan provided that if there were insufficient funds to honor all repurchase requests, pending requests may be honored among all requests for repurchase in any given repurchase period as follows: first, repurchases in full as to repurchases that would result in a stockholder owning less than $2,500 of shares; and, next, pro rata as to other repurchase requests. The Repurchase Amount, as such term is defined in our share repurchase plan, was equal to the lesser of (i) the amount per share that a stockholder paid for their shares of our common stock, or (ii) the most recent estimated value of one share of our common stock, as determined by our board. For requests submitted pursuant to a death or a qualifying disability of a stockholder, the Repurchase Amount was 100% of the amount per share the stockholder paid for their shares of common stock. Since October 5, 2016, our board had previously approved and established an estimated per share NAV annually. See the “Distribution Reinvestment Plan” section above for a discussion of our historical estimated per share NAV. Accordingly, commencing with share repurchase requests submitted during the quarter that our board approved and established an estimated per share NAV, such per share NAV served as the Repurchase Amount for stockholders who purchased their shares at a price equal to or greater than such per share NAV in our initial offering, until such time as our board determined an updated estimated per share NAV. For the years ended December 31, 2020, 2019 and 2018, we repurchased 2,410,864, 9,526,087 and 8,272,789 shares of our common stock, respectively, for an aggregate of $23,107,000, $89,888,000 and $76,577,000, respectively, at an average repurchase price of $9.58, $9.44 and $9.26 per share, respectively. As of December 31, 2020 and 2019, we cumulatively repurchased 26,257,404 and 23,846,540 shares of our common stock, respectively, for an aggregate of $244,930,000 and $221,823,000, respectively, at an average repurchase price of $9.33 and $9.30 per share, respectively. 2013 Incentive Plan We adopted our incentive plan pursuant to which our board, or a committee of our independent directors, may make grants of options, shares of our common stock, stock purchase rights, stock appreciation rights or other awards to our independent directors, employees and consultants. The maximum number of shares of our common stock that may be issued pursuant to our incentive plan is 2,000,000 shares. For the years ended December 31, 2020, 2019 and 2018, we granted an aggregate of 7,500, 22,500 and 22,500 shares of our restricted common stock, respectively, at a weighted average grant date fair value of $9.40, $9.37 and $9.27 per share, respectively, to our independent directors in connection with their re-election to our board or in consideration for their past services rendered. Such shares vest as to 20.0% of the shares on the date of grant and on each of the first four anniversaries of the grant date. For the years ended December 31, 2020, 2019 and 2018, we recognized stock compensation expense related to the independent director grants of $155,000, $215,000 and $215,000, respectively. Such stock compensation expense is included in general and administrative in our accompanying consolidated statements of operations and comprehensive income (loss).

Related Party Transactions

Related Party Transactions	12 Months Ended
	Dec. 31, 2020
Related Party Transactions [Abstract]
Related Party Transactions	14. Related Party Transactions Fees and Expenses Paid to Affiliates All of our executive officers and our non-independent directors are also executive officers and employees and/or holders of a direct or indirect interest in our advisor, one of our co-sponsors or other affiliated entities. We are affiliated with our advisor, American Healthcare Investors and AHI Group Holdings; however, we are not affiliated with Griffin Capital, our dealer manager, Colony Capital or Mr. Flaherty. We entered into the Advisory Agreement, which entitles our advisor and its affiliates to specified compensation for certain services, as well as reimbursement of certain expenses. Our board, including a majority of our independent directors, has reviewed the material transactions between our affiliates and us during the year ended December 31, 2020. Set forth below is a description of the transactions with affiliates. We believe that we have executed all of the transactions set forth below on terms that are fair and reasonable to us and on terms no less favorable to us than those available from unaffiliated third parties. In the aggregate, for the years ended December 31, 2020, 2019 and 2018, we incurred $25,875,000, $25,064,000 and $24,266,000, respectively, in fees and expenses to our affiliates as detailed below. Acquisition and Development Stage Acquisition Fee We pay our advisor or its affiliates an acquisition fee of up to 2.25% of the contract purchase price, including any contingent or earn-out payments that may be paid, for each property we acquire or 2.00% of the origination or acquisition price, including any contingent or earn-out payments that may be paid, for any real estate-related investment we originate or acquire. Our advisor or its affiliates are entitled to receive these acquisition fees for properties and real estate-related investments we acquire with funds raised in our initial offering including acquisitions completed after the termination of the Advisory Agreement, or funded with net proceeds from the sale of a property or real estate-related investment, subject to certain conditions. For the years ended December 31, 2020, 2019 and 2018, we incurred $480,000, $1,124,000 and $1,194,000, respectively, in acquisition fees to our advisor. Acquisition fees in connection with the acquisition of properties accounted for as asset acquisitions or the acquisition of real estate-related investments are capitalized as part of the associated investments in our accompanying consolidated balance sheets. Development Fee In the event our advisor or its affiliates provide development-related services, our advisor or its affiliates receive a development fee in an amount that is usual and customary for comparable services rendered for similar projects in the geographic market where the services are provided; however, we will not pay a development fee to our advisor or its affiliates if our advisor or its affiliates elect to receive an acquisition fee based on the cost of such development. For the years ended December 31, 2020, 2019 and 2018, we incurred $1,073,000, $346,000 and $137,000, respectively, in development fees to our advisor or its affiliates, which are capitalized as part of the associated investments in our accompanying consolidated balance sheets. Reimbursement of Acquisition Expenses We reimburse our advisor or its affiliates for acquisition expenses related to selecting, evaluating and acquiring assets, which are reimbursed regardless of whether an asset is acquired. The reimbursement of acquisition expenses, acquisition fees, total development costs, real estate commissions or other fees paid to unaffiliated third parties will not exceed, in the aggregate, 6.0% of the contract purchase price or real estate-related investments, unless fees in excess of such limits are approved by a majority of our directors, including a majority of our independent directors, not otherwise interested in the transaction. For the years ended December 31, 2020, 2019 and 2018, such fees and expenses noted above did not exceed 6.0% of the contract purchase price of our acquisitions of real estate or real estate-related investments. For the years ended December 31, 2020, 2019 and 2018, we did not incur any acquisition expenses to our advisor or its affiliates. Reimbursements of acquisition expenses in connection with the acquisition of properties accounted for as asset acquisitions or the acquisition of real estate-related investments are capitalized as part of the associated investments in our accompanying consolidated balance sheets. Operational Stage Asset Management Fee We pay our advisor or its affiliates a monthly fee for services rendered in connection with the management of our assets equal to one-twelfth of 0.75% of average invested assets, subject to our stockholders receiving distributions in an amount equal to 5.0% per annum, cumulative, non-compounded, of invested capital. For such purposes, average invested assets means the average of the aggregate book value of our assets invested in real estate and real estate-related investments, before deducting depreciation, amortization, bad debt and other similar non-cash reserves, computed by taking the average of such values at the end of each month during the period of calculation; and invested capital means, for a specified period, the aggregate issue price of shares of our common stock purchased by our stockholders, reduced by distributions of net sales proceeds by us to our stockholders and by any amounts paid by us to repurchase shares of our common stock pursuant to our share repurchase plan. In an effort to increase our liquidity during the ongoing uncertainty surrounding the COVID-19 pandemic, on May 29, 2020, our advisor deferred 50.0% of the asset management fees that it would otherwise have been entitled to receive pursuant to the Advisory Agreement for services performed by our advisor or its affiliates during the period from June 1, 2020 to November 30, 2020. Such deferred asset management fees of $5,207,000 as of December 31, 2020 were included in accounts payable due to affiliates in our accompanying consolidated balance sheets, and were paid in full on January 4, 2021. For the years ended December 31, 2020, 2019 and 2018, we incurred $20,693,000, $20,073,000 and $19,373,000, respectively, in asset management fees to our advisor or its affiliates. Asset management fees are included in general and administrative in our accompanying consolidated statements of operations and comprehensive income (loss). Property Management Fee Our advisor or its affiliates may directly serve as property manager of our properties or may sub-contract their property management duties to any third party and provide oversight of such third-party property manager. We pay our advisor or its affiliates a monthly management fee equal to a percentage of the gross monthly cash receipts of such property as follows: (i) a property management oversight fee of 1.0% of the gross monthly cash receipts of any stand-alone, single-tenant, net leased property; (ii) a property management oversight fee of 1.5% of the gross monthly cash receipts of any property that is not a stand-alone, single-tenant, net leased property and for which our advisor or its affiliates provide oversight of a third party that performs the duties of a property manager with respect to such property; or (iii) a fair and reasonable property management fee that is approved by a majority of our directors, including a majority of our independent directors, that is not less favorable to us than terms available from unaffiliated third parties for any property that is not a stand-alone, single-tenant, net leased property and for which our advisor or its affiliates will directly serve as the property manager without sub-contracting such duties to a third party. For the years ended December 31, 2020, 2019 and 2018, we incurred $2,632,000, $2,611,000 and $2,428,000, respectively, in property management fees to our advisor or its affiliates. Property management fees are included in rental expenses or general and administrative expenses in our accompanying consolidated statements of operations and comprehensive income (loss), as applicable. Lease Fees We pay our advisor or its affiliates a separate fee for any leasing activities in an amount not to exceed the fee customarily charged in arm’s-length transactions by others rendering similar services in the same geographic area for similar properties as determined by a survey of brokers and agents in such area. Such fee is generally expected to range from 3.0% to 6.0% of the gross revenues generated during the initial term of the lease. For the years ended December 31, 2020, 2019 and 2018, we incurred $579,000, $379,000 and $843,000, respectively, in lease fees to our advisor or its affiliates. Lease fees are capitalized as lease commissions and included in other assets, net in our accompanying consolidated balance sheets. Construction Management Fee In the event that our advisor or its affiliates assist with planning and coordinating the construction of any capital or tenant improvements, our advisor or its affiliates are paid a construction management fee of up to 5.0% of the cost of such improvements. For the years ended December 31, 2020, 2019 and 2018, we incurred $183,000, $320,000 and $91,000, respectively, in construction management fees to our advisor or its affiliates. Construction management fees are capitalized as part of the associated asset and included in real estate investments, net in our accompanying consolidated balance sheets or are expensed and included in our accompanying consolidated statements of operations and comprehensive income (loss), as applicable. Operating Expenses We reimburse our advisor or its affiliates for operating expenses incurred in rendering services to us, subject to certain limitations. However, we cannot reimburse our advisor or its affiliates at the end of any fiscal quarter for total operating expenses that, in the four consecutive fiscal quarters then ended, exceed the greater of: (i) 2.0% of our average invested assets, as defined in the Advisory Agreement; or (ii) 25.0% of our net income, as defined in the Advisory Agreement, unless our independent directors determined that such excess expenses were justified based on unusual and nonrecurring factors which they deem sufficient. For the 12 months ended December 31, 2020, 2019 and 2018, our operating expenses did not exceed the aforementioned limitations. The following table reflects our operating expenses as a percentage of average invested assets and as a percentage of net income for the 12 month periods then ended: 12 Months Ended December 31, 2020 2019 2018 Operating expenses as a percentage of average invested assets 1.0 % 0.9 % 0.9 % Operating expenses as a percentage of net income 22.1 % 18.9 % 19.1 % For the years ended December 31, 2020, 2019 and 2018, our advisor or its affiliates incurred operating expenses on our behalf of $235,000, $211,000 and $200,000, respectively. Operating expenses are generally included in general and administrative in our accompanying consolidated statements of operations and comprehensive income (loss). Liquidity Stage Disposition Fees For services relating to the sale of one or more properties, we pay our advisor or its affiliates a disposition fee of up to the lesser of 2.0% of the contract sales price or 50.0% of a customary competitive real estate commission given the circumstances surrounding the sale, in each case as determined by our board, including a majority of our independent directors, upon the provision of a substantial amount of the services in the sales effort. The amount of disposition fees paid, when added to the real estate commissions paid to unaffiliated third parties, will not exceed the lesser of the customary competitive real estate commission or an amount equal to 6.0% of the contract sales price. For the year ended December 31, 2020, our advisor agreed to waive $431,000 of disposition fees that may otherwise have been due to our advisor pursuant to the Advisory Agreement. See Note 2, Summary of Significant Accounting Policies — Properties Held for Sale, and Note 3, Real Estate Investments, Net, for discussions of our property dispositions, as well as Note 13, Equity — Noncontrolling Interests, for a discussion of the disposition of membership interests in a consolidated limited liability company. Our advisor did not receive any additional securities, shares of stock or any other form of consideration or any repayment as a result of the waiver of such disposition fees. For the years ended December 31, 2019 and 2018, we did not incur any disposition fees to our advisor or its affiliates. Subordinated Participation Interest Subordinated Distribution of Net Sales Proceeds In the event of liquidation, we will pay our advisor a subordinated distribution of net sales proceeds. The distribution will be equal to 15.0% of the remaining net proceeds from the sales of properties, after distributions to our stockholders, in the aggregate, of: (i) a full return of capital raised from stockholders (less amounts paid to repurchase shares of our common stock pursuant to our share repurchase plan); plus (ii) an annual 7.0% cumulative, non-compounded return on the gross proceeds from the sale of shares of our common stock, as adjusted for distributions of net sales proceeds. Actual amounts to be received depend on the sale prices of properties upon liquidation. For the years ended December 31, 2020, 2019 and 2018, we did not pay any such distributions to our advisor. Subordinated Distribution Upon Listing Upon the listing of shares of our common stock on a national securities exchange, in redemption of our advisor’s limited partnership units, we will pay our advisor a distribution equal to 15.0% of the amount by which: (i) the market value of our outstanding common stock at listing plus distributions paid prior to listing exceeds (ii) the sum of the total amount of capital raised from stockholders (less amounts paid to repurchase shares of our common stock pursuant to our share repurchase plan) and the amount of cash that, if distributed to stockholders as of the date of listing, would have provided them an annual 7.0% cumulative, non-compounded return on the gross proceeds from the sale of shares of our common stock through the date of listing. Actual amounts to be paid depend upon the market value of our outstanding stock at the time of listing, among other factors. For the years ended December 31, 2020, 2019 and 2018, we did not pay any such distributions to our advisor. Subordinated Distribution Upon Termination Pursuant to the Agreement of Limited Partnership, as amended, of our operating partnership, upon termination or non-renewal of the Advisory Agreement, our advisor will also be entitled to a subordinated distribution in redemption of its limited partnership units from our operating partnership equal to 15.0% of the amount, if any, by which: (i) the appraised value of our assets on the termination date, less any indebtedness secured by such assets, plus total distributions paid through the termination date, exceeds (ii) the sum of the total amount of capital raised from stockholders (less amounts paid to repurchase shares of our common stock pursuant to our share repurchase plan) and the total amount of cash equal to an annual 7.0% cumulative, non-compounded return on the gross proceeds from the sale of shares of our common stock through the termination date. In addition, our advisor may elect to defer its right to receive a subordinated distribution upon termination until either a listing or other liquidity event, including a liquidation, sale of substantially all of our assets or merger in which our stockholders receive in exchange for their shares of our common stock, shares of a company that are traded on a national securities exchange. As of December 31, 2020 and 2019, we did not have any liability related to the subordinated distribution upon termination. Accounts Payable Due to Affiliates The following amounts were outstanding to our affiliates as of December 31, 2020 and 2019: December 31, Fee 2020 2019 Asset and property management fees $ 7,155,000 $ 1,991,000 Development fees 743,000 — Construction management fees 91,000 175,000 Lease commissions 27,000 143,000 Operating expenses 10,000 12,000 $ 8,026,000 $ 2,321,000

Fair Value Measurements

Fair Value Measurements	12 Months Ended
	Dec. 31, 2020
Fair Value Disclosures [Abstract]
Fair Value Measurements	15. Fair Value Measurements Assets and Liabilities Reported at Fair Value The table below presents our assets and liabilities measured at fair value on a recurring basis as of December 31, 2020, aggregated by the level in the fair value hierarchy within which those measurements fall: Quoted Prices in Significant Other Significant Total Assets: Derivative financial instrument $ — $ — $ — $ — Total assets at fair value $ — $ — $ — $ — Liabilities: Derivative financial instruments $ — $ 7,877,000 $ — $ 7,877,000 Warrants — — 1,025,000 1,025,000 Total liabilities at fair value $ — $ 7,877,000 $ 1,025,000 $ 8,902,000 The table below presents our assets and liabilities measured at fair value on a recurring basis as of December 31, 2019, aggregated by the level in the fair value hierarchy within which those measurements fall: Quoted Prices in Significant Other Significant Total Assets: Derivative financial instrument $ — $ — $ — $ — Total assets at fair value $ — $ — $ — $ — Liabilities: Derivative financial instruments $ — $ 3,971,000 $ — $ 3,971,000 Warrants — — 1,178,000 1,178,000 Total liabilities at fair value $ — $ 3,971,000 $ 1,178,000 $ 5,149,000 There were no transfers into and out of fair value measurement levels during the years ended December 31, 2020 and 2019. Derivative Financial Instruments We use interest rate swaps and interest rate caps to manage interest rate risk associated with variable-rate debt. The valuation of these instruments is determined using widely accepted valuation techniques including a discounted cash flow analysis on the expected cash flows of each derivative. This analysis reflects the contractual terms of the derivatives, including the period to maturity, and uses observable market-based inputs, including interest rate curves, as well as option volatility. The fair values of interest rate swaps are determined by netting the discounted future fixed cash payments and the discounted expected variable cash receipts. The variable cash receipts are based on an expectation of future interest rates derived from observable market interest rate curves. We incorporate credit valuation adjustments to appropriately reflect both our own nonperformance risk and the respective counterparty’s nonperformance risk in the fair value measurements. In adjusting the fair value of our derivative contracts for the effect of nonperformance risk, we have considered the impact of netting and any applicable credit enhancements, such as collateral postings, thresholds, mutual puts and guarantees. Although we have determined that the majority of the inputs used to value our derivative financial instruments fall within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with these instruments utilize Level 3 inputs, such as estimates of current credit spreads, to evaluate the likelihood of default by us and our counterparty. However, as of December 31, 2020, we have assessed the significance of the impact of the credit valuation adjustments on the overall valuation of our derivative positions and have determined that the credit valuation adjustments are not significant to the overall valuation of our derivatives. As a result, we have determined that our derivative valuations in their entirety are classified in Level 2 of the fair value hierarchy. Contingent Consideration Liability Contingent consideration obligations are due upon certain criteria being met within specified time frames. As of December 31, 2020 and 2019, we did not have any contingent consideration obligations outstanding. When recorded by us, contingent consideration obligations will be included in security deposits, prepaid rent and other liabilities in our accompanying consolidated balance sheets. As of December 31, 2018, we had accrued $681,000 of a contingent consideration obligation in connection with our Clemmons facility within North Carolina ALF Portfolio, which was not exercised and expired in June 2019. Accordingly, for the years ended December 31, 2019 and 2018, we recorded a net gain on the change in fair value of contingent consideration obligations related to North Carolina ALF Portfolio of $681,000 and $2,843,000, respectively, which is included in acquisition related expenses in our accompanying consolidated statements of operations and comprehensive income (loss). We did not record any change in fair value of contingent consideration obligations for the year ended December 31, 2020. The following is a reconciliation of the beginning and ending balances of our contingent consideration obligations for the years ended December 31, 2020, 2019 and 2018: Years Ended December 31, 2020 2019 2018 Contingent Consideration Obligations: Beginning balance $ — $ 681,000 $ 5,107,000 Realized/unrealized gains recognized in earnings — (681,000) (2,843,000) Settlements of obligations — — (1,583,000) Ending balance $ — $ — $ 681,000 Amount of total gains included in earnings attributable to the change in unrealized gains related to obligations still held $ — $ (681,000) $ (2,843,000) Warrants As of December 31, 2020 and 2019, we have recorded $1,025,000 and $1,178,000, respectively, related to warrants in Trilogy common units held by certain members of Trilogy’s management, which is included in security deposits, prepaid rent and other liabilities in our accompanying consolidated balance sheets. Once exercised, these warrants have redemption features similar to the common units held by members of Trilogy’s management. See Note 12, Redeemable Noncontrolling Interests, for a further discussion. As of December 31, 2020 and 2019, the carrying value is a reasonable estimate of fair value. Real Estate Investment For the year ended December 31, 2018, we determined that one of our medical office buildings was impaired based upon discounted cash flow analyses where the most significant inputs were market rent, capitalization rate and discount rate. We considered these inputs as Level 3 measurements within the fair value hierarchy. The following table is a summary of the quantitative information related to the non-recurring fair value measurement for the impairment of our real estate investment as of December 31, 2018: Range of Inputs or Inputs Unobservable Inputs Market rent per square foot $13.75 to $25.00 Capitalization rate 7.50 % Discount rate 8.00 % Financial Instruments Disclosed at Fair Value Our accompanying consolidated balance sheets include the following financial instruments: debt security investment, cash and cash equivalents, accounts and other receivables, restricted cash, accounts payable and accrued liabilities, accounts payable due to affiliates, mortgage loans payable and borrowings under our lines of credit and term loans. We consider the carrying values of cash and cash equivalents, accounts and other receivables, restricted cash and accounts payable and accrued liabilities to approximate the fair value for these financial instruments based upon an evaluation of the underlying characteristics, market data and because of the short period of time between origination of the instruments and their expected realization. The fair value of accounts payable due to affiliates is not determinable due to the related party nature of the accounts payable. The fair values of the other financial instruments are classified in Level 2 of the fair value hierarchy. The fair value of our debt security investment is estimated using a discounted cash flow analysis using interest rates available to us for investments with similar terms and maturities. The fair values of our mortgage loans payable and our lines of credit and term loans are estimated using discounted cash flow analyses using borrowing rates available to us for debt instruments with similar terms and maturities. We have determined that the valuations of our debt security investment, mortgage loans payable and lines of credit and term loans are classified in Level 2 within the fair value hierarchy. The carrying amounts and estimated fair values of such financial instruments as of December 31, 2020 and 2019 were as follows: December 31, 2020 2019 Carrying Fair Carrying Fair Financial Assets: Debt security investment $ 75,851,000 $ 94,033,000 $ 72,717,000 $ 94,026,000 Financial Liabilities: Mortgage loans payable $ 810,478,000 $ 830,049,000 $ 792,870,000 $ 732,846,000 Lines of credit and term loans $ 836,770,000 $ 847,048,000 $ 807,742,000 $ 816,355,000 ___________ (1) Carrying amount is net of any discount/premium and unamortized costs.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Income Taxes	16. Income Taxes As a REIT, we generally will not be subject to federal income tax on taxable income that we distribute to our stockholders. We have elected to treat certain of our consolidated subsidiaries as TRS pursuant to the Code. TRS may participate in services that would otherwise be considered impermissible for REITs and are subject to federal and state income tax at regular corporate tax rates. On March 27, 2020, the federal government passed the CARES Act that contains economic stimulus provisions, including the temporary removal of limitations on the deductibility of net operating loss, or NOL, modifications to the carryback periods of NOL, modifications to the business interest deduction limitations and technical corrections to the tax depreciation recovery period of qualified improvement property. Accordingly, tax law changes within the CARES Act may impact income taxes accrued, deferred tax assets or liabilities and the associated valuation allowances included in our consolidated financial statements, if any. We do not anticipate that tax law changes in the CARES Act will materially impact the computation of our taxable income, including our TRS. We also do not expect that we will realize a material tax benefit as a result of the changes to the provisions of the Code made by the CARES Act. We will continue to evaluate the tax impact of the CARES Act and any guidance provided by the United States Treasury Department, the IRS, and other state and local regulatory authorities to our consolidated financial statements. The components of income or loss before taxes for the years ended December 31, 2020, 2019 and 2018, were as follows: December 31, 2020 2019 2018 Domestic $ 6,171,000 $ 1,193,000 $ 14,202,000 Foreign (386,000) (521,000) (462,000) Income before income taxes $ 5,785,000 $ 672,000 $ 13,740,000 The components of income tax benefit or expense for the years ended December 31, 2020, 2019 and 2018 were as follows: December 31, 2020 2019 2018 Federal deferred $ (4,818,000) $ (3,672,000) $ (4,647,000) State deferred (932,000) (737,000) (922,000) Federal current (361,000) (29,000) — State current — (16,000) — Foreign current 612,000 605,000 988,000 Valuation allowances 2,421,000 5,373,000 3,784,000 Total income tax (benefit) expense $ (3,078,000) $ 1,524,000 $ (797,000) Current Income Tax Federal and state income taxes are generally a function of the level of income recognized by our TRS. Foreign income taxes are generally a function of our income on our real estate located in the UK and Isle of Man. Deferred Taxes Deferred income tax is generally a function of the period’s temporary differences (primarily basis differences between tax and financial reporting for real estate assets and equity investments) and generation of tax NOL that may be realized in future periods depending on sufficient taxable income. We recognize the financial statement effects of an uncertain tax position when it is more likely than not, based on the technical merits of the tax position, that such a position will be sustained upon examination by the relevant tax authorities. If the tax benefit meets the “more likely than not” threshold, the measurement of the tax benefit will be based on our estimate of the ultimate tax benefit to be sustained if audited by the taxing authority. As of both December 31, 2020 and 2019, we did not have any tax benefits or liabilities for uncertain tax positions that we believe should be recognized in our accompanying consolidated financial statements. We assess the available evidence to estimate if sufficient future taxable income will be generated to use the existing deferred tax assets. A valuation allowance is established if we believe it is more likely than not that all or a portion of the deferred tax assets are not realizable. As of both December 31, 2020 and 2019, our valuation allowance substantially reserves the net deferred tax assets due to inherent uncertainty of future income. We will continue to monitor industry and economic conditions, and our ability to generate taxable income based on our business plan and available tax planning strategies, which would allow us to utilize the tax benefits of the net deferred tax assets and thereby allow us to reverse all, or a portion of, our valuation allowance in the future. Any increases or decreases to the deferred income tax assets or liabilities are reflected in income tax benefit (expense) in our accompanying consolidated statements of operations and comprehensive income (loss). The components of deferred tax assets and liabilities as of December 31, 2020 and 2019 were as follows: December 31, 2020 2019 Deferred income tax assets: Fixed assets and intangibles $ 5,619,000 $ 6,509,000 Expense accruals and other 13,968,000 14,233,000 Net operating loss 21,168,000 14,341,000 Reserves and accruals 6,541,000 5,540,000 Allowances for accounts receivable 1,932,000 (179,000) Investments in unconsolidated entities 2,357,000 2,326,000 Total deferred income tax assets $ 51,585,000 $ 42,770,000 Deferred income tax liabilities: Fixed assets and intangibles $ (16,840,000) $ (14,468,000) Other — temporary differences (2,868,000) (2,176,000) Total deferred income tax liabilities $ (19,708,000) $ (16,644,000) Net deferred income tax assets before valuation allowance $ 31,877,000 $ 26,126,000 Valuation allowances (31,877,000) (29,455,000) Net deferred income tax assets (liabilities) $ — $ (3,329,000) At December 31, 2020 and 2019, we had a NOL carryforward of $87,347,000 and $58,416,000, respectively, related to our TRS. These amounts can be used to offset future taxable income, if any. The NOL carryforwards incurred after December 31, 2017 will be carried forward indefinitely. Tax Treatment of Distributions For federal income tax purposes, distributions to stockholders are characterized as ordinary income, capital gain distributions or nontaxable distributions. Nontaxable distributions will reduce United States stockholders’ basis (but not below zero) in their shares. The income tax treatment for distributions reportable for the years ended December 31, 2020, 2019 and 2018 was as follows: Years Ended December 31, 2020 2019 2018 Ordinary income $ — — % $ 35,294,000 29.9 % $ 33,141,000 27.6 % Capital gain — — — — — — Return of capital 48,842,000 100 82,731,000 70.1 86,833,000 72.4 $ 48,842,000 100 % $ 118,025,000 100 % $ 119,974,000 100 % Amounts listed above do not include distributions paid on nonvested shares of our restricted common stock which have been separately reported.

Leases

Leases	12 Months Ended
	Dec. 31, 2020
Leases [Abstract]
Lessee, Finance Leases	17. Leases Lessor We have operating leases with tenants that expire at various dates through 2050. For the years ended December 31, 2020 and 2019, we recognized $114,770,000 and $118,201,000, respectively, of revenues related to operating lease payments, of which $18,452,000 and $18,942,000, respectively, was for variable lease payments. As of December 31, 2020, the following table sets forth the undiscounted cash flows for future minimum base rents due under operating leases for each of the next five years ending December 31 and thereafter for properties that we wholly own: Year Amount 2021 $ 89,484,000 2022 83,728,000 2023 76,843,000 2024 70,123,000 2025 61,594,000 Thereafter 410,526,000 Total $ 792,298,000 Lessee We lease certain land, buildings, furniture, fixtures, campus equipment, office equipment and automobiles. We have lease agreements with lease and non-lease components, which are generally accounted for separately. Most leases include one or more options to renew, with renewal terms that generally can extend at various dates through 2112, excluding extension options. The exercise of lease renewal options is at our sole discretion. Certain leases also include options to purchase the leased property. As of December 31, 2020, we had future lease payments of $44,307,000 for operating leases that had not yet commenced. Such operating leases will commence between fiscal year 2021 and 2022 with lease terms of up to 15 years. The depreciable life of assets and leasehold improvements are limited by the expected lease term, unless there is a transfer of title or purchase option reasonably certain of exercise. Certain of our lease agreements include rental payments that are adjusted periodically based on the United States Bureau of Labor Statistics’ Consumer Price Index, and may also include other variable lease costs (i.e., common area maintenance, property taxes and insurance). Our lease agreements do not contain any material residual value guarantees or material restrictive covenants. The components of lease costs were as follows: Years Ended December 31, Lease Cost Classification 2020 2019 Operating lease cost(1) Property operating expenses and rental expenses $ 32,441,000 $ 29,974,000 Finance lease cost Amortization of leased assets Depreciation and amortization 1,891,000 2,001,000 Interest on lease liabilities Interest expense 609,000 391,000 Total lease cost $ 34,941,000 $ 32,366,000 ___________ (1) Includes short-term leases and variable lease costs, which are immaterial. Additional information related to our leases for the periods presented below was as follows: December 31, Lease Term and Discount Rate 2020 2019 Weighted average remaining lease term (in years) Operating leases 13.3 13.5 Finance leases 1.3 1.3 Weighted average discount rate Operating leases 5.77 % 5.94 % Finance leases 5.62 % 7.33 % Years Ended December 31, Supplemental Disclosure of Cash Flows Information 2020 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash outflows related to operating leases $ 23,790,000 $ 22,114,000 Operating cash outflows related to finance leases $ 609,000 $ 390,000 Financing cash outflows related to finance leases $ 1,235,000 $ 3,076,000 Leased assets obtained in exchange for finance lease liabilities $ 66,000 $ — Right-of-use assets obtained in exchange for operating lease liabilities $ 14,302,000 $ 31,958,000 Operating Leases As of December 31, 2020, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for each of the next five years ending December 31 and thereafter, as well as the reconciliation of those cash flows to operating lease liabilities on our accompanying consolidated balance sheet: Year Amount 2021 $ 23,875,000 2022 24,328,000 2023 24,520,000 2024 23,756,000 2025 23,639,000 Thereafter 167,081,000 Total operating lease payments 287,199,000 Less: interest 93,565,000 Present value of operating lease liabilities $ 193,634,000 Finance Leases As of December 31, 2020, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for each of the next five years ending December 31 and thereafter, as well as a reconciliation of those cash flows to finance lease liabilities: Year Amount 2021 $ 151,000 2022 22,000 2023 16,000 2024 — 2025 — Thereafter — Total finance lease payments 189,000 Less: interest 8,000 Present value of finance lease liabilities $ 181,000
Lessor, Operating Leases	17. Leases Lessor We have operating leases with tenants that expire at various dates through 2050. For the years ended December 31, 2020 and 2019, we recognized $114,770,000 and $118,201,000, respectively, of revenues related to operating lease payments, of which $18,452,000 and $18,942,000, respectively, was for variable lease payments. As of December 31, 2020, the following table sets forth the undiscounted cash flows for future minimum base rents due under operating leases for each of the next five years ending December 31 and thereafter for properties that we wholly own: Year Amount 2021 $ 89,484,000 2022 83,728,000 2023 76,843,000 2024 70,123,000 2025 61,594,000 Thereafter 410,526,000 Total $ 792,298,000 Lessee We lease certain land, buildings, furniture, fixtures, campus equipment, office equipment and automobiles. We have lease agreements with lease and non-lease components, which are generally accounted for separately. Most leases include one or more options to renew, with renewal terms that generally can extend at various dates through 2112, excluding extension options. The exercise of lease renewal options is at our sole discretion. Certain leases also include options to purchase the leased property. As of December 31, 2020, we had future lease payments of $44,307,000 for operating leases that had not yet commenced. Such operating leases will commence between fiscal year 2021 and 2022 with lease terms of up to 15 years. The depreciable life of assets and leasehold improvements are limited by the expected lease term, unless there is a transfer of title or purchase option reasonably certain of exercise. Certain of our lease agreements include rental payments that are adjusted periodically based on the United States Bureau of Labor Statistics’ Consumer Price Index, and may also include other variable lease costs (i.e., common area maintenance, property taxes and insurance). Our lease agreements do not contain any material residual value guarantees or material restrictive covenants. The components of lease costs were as follows: Years Ended December 31, Lease Cost Classification 2020 2019 Operating lease cost(1) Property operating expenses and rental expenses $ 32,441,000 $ 29,974,000 Finance lease cost Amortization of leased assets Depreciation and amortization 1,891,000 2,001,000 Interest on lease liabilities Interest expense 609,000 391,000 Total lease cost $ 34,941,000 $ 32,366,000 ___________ (1) Includes short-term leases and variable lease costs, which are immaterial. Additional information related to our leases for the periods presented below was as follows: December 31, Lease Term and Discount Rate 2020 2019 Weighted average remaining lease term (in years) Operating leases 13.3 13.5 Finance leases 1.3 1.3 Weighted average discount rate Operating leases 5.77 % 5.94 % Finance leases 5.62 % 7.33 % Years Ended December 31, Supplemental Disclosure of Cash Flows Information 2020 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash outflows related to operating leases $ 23,790,000 $ 22,114,000 Operating cash outflows related to finance leases $ 609,000 $ 390,000 Financing cash outflows related to finance leases $ 1,235,000 $ 3,076,000 Leased assets obtained in exchange for finance lease liabilities $ 66,000 $ — Right-of-use assets obtained in exchange for operating lease liabilities $ 14,302,000 $ 31,958,000 Operating Leases As of December 31, 2020, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for each of the next five years ending December 31 and thereafter, as well as the reconciliation of those cash flows to operating lease liabilities on our accompanying consolidated balance sheet: Year Amount 2021 $ 23,875,000 2022 24,328,000 2023 24,520,000 2024 23,756,000 2025 23,639,000 Thereafter 167,081,000 Total operating lease payments 287,199,000 Less: interest 93,565,000 Present value of operating lease liabilities $ 193,634,000 Finance Leases As of December 31, 2020, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for each of the next five years ending December 31 and thereafter, as well as a reconciliation of those cash flows to finance lease liabilities: Year Amount 2021 $ 151,000 2022 22,000 2023 16,000 2024 — 2025 — Thereafter — Total finance lease payments 189,000 Less: interest 8,000 Present value of finance lease liabilities $ 181,000
Lessee, Operating Leases	17. Leases Lessor We have operating leases with tenants that expire at various dates through 2050. For the years ended December 31, 2020 and 2019, we recognized $114,770,000 and $118,201,000, respectively, of revenues related to operating lease payments, of which $18,452,000 and $18,942,000, respectively, was for variable lease payments. As of December 31, 2020, the following table sets forth the undiscounted cash flows for future minimum base rents due under operating leases for each of the next five years ending December 31 and thereafter for properties that we wholly own: Year Amount 2021 $ 89,484,000 2022 83,728,000 2023 76,843,000 2024 70,123,000 2025 61,594,000 Thereafter 410,526,000 Total $ 792,298,000 Lessee We lease certain land, buildings, furniture, fixtures, campus equipment, office equipment and automobiles. We have lease agreements with lease and non-lease components, which are generally accounted for separately. Most leases include one or more options to renew, with renewal terms that generally can extend at various dates through 2112, excluding extension options. The exercise of lease renewal options is at our sole discretion. Certain leases also include options to purchase the leased property. As of December 31, 2020, we had future lease payments of $44,307,000 for operating leases that had not yet commenced. Such operating leases will commence between fiscal year 2021 and 2022 with lease terms of up to 15 years. The depreciable life of assets and leasehold improvements are limited by the expected lease term, unless there is a transfer of title or purchase option reasonably certain of exercise. Certain of our lease agreements include rental payments that are adjusted periodically based on the United States Bureau of Labor Statistics’ Consumer Price Index, and may also include other variable lease costs (i.e., common area maintenance, property taxes and insurance). Our lease agreements do not contain any material residual value guarantees or material restrictive covenants. The components of lease costs were as follows: Years Ended December 31, Lease Cost Classification 2020 2019 Operating lease cost(1) Property operating expenses and rental expenses $ 32,441,000 $ 29,974,000 Finance lease cost Amortization of leased assets Depreciation and amortization 1,891,000 2,001,000 Interest on lease liabilities Interest expense 609,000 391,000 Total lease cost $ 34,941,000 $ 32,366,000 ___________ (1) Includes short-term leases and variable lease costs, which are immaterial. Additional information related to our leases for the periods presented below was as follows: December 31, Lease Term and Discount Rate 2020 2019 Weighted average remaining lease term (in years) Operating leases 13.3 13.5 Finance leases 1.3 1.3 Weighted average discount rate Operating leases 5.77 % 5.94 % Finance leases 5.62 % 7.33 % Years Ended December 31, Supplemental Disclosure of Cash Flows Information 2020 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash outflows related to operating leases $ 23,790,000 $ 22,114,000 Operating cash outflows related to finance leases $ 609,000 $ 390,000 Financing cash outflows related to finance leases $ 1,235,000 $ 3,076,000 Leased assets obtained in exchange for finance lease liabilities $ 66,000 $ — Right-of-use assets obtained in exchange for operating lease liabilities $ 14,302,000 $ 31,958,000 Operating Leases As of December 31, 2020, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for each of the next five years ending December 31 and thereafter, as well as the reconciliation of those cash flows to operating lease liabilities on our accompanying consolidated balance sheet: Year Amount 2021 $ 23,875,000 2022 24,328,000 2023 24,520,000 2024 23,756,000 2025 23,639,000 Thereafter 167,081,000 Total operating lease payments 287,199,000 Less: interest 93,565,000 Present value of operating lease liabilities $ 193,634,000 Finance Leases As of December 31, 2020, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for each of the next five years ending December 31 and thereafter, as well as a reconciliation of those cash flows to finance lease liabilities: Year Amount 2021 $ 151,000 2022 22,000 2023 16,000 2024 — 2025 — Thereafter — Total finance lease payments 189,000 Less: interest 8,000 Present value of finance lease liabilities $ 181,000

Segment Reporting

Segment Reporting	12 Months Ended
	Dec. 31, 2020
Segment Reporting [Abstract]
Segment Reporting Disclosure	18. Segment Reporting As of December 31, 2020, we evaluated our business and made resource allocations based on six reportable business segments: medical office buildings, hospitals, skilled nursing facilities, senior housing, senior housing — RIDEA and integrated senior health campuses. Our medical office buildings are typically leased to multiple tenants under separate leases, thus requiring active management and responsibility for many of the associated operating expenses (much of which are, or can effectively be, passed through to the tenants). In addition, our medical office buildings segment included our real estate notes receivable that were settled in full in June 2019. Our hospital investments are primarily single-tenant properties for which we lease the facilities to unaffiliated tenants under triple-net and generally master leases that transfer the obligation for all facility operating costs (including maintenance, repairs, taxes, insurance and capital expenditures) to the tenant. Our skilled nursing and senior housing facilities are similarly structured to our hospital investments. In addition, our senior housing segment includes our debt security investment. Our senior housing — RIDEA properties include senior housing facilities that are owned and operated utilizing a RIDEA structure. Our integrated senior health campuses include a range of assisted living, memory care, independent living, skilled nursing services and certain ancillary businesses that are owned and operated utilizing a RIDEA structure. We evaluate performance based upon segment net operating income, or NOI. We define segment NOI as total revenues and grant income, less property operating expenses and rental expenses, which excludes depreciation and amortization, general and administrative expenses, acquisition related expenses, interest expense, gain or loss on dispositions of real estate investments, impairment of real estate investments, foreign currency gain or loss, other income, income or loss from unconsolidated entities and income tax benefit or expense for each segment. We believe that net income (loss), as defined by GAAP, is the most appropriate earnings measurement. However, we believe that segment NOI serves as an appropriate supplemental performance measure to net income (loss) because it allows investors and our management to measure unlevered property-level operating results and to compare our operating results to the operating results of other real estate companies and between periods on a consistent basis. Interest expense, depreciation and amortization and other expenses not attributable to individual properties are not allocated to individual segments for purposes of assessing segment performance. Non-segment assets primarily consist of corporate assets including cash and cash equivalents, other receivables, deferred financing costs and other assets not attributable to individual properties. Summary information for the reportable segments during the years ended December 31, 2020, 2019 and 2018 was as follows: Integrated Senior Housing — RIDEA Medical Senior Skilled Hospitals Year Ended December 31, 2020 Revenues and grant income: Resident fees and services $ 983,169,000 $ 85,904,000 $ — $ — $ — $ — $ 1,069,073,000 Real estate revenue — — 78,424,000 14,524,000 16,107,000 10,992,000 120,047,000 Grant income 53,855,000 1,326,000 — — — — 55,181,000 Total revenues and grant income 1,037,024,000 87,230,000 78,424,000 14,524,000 16,107,000 10,992,000 1,244,301,000 Expenses: Property operating expenses 929,897,000 63,830,000 — — — — 993,727,000 Rental expenses — — 30,216,000 64,000 1,572,000 446,000 32,298,000 Segment net operating income $ 107,127,000 $ 23,400,000 $ 48,208,000 $ 14,460,000 $ 14,535,000 $ 10,546,000 $ 218,276,000 Expenses: General and administrative $ 27,007,000 Acquisition related expenses 290,000 Depreciation and amortization 98,858,000 Other income (expense): Interest expense: Interest expense (including amortization of deferred financing costs and debt discount/premium) (71,278,000) Loss in fair value of derivative financial instruments (3,906,000) Gain on dispositions of real estate investments 1,395,000 Impairment of real estate investments (11,069,000) Loss from unconsolidated entities (4,517,000) Foreign currency gain 1,469,000 Other income 1,570,000 Income before income taxes 5,785,000 Income tax benefit 3,078,000 Net income $ 8,863,000 Integrated Senior Medical Senior Skilled Hospitals Year Ended December 31, 2019 Revenues: Resident fees and services $ 1,030,934,000 $ 68,144,000 $ — $ — $ — $ — $ 1,099,078,000 Real estate revenue — — 80,805,000 18,407,000 13,345,000 11,481,000 124,038,000 Total revenues 1,030,934,000 68,144,000 80,805,000 18,407,000 13,345,000 11,481,000 1,223,116,000 Expenses: Property operating expenses 919,793,000 48,067,000 — — — — 967,860,000 Rental expenses — — 30,870,000 1,001,000 1,456,000 532,000 33,859,000 Segment net operating income $ 111,141,000 $ 20,077,000 $ 49,935,000 $ 17,406,000 $ 11,889,000 $ 10,949,000 $ 221,397,000 Expenses: General and administrative $ 29,749,000 Acquisition related expenses (161,000) Depreciation and amortization 111,412,000 Other income (expense): Interest expense: Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishment) (78,553,000) Loss in fair value of derivative financial instruments (4,541,000) Loss from unconsolidated entities (2,097,000) Foreign currency gain 1,730,000 Other income 3,736,000 Income before income taxes 672,000 Income tax expense (1,524,000) Net loss $ (852,000) Integrated Senior Housing — RIDEA Medical Senior Skilled Hospitals Year Ended December 31, 2018 Revenues: Resident fees and services $ 940,616,000 $ 65,075,000 $ — $ — $ — $ — $ 1,005,691,000 Real estate revenue — — 80,078,000 21,913,000 14,887,000 12,691,000 129,569,000 Total revenues 940,616,000 65,075,000 80,078,000 21,913,000 14,887,000 12,691,000 1,135,260,000 Expenses: Property operating expenses 844,279,000 44,792,000 — — — — 889,071,000 Rental expenses — — 30,514,000 837,000 1,816,000 1,656,000 34,823,000 Segment net operating income $ 96,337,000 $ 20,283,000 $ 49,564,000 $ 21,076,000 $ 13,071,000 $ 11,035,000 $ 211,366,000 Expenses: General and administrative $ 28,770,000 Acquisition related expenses (2,913,000) Depreciation and amortization 95,678,000 Other income (expense): Interest expense: Interest expense (including amortization of deferred financing costs and debt discount/premium) (66,281,000) Loss in fair value of derivative financial instruments (1,949,000) Impairment of real estate investment (2,542,000) Loss from unconsolidated entities (3,877,000) Foreign currency loss (2,690,000) Other income 1,248,000 Income before income taxes 13,740,000 Income tax benefit 797,000 Net income $ 14,537,000 Total assets by reportable segment as of December 31, 2020 and 2019 were as follows: December 31, 2020 2019 Integrated senior health campuses $ 1,886,878,000 $ 1,791,868,000 Medical office buildings 610,653,000 620,292,000 Senior housing — RIDEA 348,987,000 360,823,000 Senior housing 152,406,000 152,909,000 Skilled nursing facilities 115,941,000 126,606,000 Hospitals 109,663,000 113,737,000 Other 10,409,000 6,054,000 Total assets $ 3,234,937,000 $ 3,172,289,000 As of both December 31, 2020 and 2019, goodwill of $75,309,000 was allocated to integrated senior health campuses, and no other segments had goodwill. Our portfolio of properties and other investments are located in the United States, Isle of Man and the UK. Revenues and grant income and assets are attributed to the country in which the property is physically located. The following is a summary of geographic information for our operations for the periods presented: Years Ended December 31, 2020 2019 2018 Revenues and grant income: United States $ 1,239,509,000 $ 1,218,337,000 $ 1,130,350,000 International 4,792,000 4,779,000 4,910,000 $ 1,244,301,000 $ 1,223,116,000 $ 1,135,260,000 The following is a summary of real estate investments, net by geographic regions as of December 31, 2020 and 2019: December 31, 2020 2019 Real estate investments, net: United States $ 2,279,257,000 $ 2,219,882,000 International 50,743,000 50,539,000 $ 2,330,000,000 $ 2,270,421,000

Concentration of Credit Risk

Concentration of Credit Risk	12 Months Ended
	Dec. 31, 2020
Risks and Uncertainties [Abstract]
Concentration of Credit Risk	19. Concentration of Credit Risk Financial instruments that potentially subject us to a concentration of credit risk are primarily our debt security investment, cash and cash equivalents, accounts and other receivables and restricted cash. We are exposed to credit risk with respect to our debt security investment, but we believe collection of the outstanding amount is probable. Cash and cash equivalents are generally invested in investment-grade, short-term instruments with a maturity of three months or less when purchased. We have cash and cash equivalents in financial institutions that are insured by the Federal Deposit Insurance Corporation, or FDIC. As of December 31, 2020 and 2019, we had cash and cash equivalents in excess of FDIC insured limits. We believe this risk is not significant. Concentration of credit risk with respect to accounts receivable from tenants is limited. We perform credit evaluations of prospective tenants and security deposits are obtained at the time of property acquisition and upon lease execution. Based on leases in effect as of December 31, 2020, properties in one state in the United States accounted for 10.0% or more of our total property portfolio’s annualized base rent or annualized NOI. Properties located in Indiana accounted for 39.9% of our total property portfolio’s annualized base rent or annualized NOI. Accordingly, there is a geographic concentration of risk subject to fluctuations in such state’s economy. Based on leases in effect as of December 31, 2020, our six reportable business segments, integrated senior health campuses, medical office buildings, senior housing — RIDEA, skilled nursing facilities, hospitals and senior housing, accounted for 49.6%, 27.3%, 10.5%, 5.7%, 3.9% and 3.0%, respectively, of our total property portfolio’s annualized base rent or annualized NOI. As of December 31, 2020, none of our tenants at our properties accounted for 10.0% or more of our total property portfolio’s annualized base rent or annualized NOI, which is based on contractual base rent from leases in effect for our non-RIDEA properties and annualized NOI for our senior housing — RIDEA facilities and integrated senior health campuses operations as of December 31, 2020.

Per Share Data

Per Share Data	12 Months Ended
	Dec. 31, 2020
Earnings Per Share [Abstract]
Per Share Data	20. Per Share Data Basic earnings (loss) per share for all periods presented are computed by dividing net income (loss) applicable to common stock by the weighted average number of shares of our common stock outstanding during the period. Net income (loss) applicable to common stock is calculated as net income (loss) attributable to controlling interest less distributions allocated to participating securities of $9,000, $28,000 and $28,000, respectively, for the years ended December 31, 2020, 2019 and 2018. Diluted earnings (loss) per share are computed based on the weighted average number of shares of our common stock and all potentially dilutive securities, if any. Nonvested shares of our restricted common stock and redeemable limited partnership units of our operating partnership are participating securities and give rise to potentially dilutive shares of our common stock.

Schedule III Real Estate and Ac

Schedule III Real Estate and Accumulated Depreciation	12 Months Ended
	Dec. 31, 2020
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 to Company Gross Amount of Which Carried at Close of Period(f) Description(a) Encumbrances Land Buildings and Cost Land Buildings and Total(e) Accumulated Date of Date DeKalb Professional Center (Medical Office) Lithonia, GA $ — $ 479,000 $ 2,871,000 $ 271,000 $ 479,000 $ 3,142,000 $ 3,621,000 $ (766,000) 2008 06/06/14 Country Club MOB (Medical Office) Stockbridge, GA — 240,000 2,306,000 375,000 240,000 2,681,000 2,921,000 (572,000) 2002 06/26/14 Acworth Medical Complex (Medical Office) Acworth, GA — 216,000 3,135,000 192,000 216,000 3,327,000 3,543,000 (692,000) 1976/2009 07/02/14 Acworth, GA — 250,000 2,214,000 148,000 250,000 2,362,000 2,612,000 (550,000) 1976/2009 07/02/14 Acworth, GA — 104,000 774,000 3,000 104,000 777,000 881,000 (197,000) 1976/2009 07/02/14 Wichita KS MOB (Medical Office) Wichita, KS — 943,000 6,288,000 537,000 943,000 6,825,000 7,768,000 (1,648,000) 1980/1996 09/04/14 Delta Valley ALF Portfolio (Senior Housing) Batesville, MS — 331,000 5,103,000 — 331,000 5,103,000 5,434,000 (1,098,000) 1999/2005 09/11/14 Cleveland, MS — 348,000 6,369,000 — 348,000 6,369,000 6,717,000 (1,477,000) 2004 09/11/14 Springdale, AR — 891,000 6,538,000 — 891,000 6,538,000 7,429,000 (1,489,000) 1998/2005 01/08/15 Lee’s Summit MO MOB (Medical Office) Lee’s Summit, MO — 1,045,000 5,068,000 463,000 1,045,000 5,531,000 6,576,000 (1,646,000) 2006 09/18/14 Carolina Commons MOB (Medical Office) Indian Land, SC 6,419,000 1,028,000 9,430,000 2,190,000 1,028,000 11,620,000 12,648,000 (2,210,000) 2009 10/15/14 Mount Olympia MOB Portfolio (Medical Office) Mount Dora, FL — 393,000 5,633,000 — 393,000 5,633,000 6,026,000 (1,056,000) 2009 12/04/14 Olympia Fields, IL — 298,000 2,726,000 21,000 298,000 2,747,000 3,045,000 (602,000) 2005 12/04/14 Southlake TX Hospital (Hospital) Southlake, TX — 5,089,000 108,517,000 — 5,089,000 108,517,000 113,606,000 (17,696,000) 2013 12/04/14 East Texas MOB Portfolio (Medical Office) Longview, TX — — 19,942,000 111,000 — 20,053,000 20,053,000 (4,050,000) 2008 12/12/14 Longview, TX — 228,000 965,000 — 228,000 965,000 1,193,000 (321,000) 1979/1997 12/12/14 Longview, TX — 759,000 1,696,000 — 759,000 1,696,000 2,455,000 (606,000) 1998 12/12/14 Longview, TX — — 8,027,000 — — 8,027,000 8,027,000 (1,667,000) 2004 12/12/14 Longview, TX — — 696,000 29,000 — 725,000 725,000 (237,000) 1956 12/12/14 Longview, TX — — 27,601,000 3,354,000 — 30,955,000 30,955,000 (6,626,000) 1985/1993/ 2004 12/12/14 Marshall, TX — 368,000 1,711,000 99,000 368,000 1,810,000 2,178,000 (626,000) 1970 12/12/14 Initial Cost to Company Gross Amount of Which Carried at Close of Period(f) Description(a) Encumbrances Land Buildings and Cost Land Buildings and Total(e) Accumulated Date of Date Premier MOB (Medical Office) Novi, MI $ — $ 644,000 $ 10,420,000 $ 825,000 $ 644,000 $ 11,245,000 $ 11,889,000 $ (2,417,000) 2006 12/19/14 Independence MOB Portfolio (Medical Office) Southgate, KY — 411,000 11,005,000 1,914,000 411,000 12,919,000 13,330,000 (2,461,000) 1988 01/13/15 Somerville, MA 30,332,000 1,509,000 46,775,000 4,045,000 1,509,000 50,820,000 52,329,000 (8,011,000) 1990 01/13/15 Morristown, NJ 28,364,000 3,763,000 26,957,000 3,940,000 3,764,000 30,896,000 34,660,000 (6,808,000) 1980 01/13/15 Verona, NJ — 1,683,000 9,405,000 746,000 1,683,000 10,151,000 11,834,000 (2,099,000) 1970 01/13/15 Bronx, NY — — 19,593,000 2,533,000 — 22,126,000 22,126,000 (3,794,000) 1987/1988 01/26/15 King of Prussia PA MOB (Medical Office) King of Prussia, PA 8,797,000 3,427,000 13,849,000 4,803,000 3,427,000 18,652,000 22,079,000 (4,178,000) 1946/2000 01/21/15 North Carolina ALF Portfolio (Senior Housing — RIDEA) Clemmons, NC — 596,000 13,237,000 (768,000) 596,000 12,469,000 13,065,000 (2,089,000) 2014 06/29/15 Garner, NC — 1,723,000 11,517,000 15,000 1,723,000 11,532,000 13,255,000 (722,000) 2014 03/27/19 Huntersville, NC — 2,033,000 11,494,000 (192,000) 2,033,000 11,302,000 13,335,000 (1,424,000) 2015 01/18/17 Matthews, NC — 949,000 12,537,000 (188,000) 949,000 12,349,000 13,298,000 (970,000) 2017 08/30/18 Mooresville, NC — 835,000 15,894,000 (777,000) 835,000 15,117,000 15,952,000 (2,577,000) 2012 01/28/15 Raleigh, NC — 1,069,000 21,235,000 (772,000) 1,069,000 20,463,000 21,532,000 (3,298,000) 2013 01/28/15 Wake Forest, NC — 772,000 13,596,000 (864,000) 772,000 12,732,000 13,504,000 (2,005,000) 2014 06/29/15 Orange Star Medical Portfolio (Medical Office and Hospital) Durango, CO — 623,000 14,166,000 279,000 623,000 14,445,000 15,068,000 (2,399,000) 2004 02/26/15 Durango, CO — 788,000 10,467,000 604,000 788,000 11,071,000 11,859,000 (1,918,000) 2004 02/26/15 Friendswood, TX — 500,000 7,664,000 323,000 500,000 7,987,000 8,487,000 (1,476,000) 2008 02/26/15 Keller, TX — 1,604,000 7,912,000 429,000 1,604,000 8,341,000 9,945,000 (1,549,000) 2011 02/26/15 Wharton, TX — 259,000 10,590,000 243,000 259,000 10,833,000 11,092,000 (1,970,000) 1987 02/26/15 Kingwood MOB Portfolio (Medical Office) Kingwood, TX — 820,000 8,589,000 127,000 820,000 8,716,000 9,536,000 (1,647,000) 2005 03/11/15 Kingwood, TX — 781,000 3,943,000 95,000 781,000 4,038,000 4,819,000 (807,000) 2008 03/11/15 Mt Juliet TN MOB (Medical Office) Mount Juliet, TN — 1,188,000 10,720,000 166,000 1,188,000 10,886,000 12,074,000 (1,987,000) 2012 03/17/15 Initial Cost to Company Gross Amount of Which Carried at Close of Period(f) Description(a) Encumbrances Land Buildings and Cost Land Buildings and Total(e) Accumulated Date of Date Homewood AL MOB (Medical Office) Homewood, AL $ — $ 405,000 $ 6,590,000 $ (60,000) $ 405,000 $ 6,530,000 $ 6,935,000 $ (1,233,000) 2010 03/27/15 Paoli PA Medical Plaza (Medical Office) Paoli, PA 12,404,000 2,313,000 12,447,000 7,984,000 2,313,000 20,431,000 22,744,000 (2,860,000) 1951 04/10/15 Paoli, PA — 1,668,000 7,357,000 1,335,000 1,668,000 8,692,000 10,360,000 (1,987,000) 1975 04/10/15 Glen Burnie MD MOB (Medical Office) Glen Burnie, MD — 2,692,000 14,095,000 2,649,000 2,692,000 16,744,000 19,436,000 (3,533,000) 1981 05/06/15 Marietta GA MOB (Medical Office) Marietta, GA — 1,347,000 10,947,000 462,000 1,347,000 11,409,000 12,756,000 (1,927,000) 2002 05/07/15 Mountain Crest Senior Housing Portfolio (Senior Housing — RIDEA) Elkhart, IN — 793,000 6,009,000 179,000 793,000 6,188,000 6,981,000 (1,385,000) 1997 05/14/15 Elkhart, IN — 782,000 6,760,000 568,000 782,000 7,328,000 8,110,000 (1,667,000) 2000 05/14/15 Hobart, IN — 604,000 11,529,000 105,000 604,000 11,634,000 12,238,000 (2,095,000) 2008 05/14/15 LaPorte, IN — 392,000 14,894,000 343,000 392,000 15,237,000 15,629,000 (2,719,000) 2008 05/14/15 Mishawaka, IN 9,124,000 3,670,000 14,416,000 642,000 3,670,000 15,058,000 18,728,000 (2,885,000) 1978 07/14/15 Niles, MI — 404,000 5,050,000 302,000 404,000 5,352,000 5,756,000 (1,179,000) 2000 06/11/15 Mount Dora Medical Center (Medical Office) Mount Dora, FL — 736,000 14,616,000 (6,703,000) 736,000 7,913,000 8,649,000 (1,476,000) 2008 05/15/15 Nebraska Senior Housing Portfolio (Senior Housing — RIDEA) Bennington, NE — 981,000 20,427,000 467,000 981,000 20,894,000 21,875,000 (3,513,000) 2009 05/29/15 Omaha, NE — 1,274,000 38,619,000 803,000 1,274,000 39,422,000 40,696,000 (6,160,000) 2000 05/29/15 Pennsylvania Senior Housing Portfolio (Senior Housing — RIDEA) Bethlehem, PA — 1,542,000 22,249,000 538,000 1,542,000 22,787,000 24,329,000 (4,185,000) 2005 06/30/15 Boyertown, PA 22,932,000 480,000 25,544,000 464,000 480,000 26,008,000 26,488,000 (4,255,000) 2000 06/30/15 York, PA 12,432,000 972,000 29,860,000 319,000 972,000 30,179,000 31,151,000 (4,855,000) 1986 06/30/15 Southern Illinois MOB Portfolio (Medical Office) Waterloo, IL — 94,000 1,977,000 — 94,000 1,977,000 2,071,000 (384,000) 2015 07/01/15 Initial Cost to Company Gross Amount of Which Carried at Close of Period(f) Description(a) Encumbrances Land Buildings and Cost Land Buildings and Total(e) Accumulated Date of Date Waterloo, IL $ — $ 738,000 $ 6,332,000 $ 584,000 $ 738,000 $ 6,916,000 $ 7,654,000 $ (1,421,000) 1995 07/01/15, Waterloo, IL — 200,000 2,648,000 62,000 200,000 2,710,000 2,910,000 (564,000) 2011 07/01/15 Napa Medical Center (Medical Office) Napa, CA — 1,176,000 13,328,000 1,572,000 1,176,000 14,900,000 16,076,000 (3,000,000) 1980 07/02/15 Chesterfield Corporate Plaza (Medical Office) Chesterfield, MO — 8,030,000 24,533,000 2,885,000 8,030,000 27,418,000 35,448,000 (5,898,000) 1989 08/14/15 Richmond VA ALF (Senior Housing — RIDEA) North Chesterfield, VA 33,400,000 2,146,000 56,671,000 525,000 2,146,000 57,196,000 59,342,000 (8,175,000) 2009 09/11/15 Crown Senior Care Portfolio (Senior Housing) Peel, Isle of Man — 1,249,000 7,453,000 — 1,249,000 7,453,000 8,702,000 (1,189,000) 2015 09/15/15 St. Albans, UK — 1,259,000 13,716,000 249,000 1,259,000 13,965,000 15,224,000 (2,126,000) 2015 10/08/15 Salisbury, UK — 1,338,000 12,855,000 38,000 1,338,000 12,893,000 14,231,000 (1,990,000) 2015 12/08/15 Aberdeen, UK — 2,171,000 6,473,000 — 2,171,000 6,473,000 8,644,000 (773,000) 1986 11/15/16 Felixstowe, UK — 754,000 6,325,000 445,000 754,000 6,770,000 7,524,000 (777,000) 2010/2011 11/15/16 Felixstowe, UK — 569,000 2,797,000 296,000 569,000 3,093,000 3,662,000 (391,000) 2010/2011 11/15/16 Washington DC SNF (Skilled Nursing) Washington, DC — 1,194,000 34,200,000 — 1,194,000 34,200,000 35,394,000 (5,964,000) 1983 10/29/15 Stockbridge GA MOB II (Medical Office) Stockbridge, GA — 499,000 8,353,000 916,000 499,000 9,269,000 9,768,000 (1,525,000) 2006 12/03/15 Marietta GA MOB II (Medical Office) Marietta, GA — 661,000 4,783,000 301,000 661,000 5,084,000 5,745,000 (875,000) 2007 12/09/15 Naperville MOB (Medical Office) Naperville, IL — 392,000 3,765,000 32,000 392,000 3,797,000 4,189,000 (786,000) 1999 01/12/16 Naperville, IL — 548,000 11,815,000 424,000 548,000 12,239,000 12,787,000 (2,093,000) 1989 01/12/16 Lakeview IN Medical Plaza (Medical Office) Indianapolis, IN 19,947,000 2,375,000 15,911,000 5,528,000 2,375,000 21,439,000 23,814,000 (4,623,000) 1987 01/21/16 Pennsylvania Senior Housing Portfolio II (Senior Housing — RIDEA) Palmyra, PA 19,114,000 835,000 24,424,000 242,000 835,000 24,666,000 25,501,000 (4,386,000) 2007 02/01/16 Initial Cost to Company Gross Amount of Which Carried at Close of Period(f) Description(a) Encumbrances Land Buildings and Cost Land Buildings and Total(e) Accumulated Date of Date Snellville GA MOB (Medical Office) Snellville, GA $ — $ 332,000 $ 7,781,000 $ 502,000 $ 332,000 $ 8,283,000 $ 8,615,000 $ (1,355,000) 2005 02/05/16 Lakebrook Medical Center (Medical Office) Westbrook, CT — 653,000 4,855,000 393,000 653,000 5,248,000 5,901,000 (926,000) 2007 02/19/16 Stockbridge GA MOB III (Medical Office) Stockbridge, GA — 606,000 7,924,000 299,000 606,000 8,223,000 8,829,000 (1,433,000) 2007 03/29/16 Joplin MO MOB (Medical Office) Joplin, MO — 1,245,000 9,860,000 (35,000) 1,245,000 9,825,000 11,070,000 (2,220,000) 2000 05/10/16 Austell GA MOB (Medical Office) Austell, GA — 663,000 10,547,000 120,000 663,000 10,667,000 11,330,000 (1,467,000) 2008 05/25/16 Middletown OH MOB (Medical Office) Middletown, OH — — 17,389,000 795,000 — 18,184,000 18,184,000 (2,438,000) 2007 06/16/16 Fox Grape SNF Portfolio (Skilled Nursing) Braintree, MA — 1,844,000 10,847,000 31,000 1,844,000 10,878,000 12,722,000 (1,396,000) 2015 07/01/16 Brighton, MA — 779,000 2,661,000 334,000 779,000 2,995,000 3,774,000 (427,000) 1982 07/01/16 Duxbury, MA — 2,921,000 11,244,000 1,933,000 2,921,000 13,177,000 16,098,000 (1,713,000) 1983 07/01/16 Hingham, MA — 2,316,000 17,390,000 (166,000) 2,316,000 17,224,000 19,540,000 (2,202,000) 1990 07/01/16 Weymouth, MA — 1,857,000 5,286,000 (90,000) 1,857,000 5,196,000 7,053,000 (620,000) 1963 07/01/16 Quincy, MA 14,546,000 3,537,000 13,697,000 333,000 3,537,000 14,030,000 17,567,000 (1,679,000) 1995 11/01/16 Voorhees NJ MOB (Medical Office) Voorhees, NJ — 1,727,000 8,451,000 664,000 1,727,000 9,115,000 10,842,000 (1,590,000) 2008 07/08/16 Norwich CT MOB Portfolio (Medical Office) Norwich, CT — 403,000 1,601,000 1,228,000 403,000 2,829,000 3,232,000 (417,000) 2014 12/16/16 Norwich, CT — 804,000 12,094,000 497,000 804,000 12,591,000 13,395,000 (1,569,000) 1999 12/16/16 New London CT MOB (Medical Office) New London, CT — 669,000 3,479,000 355,000 670,000 3,833,000 4,503,000 (671,000) 1987 05/03/17 Middletown OH MOB II (Medical Office) Middletown, OH — — 3,949,000 387,000 — 4,336,000 4,336,000 (421,000) 2007 12/20/17 Owen Valley Health Campus Spencer, IN 8,939,000 307,000 9,111,000 224,000 307,000 9,335,000 9,642,000 (1,263,000) 1999 12/01/15 Homewood Health Campus Lebanon, IN 8,971,000 973,000 9,702,000 533,000 1,040,000 10,168,000 11,208,000 (1,397,000) 2000 12/01/15 Ashford Place Health Campus Shelbyville, IN 6,167,000 664,000 12,662,000 846,000 694,000 13,478,000 14,172,000 (1,821,000) 2004 12/01/15 Initial Cost to Company Gross Amount of Which Carried at Close of Period(f) Description(a) Encumbrances Land Buildings and Cost Land Buildings and Total(e) Accumulated Date of Date Mill Pond Health Campus Greencastle, IN $ 7,297,000 $ 1,576,000 $ 8,124,000 $ 468,000 $ 1,576,000 $ 8,592,000 $ 10,168,000 $ (1,148,000) 2005 12/01/15 St. Andrews Health Campus Batesville, IN 4,604,000 552,000 8,213,000 416,000 625,000 8,556,000 9,181,000 (1,157,000) 2005 12/01/15 Hampton Oaks Health Campus Scottsburg, IN 6,482,000 720,000 8,145,000 620,000 845,000 8,640,000 9,485,000 (1,208,000) 2006 12/01/15 Forest Park Health Campus Richmond, IN 7,078,000 535,000 9,399,000 458,000 635,000 9,757,000 10,392,000 (1,379,000) 2007 12/01/15 The Maples at Waterford Crossing Goshen, IN 5,941,000 344,000 8,027,000 48,000 347,000 8,072,000 8,419,000 (1,088,000) 2006 12/01/15 Morrison Woods Health Campus Muncie, IN (c) 1,526,000 10,144,000 11,877,000 1,862,000 21,685,000 23,547,000 (2,029,000) 2008 12/01/15 Woodbridge Health Campus Logansport, IN 8,497,000 228,000 11,812,000 316,000 257,000 12,099,000 12,356,000 (1,650,000) 2003 12/01/15 Bridgepointe Health Campus Vincennes, IN 7,273,000 572,000 7,469,000 608,000 670,000 7,979,000 8,649,000 (1,078,000) 2002 12/01/15 Greenleaf Living Center Elkhart, IN 11,633,000 492,000 12,157,000 429,000 511,000 12,567,000 13,078,000 (1,686,000) 2000 12/01/15 Forest Glen Health Campus Springfield, OH 10,264,000 846,000 12,754,000 359,000 877,000 13,082,000 13,959,000 (1,807,000) 2007 12/01/15 The Meadows of Kalida Health Campus Kalida, OH 8,042,000 298,000 7,628,000 152,000 303,000 7,775,000 8,078,000 (1,053,000) 2007 12/01/15 The Heritage Findlay, OH 13,396,000 1,312,000 13,475,000 395,000 1,382,000 13,800,000 15,182,000 (1,906,000) 1975 12/01/15 Genoa Retirement Village Genoa, OH 8,438,000 881,000 8,113,000 652,000 909,000 8,737,000 9,646,000 (1,204,000) 1985 12/01/15 Waterford Crossing Goshen, IN 8,374,000 344,000 4,381,000 874,000 349,000 5,250,000 5,599,000 (729,000) 2004 12/01/15 St. Elizabeth Healthcare Delphi, IN 9,165,000 522,000 5,463,000 5,368,000 634,000 10,719,000 11,353,000 (1,207,000) 1986 12/01/15 Cumberland Pointe West Lafayette, IN 9,727,000 1,645,000 13,696,000 600,000 1,901,000 14,040,000 15,941,000 (2,095,000) 1980 12/01/15 Franciscan Healthcare Center Louisville, KY 10,908,000 808,000 8,439,000 990,000 815,000 9,422,000 10,237,000 (1,390,000) 1975 12/01/15 Blair Ridge Health Campus Peru, IN 7,846,000 734,000 11,648,000 589,000 773,000 12,198,000 12,971,000 (1,896,000) 2001 12/01/15 Glen Oaks Health Campus New Castle, IN 5,287,000 384,000 8,189,000 149,000 384,000 8,338,000 8,722,000 (1,090,000) 2011 12/01/15 Covered Bridge Health Campus Seymour, IN (c) 386,000 9,699,000 522,000 — 10,607,000 10,607,000 (1,403,000) 2002 12/01/15 Initial Cost to Company Gross Amount of Which Carried at Close of Period(f) Description(a) Encumbrances Land Buildings and Cost Land Buildings and Total(e) Accumulated Date of Date Stonebridge Health Campus Bedford, IN $ 9,988,000 $ 1,087,000 $ 7,965,000 $ 419,000 $ 1,144,000 $ 8,327,000 $ 9,471,000 $ (1,172,000) 2004 12/01/15 RiverOaks Health Campus Princeton, IN 14,898,000 440,000 8,953,000 481,000 466,000 9,408,000 9,874,000 (1,286,000) 2004 12/01/15 Park Terrace Health Campus Louisville, KY (c) 2,177,000 7,626,000 1,208,000 2,177,000 8,834,000 11,011,000 (1,283,000) 1977 12/01/15 Cobblestone Crossing Terre Haute, IN (c) 1,462,000 13,860,000 5,690,000 1,496,000 19,516,000 21,012,000 (2,544,000) 2008 12/01/15 Creasy Springs Health Campus Lafayette, IN 16,490,000 2,111,000 14,337,000 5,906,000 2,393,000 19,961,000 22,354,000 (2,609,000) 2010 12/01/15 Avalon Springs Health Campus Valparaiso, IN 17,933,000 1,542,000 14,107,000 140,000 1,575,000 14,214,000 15,789,000 (1,923,000) 2012 12/01/15 Prairie Lakes Health Campus Noblesville, IN 9,064,000 2,204,000 13,227,000 624,000 2,342,000 13,713,000 16,055,000 (1,836,000) 2010 12/01/15 RidgeWood Health Campus Lawrenceburg, IN 14,054,000 1,240,000 16,118,000 81,000 1,261,000 16,178,000 17,439,000 (2,151,000) 2009 12/01/15 Westport Place Health Campus Louisville, KY (c) 1,245,000 9,946,000 100,000 1,262,000 10,029,000 11,291,000 (1,321,000) 2011 12/01/15 Paddock Springs Warsaw, IN 8,912,000 488,000 — 10,597,000 654,000 10,431,000 11,085,000 (557,000) 2019 02/01/19 Amber Manor Care Center Petersburg, IN 5,725,000 446,000 6,063,000 322,000 494,000 6,337,000 6,831,000 (908,000) 1990 12/01/15 The Meadows of Leipsic Health Campus Leipsic, OH (c) 1,242,000 6,988,000 576,000 1,291,000 7,515,000 8,806,000 (1,058,000) 1986 12/01/15 Springview Manor Lima, OH (c) 260,000 3,968,000 98,000 265,000 4,061,000 4,326,000 (569,000) 1978 12/01/15 Willows at Bellevue Bellevue, OH 16,798,000 587,000 15,575,000 901,000 788,000 16,275,000 17,063,000 (2,187,000) 2008 12/01/15 Briar Hill Health Campus North Baltimore, OH (c) 673,000 2,688,000 402,000 700,000 3,063,000 3,763,000 (463,000) 1977 12/01/15 Cypress Pointe Health Campus Englewood, OH (c) 921,000 10,291,000 10,271,000 1,624,000 19,859,000 21,483,000 (1,506,000) 2010 12/01/15 The Oaks at NorthPointe Woods Battle Creek, MI (c) 567,000 12,716,000 116,000 567,000 12,832,000 13,399,000 (1,707,000) 2008 12/01/15 Westlake Health Campus Commerce, MI 14,661,000 815,000 13,502,000 (232,000) 541,000 13,544,000 14,085,000 (1,814,000) 2011 12/01/15 Springhurst Health Campus Greenfield, IN 20,368,000 931,000 14,114,000 2,836,000 2,039,000 15,842,000 17,881,000 (2,372,000) 2007 12/01/15 Glen Ridge Health Campus Louisville, KY (c) 1,208,000 9,771,000 1,598,000 1,320,000 11,257,000 12,577,000 (1,564,000) 2006 12/01/15 St. Mary Healthcare Lafayette, IN 5,377,000 348,000 2,710,000 170,000 348,000 2,880,000 3,228,000 (389,000) 1969 12/01/15 Initial Cost to Company Gross Amount of Which Carried at Close of Period(f) Description(a) Encumbrances Land Buildings and Cost Land Buildings and Total(e) Accumulated Date of Date The Oaks at Woodfield Grand Blanc, MI (c) $ 897,000 $ 12,270,000 $ 245,000 $ 1,080,000 $ 12,332,000 $ 13,412,000 $ (1,683,000) 2012 12/01/15 Stonegate Health Campus Lapeer, MI (c) 538,000 13,159,000 159,000 567,000 13,289,000 13,856,000 (1,809,000) 2012 12/01/15 Senior Living at Forest Ridge New Castle, IN (c) 204,000 5,470,000 128,000 238,000 5,564,000 5,802,000 (759,000) 2005 12/01/15 Highland Oaks Health Center McConnelsville, OH (c) 880,000 1,803,000 1,039,000 1,297,000 2,425,000 3,722,000 (374,000) 1978 12/01/15 Richland Manor Bluffton, OH $ — 224,000 2,200,000 (1,826,000) 224,000 374,000 598,000 (367,000) 1940 12/01/15 River Terrace Health Campus Madison, IN (c) — 13,378,000 3,932,000 8,000 17,302,000 17,310,000 (2,214,000) 2016 03/28/16 St. Charles Health Campus Jasper, IN 11,736,000 467,000 14,532,000 913,000 518,000 15,394,000 15,912,000 (2,060,000) 2000 06/24/16 Bethany Pointe Health Campus Anderson, IN 20,117,000 2,337,000 26,524,000 1,618,000 2,445,000 28,034,000 30,479,000 (3,748,000) 1999 06/30/16 River Pointe Health Campus Evansville, IN 14,451,000 1,118,000 14,736,000 1,284,000 1,126,000 16,012,000 17,138,000 (2,229,000) 1999 06/30/16 Waterford Place Health Campus Kokomo, IN 15,295,000 1,219,000 18,557,000 1,386,000 1,373,000 19,789,000 21,162,000 (2,693,000) 2000 06/30/16 Autumn Woods Health Campus New Albany, IN (c) 1,016,000 13,414,000 1,425,000 1,031,000 14,824,000 15,855,000 (2,200,000) 2000 06/30/16 Oakwood Health Campus Tell City, IN 9,389,000 783,000 11,880,000 1,119,000 874,000 12,908,000 13,782,000 (1,894,000) 2000 06/30/16 Cedar Ridge Health Campus Cynthiana, KY (c) 102,000 8,435,000 3,574,000 205,000 11,906,000 12,111,000 (1,802,000) 2005 06/30/16 Aspen Place Health Campus Greensburg, IN 9,702,000 980,000 10,970,000 686,000 1,016,000 11,620,000 12,636,000 (1,527,000) 2012 08/16/16 The Willows at Citation Lexington, KY (c) 826,000 10,017,000 629,000 849,000 10,623,000 11,472,000 (1,383,000) 2014 08/16/16 The Willows at East Lansing East Lansing, MI 16,766,000 1,449,000 15,161,000 1,312,000 1,496,000 16,426,000 17,922,000 (2,304,000) 2014 08/16/16 The Willows at Howell Howell, MI (c) 1,051,000 12,099,000 6,568,000 1,116,000 18,602,000 19,718,000 (1,801,000) 2015 08/16/16 The Willows at Okemos Okemos, MI 7,684,000 1,171,000 12,326,000 786,000 1,210,000 13,073,000 14,283,000 (1,917,000) 2014 08/16/16 Shelby Crossing Health Campus Macomb, MI 17,620,000 2,533,000 18,440,000 1,969,000 2,612,000 20,330,000 22,942,000 (3,040,000) 2013 08/16/16 Village Green Healthcare Center Greenville, OH 7,141,000 355,000 9,696,000 446,000 373,000 10,124,000 10,497,000 (1,315,000) 2014 08/16/16 Initial Cost to Company Gross Amount of Which Carried at Close of Period(f) Description(a) Encumbrances Land Buildings and Cost Land Buildings and Total(e) Accumulated Date of Date The Oaks at Northpointe Zanesville, OH (c) $ 624,000 $ 11,665,000 $ 989,000 $ 650,000 $ 12,628,000 $ 13,278,000 $ (1,753,000) 2013 08/16/16 The Oaks at Bethesda Zanesville, OH $ 4,663,000 714,000 10,791,000 673,000 743,000 11,435,000 12,178,000 (1,510,000) 2013 08/16/16 White Oak Health Campus Monticello, IN (c) 1,005,000 13,207,000 — 1,005,000 13,207,000 14,212,000 (800,000) 2010 09/23/16 Woodmont Health Campus Boonville, IN 8,006,000 790,000 9,633,000 859,000 880,000 10,402,000 11,282,000 (1,511,000) 2000 02/01/17 Silver Oaks Health Campus Columbus, IN (c) 1,776,000 21,420,000 1,351,000 1,000 24,546,000 24,547,000 (3,329,000) 2001 02/01/17 Thornton Terrace Health Campus Hanover, IN 5,674,000 764,000 9,209,000 860,000 826,000 10,007,000 10,833,000 (1,415,000) 2003 02/01/17 The Willows at Hamburg Lexington, KY 11,815,000 1,740,000 13,422,000 553,000 1,775,000 13,940,000 15,715,000 (1,571,000) 2012 02/01/17 The Lakes at Monclova Monclova, OH 15,933,000 2,869,000 12,855,000 8,863,000 2,989,000 21,598,000 24,587,000 (1,835,000) 2013 02/01/17 The Willows at Willard Willard, OH (c) 610,000 12,256,000 9,461,000 186,000 22,141,000 22,327,000 (2,087,000) 2012 02/01/17 Pickerington Health Campus Pickerington, OH — 756,000 — 15,584,000 866,000 15,474,000 16,340,000 (473,000) 2019 11/03/17 Lakeland Rehab and Health Center Milford, IN — 306,000 2,727,000 (2,683,000) 350,000 — 350,000 — 1973 12/01/15 Westlake Health Campus — Commerce Villa Commerce, MI (c) 261,000 6,610,000 1,226,000 553,000 7,544,000 8,097,000 (721,000) 2017 11/17/17 Orchard Grove Health Campus Romeo, MI 15,994,000 2,065,000 11,510,000 11,606,000 3,284,000 21,897,000 25,181,000 (1,485,000) 2016 11/30/17 The Meadows of Ottawa Ottawa, OH (c) 695,000 7,752,000 605,000 728,000 8,324,000 9,052,000 (856,000) 2014 12/15/17 Valley View Healthcare Center Fremont, OH 10,856,000 930,000 7,635,000 1,489,000 1,089,000 8,965,000 10,054,000 (600,000) 2017 07/20/18 Novi Lakes Health Campus Novi, MI 12,856,000 1,654,000 7,494,000 2,647,000 1,663,000 10,132,000 11,795,000 (1,254,000) 2016 07/20/18 The Willows at Fritz Farm Lexington, KY 9,440,000 1,538,000 8,637,000 376,000 1,563,000 8,988,000 10,551,000 (580,000) 2017 07/20/18 Trilogy Real Estate Gahanna, LLC Gahanna, OH 13,501,000 1,146,000 — 16,939,000 1,202,000 16,883,000 18,085,000 (76,000) 2020 11/13/20 Oaks at Byron Center Byron Center, MI 14,083,000 2,000,000 — 15,789,000 2,193,000 15,596,000 17,789,000 (211,000) 2020 07/08/20 Initial Cost to Company Gross Amount of Which Carried at Close of Period(f) Description(a) Encumbrances Land Buildings and Cost Land Buildings and Total(e) Accumulated Date of Date Harrison Springs Health Campus Corydon, IN (c) $ 1,653,000 $ 11,487,000 $ 58,000 $ 1,653,000 $ 11,545,000 $ 13,198,000 $ (499,000) 2016 09/04/19 The Cloister at Silvercrest New Albany, IN $ — 139,000 634,000 — 139,000 634,000 773,000 (20,000) 1940 10/01/19 Trilogy Healthcare of Ferdinand II, LLC Ferdinand, IN 11,394,000 — — 14,589,000 — 14,589,000 14,589,000 (407,000) 2019 11/19/19 Trilogy Healthcare of Hilliard, LLC Hilliard, OH — 1,702,000 — 7,757,000 1,702,000 7,757,000 9,459,000 — — 02/11/20 Forest Springs Health Campus Louisville, KY (c) 964,000 16,691,000 — 964,000 16,691,000 17,655,000 (199,000) 2015 07/30/20 Trilogy Real Estate Butler II, LLC Liberty Township, OH — 1,147,000 — 257,000 1,147,000 257,000 1,404,000 — — 10/30/20 Gateway Springs Health Campus Hamilton, OH 8,116,000 1,277,000 — 10,923,000 1,404,000 10,796,000 12,200,000 — 2020 12/28/20 Trilogy Real Estate Hamilton III, LLC Harrison, OH 7,677,000 1,750,000 — 15,536,000 1,763,000 15,523,000 17,286,000 — — — Trilogy Real Estate Kent II, LLC Grand Rapids, MI 7,709,000 767,000 — 15,982,000 767,000 15,982,000 16,749,000 — — — $ 834,026,000 $ 195,061,000 $ 2,071,675,000 $ 306,873,000 $ 200,814,000 $ 2,372,795,000 $ 2,573,609,000 $ (344,050,000) Leased properties(d) $ — $ 306,000 $ 71,362,000 $ 112,236,000 $ 1,456,000 $ 182,448,000 $ 183,904,000 $ (81,001,000) Construction in progress — — — 4,759,000 479,000 4,280,000 4,759,000 (221,000) $ 834,026,000 $ 195,367,000 $ 2,143,037,000 $ 423,868,000 $ 202,749,000 $ 2,559,523,000 $ 2,762,272,000 $ (425,272,000) ___________ (a) We own 100% of our properties as of December 31, 2020, with the exception of Trilogy, Lakeview IN Medical Plaza and Southlake TX Hospital. (b) The cost capitalized subsequent to acquisition is shown net of dispositions and impairments. (c) These properties are used as collateral for the secured revolver portion of the 2019 Trilogy Credit Facility, which had an outstanding balance of $287,134,000 as of December 31, 2020. See Note 8, Lines of Credit and Term Loans — 2019 Trilogy Credit Facility, for a further discussion. (d) Represents furniture, fixtures, equipment, land and improvements associated with properties under operating leases. (e) The changes in total real estate for the years ended December 31, 2020, 2019 and 2018 are as follows: Amount Balance — December 31, 2017 $ 2,336,208,000 Acquisitions 60,751,000 Additions 87,061,000 Dispositions and impairments (4,142,000) Foreign currency translation adjustment (2,503,000) Balance — December 31, 2018 $ 2,477,375,000 Acquisitions $ 32,330,000 Additions 114,078,000 Dispositions (8,050,000) Foreign currency translation adjustment 2,875,000 Balance — December 31, 2019 $ 2,618,608,000 Acquisitions $ 31,157,000 Additions 129,254,000 Dispositions and impairments (18,718,000) Foreign currency translation adjustment 1,971,000 Balance — December 31, 2020 $ 2,762,272,000 (f) As of December 31, 2020, the aggregate cost of our properties was $2,627,228,000 for federal income tax purposes. (g) The changes in accumulated depreciation for the years ended December 31, 2020, 2019 and 2018 are as follows: Amount Balance — December 31, 2017 $ 172,950,000 Additions 83,309,000 Dispositions (1,603,000) Foreign currency translation adjustment 38,000 Balance — December 31, 2018 $ 254,694,000 Additions $ 90,914,000 Dispositions (7,614,000) Foreign currency translation adjustment (96,000) Balance — December 31, 2019 $ 337,898,000 Additions $ 91,617,000 Dispositions and impairments (4,530,000) Foreign currency translation adjustment 287,000 Balance — December 31, 2020 $ 425,272,000 (h) The cost of buildings and capital improvements is depreciated on a straight-line basis over the estimated useful lives of the buildings and capital improvements, up to 39 years, and the cost of tenant improvements is depreciated over the shorter of the lease term or useful life, up to 34 years. The cost of furniture, fixtures and equipment is depreciated over the estimated useful life, up to 28 years.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2020
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation Our accompanying consolidated financial statements include our accounts and those of our operating partnership, the wholly owned subsidiaries of our operating partnership and all non-wholly owned subsidiaries in which we have control, as well as any VIEs, in which we are the primary beneficiary. We evaluate our ability to control an entity, and whether the entity is a VIE and we are the primary beneficiary, by considering substantive terms of the arrangement and identifying which enterprise has the power to direct the activities of the entity that most significantly impacts the entity’s economic performance.
Use of Estimates	Use of Estimates The preparation of our accompanying consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, as well as the disclosure of contingent assets and liabilities, at the date of our consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Significant items subject to such estimates and assumptions include, but are not limited to, the initial and recurring valuation of certain assets acquired and liabilities assumed through property acquisitions, revenues and grant income, allowance for credit losses, impairment of long-lived and intangible assets and contingencies. These estimates are made and evaluated on an on-going basis using information that is currently available as well as various other assumptions believed to be reasonable under the circumstances. Actual results could differ from those estimates, perhaps in material adverse ways, and those estimates could be different under different assumptions or conditions.
Cash, Cash Equivalents and Restricted Cash	Cash, Cash Equivalents and Restricted Cash Cash and cash equivalents consist of all highly liquid investments with a maturity of three months or less when purchased. Restricted cash primarily comprises lender required accounts for property taxes, tenant improvements, capital improvements and insurance, which are restricted as to use or withdrawal.
Lessee, Leases	Leases On January 1, 2019, we adopted Financial Accounting Standards Board, or FASB, Accounting Standards Codification, or ASC, Topic 842, Leases , or ASC Topic 842. ASC Topic 842 supersedes ASC Topic 840, Leases , or ASC Topic 840. We adopted ASC Topic 842 using the modified retrospective approach whereby the cumulative effect of adoption was recognized on the adoption date and prior periods were not restated. There was no net cumulative effect adjustment to retained earnings as of January 1, 2019 as a result of this adoption. Therefore, with respect to our leases as both lessees and lessors, information is presented under ASC Topic 842 for the years ended December 31, 2020 and 2019 and under ASC Topic 840 for the year ended December 31, 2018. We determine if a contract is a lease upon inception of the lease. We maintain a distinction between finance and operating leases, which is substantially similar to the classification criteria for distinguishing between capital leases and operating leases in the previous lease guidance. Lessee : Pursuant to ASC Topic 842, lessees are required to recognize the following for all leases with terms greater than 12 months at the commencement date: (i) a lease liability, which is a lessee’s obligation to make lease payments arising from a lease; and (ii) a right-of-use asset, which is an asset that represents the lessee’s right to use, or control the use of, a specified asset for the lease term. The lease liability is calculated by using either the implicit rate of the lease or the incremental borrowing rate. As a result of the adoption of ASC Topic 842 on January 1, 2019, we recognized an initial amount of operating lease liabilities of $198,453,000 in our consolidated balance sheet for all of our operating leases for which we are the lessee, including facilities leases and ground leases. In addition, we recorded corresponding right-of-use assets of $211,679,000, which represent the lease liabilities, net of the existing prepaid rent asset and accrued straight-line rent liabilities and adjusted for unamortized above/below market ground lease intangibles. The accretion of lease liabilities and amortization expense on right-of-use assets for our operating leases are included in rental expenses and property operating expenses in our accompanying consolidated statements of operations and comprehensive income (loss). Operating lease liabilities are calculated using our incremental borrowing rate based on the information available as of the lease commencement date.
Lessor, Leases	Leases On January 1, 2019, we adopted Financial Accounting Standards Board, or FASB, Accounting Standards Codification, or ASC, Topic 842, Leases , or ASC Topic 842. ASC Topic 842 supersedes ASC Topic 840, Leases , or ASC Topic 840. We adopted ASC Topic 842 using the modified retrospective approach whereby the cumulative effect of adoption was recognized on the adoption date and prior periods were not restated. There was no net cumulative effect adjustment to retained earnings as of January 1, 2019 as a result of this adoption. Therefore, with respect to our leases as both lessees and lessors, information is presented under ASC Topic 842 for the years ended December 31, 2020 and 2019 and under ASC Topic 840 for the year ended December 31, 2018. We determine if a contract is a lease upon inception of the lease. We maintain a distinction between finance and operating leases, which is substantially similar to the classification criteria for distinguishing between capital leases and operating leases in the previous lease guidance. Lessor : Pursuant to ASC Topic 842, lessors bifurcate lease revenues into lease components and non-lease components and separately recognize and disclose non-lease components that are executory in nature. Lease components continue to be recognized on a straight-line basis over the lease term and certain non-lease components may be accounted for under the revenue recognition guidance in ASC Topic 606, Revenue from Contracts with Customers, or ASC Topic 606. See the “Revenue Recognition” section below. ASC Topic 842 also provides for a practical expedient package that permits lessors to not separate non-lease components from the associated lease component if certain conditions are met. In addition, such practical expedient causes an entity to assess whether a contract is predominately lease or service based, and recognize the revenue from the entire contract under the relevant accounting guidance. Effective upon our adoption of ASC Topic 842 on January 1, 2019, we continued to recognize revenue for our medical office buildings, senior housing, skilled nursing facilities and hospitals segments as real estate revenue. Minimum annual rental revenue is recognized on a straight-line basis over the term of the related lease (including rent holidays). Differences between real estate revenue recognized and cash amounts contractually due from tenants under the lease agreements are recorded to deferred rent receivable, which is included in other assets, net in our accompanying consolidated balance sheets. Tenant reimbursement revenue, which comprises additional amounts recoverable from tenants for common area maintenance expenses and certain other recoverable expenses, are considered non-lease components and variable lease payments. We qualified for and elected the practical expedient as outlined above to combine the non-lease component with the lease component, which is the predominant component, and therefore the non-lease component is recognized as part of real estate revenue. In addition, as lessors, we exclude certain lessor costs (i.e., property taxes and insurance) paid directly by a lessee to third parties on our behalf from our measurement of variable lease revenue and associated expense (i.e., no gross up of revenue and expense for these costs); and include lessor costs that we paid and are reimbursed by the lessee in our measurement of variable lease revenue and associated expense (i.e., gross up revenue and expense for these costs). Therefore, we no longer record revenue or expense when the lessee pays the property taxes and insurance directly to a third party. Our senior housing — RIDEA facilities offer residents room and board (lease component), standard meals and healthcare services (non-lease component) and certain ancillary services that are not contemplated in the lease with each resident (i.e., laundry, guest meals, etc.). For our senior housing — RIDEA facilities, we recognize revenue under ASC Topic 606 as resident
Revenue Recognition	Revenue Recognition Real Estate Revenue Prior to January 1, 2019, minimum annual rental revenue was recognized on a straight-line basis over the term of the related lease (including rent holidays) in accordance with ASC Topic 840. Differences between real estate revenue recognized and cash amounts contractually due from tenants under the lease agreements were recorded to deferred rent receivable. Tenant reimbursement revenue was recognized as revenue in the period in which the related expenses were incurred. Tenant reimbursements were recognized and presented in accordance with ASC Subtopic 606-10-55-36, Revenue Recognition — Principal Versus Agent Consideration, or ASC Subtopic 606. ASC Subtopic 606 requires that these reimbursements be recorded on a gross basis as we are generally primarily responsible to fulfill the promise to provide specified goods and services. We recognized lease termination fees at such time when there was a signed termination letter agreement, all of the conditions of such agreement had been met and the tenant was no longer occupying the property. Effective January 1, 2019, we recognize real estate revenue in accordance with ASC Topic 842. See the “Leases” section above. Resident Fees and Services Revenue We recognize resident fees and services revenue in accordance with ASC Topic 606. A significant portion of resident fees and services revenue represents healthcare service revenue that is reported at the amount that we expect to be entitled to in exchange for providing patient care. These amounts are due from patients, third-party payors (including health insurers and government programs), other healthcare facilities, and others and includes variable consideration for retroactive revenue adjustments due to settlement of audits, reviews, and investigations. Generally, we bill the patients, third-party payors and other healthcare facilities several days after the services are performed. Revenue is recognized as performance obligations are satisfied. Performance obligations are determined based on the nature of the services provided by us. Revenue for performance obligations satisfied over time is recognized based on actual charges incurred in relation to total expected (or actual) charges. This method provides a depiction of the transfer of services over the term of the performance obligation based on the inputs needed to satisfy the obligation. Generally, performance obligations satisfied over time relate to patients receiving long-term healthcare services, including rehabilitation services. We measure the performance obligation from admission into the facility to the point when we are no longer required to provide services to that patient. Revenue for performance obligations satisfied at a point in time is recognized when goods or services are provided and we do not believe we are required to provide additional goods or services to the patient. Generally, performance obligations satisfied at a point in time relate to sales of our pharmaceuticals business or to sales of ancillary supplies. Because all of its performance obligations relate to contracts with a duration of less than one year, we have elected to apply the optional exemption provided in ASC Topic 606 and, therefore, are not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. The performance obligations for these contracts are generally completed within months of the end of the reporting period. We determine the transaction price based on standard charges for goods and services provided, reduced, where applicable, by contractual adjustments provided to third-party payors, implicit price concessions provided to uninsured patients, and estimates of goods to be returned. We also determine the estimates of contractual adjustments based on Medicare and Medicaid pricing tables and historical experience. We determine the estimate of implicit price concessions based on the historical collection experience with each class of payor. Agreements with third-party payors typically provide for payments at amounts less than established charges. A summary of the payment arrangements with major third-party payors follows: • Medicare: Certain healthcare services are paid at prospectively determined rates based on cost-reimbursement methodologies subject to certain limits. • Medicaid: Reimbursements for Medicaid services are generally paid at prospectively determined rates. In the state of Indiana, we participate in an Upper Payment Limit program, or IGT, with various county hospital partners, which provides supplemental Medicaid payments to skilled nursing facilities that are licensed to non-state, government-owned entities such as county hospital districts. We have operational responsibility through management agreements for facilities retained by the county hospital districts including this IGT. • Other: Payment agreements with certain commercial insurance carriers, health maintenance organizations and preferred provider organizations provide for payment using prospectively determined rates per discharge, discounts from established charges and prospectively determined periodic rates. Laws and regulations concerning government programs, including Medicare and Medicaid, are complex and subject to varying interpretation. As a result of investigations by governmental agencies, various healthcare organizations have received requests for information and notices regarding alleged noncompliance with those laws and regulations, which, in some instances, have resulted in organizations entering into significant settlement agreements. Compliance with such laws and regulations may also be subject to future government review and interpretation as well as significant regulatory action, including fines, penalties and potential exclusion from the related programs. There can be no assurance that regulatory authorities will not challenge our compliance with these laws and regulations, and it is not possible to determine the impact (if any) such claims or penalties would have upon us. Settlements with third-party payors for retroactive adjustments due to audits, reviews or investigations are considered variable consideration and are included in the determination of the estimated transaction price for providing patient care. These settlements are estimated based on the terms of the payment agreement with the payor, correspondence from the payor and our historical settlement activity, including an assessment to ensure that it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the retroactive adjustment is subsequently resolved. Estimated settlements are adjusted in future periods as adjustments become known (that is, new information becomes available), or as years are settled or are no longer subject to such audits, reviews and investigations. Adjustments arising from a change in the transaction price were not significant for the years ended December 31, 2020, 2019 and 2018. Disaggregation of Resident Fees and Services Revenue Financing Component We have elected a practical expedient allowed under ASC Topic 606 and, therefore, we do not adjust the promised amount of consideration from patients and third-party payors for the effects of a significant financing component due to our expectation that the period between the time the service is provided to a patient and the time that the patient or a third-party payor pays for that service will be one year or less. Contract Costs We have applied the practical expedient provided by FASB ASC Topic 340, Other Assets and Deferred Costs , and, therefore, all incremental customer contract acquisition costs are expensed as they are incurred since the amortization period of the asset that we otherwise would have recognized is one year or less in duration.
Government Grants	Government Grants We have been granted stimulus funds through various federal and state government programs, such as through the Coronavirus Aid, Relief, and Economic Security Act, or the CARES Act, passed by the federal government on March 27, 2020, which were established for eligible healthcare providers to preserve liquidity in response to lost revenues and/or increased healthcare expenses (as such terms are defined in the applicable regulatory guidance) associated with the COVID-19 pandemic. Such grants are not loans and, as such, are not required to be repaid, subject to certain conditions. We recognize government grants as grant income or as a reduction of property operating expenses, as applicable, in our accompanying consolidated statements of operations and comprehensive income (loss) when there is reasonable assurance that the grants will be received and all conditions to retain the funds will be met. We adjust our estimates and assumptions based on the applicable guidance provided by the government and the best available information that we have. Any stimulus or other relief funds received that are not expected to be used in accordance with such terms and conditions will be returned to the government, and any related deferred income will not be recognized.
Tenant and Resident Receivables and Allowances	Tenant and Resident Receivables and Allowances On January 1, 2020, we adopted ASC Topic 326, Financial Instruments Credit Losses , or ASC Topic 326. We adopted ASC Topic 326 using the modified retrospective approach whereby the cumulative effect of adoption was recognized on the adoption date and prior periods were not restated. There was no net cumulative effect adjustment to retained earnings as of January 1, 2020. Resident receivables are carried net of an allowance for credit losses. An allowance is maintained for estimated losses resulting from the inability of residents and payors to meet the contractual obligations under their lease or service agreements. Substantially all of such allowances are recorded as direct reductions of resident fees and services revenue as contractual adjustments provided to third-party payors or implicit price concessions in our accompanying consolidated statements of operations and comprehensive income (loss). Our determination of the adequacy of these allowances is based primarily upon evaluations of historical loss experience, the residents’ financial condition, security deposits, cash collection patterns by payor and by state, current economic conditions, future expectations in estimating credit losses and other relevant factors. Prior to our adoption of ASC Topic 326 on January 1, 2020, resident receivables were carried net of an allowance for uncollectible amounts. Tenant receivables and unbilled deferred rent receivables are reduced for uncollectible amounts, which are recognized as direct reductions of real estate revenue in our accompanying consolidated statements of operations and comprehensive income (loss). Prior to our adoption of ASC Topic 842 on January 1, 2019, tenant receivables and unbilled deferred rent receivables were reduced for uncollectible amounts. Such amounts were charged to bad debt expense, which was included in general and administrative in our accompanying consolidated statements of operations and comprehensive income (loss).
Property Acquisitions	Property Acquisitions We determine whether a transaction is a business combination, which requires that the assets acquired and liabilities assumed constitute a business. If the assets acquired and liabilities assumed are not a business, we account for the transaction as an asset acquisition. Under both methods, we recognize the identifiable assets acquired and liabilities assumed; however, for a transaction accounted for as an asset acquisition, we allocate the purchase price to the identifiable assets acquired and liabilities assumed based on their relative fair values. We immediately expense acquisition related expenses associated with a business combination and capitalize acquisition related expenses directly associated with an asset acquisition. We, with assistance from independent valuation specialists, measure the fair value of tangible and identified intangible assets and liabilities, as applicable, based on their respective fair values for acquired properties. Our method for allocating the purchase price to acquired investments in real estate requires us to make subjective assessments for determining fair value of the assets acquired and liabilities assumed. This includes determining the value of the buildings, land, leasehold interests, furniture, fixtures and equipment, above- or below-market rent, in-place leases, master leases, above- or below-market debt assumed and derivative financial instruments assumed. These estimates require significant judgment and in some cases involve complex calculations. These allocation assessments directly impact our results of operations, as amounts allocated to certain assets and liabilities have different depreciation or amortization lives. In addition, we amortize the value assigned to above- or below-market rent as a component of revenue, unlike in-place leases and other intangibles, which we include in depreciation and amortization in our accompanying consolidated statements of operations and comprehensive income (loss). The determination of the fair value of land is based upon comparable sales data. In cases where a leasehold interest in the land is acquired, only the above/below market consideration is necessary where the value of the leasehold interest is determined by discounting the difference between the contract ground lease payments and a market ground lease payment back to a present value as of the acquisition date. The fair value of buildings is based upon our determination of the value under two methods: one, as if it were to be replaced and vacant using cost data and, two, also using a residual technique based on discounted cash flow models, as vacant. Factors considered by us include an estimate of carrying costs during the expected lease-up periods considering current market conditions and costs to execute similar leases. We also recognize the fair value of furniture, fixtures and equipment on the premises, as well as the above- or below-market rent, the value of in-place leases, master leases, above- or below-market debt and derivative financial instruments assumed. The value of the above- or below-market component of the acquired in-place leases is determined based upon the present value (using a discount rate that reflects the risks associated with the acquired leases) of the difference between: (i) the level payment equivalent of the contract rent paid pursuant to the lease; and (ii) our estimate of market rent payments taking into account rent steps throughout the lease. In the case of leases with options, a case-by-case analysis is performed based on all facts and circumstances of the specific lease to determine whether the option will be assumed to be exercised. The amounts related to above-market leases are included in identified intangible assets, net in our accompanying consolidated balance sheets and are amortized against real estate revenue over the remaining non-cancelable lease term of the acquired leases with each property. The amounts related to below-market leases are included in identified intangible liabilities, net in our accompanying consolidated balance sheets and are amortized to real estate revenue over the remaining non-cancelable lease term plus any below-market renewal options of the acquired leases with each property. The value of in-place lease costs are based on management’s evaluation of the specific characteristics of the tenant’s lease and our overall relationship with the tenants. Characteristics considered by us in allocating these values include the nature and extent of the credit quality and expectations of lease renewals, among other factors. The in-place lease intangible represents the value related to the economic benefit for acquiring a property with in-place leases as opposed to a vacant property, which is evaluated based on a review of comparable leases for a similar property, terms and conditions for marketing and executing new leases, and implied in the difference between the value of the whole property “as is” and “as vacant.” The net amounts related to in-place lease costs are included in identified intangible assets, net in our accompanying consolidated balance sheets and are amortized to depreciation and amortization expense over the average downtime of the acquired leases with each property. The net amounts related to the value of tenant relationships, if any, are included in identified intangible assets, net in our accompanying consolidated balance sheets and are amortized to depreciation and amortization expense over the average remaining non-cancelable lease term of the acquired leases plus the market renewal lease term. The value of a master lease, if any, in which a previous owner or a tenant is relieved of specific rental obligations as additional space is leased, is determined by discounting the expected real estate revenue associated with the master lease space over the assumed lease-up period. The value of above- or below-market debt is determined based upon the present value of the difference between the cash flow stream of the assumed mortgage and the cash flow stream of a market rate mortgage at the time of assumption. The net value of above- or below-market debt is included in mortgage loans payable, net in our accompanying consolidated balance sheets and is amortized to interest expense over the remaining term of the assumed mortgage. The value of derivative financial instruments, if any, is determined in accordance with ASC Topic 820, Fair Value Measurements and Disclosures , and is included in other assets or other liabilities in our accompanying consolidated balance sheets. The values of contingent consideration assets and liabilities are analyzed at the time of acquisition. For contingent purchase options, the fair market value of the acquired asset is compared to the specified option price at the exercise date. If the option price is below market, it is assumed to be exercised and the difference between the fair market value and the option price is discounted to the present value at the time of acquisition.
Real Estate Investments, Net	Real Estate Investments, Net We carry our operating properties at our historical cost less accumulated depreciation. The cost of operating properties includes the cost of land and completed buildings and related improvements, including those related to financing obligations. Expenditures that increase the service life of properties are capitalized and the cost of maintenance and repairs is charged to expense as incurred. The cost of buildings and capital improvements is depreciated on a straight-line basis over the estimated useful lives of the buildings and capital improvements, up to 39 years, and the cost for tenant improvements is depreciated over the shorter of the lease term or useful life, up to 34 years. The cost of furniture, fixtures and equipment is depreciated over the estimated useful life, up to 28 years. When depreciable property is retired, replaced or disposed of, the related cost and accumulated depreciation is removed from the accounts and any gain or loss is reflected in earnings. As part of the leasing process, we may provide the lessee with an allowance for the construction of leasehold improvements. These leasehold improvements are capitalized and recorded as tenant improvements and depreciated over the shorter of the useful life of the improvements or the lease term. If the allowance represents a payment for a purpose other than funding leasehold improvements, or in the event we are not considered the owner of the improvements, the allowance is considered to be a lease inducement and is included in other assets, net in our accompanying consolidated balance sheets. Lease inducement is recognized over the lease term as a reduction of real estate revenue on a straight-line basis. Factors considered during this evaluation include, among other things, who holds legal title to the improvements as well as other controlling rights provided by the lease agreement and provisions for substantiation of such costs (e.g ., unilateral control of the tenant space during the build-out process). Determination of the appropriate accounting for the payment of a tenant allowance is made on a lease-by-lease basis, considering the facts and circumstances of the individual tenant lease. Recognition of lease revenue commences when the lessee is given possession of the leased space upon completion of tenant improvements when we are the owner of the leasehold improvements. However, when the leasehold improvements are owned by the tenant, the lease inception date (and the date on which recognition of lease revenue commences) is the date the tenant obtains possession of the leased space for purposes of constructing its leasehold improvements.
Impairment of Long-Lived Assets, Goodwill and Intangible Assets	Impairment of Long-Lived Assets, Goodwill and Intangible Assets We periodically evaluate our long-lived assets, primarily consisting of investments in real estate that we carry at our historical cost less accumulated depreciation, for impairment when events or changes in circumstances indicate that its carrying value may not be recoverable. Indicators we consider important and that we believe could trigger an impairment review include, among others, the following: • significant negative industry or economic trends; • a significant underperformance relative to historical or projected future operating results; and • a significant change in the extent or manner in which the asset is used or significant physical change in the asset. If indicators of impairment of our long-lived assets are present, we evaluate the carrying value of the related real estate investments in relation to the future undiscounted cash flows of the underlying operations. In performing this evaluation, we consider market conditions and our current intentions with respect to holding or disposing of the asset. We adjust the net book value of leased properties and other long-lived assets to fair value if the sum of the expected future undiscounted cash flows, including sales proceeds, is less than carrying value. We recognize an impairment loss at the time we make any such determination. We test goodwill for impairment at least annually, and more frequently if indicators arise. We compare the fair value of a reporting segment with its carrying amount. We recognize an impairment loss to the extent the carrying value of goodwill exceeds the implied value in the current period. We also test other indefinite-lived intangible assets for impairment at least annually, and more frequently if indicators arise. We first assess qualitative factors to determine the likelihood that the fair value of the reporting group is less than its carrying value. If the carrying amount of an indefinite-lived intangible asset exceeds its fair value, an impairment loss is recognized. Fair values of other indefinite-lived intangible assets are usually determined based on discounted cash flows or appraised values, as appropriate. If impairment indicators arise with respect to intangible assets with finite useful lives, we evaluate impairment by comparing the carrying amount of the asset to the estimated future undiscounted net cash flows expected to be generated by the asset. If the estimated future undiscounted net cash flows are less than the carrying amount of the asset, then we estimate the fair value of the asset and compare the estimated fair value to the intangible asset’s carrying value. For all of our reporting units, we recognize any shortfall from carrying value as an impairment loss in the current period.
Properties Held for Sale	Properties Held for Sale A property or a group of properties is reported in discontinued operations in our consolidated statements of operations and comprehensive income (loss) for current and prior periods if the disposal represents a strategic shift that has (or will have) a major effect on an entity’s operations and financial results when either: (i) the component has been disposed of or (ii) is classified as held for sale. At such time as a property is held for sale, such property is carried at the lower of: (i) its carrying amount or (ii) fair value less costs to sell. In addition, a property being held for sale ceases to be depreciated. We classify operating properties as property held for sale in the period in which all of the following criteria are met: • management, having the authority to approve the action, commits to a plan to sell the asset; • the asset is available for immediate sale in its present condition subject only to terms that are usual and customary for sales of such assets; • an active program to locate a buyer or buyers and other actions required to complete the plan to sell the asset has been initiated; • the sale of the asset is probable and the transfer of the asset is expected to qualify for recognition as a completed sale within one year; • the asset is being actively marketed for sale at a price that is reasonable in relation to its current fair value; and • given the actions required to complete the plan to sell the asset, it is unlikely that significant changes to the plan would be made or that the plan would be withdrawn.
Debt Security Investment, Net	Debt Security Investment, NetWe classify our marketable debt security investment as held-to-maturity because we have the positive intent and ability to hold the security to maturity, and we have not recorded any unrealized holding gains or losses on such investment. Our held-to-maturity security is recorded at amortized cost and adjusted for the amortization of premiums or discounts through maturity. Prior to the adoption of ASC Topic 326 on January 1, 2020, a loss was recognized in earnings when we determined declines in the fair value of marketable securities were other-than-temporary. Effective January 1, 2020, we evaluated our debt security investment for expected future credit loss in accordance with ASC Topic 326.
Real Estate Notes Receivable, Net	Real Estate Notes Receivable, NetReal estate notes receivable consisted of mortgage loans collateralized by interests in real property. We recorded such mortgage loans at cost. Interest income on our real estate notes receivable was recognized on an accrual basis over the life of the investment using the effective interest method and was included in real estate revenue in our accompanying consolidated statements of operations and comprehensive income (loss) for the years ended December 31, 2019 and 2018. Direct loan costs were amortized over the term of the loan as an adjustment to the yield on the loan and were recorded against real estate revenue in our accompanying consolidated statements of operations and comprehensive income (loss) for the years ended December 31, 2019 and 2018.
Derivative Financial Instruments	Derivative Financial Instruments We are exposed to the effect of interest rate changes in the normal course of business. We seek to mitigate these risks by following established risk management policies and procedures, which include the occasional use of derivatives. Our primary strategy in entering into derivative contracts, such as fixed rate interest rate swaps and interest rate caps, is to add stability to interest expense and to manage our exposure to interest rate movements by effectively converting a portion of our variable-rate debt to fixed-rate debt. We do not enter into derivative instruments for speculative purposes. Derivatives are recognized as either other assets or other liabilities in our accompanying consolidated balance sheets and are measured at fair value. We do not designate our derivative instruments as hedge instruments as defined by guidance under ASC Topic 815, Derivatives and Hedges , or ASC Topic 815, which allows for gains and losses on derivatives designated as hedges to be offset by the change in value of the hedged items or to be deferred in other comprehensive income (loss). Changes in the fair value of our derivative financial instruments are recorded as a component of interest expense in gain or loss in fair value of derivative financial instruments in our accompanying consolidated statements of operations and comprehensive income (loss).
Fair Value Measurements	Fair Value Measurements The fair value of certain assets and liabilities is a market-based measurement, not an entity-specific measurement. Therefore, a fair value measurement should be determined based on the assumptions that market participants would use in pricing the asset or liability. As a basis for considering market participant assumptions in fair value measurements, we follow a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of our reporting entity (observable inputs that are classified within Levels 1 and 2 of the hierarchy) and our reporting entity’s own assumptions about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy). Level 1 inputs are quoted prices (unadjusted) in active markets for identical assets or liabilities that we have the ability to access. An active market is defined as a market in which transactions for the assets or liabilities occur with sufficient frequency and volume to provide pricing information on an ongoing basis. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs that are observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates and yield curves that are observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity’s own assumptions, as there is little, if any, related market activity. In instances where the determination of the fair value measurement is based on inputs from different levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is based on the lowest level input that is significant to the fair value measurement in its entirety. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability.
Other Assets, Net	Other Assets, NetOther assets, net primarily consists of investments in unconsolidated entities, inventory, prepaid expenses and deposits, deferred financing costs related to our lines of credit and term loans, deferred rent receivables, deferred tax assets, lease inducements and lease commissions.
Other Assets, Net	Inventory consists primarily of pharmaceutical and medical supplies and is stated at the lower of cost (first-in, first-out) or market.
Other Assets, Net	Deferred financing costs related to our lines of credit and term loans include amounts paid to lenders and others to obtain such financing. Such costs are amortized using the straight-line method over the term of the related loan, which approximates the effective interest rate method. Amortization of deferred financing costs related to our lines of credit and term loans is included in interest expense in our accompanying consolidated statements of operations and comprehensive income (loss). Lease commissions are amortized using the straight-line method over the term of the related lease. Prepaid expenses are amortized over the related contract periods.
Other Assets, Net	We report investments in unconsolidated entities using the equity method of accounting when we have the ability to exercise significant influence over the operating and financial policies. Under the equity method, our share of the investee’s earnings or losses is included in our accompanying consolidated statements of operations and comprehensive income (loss). We generally do not recognize equity method losses when such losses exceed our net equity method investment balance unless we have committed to provide such investee additional financial support or guaranteed its obligations. To the extent that our cost basis is different from the basis reflected at the entity level, the basis difference is generally amortized over the lives of the related assets and liabilities, and such amortization is included in our share of equity in earnings of the entity. The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the entity interest or the estimated fair value of the assets prior to the sale of interests in the entity. We have elected to follow the cumulative earnings approach when classifying distributions received from equity method investments in our consolidated statements of cash flows, whereby any distributions received up to the amount of cumulative equity earnings will be considered a return on investment and classified in operating activities and any excess distributions would be considered a return of investment and classified in investing activities. We evaluate our equity method investments for impairment based upon a comparison of the estimated fair value of the equity method investment to its carrying value. When we determine a decline in the estimated fair value of such an investment below its carrying value is other-than-temporary, an impairment is recorded.
Accounts Payable and Accrued Liabilities	Accounts Payable and Accrued Liabilities As of December 31, 2020 and 2019, accounts payable and accrued liabilities primarily includes reimbursement of payroll-related costs to the managers of our senior housing — RIDEA facilities and integrated senior health campuses of $46,540,000 and $24,118,000, respectively, insurance reserves of $36,251,000 and $35,581,000, respectively, accrued developments and capital expenditures to unaffiliated third parties of $21,508,000 and $25,019,000, respectively, accrued property taxes of $14,521,000 and $14,501,000, respectively, and accrued distributions of $0 and $9,974,000, respectively.
Stock Compensation	Stock Compensation We follow ASC Topic 718, Compensation — Stock Compensation On January 1, 2019, we adopted Accounting Standards Update, or ASU, 2018-07, Improvements to Nonemployee Share-Based Payment Accounting, or ASU 2018-07, which simplifies the accounting for share-based payments to nonemployees by aligning it with the accounting for share-based payments to employees, with certain exceptions. It expands the scope of ASC Topic 718 to include share-based payments granted to nonemployees in exchange for goods or services used or consumed in the entity’s own operations and supersedes the guidance of ASC Topic 505-50, Equity-Based Payments to Nonemployees.
Foreign Currency	Foreign Currency We have real estate investments in the United Kingdom, or UK, and Isle of Man for which the functional currency is the UK Pound Sterling, or GBP. We translate the results of operations of our foreign real estate investments into United States Dollars, or USD, using the average currency rates of exchange in effect during the period, and we translate assets and liabilities using the currency exchange rate in effect at the end of the period. The resulting foreign currency translation adjustments are included in accumulated other comprehensive loss, a component of stockholders’ equity, in our accompanying consolidated balance sheets. Certain balance sheet items, primarily equity and capital-related accounts, are reflected at the historical currency exchange rates. We also have intercompany notes and payables denominated in GBP with our UK subsidiaries. Gains or losses resulting from remeasuring such intercompany notes and payables into USD at the end of each reporting period are reflected in our accompanying consolidated statements of operations and comprehensive income (loss). When such intercompany notes and payables are deemed to be of a long-term investment nature, they will be reflected in accumulated other comprehensive loss in our accompanying consolidated balance sheets.
Income Taxes	Income Taxes We qualified, and elected to be taxed, as a REIT under the Code for federal income tax purposes beginning with our taxable year ended December 31, 2014, and we intend to continue to qualify to be taxed as a REIT. To maintain our qualification as a REIT, we must meet certain organizational and operational requirements, including a requirement to distribute to our stockholders a minimum of 90.0% of our annual taxable income, excluding net capital gains. Existing Internal Revenue Service, or IRS, guidance includes a safe harbor pursuant to which publicly offered REITs can satisfy the distribution requirement by distributing a combination of cash and stock to stockholders. In general, to qualify under the safe harbor, each stockholder must elect to receive either cash or stock, and the aggregate cash component of the distribution to stockholders must represent at least 20.0% of the total distribution. In May 2020, the IRS issued similar guidance that lowered the cash component of the distribution to 10.0% for dividends declared between April 1, 2020 and December 31, 2020. As a REIT, we generally will not be subject to federal income tax on taxable income that we distribute to our stockholders. If we fail to maintain our qualification as a REIT in any taxable year, we will then be subject to federal income taxes on our taxable income at regular corporate rates and will not be permitted to qualify for treatment as a REIT for federal income tax purposes for four years following the year during which qualification is lost unless the IRS grants us relief under certain statutory provisions. Such an event could have a material adverse effect on our net income and net cash available for distribution to our stockholders. We may be subject to certain state and local income taxes on our income, property or net worth in some jurisdictions, and in certain circumstances we may also be subject to federal excise taxes on undistributed income. In addition, certain activities that we undertake are conducted by subsidiaries, which we elected to be treated as taxable REIT subsidiaries, or TRS, to allow us to provide services that would otherwise be considered impermissible for REITs. Also, we have real estate investments in the UK and Isle of Man, which do not accord REIT status to United States REITs under their tax laws. Accordingly, we recognize an income tax benefit or expense for the federal, state and local income taxes incurred by our TRS and foreign income taxes on our real estate investments in the UK and Isle of Man. We account for deferred income taxes using the asset and liability method and recognize deferred tax assets and liabilities for the expected future tax consequences of events that have been included in our financial statements or tax returns. Under this method, we determine deferred tax assets and liabilities based on the temporary differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases using enacted tax rates in effect for the year in which the differences are expected to reverse. Deferred tax assets reflect the impact of the future deductibility of operating loss carryforwards. A valuation allowance is provided if we believe it is more likely than not that all or some portion of the deferred tax asset will not be realized. Any increase or decrease in the valuation allowance that results from a change in circumstances, and that causes us to change our judgment about the realizability of the related deferred tax asset, is included in income tax benefit or expense in our accompanying consolidated statements of operations and comprehensive income (loss) when such changes occur. Any increase or decrease in the deferred tax liability that results from a change in circumstances, and that causes us to change our judgment about expected future tax consequences of events, is recorded in income tax benefit or expense in our accompanying consolidated statements of operations and comprehensive income (loss).
Segment Disclosure	Segment DisclosureWe segregate our operations into reporting segments in order to assess the performance of our business in the same way that management reviews our performance and makes operating decisions.
GLA and Other Measures	GLA and Other Measures GLA and other measures used to describe real estate investments included in our accompanying consolidated financial statements are presented on an unaudited basis.
Recently Issued Accounting Pronouncements	Recently Issued Accounting Pronouncements In March 2020, the FASB issued ASU 2020-04, Facilitation of the Effects of Reference Rate Reform of Financial Reporting, or ASU 2020-04, which provides optional expedients and exceptions for applying GAAP to contract modifications, hedging relationships and other transactions, subject to meeting certain criteria. ASU 2020-04 applies to the aforementioned transactions that reference the London Inter-bank Offered Rate, or LIBOR, or another reference rate expected to be discontinued because of the reference rate reform. ASU 2020-04 is effective for fiscal years and interim periods beginning after March 12, 2020 and through December 31, 2022. We are currently evaluating this guidance to determine the impact on our disclosures. In April 2020, the FASB issued a question and answer document, or the Lease Modification Q&A, to provide guidance for the application of lease accounting modifications within ASC Topic 842 to lease concessions granted by lessors related to the effects of the COVID-19 pandemic. Lease accounting modification guidance in ASC Topic 842 addresses routine changes or enforceable rights and obligations to lease terms as a result of negotiations between the lessor and the lessee; however, the guidance does not take into consideration concessions granted to address sudden liquidity constraints of lessees arising from the COVID-19 pandemic. The underlying premise of ASC Topic 842 requires a modified lease to be accounted for as a new lease if the modified terms and conditions affect the economics of the lease for the remainder of the lease term. Further, a lease modification resulting from lease concessions would require the application of the modification framework pursuant to ASC Topic 842 on a lease-by-lease basis. The potential large volume of contracts to be assessed due to the COVID-19 pandemic may be burdensome and complex for entities to evaluate the lease modification accounting for each lease. Therefore, the Lease Modification Q&A allows entities to elect to account for lease concessions related to the effects of the COVID-19 pandemic as if they were granted under the enforceable rights included in the original contract and are outside of the lease modification framework pursuant to ASC Topic 842. Such election is available for lease concessions that do not result in a substantial increase in the rights of the lessor or the obligations of the lessee (e.g., total payments required by the modified contract being substantially the same as or less than total payments required by the original contract) and is to be applied consistently to leases with similar characteristics and circumstances. As a result of the COVID-19 pandemic, we have granted lease concessions to an insignificant number of tenants within our medical office building segment, such as in the form of rent abatements with beneficial lease term extensions and rent payment deferrals requiring payment within one year. Such concessions were not material to our consolidated financial statements, and as such, we elected not to apply the relief from lease modification accounting provided in the Lease Modification Q&A. We evaluate each lease concession granted as a result of the effects of the COVID-19 pandemic to determine whether the concession reflects: (i) a resolution of contractual rights in the original lease and is thus outside of the lease modification framework of ASC Topic 842; or (ii) a modification for which we would be required to apply the lease modification framework of ASC Topic 842. The application of the lease modification framework of ASC Topic 842 to lease concessions granted due to the effects of the COVID-19 pandemic did not have a material impact to our consolidated financial statements.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2020
Accounting Policies [Abstract]
Disaggregation of Revenue	The following table disaggregates our resident fees and services revenue by line of business, according to whether such revenue is recognized at a point in time or over time, for the years then ended: Integrated Senior Total 2020: Point in time $ 196,053,000 $ 2,861,000 $ 198,914,000 Over time 787,116,000 83,043,000 870,159,000 Total resident fees and services $ 983,169,000 $ 85,904,000 $ 1,069,073,000 2019: Point in time $ 214,650,000 $ 2,944,000 $ 217,594,000 Over time 816,284,000 65,200,000 881,484,000 Total resident fees and services $ 1,030,934,000 $ 68,144,000 $ 1,099,078,000 2018: Point in time $ 185,273,000 $ 3,079,000 $ 188,352,000 Over time 755,343,000 61,996,000 817,339,000 Total resident fees and services $ 940,616,000 $ 65,075,000 $ 1,005,691,000 The following table disaggregates our resident fees and services revenue by payor class for the years then ended: Integrated Senior Total 2020: Private and other payors $ 437,133,000 $ 84,308,000 $ 521,441,000 Medicare 356,350,000 — 356,350,000 Medicaid 189,686,000 1,596,000 191,282,000 Total resident fees and services $ 983,169,000 $ 85,904,000 $ 1,069,073,000 2019: Private and other payors $ 499,693,000 $ 67,930,000 $ 567,623,000 Medicare 338,466,000 — 338,466,000 Medicaid 192,775,000 214,000 192,989,000 Total resident fees and services $ 1,030,934,000 $ 68,144,000 $ 1,099,078,000 2018: Private and other payors $ 437,100,000 $ 65,032,000 $ 502,132,000 Medicare 332,852,000 — 332,852,000 Medicaid 170,664,000 43,000 170,707,000 Total resident fees and services $ 940,616,000 $ 65,075,000 $ 1,005,691,000 ___________ (1) Includes fees for basic housing and assisted living care. We record revenue when services are rendered at amounts billable to individual residents. Residency agreements are generally for a term of 30 days, with resident fees billed monthly in advance. For patients under reimbursement arrangements with Medicaid, revenue is recorded based on contractually agreed-upon amounts or rates on a per resident, daily basis or as services are rendered.
Contract with Customer, Asset and Liability	Accounts Receivable, Net — Resident Fees and Services Revenue The beginning and ending balances of accounts receivable, net — resident fees and services are as follows: Private Medicare Medicaid Total Beginning balance — January 1, 2020 $ 46,543,000 $ 32,127,000 $ 26,366,000 $ 105,036,000 Ending balance — December 31, 2020 36,125,000 36,479,000 14,473,000 87,077,000 (Decrease)/increase $ (10,418,000) $ 4,352,000 $ (11,893,000) $ (17,959,000) Deferred Revenue — Resident Fees and Services Revenue The beginning and ending balances of deferred revenue — resident fees and services, almost all of which relates to private and other payors, are as follows: Total Beginning balance — January 1, 2020 $ 13,518,000 Ending balance — December 31, 2020 10,597,000 Decrease $ (2,921,000)

Real Estate Investments, Net (T

Real Estate Investments, Net (Tables)	12 Months Ended
	Dec. 31, 2020
Real Estate [Abstract]
Real Estate Investments, Net	Our real estate investments, net consisted of the following as of December 31, 2020 and 2019: December 31, 2020 2019 Building, improvements and construction in process $ 2,379,337,000 $ 2,262,320,000 Land and improvements 200,319,000 195,491,000 Furniture, fixtures and equipment 174,994,000 150,508,000 2,754,650,000 2,608,319,000 Less: accumulated depreciation (424,650,000) (337,898,000) $ 2,330,000,000 $ 2,270,421,000
Summary of Acquisitions of Previously Leased Real Estate Investments	The following is a summary of such property acquisitions, which are included in our integrated senior health campuses segment: Location Date Contract Line of Credit(1) Acquisition Monticello, IN 07/30/20 $ 10,600,000 $ 13,200,000 $ 161,000 Louisville, KY 07/30/20 16,719,000 15,055,000 254,000 Total $ 27,319,000 $ 28,255,000 $ 415,000 ___________ (1) Represents borrowings under the 2019 Trilogy Credit Facility, as defined in Note 8, Lines of Credit and Term Loans, at the time of acquisition. (2) Our advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our properties, an acquisition fee of 2.25% of the portion of the contract purchase price of the properties attributed to our ownership interest in the Trilogy subsidiary that acquired the properties. Location Date Contract Line of Credit(1) Acquisition Corydon, IN 09/05/19 $ 14,082,000 $ 14,114,000 $ 215,000 ___________ (1) Represents a borrowing under the 2019 Trilogy Credit Facility, at the time of acquisition. (2) Our advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our property, an acquisition fee of 2.25% of the portion of the contract purchase price of the property attributed to our ownership interest at the time of acquisition in the Trilogy subsidiary that acquired the property. Locations Date Contract Mortgage Loan Acquisition Lexington, KY; Novi and Romeo, MI; and Fremont, OH 07/20/18 $ 47,455,000 $ 47,500,000 $ 723,000 ___________ (1) Represents the principal balance of the mortgage loan payable placed on the properties at the time of acquisition. (2) Our advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our properties, an acquisition fee of 2.25% of the portion of the contract purchase price of the properties attributed to our ownership interest at the time of acquisition in the Trilogy subsidiary that acquired the properties.
Summary of Assets Acquisitions	The following table summarizes the purchase price of the assets acquired at the time of acquisition, adjusted for $14,281,000 of operating lease right-of-use assets and $15,530,000 of operating lease liabilities, and based on their relative fair values: 2020 Building and improvements $ 26,311,000 Land 4,563,000 Total assets acquired $ 30,874,000 2019 Building and improvements $ 23,834,000 Land 8,496,000 In-place leases 3,596,000 Total assets acquired $ 35,926,000 2018 Building and improvements $ 49,757,000 Land 10,980,000 In-place leases 6,894,000 Certificates of need 1,313,000 Total assets acquired $ 68,944,000
Summary of Acquisitions	The following is a summary of such property acquisitions: Acquisition Location Type Date Contract Line of Credit Acquisition North Carolina ALF Portfolio(1) Garner, NC Senior Housing 03/27/19 $ 15,000,000 $ 15,000,000 $ 338,000 The Cloister at Silvercrest(2) New Albany, IN Integrated Senior Health Campus 10/01/19 750,000 — 11,000 Total $ 15,750,000 $ 15,000,000 $ 349,000 ___________ (1) We own 100% of such property acquired, which we added to our existing North Carolina ALF Portfolio. The other six buildings in North Carolina ALF Portfolio were acquired between January 2015 and August 2018. We borrowed under the 2019 Corporate Line of Credit, as defined in Note 8, Lines of Credit and Term Loans, at the time of acquisition. Our advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our property, an acquisition fee of 2.25% of the contract purchase price of such property. (2) We, through a majority-owned subsidiary of Trilogy, of which we owned 67.7% at the time of such property acquisition, acquired such property using cash on hand. Our advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our property, an acquisition fee of 2.25% of the portion of the contract purchase price of the property attributed to our ownership interest in the Trilogy subsidiary that acquired the property. Acquisition(1) Location Type Date Contract Line of Credit(2) Acquisition North Carolina ALF Portfolio Matthews, NC Senior Housing — RIDEA 08/30/18 $ 15,000,000 $ 13,500,000 $ 338,000 ___________ (1) We own 100% of our property acquired in 2018. (2) Represents a borrowing under the 2016 Corporate Line of Credit, as defined in Note 8, Lines of Credit and Term Loans, at the time of acquisition. (3) Our advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our property, an acquisition fee of 2.25% of the contract purchase price of such property.

Identified Intangible Assets,_2

Identified Intangible Assets, Net (Tables)	12 Months Ended
	Dec. 31, 2020
Finite-Lived Intangible Assets, Net [Abstract]
Identified Intangible Assets, Net	Identified intangible assets, net consisted of the following as of December 31, 2020 and 2019: December 31, 2020 2019 Amortized intangible assets: In-place leases, net of accumulated amortization of $22,019,000 and $21,029,000 as of December 31, 2020 and 2019, respectively (with a weighted average remaining life of 9.4 years as of both December 31, 2020 and 2019) $ 23,760,000 $ 30,407,000 Customer relationships, net of accumulated amortization of $486,000 and $336,000 as of December 31, 2020 and 2019, respectively (with a weighted average remaining life of 15.7 years and 16.8 years as of December 31, 2020 and 2019, respectively) 2,354,000 2,504,000 Above-market leases, net of accumulated amortization of $1,975,000 and $2,057,000 as of December 31, 2020 and 2019, respectively (with a weighted average remaining life of 4.6 years and 5.0 years as of December 31, 2020 and 2019, respectively) 1,032,000 1,452,000 Internally developed technology and software, net of accumulated amortization of $305,000 and $211,000 as of December 31, 2020 and 2019, respectively (with a weighted average remaining life of 1.7 years and 2.8 years as of December 31, 2020 and 2019, respectively) 165,000 259,000 Unamortized intangible assets: Certificates of need 96,589,000 94,838,000 Trade names 30,787,000 30,787,000 $ 154,687,000 $ 160,247,000
Amortization Expense on Identified Intangible Assets	As of December 31, 2020, estimated amortization expense on the identified intangible assets for each of the next five years ending December 31 and thereafter was as follows: Year Amount 2021 $ 4,639,000 2022 3,909,000 2023 3,140,000 2024 2,723,000 2025 2,210,000 Thereafter 10,690,000 $ 27,311,000

Other Assets, Net (Tables)

Other Assets, Net (Tables)	12 Months Ended
	Dec. 31, 2020
Other Assets [Abstract]
Other Assets, Net	Other assets, net consisted of the following as of December 31, 2020 and 2019: December 31, 2020 2019 Deferred rent receivables $ 38,918,000 $ 33,205,000 Prepaid expenses, deposits, other assets and deferred tax assets, net 16,618,000 40,354,000 Inventory 24,669,000 23,872,000 Investments in unconsolidated entities 16,469,000 20,176,000 Lease commissions, net of accumulated amortization of $3,413,000 and $2,201,000 as of December 31, 2020 and 2019, respectively 11,309,000 10,794,000 Deferred financing costs, net of accumulated amortization of $5,700,000 and $2,138,000 as of December 31, 2020 and 2019, respectively(1) 6,864,000 8,137,000 Lease inducement, net of accumulated amortization of $1,491,000 and $1,140,000 as of December 31, 2020 and 2019, respectively (with a weighted average remaining life of 9.9 years and 10.9 years as of December 31, 2020 and 2019, respectively) 3,509,000 3,860,000 $ 118,356,000 $ 140,398,000 ___________ (1) Deferred financing costs only include costs related to our lines of credit and term loans. See Note 8, Lines of Credit and Term Loans.

Mortgage Loans Payable, Net (Ta

Mortgage Loans Payable, Net (Tables)	12 Months Ended
	Dec. 31, 2020
Mortgage Loans Payable, Net [Abstract]
Mortgage Loans Payable, Net	Mortgage loans payable, net consisted of the following as of December 31, 2020 and 2019: December 31, 2020 2019 Total fixed-rate debt $ 742,686,000 $ 714,786,000 Total variable-rate debt 91,340,000 101,431,000 Total fixed- and variable-rate debt 834,026,000 816,217,000 Less: deferred financing costs, net (10,389,000) (9,362,000) Add: premium 204,000 304,000 Less: discount (13,363,000) (14,289,000) Mortgage loans payable, net $ 810,478,000 $ 792,870,000
Schedule of Activity Related to Mortgage Loans Payable	The following table reflects the changes in the carrying amount of mortgage loans payable, net for the years ended December 31, 2020 and 2019: Years Ended December 31, 2020 2019 Beginning balance $ 792,870,000 $ 688,262,000 Additions: Borrowings under mortgage loans payable 92,399,000 191,246,000 Amortization of deferred financing costs 796,000 1,544,000 Amortization of discount/premium on mortgage loans payable 826,000 647,000 Deductions: Scheduled principal payments on mortgage loans payable (71,990,000) (74,037,000) Early payoff of mortgage loans payable (2,601,000) (14,022,000) Deferred financing costs (1,822,000) (770,000) Ending balance $ 810,478,000 $ 792,870,000
Principal Payments Due on Mortgage Loans Payable	As of December 31, 2020, the principal payments due on our mortgage loans payable for each of the next five years ending December 31 and thereafter were as follows: Year Amount 2021 $ 54,169,000 2022 62,985,000 2023 67,651,000 2024 80,451,000 2025 15,324,000 Thereafter 553,446,000 $ 834,026,000

Derivative Financial Instrume_2

Derivative Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2020
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Derivative Financial Instruments	The following table lists the derivative financial instruments held by us as of December 31, 2020 and 2019, which are included in other assets, net, or security deposits, prepaid rent and other liabilities in our accompanying consolidated balance sheets: Fair Value December 31, Instrument Notional Amount Index Interest Rate Maturity Date 2020 2019 Cap $ 20,000,000 one month LIBOR 3.00% 09/23/21 $ — $ — Swap 250,000,000 one month LIBOR 2.10% 01/25/22 (5,245,000) (2,821,000) Swap 130,000,000 one month LIBOR 1.98% 01/25/22 (2,561,000) (1,150,000) Swap 100,000,000 one month LIBOR 0.20% 01/25/22 (71,000) — $ (7,877,000) $ (3,971,000)

Identified Intangible Liabili_2

Identified Intangible Liabilities, Net (Tables)	12 Months Ended
	Dec. 31, 2020
Identified Intangible Liabilities [Abstract]
Summary of Amortization Expense on Below Market Leases	As of December 31, 2020, estimated amortization expense on below-market leases for each of the next five years ending December 31 and thereafter was as follows: Year Amount 2021 $ 180,000 2022 89,000 2023 71,000 2024 27,000 2025 — Thereafter — $ 367,000

Redeemable Noncontrolling Int_2

Redeemable Noncontrolling Interests (Tables)	12 Months Ended
	Dec. 31, 2020
Temporary Equity [Abstract]
Redeemable Noncontrolling Interest	The changes in the carrying amount of redeemable noncontrolling interests consisted of the following for the years ended December 31, 2020 and 2019: December 31, 2020 2019 Beginning balance $ 44,105,000 $ 38,245,000 Additions — 2,000,000 Reclassification from equity 715,000 780,000 Distributions (1,271,000) (1,430,000) Repurchase of redeemable noncontrolling interests (150,000) (400,000) Adjustment to redemption value (3,714,000) 4,473,000 Net income attributable to redeemable noncontrolling interests 655,000 437,000 Ending balance $ 40,340,000 $ 44,105,000

Equity (Tables)

Equity (Tables)	12 Months Ended
	Dec. 31, 2020
Equity [Abstract]
Schedule of Accumulated Other Comprehensive Loss	The changes in accumulated other comprehensive loss, net of noncontrolling interests, by component consisted of the following for the years ended December 31, 2020 and 2019: December 31, 2020 2019 Beginning balance — foreign currency translation adjustments $ (2,255,000) $ (2,560,000) Net change in current period 247,000 305,000 Ending balance — foreign currency translation adjustments $ (2,008,000) $ (2,255,000)
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share	The following is a summary of our historical estimated per share NAV: Approval Date by our Board Estimated Per Share NAV 10/05/16 $ 9.01 10/04/17 $ 9.27 10/03/18 $ 9.37 10/03/19 $ 9.40

Related Party Transactions (Tab

Related Party Transactions (Tables)	12 Months Ended
	Dec. 31, 2020
Related Party Transactions [Abstract]
Schedule of Limitation on Affiliate Reimbursement	The following table reflects our operating expenses as a percentage of average invested assets and as a percentage of net income for the 12 month periods then ended: 12 Months Ended December 31, 2020 2019 2018 Operating expenses as a percentage of average invested assets 1.0 % 0.9 % 0.9 % Operating expenses as a percentage of net income 22.1 % 18.9 % 19.1 %
Schedule Of Amount Outstanding To Affiliates Table	The following amounts were outstanding to our affiliates as of December 31, 2020 and 2019: December 31, Fee 2020 2019 Asset and property management fees $ 7,155,000 $ 1,991,000 Development fees 743,000 — Construction management fees 91,000 175,000 Lease commissions 27,000 143,000 Operating expenses 10,000 12,000 $ 8,026,000 $ 2,321,000

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	12 Months Ended
	Dec. 31, 2020
Fair Value Disclosures [Abstract]
Assets and Liabilities Measured at Fair Value on Recurring Basis	The table below presents our assets and liabilities measured at fair value on a recurring basis as of December 31, 2020, aggregated by the level in the fair value hierarchy within which those measurements fall: Quoted Prices in Significant Other Significant Total Assets: Derivative financial instrument $ — $ — $ — $ — Total assets at fair value $ — $ — $ — $ — Liabilities: Derivative financial instruments $ — $ 7,877,000 $ — $ 7,877,000 Warrants — — 1,025,000 1,025,000 Total liabilities at fair value $ — $ 7,877,000 $ 1,025,000 $ 8,902,000 The table below presents our assets and liabilities measured at fair value on a recurring basis as of December 31, 2019, aggregated by the level in the fair value hierarchy within which those measurements fall: Quoted Prices in Significant Other Significant Total Assets: Derivative financial instrument $ — $ — $ — $ — Total assets at fair value $ — $ — $ — $ — Liabilities: Derivative financial instruments $ — $ 3,971,000 $ — $ 3,971,000 Warrants — — 1,178,000 1,178,000 Total liabilities at fair value $ — $ 3,971,000 $ 1,178,000 $ 5,149,000
Fair Value, Contingent Consideration Liability Measured on Recurring Basis, Unobservable Input Reconciliation	The following is a reconciliation of the beginning and ending balances of our contingent consideration obligations for the years ended December 31, 2020, 2019 and 2018: Years Ended December 31, 2020 2019 2018 Contingent Consideration Obligations: Beginning balance $ — $ 681,000 $ 5,107,000 Realized/unrealized gains recognized in earnings — (681,000) (2,843,000) Settlements of obligations — — (1,583,000) Ending balance $ — $ — $ 681,000 Amount of total gains included in earnings attributable to the change in unrealized gains related to obligations still held $ — $ (681,000) $ (2,843,000)
Inputs Related to Non-recurring Fair Value Measurements	The following table is a summary of the quantitative information related to the non-recurring fair value measurement for the impairment of our real estate investment as of December 31, 2018: Range of Inputs or Inputs Unobservable Inputs Market rent per square foot $13.75 to $25.00 Capitalization rate 7.50 % Discount rate 8.00 %
Fair Value, by Balance Sheet Grouping	The carrying amounts and estimated fair values of such financial instruments as of December 31, 2020 and 2019 were as follows: December 31, 2020 2019 Carrying Fair Carrying Fair Financial Assets: Debt security investment $ 75,851,000 $ 94,033,000 $ 72,717,000 $ 94,026,000 Financial Liabilities: Mortgage loans payable $ 810,478,000 $ 830,049,000 $ 792,870,000 $ 732,846,000 Lines of credit and term loans $ 836,770,000 $ 847,048,000 $ 807,742,000 $ 816,355,000 ___________ (1) Carrying amount is net of any discount/premium and unamortized costs.

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Schedule of Income before Income Tax, Domestic and Foreign	The components of income or loss before taxes for the years ended December 31, 2020, 2019 and 2018, were as follows: December 31, 2020 2019 2018 Domestic $ 6,171,000 $ 1,193,000 $ 14,202,000 Foreign (386,000) (521,000) (462,000) Income before income taxes $ 5,785,000 $ 672,000 $ 13,740,000
Schedule of Components of Income Tax (Benefit) Expense	The components of income tax benefit or expense for the years ended December 31, 2020, 2019 and 2018 were as follows: December 31, 2020 2019 2018 Federal deferred $ (4,818,000) $ (3,672,000) $ (4,647,000) State deferred (932,000) (737,000) (922,000) Federal current (361,000) (29,000) — State current — (16,000) — Foreign current 612,000 605,000 988,000 Valuation allowances 2,421,000 5,373,000 3,784,000 Total income tax (benefit) expense $ (3,078,000) $ 1,524,000 $ (797,000)
Schedule of Deferred Tax Assets and Liabilities	The components of deferred tax assets and liabilities as of December 31, 2020 and 2019 were as follows: December 31, 2020 2019 Deferred income tax assets: Fixed assets and intangibles $ 5,619,000 $ 6,509,000 Expense accruals and other 13,968,000 14,233,000 Net operating loss 21,168,000 14,341,000 Reserves and accruals 6,541,000 5,540,000 Allowances for accounts receivable 1,932,000 (179,000) Investments in unconsolidated entities 2,357,000 2,326,000 Total deferred income tax assets $ 51,585,000 $ 42,770,000 Deferred income tax liabilities: Fixed assets and intangibles $ (16,840,000) $ (14,468,000) Other — temporary differences (2,868,000) (2,176,000) Total deferred income tax liabilities $ (19,708,000) $ (16,644,000) Net deferred income tax assets before valuation allowance $ 31,877,000 $ 26,126,000 Valuation allowances (31,877,000) (29,455,000) Net deferred income tax assets (liabilities) $ — $ (3,329,000)
Summary of Tax Treatment of Distributions	The income tax treatment for distributions reportable for the years ended December 31, 2020, 2019 and 2018 was as follows: Years Ended December 31, 2020 2019 2018 Ordinary income $ — — % $ 35,294,000 29.9 % $ 33,141,000 27.6 % Capital gain — — — — — — Return of capital 48,842,000 100 82,731,000 70.1 86,833,000 72.4 $ 48,842,000 100 % $ 118,025,000 100 % $ 119,974,000 100 %

Leases (Tables)

Leases (Tables)	12 Months Ended
	Dec. 31, 2020
Leases [Abstract]
Schedule of Lease Payments to be Received	As of December 31, 2020, the following table sets forth the undiscounted cash flows for future minimum base rents due under operating leases for each of the next five years ending December 31 and thereafter for properties that we wholly own: Year Amount 2021 $ 89,484,000 2022 83,728,000 2023 76,843,000 2024 70,123,000 2025 61,594,000 Thereafter 410,526,000 Total $ 792,298,000
Schedule of Lease Cost	The components of lease costs were as follows: Years Ended December 31, Lease Cost Classification 2020 2019 Operating lease cost(1) Property operating expenses and rental expenses $ 32,441,000 $ 29,974,000 Finance lease cost Amortization of leased assets Depreciation and amortization 1,891,000 2,001,000 Interest on lease liabilities Interest expense 609,000 391,000 Total lease cost $ 34,941,000 $ 32,366,000 ___________ (1) Includes short-term leases and variable lease costs, which are immaterial. Additional information related to our leases for the periods presented below was as follows: December 31, Lease Term and Discount Rate 2020 2019 Weighted average remaining lease term (in years) Operating leases 13.3 13.5 Finance leases 1.3 1.3 Weighted average discount rate Operating leases 5.77 % 5.94 % Finance leases 5.62 % 7.33 % Years Ended December 31, Supplemental Disclosure of Cash Flows Information 2020 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash outflows related to operating leases $ 23,790,000 $ 22,114,000 Operating cash outflows related to finance leases $ 609,000 $ 390,000 Financing cash outflows related to finance leases $ 1,235,000 $ 3,076,000 Leased assets obtained in exchange for finance lease liabilities $ 66,000 $ — Right-of-use assets obtained in exchange for operating lease liabilities $ 14,302,000 $ 31,958,000
Schedule of Operating Lease Liability	As of December 31, 2020, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for each of the next five years ending December 31 and thereafter, as well as the reconciliation of those cash flows to operating lease liabilities on our accompanying consolidated balance sheet: Year Amount 2021 $ 23,875,000 2022 24,328,000 2023 24,520,000 2024 23,756,000 2025 23,639,000 Thereafter 167,081,000 Total operating lease payments 287,199,000 Less: interest 93,565,000 Present value of operating lease liabilities $ 193,634,000
Schedule of Finance Lease Liability	Finance Leases As of December 31, 2020, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for each of the next five years ending December 31 and thereafter, as well as a reconciliation of those cash flows to finance lease liabilities: Year Amount 2021 $ 151,000 2022 22,000 2023 16,000 2024 — 2025 — Thereafter — Total finance lease payments 189,000 Less: interest 8,000 Present value of finance lease liabilities $ 181,000

Segment Reporting (Tables)

Segment Reporting (Tables)	12 Months Ended
	Dec. 31, 2020
Segment Reporting [Abstract]
Summary Information by Reportable Segment	Summary information for the reportable segments during the years ended December 31, 2020, 2019 and 2018 was as follows: Integrated Senior Housing — RIDEA Medical Senior Skilled Hospitals Year Ended December 31, 2020 Revenues and grant income: Resident fees and services $ 983,169,000 $ 85,904,000 $ — $ — $ — $ — $ 1,069,073,000 Real estate revenue — — 78,424,000 14,524,000 16,107,000 10,992,000 120,047,000 Grant income 53,855,000 1,326,000 — — — — 55,181,000 Total revenues and grant income 1,037,024,000 87,230,000 78,424,000 14,524,000 16,107,000 10,992,000 1,244,301,000 Expenses: Property operating expenses 929,897,000 63,830,000 — — — — 993,727,000 Rental expenses — — 30,216,000 64,000 1,572,000 446,000 32,298,000 Segment net operating income $ 107,127,000 $ 23,400,000 $ 48,208,000 $ 14,460,000 $ 14,535,000 $ 10,546,000 $ 218,276,000 Expenses: General and administrative $ 27,007,000 Acquisition related expenses 290,000 Depreciation and amortization 98,858,000 Other income (expense): Interest expense: Interest expense (including amortization of deferred financing costs and debt discount/premium) (71,278,000) Loss in fair value of derivative financial instruments (3,906,000) Gain on dispositions of real estate investments 1,395,000 Impairment of real estate investments (11,069,000) Loss from unconsolidated entities (4,517,000) Foreign currency gain 1,469,000 Other income 1,570,000 Income before income taxes 5,785,000 Income tax benefit 3,078,000 Net income $ 8,863,000 Integrated Senior Medical Senior Skilled Hospitals Year Ended December 31, 2019 Revenues: Resident fees and services $ 1,030,934,000 $ 68,144,000 $ — $ — $ — $ — $ 1,099,078,000 Real estate revenue — — 80,805,000 18,407,000 13,345,000 11,481,000 124,038,000 Total revenues 1,030,934,000 68,144,000 80,805,000 18,407,000 13,345,000 11,481,000 1,223,116,000 Expenses: Property operating expenses 919,793,000 48,067,000 — — — — 967,860,000 Rental expenses — — 30,870,000 1,001,000 1,456,000 532,000 33,859,000 Segment net operating income $ 111,141,000 $ 20,077,000 $ 49,935,000 $ 17,406,000 $ 11,889,000 $ 10,949,000 $ 221,397,000 Expenses: General and administrative $ 29,749,000 Acquisition related expenses (161,000) Depreciation and amortization 111,412,000 Other income (expense): Interest expense: Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishment) (78,553,000) Loss in fair value of derivative financial instruments (4,541,000) Loss from unconsolidated entities (2,097,000) Foreign currency gain 1,730,000 Other income 3,736,000 Income before income taxes 672,000 Income tax expense (1,524,000) Net loss $ (852,000) Integrated Senior Housing — RIDEA Medical Senior Skilled Hospitals Year Ended December 31, 2018 Revenues: Resident fees and services $ 940,616,000 $ 65,075,000 $ — $ — $ — $ — $ 1,005,691,000 Real estate revenue — — 80,078,000 21,913,000 14,887,000 12,691,000 129,569,000 Total revenues 940,616,000 65,075,000 80,078,000 21,913,000 14,887,000 12,691,000 1,135,260,000 Expenses: Property operating expenses 844,279,000 44,792,000 — — — — 889,071,000 Rental expenses — — 30,514,000 837,000 1,816,000 1,656,000 34,823,000 Segment net operating income $ 96,337,000 $ 20,283,000 $ 49,564,000 $ 21,076,000 $ 13,071,000 $ 11,035,000 $ 211,366,000 Expenses: General and administrative $ 28,770,000 Acquisition related expenses (2,913,000) Depreciation and amortization 95,678,000 Other income (expense): Interest expense: Interest expense (including amortization of deferred financing costs and debt discount/premium) (66,281,000) Loss in fair value of derivative financial instruments (1,949,000) Impairment of real estate investment (2,542,000) Loss from unconsolidated entities (3,877,000) Foreign currency loss (2,690,000) Other income 1,248,000 Income before income taxes 13,740,000 Income tax benefit 797,000 Net income $ 14,537,000
Assets by Reportable Segment	Total assets by reportable segment as of December 31, 2020 and 2019 were as follows: December 31, 2020 2019 Integrated senior health campuses $ 1,886,878,000 $ 1,791,868,000 Medical office buildings 610,653,000 620,292,000 Senior housing — RIDEA 348,987,000 360,823,000 Senior housing 152,406,000 152,909,000 Skilled nursing facilities 115,941,000 126,606,000 Hospitals 109,663,000 113,737,000 Other 10,409,000 6,054,000 Total assets $ 3,234,937,000 $ 3,172,289,000
Revenues and Grant Income and Real Estate Investments by Geographical Areas	The following is a summary of geographic information for our operations for the periods presented: Years Ended December 31, 2020 2019 2018 Revenues and grant income: United States $ 1,239,509,000 $ 1,218,337,000 $ 1,130,350,000 International 4,792,000 4,779,000 4,910,000 $ 1,244,301,000 $ 1,223,116,000 $ 1,135,260,000 The following is a summary of real estate investments, net by geographic regions as of December 31, 2020 and 2019: December 31, 2020 2019 Real estate investments, net: United States $ 2,279,257,000 $ 2,219,882,000 International 50,743,000 50,539,000 $ 2,330,000,000 $ 2,270,421,000

Organization and Description _2

Organization and Description of Business (Detail) ft² in Thousands	Dec. 31, 2020ft²segment	Feb. 26, 2014	Dec. 31, 2020USD ($)ft²segment	Dec. 31, 2019USD ($)shares	Dec. 31, 2018USD ($)shares	Apr. 21, 2015USD ($)shares	Dec. 31, 2020USD ($)ft²shares	Mar. 29, 2019USD ($)shares	Dec. 31, 2019USD ($)shares	Dec. 31, 2020USD ($)ft²shares	Dec. 31, 2020USD ($)ft²PropertyBuildingCampus	Jan. 30, 2019USD ($)	Mar. 25, 2015USD ($)
Schedule of Capitalization, Equity [Line Items]
Issuance of common stock under the DRIP			$ 21,861,000	$ 55,440,000	$ 60,030,000				$ 305,151,000	$ 327,012,000
Issuance of common stock under the DRIP, shares | shares									32,733,694	35,059,456
Advisory agreement term		1 year
Advisory agreement renewal term		1 year
Number of reportable segments | segment	6		6
Number of properties acquired from unaffiliated parties | Property											97
Number of buildings acquired from unaffiliated parties | Building											101
Number of integrated senior health campuses acquired from unaffiliated parties | Campus											119
GLA (Sq Ft) | ft²	14,110		14,110				14,110			14,110	14,110
Acquisition aggregated cost of acquired properties purchase price, net of dispositions											$ 3,076,041,000
Acquisition aggregated cost of acquired real estate-related investments purchase price, net of principal repayments											$ 60,429,000
AHI Group Holdings, LLC [Member]
Schedule of Capitalization, Equity [Line Items]
Ownership percentage in affiliate	47.10%		47.10%				47.10%			47.10%	47.10%
Colony Capital Inc. [Member]
Schedule of Capitalization, Equity [Line Items]
Ownership percentage in affiliate	45.10%		45.10%				45.10%			45.10%	45.10%
James F. Flaherty III [Member]
Schedule of Capitalization, Equity [Line Items]
Ownership percentage in affiliate	7.80%		7.80%				7.80%			7.80%	7.80%
American Healthcare Investors [Member]
Schedule of Capitalization, Equity [Line Items]
Ownership percentage in affiliate	75.00%		75.00%				75.00%			75.00%	75.00%
Griffin Capital Company [Member]
Schedule of Capitalization, Equity [Line Items]
Ownership percentage in affiliate	25.00%		25.00%				25.00%			25.00%	25.00%
Common Stock
Schedule of Capitalization, Equity [Line Items]
Subscriptions in offering of common stock received and accepted shares | shares						184,930,598
Subscriptions in offering of common stock received and accepted value						$ 1,842,618,000
DRIP [Member]
Schedule of Capitalization, Equity [Line Items]
Subscriptions in offering of common stock received and accepted shares | shares						1,948,563
Subscriptions in offering of common stock received and accepted value						$ 18,511,000
2015 DRIP Offering [Member]
Schedule of Capitalization, Equity [Line Items]
Maximum dollar amount of common stock issuable under public offering													$ 250,000,000
Issuance of common stock under the DRIP				$ 55,440,000	$ 60,030,000			$ 245,396,000
Issuance of common stock under the DRIP, shares | shares				5,913,684	6,464,432			26,386,545
2019 DRIP Offering [Member]
Schedule of Capitalization, Equity [Line Items]
Maximum dollar amount of common stock issuable under public offering												$ 200,000,000
Issuance of common stock under the DRIP							$ 63,105,000
Issuance of common stock under the DRIP, shares | shares							6,724,348

Summary of Significant Accoun_4

Summary of Significant Accounting Policies (Detail)		Dec. 31, 2020USD ($)segment	Jun. 30, 2019USD ($)	Jun. 30, 2021	Dec. 31, 2020USD ($)Campussegment	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)	Dec. 31, 2019USD ($)	Dec. 31, 2020USD ($)	Jan. 01, 2020USD ($)	Jan. 01, 2019USD ($)
Operating lease liabilities	[1]	$ 193,634,000			$ 193,634,000	$ 207,371,000		$ 207,371,000	$ 193,634,000
Operating lease right-of-use assets, net		203,988,000			203,988,000	219,187,000		219,187,000	203,988,000
Resident fees and services					1,069,073,000	1,099,078,000	$ 1,005,691,000
Accounts receivable, allowance for credit loss		9,466,000			9,466,000	11,435,000		11,435,000	9,466,000
Accounts receivable, allowance for credit loss, increase					12,494,000	13,087,000	8,520,000
Accounts receivable, allowance for credit loss, decrease from collections or adjustments					(7,697,000)	(6,094,000)	(1,437,000)
Accounts receivable, allowance for credit loss, writeoff					(6,766,000)	(6,774,000)	(6,405,000)
Asset impairment charges					0	0	0
Other asset impairment charges					0	0	0
Payroll related costs		46,540,000			46,540,000	24,118,000		24,118,000	46,540,000
Insurance reserves		36,251,000			36,251,000	35,581,000		35,581,000	36,251,000
Accrued developments and capital expenditures		21,508,000			21,508,000	25,019,000		25,019,000	21,508,000
Accrued property taxes		14,521,000			14,521,000	14,501,000		14,501,000	14,521,000
Accrued distributions		$ 0			$ 0	9,974,000	10,189,000	9,974,000	$ 0
Percentage Of Income Required to be Distributed As Dividends		90.00%			90.00%				90.00%
Number of reportable segments | segment		6			6
Grant income					$ 55,181,000	0	0
Number of Senior Integrated Health Campuses Impaired | Campus					2
Impairment of real estate investments					$ 11,069,000	0	2,542,000
Number of integrated senior health campuses disposed of | Campus					2
Gain on dispositions of real estate investments					$ 1,395,000	0	0
Principal repayments on real estate notes receivable			$ 28,650,000		0	28,650,000	1,799,000
Government Assistance, CARES Act [Member]
Grant income, property operating expenses					519,000	0	0
Deferred grant income		$ 2,635,000			2,635,000	0		$ 0	$ 2,635,000
Proceeds from government assistance					$ 52,322,000
General Partnership [Member]
Percentage of ownership in operating partnership								99.99%	99.99%
Limited Partnership [Member]
Percentage of limited partnership interest								0.01%	0.01%
Building and Building Improvements [Member]
Estimated useful life					39 years
Leasehold Improvements [Member] | Maximum [Member]
Estimated useful life					34 years
Furniture, fixtures, and equipment [Member] | Maximum [Member]
Estimated useful life					28 years
Integrated Senior Health Campuses [Member]
Impairment of real estate investments					$ 2,719,000
Carrying value after impairment		807,000			807,000				$ 807,000
Contract sales price of dispositions					10,457,000
Gain on dispositions of real estate investments					1,380,000
Other Properties Held for Sale [Member]
Impairment of real estate investments						0	0
Accounting Standards Update 2016-02 [Member]
Operating lease liabilities											$ 198,453,000
Operating lease right-of-use assets, net											$ 211,679,000
Forecast [Member]
Deferral and Extension Term, COVID-19				1 year
Integrated Senior Health Campuses [Member]
Resident fees and services					983,169,000	1,030,934,000	940,616,000
Grant income					53,855,000	0	0
Senior Housing-RIDEA [Member]
Resident fees and services					85,904,000	68,144,000	65,075,000
Grant income					1,326,000	0	0
Resident Fees and Services [Member]
Resident fees and services					1,069,073,000	1,099,078,000	1,005,691,000
Accounts receivable, net - resident fees and services, beginning balance		87,077,000			87,077,000				87,077,000	$ 105,036,000
Accounts receivable, net - resident fees and services, ending balance		87,077,000			87,077,000				87,077,000	105,036,000
(Decrease) increase in accounts receivable, net - resident fees and services					(17,959,000)
Deferred revenue, net - resident fees and services, beginning balance		10,597,000			10,597,000				10,597,000	13,518,000
Deferred revenue, net - resident fees and services, ending balance		10,597,000			10,597,000				10,597,000	13,518,000
Decrease in deferred revenue, resident fees and services					(2,921,000)
Resident Fees and Services [Member] | Integrated Senior Health Campuses [Member]
Resident fees and services					983,169,000	1,030,934,000	940,616,000
Resident Fees and Services [Member] | Senior Housing-RIDEA [Member]
Resident fees and services					85,904,000	68,144,000	65,075,000
Resident Fees and Services [Member] | Transferred at Point in Time [Member]
Resident fees and services					198,914,000	217,594,000	188,352,000
Resident Fees and Services [Member] | Transferred at Point in Time [Member] | Integrated Senior Health Campuses [Member]
Resident fees and services					196,053,000	214,650,000	185,273,000
Resident Fees and Services [Member] | Transferred at Point in Time [Member] | Senior Housing-RIDEA [Member]
Resident fees and services					2,861,000	2,944,000	3,079,000
Resident Fees and Services [Member] | Transferred over Time [Member]
Resident fees and services					870,159,000	881,484,000	817,339,000
Resident Fees and Services [Member] | Transferred over Time [Member] | Integrated Senior Health Campuses [Member]
Resident fees and services					787,116,000	816,284,000	755,343,000
Resident Fees and Services [Member] | Transferred over Time [Member] | Senior Housing-RIDEA [Member]
Resident fees and services					83,043,000	65,200,000	61,996,000
Private and Other Payors [Member] | Resident Fees and Services [Member]
Resident fees and services					521,441,000	567,623,000	502,132,000
Accounts receivable, net - resident fees and services, beginning balance		36,125,000			36,125,000				36,125,000	46,543,000
Accounts receivable, net - resident fees and services, ending balance		36,125,000			36,125,000				36,125,000	46,543,000
(Decrease) increase in accounts receivable, net - resident fees and services					(10,418,000)
Private and Other Payors [Member] | Resident Fees and Services [Member] | Integrated Senior Health Campuses [Member]
Resident fees and services					437,133,000	499,693,000	437,100,000
Private and Other Payors [Member] | Resident Fees and Services [Member] | Senior Housing-RIDEA [Member]
Resident fees and services					84,308,000	67,930,000	65,032,000
Medicare [Member] | Resident Fees and Services [Member]
Resident fees and services					356,350,000	338,466,000	332,852,000
Accounts receivable, net - resident fees and services, beginning balance		36,479,000			36,479,000				36,479,000	32,127,000
Accounts receivable, net - resident fees and services, ending balance		36,479,000			36,479,000				36,479,000	32,127,000
(Decrease) increase in accounts receivable, net - resident fees and services					4,352,000
Medicare [Member] | Resident Fees and Services [Member] | Integrated Senior Health Campuses [Member]
Resident fees and services					356,350,000	338,466,000	332,852,000
Medicare [Member] | Resident Fees and Services [Member] | Senior Housing-RIDEA [Member]
Resident fees and services					0	0	0
Medicaid [Member] | Resident Fees and Services [Member]
Resident fees and services					191,282,000	192,989,000	170,707,000
Accounts receivable, net - resident fees and services, beginning balance		14,473,000			14,473,000				14,473,000	26,366,000
Accounts receivable, net - resident fees and services, ending balance		$ 14,473,000			14,473,000				$ 14,473,000	$ 26,366,000
(Decrease) increase in accounts receivable, net - resident fees and services					(11,893,000)
Medicaid [Member] | Resident Fees and Services [Member] | Integrated Senior Health Campuses [Member]
Resident fees and services					189,686,000	192,775,000	170,664,000
Medicaid [Member] | Resident Fees and Services [Member] | Senior Housing-RIDEA [Member]
Resident fees and services					$ 1,596,000	$ 214,000	$ 43,000
[1]	Such liabilities of Griffin-American Healthcare REIT III, Inc. as of December 31, 2020 and 2019 represented liabilities of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries. Griffin-American Healthcare REIT III Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of Griffin-American Healthcare REIT III, Inc. The creditors of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries do not have recourse against Griffin-American Healthcare REIT III, Inc., except for the 2019 Corporate Line of Credit, as defined in Note 8, held by Griffin-American Healthcare REIT III Holdings, LP in the amount of $556,500,000 and $557,000,000 as of December 31, 2020 and 2019, respectively, which is guaranteed by Griffin-American Healthcare REIT III, Inc.

Real Estate Investments, Net -

Real Estate Investments, Net - Investments in Consolidated Properties (Detail) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Real Estate Properties [Line Items]
Real estate investments, at cost	$ 2,754,650	$ 2,608,319
Less: accumulated depreciation	(424,650)	(337,898)
Real estate investments, net	2,330,000	2,270,421
Building, improvements and construction in process [Member]
Real Estate Properties [Line Items]
Real estate investments, at cost	2,379,337	2,262,320
Land and Land Improvements [Member]
Real Estate Properties [Line Items]
Real estate investments, at cost	200,319	195,491
Furniture, fixtures, and equipment [Member]
Real Estate Properties [Line Items]
Real estate investments, at cost	$ 174,994	$ 150,508

Real Estate Investments, Net _2

Real Estate Investments, Net - Additional Information (Detail)	12 Months Ended			96 Months Ended
	Dec. 31, 2020USD ($)CampusBuildingfacility	Dec. 31, 2019USD ($)BuildingCampus	Dec. 31, 2018USD ($)CampusBuilding	Dec. 31, 2020USD ($)BuildingCampus
Real Estate Properties [Line Items]
Depreciation	$ 90,997,000	$ 90,914,000	$ 83,309,000
Impairment of real estate investments	$ 11,069,000	$ 0	$ 2,542,000
Number of Medical Office Buildings Impaired | Building	1	1
Number of integrated senior health campuses development completed | Campus	6	2
Number of integrated senior health campuses expanded | Campus	2		3
Number of buildings acquired from unaffiliated parties | Building				101
Number of integrated senior health campuses acquired from unaffiliated parties | Campus				119
Number of Skilled Nursing Facilities Impaired | facility	1
Gain on dispositions of real estate investments	$ 1,395,000	$ 0	$ 0
North Carolina ALF Portfolio [Member]
Real Estate Properties [Line Items]
Number of buildings acquired from unaffiliated parties | Building		6	5
Integrated Senior Health Campuses [Member]
Real Estate Properties [Line Items]
Capital Expenditures Incurred	111,286,000	$ 93,485,000	$ 76,330,000
Total completed development cost	64,782,000	25,087,000
Total completed expansion cost	2,573,000		8,309,000
Medical Office Building [Member]
Real Estate Properties [Line Items]
Capital Expenditures Incurred	17,854,000	16,571,000	8,426,000
Senior Housing-RIDEA [Member]
Real Estate Properties [Line Items]
Capital Expenditures Incurred	1,232,000	2,015,000	1,711,000
Skilled Nursing Facilities [Member]
Real Estate Properties [Line Items]
Capital Expenditures Incurred	0	1,954,000	463,000
Hospitals [Member]
Real Estate Properties [Line Items]
Capital Expenditures Incurred	47,000	53,000	131,000
Senior Housing [Member]
Real Estate Properties [Line Items]
Capital Expenditures Incurred	0	$ 0	$ 0
Two Thousand Twenty Acquisition [Member] [Domain]
Real Estate Properties [Line Items]
Acquisition contract purchase price of land acquired	2,833,000
Asset Acquisition, Transaction Costs	$ 709,000			$ 709,000
Two Thousand Twenty Acquisitions, Previously Leased [Member]
Real Estate Properties [Line Items]
Ownership Percentage, Properties	67.60%
Percentage of contract purchase price paid acquisition fee, in cash	2.25%
Contract purchase price	$ 27,319,000
Two Thousand Twenty Acquisitions, Previously Leased [Member] | Trilogy Investors, LLC [Member]
Real Estate Properties [Line Items]
Number of integrated senior health campuses acquired from unaffiliated parties | Campus	2
Two Thousand Nineteen Acquisition [Member]
Real Estate Properties [Line Items]
Ownership Percentage, Properties		67.70%
Number of buildings acquired from unaffiliated parties | Building	2
Percentage of contract purchase price paid acquisition fee, in cash		2.25%
Acquisition contract purchase price of land acquired		$ 4,806,000
Contract purchase price		15,750,000
Asset Acquisition, Transaction Costs		$ 836,000
Two Thousand Nineteen Acquisitions, Previously Leased [Member] | Trilogy Investors, LLC [Member]
Real Estate Properties [Line Items]
Number of integrated senior health campuses acquired from unaffiliated parties | Campus		1
Two Thousand Eighteen Acquisitions [Member]
Real Estate Properties [Line Items]
Number of buildings acquired from unaffiliated parties | Building			1
Percentage of contract purchase price paid acquisition fee, in cash			2.25%
Acquisition contract purchase price of land acquired			$ 3,146,000
Asset Acquisition, Transaction Costs			$ 3,044,000
Two Thousand Eighteen Acquisitions [Member] | Land [Member]
Real Estate Properties [Line Items]
Percentage of contract purchase price paid acquisition fee, in cash			2.25%
Contract purchase price			$ 300,000
Two Thousand Eighteen Acquisitions, Previously Leased [Member] | Lexington, KY; Novi and Romeo, MI; Fremont, OH [Member]
Real Estate Properties [Line Items]
Percentage of contract purchase price paid acquisition fee, in cash			2.25%
Contract purchase price			$ 47,455,000
Two Thousand Eighteen Acquisitions, Previously Leased [Member] | Trilogy Investors, LLC [Member]
Real Estate Properties [Line Items]
Number of integrated senior health campuses acquired from unaffiliated parties | Campus			4
Medical Office Building [Member]
Real Estate Properties [Line Items]
Impairment of real estate investments		$ 2,542,000
Carrying value after impairment		$ 7,387,000
Contract sales price of dispositions	$ 3,500,000
Gain on dispositions of real estate investments	15,000
Medical Office Building and Skilled Nursing Facility [Member]
Real Estate Properties [Line Items]
Impairment of real estate investments	8,350,000
Carrying value after impairment	$ 4,256,000			$ 4,256,000

Real Estate Investments, Net _3

Real Estate Investments, Net - Summary of Acquisitions (Detail) $ in Thousands	12 Months Ended			96 Months Ended
	Dec. 31, 2020USD ($)Building	Dec. 31, 2019USD ($)Building	Dec. 31, 2018USD ($)Building	Dec. 31, 2020Building
Real Estate Properties [Line Items]
Number of buildings acquired from unaffiliated parties | Building				101
North Carolina ALF Portfolio [Member]
Real Estate Properties [Line Items]
Number of buildings acquired from unaffiliated parties | Building		6	5
Two Thousand Twenty Acquisition [Member] [Domain]
Real Estate Properties [Line Items]
Acquisition contract purchase price of land acquired	$ 2,833
Two Thousand Nineteen Acquisition [Member]
Real Estate Properties [Line Items]
Number of buildings acquired from unaffiliated parties | Building	2
Ownership Percentage, Properties		67.70%
Percentage of contract purchase price paid acquisition fee, in cash		2.25%
Contract purchase price		$ 15,750
Line of credit		15,000
Acquisition fees		349
Acquisition contract purchase price of land acquired		$ 4,806
Two Thousand Nineteen Acquisition [Member] | North Carolina ALF Portfolio - Garner [Member]
Real Estate Properties [Line Items]
Ownership Percentage, Properties		100.00%
Percentage of contract purchase price paid acquisition fee, in cash		2.25%
Date of acquisition of property		Mar. 27, 2019
Contract purchase price		$ 15,000
Line of credit		15,000
Acquisition fees		$ 338
Two Thousand Nineteen Acquisition [Member] | The Cloister at Silvercrest [Member]
Real Estate Properties [Line Items]
Percentage of contract purchase price paid acquisition fee, in cash		2.25%
Date of acquisition of property		Oct. 1, 2019
Contract purchase price		$ 750
Line of credit		0
Acquisition fees		$ 11
Two Thousand Eighteen Acquisitions [Member]
Real Estate Properties [Line Items]
Number of buildings acquired from unaffiliated parties | Building			1
Percentage of contract purchase price paid acquisition fee, in cash			2.25%
Acquisition contract purchase price of land acquired			$ 3,146
Two Thousand Eighteen Acquisitions [Member] | North Carolina ALF Portfolio - Matthews [Member]
Real Estate Properties [Line Items]
Ownership Percentage, Properties			100.00%
Percentage of contract purchase price paid acquisition fee, in cash			2.25%
Type of property acquired			Senior Housing — RIDEA
Date of acquisition of property			Aug. 30, 2018
Contract purchase price			$ 15,000
Line of credit			13,500
Acquisition fees			$ 338

Real Estate Investments, Net Re

Real Estate Investments, Net Real Estate Investments, Net - Summary of Acquisitions of Previously Leased Real Estate Investments (Details)	12 Months Ended			96 Months Ended
	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)	Dec. 31, 2020Campus
Real Estate Properties [Line Items]
Number of integrated senior health campuses acquired from unaffiliated parties | Campus				119
Two Thousand Twenty Acquisition [Member]
Real Estate Properties [Line Items]
Percentage of contract purchase price paid acquisition fee, in cash	2.25%
Two Thousand Twenty Acquisitions, Previously Leased [Member]
Real Estate Properties [Line Items]
Ownership Percentage, Properties	67.60%
Percentage of contract purchase price paid acquisition fee, in cash	2.25%
Contract purchase price	$ 27,319,000
Line of credit	28,255,000
Acquisition fees	$ 415,000
Two Thousand Twenty Acquisitions, Previously Leased [Member] | Monticello, IN [Member]
Real Estate Properties [Line Items]
Date of acquisition of property	Jul. 30, 2020
Contract purchase price	$ 10,600,000
Line of credit	13,200,000
Acquisition fees	$ 161,000
Two Thousand Twenty Acquisitions, Previously Leased [Member] | Louisville, KY [Member]
Real Estate Properties [Line Items]
Date of acquisition of property	Jul. 30, 2020
Contract purchase price	$ 16,719,000
Line of credit	15,055,000
Acquisition fees	$ 254,000
Two Thousand Nineteen Acquisitions, Previously Leased [Member] | Corydon, IN [Member]
Real Estate Properties [Line Items]
Percentage of contract purchase price paid acquisition fee, in cash		2.25%
Date of acquisition of property		Sep. 5, 2019
Contract purchase price		$ 14,082,000
Line of credit		14,114,000
Acquisition fees		$ 215,000
Two Thousand Nineteen Acquisition [Member]
Real Estate Properties [Line Items]
Ownership Percentage, Properties		67.70%
Percentage of contract purchase price paid acquisition fee, in cash		2.25%
Contract purchase price		$ 15,750,000
Line of credit		15,000,000
Acquisition fees		$ 349,000
Acquisition ownership percentage		67.60%
Two Thousand Eighteen Acquisitions, Previously Leased [Member] | Lexington, KY; Novi and Romeo, MI; Fremont, OH [Member]
Real Estate Properties [Line Items]
Percentage of contract purchase price paid acquisition fee, in cash			2.25%
Date of acquisition of property			Jul. 20, 2018
Contract purchase price			$ 47,455,000
Mortgage Loans Payable Related To Acquisition Of Properties			47,500,000
Acquisition fees			$ 723,000
Two Thousand Eighteen Acquisitions [Member]
Real Estate Properties [Line Items]
Percentage of contract purchase price paid acquisition fee, in cash			2.25%
Acquisition ownership percentage			67.70%

Real Estate Investments, Net As

Real Estate Investments, Net Assets and Liabilities Acquired (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Real Estate Properties [Line Items]
Increase (Decrease) to Right-of-Use Asset	$ 14,281	$ 13,052
Increase (Decrease) to Operating Lease Liability	15,530	12,599
Two Thousand Nineteen Acquisition [Member]
Real Estate Properties [Line Items]
Asset Acquisition, Transaction Costs		836
Building and improvements		23,834
Land		8,496
In-place leases		3,596
Total assets acquired		$ 35,926
Two Thousand Eighteen Acquisitions [Member]
Real Estate Properties [Line Items]
Asset Acquisition, Transaction Costs			$ 3,044
Building and improvements			49,757
Land			10,980
In-place leases			6,894
Certificates of need			1,313
Total assets acquired			$ 68,944
Two Thousand Twenty Acquisition [Member] [Domain]
Real Estate Properties [Line Items]
Asset Acquisition, Transaction Costs	709
Two Thousand Twenty Acquisition [Member]
Real Estate Properties [Line Items]
Building and improvements	26,311
Land	4,563
Total assets acquired	$ 30,874

Debt Security Investmen, Net -

Debt Security Investmen, Net - Additional Information (Details) - USD ($) $ in Thousands	Oct. 15, 2015	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Debt Security Investment, Net
Debt security investment, net		$ 75,851	$ 72,717
Held-to-Maturity, debt securities, unamortized closing costs		1,205	1,375
Accretion on debt security		3,304	2,987	$ 2,717
Amortization of closing costs		$ 170	$ 143	$ 119
Debt security investment [Member]
Debt Security Investment, Net
Stated interest rate	4.24%
Debt security investment maturity date	Aug. 25, 2025
Stated amount after maturity	$ 93,433
Yield to maturity interest rate	10.00%
Beneficial ownership interest in mortgage trust	10.00%

Identified Intangible Assets,_3

Identified Intangible Assets, Net - Summary of Identified Intangibles, Net (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets [Line Items]
Amortized intangible assets	$ 27,311
Identified intangible assets, net	154,687	$ 160,247
Amortization of Intangible Assets	$ 6,678	$ 19,973	$ 12,736
Weighted average remaining life	9 years 8 months 12 days	9 years 8 months 12 days
Certificates Of Need [Member]
Finite-Lived Intangible Assets [Line Items]
Unamortized intangible assets	$ 96,589	$ 94,838
Trade Names [Member]
Finite-Lived Intangible Assets [Line Items]
Unamortized intangible assets	30,787	30,787
In-Place Leases [Member]
Finite-Lived Intangible Assets [Line Items]
Amortized intangible assets	$ 23,760	$ 30,407
Weighted average remaining life	9 years 4 months 24 days	9 years 4 months 24 days
Finite-Lived Intangible Assets, Accumulated amortization	$ 22,019	$ 21,029
Customer Relationships [Member]
Finite-Lived Intangible Assets [Line Items]
Amortized intangible assets	$ 2,354	$ 2,504
Weighted average remaining life	15 years 8 months 12 days	16 years 9 months 18 days
Finite-Lived Intangible Assets, Accumulated amortization	$ 486	$ 336
Above-Market Leases [Member]
Finite-Lived Intangible Assets [Line Items]
Amortized intangible assets	$ 1,032	$ 1,452
Weighted average remaining life	4 years 7 months 6 days	5 years
Finite-Lived Intangible Assets, Accumulated amortization	$ 1,975	$ 2,057
Internally Developed Technology and Software [Member]
Finite-Lived Intangible Assets [Line Items]
Amortized intangible assets	$ 165	$ 259
Weighted average remaining life	1 year 8 months 12 days	2 years 9 months 18 days
Finite-Lived Intangible Assets, Accumulated amortization	$ 305	$ 211
Above-Market Leases [Member]
Finite-Lived Intangible Assets [Line Items]
Amortization of Intangible Assets	$ 420	$ 607	$ 967

Identified Intangible Assets,_4

Identified Intangible Assets, Net - Summary of Amortization Expense on Identified Intangible Assets, Net (Detail) $ in Thousands	Dec. 31, 2020USD ($)
Finite-Lived Intangible Assets, Net [Abstract]
2021	$ 4,639
2022	3,909
2023	3,140
2024	2,723
2025	2,210
Thereafter	10,690
Finite-lived intangible assets, gross	$ 27,311

Other Assets, Net - Schedule of

Other Assets, Net - Schedule of Other Assets, Net (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Other Assets [Abstract]
Deferred rent receivables	$ 38,918	$ 33,205
Prepaid expenses, deposits, other assets and deferred tax assets, net	16,618	40,354
Inventory	24,669	23,872
Investments in unconsolidated entities	16,469	20,176
Lease commissions, net of accumulated amortization of $3,413,000 and $2,201,000 as of December 31, 2020 and 2019, respectively	11,309	10,794
Deferred financing costs, net of accumulated amortization of $5,700,000 and $2,138,000 as of December 31, 2020 and 2019, respectively	6,864	8,137
Lease inducement, net of accumulated amortization of $1,491,000 and $1,140,000 as of December 31, 2020 and 2019, respectively (with a weighted average remaining life of 9.9 years and 10.9 years as of December 31, 2020 and 2019, respectively)	3,509	3,860
Other Assets, net	118,356	140,398
Accumulated amortization, lease commissions	3,413	2,201
Accumulated amortization, deferred financing costs	5,700	2,138
Accumulated Amortization, lease inducements	$ 1,491	$ 1,140
Lease inducements, weighted average remaining life	9 years 10 months 24 days	10 years 10 months 24 days

Other Assets, Net - Narrative (

Other Assets, Net - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Amortization expense on deferred financing costs	$ 3,559	$ 3,664	$ 4,637
Amortization of deferred lease inducements	$ 351	$ 351	$ 350

Mortgage Loans Payable, Net - S

Mortgage Loans Payable, Net - Schedule of Mortgage Loans Payable, Net (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2020USD ($)MortgageLoan		Dec. 31, 2019USD ($)MortgageLoan		Dec. 31, 2018USD ($)
Debt Instrument [Line Items]
Mortgage loans payable, gross	$ 834,026		$ 816,217
Mortgage loans payable, net	$ 810,478	[1]	$ 792,870	[1]	$ 688,262
Number of fixed-rate mortgage loans payable | MortgageLoan	62		58
Number of variable-rate mortgage loans payable | MortgageLoan	10		7
Less: deferred financing costs, net	$ (6,864)		$ (8,137)
Add: premium	204		304
Less: discount	(13,363)		(14,289)
Loss on extinguishment of debt	$ 0		$ 2,968		$ 0
Number of debt instruments extinguished | MortgageLoan			2
Secured Debt [Member]
Debt Instrument [Line Items]
Loss on extinguishment of debt			$ 2,182
Minimum [Member]
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Effective Percentage	2.21%		2.45%
Maximum [Member]
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Effective Percentage	5.23%		6.21%
Mortgage Loans Payable, Net [Member]
Debt Instrument [Line Items]
Debt, weighted average interest rate	3.58%		3.85%
Less: deferred financing costs, net	$ (10,389)		$ (9,362)
Fixed Rate Debt [Member]
Debt Instrument [Line Items]
Mortgage loans payable, gross	742,686		714,786
Variable Rate Debt [Member]
Debt Instrument [Line Items]
Mortgage loans payable, gross	$ 91,340		$ 101,431
[1]	Such liabilities of Griffin-American Healthcare REIT III, Inc. as of December 31, 2020 and 2019 represented liabilities of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries. Griffin-American Healthcare REIT III Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of Griffin-American Healthcare REIT III, Inc. The creditors of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries do not have recourse against Griffin-American Healthcare REIT III, Inc., except for the 2019 Corporate Line of Credit, as defined in Note 8, held by Griffin-American Healthcare REIT III Holdings, LP in the amount of $556,500,000 and $557,000,000 as of December 31, 2020 and 2019, respectively, which is guaranteed by Griffin-American Healthcare REIT III, Inc.

Mortgage Loans Payable, Net -_2

Mortgage Loans Payable, Net - Schedule of Activity Related to Notes Payable (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020		Dec. 31, 2019		Dec. 31, 2018
Change in Carrying Amount of Mortgage Loans Payable, Net [Roll Forward]
Beginning balance	$ 792,870	[1]	$ 688,262
Borrowings under mortgage loans payable	92,399		191,246		$ 181,594
Amortization of deferred financing costs	796		1,544
Amortization of discount/premium on mortgage loans payable	826		647
Scheduled principal payments on mortgage loans payable	(71,990)		(74,037)
Early payoff of mortgage loans payable	(2,601)		(14,022)
Deferred financing costs	(1,822)		(770)
Ending balance	$ 810,478	[1]	$ 792,870	[1]	$ 688,262
[1]	Such liabilities of Griffin-American Healthcare REIT III, Inc. as of December 31, 2020 and 2019 represented liabilities of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries. Griffin-American Healthcare REIT III Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of Griffin-American Healthcare REIT III, Inc. The creditors of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries do not have recourse against Griffin-American Healthcare REIT III, Inc., except for the 2019 Corporate Line of Credit, as defined in Note 8, held by Griffin-American Healthcare REIT III Holdings, LP in the amount of $556,500,000 and $557,000,000 as of December 31, 2020 and 2019, respectively, which is guaranteed by Griffin-American Healthcare REIT III, Inc.

Mortgage Loans Payable, Net -_3

Mortgage Loans Payable, Net - Schedule of Principal Payments Due on Mortgage Loans Payable (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Mortgage Loans Payable, Net [Abstract]
2021	$ 54,169
2022	62,985
2023	67,651
2024	80,451
2025	15,324
Thereafter	553,446
Total	$ 834,026	$ 816,217

Lines of Credit and Term Loans

Lines of Credit and Term Loans Lines of Credit and Term Loans (Details)

Jul. 28, 2020

Sep. 05, 2019USD ($)Extension

Jan. 25, 2019USD ($)Extension

Dec. 31, 2020USD ($)

Dec. 31, 2019USD ($)

Dec. 31, 2018USD ($)

Dec. 20, 2018USD ($)

Apr. 27, 2018USD ($)

Apr. 26, 2018USD ($)

Oct. 27, 2017USD ($)

Oct. 26, 2017USD ($)

Apr. 01, 2016USD ($)

Mar. 21, 2016USD ($)

Feb. 03, 2016USD ($)

Dec. 01, 2015USD ($)

Line of Credit Facility [Line Items]

Lines of credit and term loans

[1]

$ 843,634,000

$ 815,879,000

Loss on extinguishment of debt

0

(2,968,000)

$ 0

2019 Corporate Line of Credit [Member] | Line of Credit [Member]

Line of Credit Facility [Line Items]

Current borrowing capacity

630,000,000

630,000,000

Lines of credit and term loans

$ 556,500,000

$ 557,000,000

Debt, weighted average interest rate

2.70%

3.83%

2019 Corporate Line of Credit [Member] | Revolving Credit Facility [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

$ 150,000,000

2019 Corporate Line of Credit [Member] | Term Loan [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

480,000,000

Amendment to 2019 Corporate Line of Credit [Member]

Line of Credit Facility [Line Items]

Consolidated leverage ratio, equal to or less than (as a percent)

65.00%

Consolidated unencumbered leverage ratio, equal to or less than (as a percent)

65.00%

Trilogy Propco Line of Credit [Member] | Revolving Credit Facility [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

$ 250,000,000

$ 300,000,000

$ 300,000,000

Trilogy OpCo Line Of Credit [Member] | Revolving Credit Facility [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

$ 25,000,000

$ 60,000,000

$ 42,000,000

Increase to maximum borrowing capacity

$ 60,000,000

Loss on extinguishment of debt

$ 786,000

2019 Trilogy Credit Facility [Member] | Revolving Credit Facility [Member]

Line of Credit Facility [Line Items]

Current borrowing capacity

$ 360,000,000

360,000,000

Lines of credit and term loans

$ 287,134,000

$ 258,879,000

Debt, weighted average interest rate

2.94%

4.52%

Line of Credit [Member] | Two Thousand Sixteen Corporate Revolving Credit Facility [Member] | Revolving Credit Facility [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

$ 575,000,000

$ 300,000,000

Line of Credit [Member] | Two Thousand Sixteen Corporate Term Loan Facility [Member] | Term Loan [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

$ 200,000,000

Line of Credit [Member] | 2019 Corporate Line of Credit [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

630,000,000

Increase to maximum borrowing capacity

370,000,000

Potential maximum borrowing capacity

$ 1,000,000,000

Days business notice needed to increase credit facility

5 days

Debt Instrument, Maturity Date

Jan. 25, 2022

Line Of Credit Facility, number of potential extensions | Extension

1

Line Of Credit Facility, potential extension term

12 months

Line of Credit [Member] | 2019 Corporate Line of Credit [Member] | Alternate Base Rate [Member]

Line of Credit Facility [Line Items]

Debt Instrument, base rate, percent

0.00%

Line of Credit [Member] | 2019 Corporate Line of Credit [Member] | Federal Funds Rate [Member]

Line of Credit Facility [Line Items]

Variable interest rate

0.50%

Line of Credit [Member] | 2019 Corporate Line of Credit [Member] | One-Month Eurodollar [Member]

Line of Credit Facility [Line Items]

Variable interest rate

1.00%

Line of Credit [Member] | 2019 Corporate Line of Credit [Member] | Revolving Credit Facility [Member]

Line of Credit Facility [Line Items]

Commitment fee percentage when average daily used portion is greater than 50%

0.20%

Average daily used amount percentage (greater than)

50.00%

Commitment fee percentage when average daily used portion is less than 50%

0.25%

Average daily used amount percentage (less than)

50.00%

Line of Credit [Member] | 2019 Corporate Line of Credit [Member] | Standby Letters of Credit [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

$ 25,000,000

Line of Credit [Member] | 2019 Corporate Line of Credit [Member] | Swing Line Loan [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

$ 25,000,000

Line of Credit [Member] | Amendment to 2019 Corporate Line of Credit [Member] | Minimum [Member] | Eurodollar [Member]

Line of Credit Facility [Line Items]

Variable interest rate

1.85%

Line of Credit [Member] | Amendment to 2019 Corporate Line of Credit [Member] | Minimum [Member] | Alternate Base Rate [Member]

Line of Credit Facility [Line Items]

Variable interest rate

0.85%

Line of Credit [Member] | Amendment to 2019 Corporate Line of Credit [Member] | Maximum [Member] | Eurodollar [Member]

Line of Credit Facility [Line Items]

Variable interest rate

2.80%

Line of Credit [Member] | Amendment to 2019 Corporate Line of Credit [Member] | Maximum [Member] | Alternate Base Rate [Member]

Line of Credit Facility [Line Items]

Variable interest rate

1.80%

Line of Credit [Member] | 2019 Trilogy Credit Facility [Member]

Line of Credit Facility [Line Items]

Debt Instrument, Maturity Date

Sep. 5, 2023

Line Of Credit Facility, number of potential extensions | Extension

1

Line Of Credit Facility, potential extension term

12 months

Line of Credit [Member] | 2019 Trilogy Credit Facility [Member] | LIBOR [Member]

Line of Credit Facility [Line Items]

Variable interest rate

2.75%

Line of Credit [Member] | 2019 Trilogy Credit Facility [Member] | Alternate Base Rate [Member]

Line of Credit Facility [Line Items]

Variable interest rate

1.75%

Line of Credit [Member] | 2019 Trilogy Credit Facility [Member] | Federal Funds Effective Rate [Member]

Line of Credit Facility [Line Items]

Variable interest rate

0.50%

Line of Credit [Member] | 2019 Trilogy Credit Facility [Member] | One-Month LIBOR [Member]

Line of Credit Facility [Line Items]

Variable interest rate

1.00%

Line of Credit [Member] | 2019 Trilogy Credit Facility [Member] | Aggregate Real Estate Revolving Credit Obligations [Member]

Line of Credit Facility [Line Items]

Line of Credit Facility Unused Commitments Percentage Condition One

0.15%

Line of Credit Facility Daily Commitments Percentage Condition One

50.00%

Line of Credit Facility Daily Commitments Percentage Condition Two

50.00%

Line Of Credit Facility Unused Commitments Percentage Condition Two

0.20%

Line of Credit [Member] | 2019 Trilogy Credit Facility [Member] | Aggregate A/R Revolving Credit Obligations [Member]

Line of Credit Facility [Line Items]

Line of Credit Facility Unused Commitments Percentage Condition One

0.15%

Line of Credit Facility Daily Commitments Percentage Condition One

50.00%

Line of Credit Facility Daily Commitments Percentage Condition Two

50.00%

Line Of Credit Facility Unused Commitments Percentage Condition Two

0.20%

Line of Credit [Member] | 2019 Trilogy Credit Facility [Member] | Revolving Credit Facility [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

$ 360,000,000

Increase to maximum borrowing capacity

140,000,000

Potential maximum borrowing capacity

$ 500,000,000

Days business notice needed to increase credit facility

10 days

Line of Credit [Member] | 2019 Trilogy Credit Facility [Member] | Standby Letters of Credit [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

$ 15,000,000

Line of Credit [Member] | 2019 Trilogy Credit Facility [Member] | Swing Line Loan [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

35,000,000

Real Estate Assets and Ancillary Business Cash Flow [Member] | 2019 Trilogy Credit Facility [Member] | Revolving Credit Facility [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

325,000,000

Eligible Accounts Receivable [Member] | 2019 Trilogy Credit Facility [Member] | Revolving Credit Facility [Member]

Line of Credit Facility [Line Items]

Line of credit facility, maximum borrowing capacity

$ 35,000,000

[1]

Such liabilities of Griffin-American Healthcare REIT III, Inc. as of December 31, 2020 and 2019 represented liabilities of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries. Griffin-American Healthcare REIT III Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of Griffin-American Healthcare REIT III, Inc. The creditors of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries do not have recourse against Griffin-American Healthcare REIT III, Inc., except for the 2019 Corporate Line of Credit, as defined in Note 8, held by Griffin-American Healthcare REIT III Holdings, LP in the amount of $556,500,000 and $557,000,000 as of December 31, 2020 and 2019, respectively, which is guaranteed by Griffin-American Healthcare REIT III, Inc.

Derivative Financial Instrume_3

Derivative Financial Instruments (Detail) - Not Designated as Hedging Instrument [Member] - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Derivative [Line Items]
Fair Value	$ (7,877)	$ (3,971)
Cap [Member]
Derivative [Line Items]
Instrument	Cap
Derivative, Notional Amount	$ 20,000
Index	one month LIBOR
Interest Rate	3.00%
Maturity Date	Sep. 23, 2021
Fair Value	$ 0	0
Swap, 2.10% Interest Rate [Member]
Derivative [Line Items]
Instrument	Swap
Derivative, Notional Amount	$ 250,000
Index	one month LIBOR
Interest Rate	2.10%
Maturity Date	Jan. 25, 2022
Fair Value	$ (5,245)	(2,821)
Swap, 1.98% Interest Rate [Member]
Derivative [Line Items]
Instrument	Swap
Derivative, Notional Amount	$ 130,000
Index	one month LIBOR
Interest Rate	1.98%
Maturity Date	Jan. 25, 2022
Fair Value	$ (2,561)	(1,150)
Swap, 0.20% Interest Rate [Member]
Derivative [Line Items]
Instrument	Swap
Derivative, Notional Amount	$ 100,000
Index	one month LIBOR
Interest Rate	0.20%
Maturity Date	Jan. 25, 2022
Fair Value	$ (71)	$ 0

Derivative Financial Instrume_4

Derivative Financial Instruments - Additional Information (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2020USD ($)instrument	Dec. 31, 2019USD ($)instrument	Dec. 31, 2018USD ($)
Loss in fair value of derivative financial instruments | $	$ (3,906)	$ (4,541)	$ (1,949)
Not Designated as Hedging Instrument [Member]
Number of derivative financial instruments | instrument	0	0

Identified Intangible Liabili_3

Identified Intangible Liabilities, Net - Summary of Identified Intangible Liabilities (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Finite Lived Intangible Liabilities [Line Items]
Identified intangible liabilities, net	$ 367	$ 663
Below-Market Lease [Member]
Finite Lived Intangible Liabilities [Line Items]
Identified intangible liabilities, net	367	663
Net of accumulated amortization	834	1,342
Amortization expense	$ 296	$ 388	$ 517
Weighted average remaining life	2 years 7 months 6 days	4 years 3 months 18 days

Identified Intangible Liabili_4

Identified Intangible Liabilities, Net - Summary of Amortization Expense on Below-Market Leases (Details) $ in Thousands	Dec. 31, 2020USD ($)
Identified Intangible Liabilities [Abstract]
2021	$ 180
2022	89
2023	71
2024	27
2025	0
Thereafter	0
Finite Lived Intangible Liabilities Net	$ 367

Commitments and Contingencies (

Commitments and Contingencies (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	May 29, 2020
Loss Contingencies [Line Items]
Medicare services performance period	3 months
Advisor [Member]
Loss Contingencies [Line Items]
Deferred asset management fees		50.00%
Government Assistance, CARES Act [Member]
Loss Contingencies [Line Items]
Proceeds from government assistance	$ 52,322

Redeemable Noncontrolling Int_3

Redeemable Noncontrolling Interests (Detail) - shares	12 Months Ended		84 Months Ended	96 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2019	Dec. 31, 2020
Trilogy Investors, LLC [Member]
Redeemable Noncontrolling Interests [Line Items]
Noncontrolling interest, ownership percentage by noncontrolling owners	3.40%	3.40%	3.40%	3.40%
General Partnership [Member]
Redeemable Noncontrolling Interests [Line Items]
Percentage of ownership in operating partnership			99.99%	99.99%
Limited Partnership [Member]
Redeemable Noncontrolling Interests [Line Items]
Percentage of limited partnership interest			0.01%	0.01%
Trilogy REIT Holdings, LLC [Member]
Redeemable Noncontrolling Interests [Line Items]
Joint venture ownership interest	70.00%	70.00%	70.00%	70.00%
Trilogy Investors, LLC [Member]
Redeemable Noncontrolling Interests [Line Items]
Ownership percentage equity interest	96.60%	96.60%	96.60%	96.60%
Redeemable Limited Partnership Units
Redeemable Noncontrolling Interests [Line Items]
Anti-dilutive securities excluded from computation of earnings per share	222	222

Redeemable Noncontrolling Int_4

Redeemable Noncontrolling Interests Redeemable Noncontrolling Interests - Changes in Carrying Amount (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Changes in carrying amount of redeemable noncontrolling interest [Roll Forward]
Beginning balance	$ 44,105	$ 38,245
Additions	0	2,000	$ 535
Reclassification from equity	715	780	780
Distributions	(1,271)	(1,430)	(711)
Repurchase of redeemable noncontrolling interests	(150)	(400)
Adjustment to redemption value	(3,714)	4,473	5,301
Net income attributable to redeemable noncontrolling interests	655	437	134
Ending balance	$ 40,340	$ 44,105	$ 38,245

Equity (Detail)

Equity (Detail) - USD ($)	Dec. 01, 2015	Dec. 31, 2020	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Apr. 21, 2015	Dec. 31, 2020	Mar. 29, 2019	Dec. 31, 2019	Dec. 31, 2020	Apr. 07, 2020	Jan. 30, 2019	Jan. 06, 2016	Mar. 25, 2015	Feb. 26, 2014
Class of Stock [Line Items]
Number of shares of preferred stock, authorized to be issued		200,000,000	200,000,000	200,000,000			200,000,000		200,000,000	200,000,000
Par value of preferred stock, authorized to be issued		$ 0.01	$ 0.01	$ 0.01			$ 0.01		$ 0.01	$ 0.01
Preferred Stock, Shares Issued (in shares)		0	0	0			0		0	0
Preferred Stock, Shares Outstanding (in shares)		0	0	0			0		0	0
Number of shares of common stock, authorized to be issued		1,000,000,000	1,000,000,000	1,000,000,000			1,000,000,000		1,000,000,000	1,000,000,000
Par value of common stock to be offered and sold to the public		$ 0.01	$ 0.01	$ 0.01			$ 0.01		$ 0.01	$ 0.01
Issuance of common stock under the DRIP, shares									32,733,694	35,059,456
Common stock, shares, outstanding		193,889,872	193,889,872	193,967,474			193,889,872		193,967,474	193,889,872
Common stock, shares issued		193,889,872	193,889,872	193,967,474			193,889,872		193,967,474	193,889,872
Stock based compensation — nonvested restricted common stock			$ 155,000	$ 215,000	$ 215,000
Preferred Stock, Value, Subscriptions													$ 125,000
Preferred Stock, Dividend Rate, Percentage			12.50%
Issuance of common stock under the DRIP			$ 21,861,000	55,440,000	60,030,000				$ 305,151,000	$ 327,012,000
Issuance of noncontrolling interest			11,000,000	0	0
Total Stockholders' Equity
Class of Stock [Line Items]
Issuance of common stock under the DRIP			$ 21,861,000	$ 55,440,000	$ 60,030,000
Common Stock
Class of Stock [Line Items]
Issuance of common stock under the DRIP, shares			2,325,762	5,913,684	6,464,432
Issuance of common stock under the DRIP			$ 24,000	$ 59,000	$ 65,000
Profits Interests [Member]
Class of Stock [Line Items]
Forfeited (shares)			0	0	0
Exercised (shares)			0	0	0
Profits Interests [Member] | Trilogy Joint Venture [Member]
Class of Stock [Line Items]
Vesting percentage	20.00%
Vesting period	5 years
Stock based compensation — nonvested restricted common stock			$ (1,342,000)	$ 2,744,000	$ 2,898,000
Trilogy Investors, LLC [Member]
Class of Stock [Line Items]
Ownership percentage equity interest		96.60%	96.60%	96.60%			96.60%		96.60%	96.60%
Trilogy Joint Venture [Member]
Class of Stock [Line Items]
Joint venture ownership interest		70.00%	70.00%	70.00%			70.00%		70.00%	70.00%
Net earning of joint venture allocated to noncontrolling interest			30.00%	30.00%
Common Stock
Class of Stock [Line Items]
Subscriptions in offering of common stock received and accepted shares						184,930,598
DRIP [Member]
Class of Stock [Line Items]
Subscriptions in offering of common stock received and accepted shares						1,948,563
Maximum dollar amount of common stock issuable under public offering															$ 35,000,000
2015 DRIP Offering [Member]
Class of Stock [Line Items]
Maximum dollar amount of common stock issuable under public offering														$ 250,000,000
Issuance of common stock under the DRIP, shares				5,913,684	6,464,432			26,386,545
Issuance of common stock under the DRIP				$ 55,440,000	$ 60,030,000			$ 245,396,000
2019 DRIP Offering [Member]
Class of Stock [Line Items]
Maximum dollar amount of common stock issuable under public offering												$ 200,000,000
Issuance of common stock under the DRIP, shares							6,724,348
Issuance of common stock under the DRIP							$ 63,105,000
Griffin American Advisor [Member]
Class of Stock [Line Items]
Stock purchased (shares)		22,222	22,222	22,222			22,222		22,222	22,222
Lakeview IN Medical Plaza [Member]
Class of Stock [Line Items]
Joint venture ownership interest		86.00%	86.00%	86.00%			86.00%		86.00%	86.00%
Net earning of joint venture allocated to noncontrolling interest			14.00%	14.00%	14.00%
MetSL Property Investor, LLC [Member]
Class of Stock [Line Items]
Net earning of joint venture allocated to noncontrolling interest		9.40%
Issuance of Subsidiary Equity, Noncontrolling Interest											9.40%
Griffin-American Healthcare REIT IV, Inc. [Member] | Trilogy Joint Venture [Member]
Class of Stock [Line Items]
Joint venture ownership interest		6.00%	6.00%	6.00%			6.00%		6.00%	6.00%
NorthStar Healthcare Income, Inc. [Member] | Trilogy Joint Venture [Member]
Class of Stock [Line Items]
Joint venture ownership interest		24.00%	24.00%	24.00%			24.00%		24.00%	24.00%

Equity Accumulated Other Compre

Equity Accumulated Other Comprehensive Loss (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Accumulated Other Comprehensive Loss [Roll Forward]
Beginning balance Stockholders' Equity	$ 1,058,663	$ 1,218,635	$ 1,346,575
Net change in current period	247	305	(589)
Ending balance Stockholders' Equity	1,034,483	1,058,663	1,218,635
Accumulated Other Comprehensive Loss
Accumulated Other Comprehensive Loss [Roll Forward]
Beginning balance Stockholders' Equity	(2,255)	(2,560)	(1,971)
Ending balance Stockholders' Equity	$ (2,008)	$ (2,255)	$ (2,560)

Equity Equity - Estimated Per S

Equity Equity - Estimated Per Share NAV (Details) - $ / shares	Oct. 03, 2019	Oct. 03, 2018	Oct. 04, 2017	Oct. 05, 2016
DRIP [Member]
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Share price (usd per share)	$ 9.40	$ 9.37	$ 9.27	$ 9.01

Equity Equity - Share Repurchas

Equity Equity - Share Repurchase Plan (Details) - USD ($)	Feb. 26, 2014	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2019	Dec. 31, 2020
Equity [Abstract]
Maximum percentage of common stock repurchased during the period	5.00%
Cap percentage on repurchases	5.00%
Maximum number of repurchase shares owned	$ 2,500
Share repurchase plan percentage of price per-share		100.00%				100.00%
Repurchase of common stock, shares		2,410,864	9,526,087	8,272,789	23,846,540	26,257,404
Repurchase of common stock, value		$ 23,107,000	$ 89,888,000	$ 76,577,000	$ 221,823,000	$ 244,930,000
Stock acquired average cost per share		$ 9.58	$ 9.44	$ 9.26	$ 9.30	$ 9.33

Equity - Status and Changes of

Equity - Status and Changes of Nonvested Shares of Restricted Common Stock (Detail) $ / shares in Units, $ in Thousands	12 Months Ended			82 Months Ended
	Dec. 31, 2020USD ($)Anniversary$ / sharesshares	Dec. 31, 2019USD ($)$ / sharesshares	Dec. 31, 2018USD ($)$ / sharesshares	Dec. 31, 2020Anniversaryshares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (shares)				135,000
Stock based compensation — nonvested restricted common stock | $	$ 155	$ 215	$ 215
Two Thousand Thirteen Incentive Plan [Member] | Common Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement by share-based payment award, number of shares authorized	2,000,000			2,000,000
Restricted Stock [Member] | Two Thousand Thirteen Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock based compensation — nonvested restricted common stock | $	$ 155	$ 215	$ 215
Restricted Stock [Member] | Independent Directors [Member] | Two Thousand Thirteen Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (shares)	7,500	22,500	22,500
Granted (usd per share) | $ / shares	$ 9.40	$ 9.37	$ 9.27
Share based compensation arrangement by share based payment award equity instruments other than options, number of vesting anniversaries | Anniversary	4			4
Restricted Stock [Member] | Re-elected or Newly Elected Independent Directors [Member] | Two Thousand Thirteen Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based compensation arrangement by share based payment award equity instruments other than options vesting percentage	20.00%			20.00%

Related Party Transactions - Ad

Related Party Transactions - Additional Information (Detail) $ in Thousands	12 Months Ended			71 Months Ended	82 Months Ended
	Dec. 31, 2020USD ($)Quarter	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)	Dec. 31, 2020USD ($)Quarter	Dec. 31, 2020USD ($)Quarter	May 29, 2020
Related Party Transaction [Line Items]
Related party transaction, expenses from transactions with related party	$ 25,875	$ 25,064	$ 24,266
Advisor [Member]
Related Party Transaction [Line Items]
Percentage of contract purchase price paid acquisition fee, in cash				2.25%
Acquisition price for any real estate-related investment we originate or acquire				2.00%
Maximum percentage of fees and expenses associated with the acquisition	6.00%	6.00%	6.00%		6.00%
Asset Management Fee Percent					0.75%
Subordinated asset management fee subject to stockholders receiving distributions, percentage	5.00%			5.00%	5.00%
Deferred asset management fees						50.00%
Percentage of property oversight fee	1.00%			1.00%	1.00%
Percentage of property oversight fees - multiple tenants	1.50%			1.50%	1.50%
Minimum percentage of lease fee	3.00%			3.00%	3.00%
Maximum percentage of lease fee	6.00%			6.00%	6.00%
Maximum percentage of construction management fee	5.00%			5.00%	5.00%
Number of consecutive fiscal quarters for reimbursement measurement | Quarter	4			4	4
Percentage of operating expenses of average invested asset	2.00%			2.00%	2.00%
Percentage of operating expense of net income	25.00%
Disposition fees as percentage of contract sales price	2.00%			2.00%	2.00%
Disposition fees as percentage of customary competitive real estate commission	50.00%			50.00%	50.00%
Maximum percentage of disposition fee	6.00%			6.00%	6.00%
Asset management fee percentage	0.0625%			0.0625%	0.0625%
Acquistion Fees [Member]
Related Party Transaction [Line Items]
Related party transaction, expenses from transactions with related party	$ 480	$ 1,124	$ 1,194
Development Fees [Member]
Related Party Transaction [Line Items]
Related party transaction, expenses from transactions with related party	1,073	346	137
Acquisition Expenses [Member]
Related Party Transaction [Line Items]
Related party transaction, expenses from transactions with related party	0	0	0
Asset Management [Member]
Related Party Transaction [Line Items]
Related party transaction, expenses from transactions with related party	20,693	20,073	19,373
Asset Management [Member] | Due to Related Parties [Member]
Related Party Transaction [Line Items]
Related Party Transactions, Deferred Expenses from Transactions with Related Party	5,207			$ 5,207	$ 5,207
Property Management Fee [Member]
Related Party Transaction [Line Items]
Related party transaction, expenses from transactions with related party	2,632	2,611	2,428
Lease Commissions [Member]
Related Party Transaction [Line Items]
Related party transaction, expenses from transactions with related party	579	379	843
Construction Management Fee [Member]
Related Party Transaction [Line Items]
Related party transaction, expenses from transactions with related party	183	320	91
Operating Expense [Member]
Related Party Transaction [Line Items]
Related party transaction, expenses from transactions with related party	235	$ 211	$ 200
Disposition Fees Waived [Member]
Related Party Transaction [Line Items]
Related party transaction, expenses from transactions with related party	$ 431
Subordinated distribution of net sales proceeds [Member]
Related Party Transaction [Line Items]
Percentage of distribution of net proceeds from sales of properties	15.00%			15.00%	15.00%
Annual cumulative non compounded return on gross proceeds from sale of shares	7.00%			7.00%	7.00%
Subordinated Distribution Upon Listing [Member]
Related Party Transaction [Line Items]
Percentage of distribution of net proceeds from sales of properties	15.00%			15.00%	15.00%
Annual cumulative non compounded return upon listing of shares	7.00%			7.00%	7.00%
Subordinated Distribution Upon Termination [Member]
Related Party Transaction [Line Items]
Annual cumulative non compounded return on gross proceeds from sale of shares	7.00%			7.00%	7.00%
Distribution rate of partnership amount to sub advisor	15.00%			15.00%	15.00%

Related Party Transactions - Op

Related Party Transactions - Operating Expenses as Percentage (Details) - Operating Expense [Member]	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Related Party Transaction [Line Items]
Percentage of operating expenses of average invested assets	1.00%	0.90%	0.90%
Percentage of operating expenses of net income	22.10%	18.90%	19.10%

Related Party Transactions - Sc

Related Party Transactions - Schedule of Amounts Outstanding to Affiliates (Detail) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Related Party Transaction [Line Items]
Due to affiliate	$ 8,026	$ 2,321
Asset And Property Management Fees [Member]
Related Party Transaction [Line Items]
Due to affiliate	7,155	1,991
Development Fees [Member]
Related Party Transaction [Line Items]
Due to affiliate	743	0
Construction Management Fee [Member]
Related Party Transaction [Line Items]
Due to affiliate	91	175
Lease Commissions [Member]
Related Party Transaction [Line Items]
Due to affiliate	27	143
Operating Expense [Member]
Related Party Transaction [Line Items]
Due to affiliate	$ 10	$ 12

Fair Value Measurements - Sched

Fair Value Measurements - Schedule of Assets and Liabilities Measured at Fair Value on Recurring Basis (Details) - Fair Value, Recurring [Member] - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Assets:
Derivative financial instrument	$ 0	$ 0
Total assets at fair value	0	0
Liabilities:
Derivative financial instruments	7,877	3,971
Warrants	1,025	1,178
Total liabilities at fair value	8,902	5,149
Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1) [Member]
Assets:
Derivative financial instrument	0	0
Total assets at fair value	0	0
Liabilities:
Derivative financial instruments	0	0
Warrants	0	0
Total liabilities at fair value	0	0
Significant Other Observable Inputs (Level 2) [Member]
Assets:
Derivative financial instrument	0	0
Total assets at fair value	0	0
Liabilities:
Derivative financial instruments	7,877	3,971
Warrants	0	0
Total liabilities at fair value	7,877	3,971
Significant Unobservable Inputs (Level 3) [Member]
Assets:
Derivative financial instrument	0	0
Total assets at fair value	0	0
Liabilities:
Derivative financial instruments	0	0
Warrants	1,025	1,178
Total liabilities at fair value	$ 1,025	$ 1,178

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2020USD ($)Building	Dec. 31, 2019USD ($)Building	Dec. 31, 2018USD ($)
Business Acquisitions [Line Items]
Change in fair value of contingent consideration	$ 0	$ (681)	$ (2,843)
Contingent consideration obligation			681
Number of Medical Office Buildings Impaired | Building	1	1
Acquisition-related Costs [Member]
Business Acquisitions [Line Items]
Change in fair value of contingent consideration		$ (681)	$ (2,843)
Fair Value, Recurring [Member]
Business Acquisitions [Line Items]
Warrants	$ 1,025	1,178
Fair Value, Recurring [Member] | Significant Unobservable Inputs (Level 3) [Member]
Business Acquisitions [Line Items]
Warrants	$ 1,025	$ 1,178

Fair Value Measurements - Recon

Fair Value Measurements - Reconciliation of Contingent Consideration Assets and Obligations (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Contingent Consideration Obligations:
Beginning balance	$ 0	$ 681	$ 5,107
Realized/unrealized gains recognized in earnings	0	(681)	(2,843)
Settlements of obligations	0	0	(1,583)
Ending balance	0	0	681
Amount of total gains included in earnings attributable to the change in unrealized gains related to obligations still held	$ 0	$ (681)	$ (2,843)

Fair Value Measurements - Real

Fair Value Measurements - Real Estate (Details)	Dec. 31, 2018
Market rent per square foot | Minimum [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Unobservable Inputs	13.75
Market rent per square foot | Maximum [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Unobservable Inputs	25
Capitalization rate
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Unobservable Inputs	0.0750
Discount rate
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Unobservable Inputs	0.0800

Fair Value Measurements Fair Va

Fair Value Measurements Fair Value by Balance Sheet Grouping (Details) - USD ($) $ in Thousands	Dec. 31, 2020		Dec. 31, 2019		Dec. 31, 2018
Financial Instruments, Financial Assets, Balance Sheet Groupings [Abstract]
Debt security investment, net	$ 75,851		$ 72,717
Debt security investment, fair value	94,033		94,026
Financial Instruments, Financial Liabilities, Balance Sheet Groupings [Abstract]
Mortgage loans payable, net	810,478	[1]	792,870	[1]	$ 688,262
Mortgage loans payable, net fair value	830,049		732,846
Lines of credit and term loan, net	836,770		807,742
Lines of credit and term loan, net fair value	$ 847,048		$ 816,355
[1]	Such liabilities of Griffin-American Healthcare REIT III, Inc. as of December 31, 2020 and 2019 represented liabilities of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries. Griffin-American Healthcare REIT III Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of Griffin-American Healthcare REIT III, Inc. The creditors of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries do not have recourse against Griffin-American Healthcare REIT III, Inc., except for the 2019 Corporate Line of Credit, as defined in Note 8, held by Griffin-American Healthcare REIT III Holdings, LP in the amount of $556,500,000 and $557,000,000 as of December 31, 2020 and 2019, respectively, which is guaranteed by Griffin-American Healthcare REIT III, Inc.

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
NOL carryforwards	$ 87,347	$ 58,416

Income Taxes - Income Before In

Income Taxes - Income Before Income Tax (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Domestic	$ 6,171	$ 1,193	$ 14,202
Foreign	(386)	(521)	(462)
Income before income taxes	$ 5,785	$ 672	$ 13,740

Income Taxes - Income Tax (Bene

Income Taxes - Income Tax (Benefit) Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Federal deferred	$ (4,818)	$ (3,672)	$ (4,647)
State deferred	(932)	(737)	(922)
Federal current	(361)	(29)	0
State current	0	(16)	0
Foreign current	612	605	988
Valuation allowances	2,421	5,373	3,784
Total income tax (benefit) expense	$ (3,078)	$ 1,524	$ (797)

Income Taxes - Deferred Taxes (

Income Taxes - Deferred Taxes (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Fixed assets and intangibles	$ 5,619	$ 6,509
Expense accruals and other	13,968	14,233
Net operating loss	21,168	14,341
Reserves and accruals	6,541	5,540
Allowances for accounts receivable	1,932	(179)
Investments in unconsolidated entities	2,357	2,326
Total deferred income tax assets	51,585	42,770
Fixed assets and intangibles	(16,840)	(14,468)
Other — temporary differences	(2,868)	(2,176)
Total deferred income tax liabilities	19,708	16,644
Net deferred income tax assets before valuation allowance	31,877	26,126
Valuation allowances	(31,877)	(29,455)
Net deferred income tax assets (liabilities)	$ 0	$ (3,329)

Income Taxes - Tax Treatment of

Income Taxes - Tax Treatment of Distributions (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Ordinary income	$ 0	$ 35,294	$ 33,141
Capital gain	0	0	0
Return of capital	48,842	82,731	86,833
Distributions reportable	$ 48,842	$ 118,025	$ 119,974
Ordinary income	0.00%	29.90%	27.60%
Capital gain	0.00%	0.00%	0.00%
Return of capital	100.00%	70.10%	72.40%
Percentage distribution reportable	100.00%	100.00%	100.00%

Leases Additional Information (

Leases Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Lessee, Lease, Description [Line Items]
Operating lease revenues	$ 114,770	$ 118,201
Variable lease payments	18,452	$ 18,942
Lessee, operating lease, leases not yet commenced	$ 44,307
Maximum [Member]
Lessee, Lease, Description [Line Items]
Lease not yet commenced, term of contract	15 years

Leases Lessor, Future Minimum R

Leases Lessor, Future Minimum Rents Due (Details) $ in Thousands	Dec. 31, 2020USD ($)
Future Minimum Rent [Abstract]
2021	$ 89,484
2022	83,728
2023	76,843
2024	70,123
2025	61,594
Thereafter	410,526
Total	$ 792,298

Leases Components of Lease Cost

Leases Components of Lease Cost (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Leases [Abstract]
Operating Lease, Cost	$ 32,441	$ 29,974
Amortization of leased assets	1,891	2,001
Interest on lease liabilities	609	391
Total lease cost	$ 34,941	$ 32,366

Leases Lease Term and Discount

Leases Lease Term and Discount Rate (Details)	Dec. 31, 2020	Dec. 31, 2019
Leases [Abstract]
Operating leases, weighted average remaining lease term	13 years 3 months 18 days	13 years 6 months
Finance leases, weighted average remaining lease term	1 year 3 months 18 days	1 year 3 months 18 days
Operating leases, weighted average discount rate	5.77%	5.94%
Finance leases, weighted average discount rate	5.62%	7.33%

Leases Supplemental Disclosure

Leases Supplemental Disclosure of Cash Flows Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Leases [Abstract]
Operating cash outflows related to operating leases	$ 23,790	$ 22,114
Operating cash outflows related to finance leases	609	390
Financing cash outflows related to finance leases	1,235	3,076
Leased assets obtained in exchange for finance lease liabilities	66	0
Right-of-use assets obtained in exchange for operating lease liabilities	$ 14,302	$ 31,958

Leases Future Minimum Rent Paym

Leases Future Minimum Rent Payments, Operating Leases (Details) - USD ($) $ in Thousands		Dec. 31, 2020	Dec. 31, 2019
Lessee, Operating Lease, Description [Abstract]
2021		$ 23,875
2022		24,328
2023		24,520
2024		23,756
2025		23,639
Thereafter		167,081
Total operating lease payments		287,199
Less: interest		93,565
Present value of operating lease liabilities	[1]	$ 193,634	$ 207,371
[1]	Such liabilities of Griffin-American Healthcare REIT III, Inc. as of December 31, 2020 and 2019 represented liabilities of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries. Griffin-American Healthcare REIT III Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of Griffin-American Healthcare REIT III, Inc. The creditors of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries do not have recourse against Griffin-American Healthcare REIT III, Inc., except for the 2019 Corporate Line of Credit, as defined in Note 8, held by Griffin-American Healthcare REIT III Holdings, LP in the amount of $556,500,000 and $557,000,000 as of December 31, 2020 and 2019, respectively, which is guaranteed by Griffin-American Healthcare REIT III, Inc.

Leases Future Minimum Rent Pa_2

Leases Future Minimum Rent Payments, Finance Leases (Details) $ in Thousands	Dec. 31, 2020USD ($)
Lessee, Finance Lease, Description [Abstract]
2021	$ 151
2022	22
2023	16
2024	0
2025	0
Thereafter	0
Total finance lease payments	189
Less: interest	8
Present value of finance lease liabilities	$ 181

Segment Reporting - Summary Inf

Segment Reporting - Summary Information for Reportable Segments (Details) $ in Thousands	Dec. 31, 2020USD ($)segment	Dec. 31, 2020USD ($)segment	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)
Segment Reporting [Line Items]
Number of reportable segments | segment	6	6
Goodwill	$ 75,309	$ 75,309	$ 75,309
Revenues and grant income:
Resident fees and services		1,069,073	1,099,078	$ 1,005,691
Real estate revenue		120,047	124,038	129,569
Grant income		55,181	0	0
Total revenues and grant income		1,244,301	1,223,116	1,135,260
Expenses:
Property operating expenses		993,727	967,860	889,071
Rental expenses		32,298	33,859	34,823
Segment net operating income		218,276	221,397	211,366
Expenses:
General and administrative		27,007	29,749	28,770
Acquisition related expenses		290	(161)	(2,913)
Depreciation and amortization		98,858	111,412	95,678
Other income (expense):
Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishment)		(71,278)	(78,553)	(66,281)
Loss in fair value of derivative financial instruments		(3,906)	(4,541)	(1,949)
Gain on dispositions of real estate investments		1,395	0	0
Impairment of real estate investments		(11,069)	0	(2,542)
Loss from unconsolidated entities		(4,517)	(2,097)	(3,877)
Foreign currency gain (loss)		1,469	1,730	(2,690)
Other income		1,570	3,736	1,248
Income before income taxes		5,785	672	13,740
Income tax benefit (expense)		3,078	(1,524)	797
Net income (loss),		8,863	(852)	14,537
Integrated Senior Health Campuses [Member]
Revenues and grant income:
Resident fees and services		983,169	1,030,934	940,616
Real estate revenue		0	0	0
Grant income		53,855	0	0
Total revenues and grant income		1,037,024	1,030,934	940,616
Expenses:
Property operating expenses		929,897	919,793	844,279
Rental expenses		0	0	0
Segment net operating income		107,127	111,141	96,337
Senior Housing-RIDEA [Member]
Revenues and grant income:
Resident fees and services		85,904	68,144	65,075
Real estate revenue		0	0	0
Grant income		1,326	0	0
Total revenues and grant income		87,230	68,144	65,075
Expenses:
Property operating expenses		63,830	48,067	44,792
Rental expenses		0	0	0
Segment net operating income		23,400	20,077	20,283
Medical Office Building [Member]
Revenues and grant income:
Resident fees and services		0	0	0
Real estate revenue		78,424	80,805	80,078
Grant income		0	0	0
Total revenues and grant income		78,424	80,805	80,078
Expenses:
Property operating expenses		0	0	0
Rental expenses		30,216	30,870	30,514
Segment net operating income		48,208	49,935	49,564
Senior Housing [Member]
Revenues and grant income:
Resident fees and services		0	0	0
Real estate revenue		14,524	18,407	21,913
Grant income		0	0	0
Total revenues and grant income		14,524	18,407	21,913
Expenses:
Property operating expenses		0	0	0
Rental expenses		64	1,001	837
Segment net operating income		14,460	17,406	21,076
Skilled Nursing Facilities [Member]
Revenues and grant income:
Resident fees and services		0	0	0
Real estate revenue		16,107	13,345	14,887
Grant income		0	0	0
Total revenues and grant income		16,107	13,345	14,887
Expenses:
Property operating expenses		0	0	0
Rental expenses		1,572	1,456	1,816
Segment net operating income		14,535	11,889	13,071
Hospitals [Member]
Revenues and grant income:
Resident fees and services		0	0	0
Real estate revenue		10,992	11,481	12,691
Grant income		0	0	0
Total revenues and grant income		10,992	11,481	12,691
Expenses:
Property operating expenses		0	0	0
Rental expenses		446	532	1,656
Segment net operating income		$ 10,546	$ 10,949	$ 11,035

Segment Reporting - Assets by R

Segment Reporting - Assets by Reportable Segment (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Segment Reporting [Line Items]
Total assets	$ 3,234,937	$ 3,172,289
Goodwill	75,309	75,309
Integrated Senior Health Campuses [Member]
Segment Reporting [Line Items]
Total assets	1,886,878	1,791,868
Medical Office Building [Member]
Segment Reporting [Line Items]
Total assets	610,653	620,292
Senior Housing-RIDEA [Member]
Segment Reporting [Line Items]
Total assets	348,987	360,823
Senior Housing [Member]
Segment Reporting [Line Items]
Total assets	152,406	152,909
Skilled Nursing Facilities [Member]
Segment Reporting [Line Items]
Total assets	115,941	126,606
Hospitals [Member]
Segment Reporting [Line Items]
Total assets	109,663	113,737
Other [Member]
Segment Reporting [Line Items]
Total assets	$ 10,409	$ 6,054

Segment Reporting - Segment Inf

Segment Reporting - Segment Information by Geographic Region (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Segment Reporting [Line Items]
Real estate investments, net	$ 2,330,000	$ 2,270,421
Total revenues and grant income	1,244,301	1,223,116	$ 1,135,260
United States [Member]
Segment Reporting [Line Items]
Real estate investments, net	2,279,257	2,219,882
Total revenues and grant income	1,239,509	1,218,337	1,130,350
International [Member]
Segment Reporting [Line Items]
Real estate investments, net	50,743	50,539
Total revenues and grant income	$ 4,792	$ 4,779	$ 4,910

Concentration of Credit Risk (D

Concentration of Credit Risk (Details)	Dec. 31, 2020segmenttenantState	Dec. 31, 2020tenantsegmentState
Concentration of Credit Risk
Number of states that generated at least 10% of annualized base rent | State	1	1
Minimum percent share of each state annualized base rent that company owned	10.00%	10.00%
Number of reportable segments | segment	6	6
Number of tenants with more than ten percent of annual base rent | tenant	0	0
Minimum percent share of annualized base rent accounted by tenants	10.00%	10.00%
Integrated Senior Health Campuses [Member]
Concentration of Credit Risk
Percentage of annual base rent	49.60%	49.60%
Medical Office Building [Member]
Concentration of Credit Risk
Percentage of annual base rent	27.30%	27.30%
Senior Housing-RIDEA [Member]
Concentration of Credit Risk
Percentage of annual base rent	10.50%	10.50%
Skilled Nursing Facilities [Member]
Concentration of Credit Risk
Percentage of annual base rent	5.70%	5.70%
Hospitals [Member]
Concentration of Credit Risk
Percentage of annual base rent	3.90%	3.90%
Senior Housing [Member]
Concentration of Credit Risk
Percentage of annual base rent	3.00%	3.00%
Indiana [Member]
Concentration of Credit Risk
Percentage of annual base rent	39.90%	39.90%

Per Share Data (Detail)

Per Share Data (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Anti-dilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Participating securities, distributed and undistributed earnings (loss), basic	$ 9	$ 28	$ 28
Restricted Common Stock [Member]
Anti-dilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from computation of earnings per share	33,000	46,500
Redeemable Limited Partnership Units
Anti-dilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from computation of earnings per share	222	222

Schedule III Real Estate and _2

Schedule III Real Estate and Accumulated Depreciation (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 834,026
Initial cost to company, land	195,367
Initial cost to company, buildings and improvements	2,143,037
Cost capitalized subsequent to acquisition	423,868
Gross amount of which carried at close of period, land	202,749
Gross amount of which carried at close of period, buildings and improvements	2,559,523
Gross amount of which carried at close of period, total	2,762,272	$ 2,618,608	$ 2,477,375	$ 2,336,208
Gross amount of which carried at close of period, accumulated deprecation	(425,272)	$ (337,898)	$ (254,694)	$ (172,950)
Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	834,026
Initial cost to company, land	195,061
Initial cost to company, buildings and improvements	2,071,675
Cost capitalized subsequent to acquisition	306,873
Gross amount of which carried at close of period, land	200,814
Gross amount of which carried at close of period, buildings and improvements	2,372,795
Gross amount of which carried at close of period, total	2,573,609
Gross amount of which carried at close of period, accumulated deprecation	(344,050)
Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	306
Initial cost to company, buildings and improvements	71,362
Cost capitalized subsequent to acquisition	112,236
Gross amount of which carried at close of period, land	1,456
Gross amount of which carried at close of period, buildings and improvements	182,448
Gross amount of which carried at close of period, total	183,904
Gross amount of which carried at close of period, accumulated deprecation	(81,001)
Construction in Progress [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	0
Initial cost to company, buildings and improvements	0
Cost capitalized subsequent to acquisition	4,759
Gross amount of which carried at close of period, land	479
Gross amount of which carried at close of period, buildings and improvements	4,280
Gross amount of which carried at close of period, total	4,759
Gross amount of which carried at close of period, accumulated deprecation	(221)
DeKalb Professional Center [Member] | Lithonia, GA [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	479
Initial cost to company, buildings and improvements	2,871
Cost capitalized subsequent to acquisition	271
Gross amount of which carried at close of period, land	479
Gross amount of which carried at close of period, buildings and improvements	3,142
Gross amount of which carried at close of period, total	3,621
Gross amount of which carried at close of period, accumulated deprecation	(766)
Country Club MOB [Member] | Stockbridge, GA [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	240
Initial cost to company, buildings and improvements	2,306
Cost capitalized subsequent to acquisition	375
Gross amount of which carried at close of period, land	240
Gross amount of which carried at close of period, buildings and improvements	2,681
Gross amount of which carried at close of period, total	2,921
Gross amount of which carried at close of period, accumulated deprecation	(572)
Acworth Medical Complex [Member] | Acworth, GA One [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	216
Initial cost to company, buildings and improvements	3,135
Cost capitalized subsequent to acquisition	192
Gross amount of which carried at close of period, land	216
Gross amount of which carried at close of period, buildings and improvements	3,327
Gross amount of which carried at close of period, total	3,543
Gross amount of which carried at close of period, accumulated deprecation	(692)
Acworth Medical Complex [Member] | Acworth, GA Two [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	250
Initial cost to company, buildings and improvements	2,214
Cost capitalized subsequent to acquisition	148
Gross amount of which carried at close of period, land	250
Gross amount of which carried at close of period, buildings and improvements	2,362
Gross amount of which carried at close of period, total	2,612
Gross amount of which carried at close of period, accumulated deprecation	(550)
Acworth Medical Complex [Member] | Acworth, GA Three [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	104
Initial cost to company, buildings and improvements	774
Cost capitalized subsequent to acquisition	3
Gross amount of which carried at close of period, land	104
Gross amount of which carried at close of period, buildings and improvements	777
Gross amount of which carried at close of period, total	881
Gross amount of which carried at close of period, accumulated deprecation	(197)
Wichita KS MOB [Member] | Wichita, KS [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	943
Initial cost to company, buildings and improvements	6,288
Cost capitalized subsequent to acquisition	537
Gross amount of which carried at close of period, land	943
Gross amount of which carried at close of period, buildings and improvements	6,825
Gross amount of which carried at close of period, total	7,768
Gross amount of which carried at close of period, accumulated deprecation	(1,648)
Delta Valley ALF Portfolio [Member] | Batesville, MS [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	331
Initial cost to company, buildings and improvements	5,103
Cost capitalized subsequent to acquisition	0
Gross amount of which carried at close of period, land	331
Gross amount of which carried at close of period, buildings and improvements	5,103
Gross amount of which carried at close of period, total	5,434
Gross amount of which carried at close of period, accumulated deprecation	(1,098)
Delta Valley ALF Portfolio [Member] | Cleveland, MS [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	348
Initial cost to company, buildings and improvements	6,369
Cost capitalized subsequent to acquisition	0
Gross amount of which carried at close of period, land	348
Gross amount of which carried at close of period, buildings and improvements	6,369
Gross amount of which carried at close of period, total	6,717
Gross amount of which carried at close of period, accumulated deprecation	(1,477)
Delta Valley ALF Portfolio [Member] | Springdale, AR [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	891
Initial cost to company, buildings and improvements	6,538
Cost capitalized subsequent to acquisition	0
Gross amount of which carried at close of period, land	891
Gross amount of which carried at close of period, buildings and improvements	6,538
Gross amount of which carried at close of period, total	7,429
Gross amount of which carried at close of period, accumulated deprecation	(1,489)
Lee's Summit MO MOB [Member] | Lee's Summit, MO [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,045
Initial cost to company, buildings and improvements	5,068
Cost capitalized subsequent to acquisition	463
Gross amount of which carried at close of period, land	1,045
Gross amount of which carried at close of period, buildings and improvements	5,531
Gross amount of which carried at close of period, total	6,576
Gross amount of which carried at close of period, accumulated deprecation	(1,646)
Carolina Commons MOB [Member] | Indian Land, SC [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	6,419
Initial cost to company, land	1,028
Initial cost to company, buildings and improvements	9,430
Cost capitalized subsequent to acquisition	2,190
Gross amount of which carried at close of period, land	1,028
Gross amount of which carried at close of period, buildings and improvements	11,620
Gross amount of which carried at close of period, total	12,648
Gross amount of which carried at close of period, accumulated deprecation	(2,210)
Mount Olympia MOB Portflio [Member] | Mount Dora, FL [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	393
Initial cost to company, buildings and improvements	5,633
Cost capitalized subsequent to acquisition	0
Gross amount of which carried at close of period, land	393
Gross amount of which carried at close of period, buildings and improvements	5,633
Gross amount of which carried at close of period, total	6,026
Gross amount of which carried at close of period, accumulated deprecation	(1,056)
Mount Olympia MOB Portflio [Member] | Olympia Fields, IL [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	298
Initial cost to company, buildings and improvements	2,726
Cost capitalized subsequent to acquisition	21
Gross amount of which carried at close of period, land	298
Gross amount of which carried at close of period, buildings and improvements	2,747
Gross amount of which carried at close of period, total	3,045
Gross amount of which carried at close of period, accumulated deprecation	(602)
Southlake TX Hospital [Member] | Southlake, TX [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	5,089
Initial cost to company, buildings and improvements	108,517
Cost capitalized subsequent to acquisition	0
Gross amount of which carried at close of period, land	5,089
Gross amount of which carried at close of period, buildings and improvements	108,517
Gross amount of which carried at close of period, total	113,606
Gross amount of which carried at close of period, accumulated deprecation	(17,696)
East Texas MOB Portfolio [Member] | Longview, TX One [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	0
Initial cost to company, buildings and improvements	19,942
Cost capitalized subsequent to acquisition	111
Gross amount of which carried at close of period, land	0
Gross amount of which carried at close of period, buildings and improvements	20,053
Gross amount of which carried at close of period, total	20,053
Gross amount of which carried at close of period, accumulated deprecation	(4,050)
East Texas MOB Portfolio [Member] | Longview, TX Two [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	228
Initial cost to company, buildings and improvements	965
Cost capitalized subsequent to acquisition	0
Gross amount of which carried at close of period, land	228
Gross amount of which carried at close of period, buildings and improvements	965
Gross amount of which carried at close of period, total	1,193
Gross amount of which carried at close of period, accumulated deprecation	(321)
East Texas MOB Portfolio [Member] | Longview, TX Three [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	759
Initial cost to company, buildings and improvements	1,696
Cost capitalized subsequent to acquisition	0
Gross amount of which carried at close of period, land	759
Gross amount of which carried at close of period, buildings and improvements	1,696
Gross amount of which carried at close of period, total	2,455
Gross amount of which carried at close of period, accumulated deprecation	(606)
East Texas MOB Portfolio [Member] | Longview, TX Four [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	0
Initial cost to company, buildings and improvements	8,027
Cost capitalized subsequent to acquisition	0
Gross amount of which carried at close of period, land	0
Gross amount of which carried at close of period, buildings and improvements	8,027
Gross amount of which carried at close of period, total	8,027
Gross amount of which carried at close of period, accumulated deprecation	(1,667)
East Texas MOB Portfolio [Member] | Longview, TX Five [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	0
Initial cost to company, buildings and improvements	696
Cost capitalized subsequent to acquisition	29
Gross amount of which carried at close of period, land	0
Gross amount of which carried at close of period, buildings and improvements	725
Gross amount of which carried at close of period, total	725
Gross amount of which carried at close of period, accumulated deprecation	(237)
East Texas MOB Portfolio [Member] | Longview, TX Six [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	0
Initial cost to company, buildings and improvements	27,601
Cost capitalized subsequent to acquisition	3,354
Gross amount of which carried at close of period, land	0
Gross amount of which carried at close of period, buildings and improvements	30,955
Gross amount of which carried at close of period, total	30,955
Gross amount of which carried at close of period, accumulated deprecation	(6,626)
East Texas MOB Portfolio [Member] | Marshall, TX [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	368
Initial cost to company, buildings and improvements	1,711
Cost capitalized subsequent to acquisition	99
Gross amount of which carried at close of period, land	368
Gross amount of which carried at close of period, buildings and improvements	1,810
Gross amount of which carried at close of period, total	2,178
Gross amount of which carried at close of period, accumulated deprecation	(626)
Premier MOB [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	644
Initial cost to company, buildings and improvements	10,420
Cost capitalized subsequent to acquisition	825
Gross amount of which carried at close of period, land	644
Gross amount of which carried at close of period, buildings and improvements	11,245
Gross amount of which carried at close of period, total	11,889
Gross amount of which carried at close of period, accumulated deprecation	(2,417)
Independence MOB Portfolio [Member] | Southgate, KY [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	411
Initial cost to company, buildings and improvements	11,005
Cost capitalized subsequent to acquisition	1,914
Gross amount of which carried at close of period, land	411
Gross amount of which carried at close of period, buildings and improvements	12,919
Gross amount of which carried at close of period, total	13,330
Gross amount of which carried at close of period, accumulated deprecation	(2,461)
Independence MOB Portfolio [Member] | Somerville, MA [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	30,332
Initial cost to company, land	1,509
Initial cost to company, buildings and improvements	46,775
Cost capitalized subsequent to acquisition	4,045
Gross amount of which carried at close of period, land	1,509
Gross amount of which carried at close of period, buildings and improvements	50,820
Gross amount of which carried at close of period, total	52,329
Gross amount of which carried at close of period, accumulated deprecation	(8,011)
Independence MOB Portfolio [Member] | Morristown, NJ [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	28,364
Initial cost to company, land	3,763
Initial cost to company, buildings and improvements	26,957
Cost capitalized subsequent to acquisition	3,940
Gross amount of which carried at close of period, land	3,764
Gross amount of which carried at close of period, buildings and improvements	30,896
Gross amount of which carried at close of period, total	34,660
Gross amount of which carried at close of period, accumulated deprecation	(6,808)
Independence MOB Portfolio [Member] | Verona, NJ [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,683
Initial cost to company, buildings and improvements	9,405
Cost capitalized subsequent to acquisition	746
Gross amount of which carried at close of period, land	1,683
Gross amount of which carried at close of period, buildings and improvements	10,151
Gross amount of which carried at close of period, total	11,834
Gross amount of which carried at close of period, accumulated deprecation	(2,099)
Independence MOB Portfolio [Member] | Bronx, NY [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	0
Initial cost to company, buildings and improvements	19,593
Cost capitalized subsequent to acquisition	2,533
Gross amount of which carried at close of period, land	0
Gross amount of which carried at close of period, buildings and improvements	22,126
Gross amount of which carried at close of period, total	22,126
Gross amount of which carried at close of period, accumulated deprecation	(3,794)
King of Prussia PA MOB [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	8,797
Initial cost to company, land	3,427
Initial cost to company, buildings and improvements	13,849
Cost capitalized subsequent to acquisition	4,803
Gross amount of which carried at close of period, land	3,427
Gross amount of which carried at close of period, buildings and improvements	18,652
Gross amount of which carried at close of period, total	22,079
Gross amount of which carried at close of period, accumulated deprecation	(4,178)
North Carolina ALF Portfolio [Member] | Clemmons, NC [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	596
Initial cost to company, buildings and improvements	13,237
Cost capitalized subsequent to acquisition	(768)
Gross amount of which carried at close of period, land	596
Gross amount of which carried at close of period, buildings and improvements	12,469
Gross amount of which carried at close of period, total	13,065
Gross amount of which carried at close of period, accumulated deprecation	(2,089)
North Carolina ALF Portfolio [Member] | Garner, NC [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,723
Initial cost to company, buildings and improvements	11,517
Cost capitalized subsequent to acquisition	15
Gross amount of which carried at close of period, land	1,723
Gross amount of which carried at close of period, buildings and improvements	11,532
Gross amount of which carried at close of period, total	13,255
Gross amount of which carried at close of period, accumulated deprecation	(722)
North Carolina ALF Portfolio [Member] | Huntersville, NC [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	2,033
Initial cost to company, buildings and improvements	11,494
Cost capitalized subsequent to acquisition	(192)
Gross amount of which carried at close of period, land	2,033
Gross amount of which carried at close of period, buildings and improvements	11,302
Gross amount of which carried at close of period, total	13,335
Gross amount of which carried at close of period, accumulated deprecation	(1,424)
North Carolina ALF Portfolio [Member] | Matthews, NC [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	949
Initial cost to company, buildings and improvements	12,537
Cost capitalized subsequent to acquisition	(188)
Gross amount of which carried at close of period, land	949
Gross amount of which carried at close of period, buildings and improvements	12,349
Gross amount of which carried at close of period, total	13,298
Gross amount of which carried at close of period, accumulated deprecation	(970)
North Carolina ALF Portfolio [Member] | Mooresville, NC [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	835
Initial cost to company, buildings and improvements	15,894
Cost capitalized subsequent to acquisition	(777)
Gross amount of which carried at close of period, land	835
Gross amount of which carried at close of period, buildings and improvements	15,117
Gross amount of which carried at close of period, total	15,952
Gross amount of which carried at close of period, accumulated deprecation	(2,577)
North Carolina ALF Portfolio [Member] | Raleigh, NC [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,069
Initial cost to company, buildings and improvements	21,235
Cost capitalized subsequent to acquisition	(772)
Gross amount of which carried at close of period, land	1,069
Gross amount of which carried at close of period, buildings and improvements	20,463
Gross amount of which carried at close of period, total	21,532
Gross amount of which carried at close of period, accumulated deprecation	(3,298)
North Carolina ALF Portfolio [Member] | Wake Forest, NC [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	772
Initial cost to company, buildings and improvements	13,596
Cost capitalized subsequent to acquisition	(864)
Gross amount of which carried at close of period, land	772
Gross amount of which carried at close of period, buildings and improvements	12,732
Gross amount of which carried at close of period, total	13,504
Gross amount of which carried at close of period, accumulated deprecation	(2,005)
Orange Star Medical Portfolio [Member] | Durango, CO One [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	623
Initial cost to company, buildings and improvements	14,166
Cost capitalized subsequent to acquisition	279
Gross amount of which carried at close of period, land	623
Gross amount of which carried at close of period, buildings and improvements	14,445
Gross amount of which carried at close of period, total	15,068
Gross amount of which carried at close of period, accumulated deprecation	(2,399)
Orange Star Medical Portfolio [Member] | Durango, CO Two [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	788
Initial cost to company, buildings and improvements	10,467
Cost capitalized subsequent to acquisition	604
Gross amount of which carried at close of period, land	788
Gross amount of which carried at close of period, buildings and improvements	11,071
Gross amount of which carried at close of period, total	11,859
Gross amount of which carried at close of period, accumulated deprecation	(1,918)
Orange Star Medical Portfolio [Member] | Friendswood, TX [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	500
Initial cost to company, buildings and improvements	7,664
Cost capitalized subsequent to acquisition	323
Gross amount of which carried at close of period, land	500
Gross amount of which carried at close of period, buildings and improvements	7,987
Gross amount of which carried at close of period, total	8,487
Gross amount of which carried at close of period, accumulated deprecation	(1,476)
Orange Star Medical Portfolio [Member] | Keller, TX [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,604
Initial cost to company, buildings and improvements	7,912
Cost capitalized subsequent to acquisition	429
Gross amount of which carried at close of period, land	1,604
Gross amount of which carried at close of period, buildings and improvements	8,341
Gross amount of which carried at close of period, total	9,945
Gross amount of which carried at close of period, accumulated deprecation	(1,549)
Orange Star Medical Portfolio [Member] | Wharton, TX [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	259
Initial cost to company, buildings and improvements	10,590
Cost capitalized subsequent to acquisition	243
Gross amount of which carried at close of period, land	259
Gross amount of which carried at close of period, buildings and improvements	10,833
Gross amount of which carried at close of period, total	11,092
Gross amount of which carried at close of period, accumulated deprecation	(1,970)
Kingwood MOB Portfolio [Member] | Kingwood, TX One [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	820
Initial cost to company, buildings and improvements	8,589
Cost capitalized subsequent to acquisition	127
Gross amount of which carried at close of period, land	820
Gross amount of which carried at close of period, buildings and improvements	8,716
Gross amount of which carried at close of period, total	9,536
Gross amount of which carried at close of period, accumulated deprecation	(1,647)
Kingwood MOB Portfolio [Member] | Kingwood, TX Two [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	781
Initial cost to company, buildings and improvements	3,943
Cost capitalized subsequent to acquisition	95
Gross amount of which carried at close of period, land	781
Gross amount of which carried at close of period, buildings and improvements	4,038
Gross amount of which carried at close of period, total	4,819
Gross amount of which carried at close of period, accumulated deprecation	(807)
Mt. Juliet TN MOB [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,188
Initial cost to company, buildings and improvements	10,720
Cost capitalized subsequent to acquisition	166
Gross amount of which carried at close of period, land	1,188
Gross amount of which carried at close of period, buildings and improvements	10,886
Gross amount of which carried at close of period, total	12,074
Gross amount of which carried at close of period, accumulated deprecation	(1,987)
Homewood AL MOB [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	405
Initial cost to company, buildings and improvements	6,590
Cost capitalized subsequent to acquisition	(60)
Gross amount of which carried at close of period, land	405
Gross amount of which carried at close of period, buildings and improvements	6,530
Gross amount of which carried at close of period, total	6,935
Gross amount of which carried at close of period, accumulated deprecation	(1,233)
Paoli PA Medical Plaza [Member] | Paoli, PA One [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	12,404
Initial cost to company, land	2,313
Initial cost to company, buildings and improvements	12,447
Cost capitalized subsequent to acquisition	7,984
Gross amount of which carried at close of period, land	2,313
Gross amount of which carried at close of period, buildings and improvements	20,431
Gross amount of which carried at close of period, total	22,744
Gross amount of which carried at close of period, accumulated deprecation	(2,860)
Paoli PA Medical Plaza [Member] | Paoli, PA Two [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,668
Initial cost to company, buildings and improvements	7,357
Cost capitalized subsequent to acquisition	1,335
Gross amount of which carried at close of period, land	1,668
Gross amount of which carried at close of period, buildings and improvements	8,692
Gross amount of which carried at close of period, total	10,360
Gross amount of which carried at close of period, accumulated deprecation	(1,987)
Glen Burnie MD MOB [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	2,692
Initial cost to company, buildings and improvements	14,095
Cost capitalized subsequent to acquisition	2,649
Gross amount of which carried at close of period, land	2,692
Gross amount of which carried at close of period, buildings and improvements	16,744
Gross amount of which carried at close of period, total	19,436
Gross amount of which carried at close of period, accumulated deprecation	(3,533)
Marietta GA MOB [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,347
Initial cost to company, buildings and improvements	10,947
Cost capitalized subsequent to acquisition	462
Gross amount of which carried at close of period, land	1,347
Gross amount of which carried at close of period, buildings and improvements	11,409
Gross amount of which carried at close of period, total	12,756
Gross amount of which carried at close of period, accumulated deprecation	(1,927)
Mountain Crest Senior Housing Portfolio [Member] | Elkhart, IN One [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	793
Initial cost to company, buildings and improvements	6,009
Cost capitalized subsequent to acquisition	179
Gross amount of which carried at close of period, land	793
Gross amount of which carried at close of period, buildings and improvements	6,188
Gross amount of which carried at close of period, total	6,981
Gross amount of which carried at close of period, accumulated deprecation	(1,385)
Mountain Crest Senior Housing Portfolio [Member] | Elkhart, IN Two [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	782
Initial cost to company, buildings and improvements	6,760
Cost capitalized subsequent to acquisition	568
Gross amount of which carried at close of period, land	782
Gross amount of which carried at close of period, buildings and improvements	7,328
Gross amount of which carried at close of period, total	8,110
Gross amount of which carried at close of period, accumulated deprecation	(1,667)
Mountain Crest Senior Housing Portfolio [Member] | Hobart, IN [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	604
Initial cost to company, buildings and improvements	11,529
Cost capitalized subsequent to acquisition	105
Gross amount of which carried at close of period, land	604
Gross amount of which carried at close of period, buildings and improvements	11,634
Gross amount of which carried at close of period, total	12,238
Gross amount of which carried at close of period, accumulated deprecation	(2,095)
Mountain Crest Senior Housing Portfolio [Member] | LaPorte, IN [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	392
Initial cost to company, buildings and improvements	14,894
Cost capitalized subsequent to acquisition	343
Gross amount of which carried at close of period, land	392
Gross amount of which carried at close of period, buildings and improvements	15,237
Gross amount of which carried at close of period, total	15,629
Gross amount of which carried at close of period, accumulated deprecation	(2,719)
Mountain Crest Senior Housing Portfolio [Member] | Mishawaka, IN [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	9,124
Initial cost to company, land	3,670
Initial cost to company, buildings and improvements	14,416
Cost capitalized subsequent to acquisition	642
Gross amount of which carried at close of period, land	3,670
Gross amount of which carried at close of period, buildings and improvements	15,058
Gross amount of which carried at close of period, total	18,728
Gross amount of which carried at close of period, accumulated deprecation	(2,885)
Mountain Crest Senior Housing Portfolio [Member] | Niles, MI [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	404
Initial cost to company, buildings and improvements	5,050
Cost capitalized subsequent to acquisition	302
Gross amount of which carried at close of period, land	404
Gross amount of which carried at close of period, buildings and improvements	5,352
Gross amount of which carried at close of period, total	5,756
Gross amount of which carried at close of period, accumulated deprecation	(1,179)
Mount Dora Medical Center [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	736
Initial cost to company, buildings and improvements	14,616
Cost capitalized subsequent to acquisition	(6,703)
Gross amount of which carried at close of period, land	736
Gross amount of which carried at close of period, buildings and improvements	7,913
Gross amount of which carried at close of period, total	8,649
Gross amount of which carried at close of period, accumulated deprecation	(1,476)
Nebraska Senior Housing Portfolio [Member] | Bennington, NE [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	981
Initial cost to company, buildings and improvements	20,427
Cost capitalized subsequent to acquisition	467
Gross amount of which carried at close of period, land	981
Gross amount of which carried at close of period, buildings and improvements	20,894
Gross amount of which carried at close of period, total	21,875
Gross amount of which carried at close of period, accumulated deprecation	(3,513)
Nebraska Senior Housing Portfolio [Member] | Omaha, NE [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,274
Initial cost to company, buildings and improvements	38,619
Cost capitalized subsequent to acquisition	803
Gross amount of which carried at close of period, land	1,274
Gross amount of which carried at close of period, buildings and improvements	39,422
Gross amount of which carried at close of period, total	40,696
Gross amount of which carried at close of period, accumulated deprecation	(6,160)
Pennsylvania Senior Housing Portfolio [Member] | Bethlehem, PA [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,542
Initial cost to company, buildings and improvements	22,249
Cost capitalized subsequent to acquisition	538
Gross amount of which carried at close of period, land	1,542
Gross amount of which carried at close of period, buildings and improvements	22,787
Gross amount of which carried at close of period, total	24,329
Gross amount of which carried at close of period, accumulated deprecation	(4,185)
Pennsylvania Senior Housing Portfolio [Member] | Boyertown, PA [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	22,932
Initial cost to company, land	480
Initial cost to company, buildings and improvements	25,544
Cost capitalized subsequent to acquisition	464
Gross amount of which carried at close of period, land	480
Gross amount of which carried at close of period, buildings and improvements	26,008
Gross amount of which carried at close of period, total	26,488
Gross amount of which carried at close of period, accumulated deprecation	(4,255)
Pennsylvania Senior Housing Portfolio [Member] | York, PA [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	12,432
Initial cost to company, land	972
Initial cost to company, buildings and improvements	29,860
Cost capitalized subsequent to acquisition	319
Gross amount of which carried at close of period, land	972
Gross amount of which carried at close of period, buildings and improvements	30,179
Gross amount of which carried at close of period, total	31,151
Gross amount of which carried at close of period, accumulated deprecation	(4,855)
Southern Illinois MOB Portfolio [Member] | Waterloo, IL One [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	94
Initial cost to company, buildings and improvements	1,977
Cost capitalized subsequent to acquisition	0
Gross amount of which carried at close of period, land	94
Gross amount of which carried at close of period, buildings and improvements	1,977
Gross amount of which carried at close of period, total	2,071
Gross amount of which carried at close of period, accumulated deprecation	(384)
Southern Illinois MOB Portfolio [Member] | Waterloo, IL Two [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	738
Initial cost to company, buildings and improvements	6,332
Cost capitalized subsequent to acquisition	584
Gross amount of which carried at close of period, land	738
Gross amount of which carried at close of period, buildings and improvements	6,916
Gross amount of which carried at close of period, total	7,654
Gross amount of which carried at close of period, accumulated deprecation	(1,421)
Southern Illinois MOB Portfolio [Member] | Waterloo, IL Three [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	200
Initial cost to company, buildings and improvements	2,648
Cost capitalized subsequent to acquisition	62
Gross amount of which carried at close of period, land	200
Gross amount of which carried at close of period, buildings and improvements	2,710
Gross amount of which carried at close of period, total	2,910
Gross amount of which carried at close of period, accumulated deprecation	(564)
Napa Medical Center [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,176
Initial cost to company, buildings and improvements	13,328
Cost capitalized subsequent to acquisition	1,572
Gross amount of which carried at close of period, land	1,176
Gross amount of which carried at close of period, buildings and improvements	14,900
Gross amount of which carried at close of period, total	16,076
Gross amount of which carried at close of period, accumulated deprecation	(3,000)
Chesterfield Corporate Plaza [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	8,030
Initial cost to company, buildings and improvements	24,533
Cost capitalized subsequent to acquisition	2,885
Gross amount of which carried at close of period, land	8,030
Gross amount of which carried at close of period, buildings and improvements	27,418
Gross amount of which carried at close of period, total	35,448
Gross amount of which carried at close of period, accumulated deprecation	(5,898)
Richmond VA ALF Senior Housing Portfolio [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	33,400
Initial cost to company, land	2,146
Initial cost to company, buildings and improvements	56,671
Cost capitalized subsequent to acquisition	525
Gross amount of which carried at close of period, land	2,146
Gross amount of which carried at close of period, buildings and improvements	57,196
Gross amount of which carried at close of period, total	59,342
Gross amount of which carried at close of period, accumulated deprecation	(8,175)
Crown Senior Care Portfolio - Peel, Isle of Man [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,249
Initial cost to company, buildings and improvements	7,453
Cost capitalized subsequent to acquisition	0
Gross amount of which carried at close of period, land	1,249
Gross amount of which carried at close of period, buildings and improvements	7,453
Gross amount of which carried at close of period, total	8,702
Gross amount of which carried at close of period, accumulated deprecation	(1,189)
Crown Senior Care Portfolio - St. Albans [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,259
Initial cost to company, buildings and improvements	13,716
Cost capitalized subsequent to acquisition	249
Gross amount of which carried at close of period, land	1,259
Gross amount of which carried at close of period, buildings and improvements	13,965
Gross amount of which carried at close of period, total	15,224
Gross amount of which carried at close of period, accumulated deprecation	(2,126)
Crown Senior Care Portfolio - Salisbury [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,338
Initial cost to company, buildings and improvements	12,855
Cost capitalized subsequent to acquisition	38
Gross amount of which carried at close of period, land	1,338
Gross amount of which carried at close of period, buildings and improvements	12,893
Gross amount of which carried at close of period, total	14,231
Gross amount of which carried at close of period, accumulated deprecation	(1,990)
Crown Senior Care Portfolio - Aberdeen [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	2,171
Initial cost to company, buildings and improvements	6,473
Cost capitalized subsequent to acquisition	0
Gross amount of which carried at close of period, land	2,171
Gross amount of which carried at close of period, buildings and improvements	6,473
Gross amount of which carried at close of period, total	8,644
Gross amount of which carried at close of period, accumulated deprecation	(773)
Crown Senior Care Portfolio - Felixstowe One [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	754
Initial cost to company, buildings and improvements	6,325
Cost capitalized subsequent to acquisition	445
Gross amount of which carried at close of period, land	754
Gross amount of which carried at close of period, buildings and improvements	6,770
Gross amount of which carried at close of period, total	7,524
Gross amount of which carried at close of period, accumulated deprecation	(777)
Crown Senior Care Portfolio - Felixstowe Two [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	569
Initial cost to company, buildings and improvements	2,797
Cost capitalized subsequent to acquisition	296
Gross amount of which carried at close of period, land	569
Gross amount of which carried at close of period, buildings and improvements	3,093
Gross amount of which carried at close of period, total	3,662
Gross amount of which carried at close of period, accumulated deprecation	(391)
Washington DC SNF [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,194
Initial cost to company, buildings and improvements	34,200
Cost capitalized subsequent to acquisition	0
Gross amount of which carried at close of period, land	1,194
Gross amount of which carried at close of period, buildings and improvements	34,200
Gross amount of which carried at close of period, total	35,394
Gross amount of which carried at close of period, accumulated deprecation	(5,964)
Stockbridge GA MOB II [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	499
Initial cost to company, buildings and improvements	8,353
Cost capitalized subsequent to acquisition	916
Gross amount of which carried at close of period, land	499
Gross amount of which carried at close of period, buildings and improvements	9,269
Gross amount of which carried at close of period, total	9,768
Gross amount of which carried at close of period, accumulated deprecation	(1,525)
Marietta GA MOB II [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	661
Initial cost to company, buildings and improvements	4,783
Cost capitalized subsequent to acquisition	301
Gross amount of which carried at close of period, land	661
Gross amount of which carried at close of period, buildings and improvements	5,084
Gross amount of which carried at close of period, total	5,745
Gross amount of which carried at close of period, accumulated deprecation	(875)
Naperville MOB [Member] | Naperville, IL One | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	392
Initial cost to company, buildings and improvements	3,765
Cost capitalized subsequent to acquisition	32
Gross amount of which carried at close of period, land	392
Gross amount of which carried at close of period, buildings and improvements	3,797
Gross amount of which carried at close of period, total	4,189
Gross amount of which carried at close of period, accumulated deprecation	(786)
Naperville MOB [Member] | Naperville, IL Two | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	548
Initial cost to company, buildings and improvements	11,815
Cost capitalized subsequent to acquisition	424
Gross amount of which carried at close of period, land	548
Gross amount of which carried at close of period, buildings and improvements	12,239
Gross amount of which carried at close of period, total	12,787
Gross amount of which carried at close of period, accumulated deprecation	(2,093)
Lakeview IN Medical Plaza [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	19,947
Initial cost to company, land	2,375
Initial cost to company, buildings and improvements	15,911
Cost capitalized subsequent to acquisition	5,528
Gross amount of which carried at close of period, land	2,375
Gross amount of which carried at close of period, buildings and improvements	21,439
Gross amount of which carried at close of period, total	23,814
Gross amount of which carried at close of period, accumulated deprecation	(4,623)
Pennsylvania Senior Housing Portfolio II [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	19,114
Initial cost to company, land	835
Initial cost to company, buildings and improvements	24,424
Cost capitalized subsequent to acquisition	242
Gross amount of which carried at close of period, land	835
Gross amount of which carried at close of period, buildings and improvements	24,666
Gross amount of which carried at close of period, total	25,501
Gross amount of which carried at close of period, accumulated deprecation	(4,386)
Snellville GA MOB [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	332
Initial cost to company, buildings and improvements	7,781
Cost capitalized subsequent to acquisition	502
Gross amount of which carried at close of period, land	332
Gross amount of which carried at close of period, buildings and improvements	8,283
Gross amount of which carried at close of period, total	8,615
Gross amount of which carried at close of period, accumulated deprecation	(1,355)
Lakebrook Medical Center [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	653
Initial cost to company, buildings and improvements	4,855
Cost capitalized subsequent to acquisition	393
Gross amount of which carried at close of period, land	653
Gross amount of which carried at close of period, buildings and improvements	5,248
Gross amount of which carried at close of period, total	5,901
Gross amount of which carried at close of period, accumulated deprecation	(926)
Stockbridge GA MOB III [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	606
Initial cost to company, buildings and improvements	7,924
Cost capitalized subsequent to acquisition	299
Gross amount of which carried at close of period, land	606
Gross amount of which carried at close of period, buildings and improvements	8,223
Gross amount of which carried at close of period, total	8,829
Gross amount of which carried at close of period, accumulated deprecation	(1,433)
Joplin MO MOB [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,245
Initial cost to company, buildings and improvements	9,860
Cost capitalized subsequent to acquisition	(35)
Gross amount of which carried at close of period, land	1,245
Gross amount of which carried at close of period, buildings and improvements	9,825
Gross amount of which carried at close of period, total	11,070
Gross amount of which carried at close of period, accumulated deprecation	(2,220)
Austell GA MOB [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	663
Initial cost to company, buildings and improvements	10,547
Cost capitalized subsequent to acquisition	120
Gross amount of which carried at close of period, land	663
Gross amount of which carried at close of period, buildings and improvements	10,667
Gross amount of which carried at close of period, total	11,330
Gross amount of which carried at close of period, accumulated deprecation	(1,467)
Middletown OH MOB [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	0
Initial cost to company, buildings and improvements	17,389
Cost capitalized subsequent to acquisition	795
Gross amount of which carried at close of period, land	0
Gross amount of which carried at close of period, buildings and improvements	18,184
Gross amount of which carried at close of period, total	18,184
Gross amount of which carried at close of period, accumulated deprecation	(2,438)
Fox Grape SNF Portfolio - Braintree, MA [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,844
Initial cost to company, buildings and improvements	10,847
Cost capitalized subsequent to acquisition	31
Gross amount of which carried at close of period, land	1,844
Gross amount of which carried at close of period, buildings and improvements	10,878
Gross amount of which carried at close of period, total	12,722
Gross amount of which carried at close of period, accumulated deprecation	(1,396)
Fox Grape SNF Portfolio - Brighton, MA [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	779
Initial cost to company, buildings and improvements	2,661
Cost capitalized subsequent to acquisition	334
Gross amount of which carried at close of period, land	779
Gross amount of which carried at close of period, buildings and improvements	2,995
Gross amount of which carried at close of period, total	3,774
Gross amount of which carried at close of period, accumulated deprecation	(427)
Fox Grape SNF Portfolio - Duxbury, MA [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	2,921
Initial cost to company, buildings and improvements	11,244
Cost capitalized subsequent to acquisition	1,933
Gross amount of which carried at close of period, land	2,921
Gross amount of which carried at close of period, buildings and improvements	13,177
Gross amount of which carried at close of period, total	16,098
Gross amount of which carried at close of period, accumulated deprecation	(1,713)
Fox Grape SNF Portfolio - Hingham, MA [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	2,316
Initial cost to company, buildings and improvements	17,390
Cost capitalized subsequent to acquisition	(166)
Gross amount of which carried at close of period, land	2,316
Gross amount of which carried at close of period, buildings and improvements	17,224
Gross amount of which carried at close of period, total	19,540
Gross amount of which carried at close of period, accumulated deprecation	(2,202)
Fox Grape SNF Portfolio - Weymouth, MA [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,857
Initial cost to company, buildings and improvements	5,286
Cost capitalized subsequent to acquisition	(90)
Gross amount of which carried at close of period, land	1,857
Gross amount of which carried at close of period, buildings and improvements	5,196
Gross amount of which carried at close of period, total	7,053
Gross amount of which carried at close of period, accumulated deprecation	(620)
Fox Grape SNF Portfolio - Quincy, MA [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	14,546
Initial cost to company, land	3,537
Initial cost to company, buildings and improvements	13,697
Cost capitalized subsequent to acquisition	333
Gross amount of which carried at close of period, land	3,537
Gross amount of which carried at close of period, buildings and improvements	14,030
Gross amount of which carried at close of period, total	17,567
Gross amount of which carried at close of period, accumulated deprecation	(1,679)
Voorhees NJ MOB [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,727
Initial cost to company, buildings and improvements	8,451
Cost capitalized subsequent to acquisition	664
Gross amount of which carried at close of period, land	1,727
Gross amount of which carried at close of period, buildings and improvements	9,115
Gross amount of which carried at close of period, total	10,842
Gross amount of which carried at close of period, accumulated deprecation	(1,590)
Norwich CT MOB Portfolio [Member] | Norwich, CT One [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	403
Initial cost to company, buildings and improvements	1,601
Cost capitalized subsequent to acquisition	1,228
Gross amount of which carried at close of period, land	403
Gross amount of which carried at close of period, buildings and improvements	2,829
Gross amount of which carried at close of period, total	3,232
Gross amount of which carried at close of period, accumulated deprecation	(417)
Norwich CT MOB Portfolio [Member] | Norwich, CT Two [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	804
Initial cost to company, buildings and improvements	12,094
Cost capitalized subsequent to acquisition	497
Gross amount of which carried at close of period, land	804
Gross amount of which carried at close of period, buildings and improvements	12,591
Gross amount of which carried at close of period, total	13,395
Gross amount of which carried at close of period, accumulated deprecation	(1,569)
New London CT MOB [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	669
Initial cost to company, buildings and improvements	3,479
Cost capitalized subsequent to acquisition	355
Gross amount of which carried at close of period, land	670
Gross amount of which carried at close of period, buildings and improvements	3,833
Gross amount of which carried at close of period, total	4,503
Gross amount of which carried at close of period, accumulated deprecation	(671)
Middletown OH MOB II [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	0
Initial cost to company, buildings and improvements	3,949
Cost capitalized subsequent to acquisition	387
Gross amount of which carried at close of period, land	0
Gross amount of which carried at close of period, buildings and improvements	4,336
Gross amount of which carried at close of period, total	4,336
Gross amount of which carried at close of period, accumulated deprecation	(421)
Owen Valley Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	8,939
Initial cost to company, land	307
Initial cost to company, buildings and improvements	9,111
Cost capitalized subsequent to acquisition	224
Gross amount of which carried at close of period, land	307
Gross amount of which carried at close of period, buildings and improvements	9,335
Gross amount of which carried at close of period, total	9,642
Gross amount of which carried at close of period, accumulated deprecation	(1,263)
Homewood Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	8,971
Initial cost to company, land	973
Initial cost to company, buildings and improvements	9,702
Cost capitalized subsequent to acquisition	533
Gross amount of which carried at close of period, land	1,040
Gross amount of which carried at close of period, buildings and improvements	10,168
Gross amount of which carried at close of period, total	11,208
Gross amount of which carried at close of period, accumulated deprecation	(1,397)
Ashford Place Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	6,167
Initial cost to company, land	664
Initial cost to company, buildings and improvements	12,662
Cost capitalized subsequent to acquisition	846
Gross amount of which carried at close of period, land	694
Gross amount of which carried at close of period, buildings and improvements	13,478
Gross amount of which carried at close of period, total	14,172
Gross amount of which carried at close of period, accumulated deprecation	(1,821)
Mill Pond Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	7,297
Initial cost to company, land	1,576
Initial cost to company, buildings and improvements	8,124
Cost capitalized subsequent to acquisition	468
Gross amount of which carried at close of period, land	1,576
Gross amount of which carried at close of period, buildings and improvements	8,592
Gross amount of which carried at close of period, total	10,168
Gross amount of which carried at close of period, accumulated deprecation	(1,148)
St. Andrews Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	4,604
Initial cost to company, land	552
Initial cost to company, buildings and improvements	8,213
Cost capitalized subsequent to acquisition	416
Gross amount of which carried at close of period, land	625
Gross amount of which carried at close of period, buildings and improvements	8,556
Gross amount of which carried at close of period, total	9,181
Gross amount of which carried at close of period, accumulated deprecation	(1,157)
Hampton Oaks Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	6,482
Initial cost to company, land	720
Initial cost to company, buildings and improvements	8,145
Cost capitalized subsequent to acquisition	620
Gross amount of which carried at close of period, land	845
Gross amount of which carried at close of period, buildings and improvements	8,640
Gross amount of which carried at close of period, total	9,485
Gross amount of which carried at close of period, accumulated deprecation	(1,208)
Forest Park Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	7,078
Initial cost to company, land	535
Initial cost to company, buildings and improvements	9,399
Cost capitalized subsequent to acquisition	458
Gross amount of which carried at close of period, land	635
Gross amount of which carried at close of period, buildings and improvements	9,757
Gross amount of which carried at close of period, total	10,392
Gross amount of which carried at close of period, accumulated deprecation	(1,379)
The Maples at Waterford Crossing [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	5,941
Initial cost to company, land	344
Initial cost to company, buildings and improvements	8,027
Cost capitalized subsequent to acquisition	48
Gross amount of which carried at close of period, land	347
Gross amount of which carried at close of period, buildings and improvements	8,072
Gross amount of which carried at close of period, total	8,419
Gross amount of which carried at close of period, accumulated deprecation	(1,088)
Morrison Woods Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	1,526
Initial cost to company, buildings and improvements	10,144
Cost capitalized subsequent to acquisition	11,877
Gross amount of which carried at close of period, land	1,862
Gross amount of which carried at close of period, buildings and improvements	21,685
Gross amount of which carried at close of period, total	23,547
Gross amount of which carried at close of period, accumulated deprecation	(2,029)
Woodbridge Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	8,497
Initial cost to company, land	228
Initial cost to company, buildings and improvements	11,812
Cost capitalized subsequent to acquisition	316
Gross amount of which carried at close of period, land	257
Gross amount of which carried at close of period, buildings and improvements	12,099
Gross amount of which carried at close of period, total	12,356
Gross amount of which carried at close of period, accumulated deprecation	(1,650)
Bridgepointe Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	7,273
Initial cost to company, land	572
Initial cost to company, buildings and improvements	7,469
Cost capitalized subsequent to acquisition	608
Gross amount of which carried at close of period, land	670
Gross amount of which carried at close of period, buildings and improvements	7,979
Gross amount of which carried at close of period, total	8,649
Gross amount of which carried at close of period, accumulated deprecation	(1,078)
Greenleaf Living Center [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	11,633
Initial cost to company, land	492
Initial cost to company, buildings and improvements	12,157
Cost capitalized subsequent to acquisition	429
Gross amount of which carried at close of period, land	511
Gross amount of which carried at close of period, buildings and improvements	12,567
Gross amount of which carried at close of period, total	13,078
Gross amount of which carried at close of period, accumulated deprecation	(1,686)
Forest Glen Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	10,264
Initial cost to company, land	846
Initial cost to company, buildings and improvements	12,754
Cost capitalized subsequent to acquisition	359
Gross amount of which carried at close of period, land	877
Gross amount of which carried at close of period, buildings and improvements	13,082
Gross amount of which carried at close of period, total	13,959
Gross amount of which carried at close of period, accumulated deprecation	(1,807)
The Meadows of Kalida Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	8,042
Initial cost to company, land	298
Initial cost to company, buildings and improvements	7,628
Cost capitalized subsequent to acquisition	152
Gross amount of which carried at close of period, land	303
Gross amount of which carried at close of period, buildings and improvements	7,775
Gross amount of which carried at close of period, total	8,078
Gross amount of which carried at close of period, accumulated deprecation	(1,053)
The Heritage [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	13,396
Initial cost to company, land	1,312
Initial cost to company, buildings and improvements	13,475
Cost capitalized subsequent to acquisition	395
Gross amount of which carried at close of period, land	1,382
Gross amount of which carried at close of period, buildings and improvements	13,800
Gross amount of which carried at close of period, total	15,182
Gross amount of which carried at close of period, accumulated deprecation	(1,906)
Genoa Retirement Village [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	8,438
Initial cost to company, land	881
Initial cost to company, buildings and improvements	8,113
Cost capitalized subsequent to acquisition	652
Gross amount of which carried at close of period, land	909
Gross amount of which carried at close of period, buildings and improvements	8,737
Gross amount of which carried at close of period, total	9,646
Gross amount of which carried at close of period, accumulated deprecation	(1,204)
Waterford Crossing [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	8,374
Initial cost to company, land	344
Initial cost to company, buildings and improvements	4,381
Cost capitalized subsequent to acquisition	874
Gross amount of which carried at close of period, land	349
Gross amount of which carried at close of period, buildings and improvements	5,250
Gross amount of which carried at close of period, total	5,599
Gross amount of which carried at close of period, accumulated deprecation	(729)
St. Elizabeth Healthcare [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	9,165
Initial cost to company, land	522
Initial cost to company, buildings and improvements	5,463
Cost capitalized subsequent to acquisition	5,368
Gross amount of which carried at close of period, land	634
Gross amount of which carried at close of period, buildings and improvements	10,719
Gross amount of which carried at close of period, total	11,353
Gross amount of which carried at close of period, accumulated deprecation	(1,207)
Cumberland Pointe [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	9,727
Initial cost to company, land	1,645
Initial cost to company, buildings and improvements	13,696
Cost capitalized subsequent to acquisition	600
Gross amount of which carried at close of period, land	1,901
Gross amount of which carried at close of period, buildings and improvements	14,040
Gross amount of which carried at close of period, total	15,941
Gross amount of which carried at close of period, accumulated deprecation	(2,095)
Franciscan Healthcare Center [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	10,908
Initial cost to company, land	808
Initial cost to company, buildings and improvements	8,439
Cost capitalized subsequent to acquisition	990
Gross amount of which carried at close of period, land	815
Gross amount of which carried at close of period, buildings and improvements	9,422
Gross amount of which carried at close of period, total	10,237
Gross amount of which carried at close of period, accumulated deprecation	(1,390)
Blair Ridge Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	7,846
Initial cost to company, land	734
Initial cost to company, buildings and improvements	11,648
Cost capitalized subsequent to acquisition	589
Gross amount of which carried at close of period, land	773
Gross amount of which carried at close of period, buildings and improvements	12,198
Gross amount of which carried at close of period, total	12,971
Gross amount of which carried at close of period, accumulated deprecation	(1,896)
Glen Oaks Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	5,287
Initial cost to company, land	384
Initial cost to company, buildings and improvements	8,189
Cost capitalized subsequent to acquisition	149
Gross amount of which carried at close of period, land	384
Gross amount of which carried at close of period, buildings and improvements	8,338
Gross amount of which carried at close of period, total	8,722
Gross amount of which carried at close of period, accumulated deprecation	(1,090)
Covered Bridge Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	386
Initial cost to company, buildings and improvements	9,699
Cost capitalized subsequent to acquisition	522
Gross amount of which carried at close of period, land	0
Gross amount of which carried at close of period, buildings and improvements	10,607
Gross amount of which carried at close of period, total	10,607
Gross amount of which carried at close of period, accumulated deprecation	(1,403)
Stonebridge Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	9,988
Initial cost to company, land	1,087
Initial cost to company, buildings and improvements	7,965
Cost capitalized subsequent to acquisition	419
Gross amount of which carried at close of period, land	1,144
Gross amount of which carried at close of period, buildings and improvements	8,327
Gross amount of which carried at close of period, total	9,471
Gross amount of which carried at close of period, accumulated deprecation	(1,172)
RiverOaks Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	14,898
Initial cost to company, land	440
Initial cost to company, buildings and improvements	8,953
Cost capitalized subsequent to acquisition	481
Gross amount of which carried at close of period, land	466
Gross amount of which carried at close of period, buildings and improvements	9,408
Gross amount of which carried at close of period, total	9,874
Gross amount of which carried at close of period, accumulated deprecation	(1,286)
Park Terrace Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	2,177
Initial cost to company, buildings and improvements	7,626
Cost capitalized subsequent to acquisition	1,208
Gross amount of which carried at close of period, land	2,177
Gross amount of which carried at close of period, buildings and improvements	8,834
Gross amount of which carried at close of period, total	11,011
Gross amount of which carried at close of period, accumulated deprecation	(1,283)
Cobblestone Crossing [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	1,462
Initial cost to company, buildings and improvements	13,860
Cost capitalized subsequent to acquisition	5,690
Gross amount of which carried at close of period, land	1,496
Gross amount of which carried at close of period, buildings and improvements	19,516
Gross amount of which carried at close of period, total	21,012
Gross amount of which carried at close of period, accumulated deprecation	(2,544)
Creasy Springs Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	16,490
Initial cost to company, land	2,111
Initial cost to company, buildings and improvements	14,337
Cost capitalized subsequent to acquisition	5,906
Gross amount of which carried at close of period, land	2,393
Gross amount of which carried at close of period, buildings and improvements	19,961
Gross amount of which carried at close of period, total	22,354
Gross amount of which carried at close of period, accumulated deprecation	(2,609)
Avalon Springs Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	17,933
Initial cost to company, land	1,542
Initial cost to company, buildings and improvements	14,107
Cost capitalized subsequent to acquisition	140
Gross amount of which carried at close of period, land	1,575
Gross amount of which carried at close of period, buildings and improvements	14,214
Gross amount of which carried at close of period, total	15,789
Gross amount of which carried at close of period, accumulated deprecation	(1,923)
Prairie Lakes Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	9,064
Initial cost to company, land	2,204
Initial cost to company, buildings and improvements	13,227
Cost capitalized subsequent to acquisition	624
Gross amount of which carried at close of period, land	2,342
Gross amount of which carried at close of period, buildings and improvements	13,713
Gross amount of which carried at close of period, total	16,055
Gross amount of which carried at close of period, accumulated deprecation	(1,836)
RidgeWood Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	14,054
Initial cost to company, land	1,240
Initial cost to company, buildings and improvements	16,118
Cost capitalized subsequent to acquisition	81
Gross amount of which carried at close of period, land	1,261
Gross amount of which carried at close of period, buildings and improvements	16,178
Gross amount of which carried at close of period, total	17,439
Gross amount of which carried at close of period, accumulated deprecation	(2,151)
Westport Place Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	1,245
Initial cost to company, buildings and improvements	9,946
Cost capitalized subsequent to acquisition	100
Gross amount of which carried at close of period, land	1,262
Gross amount of which carried at close of period, buildings and improvements	10,029
Gross amount of which carried at close of period, total	11,291
Gross amount of which carried at close of period, accumulated deprecation	(1,321)
Paddock Springs [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	8,912
Initial cost to company, land	488
Initial cost to company, buildings and improvements	0
Cost capitalized subsequent to acquisition	10,597
Gross amount of which carried at close of period, land	654
Gross amount of which carried at close of period, buildings and improvements	10,431
Gross amount of which carried at close of period, total	11,085
Gross amount of which carried at close of period, accumulated deprecation	(557)
Amber Manor Care Center [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	5,725
Initial cost to company, land	446
Initial cost to company, buildings and improvements	6,063
Cost capitalized subsequent to acquisition	322
Gross amount of which carried at close of period, land	494
Gross amount of which carried at close of period, buildings and improvements	6,337
Gross amount of which carried at close of period, total	6,831
Gross amount of which carried at close of period, accumulated deprecation	(908)
The Meadows of Leipsic Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	1,242
Initial cost to company, buildings and improvements	6,988
Cost capitalized subsequent to acquisition	576
Gross amount of which carried at close of period, land	1,291
Gross amount of which carried at close of period, buildings and improvements	7,515
Gross amount of which carried at close of period, total	8,806
Gross amount of which carried at close of period, accumulated deprecation	(1,058)
Springview Manor [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	260
Initial cost to company, buildings and improvements	3,968
Cost capitalized subsequent to acquisition	98
Gross amount of which carried at close of period, land	265
Gross amount of which carried at close of period, buildings and improvements	4,061
Gross amount of which carried at close of period, total	4,326
Gross amount of which carried at close of period, accumulated deprecation	(569)
Willows at Bellevue [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	16,798
Initial cost to company, land	587
Initial cost to company, buildings and improvements	15,575
Cost capitalized subsequent to acquisition	901
Gross amount of which carried at close of period, land	788
Gross amount of which carried at close of period, buildings and improvements	16,275
Gross amount of which carried at close of period, total	17,063
Gross amount of which carried at close of period, accumulated deprecation	(2,187)
Briar Hill Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	673
Initial cost to company, buildings and improvements	2,688
Cost capitalized subsequent to acquisition	402
Gross amount of which carried at close of period, land	700
Gross amount of which carried at close of period, buildings and improvements	3,063
Gross amount of which carried at close of period, total	3,763
Gross amount of which carried at close of period, accumulated deprecation	(463)
Cypress Pointe Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	921
Initial cost to company, buildings and improvements	10,291
Cost capitalized subsequent to acquisition	10,271
Gross amount of which carried at close of period, land	1,624
Gross amount of which carried at close of period, buildings and improvements	19,859
Gross amount of which carried at close of period, total	21,483
Gross amount of which carried at close of period, accumulated deprecation	(1,506)
The Oaks at NorthPointe Woods [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	567
Initial cost to company, buildings and improvements	12,716
Cost capitalized subsequent to acquisition	116
Gross amount of which carried at close of period, land	567
Gross amount of which carried at close of period, buildings and improvements	12,832
Gross amount of which carried at close of period, total	13,399
Gross amount of which carried at close of period, accumulated deprecation	(1,707)
Westlake Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	14,661
Initial cost to company, land	815
Initial cost to company, buildings and improvements	13,502
Cost capitalized subsequent to acquisition	(232)
Gross amount of which carried at close of period, land	541
Gross amount of which carried at close of period, buildings and improvements	13,544
Gross amount of which carried at close of period, total	14,085
Gross amount of which carried at close of period, accumulated deprecation	(1,814)
Springhurst Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	20,368
Initial cost to company, land	931
Initial cost to company, buildings and improvements	14,114
Cost capitalized subsequent to acquisition	2,836
Gross amount of which carried at close of period, land	2,039
Gross amount of which carried at close of period, buildings and improvements	15,842
Gross amount of which carried at close of period, total	17,881
Gross amount of which carried at close of period, accumulated deprecation	(2,372)
Glen Ridge Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	1,208
Initial cost to company, buildings and improvements	9,771
Cost capitalized subsequent to acquisition	1,598
Gross amount of which carried at close of period, land	1,320
Gross amount of which carried at close of period, buildings and improvements	11,257
Gross amount of which carried at close of period, total	12,577
Gross amount of which carried at close of period, accumulated deprecation	(1,564)
St. Mary Healthcare [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	5,377
Initial cost to company, land	348
Initial cost to company, buildings and improvements	2,710
Cost capitalized subsequent to acquisition	170
Gross amount of which carried at close of period, land	348
Gross amount of which carried at close of period, buildings and improvements	2,880
Gross amount of which carried at close of period, total	3,228
Gross amount of which carried at close of period, accumulated deprecation	(389)
The Oaks at Woodfield [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	897
Initial cost to company, buildings and improvements	12,270
Cost capitalized subsequent to acquisition	245
Gross amount of which carried at close of period, land	1,080
Gross amount of which carried at close of period, buildings and improvements	12,332
Gross amount of which carried at close of period, total	13,412
Gross amount of which carried at close of period, accumulated deprecation	(1,683)
Stonegate Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	538
Initial cost to company, buildings and improvements	13,159
Cost capitalized subsequent to acquisition	159
Gross amount of which carried at close of period, land	567
Gross amount of which carried at close of period, buildings and improvements	13,289
Gross amount of which carried at close of period, total	13,856
Gross amount of which carried at close of period, accumulated deprecation	(1,809)
Senior Living at Forest Ridge [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	204
Initial cost to company, buildings and improvements	5,470
Cost capitalized subsequent to acquisition	128
Gross amount of which carried at close of period, land	238
Gross amount of which carried at close of period, buildings and improvements	5,564
Gross amount of which carried at close of period, total	5,802
Gross amount of which carried at close of period, accumulated deprecation	(759)
Highland Oaks Health Center [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	880
Initial cost to company, buildings and improvements	1,803
Cost capitalized subsequent to acquisition	1,039
Gross amount of which carried at close of period, land	1,297
Gross amount of which carried at close of period, buildings and improvements	2,425
Gross amount of which carried at close of period, total	3,722
Gross amount of which carried at close of period, accumulated deprecation	(374)
Richland Manor [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	224
Initial cost to company, buildings and improvements	2,200
Cost capitalized subsequent to acquisition	(1,826)
Gross amount of which carried at close of period, land	224
Gross amount of which carried at close of period, buildings and improvements	374
Gross amount of which carried at close of period, total	598
Gross amount of which carried at close of period, accumulated deprecation	(367)
River Terrace Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	0
Initial cost to company, buildings and improvements	13,378
Cost capitalized subsequent to acquisition	3,932
Gross amount of which carried at close of period, land	8
Gross amount of which carried at close of period, buildings and improvements	17,302
Gross amount of which carried at close of period, total	17,310
Gross amount of which carried at close of period, accumulated deprecation	(2,214)
St. Charles Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	11,736
Initial cost to company, land	467
Initial cost to company, buildings and improvements	14,532
Cost capitalized subsequent to acquisition	913
Gross amount of which carried at close of period, land	518
Gross amount of which carried at close of period, buildings and improvements	15,394
Gross amount of which carried at close of period, total	15,912
Gross amount of which carried at close of period, accumulated deprecation	(2,060)
Bethany Pointe Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	20,117
Initial cost to company, land	2,337
Initial cost to company, buildings and improvements	26,524
Cost capitalized subsequent to acquisition	1,618
Gross amount of which carried at close of period, land	2,445
Gross amount of which carried at close of period, buildings and improvements	28,034
Gross amount of which carried at close of period, total	30,479
Gross amount of which carried at close of period, accumulated deprecation	(3,748)
River Pointe Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	14,451
Initial cost to company, land	1,118
Initial cost to company, buildings and improvements	14,736
Cost capitalized subsequent to acquisition	1,284
Gross amount of which carried at close of period, land	1,126
Gross amount of which carried at close of period, buildings and improvements	16,012
Gross amount of which carried at close of period, total	17,138
Gross amount of which carried at close of period, accumulated deprecation	(2,229)
Waterford Place Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	15,295
Initial cost to company, land	1,219
Initial cost to company, buildings and improvements	18,557
Cost capitalized subsequent to acquisition	1,386
Gross amount of which carried at close of period, land	1,373
Gross amount of which carried at close of period, buildings and improvements	19,789
Gross amount of which carried at close of period, total	21,162
Gross amount of which carried at close of period, accumulated deprecation	(2,693)
Autumn Woods Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	1,016
Initial cost to company, buildings and improvements	13,414
Cost capitalized subsequent to acquisition	1,425
Gross amount of which carried at close of period, land	1,031
Gross amount of which carried at close of period, buildings and improvements	14,824
Gross amount of which carried at close of period, total	15,855
Gross amount of which carried at close of period, accumulated deprecation	(2,200)
Oakwood Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	9,389
Initial cost to company, land	783
Initial cost to company, buildings and improvements	11,880
Cost capitalized subsequent to acquisition	1,119
Gross amount of which carried at close of period, land	874
Gross amount of which carried at close of period, buildings and improvements	12,908
Gross amount of which carried at close of period, total	13,782
Gross amount of which carried at close of period, accumulated deprecation	(1,894)
Cedar Ridge Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	102
Initial cost to company, buildings and improvements	8,435
Cost capitalized subsequent to acquisition	3,574
Gross amount of which carried at close of period, land	205
Gross amount of which carried at close of period, buildings and improvements	11,906
Gross amount of which carried at close of period, total	12,111
Gross amount of which carried at close of period, accumulated deprecation	(1,802)
Aspen Place Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	9,702
Initial cost to company, land	980
Initial cost to company, buildings and improvements	10,970
Cost capitalized subsequent to acquisition	686
Gross amount of which carried at close of period, land	1,016
Gross amount of which carried at close of period, buildings and improvements	11,620
Gross amount of which carried at close of period, total	12,636
Gross amount of which carried at close of period, accumulated deprecation	(1,527)
The Willows at Citation [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	826
Initial cost to company, buildings and improvements	10,017
Cost capitalized subsequent to acquisition	629
Gross amount of which carried at close of period, land	849
Gross amount of which carried at close of period, buildings and improvements	10,623
Gross amount of which carried at close of period, total	11,472
Gross amount of which carried at close of period, accumulated deprecation	(1,383)
The WIllows at East Lansing [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	16,766
Initial cost to company, land	1,449
Initial cost to company, buildings and improvements	15,161
Cost capitalized subsequent to acquisition	1,312
Gross amount of which carried at close of period, land	1,496
Gross amount of which carried at close of period, buildings and improvements	16,426
Gross amount of which carried at close of period, total	17,922
Gross amount of which carried at close of period, accumulated deprecation	(2,304)
The Willows at Howell [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	1,051
Initial cost to company, buildings and improvements	12,099
Cost capitalized subsequent to acquisition	6,568
Gross amount of which carried at close of period, land	1,116
Gross amount of which carried at close of period, buildings and improvements	18,602
Gross amount of which carried at close of period, total	19,718
Gross amount of which carried at close of period, accumulated deprecation	(1,801)
The Willows at Okemos [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	7,684
Initial cost to company, land	1,171
Initial cost to company, buildings and improvements	12,326
Cost capitalized subsequent to acquisition	786
Gross amount of which carried at close of period, land	1,210
Gross amount of which carried at close of period, buildings and improvements	13,073
Gross amount of which carried at close of period, total	14,283
Gross amount of which carried at close of period, accumulated deprecation	(1,917)
Shelby Crossing Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	17,620
Initial cost to company, land	2,533
Initial cost to company, buildings and improvements	18,440
Cost capitalized subsequent to acquisition	1,969
Gross amount of which carried at close of period, land	2,612
Gross amount of which carried at close of period, buildings and improvements	20,330
Gross amount of which carried at close of period, total	22,942
Gross amount of which carried at close of period, accumulated deprecation	(3,040)
Village Green Healthcare Center [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	7,141
Initial cost to company, land	355
Initial cost to company, buildings and improvements	9,696
Cost capitalized subsequent to acquisition	446
Gross amount of which carried at close of period, land	373
Gross amount of which carried at close of period, buildings and improvements	10,124
Gross amount of which carried at close of period, total	10,497
Gross amount of which carried at close of period, accumulated deprecation	(1,315)
The Oaks at Northpointe [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	624
Initial cost to company, buildings and improvements	11,665
Cost capitalized subsequent to acquisition	989
Gross amount of which carried at close of period, land	650
Gross amount of which carried at close of period, buildings and improvements	12,628
Gross amount of which carried at close of period, total	13,278
Gross amount of which carried at close of period, accumulated deprecation	(1,753)
The Oaks at Bethesda [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	4,663
Initial cost to company, land	714
Initial cost to company, buildings and improvements	10,791
Cost capitalized subsequent to acquisition	673
Gross amount of which carried at close of period, land	743
Gross amount of which carried at close of period, buildings and improvements	11,435
Gross amount of which carried at close of period, total	12,178
Gross amount of which carried at close of period, accumulated deprecation	(1,510)
White Oak Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	1,005
Initial cost to company, buildings and improvements	13,207
Cost capitalized subsequent to acquisition	0
Gross amount of which carried at close of period, land	1,005
Gross amount of which carried at close of period, buildings and improvements	13,207
Gross amount of which carried at close of period, total	14,212
Gross amount of which carried at close of period, accumulated deprecation	(800)
Woodmont Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	8,006
Initial cost to company, land	790
Initial cost to company, buildings and improvements	9,633
Cost capitalized subsequent to acquisition	859
Gross amount of which carried at close of period, land	880
Gross amount of which carried at close of period, buildings and improvements	10,402
Gross amount of which carried at close of period, total	11,282
Gross amount of which carried at close of period, accumulated deprecation	(1,511)
Silver Oaks Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	1,776
Initial cost to company, buildings and improvements	21,420
Cost capitalized subsequent to acquisition	1,351
Gross amount of which carried at close of period, land	1
Gross amount of which carried at close of period, buildings and improvements	24,546
Gross amount of which carried at close of period, total	24,547
Gross amount of which carried at close of period, accumulated deprecation	(3,329)
Thornton Terrace Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	5,674
Initial cost to company, land	764
Initial cost to company, buildings and improvements	9,209
Cost capitalized subsequent to acquisition	860
Gross amount of which carried at close of period, land	826
Gross amount of which carried at close of period, buildings and improvements	10,007
Gross amount of which carried at close of period, total	10,833
Gross amount of which carried at close of period, accumulated deprecation	(1,415)
The Willows at Hamburg [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	11,815
Initial cost to company, land	1,740
Initial cost to company, buildings and improvements	13,422
Cost capitalized subsequent to acquisition	553
Gross amount of which carried at close of period, land	1,775
Gross amount of which carried at close of period, buildings and improvements	13,940
Gross amount of which carried at close of period, total	15,715
Gross amount of which carried at close of period, accumulated deprecation	(1,571)
The Lakes at Monclova [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	15,933
Initial cost to company, land	2,869
Initial cost to company, buildings and improvements	12,855
Cost capitalized subsequent to acquisition	8,863
Gross amount of which carried at close of period, land	2,989
Gross amount of which carried at close of period, buildings and improvements	21,598
Gross amount of which carried at close of period, total	24,587
Gross amount of which carried at close of period, accumulated deprecation	(1,835)
The Willows at Willard [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	610
Initial cost to company, buildings and improvements	12,256
Cost capitalized subsequent to acquisition	9,461
Gross amount of which carried at close of period, land	186
Gross amount of which carried at close of period, buildings and improvements	22,141
Gross amount of which carried at close of period, total	22,327
Gross amount of which carried at close of period, accumulated deprecation	(2,087)
Pickerington Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	756
Initial cost to company, buildings and improvements	0
Cost capitalized subsequent to acquisition	15,584
Gross amount of which carried at close of period, land	866
Gross amount of which carried at close of period, buildings and improvements	15,474
Gross amount of which carried at close of period, total	16,340
Gross amount of which carried at close of period, accumulated deprecation	(473)
Lakeland Rehab and Health Center [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	306
Initial cost to company, buildings and improvements	2,727
Cost capitalized subsequent to acquisition	(2,683)
Gross amount of which carried at close of period, land	350
Gross amount of which carried at close of period, buildings and improvements	0
Gross amount of which carried at close of period, total	350
Gross amount of which carried at close of period, accumulated deprecation	0
Westlake Health Campus - Commerce Villa [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	261
Initial cost to company, buildings and improvements	6,610
Cost capitalized subsequent to acquisition	1,226
Gross amount of which carried at close of period, land	553
Gross amount of which carried at close of period, buildings and improvements	7,544
Gross amount of which carried at close of period, total	8,097
Gross amount of which carried at close of period, accumulated deprecation	(721)
Orchard Grove Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	15,994
Initial cost to company, land	2,065
Initial cost to company, buildings and improvements	11,510
Cost capitalized subsequent to acquisition	11,606
Gross amount of which carried at close of period, land	3,284
Gross amount of which carried at close of period, buildings and improvements	21,897
Gross amount of which carried at close of period, total	25,181
Gross amount of which carried at close of period, accumulated deprecation	(1,485)
The Meadows of Ottawa [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	695
Initial cost to company, buildings and improvements	7,752
Cost capitalized subsequent to acquisition	605
Gross amount of which carried at close of period, land	728
Gross amount of which carried at close of period, buildings and improvements	8,324
Gross amount of which carried at close of period, total	9,052
Gross amount of which carried at close of period, accumulated deprecation	(856)
Valley View Healthcare Center [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	10,856
Initial cost to company, land	930
Initial cost to company, buildings and improvements	7,635
Cost capitalized subsequent to acquisition	1,489
Gross amount of which carried at close of period, land	1,089
Gross amount of which carried at close of period, buildings and improvements	8,965
Gross amount of which carried at close of period, total	10,054
Gross amount of which carried at close of period, accumulated deprecation	(600)
Novi Lakes Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	12,856
Initial cost to company, land	1,654
Initial cost to company, buildings and improvements	7,494
Cost capitalized subsequent to acquisition	2,647
Gross amount of which carried at close of period, land	1,663
Gross amount of which carried at close of period, buildings and improvements	10,132
Gross amount of which carried at close of period, total	11,795
Gross amount of which carried at close of period, accumulated deprecation	(1,254)
The Willows at Fritz Farm [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	9,440
Initial cost to company, land	1,538
Initial cost to company, buildings and improvements	8,637
Cost capitalized subsequent to acquisition	376
Gross amount of which carried at close of period, land	1,563
Gross amount of which carried at close of period, buildings and improvements	8,988
Gross amount of which carried at close of period, total	10,551
Gross amount of which carried at close of period, accumulated deprecation	(580)
Trilogy Real Estate Gahanna, LLC [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	13,501
Initial cost to company, land	1,146
Initial cost to company, buildings and improvements	0
Cost capitalized subsequent to acquisition	16,939
Gross amount of which carried at close of period, land	1,202
Gross amount of which carried at close of period, buildings and improvements	16,883
Gross amount of which carried at close of period, total	18,085
Gross amount of which carried at close of period, accumulated deprecation	(76)
Oaks at Byron Center [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	14,083
Initial cost to company, land	2,000
Initial cost to company, buildings and improvements	0
Cost capitalized subsequent to acquisition	15,789
Gross amount of which carried at close of period, land	2,193
Gross amount of which carried at close of period, buildings and improvements	15,596
Gross amount of which carried at close of period, total	17,789
Gross amount of which carried at close of period, accumulated deprecation	(211)
Harrison Springs Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	1,653
Initial cost to company, buildings and improvements	11,487
Cost capitalized subsequent to acquisition	58
Gross amount of which carried at close of period, land	1,653
Gross amount of which carried at close of period, buildings and improvements	11,545
Gross amount of which carried at close of period, total	13,198
Gross amount of which carried at close of period, accumulated deprecation	(499)
The Cloister at Silvercrest [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	139
Initial cost to company, buildings and improvements	634
Cost capitalized subsequent to acquisition	0
Gross amount of which carried at close of period, land	139
Gross amount of which carried at close of period, buildings and improvements	634
Gross amount of which carried at close of period, total	773
Gross amount of which carried at close of period, accumulated deprecation	(20)
Trilogy Healthcare of Ferdinand II, LLC [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	11,394
Initial cost to company, land	0
Initial cost to company, buildings and improvements	0
Cost capitalized subsequent to acquisition	14,589
Gross amount of which carried at close of period, land	0
Gross amount of which carried at close of period, buildings and improvements	14,589
Gross amount of which carried at close of period, total	14,589
Gross amount of which carried at close of period, accumulated deprecation	(407)
Trilogy Healthcare of Hilliard, LLC [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,702
Initial cost to company, buildings and improvements	0
Cost capitalized subsequent to acquisition	7,757
Gross amount of which carried at close of period, land	1,702
Gross amount of which carried at close of period, buildings and improvements	7,757
Gross amount of which carried at close of period, total	9,459
Gross amount of which carried at close of period, accumulated deprecation	0
Forest Springs Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, land	964
Initial cost to company, buildings and improvements	16,691
Cost capitalized subsequent to acquisition	0
Gross amount of which carried at close of period, land	964
Gross amount of which carried at close of period, buildings and improvements	16,691
Gross amount of which carried at close of period, total	17,655
Gross amount of which carried at close of period, accumulated deprecation	(199)
Trilogy Real Estate Butler II, LLC [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,147
Initial cost to company, buildings and improvements	0
Cost capitalized subsequent to acquisition	257
Gross amount of which carried at close of period, land	1,147
Gross amount of which carried at close of period, buildings and improvements	257
Gross amount of which carried at close of period, total	1,404
Gross amount of which carried at close of period, accumulated deprecation	0
Gateway Springs Health Campus [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	8,116
Initial cost to company, land	1,277
Initial cost to company, buildings and improvements	0
Cost capitalized subsequent to acquisition	10,923
Gross amount of which carried at close of period, land	1,404
Gross amount of which carried at close of period, buildings and improvements	10,796
Gross amount of which carried at close of period, total	12,200
Gross amount of which carried at close of period, accumulated deprecation	0
Trilogy Real Estate Hamilton III, LLC [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	7,677
Initial cost to company, land	1,750
Initial cost to company, buildings and improvements	0
Cost capitalized subsequent to acquisition	15,536
Gross amount of which carried at close of period, land	1,763
Gross amount of which carried at close of period, buildings and improvements	15,523
Gross amount of which carried at close of period, total	17,286
Gross amount of which carried at close of period, accumulated deprecation	0
Trilogy Real Estate Kent II, LLC [Member] | Property, Excluding Leased Property [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	7,709
Initial cost to company, land	767
Initial cost to company, buildings and improvements	0
Cost capitalized subsequent to acquisition	15,982
Gross amount of which carried at close of period, land	767
Gross amount of which carried at close of period, buildings and improvements	15,982
Gross amount of which carried at close of period, total	16,749
Gross amount of which carried at close of period, accumulated deprecation	$ 0

Schedule III Real Estate and _3

Schedule III Real Estate and Accumulated Depreciation (Details 2) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2020	Dec. 31, 2019
Real Estate and Accumulated Depreciation [Line Items]
Ownership percentage, excluding joint venture, properties		100.00%
Lines of credit and term loans	[1]	$ 843,634	$ 815,879
Aggregate cost of properties for federal income tax purposes		$ 2,627,228
Building and Building Improvements [Member]
Real Estate and Accumulated Depreciation [Line Items]
Estimated useful life		39 years
Leasehold Improvements [Member] | Maximum [Member]
Real Estate and Accumulated Depreciation [Line Items]
Estimated useful life		34 years
Furniture, fixtures, and equipment [Member] | Maximum [Member]
Real Estate and Accumulated Depreciation [Line Items]
Estimated useful life		28 years
Revolving Credit Facility [Member] | 2019 Trilogy Credit Facility [Member]
Real Estate and Accumulated Depreciation [Line Items]
Lines of credit and term loans		$ 287,134	$ 258,879
[1]	Such liabilities of Griffin-American Healthcare REIT III, Inc. as of December 31, 2020 and 2019 represented liabilities of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries. Griffin-American Healthcare REIT III Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of Griffin-American Healthcare REIT III, Inc. The creditors of Griffin-American Healthcare REIT III Holdings, LP or its consolidated subsidiaries do not have recourse against Griffin-American Healthcare REIT III, Inc., except for the 2019 Corporate Line of Credit, as defined in Note 8, held by Griffin-American Healthcare REIT III Holdings, LP in the amount of $556,500,000 and $557,000,000 as of December 31, 2020 and 2019, respectively, which is guaranteed by Griffin-American Healthcare REIT III, Inc.

Schedule III Real Estate and _4

Schedule III Real Estate and Accumulated Depreciation (Changes in Total Real Estate Assets) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Reconciliation of Carrying Amount of Real Estate Investments [Roll Forward]
Beginning balance	$ 2,618,608	$ 2,477,375	$ 2,336,208
Acquisitions	31,157	32,330	60,751
Additions	129,254	114,078	87,061
Dispositions and impairments	(18,718)	(8,050)	(4,142)
Foreign currency translation adjustment	1,971	2,875	(2,503)
Ending balance	$ 2,762,272	$ 2,618,608	$ 2,477,375

Schedule III Real Estate and _5

Schedule III Real Estate and Accumulated Depreciation (Changes in Accumulated Depreciation) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Reconciliation of Real Estate Accumulated Depreciation [Roll Forward]
Beginning balance	$ 337,898	$ 254,694	$ 172,950
Additions	91,617	90,914	83,309
Dispositions and impairments	(4,530)	(7,614)	(1,603)
Foreign currency translation adjustment	287	(96)	38
Ending balance	$ 425,272	$ 337,898	$ 254,694