CareTrust REIT (CTRE) 10-Q 8 Nov 22 2022 Q3 Quarterly report Financial data

Cover

Cover - shares	9 Months Ended
	Sep. 30, 2022	Nov. 07, 2022
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2022
Document Transition Report	false
Entity File Number	001-36181
Entity Registrant Name	CareTrust REIT, Inc.
Entity Incorporation, State or Country Code	MD
Entity Tax Identification Number	46-3999490
Entity Address, Address Line One	905 Calle Amanecer
Entity Address, Address Line Two	Suite 300
Entity Address, City or Town	San Clemente
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	92673
City Area Code	949
Local Phone Number	542-3130
Title of 12(b) Security	Common Stock, par value $0.01 per share
Trading Symbol	CTRE
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		97,028,742
Entity Central Index Key	0001590717
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q3
Amendment Flag	false

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Assets:
Real estate investments, net	$ 1,384,166	$ 1,589,971
Other real estate related investments, at fair value (including accrued interest of $1,218 as of September 30, 2022 and $155 as of December 31, 2021)	158,662	15,155
Assets held for sale, net	77,708	4,835
Cash and cash equivalents	4,861	19,895
Accounts and other receivables	808	2,418
Prepaid expenses and other assets, net	19,046	7,512
Deferred financing costs, net	327	1,062
Total assets	1,645,578	1,640,848
Liabilities and Equity:
Senior unsecured notes payable, net	394,928	394,262
Senior unsecured term loan, net	199,295	199,136
Unsecured revolving credit facility	180,000	80,000
Accounts payable, accrued liabilities and deferred rent liabilities	30,851	25,408
Dividends payable	26,827	26,285
Total liabilities	831,901	725,091
Commitments and contingencies (Note 11)
Equity:
Preferred stock, $0.01 par value; 100,000,000 shares authorized, no shares issued and outstanding as of September 30, 2022 and December 31, 2021	0	0
Common stock, $0.01 par value; 500,000,000 shares authorized, 96,605,112 and 96,296,673 shares issued and outstanding as of September 30, 2022 and December 31, 2021, respectively	966	963
Additional paid-in capital	1,196,662	1,196,839
Cumulative distributions in excess of earnings	(383,951)	(282,045)
Total equity	813,677	915,757
Total liabilities and equity	$ 1,645,578	$ 1,640,848

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Other real estate related investments, accrued interest	$ 1,218	$ 155
Preferred stock, par value (in usd per share)	$ 0.01	$ 0.01
Preferred stock, authorized (shares)	100,000,000	100,000,000
Preferred stock, issued (shares)	0	0
Preferred stock, outstanding (shares)	0	0
Common stock, par value (in usd per share)	$ 0.01	$ 0.01
Common stock, authorized (shares)	500,000,000	500,000,000
Common stock, issued (shares)	96,605,112	96,296,673
Common stock, outstanding (shares)	96,605,112	96,296,673

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Revenues:
Rental income	$ 47,018	$ 48,087	$ 139,831	$ 141,077
Interest and other income	3,275	518	4,491	1,537
Total revenues	50,293	48,605	144,322	142,614
Expenses:
Depreciation and amortization	12,256	13,968	38,390	41,284
Interest expense	8,355	5,692	20,400	17,988
Property taxes	691	1,004	3,365	2,466
Impairment of real estate investments	12,322	0	73,706	0
Provision for loan losses, net	0	0	3,844	0
Property operating expenses	3,808	0	4,344	0
General and administrative	5,159	5,196	15,352	16,136
Total expenses	42,591	25,860	159,401	77,874
Other loss:
Loss on extinguishment of debt	0	(10,827)	0	(10,827)
Loss on sale of real estate, net	(2,287)	0	(2,101)	(192)
Unrealized loss on other real estate related investments	(4,706)	0	(4,706)	0
Total other loss	(6,993)	(10,827)	(6,807)	(11,019)
Net income (loss)	$ 709	$ 11,918	$ (21,886)	$ 53,721
Earnings (loss) per common share:
Basic (in usd per share)	$ 0.01	$ 0.12	$ (0.23)	$ 0.56
Diluted (in usd per share)	$ 0.01	$ 0.12	$ (0.23)	$ 0.56
Weighted-average number of common shares:
Basic (in shares)	96,605	96,297	96,527	95,922
Diluted (in shares)	96,625	96,297	96,527	95,937

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Equity - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Cumulative Distributions in Excess of Earnings
Beginning balance (in shares) at Dec. 31, 2020		95,215,797
Beginning balance at Dec. 31, 2020	$ 914,142	$ 952	$ 1,164,402	$ (251,212)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock, net, (in shares)		702,000
Issuance of common stock, net	16,191	$ 7	16,184
Vesting of restricted common stock, net of shares withheld for employee taxes (in shares)		63,265
Vesting of restricted common stock, net of shares withheld for employee taxes	(1,330)	$ 1	(1,331)
Amortization of stock-based compensation	1,585		1,585
Common dividends	(25,633)			(25,633)
Net (loss) income	20,486			20,486
Ending balance (in shares) at Mar. 31, 2021		95,981,062
Ending balance at Mar. 31, 2021	925,441	$ 960	1,180,840	(256,359)
Beginning balance (in shares) at Dec. 31, 2020		95,215,797
Beginning balance at Dec. 31, 2020	914,142	$ 952	1,164,402	(251,212)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net (loss) income	53,721
Ending balance (in shares) at Sep. 30, 2021		96,296,673
Ending balance at Sep. 30, 2021	917,615	$ 963	1,191,204	(274,552)
Beginning balance (in shares) at Mar. 31, 2021		95,981,062
Beginning balance at Mar. 31, 2021	925,441	$ 960	1,180,840	(256,359)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock, net, (in shares)		288,000
Issuance of common stock, net	6,755	$ 3	6,752
Vesting of restricted common stock, net of shares withheld for employee taxes (in shares)		27,611
Amortization of stock-based compensation	1,810		1,810
Common dividends	(25,714)			(25,714)
Net (loss) income	21,317			21,317
Ending balance (in shares) at Jun. 30, 2021		96,296,673
Ending balance at Jun. 30, 2021	929,609	$ 963	1,189,402	(260,756)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Amortization of stock-based compensation	1,802		1,802
Common dividends	(25,714)			(25,714)
Net (loss) income	11,918			11,918
Ending balance (in shares) at Sep. 30, 2021		96,296,673
Ending balance at Sep. 30, 2021	$ 917,615	$ 963	1,191,204	(274,552)
Beginning balance (in shares) at Dec. 31, 2021	96,296,673	96,296,673
Beginning balance at Dec. 31, 2021	$ 915,757	$ 963	1,196,839	(282,045)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Vesting of restricted common stock, net of shares withheld for employee taxes (in shares)		190,393
Vesting of restricted common stock, net of shares withheld for employee taxes	(2,772)	$ 2	(2,774)
Amortization of stock-based compensation	1,521		1,521
Common dividends	(26,659)			(26,659)
Net (loss) income	(43,264)			(43,264)
Ending balance (in shares) at Mar. 31, 2022		96,487,066
Ending balance at Mar. 31, 2022	$ 844,583	$ 965	1,195,586	(351,968)
Beginning balance (in shares) at Dec. 31, 2021	96,296,673	96,296,673
Beginning balance at Dec. 31, 2021	$ 915,757	$ 963	1,196,839	(282,045)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net (loss) income	$ (21,886)
Ending balance (in shares) at Sep. 30, 2022	96,605,112	96,605,112
Ending balance at Sep. 30, 2022	$ 813,677	$ 966	1,196,662	(383,951)
Beginning balance (in shares) at Mar. 31, 2022		96,487,066
Beginning balance at Mar. 31, 2022	844,583	$ 965	1,195,586	(351,968)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Vesting of restricted common stock, net of shares withheld for employee taxes (in shares)		118,046
Vesting of restricted common stock, net of shares withheld for employee taxes	(1,697)	$ 1	(1,698)
Amortization of stock-based compensation	1,394		1,394
Common dividends	(26,681)			(26,681)
Net (loss) income	20,669			20,669
Ending balance (in shares) at Jun. 30, 2022		96,605,112
Ending balance at Jun. 30, 2022	838,268	$ 966	1,195,282	(357,980)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Amortization of stock-based compensation	1,380		1,380
Common dividends	(26,680)			(26,680)
Net (loss) income	$ 709			709
Ending balance (in shares) at Sep. 30, 2022	96,605,112	96,605,112
Ending balance at Sep. 30, 2022	$ 813,677	$ 966	$ 1,196,662	$ (383,951)

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Equity (Parenthetical) - $ / shares	3 Months Ended
	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021
Statement of Stockholders' Equity [Abstract]
Common dividends (in usd per share)	$ 0.275	$ 0.275	$ 0.275	$ 0.265	$ 0.265	$ 0.265

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Cash flows from operating activities:
Net (loss) income	$ 709	$ 11,918	$ (21,886)	$ 53,721
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization (including below-market ground leases)			38,437	41,328
Amortization of deferred financing costs			1,560	1,531
Loss on extinguishment of debt	0	10,827	0	10,827
Unrealized loss on other real estate related investments	4,706	0	4,706	0
Amortization of stock-based compensation	1,380	1,802	4,295	5,197
Straight-line rental income	(3)	(6)	(14)	(26)
Adjustment for collectibility of rental income			977	0
Noncash interest income			(1,063)	0
Loss on sale of real estate, net	2,287	0	2,101	192
Impairment of real estate investments	12,322	0	73,706	0
Provision for loan losses, net	0	0	3,844	0
Change in operating assets and liabilities:
Accounts and other receivables			648	(1,775)
Prepaid expenses and other assets, net			(2,082)	(20)
Accounts payable, accrued liabilities and deferred rent liabilities			5,443	7,388
Net cash provided by operating activities			110,672	118,363
Cash flows from investing activities:
Acquisitions of real estate, net of deposits applied			(21,915)	(180,323)
Purchases of equipment, furniture and fixtures and improvements to real estate			(5,475)	(4,826)
Investment in real estate related investments and other loans receivable			(149,650)	(700)
Principal payments received on other loans receivable			1,166	172
Escrow deposits for potential acquisitions of real estate			0	(3,100)
Net proceeds from sales of real estate			34,115	6,814
Net cash used in investing activities			(141,759)	(181,963)
Cash flows from financing activities:
Proceeds from the issuance of common stock, net			0	22,946
Proceeds from the issuance of senior unsecured notes payable			0	400,000
Borrowings under unsecured revolving credit facility			145,000	220,000
Payments on senior unsecured notes payable			0	(300,000)
Payments on unsecured revolving credit facility			(45,000)	(190,000)
Payments on debt extinguishment and deferred financing costs			0	(14,070)
Net-settle adjustment on restricted stock			(4,469)	(1,331)
Dividends paid on common stock			(79,478)	(75,148)
Net cash provided by financing activities			16,053	62,397
Net decrease in cash and cash equivalents			(15,034)	(1,203)
Cash and cash equivalents as of the beginning of period			19,895	18,919
Cash and cash equivalents as of the end of period	$ 4,861	$ 17,716	4,861	17,716
Supplemental disclosures of cash flow information:
Interest paid			14,898	13,267
Supplemental schedule of noncash investing and financing activities:
Increase in dividends payable			542	1,913
Transfer of pre-acquisition costs to acquired assets			7	358
Sale of real estate settled with notes receivable			$ 12,000	$ 0

Organization

Organization	9 Months Ended
	Sep. 30, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization	ORGANIZATION Description of Business— CareTrust REIT, Inc.’s (“CareTrust REIT” or the “Company”) primary business consists of acquiring, financing, developing and owning real property to be leased to third-party tenants in the healthcare sector. As of September 30, 2022, the Company owned and leased to independent ope rators , 221 skilled nursing facilities (“SNFs”), multi-service campuses, assisted living facilities (“ALFs”) and independent living facilities (“ILFs”) consisting of 23,135 operational beds and un its located in 29 st ates with the highest concentration of properties by rental income located in California, Texas, Louisiana, Idaho and Arizona. As of September 30, 2022, the Company also had other real estate related inves tments consisting of three real estate secured loans receivable and two mezzanine loans receivable with an aggregate carrying value of $158.7 million. COVID-19— The COVID-19 pandemic has had and may continue to have an adverse impact on the economy generally and the Company’s business, results of operations and financial condition. The duration and extent of the COVID-19 pandemic’s effect on the Company’s operational and financial performance, and the operational and financial performance of the Company’s tenants, will depend on future developments, which are highly uncertain and cannot be predicted at this time, including the rate of public acceptance and usage of vaccines and the effectiveness of vaccines in limiting the spread of COVID-19 and its variants, resurgences of COVID-19 and, in particular, new and more contagious and/or vaccine resistant variants, actions taken to contain the spread of COVID-19 and how quickly and to what extent normal economic and operating conditions can resume. The adverse impact of the COVID-19 pandemic on the Company’s business, results of operations and financial condition could be material.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2022
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Basis of Presentation —The accompanying condensed consolidated financial statements of the Company were prepared in accordance with accounting principles generally accepted in the United States (“GAAP”) for interim financial information and Article 10 of Regulation S-X. Accordingly, the condensed consolidated financial statements do not include all of the disclosures required by GAAP for a complete set of annual audited financial statements. The condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2021. In the opinion of management, all adjustments which are of a normal and recurring nature and considered necessary for a fair presentation of the results of the interim periods presented have been included. The results of operations for the interim periods are not necessarily indicative of results for the full year. All intercompany transactions and account balances within the Company have been eliminated. Recent Accounting Pronouncements —In March 2020, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2020-04, Reference Rate Reform (Topic 848) - Facilitation of the Effects of Reference Rate Reform on Financial Reporting (“ASU 2020-04”), which provides optional relief to applying reference rate reform to contracts, hedging relationships, and other transactions that reference the London Interbank Offered Rate (“LIBOR”). For U.S. Dollar LIBOR, the overnight, one-month, three-month, six-mo nth and one-year LIBOR rates will be discontinued in June 2023, while other U.S. Dollar LIBOR rates were discontinued at the end of 2021. The amendments in this update are effective immediately and may be applied through December 31, 2022. Adoption of this ASU did not have a material impact on the Company’s consolidated financial statements.

Real Estate Investments, Net

Real Estate Investments, Net	9 Months Ended
	Sep. 30, 2022
Real Estate [Abstract]
Real Estate Investments, Net	REAL ESTATE INVESTMENTS, NET The following table summarizes the Company’s real estate properties held for investment at September 30, 2022 and December 31, 2021 (dollars in thousands): September 30, 2022 December 31, 2021 Land $ 236,298 $ 251,787 Buildings and improvements 1,437,292 1,622,019 Integral equipment, furniture and fixtures 96,306 104,722 Identified intangible assets 2,832 1,257 Real estate investments 1,772,728 1,979,785 Accumulated depreciation and amortization (388,562) (389,814) Real estate investments, net $ 1,384,166 $ 1,589,971 As of September 30, 2022, 217 of the Company ’s 221 fac ilities wer e leased to various operators under triple-net leases. All of these leases contain annual escalators based on the percentage change in the Consumer Price Index (“CPI”) (but not less than zero), some of which are subject to a cap, or fixed rent escalators. During the second and third quarters of 2022, the Company entered into triple-net lease agreements for two of the Company’s 221 f acilities which are being repurposed to behavioral health facilities with rent commencing 12 to 18 months following lease commencement. Two of the Company’s 221 facilities are non-operational and are leased under a short term lease with an expected term of less than one year as of September 30, 2022. As of September 30, 2022, 19 facilities were held for sale. See Note 4, Impairment of Real Estate Investments, Assets Held for Sale, Net and Asset Sales for additional information. As of September 30, 2022, the Company’s total future contractual minimum rental income for all of its tenants, excluding operating expense reimbursements, was as follows (dollars in thousands): Year Amount 2022 (three months) $ 48,193 2023 192,638 2024 192,396 2025 192,555 2026 192,661 2027 189,653 Thereafter 1,001,323 Total $ 2,009,419 Tenant Purchase Options Certain of the Company’s operators hold purchase options allowing them to acquire properties they currently lease from the Company. A summary of these purchase options is presented below (dollars in thousands): Asset Type Properties Lease Expiration Next Option Open Date Option Type (1) Current Cash Rent (2) ALF 5 (6) October 2034 1/1/2023 (3) A $ 2,287 SNF 11 November 2030 1/1/2023 (3) C 5,092 SNF 1 March 2029 4/1/2022 (4) B / C (5) 805 SNF / Campus 2 October 2032 1/1/2023 (3) B 1,065 SNF 4 November 2034 12/1/2024 (4) B 3,796 ALF 2 (6) October 2034 1/1/2026 (3) A 1,598 (1) Option type includes: A - Fixed base price plus a specified share on any appreciation. B - Fixed base price. C - Fixed capitalization rate on lease revenue. (2) Based on annualized cash revenue for contracts in place as of September 30, 2022. (3) Option window is open for six months. (4) Option window is open until the expiration of the lease term. (5) Purchase option reflects two option types. (6) Includes properties classified as held for sale as of September 30, 2022. Rental Income The following table summarizes components of the Company’s rental income (dollars in thousands): For the Three Months Ended September 30, For the Nine Months Ended September 30, Rental Income 2022 2021 2022 2021 Contractual rent due (1) $ 47,015 $ 48,081 $ 140,794 $ 140,988 Straight-line rent 3 6 14 26 Adjustment for collectibility (2) — — (977) — Lease termination revenue (3) — — — 63 Total $ 47,018 $ 48,087 $ 139,831 $ 141,077 (1) Includes initial contractual cash rent and tenant operating expense reimbursements, as adjusted for applicable rental escalators and rent increases due to capital expenditures funded by the Company. For tenants on a cash basis, this represents the lesser of the amount that would be recognized on a straight-line basis or cash that has been received. Tenant operating expense reimbursements for the three months ended September 30, 2022 and 2021 were $0.7 million and $1.0 million, respectively. Tenant operating expense reimbursements for the nine months ended September 30, 2022 and 2021 were $2.0 million and $2.5 million, respectively. ( 2) During the nine months ended September 30, 2022, and in accordance with Accounting Standards Codification 842, the Company evaluated the collectibility of lease payments through maturity and determined that it was not probable that the Company would collect substantially all of the contractual obligations from four existing and former operators. As such, the Company reversed $0.7 million of operating expense reimbursements, $0.2 million of contractual rent and $0.1 million of straight-line rent during the nine months ended September 30, 2022. If lease payments are subsequently deemed probable of collection, the Company will increase rental income for such recoveries. (3) During the nine months ended September 30, 2021, in connection with the agreement to terminate its lease agreements with Metron Integrated Health Systems (“Metron”) and to sell the facilities to a third party, the Company received approximately $0.1 million from Metron affiliates. Recent Real Estate Acquisitions The following table summarizes the Company’s acquisitions for the nine months ended September 30, 2022 (dollars in thousands): Type of Property Purchase Price (1) Initial Annual Cash Rent Number of Properties Number of Beds/Units (2) Skilled nursing $ 8,918 $ 815 1 135 Multi-service campuses 13,003 1,235 1 130 Total $ 21,921 $ 2,050 2 265 (1) Purchase price includes capitalized acquisition costs. (2) The number of beds/units includes operating beds at the acquisition date. Lease Amendments Noble Partial Lease Termination and New Landmark Leases. On August 29, 2022, one ALF in Maryland was removed from a master lease with affiliates of Noble Senior Services (“Noble”) and the Company amended the applicable Noble master lease to reflect the removal of the ALF. Annual cash rent under the applicable Noble master lease decreased by approximate ly $0.5 million. In connection with the partial lease terminatio n, the Company entered into a lease with Landmark Recovery of Maryland, LLC (“Landmark Maryland”) to repurpose the facility to a be havioral health treatment center. Rent under the lease will commence 18 months following commencement of the lease term or, if earlier, upon Landmark Maryland obtaining all licensure, permits, and other required regulatory authorizations with respect to operating the facility. The lease will expire on the 20th anniversary of the rent commencement date and contains one 10-year renewal option and CPI-based rent escalators. On June 16, 2022, one ALF in Florida was removed from a master lease with affiliates of Noble and the Company amended the applicable Noble master lease to reflect the removal of the ALF. Annual cash rent under the applicable Noble master lease decreased by approximately $0.6 million. In connection with the partial lease termination, the Company entered into a lease with Landmark Recovery of Florida, LLC (“Landmark Florida”) to repurpose the facility to a behavioral health treatment center. Rent under the lease will commence one year following commencement of the lease term or, if earlier, upon Landmark Florida obtaining all licensure, permits, and other required regulatory authorizations with respect to operating the facility. The lease will expire on the 20th anniversary of the rent commencement date and contains one 10-year renewal option and CPI-based rent escalators. Pennant Partial Lease Termination and Amended Ensign Master Leases. On April 1, 2022, operations at two ALFs in California and Washington operated by affiliates of The Pennant Group, Inc. (“Pennant”) were transferred to affiliates of The Ensign Group, Inc. (“Ensign”). In connection with the transfers, the Company amended the Pennant master lease to reflect the removal of the two ALFs and amended two existing triple-net master leases with Ensign to include the two ALFs. The applicable Ensign master leases, as amended, had a remaining term at the date of amendment of approximately five years and 16 years, respectively, both with three five-year renewal options and CPI-based rent escalators. Annual cash rent under each of the two applicable Ensign master leases, as amended, increased by approximately $0.4 million and annual cash rent under the Pennant master lease, as amended, decreased by $0.8 million. On March 1, 2022, operations at one ALF in Arizona operated by affiliates of Pennant were transferred to affiliates of Ensign. In connection with the transfer, the Company amended the Pennant master lease to reflect the removal of the ALF and amended an existing triple-net master lease with Ensign to include the one ALF. The applicable Ensign master lease, as amended, had a remaining term at the date of amendment of approximately 11 years, with two five-year renewal options and CPI-based rent escalators. Annual cash rent under the applicable Ensign master lease, as amended, increased by approximately $0.3 million and annual cash rent under the Pennant master lease, as amended, decreased by the same amount. Amended Eduro Master Lease. On February 1, 2022, the Company acquired one SNF. In conjunction with the acquisition, the Company amended its existing triple-net master lease with affiliates of Eduro Healthcare, LLC (“Eduro”) to include the one SNF and extended the initial lease term. The Eduro master lease, as amended, had a remaining term at the date of amendment of approximately 12 years, wit h two five-year re newal options and CPI-based rent escalators. Annual cash rent under the Eduro master lease, as amended, increased by approximately $0.8 million. Amended WLC Master Lease. On March 1, 2022, the Company acquired one multi-service campus. In conjunction with the acquisition, the Company amended its existing triple-net master lease with affiliates of WLC Management Firm, LLC (“WLC”) to include the one multi-service campus. The WLC master lease, as amended, had a remaining term at the date of amendment of approximately 12 years, with two five-year renewal options and CPI-based rent escalators. Annual cash rent under the WLC master lease, as amended, increased by approximately $1.2 million.

Impairment of Real Estate Inves

Impairment of Real Estate Investments, Assets Held for Sale, Net and Asset Sales	9 Months Ended
	Sep. 30, 2022
Discontinued Operations and Disposal Groups [Abstract]
Impairment of Real Estate Investments, Assets Held for Sale, Net and Asset Sales	IMPAIRMENT OF REAL ESTATE INVESTMENTS, ASSETS HELD FOR SALE, NET AND ASSET SALES In connection with the Company’s ongoing review and monitoring of its investment portfolio and the performance of its tenants, during the first quarter of 2022, the Company determined to pursue the sale of 27 properties and the repurposing of three properties representing an aggregate of approximately 10% of contractual cash rent as of March 31, 2022. A s of March 31, 2022, the Company determined that these 27 properties met the criteria to be classified as assets held for sale and, in connection with this determination, the Company recognized an aggregate impairment charge of $59.7 million related to 20 of the 27 held for sale properties, which is reported in impairment of real estate investments in the condensed consolidated statements of operations for the nine months ended September 30, 2022. The impairment charge was recognized to write down the properties’ aggregate carrying value to their aggregate fair value, less estimated costs to sell. Following the asset sales and held for sale reclassifications discussed below, 19 properties continued to meet the criteria to be classified as held for sale as of September 30, 2022. During the third quarter of 2022, the Company recognized an additional aggregate impairment charge of $12.3 million related to 16 of the 19 held for sale properties to reduce their carrying value to estimated fair value less costs to sell. As of September 30, 2022, the real estate comprising the remaining 19 properties classified as held for sale had an aggregate carrying value of $77.7 million. The fair value of the assets held for sale was based on estimated sales prices, which are considered to be Level 3 measurements within the fair value hierarchy. Estimated sales prices were determined using a market approach (comparable sales model), which relies on certain assumptions by management, including: (i) comparable market transactions, (ii) estimated prices per unit, and (iii) binding agreements for sales and non-binding offers to purchase from unrelated third-parties. There are inherent uncertainties in making these assumptions. For the Company’s impairment calculations, the Company’s fair value estimates primarily relied on a market approach and utilized prices per unit ranging from $35,000 to $145,000, with a weighted average price per unit of $80,000. During the second quarter of 2022, the Company recognized an impairment charge of $1.7 million related to one SNF. The Company wrote down its carrying value of $2.8 million to its estimated fair value of $1.1 million, which is included in real estate investments, net on the Company’s condensed consolidated balance sheets. The fair value of the asset was based on comparable market transactions. For the Company’s impairment calculation, the Company’s fair value estimates primarily relied on a market approach and utilized prices per unit of $20,000. Asset Sales and Held for Sale Reclassifications During the first quarter of 2022, the Company determined that one ALF that was classified as held for sale at December 31, 2021 no longer met the held for sale criteria. The Company reclassified this ALF’s carrying value of $4.8 million out of assets held for sale and recorded catch-up depreciation of approximately $0.1 million during the nine months ended September 30, 2022. On February 22, 2022, the Company closed on the sale of one SNF, operated by affiliates of Cascadia Healthcare, LLC (“Cascadia”), consisting of 83 beds located in Washington with a carrying value of $0.8 million, for net sales proceeds of $1.0 million. During the nine months ended September 30, 2022, the Company recorded a gain of $0.2 million in connection with the sale. There was no rent reduction under the Cascadia master lease in connection with the sale. On September 29, 2022, the Company closed on the sale of six SNFs and one multi-service campus, operated by affiliates of Trio Healthcare Holdings, LLC (“Trio”), consisting of 708 beds located in Ohio for net proceeds of $32.8 million. In connection with the sale, the Company provided affiliates of the purchaser of the properties with a $7.0 million term loan that bears interest at 8.5% and has a maturity date of September 30, 2025. The Company also provided a $5.0 million bridge loan to four individuals that bears interest at 8.5% and has a maturity date of November 29, 2022. The seven properties were classified as held for sale at June 30, 2022 with a carrying value of $46.9 million

Other Real Estate Related Inves

Other Real Estate Related Investments, At Fair Value, And Other Loans Receivable	9 Months Ended
	Sep. 30, 2022
Investments, All Other Investments [Abstract]
Other Real Estate Related Investments, At Fair Value, And Other Loans Receivable	OTHER REAL ESTATE RELATED INVESTMENTS, AT FAIR VALUE, AND OTHER LOANS RECEIVABLE As of September 30, 2022 and December 31, 2021, the Company’s other real estate related investments, at fair value, consisted of the following (dollars in thousands): As of September 30, 2022 Investment Facility Count and Type Principal Balance as of September 30, 2022 Book Value as of September 30, 2022 Book Value as of December 31, 2021 Weighted Average Contractual Interest Rate Maturity Date Senior secured loan receivable 18 SNF/Campus $ 75,000 $ 72,525 $ — 8.4 % [1] 6/30/2027 Secured loan receivable 5 SNF 22,250 22,423 — 9.6 % [2] 8/1/2025 Secured loan receivable 4 SNF 24,900 25,043 — 9.0 % [2] 9/8/2025 Mezzanine loan receivable 9 SNF 15,000 14,667 15,155 12.0 % 11/30/2025 Mezzanine loan receivable 18 SNF/Campus 25,000 24,004 — 11.0 % 6/30/2032 $ 162,150 $ 158,662 $ 15,155 [1] Rate is net of subservicing fee. [2] Term secured overnight financing rate (“SOFR”) used as of September 30, 2022 was 3.02%. Rates are net of subservicing fees. The following table summarizes the Company’s other real estate related investments activity for the nine months ended September 30, 2022 and 2021 (dollars in thousands): Nine Months Ended September 30, 2022 2021 Origination of other real estate related investments $ 147,150 $ — Accrued interest, net 1,063 150 Unrealized loss on other real estate related investments (4,706) — Net increase in other real estate related investments, at fair value $ 143,507 $ 150 In September 2022, the Company extended a $24.9 million term loan as part of a larger, multi-tranche real estate secured term loan facility to a skilled nursing real estate owner. The secured term loan was structured with an “A” and a “B” tranche (with the payments on the “B” tranche being subordinate to the “A” tranche pursuant to the terms of a written agreement between the lenders). The Company’s $24.9 million secured term loan constituted the entirety of the “B” tranche with its payments subordinated accordingly. The secured term loan is primarily secured by four skilled nursing faciliti es operated by an operator in the Southeast. The “B” tranche secured term loan is set to mature on September 8, 2025, with two one-year extension options and ma y (subject to certain restrictions) be prepaid in whole or in part before the maturity date for an exit fee ranging from 1% to 3% of the loan plus unpaid interest payments; provided, however, that no exit fee is payable in connection with portions of the loan being refinanced pursuant to a loan (or loans) provided by or insured by the United States Department of Housing and Urban Development, Federal Housing Administration, or a similar governmental authority. The “B” tranche secured term loan provides for an earnout advance of $4.7 million if certain conditions are met. The "B" tranche secured term loan bears interest at a rate based on term SOFR, calculated as a fraction, with the numerator being the difference between (i) the monthly payment of interest of term SOFR plus a 4.50% spread and (ii) the amount of such monthly payment of interest of term SOFR plus a 2.85% spread, and with the denominator being the average daily balance of the outstanding principal amount during the applicable month, with such fraction expressed as a percentage and annualized, with a term SOFR floor of 1.0% and less a subservicing fee of 100% over 9.00%. The “B” tranche secured term loan requires monthly interest payments. The Company elected the fair value option for the “B” tranche secured term loan. In August 2022, the Company extended a $22.3 million term loan as part of a larger, multi-tranche real estate secured term loan facility to a skilled nursing real estate owner. The secured term loan was structured with an “A” and a “B” tranche (with the payments on the “B” tranche being subordinate to the “A” tranche pursuant to the terms of a written agreement between the lenders). The Company’s $22.3 million secured term loan constituted the entirety of the “B” tranche with its payments subordinated accordingly. The secured term loan is primarily secured by five skilled nursing facilities, four of which will be operated by an existing operator and one of which will be operate d by a large, regional skilled nursing operator. The “B” tranche secured term loan is set to mature on August 1, 2025, with two one-year extension options and may (subject to certain restrictions) be prepaid in whole or in part before the maturity date for an ex it fee ranging from 2% to 3% of the loan plus unpaid interest payments; provided, however, that no exit fee is payable in connection with portions of the loan being refinanced pursuant to a loan (or loans) provided by or insured by the United States Department of Housing and Urban Development, Federal Housing Administration, or a similar governmental authority. The "B" tranche secured term loan bears interest at a rate based on term secured overnight financing rate, calculated as a fraction, with the numerator being the difference between (i) the monthly payment of interest of term SOFR plus a 4.25% spread and (ii) the amount of such monthly payment of interest of term SOFR plus a 2.75% spread, and with the denominator being the average daily balance of the outstanding principal amount during the applicable month, with such fraction expressed as a percentage and annualized, with a term SOFR floor of 1.0% and less a subservicing fee of 50% over 8.25%. The “B” tranche secured term loan requires monthly interest payments. The Company elected the fair value option for the “B” tranche secured term loan. In June 2022, the Company extended a $75.0 million term loan to a skilled nursing real estate owner as part of a larger, multi-tranche, senior secured term loan facility. The senior secured term loan was structured with an “A” tranche, a “B” tranche, and a “C” tranche (with the “C” tranche being the most subordinate). The Company’s $75.0 million term loan constituted the entirety of the “C” tranche with its payments subordinated accordingly. The senior secured term loan facility is secured by an 18-facility skilled nursing portfolio in the Mid-Atlantic region, operated by a large, regional skilled nursing operator. In connection with the senior secured term loan facility and the borrower’s acquisition of the skilled nursing portfolio, the Company also extended to the borrower group a $25.0 million mezzanine loan. The “C” tranche of the senior secured term loan bears interest at 8.5%, less a servicing fee equal to the positive difference, if any, between the lesser of the contractual interest payment and actual payment of interest made by the borrower and a hypothetical interest payment at a rate of 8.25%, resulting in an effective interest rate of 8.375%. The “C” tranche senior secured term loan is set to mature on June 30, 2027 and may (subject to certain restrictions) be prepaid in whole or in part before the maturity date for an exit fee ranging from 1% to 3% of the loan plus unpaid interest payments through the end of the month of prepayment; provided, however, that no exit fee is payable in connection with portions of the loan being refinanced pursuant to a loan (or loans) provided by or insured by the United States Department of Housing and Urban Development, Federal Housing Administration, or a similar governmental authority. The mezzanine loan bears interest at 11% and is secured by a pledge of membership interests in an up-tier affiliate of the borrower group. The mezzanine loan is set to mature on June 30, 2032, and may (subject to certain restrictions) be prepaid in whole or in part before the maturity date, commencing on June 30, 2029, for an exit fee ranging from 1% to 3% of the loan plus unpaid interest payments through the date of prepayment. The “C” tranche senior secured term loan and mezzanine loan both require monthly interest payments. The Company elected the fair value option for both the “C” tranche term loan and the mezzanine loan. The fair value option is elected on an instrument by instrument basis and must be applied to an entire instrument and is irrevocable once elected. The Company’s primary purpose in electing the fair value option for these instruments was to align with management’s view of the underlying economics of the loans and the manner in which they are managed. As of September 30, 2022 and December 31, 2021, the Company’s other loans receivable, included in prepaid expenses and other assets, net on the Company’s condensed consolidated balance sheets, consisted of the following (dollars in thousands): As of September 30, 2022 Investment Principal Balance as of September 30, 2022 Book Value as of September 30, 2022 Book Value as of December 31, 2021 Weighted Average Contractual Interest Rate Maturity Date Other loans receivable $ 14,738 $ 14,742 $ 3,161 8.5 % 11/29/2022 - 9/30/2025 Expected credit loss (2,094) (2,094) — Total $ 12,644 $ 12,648 $ 3,161 The following table summarizes the Company’s other loans receivable activity for the nine months ended September 30, 2022 and 2021 (dollars in thousands): Nine Months Ended September 30, 2022 2021 Origination of loans receivable $ 14,500 $ 700 Principal payments (416) (172) Accrued interest, net (3) 39 Expected credit loss (5,344) — Loan loss recovery 750 — Net increase in other loans receivable $ 9,487 $ 567 Expected credit losses and recoveries are recorded in provision for loan losses, net in the condensed consolidated statements of operations. During the nine months ended September 30, 2022, the Company recorded a $4.6 million expected credit loss related to two other loans receivable that were placed on non-accrual status, net of a loan loss recovery of $0.8 million related to a loan previously written-off. During the three months ended September 30, 2022, the Company wrote-off $2.5 million, related to one other loan receivable that was previously fully reserved, in connection with the sale of six SNFs and one multi-service campus. As of December 31, 2021, the Company had no expected credit loss and did not consider any loan receivable investments to be impaired. The following table summarizes the interest and other income recognized from the Company’s loans receivable and other investments during the three and nine months ended September 30, 2022 and 2021 (dollars in thousands): For the Three Months Ended September 30, For the Nine Months Ended September 30, Investment 2022 2021 2022 2021 Secured loans receivable $ 2,098 $ — $ 2,115 $ — Mezzanine loans receivable 1,163 460 2,326 1,365 Other 14 58 50 172 Total $ 3,275 $ 518 $ 4,491 $ 1,537

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2022
Fair Value Disclosures [Abstract]
Fair Value Measurements	FAIR VALUE MEASUREMENTS The Company determines fair value based on quoted prices when available or through the use of alternative approaches, such as discounting the expected cash flows using market interest rates commensurate with the credit quality and duration of the investment. GAAP guidance defines three levels of inputs that may be used to measure fair value: Level 1 – Quoted prices in active markets for identical assets and liabilities that the reporting entity has the ability to access at the measurement date. Level 2 – Inputs other than quoted prices included within Level 1 that are observable for the asset or liability or can be corroborated with observable market data for substantially the entire contractual term of the asset or liability. Level 3 – Unobservable inputs reflect the entity’s own assumptions about the assumptions that market participants would use in the pricing of the asset or liability and are consequently not based on market activity, but rather through particular valuation techniques. The determination of where an asset or liability falls in the hierarchy requires significant judgment and considers factors specific to the asset or liability. 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. The Company evaluates its hierarchy disclosures each quarter and, depending on various factors, it is possible that an asset or liability may be classified differently from quarter to quarter. Changes in the type of inputs may result in a reclassification for certain assets. The Company does not expect that changes in classifications between levels will be frequent. Items Measured at Fair Value on a Recurring Basis The following table presents information about the Company’s assets and liabilities measured at fair value on a recurring basis as of September 30, 2022 and December 31, 2021, aggregated by the level in the fair value hierarchy within which those instruments fall (dollars in thousands): Level 1 Level 2 Level 3 Balance as of September 30, 2022 Assets: Secured loans receivable $ — $ — $ 119,991 $ 119,991 Mezzanine loans receivable — — 38,671 38,671 Total $ — $ — $ 158,662 $ 158,662 Level 1 Level 2 Level 3 Balance as of December 31, 2021 Assets: Mezzanine loan receivable $ — $ — $ 15,155 $ 15,155 The following table details the Company’s assets measured at fair value on a recurring basis using Level 3 inputs (dollars in thousands): Investments in Real Estate Secured Loans Investments in Mezzanine Loans Balance at December 31, 2021 $ — $ 15,155 Loan originations 122,150 25,000 Accrued interest, net 839 224 Unrealized loss on other real estate related investments (2,998) (1,708) Balance as of September 30, 2022 $ 119,991 $ 38,671 Real estate secured and mezzanine loans receivables: The fair value of the secured and mezzanine loans receivables were estimated using an internal valuation model that considered the expected future cash flows of the investment, the underlying collateral value, market interest rates and other credit enhancements. As such, the Company classifies each instrument as Level 3 due to the significant unobservable inputs used in determining market interest rates for investments with similar terms. During the three months ended September 30, 2022, the Company recorded an unrealized loss of $4.7 million on the Company’s secured and mezzanine loans receivable due to rising interest rates. Future changes in market interest rates could materially impact the estimated discounted cash flows that are used to determine the fair value of the secured and mezzanine loans receivable. As of September 30, 2022 and December 31, 2021, the Company did not have any loans measured at fair value that were 90 days or more past due. The following table shows the quantitative information about unobservable inputs related to the Level 3 fair value measurements comprising the investments in secured and mezzanine loans receivables as of September 30, 2022 : Type Book Value as of September 30, 2022 Valuation Technique Unobservable Inputs Range Secured loans receivable $ 119,991 Discounted cash flow Discount Rate 9% - 13% Mezzanine loans receivable 38,671 Discounted cash flow Discount Rate 12% - 14% For the three and nine months ended September 30, 2022, there were no classification changes in assets and liabilities with Level 3 inputs in the fair value hierarchy. Items Disclosed at Fair Value Considerable judgment is necessary to estimate the fair value disclosure of financial instruments. The estimates of fair value presented herein are not necessarily indicative of the amounts that could be realized upon disposition of the financial instruments. A summary of the face value, carrying amount and fair value of the Notes (as defined in Note 7, Debt, below) as of September 30, 2022 and December 31, 2021 using Level 2 inputs is as follows (dollars in thousands): September 30, 2022 December 31, 2021 Level Face Carrying Fair Face Carrying Fair Financial liabilities: Senior unsecured notes payable 2 $ 400,000 $ 394,928 $ 331,000 $ 400,000 $ 394,262 $ 410,500 Cash and cash equivalents, accounts and other receivables, accounts payable, and accrued liabilities: The carrying values for these instruments approximate their fair values due to the short-term nature of these instruments. Senior unsecured notes payable: The fair value of the Notes was determined using third-party quotes derived from orderly trades. Unsecured revolving credit facility and senior unsecured term loan: The fair values approximate their carrying values as the interest rates are variable and approximate prevailing market interest rates for similar debt arrangements.

Debt

Debt	9 Months Ended
	Sep. 30, 2022
Debt Disclosure [Abstract]
Debt	DEBT The following table summarizes the balance of the Company’s indebtedness as of September 30, 2022 and December 31, 2021 (dollars in thousands): September 30, 2022 December 31, 2021 Principal Amount Deferred Loan Fees Carrying Value Principal Amount Deferred Loan Fees Carrying Value Senior unsecured notes payable $ 400,000 $ (5,072) $ 394,928 $ 400,000 $ (5,738) $ 394,262 Senior unsecured term loan 200,000 (705) 199,295 200,000 (864) 199,136 Unsecured revolving credit facility 180,000 — 180,000 80,000 — 80,000 $ 780,000 $ (5,777) $ 774,223 $ 680,000 $ (6,602) $ 673,398 Senior Unsecured Notes Payable 2028 Senior Notes. On June 17, 2021, the Company’s wholly owned subsidiary, CTR Partnership, L.P. (the “Operating Partnership”), and its wholly owned subsidiary, CareTrust Capital Corp. (together with the Operating Partnership, the “Issuers”), completed a private offering of $400.0 million aggregate principal amount of 3.875% Senior Notes due 2028 (the “Notes”) to persons reasonably believed to be qualified institutional buyers pursuant to Rule 144A and to non-U.S. persons outside the United States in reliance on Regulation S under the Securities Act of 1933, as amended. The Notes were issued at par, resulting in gross proceeds of $400.0 million and net proceeds of approximately $393.8 million after deducting underwriting fees and other offering expenses. The Notes mature on June 30, 2028. The Notes accrue interest at a rate of 3.875% per annum payable semiannually in arrears on June 30 and December 30 of each year, commencing on December 30, 2021. The Issuers may redeem some or all of the Notes at any time prior to March 30, 2028 at a price equal to 100% of the principal amount of the Notes redeemed plus accrued and unpaid interest on the Notes, if any, to, but not including, the redemption date, plus a “make-whole” premium. At any time on or after March 30, 2028, the Issuers may redeem some or all of the Notes at a redemption price equal to 100% of the principal amount of the Notes redeemed plus accrued interest on the Notes, if any, to, but not including, the redemption date. In addition, at any time on or prior to June 30, 2024, up to 40% of the aggregate principal amount of the Notes may be redeemed with the net proceeds of certain equity offerings at a redemption price of 103.875% of the aggregate principal amount of Notes to be redeemed plus accrued and unpaid interest on the Notes, if any, to, but not including, the redemption date. If certain changes of control of the Company occur, the Issuers will be required to make an offer to holders of the Notes to repurchase their Notes at a price of 101% of their principal amount plus accrued and unpaid interest, if any, to, but not including, the repurchase date. The obligations under the Notes are fully and unconditionally guaranteed, jointly and severally, on an unsecured basis, by the Company and all of CareTrust’s existing and future subsidiaries (other than the Issuers) that guarantee obligations under the Amended Credit Facility (as defined below); provided, however, that such guarantees are subject to automatic release under certain customary circumstances. The indenture governing the Notes contains customary covenants such as limiting the ability of the Company and its restricted subsidiaries to: incur or guarantee additional indebtedness; incur or guarantee secured indebtedness; pay dividends or distributions on, or redeem or repurchase, capital stock; make certain investments or other restricted payments; sell assets; enter into transactions with affiliates; merge or consolidate or sell all or substantially all of their assets; and create restrictions on the ability of the Issuers and their restricted subsidiaries to pay dividends or other amounts to the Issuers. The indenture governing the Notes also requires the Company and its restricted subsidiaries to maintain a specified ratio of unencumbered assets to unsecured indebtedness. These covenants are subject to a number of important and significant limitations, qualifications and exceptions. The indenture governing the Notes also contains customary events of default. As of September 30, 2022, the Company was in compliance with all applicable financial covenants under the indenture governing the Notes. Unsecured Revolving Credit Facility and Term Loan On February 8, 2019, the Operating Partnership, as the borrower, the Company, as guarantor, CareTrust GP, LLC, and certain of the Operating Partnership’s wholly owned subsidiaries entered into an amended and restated credit and guaranty agreement with KeyBank National Association, as administrative agent, an issuing bank and swingline lender, and the lenders party thereto (the “Amended Credit Agreement”). The Amended Credit Agreement, which amended and restated the Company’s prior credit agreement, provides for: (i) an unsecured revolving credit facility (the “Revolving Facility”) with revolving commitments in an aggregate principal amount of $600.0 million, including a letter of credit subfacility for 10% of the then available revolving commitments and a swingline loan subfacility for 10% of the then available revolving commitments and (ii) an unsecured term loan credit facility (the “Term Loan” and, together with the Revolving Facility, the “Amended Credit Facility”) in an aggregate principal amount of $200.0 million. Borrowing availability under the Revolving Facility is subject to no default or event of default under the Amended Credit Agreement having occurred at the time of borrowing. Future borrowings under the Amended Credit Facility will be used for working capital purposes, for capital expenditures, to fund acquisitions and for general corporate purposes. The interest rates applicable to loans under the Revolving Facility are, at the Operating Partnership’s option, equal to either a base rate plus a margin ranging from 0.10% to 0.55% per annum or LIBOR plus a margin ranging from 1.10% to 1.55% per annum based on the debt to asset value ratio of the Company and its consolidated subsidiaries (subject to decrease at the Operating Partnership’s election if the Company obtains certain specified investment grade ratings on its senior long-term unsecured debt). The interest rates applicable to loans under the Term Loan are, at the Operating Partnership’s option, equal to either a base rate plus a margin ranging from 0.50% to 1.20% per annum or LIBOR plus a margin ranging from 1.50% to 2.20% per annum based on the debt to asset value ratio of the Company and its consolidated subsidiaries (subject to decrease at the Operating Partnership’s election if the Company obtains certain specified investment grade ratings on its senior long-term unsecured debt). In addition, the Operating Partnership will pay a facility fee on the revolving commitments under the Revolving Facility ranging from 0.15% to 0.35% per annum, based on the debt to asset value ratio of the Company and its consolidated subsidiaries (unless the Company obtains certain specified investment grade ratings on its senior long-term unsecured debt and the Operating Partnership elects to decrease the applicable margin as described above, in which case the Operating Partnership will pay a facility fee on the revolving commitments ranging from 0.125% to 0.30% per annum based on the credit ratings of the Company’s senior long-term unsecured debt). As of September 30, 2022, the Operating Partnership had $200.0 million of borrowings outstanding under the Term Loan and $180.0 million outstanding under the Revolving Facility. The Revolving Facility has a maturity date of February 8, 2023, and includes, at the sole discretion of the Operating Partnership, two, six-month extension options. The Term Loan has a maturity date of February 8, 2026. The Amended Credit Facility is guaranteed, jointly and severally, by the Company and its wholly owned subsidiaries that are party to the Amended Credit Agreement (other than the Operating Partnership). The Amended Credit Agreement contains customary covenants that, among other things, restrict, subject to certain exceptions, the ability of the Company and its subsidiaries to grant liens on their assets, incur indebtedness, sell assets, make investments, engage in acquisitions, mergers or consolidations, amend organizational documents and pay certain dividends and other restricted payments. The Amended Credit Agreement requires the Company to comply with financial maintenance covenants to be tested quarterly, consisting of a maximum debt to asset value ratio, a minimum fixed charge coverage ratio, a minimum tangible net worth, a maximum cash distributions to operating income ratio, a maximum secured debt to asset value ratio, a maximum secured recourse debt to asset value ratio, a maximum unsecured debt to unencumbered properties asset value ratio, a minimum unsecured interest coverage ratio and a minimum rent coverage ratio. The Amended Credit Agreement also contains certain customary events of default, including the failure to make timely payments under the Amended Credit Facility or other material indebtedness, the failure to satisfy certain covenants (including the financial maintenance covenants), the occurrence of change of control and specified events of bankruptcy and insolvency. As of September 30, 2022, the Company was in compliance with all applicable financial covenants under the Amended Credit Agreement.

Equity

Equity	9 Months Ended
	Sep. 30, 2022
Equity [Abstract]
Equity	EQUITY Common Stock At-The-Market Offering —On March 10, 2020, the Company entered into a new equity distribution agreement to issue and sell, from time to time, up to $500.0 million in aggregate offering price of its common stock through an “at-the-market” equity offering program (the “ATM Program”). There was no ATM Program activity for the three and nine months ended September 30, 2022 and the three months ended September 30, 2021. The following table summarizes the ATM Program activity for the nine months ended September 30, 2021 (in thousands, except per share amounts). For the Nine Months Ended September 30, 2021 Number of shares 990 Average sales price per share $ 23.74 Gross proceeds (1) $ 23,505 (1) Total gross proceeds is before $0.3 million of commissions paid to the sales agents during the nine months ended September 30, 2021 under the ATM Program. As of September 30, 2022, the Company had $476.5 million available for future issuances under the ATM Program. Share Repurchase Program —On March 20, 2020, the Company’s Board of Directors authorized a share repurchase program for up to $150.0 million of outstanding shares of the Company’s common stock (the “Repurchase Program”). Repurchases under the Repurchase Program, which expires on March 31, 2023, may be made through open market purchases, privately negotiated transactions, structured or derivative transactions, including accelerated share repurchase transactions, or other methods of acquiring shares, in each case subject to market conditions and at such times as shall be permitted by applicable securities laws and determined by management. Repurchases under the Repurchase Program may also be made pursuant to a plan adopted under Rule 10b5-1 promulgated under the Securities Exchange Act of 1934, as amended. The Company expects to finance any share repurchases under the Repurchase Program using available cash and may also use short-term borrowings under the Revolving Facility. Through September 30, 2022, t he Company has not repurchased any shares of common stock under the Repurchase Program. As of September 30, 2022 , $150.0 million remained available under the Repurchase Program. The Repurchase Program may be modified, discontinued or suspended at any time. Dividends on Common Stock —The following table summarizes the cash dividends per share of common stock declared by the Company’s Board of Directors for the first nine months of 2022 (dollars in thousands, except per share amounts): For the Three Months Ended March 31, 2022 June 30, 2022 September 30, 2022 Dividends declared per share $ 0.275 $ 0.275 $ 0.275 Dividends payment date April 15, 2022 July 15, 2022 October 14, 2022 Dividends payable as of record date (1) $ 26,691 $ 26,683 $ 26,683 Dividends record date March 31, 2022 June 30, 2022 September 30, 2022 (1) Dividends payable includes dividends on performance stock awards that will be paid if and when the shares subject to such awards vest.

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2022
Share-Based Payment Arrangement [Abstract]
Stock-Based Compensation	STOCK-BASED COMPENSATION All stock-based awards are subject to the terms of the CareTrust REIT, Inc. and CTR Partnership, L.P. Incentive Award Plan (the “Plan”). The Plan provides for the granting of stock-based compensation, including stock options, restricted stock, performance awards, restricted stock units, relative total stockholder return based stock awards (“TSR Awards”) and other incentive awards to officers, employees and directors in connection with their employment with or services provided to the Company. Under the Plan, 5,000,000 shares have been authorized for awards. Under the Plan, restricted stock awards (“RSAs”) granted in fiscal 2022 to employees vest in equal annual installments beginning on the first anniversary of the grant date over a three year period. RSAs granted to non-employee members of the Board of Directors (“Board Awards”) vest in full on the earlier to occur of the Company’s next annual meeting of stockholders or the first anniversary of the grant date. Performance stock awards (“PSA”) granted to employees are subject to both time and performance based conditions and vest over a one one The following table summarizes the RSAs and PSAs activity for the nine months ended September 30, 2022: Shares Weighted Average Share Price Unvested balance at December 31, 2021 891,333 $ 20.91 Granted: RSAs 9,684 17.56 Board Awards 25,992 16.93 Vested (501,479) 20.60 Forfeited (1,900) 21.50 Unvested balance at September 30, 2022 423,630 $ 20.96 As of September 30, 2022, the weighted-average remaining vesting period of such awards w as 1.6 years. The following table summarizes the stock-based compensation expense recognized for the periods presented (dollars in thousands): For the Three Months Ended September 30, For the Nine Months Ended September 30, 2022 2021 2022 2021 Stock-based compensation expense $ 1,380 $ 1,802 $ 4,295 $ 5,197

Earnings (Loss) Per Common Shar

Earnings (Loss) Per Common Share	9 Months Ended
	Sep. 30, 2022
Earnings Per Share [Abstract]
Earnings (Loss) Per Common Share	EARNINGS (LOSS) PER COMMON SHARE The following table presents the calculation of basic and diluted earnings (loss) per common share (“EPS”) for the Company’s common stock for the three and nine months ended September 30, 2022 and 2021, and reconciles the weighted-average common shares outstanding used in the calculation of basic EPS to the weighted-average common shares outstanding used in the calculation of diluted EPS (amounts in thousands, except per share amounts): For the Three Months Ended September 30, For the Nine Months Ended September 30, 2022 2021 2022 2021 Numerator: Net income (loss) $ 709 $ 11,918 $ (21,886) $ 53,721 Less: Net income allocated to participating securities (94) (116) (305) (350) Numerator for basic and diluted earnings available to common stockholders $ 615 $ 11,802 $ (22,191) $ 53,371 Denominator: Weighted-average basic common shares outstanding 96,605 96,297 96,527 95,922 Dilutive performance stock awards 20 — — 15 Weighted-average diluted common shares outstanding 96,625 96,297 96,527 95,937 Earnings (loss) per common share, basic $ 0.01 $ 0.12 $ (0.23) $ 0.56 Earnings (loss) per common share, diluted $ 0.01 $ 0.12 $ (0.23) $ 0.56 Antidilutive unvested RSAs, PSAs and TSR Awards excluded from the computation 341 535 478 436

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2022
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	COMMITMENTS AND CONTINGENCIES The Company and its subsidiaries are and may become from time to time a party to various claims and lawsuits arising in the ordinary course of business, which are not individually or in the aggregate anticipated to have a material adverse effect on the Company’s results of operations, financial condition or cash flows. Claims and lawsuits may include matters involving general or professional liability asserted against the Company’s tenants, which are the responsibility of the Company’s tenants and for which the Company is entitled to be indemnified by its tenants under the insurance and indemnification provisions in the applicable leases. Capital expenditures for each property leased under the Company’s triple-net leases are generally the responsibility of the tenant, except that, for the facilities leased to subsidiaries of Ensign and Pennant, the tenant will have an option to require the Company to finance certain capital expenditures up to an aggregate of 20% of the Company’s initial investment in such property, subject to a corresponding rent increase at the time of funding. For the Company’s other triple-net master leases, the tenants also have the option to request capital expenditure funding that would generally be subject to a corresponding rent increase at the time of funding, which are subject to tenant compliance with the conditions to the Company’s approval and funding of their requests. As of September 30, 2022, the Company had committed to fund expansions, construction and capital improvements at certain triple-net leased facilities totali ng $16.1 million, of which $3.9 million is subject to rent increase at the time of funding.

Concentration of Risk

Concentration of Risk	9 Months Ended
	Sep. 30, 2022
Risks and Uncertainties [Abstract]
Concentration of Risk	CONCENTRATION OF RISKConcentrations of credit risk arise when one or more tenants, operators, or obligors related to the Company’s investments are engaged in similar business activities or activities in the same geographic region, or have similar economic features that would cause their ability to meet contractual obligations, including those to the Company, to be similarly affected by changes in economic conditions. Major operator concentration - The Company has operators from which it derived 10% or more of its rental revenue for the three and nine months ended September 30, 2022 and 2021. The following table sets forth information regarding the Company’s major operators as of September 30, 2022 and 2021: Number of Facilities Number of Beds/Units Percentage of Total Revenue (1) Operator SNF Campus ALF/ILF SNF Campus ALF/ILF Three Months Ended Nine Months Ended September 30, 2022 Ensign (2) 83 8 7 8,741 997 661 36 % 35 % Priority Management Group 13 2 — 1,742 402 — 16 % 16 % September 30, 2021 Ensign (2) 83 8 4 8,756 997 395 33 % 32 % Priority Management Group 13 2 — 1,742 402 — 15 % 15 % (1) The Company’s rental income, exclusive of operating expense reimbursements. (2) Ensign is subject to the registration and reporting requirements of the SEC and is required to file with the SEC annual reports containing audited financial information and quarterly reports containing unaudited financial information. Ensign’s financial statements, as filed with the SEC, can be found at http://www.sec.gov. The Company has not verified this information through an independent investigation or otherwise. Major geographic concentration – The following table provides information regarding the Company’s concentrations with respect to certain states, from which the Company derived 10% or more of its rental revenue for the three and nine months ended September 30, 2022: Number of Facilities Number of Beds/Units Percentage of Total Revenue (1) State SNF Campus ALF/ILF SNF Campus ALF/ILF Three Months Ended September 30, 2022 Nine Months Ended September 30, 2022 CA 27 8 5 3,048 1,359 437 27 % 27 % TX 38 3 3 4,849 536 242 22 % 22 % (1) The Company’s rental income, exclusive of operating expense reimbursements.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2022
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation —The accompanying condensed consolidated financial statements of the Company were prepared in accordance with accounting principles generally accepted in the United States (“GAAP”) for interim financial information and Article 10 of Regulation S-X. Accordingly, the condensed consolidated financial statements do not include all of the disclosures required by GAAP for a complete set of annual audited financial statements. The condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2021. In the opinion of management, all adjustments which are of a normal and recurring nature and considered necessary for a fair presentation of the results of the interim periods presented have been included. The results of operations for the interim periods are not necessarily indicative of results for the full year. All intercompany transactions and account balances within the Company have been eliminated.
Recent Accounting Pronouncements	Recent Accounting Pronouncements —In March 2020, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2020-04, Reference Rate Reform (Topic 848) - Facilitation of the Effects of Reference Rate Reform on Financial Reporting (“ASU 2020-04”), which provides optional relief to applying reference rate reform to contracts, hedging relationships, and other transactions that reference the London Interbank Offered Rate (“LIBOR”). For U.S. Dollar LIBOR, the overnight, one-month, three-month, six-mo nth and one-year LIBOR rates will be discontinued in June 2023, while other U.S. Dollar LIBOR rates were discontinued at the end of 2021. The amendments in this update are effective immediately and may be applied through December 31, 2022. Adoption of this ASU did not have a material impact on the Company’s consolidated financial statements.
Fair Value Measurements	The Company determines fair value based on quoted prices when available or through the use of alternative approaches, such as discounting the expected cash flows using market interest rates commensurate with the credit quality and duration of the investment. GAAP guidance defines three levels of inputs that may be used to measure fair value: Level 1 – Quoted prices in active markets for identical assets and liabilities that the reporting entity has the ability to access at the measurement date. Level 2 – Inputs other than quoted prices included within Level 1 that are observable for the asset or liability or can be corroborated with observable market data for substantially the entire contractual term of the asset or liability. Level 3 – Unobservable inputs reflect the entity’s own assumptions about the assumptions that market participants would use in the pricing of the asset or liability and are consequently not based on market activity, but rather through particular valuation techniques. The determination of where an asset or liability falls in the hierarchy requires significant judgment and considers factors specific to the asset or liability. 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. The Company evaluates its hierarchy disclosures each quarter and, depending on various factors, it is possible that an asset or liability may be classified differently from quarter to quarter. Changes in the type of inputs may result in a reclassification for certain assets. The Company does not expect that changes in classifications between levels will be frequent.

Real Estate Investments, Net (T

Real Estate Investments, Net (Tables)	9 Months Ended
	Sep. 30, 2022
Real Estate [Abstract]
Summary of Investment in Owned Properties	The following table summarizes the Company’s real estate properties held for investment at September 30, 2022 and December 31, 2021 (dollars in thousands): September 30, 2022 December 31, 2021 Land $ 236,298 $ 251,787 Buildings and improvements 1,437,292 1,622,019 Integral equipment, furniture and fixtures 96,306 104,722 Identified intangible assets 2,832 1,257 Real estate investments 1,772,728 1,979,785 Accumulated depreciation and amortization (388,562) (389,814) Real estate investments, net $ 1,384,166 $ 1,589,971
Schedule of Total Future Contractual Minimum Rental Income	As of September 30, 2022, the Company’s total future contractual minimum rental income for all of its tenants, excluding operating expense reimbursements, was as follows (dollars in thousands): Year Amount 2022 (three months) $ 48,193 2023 192,638 2024 192,396 2025 192,555 2026 192,661 2027 189,653 Thereafter 1,001,323 Total $ 2,009,419
Schedule Of Tenant Purchase Options	Certain of the Company’s operators hold purchase options allowing them to acquire properties they currently lease from the Company. A summary of these purchase options is presented below (dollars in thousands): Asset Type Properties Lease Expiration Next Option Open Date Option Type (1) Current Cash Rent (2) ALF 5 (6) October 2034 1/1/2023 (3) A $ 2,287 SNF 11 November 2030 1/1/2023 (3) C 5,092 SNF 1 March 2029 4/1/2022 (4) B / C (5) 805 SNF / Campus 2 October 2032 1/1/2023 (3) B 1,065 SNF 4 November 2034 12/1/2024 (4) B 3,796 ALF 2 (6) October 2034 1/1/2026 (3) A 1,598 (1) Option type includes: A - Fixed base price plus a specified share on any appreciation. B - Fixed base price. C - Fixed capitalization rate on lease revenue. (2) Based on annualized cash revenue for contracts in place as of September 30, 2022. (3) Option window is open for six months. (4) Option window is open until the expiration of the lease term. (5) Purchase option reflects two option types. (6) Includes properties classified as held for sale as of September 30, 2022.
Schedule of Rental Income	The following table summarizes components of the Company’s rental income (dollars in thousands): For the Three Months Ended September 30, For the Nine Months Ended September 30, Rental Income 2022 2021 2022 2021 Contractual rent due (1) $ 47,015 $ 48,081 $ 140,794 $ 140,988 Straight-line rent 3 6 14 26 Adjustment for collectibility (2) — — (977) — Lease termination revenue (3) — — — 63 Total $ 47,018 $ 48,087 $ 139,831 $ 141,077 (1) Includes initial contractual cash rent and tenant operating expense reimbursements, as adjusted for applicable rental escalators and rent increases due to capital expenditures funded by the Company. For tenants on a cash basis, this represents the lesser of the amount that would be recognized on a straight-line basis or cash that has been received. Tenant operating expense reimbursements for the three months ended September 30, 2022 and 2021 were $0.7 million and $1.0 million, respectively. Tenant operating expense reimbursements for the nine months ended September 30, 2022 and 2021 were $2.0 million and $2.5 million, respectively. ( 2) During the nine months ended September 30, 2022, and in accordance with Accounting Standards Codification 842, the Company evaluated the collectibility of lease payments through maturity and determined that it was not probable that the Company would collect substantially all of the contractual obligations from four existing and former operators. As such, the Company reversed $0.7 million of operating expense reimbursements, $0.2 million of contractual rent and $0.1 million of straight-line rent during the nine months ended September 30, 2022. If lease payments are subsequently deemed probable of collection, the Company will increase rental income for such recoveries. (3) During the nine months ended
Schedule of Real Estate Acquisitions	The following table summarizes the Company’s acquisitions for the nine months ended September 30, 2022 (dollars in thousands): Type of Property Purchase Price (1) Initial Annual Cash Rent Number of Properties Number of Beds/Units (2) Skilled nursing $ 8,918 $ 815 1 135 Multi-service campuses 13,003 1,235 1 130 Total $ 21,921 $ 2,050 2 265 (1) Purchase price includes capitalized acquisition costs.

Other Real Estate Related Inv_2

Other Real Estate Related Investments, At Fair Value, And Other Loans Receivable (Tables)	9 Months Ended
	Sep. 30, 2022
Investments, All Other Investments [Abstract]
Schedule of Other Real Estate Related Investments, At Fair Value	As of September 30, 2022 and December 31, 2021, the Company’s other real estate related investments, at fair value, consisted of the following (dollars in thousands): As of September 30, 2022 Investment Facility Count and Type Principal Balance as of September 30, 2022 Book Value as of September 30, 2022 Book Value as of December 31, 2021 Weighted Average Contractual Interest Rate Maturity Date Senior secured loan receivable 18 SNF/Campus $ 75,000 $ 72,525 $ — 8.4 % [1] 6/30/2027 Secured loan receivable 5 SNF 22,250 22,423 — 9.6 % [2] 8/1/2025 Secured loan receivable 4 SNF 24,900 25,043 — 9.0 % [2] 9/8/2025 Mezzanine loan receivable 9 SNF 15,000 14,667 15,155 12.0 % 11/30/2025 Mezzanine loan receivable 18 SNF/Campus 25,000 24,004 — 11.0 % 6/30/2032 $ 162,150 $ 158,662 $ 15,155 [1] Rate is net of subservicing fee. [2] Term secured overnight financing rate (“SOFR”) used as of September 30, 2022 was 3.02%. Rates are net of subservicing fees.
Schedule of Other Real Estate Related Investment Activity	The following table summarizes the Company’s other real estate related investments activity for the nine months ended September 30, 2022 and 2021 (dollars in thousands): Nine Months Ended September 30, 2022 2021 Origination of other real estate related investments $ 147,150 $ — Accrued interest, net 1,063 150 Unrealized loss on other real estate related investments (4,706) — Net increase in other real estate related investments, at fair value $ 143,507 $ 150 As of September 30, 2022 and December 31, 2021, the Company’s other loans receivable, included in prepaid expenses and other assets, net on the Company’s condensed consolidated balance sheets, consisted of the following (dollars in thousands): As of September 30, 2022 Investment Principal Balance as of September 30, 2022 Book Value as of September 30, 2022 Book Value as of December 31, 2021 Weighted Average Contractual Interest Rate Maturity Date Other loans receivable $ 14,738 $ 14,742 $ 3,161 8.5 % 11/29/2022 - 9/30/2025 Expected credit loss (2,094) (2,094) — Total $ 12,644 $ 12,648 $ 3,161
Schedule of Loan Receivable Activity	The following table summarizes the Company’s other loans receivable activity for the nine months ended September 30, 2022 and 2021 (dollars in thousands): Nine Months Ended September 30, 2022 2021 Origination of loans receivable $ 14,500 $ 700 Principal payments (416) (172) Accrued interest, net (3) 39 Expected credit loss (5,344) — Loan loss recovery 750 — Net increase in other loans receivable $ 9,487 $ 567
Schedule of Interest and Other Income	The following table summarizes the interest and other income recognized from the Company’s loans receivable and other investments during the three and nine months ended September 30, 2022 and 2021 (dollars in thousands): For the Three Months Ended September 30, For the Nine Months Ended September 30, Investment 2022 2021 2022 2021 Secured loans receivable $ 2,098 $ — $ 2,115 $ — Mezzanine loans receivable 1,163 460 2,326 1,365 Other 14 58 50 172 Total $ 3,275 $ 518 $ 4,491 $ 1,537

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2022
Fair Value Disclosures [Abstract]
Schedule of Items Measured at Fair Value on a Recurring Basis	The following table presents information about the Company’s assets and liabilities measured at fair value on a recurring basis as of September 30, 2022 and December 31, 2021, aggregated by the level in the fair value hierarchy within which those instruments fall (dollars in thousands): Level 1 Level 2 Level 3 Balance as of September 30, 2022 Assets: Secured loans receivable $ — $ — $ 119,991 $ 119,991 Mezzanine loans receivable — — 38,671 38,671 Total $ — $ — $ 158,662 $ 158,662 Level 1 Level 2 Level 3 Balance as of December 31, 2021 Assets: Mezzanine loan receivable $ — $ — $ 15,155 $ 15,155
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation	The following table details the Company’s assets measured at fair value on a recurring basis using Level 3 inputs (dollars in thousands): Investments in Real Estate Secured Loans Investments in Mezzanine Loans Balance at December 31, 2021 $ — $ 15,155 Loan originations 122,150 25,000 Accrued interest, net 839 224 Unrealized loss on other real estate related investments (2,998) (1,708) Balance as of September 30, 2022 $ 119,991 $ 38,671
Schedule of Quantitative Information About Unobservable Inputs Related To Level 3 Fair Value Measurements	The following table shows the quantitative information about unobservable inputs related to the Level 3 fair value measurements comprising the investments in secured and mezzanine loans receivables as of September 30, 2022 : Type Book Value as of September 30, 2022 Valuation Technique Unobservable Inputs Range Secured loans receivable $ 119,991 Discounted cash flow Discount Rate 9% - 13% Mezzanine loans receivable 38,671 Discounted cash flow Discount Rate 12% - 14%
Summary of Face Value, Carrying Amount and Fair Value of Financial Instruments	A summary of the face value, carrying amount and fair value of the Notes (as defined in Note 7, Debt, below) as of September 30, 2022 and December 31, 2021 using Level 2 inputs is as follows (dollars in thousands): September 30, 2022 December 31, 2021 Level Face Carrying Fair Face Carrying Fair Financial liabilities: Senior unsecured notes payable 2 $ 400,000 $ 394,928 $ 331,000 $ 400,000 $ 394,262 $ 410,500

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2022
Debt Disclosure [Abstract]
Schedule of Debt Instruments	The following table summarizes the balance of the Company’s indebtedness as of September 30, 2022 and December 31, 2021 (dollars in thousands): September 30, 2022 December 31, 2021 Principal Amount Deferred Loan Fees Carrying Value Principal Amount Deferred Loan Fees Carrying Value Senior unsecured notes payable $ 400,000 $ (5,072) $ 394,928 $ 400,000 $ (5,738) $ 394,262 Senior unsecured term loan 200,000 (705) 199,295 200,000 (864) 199,136 Unsecured revolving credit facility 180,000 — 180,000 80,000 — 80,000 $ 780,000 $ (5,777) $ 774,223 $ 680,000 $ (6,602) $ 673,398

Equity (Tables)

Equity (Tables)	9 Months Ended
	Sep. 30, 2022
Equity [Abstract]
Summary of the At-The-Market Offering Program	The following table summarizes the ATM Program activity for the nine months ended September 30, 2021 (in thousands, except per share amounts). For the Nine Months Ended September 30, 2021 Number of shares 990 Average sales price per share $ 23.74 Gross proceeds (1) $ 23,505
Schedule of Dividends on Common Stock	The following table summarizes the cash dividends per share of common stock declared by the Company’s Board of Directors for the first nine months of 2022 (dollars in thousands, except per share amounts): For the Three Months Ended March 31, 2022 June 30, 2022 September 30, 2022 Dividends declared per share $ 0.275 $ 0.275 $ 0.275 Dividends payment date April 15, 2022 July 15, 2022 October 14, 2022 Dividends payable as of record date (1) $ 26,691 $ 26,683 $ 26,683 Dividends record date March 31, 2022 June 30, 2022 September 30, 2022

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2022
Share-Based Payment Arrangement [Abstract]
Summary of Restricted Stock Award and Performance Award Activity	The following table summarizes the RSAs and PSAs activity for the nine months ended September 30, 2022: Shares Weighted Average Share Price Unvested balance at December 31, 2021 891,333 $ 20.91 Granted: RSAs 9,684 17.56 Board Awards 25,992 16.93 Vested (501,479) 20.60 Forfeited (1,900) 21.50 Unvested balance at September 30, 2022 423,630 $ 20.96
Schedule of Stock-Based Compensation Expense	The following table summarizes the stock-based compensation expense recognized for the periods presented (dollars in thousands): For the Three Months Ended September 30, For the Nine Months Ended September 30, 2022 2021 2022 2021 Stock-based compensation expense $ 1,380 $ 1,802 $ 4,295 $ 5,197

Earnings (Loss) Per Common Sh_2

Earnings (Loss) Per Common Share (Tables)	9 Months Ended
	Sep. 30, 2022
Earnings Per Share [Abstract]
Reconciliation of Weighted-Average Common Shares Outstanding Used in Calculation of Basic EPS to Diluted EPS	The following table presents the calculation of basic and diluted earnings (loss) per common share (“EPS”) for the Company’s common stock for the three and nine months ended September 30, 2022 and 2021, and reconciles the weighted-average common shares outstanding used in the calculation of basic EPS to the weighted-average common shares outstanding used in the calculation of diluted EPS (amounts in thousands, except per share amounts): For the Three Months Ended September 30, For the Nine Months Ended September 30, 2022 2021 2022 2021 Numerator: Net income (loss) $ 709 $ 11,918 $ (21,886) $ 53,721 Less: Net income allocated to participating securities (94) (116) (305) (350) Numerator for basic and diluted earnings available to common stockholders $ 615 $ 11,802 $ (22,191) $ 53,371 Denominator: Weighted-average basic common shares outstanding 96,605 96,297 96,527 95,922 Dilutive performance stock awards 20 — — 15 Weighted-average diluted common shares outstanding 96,625 96,297 96,527 95,937 Earnings (loss) per common share, basic $ 0.01 $ 0.12 $ (0.23) $ 0.56 Earnings (loss) per common share, diluted $ 0.01 $ 0.12 $ (0.23) $ 0.56 Antidilutive unvested RSAs, PSAs and TSR Awards excluded from the computation 341 535 478 436

Concentration of Risk (Tables)

Concentration of Risk (Tables)	9 Months Ended
	Sep. 30, 2022
Risks and Uncertainties [Abstract]
Schedules of Concentration of Risk	Major operator concentration - The Company has operators from which it derived 10% or more of its rental revenue for the three and nine months ended September 30, 2022 and 2021. The following table sets forth information regarding the Company’s major operators as of September 30, 2022 and 2021: Number of Facilities Number of Beds/Units Percentage of Total Revenue (1) Operator SNF Campus ALF/ILF SNF Campus ALF/ILF Three Months Ended Nine Months Ended September 30, 2022 Ensign (2) 83 8 7 8,741 997 661 36 % 35 % Priority Management Group 13 2 — 1,742 402 — 16 % 16 % September 30, 2021 Ensign (2) 83 8 4 8,756 997 395 33 % 32 % Priority Management Group 13 2 — 1,742 402 — 15 % 15 % (1) The Company’s rental income, exclusive of operating expense reimbursements. (2) Ensign is subject to the registration and reporting requirements of the SEC and is required to file with the SEC annual reports containing audited financial information and quarterly reports containing unaudited financial information. Ensign’s financial statements, as filed with the SEC, can be found at http://www.sec.gov. The Company has not verified this information through an independent investigation or otherwise. Major geographic concentration – The following table provides information regarding the Company’s concentrations with respect to certain states, from which the Company derived 10% or more of its rental revenue for the three and nine months ended September 30, 2022: Number of Facilities Number of Beds/Units Percentage of Total Revenue (1) State SNF Campus ALF/ILF SNF Campus ALF/ILF Three Months Ended September 30, 2022 Nine Months Ended September 30, 2022 CA 27 8 5 3,048 1,359 437 27 % 27 % TX 38 3 3 4,849 536 242 22 % 22 % (1) The Company’s rental income, exclusive of operating expense reimbursements.

Organization (Details)

Organization (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2022 USD ($) loan bed	Sep. 30, 2022 state	Sep. 30, 2022 facility	Dec. 31, 2021 USD ($)
Real Estate Properties [Line Items]
Number of facilities		19	19
Number of states with properties | state		29
Aggregate carrying value | $	$ 158,662			$ 15,155
Secured Loan Receivable
Real Estate Properties [Line Items]
Number of loans	3
Mezzanine loan receivable
Real Estate Properties [Line Items]
Number of loans	2
Skilled nursing, multi-service campuses, assisted living and independent living facilities
Real Estate Properties [Line Items]
Number of facilities | facility			221
Number of operational beds and units in facilities | bed	23,135

Real Estate Investments, Net -

Real Estate Investments, Net - Real Estate Properties Held for Investment (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Real Estate [Abstract]
Land	$ 236,298	$ 251,787
Buildings and improvements	1,437,292	1,622,019
Integral equipment, furniture and fixtures	96,306	104,722
Identified intangible assets	2,832	1,257
Real estate investments	1,772,728	1,979,785
Accumulated depreciation and amortization	(388,562)	(389,814)
Real estate investments, net	$ 1,384,166	$ 1,589,971

Real Estate Investments, Net _2

Real Estate Investments, Net - Narrative (Details)	9 Months Ended
	Sep. 30, 2022 facility	Sep. 30, 2022 lease	Sep. 30, 2022 state	Jun. 30, 2022 lease	Mar. 31, 2022 facility
Real Estate [Line Items]
Number of facilities	19		19
Held for sale
Real Estate [Line Items]
Number of facilities	16				27
Skilled nursing, multi-service campuses, assisted living and independent living facilities
Real Estate [Line Items]
Number of facilities	221
Skilled nursing, multi-service campuses, assisted living and independent living facilities | Minimum
Real Estate [Line Items]
Term of rent commencement (months)	12 months
Skilled nursing, multi-service campuses, assisted living and independent living facilities | Maximum
Real Estate [Line Items]
Term of rent commencement (months)	18 months
Skilled nursing, multi-service campuses, assisted living and independent living facilities | Held for sale
Real Estate [Line Items]
Number of facilities	19
Skilled nursing, multi-service campuses, assisted living and independent living facilities | Short-term lease
Real Estate [Line Items]
Number of facilities	2
Skilled nursing, multi-service campuses, assisted living and independent living facilities | Triple-net leases | Rent Commencing 12 to 18 months
Real Estate [Line Items]
Number of facilities | lease		2		2
Skilled nursing, multi-service campuses, assisted living and independent living facilities | Triple-net leases | Various other operators
Real Estate [Line Items]
Number of facilities	217

Real Estate Investments, Net _3

Real Estate Investments, Net - Future Contractual Minimum Rental Income (Details) $ in Thousands	Sep. 30, 2022 USD ($)
Future Contractual Minimum Rental Income
2022 (three months)	$ 48,193
2023	192,638
2024	192,396
2025	192,555
2026	192,661
2027	189,653
Thereafter	1,001,323
Total	$ 2,009,419

Real Estate Investments, Net _4

Real Estate Investments, Net - Tenant Purchase Options (Details) $ in Thousands	Sep. 30, 2022 USD ($) property
ALF | Lease Expiration October 2034, Next option 2023
Lessor, Lease, Description [Line Items]
Properties | property	5
Current Cash Rent | $	$ 2,287
ALF | Lease Expiration October 2034, Next option 2026
Lessor, Lease, Description [Line Items]
Properties | property	2
Current Cash Rent | $	$ 1,598
SNF | Lease Expiration November 2030, Next option 2023
Lessor, Lease, Description [Line Items]
Properties | property	11
Current Cash Rent | $	$ 5,092
SNF | Lease Expiration March 2029, Next option 2022
Lessor, Lease, Description [Line Items]
Properties | property	1
Current Cash Rent | $	$ 805
SNF | Lease Expiration November 2034, Next option 2024
Lessor, Lease, Description [Line Items]
Properties | property	4
Current Cash Rent | $	$ 3,796
SNF / Campus | Lease Expiration October 2032, Next option 2023
Lessor, Lease, Description [Line Items]
Properties | property	2
Current Cash Rent | $	$ 1,065

Real Estate Investments, Net _5

Real Estate Investments, Net - Rental Income (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($) operator	Sep. 30, 2021 USD ($)
Rental Income
Contractual rent due	$ 47,015	$ 48,081	$ 140,794	$ 140,988
Straight-line rent	3	6	14	26
Adjustments for collectibility	0	0	(977)	0
Lease termination revenue	0	0	0	63
Total	47,018	48,087	139,831	141,077
Tenant operating expense reimbursement	$ 700	$ 1,000	$ 2,000	2,500
Number of existing and former operators with doubtful collectability | operator			4
Metron
Rental Income
Lease termination revenue				$ 100
Operating expense reimbursements
Rental Income
Adjustments for collectability, reversed			$ 700
Contractual rent
Rental Income
Adjustments for collectability, reversed			200
Straight-line rent
Rental Income
Adjustments for collectability, reversed			$ 100

Real Estate Investments, Net _6

Real Estate Investments, Net - Recent Real Estate Acquisitions (Details) $ in Thousands		9 Months Ended
	Mar. 01, 2022 facility	Sep. 30, 2022 USD ($) unit_bed property
Business Acquisition [Line Items]
Purchase Price		$ 21,921
Initial Annual Cash Rent		$ 2,050
Number of Properties | property		2
Number of Beds/Units | unit_bed		265
Skilled nursing
Business Acquisition [Line Items]
Purchase Price		$ 8,918
Initial Annual Cash Rent		$ 815
Number of Properties | property		1
Number of Beds/Units | unit_bed		135
Multi-service campuses
Business Acquisition [Line Items]
Purchase Price		$ 13,003
Initial Annual Cash Rent		$ 1,235
Number of Properties	1	1
Number of Beds/Units | unit_bed		130

Real Estate Investments, Net _7

Real Estate Investments, Net - Lease Amendments Narrative (Details) $ in Millions				9 Months Ended
	Aug. 29, 2022 USD ($) extension_option facility	Mar. 01, 2022 USD ($) facility extension_option	Feb. 01, 2022 USD ($) facility extension_option	Sep. 30, 2022 property	Jun. 16, 2022 USD ($) extension_option facility	Apr. 01, 2022 USD ($) extension_option state facility
Real Estate [Line Items]
Number of properties acquired | property				2
Landmark Maryland
Real Estate [Line Items]
Annual cash rent decrease under amended lease | $	$ 0.5
Term of lease commencement (in months)	18 months
Number of renewal options | extension_option	1
Lease renewal term (in years)	10 years
Landmark Florida
Real Estate [Line Items]
Annual cash rent decrease under amended lease | $					$ 0.6
Number of renewal options | extension_option					1
Lease renewal term (in years)					10 years
Ensign Amended Triple-net Master Lease Combined
Real Estate [Line Items]
Number of renewal options | extension_option						3
Lease renewal term (in years)						5 years
Ensign amended triple-net master lease
Real Estate [Line Items]
Annual cash rent decrease under amended lease | $						$ 0.8
Number of renewal options | extension_option		2
Lease renewal term (in years)		5 years
Initial lease term (in years)		11 years				5 years
Annual cash rent increase under amended lease | $		$ 0.3				$ 0.4
Ensign amended triple-net master lease 2
Real Estate [Line Items]
Initial lease term (in years)						16 years
Eduro amended triple-net master lease
Real Estate [Line Items]
Number of renewal options | extension_option			2
Lease renewal term (in years)			5 years
Initial lease term (in years)			12 years
Annual cash rent increase under amended lease | $			$ 0.8
WLC amended triple-net master lease
Real Estate [Line Items]
Number of renewal options | extension_option		2
Lease renewal term (in years)		5 years
Initial lease term (in years)		12 years
Annual cash rent increase under amended lease | $		$ 1.2
Assisted living
Real Estate [Line Items]
Leases with terminated operations | facility	1				1
Skilled nursing facility
Real Estate [Line Items]
Number of properties acquired | facility			1
Multi-service campuses
Real Estate [Line Items]
Number of properties acquired		1		1
Ensign | Assisted living
Real Estate [Line Items]
Number of properties transferred | facility		1				2
Number of properties removed | state						2
Number of properties included | state						2
Ensign | Triple-net leases
Real Estate [Line Items]
Number of properties amended | state						2

Impairment of Real Estate Inv_2

Impairment of Real Estate Investments, Assets Held for Sale, Net and Asset Sales (Details) $ in Thousands			3 Months Ended			9 Months Ended
	Sep. 29, 2022 USD ($) bed facility	Feb. 22, 2022 USD ($) bed facility	Sep. 30, 2022 USD ($)	Jun. 30, 2022 USD ($) state facility	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2022 facility	Sep. 30, 2022 state	Mar. 31, 2022 facility	Dec. 31, 2021 USD ($)
Real Estate [Line Items]
Number of properties								19	19
Number of properties to be repurposed | facility										3
Contractual cash rent attributable to properties held for sale and repurposed (percent)										10%
Assets held for sale, net			$ 77,708			$ 77,708					$ 4,835
Real estate investment property, at cost			1,772,728			1,772,728					1,979,785
Real estate investments, net			1,384,166			1,384,166					$ 1,589,971
Amount transferred out of assets held-for-sale						4,800
Catch-up depreciation						100
Proceeds from sale						34,115	$ 6,814
Gain (loss) on sale of real estate			(2,287)		$ 0	(2,101)	$ (192)
Term loan | Term Loan with 3 Years Maturity Term
Real Estate [Line Items]
Debt instrument face amount	$ 7,000
Interest rate (percent)	8.50%
Term loan | Term Loan Maturity Date of November 29, 2022
Real Estate [Line Items]
Debt instrument face amount	$ 5,000
Interest rate (percent)	8.50%
ALF
Real Estate [Line Items]
Amount transferred out of assets held-for-sale			4,900
Valuation, market approach | Level 3 | Skilled nursing facility
Real Estate [Line Items]
Prices per unit input				$ 20
Valuation, market approach | Level 3 | ALF
Real Estate [Line Items]
Prices per unit input			125			125
Valuation, market approach | Level 3 | Minimum
Real Estate [Line Items]
Prices per unit input			35			35
Valuation, market approach | Level 3 | Maximum
Real Estate [Line Items]
Prices per unit input			145			145
Valuation, market approach | Level 3 | Weighted average
Real Estate [Line Items]
Prices per unit input			80			80
Held for sale
Real Estate [Line Items]
Number of properties | facility								16		27
Impairment expense to reduce carrying value to fair value less costs to sell			12,300			59,700
Number of properties impaired | facility								20
Held for sale | Skilled nursing facility
Real Estate [Line Items]
Number of properties | state				1
Impairment expense to reduce carrying value to fair value less costs to sell				$ 1,700
Real estate investment property, at cost				2,800
Real estate investments, net				$ 1,100
Held for sale | ALF
Real Estate [Line Items]
Number of properties | facility								1		1
Held for sale | Trio Healthcare Holdings, LLC | Skilled nursing
Real Estate [Line Items]
Number of properties | facility	6
Held for sale | Trio Healthcare Holdings, LLC | Multi-service campuses
Real Estate [Line Items]
Number of properties | facility	1
Disposed of by sale | Skilled nursing facility
Real Estate [Line Items]
Number of properties | facility		1
Real estate investment property, at cost		$ 800
Number of operational beds | bed		83
Proceeds from sale		$ 1,000
Gain (loss) on sale of real estate						$ 200
Disposed of by sale | Trio Healthcare Holdings, LLC
Real Estate [Line Items]
Number of properties | facility				7
Real estate investment property, at cost				$ 46,900
Number of operational beds | bed	708
Proceeds from sale	$ 32,800
Gain (loss) on sale of real estate			$ 2,100

Other Real Estate Related Inv_3

Other Real Estate Related Investments, At Fair Value, And Other Loans Receivable - Other Real Estate Related Investments, At Fair Value (Details)	9 Months Ended
	Sep. 30, 2022 USD ($) facility	Dec. 31, 2021 USD ($) facility
Real Estate Properties [Line Items]
Principal Amount	$ 162,150,000
Book value	158,662,000	$ 15,155,000
Expected credit loss		0
Senior secured loan receivable
Real Estate Properties [Line Items]
Principal Amount	75,000,000
Book value	$ 72,525,000	$ 0
Weighted Average Contractual Interest Rate	8.40%
Senior secured loan receivable | Skilled nursing and campus facilities
Real Estate Properties [Line Items]
Facility Count and Type | facility	18	18
Secured loan receivable
Real Estate Properties [Line Items]
Principal Amount	$ 22,250,000
Book value	$ 22,423,000	$ 0
Weighted Average Contractual Interest Rate	9.60%
Secured loan receivable | SOFR
Real Estate Properties [Line Items]
Basis spread on variable rate (percent)	3.02%
Secured loan receivable | Skilled nursing facility
Real Estate Properties [Line Items]
Facility Count and Type | facility	5	5
Secured loan receivable
Real Estate Properties [Line Items]
Principal Amount	$ 24,900,000
Book value	$ 25,043,000	$ 0
Weighted Average Contractual Interest Rate	9%
Secured loan receivable | Skilled nursing facility
Real Estate Properties [Line Items]
Facility Count and Type | facility	4	4
Mezzanine loan receivable
Real Estate Properties [Line Items]
Principal Amount	$ 15,000,000
Book value	$ 14,667,000	$ 15,155,000
Weighted Average Contractual Interest Rate	12%
Mezzanine loan receivable | Skilled nursing facility
Real Estate Properties [Line Items]
Facility Count and Type | facility	9	9
Mezzanine loan receivable
Real Estate Properties [Line Items]
Principal Amount	$ 25,000,000
Book value	$ 24,004,000	$ 0
Weighted Average Contractual Interest Rate	11%
Mezzanine loan receivable | Skilled nursing and campus facilities
Real Estate Properties [Line Items]
Facility Count and Type | facility	18	18
Other
Real Estate Properties [Line Items]
Principal Amount	$ 14,738,000
Book value	14,742,000	$ 3,161,000
Expected credit loss	(2,094,000)	0
Principal amount after allowance for credit loss	12,644,000
Net increase in other real estate related investments, at fair value	$ 12,648,000	$ 3,161,000
Weighted Average Contractual Interest Rate	8.50%

Other Real Estate Related Inv_4

Other Real Estate Related Investments, At Fair Value, And Other Loans Receivable - Other Real Estate Related Investment Activity (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Sep. 30, 2021
Financing Receivable, Allowance for Credit Loss [Line Items]
Origination of other real estate related investments	$ 162,150
Other Real Estate Related Investments
Financing Receivable, Allowance for Credit Loss [Line Items]
Origination of other real estate related investments	147,150	$ 0
Accrued interest, net	1,063	150
Unrealized loss on other real estate related investments	(4,706)	0
Net increase in other real estate related investments, at fair value	$ 143,507	$ 150

Other Real Estate Related Inv_5

Other Real Estate Related Investments, At Fair Value, And Other Loans Receivable - Narrative (Details)	1 Months Ended			3 Months Ended		9 Months Ended
	Sep. 30, 2022 USD ($) facility extension_option	Aug. 31, 2022 USD ($) facility operator extension_option	Jun. 30, 2022 USD ($) facility	Sep. 30, 2022 USD ($) loan	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($) loan	Sep. 30, 2021 USD ($)	Dec. 31, 2021 USD ($)
Financing Receivable, Allowance for Credit Loss [Line Items]
Principal amount	$ 162,150,000			$ 162,150,000		$ 162,150,000
Number operated by existing operator | operator		4
Number operated by large, regional operator | operator		1
Expected credit loss				0	$ 0	3,844,000	$ 0
Expected credit loss								$ 0
Skilled nursing facility
Financing Receivable, Allowance for Credit Loss [Line Items]
Number of facilities acquired | facility	4
Skilled nursing facility | Next WV Realty, LLC
Financing Receivable, Allowance for Credit Loss [Line Items]
Number of facilities acquired | facility			18
Secured Loan Receivable
Financing Receivable, Allowance for Credit Loss [Line Items]
Principal amount	$ 24,900,000	$ 22,300,000		24,900,000		24,900,000
Number of extension option | extension_option	2	2
Extension option, term (year)	1 year	1 year
Earnout advance	$ 4,700,000			$ 4,700,000		$ 4,700,000
Subservicing fee percentage	100%	50%		100%		100%
Secured Loan Receivable | SOFR
Financing Receivable, Allowance for Credit Loss [Line Items]
Monthly payment interest rate	4.50%	4.25%
Secured Loan Receivable | SOFR Floor
Financing Receivable, Allowance for Credit Loss [Line Items]
Floor rate	1%	1%
Secured Loan Receivable | Next WV Realty, LLC
Financing Receivable, Allowance for Credit Loss [Line Items]
Principal amount			$ 75,000,000
Loan receivable interest rate			8.50%
Servicing fee threshold			8.25%
Effective rate			8.375%
Secured Loan Receivable | Minimum
Financing Receivable, Allowance for Credit Loss [Line Items]
Early termination fee	1%	2%		1%		1%
Subservicing fee percentage	9%	8.25%		9%		9%
Secured Loan Receivable | Minimum | Next WV Realty, LLC
Financing Receivable, Allowance for Credit Loss [Line Items]
Early termination fee			1%
Secured Loan Receivable | Maximum
Financing Receivable, Allowance for Credit Loss [Line Items]
Early termination fee	3%	3%		3%		3%
Secured Loan Receivable | Maximum | Next WV Realty, LLC
Financing Receivable, Allowance for Credit Loss [Line Items]
Early termination fee			3%
Secured Loan Receivable | Weighted average | SOFR
Financing Receivable, Allowance for Credit Loss [Line Items]
Monthly payment interest rate	2.85%	2.75%
Mezzanine loan receivable
Financing Receivable, Allowance for Credit Loss [Line Items]
Principal amount	$ 15,000,000			$ 15,000,000		$ 15,000,000
Mezzanine loan receivable | Next WV Realty, LLC
Financing Receivable, Allowance for Credit Loss [Line Items]
Principal amount			$ 25,000,000
Loan receivable interest rate			11%
Mezzanine loan receivable | Minimum | Next WV Realty, LLC
Financing Receivable, Allowance for Credit Loss [Line Items]
Early termination fee			1%
Mezzanine loan receivable | Maximum | Next WV Realty, LLC
Financing Receivable, Allowance for Credit Loss [Line Items]
Early termination fee			3%
Other
Financing Receivable, Allowance for Credit Loss [Line Items]
Principal amount	14,738,000			$ 14,738,000		14,738,000
Expected credit loss						$ 4,600,000
Number of loans receivable with provision | loan				1		2
Write-off				$ 2,500,000
Loan loss recovery						$ 800,000
Expected credit loss	$ 2,094,000			$ 2,094,000		$ 2,094,000		$ 0
B Tranche Mortgage Loan
Financing Receivable, Allowance for Credit Loss [Line Items]
Number of facilities acquired by borrower | facility		5

Other Real Estate Related Inv_6

Other Real Estate Related Investments, At Fair Value, And Other Loans Receivable - Loan Activity (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Investments, All Other Investments [Abstract]
Origination of loans receivable	$ 14,500	$ 700
Principal payments	(416)	(172)
Accrued interest, net	(3)	39
Expected credit loss	(5,344)	0
Loan loss recovery	750	0
Net increase in other loans receivable	$ 9,487	$ 567

Other Real Estate Related Inv_7

Other Real Estate Related Investments, At Fair Value, And Other Loans Receivable - Interest and Other Income (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Real Estate Properties [Line Items]
Interest and other income	$ 3,275	$ 518	$ 4,491	$ 1,537
Secured Loan Receivable
Real Estate Properties [Line Items]
Interest and other income	2,098	0	2,115	0
Mezzanine loan receivable
Real Estate Properties [Line Items]
Interest and other income	1,163	460	2,326	1,365
Other
Real Estate Properties [Line Items]
Interest and other income	$ 14	$ 58	$ 50	$ 172

Fair Value Measurements - Items

Fair Value Measurements - Items Measured at Fair Value on Recurring Basis (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Senior Secured and Mezzanine Loans Receivable
Assets:
Loan receivable	$ 158,662
Recurring | Secured Loan Receivable
Assets:
Loan receivable	119,991
Recurring | Mezzanine loan receivable
Assets:
Loan receivable	38,671	$ 15,155
Recurring | Level 1 | Senior Secured and Mezzanine Loans Receivable
Assets:
Loan receivable	0
Recurring | Level 1 | Secured Loan Receivable
Assets:
Loan receivable	0
Recurring | Level 1 | Mezzanine loan receivable
Assets:
Loan receivable	0	0
Recurring | Level 2 | Senior Secured and Mezzanine Loans Receivable
Assets:
Loan receivable	0
Recurring | Level 2 | Secured Loan Receivable
Assets:
Loan receivable	0
Recurring | Level 2 | Mezzanine loan receivable
Assets:
Loan receivable	0	0
Recurring | Level 3 | Senior Secured and Mezzanine Loans Receivable
Assets:
Loan receivable	158,662
Recurring | Level 3 | Secured Loan Receivable
Assets:
Loan receivable	119,991
Recurring | Level 3 | Mezzanine loan receivable
Assets:
Loan receivable	$ 38,671	$ 15,155

Fair Value Measurements - Asset

Fair Value Measurements - Assets at Fair Value Measured Using Level 3 (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Unrealized loss on other real estate related investments	$ 4,706	$ 0	$ 4,706	$ 0
Investments in Real Estate Secured Loans
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance at December 31, 2021			0
Loan originations			122,150
Accrued interest, net			839
Unrealized loss on other real estate related investments			(2,998)
Balance as of September 30, 2022	119,991		119,991
Investments in Mezzanine Loans
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance at December 31, 2021			15,155
Loan originations			25,000
Accrued interest, net			224
Unrealized loss on other real estate related investments			(1,708)
Balance as of September 30, 2022	$ 38,671		$ 38,671

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Financing Receivable, Past Due [Line Items]
Unrealized loss on other real estate related investments	$ (4,706,000)	$ 0	$ (4,706,000)	$ 0
Mortgage loan receivable	158,662,000		158,662,000		$ 15,155,000
Secured And Mezzanine Loans Receivable
Financing Receivable, Past Due [Line Items]
Unrealized loss on other real estate related investments	(4,700,000)
Greater than 90 days past due
Financing Receivable, Past Due [Line Items]
Mortgage loan receivable	$ 0		$ 0		$ 0

Fair Value Measurements - Quant

Fair Value Measurements - Quantitative Information About Unobservable Inputs Related To Level 3 Fair Value Measurements (Details) - Level 3 - Measurement Input, Discount Rate - Valuation Technique, Discounted Cash Flow $ in Thousands	Sep. 30, 2022 USD ($)
Secured Loan Receivable
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Loans receivable, book value	$ 119,991
Secured Loan Receivable | Minimum
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Loans receivable, measurement input	0.09
Secured Loan Receivable | Maximum
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Loans receivable, measurement input	0.13
Mezzanine loan receivable
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Loans receivable, book value	$ 38,671
Mezzanine loan receivable | Minimum
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Loans receivable, measurement input	0.12
Mezzanine loan receivable | Maximum
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Loans receivable, measurement input	0.14

Fair Value Measurements - Face

Fair Value Measurements - Face Value, Carrying Amount and Fair Value of Financial Instruments (Details) - Level 2 - Senior unsecured notes payable - Senior unsecured notes payable - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Financial liabilities:
Face Value	$ 400,000	$ 400,000
Carrying Amount
Financial liabilities:
Notes payable, fair value disclosure	394,928	394,262
Fair Value
Financial liabilities:
Notes payable, fair value disclosure	$ 331,000	$ 410,500

Debt - Schedule of Debt (Detail

Debt - Schedule of Debt (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Principal Amount	$ 780,000	$ 680,000
Deferred Loan Fees	(5,777)	(6,602)
Carrying Value	774,223	673,398
Revolving credit facility
Debt Instrument [Line Items]
Principal Amount	180,000	80,000
Deferred Loan Fees	0	0
Carrying Value	180,000	80,000
Notes payable | Senior unsecured notes payable
Debt Instrument [Line Items]
Principal Amount	400,000	400,000
Deferred Loan Fees	(5,072)	(5,738)
Carrying Value	394,928	394,262
Term loan | Senior unsecured term loan
Debt Instrument [Line Items]
Principal Amount	200,000	200,000
Deferred Loan Fees	(705)	(864)
Carrying Value	$ 199,295	$ 199,136

Debt - Senior Unsecured Notes P

Debt - Senior Unsecured Notes Payable Narrative (Details) - USD ($)		9 Months Ended
	Jun. 17, 2021	Sep. 30, 2022	Sep. 30, 2021
Debt Instrument [Line Items]
Gross proceeds from issuance		$ 0	$ 400,000,000
Notes payable | 2028 Senior Notes
Debt Instrument [Line Items]
Debt instrument face amount	$ 400,000,000
Interest rate (percent)	3.875%
Gross proceeds from issuance	$ 400,000,000
Net proceeds from issuance	$ 393,800,000
Redemption price, percentage upon change of control (percent)	101%
Notes payable | 2028 Senior Notes | Period prior to March 30 2028
Debt Instrument [Line Items]
Redemption price of notes (percent)	100%
Notes payable | 2028 Senior Notes | Period after March 30 2028
Debt Instrument [Line Items]
Redemption price of notes (percent)	100%
Notes payable | 2028 Senior Notes | Period prior to June 30 2024
Debt Instrument [Line Items]
Redemption price of notes (percent)	103.875%
Percentage of principal amount (percent)	40%

Debt - Unsecured Revolving Cred

Debt - Unsecured Revolving Credit Facility and Term Loan Narrative (Details)	Feb. 08, 2019 USD ($) extension_option	Sep. 30, 2022 USD ($)	Dec. 31, 2021 USD ($)
Line of Credit Facility [Line Items]
Outstanding amounts		$ 780,000,000	$ 680,000,000
Borrowings outstanding		180,000,000	80,000,000
Revolving credit facility
Line of Credit Facility [Line Items]
Credit facility borrowing capacity	$ 600,000,000
Outstanding amounts		180,000,000	80,000,000
Borrowings outstanding		180,000,000
Number of extension options | extension_option	2
Extension option term (in months)	6 months
Revolving credit facility | Minimum
Line of Credit Facility [Line Items]
Facility fee on revolving commitment fees (percent)	0.15%
Facility fee on revolving commitment fee based on investment grade ratings (percent)	0.125%
Revolving credit facility | Minimum | Base Rate
Line of Credit Facility [Line Items]
Basis spread on variable rate (percent)	0.10%
Revolving credit facility | Minimum | LIBOR
Line of Credit Facility [Line Items]
Basis spread on variable rate (percent)	1.10%
Revolving credit facility | Maximum
Line of Credit Facility [Line Items]
Facility fee on revolving commitment fees (percent)	0.35%
Facility fee on revolving commitment fee based on investment grade ratings (percent)	0.30%
Revolving credit facility | Maximum | Base Rate
Line of Credit Facility [Line Items]
Basis spread on variable rate (percent)	0.55%
Revolving credit facility | Maximum | LIBOR
Line of Credit Facility [Line Items]
Basis spread on variable rate (percent)	1.55%
Letter of credit
Line of Credit Facility [Line Items]
Subfacility capacity as percentage of available revolving commitments (percent)	10%
Swingline loan
Line of Credit Facility [Line Items]
Subfacility capacity as percentage of available revolving commitments (percent)	10%
Term loan | Senior unsecured term loan
Line of Credit Facility [Line Items]
Debt instrument face amount	$ 200,000,000
Outstanding amounts		$ 200,000,000	$ 200,000,000
Term loan | Senior unsecured term loan | Minimum | Base Rate
Line of Credit Facility [Line Items]
Basis spread on variable rate (percent)	0.50%
Term loan | Senior unsecured term loan | Minimum | LIBOR
Line of Credit Facility [Line Items]
Basis spread on variable rate (percent)	1.50%
Term loan | Senior unsecured term loan | Maximum | Base Rate
Line of Credit Facility [Line Items]
Basis spread on variable rate (percent)	1.20%
Term loan | Senior unsecured term loan | Maximum | LIBOR
Line of Credit Facility [Line Items]
Basis spread on variable rate (percent)	2.20%

Equity - Narrative (Details)

Equity - Narrative (Details) - USD ($)	3 Months Ended		6 Months Ended	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2022	Sep. 30, 2021	Mar. 20, 2020	Mar. 10, 2020
Class of Stock [Line Items]
Share repurchase program authorization						$ 150,000,000
Shares repurchased (in shares)			0
Remaining available authorization	$ 150,000,000		$ 150,000,000	$ 150,000,000
ATM Program
Class of Stock [Line Items]
Issuance of common stock, net, (in shares)	0	0		0	990,000
Remaining offering amount available	$ 476,500,000		$ 476,500,000	$ 476,500,000
ATM Program | Maximum
Class of Stock [Line Items]
Authorized aggregate offering price of common stock							$ 500,000,000

Equity - At-The-Market Offering

Equity - At-The-Market Offering (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Class of Stock [Line Items]
Gross proceeds			$ 0	$ 22,946
ATM Program
Class of Stock [Line Items]
Number of shares	0	0	0	990,000
Average sales price per share (in usd per share)				$ 23.74
Gross proceeds				$ 23,505
Commissions paid on stock issuance				$ 300

Equity - Dividends on Common St

Equity - Dividends on Common Stock (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021
Dividends on common stock
Dividends declared per share	$ 0.275	$ 0.275	$ 0.275	$ 0.265	$ 0.265	$ 0.265
Dividends payment date	Oct. 14, 2022	Jul. 15, 2022	Apr. 15, 2022
Dividends payable as of record date	$ 26,683	$ 26,683	$ 26,691
Dividends record date	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022

Stock-Based Compensation - Narr

Stock-Based Compensation - Narrative (Details) $ in Millions	9 Months Ended
	Sep. 30, 2022 USD ($) shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares authorized for awards | shares	5,000,000
Unamortized stock-based compensation expense | $	$ 7.6
RSAs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)	3 years
Performance Stock Awards | Minimum | Vesting Period Range One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)	1 year
Performance Stock Awards | Minimum | Vesting Period Range Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)	1 year
Performance Stock Awards | Maximum | Vesting Period Range One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)	3 years
Performance Stock Awards | Maximum | Vesting Period Range Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)	4 years
RSAs and PSAs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted-average remaining vesting period (in years)	1 year 7 months 6 days

Stock-Based Compensation - Rest

Stock-Based Compensation - Restricted Stock and Performance Awards Activity (Details)	9 Months Ended
	Sep. 30, 2022 $ / shares shares
Shares
Unvested, beginning balance (in shares) | shares	891,333
Vested (in shares) | shares	(501,479)
Forfeited (in shares) | shares	(1,900)
Unvested, ending balance (in shares) | shares	423,630
Weighted Average Share Price
Unvested, beginning balance (in usd per share) | $ / shares	$ 20.91
Vested (in usd per share) | $ / shares	20.60
Forfeited (in usd per share) | $ / shares	21.50
Unvested, ending balance (in usd per share) | $ / shares	$ 20.96
RSAs
Shares
Granted (in shares) | shares	9,684
Weighted Average Share Price
Granted (in usd per share) | $ / shares	$ 17.56
Board Awards
Shares
Granted (in shares) | shares	25,992
Weighted Average Share Price
Granted (in usd per share) | $ / shares	$ 16.93

Stock-Based Compensation - Stoc

Stock-Based Compensation - Stock-Based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Share-Based Payment Arrangement [Abstract]
Stock-based compensation expense	$ 1,380	$ 1,802	$ 4,295	$ 5,197

Earnings (Loss) Per Common Sh_3

Earnings (Loss) Per Common Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Sep. 30, 2022	Sep. 30, 2021
Numerator:
Net income (loss)	$ 709	$ 20,669	$ (43,264)	$ 11,918	$ 21,317	$ 20,486	$ (21,886)	$ 53,721
Less: Net income allocated to participating securities	(94)			(116)			(305)	(350)
Numerator for basic earnings available to common stockholders	615			11,802			(22,191)	53,371
Numerator for diluted earnings available to common stockholders	$ 615			$ 11,802			$ (22,191)	$ 53,371
Denominator:
Weighted-average basic common shares outstanding (in shares)	96,605			96,297			96,527	95,922
Dilutive performance stock awards (in shares)	20			0			0	15
Weighted-average diluted common shares outstanding (in shares)	96,625			96,297			96,527	95,937
Earnings (loss) per common share, basic (in usd per share)	$ 0.01			$ 0.12			$ (0.23)	$ 0.56
Earnings (loss) per common share, diluted (in usd per share)	$ 0.01			$ 0.12			$ (0.23)	$ 0.56
Antidilutive unvested RSAs, PSAs and TSR Awards excluded from the computation (in shares)	341			535			478	436

Commitments and Contingencies (

Commitments and Contingencies (Details) $ in Millions	Sep. 30, 2022 USD ($)
Certain capital improvements at triple-net leased facilities
Other Commitments [Line Items]
Funding commitment	$ 16.1
Portion of funding commitment subject to rent increase at time of funding	$ 3.9
Ensign and Pennant
Other Commitments [Line Items]
Aggregate required financing of capital expenditures as percentage of initial investment in property (percent)	20%

Concentration of Risk (Details)

Concentration of Risk (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2022 facility bed unit_bed	Sep. 30, 2021 bed facility	Sep. 30, 2022 facility bed unit_bed	Sep. 30, 2021 bed facility
CA | SNF
Concentration Risk [Line Items]
Number of Facilities	27		27
Number of Beds/Units | unit_bed	3,048		3,048
CA | Campus
Concentration Risk [Line Items]
Number of Facilities	8		8
Number of Beds/Units | unit_bed	1,359		1,359
CA | ALF/ILF
Concentration Risk [Line Items]
Number of Facilities	5		5
Number of Beds/Units | unit_bed	437		437
CA | Rental revenue | Geographic concentration risk
Concentration Risk [Line Items]
Percentage of Total Revenue	27%		27%
TX | SNF
Concentration Risk [Line Items]
Number of Facilities	38		38
Number of Beds/Units | unit_bed	4,849		4,849
TX | Campus
Concentration Risk [Line Items]
Number of Facilities	3		3
Number of Beds/Units | unit_bed	536		536
TX | ALF/ILF
Concentration Risk [Line Items]
Number of Facilities	3		3
Number of Beds/Units | unit_bed	242		242
TX | Rental revenue | Geographic concentration risk
Concentration Risk [Line Items]
Percentage of Total Revenue	22%		22%
Ensign | SNF
Concentration Risk [Line Items]
Number of Facilities	83	83	83	83
Number of Beds/Units | bed	8,741	8,756	8,741	8,756
Ensign | Campus
Concentration Risk [Line Items]
Number of Facilities	8	8	8	8
Number of Beds/Units | bed	997	997	997	997
Ensign | ALF/ILF
Concentration Risk [Line Items]
Number of Facilities	7	4	7	4
Number of Beds/Units | bed	661	395	661	395
Ensign | Rental revenue | Customer concentration risk
Concentration Risk [Line Items]
Percentage of Total Revenue	36%	33%	35%	32%
Priority Management Group | SNF
Concentration Risk [Line Items]
Number of Facilities	13	13	13	13
Number of Beds/Units | bed	1,742	1,742	1,742	1,742
Priority Management Group | Campus
Concentration Risk [Line Items]
Number of Facilities	2	2	2	2
Number of Beds/Units | bed	402	402	402	402
Priority Management Group | ALF/ILF
Concentration Risk [Line Items]
Number of Facilities	0	0	0	0
Number of Beds/Units | bed	0	0	0	0
Priority Management Group | Rental revenue | Customer concentration risk
Concentration Risk [Line Items]
Percentage of Total Revenue	16%	15%	16%	15%