National Health Investors (NHI) 10-Q 8 Nov 21 2021 FY Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	9 Months Ended
	Sep. 30, 2021	Nov. 01, 2021
Document And Entity Information [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2021
Document Transition Report	false
Entity File Number	001-10822
Entity Registrant Name	National Health Investors Inc
Entity Incorporation, State or Country Code	MD
Entity Tax Identification Number	62-1470956
Entity Address, Address Line One	222 Robert Rose Drive
Entity Address, City or Town	Murfreesboro
Entity Address, State or Province	TN
Entity Address, Postal Zip Code	37129
City Area Code	(615)
Local Phone Number	890-9100
Title of 12(b) Security	Common Stock, $0.01 par value
Trading Symbol	NHI
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		45,850,599
Amendment Flag	false
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	FY
Entity Central Index Key	0000877860
Current Fiscal Year End Date	--12-31

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020	Sep. 30, 2020
Assets:
Land	$ 200,559	$ 220,361
Buildings and improvements	2,818,321	3,041,616
Construction in progress	2,784	3,093
Real estate properties, gross	3,021,664	3,265,070
Less accumulated depreciation	(593,215)	(597,638)
Real estate properties, net	2,428,449	2,667,432
Mortgage and other notes receivable, net	284,608	292,427
Cash and cash equivalents	48,393	43,344
Straight-line rent receivable	99,895	95,703
Assets held for sale, net	17,443		$ 0
Other assets	33,389	21,583
Total Assets	2,912,177	3,120,489
Liabilities and Stockholders' Equity:
Debt	1,285,287	1,499,285
Accounts payable and accrued expenses	20,886	25,189
Dividends Payable	41,266	49,818
Lease deposit liabilities	8,838	10,638
Deferred income	6,694	12,614
Total Liabilities	1,362,971	1,597,544
Commitments and Contingencies
National Health Investors, Inc. Stockholders' Equity:
Common stock, $.01 par value; 60,000,000 shares authorized; 43,357,018 and 42,700,411 shares issued and outstanding, respectively	459	452
Capital in excess of par value	1,590,194	1,540,946
Cumulative net income in excess of dividends	(49,768)	(22,015)
Accumulated other comprehensive income	(1,828)	(7,149)
Total National Health Investors, Inc. Stockholders' Equity	1,539,057	1,512,234
Noncontrolling interest	10,149	10,711
Total Equity	1,549,206	1,522,945	$ 1,504,002
Total Liabilities and Equity	$ 2,912,177	$ 3,120,489

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Statement of Financial Position [Abstract]
Financing Receivable, Allowance for Credit Loss	$ 5,139	$ 4,946
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	100,000,000	100,000,000
Common stock, shares issued	45,850,599	45,185,992
Common stock, shares outstanding	45,850,599	45,185,992

Consolidated Statements Of Inco

Consolidated Statements Of Income - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Revenues:
Lease Income	$ 67,043	$ 77,821	$ 210,143	$ 232,266
Interest income and other	6,790	6,480	18,905	19,306
Revenues	73,833	84,301	229,048	251,572
Expenses:
Depreciation	20,035	20,836	61,499	62,126
Interest	12,715	12,892	38,528	40,589
Legal	117	241	207	826
Franchise, excise and other taxes	244	164	709	553
General and administrative	3,650	2,785	15,229	10,127
Property taxes and insurance on leased properties	3,182	4,187	7,519	7,190
Loan and realty losses	22,425	(193)	23,596	1,002
Total operating expenses	62,368	40,912	147,287	122,413
Income (Loss) from Equity Method Investments	(557)	(728)	(2,274)	(2,018)
Gains (Losses) on Sales of Investment Real Estate	19,941	0	26,426	21,007
Net income	30,849	42,661	105,462	148,148
Less: net loss attributable to noncontrolling interest	(35)	(66)	(135)	(162)
Net income	$ 30,814	$ 42,595	$ 105,327	$ 147,986
Weighted average common shares outstanding:
Basic	45,850,599	44,661,650	45,668,762	44,641,748
Diluted	45,851,424	44,662,403	45,689,091	44,643,514
Basic:
Net income attributable to common stockholders - basic	$ 0.67	$ 0.95	$ 2.31	$ 3.31
Diluted:
Net income attributable to common stockholders - diluted	$ 0.67	$ 0.95	$ 2.31	$ 3.31
Gains (Losses) on Sales of Investment Real Estate	$ 19,941	$ 0	$ 26,426	$ 21,007
Gain (Loss) on Extinguishment of Debt	$ 0	$ 0	(451)	$ 0
$100M Term Loan [Member]
Gain (Loss) on Extinguishment of Debt			$ (451)

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Statement of Comprehensive Income [Abstract]
Net income	$ 30,849	$ 42,661	$ 105,462	$ 148,148
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), after Reclassification and Tax	(46)	92	(128)	(9,966)
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax	(1,851)	(1,778)	(5,449)	(4,533)
Other comprehensive income (loss):
Total other comprehensive income (loss)	1,805	1,870	5,321	(5,433)
Comprehensive income	32,654	44,531	110,783	142,715
Comprehensive Income (Loss), Net of Tax, Attributable to Noncontrolling Interest	35	66	135	162
Comprehensive income	$ 32,619	$ 44,465	$ 110,648	$ 142,553

Consolidated Statements Of Cash

Consolidated Statements Of Cash Flows - USD ($)	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Cash flows from operating activities:
Net income	$ 105,462,000	$ 148,148,000
Changes in operating assets and liabilities:
Depreciation	61,499,000	62,126,000
Amortization of Debt Issuance Costs	3,281,000	3,775,000
Amortization of commitment fees	(645,000)	(581,000)
Amortization of lease incentives	774,000	735,000
Straight-line rental income	(12,189,000)	(15,481,000)
Non-cash interest income on construction loan	(1,351,000)	(2,865,000)
Gains (Losses) on Sales of Investment Real Estate	(26,426,000)	(21,007,000)
Income (Loss) from Equity Method Investments	2,274,000	2,018,000
Gain (Loss) on Extinguishment of Debt	451,000	0
Loan and realty losses	23,596,000	1,002,000
Payment of Tenant Lease Incentives	(1,042,000)	(498,000)
Share-based compensation	7,427,000	2,772,000
Change in operating assets and liabilities:
Other assets	(3,138,000)	(835,000)
Accounts payable and accrued expenses	(2,591,000)	(2,513,000)
Deferred income	119,000	(269,000)
Net cash provided by operating activities	157,501,000	176,527,000
Cash flows from investing activities:
Investment in mortgage and other notes receivable	(54,887,000)	(41,715,000)
Collection of mortgage and other notes receivable	64,509,000	33,895,000
Investment in real estate	(46,817,000)	(102,712,000)
Proceeds from Sale of Wholly Owned Real Estate and Real Estate Acquired in Settlement of Loans	203,147,000	39,260,000
Payments to Renovate Real Estate	(3,006,000)	(11,113,000)
Payments to Develop Real Estate Assets	(64,000)	(158,000)
Payments to Acquire Equity Method Investments	0	(875,000)
Proceeds from Equity Method Investment, Distribution	476,000	0
Net cash used in investing activities	163,358,000	(83,418,000)
Cash flows from financing activities:
Proceeds from revolving credit facilities	95,000,000	145,000,000
Payments on revolving credit facilities	(393,000,000)	(157,000,000)
Borrowings on term loan	0	100,000,000
Repayments of Long-term Debt	(250,277,000)	(917,000)
Proceeds from Issuance of Senior Long-term Debt	396,784,000	0
Debt issuance costs	(5,018,000)	(1,039,000)
Proceeds from issuance of common shares, net	47,904,000	4,791,000
Payments to Noncontrolling Interests	(692,000)	(537,000)
Payments for Repurchase of Redeemable Convertible Preferred Stock	(66,076,000)	0
Dividends paid to stockholders	(141,632,000)	(145,270,000)
Value of shares withheld from options exercised for employee tax withholding	0	(2,705,000)
Proceeds from Noncontrolling Interests	0	13,000
Net cash provided by (used in) financing activities	(317,007,000)	(57,664,000)
Increase in cash and cash equivalents and restricted cash	3,852,000	35,445,000
Cash and cash equivalents and restricted cash, beginning of period	50,195,000	51,114,000
Supplemental disclosure of cash flow information:
Interest paid, net of amounts capitalized	34,991,000	33,174,000
Supplemental schedule of non-cash investing and financing activities:
Change in mortgage notes receivable related to investments in real estate		63,220,000
Noncontrolling Interest, Noncash Increase from Subsidiary Equity Issuance		10,778,000
Increase in mortgage note receivable from sale of real estate		4,000,000
Change in other assets related to investments in real estate		348,000
Noncash or Part Noncash Acquisition, Other Assets Acquired	12,814,000
Change in accounts payable related to investments in real estate construction	(112,000)	(1,744,000)
Change in accounts payable related to distributions to noncontrolling interests	$ 5,000	85,000
Change in Accounts Payable, Renovations of existing real estate		$ 355,000

Consolidated Statement Of Equit

Consolidated Statement Of Equity - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Cumulative Dividends In Excess Of Net Income [Member]	Cumulative Dividends In Excess Of Net Income [Member]Revision of Prior Period, Accounting Standards Update, Adjustment	Accumulated Other Comprehensive Income (Loss) [Member]	Parent [Member]	Noncontrolling Interest [Member]
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest	$ 1,498,252	$ 446	$ 1,505,948	$ (5,331)		$ (3,432)	$ 1,497,631	$ 621
Balance, shares at Dec. 31, 2019		44,587,486
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss) attributable to common stockholders	147,986
Comprehensive Income (Loss), Net of Tax, Attributable to Noncontrolling Interest	162
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest	142,715
Dividends declared, $1.54 per share				(98,453)
Balance, shares at Sep. 30, 2020		44,729,157
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest	1,504,002	$ 447	1,510,804	(9,337)		(8,865)	1,493,049	10,953
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Retained Earnings (Accumulated Deficit)					$ (4,225)
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest	$ 1,522,945	$ 452	1,540,946	(22,015)		(7,149)	1,512,234	10,711
Balance, shares at Dec. 31, 2020	45,185,992	45,185,992
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock Issued During Period, Shares, New Issues	661,951
Net income (loss) attributable to common stockholders	$ 105,327
Comprehensive Income (Loss), Net of Tax, Attributable to Noncontrolling Interest	135
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest	$ 110,783
Balance, shares at Sep. 30, 2021	45,850,599	45,850,599
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest	$ 1,549,206	$ 459	$ 1,590,194	$ (49,768)		$ (1,828)	$ 1,539,057	$ 10,149

Consolidated Statement Of Equ_2

Consolidated Statement Of Equity Consolidated Statement of Equity (Parenthetical) - $ / shares	3 Months Ended		6 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Jun. 30, 2021	Jun. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Statement of Stockholders' Equity [Abstract]
Common Stock, Dividends, Per Share, Declared	$ 0.90	$ 1.1025	$ 2.0025	$ 2.2050	$ 2.9025	$ 3.3075

Organization, Consolidation and

Organization, Consolidation and Presentation of Financial Statements	9 Months Ended
	Sep. 30, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization, Consolidation and Presentation of Financial Statements Disclosure	Note 1. Organization and Nature of Business National Health Investors, Inc. (“NHI,” “the Company,” “we,” “us,” or “our”), established in 1991 as a Maryland corporation, is a self-managed real estate investment trust (“REIT”) specializing in sale-leaseback, joint venture, mortgage and mezzanine financing of need-driven and discretionary senior housing and medical facility investments. Our portfolio consists of lease, mortgage and other note investments in independent living facilities, assisted living facilities, entrance-fee communities, senior living campuses, skilled nursing facilities, hospitals and a medical office building. As of September 30, 2021, we had investments of approximately $3.0 billion in 208 health care real estate properties located in 34 states and leased pursuant primarily to triple-net leases to 33 lessees consisting of 133 senior housing communities (“SHO”), 72 skilled nursing facilities, two hospitals and one medical office building, excluding three properties classified to assets held for sale. Our portfolio of 14 mortgages along with other notes receivable totaled $289.7 million, excluding an allowance for expected credit losses of $5.1 million, as of September 30, 2021.

Significant Accounting Policies

Significant Accounting Policies	9 Months Ended
	Sep. 30, 2021
Accounting Policies [Abstract]
Significant Accounting Policies	Note 2. Basis of Presentation and Significant Accounting Policies Basis of Presentation The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) for interim financial statements. In our opinion, the accompanying unaudited condensed consolidated financial statements reflect all adjustments consisting of normal recurring adjustments necessary for a fair presentation. Interim results of operations are not necessarily indicative of the results that may be achieved for a full year. The condensed consolidated financial statements and related notes do not include all information and footnotes required by GAAP for annual reports. These interim condensed consolidated financial statements should be read in conjunction with our audited consolidated financial statements and notes thereto as of and for the year ended December 31, 2020, included in our 2020 Annual Report on Form 10-K filed with the Securities and Exchange Commission (the “SEC”). Principles of Consolidation The condensed consolidated financial statements include the accounts of the Company, its wholly owned subsidiaries and subsidiaries in which we have a controlling interest. We also consolidate certain entities when control of such entities can be achieved through means other than voting rights (“variable interest entities” or “VIEs”) if the Company is deemed to be the primary beneficiary of such entities. All material intercompany transactions and balances are eliminated in consolidation. At September 30, 2021, we held interests in ten unconsolidated VIEs, and, because we lack either directly or through related parties the power to direct the activities that most significantly impact their economic performance, we have concluded that the Company is not the primary beneficiary. Accordingly, we account for our transactions with these entities and their subsidiaries at either amortized cost or net realizable value for straight-line rent receivables, excluding our investment accounted for under the equity method discussed in Note 5. The Company’s unconsolidated VIEs are summarized below by date of initial involvement. For further discussion of the nature of the relationships, including the sources of exposure to these VIEs, see the notes to our condensed consolidated financial statements cross-referenced below ( $ in thousands ). Date Name Source of Exposure Carrying Amount Maximum Exposure to Loss Note Reference 2012 Bickford Senior Living Various 1 $ 67,000 $ 88,000 Notes 3, 4 2014 Senior Living Communities Notes and straight-line receivable $ 83,000 $ 93,000 Notes 3, 4 2016 Senior Living Management Notes and straight-line receivable $ 27,000 $ 27,000 — 2018 Sagewood, LCS affiliate Notes $ 109,000 $ 109,000 Note 4 2019 41 Management, LLC Notes and straight-line receivable $ 25,000 $ 34,000 — 2020 Timber Ridge OpCo, LLC Various 2 $ (5,000) $ 5,000 Note 5 2020 Watermark Retirement Notes and straight-line receivable $ 9,000 $ 10,000 — 2021 Montecito Medical Real Estate Notes and funding commitment $ 2,000 $ 50,000 Note 4 2021 Vizion Health Notes and straight-line receivable $ 20,000 $ 22,000 Notes 3, 4 2021 Navion Senior Solutions Notes and straight-line receivable $ 7,000 $ 14,000 Notes 3, 4 1 Notes, loan commitments, straight-line rent receivables, and unamortized lease incentives 2 Loan commitment, equity method investment and straight-line rent receivables We are not obligated to provide support beyond our stated commitments to these tenants and borrowers whom we classify as VIEs, and accordingly, our maximum exposure to loss as a result of these relationships is limited to the amount of our commitments, as shown above and discussed in the notes. Economic loss on a lease, in excess of what is presented in the table above, if any, would be limited to that resulting from any period of arrearage and non-payment of monthly rent before we are able to take effective remedial action, as well as costs incurred in transitioning the lease to a new tenant. The potential extent of such loss would be dependent upon individual facts and circumstances, and is therefore not included in the table above. In the future, NHI may be deemed the primary beneficiary of the operations if the tenants do not have adequate liquidity to accept the risks and rewards as the tenant and operator of the properties and might be required to consolidate the financial position and results of operations of the tenants into our consolidated financial statements. We consolidate two real estate partnerships formed with our partners, Discovery Senior Housing Investor XXIV, LLC, (“Discovery”) and LCS Timber Ridge LLC (“LCS”), to invest in senior housing facilities. As of and for the three and nine months ended September 30, 2021 and 2020, our noncontrolling interests relate to these partnerships with Discovery and LCS. We use the equity method of accounting when we own an interest in an entity whereby we can exert significant influence over but cannot control the entity’s operations. We discontinue equity method accounting if our investment in an entity (and net advances) is reduced to zero unless we have guaranteed obligations of the entity or are otherwise committed to provide further financial support for the entity. Cash and Cash Equivalents and Restricted Cash Cash equivalents consist of all highly liquid investments with an original maturity of three months or less. Restricted cash includes amounts required to be held on deposit or subject to an agreement (e.g., with a qualified intermediary subject to an Internal Revenue Code §1031 exchange agreement or in accordance with agency agreements governing our mortgages). The following table sets forth our “ Cash, cash equivalents and restricted cash ” reported within the Company’s Condensed Consolidated Statements of Cash Flows ($ in thousands) : September 30, September 30, Cash and cash equivalents $ 48,393 $ 42,198 Restricted cash (included in Other assets) 1,802 8,916 $ 50,195 $ 51,114 Assets Held for Sale We consider properties to be assets held for sale when (1) management commits to a plan to sell the property; (2) it is unlikely that the disposal plan will be significantly modified or discontinued; (3) the property is available for immediate sale in its present condition; (4) actions required to complete the sale of the property have been initiated; (5) sale of the property is probable and we anticipate the completed sale will occur within one year; and (6) the property is actively being marketed for sale at a price that is reasonable given our estimate of current market value. Upon designation of a property as an asset held for sale, we record the property’s value at the lower of its carrying value or its estimated fair value, less estimated transaction costs. Depreciation and amortization of the property are discontinued. Real Estate Investment Impairment We evaluate the recoverability of the carrying amount of our real estate properties on a property-by-property basis. We review our properties for recoverability when events or circumstances, including significant physical changes in the property, significant adverse changes in general economic conditions and significant deterioration of the underlying cash flows of the property, indicate that the carrying amount of the property may not be recoverable. The need to recognize an impairment charge is based on estimated undiscounted future cash flows from a property compared to the carrying amount of that property. If recognition of an impairment charge is necessary, it is measured as the amount by which the carrying amount of the property exceeds the estimated fair value of the property. During the three and nine months ended September 30, 2021, we recognized impairment charges on five real estate properties of approximately $22.5 million included in “ Loan and realty losses (gains) ” in our Condensed Consolidated Statement of Income for the nine months ended September 30, 2021. Reference Note 3 for more discussion. Rental Income Our leases generally provide for rent escalators throughout the term of the lease. Base rental income is recognized using the straight-line method over the term of the lease to the extent that lease payments are considered collectible and the lease provides for specific contractual escalators. The Company reviews its operating lease receivables for collectibility on a regular basis, taking into consideration changes in factors such as the tenant’s payment history, the financial condition of the tenant, business conditions in which the tenant operates and economic conditions in the area where the property is located. In the event that collectibility with respect to any tenant is not probable, a direct write-off of the receivable is made as an adjustment to rental income and any future rental revenue is recognized only when the tenant makes a rental payment. On July 30, 2021, Atria Senior Living acquired the management services of the legacy Holiday Retirement (“Holiday”) portfolio who is the tenant for 17 independent living facilities leased pursuant to a master lease. We have not received any contractual rent due under the master lease since this transaction. Accordingly, we have placed the tenant on cash basis. Rent due but uncollected and unrecognized for August and September 2021 totaled $4.8 million. Accounting for Lease Modifications related to Coronavirus Disease 2019 In April 2020, the FASB issued a question-and-answer document (the “Lease Modification Q&A”) focused on the application of lease accounting guidance to lease concessions provided as a result of the coronavirus (“COVID-19”) pandemic. The Lease Modification Q&A clarifies that entities may elect not to evaluate whether lease-related relief provided to mitigate the economic effects of the COVID-19 pandemic is a lease modification under Accounting Standard Codification (“ASC”) 842, Leases (“ASC 842”). Instead, an entity that elects not to evaluate whether a concession directly related to the COVID-19 pandemic, which does not substantially increase either its rights as lessor or the obligations of the tenant, is a lease modification can decide whether or not to apply the modification guidance. An entity should apply the election consistently to leases with similar characteristics and similar circumstances. NHI has elected not to apply the modification guidance under ASC 842 and has accounted for qualified rent concessions as variable lease payments when applicable, recorded as rental income when received. During the three and nine months ended September 30, 2021, we provided $5.8 million and $19.9 million, respectively, in lease concessions as a result of the COVID-19 pandemic, as discussed in more detail in Note 7.

Real Estate

Real Estate	9 Months Ended
	Sep. 30, 2021
Real Estate [Abstract]
Real Estate Disclosure [Text Block]	Note 3. Real Estate Properties and Investments During the nine months ended September 30, 2021, we completed the following real estate acquisitions as described below ($ in thousands) : Operator Date Properties Asset Class Land Building and Improvements Total Vizion Health Q2 2021 1 HOSP $ 1,470 $ 38,780 $ 40,250 Navion Senior Solutions Q2 2021 1 SHO 531 6,069 6,600 $ 2,001 $ 44,849 $ 46,850 Vizion Health In May 2021, we acquired a 64-bed specialty behavioral hospital located in Oklahoma for a total purchase price of $40.3 million, including $0.3 million in closing costs, and concurrently leased the hospital to an affiliate of Vizion Health. The 15-year master lease, which includes two five Navion Senior Solutions In June 2021, we acquired a 48-unit assisted living and memory care community in Tennessee for a purchase price of $6.6 million, including closing costs of $0.1 million. The community was added to an existing master lease with Navion Senior Solutions (“Navion”) whose term was reset for 12 years, has a lease rate of 7.5% with fixed annual escalators of 2.5% and offers two optional extensions of five years each. Asset Dispositions During the nine months ended September 30, 2021, we completed the following real estate dispositions as described below ($ in thousands) : Operator Date Properties Asset Class Net Proceeds Net Real Estate Investment Other 1 Gain/(Impairment) 2 Bickford Q2 2021 6 SHO $ 39,924 $ 34,485 $ 1,871 $ 3,568 $ 3,568 Community Health Systems Q2 2021 1 MOB 3,887 946 62 2,879 TrustPoint Hospital Q3 2021 1 HOSP 31,215 21,018 1,562 8,635 Holiday Q3 2021 8 SHO 114,133 113,611 (1,360) 1,882 Quorum Health Q3 2021 1 HOSP 8,314 9,568 — (1,254) Senior Living Management Q3 2021 1 SHO 12,847 3,212 210 9,425 Holiday Q3 2021 1 SHO 5,666 10,388 (81) (4,641) $ 215,986 $ 193,228 $ 2,264 $ 20,494 1 includes straight-line rent and deferred lease intangibles 2 impairment charges are included in “Loan and realty losses (gains)” in our Condensed Consolidated Income Statement as of September 30, 2021 Bickford During the second quarter of 2021, we sold to affiliates of Bickford a portfolio of six properties that were being leased to Bickford for a purchase price of $52.9 million. We received approximately $39.9 million in cash consideration upon sale and originated a second mortgage note receivable for the remaining purchase price of $13.0 million. A gain was not recognized related to the $13.0 million second mortgage note receivable, which is discussed in more detail in Note 4. We recorded a gain upon completion of this transaction totaling approximately $3.6 million representing the excess of the $39.9 million cash consideration received over the net book value of the assets sold of $34.5 million and the write off of straight-line rents receivable of approximately $1.9 million. Rental income from this portfolio was $1.6 million and $4.5 million for the nine months ended September 30, 2021 and 2020, respectively. Upon completion of the sale, Bickford satisfied the terms of our prior agreement that contingently waived $2.1 million in rental income for the third quarter of 2020. These properties were part of our ongoing negotiations for the sale to Bickford of nine properties being leased to Bickford. We continue to explore our options for the remaining three properties, which could include a sale to a third party, re-tenanting, or retaining the existing lease with Bickford. Reference Note 7 for discussion of additional contingent consideration associated with this disposition that was not included in the transaction price at the time of closing. Community Health Systems During the second quarter of 2021, we sold a medical office building located in Florida for approximately $4.3 million in cash consideration, and incurred $0.4 million of transaction costs, resulting in a gain of approximately $2.9 million. Revenue for this property was $0.1 million and $0.3 million for the nine months ended September 30, 2021 and 2020, respectively. TrustPoint Hospital In July 2021, we sold a behavioral hospital located in Tennessee for cash consideration of $31.2 million and recorded a gain of approximately $8.6 million. Rental income was $0.1 million and $1.4 million, for the three and nine months ended September 30, 2021, respectively, and $0.7 million and $2.0 million for the three and nine months ended September 30, 2020, respectively. Holiday In August 2021, we sold a portfolio of eight properties that was leased to Holiday with an aggregate net book value of $113.6 million for total cash consideration of $115.0 million, and incurred transaction costs of $0.9 million, and recognized a gain of approximately $1.9 million associated with this transaction. Rental income was $0.9 million and $5.9 million, for the three and nine months ended September 30, 2021, respectively, and $2.5 million and $7.5 million for the three and nine months ended September 30, 2020, respectively. In September 2021, we sold a property that was leased to Holiday located in Indiana with a net book value of $10.4 million for total cash consideration of $5.8 million, incurred transactions costs of $0.1 million, and recognized an impairment of approximately $4.6 million associated with this transaction. Rental income was $0.1 million and $0.4 million, for the three and nine months ended September 30, 2021, respectively and $0.2 million and $0.5 million for the three and nine months ended September 30, 2020, respectively. Quorum Health In September 2021, we sold an acute care hospital located in Kentucky for cash consideration of $9.0 million, incurred $0.7 million of transaction costs, and recorded an impairment charge of approximately $1.3 million. Rental income was $0.7 million and $2.5 million, for the three and nine months ended September 30, 2021, respectively, and $0.9 million and $2.3 million, for the three and nine months ended September 30, 2020, respectively. Senior Living Management On September 30 2021, we sold a senior living community located in Florida for cash consideration of $14.0 million that was received October 1, 2021, incurred transaction costs of $1.2 million and recorded a gain of approximately $9.4 million. Rental income was $0.3 million and $0.8 million, for the three and nine months ended September 30, 2021, respectively, and $0.3 million and $1.0 million for the three and nine months ended September 30, 2020, respectively. The consideration receivable for the sale is included in “ Other assets ” in our Condensed Consolidated Balance Sheet as of September 30, 2021. Assets Held for Sale and Impairment of Real Estate During the third quarter of 2021, we reclassified three transition properties to assets held for sale on our Condensed Consolidated Balance Sheet as of September 30, 2021 and recorded impairment charges of approximately $16.6 million to reduce their net book values to estimated fair values less estimated transaction costs. Two of the properties are located in Texas and one property is located in Tennessee. Rental income for these properties was based on operating income, net of management fees, and did not generate significant revenues for either the nine months ended September 30, 2021 or the nine months ended September 30, 2020. As discussed above, we recognized real estate impairment charges of approximately $5.9 million during the three and nine months ended September 30, 2021, related to the disposition of one Holiday property located in Indiana and an acute care hospital located in Kentucky. Tenant Concentration The following table contains information regarding tenant concentration in our portfolio, excluding $2.6 million for our corporate office and a credit loss reserve balance of $5.1 million, based on the percentage of revenues for the nine months ended September 30, 2021 and 2020, related to tenants or affiliates of tenants, that exceed 10% of total revenue ( $ in thousands ): as of September 30, 2021 Revenues 1 Asset Number of Real Notes Nine Months Ended September 30, Class Properties Estate Receivable 2021 2020 Senior Living Communities EFC 10 $ 573,631 $ 42,609 $ 38,094 17% $ 38,972 15% National HealthCare Corporation (NHC) SNF 42 171,188 — 28,290 12% 28,362 11% Bickford Senior Living ALF 42 490,308 38,751 26,224 11% 39,142 16% Holiday ILF 17 377,735 — 22,811 10% 30,529 12% All others, net 2 Various 1,406,251 208,387 106,110 46% 107,377 43% Escrow funds received from tenants for property operating expenses Various — — 7,519 4% 7,190 3% $ 3,019,113 $ 289,747 $ 229,048 $ 251,572 1 includes interest income on notes receivable 2 includes prior period amounts for disposals or transitioned to new operators At September 30, 2021, the two states in which we had an investment concentration of 10% or more were South Carolina (11.1%) and Texas (10.1%). Two of our board members, including our chairman, are also members of NHC’s board of directors. Tenant Purchase Options Certain of our leases contain purchase options allowing tenants to acquire the leased properties. At September 30, 2021, we had a net investment of $18.8 million in five real estate properties which are subject to exercisable tenant purchase options. Tenant purchase options on 10 properties in which we had an aggregate net investment of $90.5 million at September 30, 2021, become exercisable between 2025 and 2028. Rental income from all leased properties with tenant purchase options was $3.4 million and $10.3 million for the three and nine months ended September 30, 2021, respectively, and $3.4 million and $10.0 million for the three and nine months ended September 30, 2020, respectively. In June 2021, we received notification of a tenant’s intention to acquire, pursuant to a purchase option, a hospital located in California. The purchase option calls for a minimum purchase price of $15.0 million with any appreciation above $15.0 million to be split evenly between the parties. The net investment at September 30, 2021 was $9.5 million. Rental income was $0.5 million and $1.4 million, for both the three and nine months ended September 30, 2021 and 2020, respectively. The transaction will close no earlier than one year after the receipt of the notice of exercise. We cannot reasonably estimate at this time the probability that any other purchase options will be exercised in the future. Consideration to be received from the exercise of any tenant purchase option is expected to exceed our net investment in the leased property or properties. Tenant Transitioning Nine properties were transitioned during 2019 to five new tenants following a period of non-compliance by the former operators. We recognized rental income from these nine properties of $0.7 million and $2.4 million for the three and nine months ended September 30, 2021, respectively, and $0.9 million and $3.7 million for the three and nine months ended September 30, 2020, respectively. Three of the properties were reclassified to assets held for sale on our Condensed Consolidated Balance Sheet as of September 30, 2021, as noted above. Future Minimum Base Rent Future minimum lease payments to be received by us under our operating leases at September 30, 2021, are as follows ( $ in thousands ): Remainder of 2021 $ 68,151 2022 271,682 2023 267,619 2024 263,266 2025 264,666 2026 268,736 Thereafter 1,102,245 $ 2,506,365 Variable Lease Payments Most of our existing leases contain annual escalators in rent payments. For financial statement purposes, rental income is recognized on a straight-line basis over the term of the lease where the lease contains fixed escalators. Some of our leases contain escalators that are determined annually based on a variable index or other factor that is indeterminable at the inception of the lease. The table below indicates the revenue recognized as a result of fixed and variable lease escalators ( $ in thousands ): Three Months Ended Nine Months Ended September 30, September 30, 2021 2020 2021 2020 Lease payments based on fixed escalators, net of deferrals $ 59,027 $ 67,592 $ 188,008 $ 206,179 Lease payments based on variable escalators 1,288 1,386 3,201 4,151 Straight-line rent income 3,798 5,086 12,189 15,481 Escrow funds received from tenants for property operating expenses 3,182 4,007 7,519 7,190 Amortization of lease incentives (252) (250) (774) (735) Rental income $ 67,043 $ 77,821 $ 210,143 $ 232,266

Mortgage And Other Notes Receiv

Mortgage And Other Notes Receivable	9 Months Ended
	Sep. 30, 2021
Mortgage and Other Notes Receivable [Abstract]
Mortgage Notes Receivable	Mortgage and Other Notes Receivable At September 30, 2021, our investments in mortgage notes receivable totaled $224.2 million secured by real estate and other assets of the borrower (e.g., UCC liens on personal property) related to 14 facilities and other notes receivable totaled $65.6 million substantially all of which are guaranteed by significant parties to the notes or by cross-collateralization of properties with the same owner. These balances exclude a credit loss reserve of $5.1 million at September 30, 2021. All our notes were on full accrual basis at September 30, 2021. Montecito Medical Real Estate In April 2021, the Company entered into a $50.0 million mezzanine loan and security agreement with Montecito Medical Real Estate for a new fund that will invest in medical real estate, including medical office buildings, throughout the United States. Amounts under the loan agreement will be funded as real estate investments are identified for acquisition. Borrowings under the loan agreement will bear interest at an annual rate of 9.5% and accrue an additional 2.5% in interest to be paid upon certain future events including repayments, sales of fund investments, and refinancings. Funds drawn in accordance with this agreement are required to be repaid on a per-investment basis five years from deployment of the funds for the applicable investment and includes two one Vizion Health - Brookhaven In May 2021, we provided a $20.0 million, five Bickford As part of the sale of six properties to Bickford discussed in Note 3, we executed a $13.0 million second mortgage as a component of the purchase price consideration. The loan is secured by a security interest in the portfolio that is subordinate only to the first mortgage on the portfolio held by a third party. This second mortgage note receivable bears interest at a 10% annual rate and matures in April 2026. Commencing in January 2022, payments of principal and interest are required based on a 15-year amortization schedule. In addition, the interest rate will be reset to 8% if Bickford prepays approximately $5.3 million in principal prior to December 31, 2022. Interest income was $0.3 million and $0.6 million, for the three and nine months ended September 30, 2021. Given the size of the Company financing provided relative to the purchase price, its subordination to the first mortgage outstanding and the ongoing negative impact of the COVID-19 pandemic on Bickford’s operating results, we did not include this note receivable in the determination of the gain to be recognized upon sale of the portfolio in accordance with the provisions of ASC 610-20, Other Income – Gains and Losses from the Derecognition of Nonfinancial Assets . Therefore, this note receivable is not reflected in “ Mortgage and other notes receivable, net ” in the Condensed Consolidated Balance Sheet as of September 30, 2021. We will re-evaluate the collectability of this note receivable each reporting period and recognize the note receivable and related deferred gain at such time the note receivable is considered probable of collection in accordance with ASC 610-20. Navion Senior Solutions In May 2021, we provided a ten Life Care Services - Sagewood During the three and nine months ended September 30, 2021, LCS-Westminster Partnership IV LLP, an affiliate of LCS, repaid the remaining principal of $9.8 million and $61.2 million on its second note of two notes under a master credit agreement (“Note B”). As a result, we recognized the remaining Note B commitment fee of $0.4 million in “ Interest income and other ” during the third quarter of 2021. The balance on its first note (“Note A”) was $109.2 million as of September 30, 2021. Credit Loss Reserve Our principal measures of credit quality, except for construction mortgages, are debt service coverage for amortizing loans and interest or fixed charge coverage for non-amortizing loans collectively (“Coverage”). A Coverage ratio provides a measure of the borrower’s ability to make scheduled principal and interest payments. The Coverage ratios presented in the following table have been calculated utilizing the most recent date for which data is available, June 30, 2021, using EBITDARM (earnings before interest, taxes, depreciation, amortization, rent and management fees) and the requisite debt service, interest service or fixed charges, as defined in the applicable loan agreement. We categorize Coverage into three levels: (i) more than 1.5x, (ii) between 1.0x and 1.5x, and (iii) less than 1.0x. We update the calculation of coverage on a quarterly basis. Coverage is not a meaningful credit quality indicator for construction mortgages as either these developments are not generating any operating income, or they have insufficient operating income as occupancy levels necessary to stabilize the properties have not yet been achieved. We measure credit quality for these mortgages by considering the construction and stabilization timeline and the financial condition of the borrower as well as economic and market conditions. As of September 30, 2021, we did not have any construction loans that we considered underperforming. The tables below present outstanding note balances as of September 30, 2021 at amortized cost. We consider the guidance in ASC 310-20 when determining whether a modification, extension or renewal constitutes a current period origination. The credit quality indicator as of September 30, 2021, is presented below for the amortized cost, net by year of origination of ( $ in thousands ): 2021 2020 2019 2018 2017 Prior Total Mortgages more than 1.5x $ — $ 20,382 $ 9,013 $ 28,700 $ — $ 4,402 $ 62,497 between 1.0x and 1.5x — — — 108,606 — — 108,606 less than 1.0x — 3,960 39,123 — — 10,000 53,083 — 24,342 48,136 $ 137,306 — 14,402 224,186 Mezzanine more than 1.5x 3,566 — — — — — 3,566 between 1.0x and 1.5x 22,233 — — — — 10,472 32,705 less than 1.0x — — — — — 14,500 14,500 No coverage available — — 750 — — — 750 25,799 — 750 — — 24,972 51,521 Revolver more than 1.5x 4,131 between 1.0x and 1.5x 9,909 less than 1.0x — 14,040 Credit loss reserve (5,139) $ 284,608 Due to the economic uncertainty created by the COVID-19 pandemic and the potential impact on the collectability of our mortgages and other notes receivable, we forecasted at the beginning of the pandemic a 20% increase in the probability of a default and a 20% increase in the amount of loss from a default resulting in an effective adjustment of 44%. The allowance for expected credit losses is presented in the following table for the nine months ended September 30, 2021 ( $ in thousands ): Beginning balance January 1, 2021 $ 4,946 Provision for expected credit losses 193 Balance September 30, 2021 $ 5,139 Bickford Construction Loans As of September 30, 2021, we had commitments of $42.9 million in three construction loans to Bickford. At September 30, 2021, we had funded $34.8 million toward these commitments. The construction loans are secured by first mortgage liens on substantially all real and personal property as well as a pledge of any and all leases or agreements which may grant a right of use to the property. Usual and customary covenants extend to the agreements, including the borrower’s obligation for payment of insurance and taxes. NHI has a fair market value purchase option on the properties at stabilization of the underlying operations. On these development projects, Bickford, as borrower, is entitled to up to $2.0 million per project in incentives based on the achievement of predetermined operational milestones and, if funded, will increase NHI's future purchase price and eventual NHI lease payment. Senior Living Communities On March 30, 2021, we amended the revolving line of credit agreement with Senior Living Communities (“Senior Living”) to increase availability from $15.0 million to $20.0 million. Borrowings by Senior Living under the revolver are to be used for working capital needs and to finance construction projects within its portfolio, including building additional units. Beginning January 1, 2023, availability under the revolver reduces to $15.0 million. The revolver matures in December 2029 at the time of lease maturity. At September 30, 2021, the $9.9 million outstanding under the facility bears interest at 7.52% per annum, the prevailing 10-year U.S. Treasury rate plus 6%. The Company also has a mortgage loan of $32.7 million with Senior Living originated in July 2019 for the acquisition of a 248-unit continuing care retirement community (“CCRC”) in Columbia, South Carolina. The mortgage loan is for a term of five

Equity Method Investment

Equity Method Investment	9 Months Ended
	Sep. 30, 2021
Equity Method Investments and Joint Ventures [Abstract]
Equity Method Investments and Joint Ventures Disclosure	Note 5. Equity Method Investment Our initial $0.9 million investment in the operating company, Timber Ridge OpCo, held by our Taxable REIT Subsidiary (“TRS”) arose in conjunction with the acquisition of a CCRC from LCS-Westminster Partnership III, LLP, in January 2020. We structured our arrangement with our JV partner, LCS Timber Ridge LLC, to be compliant with the provisions of the REIT Investment Diversification and Empowerment Act of 2007 (“RIDEA”). Accordingly, the TRS holds our 25% equity interest in Timber Ridge OpCo, which permits the TRS to engage in activities and share in cash flows that would otherwise be non-qualifying income under the REIT gross income test. As part of our investment, we provided Timber Ridge OpCo a revolving credit facility of up to $5.0 million of which no funds have been drawn. We account for our investment in Timber Ridge OpCo under the equity method since we are not the primary beneficiary of Timber Ridge OpCo as our participating rights do not give us the power to direct the activities that most significantly impact Timber Ridge OpCo’s economic performance. Our equity share in the losses of Timber Ridge OpCo during the nine months ended September 30, 2021 and 2020, was $2.3 million and $2.0 million, respectively. During the nine months ended September 30, 2021, we received $0.5 million in cash distributions from Timber Ridge OpCo. Under the equity method, we decrease the carrying value of our investment for losses in the entity and distributions to NHI for cumulative amounts up to and including our basis plus any commitments to fund operations. Our commitments are currently limited to the additional $5.0 million under the revolving credit facility. As of September 30, 2021, we have recognized our share of Timber Ridge OpCo’s operating losses in excess of our initial investment. These cumulative losses of $5.0 million in excess of our original basis are included in “ Accounts payable and accrued expenses ” in our Condensed Consolidated Balance Sheet as of September 30, 2021. Excess unrecognized equity method losses were $0.3 million as of September 30, 2021. The Timber Ridge property is subject to early resident mortgages secured by a Deed of Trust and Indenture of Trust (the “Deed and Indenture”). As part of our acquisition, Timber Ridge PropCo acquired the Timber Ridge property and a subordination agreement was entered into pursuant to which the Trustee acknowledged and confirmed that the security interests created under the Deed and Indenture were subordinate to any security interests granted in connection with the loan made by NHI to Timber Ridge PropCo. In addition, by terms of the resident loan assumption agreement, during the term of the lease (seven years with two renewal options), Timber Ridge OpCo is to indemnify Timber Ridge PropCo for any repayment by Timber Ridge PropCo of these liabilities under the guarantee. As a result of the subordination and resident loan assumption agreements, a liability was not recorded for the resident loan obligation upon acquisition and as of September 30, 2021. The balance secured by the Deed and Indenture was $15.5 million at September 30, 2021.

Debt

Debt	3 Months Ended
	Sep. 30, 2021
Debt Instruments [Abstract]
Debt Disclosure	Debt Debt consists of the following ( $ in thousands ): September 30, December 31, Revolving credit facility - unsecured $ — $ 298,000 Bank term loans - unsecured 400,000 650,000 Senior notes - unsecured, net of discount of $3,002 396,998 — Private placement term loans - unsecured 400,000 400,000 Fannie Mae term loans - secured, non-recourse 95,077 95,354 Convertible senior notes - unsecured — 60,000 Unamortized loan costs (6,788) (4,069) $ 1,285,287 $ 1,499,285 Aggregate principal maturities of debt as of September 30, 2021 are as follows ( $ in thousands ): Remainder of 2021 $ 95 2022 100,389 2023 475,408 2024 75,425 2025 143,761 2026 — Thereafter 496,997 1,292,075 Less: unamortized loan costs (6,788) $ 1,285,287 Convertible senior notes On April 1, 2021, our 3.25% senior unsecured convertible notes (the “Convertible Notes”) matured. The Company paid $67.1 million, including accrued interest of $1.0 million and a $6.1 million conversion premium, to retire the Convertible Notes. The conversion premium was recorded as a reduction of “ Capital in excess of par value” in our Condensed Consolidated Balance Sheet as of September 30, 2021. Unsecured revolving credit facility and bank term loans Our unsecured bank credit facility consists of two term loans - $100.0 million maturing in August 2022 and $300.0 million maturing in September 2023 - and a $550.0 million revolving credit facility that was initially scheduled to mature in August 2021. In April 2021, the Company elected to exercise the extension option on the revolving credit facility available after payment of a 10 basis point extension fee totaling $0.6 million, extending the maturity of the revolver to August 2022. Some combination of cash on hand, proceeds from recent and planned asset sales and operating cash flows is expected to be used to pay off the $100.0 million term loan at its maturity in August 2022. We also plan to execute a multiple year extension of our revolving credit facility prior to the August 2022 maturity date at an amount at least equal to the current $550.0 million capacity. We have swap agreements to fix the interest rates on $400.0 million of term loans that expire in December 2021. In January 2021, we repaid a $100.0 million term loan that was entered into July 2020 with the net proceeds from the 2031 Senior Notes offering discussed below. The term loan bore interest at a rate of 30-day LIBOR (with a 50 basis point floor) plus 185 basis points (“bps”), based on our current leverage ratios. Upon repayment, the Company expensed approximately $0.5 million of deferred financing cost associated with this loan which is included in “ Loss on early retirement of debt ” in our Condensed Consolidated Statement of Income for the nine months ended September 30, 2021. The revolving facility fee is currently 25 bps per annum and based on our current credit ratings, the facility presently provides for floating interest on the revolver and the term loans at 30-day LIBOR plus 120 bps and a blended 128 bps, respectively. At September 30, 2021 and December 31, 2020, 30-day LIBOR was 8 bps and 14 bps, respectively. At September 30, 2021, we had $550.0 million available to draw on the revolving portion of our credit facility, subject to usual and customary covenants. Among other stipulations, the unsecured credit facility agreement requires that we maintain certain financial ratios within limits set by our creditors. At September 30, 2021, we were in compliance with these ratios. Pinnacle Bank is a participating member of our banking group. A member of NHI’s Board of Directors and chairman of our audit committee is also the chairman of Pinnacle Financial Partners, Inc., the holding company for Pinnacle Bank. NHI’s local banking transactions are conducted primarily through Pinnacle Bank. Senior Notes 2031 On January 26, 2021, we issued $400.0 million aggregate principal amount of 3.00% senior notes that mature on February 1, 2031 and pay interest semi-annually (the “2031 Senior Notes”). The 2031 Senior Notes were sold at an issue price of 99.196% of face value before the underwriters’ discount. Our net proceeds from the 2031 Senior Notes offering, after deducting underwriting discounts and expenses, were approximately $392.3 million. We used the net proceeds from the 2031 Senior Notes offering to repay our $100.0 million term loan that was entered into in July 2020 and reduce borrowings outstanding under our revolving credit facility. The 2031 Senior Notes are subject to affirmative and negative covenants, including financial covenants. As of September 30, 2021, we were in compliance with all affirmative and negative covenants, including financial covenants for our 2031 Senior Notes borrowings. Private placement term loans Our unsecured private placement term loans, payable interest-only, are summarized below ( $ in thousands ): Amount Inception Maturity Fixed Rate $ 125,000 January 2015 January 2023 3.99% 50,000 November 2015 November 2023 3.99% 75,000 September 2016 September 2024 3.93% 50,000 November 2015 November 2025 4.33% 100,000 January 2015 January 2027 4.51% $ 400,000 Except for specific debt-coverage ratios and net worth minimums, covenants pertaining to the private placement term loans are generally conformed with those governing our credit facility. Our unsecured private placement term loan agreements include a rate increase provision that is effective if any rating agency lowers our credit rating on our senior unsecured debt below investment grade and our compliance leverage increases to 50% or more. Fannie Mae term loans In March 2015, we obtained $78.1 million in Fannie Mae financing. The term-debt financing consists of interest-only payments at an annual rate of 3.79% and a 10-year maturity. The mortgages are non-recourse and secured by thirteen properties leased to Bickford. In a December 2017 acquisition, we assumed additional Fannie Mae debt that amortizes through 2025 when a balloon payment will be due, is subject to prepayment penalties until 2024, bears interest at a nominal rate of 4.6%, and has a remaining balance of $17.0 million at September 30, 2021. Collectively, these notes are secured by facilities having a net book value of $127.0 million at September 30, 2021. Interest Rate Swap Agreements Our existing interest rate swap agreements will collectively continue through December 2021 to hedge against fluctuations in variable interest rates applicable to $400.0 million of our bank loans. During the remainder of 2021, approximately $1.8 million of losses, which are included in “ Accumulated other comprehensive loss ” in our Condensed Consolidated Balance Sheets, are projected to be reclassified into earnings. As of September 30, 2021, we employed the following interest rate swap contracts to mitigate our interest rate risk on our bank term and revolver loans described above ( $ in thousands ): Date Entered Maturity Date Swap Rate Rate Index Notional Amount Fair Value (Liability) March 2019 December 2021 2.22% 1-month LIBOR $ 100,000 $ (533) March 2019 December 2021 2.21% 1-month LIBOR $ 100,000 $ (537) June 2019 December 2021 1.61% 1-month LIBOR $ 150,000 $ (567) June 2019 December 2021 1.63% 1-month LIBOR $ 50,000 $ (191) If the fair value of the hedge is an asset, we include it in our Condensed Consolidated Balance Sheets in the line item “ Other assets ”, and, if a liability, as a component of “ Accounts payable and accrued expenses ”. See Note 11 for fair value disclosures about our interest rate swap agreements. Net liability balances for our hedges included as components of “ Accounts payable and accrued expenses ” on September 30, 2021 and December 31, 2020, were $1.8 million and $7.1 million, respectively. The following table summarizes interest expense ($ in thousands ): Three Months Ended Nine Months Ended September 30, September 30, 2021 2020 2021 2020 Interest expense on debt at contractual rates $ 10,234 $ 10,129 $ 31,055 $ 33,701 Losses reclassified from accumulated other comprehensive income into interest expense 1,851 1,778 5,449 4,533 Capitalized interest (6) (9) (40) (169) Amortization of debt issuance costs, debt discount and other 636 994 2,064 2,524 Total interest expense $ 12,715 $ 12,892 $ 38,528 $ 40,589

Commitments And Contingencies

Commitments And Contingencies	9 Months Ended
	Sep. 30, 2021
Commitments and Contingencies Disclosure [Abstract]
Commitments And Contingencies	Commitments, Contingencies and Uncertainties In the normal course of business, we enter into a variety of commitments, typically consisting of funding of revolving credit arrangements, construction and mezzanine loans to our operators to conduct expansions and acquisitions for their own account, and commitments for the funding of construction for expansion or renovation to our existing properties under lease. In our leasing operations, we offer to our tenants and to sellers of newly acquired properties a variety of inducements which originate contractually as contingencies but which may become commitments upon the satisfaction of the contingent event. Contingent payments earned will be included in the respective lease bases when funded. As of September 30, 2021, we had working capital, construction and mezzanine loan commitments to seven operators for $274.7 million, of which we had funded $183.6 million toward these commitments. As of September 30, 2021, we had $31.3 million of development commitments for construction and renovation for ten properties of which we had funded $21.6 million toward these commitments. In addition to these commitments, Discovery PropCo, discussed more fully in Note 2 to the condensed consolidated financial statements, has committed to funding up to $2.0 million for the purchase of condominium units located at one of the facilities of which $1.0 million had been funded. As of September 30, 2021, we had $33.9 million of contingent lease inducement commitments in seven lease agreements which are generally based on the performance of facility operations and may or may not be met by the tenant. At September 30, 2021, we had funded $1.5 million toward these commitments of which $1.0 million was funded during the nine months ended September 30, 2021. As provided above, loans funded do not include the effects of discounts or commitment fees. The credit loss liability for unfunded loan commitments is estimated using the same methodology as for our funded mortgage and other notes receivable based on the estimated amount that we expect to fund. We applied the same COVID-19 pandemic adjustments as discussed in Note 4. The liability for expected credit losses on our unfunded loans is presented in the following table for the nine months ended September 30, 2021 ( $ in thousands ): Beginning balance January 1, 2021 $ 270 Provision for expected credit losses 941 Balance at September 30, 2021 $ 1,211 Bickford Contingent Note Arrangement Related to the sale of six properties to Bickford discussed further in Note 3, we reached an agreement with Bickford in the third quarter of 2021 whereby Bickford would owe us up to $4.5 million under a contingent note arrangement. We have the one-time option to determine fair market value of the portfolio between May 1, 2023 and April 30, 2026, at which time the amount owed under the contingent note arrangement, if any, will be determined as the lesser of (i) the difference between the fair market value of the portfolio and $52.1 million, which amount represents the purchase consideration for the portfolio of $52.9 million less $0.8 million in mortgage debt repayment fees previously paid by us associated with this portfolio, and (ii) $4.5 million. Any amount due on the contingent note arrangement will accrue interest at an annual rate of 10% and will be due in five years from the determination date. COVID-19 Pandemic Contingencies Since the World Health Organization declared coronavirus disease 2019 a pandemic on March 11, 2020, the continually evolving pandemic has resulted in a widespread health crisis adversely affecting governments, businesses, and financial markets. The COVID-19 pandemic and related health and safety measures continue to impact the operations of many of the Company’s tenants, operators and borrowers. The federal government has provided economic assistance and other forms of assistance which mitigated to some extent the negative financial impact of the pandemic for certain of our tenants and operators who are eligible. Revenues for the operators of our properties continue to be significantly impacted by occupancy. Building occupancy rates have been and may continue to be adversely affected by the COVID-19 pandemic if it continues to cause sustained negative trends such as early resident move-outs, delays in admitting new residents, or other collateral events. In addition, our operators may experience a material increase in their operating costs, including costs related to enhanced health and safety precautions among other measures. A decrease in occupancy or increase in costs could have a material adverse effect on the ability of our operators to meet their financial and other contractual obligations to us, including the payment of rent, as well as on our results of operations. Since the pandemic began, our rent concessions activity is as shown in the following table ($ in thousands) : Year ended Three months ended Nine months ended December 31, 2020 September 30, 2021 September 30, 2021 Cumulative Totals Deferrals Abatements Deferrals Collections Deferrals Collections Deferrals Abatements Collections Bickford $ 3,750 $ 2,100 $ 3,500 $ — $ 13,750 $ — $ 17,500 $ 2,100 $ — Holiday — — 600 — 1,800 — 1,800 — — All Others 1,232 50 1,675 44 4,323 44 5,555 50 44 $ 4,982 $ 2,150 $ 5,775 $ 44 $ 19,873 $ 44 $ 24,855 $ 2,150 $ 44 The majority of the deferred amounts noted in the table above accrue interest starting at 8% per annum from the date of the deferral until paid in full under the terms of each tenant’s deferral agreement. In addition to the concessions noted above, we have agreed with Bickford to defer $4.5 million in contractual rent due for the fourth quarter of 2021 and expect to grant up to $4.0 million in deferrals in the first quarter of 2022. We have also reached agreement with two other tenants regarding additional rent deferrals of approximately $0.5 million for the fourth quarter of 2021. We agreed with Holiday to utilize $0.6 million of the lease deposit towards July 2021 contractual rent. The balance of the lease deposit at September 30, 2021 was $8.8 million. Reference Note 2 for discussion of additional Holiday contractual rent activity. When applicable, we have accounted for rent concessions as variable lease payments, recorded as rental income when received, in accordance with the FASB's Lease Modification Q&A. Reference Note 2 for further discussion. We will evaluate any rent deferral requests as a result of the COVID-19 pandemic on a tenant-by-tenant basis. The extent of future concessions we make as a result of the COVID-19 pandemic, which could have a material impact on our future operating results, cannot be reasonably or reliably projected by us at this time. Litigation Our facilities are subject to claims and suits in the ordinary course of business. Our lessees and borrowers have indemnified, and are obligated to continue to indemnify us, against all liabilities arising from the operation of the facilities, and are further obligated to indemnify us against environmental or title problems affecting the real estate underlying such facilities. While there may be lawsuits pending against certain of the owners and/or lessees of the facilities, management believes that the ultimate resolution of all such pending proceedings will have no direct material adverse effect on our financial condition, results of operations or cash flows. In June 2018, East Lake Capital Management LLC and certain related entities, including Regency (for three assisted living facilities in Tennessee, Indiana and North Carolina) (“East Lake”), filed suit against NHI in Texas seeking injunctive and declaratory relief and unspecified monetary damages. NHI responded with counterclaims and filed motions requesting the immediate appointment of a receiver and for pre-judgment possession. Resulting from these claims and counterclaims, on December 6, 2018, the parties entered into an agreement resulting in Regency vacating the facilities in December 2018. On September 22, 2021, all parties entered into an agreement whereby NHI is entitled to receive $0.4 million, due in the fourth quarter of 2021, to settle all claims for this matter. We will recognize the settlement amount as other income when it is received. In addition, we had approximately $0.3 million in liabilities recorded related to the facilities subject to the litigation that was reversed and recognized in “ Interest and other income ” during the third quarter of 2021.

Equity

Equity	9 Months Ended
	Sep. 30, 2021
Equity [Abstract]
Stockholders' Equity Note Disclosure	Note 8. Equity and Dividends At-the-Market (ATM) Equity Program During the nine months ended September 30, 2021, we sold 661,951 common shares through the ATM program with an average price of $73.62, resulting in net proceeds of approximately $47.9 million. We intend to use the proceeds from any further activity under the ATM program for general corporate purposes, which may include future acquisitions and repayment of indebtedness, including borrowings under our credit facility. Dividends The following table summarizes dividends declared by the Board of Directors or paid during the nine months ended September 30, 2021 and 2020: Nine Months Ended September 30, 2021 Date of Declaration Date of Record Date Paid/Payable Quarterly Dividend December 15, 2020 December 31, 2020 January 29, 2021 $1.1025 March 12, 2021 March 31, 2021 May 7, 2021 $1.1025 June 3, 2021 June 30, 2021 August 6, 2021 $0.90 August 6, 2021 September 30, 2021 November 5, 2021 $0.90 Nine Months Ended September 30, 2020 Date of Declaration Date of Record Date Paid/Payable Quarterly Dividend November 7, 2019 December 31, 2019 January 31, 2020 $1.05 February 19, 2020 March 31, 2020 May 8, 2020 $1.1025 June 15, 2020 June 30, 2020 August 7, 2020 $1.1025 September 14, 2020 September 30, 2020 November 6, 2020 $1.1025 On November 5, 2021, the Board of Directors declared a $0.90 per share dividend to common stockholders of record on December 31, 2021, payable on January 31, 2022.

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2021
Deferred Compensation Arrangements [Abstract]
Stock-Based Compensation	Note 9. Stock-Based Compensation The Company’s outstanding stock incentive awards have been granted under two incentive plans – the 2012 Stock Incentive Plan (“2012 Plan”) and the 2019 Stock Incentive Plan (“2019 Plan”). During the first quarter of 2021, we granted stock options under the 2019 Plan of 639,500 and the remaining 12,500 awards available under the 2012 Plan. As of September 30, 2021, shares available for future grants totaled 2,117,336 all under the 2019 plan. The following is a summary of stock-based compensation expense, net of any forfeitures, included in “ General and administrative expenses ” in the Condensed Consolidated Statements of Income ( $ in thousands ): Three Months Ended Nine Months Ended September 30, September 30, 2021 2020 2021 2020 Non-cash stock-based compensation expense $ 989 $ 457 $ 7,427 $ 2,772 The weighted average fair value of options granted during the nine months ended September 30, 2021 and 2020 was $14.54 and $5.54 per option, respectively. The fair value of each grant is estimated on the date of grant using the Black-Scholes option-pricing model with the following weighted average assumptions: 2021 2020 Dividend yield 6.7% 5.1% Expected volatility 48.1% 17.1% Expected lives 2.9 years 2.9 years Risk-free interest rate 0.33% 1.30% The following table summarizes our outstanding stock options: Weighted Average Number Weighted Average Remaining of Shares Exercise Price Contractual Life (Years) Options outstanding, January 1, 2020 1,004,014 $74.35 Options granted 592,000 $90.32 Options exercised (512,509) $72.98 Options forfeited (10,500) $88.73 Options outstanding, September 30, 2020 1,073,005 $83.68 Exercisable at September 30, 2020 601,994 $81.09 Options outstanding, January 1, 2021 1,033,838 $83.54 Options granted 652,000 $69.20 Options exercised (20,000) $60.52 Options outstanding, September 30, 2021 1,665,838 $78.20 3.37 Exercisable at September 30, 2021 1,183,324 $79.25 3.08 At September 30, 2021, the stock options outstanding and exercisable had no intrinsic value. The aggregate intrinsic value of stock options exercised during the nine months ended September 30, 2021 and 2020 was $0.2 million or $9.27 per share and $8.1 million or $15.84 per share, respectively. As of September 30, 2021, unrecognized compensation expense totaling $2.8 million associated with unvested stock options is expected to be recognized over the following periods: remainder of 2021 - $1.0 million, 2022 - $1.6 million and 2023 - $0.2 million.

Earnings and Dividends Per Shar

Earnings and Dividends Per Share	9 Months Ended
	Sep. 30, 2021
Earnings Per Share [Abstract]
Earnings Per Share	Earnings Per Common ShareThe weighted average number of common shares outstanding during the reporting period is used to calculate basic earnings per common share. Diluted earnings per common share assume the exercise of stock options and the conversion of our convertible debt prior to its retirement using the treasury stock method, to the extent dilutive. Dilution resulting from the conversion option within our convertible debt was determined by computing an average of incremental shares included in each diluted EPS computation. The following table summarizes the average number of common shares and the net income used in the calculation of basic and diluted earnings per common share ($ in thousands, except share and per share amounts) : Three Months Ended Nine Months Ended September 30, September 30, 2021 2020 2021 2020 Net income attributable to common stockholders $ 30,814 $ 42,595 $ 105,327 $ 147,986 BASIC: Weighted average common shares outstanding 45,850,599 44,661,650 45,668,762 44,641,748 DILUTED: Weighted average common shares outstanding 45,850,599 44,661,650 45,668,762 44,641,748 Stock options 825 753 6,391 1,766 Convertible senior notes — — 13,938 — Weighted average dilutive common shares outstanding 45,851,424 44,662,403 45,689,091 44,643,514 Net income attributable to common stockholders - basic $ 0.67 $ 0.95 $ 2.31 $ 3.31 Net income attributable to common stockholders - diluted $ 0.67 $ 0.95 $ 2.31 $ 3.31 Incremental anti-dilutive shares excluded: Net share effect of stock options with an exercise price in excess of the average market price for our common shares 505,459 410,012 308,313 427,180 Regular dividends declared per common share $ 0.90 $ 1.1025 $ 2.9025 $ 3.3075

Fair Value Of Financial Instrum

Fair Value Of Financial Instruments	9 Months Ended
	Sep. 30, 2021
Fair Value Of Financial Instruments [Abstract]
Fair Value Disclosures [Text Block]	Fair Value of Financial Instruments Our financial assets and liabilities measured at fair value on a recurring basis include derivative financial instruments. Derivative financial instruments include our interest rate swap agreements. Derivative financial instruments . Derivative financial instruments are valued in the market using discounted cash flow techniques. These techniques incorporate Level 1 and Level 2 inputs. The market inputs are utilized in the discounted cash flow calculation considering the instrument’s term, notional amount, discount rate and credit risk. Significant inputs to the derivative valuation model for interest rate swaps are observable in active markets and are classified as Level 2 in the hierarchy. Assets and liabilities measured at fair value on a recurring basis are as follows ($ in thousands) : Fair Value Measurement Balance Sheet Classification September 30, December 31, 2020 Level 2 Interest rate swap liability Accounts payable and accrued expenses $ 1,828 $ 7,150 Carrying amounts and fair values of financial instruments that are not carried at fair value at September 30, 2021 and December 31, 2020 in the Condensed Consolidated Balance Sheets are as follows ($ in thousands ): Carrying Amount Fair Value Measurement September 30, 2021 December 31, 2020 September 30, 2021 December 31, 2020 Level 2 Variable rate debt $ 398,311 $ 945,078 $ 400,000 $ 948,000 Fixed rate debt $ 886,976 $ 554,207 $ 876,917 $ 575,292 Level 3 Mortgage and other notes receivable, net $ 284,608 $ 292,427 $ 301,053 $ 321,021 Fixed rate debt. Fixed rate debt is classified as Level 2 and its value is based on quoted prices for similar instruments or calculated utilizing model derived valuations in which significant inputs are observable in active markets. Mortgage and other notes receivable. The fair value of mortgage and other notes receivable is based on credit risk and discount rates that are not observable in the marketplace and therefore represents a Level 3 measurement. Carrying amounts of cash and cash equivalents and restricted cash, accounts receivable and accounts payable approximate fair value due to their short-term nature. The fair values of our borrowings under our revolving credit facility and other variable rate debt are reasonably estimated at their notional amounts at September 30, 2021 and December 31, 2020, due to the predominance of floating interest rates, which generally reflect market conditions.

Significant Accounting Polici_2

Significant Accounting Policies (Policy)	9 Months Ended
	Sep. 30, 2021
Policy Text Block [Abstract]
Basis of Accounting, Policy	Basis of Presentation The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) for interim financial statements. In our opinion, the accompanying unaudited condensed consolidated financial statements reflect all adjustments consisting of normal recurring adjustments necessary for a fair presentation. Interim results of operations are not necessarily indicative of the results that may be achieved for a full year. The condensed consolidated financial statements and related notes do not include all information and footnotes required by GAAP for annual reports. These interim condensed consolidated financial statements should be read in conjunction with our audited consolidated financial statements and notes thereto as of and for the year ended December 31, 2020, included in our 2020 Annual Report on Form 10-K filed with the Securities and Exchange Commission (the “SEC”).
Consolidation, Policy	Principles of Consolidation The condensed consolidated financial statements include the accounts of the Company, its wholly owned subsidiaries and subsidiaries in which we have a controlling interest. We also consolidate certain entities when control of such entities can be achieved through means other than voting rights (“variable interest entities” or “VIEs”) if the Company is deemed to be the primary beneficiary of such entities. All material intercompany transactions and balances are eliminated in consolidation. At September 30, 2021, we held interests in ten unconsolidated VIEs, and, because we lack either directly or through related parties the power to direct the activities that most significantly impact their economic performance, we have concluded that the Company is not the primary beneficiary. Accordingly, we account for our transactions with these entities and their subsidiaries at either amortized cost or net realizable value for straight-line rent receivables, excluding our investment accounted for under the equity method discussed in Note 5. The Company’s unconsolidated VIEs are summarized below by date of initial involvement. For further discussion of the nature of the relationships, including the sources of exposure to these VIEs, see the notes to our condensed consolidated financial statements cross-referenced below ( $ in thousands ). Date Name Source of Exposure Carrying Amount Maximum Exposure to Loss Note Reference 2012 Bickford Senior Living Various 1 $ 67,000 $ 88,000 Notes 3, 4 2014 Senior Living Communities Notes and straight-line receivable $ 83,000 $ 93,000 Notes 3, 4 2016 Senior Living Management Notes and straight-line receivable $ 27,000 $ 27,000 — 2018 Sagewood, LCS affiliate Notes $ 109,000 $ 109,000 Note 4 2019 41 Management, LLC Notes and straight-line receivable $ 25,000 $ 34,000 — 2020 Timber Ridge OpCo, LLC Various 2 $ (5,000) $ 5,000 Note 5 2020 Watermark Retirement Notes and straight-line receivable $ 9,000 $ 10,000 — 2021 Montecito Medical Real Estate Notes and funding commitment $ 2,000 $ 50,000 Note 4 2021 Vizion Health Notes and straight-line receivable $ 20,000 $ 22,000 Notes 3, 4 2021 Navion Senior Solutions Notes and straight-line receivable $ 7,000 $ 14,000 Notes 3, 4 1 Notes, loan commitments, straight-line rent receivables, and unamortized lease incentives 2 Loan commitment, equity method investment and straight-line rent receivables We are not obligated to provide support beyond our stated commitments to these tenants and borrowers whom we classify as VIEs, and accordingly, our maximum exposure to loss as a result of these relationships is limited to the amount of our commitments, as shown above and discussed in the notes. Economic loss on a lease, in excess of what is presented in the table above, if any, would be limited to that resulting from any period of arrearage and non-payment of monthly rent before we are able to take effective remedial action, as well as costs incurred in transitioning the lease to a new tenant. The potential extent of such loss would be dependent upon individual facts and circumstances, and is therefore not included in the table above. In the future, NHI may be deemed the primary beneficiary of the operations if the tenants do not have adequate liquidity to accept the risks and rewards as the tenant and operator of the properties and might be required to consolidate the financial position and results of operations of the tenants into our consolidated financial statements. We consolidate two real estate partnerships formed with our partners, Discovery Senior Housing Investor XXIV, LLC, (“Discovery”) and LCS Timber Ridge LLC (“LCS”), to invest in senior housing facilities. As of and for the three and nine months ended September 30, 2021 and 2020, our noncontrolling interests relate to these partnerships with Discovery and LCS. We use the equity method of accounting when we own an interest in an entity whereby we can exert significant influence over but cannot control the entity’s operations. We discontinue equity method accounting if our investment in an entity (and net advances) is reduced to zero unless we have guaranteed obligations of the entity or are otherwise committed to provide further financial support for the entity.
Cash and Cash Equivalents, Restricted Cash and Cash Equivalents, Policy [Policy Text Block]	Cash and Cash Equivalents and Restricted Cash Cash equivalents consist of all highly liquid investments with an original maturity of three months or less. Restricted cash includes amounts required to be held on deposit or subject to an agreement (e.g., with a qualified intermediary subject to an Internal Revenue Code §1031 exchange agreement or in accordance with agency agreements governing our mortgages). The following table sets forth our “ Cash, cash equivalents and restricted cash ” reported within the Company’s Condensed Consolidated Statements of Cash Flows ($ in thousands) : September 30, September 30, Cash and cash equivalents $ 48,393 $ 42,198 Restricted cash (included in Other assets) 1,802 8,916 $ 50,195 $ 51,114
Real Estate Held for Development and Sale, Policy	Assets Held for Sale We consider properties to be assets held for sale when (1) management commits to a plan to sell the property; (2) it is unlikely that the disposal plan will be significantly modified or discontinued; (3) the property is available for immediate sale in its present condition; (4) actions required to complete the sale of the property have been initiated; (5) sale of the property is probable and we anticipate the completed sale will occur within one year; and (6) the property is actively being marketed for sale at a price that is
Impairment or Disposal of Long-Lived Assets, Policy	Real Estate Investment Impairment We evaluate the recoverability of the carrying amount of our real estate properties on a property-by-property basis. We review our properties for recoverability when events or circumstances, including significant physical changes in the property, significant adverse changes in general economic conditions and significant deterioration of the underlying cash flows of the property, indicate that the carrying amount of the property may not be recoverable. The need to recognize an impairment charge is based on estimated undiscounted future cash flows from a property compared to the carrying amount of that property. If recognition of an impairment charge is necessary, it is measured as the amount by which the carrying amount of the property exceeds the estimated fair value of the property. During the three and nine months ended September 30, 2021, we recognized impairment charges on five real estate properties of approximately $22.5 million included in “ Loan and realty losses (gains) ” in our Condensed Consolidated Statement of Income for the nine months ended September 30, 2021. Reference Note 3 for more discussion.
Revenue Recognition, Leases	Rental Income Our leases generally provide for rent escalators throughout the term of the lease. Base rental income is recognized using the straight-line method over the term of the lease to the extent that lease payments are considered collectible and the lease provides for specific contractual escalators. The Company reviews its operating lease receivables for collectibility on a regular basis, taking into consideration changes in factors such as the tenant’s payment history, the financial condition of the tenant, business conditions in which the tenant operates and economic conditions in the area where the property is located. In the event that collectibility with respect to any tenant is not probable, a direct write-off of the receivable is made as an adjustment to rental income and any future rental revenue is recognized only when the tenant makes a rental payment. On July 30, 2021, Atria Senior Living acquired the management services of the legacy Holiday Retirement (“Holiday”) portfolio who is the tenant for 17 independent living facilities leased pursuant to a master lease. We have not received any contractual rent due under the master lease since this transaction. Accordingly, we have placed the tenant on cash basis. Rent due but uncollected and unrecognized for August and September 2021 totaled $4.8 million.
New Accounting Pronouncements, Policy	Accounting for Lease Modifications related to Coronavirus Disease 2019 In April 2020, the FASB issued a question-and-answer document (the “Lease Modification Q&A”) focused on the application of lease accounting guidance to lease concessions provided as a result of the coronavirus (“COVID-19”) pandemic. The Lease Modification Q&A clarifies that entities may elect not to evaluate whether lease-related relief provided to mitigate the economic effects of the COVID-19 pandemic is a lease modification under Accounting Standard Codification (“ASC”) 842, Leases (“ASC 842”). Instead, an entity that elects not to evaluate whether a concession directly related to the COVID-19 pandemic, which does not substantially increase either its rights as lessor or the obligations of the tenant, is a lease modification can decide whether or not to apply the modification guidance. An entity should apply the election consistently to leases with similar characteristics and similar circumstances. NHI has elected not to apply the modification guidance under ASC 842 and has accounted for qualified rent concessions as variable lease payments when applicable, recorded as rental income when received. During the three and nine months ended September 30, 2021, we provided $5.8 million and $19.9 million, respectively, in lease concessions as a result of the COVID-19 pandemic, as discussed in more detail in Note 7.

Significant Accounting Polici_3

Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2021
Accounting Policies [Abstract]
Schedule of Variable Interest Entities [Table Text Block]	VIEs are summarized below by date of initial involvement. For further discussion of the nature of the relationships, including the sources of exposure to these VIEs, see the notes to our condensed consolidated financial statements cross-referenced below ( $ in thousands ). Date Name Source of Exposure Carrying Amount Maximum Exposure to Loss Note Reference 2012 Bickford Senior Living Various 1 $ 67,000 $ 88,000 Notes 3, 4 2014 Senior Living Communities Notes and straight-line receivable $ 83,000 $ 93,000 Notes 3, 4 2016 Senior Living Management Notes and straight-line receivable $ 27,000 $ 27,000 — 2018 Sagewood, LCS affiliate Notes $ 109,000 $ 109,000 Note 4 2019 41 Management, LLC Notes and straight-line receivable $ 25,000 $ 34,000 — 2020 Timber Ridge OpCo, LLC Various 2 $ (5,000) $ 5,000 Note 5 2020 Watermark Retirement Notes and straight-line receivable $ 9,000 $ 10,000 — 2021 Montecito Medical Real Estate Notes and funding commitment $ 2,000 $ 50,000 Note 4 2021 Vizion Health Notes and straight-line receivable $ 20,000 $ 22,000 Notes 3, 4 2021 Navion Senior Solutions Notes and straight-line receivable $ 7,000 $ 14,000 Notes 3, 4 1 Notes, loan commitments, straight-line rent receivables, and unamortized lease incentives 2 Loan commitment, equity method investment and straight-line rent receivables
Schedule of Cash, Cash Equivalents and Restricted Cash [Table Text Block]	The following table sets forth our “ Cash, cash equivalents and restricted cash ” reported within the Company’s Condensed Consolidated Statements of Cash Flows ($ in thousands) : September 30, September 30, Cash and cash equivalents $ 48,393 $ 42,198 Restricted cash (included in Other assets) 1,802 8,916 $ 50,195 $ 51,114

Real Estate (Tables)

Real Estate (Tables)	9 Months Ended
	Sep. 30, 2021
Real Estate [Abstract]
New Real Estate Investments [Table Text Block]	During the nine months ended September 30, 2021, we completed the following real estate acquisitions as described below ($ in thousands) : Operator Date Properties Asset Class Land Building and Improvements Total Vizion Health Q2 2021 1 HOSP $ 1,470 $ 38,780 $ 40,250 Navion Senior Solutions Q2 2021 1 SHO 531 6,069 6,600 $ 2,001 $ 44,849 $ 46,850
Asset Disposition	During the nine months ended September 30, 2021, we completed the following real estate dispositions as described below ($ in thousands) : Operator Date Properties Asset Class Net Proceeds Net Real Estate Investment Other 1 Gain/(Impairment) 2 Bickford Q2 2021 6 SHO $ 39,924 $ 34,485 $ 1,871 $ 3,568 $ 3,568 Community Health Systems Q2 2021 1 MOB 3,887 946 62 2,879 TrustPoint Hospital Q3 2021 1 HOSP 31,215 21,018 1,562 8,635 Holiday Q3 2021 8 SHO 114,133 113,611 (1,360) 1,882 Quorum Health Q3 2021 1 HOSP 8,314 9,568 — (1,254) Senior Living Management Q3 2021 1 SHO 12,847 3,212 210 9,425 Holiday Q3 2021 1 SHO 5,666 10,388 (81) (4,641) $ 215,986 $ 193,228 $ 2,264 $ 20,494 1 includes straight-line rent and deferred lease intangibles 2 impairment charges are included in “Loan and realty losses (gains)” in our Condensed Consolidated Income Statement as of September 30, 2021
Schedule of Tenant Concentrations	Tenant Concentration The following table contains information regarding tenant concentration in our portfolio, excluding $2.6 million for our corporate office and a credit loss reserve balance of $5.1 million, based on the percentage of revenues for the nine months ended September 30, 2021 and 2020, related to tenants or affiliates of tenants, that exceed 10% of total revenue ( $ in thousands ): as of September 30, 2021 Revenues 1 Asset Number of Real Notes Nine Months Ended September 30, Class Properties Estate Receivable 2021 2020 Senior Living Communities EFC 10 $ 573,631 $ 42,609 $ 38,094 17% $ 38,972 15% National HealthCare Corporation (NHC) SNF 42 171,188 — 28,290 12% 28,362 11% Bickford Senior Living ALF 42 490,308 38,751 26,224 11% 39,142 16% Holiday ILF 17 377,735 — 22,811 10% 30,529 12% All others, net 2 Various 1,406,251 208,387 106,110 46% 107,377 43% Escrow funds received from tenants for property operating expenses Various — — 7,519 4% 7,190 3% $ 3,019,113 $ 289,747 $ 229,048 $ 251,572 1 includes interest income on notes receivable 2 includes prior period amounts for disposals or transitioned to new operators
Schedule of Fixed and Variable Lease Payments [Table Text Block]	The table below indicates the revenue recognized as a result of fixed and variable lease escalators ( $ in thousands ): Three Months Ended Nine Months Ended September 30, September 30, 2021 2020 2021 2020 Lease payments based on fixed escalators, net of deferrals $ 59,027 $ 67,592 $ 188,008 $ 206,179 Lease payments based on variable escalators 1,288 1,386 3,201 4,151 Straight-line rent income 3,798 5,086 12,189 15,481 Escrow funds received from tenants for property operating expenses 3,182 4,007 7,519 7,190 Amortization of lease incentives (252) (250) (774) (735) Rental income $ 67,043 $ 77,821 $ 210,143 $ 232,266
Lessor, Operating Lease, Payment to be Received, Fiscal Year Maturity	Future minimum lease payments to be received by us under our operating leases at September 30, 2021, are as follows ( $ in thousands ): Remainder of 2021 $ 68,151 2022 271,682 2023 267,619 2024 263,266 2025 264,666 2026 268,736 Thereafter 1,102,245 $ 2,506,365

Mortgage And Other Notes Rece_2

Mortgage And Other Notes Receivable (Tables)	9 Months Ended
	Sep. 30, 2021
Mortgage and Other Notes Receivable [Abstract]
Financing Receivable Credit Quality Indicators	net by year of origination of ( $ in thousands ): 2021 2020 2019 2018 2017 Prior Total Mortgages more than 1.5x $ — $ 20,382 $ 9,013 $ 28,700 $ — $ 4,402 $ 62,497 between 1.0x and 1.5x — — — 108,606 — — 108,606 less than 1.0x — 3,960 39,123 — — 10,000 53,083 — 24,342 48,136 $ 137,306 — 14,402 224,186 Mezzanine more than 1.5x 3,566 — — — — — 3,566 between 1.0x and 1.5x 22,233 — — — — 10,472 32,705 less than 1.0x — — — — — 14,500 14,500 No coverage available — — 750 — — — 750 25,799 — 750 — — 24,972 51,521 Revolver more than 1.5x 4,131 between 1.0x and 1.5x 9,909 less than 1.0x — 14,040 Credit loss reserve (5,139) $ 284,608
Schedule of Financing Receivable, Allowance for Credit Loss, Roll Forward	The allowance for expected credit losses is presented in the following table for the nine months ended September 30, 2021 ( $ in thousands ): Beginning balance January 1, 2021 $ 4,946 Provision for expected credit losses 193 Balance September 30, 2021 $ 5,139

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2021
Debt Instruments [Abstract]
Schedule of Debt	Debt consists of the following ( $ in thousands ): September 30, December 31, Revolving credit facility - unsecured $ — $ 298,000 Bank term loans - unsecured 400,000 650,000 Senior notes - unsecured, net of discount of $3,002 396,998 — Private placement term loans - unsecured 400,000 400,000 Fannie Mae term loans - secured, non-recourse 95,077 95,354 Convertible senior notes - unsecured — 60,000 Unamortized loan costs (6,788) (4,069) $ 1,285,287 $ 1,499,285
Schedule of Maturities of Long-term Debt	Aggregate principal maturities of debt as of September 30, 2021 are as follows ( $ in thousands ): Remainder of 2021 $ 95 2022 100,389 2023 475,408 2024 75,425 2025 143,761 2026 — Thereafter 496,997 1,292,075 Less: unamortized loan costs (6,788) $ 1,285,287
Schedule of Unsecured Term Loans	Our unsecured private placement term loans, payable interest-only, are summarized below ( $ in thousands ): Amount Inception Maturity Fixed Rate $ 125,000 January 2015 January 2023 3.99% 50,000 November 2015 November 2023 3.99% 75,000 September 2016 September 2024 3.93% 50,000 November 2015 November 2025 4.33% 100,000 January 2015 January 2027 4.51% $ 400,000
Schedule of Interest Rate Derivatives	September 30, 2021, we employed the following interest rate swap contracts to mitigate our interest rate risk on our bank term and revolver loans described above ( $ in thousands ): Date Entered Maturity Date Swap Rate Rate Index Notional Amount Fair Value (Liability) March 2019 December 2021 2.22% 1-month LIBOR $ 100,000 $ (533) March 2019 December 2021 2.21% 1-month LIBOR $ 100,000 $ (537) June 2019 December 2021 1.61% 1-month LIBOR $ 150,000 $ (567) June 2019 December 2021 1.63% 1-month LIBOR $ 50,000 $ (191)
Schedule of Interest Expense	The following table summarizes interest expense ($ in thousands ): Three Months Ended Nine Months Ended September 30, September 30, 2021 2020 2021 2020 Interest expense on debt at contractual rates $ 10,234 $ 10,129 $ 31,055 $ 33,701 Losses reclassified from accumulated other comprehensive income into interest expense 1,851 1,778 5,449 4,533 Capitalized interest (6) (9) (40) (169) Amortization of debt issuance costs, debt discount and other 636 994 2,064 2,524 Total interest expense $ 12,715 $ 12,892 $ 38,528 $ 40,589

Commitments and Contingencies (

Commitments and Contingencies (Tables)	9 Months Ended
	Sep. 30, 2021
Commitments and Contingencies Disclosure [Abstract]
Schedule of Loan Commitments [Table Text Block]	As provided above, loans funded do not include the effects of discounts or commitment fees.
Off Balance Sheet, Credit Loss, Liability, Roll Forward	The liability for expected credit losses on our unfunded loans is presented in the following table for the nine months ended September 30, 2021 ( $ in thousands ): Beginning balance January 1, 2021 $ 270 Provision for expected credit losses 941 Balance at September 30, 2021 $ 1,211
Schedule of Rent Concessions	Since the pandemic began, our rent concessions activity is as shown in the following table ($ in thousands) : Year ended Three months ended Nine months ended December 31, 2020 September 30, 2021 September 30, 2021 Cumulative Totals Deferrals Abatements Deferrals Collections Deferrals Collections Deferrals Abatements Collections Bickford $ 3,750 $ 2,100 $ 3,500 $ — $ 13,750 $ — $ 17,500 $ 2,100 $ — Holiday — — 600 — 1,800 — 1,800 — — All Others 1,232 50 1,675 44 4,323 44 5,555 50 44 $ 4,982 $ 2,150 $ 5,775 $ 44 $ 19,873 $ 44 $ 24,855 $ 2,150 $ 44

Equity (Tables)

Equity (Tables)	9 Months Ended
	Sep. 30, 2021
Equity [Abstract]
Dividends Declared	The following table summarizes dividends declared by the Board of Directors or paid during the nine months ended September 30, 2021 and 2020: Nine Months Ended September 30, 2021 Date of Declaration Date of Record Date Paid/Payable Quarterly Dividend December 15, 2020 December 31, 2020 January 29, 2021 $1.1025 March 12, 2021 March 31, 2021 May 7, 2021 $1.1025 June 3, 2021 June 30, 2021 August 6, 2021 $0.90 August 6, 2021 September 30, 2021 November 5, 2021 $0.90 Nine Months Ended September 30, 2020 Date of Declaration Date of Record Date Paid/Payable Quarterly Dividend November 7, 2019 December 31, 2019 January 31, 2020 $1.05 February 19, 2020 March 31, 2020 May 8, 2020 $1.1025 June 15, 2020 June 30, 2020 August 7, 2020 $1.1025 September 14, 2020 September 30, 2020 November 6, 2020 $1.1025

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2021
Deferred Compensation Arrangements [Abstract]
Share-based Payment Arrangement, Expensed and Capitalized, Amount	The following is a summary of stock-based compensation expense, net of any forfeitures, included in “ General and administrative expenses ” in the Condensed Consolidated Statements of Income ( $ in thousands ): Three Months Ended Nine Months Ended September 30, September 30, 2021 2020 2021 2020 Non-cash stock-based compensation expense $ 989 $ 457 $ 7,427 $ 2,772
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]	The fair value of each grant is estimated on the date of grant using the Black-Scholes option-pricing model with the following weighted average assumptions: 2021 2020 Dividend yield 6.7% 5.1% Expected volatility 48.1% 17.1% Expected lives 2.9 years 2.9 years Risk-free interest rate 0.33% 1.30%
Schedule of Stock Option Activity	The following table summarizes our outstanding stock options: Weighted Average Number Weighted Average Remaining of Shares Exercise Price Contractual Life (Years) Options outstanding, January 1, 2020 1,004,014 $74.35 Options granted 592,000 $90.32 Options exercised (512,509) $72.98 Options forfeited (10,500) $88.73 Options outstanding, September 30, 2020 1,073,005 $83.68 Exercisable at September 30, 2020 601,994 $81.09 Options outstanding, January 1, 2021 1,033,838 $83.54 Options granted 652,000 $69.20 Options exercised (20,000) $60.52 Options outstanding, September 30, 2021 1,665,838 $78.20 3.37 Exercisable at September 30, 2021 1,183,324 $79.25 3.08

Earnings and Dividends Per Sh_2

Earnings and Dividends Per Share (Tables)	9 Months Ended
	Sep. 30, 2021
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	The following table summarizes the average number of common shares and the net income used in the calculation of basic and diluted earnings per common share ($ in thousands, except share and per share amounts) : Three Months Ended Nine Months Ended September 30, September 30, 2021 2020 2021 2020 Net income attributable to common stockholders $ 30,814 $ 42,595 $ 105,327 $ 147,986 BASIC: Weighted average common shares outstanding 45,850,599 44,661,650 45,668,762 44,641,748 DILUTED: Weighted average common shares outstanding 45,850,599 44,661,650 45,668,762 44,641,748 Stock options 825 753 6,391 1,766 Convertible senior notes — — 13,938 — Weighted average dilutive common shares outstanding 45,851,424 44,662,403 45,689,091 44,643,514 Net income attributable to common stockholders - basic $ 0.67 $ 0.95 $ 2.31 $ 3.31 Net income attributable to common stockholders - diluted $ 0.67 $ 0.95 $ 2.31 $ 3.31 Incremental anti-dilutive shares excluded: Net share effect of stock options with an exercise price in excess of the average market price for our common shares 505,459 410,012 308,313 427,180 Regular dividends declared per common share $ 0.90 $ 1.1025 $ 2.9025 $ 3.3075

Fair Value Of Financial Instr_2

Fair Value Of Financial Instruments Fair Value Of Financial Instruments (Tables)	9 Months Ended
	Sep. 30, 2021
Fair Value Of Financial Instruments [Abstract]
Schedule of Assets and Liabilities Measured on Recurring Basis	iabilities measured at fair value on a recurring basis are as follows ($ in thousands) : Fair Value Measurement Balance Sheet Classification September 30, December 31, 2020 Level 2 Interest rate swap liability Accounts payable and accrued expenses $ 1,828 $ 7,150
Fair Value Measurements, Nonrecurring [Table Text Block]	Carrying amounts and fair values of financial instruments that are not carried at fair value at September 30, 2021 and December 31, 2020 in the Condensed Consolidated Balance Sheets are as follows ($ in thousands ): Carrying Amount Fair Value Measurement September 30, 2021 December 31, 2020 September 30, 2021 December 31, 2020 Level 2 Variable rate debt $ 398,311 $ 945,078 $ 400,000 $ 948,000 Fixed rate debt $ 886,976 $ 554,207 $ 876,917 $ 575,292 Level 3 Mortgage and other notes receivable, net $ 284,608 $ 292,427 $ 301,053 $ 321,021

Organization, Consolidation a_2

Organization, Consolidation and Presentation of Financial Statements (Details) $ in Thousands	Sep. 30, 2021USD ($)	Sep. 30, 2021properties	Sep. 30, 2021	Sep. 30, 2021beds_or_units	Dec. 31, 2020USD ($)
Real Estate Investment Property, Portfolio Assets | $	$ 3,000,000
Number of Properties		208
Number of States in which Entity Operates			34
Number of Lessees			33
Number of health care properties related to mortgage notes receivables		14		14
Loans and Leases Receivable, Gross | $	289,747
Financing Receivable, Allowance for Credit Loss | $	$ 5,139				$ 4,946
Senior Housing Community [Member]
Number of Properties		133
Skilled Nursing Facility [Member]
Number of Properties		72
Hospital [Member]
Number of Properties		2
Medical Office Building [Member]
Number of Properties		1
Asset Held For Sale [Member]
Number of Properties		3

Significant Accounting Polici_4

Significant Accounting Policies (Schedule of Variable Interest Entities) (Details) $ in Thousands	Sep. 30, 2021USD ($)
Straight-Line Rent Receivable [Member] | Bickford Senior Living [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Reporting Entity Involvement, Carrying Amount	$ (67,000)
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	88,000
Straight-Line Rent Receivable [Member] | Senior Living Communities [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Reporting Entity Involvement, Carrying Amount	(83,000)
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	93,000
Straight-Line Rent Receivable [Member] | Senior Living Management [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Reporting Entity Involvement, Carrying Amount	(27,000)
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	27,000
Notes Receivable [Member] | LCS Sagewood [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Reporting Entity Involvement, Carrying Amount	(109,000)
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	109,000
Notes Receivable [Member] | 41 Management [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Reporting Entity Involvement, Carrying Amount	(25,000)
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	34,000
Notes Receivable [Member] | Timber Ridge OpCo
Variable Interest Entity [Line Items]
Variable Interest Entity, Reporting Entity Involvement, Carrying Amount	(5,000)
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	5,000
Notes Receivable [Member] | Watermark Retirement [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Reporting Entity Involvement, Carrying Amount	(9,000)
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	10,000
Notes Receivable [Member] | Montecito Medical Real Estate
Variable Interest Entity [Line Items]
Variable Interest Entity, Reporting Entity Involvement, Carrying Amount	(2,000)
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	50,000
Notes Receivable [Member] | Vizion Health
Variable Interest Entity [Line Items]
Variable Interest Entity, Reporting Entity Involvement, Carrying Amount	(20,000)
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	22,000
Notes Receivable [Member] | Navion Senior Solutions [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Reporting Entity Involvement, Carrying Amount	(7,000)
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	$ 14,000

Significant Accounting Polici_5

Significant Accounting Policies Schedule of Cash (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020	Sep. 30, 2020	Dec. 31, 2019
Schedule of Cash [Abstract]
Cash and cash equivalents	$ 48,393		$ 42,198
Restricted cash	1,802		8,916
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents	$ 50,195	$ 46,343	$ 51,114	$ 15,669

Significant Accounting Polici_6

Significant Accounting Policies (Details) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2021USD ($)properties	Sep. 30, 2021USD ($)properties
Variable Interest Entity Number Of Entities Not Primary Beneficiary | properties	10	10
Impairment of Real Estate		$ (22,500)
Number of Properties | properties	208	208
Real Estate. Impairment
Number of Properties | properties	5	5
Holiday Acquisition Holdings [Member]
Number of Properties | properties	17	17
Contractual rent due but not paid	$ 4,800
Lease Payment Deferral [Member]
Operating Lease, Lease Income		$ 24,855
Lease Payment Deferral [Member] | Holiday Acquisition Holdings [Member]
Operating Lease, Lease Income		1,800
Lease Payment Deferral [Member] | Rent Deferred Second Quarter of 2021
Operating Lease, Lease Income	5,775
Lease Payment Deferral [Member] | Rent Deferred Six Months of 2021
Operating Lease, Lease Income		19,873
Lease Payment Deferral [Member] | Rent Deferred Six Months of 2021 | Holiday Acquisition Holdings [Member]
Operating Lease, Lease Income		1,800
Lease Payment Deferral [Member] | Rent Deferred Third Quarter of 2021 | Holiday Acquisition Holdings [Member]
Operating Lease, Lease Income	600
Lease Payment Deferral 2021 [Member]
Operating Lease, Lease Income		$ 19,900
Lease Payment Deferral 2021 [Member] | Rent Deferred Third Quarter of 2021
Operating Lease, Lease Income	$ 5,800

Real Estate (New Real Estate In

Real Estate (New Real Estate Investments) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2021USD ($)properties	Dec. 31, 2020USD ($)
Land	$ 200,559	$ 220,361
Number of Properties | properties	208
Current Period Real Estate Acquisition
Land	$ 2,001
Buildings and Improvements, Gross	44,849
Real Estate Investments During The Period	46,850
Vizion Health | Current Period Real Estate Acquisition
Land	1,470
Buildings and Improvements, Gross	38,780
Real Estate Investments During The Period	$ 40,250
Number of Properties | properties	1
Navion Senior Solutions [Member] | Current Period Real Estate Acquisition
Land	$ 531
Buildings and Improvements, Gross	6,069
Real Estate Investments During The Period	$ 6,600
Number of Properties | properties	1
Bickford Senior Living [Member]
Number of Properties | properties	42
Bickford Senior Living [Member] | Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member]
Number of Properties | properties	6

Asset Disposition (Details)

Asset Disposition (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021USD ($)properties	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)properties	Sep. 30, 2020USD ($)	Aug. 05, 2021beds_or_units
Number of Properties | properties	208		208
Gains (Losses) on Sales of Investment Real Estate	$ 19,941	$ 0	$ 26,426	$ 21,007
Proceeds from Sale of Wholly Owned Real Estate and Real Estate Acquired in Settlement of Loans			203,147	$ 39,260
Net Proceeds from the Sale of Real Estate			215,986
Impairment of Real Estate			(22,500)
Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member]
Real Estate Investments, Net	$ 193,228		193,228
2019 Straight Line Rent			(2,264)
Gains (Losses) on Sales of Investment Real Estate			$ 20,494
Bickford Senior Living [Member]
Number of Properties | properties	42		42
Gains (Losses) on Sales of Investment Real Estate			$ 3,568
Proceeds from Sale of Wholly Owned Real Estate and Real Estate Acquired in Settlement of Loans			39,924
Bickford Senior Living [Member] | Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member]
Real Estate Investments, Net	$ 34,485		$ 34,485
Number of Properties | properties	6		6
2019 Straight Line Rent			$ 1,871
Proceeds from Sale of Wholly Owned Real Estate and Real Estate Acquired in Settlement of Loans	$ 52,100
Community Health Systems
Gains (Losses) on Sales of Investment Real Estate			2,879
Net Proceeds from the Sale of Real Estate			3,887
Community Health Systems | Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member]
Real Estate Investments, Net	$ 946		$ 946
Number of Properties | properties	1		1
2019 Straight Line Rent			$ (62)
TrustPoint Hospital
Gains (Losses) on Sales of Investment Real Estate	$ 8,600		8,635
Net Proceeds from the Sale of Real Estate			31,215
TrustPoint Hospital | Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member]
Real Estate Investments, Net	$ 21,018		$ 21,018
Number of Properties | properties	1		1
2019 Straight Line Rent			$ (1,562)
Holiday Acquisition Holding Eight | Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member]
Real Estate Investments, Net	$ 113,611		113,611
Quorum Health [Member]
Net Proceeds from the Sale of Real Estate			8,314
Impairment of Real Estate	(1,300)		(1,254)
Quorum Health [Member] | Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member]
Real Estate Investments, Net	9,568		9,568
Number of Properties | beds_or_units					1
Senior Living Management [Member]
Gains (Losses) on Sales of Investment Real Estate	9,400		9,425
Net Proceeds from the Sale of Real Estate			12,847
Senior Living Management [Member] | Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member]
Real Estate Investments, Net	$ 3,212		3,212
Number of Properties | beds_or_units					1
2019 Straight Line Rent			$ (210)
Holiday Acquisition Holdings [Member]
Number of Properties | properties	17		17
Gains (Losses) on Sales of Investment Real Estate	$ 1,900		$ 1,882
Net Proceeds from the Sale of Real Estate			$ 114,133
Holiday Acquisition Holdings [Member] | Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member]
Number of Properties	8		8		8
2019 Straight Line Rent			$ 1,360
Holiday Arbor Glenn
Net Proceeds from the Sale of Real Estate			5,666
Impairment of Real Estate	$ (4,600)		(4,641)
Holiday Arbor Glenn | Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member]
Real Estate Investments, Net	$ 10,388		10,388
Number of Properties | beds_or_units					1
2019 Straight Line Rent			$ 81

Real Estate (Schedule of Tenant

Real Estate (Schedule of Tenant Concentrations) (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021USD ($)properties	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)properties	Sep. 30, 2020USD ($)	Dec. 31, 2020USD ($)
Number of Properties | properties	208		208
Property, Plant and Equipment, Gross	$ 3,021,664		$ 3,021,664		$ 3,265,070
Loans and Leases Receivable, Net Amount	284,608		284,608		$ 292,427
Revenues	73,833	$ 84,301	229,048	$ 251,572
Lease Income	67,043	77,821	210,143	$ 232,266
Real Estate Investment Property, at Cost	3,019,113		3,019,113
Loans and Leases Receivable, Gross	289,747		289,747
Nonportfolio Assets, Original Cost	2,600		$ 2,600
Escrow Funds Received From Tenants [Member]
Percentage of Continuing Revenue			4.00%	3.00%
Lease Income	$ 3,182	$ 4,007	$ 7,519	$ 7,190
Senior Living Communities [Member]
Number of Properties | properties	10		10
Property, Plant and Equipment, Gross	$ 573,631		$ 573,631
Loans and Leases Receivable, Net Amount	$ 42,609		$ 42,609
Percentage of Continuing Revenue			17.00%	15.00%
Lease Income			$ 38,094	$ 38,972
National Healthcare Corporation [Member]
Number of Properties | properties	42		42
Property, Plant and Equipment, Gross	$ 171,188		$ 171,188
Percentage of Continuing Revenue			12.00%	11.00%
Lease Income			$ 28,290	$ 28,362
Bickford Senior Living [Member]
Number of Properties | properties	42		42
Property, Plant and Equipment, Gross	$ 490,308		$ 490,308
Loans and Leases Receivable, Net Amount	$ 38,751		$ 38,751
Percentage of Continuing Revenue			11.00%	16.00%
Lease Income			$ 26,224	$ 39,142
Holiday Acquisition Holdings [Member]
Number of Properties | properties	17		17
Property, Plant and Equipment, Gross	$ 377,735		$ 377,735
Percentage of Continuing Revenue			10.00%	12.00%
Lease Income			$ 22,811	$ 30,529
Less than 10% Operators [Member]
Property, Plant and Equipment, Gross	1,406,251		1,406,251
Loans and Leases Receivable, Net Amount	$ 208,387		$ 208,387
Percentage of Continuing Revenue		43.00%	46.00%
Lease Income			$ 106,110	$ 107,377

Real Estate (Schedule of Future

Real Estate (Schedule of Future Minimum Lease Payments) (Details) $ in Thousands	Sep. 30, 2021USD ($)
Operating Leases, Future Minimum Payments Due, Rolling Maturity [Abstract]
Operating Leases, Future Minimum Payments, Remainder of Fiscal Year	$ 68,151
Operating Leases, Future Minimum Payments Due, Next Twelve Months	271,682
Operating Leases, Future Minimum Payments, Due in Two Years	267,619
Operating Leases, Future Minimum Payments, Due in Three Years	263,266
Operating Leases, Future Minimum Payments, Due in Four Years	264,666
Operating Leases, Future Minimum Payments, Due in Five Years	268,736
Operating Leases, Future Minimum Payments, Due Thereafter	1,102,245
Operating Leases, Future Minimum Payments Due	$ 2,506,365

Real Estate (Schedule of Fixed

Real Estate (Schedule of Fixed and Variable Lease Payments) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Lease Income	$ 67,043	$ 77,821	$ 210,143	$ 232,266
Fixed Lease Escalation [Member]
Lease Income	59,027	67,592	188,008	206,179
Variable Lease Escalation [Member]
Lease Income	1,288	1,386	3,201	4,151
Straight Line Rent Income [Member]
Lease Income	3,798	5,086	12,189	15,481
Escrow Funds Received From Tenants [Member]
Lease Income	3,182	4,007	7,519	7,190
Lease Incentives
Amortization	$ (252)	$ (250)	$ (774)	$ (735)

Real Estate (Narrative) (Detail

Real Estate (Narrative) (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021USD ($)beds_or_unitspropertiesnumberOfBoardMembersrenewalOptions	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)beds_or_unitspropertiesnumberOfBoardMembersrenewalOptions	Sep. 30, 2020USD ($)	Aug. 05, 2021beds_or_units	Dec. 31, 2020USD ($)
Number of Real Estate Properties | properties	208		208
Number of States in which Entity Operates	34		34
Property, Plant and Equipment, Net	$ 2,428,449		$ 2,428,449			$ 2,667,432
Loans and Leases Receivable, Gross	289,747		289,747
Loans and Leases Receivable, Commitments, Fixed Rates			274,700
Gains (Losses) on Sales of Investment Real Estate	19,941	$ 0	26,426	$ 21,007
Impairment of Real Estate			$ (22,500)
Minimum Holding Period After Purchase Option Exercise			1 year
Financing Receivable, Allowance for Credit Loss	(5,139)		$ (5,139)			$ (4,946)
Lease Income	$ 67,043	77,821	$ 210,143	232,266
Revenue as % of Total, Exceeds 10% [Member]
Number of States in which Entity Operates | beds_or_units	2		2
Open Now [Member]
Number of Real Estate Properties | properties	5		5
Minimum Annual Lease Income	$ 3,400	3,400	$ 10,300	$ 10,000
Property, Plant and Equipment, Net	$ 18,800		$ 18,800
After 2021 [Member]
Number of Real Estate Properties | beds_or_units	10		10
Property, Plant and Equipment, Net	$ 90,500		$ 90,500
Bickford Senior Living [Member]
Number of Real Estate Properties | properties	42		42
Percentage of Continuing Revenue			11.00%	16.00%
Proceeds from Sale of Real Estate			$ 39,900
Gains (Losses) on Sales of Investment Real Estate			3,568
Lease Income			$ 26,224	$ 39,142
Non-Performing Lease [Member]
Number of Real Estate Properties | beds_or_units	9		9
Number of Operators/Tenants | beds_or_units	5		5
Lease Income	$ 700	900	$ 2,400	$ 3,700
NHC Board Members [Member]
Number of Board Members | numberOfBoardMembers	2		2
Vizion Health
Loans and Leases Receivable, Commitments, Fixed Rates			$ 20,000
Number of Units in Real Estate Property | beds_or_units	64		64
Lessor, Operating Lease, Term of Contract	15 years		15 years
Lessee, Operating Lease, Renewal Term	5 years		5 years
Initial lease rate	8.50%		8.50%
Lease Escalator Minimum	2.50%		2.50%
Number of Additional Lease Renewal Options | renewalOptions	2		2
Payments for Capital Improvements			$ 2,000
Navion Senior Solutions [Member]
Loans and Leases Receivable, Commitments, Fixed Rates			$ 3,600
Number of Units in Real Estate Property | beds_or_units	48		48
Lessor, Operating Lease, Term of Contract	12 years		12 years
Lessee, Operating Lease, Renewal Term	5 years		5 years
Initial lease rate	7.50%		7.50%
Lease Escalator Minimum	2.50%		2.50%
Number of Additional Lease Renewal Options | renewalOptions	2		2
Holiday Acquisition Holdings [Member]
Number of Real Estate Properties | properties	17		17
Percentage of Continuing Revenue			10.00%	12.00%
Proceeds from Sale of Real Estate	$ 115,000
Gains (Losses) on Sales of Investment Real Estate	1,900		$ 1,882
Lease Income			22,811	$ 30,529
TrustPoint Hospital
Proceeds from Sale of Property Held-for-sale	31,200
Gains (Losses) on Sales of Investment Real Estate	8,600		8,635
Lease Income	100	700	1,400	2,000
Community Health Systems
Proceeds from Sale of Real Estate			4,300
Gains (Losses) on Sales of Investment Real Estate			2,879
Asset Disposition Transaction Cost			(400)
Quorum Health [Member]
Proceeds from Sale of Real Estate	9,000
Impairment of Real Estate	(1,300)		(1,254)
Asset Disposition Transaction Cost	(700)
Senior Living Management [Member]
Proceeds from Sale of Real Estate	14,000
Gains (Losses) on Sales of Investment Real Estate	9,400		9,425
Lease Income			800
Holiday Arbor Glenn
Proceeds from Sale of Real Estate	5,800
Impairment of Real Estate	(4,600)		$ (4,641)
Holiday Acquisition Holdings [Member]
Asset Disposition Transaction Cost	(900)
Senior Living Management [Member]
Asset Disposition Transaction Cost	(1,200)
Holiday Arbor Glenn
Asset Disposition Transaction Cost	$ (100)
Hospital [Member]
Number of Real Estate Properties | properties	2		2
Hospital [Member] | Open Now [Member]
Minimum Annual Lease Income	$ (500)		$ (1,400)
Property, Plant and Equipment, Net	9,500		9,500
Purchase Option, Amount, Minimum	$ 15,000		15,000
Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member]
Gains (Losses) on Sales of Investment Real Estate			20,494
2019 Straight Line Rent			$ 2,264
Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member] | Bickford Senior Living [Member]
Number of Real Estate Properties | properties	6		6
Property, Plant and Equipment, Net	$ 34,500		$ 34,500
Proceeds from Sale of Real Estate	$ 52,900
Loans and Leases Receivable, Commitments, Fixed Rates			13,000
2019 Straight Line Rent			(1,871)
Lease Income			$ 1,600	4,500
Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member] | Holiday Acquisition Holdings [Member]
Number of Real Estate Properties	8		8		8
Property, Plant and Equipment, Net	$ 113,600		$ 113,600
2019 Straight Line Rent			(1,360)
Lease Income	$ 900	2,500	$ 5,900	7,500
Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member] | TrustPoint Hospital
Number of Real Estate Properties | properties	1		1
2019 Straight Line Rent			$ 1,562
Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member] | Community Health Systems
Number of Real Estate Properties | properties	1		1
2019 Straight Line Rent			$ 62
Lease Income			100	300
Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member] | Quorum Health [Member]
Number of Real Estate Properties | beds_or_units					1
Lease Income	$ 700	900	2,500	2,300
Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member] | Senior Living Management [Member]
Number of Real Estate Properties | beds_or_units					1
2019 Straight Line Rent			210
Lease Income		300		1,000
Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member] | Holiday Arbor Glenn
Number of Real Estate Properties | beds_or_units					1
Property, Plant and Equipment, Net	10,400		10,400
2019 Straight Line Rent			(81)
Lease Income	$ 100	$ 200	$ 400	$ 500
Negotiations to sale | Bickford Senior Living [Member]
Number of Real Estate Properties | beds_or_units	9		9
Current Period Real Estate Acquisition
Real Estate Investments During The Period			$ 46,850
Current Period Real Estate Acquisition | Vizion Health
Number of Real Estate Properties | properties	1		1
Real Estate Investments During The Period			$ 40,250
Asset Purchase Transaction Costs			$ 300
Current Period Real Estate Acquisition | Navion Senior Solutions [Member]
Number of Real Estate Properties | properties	1		1
Real Estate Investments During The Period			$ 6,600
Asset Purchase Transaction Costs			100
Asset Held For Sale [Member]
Impairment of Real Estate			$ (16,600)
Asset Held For Sale [Member] | Non-Performing Lease [Member]
Number of Real Estate Properties | properties	3		3
Discontinued Operations, Disposed of by Sale | Senior Living Management [Member]
Lease Income	$ 300
Disposal Group, Disposed of by Means Other than Sale, Not Discontinued Operations, Spinoff
Impairment of Real Estate	$ (5,900)
TEXAS
Percentage of Continuing Revenue			10.10%
TEXAS | Asset Held For Sale [Member]
Number of Real Estate Properties | properties	2		2
TENNESSEE | Asset Held For Sale [Member]
Number of Real Estate Properties | properties	1		1
SOUTH CAROLINA
Percentage of Continuing Revenue			11.10%

Mortgage And Other Notes Rece_3

Mortgage And Other Notes Receivable (Schedule of Financing Receivables By Credit Quality Indicator) (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	$ 289,747
Financing Receivable, Allowance for Credit Loss	5,139	$ 4,946
Loans and Leases Receivable, Net Amount	284,608	$ 292,427
Mortgages [Member]
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	224,186
Mortgages [Member] | 2020 [Member]
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	24,342
Mortgages [Member] | 2019
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	48,136
Mortgages [Member] | 2018
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	137,306
Mortgages [Member] | EBITDARM Coverage above 1.5x
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	62,497
Mortgages [Member] | EBITDARM Coverage above 1.5x | 2020 [Member]
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	20,382
Mortgages [Member] | EBITDARM Coverage above 1.5x | 2019
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	9,013
Mortgages [Member] | EBITDARM Coverage above 1.5x | 2018
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	28,700
Mortgages [Member] | EBITDARM Coverage, 1.0x to 1.5x
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	108,606
Mortgages [Member] | EBITDARM Coverage, 1.0x to 1.5x | 2018
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	108,606
Mortgages [Member] | EBITDARM Coverage Below 1.0x
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	53,083
Mortgages [Member] | EBITDARM Coverage Below 1.0x | 2020 [Member]
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	3,960
Mortgages [Member] | EBITDARM Coverage Below 1.0x | 2019
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	39,123
Mezzanine
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	51,521
Mezzanine | 2019
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	750
Mezzanine | EBITDARM Coverage above 1.5x
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	3,566
Mezzanine | EBITDARM Coverage, 1.0x to 1.5x
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	32,705
Mezzanine | EBITDARM Coverage Below 1.0x
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	14,500
Mezzanine | EBITDARM Coverage Not Available
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	750
Mezzanine | EBITDARM Coverage Not Available | 2019
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	750
Revolving Credit Facility
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	14,040
Revolving Credit Facility | EBITDARM Coverage above 1.5x
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	4,131
Revolving Credit Facility | EBITDARM Coverage, 1.0x to 1.5x
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and Leases Receivable, Gross	$ 9,909

Mortgage And Other Notes Rece_4

Mortgage And Other Notes Receivable (Schedule of Financing Receivables, Allowance for Credit Loss Roll Forward) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2021USD ($)
Financing Receivable, Allowance for Credit Loss [Line Items]
Financing Receivable, Allowance for Credit Loss, Beginning Balance	$ 4,946
Financing Receivable, Allowance for Credit Loss, Period Increase (Decrease)	193
Financing Receivable, Allowance for Credit Loss, Ending Balance	5,139
Loans and Leases Receivable, Gross	289,747
Mortgages [Member]
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	224,186
Mortgages [Member] | EBITDARM Coverage Below 1.0x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	53,083
Mortgages [Member] | EBITDARM Coverage above 1.5x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	62,497
Mortgages [Member] | EBITDARM Coverage, 1.0x to 1.5x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	108,606
Mezzanine
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	51,521
Mezzanine | EBITDARM Coverage Below 1.0x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	14,500
Mezzanine | EBITDARM Coverage above 1.5x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	3,566
Mezzanine | EBITDARM Coverage, 1.0x to 1.5x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	32,705
Mezzanine | EBITDARM Coverage Not Available
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	750
Revolving Credit Facility
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	14,040
Revolving Credit Facility | EBITDARM Coverage above 1.5x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	4,131
Revolving Credit Facility | EBITDARM Coverage, 1.0x to 1.5x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	9,909
2021 | Mezzanine
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	25,799
2021 | Mezzanine | EBITDARM Coverage above 1.5x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	3,566
2021 | Mezzanine | EBITDARM Coverage, 1.0x to 1.5x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	22,233
2020 [Member] | Mortgages [Member]
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	24,342
2020 [Member] | Mortgages [Member] | EBITDARM Coverage Below 1.0x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	3,960
2020 [Member] | Mortgages [Member] | EBITDARM Coverage above 1.5x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	20,382
2019 | Mortgages [Member]
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	48,136
2019 | Mortgages [Member] | EBITDARM Coverage Below 1.0x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	39,123
2019 | Mortgages [Member] | EBITDARM Coverage above 1.5x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	9,013
2019 | Mezzanine
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	750
2019 | Mezzanine | EBITDARM Coverage Not Available
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	750
2018 | Mortgages [Member]
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	137,306
2018 | Mortgages [Member] | EBITDARM Coverage above 1.5x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	28,700
2018 | Mortgages [Member] | EBITDARM Coverage, 1.0x to 1.5x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	108,606
Prior to 2017 | Mortgages [Member]
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	14,402
Prior to 2017 | Mortgages [Member] | EBITDARM Coverage Below 1.0x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	10,000
Prior to 2017 | Mortgages [Member] | EBITDARM Coverage above 1.5x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	4,402
Prior to 2017 | Mezzanine
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	24,972
Prior to 2017 | Mezzanine | EBITDARM Coverage Below 1.0x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	14,500
Prior to 2017 | Mezzanine | EBITDARM Coverage, 1.0x to 1.5x
Financing Receivable, Allowance for Credit Loss [Line Items]
Loans and Leases Receivable, Gross	$ 10,472

Mortgage And Other Notes Rece_5

Mortgage And Other Notes Receivable (Schedule of Bickford Construction Loans) (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Dec. 31, 2020
Loans and Leases Receivable, Commitments, Fixed Rates	$ 274,700
Loans and Leases Receivable, Net Amount	(284,608)	$ (292,427)
Bickford Note Investment [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	42,900
Loans and Leases Receivable, Net Amount	$ (34,800)

Mortgage And Other Notes Rece_6

Mortgage And Other Notes Receivable (Narrative) (Details) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2021USD ($)properties	Sep. 30, 2021USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2021beds_or_units	Sep. 30, 2021renewalOptions	Sep. 30, 2021	Sep. 30, 2021properties	Sep. 30, 2021number_of_loans	Dec. 31, 2020USD ($)
Number of health care properties related to mortgage notes receivables				14			14
Probability of Default, Increase, Current Conditions Adjustment						20.00%
Estimated Credit Losses, Current Conditions Adjustment, Combined						44.00%
Loans and Leases Receivable, Gross	$ 289,747	$ 289,747
Loans and Leases Receivable, Net Amount	284,608	284,608							$ 292,427
Loans and Leases Receivable, Commitments, Fixed Rates		274,700
Financing Receivable, Allowance for Credit Loss	(5,139)	(5,139)							$ (4,946)
Increase in mortgage note receivable from sale of real estate			$ 4,000
Number of Construction Loans | number_of_loans								3
Interest Rate Swaps, Maturity Date, After June 2020 [Member]
Derivative, Notional Amount	400,000	400,000
Bickford Note Investment [Member]
Contingent Incentive Payments	2,000	2,000
Loans and Leases Receivable, Net Amount	34,800	34,800
Loans and Leases Receivable, Commitments, Fixed Rates		42,900
LCS Sagewood [Member]
Loans and Leases Receivable, Commitments, Fixed Rates		109,200
Increase (Decrease) in Notes Receivables	9,800	61,200
Interest and Fee Income, Other Loans	400
Timber Ridge OpCo
Financing Receivable, Revolving	5,000	5,000
Senior Living Communities [Member]
Loans and Lease Receivable, Maximum Revolving Amount	20,000	20,000
Revolving Note Receivable, Amount Outstanding	(9,900)	$ (9,900)
Loans Receivable, Description of Variable Rate Basis, Reference Rate Maturity		10 years
Loans Receivable, Basis Spread on Variable Rate						6.00%
Loans Receivable, Description, Variable Rate Basis, Reference Rate		7.52%
Loans and Leases Receivable, Net Amount	42,609	$ 42,609
Number of Additional Lease Renewal Options | properties							2
Note Receivable Renewal Term		1 year
Purchase Option, Amount, Minimum	38,300	$ 38,300
Percentage of Continuing Revenue		17.00%	15.00%
Montecito Medical Real Estate
Notes Receivable, Interest Rate, Master Credit Agreement						9.50%
Loan Term		5 years
Loans and Leases Receivable, Net Amount	2,100	$ 2,100
Number of Additional Lease Renewal Options | renewalOptions					2
Note Receivable Renewal Term		1 year
Loans and Leases Receivable, Commitments, Fixed Rates		$ 50,000
Incremental Percentage Increase in the Stated Rate of a Note Receivable						2.50%
Bickford Senior Living [Member]
Loans and Leases Receivable, Net Amount	38,751	$ 38,751
Percentage of Continuing Revenue		11.00%	16.00%
Proceeds from Interest Received	300	$ 600
Bickford Senior Living [Member] | Loan Balance Threshold Payment Terms Change
Loans and Leases Receivable, Commitments, Fixed Rates		$ 5,300
Bickford Senior Living [Member] | Contractual Interest Rate Reduction
Note Receivable Interest Rate						8.00%
Vizion Health
Number of Units in Real Estate Property | beds_or_units				64
Notes Receivable, Interest Rate, Master Credit Agreement						8.50%
Loan Term		5 years
Number of Additional Lease Renewal Options | renewalOptions					2
Loans and Leases Receivable, Commitments, Fixed Rates		$ 20,000
Incremental Percentage Increase in the Stated Rate of a Note Receivable						2.50%
Note receivable, Payment Terms, Reduced Percent of Excess Operating Cash Flow						50.00%
Note receivable, Payment Terms, Initial Percent of Excess Operating Cash Flow						90.00%
Vizion Health | Loan Balance Threshold Payment Terms Change
Loans and Leases Receivable, Commitments, Fixed Rates		$ 15,000
Navion Senior Solutions [Member]
Number of Units in Real Estate Property | beds_or_units				48
Loan Term		10 years
Note Receivable Interest Rate						8.00%
Number of Additional Lease Renewal Options | renewalOptions					2
Loans and Leases Receivable, Commitments, Fixed Rates		$ 3,600
Not Secured By Real Estate [Member]
Loans and Leases Receivable, Net Amount	65,600	65,600
After 2021 [Member] | Senior Living Communities [Member]
Loans and Lease Receivable, Maximum Revolving Amount	15,000	15,000
Secured By Real Estate
Loans and Leases Receivable, Net Amount	$ 224,200	$ 224,200
June 2019 Transaction | Senior Living Communities [Member]
Number of Units in Real Estate Property | beds_or_units				248
Notes Receivable, Interest Rate, Master Credit Agreement						7.25%
Loan Term		5 years
Loans and Leases Receivable, Commitments, Fixed Rates		$ 32,700
Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member] | Bickford Senior Living [Member]
Loan Term	15 years
Note Receivable Interest Rate						10.00%
Loans and Leases Receivable, Commitments, Fixed Rates		13,000
Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member] | Bickford Senior Living [Member] | Unlikely to be Collected Financing Receivable
Increase in mortgage note receivable from sale of real estate	$ 13,000
Current Period Real Estate Acquisition
Real Estate Investments During The Period		46,850
Current Period Real Estate Acquisition | Vizion Health
Real Estate Investments During The Period		40,250
Current Period Real Estate Acquisition | Navion Senior Solutions [Member]
Real Estate Investments During The Period		6,600
Property Held by Fund | Montecito Medical Real Estate
Real Estate Investments During The Period		$ 11,100
Number Of Real Estate Properties Acquired | properties	2

Equity Method Investment (Detai

Equity Method Investment (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Guarantor Obligations, Maximum Exposure, Undiscounted	$ 15,500		$ 15,500
Income (Loss) from Equity Method Investments	(557)	$ (728)	(2,274)	$ (2,018)
Equity Method Investments	(5,000)		(5,000)
Proceeds from Equity Method Investment, Distribution			476	$ 0
Noncontrolling Interest [Member] | Real Estate Operating Company [Member]
Investments in and Advance to Affiliates, Subsidiaries, Associates, and Joint Ventures	900		900
Timber Ridge OpCo
Financing Receivable, Revolving	5,000		5,000
Proceeds from Equity Method Investment, Distribution			500
Equity Method Investment, Difference Between Carrying Amount and Underlying Equity	$ 300		$ 300
LCS Timber Ridge [Member] | Real Estate Operating Company [Member]
Noncash or Part Noncash Acquisition, Interest Acquired			25.00%

Debt (Schedule of Debt) (Detail

Debt (Schedule of Debt) (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020	Sep. 30, 2020
Debt Instrument [Line Items]
Revolving credit facility - unsecured	$ 0	$ 298,000
Bank term loans - unsecured	400,000
Convertible senior notes - unsecured	0	60,000
Unamortized loan costs	(6,788)	(4,069)
Debt, Long-term and Short-term, Combined Amount	1,285,287	1,499,285
Bank Term Loans [Member]
Debt Instrument [Line Items]
Bank term loans - unsecured	400,000	650,000
Senior Notes Due 2031
Debt Instrument [Line Items]
Bank term loans - unsecured	396,998		$ 0
Debt Instrument, Unamortized Discount	(3,002)
Private Placement Term Loans [Member]
Debt Instrument [Line Items]
Bank term loans - unsecured	400,000	400,000
Debt Instrument, Name, Fannie Mae Term Loans [Member]
Debt Instrument [Line Items]
Secured Debt	$ 95,077	$ 95,354

Debt (Schedule of Maturities of

Debt (Schedule of Maturities of Long-term Debt) (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Long-term Debt, Fiscal Year Maturity [Abstract]
Long-Term Debt, Maturity, Remainder of Fiscal Year	$ 95
Long-term Debt, Maturities, Repayments of Principal in Next Rolling Twelve Months	100,389
Long-term Debt, Maturities, Repayments of Principal in Rolling Year Two	475,408
Long-term Debt, Maturities, Repayments of Principal in Rolling Year Three	75,425
Long-term Debt, Maturities, Repayments of Principal in Rolling Year Four	143,761
Long-term Debt, Maturities, Repayments of Principal in Rolling Year Five	0
Long-term Debt, Maturities, Repayments of Principal in Rolling after Year Five	496,997
Long-term Debt, Gross	1,292,075
Unamortized loan costs	(6,788)	$ (4,069)
Debt	$ 1,285,287	$ 1,499,285

Debt (Schedule of Unsecured Ter

Debt (Schedule of Unsecured Term Loans) (Details) $ in Thousands	Sep. 30, 2021USD ($)
Unsecured Debt	$ 400,000
January 2023 [Member]
Unsecured Debt	$ 125,000
Debt Instrument, Interest Rate, Stated Percentage	3.99%
November 2023 [Member]
Unsecured Debt	$ 50,000
Debt Instrument, Interest Rate, Stated Percentage	3.99%
September 2024 [Member]
Unsecured Debt	$ 75,000
Debt Instrument, Interest Rate, Stated Percentage	3.93%
November 2025 [Member]
Unsecured Debt	$ 50,000
Debt Instrument, Interest Rate, Stated Percentage	4.33%
January 2027 [Member]
Unsecured Debt	$ 100,000
Debt Instrument, Interest Rate, Stated Percentage	4.51%

Debt (Schedule of Interest Rate

Debt (Schedule of Interest Rate Derivatives) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2021USD ($)
Interest Rate Swap, Date Entered, March 2019 - 2.22%
Derivative [Line Items]
Derivative, Fixed Interest Rate	2.22%
Debt Instrument, Description of Variable Rate Basis	1-month LIBOR
Derivative, Notional Amount	$ 100,000
Interest Rate Derivative Liabilities, at Fair Value	$ (533)
Interest Rate Swap, Date Entered, March 2019 - 2.21%
Derivative [Line Items]
Derivative, Fixed Interest Rate	2.21%
Debt Instrument, Description of Variable Rate Basis	1-month LIBOR
Derivative, Notional Amount	$ 100,000
Interest Rate Derivative Liabilities, at Fair Value	$ (537)
Interest Rate Swap, Date Entered, June 2019 - 1.61%
Derivative [Line Items]
Derivative, Fixed Interest Rate	1.61%
Debt Instrument, Description of Variable Rate Basis	1-month LIBOR
Derivative, Notional Amount	$ 150,000
Interest Rate Derivative Liabilities, at Fair Value	$ (567)
Interest Rate Swap, Date Entered, June 2019 - 1.63%
Derivative [Line Items]
Derivative, Fixed Interest Rate	1.63%
Debt Instrument, Description of Variable Rate Basis	1-month LIBOR
Derivative, Notional Amount	$ 50,000
Interest Rate Derivative Liabilities, at Fair Value	$ (191)

Debt (Schedule of Interest Expe

Debt (Schedule of Interest Expense) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Schedule of Interest Expense [Abstract]
Interest expense on debt at contractual rates	$ 10,234	$ 10,129	$ 31,055	$ 33,701
Losses reclassified from accumulated other comprehensive income (loss) into interest expense	1,851	1,778	5,449	4,533
Capitalized interest	(6)	(9)	(40)	(169)
Amortization of debt issuance costs and debt discount	636	994	2,064	2,524
Total Interest Expense	$ 12,715	$ 12,892	$ 38,528	$ 40,589

Debt (Narrative) (Details)

Debt (Narrative) (Details) $ in Thousands, beds_or_units in Millions	3 Months Ended	9 Months Ended
	Sep. 30, 2021USD ($)	Sep. 30, 2021USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2021properties	Sep. 30, 2021beds_or_units	Sep. 30, 2021	Dec. 31, 2020USD ($)
Convertible Debt	$ 0	$ 0					$ 60,000
Debt Leverage Limit, Coupon Change, Trigger		50.00%
Credit Facility, Current Revolving Borrowing Capacity	550,000	$ 550,000
Line of Credit Facility, Unused Capacity, Commitment Fee Percentage		0.25%
Debt Instrument, Variable Rate Basis, Minimum						800.00%	1400.00%
Number of Real Estate Properties | properties				208
Interest Rate Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months, Net	1,800	$ 1,800
Derivative, Fair Value, Net							$ (7,100)
Repayments of Convertible Debt		67,100
Long-term Debt, Gross	1,292,075	1,292,075
Debt Instrument, Convertible, Liquidation Preference, Value	6,100	6,100
Interest on Convertible Debt, Net of Tax	1,000
Proceeds from Issuance of Senior Long-term Debt		396,784	$ 0
Fair Value, Inputs, Level 2 [Member]
Interest rate swap liability	(1,828)	(1,828)	$ (7,150)
$250M Term Loan [Member]
Term Loans, Outstanding Balance	100,000	100,000
$300M Term Loan [Member]
Term Loans, Outstanding Balance	300,000	$ 300,000
Debt Instrument, Name, Revolving Credit Facility [Member]
Debt Instrument, Basis Spread on Variable Rate		1.20%
Unused balance of the unsecured revolving credit facility	550,000	$ 550,000
Bank Term Loans [Member]
Debt Instrument, Basis Spread on Variable Rate		1.28%
Debt Instrument, Name, Fannie Mae Term Loans [Member]
Number of Real Estate Properties						13
Net Book Value of Real Estate Pledged Toward Mortgage	127,000	$ 127,000
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate, Face Amount of Mortgages	78,100	$ 78,100
Debt Instrument, Interest Rate, Stated Percentage						3.79%
Debt Instrument, Term		10 years
FNMA Berkadia Note [Member]
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate, Face Amount of Mortgages	17,000	$ 17,000
Debt Instrument, Interest Rate, Stated Percentage						4.60%
Debt Instrument, Name, Convertible Senior Notes [Member]
Debt Instrument, Interest Rate, Stated Percentage						3.25%
$100M Term Loan [Member]
Term Loans, Outstanding Balance	100,000	$ 100,000
Debt Instrument, Basis Spread on Variable Rate		1.85%
Debt Instrument, Variable Rate Basis, Minimum						0.50%
Payment for Debt Extinguishment or Debt Prepayment Cost		$ (500)
Revolving Credit Facility [Member]
Debt Instrument, Maturity, Renewal Fee					0.6	10
Senior Notes Due 2031 | Senior Notes
Debt Instrument, Interest Rate, Stated Percentage						3.00%
Debt Instrument, Face Amount	400,000	400,000
Percentage of Issue Price On Face Value						0.99196%
Proceeds from Issuance of Senior Long-term Debt		392,300
Interest Rate Swap(s), Date Entered, March & June 2019 [Member] | Bank Term Loans [Member]
Derivative, Notional Amount	400,000	400,000
Interest Rate Swaps, Maturity Date, After June 2020 [Member]
Derivative, Notional Amount	$ 400,000	$ 400,000

Commitments and Contingencies_2

Commitments and Contingencies (Schedule of Loan Commitments) (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Dec. 31, 2020
Loans and Leases Receivable, Commitments, Fixed Rates	$ 274,700
Loans and Leases Receivable, Net Amount	(284,608)	$ (292,427)
LCS Sagewood [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	109,200
Bickford Senior Living [Member]
Loans and Leases Receivable, Net Amount	(38,751)
Senior Living Communities [Member]
Loans and Leases Receivable, Net Amount	(42,609)
Montecito Medical Real Estate
Loans and Leases Receivable, Commitments, Fixed Rates	50,000
Loans and Leases Receivable, Net Amount	(2,100)
Notes Receivable Remain Unfunded [Member]
Loans and Leases Receivable, Net Amount	$ (183,600)

Commitments And Contingencies_3

Commitments And Contingencies (Off Balance Sheet Credit Loss Liability Roll Forward Schedule) (Details)	9 Months Ended
	Sep. 30, 2021USD ($)
Off-Balance Sheet, Credit Loss, Liability, Credit Loss Expense (Reversal)	$ 941,000
Off-Balance Sheet, Credit Loss, Liability, Ending Balance	1,211,000
Accounting Standards Update 2016-13 [Member]
Off-Balance Sheet, Credit Loss, Liability, Ending Balance	$ 270,000

Commitments and Contingencies_4

Commitments and Contingencies (Schedule of Lease Commitments) (Details) $ in Millions	Sep. 30, 2021USD ($)
Maximum Commitment For All Active Development Projects	$ 31.3
Development in Process	$ (21.6)

Commitments And Contingencies_5

Commitments And Contingencies (Schedule of Rent Concessions) (Details) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2021
Lease Payment Deferral [Member]
Operating Lease, Lease Income		$ 24,855
Lease Payment Deferral [Member] | Lease Payment Deferral 2020
Operating Lease, Lease Income		4,982
Lease Payment Deferral [Member] | Rent Deferred Second Quarter of 2021
Operating Lease, Lease Income	$ 5,775
Lease Payment Deferral [Member] | Rent Deferred Six Months of 2021
Operating Lease, Lease Income		19,873
Lease Payment Deferral [Member] | Collection of Rent Deferred
Operating Lease, Lease Income	44	44
Lease Payment Deferral [Member] | Bickford Senior Living [Member]
Operating Lease, Lease Income		17,500
Lease Payment Deferral [Member] | Bickford Senior Living [Member] | Lease Payment Deferral 2020
Operating Lease, Lease Income		3,750
Lease Payment Deferral [Member] | Bickford Senior Living [Member] | Rent Deferred Six Months of 2021
Operating Lease, Lease Income		13,750
Lease Payment Deferral [Member] | Bickford Senior Living [Member] | Rent Deferred Third Quarter of 2021
Operating Lease, Lease Income	3,500
Lease Payment Deferral [Member] | Bickford Senior Living [Member] | Rent Deferred Nine Months of 2021
Operating Lease, Lease Income		13,750
Lease Payment Deferral [Member] | Holiday Acquisition Holdings [Member]
Operating Lease, Lease Income		1,800
Lease Payment Deferral [Member] | Holiday Acquisition Holdings [Member] | Rent Deferred Six Months of 2021
Operating Lease, Lease Income		1,800
Lease Payment Deferral [Member] | Holiday Acquisition Holdings [Member] | Rent Deferred Third Quarter of 2021
Operating Lease, Lease Income	600
Lease Payment Deferral [Member] | Holiday Acquisition Holdings [Member] | Rent Deferred Nine Months of 2021
Operating Lease, Lease Income		1,800
Lease Payment Deferral [Member] | Other Than Bickford and Holiday
Operating Lease, Lease Income		5,555
Lease Payment Deferral [Member] | Other Than Bickford and Holiday | Lease Payment Deferral 2020
Operating Lease, Lease Income		1,232
Lease Payment Deferral [Member] | Other Than Bickford and Holiday | Rent Deferred Six Months of 2021
Operating Lease, Lease Income		4,323
Lease Payment Deferral [Member] | Other Than Bickford and Holiday | Rent Deferred Third Quarter of 2021
Operating Lease, Lease Income	1,675
Lease Payment Deferral [Member] | Other Than Bickford and Holiday | Rent Deferred Nine Months of 2021
Operating Lease, Lease Income		4,323
Lease Payment Deferral [Member] | Other Than Bickford and Holiday | Collection of Rent Deferred
Operating Lease, Lease Income	$ 44	44
Lease Abatement [Member]
Operating Lease, Lease Income		2,150
Lease Abatement [Member] | Lease Abatement for 2020
Operating Lease, Lease Income		2,150
Lease Abatement [Member] | Bickford Senior Living [Member]
Operating Lease, Lease Income		2,100
Lease Abatement [Member] | Bickford Senior Living [Member] | Lease Abatement for 2020
Operating Lease, Lease Income		2,100
Lease Abatement [Member] | Other Than Bickford and Holiday
Operating Lease, Lease Income		50
Lease Abatement [Member] | Other Than Bickford and Holiday | Lease Abatement for 2020
Operating Lease, Lease Income		$ 50

Commitments And Contingencies_6

Commitments And Contingencies (Narrative) (Details) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2021USD ($)propertiesnumber_of_loansbeds_or_units	Sep. 30, 2021USD ($)propertiesnumber_of_loansbeds_or_units	Sep. 30, 2020USD ($)	Aug. 05, 2021beds_or_units	Dec. 31, 2020USD ($)
Maximum Commitment For All Active Development Projects	$ 31,300	$ 31,300
Development in Process	21,600	21,600
Contingent Funding Commitment	$ 33,900	$ 33,900
Number of Properties | properties	208	208
Contingent Funding Commitment, Amount Funded	$ 1,000	$ 1,000
Lease deposit liabilities	8,838	8,838			$ 10,638
Loans and Leases Receivable, Commitments, Fixed Rates		274,700
Loans and Leases Receivable, Net Amount	284,608	284,608			$ 292,427
Litigation Settlement, Amount Awarded from Other Party	400
Other Noncash Income	$ 300	1,351	$ 2,865
Proceeds from Sale of Wholly Owned Real Estate and Real Estate Acquired in Settlement of Loans		203,147	$ 39,260
Lease Payment Deferral [Member]
Operating Lease, Lease Income		24,855
Lease Abatement [Member]
Operating Lease, Lease Income		$ 2,150
Initial Interest Rate [Member]
Deferred Lease Payments, Accrual Interest Rate	8.00%	8.00%
Discovery PropCo [Member]
Maximum Commitment For All Active Development Projects	$ 2,000	$ 2,000
Bickford Senior Living [Member]
Number of Properties | properties	42	42
Loans and Leases Receivable, Net Amount	$ 38,751	$ 38,751
Proceeds from Sale of Real Estate		39,900
Proceeds from Sale of Wholly Owned Real Estate and Real Estate Acquired in Settlement of Loans		39,924
Bickford Senior Living [Member] | Assessed not probable to occur
Asset disposition, contingent consideration, note receivable	$ 4,500	4,500
Bickford Senior Living [Member] | Lease Payment Deferral [Member]
Operating Lease, Lease Income		17,500
Bickford Senior Living [Member] | Lease Abatement [Member]
Operating Lease, Lease Income		$ 2,100
Senior Living Communities [Member]
Number of Properties | properties	10	10
Loans and Leases Receivable, Net Amount	$ 42,609	$ 42,609
Navion Senior Solutions [Member]
Loans and Leases Receivable, Commitments, Fixed Rates		$ 3,600
Note Receivable Interest Rate	8.00%	8.00%
Loan Term		10 years
Holiday Acquisition Holdings [Member]
Number of Properties | properties	17	17
Lease deposit liabilities	$ 8,800	$ 8,800
Proceeds from Sale of Real Estate	$ 115,000
Holiday Acquisition Holdings [Member] | Lease Payment Deferral [Member]
Operating Lease, Lease Income		1,800
Other Than Bickford and Holiday | Lease Payment Deferral [Member]
Operating Lease, Lease Income		5,555
Other Than Bickford and Holiday | Lease Abatement [Member]
Operating Lease, Lease Income		$ 50
Development Commitment [Member]
Number of Operators/Tenants | number_of_loans	10	10
Lease Inducement [Member]
Number of Properties | beds_or_units	7	7
Contingent Funding Commitment, Amount Funded	$ 1,500	$ 1,500
Lease Inducement [Member] | Navion Senior Solutions [Member]
Contingent Funding Commitment, Amount Funded	1,000	1,000
Rent Deferred Second Quarter of 2021 | Lease Payment Deferral [Member]
Operating Lease, Lease Income	5,775
Rent Deferred Third Quarter of 2021 | Bickford Senior Living [Member] | Lease Payment Deferral [Member]
Operating Lease, Lease Income	3,500
Rent Deferred Third Quarter of 2021 | Holiday Acquisition Holdings [Member] | Lease Payment Deferral [Member]
Operating Lease, Lease Income	600
Rent Deferred Third Quarter of 2021 | Other Than Bickford and Holiday | Lease Payment Deferral [Member]
Operating Lease, Lease Income	$ 1,675
Rent Deferred Nine Months of 2021 | Bickford Senior Living [Member] | Lease Payment Deferral [Member]
Operating Lease, Lease Income		13,750
Rent Deferred Nine Months of 2021 | Holiday Acquisition Holdings [Member] | Lease Payment Deferral [Member]
Operating Lease, Lease Income		1,800
Rent Deferred Nine Months of 2021 | Other Than Bickford and Holiday | Lease Payment Deferral [Member]
Operating Lease, Lease Income		$ 4,323
Rent Deferred Fourth Quarter of 2021 | Lease Payment Deferral [Member]
Number of Operators/Tenants | properties	2	2
Rent Deferred Fourth Quarter of 2021 | Bickford Senior Living [Member] | Lease Payment Deferral [Member]
Operating Lease, Lease Income		$ 4,500
Rent Deferred Fourth Quarter of 2021 | Other Than Bickford and Holiday | Lease Payment Deferral [Member]
Operating Lease, Lease Income		500
Rent Deferred First Quarter of 2022 | Bickford Senior Living [Member] | Lease Payment Deferral [Member]
Operating Lease, Lease Income		$ 4,000
Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member] | Bickford Senior Living [Member]
Number of Properties | properties	6	6
Loans and Leases Receivable, Commitments, Fixed Rates		$ 13,000
Proceeds from Sale of Real Estate	$ 52,900
Repayments of Secured Debt		$ 800
Proceeds from Sale of Wholly Owned Real Estate and Real Estate Acquired in Settlement of Loans	$ 52,100
Note Receivable Interest Rate	10.00%	10.00%
Loan Term	15 years
Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member] | Holiday Acquisition Holdings [Member]
Number of Properties	8	8		8
Notes Receivable Remain Unfunded [Member]
Loans and Leases Receivable, Net Amount	$ 183,600	$ 183,600
Loans Receivable
Number of Operators/Tenants | number_of_loans	7	7

Equity (Schedule of Dividends D

Equity (Schedule of Dividends Declared) (Details) - $ / shares	3 Months Ended		6 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Jun. 30, 2021	Jun. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Common Stock, Dividends, Per Share, Declared	$ 0.90	$ 1.1025	$ 2.0025	$ 2.2050	$ 2.9025	$ 3.3075
Declared December 15, 2020
Common Stock, Dividends, Per Share, Declared					1.1025
Declared March 12, 2021
Common Stock, Dividends, Per Share, Declared					1.1025
Declared June 3, 2021
Common Stock, Dividends, Per Share, Declared					0.90
Declared November 7, 2019
Common Stock, Dividends, Per Share, Declared					1.05
Declared February 19, 2020
Common Stock, Dividends, Per Share, Declared					1.1025
Declared June 15, 2020
Common Stock, Dividends, Per Share, Declared					1.1025
Declared August 6, 2021
Common Stock, Dividends, Per Share, Declared					0.90
Declared September 14, 2020
Common Stock, Dividends, Per Share, Declared					$ 1.1025

Equity (Narrative) (Details)

Equity (Narrative) (Details) - USD ($) $ / shares in Units, $ in Thousands	Nov. 05, 2021	Sep. 30, 2021	Sep. 30, 2020	Jun. 30, 2021	Jun. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Equity [Abstract]
Stock Issued During Period, Shares, New Issues						661,951
Shares Issued, Price Per Share		$ 73.62				$ 73.62
Proceeds from issuance of common shares, net						$ 47,904	$ 4,791
Common Stock, Dividends, Per Share, Declared		$ 0.90	$ 1.1025	$ 2.0025	$ 2.2050	$ 2.9025	$ 3.3075
Proceeds from issuance of common shares, net						$ 47,904	$ 4,791
Declared August 6, 2021
Common Stock, Dividends, Per Share, Declared						$ 0.90
Declared November 5, 2021 | Subsequent Event [Member]
Common Stock, Dividends, Per Share, Declared	$ 0.9

Stock-Based Compensation (Sched

Stock-Based Compensation (Schedule of Share-Based Payments) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Share-based Payment Arrangement [Abstract]
Share-based compensation	$ 989	$ 457	$ 7,427	$ 2,772

Stock-Based Compensation (Sch_2

Stock-Based Compensation (Schedule of Stock Option Valuation Assumptions) (Details)	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Schedule of Stock Option Valuation Assumptions [Abstract]
Dividend yield	6.70%	5.10%
Expected volatility	48.10%	17.10%
Expected lives	2 years 10 months 24 days	2 years 10 months 24 days
Risk-free interest rate	0.33%	1.30%

Stock-Based Compensation (Sch_3

Stock-Based Compensation (Schedule Of Stock Option Activity) (Details) - $ / shares	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020	Dec. 31, 2019
Options outstanding January 1,	1,033,838	1,004,014
Options granted under 2012 Plan	652,000	592,000
Options exercised under 2012 Plan	(20,000)	(512,509)
Options outstanding, June 30,	1,665,838	1,073,005
Exercisable at June 30,	1,183,324	601,994
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price	$ 78.20	$ 83.68	$ 83.54	$ 74.35
Share-based Compensation Arrangements by Share-based Payment Award, Options, Grants in Period, Weighted Average Exercise Price	69.20	90.32
Share-based Compensation Arrangements by Share-based Payment Award, Options, Exercises in Period, Weighted Average Exercise Price	60.52	$ 72.98
Share-based Compensation Arrangement by Share-based Payment Award, Options, Forfeitures in Period		10,500
Share-based Compensation Arrangements by Share-based Payment Award, Options, Forfeitures in Period, Weighted Average Exercise Price		$ 88.73
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercisable, Weighted Average Exercise Price	$ 79.25	$ 81.09
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Remaining Contractual Term	3 years 4 months 13 days
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercisable, Weighted Average Remaining Contractual Term	3 years 29 days
2012 Plan [Member]
Options granted under 2012 Plan	12,500

Stock-Based Compensation (Narra

Stock-Based Compensation (Narrative) (Details) - USD ($) $ / shares in Units, $ in Millions	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Options granted under 2012 Plan	652,000	592,000
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period, Intrinsic Value	$ 0.2	$ 8.1
Aggregate Intrinsic Value Per Share Options Exercised	$ 9.27	$ 15.84
Unrecognized compensation cost	$ 2.8
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Weighted Average Grant Date Fair Value	$ 14.54	$ 5.54
2012 Plan [Member]
Options granted under 2012 Plan	12,500
Two Thousand Nineteen Stock Option Plan
Shares available for grants	2,117,336
Options granted under 2012 Plan	639,500
Expected To Be Recognized Remainder of 2021
Unrecognized compensation cost	$ 1
Expected To Be Recognized During 2022 [Member]
Unrecognized compensation cost	1.6
Expected To Be Recognized During 2023
Unrecognized compensation cost	$ 0.2

Earnings and Dividends Per Sh_3

Earnings and Dividends Per Share (Summary Of Calculation Of Basic And Diluted Earnings Per Share) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Jun. 30, 2021	Jun. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Earnings Per Share [Abstract]
Net income (loss) attributable to common stockholders	$ 30,814	$ 42,595			$ 105,327	$ 147,986
BASIC:
Weighted average common shares outstanding	45,850,599	44,661,650			45,668,762	44,641,748
Net income per common share - basic	$ 0.67	$ 0.95			$ 2.31	$ 3.31
DILUTED:
Weighted average common shares outstanding	45,850,599	44,661,650			45,668,762	44,641,748
Stock options	825	753			6,391	1,766
Convertible subordinated debentures	0	0			13,938	0
Weighed average dilutive common shares outstanding	45,851,424	44,662,403			45,689,091	44,643,514
Net income per common share - diluted	$ 0.67	$ 0.95			$ 2.31	$ 3.31
Incremental shares excluded since anti-dilutive:
Net share effect of stock options with an exercise price in excess of the average market price for our common shares	505,459	410,012			308,313	427,180
Common Stock, Dividends, Per Share, Declared	$ 0.90	$ 1.1025	$ 2.0025	$ 2.2050	$ 2.9025	$ 3.3075

Fair Value Of Financial Instr_3

Fair Value Of Financial Instruments (Schedule Of Assets And Liabilities Measured On A Recurring Basis) (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Sep. 30, 2020
Fair Value, Inputs, Level 2 [Member]
Interest rate swap liability	$ (1,828)	$ (7,150)

Fair Value of Financial Instr_4

Fair Value of Financial Instruments (Fair Value Measurements, Nonrecurring) (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Loans and Leases Receivable, Net Amount	$ 284,608	$ 292,427
Fair Value, Inputs, Level 3 [Member] | Reported Value Measurement [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Loans and Leases Receivable, Net Amount	284,608	292,427
Fair Value, Inputs, Level 3 [Member] | Estimate of Fair Value Measurement [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Loans and Leases Receivable, Net Amount	301,053	321,021
Variable Interest Rate Debt [Member] | Fair Value, Inputs, Level 2 [Member] | Reported Value Measurement [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt Instrument, Fair Value Disclosure	398,311	945,078
Variable Interest Rate Debt [Member] | Fair Value, Inputs, Level 2 [Member] | Estimate of Fair Value Measurement [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt Instrument, Fair Value Disclosure	400,000	948,000
Fixed Interest Rate Debt [Member] | Fair Value, Inputs, Level 2 [Member] | Reported Value Measurement [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt Instrument, Fair Value Disclosure	886,976	554,207
Fixed Interest Rate Debt [Member] | Fair Value, Inputs, Level 2 [Member] | Estimate of Fair Value Measurement [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt Instrument, Fair Value Disclosure	$ 876,917	$ 575,292

Uncategorized Items - nhi-20210

Label	Element	Value
Adjustments to Additional Paid in Capital, Stock Issued, Issuance Costs	us-gaap_AdjustmentsToAdditionalPaidInCapitalStockIssuedIssuanceCosts	$ 47,000
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	5,082,000
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	(291,000)
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	47,951,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	98,453,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	49,314,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	91,816,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	41,266,000
Noncontrolling Interest, Increase from Subsidiary Equity Issuance	us-gaap_NoncontrollingInterestIncreaseFromSubsidiaryEquityIssuance	10,791,000
Noncontrolling Interest, Increase from Subsidiary Equity Issuance	us-gaap_NoncontrollingInterestIncreaseFromSubsidiaryEquityIssuance	223,000
Stock Issued During Period, Value, Stock Options Exercised	us-gaap_StockIssuedDuringPeriodValueStockOptionsExercised	1,000
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	231,000
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	466,000
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation	2,705,000
Share-based Payment Arrangement, Noncash Expense	us-gaap_ShareBasedCompensation	6,438,000
Share-based Payment Arrangement, Noncash Expense	us-gaap_ShareBasedCompensation	457,000
Share-based Payment Arrangement, Noncash Expense	us-gaap_ShareBasedCompensation	989,000
Share-based Payment Arrangement, Noncash Expense	us-gaap_ShareBasedCompensation	2,315,000
Retained Earnings, Appropriated [Member]
Net Income (Loss) Attributable to Parent	us-gaap_NetIncomeLoss	42,595,000
Net Income (Loss) Attributable to Parent	us-gaap_NetIncomeLoss	105,391,000
Net Income (Loss) Attributable to Parent	us-gaap_NetIncomeLoss	74,515,000
Net Income (Loss) Attributable to Parent	us-gaap_NetIncomeLoss	30,814,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	41,266,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	91,816,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	49,314,000
Additional Paid-in Capital [Member]
Adjustments to Additional Paid in Capital, Stock Issued, Issuance Costs	us-gaap_AdjustmentsToAdditionalPaidInCapitalStockIssuedIssuanceCosts	47,000
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	5,082,000
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	(291,000)
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	47,944,000
Stock Issued During Period, Value, Stock Options Exercised	us-gaap_StockIssuedDuringPeriodValueStockOptionsExercised	2,000
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation	(2,705,000)
Share-based Payment Arrangement, Noncash Expense	us-gaap_ShareBasedCompensation	457,000
Share-based Payment Arrangement, Noncash Expense	us-gaap_ShareBasedCompensation	2,315,000
Share-based Payment Arrangement, Noncash Expense	us-gaap_ShareBasedCompensation	989,000
Share-based Payment Arrangement, Noncash Expense	us-gaap_ShareBasedCompensation	6,438,000
AOCI Attributable to Parent [Member]
Net Income (Loss) Attributable to Parent	us-gaap_NetIncomeLoss	3,516,000
Net Income (Loss) Attributable to Parent	us-gaap_NetIncomeLoss	1,805,000
Net Income (Loss) Attributable to Parent	us-gaap_NetIncomeLoss	1,870,000
Net Income (Loss) Attributable to Parent	us-gaap_NetIncomeLoss	(7,303,000)
Common Stock [Member]
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	$ 7,000
Shares Issued, Shares, Share-based Payment Arrangement, after Forfeiture	us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation	62,516
Shares Issued, Shares, Share-based Payment Arrangement, after Forfeiture	us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation	2,656
Stock Issued During Period, Value, Stock Options Exercised	us-gaap_StockIssuedDuringPeriodValueStockOptionsExercised	$ 1,000
Stock Issued During Period, Shares, New Issues	us-gaap_StockIssuedDuringPeriodSharesNewIssues	79,155
Common Stock [Member] | At-The-Market [Member]
Stock Issued During Period, Shares, New Issues	us-gaap_StockIssuedDuringPeriodSharesNewIssues	661,951
Noncontrolling Interest [Member]
Noncontrolling Interest, Increase from Subsidiary Equity Issuance	us-gaap_NoncontrollingInterestIncreaseFromSubsidiaryEquityIssuance	$ 10,791,000
Noncontrolling Interest, Increase from Subsidiary Equity Issuance	us-gaap_NoncontrollingInterestIncreaseFromSubsidiaryEquityIssuance	223,000
Comprehensive Income (Loss), Net of Tax, Attributable to Noncontrolling Interest	us-gaap_ComprehensiveIncomeNetOfTaxAttributableToNoncontrollingInterest	100,000
Comprehensive Income (Loss), Net of Tax, Attributable to Noncontrolling Interest	us-gaap_ComprehensiveIncomeNetOfTaxAttributableToNoncontrollingInterest	35,000
Comprehensive Income (Loss), Net of Tax, Attributable to Noncontrolling Interest	us-gaap_ComprehensiveIncomeNetOfTaxAttributableToNoncontrollingInterest	66,000
Comprehensive Income (Loss), Net of Tax, Attributable to Noncontrolling Interest	us-gaap_ComprehensiveIncomeNetOfTaxAttributableToNoncontrollingInterest	96,000
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	(231,000)
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	(398,000)
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	(466,000)
Parent [Member]
Net Income (Loss) Attributable to Parent	us-gaap_NetIncomeLoss	98,088,000
Net Income (Loss) Attributable to Parent	us-gaap_NetIncomeLoss	78,031,000
Net Income (Loss) Attributable to Parent	us-gaap_NetIncomeLoss	32,619,000
Net Income (Loss) Attributable to Parent	us-gaap_NetIncomeLoss	44,465,000
Adjustments to Additional Paid in Capital, Stock Issued, Issuance Costs	us-gaap_AdjustmentsToAdditionalPaidInCapitalStockIssuedIssuanceCosts	47,000
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	5,082,000
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	(291,000)
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	47,951,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	98,453,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	91,816,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	41,266,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	49,314,000
Stock Issued During Period, Value, Stock Options Exercised	us-gaap_StockIssuedDuringPeriodValueStockOptionsExercised	1,000
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation	(2,705,000)
Share-based Payment Arrangement, Noncash Expense	us-gaap_ShareBasedCompensation	6,438,000
Share-based Payment Arrangement, Noncash Expense	us-gaap_ShareBasedCompensation	457,000
Share-based Payment Arrangement, Noncash Expense	us-gaap_ShareBasedCompensation	2,315,000
Share-based Payment Arrangement, Noncash Expense	us-gaap_ShareBasedCompensation	989,000
Adjustments to Additional Paid in Capital, Equity Component of Convertible Debt	us-gaap_AdjustmentsToAdditionalPaidInCapitalEquityComponentOfConvertibleDebt	$ (6,076,000)
Notes Receivable [Member] | Assessed not probable to occur [Member] | Bickford Senior Living [Member]
Loan Term	nhi_LoanTerm	5 years
Note Receivable Interest Rate	nhi_NoteReceivableInterestRate	10.00%