National Health Investors (NHI) 10-Q 8 Nov 22 2022 Q3 Quarterly report Financial data

Cover

Cover - shares	9 Months Ended
	Sep. 30, 2022	Nov. 01, 2022
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2022
Document Transition Report	false
Entity File Number	001-10822
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		43,388,742
Amendment Flag	false
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q3
Entity Central Index Key	0000877860
Current Fiscal Year End Date	--12-31

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Assets:
Land	$ 176,795	$ 186,658
Buildings and improvements	2,560,646	2,707,422
Construction in progress	2,835	468
Real estate properties, gross	2,740,276	2,894,548
Less accumulated depreciation	(599,423)	(576,668)
Real estate properties, net	2,140,853	2,317,880
Mortgage and other notes receivable, net of reserve of $6,940 and $5,210, respectively	207,169	299,952
Cash and cash equivalents	28,811	37,412
Straight-line rent receivable	81,959	96,198
Assets held for sale, net	32,608	66,398
Other assets, net	17,385	21,036
Total Assets	2,508,785	2,838,876
Liabilities and Stockholders’ Equity:
Debt	1,114,999	1,242,883
Accounts payable and accrued expenses	22,997	23,181
Dividends payable	39,050	41,266
Lease deposit liabilities	0	8,838
Deferred income	5,094	5,725
Total Liabilities	1,182,140	1,321,893
Commitments and contingencies
Redeemable noncontrolling interests	11,197	0
National Health Investors, Inc. Stockholders’ Equity:
43,388,742 and 45,850,599 shares issued and outstanding, respectively	434	459
Capital in excess of par value	1,598,385	1,591,182
Cumulative dividends in excess of net income	(292,449)	(84,558)
Total National Health Investors, Inc. Stockholders’ Equity	1,306,370	1,507,083
Noncontrolling interests	9,078	9,900
Total Equity	1,315,448	1,516,983
Total Liabilities and Stockholders’ Equity	$ 2,508,785	$ 2,838,876

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Credit loss reserve	$ 6,940	$ 5,210
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	100,000,000	100,000,000
Common stock, shares issued (in shares)	43,388,742	45,850,599
Common stock, shares outstanding (in shares)	43,388,742	45,850,599

Condensed Consolidated Statemen

Condensed Consolidated Statements Of Income - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Revenues:
Rental income	$ 59,394	$ 67,043	$ 163,935	$ 210,143
Resident fees and services	12,013	0	24,005	0
Interest income and other	4,891	6,790	19,584	18,905
Total revenues	76,298	73,833	207,524	229,048
Expenses:
Depreciation	17,533	20,035	53,577	61,499
Interest	11,412	12,715	32,472	38,528
Senior housing operating expenses	9,239	0	18,352	0
Legal	88	117	2,254	207
Franchise, excise and other taxes	225	244	694	709
General and administrative	4,744	3,650	17,893	15,229
Taxes and insurance on leased properties	2,358	3,182	7,553	7,519
Loan and realty losses	11,329	22,425	39,951	23,596
Total operating expenses	56,928	62,368	172,746	147,287
Gains on sales of real estate, net	14,840	19,941	28,342	26,426
Gain (loss) on operations transfer, net	19	0	(710)	0
Gain on note payoff	0	0	1,113	0
Loss on early retirement of debt	0	0	(151)	(451)
(Losses) gains from equity method investment	0	(557)	569	(2,274)
Net income	34,229	30,849	63,941	105,462
Less: net loss (income) attributable to noncontrolling interests	239	(35)	599	(135)
Net income attributable to common stockholders	$ 34,468	$ 30,814	$ 64,540	$ 105,327
Weighted average common shares outstanding:
Basic (in shares)	44,339,975	45,850,599	45,236,696	45,668,762
Diluted (in shares)	44,402,582	45,851,424	45,261,123	45,689,091
Basic:
Net income attributable to common stockholders - basic (in US dollars per share)	$ 0.78	$ 0.67	$ 1.43	$ 2.31
Diluted:
Net income attributable to common stockholders - diluted (in US dollars per share)	$ 0.78	$ 0.67	$ 1.43	$ 2.31

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Statement of Comprehensive Income [Abstract]
Net income	$ 34,229	$ 30,849	$ 63,941	$ 105,462
Other comprehensive income:
Increase in fair value of cash flow hedges	0	(46)	0	(128)
Reclassification for amounts recognized as interest expense	0	1,851	0	5,449
Total other comprehensive income	0	1,805	0	5,321
Comprehensive income	34,229	32,654	63,941	110,783
Less: comprehensive loss (income) attributable to noncontrolling interests	239	(35)	599	(135)
Comprehensive income attributable to common stockholders	$ 34,468	$ 32,619	$ 64,540	$ 110,648

Condensed Consolidated Statem_3

Condensed Consolidated Statements Of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Cash flows from operating activities:
Net income	$ 63,941	$ 105,462
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	53,577	61,499
Amortization of debt issuance costs, debt discounts and prepaids	3,216	3,281
Amortization of commitment fees and note receivable discounts	(802)	(645)
Amortization of lease incentives	7,477	774
Straight-line rent adjustments	11,360	(12,189)
Non-cash interest income on mortgage and other notes receivable	(3,256)	(1,351)
Non-cash lease deposit liability recognized as rental income	(8,838)	0
Gains on sales of real estate, net	(28,342)	(26,426)
Gain on note payoff	(1,113)	0
(Gains) losses from equity method investment	(569)	2,274
Loss on operations transfer, net	710	0
Loss on early retirement of debt	151	451
Loan and realty losses	39,951	23,596
Payment of lease incentives	0	(1,042)
Non-cash share-based compensation	7,576	7,427
Changes in operating assets and liabilities:
Other assets	(4,213)	(3,138)
Accounts payable and accrued expenses	(2,555)	(2,591)
Deferred income	712	119
Net cash provided by operating activities	138,983	157,501
Cash flows from investing activities:
Investments in mortgage and other notes receivable	(30,820)	(54,887)
Collections of mortgage and other notes receivable	117,973	64,509
Acquisition of real estate	(4,876)	(46,817)
Proceeds from sales of real estate	168,957	203,147
Investments in renovations of existing real estate	(4,132)	(3,006)
Investments in equipment	(528)	(64)
Distributions from equity method investment	569	476
Net cash provided by investing activities	247,143	163,358
Cash flows from financing activities:
Proceeds from revolving credit facility	165,000	95,000
Payments on revolving credit facility	(155,000)	(393,000)
Payments on term loans	(135,290)	(250,277)
Proceeds from issuance of senior notes	0	396,784
Debt issuance costs	(4,607)	(5,018)
Equity issuance costs	(21)	0
Proceeds from issuance of common shares, net	0	47,904
Distributions to noncontrolling interests	(757)	(692)
Convertible note redemption	0	(66,076)
Dividends paid to stockholders	(122,721)	(141,632)
Taxes remitted on employee stock awards	(288)	0
Proceeds from redeemable noncontrolling interests	11,738	0
Payments to repurchase shares of common stock	(151,951)	0
Net cash used in financing activities	(393,897)	(317,007)
(Decrease) increase in cash and cash equivalents and restricted cash	(7,771)	3,852
Cash and cash equivalents and restricted cash, beginning of period	39,485	46,343
Cash and cash equivalents and restricted cash, end of period	31,714	50,195
Supplemental disclosure of cash flow information:
Interest paid, net of amounts capitalized	33,927	34,991
Supplemental disclosure of non-cash investing and financing activities:
Real estate acquired in exchange for mortgage notes receivable	9,071	0
Change in other assets related to sales of real estate	102	12,814
Change in accounts payable related to investments in real estate construction	0	(112)
Change in accounts payable related to renovations of existing real estate	208	0
Change in accounts payable related to distributions to noncontrolling interests	6	5
Change in accounts payable related to equity issuance cost	64	0
Operating equipment received in transfer of operations	1,287	0
Increase in accounts payable related to transfer of operations	$ 300	$ 0

Condensed Consolidated Statem_4

Condensed Consolidated Statement Of Equity - USD ($) $ in Thousands	Total	Common Stock	Capital in Excess of Par Value	Cumulative Dividends in Excess of Net Income	Accumulated Other Comprehensive Loss	Total National Health Investors, Inc. Stockholders’ Equity	Noncontrolling Interests
Beginning balance, common stock (in shares) at Dec. 31, 2020		45,185,992
Beginning balance at Dec. 31, 2020	$ 1,522,945	$ 452	$ 1,540,946	$ (22,015)	$ (7,149)	$ 1,512,234	$ 10,711
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Total comprehensive income	110,783
Ending balance, common stock (in shares) at Sep. 30, 2021		45,850,599
Ending balance at Sep. 30, 2021	$ 1,549,206	$ 459	1,590,194	(49,768)	(1,828)	1,539,057	10,149
Beginning balance, common stock (in shares) at Dec. 31, 2021	45,850,599	45,850,599
Beginning balance at Dec. 31, 2021	$ 1,516,983	$ 459	1,591,182	(84,558)	0	1,507,083	9,900
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Total comprehensive income	$ 63,941
Repurchases of common stock (in shares)	(2,468,354)
Ending balance, common stock (in shares) at Sep. 30, 2022	43,388,742	43,388,742
Ending balance at Sep. 30, 2022	$ 1,315,448	$ 434	$ 1,598,385	$ (292,449)	$ 0	$ 1,306,370	$ 9,078

Condensed Consolidated Statem_5

Condensed Consolidated Statement Of Equity Consolidated Statement of Equity (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Jun. 30, 2022	Jun. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Statement of Stockholders' Equity [Abstract]
Distributions	$ 12		$ 24		$ 36
Dividends to common stockholders (in dollars per share)	$ 0.90	$ 0.90	$ 1.80	$ 2.0025	$ 2.70	$ 2.9025
Net Income (Loss) attributable to redeemable noncontrolling interest	$ 278		$ 227		$ 505

Organization and Nature of Busi

Organization and Nature of Business	9 Months Ended
	Sep. 30, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Nature of Business	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. We operate through two reportable segments: Real Estate Investments and Senior Housing Operating Portfolio (“SHOP”). Our Real Estate Investments segment consists of lease, mortgage and other note investments in independent living facilities (“ILF”), assisted living facilities (“ALF”), entrance-fee communities (“EFC”), senior living campuses (“SLC”), skilled nursing facilities (“SNF”) and a hospital (“HOSP”). As of September 30, 2022, we had investments of approximately $2.4 billion in 162 health care real estate properties located in 32 states and leased pursuant primarily to triple-net leases to 24 lessees consisting of 96 senior housing communities, 65 skilled nursing facilities and one hospital, excluding ten properties classified as assets held for sale. Our portfolio of 13 mortgages along with other notes receivable totaled $214.1 million, excluding an allowance for expected credit losses of $6.9 million, as of September 30, 2022. Our SHOP segment is comprised of two ventures that own the operations of ILFs. As of September 30, 2022, we had investments of approximately $336.6 million in 15 properties with a combined 1,731 units located in eight states that are operated on behalf of the Company by two independent managers pursuant to the terms of separate management agreements that commenced April 1, 2022. The third-party managers, or related affiliates of the managers, own equity interests in the respective ventures.

Basis of Presentation and Signi

Basis of Presentation and Significant Accounting Policies	9 Months Ended
	Sep. 30, 2022
Accounting Policies [Abstract]
Basis of Presentation and Significant Accounting Policies	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, 2021, included in our 2021 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, joint ventures 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. Effective April 1, 2022 and at September 30, 2022, our consolidated total assets and liabilities include two consolidated ventures comprising our SHOP activities formed with two separate partners - Merrill Gardens, L.L.C. (“Merrill”) and DSHI NHI Holiday LLC (the “Discovery member”), a controlled affiliate of Discovery Senior Living. We consider both ventures to be VIEs as either the members, as a group, lack the characteristics of a controlling financial interest or there are disproportionate voting rights but substantially all of the activities are performed on behalf of the Company. We are deemed to be the primary beneficiary because we have the ability to control the activities that most significantly impact each VIE’s economic performance. The assets of the ventures primarily consist of real estate properties, cash and cash equivalents, and resident fees and services (accounts receivable). Their obligations primarily consist of operating expenses of the ILFs (accounts payable and accrued expenses) and capital expenditures for the properties. As of and for the three and nine months ended September 30, 2022, our redeemable noncontrolling interests relate to these ventures. Assets of the consolidated SHOP ventures that can be used only to settle obligations of each respective SHOP venture primarily include approximately $261.3 million of real estate properties, net, and $9.6 million of cash and cash equivalents. Liabilities of the consolidated SHOP ventures for which creditors do not have recourse to the general credit of the Company are not material. Reference Notes 5 and 9 for further discussion of these new ventures. We also consolidate two real estate partnerships formed with our partners, Discovery Senior Housing Investor XXIV, LLC, a controlled affiliate of Discovery Senior Living, and LCS Timber Ridge LLC, to invest in senior housing facilities. We consider both partnerships to be VIEs, based on our determination that the total equity at risk in each is insufficient to finance activities without additional subordinated financial support. NHI directs the activities that most significantly impact economic performance of these ventures, subject to limited protective rights extended to our partners for specified business decisions. Because of our control of these partnerships, we include their assets, liabilities, noncontrolling interests and operations in our consolidated financial statements. At September 30, 2022, we held interests in nine 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. 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 2014 Senior Living Communities Notes and straight-line receivable $ 88,237 $ 94,268 Notes 3, 4 2016 Senior Living Management Notes and straight-line receivable $ 26,788 $ 26,788 — 2018 Bickford Senior Living Notes and funding commitment $ 46,769 $ 60,246 Notes 3, 4 2019 Encore Senior Living Notes and straight-line receivable $ 33,688 $ 53,303 Notes 3, 4 2020 Timber Ridge OpCo, LLC Various 1 $ (5,000) $ 5,000 Note 6 2020 Watermark Retirement Notes and straight-line receivable $ 7,691 $ 10,715 — 2021 Montecito Medical Real Estate Notes and funding commitment $ 20,255 $ 50,000 Note 4 2021 Vizion Health Notes and straight-line receivable $ 20,064 $ 22,869 — 2021 Navion Senior Solutions Various 2 $ 8,038 $ 13,988 — 1 Loan commitment, equity method investment and straight-line rents receivable 2 Notes, loan commitments, straight-line rents receivable, and unamortized lease incentives 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 non-payment of 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 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. Reference Note 6 for further discussion of our equity method investment. Noncontrolling Interests Contingently redeemable noncontrolling interests are recorded at their initial carrying amounts upon issuance and are subsequently adjusted to reflect their share of gains or losses and distributions attributable to the noncontrolling interests. In periods where they are or will become probable of redemption, an adjustment to the redemption value of the noncontrolling interests is also recognized through Capital in excess of par value on the Company’s Consolidated Balance Sheets and included in our computation of earnings per share. As of September 30, 2022, these noncontrolling interests were classified as mezzanine equity, as discussed further in Note 9. As of September 30, 2022 and December 31, 2021, the noncontrolling interests associated with our two consolidated real estate partnerships are classified in equity. 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 and 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 $ 28,811 $ 48,393 Restricted cash (included in Other assets, net) 2,903 1,802 $ 31,714 $ 50,195 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. Impairment of Long-Lived Assets We evaluate the recoverability of the carrying amount of our long-lived assets when events or circumstances, including significant physical changes, significant adverse changes in general economic conditions and significant deterioration of the underlying cash flows of the long-lived assets, indicate that the carrying amount of the long-lived assets may not be recoverable. The need to recognize an impairment charge is based on estimated undiscounted future cash flows compared to the carrying amount. If recognition of an impairment charge is necessary, it is measured as the amount by which the carrying amount exceeds the estimated fair value of the long-lived asset. During the three and nine months ended September 30, 2022, we recognized impairment charges of approximately $9.5 million and $38.3 million, respectively, included in “ Loan and realty losses ” in our Condensed Consolidated Statements of Income. Reference Note 3 for more discussion. Revenue Recognition 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. During the second quarter of 2022, we placed Bickford Senior Living (“Bickford”) on the cash basis of revenue recognition for lease purposes and recorded write offs of $18.1 million of straight-line rents receivable and $7.1 million of lease incentives related to our Bickford master lease agreements. Reference Note 3 for further discussion. Resident Fees and Services - Resident fee revenue associated with our SHOP activities is recorded when services are rendered and includes resident room and care charges, community fees and other resident charges. Residency agreements are generally short term (30 days to one year), with resident fees billed monthly in advance. Revenue for certain related services is recognized as services are provided and billed monthly in arrears. Accounting for Lease Modifications related to the Coronavirus Pandemic 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. We have elected not to apply the modification guidance under ASC 842 and have accounted for qualified rent concessions as variable lease payments when applicable, and recorded as rental income when received. During the nine months ended September 30, 2022, we provided $10.7 million in lease concessions directly related to the COVID-19 pandemic, as discussed in more detail in Note 8. During the three months ended September 30, 2022, we did not provide any lease concessions directly related to the COVID-19 pandemic. Income Tax We intend at all times to qualify as a REIT under Sections 856 through 860 of the Internal Revenue Code of 1986, as amended. Accordingly, we will generally not be subject to U.S. federal income tax, provided that we continue to qualify as a REIT and make distributions to stockholders at least equal to or in excess of 90% our taxable income. Certain activities that we undertake may be conducted by entities that have elected to be treated as taxable REIT subsidiaries (TRSs). TRSs are subject to federal, state, and local income taxes. Accordingly, a provision for income taxes has been made in the consolidated financial statements. A failure to qualify under the applicable REIT qualification rules and regulations would have a material adverse impact on our financial position, results of operations and cash flows. Segments We operate our business through two reportable segments: Real Estate Investments and SHOP. In our Real Estate Investments segment, we invest in i) senior housing and healthcare real estate and lease those properties to healthcare operating companies under triple-net leases that obligate tenants to pay all property-related expenses and ii) mortgage and other notes receivable throughout the United States. Our SHOP segment is comprised of the operations of 15 ILFs located throughout the United States that are operated on behalf of the Company by two independent managers pursuant to the terms of separate management agreements that commenced April 1, 2022. Reference Notes 5 and 14 for additional information.

Investment Activity

Investment Activity	9 Months Ended
	Sep. 30, 2022
Real Estate [Abstract]
Investment Activity	Investment Activity Asset Acquisition In the second quarter of 2022, we acquired a 53-unit assisted living facility located in Oshkosh, Wisconsin, from Encore Senior Living. The acquisition price was $13.3 million and included the full payment of an outstanding construction note receivable to us of $9.1 million, including interest. We have agreed to pay up to $0.8 million in additional cash consideration pending the results of an ongoing property tax appeal. As of September 30, 2022, no amount of this consideration is expected to be paid. We added the facility to an existing master lease for a term of 15 years at an initial lease rate of 7.25%, with an annual escalator of 2.5%. Asset Dispositions During the nine months ended September 30, 2022, we completed the following real estate property dispositions within our Real Estate Investments reportable segment as described below ( $ in thousands ): Operator Date Properties Asset Class Net Proceeds Net Real Estate Investment Gain Impairment 1 Hospital Corporation of America Q1 2022 1 MOB $ 4,868 $ 1,904 $ 2,964 $ — Vitality Senior Living 2 Q1 2022 1 SLC 8,302 8,285 17 — Holiday Retirement (“Holiday”) 2 Q2 2022 1 ILF 2,990 3,020 — 30 Chancellor Senior Living 2 Q2 2022 2 ALF 7,305 7,357 — 52 Bickford 2 Q2 2022 3 ALF 25,959 28,268 — 2,309 Comfort Care Q2 2022 4 ALF 40,000 38,445 1,556 — Helix Healthcare Q2 2022 1 HOSP 19,500 10,535 8,965 — Discovery Senior Living 2 Q3 2022 2 ALF/SLC 16,379 15,159 1,220 — National HealthCare Corporation (“NHC”) Q3 2022 7 SNF 43,686 30,066 13,620 — $ 168,989 $ 143,039 $ 28,342 $ 2,391 1 Impairments are included in “ Loan and realty losses ” in Condensed Consolidated Statements of Income for the nine months ended September 30, 2022. 2 Total impairment charges recognized on these properties were $65.4 million, of which $28.5 million were recognized in the nine months ended September 30, 2022. The disposal transactions for the three Bickford properties in the second quarter of 2022 included $2.4 million in contingent consideration representing cash placed in escrow that will be returned to the buyers to the extent the sold properties generate negative monthly cash flows over the twelve months following from the dates of sale. After the twelve-month period, any remaining funds not distributed will be paid to the Company. We have assessed that it was not probable that any of the escrowed funds would be received by the Company. To the extent this assessment changes, or funds are ultimately received, we will recognize the amount as a gain on the sale of real estate. Discovery In the third quarter of 2022, we sold an assisted living facility in Indiana and a senior living campus in Florida for approximately $16.9 million in cash consideration, and incurred $0.5 million of transaction costs, resulting in an approximate gain of $1.2 million. The properties were classified as assets held for sale on the Condensed Consolidated Balance Sheet for the quarter ended June 30, 2022. Prior impairment charges recognized on the properties totaled $23.7 million. NHC On September 1, 2022, we sold a portfolio of seven skilled nursing facilities in New Hampshire and Massachusetts for approximately $44.4 million in net cash consideration, and incurred $0.7 million of transaction costs. These properties were leased to NHC pursuant to a master lease agreement dated August 30, 2013 with an original maturity date of August 31, 2028 that was terminated upon completion of the sale. The properties were classified as assets held for sale on the Condensed Consolidated Balance Sheet for the quarter ended June 30, 2022. Rental income was $0.6 million and $2.4 million for the three and nine months ended September 30, 2022, respectively, and $0.9 million and $2.8 million for the three and nine months ended September 30, 2021, respectively. In connection with the sale of this portfolio, we amended the master lease for 35 facilities dated October 17, 1991 by and between NHI and NHC/OP, L.P., an affiliate of NHC that is discussed below in “ Tenant Concentration. ” Assets Held for Sale and Long-Lived Assets At September 30, 2022, ten properties in our Real Estate Investments reportable segment, with an aggregate net real estate balance of $32.6 million, were classified as assets held for sale on our Condensed Consolidated Balance Sheet, including six properties that were transferred into assets held for sale during the third quarter of 2022. Rental income associated with the ten properties was $1.1 million and $2.0 million for the three and nine months ended September 30, 2022, respectively, and $1.2 million and $3.5 million for the three and nine months ended September 30, 2021, respectively. During the three and nine months ended September 30, 2022, we recorded impairment charges of $9.5 million and $38.3 million, respectively, including $5.7 million on two properties held in use, related to our Real Estate Investments reportable segment. The impairment charges are included in “ Loan and realty losses ” in the Condensed Consolidated Statements of Income. We reduce the carrying value of impaired properties to their estimated fair value or, with respect to the properties classified as held for sale, to estimated fair value less costs to sell. To estimate the fair values of the properties, we utilized a market approach which considered binding agreements for sales (Level 1 inputs), non-binding offers to purchase from unrelated third parties and/or broker quotes of estimated values (Level 3 inputs), and/or independent third-party valuations (Level 1 and 3 inputs). Tenant Concentration The following table contains information regarding tenant concentration, excluding $2.6 million for our corporate office, $336.6 million for SHOP, and a credit loss reserve of $6.9 million, based on the percentage of revenues for the nine months ended September 30, 2022 and 2021, related to tenants or affiliates of tenants, that exceed 10% of total revenues ( $ in thousands ): as of September 30, 2022 Revenues 1 Asset Gross Real Notes Nine Months Ended September 30, Class Estate 2 Receivable 2022 2021 Senior Living Communities EFC $ 573,631 $ 46,669 $ 38,325 18% $ 38,094 17% NHC SNF 133,770 — 27,875 13% 28,290 12% Bickford 3 ALF 412,304 46,422 N/A N/A 26,224 11% Holiday 3 ILF — — N/A N/A 22,811 10% All others, net Various 1,313,238 121,018 109,766 53% 106,110 46% Escrow funds from tenants for property operating expenses Various — — 7,553 4% 7,519 4% $ 2,432,943 $ 214,109 183,519 229,048 Resident fees and services 4 24,005 12% — —% $ 207,524 $ 229,048 1 Includes interest income on notes receivable and rental income from properties classified as held for sale. 2 Amounts include any properties classified as held for sale. 3 Below 10% for the nine months ended September 30, 2022. Therefore, revenues are included in All others, net. 4 There is no tenant concentration in resident fees and services because these agreements are with individual residents. At September 30, 2022, the two states in which we had an investment concentration of 10% or more were South Carolina (12.1%) and Texas (11.1%). Senior Living Communities As of September 30, 2022, we leased ten retirement communities to Senior Living Communities, LLC (“Senior Living”). We recognized straight-line rent revenue of $0.1 million and $0.3 million from Senior Living for the three and nine months ended September 30, 2022, respectively, and $0.7 million and $1.8 million for the three and nine months ended September 30, 2021, respectively. NHC Effective September 1, 2022, we amended the master lease dated October 17, 1991, as previously amended by and between NHI and NHC/OP, L.P., an affiliate of NHC, for 35 facilities. This amendment was executed concurrently with the sale of a portfolio of seven skilled nursing facilities as described above and increases the annual base rent due each year through the expiration of the master lease on December 31, 2026. The annual base rent prior to the amendment was $30.8 million and was increased to $34.3 million for the year ended December 31, 2022, with credit given for rent paid in 2022 related to the sold portfolio. In addition to the base rent, NHC will continue to pay any additional rent and percentage rent as required by the master lease. Two of our board members, including our chairman, are also members of NHC’s board of directors. Bickford Senior Living As of September 30, 2022, we leased 36 facilities, excluding two facilities classified as assets held for sale, under four leases to Bickford. Revenues from Bickford reflect the impact of pandemic-related rent concessions of approximately $5.5 million for the nine months ended September 30, 2022 and $3.5 million and $13.8 million for the three and nine months ended September 30, 2021, respectively. During the three months ended September 30, 2022, we did not provide any lease concessions to Bickford. In the second quarter of 2022, we wrote off approximately $18.1 million of straight-line rents receivable and $7.1 million of lease incentives, that were included in “ Other assets, net ” on the Condensed Consolidated Balance Sheet, to rental income upon converting Bickford to the cash basis of accounting. These write offs were the result of a change in our evaluation of collectability of future rent payments due under its four master lease agreements based upon information we obtained from Bickford regarding its financial condition that raised substantial doubt as to its ability to continue as a going concern. Cash rent received from Bickford for the three and nine months ended September 30, 2022 was $7.1 million and $17.0 million, respectively. In addition to the three properties sold that are included in the asset dispositions table above, we completed various restructuring activities in the Bickford leased property portfolio during the first and second quarters of 2022. In March 2022, we transferred one assisted living facility located in Pennsylvania from the Bickford portfolio to a new operator that is leased pursuant to a ten-year triple net lease and wrote off approximately $0.7 million in a straight-line rent receivable, reducing rental income. In the second quarter of 2022, we restructured and amended three of Bickford’s master lease agreements covering 27 properties and reached agreement on the repayment terms of the $26.0 million in outstanding pandemic-related deferrals. Significant terms of these agreements are as follows: • Extends the maturity dates of the modified leases to 2033 and 2035. The remaining master lease agreement covering 11 properties with an original maturity in 2023 was previously extended to 2028. • Reduces the combined rent for the portfolio to approximately $28.3 million per year through April 1, 2024, subject to a nominal annual increase, at which time the rent will be reset to a fair market value, not less than 8.0% of our initial gross investment. • Requires monthly payments beginning October 2022 through December 2024 based on a percentage of Bickford’s monthly revenues exceeding an established threshold. The deferrals may be reduced by up to $6.0 million upon Bickford achieving certain performance targets and the sale or transition of certain properties to new operators. Tenant Purchase Options Certain of our leases contain purchase options allowing tenants to acquire the leased properties. At September 30, 2022, we had tenant purchase options on three properties with an aggregate net investment of $60.1 million that will become exercisable between 2027 and 2028. Rental income from these properties with tenant purchase options was $1.8 million and $5.3 million for the three and nine months ended September 30, 2022, respectively, and $1.7 million and $5.1 million for the three and nine months ended September 30, 2021, respectively. We cannot reasonably estimate at this time the probability that any 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. Future Minimum Base Rent Future minimum lease payments to be received by us under our operating leases at September 30, 2022, are as follows ( $ in thousands ): Remainder of 2022 $ 47,241 2023 183,792 2024 183,825 2025 186,425 2026 189,282 2027 149,849 Thereafter 599,001 $ 1,539,415 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 factors 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, 2022 2021 2022 2021 Lease payments based on fixed escalators, net of deferrals $ 53,394 $ 59,027 $ 172,767 $ 188,008 Lease payments based on variable escalators 1,224 1,288 2,452 3,201 Straight-line rent income 2,476 3,798 (11,360) 12,189 Escrow funds received from tenants for property operating expenses 2,358 3,182 7,553 7,519 Amortization and write-off of lease incentives (58) (252) (7,477) (774) Rental income $ 59,394 $ 67,043 $ 163,935 $ 210,143

Mortgage And Other Notes Receiv

Mortgage And Other Notes Receivable	9 Months Ended
	Sep. 30, 2022
Mortgage and Other Notes Receivable [Abstract]
Mortgage and Other Notes Receivable	Mortgage and Other Notes Receivable At September 30, 2022, our investments in mortgage notes receivable totaled $130.6 million secured by real estate and other assets of the borrower (e.g., UCC liens on personal property) related to 13 facilities and other notes receivable totaling $83.5 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 $6.9 million at September 30, 2022. All our notes were on full accrual basis at September 30, 2022. Mortgage and Other Notes Receivable Life-Care Services - Sagewood In the second quarter of 2022, we received repayment of a $111.3 million mortgage note receivable along with all accrued interest and a prepayment fee of $1.1 million which is reflected in “ Gain on note payoff ” on the Condensed Consolidated Statements of Income for the nine months ended September 30, 2022. Interest income was $5.2 million for the nine months ended September 30, 2022, and $2.4 million and $8.1 million, for the three and nine months ended September 30, 2021, respectively. Encore Senior Living In January 2022, we entered into an agreement to fund a $28.5 million development loan with Encore Senior Living to construct a 108-unit assisted living and memory care community in Fitchburg, Wisconsin. The four-year loan agreement has an annual interest rate of 8.5% and two one-year extensions. We have a purchase option on the property once it has stabilized. The total amount funded on the note was $8.7 million as of September 30, 2022. Montecito Medical Real Estate We have a $50.0 million mezzanine loan and security agreement with Montecito Medical Real Estate for a fund that invests in medical real estate, including medical office buildings, throughout the United States. During the nine months ended September 30, 2022, we funded $4.5 million on two real estate investments. As of September 30, 2022, we have funded $20.3 million of our commitment that was used to acquire nine medical office buildings for a combined purchase price of approximately $86.7 million. For the three and nine months ended September 30, 2022, we received interest of $0.5 million and $1.3 million, respectively. For the nine months ended September 30, 2022, we received principal of $0.3 million. The loan agreement was modified in April 2022, so that these two real estate investments accrue interest at an annual rate of 7.5% that is paid monthly in arrears and 4.5% per year in interest to be paid upon certain future events including repayments, sales of fund investments, and refinancings (the “Deferred Interest”). Prior borrowings under the loan agreement bear interest at an annual rate of 9.5% and accrue an additional 2.5% in Deferred Interest. 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-year extensions. Bickford construction and mortgage loans As part of the June 2021 sale of six properties to Bickford, we executed a $13.0 million second mortgage as a component of the purchase price consideration. This second mortgage note receivable bears interest at a 10% annual rate and matures in April 2026. Interest income was $0.3 million and $1.0 million, respectively, for the three and nine months ended September 30, 2022. We did not include this note receivable in the determination of the gain to be recognized upon sale of the portfolio. Therefore, this note receivable is not reflected in “ Mortgage and other notes receivable, net ” in the Condensed Consolidated Balance Sheets as of September 30, 2022 and December 31, 2021. As of September 30, 2022, we had two fully funded construction loans of $28.7 million and one $14.2 million construction loan with $13.8 million funded to Bickford. 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 certain 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. We also have a mortgage loan of $4.0 million to Bickford due February 2025, bearing interest at 7%, that amortizes on a twenty-five-year basis. Senior Living Communities We provided a $20.0 million revolving line of credit to Senior Living whose borrowings 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, 2022, the $14.0 million outstanding under the facility bears interest at 9.83% 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 that 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 years with two one-year extensions and carries an interest rate of 7.25%. Additionally, the loan conveys to NHI a purchase option at a stated minimum price of $38.3 million, subject to adjustment for market conditions. 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 referred to as “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, 2022, 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, 2022, we did not have any construction loans that we considered underperforming. 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, 2022, is presented below for the amortized cost, net by year of origination of ( $ in thousands ): 2022 2021 2020 2019 2018 Prior Total Mortgages more than 1.5x $ 8,571 $ — $ 36,173 $ 32,700 $ 14,000 $ 4,106 $ 95,550 between 1.0x and 1.5x — — — — 14,700 — 14,700 less than 1.0x — — 3,890 6,423 — 10,000 20,313 8,571 — 40,063 39,123 28,700 14,106 130,563 Mezzanine more than 1.5x — 19,195 — — — — 19,195 between 1.0x and 1.5x — 23,978 — — — 9,178 33,156 less than 1.0x — — — — — 14,500 14,500 No coverage available — — — 750 — — 750 — 43,173 — 750 — 23,678 67,601 Revolver more than 1.5x 1,976 between 1.0x and 1.5x 13,969 less than 1.0x — 15,945 Credit loss reserve (6,940) $ 207,169 Due to the economic uncertainty created by the COVID-19 pandemic and the continuing challenges in financial markets and the potential impact on the collectability of our mortgages and other notes receivable, we forecasted 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, 2022 ( $ in thousands ): Beginning balance January 1, 2022 $ 5,210 Provision for expected credit losses 1,730 Balance September 30, 2022 $ 6,940

Senior Housing Operating Portfo

Senior Housing Operating Portfolio Formation Activities	9 Months Ended
	Sep. 30, 2022
Senior Housing Operating Portfolio Formation Activities [Abstract]
Senior Housing Operating Portfolio Formation Activities	Senior Housing Operating Portfolio Formation ActivitiesConcurrently with the settlement of the outstanding litigation with Welltower discussed more fully in Note 8, we terminated the master lease with a Welltower-controlled subsidiary for the legacy Holiday properties effective April 1, 2022 and transitioned the operations of 15 ILFs from the Welltower-controlled tenant into two new ventures. These new ventures, consolidated by the Company, are structured to comply with REIT requirements and utilize the TRS for activities that would otherwise be non-qualifying for REIT purposes. The properties in each venture are operated by a property manager in exchange for a management fee. The equity structure of these ventures is comprised of 65% and 35% preferred and common equity interests, respectively. The Company owns 100% of the preferred equity interests in these ventures and an aggregate blended common equity interest of 89%. As of September 30, 2022, the annual fixed preferred return was approximately $10.2 million. Additionally, the managers, or affiliates of the managers, own common equity interests in their respective ventures. Given certain provisions of the operating agreements, including provisions related to a Company change in control, the noncontrolling interests associated with the ventures were determined to be contingently redeemable, as discussed further in Note 9. Each venture is discussed in more detail below. Merrill Gardens Managed Portfolio We transferred six ILFs located in California and Washington into a consolidated venture with Merrill. Merrill contributed $10.6 million in cash for its common equity interest in the venture. The operating agreement includes additional contingent distributions to the partners based on the attainment of certain yields on investment calculated on an annual basis. The properties are managed by Merrill pursuant to a management agreement with an initial term through March 2032 that automatically renews on a year-to-year basis thereafter unless terminated by either party with notice. The management agreement entitles Merrill to a base management fee of 5% of net revenue and a real estate services fee of 5% of real estate costs incurred during any calendar year that exceed $1,000 times the number of units at each facility. Discovery Managed Portfolio We transferred nine ILFs located in Arkansas, Georgia, Ohio, Oklahoma, New Jersey, and South Carolina into a consolidated venture with the Discovery member. The Discovery member contributed $1.1 million in cash for its common equity interest in the venture. The operating agreement includes additional contingent distributions to the partners based on the attainment of certain yields on investment calculated on an annual basis. The properties are managed by separate controlled affiliates of Discovery pursuant to management agreements with an initial term through March 2032 that automatically renews on a year-to-year basis thereafter unless terminated by either party with notice. The management agreement entitles the managers to a base management fee of 5% of net revenue.

Equity Method Investment

Equity Method Investment	9 Months Ended
	Sep. 30, 2022
Equity Method Investments and Joint Ventures [Abstract]
Equity Method Investment	Equity Method Investment Our initial $0.9 million investment in the operating company, Timber Ridge OpCo, LLC (“Timber Ridge OpCo”) held by our 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. 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 and 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, 2022, 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 Sheets as of September 30, 2022 and December 31, 2021. Excess unrecognized equity method losses for the three and nine months ended September 30, 2022 were $0.9 million and $2.6 million, respectively. Cumulative unrecognized losses were $4.8 million through September 30, 2022. We recognized gains of approximately $0.6 million, representing cash distributions received for the nine months ended September 30, 2022, and losses of approximately $0.6 million and $2.3 million related to our investment in Timber Ridge OpCo for the three and nine months ended September 30, 2021, respectively. 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, NHI-LCS JV I, LLC (“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, no liability has been recorded as of September 30, 2022. The balance secured by the Deed and Indenture was $14.7 million at September 30, 2022.

Debt

Debt	9 Months Ended
	Sep. 30, 2022
Debt Instruments [Abstract]
Debt	Debt Debt consists of the following ( $ in thousands ): September 30, December 31, Revolving credit facility - unsecured $ 10,000 $ — Bank term loans - unsecured 240,000 375,000 Senior notes - unsecured, net of discount of $2,680 and $2,921 397,320 397,079 Private placement term loans - unsecured 400,000 400,000 Fannie Mae term loans - secured, non-recourse 76,748 77,038 Unamortized loan costs (9,069) (6,234) $ 1,114,999 $ 1,242,883 Aggregate principal maturities of debt as of September 30, 2022 are as follows ( $ in thousands ): Remainder of 2022 $ 99 2023 415,408 2024 75,425 2025 125,816 2026 10,000 2027 100,000 Thereafter 400,000 1,126,748 Less: discount (2,680) Less: unamortized loan costs (9,069) $ 1,114,999 Unsecured revolving credit facility and bank term loans On March 31, 2022, we entered into a new unsecured revolving credit agreement (the “2022 Credit Agreement”) providing us with a $700.0 million unsecured revolving credit facility, replacing our previous $550.0 million unsecured revolver. The 2022 Credit Agreement matures in March 2026, but may be extended at our option, subject to the satisfaction of certain conditions, for two additional six-month periods. Borrowings under the 2022 Credit Agreement bear interest, at our election, at either (i) Term Secured Overnight Financing Rate (“SOFR”) (plus a credit spread adjustment) plus a margin ranging from 0.725% to 1.40%, (ii) Daily SOFR (plus a credit spread adjustment) plus a margin ranging from 0.725% to 1.40% or (iii) the base rate plus a margin ranging from 0.00% to 0.40%. In each election, the actual margin is determined according to our credit ratings. The base rate means, for any day, a fluctuating rate per annum equal to the highest of (i) the Agent’s prime rate, (ii) the federal funds rate on such day plus 0.50% or (iii) the adjusted Term SOFR for a one-month tenor in effect on such day plus 1.0%. In addition, the 2022 Credit Agreement requires a facility fee equal to 0.125% to 0.30%, based on our rating. We incurred $4.5 million of deferred costs in connection with the 2022 Credit Agreement which are included as a component of “ Debt ” on the Condensed Consolidated Balance Sheet as of September 30, 2022. Concurrently with the execution of the 2022 Credit Agreement, we amended our $300.0 million term loan, maturing in September 2023 (“2023 Term Loan”). The amendment modifies the existing covenants to align with provisions in the 2022 Credit Agreement and to accrue interest on borrowings based on SOFR (plus a credit spread adjustment) that were previously based on LIBOR, with no change to the existing applicable interest rate margins. We may also elect for the 2023 Term Loan to accrue interest at a base rate plus the applicable margin. As of September 30, 2022, we repaid $60.0 million of the 2023 Term Loan. In March 2022, we repaid a $75.0 million term loan maturing August 2022 with proceeds from the revolving credit facility. 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, we expensed approximately $0.2 million of unamortized loan costs 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, 2022. The revolving facility fee was 25 bps per annum during the third quarter of 2022 and based on our current credit ratings, the facility provided for floating interest on the revolver and the term loans at SOFR CME Term Option one-month loan (plus a 10 bps spread adjustment) plus 105 bps and 125 bps. At September 30, 2022, the SOFR CME Term Option one-month was 304 bps. At September 30, 2022, we had $690.0 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, 2022, 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 In January 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”). We used a portion of the net proceeds from the 2031 Senior Notes offering to repay a $100.0 million term loan and recognized a loss on early retirement of debt of $0.5 million for the nine months ended September 30, 2021, representing the unamortized loan costs expensed upon early repayment of the term loan. The 2031 Senior Notes are subject to affirmative and negative covenants, including financial covenants. As of September 30, 2022, 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 Covenants pertaining to the private placement term loans are generally conformed with those governing our credit facility, except for specific debt-coverage ratios that are more restrictive. 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 As of September 30, 2022, we had $60.1 million Fannie Mae term-debt financing, originating March 2015, consisting of interest-only payments at an annual rate of 3.79% and a 10-year maturity. The mortgages are non-recourse and secured by eleven 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 $16.6 million at September 30, 2022. Collectively, these notes are secured by facilities having a net book value of $105.2 million at September 30, 2022. Interest Expense and Rate Swap Agreements The following table summarizes interest expense ($ in thousands ): Three Months Ended Nine Months Ended September 30, September 30, 2022 2021 2022 2021 Interest expense on debt at contractual rates $ 10,821 $ 10,234 $ 30,640 $ 31,055 Losses reclassified from accumulated other comprehensive income into interest expense — 1,851 — 5,449 Capitalized interest (18) (6) (28) (40) Amortization of debt issuance costs, debt discount and other 609 636 1,860 2,064 Total interest expense $ 11,412 $ 12,715 $ 32,472 $ 38,528 On December 31, 2021, our $400.0 million interest rate swap agreements matured that were in place to hedge against fluctuations in variable interest rates applicable to our bank loans.

Commitments. Contingencies and

Commitments. Contingencies and Uncertainties	9 Months Ended
	Sep. 30, 2022
Commitments and Contingencies Disclosure [Abstract]
Commitments, Contingencies and Uncertainties	Commitments, Contingencies and Uncertainties In the normal course of business, we enter into a variety of commitments, typically consisting of funding 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 that 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, 2022, we had working capital, construction and mezzanine loan commitments to five operators for $173.6 million, of which we had funded $109.7 million toward these commitments. As provided above, loans funded do not include the effects of discounts or commitment fees. As of September 30, 2022, we had $33.5 million of development commitments for construction and renovation for nine properties of which we had funded $24.2 million toward these commitments. In addition to these commitments, we have agreed to pay up to $0.8 million in additional cash consideration pending the results of an ongoing property tax appeal related to a property acquired in the second quarter of 2022. As of September 30, 2022, no amount of this consideration is expected to be paid. Discovery PropCo has committed to fund up to $2.0 million toward the purchase of condominium units located at one of the facilities of which $1.0 million had been funded as of September 30, 2022. As of September 30, 2022, we had $28.6 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, 2022, we had funded $1.5 million toward these commitments. 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 reflected in “ Accounts payable and accrued expenses ” on the Condensed Consolidated Balance Sheets as of September 30, 2022 and December 31, 2021 is presented in the following table for the nine months ended September 30, 2022 ( $ in thousands ): Beginning balance January 1, 2022 $ 955 Provision for expected credit losses (50) Balance at September 30, 2022 $ 905 COVID-19 Pandemic Contingencies Since the World Health Organization declared COVID-19 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. 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. As of September 30, 2022, aggregate pandemic-related rent concessions granted to tenants that have been accounted for as variable lease payments totaled approximately $53.2 million, net of cumulative repayments of $0.3 million and excluding any interest accrued. Of this total, net rent deferrals that are contractually agreed to be repaid are $47.3 million. During the three months ended September 30, 2022, we did not grant any pandemic-related rent deferrals. During the nine months ended September 30, 2022, we granted pandemic-related rent deferrals of $9.2 million to seven tenants. In addition, we granted rent abatements in the first quarter of 2022 to Bickford of approximately $1.5 million. Repayments of rent deferrals during the nine months ended September 30, 2022 were $0.2 million. Rent deferrals granted for the three and nine months ended September 30, 2021 totaled approximately $5.8 million and $19.9 million, respectively, of which Bickford accounted for approximately $3.5 million and $13.8 million, respectively. 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. In addition, such claims may include, among other things professional liability and general liability claims, as well as regulatory proceedings related to our SHOP segment where we are the holder of the applicable healthcare license. While there may be lawsuits pending against us and 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. Welltower, Inc. In June 2021, Welltower announced that it would acquire certain assets from the senior housing portfolio of Holiday, a privately held senior living management company, that included 17 senior living facilities governed by a master lease originally executed between a Holiday subsidiary and NHI in 2013. We received no rent due under the master lease from the tenant for these facilities after this change in tenant ownership occurred in late July 2021. On December 20, 2021, NHI and its subsidiaries NHI-REIT of Next House, LLC, Myrtle Beach Retirement Resident LLC, and Voorhees Retirement Residence LLC filed suit against Welltower, Inc., Welltower Victory II TRS LLC, and Well Churchill Leasehold Owner LLC (collectively the "Defendants") in the Delaware Court of Chancery (Case No. 2021-1097-MTZ). In the litigation, we contended that the Defendants repeatedly failed to honor their legal obligations to NHI. In particular, we asserted that the Defendants acquired assets from a third party, Holiday, that included leases to NHI senior living facilities and fraudulently induced NHI to consent to the assignment of the leases, and then immediately failed to pay rent or provide a promised security agreement that was intended to secure against their default, all as part of an effort to pressure NHI to agree to new conditions outside the assignment agreement or force a sale of the properties to the Defendants. The lawsuit further asserted that the Defendants owed unpaid contractual rent. In connection with a memorandum of understanding between the parties dated March 4, 2022, NHI applied the remaining approximately $8.8 million lease deposit to past due rents in the first quarter of 2022. Also, as provided by the memorandum of understanding, Welltower transferred approximately $6.9 million to an escrow account to be released upon satisfactory transition of the facility operations and mutual dismissal of the lawsuit. NHI and certain of its subsidiaries entered into a settlement agreement dated March 31, 2022 with Defendants formalizing the terms to settle the lawsuit. NHI and certain of its subsidiaries terminated the master lease with Well Churchill Leasehold Owner, LLC as successor in interest to NHI Master Tenant LLC, effective April 1, 2022, upon completion of the transition of the properties subject to the master lease, as follows: (i) one property was sold to a third party, (ii) one property was transitioned to an existing operator Also effective April 1, 2022, the parties agreed to dismiss the lawsuit and mutually release all claims related to or arising out of the litigation and the $6.9 million in escrowed funds were released to NHI and recognized as rental income during the second quarter of 2022. We recognized approximately $0.7 million as a “ Gain (loss) on operations transfer, net”

Redeemable Noncontrolling Inter

Redeemable Noncontrolling Interests	9 Months Ended
	Sep. 30, 2022
Noncontrolling Interest [Abstract]
Redeemable Noncontrolling Interests	Redeemable Noncontrolling Interests Interests held by Merrill and the Discovery member in the SHOP ventures are noncontrolling interests. Certain provisions within the operating agreements of the ventures provide the noncontrolling interest holders with put rights upon certain contingent events that are not solely within the control of the Company. Therefore, these noncontrolling interests were determined to be contingently redeemable and are presented as “ Redeemable noncontrolling interests ” in the mezzanine section between Total liabilities and Stockholders’ equity on our Condensed Consolidated Balance Sheet at September 30, 2022. At inception, the Company recorded noncontrolling interests of $11.7 million, representing the initial carrying amount of the noncontrolling interest holders’ ownership interests in the ventures. The redeemable noncontrolling interests are not currently redeemable and we concluded a contingent redemption event is not probable to occur as of September 30, 2022. Consequently, the noncontrolling interests will not be subsequently remeasured to its redemption amount until such contingency event and the related redemption are probable to occur. We will continue to reflect the attribution of gains or losses to the redeemable noncontrolling interests each quarter. The following table presents the change in Redeemable noncontrolling interests for the nine months ended September 30, 2022 ( $ in thousands ): Nine Months Ended September 30, 2022 Balance at January 1, $ — Initial carrying amount 11,738 Net loss (505) Distributions (36) Balance at September 30, $ 11,197

Equity and Dividends

Equity and Dividends	9 Months Ended
	Sep. 30, 2022
Equity [Abstract]
Equity and Dividends	Equity and Dividends Share Repurchase Plan On April 15, 2022, the Company’s Board of Directors approved a stock repurchase plan (the “2022 Repurchase Plan”) for up to $240.0 million of the Company’s common stock. The plan is effective for a period of one year. Shares may be repurchased from time-to-time in open market transactions at prevailing market prices, in privately negotiated transactions or by other means in accordance with the terms of Rule 10b-18 of the Securities Exchange Act of 1934 as amended and shall be made in accordance with all applicable laws and regulations in effect. The timing and number of shares repurchased will depend on a variety of factors, including price, general market and economic conditions, alternative investment opportunities and other corporate considerations. During the three and nine months ended September 30, 2022, we repurchased through open market transactions 1,272,179 and 2,468,354 shares of our common stock, respectively, for an average price of $64.44 and $61.56 per share, respectively, excluding commissions. All shares received were constructively retired upon receipt, and the excess of the purchase price over the par value per share was recorded to “ Cumulative dividends in excess of net income ” in the Condensed Consolidated Balance Sheet. As of September 30, 2022, we had approximately $88.4 million remaining under the 2022 Repurchase Plan. Dividends The following table summarizes dividends declared by the Board of Directors or paid during the nine months ended September 30, 2022 and 2021: Nine Months Ended September 30, 2022 Date of Declaration Date of Record Date Paid/Payable Quarterly Dividend November 5, 2021 December 31, 2021 January 31, 2022 $0.90 February 16, 2022 March 31, 2022 May 6, 2022 $0.90 May 6, 2022 June 30, 2022 August 5, 2022 $0.90 August 5, 2022 September 30, 2022 November 4, 2022 $0.90 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 3, 2021 September 30, 2021 November 5, 2021 $0.90 On November 6, 2022, the Board of Directors declared a $0.90 per share dividend to common stockholders of record on December 30, 2022, payable on January 27, 2023.

Share-Based Compensation

Share-Based Compensation	9 Months Ended
	Sep. 30, 2022
Share-based Payment Arrangement [Abstract]
Stock-Based Compensation	Share-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 nine months ended September 30, 2022, we granted options to purchase 0.7 million shares of common stock under the 2019 Plan. As of September 30, 2022, shares available for future grants totaled 1.4 million under the 2019 Plan. The following is a summary of share-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, 2022 2021 2022 2021 Non-cash share-based compensation expense $ 1,065 $ 989 $ 7,576 $ 7,427 The weighted average fair value of options granted during the nine months ended September 30, 2022 and 2021 was $11.92 and $14.54 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: 2022 2021 Dividend yield 7.0% 6.7% Expected volatility 49.3% 48.1% Expected lives 2.9 years 2.9 years Risk-free interest rate 1.75% 0.33% 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, 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 Exercisable at September 30, 2021 1,183,324 $79.25 Options outstanding, January 1, 2022 1,652,505 $78.10 Options granted 718,000 $53.62 Options exercised (56,832) $53.41 Options forfeited (23,000) $62.33 Options expired (74,498) $77.93 Options outstanding, September 30, 2022 2,216,175 $70.97 3.06 Exercisable at September 30, 2022 1,695,155 $74.73 2.75 At September 30, 2022, the aggregate intrinsic value of stock options outstanding and exercisable was $2.0 million and $0.9 million, respectively. The aggregate intrinsic value of stock options exercised during the nine months ended September 30, 2022 and 2021 was $0.1 million or $4.94 per share; and $0.2 million or $9.27 per share, respectively. As of September 30, 2022, unrecognized compensation expense totaling $2.7 million associated with unvested stock options is expected to be recognized over the following periods: remainder of 2022 - $1.0 million, 2023 - $1.5 million and 2024 - $0.2 million.

Earnings Per Common Share

Earnings Per Common Share	9 Months Ended
	Sep. 30, 2022
Earnings Per Share [Abstract]
Earnings Per Common Share	Earnings Per Common Share The 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 that was repaid in April 2021 was determined by computing an average of incremental shares included in the three months ended March 31, 2021 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, 2022 2021 2022 2021 Net income attributable to common stockholders $ 34,468 $ 30,814 $ 64,540 $ 105,327 BASIC: Weighted average common shares outstanding 44,339,975 45,850,599 45,236,696 45,668,762 DILUTED: Weighted average common shares outstanding 44,339,975 45,850,599 45,236,696 45,668,762 Stock options 62,607 825 24,427 6,391 Convertible senior notes — — — 13,938 Weighted average dilutive common shares outstanding 44,402,582 45,851,424 45,261,123 45,689,091 Net income attributable to common stockholders - basic $ 0.78 $ 0.67 $ 1.43 $ 2.31 Net income attributable to common stockholders - diluted $ 0.78 $ 0.67 $ 1.43 $ 2.31 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 390,159 505,459 501,183 308,313 Regular dividends declared per common share $ 0.90 $ 0.90 $ 2.70 $ 2.9025

Fair Value of Financial Instrum

Fair Value of Financial Instruments	9 Months Ended
	Sep. 30, 2022
Fair Value Of Financial Instruments [Abstract]
Fair Value of Financial Instruments	Fair Value of Financial Instruments Carrying amounts and fair values of financial instruments that are not carried at fair value at September 30, 2022 and December 31, 2021 in the Condensed Consolidated Balance Sheets are as follows ($ in thousands ): Carrying Amount Fair Value Measurement September 30, 2022 December 31, 2021 September 30, 2022 December 31, 2021 Level 2 Variable rate debt $ 245,357 $ 373,682 $ 250,000 $ 375,000 Fixed rate debt $ 869,642 $ 869,201 $ 776,372 $ 858,124 Level 3 Mortgage and other notes receivable, net $ 207,169 $ 299,952 $ 205,460 $ 314,821 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, 2022 and December 31, 2021, due to the predominance of floating interest rates, which generally reflect market conditions.

Segment Reporting

Segment Reporting	9 Months Ended
	Sep. 30, 2022
Segment Reporting [Abstract]
Segment Reporting	Segment Reporting We evaluate our business and make resource allocations on our two operating segments: Real Estate Investments and SHOP. Our Real Estate Investments includes lease, mortgage and other note investments in independent living facilities, assisted living facilities, entrance-fee communities, senior living campuses, skilled nursing facilities and a hospital. Under the Real Estate Investment segment, we invest in senior housing and health care real estate through acquisition and financing of primarily single- tenant properties. Properties acquired are primarily leased under triple-net leases, and we are not involved in the management of the property. SHOP includes multi-tenant independent living facilities. The SHOP properties and related operations are controlled by the Company and are operated by property managers in exchange for a management fee (reference Note 5). We formed the SHOP segment effective April 1, 2022 upon termination of the triple-net lease for the legacy Holiday portfolio at which time the operations and properties of 15 ILFs were transferred into two separate ventures, as discussed further in Notes 5 and 8. The results associated with the prior triple-net lease structure for these properties are included in the Real Estate Investments segment and the results from operating these SHOP properties after the transition are included in our new SHOP segment. There is no impact to prior year’s presentation. Our chief operating decision maker evaluates performance based upon segment NOI. We define NOI as total revenues, less tenant reimbursements and property operating expenses. We use NOI to make decisions about resource allocations and to assess the property level performance of our properties. There were no intersegment transactions for the three and nine months ended September 30, 2022. Capital expenditures for the nine months ended September 30, 2022 were approximately $7.6 million for the Real Estate Investments segment and $1.8 million for the SHOP segment. Non-segment revenue consists mainly of other income. Non-segment assets consist of corporate assets including cash, deferred loan expenses and corporate offices and equipment among others. Non-property specific revenues and expenses are not allocated to individual segments in determining NOI. The accounting policies of the segments are the same as those described in the summary of significant accounting policies (see Note 2). The results of operations for all acquisitions described in Notes 3 and 4 are included in our consolidated results of operations from the acquisition dates and are components of the appropriate segments. Summary information for the reportable segments during the three and nine months ended September 30, 2022 is as follows ( $ in thousands ): For the three months ended September 30, 2022: Real Estate Investment SHOP Non-segment/Corporate Total Rental income $ 59,394 $ — $ — $ 59,394 Resident fees and services — 12,013 — 12,013 Interest income and other 4,820 — 71 4,891 Total revenues 64,214 12,013 71 76,298 Senior housing operating expenses — 9,239 — 9,239 Taxes and insurance on leased properties 2,358 — — 2,358 NOI 61,856 2,774 71 64,701 Depreciation 15,390 2,129 14 17,533 Interest 837 — 10,575 11,412 Legal — — 88 88 Franchise, excise and other taxes — — 225 225 General and administrative — — 4,744 4,744 Loan and realty losses 11,329 — — 11,329 Gains on sales of real estate, net (14,840) — — (14,840) Gain on operations transfer (19) — — (19) Net Income (loss) $ 49,159 $ 645 $ (15,575) $ 34,229 Total assets $ 2,214,475 $ 290,708 $ 3,602 $ 2,508,785 For the nine months ended September 30, 2022: Real Estate Investment SHOP Non-segment/Corporate Total Rental income $ 163,935 $ — $ — $ 163,935 Resident fees and services — 24,005 — 24,005 Interest income and other 19,362 — 222 19,584 Total revenues 183,297 24,005 222 207,524 Senior housing operating expenses — 18,352 — 18,352 Taxes and insurance on leased properties 7,553 — — 7,553 NOI 175,744 5,653 222 181,619 Depreciation 49,282 4,245 50 53,577 Interest 2,371 — 30,101 32,472 Legal — — 2,254 2,254 Franchise, excise and other taxes — — 694 694 General and administrative — — 17,893 17,893 Loan and realty losses 39,951 — — 39,951 Gains on sales of real estate, net (28,342) — — (28,342) Loss on operations transfer, net 710 — — 710 Gain on note payoff (1,113) — — (1,113) Loss on early retirement of debt — — 151 151 Gains from equity method investment (569) — — (569) Net Income (loss) $ 113,454 $ 1,408 $ (50,921) $ 63,941

Basis of Presentation and Sig_2

Basis of Presentation and Significant Accounting Policies (Policy)	9 Months Ended
	Sep. 30, 2022
Accounting Policies [Abstract]
Basis of Presentation	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, 2021, included in our 2021 Annual Report on Form 10-K filed with the Securities and Exchange Commission (the “SEC”).
Principles of Consolidation	Principles of Consolidation The condensed consolidated financial statements include the accounts of the Company, its wholly owned subsidiaries, joint ventures 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. Effective April 1, 2022 and at September 30, 2022, our consolidated total assets and liabilities include two consolidated ventures comprising our SHOP activities formed with two separate partners - Merrill Gardens, L.L.C. (“Merrill”) and DSHI NHI Holiday LLC (the “Discovery member”), a controlled affiliate of Discovery Senior Living. We consider both ventures to be VIEs as either the members, as a group, lack the characteristics of a controlling financial interest or there are disproportionate voting rights but substantially all of the activities are performed on behalf of the Company. We are deemed to be the primary beneficiary because we have the ability to control the activities that most significantly impact each VIE’s economic performance. The assets of the ventures primarily consist of real estate properties, cash and cash equivalents, and resident fees and services (accounts receivable). Their obligations primarily consist of operating expenses of the ILFs (accounts payable and accrued expenses) and capital expenditures for the properties. As of and for the three and nine months ended September 30, 2022, our redeemable noncontrolling interests relate to these ventures. Assets of the consolidated SHOP ventures that can be used only to settle obligations of each respective SHOP venture primarily include approximately $261.3 million of real estate properties, net, and $9.6 million of cash and cash equivalents. Liabilities of the consolidated SHOP ventures for which creditors do not have recourse to the general credit of the Company are not material. Reference Notes 5 and 9 for further discussion of these new ventures. We also consolidate two real estate partnerships formed with our partners, Discovery Senior Housing Investor XXIV, LLC, a controlled affiliate of Discovery Senior Living, and LCS Timber Ridge LLC, to invest in senior housing facilities. We consider both partnerships to be VIEs, based on our determination that the total equity at risk in each is insufficient to finance activities without additional subordinated financial support. NHI directs the activities that most significantly impact economic performance of these ventures, subject to limited protective rights extended to our partners for specified business decisions. Because of our control of these partnerships, we include their assets, liabilities, noncontrolling interests and operations in our consolidated financial statements. At September 30, 2022, we held interests in nine 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. 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 2014 Senior Living Communities Notes and straight-line receivable $ 88,237 $ 94,268 Notes 3, 4 2016 Senior Living Management Notes and straight-line receivable $ 26,788 $ 26,788 — 2018 Bickford Senior Living Notes and funding commitment $ 46,769 $ 60,246 Notes 3, 4 2019 Encore Senior Living Notes and straight-line receivable $ 33,688 $ 53,303 Notes 3, 4 2020 Timber Ridge OpCo, LLC Various 1 $ (5,000) $ 5,000 Note 6 2020 Watermark Retirement Notes and straight-line receivable $ 7,691 $ 10,715 — 2021 Montecito Medical Real Estate Notes and funding commitment $ 20,255 $ 50,000 Note 4 2021 Vizion Health Notes and straight-line receivable $ 20,064 $ 22,869 — 2021 Navion Senior Solutions Various 2 $ 8,038 $ 13,988 — 1 Loan commitment, equity method investment and straight-line rents receivable 2 Notes, loan commitments, straight-line rents receivable, and unamortized lease incentives 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 non-payment of 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 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. Reference Note 6 for further discussion of our equity method investment.
Noncontrolling Interests	Noncontrolling Interests Contingently redeemable noncontrolling interests are recorded at their initial carrying amounts upon issuance and are subsequently adjusted to reflect their share of gains or losses and distributions attributable to the noncontrolling interests. In periods where they are or will become probable of redemption, an adjustment to the redemption value of the noncontrolling interests is also recognized through Capital in excess of par value on the Company’s Consolidated Balance Sheets and included in our computation of earnings per share. As of September 30, 2022, these noncontrolling interests were classified as mezzanine equity, as discussed further in Note 9.
Cash and Cash Equivalents and Restricted Cash	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).
Assets Held for Sale	Assets Held for SaleWe 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.
Impairment of Long-Lived Assets	Impairment of Long-Lived Assets We evaluate the recoverability of the carrying amount of our long-lived assets when events or circumstances, including significant physical changes, significant adverse changes in general economic conditions and significant deterioration of the underlying cash flows of the long-lived assets, indicate that the carrying amount of the long-lived assets may not be recoverable. The need to recognize an impairment charge is based on estimated undiscounted future cash flows compared to the carrying amount. If recognition of an impairment charge is necessary, it is measured as the amount by which the carrying amount exceeds the estimated fair value of the long-lived asset.
Revenue Recognition	Revenue Recognition 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. During the second quarter of 2022, we placed Bickford Senior Living (“Bickford”) on the cash basis of revenue recognition for lease purposes and recorded write offs of $18.1 million of straight-line rents receivable and $7.1 million of lease incentives related to our Bickford master lease agreements. Reference Note 3 for further discussion. Resident Fees and Services - Resident fee revenue associated with our SHOP activities is recorded when services are rendered and includes resident room and care charges, community fees and other resident charges. Residency agreements are generally
Accounting for Lease Modifications related to the Coronavirus Pandemic	Accounting for Lease Modifications related to the Coronavirus PandemicIn 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. We have elected not to apply the modification guidance under ASC 842 and have accounted for qualified rent concessions as variable lease payments when applicable, and recorded as rental income when received.
Income Tax	Income Tax We intend at all times to qualify as a REIT under Sections 856 through 860 of the Internal Revenue Code of 1986, as amended. Accordingly, we will generally not be subject to U.S. federal income tax, provided that we continue to qualify as a REIT and make distributions to stockholders at least equal to or in excess of 90% our taxable income. Certain activities that we undertake may be conducted by entities that have elected to be treated as taxable REIT subsidiaries (TRSs). TRSs are subject to federal, state, and local income taxes. Accordingly, a provision for income taxes has been made in the consolidated financial statements. A failure to qualify under the applicable REIT qualification rules and regulations would have a material adverse impact on our financial position, results of operations and cash flows.
Segments	Segments We operate our business through two reportable segments: Real Estate Investments and SHOP. In our Real Estate Investments segment, we invest in i) senior housing and healthcare real estate and lease those properties to healthcare operating companies under triple-net leases that obligate tenants to pay all property-related expenses and ii) mortgage and other notes receivable throughout the United States. Our SHOP segment is comprised of the operations of 15 ILFs located throughout the United States that are operated on behalf of the Company by two independent managers pursuant to the terms of separate management agreements that commenced April 1, 2022. Reference Notes 5 and 14 for additional information.

Basis of Presentation and Sig_3

Basis of Presentation and Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2022
Accounting Policies [Abstract]
Schedule of variable interest entities	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 2014 Senior Living Communities Notes and straight-line receivable $ 88,237 $ 94,268 Notes 3, 4 2016 Senior Living Management Notes and straight-line receivable $ 26,788 $ 26,788 — 2018 Bickford Senior Living Notes and funding commitment $ 46,769 $ 60,246 Notes 3, 4 2019 Encore Senior Living Notes and straight-line receivable $ 33,688 $ 53,303 Notes 3, 4 2020 Timber Ridge OpCo, LLC Various 1 $ (5,000) $ 5,000 Note 6 2020 Watermark Retirement Notes and straight-line receivable $ 7,691 $ 10,715 — 2021 Montecito Medical Real Estate Notes and funding commitment $ 20,255 $ 50,000 Note 4 2021 Vizion Health Notes and straight-line receivable $ 20,064 $ 22,869 — 2021 Navion Senior Solutions Various 2 $ 8,038 $ 13,988 — 1 Loan commitment, equity method investment and straight-line rents receivable 2 Notes, loan commitments, straight-line rents receivable, and unamortized lease incentives
Schedule of Cash and Cash Equivalents	The following table sets forth our “ Cash and 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 $ 28,811 $ 48,393 Restricted cash (included in Other assets, net) 2,903 1,802 $ 31,714 $ 50,195
Restrictions on Cash and Cash Equivalents	The following table sets forth our “ Cash and 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 $ 28,811 $ 48,393 Restricted cash (included in Other assets, net) 2,903 1,802 $ 31,714 $ 50,195

Investment Activity (Tables)

Investment Activity (Tables)	9 Months Ended
	Sep. 30, 2022
Real Estate [Abstract]
Schedule of Asset Disposition	During the nine months ended September 30, 2022, we completed the following real estate property dispositions within our Real Estate Investments reportable segment as described below ( $ in thousands ): Operator Date Properties Asset Class Net Proceeds Net Real Estate Investment Gain Impairment 1 Hospital Corporation of America Q1 2022 1 MOB $ 4,868 $ 1,904 $ 2,964 $ — Vitality Senior Living 2 Q1 2022 1 SLC 8,302 8,285 17 — Holiday Retirement (“Holiday”) 2 Q2 2022 1 ILF 2,990 3,020 — 30 Chancellor Senior Living 2 Q2 2022 2 ALF 7,305 7,357 — 52 Bickford 2 Q2 2022 3 ALF 25,959 28,268 — 2,309 Comfort Care Q2 2022 4 ALF 40,000 38,445 1,556 — Helix Healthcare Q2 2022 1 HOSP 19,500 10,535 8,965 — Discovery Senior Living 2 Q3 2022 2 ALF/SLC 16,379 15,159 1,220 — National HealthCare Corporation (“NHC”) Q3 2022 7 SNF 43,686 30,066 13,620 — $ 168,989 $ 143,039 $ 28,342 $ 2,391 1 Impairments are included in “ Loan and realty losses ” in Condensed Consolidated Statements of Income for the nine months ended September 30, 2022. 2 Total impairment charges recognized on these properties were $65.4 million, of which $28.5 million were recognized in the nine months ended September 30, 2022.
Schedule of Tenant Concentrations	The following table contains information regarding tenant concentration, excluding $2.6 million for our corporate office, $336.6 million for SHOP, and a credit loss reserve of $6.9 million, based on the percentage of revenues for the nine months ended September 30, 2022 and 2021, related to tenants or affiliates of tenants, that exceed 10% of total revenues ( $ in thousands ): as of September 30, 2022 Revenues 1 Asset Gross Real Notes Nine Months Ended September 30, Class Estate 2 Receivable 2022 2021 Senior Living Communities EFC $ 573,631 $ 46,669 $ 38,325 18% $ 38,094 17% NHC SNF 133,770 — 27,875 13% 28,290 12% Bickford 3 ALF 412,304 46,422 N/A N/A 26,224 11% Holiday 3 ILF — — N/A N/A 22,811 10% All others, net Various 1,313,238 121,018 109,766 53% 106,110 46% Escrow funds from tenants for property operating expenses Various — — 7,553 4% 7,519 4% $ 2,432,943 $ 214,109 183,519 229,048 Resident fees and services 4 24,005 12% — —% $ 207,524 $ 229,048 1 Includes interest income on notes receivable and rental income from properties classified as held for sale. 2 Amounts include any properties classified as held for sale. 3 Below 10% for the nine months ended September 30, 2022. Therefore, revenues are included in All others, net. 4 There is no tenant concentration in resident fees and services because these agreements are with individual residents.
Schedule of Future Minimum Base Rent	Future minimum lease payments to be received by us under our operating leases at September 30, 2022, are as follows ( $ in thousands ): Remainder of 2022 $ 47,241 2023 183,792 2024 183,825 2025 186,425 2026 189,282 2027 149,849 Thereafter 599,001 $ 1,539,415
Schedule of Fixed and Variable Lease Payments	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, 2022 2021 2022 2021 Lease payments based on fixed escalators, net of deferrals $ 53,394 $ 59,027 $ 172,767 $ 188,008 Lease payments based on variable escalators 1,224 1,288 2,452 3,201 Straight-line rent income 2,476 3,798 (11,360) 12,189 Escrow funds received from tenants for property operating expenses 2,358 3,182 7,553 7,519 Amortization and write-off of lease incentives (58) (252) (7,477) (774) Rental income $ 59,394 $ 67,043 $ 163,935 $ 210,143

Mortgage And Other Notes Rece_2

Mortgage And Other Notes Receivable (Tables)	9 Months Ended
	Sep. 30, 2022
Mortgage and Other Notes Receivable [Abstract]
Financing Receivable Credit Quality Indicators	The credit quality indicator as of September 30, 2022, is presented below for the amortized cost, net by year of origination of ( $ in thousands ): 2022 2021 2020 2019 2018 Prior Total Mortgages more than 1.5x $ 8,571 $ — $ 36,173 $ 32,700 $ 14,000 $ 4,106 $ 95,550 between 1.0x and 1.5x — — — — 14,700 — 14,700 less than 1.0x — — 3,890 6,423 — 10,000 20,313 8,571 — 40,063 39,123 28,700 14,106 130,563 Mezzanine more than 1.5x — 19,195 — — — — 19,195 between 1.0x and 1.5x — 23,978 — — — 9,178 33,156 less than 1.0x — — — — — 14,500 14,500 No coverage available — — — 750 — — 750 — 43,173 — 750 — 23,678 67,601 Revolver more than 1.5x 1,976 between 1.0x and 1.5x 13,969 less than 1.0x — 15,945 Credit loss reserve (6,940) $ 207,169
Financing Receivable, Allowance for Credit Loss	The allowance for expected credit losses is presented in the following table for the nine months ended September 30, 2022 ( $ in thousands ): Beginning balance January 1, 2022 $ 5,210 Provision for expected credit losses 1,730 Balance September 30, 2022 $ 6,940

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2022
Debt Instruments [Abstract]
Schedule of Debt	Debt consists of the following ( $ in thousands ): September 30, December 31, Revolving credit facility - unsecured $ 10,000 $ — Bank term loans - unsecured 240,000 375,000 Senior notes - unsecured, net of discount of $2,680 and $2,921 397,320 397,079 Private placement term loans - unsecured 400,000 400,000 Fannie Mae term loans - secured, non-recourse 76,748 77,038 Unamortized loan costs (9,069) (6,234) $ 1,114,999 $ 1,242,883
Schedule of Maturities of Long-term Debt	Aggregate principal maturities of debt as of September 30, 2022 are as follows ( $ in thousands ): Remainder of 2022 $ 99 2023 415,408 2024 75,425 2025 125,816 2026 10,000 2027 100,000 Thereafter 400,000 1,126,748 Less: discount (2,680) Less: unamortized loan costs (9,069) $ 1,114,999
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 Expense	The following table summarizes interest expense ($ in thousands ): Three Months Ended Nine Months Ended September 30, September 30, 2022 2021 2022 2021 Interest expense on debt at contractual rates $ 10,821 $ 10,234 $ 30,640 $ 31,055 Losses reclassified from accumulated other comprehensive income into interest expense — 1,851 — 5,449 Capitalized interest (18) (6) (28) (40) Amortization of debt issuance costs, debt discount and other 609 636 1,860 2,064 Total interest expense $ 11,412 $ 12,715 $ 32,472 $ 38,528 On December 31, 2021, our $400.0 million interest rate swap agreements matured that were in place to hedge against fluctuations in variable interest rates applicable to our bank loans.

Commitments. Contingencies an_2

Commitments. Contingencies and Uncertainties (Tables)	9 Months Ended
	Sep. 30, 2022
Commitments and Contingencies Disclosure [Abstract]
Off Balance Sheet, Credit Loss, Liability, Roll Forward	The liability for expected credit losses on our unfunded loans reflected in “ Accounts payable and accrued expenses ” on the Condensed Consolidated Balance Sheets as of September 30, 2022 and December 31, 2021 is presented in the following table for the nine months ended September 30, 2022 ( $ in thousands ): Beginning balance January 1, 2022 $ 955 Provision for expected credit losses (50) Balance at September 30, 2022 $ 905

Redeemable Noncontrolling Int_2

Redeemable Noncontrolling Interest (Tables)	9 Months Ended
	Sep. 30, 2022
Noncontrolling Interest [Abstract]
Redeemable Noncontrolling Interest	The following table presents the change in Redeemable noncontrolling interests for the nine months ended September 30, 2022 ( $ in thousands ): Nine Months Ended September 30, 2022 Balance at January 1, $ — Initial carrying amount 11,738 Net loss (505) Distributions (36) Balance at September 30, $ 11,197

Equity and Dividends (Tables)

Equity and Dividends (Tables)	9 Months Ended
	Sep. 30, 2022
Equity [Abstract]
Dividends Declared	The following table summarizes dividends declared by the Board of Directors or paid during the nine months ended September 30, 2022 and 2021: Nine Months Ended September 30, 2022 Date of Declaration Date of Record Date Paid/Payable Quarterly Dividend November 5, 2021 December 31, 2021 January 31, 2022 $0.90 February 16, 2022 March 31, 2022 May 6, 2022 $0.90 May 6, 2022 June 30, 2022 August 5, 2022 $0.90 August 5, 2022 September 30, 2022 November 4, 2022 $0.90 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 3, 2021 September 30, 2021 November 5, 2021 $0.90

Share-Based Compensation (Table

Share-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2022
Share-based Payment Arrangement [Abstract]
Share-based Payment Arrangement, Expensed and Capitalized, Amount	The following is a summary of share-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, 2022 2021 2022 2021 Non-cash share-based compensation expense $ 1,065 $ 989 $ 7,576 $ 7,427
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions	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: 2022 2021 Dividend yield 7.0% 6.7% Expected volatility 49.3% 48.1% Expected lives 2.9 years 2.9 years Risk-free interest rate 1.75% 0.33%
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, 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 Exercisable at September 30, 2021 1,183,324 $79.25 Options outstanding, January 1, 2022 1,652,505 $78.10 Options granted 718,000 $53.62 Options exercised (56,832) $53.41 Options forfeited (23,000) $62.33 Options expired (74,498) $77.93 Options outstanding, September 30, 2022 2,216,175 $70.97 3.06 Exercisable at September 30, 2022 1,695,155 $74.73 2.75

Earnings Per Common Share (Tabl

Earnings Per Common Share (Tables)	9 Months Ended
	Sep. 30, 2022
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, 2022 2021 2022 2021 Net income attributable to common stockholders $ 34,468 $ 30,814 $ 64,540 $ 105,327 BASIC: Weighted average common shares outstanding 44,339,975 45,850,599 45,236,696 45,668,762 DILUTED: Weighted average common shares outstanding 44,339,975 45,850,599 45,236,696 45,668,762 Stock options 62,607 825 24,427 6,391 Convertible senior notes — — — 13,938 Weighted average dilutive common shares outstanding 44,402,582 45,851,424 45,261,123 45,689,091 Net income attributable to common stockholders - basic $ 0.78 $ 0.67 $ 1.43 $ 2.31 Net income attributable to common stockholders - diluted $ 0.78 $ 0.67 $ 1.43 $ 2.31 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 390,159 505,459 501,183 308,313 Regular dividends declared per common share $ 0.90 $ 0.90 $ 2.70 $ 2.9025

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	9 Months Ended
	Sep. 30, 2022
Fair Value Of Financial Instruments [Abstract]
Fair Value Measurements, Nonrecurring	Carrying amounts and fair values of financial instruments that are not carried at fair value at September 30, 2022 and December 31, 2021 in the Condensed Consolidated Balance Sheets are as follows ($ in thousands ): Carrying Amount Fair Value Measurement September 30, 2022 December 31, 2021 September 30, 2022 December 31, 2021 Level 2 Variable rate debt $ 245,357 $ 373,682 $ 250,000 $ 375,000 Fixed rate debt $ 869,642 $ 869,201 $ 776,372 $ 858,124 Level 3 Mortgage and other notes receivable, net $ 207,169 $ 299,952 $ 205,460 $ 314,821

Segment Reporting (Tables)

Segment Reporting (Tables)	9 Months Ended
	Sep. 30, 2022
Segment Reporting [Abstract]
Schedule of Segment Reporting Information, by Segment	Summary information for the reportable segments during the three and nine months ended September 30, 2022 is as follows ( $ in thousands ): For the three months ended September 30, 2022: Real Estate Investment SHOP Non-segment/Corporate Total Rental income $ 59,394 $ — $ — $ 59,394 Resident fees and services — 12,013 — 12,013 Interest income and other 4,820 — 71 4,891 Total revenues 64,214 12,013 71 76,298 Senior housing operating expenses — 9,239 — 9,239 Taxes and insurance on leased properties 2,358 — — 2,358 NOI 61,856 2,774 71 64,701 Depreciation 15,390 2,129 14 17,533 Interest 837 — 10,575 11,412 Legal — — 88 88 Franchise, excise and other taxes — — 225 225 General and administrative — — 4,744 4,744 Loan and realty losses 11,329 — — 11,329 Gains on sales of real estate, net (14,840) — — (14,840) Gain on operations transfer (19) — — (19) Net Income (loss) $ 49,159 $ 645 $ (15,575) $ 34,229 Total assets $ 2,214,475 $ 290,708 $ 3,602 $ 2,508,785 For the nine months ended September 30, 2022: Real Estate Investment SHOP Non-segment/Corporate Total Rental income $ 163,935 $ — $ — $ 163,935 Resident fees and services — 24,005 — 24,005 Interest income and other 19,362 — 222 19,584 Total revenues 183,297 24,005 222 207,524 Senior housing operating expenses — 18,352 — 18,352 Taxes and insurance on leased properties 7,553 — — 7,553 NOI 175,744 5,653 222 181,619 Depreciation 49,282 4,245 50 53,577 Interest 2,371 — 30,101 32,472 Legal — — 2,254 2,254 Franchise, excise and other taxes — — 694 694 General and administrative — — 17,893 17,893 Loan and realty losses 39,951 — — 39,951 Gains on sales of real estate, net (28,342) — — (28,342) Loss on operations transfer, net 710 — — 710 Gain on note payoff (1,113) — — (1,113) Loss on early retirement of debt — — 151 151 Gains from equity method investment (569) — — (569) Net Income (loss) $ 113,454 $ 1,408 $ (50,921) $ 63,941

Organization and Nature of Bu_2

Organization and Nature of Business (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2022 USD ($) segment	Sep. 30, 2022 property	Sep. 30, 2022 state	Sep. 30, 2022 lessee	Sep. 30, 2022 mortgage	Sep. 30, 2022 jointVenture	Sep. 30, 2022 bedOrUnitInTheProperty	Sep. 30, 2022 manager	Apr. 01, 2022 property	Dec. 31, 2021 USD ($)
Real Estate Properties [Line Items]
Number of reportable segments | segment	2
Number of health care properties related to mortgage notes receivables		13			13
Loans and leases receivable, gross | $	$ 214,109
Credit loss reserve | $	(6,940)									$ (5,210)
Number of joint ventures | jointVenture						2
Number of independent managers | manager								2
Real Estate
Real Estate Properties [Line Items]
Real estate investment property, portfolio assets | $	2,400,000
Properties		162
Number of states in which entity operates | state			32
Number of lessees | lessee				24
Asset Held For Sale
Real Estate Properties [Line Items]
Properties		2
Asset Held For Sale | Real Estate
Real Estate Properties [Line Items]
Properties		10
Senior Housing Community | Real Estate
Real Estate Properties [Line Items]
Properties		96
Skilled Nursing Facility | Real Estate
Real Estate Properties [Line Items]
Properties		65
Hospital | Real Estate
Real Estate Properties [Line Items]
Properties		1
Independent Living Facility
Real Estate Properties [Line Items]
Number of states in which entity operates | state			8
Number of joint ventures | jointVenture						2
Independent Living Facility | SHOP
Real Estate Properties [Line Items]
Real estate investment property, portfolio assets | $	$ 336,600
Properties		15							15
Number of units acquired in a assisted living facility | bedOrUnitInTheProperty							1,731

Basis of Presentation and Sig_4

Basis of Presentation and Significant Accounting Policies (Details)	3 Months Ended			9 Months Ended
	Sep. 30, 2022 USD ($) property jointVenture realEstatePartnership manager	Jun. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($) property jointVenture segment realEstatePartnership manager	Sep. 30, 2021 USD ($)	May 31, 2022 property	Apr. 01, 2022 property	Dec. 31, 2021 USD ($)
Accounting Policies [Line Items]
Number of consolidated ventures | jointVenture	2			2
Number of real estate partnerships | realEstatePartnership	2			2
Real estate properties, net	$ 2,140,853,000			$ 2,140,853,000				$ 2,317,880,000
Cash and cash equivalents	$ 28,811,000			$ 28,811,000				$ 37,412,000
Number of unconsolidated variable interest entities | property	9			9
Impairment of real estate	$ 9,500,000			$ 38,300,000
Rental income	$ 59,394,000		$ 67,043,000	$ 163,935,000	$ 210,143,000
Number of reportable segments | segment				2
Number of independent managers | manager	2			2
Maximum
Accounting Policies [Line Items]
Residency agreement, term				1 year
Minimum
Accounting Policies [Line Items]
Residency agreement, term				30 days
COVID-19
Accounting Policies [Line Items]
Lessor, lease concessions granted	$ 0
Bickford Senior Living
Accounting Policies [Line Items]
Loan and lease losses, write-offs		$ 18,100,000
Lease incentives		$ 7,100,000
Rental income	$ 7,100,000			$ 17,000,000	$ 26,224,000
Properties | property	36			36		3
Independent Living Facility
Accounting Policies [Line Items]
Number of consolidated ventures | jointVenture	2			2
SHOP
Accounting Policies [Line Items]
Real estate properties, net	$ 261,300,000			$ 261,300,000
Cash and cash equivalents	$ 9,600,000			$ 9,600,000
SHOP | Independent Living Facility
Accounting Policies [Line Items]
Properties | property	15			15			15
Lease Payment Deferral and Abatement
Accounting Policies [Line Items]
Rental income				$ 10,700,000

Basis of Presentation and Sig_5

Basis of Presentation and Significant Accounting Policies (Schedule of Variable Interest Entities) (Details) - USD ($) $ / shares in Units, $ in Thousands								9 Months Ended
	Nov. 04, 2022	Aug. 05, 2022	May 06, 2022	Jan. 31, 2022	Nov. 05, 2021	May 07, 2021	Jan. 29, 2021	Sep. 30, 2021	Sep. 30, 2022
Variable Interest Entity [Line Items]
Quarterly dividend (in dollars per share)		$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 1.1025	$ 1.1025	$ 0.90
Subsequent Event
Variable Interest Entity [Line Items]
Quarterly dividend (in dollars per share)	$ 0.90
Straight-Line Rent Receivable | Bickford Senior Living
Variable Interest Entity [Line Items]
Carrying Amount									$ 46,769
Maximum Exposure to Loss									60,246
Straight-Line Rent Receivable | Senior Living Communities
Variable Interest Entity [Line Items]
Carrying Amount									88,237
Maximum Exposure to Loss									94,268
Straight-Line Rent Receivable | Senior Living Management
Variable Interest Entity [Line Items]
Carrying Amount									26,788
Maximum Exposure to Loss									26,788
Notes Receivable | Encore Senior Living
Variable Interest Entity [Line Items]
Carrying Amount									33,688
Maximum Exposure to Loss									53,303
Notes Receivable | Timber Ridge OpCo, LLC
Variable Interest Entity [Line Items]
Carrying Amount									5,000
Maximum Exposure to Loss									5,000
Notes Receivable | Watermark Retirement
Variable Interest Entity [Line Items]
Carrying Amount									7,691
Maximum Exposure to Loss									10,715
Notes Receivable | Montecito Medical Real Estate
Variable Interest Entity [Line Items]
Carrying Amount									20,255
Maximum Exposure to Loss									50,000
Notes Receivable | Vizion Health
Variable Interest Entity [Line Items]
Carrying Amount									20,064
Maximum Exposure to Loss									22,869
Notes Receivable | Navion Senior Solutions
Variable Interest Entity [Line Items]
Carrying Amount									8,038
Maximum Exposure to Loss									$ 13,988

Basis of Presentation and Sig_6

Basis of Presentation and Significant Accounting Policies (Schedule of Cash and Cash Equivalents and Restricted Cash) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021	Sep. 30, 2021	Dec. 31, 2020
Accounting Policies [Abstract]
Cash and cash equivalents	$ 28,811		$ 48,393
Restricted cash (included in Other assets, net)	2,903		1,802
Cash and cash equivalents and restricted cash	$ 31,714	$ 39,485	$ 50,195	$ 46,343

Investment Activity (Narrative)

Investment Activity (Narrative) (Details)		1 Months Ended		3 Months Ended				9 Months Ended
	Sep. 01, 2022 USD ($) property facility	Apr. 30, 2022 USD ($) bedOrUnitInTheProperty	Mar. 31, 2022 USD ($) property	Sep. 30, 2022 USD ($) property boardMember facility lease	Jun. 30, 2022 USD ($) property	Mar. 31, 2022 USD ($) property	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($) property boardMember facility lease	Sep. 30, 2021 USD ($)	Aug. 31, 2022 USD ($)	May 31, 2022 property	Apr. 01, 2022 property masterLease	Dec. 31, 2021 USD ($)	Jun. 30, 2021 property
Real Estate [Line Items]
Full payment of an outstanding construction note receivable		$ 9,100,000
Gains on sales of real estate, net				$ 14,840,000			$ 19,941,000	$ 28,342,000	$ 26,426,000
Impairment of real estate				9,500,000				38,300,000
Rental income				59,394,000			67,043,000	163,935,000	$ 210,143,000
Net real estate balance				$ 32,600,000				$ 32,600,000
Percentage of continuing revenue								12%	0%
Straight-line rental income								$ (11,360,000)	$ 12,189,000
Number of leases | lease				4				4
Real estate properties, net				$ 2,140,853,000				$ 2,140,853,000					$ 2,317,880,000
Real Estate
Real Estate [Line Items]
Impairment of real estate								$ 5,700,000
Number of real estate properties | property				162				162
SHOP
Real Estate [Line Items]
Real estate properties, net				$ 261,300,000				$ 261,300,000
Lease Option
Real Estate [Line Items]
Number of real estate properties | property				3				3
Lease Option, Between 2025 and 2028
Real Estate [Line Items]
Rental income				$ 1,800,000			1,700,000	$ 5,300,000	5,100,000
Real estate properties, net				$ 60,100,000				$ 60,100,000
Lease Extended Until 2028
Real Estate [Line Items]
Lease escalator minimum				8%				8%
Lease Payment Deferral and Abatement
Real Estate [Line Items]
Rental income								$ 10,700,000
Lease Payment Deferral
Real Estate [Line Items]
Operating lease income								$ 47,300,000
Geographic Concentration Risk | Investment Consideration Benchmark | South Carolina
Real Estate [Line Items]
Concentration risk percentage								12.10%
Geographic Concentration Risk | Investment Consideration Benchmark | Texas
Real Estate [Line Items]
Concentration risk percentage								11.10%
Asset Held For Sale
Real Estate [Line Items]
Number of real estate properties | property				2				2
Asset Held For Sale | Real Estate
Real Estate [Line Items]
Number of real estate properties | property				10				10
Reclassified to assets held for sale in the second quarter of 2022
Real Estate [Line Items]
Number of real estate properties | property				6				6
Disposal Group, Held-for-sale, Not Discontinued Operations
Real Estate [Line Items]
Rental income				$ 1,100,000			1,200,000	$ 2,000,000	3,500,000
Encore Senior Living
Real Estate [Line Items]
Number of units acquired in a assisted living facility | bedOrUnitInTheProperty		53
Acquisition price		$ 13,300,000
Cash consideration of an ongoing property tax appeal		$ 800,000
Cash consideration expected to be paid								$ 0
Master lease, term				15 years				15 years
Initial lease rate				7.25%				7.25%
Annual escalator of lease				2.50%				2.50%
Bickford Senior Living
Real Estate [Line Items]
Escrow deposit				$ 2,400,000				$ 2,400,000
Rental income				$ 7,100,000				$ 17,000,000	$ 26,224,000
Number of real estate properties | property				36				36			3
Percentage of continuing revenue									11%
Loan and lease losses, write-offs					$ 18,100,000
Lease incentives					$ 7,100,000
Amortization of rate deferral								$ 6,000,000
Bickford Senior Living | Lease Extended Until 2028
Real Estate [Line Items]
Rental income								28,300,000
Number of real estate properties | property					11							27
Number of master lease agreements | masterLease												3
Bickford Senior Living | Lease Payment Deferral and Abatement
Real Estate [Line Items]
Operating lease income							3,500,000	5,500,000	$ 13,800,000
Bickford Senior Living | Lease Payment Deferral
Real Estate [Line Items]
Operating lease income						$ 1,500,000		$ 26,000,000
Bickford Senior Living | Facilities Transitioned To Other Operators
Real Estate [Line Items]
Number of real estate properties | property			1			1
Lessor, operating lease, term of contract			10 years			10 years
Bickford Senior Living | Assisted Living Facility
Real Estate [Line Items]
Straight-line rent receivable			$ 700,000
Bickford Senior Living | Asset Held For Sale
Real Estate [Line Items]
Number of real estate properties | property				2				2
Bickford Senior Living | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Number of real estate properties | property														6
Discovery
Real Estate [Line Items]
Impairment of real estate				$ 23,700,000
Discovery | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Amount of real estate sold in cash consideration				16,900,000
Asset disposition transaction cost				500,000
National HealthCare Corporation (“NHC”)
Real Estate [Line Items]
Rental income								$ 27,875,000	$ 28,290,000
Percentage of continuing revenue								13%	12%
Number of facilities | facility	35
Annual base rent				$ 34,300,000				$ 34,300,000		$ 30,800,000
Number of board members | boardMember				2				2
National HealthCare Corporation (“NHC”) | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Amount of real estate sold in cash consideration	$ 44,400,000
Asset disposition transaction cost	$ 700,000
Real estate properties sold | property	7
Rental income				$ 600,000			900,000	$ 2,400,000	$ 2,800,000
Number of facilities | facility				35				35
Senior Living Communities
Real Estate [Line Items]
Rental income								$ 38,325,000	$ 38,094,000
Number of real estate properties | property				10				10
Percentage of continuing revenue								18%	17%
Straight-line rental income				$ (100,000)			$ (700,000)	$ (300,000)	$ (1,800,000)
Holiday Transition
Real Estate [Line Items]
Rental income									$ 22,811,000
Number of real estate properties | property				17				17
Percentage of continuing revenue									10%
Holiday Transition | Facilities Transitioned To Other Operators
Real Estate [Line Items]
Number of real estate properties | property												1
Holiday Transition | Asset Held For Sale
Real Estate [Line Items]
Number of real estate properties | property												1

Investment Activity (Asset Disp

Investment Activity (Asset Disposition) (Details) $ in Thousands	3 Months Ended				9 Months Ended
	Sep. 30, 2022 USD ($) property	Jun. 30, 2022 USD ($) property	Mar. 31, 2022 USD ($) property	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($) property	Sep. 30, 2021 USD ($)	May 31, 2022 property
Property, Plant and Equipment [Line Items]
Net Proceeds					$ 168,957	$ 203,147
Gain/ (Impairment)	$ 14,840			$ 19,941	28,342	$ 26,426
Impairment of real estate	$ 9,500				$ 38,300
Bickford
Property, Plant and Equipment [Line Items]
Properties | property	36				36		3
Vitality, Holiday, Chancellor, and Bickford
Property, Plant and Equipment [Line Items]
Accumulated impaired real estate	$ 65,400				$ 65,400
Impairment of real estate					28,500
Discovery
Property, Plant and Equipment [Line Items]
Impairment of real estate	23,700
Disposal Group, Disposed of by Sale, Not Discontinued Operations
Property, Plant and Equipment [Line Items]
Net Proceeds					168,989
Net Real Estate Investment	$ 143,039				143,039
Gain/ (Impairment)					28,342
Impairment of real estate					$ 2,391
Disposal Group, Disposed of by Sale, Not Discontinued Operations | Hospital Corporation of America
Property, Plant and Equipment [Line Items]
Properties | property			1
Net Proceeds			$ 4,868
Net Real Estate Investment			1,904
Gain/ (Impairment)			$ 2,964
Disposal Group, Disposed of by Sale, Not Discontinued Operations | Vitality Senior Living
Property, Plant and Equipment [Line Items]
Properties | property			1
Net Proceeds			$ 8,302
Net Real Estate Investment			8,285
Gain/ (Impairment)			$ 17
Disposal Group, Disposed of by Sale, Not Discontinued Operations | Holiday Retirement
Property, Plant and Equipment [Line Items]
Properties | property		1
Net Proceeds		$ 2,990
Net Real Estate Investment		3,020
Impairment of real estate		$ 30
Disposal Group, Disposed of by Sale, Not Discontinued Operations | Chancellor Senior Living
Property, Plant and Equipment [Line Items]
Properties | property		2
Net Proceeds		$ 7,305
Net Real Estate Investment		7,357
Impairment of real estate		$ 52
Disposal Group, Disposed of by Sale, Not Discontinued Operations | Bickford
Property, Plant and Equipment [Line Items]
Properties | property		3
Net Proceeds		$ 25,959
Net Real Estate Investment		28,268
Impairment of real estate		$ 2,309
Disposal Group, Disposed of by Sale, Not Discontinued Operations | Comfort Care
Property, Plant and Equipment [Line Items]
Properties | property		4
Net Proceeds		$ 40,000
Net Real Estate Investment		38,445
Gain/ (Impairment)		$ 1,556
Disposal Group, Disposed of by Sale, Not Discontinued Operations | Helix Healthcare
Property, Plant and Equipment [Line Items]
Properties | property		1
Net Proceeds		$ 19,500
Net Real Estate Investment		10,535
Gain/ (Impairment)		$ 8,965
Disposal Group, Disposed of by Sale, Not Discontinued Operations | Discovery Senior Living
Property, Plant and Equipment [Line Items]
Properties | property	2				2
Net Proceeds	$ 16,379
Net Real Estate Investment	15,159				$ 15,159
Gain/ (Impairment)	$ 1,220
Disposal Group, Disposed of by Sale, Not Discontinued Operations | National HealthCare Corporation (“NHC”)
Property, Plant and Equipment [Line Items]
Properties | property	7				7
Net Proceeds	$ 43,686
Net Real Estate Investment	30,066				$ 30,066
Gain/ (Impairment)	13,620
Disposal Group, Disposed of by Sale, Not Discontinued Operations | Discovery
Property, Plant and Equipment [Line Items]
Gain/ (Impairment)	$ (1,200)

Investment Activity (Schedule o

Investment Activity (Schedule of Tenant Concentrations) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Tenant Concentration [Line Items]
Cost of corporate office	$ 2,600		$ 2,600
Credit loss reserve	6,940		6,940		$ 5,210
Real estate	2,740,276		2,740,276		2,894,548
Real estate, at cost	2,432,943		2,432,943
Mortgage and other notes receivable, net	207,169		207,169		$ 299,952
Loans and leases receivable, gross	214,109		214,109
Rental income	59,394	$ 67,043	163,935	$ 210,143
Resident fees and services	12,013	0	24,005	0
Total revenues	76,298	73,833	$ 207,524	$ 229,048
Percentage of continuing revenue			12%	0%
Independent Living Facility | SHOP
Tenant Concentration [Line Items]
Real estate investment property, portfolio assets	336,600		$ 336,600
Escrow funds received from tenants for property operating expenses
Tenant Concentration [Line Items]
Real estate	0		0
Mortgage and other notes receivable, net	0		0
Rental income	2,358	$ 3,182	$ 7,553	$ 7,519
Percentage of continuing revenue			4%	4%
Senior Living Communities
Tenant Concentration [Line Items]
Real estate	573,631		$ 573,631
Mortgage and other notes receivable, net	46,669		46,669
Rental income			$ 38,325	$ 38,094
Percentage of continuing revenue			18%	17%
National HealthCare Corporation (“NHC”)
Tenant Concentration [Line Items]
Real estate	133,770		$ 133,770
Mortgage and other notes receivable, net	0		0
Rental income			$ 27,875	$ 28,290
Percentage of continuing revenue			13%	12%
Bickford Senior Living
Tenant Concentration [Line Items]
Real estate	412,304		$ 412,304
Mortgage and other notes receivable, net	46,422		46,422
Rental income	7,100		17,000	$ 26,224
Percentage of continuing revenue				11%
Holiday Transition
Tenant Concentration [Line Items]
Real estate	0		0
Mortgage and other notes receivable, net	0		0
Rental income				$ 22,811
Percentage of continuing revenue				10%
Less than 10% Operators
Tenant Concentration [Line Items]
Real estate	1,313,238		1,313,238
Mortgage and other notes receivable, net	$ 121,018		121,018
Rental income			$ 109,766	$ 106,110
Percentage of continuing revenue			53%	46%
More than 10% Operators
Tenant Concentration [Line Items]
Rental income			$ 183,519	$ 229,048

Investment Activity (Schedule_2

Investment Activity (Schedule of Future Minimum Lease Payments) (Details) $ in Thousands	Sep. 30, 2022 USD ($)
Real Estate [Abstract]
Rent remainder of fiscal year	$ 47,241
2023	183,792
2024	183,825
2025	186,425
2026	189,282
2027	149,849
Thereafter	599,001
Future minimum lease payments	$ 1,539,415

Investment Activity (Schedule_3

Investment Activity (Schedule of Fixed and Variable Lease Payments) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Fixed and Variable Lease Payments [Line Items]
Rental income	$ 59,394	$ 67,043	$ 163,935	$ 210,143
Straight-line rental income			(11,360)	12,189
Lease payments based on fixed escalators, net of deferrals
Fixed and Variable Lease Payments [Line Items]
Rental income	53,394	59,027	172,767	188,008
Lease payments based on variable escalators
Fixed and Variable Lease Payments [Line Items]
Rental income	1,224	1,288	2,452	3,201
Straight-line rent income
Fixed and Variable Lease Payments [Line Items]
Straight-line rental income	2,476	3,798	(11,360)	12,189
Escrow funds received from tenants for property operating expenses
Fixed and Variable Lease Payments [Line Items]
Rental income	2,358	3,182	7,553	7,519
Amortization and write-off of lease incentives
Fixed and Variable Lease Payments [Line Items]
Amortization and write-off of lease incentives	$ (58)	$ (252)	$ (7,477)	$ (774)

Mortgage And Other Notes Rece_3

Mortgage And Other Notes Receivable (Narrative) (Details) $ in Thousands	1 Months Ended		3 Months Ended			9 Months Ended
	Jan. 31, 2022 USD ($) bedOrUnitInTheProperty	Jun. 30, 2021 USD ($) property	Sep. 30, 2022 USD ($)	Jun. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($) property	Sep. 30, 2021 USD ($)	Sep. 30, 2022 property	Sep. 30, 2022 mortgage	Sep. 30, 2022 bedOrUnitInTheProperty	Sep. 30, 2022	Sep. 30, 2022 realEstateInvestment	Sep. 30, 2022 renewalOption	Sep. 30, 2022 loan	May 31, 2022 property	Dec. 31, 2021 USD ($)
Accounts, Notes, Loans and Financing Receivable [Line Items]
Mortgage and other notes receivable, net			$ 207,169			$ 207,169										$ 299,952
Number of health care properties related to mortgage notes receivables								13	13
Credit loss reserve			(6,940)			(6,940)										$ (5,210)
Collections of mortgage and other notes receivable						117,973	$ 64,509
Interest income and other			4,891		$ 6,790	19,584	18,905
Loans and leases agreement						173,600
Amount funded on real estate investments			1,000			1,000
Increase rate in the amount of loss from a default											20%
Effective adjustment rate											44%
Life- Care Services - Sagewood
Accounts, Notes, Loans and Financing Receivable [Line Items]
Collections of mortgage and other notes receivable				$ 111,300
Accrued interest and prepayment fee				$ 1,100
Interest income and other					$ 2,400	5,200	$ 8,100
Encore Senior Living
Accounts, Notes, Loans and Financing Receivable [Line Items]
Mortgage and other notes receivable, net			8,700			8,700
Loans and leases agreement	$ 28,500
Number of units acquired in a assisted living facility | bedOrUnitInTheProperty	108
Loan agreement term	4 years
Annual interest rate from master credit agreement	8.50%
Number of extensions | bedOrUnitInTheProperty	2
Note receivable renewal term	1 year
Montecito Medical Real Estate
Accounts, Notes, Loans and Financing Receivable [Line Items]
Mortgage and other notes receivable, net			20,300			20,300
Loans and leases agreement						$ 50,000
Loan agreement term						5 years
Annual interest rate from master credit agreement											9.50%
Number of extensions | renewalOption													2
Note receivable renewal term						1 year
Amount funded on real estate investments			4,500			$ 4,500
Number of real estate investments | realEstateInvestment												2
Investment accrue interest rate											7.50%
Deferred interest rate to be paid upon certain future events											4.50%
Deferred interest											2.50%
Interest income and other			500			1,300
Payments for loans						300
Bickford Senior Living
Accounts, Notes, Loans and Financing Receivable [Line Items]
Mortgage and other notes receivable, net			46,422			46,422
Interest income and other			300			1,000
Loans and leases agreement						$ 4,000
Properties | property								36							3
Note receivable interest rate											7%
Mortgage loan amortization period						25 years
Bickford Note Investment
Accounts, Notes, Loans and Financing Receivable [Line Items]
Mortgage and other notes receivable, net			13,800			$ 13,800
Contingent incentive payments			2,000			2,000
Senior Living Communities
Accounts, Notes, Loans and Financing Receivable [Line Items]
Mortgage and other notes receivable, net			46,669			46,669
Number of extensions | property								2
Properties | property								10
Revolving amount line of credit			20,000			20,000
Revolving note receivable amount outstanding			(14,000)			$ (14,000)
Loans receivable facility bears interest rate						9.83%
Loans receivable maturity date						10 years
Loans receivable, U.S. Treasury rate											6%
Purchase option at a stated minimum price			38,300			$ 38,300
Secured By Real Estate
Accounts, Notes, Loans and Financing Receivable [Line Items]
Mortgage and other notes receivable, net			130,600			130,600
Not Secured By Real Estate
Accounts, Notes, Loans and Financing Receivable [Line Items]
Mortgage and other notes receivable, net			83,500			$ 83,500
Property Held by Fund | Montecito Medical Real Estate
Accounts, Notes, Loans and Financing Receivable [Line Items]
Number of medical office buildings | property						9
Combined purchase price of medical office buildings						$ 86,700
Disposal Group, Disposed of by Sale, Not Discontinued Operations | Bickford Senior Living
Accounts, Notes, Loans and Financing Receivable [Line Items]
Properties | property		6
Note receivable interest rate		10%
Disposal Group, Disposed of by Sale, Not Discontinued Operations | Bickford Senior Living | Unlikely to be Collected Financing Receivable
Accounts, Notes, Loans and Financing Receivable [Line Items]
Increase in mortgage note receivable from sale of real estate		$ 13,000
Fully Funded | Bickford Senior Living
Accounts, Notes, Loans and Financing Receivable [Line Items]
Loans and leases agreement						28,700
Number of construction loans | loan														2
Partially Funded | Bickford Senior Living
Accounts, Notes, Loans and Financing Receivable [Line Items]
Loans and leases agreement						14,200
Number of construction loans | loan														1
After 2021 | Senior Living Communities
Accounts, Notes, Loans and Financing Receivable [Line Items]
Revolving amount line of credit			$ 15,000			15,000
July 2019 Transaction | Senior Living Communities
Accounts, Notes, Loans and Financing Receivable [Line Items]
Loans and leases agreement						$ 32,700
Number of units acquired in a assisted living facility | bedOrUnitInTheProperty										248
Loan agreement term						5 years
Annual interest rate from master credit agreement											7.25%

Mortgage And Other Notes Rece_4

Mortgage And Other Notes Receivable (Schedule of Financing Receivables By Credit Quality Indicator) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and leases receivable, gross	$ 214,109
Credit loss reserve	(6,940)	$ (5,210)
Mortgage and other notes receivable, net	207,169	$ 299,952
Mortgages
Financing Receivable, Credit Quality Indicator [Line Items]
2022	8,571
2021	0
2020	40,063
2019	39,123
2018	28,700
Prior	14,106
Loans and leases receivable, gross	130,563
Mortgages | more than 1.5x
Financing Receivable, Credit Quality Indicator [Line Items]
2022	8,571
2021	0
2020	36,173
2019	32,700
2018	14,000
Prior	4,106
Loans and leases receivable, gross	95,550
Mortgages | between 1.0x and 1.5x
Financing Receivable, Credit Quality Indicator [Line Items]
2022	0
2021	0
2020	0
2019	0
2018	14,700
Prior	0
Loans and leases receivable, gross	14,700
Mortgages | less than 1.0x
Financing Receivable, Credit Quality Indicator [Line Items]
2022	0
2021	0
2020	3,890
2019	6,423
2018	0
Prior	10,000
Loans and leases receivable, gross	20,313
Mezzanine
Financing Receivable, Credit Quality Indicator [Line Items]
2022	0
2021	43,173
2020	0
2019	750
2018	0
Prior	23,678
Loans and leases receivable, gross	67,601
Mezzanine | more than 1.5x
Financing Receivable, Credit Quality Indicator [Line Items]
2022	0
2021	19,195
2020	0
2019	0
2018	0
Prior	0
Loans and leases receivable, gross	19,195
Mezzanine | between 1.0x and 1.5x
Financing Receivable, Credit Quality Indicator [Line Items]
2022	0
2021	23,978
2020	0
2019	0
2018	0
Prior	9,178
Loans and leases receivable, gross	33,156
Mezzanine | less than 1.0x
Financing Receivable, Credit Quality Indicator [Line Items]
2022	0
2021	0
2020	0
2019	0
2018	0
Prior	14,500
Loans and leases receivable, gross	14,500
Mezzanine | No coverage available
Financing Receivable, Credit Quality Indicator [Line Items]
2022	0
2021	0
2020	0
2019	750
2018	0
Prior	0
Loans and leases receivable, gross	750
Revolver
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and leases receivable, gross	15,945
Revolver | more than 1.5x
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and leases receivable, gross	1,976
Revolver | between 1.0x and 1.5x
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and leases receivable, gross	13,969
Revolver | less than 1.0x
Financing Receivable, Credit Quality Indicator [Line Items]
Loans and leases receivable, gross	$ 0

Mortgage And Other Notes Rece_5

Mortgage And Other Notes Receivable (Schedule of Financing Receivables By Allowance for Credit Loss) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2022 USD ($)
Financing Receivable, Allowance for Credit Loss [Roll Forward]
Beginning balance	$ 5,210
Provision for expected credit losses	1,730
Ending balance	$ 6,940

Senior Housing Operating Port_2

Senior Housing Operating Portfolio Formation Activities (Details)	9 Months Ended
	Sep. 30, 2022 USD ($) property jointVenture bedOrUnitInTheProperty	Apr. 01, 2022 property
Senior Housing Operating Portfolio Formation Activities [Line Items]
Number of joint ventures | jointVenture	2
Annual fixed preferred return	$ 10,200,000
New Venture
Senior Housing Operating Portfolio Formation Activities [Line Items]
Interest of an aggregate blended common equity the company owns	89%
Minimum
Senior Housing Operating Portfolio Formation Activities [Line Items]
Management fee multiplier	$ 1,000
SHOP
Senior Housing Operating Portfolio Formation Activities [Line Items]
Preferred interest	65%
Common equity interest	35%
SHOP | New Venture
Senior Housing Operating Portfolio Formation Activities [Line Items]
Ownership percentage	100%
Merrill Gardens Managed Portfolio
Senior Housing Operating Portfolio Formation Activities [Line Items]
Cash contributed for its common equity interest in the venture	$ 10,600,000
Management fee	5%
Real estate services fee	5%
Discovery Managed Portfolio
Senior Housing Operating Portfolio Formation Activities [Line Items]
Cash contributed for its common equity interest in the venture	$ 1,100,000
Management fee	5%
Independent Living Facility
Senior Housing Operating Portfolio Formation Activities [Line Items]
Number of joint ventures | jointVenture	2
Independent Living Facility | SHOP
Senior Housing Operating Portfolio Formation Activities [Line Items]
Properties | property	15	15
Independent Living Facility | Merrill Gardens Managed Portfolio
Senior Housing Operating Portfolio Formation Activities [Line Items]
Properties | bedOrUnitInTheProperty	6
Independent Living Facility | Discovery Managed Portfolio
Senior Housing Operating Portfolio Formation Activities [Line Items]
Properties | bedOrUnitInTheProperty	9

Equity Method Investment (Detai

Equity Method Investment (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($) extensionOption	Sep. 30, 2021 USD ($)	Dec. 31, 2021 USD ($)
Schedule of Equity Method Investments [Line Items]
Mortgage and other notes receivable, net	$ 207,169		$ 207,169		$ 299,952
Cumulative unrecognized equity method losses	5,000		5,000		$ 5,000
(Losses) gains from equity method investment	$ 0	$ (557)	$ 569	$ (2,274)
Operating lease term	7 years		7 years
Number of renewal options | extensionOption			2
Balance secured by the deed and indenture	$ 14,700		$ 14,700
Timber Ridge OpCo, LLC
Schedule of Equity Method Investments [Line Items]
Financing receivable of revolving credit facility	5,000		5,000
Mortgage and other notes receivable, net	0		0
Unrecognized equity method losses	900		$ 2,600
(Losses) gains from equity method investment		$ (600)		$ (2,300)
Real Estate Operating Company | LCS Timber Ridge
Schedule of Equity Method Investments [Line Items]
Equity interest in affiliates			25%
Cumulative Amount | Timber Ridge OpCo, LLC
Schedule of Equity Method Investments [Line Items]
Cumulative unrecognized equity method losses	(4,800)		$ (4,800)
Noncontrolling Interests | Real Estate Operating Company | Timber Ridge OpCo, LLC
Schedule of Equity Method Investments [Line Items]
Investments in affiliates	$ 900		$ 900

Debt (Schedule of Debt) (Detail

Debt (Schedule of Debt) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Revolving credit facility - unsecured	$ 10,000	$ 0
Bank term loans - unsecured	400,000
Unamortized loan costs	(9,069)	(6,234)
Debt	1,114,999	1,242,883
Less: discount	(2,680)
Bank Term Loans
Debt Instrument [Line Items]
Bank term loans - unsecured	240,000	375,000
Senior Notes Due 2031
Debt Instrument [Line Items]
Bank term loans - unsecured	397,320	397,079
Less: discount	(2,680)	(2,921)
Private Placement Term Loans
Debt Instrument [Line Items]
Bank term loans - unsecured	400,000	400,000
Fannie Mae Term Loans
Debt Instrument [Line Items]
Fannie Mae term loans - secured, non-recourse	$ 76,748	$ 77,038

Debt (Schedule of Maturities of

Debt (Schedule of Maturities of Long-term Debt) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Debt Instruments [Abstract]
Remainder of 2022	$ 99
2023	415,408
2024	75,425
2025	125,816
2026	10,000
2027	100,000
Thereafter	400,000
Long-term debt, gross	1,126,748
Less: discount	(2,680)
Unamortized loan costs	(9,069)	$ (6,234)
Debt	$ 1,114,999	$ 1,242,883

Debt (Narrative) (Details)

Debt (Narrative) (Details) $ in Millions		1 Months Ended	3 Months Ended	9 Months Ended
	Mar. 31, 2022 USD ($) extensionOption	Mar. 31, 2022 USD ($)	Sep. 30, 2022 USD ($) property	Sep. 30, 2022 USD ($) property	Sep. 30, 2021 USD ($)	Mar. 30, 2022 USD ($)	Jan. 31, 2021 USD ($)
Debt Instrument [Line Items]
Debt leverage limit				50%
Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Basis spread on variable rate	1%		0.10%
Fed Funds Effective Rate Overnight Index Swap Rate
Debt Instrument [Line Items]
Basis spread on variable rate	0.50%
Minimum
Debt Instrument [Line Items]
Facility fee percentage	0.125%
Maximum
Debt Instrument [Line Items]
Facility fee percentage	0.30%
Revolving Credit Facility | Base Rate
Debt Instrument [Line Items]
Commitment fee			0.25%
Revolving Credit Facility | Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Basis spread on variable rate			1.05%
Revolving Credit Facility | Minimum | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate	0%
Revolving Credit Facility | Minimum | Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Basis spread on variable rate	0.725%
Revolving Credit Facility | Maximum | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate	0.40%
Revolving Credit Facility | Maximum | Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Basis spread on variable rate	1.40%
Unsecured Debt | Revolving Credit Facility
Debt Instrument [Line Items]
Unsecured revolving credit facility	$ 700	$ 700				$ 550
Debt instrument, number of extension options | extensionOption	2
Debt instrument, extension period	6 months
Deferred costs			$ 4.5	$ 4.5
Unused balance of the unsecured revolving credit facility			$ 690	690
Term Loans | Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Basis spread on variable rate			1.25%
$300M Term Loan
Debt Instrument [Line Items]
Long-term debt	$ 300	$ 300
Repayments of term loan				60
$75M Term Loan
Debt Instrument [Line Items]
Basis spread on variable rate		1.85%
Repayments of term loan		$ 75
Basis point floor	0.50%	0.50%
Write off of unamortized loan costs				$ 0.2
$75M Term Loan | Revolving Credit Facility | Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Interest rate at period end			3.04%	3.04%
$100M Term Loan
Debt Instrument [Line Items]
Repayments of term loan					$ 100
Write off of unamortized loan costs					$ 0.5
Senior Notes Due 2031 | Senior Notes
Debt Instrument [Line Items]
Aggregate principle amount issued							$ 400
Fixed Rate							3%
Fannie Mae Term Loans
Debt Instrument [Line Items]
Long-term debt			$ 60.1	$ 60.1
Fixed Rate			3.79%	3.79%
Term of debt				10 years
Number of real estate properties | property			11	11
Net book value			$ 105.2	$ 105.2
FNMA Berkadia Note
Debt Instrument [Line Items]
Long-term debt			$ 16.6	$ 16.6
Fixed Rate			4.60%	4.60%

Debt (Schedule of Unsecured Ter

Debt (Schedule of Unsecured Term Loans) (Details) $ in Thousands	Sep. 30, 2022 USD ($)
Unsecured Term Loans [Line Items]
Amount	$ 400,000
January 2023
Unsecured Term Loans [Line Items]
Amount	$ 125,000
Fixed Rate	3.99%
November 2023
Unsecured Term Loans [Line Items]
Amount	$ 50,000
Fixed Rate	3.99%
September 2024
Unsecured Term Loans [Line Items]
Amount	$ 75,000
Fixed Rate	3.93%
November 2025
Unsecured Term Loans [Line Items]
Amount	$ 50,000
Fixed Rate	4.33%
January 2027
Unsecured Term Loans [Line Items]
Amount	$ 100,000
Fixed Rate	4.51%

Debt (Schedule of Interest Expe

Debt (Schedule of Interest Expense) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Interest Expense [Line Items]
Interest expense on debt at contractual rates	$ 10,821	$ 10,234	$ 30,640	$ 31,055
comprehensive income into interest expense	0	1,851	0	5,449
Capitalized interest	(18)	(6)	(28)	(40)
Amortization of debt issuance costs, debt discount and other	609	636	1,860	2,064
Total interest expense	$ 11,412	$ 12,715	$ 32,472	$ 38,528
Interest rate swaps, Matured December 2021
Interest Expense [Line Items]
Derivative, notional amount					$ 400,000

Commitments. Contingencies an_3

Commitments. Contingencies and Uncertainties (Narrative) (Details) $ in Thousands	1 Months Ended	3 Months Ended				9 Months Ended
	Jan. 31, 2022 USD ($)	Sep. 30, 2022 USD ($) leaseAgreement operator property tenant jointVenture	Jun. 30, 2022 USD ($)	Mar. 31, 2022 USD ($) property	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($) leaseAgreement operator property tenant jointVenture	Sep. 30, 2021 USD ($)	May 31, 2022 property	Apr. 01, 2022 property jointVenture	Dec. 31, 2021 USD ($)
Commitment and Contingencies [Line Items]
Loans and leases agreement						$ 173,600
Mortgage and other notes receivable, net		$ 207,169				207,169				$ 299,952
Development commitments for construction and renovation		33,500				33,500
Amount funded toward the development commitments		24,200				24,200
Amount funded on real estate investments		1,000				1,000
Contingent lease inducement commitments and contingent consideration of acquisitions		28,600				28,600
Lease deposit liabilities		$ 0				$ 0				$ 8,838
Amount transferred to an escrow account				$ 6,900
Number of joint ventures | jointVenture		2				2
Gain (loss) on operations transfer, net		$ 19	$ (700)		$ 0	$ (710)	$ 0
Aggregate lease concessions granted to tenants
Commitment and Contingencies [Line Items]
Operating lease income						53,200
Lease Payment Deferral
Commitment and Contingencies [Line Items]
Operating lease income						47,300
Encore Senior Living
Commitment and Contingencies [Line Items]
Loans and leases agreement	$ 28,500
Mortgage and other notes receivable, net		8,700				8,700
Discovery PropCo
Commitment and Contingencies [Line Items]
Development commitments for construction and renovation		2,000				2,000
Bickford Senior Living
Commitment and Contingencies [Line Items]
Loans and leases agreement						4,000
Mortgage and other notes receivable, net		$ 46,422				$ 46,422
Properties | property		36				36		3
Bickford Senior Living | Facilities Transitioned To Other Operators
Commitment and Contingencies [Line Items]
Properties | property				1
Bickford Senior Living | Lease Payment Deferral
Commitment and Contingencies [Line Items]
Operating lease income				$ 1,500		$ 26,000
Holiday Transition
Commitment and Contingencies [Line Items]
Mortgage and other notes receivable, net		$ 0				$ 0
Properties | property		17				17
Lease deposit liabilities				$ 8,800
Number of joint ventures | jointVenture									2
Holiday Transition | Facilities Transitioned To Other Operators
Commitment and Contingencies [Line Items]
Properties | property									1
Holiday Transition | Facilities Transitioned to SHOP Partnership Ventures
Commitment and Contingencies [Line Items]
Properties | property									15
Loans Receivable
Commitment and Contingencies [Line Items]
Number of operators/tenants | operator		5				5
Notes Receivable Remain Unfunded
Commitment and Contingencies [Line Items]
Mortgage and other notes receivable, net		$ 109,700				$ 109,700
Development Commitment
Commitment and Contingencies [Line Items]
Number of operators/tenants | property		9				9
Lease Inducement
Commitment and Contingencies [Line Items]
Amount funded on real estate investments		$ 1,500				$ 1,500
Properties | leaseAgreement		7				7
Collection of Rent Deferred | Lease Payment Deferral
Commitment and Contingencies [Line Items]
Operating lease income						$ 300
Rent Deferred Second Quarter of 2022 | Lease Payment Deferral
Commitment and Contingencies [Line Items]
Number of operators/tenants | tenant		7				7
Operating lease income						$ 9,200
First Quarter Collection of Rent Deferred | Lease Payment Deferral
Commitment and Contingencies [Line Items]
Operating lease income						$ 200
Rent Deferred Second Quarter of 2021 | Lease Payment Deferral
Commitment and Contingencies [Line Items]
Operating lease income					$ 5,800		$ 19,900
Asset Held For Sale
Commitment and Contingencies [Line Items]
Properties | property		2				2
Asset Held For Sale | Bickford Senior Living
Commitment and Contingencies [Line Items]
Properties | property		2				2
Asset Held For Sale | Holiday Transition
Commitment and Contingencies [Line Items]
Properties | property									1

Commitments. Contingencies an_4

Commitments. Contingencies and Uncertainties (Off Balance Sheet Credit Loss Liability Roll Forward Schedule) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2022 USD ($)
Off Balance Sheet, Credit Loss [Roll Forward]
Provision for expected credit losses	$ (50)
Ending balance	905
Accounting Standards Update 2016-13
Off Balance Sheet, Credit Loss [Roll Forward]
Beginning balance	$ 955

Redeemable Noncontrolling Int_3

Redeemable Noncontrolling Interest (Details) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended	9 Months Ended
	Sep. 30, 2022	Jun. 30, 2022	Sep. 30, 2022
Redeemable Noncontrolling Interests [Roll Forward]
Beginning balance		$ 0	$ 0
Initial carrying amount	$ 11,700		11,738
Net loss	(278)	(227)	(505)
Distributions	(12)	$ (24)	(36)
Ending balance	$ 11,197		$ 11,197

Equity and Dividends (Narrative

Equity and Dividends (Narrative) (Details) - USD ($) $ / shares in Units, $ in Millions			3 Months Ended		6 Months Ended		9 Months Ended
	Nov. 06, 2022	Apr. 15, 2022	Sep. 30, 2022	Sep. 30, 2021	Jun. 30, 2022	Jun. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Equity, Class of Treasury Stock [Line Items]
2022 repurchase plan		$ 240
Effective period of stock repurchase plan		1 year
Shares of common stock repurchased through the open market transactions (in shares)			1,272,179				2,468,354
Average price of shares repurchased (in dollars per share)			$ 64.44				$ 61.56
Remaining amount of 2022 repurchase plan			$ 88.4				$ 88.4
Dividends to common stockholders (in dollars per share)			$ 0.90	$ 0.90	$ 1.80	$ 2.0025	$ 2.70	$ 2.9025
Subsequent Event | Declared November 6, 2022
Equity, Class of Treasury Stock [Line Items]
Dividends to common stockholders (in dollars per share)	$ 0.9

Equity and Dividends (Schedule

Equity and Dividends (Schedule of Dividends Declared) (Details) - $ / shares								9 Months Ended
	Nov. 04, 2022	Aug. 05, 2022	May 06, 2022	Jan. 31, 2022	Nov. 05, 2021	May 07, 2021	Jan. 29, 2021	Sep. 30, 2021
Equity, Class of Treasury Stock [Line Items]
Quarterly dividend (in dollars per share)		$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 1.1025	$ 1.1025	$ 0.90
Subsequent Event
Equity, Class of Treasury Stock [Line Items]
Quarterly dividend (in dollars per share)	$ 0.90

Share-Based Compensation (Narra

Share-Based Compensation (Narrative) (Details) $ / shares in Units, $ in Millions	9 Months Ended
	Sep. 30, 2022 USD ($) plan $ / shares shares	Sep. 30, 2021 USD ($) $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of incentive plans | plan	2
Options granted (in shares) | shares		652,000
Weighted average fair value of options granted (in US dollars per share) | $ / shares	$ 11.92	$ 14.54
Aggregate intrinsic value of stock options outstanding	$ 2
Aggregate intrinsic value of stock options exercisable	$ 0.9
Weighted average aggregate intrinsic value options exercised (in US dollars per share) | $ / shares	$ 4.94	$ 9.27
Aggregate intrinsic value of stock options exercised	$ 0.1	$ 0.2
Unrecognized compensation cost	$ 2.7
2019 Stock Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares) | shares	718,000
Shares available for grants | shares	1,400,000
Expected To Be Recognized Remainder Of 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost	$ 1
Expected To Be Recognized During 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost	1.5
Expected To Be Recognized During 2024
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost	$ 0.2

Share-Based Compensation (Sched

Share-Based Compensation (Schedule of Share-Based Payments) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Share-based Payment Arrangement [Abstract]
Non-cash share-based compensation	$ 1,065	$ 989	$ 7,576	$ 7,427

Share-Based Compensation (Sch_2

Share-Based Compensation (Schedule of Stock Option Valuation Assumptions) (Details)	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Share-based Payment Arrangement [Abstract]
Dividend yield	7%	6.70%
Expected volatility	49.30%	48.10%
Expected lives	2 years 10 months 24 days	2 years 10 months 24 days
Risk-free interest rate	1.75%	0.33%

Share-Based Compensation (Sch_3

Share-Based Compensation (Schedule Of Stock Option Activity) (Details) - $ / shares	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding [Roll Forward]
Options outstanding beginning balance (in shares)	1,652,505	1,033,838
Options granted (in shares)		652,000
Options exercised (in shares)	(56,832)	(20,000)
Options forfeited (in shares)	(23,000)
Options expired (in shares)	(74,498)
Options outstanding, ending balance (in shares)	2,216,175	1,665,838
Stock Options Weighted Average Exercise Price
Options outstanding, weighted average exercise price, beginning balance (in US dollars per share)	$ 78.10	$ 83.54
Options granted, weighted average exercise price (in US dollars per share)	53.62	69.20
Options exercised, weighted average exercise price (in US dollars per share)	53.41	60.52
Options forfeited, weighted average exercise price (in US dollars per share)	62.33
Options expired, weighted average exercise price (in US dollars per share)	77.93
Options outstanding, weighted average exercise price, ending balance (in US dollars per share)	$ 70.97	$ 78.20
Stock Options Additional Disclosures
Options exercisable (in shares)	1,695,155	1,183,324
Options exercisable, weighted average exercise price (in US dollars per share)	$ 74.73	$ 79.25
Options outstanding, weighted average remaining contractual life (in years)	3 years 21 days
Options exercisable, weighted average remaining contractual life (in years)	2 years 9 months
2019 Stock Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding [Roll Forward]
Options granted (in shares)	718,000

Earnings Per Common Share (Summ

Earnings Per Common 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, 2022	Sep. 30, 2021	Jun. 30, 2022	Jun. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Earnings Per Share [Abstract]
Net income attributable to common stockholders	$ 34,468	$ 30,814			$ 64,540	$ 105,327
BASIC:
Weighted average common shares outstanding (in shares)	44,339,975	45,850,599			45,236,696	45,668,762
DILUTED:
Weighted average common shares outstanding (in shares)	44,339,975	45,850,599			45,236,696	45,668,762
Stock options (in shares)	62,607	825			24,427	6,391
Convertible senior notes (in shares)	0	0			0	13,938
Weighed average dilutive common shares outstanding (in shares)	44,402,582	45,851,424			45,261,123	45,689,091
Net income per common share - basic (in US dollars per share)	$ 0.78	$ 0.67			$ 1.43	$ 2.31
Net income per common share - diluted (in US dollars per share)	$ 0.78	$ 0.67			$ 1.43	$ 2.31
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 (in shares)	390,159	505,459			501,183	308,313
Regular dividends declared per common share (in US dollars per share)	$ 0.90	$ 0.90	$ 1.80	$ 2.0025	$ 2.70	$ 2.9025

Fair Value of Financial Instr_3

Fair Value of Financial Instruments (Fair Value Measurements, Nonrecurring) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Fair Value of Financial Instruments [Line Items]
Mortgage and other notes receivable, net	$ 207,169	$ 299,952
Level 3 | Carrying Amount
Fair Value of Financial Instruments [Line Items]
Mortgage and other notes receivable, net	207,169	299,952
Level 3 | Fair Value Measurement
Fair Value of Financial Instruments [Line Items]
Mortgage and other notes receivable, net	205,460	314,821
Variable rate debt | Level 2 | Carrying Amount
Fair Value of Financial Instruments [Line Items]
Debt instrument, fair value disclosure	245,357	373,682
Variable rate debt | Level 2 | Fair Value Measurement
Fair Value of Financial Instruments [Line Items]
Debt instrument, fair value disclosure	250,000	375,000
Fixed rate debt | Level 2 | Carrying Amount
Fair Value of Financial Instruments [Line Items]
Debt instrument, fair value disclosure	869,642	869,201
Fixed rate debt | Level 2 | Fair Value Measurement
Fair Value of Financial Instruments [Line Items]
Debt instrument, fair value disclosure	$ 776,372	$ 858,124

Segment Reporting (Narrative) (

Segment Reporting (Narrative) (Details) $ in Millions	9 Months Ended
	Sep. 30, 2022 USD ($) property jointVenture operatingSegment	Apr. 01, 2022 property jointVenture
Segment Reporting Information [Line Items]
Number of operating segments | operatingSegment	2
Number of joint ventures | jointVenture	2
SHOP
Segment Reporting Information [Line Items]
Capital expenditures | $	$ 1.8
Real Estate
Segment Reporting Information [Line Items]
Properties | property	162
Capital expenditures | $	$ 7.6
Holiday Transition
Segment Reporting Information [Line Items]
Properties | property	17
Number of joint ventures | jointVenture		2
Independent Living Facility
Segment Reporting Information [Line Items]
Number of joint ventures | jointVenture	2
Independent Living Facility | SHOP
Segment Reporting Information [Line Items]
Properties | property	15	15

Segment Reporting (Schedule of

Segment Reporting (Schedule of Segment Reporting Information, by Segment) (Details) - USD ($) $ in Thousands	3 Months Ended			9 Months Ended
	Sep. 30, 2022	Jun. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Segment Reporting Information [Line Items]
Rental income	$ 59,394		$ 67,043	$ 163,935	$ 210,143
Resident fees and services	12,013		0	24,005	0
Interest income and other	4,891		6,790	19,584	18,905
Total revenues	76,298		73,833	207,524	229,048
Senior housing operating expenses	9,239		0	18,352	0
Taxes and insurance on leased properties	2,358		3,182	7,553	7,519
NOI	64,701			181,619
Depreciation	17,533		20,035	53,577	61,499
Interest	11,412		12,715	32,472	38,528
Legal	88		117	2,254	207
Franchise, excise and other taxes	225		244	694	709
General and administrative	4,744		3,650	17,893	15,229
Loan and realty losses	11,329		22,425	39,951	23,596
Gains on sales of real estate, net	(14,840)		(19,941)	(28,342)	(26,426)
Gain (loss) on operations transfer, net	(19)	$ 700	0	710	0
Gain on note payoff	0		0	(1,113)	0
Loss on early retirement of debt	0		0	151	451
(Gains) losses from equity method investment	0		557	(569)	2,274
Net income	34,229		$ 30,849	63,941	$ 105,462
Total assets	2,508,785			2,508,785		$ 2,838,876
Operating Segments | Real Estate
Segment Reporting Information [Line Items]
Rental income	59,394			163,935
Resident fees and services	0			0
Interest income and other	4,820			19,362
Total revenues	64,214			183,297
Senior housing operating expenses	0			0
Taxes and insurance on leased properties	2,358			7,553
NOI	61,856			175,744
Depreciation	15,390			49,282
Interest	837			2,371
Legal	0			0
Franchise, excise and other taxes	0			0
General and administrative	0			0
Loan and realty losses	11,329			39,951
Gains on sales of real estate, net	(14,840)			(28,342)
Gain (loss) on operations transfer, net	(19)			710
Gain on note payoff				(1,113)
Loss on early retirement of debt				0
(Gains) losses from equity method investment				(569)
Net income	49,159			113,454
Total assets	2,214,475			2,214,475
Operating Segments | SHOP
Segment Reporting Information [Line Items]
Rental income	0			0
Resident fees and services	12,013			24,005
Interest income and other	0			0
Total revenues	12,013			24,005
Senior housing operating expenses	9,239			18,352
Taxes and insurance on leased properties	0			0
NOI	2,774			5,653
Depreciation	2,129			4,245
Interest	0			0
Legal	0			0
Franchise, excise and other taxes	0			0
General and administrative	0			0
Loan and realty losses	0			0
Gains on sales of real estate, net	0			0
Gain (loss) on operations transfer, net	0			0
Gain on note payoff				0
Loss on early retirement of debt				0
(Gains) losses from equity method investment				0
Net income	645			1,408
Total assets	290,708			290,708
Non-segment/Corporate
Segment Reporting Information [Line Items]
Rental income	0			0
Resident fees and services	0			0
Interest income and other	71			222
Total revenues	71			222
Senior housing operating expenses	0			0
Taxes and insurance on leased properties	0			0
NOI	71			222
Depreciation	14			50
Interest	10,575			30,101
Legal	88			2,254
Franchise, excise and other taxes	225			694
General and administrative	4,744			17,893
Loan and realty losses	0			0
Gains on sales of real estate, net	0			0
Gain (loss) on operations transfer, net	0			0
Gain on note payoff				0
Loss on early retirement of debt				151
(Gains) losses from equity method investment				0
Net income	(15,575)			(50,921)
Total assets	$ 3,602			$ 3,602

Uncategorized Items - nhi-20220

Label	Element	Value
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation	$ 14,000
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation	274,000
Comprehensive Income (Loss), Net of Tax, Excluding Loss, Attributable to Noncontrolling Interest	nhi_ComprehensiveIncomeLossNetOfTaxExcludingLossAttributableToNoncontrollingInterest	29,939,000
Comprehensive Income (Loss), Net of Tax, Excluding Loss, Attributable to Noncontrolling Interest	nhi_ComprehensiveIncomeLossNetOfTaxExcludingLossAttributableToNoncontrollingInterest	34,506,000
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	1,065,000
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	989,000
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	6,511,000
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	6,438,000
Adjustments to Additional Paid in Capital, Equity Component of Convertible Debt	us-gaap_AdjustmentsToAdditionalPaidInCapitalEquityComponentOfConvertibleDebt	(6,076,000)
Stock Repurchased During Period, Value	us-gaap_StockRepurchasedDuringPeriodValue	69,977,000
Stock Repurchased During Period, Value	us-gaap_StockRepurchasedDuringPeriodValue	81,974,000
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	466,000
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	241,000
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	486,000
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	231,000
Adjustments to Additional Paid in Capital, Stock Issued, Issuance Costs	us-gaap_AdjustmentsToAdditionalPaidInCapitalStockIssuedIssuanceCosts	47,000
Adjustments to Additional Paid in Capital, Stock Issued, Issuance Costs	us-gaap_AdjustmentsToAdditionalPaidInCapitalStockIssuedIssuanceCosts	85,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	81,455,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	39,050,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	91,816,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	41,266,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(115,482,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(86,053,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	34,115,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(7,854,000)
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	47,951,000
Additional Paid-in Capital [Member]
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation	14,000
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation	274,000
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	6,438,000
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	6,511,000
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	989,000
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	1,065,000
Adjustments to Additional Paid in Capital, Equity Component of Convertible Debt	us-gaap_AdjustmentsToAdditionalPaidInCapitalEquityComponentOfConvertibleDebt	(6,076,000)
Adjustments to Additional Paid in Capital, Stock Issued, Issuance Costs	us-gaap_AdjustmentsToAdditionalPaidInCapitalStockIssuedIssuanceCosts	47,000
Adjustments to Additional Paid in Capital, Stock Issued, Issuance Costs	us-gaap_AdjustmentsToAdditionalPaidInCapitalStockIssuedIssuanceCosts	85,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	989,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	6,497,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	706,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	48,259,000
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	47,944,000
AOCI Attributable to Parent [Member]
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest	us-gaap_ComprehensiveIncomeNetOfTaxIncludingPortionAttributableToNoncontrollingInterest	3,516,000
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest	us-gaap_ComprehensiveIncomeNetOfTaxIncludingPortionAttributableToNoncontrollingInterest	1,805,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	0
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	3,516,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	1,805,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	0
Parent [Member]
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation	14,000
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation	274,000
Comprehensive Income (Loss), Net of Tax, Excluding Loss, Attributable to Noncontrolling Interest	nhi_ComprehensiveIncomeLossNetOfTaxExcludingLossAttributableToNoncontrollingInterest	30,072,000
Comprehensive Income (Loss), Net of Tax, Excluding Loss, Attributable to Noncontrolling Interest	nhi_ComprehensiveIncomeLossNetOfTaxExcludingLossAttributableToNoncontrollingInterest	34,468,000
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest	us-gaap_ComprehensiveIncomeNetOfTaxIncludingPortionAttributableToNoncontrollingInterest	78,031,000
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest	us-gaap_ComprehensiveIncomeNetOfTaxIncludingPortionAttributableToNoncontrollingInterest	32,619,000
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	6,438,000
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	6,511,000
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	989,000
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	1,065,000
Adjustments to Additional Paid in Capital, Equity Component of Convertible Debt	us-gaap_AdjustmentsToAdditionalPaidInCapitalEquityComponentOfConvertibleDebt	(6,076,000)
Stock Repurchased During Period, Value	us-gaap_StockRepurchasedDuringPeriodValue	69,977,000
Stock Repurchased During Period, Value	us-gaap_StockRepurchasedDuringPeriodValue	81,974,000
Adjustments to Additional Paid in Capital, Stock Issued, Issuance Costs	us-gaap_AdjustmentsToAdditionalPaidInCapitalStockIssuedIssuanceCosts	47,000
Adjustments to Additional Paid in Capital, Stock Issued, Issuance Costs	us-gaap_AdjustmentsToAdditionalPaidInCapitalStockIssuedIssuanceCosts	(85,000)
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	39,050,000
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	81,455,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(85,850,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	34,481,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(7,658,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(114,863,000)
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	47,951,000
Retained Earnings, Appropriated [Member]
Comprehensive Income (Loss), Net of Tax, Excluding Loss, Attributable to Noncontrolling Interest	nhi_ComprehensiveIncomeLossNetOfTaxExcludingLossAttributableToNoncontrollingInterest	34,468,000
Comprehensive Income (Loss), Net of Tax, Excluding Loss, Attributable to Noncontrolling Interest	nhi_ComprehensiveIncomeLossNetOfTaxExcludingLossAttributableToNoncontrollingInterest	30,072,000
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest	us-gaap_ComprehensiveIncomeNetOfTaxIncludingPortionAttributableToNoncontrollingInterest	74,515,000
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest	us-gaap_ComprehensiveIncomeNetOfTaxIncludingPortionAttributableToNoncontrollingInterest	30,814,000
Stock Repurchased During Period, Value	us-gaap_StockRepurchasedDuringPeriodValue	69,965,000
Stock Repurchased During Period, Value	us-gaap_StockRepurchasedDuringPeriodValue	81,961,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	39,050,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	41,266,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	81,455,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	91,816,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(17,301,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(10,452,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(121,348,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	$ (86,543,000)
Common Stock [Member]
Shares Issued, Shares, Share-based Payment Arrangement, after Forfeiture	us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation	2,656
Shares Issued, Shares, Share-based Payment Arrangement, after Forfeiture	us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation	5,765
Shares Issued, Shares, Share-based Payment Arrangement, after Forfeiture	us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation	732
Stock Repurchased During Period, Value	us-gaap_StockRepurchasedDuringPeriodValue	$ 13,000
Stock Repurchased During Period, Value	us-gaap_StockRepurchasedDuringPeriodValue	$ 12,000
Stock Repurchased During Period, Shares	us-gaap_StockRepurchasedDuringPeriodShares	1,272,179
Stock Repurchased During Period, Shares	us-gaap_StockRepurchasedDuringPeriodShares	1,196,175
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	$ 0
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(12,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(13,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	$ 7,000
Stock Issued During Period, Shares, Period Increase (Decrease)	us-gaap_StockIssuedDuringPeriodSharesPeriodIncreaseDecrease	0
Stock Issued During Period, Shares, Period Increase (Decrease)	us-gaap_StockIssuedDuringPeriodSharesPeriodIncreaseDecrease	1,195,443
Stock Issued During Period, Shares, Period Increase (Decrease)	us-gaap_StockIssuedDuringPeriodSharesPeriodIncreaseDecrease	1,266,414
Stock Issued During Period, Shares, Period Increase (Decrease)	us-gaap_StockIssuedDuringPeriodSharesPeriodIncreaseDecrease	664,607
Stock Issued During Period, Shares, New Issues	us-gaap_StockIssuedDuringPeriodSharesNewIssues	661,951
Stock Issued During Period, Value, New Issues	us-gaap_StockIssuedDuringPeriodValueNewIssues	$ 7,000
Noncontrolling Interest [Member]
Comprehensive Income (Loss), Net of Tax, Excluding Loss, Attributable to Noncontrolling Interest	nhi_ComprehensiveIncomeLossNetOfTaxExcludingLossAttributableToNoncontrollingInterest	(133,000)
Comprehensive Income (Loss), Net of Tax, Excluding Loss, Attributable to Noncontrolling Interest	nhi_ComprehensiveIncomeLossNetOfTaxExcludingLossAttributableToNoncontrollingInterest	38,000
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest	us-gaap_ComprehensiveIncomeNetOfTaxIncludingPortionAttributableToNoncontrollingInterest	100,000
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest	us-gaap_ComprehensiveIncomeNetOfTaxIncludingPortionAttributableToNoncontrollingInterest	35,000
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	486,000
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	466,000
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	241,000
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	231,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(619,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(203,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(366,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	$ (196,000)