National Health Investors (NHI) 10-K 20 Feb 24 2023 FY Annual report Financial data

Cover Page

Cover Page - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Feb. 15, 2024	Jun. 30, 2023
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2023
Current Fiscal Year End Date	--12-31
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 Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
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
ICFR Auditor Attestation Flag	true
Document Financial Statement Error Correction [Flag]	false
Entity Shell Company	false
Entity Public Float (in shares)			$ 2,165,587
Entity Common Stock, Shares Outstanding (in shares)		43,409,841
Documents Incorporated by Reference	Portions of the registrant’s definitive proxy statement for its 2024 annual meeting of stockholders are incorporated by reference into Part III, Items 10, 11, 12, 13, and 14 of this Annual Report on Form 10-K.
Amendment Flag	false
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY
Entity Central Index Key	0000877860

Audit Information

Audit Information	12 Months Ended
	Dec. 31, 2023
Audit Information [Abstract]
Auditor Name	BDO USA, P.C.
Auditor Location	Nashville, Tennessee
Auditor Firm ID	243

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands		Dec. 31, 2023	Dec. 31, 2022
Real estate properties:
Land		$ 180,749	$ 177,527
Buildings and improvements		2,593,696	2,549,019
Construction in progress		5,913	3,352
Real estate properties, gross		2,780,358	2,729,898
Less accumulated depreciation		(673,276)	(611,688)
Real estate properties, net		2,107,082	2,118,210
Mortgage and other notes receivable, net of reserve of $15,476 and $15,338, respectively		245,271	233,141
Cash and cash equivalents		22,347	19,291
Straight-line rents receivable		84,713	76,895
Assets held for sale, net		5,004
Other assets, net		24,063	16,585
Total Assets	[1]	2,488,480	2,507,424
Liabilities and Equity:
Debt		1,135,051	1,147,511
Accounts payable and accrued expenses		34,304	25,905
Dividends payable		39,069	39,050
Deferred income		6,009	5,052
Total Liabilities	[1]	1,214,433	1,217,518
Commitments and Contingencies
Redeemable noncontrolling interest		9,656	9,825
National Health Investors, Inc. Stockholders' Equity:
Common stock		434	434
Capital in excess of par value		1,603,757	1,599,427
Retained earnings		2,466,844	2,331,190
Cumulative dividends		(2,817,083)	(2,660,826)
Total National Health Investors, Inc. Stockholders' Equity		1,253,952	1,270,225
Noncontrolling interests		10,439	9,856
Total Equity		1,264,391	1,280,081
Total Liabilities and Equity		$ 2,488,480	$ 2,507,424
[1] The consolidated balance sheets include the following amounts related to our consolidated Variable Interest Entities (VIEs): $513.2 million and $519.8 million of Real estate properties, net; $10.9 million and $10.3 million of Cash and cash equivalents; $9.7 million and $7.1 million of Straight-line rents receivable; $9.4 million and $1.3 million of Other assets, net; and $4.7 million and $3.3 million of Accounts payable and accrued expenses as of December 31, 2023 and 2022, respectively.

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Mortgage and other notes receivable, net of reserve	$ 15,476	$ 15,338
Common stock, par value (in usd per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	100,000,000	100,000,000
Common stock, shares issued (in shares)	43,409,841	43,388,742
Common stock, shares outstanding (in shares)	43,409,841	43,388,742
Property, plant and equipment, net	$ 2,107,082	$ 2,118,210
Cash and cash equivalents	22,347	19,291
Straight-line rents receivable	84,713	76,895
Other assets, net	24,063	16,585
Accounts payable and accrued expenses	34,304	25,905
Variable Interest Entity, Primary Beneficiary
Property, plant and equipment, net	513,200	519,800
Cash and cash equivalents	10,900	10,300
Straight-line rents receivable	9,700	7,100
Other assets, net	9,400	1,300
Accounts payable and accrued expenses	$ 4,700	$ 3,300

Consolidated Statements of Inco

Consolidated Statements of Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Revenues:
Rental income	$ 249,227	$ 217,700	$ 271,049
Resident fees and services	48,809	35,796	0
Interest income and other	21,799	24,698	27,666
Revenues	319,835	278,194	298,715
Expenses:
Depreciation	69,973	70,880	80,798
Interest	58,160	44,917	50,810
Senior housing operating expenses	39,587	28,193	0
Legal	507	2,555	908
Franchise, excise and other taxes	449	844	788
General and administrative	19,314	22,768	18,431
Taxes and insurance on leased properties	11,513	9,788	11,638
Loan and realty losses, net	1,376	61,911	52,766
Total operating expenses	200,879	241,856	216,139
Gain (loss) on operations transfer, net	20	(710)	0
Gain on note receivable payoff	0	1,113	0
Loss on early retirement of debt	(73)	(151)	(1,912)
Gains (losses) from equity method investment	555	569	(1,545)
Gains on sales of real estate, net	14,721	28,342	32,498
Other income	202	0	350
Net income (loss)	134,381	65,501	111,967
Add: net loss (income) attributable to noncontrolling interests	1,273	902	(163)
Net income attributable to stockholders	135,654	66,403	111,804
Less: net income attributable to unvested restricted stock awards	(57)	0	0
Net income attributable to common stockholders	$ 135,597	$ 66,403	$ 111,804
Weighted average common shares outstanding:
Basic (in shares)	43,388,794	44,774,708	45,714,221
Diluted (in shares)	43,389,466	44,794,236	45,729,497
Earnings per common share - basic (in usd per share)	$ 3.13	$ 1.48	$ 2.45
Earnings per common share - diluted (in usd per share)	$ 3.13	$ 1.48	$ 2.44

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Statement of Comprehensive Income [Abstract]
Net income	$ 134,381	$ 65,501	$ 111,967
Other comprehensive income:
Decrease in fair value of cash flow hedges	0	0	(137)
Reclassification adjustment for amounts recognized in net income	0	0	7,286
Total other comprehensive income	0	0	7,149
Comprehensive income	134,381	65,501	119,116
Less: comprehensive loss (income) attributable to noncontrolling interests	1,273	902	(163)
Comprehensive income attributable to stockholders	$ 135,654	$ 66,403	$ 118,953

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Cash flows from operating activities:
Net income	$ 134,381	$ 65,501	$ 111,967
Adjustments to reconcile net income to net cash provided by
Depreciation	69,973	70,880	80,798
Amortization of deferred loan costs, debt discounts and prepaids	4,685	4,283	4,354
Amortization of commitment fees and note receivable discounts	(412)	(872)	(729)
Amortization of lease incentives	2,521	7,555	1,026
Straight-line lease revenue	(6,961)	16,681	(14,603)
Non-cash rental income	(2,500)	(3,000)	0
Non-cash interest income on mortgage and other notes receivable	(1,302)	(4,314)	(2,614)
Non-cash lease deposit liability recognized as rental income	0	(8,838)	0
Gains on sales of real estate, net	(14,721)	(28,342)	(32,498)
Gain on note receivable payoff	0	(1,113)	0
Loss on operations transfer, net	(20)	710	0
Loss on early retirement of debt	73	151	1,912
Gains from equity method investment	(555)	(569)	1,545
Loan and realty losses, net	1,376	61,911	52,766
Payment of lease incentives	(10,000)	(1,200)	(1,042)
Non-cash share-based compensation	4,605	8,613	8,415
Changes in operating assets and liabilities:
Other assets, net	(2,743)	(3,534)	(4,050)
Accounts payable and accrued expenses	5,929	425	3,352
Deferred income	101	412	260
Net cash provided by operating activities	184,450	185,340	210,859
Cash flows from investing activities:
Investment in mortgage and other notes receivable	(35,625)	(79,801)	(72,236)
Collection of mortgage and other notes receivable	13,465	119,212	67,790
Acquisition of real estate	(38,081)	(6,364)	(46,817)
Proceeds from sales of real estate	57,031	168,958	238,864
Investments in renovations of existing real estate	(7,732)	(4,629)	(3,465)
Investments in equipment	(3,743)	0	(64)
Distributions from equity method investment	3,055	569	1,205
Net cash (used in) provided by investing activities	(11,630)	197,945	185,277
Cash flows from financing activities:
Proceeds from revolving credit facility	364,000	225,000	95,000
Payments on revolving credit facility	(161,000)	(183,000)	(393,000)
Borrowings on term loans	200,000	0	0
Payments on term loans and private placement notes	(415,427)	(135,388)	(293,316)
Proceeds from issuance of senior notes	0	0	396,784
Prepayment fee for early retirement of debt	0	0	(1,462)
Deferred loan costs	(2,747)	(4,612)	(5,018)
Distributions to noncontrolling interests	(1,280)	(916)	(910)
Proceeds from noncontrolling interests	2,973	11,738	0
Taxes remitted on employee stock awards	0	(288)	0
Proceeds from equity offering, net	0	0	47,904
Equity issuance costs	0	(66)	0
Convertible bond redemption	0	0	(66,076)
Dividends paid to stockholders	(156,238)	(161,771)	(182,900)
Payments to repurchase shares of common stock	0	(151,951)	0
Net cash used in financing activities	(169,719)	(401,254)	(402,994)
Increase (decrease) in cash and cash equivalents and restricted cash	3,101	(17,969)	(6,858)
Cash and cash equivalents and restricted cash, beginning of year	21,516	39,485	46,343
Cash and cash equivalents and restricted cash, end of year	24,617	21,516	39,485
Supplemental disclosure of cash flow information:
Interest paid, net of amounts capitalized	51,897	42,659	43,680
Supplemental disclosure of non-cash investing and financing activities:
Real estate acquired in exchange for mortgage notes receivable	14,200	23,071	0
Increase in mortgage note receivable from sale of real estate	2,249	0	0
Change in other assets related to sales of real estate	0	102	(33)
Change in accounts payable related to investments in real estate construction	325	20	(62)
Right of use asset in exchange for lease liability	101	0	0
Change in accounts payable related to renovations of existing real estate	0	(37)	0
Change in accounts payable related to distributions to noncontrolling interests	6	139	64
Operating equipment received in lease termination	0	1,287	0
Increase in accounts payable related to transfer of operations	0	300	0
Reclassification of prepaid equity issuance costs to capital in excess of par value	$ 275	$ 0	$ 0

Consolidated Statement of Equit

Consolidated Statement of Equity - USD ($) $ in Thousands	Total	Total National Health Investors Stockholders’ Equity	Common Stock	Capital in Excess of Par Value	Retained Earnings	Cumulative Dividends	Accumulated Other Comprehensive Income	Noncontrolling Interests
Beginning balance (in shares) at Dec. 31, 2020			45,185,992
Beginning balance, amount at Dec. 31, 2020	$ 1,522,945	$ 1,512,234	$ 452	$ 1,540,946	$ 2,304,909	$ (2,326,924)	$ (7,149)	$ 10,711
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Distributions declared to noncontrolling interests	(974)							(974)
Total other comprehensive income	119,116	118,953			111,804		7,149	163
Equity component in redemption of convertible debt	$ (6,076)	(6,076)		(6,076)
Issuance of common stock, net (in shares)	661,951		661,951
Net income, excluding, excluding a loss attributable to redeemable noncontrolling interests	$ 111,804
Issuance of common stock, net & Equity issuance cost	47,904	47,904	$ 7	47,897
Shares issued on stock options exercised (in shares)			2,656
Share-based compensation	8,415	8,415		8,415
Dividends declared	(174,347)	(174,347)				(174,347)
Ending balance (in shares) at Dec. 31, 2021			45,850,599
Ending balance, amount at Dec. 31, 2021	1,516,983	1,507,083	$ 459	1,591,182	2,416,713	(2,501,271)	0	9,900
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Distributions declared to noncontrolling interests	(1,015)							(1,015)
Net income, excluding loss attributable to redeemable noncontrolling interest	66,344	66,403			66,403			(59)
Total other comprehensive income	65,501
Reclassification of redeemable noncontrolling interest	$ 1,030							1,030
Issuance of common stock, net (in shares)	0
Net income, excluding, excluding a loss attributable to redeemable noncontrolling interests	$ 66,403
Issuance of common stock, net & Equity issuance cost	(80)	(80)		(80)
Taxes paid/remitted on employee stock options exercised & awards	$ (288)	(288)		(288)
Shares issued on stock options exercised (in shares)			6,497
Repurchases of common stock (in shares)	(2,468,354)		(2,468,354)
Repurchases of common stock	$ (151,951)	(151,951)	$ (25)		(151,926)
Share-based compensation	8,613	8,613		8,613
Dividends declared	$ (159,555)	(159,555)				(159,555)
Ending balance (in shares) at Dec. 31, 2022	43,388,742		43,388,742
Ending balance, amount at Dec. 31, 2022	$ 1,280,081	1,270,225	$ 434	1,599,427	2,331,190	(2,660,826)	0	9,856
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Noncontrolling interests capital contributions, excluding $922 attributable to redeemable noncontrolling interest	2,051							2,051
Distributions declared to noncontrolling interests	(1,286)							(1,286)
Net income, excluding loss attributable to redeemable noncontrolling interest	135,472	135,654			135,654			(182)
Total other comprehensive income	$ 134,381
Issuance of common stock, net (in shares)	0
Net income, excluding, excluding a loss attributable to redeemable noncontrolling interests	$ 135,654
Issuance of common stock, net & Equity issuance cost	$ (275)	(275)		(275)
Grants of restricted stock (in shares)			21,000
Shares issued on stock options exercised (in shares)	5,166		99
Shares issued on stock options exercised	$ 0	0	$ 0	0
Share-based compensation	4,605	4,605		4,605
Dividends declared	$ (156,257)	(156,257)			0	(156,257)
Ending balance (in shares) at Dec. 31, 2023	43,409,841		43,409,841
Ending balance, amount at Dec. 31, 2023	$ 1,264,391	$ 1,253,952	$ 434	$ 1,603,757	$ 2,466,844	$ (2,817,083)	$ 0	$ 10,439

Consolidated Statements Equity

Consolidated Statements Equity (Parenthetical) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($) $ / shares
Statement of Stockholders' Equity [Abstract]
Regular dividends declared per common share (in usd per share) | $ / shares	$ 3.60
Distributions	$ 0
Net loss attributable to redeemable noncontrolling interest	1,091
Capital contribution attributable to redeemable noncontrolling interest	$ 922

Organization and Nature of Busi

Organization and Nature of Business	12 Months Ended
	Dec. 31, 2023
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 and 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 real estate investments and leases, mortgages and other notes receivables 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 December 31, 2023, we had gross investments of approximately $2.4 billion in 163 healthcare real estate properties located in 31 states and leased pursuant primarily to triple-net leases to 25 tenants consisting of 97 senior housing communities (“SHO”), 65 SNFs and one HOSP, excluding one property classified as assets held for sale. Our portfolio of eight mortgages along with other notes receivable totaled $260.7 million, excluding an allowance for expected credit losses of $15.5 million, as of December 31, 2023. Units, beds and property count disclosures in these footnotes to the consolidated financial statements are unaudited. Our SHOP segment is comprised of two ventures that own the operations of ILFs. As of December 31, 2023, we had gross investments of approximately $347.4 million in 15 properties with a combined 1,733 units located in eight states that are operated on behalf of the Company by independent managers pursuant to the terms of separate management agreements that commenced April 1, 2022. The third-party managers, or related parties of the managers, own equity interests in the respective ventures.

Basis of Presentation and Signi

Basis of Presentation and Significant Accounting Policies	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Basis of Presentation and Significant Accounting Policies	Basis of Presentation and Significant Accounting Policies Principles of Consolidation - The consolidated financial statements include the accounts of the Company, and 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. A VIE is broadly defined as an entity with one or more of the following characteristics: (a) the total equity investment at risk is insufficient to finance the entity’s activities without additional subordinated financial support; (b) as a group, the holders of the equity investment at risk lack (i) the ability to make decisions about the entity’s activities through voting or similar rights, (ii) the obligation to absorb the expected losses of the entity, or (iii) the right to receive the expected residual returns of the entity; or (c) the equity investors have voting rights that are not proportional to their economic interests, and substantially all of the entity’s activities either involve, or are conducted on behalf of, an investor that has disproportionately few voting rights. We evaluate our arrangements with VIEs to identify entities for which control is achieved through means other than voting rights and to determine which business enterprise is the primary beneficiary of the VIE. In accordance with FASB guidance, management must evaluate each of the Company’s contractual relationships which creates a variable interest in other entities. If the Company has a variable interest and the entity is a VIE, then management must determine whether the Company is the primary beneficiary of the VIE. If it is determined that the Company is the primary beneficiary, NHI would consolidate the VIE. We identify the primary beneficiary of a VIE as the enterprise that has both: (i) the power to direct the activities of the VIE that most significantly impact the entity’s economic performance; and (ii) the obligation to absorb losses or the right to receive benefits of the VIE that could be significant to the entity. We perform this analysis on an ongoing basis. If the Company has determined that an entity is not a VIE, the Company assesses the need for consolidation under all other provisions of Accounting Standards Codification (“ASC”) Topic 810, Consolidation . These provisions provide for consolidation of majority-owned entities where a majority voting interest held by the Company demonstrates control of such entities in the absence of any legal constraints. Effective April 1, 2022 and at December 31, 2023, our consolidated total assets and liabilities include two consolidated ventures comprising our SHOP activities, each formed with a separate partner - Merrill Gardens, L.L.C. (“Merrill”) and DSHI NHI Holiday LLC (the “Discovery member”), a related party of Discovery Senior Living (“Discovery”). We consider both ventures to be VIEs as the members of each, as a group, lack the characteristics of a controlling financial interest. We are deemed to be the primary beneficiary of each VIE because we have the ability to control the activities that most significantly impact each VIE’s economic performance. Reference Notes 5 and 17 for further discussion of our SHOP ventures. We also consolidate two real estate partnerships formed with our partners, Discovery Senior Housing Investor XXIV, LLC, a related party of Discovery, beginning in June 2019, and LCS Timber Ridge LLC (“LCS”), beginning in January 2020, to invest in senior housing facilities. We consider both partnerships to be VIEs as either the members, as a group, lack the characteristics of a controlling financial interest or the total equity at risk is insufficient to finance activities without additional subordinated financial support. NHI directs the activities that most significantly impact economic performance of these partnerships, 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. Reference Note 17 for further discussion of these real estate partnerships. 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. We have concluded that the Company is not the primary beneficiary for certain investments where we lack either directly or through related parties the power to direct the activities that most significantly impact the investments’ economic performance. Accordingly, we account for our transactions with these entities and their subsidiaries at either amortized cost or net realizable value for straight-line rents receivable, excluding our investments accounted for under the equity method. See Note 17 for information on unconsolidated VIEs. 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 December 31, 2023 and 2022, the Merrill SHOP venture noncontrolling interest was classified in mezzanine equity, as discussed further in Note 10. The noncontrolling interests associated with our consolidated real estate partnerships, and our Discovery member SHOP venture were classified in equity as of December 31, 2023 and 2022. Use of Estimates - The preparation of consolidated financial statements in conformity with accounting principles generally accepted in the U.S. requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the financial statements, and the reported amounts of revenues and expenses during the reporting period. Significant assumptions and estimates include purchase price allocations to record investments in real estate, impairment of real estate, and allowance for credit losses. Actual results could differ from those estimates. Earnings Per Share - Our unvested restricted stock awards contain non-forfeitable rights to dividends, and accordingly, these awards are deemed to be participating securities. Therefore, the Company applies the two-class method to calculate basic and diluted earnings. Under the two-class method, we allocate net income attributable to stockholders to common stockholders and holders of unvested restricted stock by using the weighted-average shares of each class outstanding for quarter-to-date and year-to-date periods, based on their respective participation rights to dividends declared and undistributed earnings. Basic earnings per common share is computed by dividing net income attributable to common stockholders by the weighted number of shares of common stock outstanding during the period. Diluted earnings per common share reflects the effect of dilutive securities. We apply the treasury stock method to any convertible debt instruments, the effect of which is that conversion will not be assumed for purposes of computing diluted earnings per share unless the average share price of our common stock for the period exceeds the conversion price per share. Diluted earnings per share for the year ended December 31, 2021 includes the potential dilutive impact of our convertible debt that was repaid in 2021. Reclassifications - In prior years, the Company presented " Cumulative dividends in excess of net income " as a single line item on the Consolidated Balance Sheets and the Consolidated Statements of Equity. Beginning January 1, 2023, the Company separated this line item into two components, " Retained earnings " and " Cumulative dividends, " and reclassified prior year information to conform to the current period presentation. Fair Value Measurements - Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants at the measurement date. A three-level fair value hierarchy is required to prioritize the inputs used to measure fair value. This hierarchy requires entities to maximize the use of observable inputs and minimize the use of unobservable inputs. The three levels of inputs used to measure fair value are as follows: Level 1 - Quoted prices in active markets for identical assets or liabilities. Level 2 - Observable inputs other than quoted prices included in Level 1, such as quoted prices for similar assets and liabilities in active markets; quoted prices for identical or similar assets and liabilities in markets that are not active; or other inputs that are observable or can be corroborated by observable market data. Level 3 - Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities. This includes certain pricing models, discounted cash flow methodologies and similar techniques that use significant unobservable inputs. If the fair value measurement is based on inputs from different levels of the hierarchy, the level within which the entire fair value measurement falls is the lowest level input that is significant to the fair value measurement in its entirety. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability. When an event or circumstance alters our assessment of the observability and thus the appropriate classification of an input to a fair value measurement which we deem to be significant to the fair value measurement as a whole, we will transfer that fair value measurement to the appropriate level within the fair value hierarchy. Real Property Owned - Real estate properties are recorded at cost or, if acquired through business combination, at fair value, including the fair value of contingent consideration, if any. Cost or fair value at the time of acquisition is allocated among land, buildings, improvements, personal property and lease and other intangibles. For properties acquired in transactions accounted for as asset purchases, the purchase price, which includes transaction costs, is allocated based on the relative fair values of the assets acquired. Cost includes the amount of contingent consideration, if any, deemed to be probable at the acquisition date. Contingent consideration is deemed to be probable to the extent that a significant reversal in amounts recognized is not likely to occur when the uncertainty associated with the contingent consideration is subsequently resolved. Cost also includes capitalized interest during construction periods. We use the straight-line method of depreciation for buildings over their estimated useful lives of 40 years, and improvements, including any equipment related to the SHOP segment, over their estimated useful lives ranging from 5 to 25 years. For contingent consideration arising from business combinations, the liability is adjusted to estimated fair value at each reporting date through earnings. Expenditures for repairs and maintenance are expensed as incurred. 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 or significant deterioration of the underlying cash flows of the long-lived assets, indicate that the carrying amount of the long-lived asset 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 of the property exceeds the estimated fair value of the long-lived asset. During the years ended December 31, 2023, 2022 and 2021, we recognized impairment charges of approximately $1.6 million, $51.6 million and $51.8 million, respectively, included in “ Loan and realty losses, net ” in our Consolidated Statements of Income. Reference Note 3 for more discussion. Leases - All of our leases within the Real Estate Investment segment are classified as operating leases and generally have an initial leasehold term of 10 to 15 years followed by one or more five-year tenant renewal options. The leases are “triple-net leases” under which the tenant is responsible for the payment of all taxes, utilities, insurance premiums, repairs and other charges relating to the operation of the properties, including required levels of capital expenditures each year. The tenant is obligated at its expense to keep all improvements, fixtures and other components of the properties covered by “all risk” insurance in an amount equal to at least the full replacement cost thereof, and to maintain specified minimal personal injury and property damage insurance. The leases also require the tenant to indemnify and hold us harmless from all claims resulting from the use, occupancy and related activities of each property by the tenant, and to indemnify us against all costs related to any release, discovery, clean-up and removal of hazardous substances or materials, or other environmental responsibility with respect to each facility. While we do not incorporate residual value guarantees, the lease provisions and considerations discussed above impact our expectation of realizable value from our properties upon the expiration of their lease terms. The residual value of our real estate under lease is still subject to various market, asset, and tenant-specific risks and characteristics. As the classification of our leases is dependent on the fair value of estimated cash flows at lease commencement, management’s projected residual values represent significant assumptions in our accounting for operating leases. Similarly, the exercise of renewal options is also subject to these same risks, making a tenant’s lease term another significant variable in a lease’s cash flows. Initial direct costs that are incremental to entering into a lease are capitalized in accordance with the provisions of ASC Topic 842. FASB Lease Modifications Related to Effects of the COVID-19 Pandemic - In accordance with the FASB’s question-and-answer document issued in April 2020, we elected to account for qualified rent concessions provided as a result of the coronavirus pandemic (“COVID-19”) as variable lease payments, recorded as rental income when received and not as lease modifications under ASC Topic 842. This guidance was applicable to certain rent concessions granted in 2021 and 2022. Reference Note 3 for more detail. Financial Instruments - Credit Losses - We estimate and record an allowance for credit losses upon origination of the loan, based on expected credit losses over the term of the loan and update this estimate each reporting period. We calculate the estimated credit losses on mortgages by pooling these loans into two groups – investments in existing or new mortgages and construction mortgages. Mezzanine, revolving lines of credit and loans designated as non-performing are evaluated at the individual loan level. We estimate the allowance for credit losses by utilizing a loss model that relies on future expected credit losses, rather than incurred losses. This loss model incorporates our historical experience, adjusted for current conditions and our forecasts, using the probability of default and loss given default method. Incorporated into the construction mortgage loss model is an estimate of the probability that NHI will acquire the property. Using the resulting estimate, a portion of the outstanding construction mortgage balance which we currently expect will be reduced by our acquisition of the underlying property when construction is complete, is deducted from the construction mortgage balance included in the expected loss calculation. Mezzanine loans, revolving lines of credit and loans designated as non-performing are also based on the loss model to recognize expected future credit losses and are applied to each individual loan using borrower specific information. We also perform a qualitative assessment beyond model estimates and apply adjustments as necessary. The credit loss estimate is based on the net amortized cost balance of our mortgage and other notes receivables as of the balance sheet date. Calculation of the allowance for credit losses involves significant judgment. It is possible that actual credit losses will differ materially from our current estimates. Write-offs are deducted from the allowance for credit losses when we judge the principal to be uncollectible. 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 exchange agreement pursuant to Section 1031 of the Internal Revenue Code of 1986, as amended (the “Internal Revenue Code”) 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 Consolidated Statements of Cash Flows ( $ in thousands ): As of December 31, 2023 2022 Beginning of period: Cash and cash equivalents $ 19,291 $ 37,412 Restricted cash (included in Other assets, net ) 2,225 2,073 Cash, cash equivalents, and restricted cash $ 21,516 $ 39,485 End of period: Cash and cash equivalents $ 22,347 $ 19,291 Restricted cash (included in Other assets, net ) 2,270 2,225 Cash, cash equivalents, and restricted cash $ 24,617 $ 21,516 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. If a property subsequently no longer meets the criteria to be classified as held for sale, it is reclassified as held and used and measured at the lower of i) its original carrying amount before the asset was classified as held for sale, adjusted for any depreciation expense not recognized while it was classified as held for sale, and ii) its fair value. Concentration of Credit Risks - Our credit risks primarily relate to cash and cash equivalents and investments in mortgage and other notes receivable. Cash and cash equivalents are primarily held in bank accounts and overnight investments. We maintain our bank deposit accounts with large financial institutions in amounts that may exceed federally insured limits. We have not experienced any losses in such accounts. Our mortgages and other notes receivable consist primarily of secured loans on facilities. Our financial instruments, principally our investments in notes receivable, are subject to the possibility of loss of the carrying values as a result of the failure of other parties to perform according to their contractual obligations which may make the instruments less valuable. We obtain collateral in the form of mortgage liens and other protective rights for notes receivable and continually monitor these rights in order to reduce such possibilities of loss. We evaluate the need to provide for reserves for potential losses on our financial instruments based on management’s periodic review of our portfolio on an instrument-by-instrument basis. Deferred Loan Costs - Costs incurred to acquire debt are capitalized and amortized by the straight-line method, which approximates the effective-interest method, over the term of the related debt. Deferred Income - Deferred income primarily includes rents received in advance from tenants and residents and non-refundable commitment fees received by us, which are amortized into income over the expected period of the related loan or lease. In the event that our financing commitment to a potential borrower or tenant expires, the related commitment fees are recognized into income immediately. Commitment fees may be charged based on the terms of the lease agreements and the creditworthiness of the parties. 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. Under certain leases, we receive additional contingent rent, which is calculated on the increase in revenues of the tenant over a target threshold. We recognize contingent rent periodically based on the actual revenues of the tenant once the target threshold has been achieved. Lease payments that depend on a factor directly related to future use of the property, such as an increase in annual revenues over a base year, are considered to be contingent rent payments and are excluded from the determination of minimum lease payments. If rental income calculated on a straight-line basis exceeds the cash rent due under a lease, the difference is recorded as an increase to straight-line rents receivable in the Consolidated Balance Sheets and an increase in rental income in the Consolidated Statements of Income. If rental income on a straight-line basis is calculated to be less than cash received, there is a decrease in the same accounts. Property operating expenses that are reimbursed by our operators are recorded as “ Rental income” in the Consolidated Statements of Income. Accordingly, we record a corresponding expense, reflected in “ Taxes and insurance on leased properties” in the Consolidated Statements of Income. Rental income includes reimbursement of property operating expenses for the years ended December 2023, 2022 and 2021, totaling $11.5 million, $9.8 million and $11.6 million, respectively. Rental income is reduced for the non-cash amortization of payments made upon the eventual settlement of commitments and contingencies originally identified and recorded as lease inducements. We record lease inducements to the extent that it is probable that a significant reversal of amounts recognized will not occur when the uncertainty associated with the contingent consideration is subsequently resolved. The Company reviews its operating lease receivables for collectability 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 collectability 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. As of December 31, 2023, we had three tenants, including Bickford Senior Living (“Bickford”), on the cash basis of revenue recognition for their lease arrangements. During the year ended December 31, 2022, we placed three operators on the cash basis of rental income recognition. During the year ended December 31, 2021, we placed Holiday Retirement (“Holiday”) on cash basis for its master lease which was terminated in 2022 upon the formation of the SHOP ventures. Reference Note 3 for further discussion of cash basis tenants. Resident Fees and Services - Resident fee and services revenue associated with our SHOP activities is recognized as the related performance obligations are satisfied and includes resident room charges, community fees and other resident charges. Residency agreements are generally short term (30 days to one year), and entitle the resident to certain room and care services for a monthly fee billed in advance. Revenue for certain related services is billed monthly in arrears. The Company has elected the lessor practical expedient within ASC Topic 842, Leases, not to separate the lease and nonlease components within our resident agreements as the timing and pattern of transfer to the resident are the same. The Company has determined that the nonlease component is the predominant component within the contract and will recognize revenue under ASC Topic 606, Revenue Recognition from Contracts with Customers . Interest Income from Mortgage and Other Notes Receivable - Interest income is recognized based on the interest rates and principal amounts outstanding on the notes receivable. We identify a mortgage note as non-performing based on various criteria including timeliness of required payments, compliance with other provisions under the related note agreement, and an evaluation of the borrower’s current financial condition for indicators that it is probable it cannot pay its contractual amounts. A non-performing loan is returned to accrual status at such time as the note becomes contractually current and management believes all future principal and interest will be received according to the contractual terms of the note. As of December 31, 2023, we had two mortgage notes receivable and a mezzanine loan totaling an aggregate of $26.6 million with affiliates of two operators/borrowers, including Bickford, designated as non-performing. Derivatives - In the normal course of business, we are subject to risk from adverse fluctuations in interest rates. Occasionally, we may choose to manage this risk through the use of derivative financial instruments, primarily interest rate swaps. Counterparties to these contracts are major financial institutions. We are exposed to credit loss in the event of nonperformance by these counterparties. We do not use derivative instruments for trading or speculative purposes. Our objective in managing exposure to market risk is to limit the impact on cash flows relating to the change in market interest rates on our variable rate debt. To qualify for hedge accounting, our interest rate swaps must effectively reduce the risk exposure that they are designed to hedge. In addition, at inception of a qualifying cash flow hedging relationship, the underlying transaction or transactions must be, and be expected to remain, probable of occurring in accordance with our related assertions. All of our hedges are cash flow hedges. We recognize all derivative instruments, including embedded derivatives required to be bifurcated, as assets or liabilities at their fair value in the Consolidated Balance Sheets. Changes in the fair value of derivative instruments that are not designated as hedges or that do not meet the criteria of hedge accounting are recognized in earnings. For derivatives designated in qualifying cash flow hedging relationships, the change in fair value of the effective portion of the derivatives is recognized in accumulated other comprehensive income (loss), whereas the change in fair value of any ineffective portion is recognized in earnings. Gains and losses are reclassified from accumulated other comprehensive income (loss) into earnings once the underlying hedged transaction is recognized in earnings. Income Taxes - We intend at all times to qualify as a REIT under Sections 856 through 860 of the Internal Revenue Code. 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 equal to or in excess of 90% of our taxable income. 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. Certain activities that we undertake may be conducted by subsidiary entities that have elected to be treated as 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. Earnings and profits, which determine the taxability of dividends to stockholders, differ from net income reported for financial reporting purposes due primarily to differences in the basis of assets, estimated useful lives used to compute depreciation expense, gains on sales of real estate, non-cash compensation expense and recognition of commitment fees. Our tax returns filed for years beginning in 2020 are subject to examination by taxing authorities. We classify interest and penalties related to uncertain tax positions, if any, in our Consolidated Statements of Income as a component of income tax expense. 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 primarily 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 independent managers pursuant to the terms of separate management agreements. Reference Notes 5 and 16 for additional information. Recent Accounting Pronouncements -

Investment Activity

Investment Activity	12 Months Ended
	Dec. 31, 2023
Real Estate [Abstract]
Investment Activity	Investment Activity Asset Acquisition 2023 Acquisitions and New Leases of Real Estate During the year ended December 31, 2023, we completed the following real estate acquisitions within our Real Estate Investments segment ( $ in thousands ): Operator Date Properties Asset Class Land Building and Improvements Total Silverado Senior Living Q1 2023 2 ALF $ 3,894 $ 33,599 $ 37,493 Bickford Q1 2023 1 ALF 1,746 15,542 17,288 $ 5,640 $ 49,141 $ 54,781 In February 2023, we acquired two memory care communities operated by Silverado Senior Living for approximately $37.5 million. The newly developed properties opened in 2022 and include a 60-unit community in Summerlin, Nevada and a 60-unit community in Frederick, Maryland. They are leased pursuant to 20-year leases with a first-year lease rate of 7.5% and annual escalators of 2.0%. In February 2023, we also acquired a 64-unit assisted living and memory care community in Chesapeake, Virginia from Bickford. The acquisition price was $17.3 million, including the satisfaction of an outstanding construction note receivable of $14.2 million including interest, cash consideration of $0.5 million and approximately $0.1 million in closing costs. The acquisition price also included a reduction of $2.5 million in Bickford’s outstanding pandemic-related rent deferrals that has been recognized in “ Rental income. ” We added the community to an existing master lease with Bickford at an initial rate of 8.0%. 2022 Acquisitions and New Leases of Real Estate During the year ended December 31, 2022, we completed the following real estate acquisitions within our Real Estate Investments segment ( $ in thousands ): Operator Date Properties Asset Class Land Building and Improvements Total Encore Senior Living Q2 2022 1 ALF $ 542 $ 12,758 $ 13,300 Bickford Q4 2022 1 ALF 2,052 15,148 17,200 $ 2,594 $ 27,906 $ 30,500 In April 2022, we acquired a 53-unit ALF located in Oshkosh, Wisconsin, from Encore Senior Living. The acquisition price was $13.3 million and included the cancellation of an outstanding construction note receivable to us of $9.1 million, including interest. 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%. In November 2022, we acquired a 60-unit ALF located in Virginia Beach, Virginia, from Bickford. The acquisition price was $17.2 million, including $0.2 million in closing costs, and the cancellation of an outstanding construction note receivable of $14.0 million including interest. The acquisition price also included a reduction of $3.0 million in Bickford’s outstanding pandemic-related rent deferrals that were recognized in rental income in the fourth quarter of 2022 based on the fair value of the real estate assets received. We added the facility to an existing master lease with Bickford for a term of 10.5 years at an initial rate of 8.0%, with annual CPI escalators subject to a floor and ceiling. Asset Dispositions 2023 Asset Dispositions During the year ended December 31, 2023, we completed the following real estate property dispositions within our Real Estate Investments segment ( $ in thousands ): Operator Date Properties Asset Class Net Proceeds Net Real Estate Investment Gain Impairment 2 BAKA Enterprises, LLC 1,3 Q1 2023 1 ALF $ 7,478 $ 7,505 $ — $ 27 Bickford 1 Q1 2023 1 ALF 2,553 1,421 1,132 — Chancellor Health Care 1,3 Q2 2023 1 ALF 2,355 1,977 378 — Milestone Retirement 1,3,4 Q2 2023 2 ALF 3,803 3,934 — 131 Chancellor Health Care 1,3 Q2 2023 1 ALF 7,633 6,140 1,493 — Milestone Retirement 1,3,4 Q2 2023 1 ALF 1,602 1,452 150 — Chancellor Health Care Q2 2023 1 ALF 23,724 14,476 9,248 — Chancellor Health Care 1,3 Q3 2023 1 ALF 2,923 2,292 631 — Senior Living Management 1,4 Q4 2023 2 ALF 5,522 4,770 752 — Senior Living Management 1,3 Q4 2023 1 ALF 1,515 1,100 415 — 12 $ 59,108 $ 45,067 $ 14,199 $ 158 1 Assets were previously classified as “ Assets held for sale ” in the Consolidated Balance Sheet at December 31, 2022. 2 Impairments are included in “ Loan and realty losses, net ” in the Consolidated Statements of Income for the year ended December 31, 2023. 3 Total aggregate impairment charges previously recognized on these properties were $0.3 million and $17.4 million for the years ended December 31, 2023 and 2022, respectively. 4 The Company provided aggregate financing of approximately $2.2 million, net of discounts, on these transactions in the form of notes receivable, which is included net proceeds. Total rental income related to the disposed properties was $3.3 million, $0.7 million and $6.1 million for years ended December 31, 2023, 2022 and 2021, respectively. 2022 Asset Dispositions During the year ended December 31, 2022, we completed the following real estate property dispositions within our Real Estate Investments segment ( $ 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 2 Q2 2022 1 ILF 2,990 3,020 — 30 Chancellor Health Care 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 38,444 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 — 22 $ 168,989 $ 143,038 $ 28,342 $ 2,391 1 Impairments are included in “ Loan and realty losses, net ” in the Consolidated Statement of Income for the year ended December 31, 2022. 2 Total impairment charges recognized on these properties were $28.5 million for the year ended December 31, 2022. Total rental income related to the disposed properties was $7.0 million and $10.9 million for years ended December 31, 2022 and 2021, respectively. Assets Held for Sale and Long-Lived Assets The following is a summary of our assets held for sale ( $ in thousands ): For the Year Ended December 31, 2023 2022 Number of facilities 1 13 Real estate, net $5,004 $43,302 Rental income associated with the asset held for sale as of December 31, 2023 totaled $1.7 million, $0.9 million, and $1.1 million for the years ended December 31, 2023, 2022 and 2021, respectively. Rental income associated with the assets held for sale as of December 31, 2022 totaled $2.1 million and $5.6 million for the years ended December 31, 2022 and 2021, respectively. During the year ended December 31, 2023, we recorded impairment charges of approximately $1.6 million for four properties in our Real Estate Investments segment, of which $0.5 million related to three properties either sold or classified as assets held for sale. During the year ended December 31, 2022, we recorded impairment charges of approximately $51.6 million for 19 properties which were sold or classified as held for sale in our Real Estate Investments segment. Impairment charges are included in “ Loan and realty losses, net ” in the 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, $347.4 million for the SHOP segment, and a credit loss reserve of $15.5 million, based on the percentage of revenues for the years ended December 31, 2023, 2022 and 2021 related to tenants or affiliates of tenants, that exceed 10% of total revenue ( $ in thousands ): As of December 31, 2023 Revenues 1 Asset Gross Real Notes Year Ended December 31, Class Estate 2 Receivable 2023 2022 2021 Senior Living Communities EFC $ 573,631 $ 48,950 $ 51,274 16% $ 51,183 18% $ 50,726 17% NHC SNF 133,770 — 37,335 12% 36,893 13% 37,735 12% Bickford 3 ALF 429,043 16,795 38,688 12% N/A N/A 34,599 12% All others, net Various 1,293,969 195,002 132,216 41% 144,534 52% 164,017 55% Escrow funds received from tenants for property operating expenses Various — — 11,513 4% 9,788 4% 11,638 4% $ 2,430,413 $ 260,747 271,026 242,398 298,715 Resident fees and services 4 48,809 15% 35,796 13% — —% $ 319,835 $ 278,194 $ 298,715 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 Revenues included in All others, net for years when less than 10%. 4 There is no tenant concentration in resident fees and services because these agreements are with individual residents. At December 31, 2023 and 2022, the two states in which we had an investment concentration of 10% or more were South Carolina (12.1%) and Texas (10.7%). Senior Living Communities As of December 31, 2023, we leased ten retirement communities totaling 2,216 units to Senior Living Communities, LLC (“Senior Living”) pursuant to triple-net lease agreements maturing through December 2029. We recognized straight-line rent revenue of $(1.2) million, $0.4 million and $2.5 million from the Senior Living lease agreements for the years ended December 31, 2023, 2022 and 2021, respectively. NHC The facilities leased to NHC, a publicly held company, are under a master lease and consist of three ILFs and 32 SNFs (four of which are subleased to other parties for whom the lease payments are guaranteed to us by NHC). Effective September 1, 2022, we amended the master lease dated October 17, 1991, concurrently with the sale of a portfolio of seven SNFs to increase the annual base rent due each year through the expiration of the master lease on December 31, 2026. There are two additional five-year renewal options at a fair rental value as negotiated between the parties. In addition to the base rent, NHC pays any additional rent and percentage rent as required by the master lease. Under the terms of the amended lease, the base annual rent escalates by 4% of the increase, if any, in each facility’s annual revenue over a 2007 base year. We refer to this additional rent component as “percentage rent.” Straight-line rent of $(1.2) million and $(0.5) million was recognized for NHC for the years ended December 31, 2023 and 2022, respectively. No material straight-line rent was recognized for the year ended December 31, 2021. The following table summarizes the percentage rent income from NHC ( $ in thousands ): Year Ended December 31, 2023 2022 2021 Current year $ 3,862 $ 3,332 $ 3,536 Prior year final certification 1 630 (206) (5) Total percentage rent income $ 4,492 $ 3,126 $ 3,531 1 For purposes of the percentage rent calculation described in the master lease agreement, NHC’s annual revenue by facility for a given year is certified to NHI by March 31st of the following year. Two of our board members, including our chairman, are also members of NHC’s board of directors. As of December 31, 2023, NHC owned 1,630,642 shares of our common stock. Bickford As of December 31, 2023, we leased 39 facilities to Bickford under four leases. During the second quarter of 2022, we converted Bickford to the cash basis of revenue recognition based upon information obtained from Bickford regarding its financial condition that raised substantial doubt as to its ability to continue as a going concern. As a result, 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 Consolidated Balance Sheet, to rental income in 2022. Straight-line rent revenue of $(18.2) million and $1.7 million was recognized from the Bickford leases for the years ended December 31, 2022 and 2021, respectively. Cash rent received from Bickford for the years ended December 31, 2023, 2022 and 2021 was $33.4 million, $27.6 million and $29.5 million, respectively, including its repayment of outstanding pandemic-related rent deferrals of $2.3 million and $0.2 million for the years ended December 31, 2023 and 2022, respectively. These amounts exclude $2.5 million and $3.0 million of rental income for the years ended December 31, 2023 and 2022, respectively, related to the reduction of pandemic-related rent deferrals in connection with the acquisition of two ALFs located in Virginia discussed above. As of December 31, 2023, Bickford’s outstanding pandemic-related rent deferrals were $18.0 million. During the first half of 2022, we transferred one ALF 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 rents receivable, reducing rental income. Effective April 1, 2022, we restructured and amended three of Bickford’s master lease agreements covering 28 properties and reached agreement on the repayment terms of its outstanding pandemic-related rent deferrals. Significant terms of these agreements are as follows: • Extended 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. • Reduced the combined rent for the portfolio to approximately $28.3 million (excluding the ALF in Virginia Beach acquired in the fourth quarter of 2022) 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, but not less than 8.0% of our initial gross investment. • Required monthly payments from October 2022 through December 2024 based on a percentage of Bickford’s monthly revenues exceeding an established threshold to be applied to the outstanding pandemic-related rent deferrals granted to Bickford. 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 of which $2.5 million was earned in the first quarter of 2023 and $3.0 million was earned in the fourth quarter of 2022. Holiday During the third quarter of 2021, Welltower Inc. (“Welltower”) completed an acquisition that resulted in a Welltower-controlled subsidiary becoming a tenant under our master lease for the NHI-owned Holiday real estate assets. We placed the tenant on the cash basis of accounting effective in the third quarter of 2021 because of non-payment of rent and completed the transitioning of the remaining properties in this portfolio effective April 1, 2022. Reference Note 9 for more discussion. Other Portfolio Activity Cash Basis Operators and Straight-line Rents Receivable Write-offs We placed three operators on the cash basis of accounting for their leases during 2022, including Bickford discussed above. During 2021, the Welltower-controlled tenant of our Holiday portfolio was the only tenant on the cash basis prior to the completion of the portfolio transition. Rental income associated with these tenants totaled $48.3 million, $21.4 million and $68.8 million for the years ended December 31, 2023, 2022 and 2021, respectively, which includes the impact of write-offs of $26.0 million in total straight-line rents receivable and $7.1 million of lease incentives during the year ended December 31, 2022. Included in rental income are amounts received from prior rent deferrals granted to cash basis tenants totaling $2.8 million and $0.3 million for the years ended December 31, 2023 and 2022, respectively. Tenant Purchase Options Certain of our leases contain purchase options allowing tenants to acquire the leased properties. At December 31, 2023, we had tenant purchase options on three properties with an aggregate net investment of $58.4 million that will become exercisable between 2027 and 2028. Rental income from these properties with tenant purchase options was $7.2 million, $7.0 million and $6.9 million for the years ended December 31, 2023, 2022 and 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. Lease Costs As of December 31, 2023, we are a lessee under a ground lease related to an ALF located in Ohio. For the years ended December 31, 2023, 2022 and 2021, the expense associated with this operating lease was $0.1 million and is included within “ General and administrative expense ” on the Consolidated Statements of Income. Future minimum lease payments are approximately $0.1 million annually for 2024 through 2028 with cumulative payments of $2.5 million thereafter reflecting an aggregate of $1.3 million of imputed interest. At December 31, 2023, the discount rate for this lease approximated 4.7%. Supplemental balance sheet information related to the lease is as follows ( $ in thousands ): As of December 31, 2023 2022 Buildings and improvements - right of use asset $ 1,562 $ 1,599 Accounts payable and accrued expenses - lease liability $ 1,705 $ 1,724 Rent Concessions During 2022 and 2021, we granted various rent concessions to tenants whose operations were adversely affected by the COVID-19 pandemic. When applicable, we elected not to apply the modification guidance under ASC Topic 842 and accounted for the related concessions as variable lease payments until those leases were subsequently modified under ASC Topic 842. Rent deferrals accounted for as variable lease payments, reducing rental income, granted for the years ended December 31, 2022 and 2021 totaled approximately $9.3 million and $26.4 million, respectively. Of these totals, Bickford accounted for $4.0 million and $18.3 million for the years ended December 31, 2022 and 2021, respectively. There were no pandemic-related rent deferrals granted during the year ended December 31, 2023. Future Minimum Lease Payments Future minimum lease payments to be received by us under our operating leases, including cash basis tenants, at December 31, 2023 are as follows ( $ in thousands ): Year Ending December 31, Amount 2024 $ 232,059 2025 237,981 2026 244,581 2027 198,598 2028 192,179 Thereafter 684,840 $ 1,790,238 Variable Lease Payments Most of our existing leases contain annual escalators in rent payments. 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 ): Year Ended December 31, 2023 2022 2021 Lease payments based on fixed escalators and deferral repayments $ 225,565 $ 226,873 $ 241,172 Lease payments based on variable escalators 7,709 5,275 4,662 Straight-line rent income, net of write-offs 6,961 (16,681) 14,603 Escrow funds received from tenants for property operating expenses 11,513 9,788 11,638 Amortization and write-off of lease incentives (2,521) (7,555) (1,026) Rental income $ 249,227 $ 217,700 $ 271,049

Mortgage and Other Notes Receiv

Mortgage and Other Notes Receivable	12 Months Ended
	Dec. 31, 2023
Mortgage and Other Notes Receivable [Abstract]
Mortgage and Other Notes Receivable	Mortgage and Other Notes Receivable At December 31, 2023, our investments in mortgage notes receivable totaled $162.4 million secured by real estate and other assets of the borrower ( e.g ., UCC liens on personal property) related to 16 facilities and in other notes receivable totaled $98.3 million, substantially all of which are guaranteed by significant parties to the notes or by cross-collateralization of properties with the same owner. At December 31, 2022, our investments in mortgage notes receivable totaled $164.6 million and other notes receivable totaled $83.9 million. These balances exclude a credit loss reserve of $15.5 million and $15.3 million at December 31, 2023 and 2022, respectively. Our loans designated as non-performing as of December 31, 2023 and 2022 include a mortgage note receivable of $10.0 million and a mezzanine loan of $14.5 million with affiliates of one operator/borrower. This operator/borrower is also one of the tenants on the cash basis of accounting for its leases discussed in Note 3. During the third quarter of 2023, we designated as non-performing a mortgage note receivable of $2.1 million due from Bickford. Interest income recognized from these non-performing loans was $1.8 million, $1.7 million and $2.1 million, respectively, for the years ended December 31, 2023, 2022 and 2021. All other loans were on full accrual basis at December 31, 2023 and 2022. 2023 Mortgage and Other Notes Receivable Capital Funding Group, Inc. Loan Extension In September 2023, we amended a mezzanine loan with Capital Funding Group, Inc. Pursuant to the terms of the agreement, the loan increased from its balance at June 30, 2023 of $8.1 million to $25.0 million. The interest rate on the loan was increased to 10% and the maturity was extended to December 31, 2028. 2022 Mortgage and Other Notes Receivable 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 $27.7 million and $14.2 million as of December 31, 2023 and 2022, respectively. Capital Funding Group, Inc. In November 2022, we funded a $42.5 million senior loan to refinance a portfolio of five skilled nursing facilities located in Texas. The loan was made to affiliates of Capital Funding Group and the properties are leased by subsidiaries of The Ensign Group. The five-year loan agreement has an annual interest rate of 7.25% and two one-year extensions. 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. As of December 31, 2023 and 2022, we had 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. Interest accrues at an annual rate ranging between 7.5% and 9.5% that is paid monthly in arrears. Deferred interest accrues at an additional annual rate ranging between 2.5% and 4.5% to be paid upon certain future events including repayments, sales of fund investments, and refinancings. The deferred interest will be recognized as interest income upon receipt. For the years ended December 31, 2023, 2022 and 2021, we received interest of $1.8 million, $1.8 million and $0.2 million, respectively. For the year ended December 31, 2022, we received principal of $0.3 million. 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, subject to two one-year extensions. Other Activity Bickford Construction and Mortgage Loans As of December 31, 2023, we had one fully funded construction loan of $14.7 million to Bickford. The construction loan is 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 property upon stabilization of the underlying operations. On certain development projects, Bickford is entitled to up to $2.0 million per project in incentives based on the achievement of predetermined operational milestones, which if earned, will increase NHI's future purchase price and eventual lease payments to NHI. We held a second mortgage note receivable with a balance of $12.7 million and $13.0 million as of December 31, 2023 and 2022, respectively, originated in connection with the sale of six properties to Bickford in 2021. This second mortgage note receivable bears interest at a 10% annual rate and matures in April 2026. Interest income was $1.2 million, $1.3 million and $0.9 million for the years ended December 31, 2023, 2022 and 2021, respectively, related to the second mortgage. We did not include this note receivable in the determination of the gain recognized upon sale of the portfolio. Therefore, this note receivable is not reflected in “ Mortgage and other notes receivable, net ” in the Consolidated Balance Sheets as of December 31, 2023 and 2022. During the year ended December 31, 2023, Bickford repaid $0.3 million of principal on this note receivable which is reflected in “ Gains on sale of real estate, net ” in the Consolidated Statement of Income. As noted previously, we designated a mortgage note receivable of $2.1 million due from Bickford as non-performing during the third quarter of 2023. Life Care Services - Sagewood During the year ended December 31, 2021, an affiliate of Life Care Services repaid in full a $61.2 million mortgage note. As a result, we recognized the remaining commitment fee of $0.4 million in “ Interest income and other ” on the Consolidated Statement of Income for the year ended December 31, 2021. 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 receivable payoff ” on the Consolidated Statement of Income for the year ended December 31, 2022. Interest income was $5.2 million and $10.2 million and for the years ended December 31, 2022 and 2021, respectively. Senior Living Communities We have provided a $20.0 million revolving line of credit to Senior Living whose borrowings under the revolver are to be used for working capital and to finance construction projects within its portfolio, including building additional units. Beginning January 1, 2025, availability under the revolver will be reduced to $15.0 million. The revolver matures in December 2029 at the time of lease maturity. At December 31, 2023, the $16.3 million outstanding under the revolver bears interest at 8.0% per annum. The Company also has a mortgage loan of $32.7 million with Senior Living that originated in July 2019 secured by a 248-unit 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 table below have been calculated utilizing the most recent date for which data is available, September 30, 2023, 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. The tables below present outstanding note balances as of December 31, 2023 at amortized cost. We consider the guidance in ASC Topic 310-20, Receivables - Nonrefundable Fees and Other Costs , when determining whether a modification, extension or renewal constitutes a current period origination. The credit quality indicator as of December 31, 2023, is presented below for the amortized cost, net by year of origination of ( $ in thousands ): 2023 2022 2021 2020 2019 Prior Total Mortgages more than 1.5x $ — $ 70,042 $ — $ 22,337 $ 32,700 $ 2,587 $ 127,666 between 1.0x and 1.5x 1,550 — — — — 14,700 16,250 less than 1.0x — — — — 6,423 — 6,423 1,550 70,042 — 22,337 39,123 17,287 150,339 Mezzanine more than 1.5x 720 — 14,933 — — — 15,653 between 1.0x and 1.5x — — 23,934 — — — 23,934 less than 1.0x — — — — — 25,000 25,000 720 — 38,867 — — 25,000 64,587 Non-performing less than 1.0x — — — 2,095 — 24,500 26,595 — — — 2,095 — 24,500 26,595 Revolver between 1.0x and 1.5x 19,226 19,226 Credit loss reserve (15,476) $ 245,271 Due to 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 on all loans, other than those designated as non-performing, resulting in an effective adjustment of 44%. The methodology for estimating the reserves for non-performing loans incorporates the sufficiency of the under lying collateral and the current conditions and forecasts of future economic conditions of these loans, including qualitative factors, which may differ from conditions existing in the historical period. The allowance for expected credit losses is presented in the following table for the year ended December 31, 2023 ( $ in thousands ): Balance at January 1, 2023 $ 15,338 Provision for expected credit losses 138 Balance at December 31, 2023 $ 15,476

Senior Housing Operating Portfo

Senior Housing Operating Portfolio Formation Activities	12 Months Ended
	Dec. 31, 2023
Senior Housing Operating Portfolio Formation Activities [Abstract]
Senior Housing Operating Portfolio Formation Activities	Senior Housing Operating Portfolio Formation Activities Effective April 1, 2022, we transitioned the operations of 15 ILFs previously leased pursuant to a triple-net lease into two new ventures comprising our SHOP activities. 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 preferred and common equity interests. The Company owns 100% of the preferred equity interests in these ventures with an annual fixed preferred return of approximately $10.2 million as of December 31, 2023. Additionally, the managers, or related parties of the managers, own common equity interests in their respective ventures. Each venture is discussed in more detail below. Merrill Managed Portfolio We transferred six ILFs located in California and Washington into a consolidated venture with Merrill. Merrill initially contributed $10.6 million in cash for its 20% common equity interest in the venture. In the second quarter of 2023, the members of this venture contributed an additional $4.6 million to fund additional capital expenditures, which was funded in cash in accordance with each member’s common equity interest percentage in the venture. The operating agreement for the venture provides for contingent distributions to the members 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. Given certain provisions of the operating agreement, including provisions related to a Company change in control, the noncontrolling interest associated with the venture was determined to be contingently redeemable and classified in mezzanine equity as of December 31, 2023 and 2022, as discussed further in Note 10. 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, a related party of Discovery. The Discovery member initially contributed $1.1 million in cash for its 2% common equity interest in the venture. In the fourth quarter of 2023, the members contributed an additional $2.6 million to fund additional capital expenditures, which was funded in cash in accordance with each member’s common equity interest percentage in the venture. The operating agreement for the venture provides for contingent distributions to the members based on the attainment of certain yields on investment calculated on an annual basis. At inception, the noncontrolling interest associated with this venture was determined to be contingently redeemable and classified in mezzanine equity on the Consolidated Balance Sheet. Effective in the fourth quarter of 2022, the operating agreement was amended, resulting in the noncontrolling interest no longer being contingently redeemable. The noncontrolling interest is classified in “ Equity ” on the Consolidated Balance Sheets as of December 31, 2023 and 2022. The properties are managed by separate related parties of Discovery pursuant to management agreements, each 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 agreements entitle the managers to a base management fee of 5% of net revenue.

Equity Method Investment

Equity Method Investment	12 Months Ended
	Dec. 31, 2023
Equity Method Investments and Joint Ventures [Abstract]
Equity Method Investment	Equity Method Investment Concurrently with the acquisition of a CCRC from LCS-Westminster Partnership III, LLP in January 2020, we invested $0.9 million in the operating company, Timber Ridge OpCo, LLC (“Timber Ridge OpCo”) representing a 25% equity interest. This investment is held by a TRS to be compliant with the provisions of the REIT Investment Diversification and Empowerment Act of 2007. 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 guaranteed or implied commitments to fund operations. In February 2023, we received $2.5 million from Timber Ridge OpCo, representing the Company’s proportionate share of a lease incentive earned, as discussed in Note 7, based on its equity interest in the entity. Our guaranteed and implied commitments are currently limited to the additional $5.0 million under the revolving credit facility and the $2.5 million lease incentive distribution received. As of December 31, 2023, 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 and the $2.5 million lease incentive distribution received are included in “ Accounts payable and accrued expenses ” in our Consolidated Balance Sheet as of December 31, 2023. Excess unrecognized equity method losses for the years ended December 31, 2023 and 2022 were $2.7 million and $4.2 million, respectively. Cumulative unrecognized losses were $9.1 million through December 31, 2023. We recognized gains of approximately $0.6 million, representing cash distributions received related to our investment in Timber Ridge OpCo for both the years ended December 31, 2023 and 2022, respectively and losses of approximately $1.5 million related to our investment in Timber Ridge OpCo for year ended December 31, 2021. The Timber Ridge property is subject to early resident mortgages secured by a Deed of Trust and Indenture of Trust (the “Deed and Indenture”). As part of our acquisition, NHI-LCS JV I, LLC (“Timber Ridge PropCo”) acquired the Timber Ridge CCRC 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, under the 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 agreement and the resident loan assumption agreements, no liability has been recorded as of December 31, 2023. The balance secured by the Deed and Indenture was $11.8 million at December 31, 2023.

Other Assets

Other Assets	12 Months Ended
	Dec. 31, 2023
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Other Assets	Other Assets Other assets, net consist of the following ( $ in thousands ): December 31, 2023 December 31, 2022 SHOP accounts receivable, net of allowance of $343 and $375, and other assets $ 1,620 $ 1,341 Real estate investments accounts receivable and prepaid expenses 3,296 3,621 Lease incentive payments, net 10,669 3,190 Regulatory escrows 6,208 6,208 Restricted cash 2,270 2,225 $ 24,063 $ 16,585 In February 2023, Timber Ridge PropCo, the consolidated senior housing partnership with LCS that owns the Timber Ridge CCRC, paid a $10.0 million lease incentive earned by Timber Ridge OpCo. The lease incentive is being amortized on a straight-line basis through the remaining initial lease term ending January 2027.

Debt

Debt	12 Months Ended
	Dec. 31, 2023
Debt Instruments [Abstract]
Debt	Debt Debt consists of the following ( $ in thousands ): December 31, December 31, 2022 Revolving credit facility - unsecured $ 245,000 $ 42,000 Bank term loans - unsecured 200,000 240,000 2031 Senior Notes - unsecured, net of discount of $2,278 and $2,600 397,722 397,400 Private placement notes - unsecured 225,000 400,000 Fannie Mae term loans - secured, non-recourse 76,241 76,649 Unamortized loan costs (8,912) (8,538) $ 1,135,051 $ 1,147,511 Aggregate principal maturities of debt as of December 31, 2023 for each of the next five years and thereafter are included in the table below. These maturities do not include the impact of any debt incurred or repaid subsequent to December 31, 2023 ( $ in thousands ): For The Year Ending December 31, Amount 2024 $ 75,425 2025 325,816 2026 245,000 2027 100,000 2028 — Thereafter 400,000 1,146,241 Less: discount (2,278) Less: unamortized loan costs (8,912) $ 1,135,051 Unsecured revolving credit facility and bank term loans On March 31, 2022, we entered into an 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 one of the following (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%. We incurred $4.5 million of deferred financing costs in connection with the 2022 Credit Agreement which are included as a component of “ Debt ” on the Consolidated Balance Sheets as of December 31, 2023 and 2022. Concurrently with the execution of the 2022 Credit Agreement, we amended our $300.0 million 2023 Term Loan. The amendment modified 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. As of December 31, 2022, we had repaid $60.0 million of the 2023 Term Loan. In the first quarter of 2023, we repaid $20.0 million of the 2023 Term Loan. In June 2023, we entered into the two-year $200.0 million 2025 Term Loan bearing interest at a variable rate which is SOFR-based with a margin determined according to our credit ratings plus a 0.10% credit spread adjustment. The Company incurred approximately $2.7 million of deferred financing cost associated with this loan. The 2025 Term Loan proceeds were used to repay a portion of the remaining $220.0 million 2023 Term Loan balance, which was repaid in full in June 2023. Upon repayment, we expensed approximately $0.1 million of unamortized loan costs associated with this loan which are included in “ Loss on early retirement of debt ” in our Consolidated Statement of Income for the year ended December 31, 2023. In March 2022, we repaid a $75.0 million term loan with a maturity in August 2022 with proceeds primarily from the revolving credit facility. The term loan bore interest at a rate of 30-day LIBOR plus 135 basis points (“bps”), based on our current ratings. 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 Consolidated Statement of Income for the year ended December 31, 2022. In January 2021, we repaid a $100.0 million term loan that originated in July 2020 with the net proceeds from the 2031 Senior Notes offering discussed below. The term loan bore interest at a rate of 30-day LIBOR (with a 50 basis point floor) plus 185 bps, based on our current leverage ratios. Upon repayment, the Company expensed approximately $1.9 million of deferred financing costs associated with this loan which is included in “ Loss on early retirement of debt ” in our Consolidated Statement of Income for the year ended December 31, 2021. The 2022 Credit Agreement requires a facility fee equal to 0.125% to 0.30%, based on our credit rating, the facility presently provides for floating interest on the unsecured revolving credit facility and the 2025 Term Loan at SOFR CME Term Option one-month loan (plus a 10 bps spread adjustment) plus 105 bps and a blended 125 bps, respectively. At December 31, 2023 and 2022, the SOFR CME Term Option one-month was 534 bps and 436 bps, respectively. At December 31, 2023, we had $455.0 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 December 31, 2023, 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 chairperson of the Audit Committee of the Board of Directors 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. 2031 Senior Notes 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”). The 2031 Senior Notes were sold at an issue price of 99.196% of face value before the underwriters’ discount. Our net proceeds from the 2031 Senior Notes offering, after deducting underwriting discounts and expenses, were approximately $392.3 million. We used 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 year ended December 31, 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 with which we were in compliance at December 31, 2023. Private Placement Notes During 2023, we repaid $175.0 million of the private placement notes primarily with proceeds from the unsecured revolving credit facility. Our remaining unsecured private placement notes as of December 31, 2023, payable interest-only, are summarized below ( $ in thousands ): Amount Inception Maturity Fixed Rate $ 75,000 September 2016 September 2024 3.93 % 50,000 November 2015 November 2025 4.33 % 100,000 January 2015 January 2027 4.51 % $ 225,000 Covenants pertaining to the private placement notes are generally conformed with those governing our credit facility, except for specific debt-coverage ratios that are more restrictive. Our unsecured private placement notes 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 mo re. Fannie Mae Term Loans As of December 31, 2023, we had $60.1 million in Fannie Mae term-debt financing, that originated in March 2015, requiring interest-only payments at an annual rate of 3.79% with a 10-year maturity. The mortgages are non-recourse and secured by 11 properties leased to Bickford. For the year ended December 31, 2021, we recognized a $1.5 million loss on early retirement of debt upon repayment of two Fannie Mae term loans with a combined balance of $17.9 million, plus accrued interest of $0.1 million. 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 rate of 4.6%, and has a remaining balance of $16.1 million at December 31, 2023. Collectively, the Fannie Mae debt is secured by properties having a net book value of $100.9 million at December 31, 2023. Interest Expense and Rate Swap Agreements On December 31, 2021, our remaining $400.0 million interest rate swap agreements in place to hedge against fluctuations in variable interest rates applicable to our bank loans matured. The matured swaps had an average interest rate of 1.92% for the year ended December 31, 2021. The following table summarizes interest expense ( $ in thousands ): Year Ended December 31, 2023 2022 2021 Interest expense on debt at contractual rates $ 55,603 $ 42,487 $ 40,866 Losses reclassified from accumulated other comprehensive income into interest expense — — 7,286 Capitalized interest (90) (46) (40) Amortization of debt issuance costs, debt discount and other 2,647 2,476 2,698 Total interest expense $ 58,160 $ 44,917 $ 50,810

Commitments, Contingencies and

Commitments, Contingencies and Uncertainties	12 Months Ended
	Dec. 31, 2023
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 of revolving credit arrangements, construction and mezzanine loans to our operators to conduct expansions and acquisitions for their own account classified below as loan commitments, and commitments for the funding of construction for expansion or renovation to our existing properties under lease classified below as development commitments. 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. The tables below summarize our existing, known commitments and contingencies as of December 31, 2023 according to the nature of their impact on our leasehold or loan portfolios ($ in thousands) : Asset Class Type Total Funded Remaining Loan Commitments: Encore Senior Living SHO Construction $ 50,725 $ (49,846) $ 879 Senior Living SHO Revolving Credit 20,000 (16,250) 3,750 Timber Ridge OpCo SHO Working Capital 5,000 — 5,000 Watermark Retirement SHO Working Capital 5,000 (2,976) 2,024 Montecito Medical Real Estate MOB Mezzanine Loan 50,000 (20,255) 29,745 $ 130,725 $ (89,327) $ 41,398 See Note 4 for further details of our loan commitments. Loans funded do not include the effects of discounts or commitment fees. The credit loss liability for unfunded loan commitments is estimated using the same methodology as used for our funded mortgage and other notes receivable based on the estimated amount that we expect to fund. We applied the same market 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 Consolidated Balance Sheets as of December 31, 2023 and 2022 is presented in the following table for the year ended December 31, 2023 ( $ in thousands ): Balance at December 31, 2022 $ 683 Provision for expected credit losses (404) Balance at December 31, 2023 $ 279 Asset Class Type Total Funded Remaining Development Commitments: Woodland Village SHO Renovation $ 7,515 $ (7,425) $ 90 Navion Senior Solutions SHO Renovation 3,500 (2,059) 1,441 Vizion Health SHO Renovation 2,000 (250) 1,750 SHOP ILF Renovation 1,500 (1,221) 279 $ 14,515 $ (10,955) $ 3,560 In addition to these commitments listed above, 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 December 31, 2023. As of December 31, 2023, we had the following contingent lease inducement commitments which are generally based on the performance of facility operations and may or may not be met by the tenant ( $ in thousands ): Asset Class Total Funded Remaining Contingencies (Lease Inducements): IntegraCare SHO $ 750 — $ 750 Navion Senior Solutions SHO 4,850 (2,700) 2,150 Discovery SHO 4,000 — 4,000 Ignite Medical Resorts SNF 2,000 — 2,000 $ 11,600 $ (2,700) $ 8,900 Bickford Contingent Note Arrangement Related to the sale of six properties to Bickford in 2021 we reached an agreement with Bickford whereby Bickford would owe us up to $4.5 million under a contingent note arrangement. We have the one-time option to determine fair market value of the portfolio between May 1, 2023 and April 30, 2026, at which time the amount owed under the contingent note arrangement, if any, will be determined as the lesser of (i) the difference between the fair market value of the portfolio and $52.1 million, which amount represents the purchase consideration for the portfolio of $52.9 million less $0.8 million in mortgage debt repayment fees previously paid by us associated with this portfolio, and (ii) $4.5 million. Any amount due on the contingent note arrangement will accrue interest at an annual rate of 10% and will be due in five years from the determination date. Litigation Our facilities are subject to claims and suits in the ordinary course of business. Our managers, tenants 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. 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 relationship and leased pursuant to an existing master lease, and (iii) the remaining 15 properties were transitioned into two new SHOP partnership ventures. See Note 5 for more information on these new ventures. 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 year ended December 31, 2022. We recognized approximately $0.7 million as a “ Loss on operations transfer, net”

Redeemable Noncontrolling Inter

Redeemable Noncontrolling Interest	12 Months Ended
	Dec. 31, 2023
Noncontrolling Interest [Abstract]
Redeemable Noncontrolling Interest	Redeemable Noncontrolling Interest The interest held by Merrill in its SHOP venture was classified as a “ Redeemable noncontrolling interest ” in the mezzanine section between Total liabilities and Stockholders’ equity on our Consolidated Balance Sheet as of December 31, 2023 and 2022. Certain provisions within the operating agreement of the Merrill venture provide Merrill with put rights upon certain contingent events that are not solely within the control of the Company. Therefore, Merrill’s noncontrolling interest was determined to be contingently redeemable. The redeemable noncontrolling interest is not currently redeemable and we concluded a contingent redemption event is not probable to occur as of December 31, 2023. Consequently, the noncontrolling interest will not be subsequently remeasured to its redemption amount until such contingent event and the related redemption are probable to occur. We will continue to reflect the attribution of gains or losses to the redeemable noncontrolling interest each period. The Discovery member’s noncontrolling interest in its SHOP venture was also determined to be contingently redeemable at inception of the arrangement. The Discovery member’s agreement was amended in the fourth quarter of 2022 to remove the contingently redeemable feature, among other things. The noncontrolling interest is presented within the “ Liabilities and Equity ” section in the Consolidated Balance Sheets as of December 31, 2023 and 2022. The following table presents the change in “ Redeemable noncontrolling interest ” for the years ended December 31, 2023 and 2022 ( $ in thousands ): Year Ended December 31, 2023 2022 Balance at January 1, $ 9,825 $ — Initial carrying amount — 11,738 Reclassification of Discovery member noncontrolling interest — (1,030) Contributions 922 — Net loss (1,091) (843) Distributions — (40) Balance at December 31, $ 9,656 $ 9,825

Equity and Dividends

Equity and Dividends	12 Months Ended
	Dec. 31, 2023
Equity [Abstract]
Equity and Dividends	Equity and Dividends Share Repurchase Plan Beginning in April 2022, our Board of Directors has authorized a stock repurchase plan. No common stock was repurchased under this plan during 2023. During the year ended December 31, 2022, we repurchased through open market transactions 2,468,354 shares of common stock for an average price of $61.56 per share, 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 “Retained earnings” in the Consolidated Balance Sheet. On February 16, 2024, our Board of Directors renewed the stock repurchase plan pursuant to which we may purchase up to $160.0 million in shares of our issued and outstanding common stock, par value $0.01 per share. The stock repurchase plan is effective for a period of one year and does not require us to repurchase any specific number of shares. It may be suspended or discontinued at any time. 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 (the “Exchange Act”) and shall be made in accordance with all applicable laws and regulations in effect. The timing and number of shares repurchased, if any, will depend on a variety of factors, including price, general market and economic conditions, alternative investment opportunities and other corporate considerations. At-the-Market (“ATM”) Equity Program Our ATM equity offering sales agreement allows us to sell, from time to time, up to an aggregate sales price of $500 million of the Company’s common shares through the ATM equity program. No shares were issued during the years ended December 31, 2023 and 2022. During the year ended December 31, 2021, we issued 661,951 common shares through the ATM equity program with an average price of $73.62, resulting in net proceeds after transaction costs of approximately $47.9 million. Dividends The following table summarizes dividends declared or paid by the Board of Directors during the years ended December 31, 2023 and 2022: Year Ended December 31, 2023 Date of Declaration Date of Record Date Paid/Payable Quarterly Dividend February 17, 2023 March 31, 2023 May 5, 2023 $0.90 May 5, 2023 June 30, 2023 August 4, 2023 $0.90 August 4, 2023 September 29, 2023 November 3, 2023 $0.90 November 3, 2023 December 29, 2023 January 26, 2024 $0.90 Year Ended December 31, 2022 Date of Declaration Date of Record Date Paid/Payable Quarterly Dividend 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 November 6, 2022 December 30, 2022 January 27, 2023 $0.90 On February 16, 2024, the Board of Directors declared a $0.90 per share dividend to common stockholders of record on March 28, 2024, payable May 3, 2024.

Share-Based Compensation

Share-Based Compensation	12 Months Ended
	Dec. 31, 2023
Share-Based Payment Arrangement [Abstract]
Share-Based Compensation	Share-Based Compensation We recognize share-based compensation for all stock options granted over the requisite service period using the fair value of these grants as estimated at the date of grant using the Black-Scholes pricing model over the requisite service period using the market value of our publicly traded common stock on the date of grant. Restricted stock are issued with a grant date fair value based on the market value of our common stock on the date of grant. The restricted stock vest over five years, with 20% vesting on each anniversary of the date of grant. The restricted stock awards contain non-forfeitable rights to dividends or dividend equivalents during the vesting periods. Share-Based Compensation Plans The Compensation Committee of the Board of Directors (the “Committee”) has the authority to select the participants to be granted options; to designate whether the option granted is an incentive stock option (“ISO”), a non-qualified option, or a stock appreciation right; to establish the number of shares of common stock that may be issued upon exercise of the option; to establish the vesting provision for any award; and to establish the term any award may be outstanding. The exercise price of any ISO’s granted will not be less than 100% of the fair market value of the shares of common stock on the date granted and the term of an ISO may not be more than ten years. The exercise price of any non-qualified options granted will not be less than 100% of the fair market value of the shares of common stock on the date granted unless so determined by the Committee. The Company’s outstanding stock incentive awards have been granted under two incentive plans – the 2012 Stock Incentive Plan and the 2019 Stock Incentive Plan, which was amended and restated in May 2023 (collectively the “2019 Plan”). The individual awards may vest over periods up to five years. The term of the award under the 2019 Plan is up to ten years from the date of grant. As of December 31, 2023, shares available for future grants totaled 4,089,168 under the 2019 Plan. The amendment and restatement of the 2019 Plan, which was approved by stockholders in May 2023, increased the number of shares of common stock authorized for issuance under the 2019 Plan from 3,000,000 to 6,000,000 and added the ability of the Company to award shares of restricted stock and restricted stock units subject to such conditions and restrictions as the Company may determine. In May 2023, 21,000 shares of restricted stock were issued to executive officers with a grant date fair value of $49.30 per share based on the market value of our common stock on the date of grant. The restricted stock will vest over five years, with 20% vesting on each anniversary of the date of grant. The restricted stock awards contain non-forfeitable rights to dividends or dividend equivalents during the vesting periods. Compensation expense is recognized only for the awards that ultimately vest. Accordingly, forfeitures that were not expected may result in the reversal of previously recorded compensation expense. The following is a summary of share-based compensation expense, net of any forfeitures, included in “ General and administrative expenses ” in the Consolidated Statements of Income ( $ in thousands ): December 31, 2023 December 31, 2022 December 31, 2021 Shared-based compensation components: Restricted stock expense $ 310 $ — $ — Stock option expense 4,295 8,613 8,415 Total share-based compensation expense $ 4,605 $ 8,613 $ 8,415 Determining Fair Value of Option Awards The fair value of each option award was estimated on the grant date using the Black-Scholes option valuation model with the weighted average assumptions indicated in the following table. Each grant is valued as a single award with an expected term based upon expected employee and termination behavior. Compensation expense is recognized on the graded vesting method over the requisite service period for each separately vesting tranche of the award as though the award were, in substance, multiple awards. The expected volatility is derived using daily historical data for periods preceding the date of grant. The risk-free interest rate is the approximate yield on the United States Treasury Strips having a life equal to the expected option life on the date of grant. The expected life is an estimate of the number of years an option will be held before it is exercised. Stock Options The weighted average fair value of options granted was $10.56, $11.92 and $14.54 for the years ended December 31, 2023, 2022 and 2021, 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: December 31, 2023 December 31, 2022 December 31, 2021 Dividend yield 6.9% 7.0% 6.7% Expected volatility 39.0% 49.3% 48.1% Expected lives 2.9 years 2.9 years 2.9 years Risk-free interest rate 4.56% 1.75% 0.33% Stock Option Activity The following tables summarize our outstanding stock options: Weighted Average Number Weighted Average Remaining of Shares Exercise Price Contractual Life (Years) Outstanding December 31, 2020 1,033,838 $83.54 Options granted under 2012 Plan 12,500 $69.20 Options granted under 2019 Plan 639,500 $69.20 Options exercised under 2012 Plan (20,000) $60.52 Options forfeited under 2019 Plan (13,333) $90.79 Outstanding December 31, 2021 1,652,505 $78.10 Options granted under 2019 Plan 718,000 $53.62 Options exercised under 2019 Plan (56,832) $53.41 Options forfeited (23,000) $62.33 Options expired (74,498) $77.93 Outstanding December 31, 2022 2,216,175 $70.97 Options granted under 2019 Plan 385,500 $54.73 Options exercised (5,166) $53.41 Options forfeited (61,168) $66.44 Options expired (88,170) $64.33 Options outstanding, December 31, 2023 2,447,171 $68.80 2.26 Exercisable at December 31, 2023 2,078,827 $71.40 2.00 Remaining Grant Number Exercise Contractual Date of Shares Price Life in Years 2/21/2019 301,837 $ 79.96 0.14 2/21/2020 516,000 $ 90.79 1.15 5/1/2020 7,500 $ 53.76 1.33 2/25/2021 616,000 $ 69.20 2.16 2/25/2022 610,834 $ 53.41 3.16 6/1/2022 25,000 $ 59.43 3.42 2/24/2023 370,000 $ 54.73 4.15 Options outstanding, December 31, 2023 2,447,171 The following table summarizes our outstanding non-vested stock options: Number of Shares Weighted Average Grant Date Fair Value Non-vested December 31, 2022 515,020 $12.51 Options granted under 2019 Plan 385,500 $11.33 Options vested under 2012 Plan (4,168) $14.33 Options vested under 2019 Plan (505,007) $12.37 Non-vested options forfeited under 2019 Plan (23,001) $11.80 Non-vested December 31, 2023 368,344 $11.48 As of December 31, 2023, unrecognized compensation expense totaling $1.8 million associated with stock-based awards is expected to be recognized over the following periods: 2024 - $1.3 million, 2025 - $0.3 million, and thereafter - $0.2 million. Share-based compensation expense is included in “ General and administrative expense ” in the Consolidated Statements of Income. At December 31, 2023, the aggregate intrinsic value of stock options outstanding and exercisable was $1.9 million and $1.3 million, respectfully. The aggregate intrinsic value of stock options exercised during the years ended December 31, 2023, 2022 and 2021 was less than $0.1 million or $1.23 per share; $0.1 million or $6.13 per share, and $0.2 million or $9.27 per share, respectively.

Earnings Per Common Share

Earnings Per Common Share	12 Months Ended
	Dec. 31, 2023
Earnings Per Share [Abstract]
Earnings Per Common Share	Earnings Per Common Share Our unvested restricted stock awards contain non-forfeitable rights to dividends, and accordingly, these awards are deemed to be participating securities. Therefore, the Company applies the two-class method to calculate basic and diluted earnings. Under the two-class method, we allocate net income attributable to stockholders to common stockholders and holders of unvested restricted stock by using the weighted-average shares of each class outstanding for quarter-to-date and year-to-date periods, based on their respective participation rights to dividends declared and undistributed earnings. Basic earnings per common share is computed by dividing net income attributable to common stockholders by the weighted number of shares of common stock outstanding during the period. Diluted earnings per common share reflects the effect of dilutive securities. 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 ): Year Ended December 31, 2023 2022 2021 Net income $ 134,381 $ 65,501 $ 111,967 Add: net loss (income) attributable to noncontrolling interests 1,273 902 $ (163) Net income attributable to stockholders 135,654 66,403 111,804 Less: net income attributable to unvested restricted stock awards (57) — — Net income attributable to common stockholders $ 135,597 $ 66,403 $ 111,804 BASIC: Weighted average common shares outstanding 43,388,794 44,774,708 45,714,221 DILUTED: Weighted average common shares outstanding 43,388,794 44,774,708 45,714,221 Stock options 672 19,528 4,823 Convertible debt — — 10,453 Weighted average dilutive common shares outstanding 43,389,466 44,794,236 45,729,497 Earnings per common share - basic $ 3.13 $ 1.48 $ 2.45 Earnings per common share - diluted $ 3.13 $ 1.48 $ 2.44 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 802,506 564,803 383,716 Regular dividends declared per common share $ 3.60 $ 3.60 $ 3.8025

Fair Value of Financial Instrum

Fair Value of Financial Instruments	12 Months Ended
	Dec. 31, 2023
Fair Value Disclosures [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 December 31, 2023 and December 31, 2022 in the Consolidated Balance Sheets are as follows ( $ in thousands ): Carrying Amount Fair Value Measurement 2023 2022 2023 2022 Level 2 Variable rate debt $ 439,693 $ 277,699 $ 445,000 $ 282,000 Fixed rate debt $ 695,358 $ 869,812 $ 616,852 $ 773,994 Level 3 Mortgage and other notes receivable, net $ 245,271 $ 233,141 $ 237,646 $ 227,611 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 unsecured revolving credit facility and other variable rate debt are reasonably estimated at their notional amounts at December 31, 2023 and 2022, due to the predominance of floating interest rates, which generally reflect market conditions.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2023
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes Beginning with our inception in 1991, we have elected to be taxed as a REIT under the Internal Revenue Code. We have recorded state income tax expense of $0.1 million related to a Texas franchise tax that has attributes of an income tax for each of the years ended December 31, 2023, 2022, and 2021. Some of our leases require taxes to be reimbursed by our tenants. State income taxes are combined in “ Franchise, excise and other taxes ” in our Consolidated Statements of Income. The Company has a deferred tax asset, which is fully reserved through a valuation allowance, of $2.2 million and $1.5 million as of December 31, 2023 and 2022, respectively. The deferred tax asset is primarily a result of net operating losses from its participation in the operations of a joint venture during the years 2012 through 2016 and by entities that are structured as TRSs under provisions of the Internal Revenue Code. See Notes 5 and 6 for a discussion of SHOP ventures and Timber Ridge OpCo. The Company made state income tax payments of $0.1 million for each of the years ended December 31, 2023, 2022, and 2021. Dividend payments to common stockholders for the last three years are characterized for tax purposes as follows on a per share basis: (Unaudited) December 31, 2023 December 31, 2022 December 31, 2021 Ordinary income $ 2.40807 $ 2.61966 $ 2.87799 Capital gain 0.24805 — 0.43890 Return of capital 0.94388 0.98034 0.48562 Dividends paid per common share $ 3.60 $ 3.60 $ 3.8025

Segment Reporting

Segment Reporting	12 Months Ended
	Dec. 31, 2023
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 segment includes real estate investments and mortgages and other note investments in ILFs, ALFs, EFCs, SLCs, SNFs and a HOSP. Under the Real Estate Investments segment, we invest in senior housing and healthcare 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 properties. The SHOP segment includes multi-tenant ILFs. The SHOP properties and related operations are controlled by the Company and are operated by property managers in exchange for a management fee. See Note 5 for further discussion. 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 SHOP segment. There is no impact to the prior year’s presentation. Our CODM evaluates performance based upon segment net operating income (“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 either the year ended December 31, 2023 and 2022. Capital expenditures for the year ended December 31, 2023 were approximately $56.9 million for the Real Estate Investments segment and $9.3 million for the SHOP segment. Capital expenditures for the year ended December 31, 2022 were approximately $30.8 million for the Real Estate Investments segment and $3.3 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 discussed in Note 2. The results of operations for all acquisitions described in Note 3 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 year ended December 31, 2023 and 2022 is as follows ( $ in thousands ): For the year ended December 31, 2023: Real Estate Investments SHOP Non-segment/Corporate Total Rental income $ 249,227 $ — $ — $ 249,227 Resident fees and services — 48,809 — 48,809 Interest income and other 21,448 — 351 21,799 Total revenues 270,675 48,809 351 319,835 Senior housing operating expenses — 39,587 — 39,587 Taxes and insurance on leased properties 11,513 — — 11,513 NOI 259,162 9,222 351 268,735 Depreciation 60,764 9,158 51 69,973 Interest 3,071 — 55,089 58,160 Legal — — 507 507 Franchise, excise and other taxes — — 449 449 General and administrative — — 19,314 19,314 Loan and realty losses, net 1,376 — — 1,376 Gains on sales of real estate, net (14,721) — — (14,721) Loss on operations transfer, net (20) — — (20) Other income (202) — — (202) Loss on early retirement of debt — — 73 73 Gains from equity method investment (555) — — (555) Net income (loss) $ 209,449 $ 64 $ (75,132) $ 134,381 Total assets $ 2,202,647 $ 270,051 $ 15,782 $ 2,488,480 For the year ended December 31, 2022: Real Estate Investments SHOP Non-segment/Corporate Total Rental income $ 217,700 $ — $ — $ 217,700 Resident fees and services — 35,796 — 35,796 Interest income and other 24,383 — 315 24,698 Total revenues 242,083 35,796 315 278,194 Senior housing operating expenses — 28,193 — 28,193 Taxes and insurance on leased properties 9,788 — — 9,788 NOI 232,295 7,603 315 240,213 Depreciation 64,407 6,408 65 70,880 Interest 3,089 — 41,828 44,917 Legal — — 2,555 2,555 Franchise, excise and other taxes — — 844 844 General and administrative — — 22,768 22,768 Loan and realty losses, net 61,911 — — 61,911 Gains on sales of real estate, net (28,342) — — (28,342) Gain on operations transfer, net 710 — — 710 Gain on note receivable payoff (1,113) — — (1,113) Loss on early retirement of debt — — 151 151 Gains from equity method investment (569) — — (569) Net income (loss) $ 132,202 $ 1,195 $ (67,896) $ 65,501 Total assets $ 2,225,176 $ 274,135 $ 8,113 $ 2,507,424

Variable Interest Entities

Variable Interest Entities	12 Months Ended
	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Variable Interest Entities	Variable Interest Entities Consolidated Variable Interest Entities SHOP - The assets of the SHOP ventures primarily consist of real estate properties, cash and cash equivalents, and resident fees and services (accounts receivable). The obligations of the ventures primarily consist of operating expenses of the ILFs (accounts payable and accrued expenses) and capital expenditures for the properties. Aggregate assets of the consolidated SHOP ventures that can be used only to settle obligations of each respective SHOP venture primarily include approximately $260.7 million and $260.6 million of real estate properties, net, $7.7 million and $6.9 million of cash and cash equivalents, $0.9 million and $0.7 million of other assets, and $0.8 million and $0.7 million of accounts receivable, net as of December 31, 2023 and 2022, respectively. Liabilities of the consolidated SHOP ventures for which creditors do not have recourse to the general credit of the Company are $4.7 million and $3.3 million as of December 31, 2023 and 2022, respectively. Reference Note 5 for further discussion of these ventures. Real Estate Partnerships - The aggregate assets of the two consolidated real estate partnerships that can be used only to settle obligations of each respective partnership for the years ended December 31, 2023 and 2022 include approximately $252.5 million and $259.2 million of real estate properties, net, $9.7 million and $7.1 million in straight-line rents receivable, $3.2 million and $3.4 million of cash and cash equivalents and $7.8 million and less than $0.1 million of other assets, respectively. Liabilities of these partnerships for which creditors do not have recourse to the general credit of the Company are not material. Unconsolidated Variable Interest Entities 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 cross-referenced below ( $ in thousands ). Date Name Source of Exposure Carrying Amount Maximum Exposure to Loss Note Reference 2014 Senior Living Notes and straight-line receivable $ 89,406 $ 93,156 Notes 3, 4 2016 Senior Living Management Notes $ 24,500 $ 24,500 — 2018 Bickford Notes and funding commitment $ 16,909 $ 29,550 Notes 3, 4 2019 Encore Senior Living Various 1 $ 56,578 $ 57,432 — 2020 Timber Ridge OpCo Various 2 $ 1,348 $ 6,348 Notes 6, 7 2020 Watermark Retirement Notes and straight-line receivable $ 9,551 $ 11,574 — 2021 Montecito Medical Real Estate Notes and funding commitment $ 20,509 $ 50,254 Note 4 2021 Vizion Health Notes and straight-line receivable $ 16,481 $ 16,481 — 2021 Navion Senior Solutions Various 3 $ 7,992 $ 7,992 — 2023 Kindcare Senior Living Notes 4 $ 751 $ 751 — 1 Notes, straight-line rents receivable, and lease receivables 2 Loan commitment, equity method investment, straight-line rents receivable and unamortized lease incentive 3 Notes, loan commitments, straight-line rents receivable, and unamortized lease incentive 4 Represents two mezzanine loans originated from the sales of real estate 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 or borrowers do not have adequate liquidity to accept the risks and rewards as the tenants and operators of the properties and NHI may be required to consolidate the financial position and results of operations of the tenants or borrowers into our consolidated financial statements.

Schedule III - Real Estate and

Schedule III - Real Estate and Accumulated Depreciation Schedule III - Real Estate and Accumulated Depreciation	12 Months Ended
	Dec. 31, 2023
Schedule III - Real Estate and Accumulated Depreciation [Abstract]
Schedule III - Real Estate and Accumulated Depreciation	NATIONAL HEALTH INVESTORS, INC. SCHEDULE III - REAL ESTATE AND ACCUMULATED DEPRECIATION December 31, 2023 ($ in thousands) Costs Initial Cost to Company (C) Capitalized Date Buildings & Subsequent to Buildings & Accumulated Acquired/ Encumbrances (A) Land Improvements Acquisition Land Improvements (D) Total (E) Depreciation (B) Constructed Real Estate Investments Skilled Nursing Facilities Anniston, AL $ — $ 70 $ 4,477 $ — $ 70 $ 4,477 $ 4,547 $ 3,795 10/17/1991 Moulton, AL — 25 688 — 25 688 713 688 10/17/1991 Avondale, AZ — 453 6,678 — 453 6,678 7,131 4,642 8/13/1996 Brooksville, FL — 1,217 16,166 — 1,217 16,166 17,383 5,624 2/1/2010 Crystal River, FL — 912 12,117 — 912 12,117 13,029 4,216 2/1/2010 Dade City, FL — 605 8,042 — 605 8,042 8,647 2,798 2/1/2010 Hudson, FL (2 facilities) — 1,290 22,392 — 1,290 22,392 23,682 13,323 Various Merritt Island, FL — 701 8,869 — 701 8,869 9,570 7,832 10/17/1991 New Port Richey, FL — 228 3,023 — 228 3,023 3,251 1,052 2/1/2010 Plant City, FL — 405 8,777 — 405 8,777 9,182 7,687 10/17/1991 Stuart, FL — 787 9,048 — 787 9,048 9,835 8,146 10/17/1991 Trenton, FL — 851 11,312 — 851 11,312 12,163 3,935 2/1/2010 Glasgow, KY — 33 2,110 — 33 2,110 2,143 2,069 10/17/1991 Desloge, MO — 178 3,804 — 178 3,804 3,982 3,804 10/17/1991 Joplin, MO — 175 4,034 — 175 4,034 4,209 3,381 10/17/1991 Kennett, MO — 180 4,928 — 180 4,928 5,108 4,814 10/17/1991 Maryland Heights, MO — 150 4,790 — 150 4,790 4,940 4,675 10/17/1991 St. Charles, MO — 420 5,512 — 420 5,512 5,932 5,512 10/17/1991 Albany, OR — 190 10,415 — 190 10,415 10,605 2,959 3/31/2014 Creswell, OR — 470 8,946 — 470 8,946 9,416 2,439 3/31/2014 Forest Grove, OR — 540 11,848 — 540 11,848 12,388 3,286 3/31/2014 Anderson, SC — 308 4,643 — 308 4,643 4,951 4,504 10/17/1991 Greenwood, SC — 174 3,457 — 174 3,457 3,631 3,291 10/17/1991 Laurens, SC — 42 3,426 — 42 3,426 3,468 3,185 10/17/1991 Orangeburg, SC — 300 3,714 — 300 3,714 4,014 1,478 9/25/2008 Athens, TN — 38 1,463 — 38 1,463 1,501 1,377 10/17/1991 Chattanooga, TN — 143 2,309 — 143 2,309 2,452 2,300 10/17/1991 Dickson, TN — 90 3,541 — 90 3,541 3,631 3,294 10/17/1991 Franklin, TN — 47 1,130 — 47 1,130 1,177 1,130 10/17/1991 NATIONAL HEALTH INVESTORS, INC. SCHEDULE III - REAL ESTATE AND ACCUMULATED DEPRECIATION December 31, 2023 ($ in thousands) Costs Initial Cost to Company (C) Capitalized Date Buildings & Subsequent to Buildings & Accumulated Acquired/ Encumbrances (A) Land Improvements Acquisition Land Improvements (D) Total (E) Depreciation (B) Constructed Hendersonville, TN — 363 3,837 — 363 3,837 4,200 3,438 10/17/1991 Johnson City, TN — 85 1,918 — 85 1,918 2,003 1,917 10/17/1991 Lewisburg, TN (2 facilities) — 46 994 — 46 994 1,040 994 10/17/1991 McMinnville, TN — 73 3,618 — 73 3,618 3,691 3,283 10/17/1991 Milan, TN — 41 1,826 — 41 1,826 1,867 1,712 10/17/1991 Pulaski, TN — 53 3,921 — 53 3,921 3,974 3,536 10/17/1991 Lawrenceburg, TN — 98 2,900 — 98 2,900 2,998 2,509 10/17/1991 Dunlap, TN — 35 3,679 — 35 3,679 3,714 3,182 10/17/1991 Smithville, TN — 35 3,816 — 35 3,816 3,851 3,389 10/18/1991 Somerville, TN — 26 677 — 26 677 703 678 10/19/1991 Sparta, TN — 80 1,602 — 80 1,602 1,682 1,547 10/20/1991 Austin, TX — 606 9,895 — 606 9,895 10,501 2,232 4/1/2016 Canton, TX — 420 12,330 — 420 12,330 12,750 4,014 4/18/2013 Corinth, TX — 1,075 13,935 — 1,075 13,935 15,010 4,745 4/18/2013 Ennis, TX — 986 9,025 — 986 9,025 10,011 3,305 10/31/2011 Euless, TX — 1,241 12,629 — 1,241 12,629 13,870 3,070 4/1/2016 Fort Worth, TX — 1,380 14,370 — 1,380 14,370 15,750 2,738 5/10/2018 Garland, TX — 1,440 14,310 — 1,440 14,310 15,750 2,721 5/10/2018 Gladewater, TX — 70 17,840 — 70 17,840 17,910 3,835 4/1/2016 Greenville, TX — 1,800 13,948 — 1,800 13,948 15,748 4,886 10/31/2011 Houston, TX (3 facilities) — 2,808 42,511 — 2,808 42,511 45,319 15,482 Various Katy, TX — 610 13,893 — 610 13,893 14,503 3,159 4/1/2016 Kyle, TX — 1,096 12,279 — 1,096 12,279 13,375 4,346 6/11/2012 Marble Falls, TX — 480 14,989 — 480 14,989 15,469 3,331 4/1/2016 McAllen, TX — 1,175 8,259 — 1,175 8,259 9,434 2,045 4/1/2016 New Braunfels, TX — 1,430 13,666 — 1,430 13,666 15,096 3,174 2/24/2017 San Antonio, TX (3 facilities) — 2,370 40,054 — 2,370 40,054 42,424 11,730 Various Waxahachie, TX — 1,330 14,349 — 1,330 14,349 15,679 2,879 1/17/2018 Bristol, VA — 176 2,511 — 176 2,511 2,687 2,511 10/17/1991 Oak Creek, WI — 2,000 14,903 7,403 2,000 22,306 24,306 3,003 12/7/2018 — 34,450 516,143 7,403 34,450 523,546 557,996 226,627 NATIONAL HEALTH INVESTORS, INC. SCHEDULE III - REAL ESTATE AND ACCUMULATED DEPRECIATION December 31, 2023 ($ in thousands) Costs Initial Cost to Company (C) Capitalized Date Buildings & Subsequent to Buildings & Accumulated Acquired/ Encumbrances (A) Land Improvements Acquisition Land Improvements (D) Total (E) Depreciation (B) Constructed Assisted Living Facilities Rainbow City, AL — 670 11,330 — 670 11,330 12,000 3,211 10/31/2013 Sacramento, CA — 660 10,840 — 660 10,840 11,500 2,962 6/1/2014 Pueblo West, CO — 169 7,431 — 169 7,431 7,600 984 7/23/2019 Greensboro, GA — 672 4,849 631 672 5,480 6,152 1,694 9/15/2011 Ames, IA 3,193 360 4,670 — 360 4,670 5,030 1,377 6/28/2013 Burlington, IA 3,901 200 8,374 — 200 8,374 8,574 2,477 6/28/2013 Cedar Falls, IA — 260 4,700 30 260 4,730 4,990 1,428 6/28/2013 Ft. Dodge, IA 4,008 100 7,208 — 100 7,208 7,308 2,090 6/28/2013 Iowa City, IA — 297 2,725 33 297 2,758 3,055 1,040 6/30/2010 Marshalltown, IA 5,714 240 6,208 — 240 6,208 6,448 1,829 6/28/2013 Urbandale, IA 8,113 540 4,292 — 540 4,292 4,832 1,305 6/28/2013 Caldwell, ID — 320 9,353 — 320 9,353 9,673 2,558 3/31/2014 Aurora, IL — 1,195 11,713 — 1,195 11,713 12,908 2,743 5/9/2017 Bolingbrook, IL — 1,290 14,677 — 1,290 14,677 15,967 2,783 3/16/2017 Bourbonnais, IL 7,974 170 16,594 — 170 16,594 16,764 4,743 6/28/2013 Crystal Lake, IL (2 facilities) — 1,060 30,043 170 1,060 30,213 31,273 5,917 Various Gurnee, IL — 1,244 13,856 — 1,244 13,856 15,100 1,781 9/10/2019 Moline, IL 3,896 250 5,630 — 250 5,630 5,880 1,674 6/28/2013 Oswego, IL — 390 20,957 212 390 21,169 21,559 4,251 6/1/2016 Quincy, IL 6,055 360 12,403 — 360 12,403 12,763 3,596 6/28/2013 Rockford, IL 6,412 390 12,575 — 390 12,575 12,965 3,664 6/28/2013 South Barrington, IL — 1,610 13,456 — 1,610 13,456 — 15,066 2,604 3/16/2017 St. Charles, IL — 820 22,188 252 820 22,440 23,260 4,547 6/1/2016 Tinley Park, IL — 1,622 11,354 — 1,622 11,354 12,976 2,765 6/23/2016 Attica, IN — 284 7,891 — 284 7,891 8,175 874 5/1/2020 Carmel, IN — 463 7,055 — 463 7,055 7,518 2,346 11/12/2014 Crawfordsville, IN — 300 1,961 — 300 1,961 2,261 921 6/28/2013 Crown Point, IN — 574 7,336 353 574 7,689 8,263 2,473 10/30/2013 Greenwood, IN — 791 7,020 227 791 7,247 8,038 2,418 11/7/2013 Linton, IN — 60 6,015 — 60 6,015 6,075 668 5/1/2020 Bastrop, LA — 325 2,456 — 325 2,456 2,781 880 4/30/2011 Bossier City, LA — 500 3,344 — 500 3,344 3,844 1,230 4/30/2011 NATIONAL HEALTH INVESTORS, INC. SCHEDULE III - REAL ESTATE AND ACCUMULATED DEPRECIATION December 31, 2023 ($ in thousands) Costs Initial Cost to Company (C) Capitalized Date Buildings & Subsequent to Buildings & Accumulated Acquired/ Encumbrances (A) Land Improvements Acquisition Land Improvements (D) Total (E) Depreciation (B) Constructed Minden, LA — 280 1,698 — 280 1,698 1,978 606 4/30/2011 West Monroe, LA — 770 5,627 — 770 5,627 6,397 1,953 4/30/2011 Frederick, MD — 1,942 17,415 — 1,942 17,415 19,357 486 2/4/2023 Battle Creek, MI — 398 3,093 197 398 3,290 3,688 1,357 10/19/2009 Lansing, MI — 1,020 9,684 174 1,020 9,858 10,878 2,022 10/19/2009 Okemos, MI — 340 8,082 — 340 8,082 8,422 3,123 11/19/2009 Shelby, MI — 1,588 13,512 — 1,588 13,512 15,100 1,610 1/27/2020 Champlin, MN — 980 4,475 — 980 4,475 5,455 1,664 3/10/2010 Hugo, MN — 400 3,945 113 400 4,058 4,458 1,440 3/10/2010 Maplewood, MN — 1,700 6,544 — 1,700 6,544 8,244 2,433 3/10/2010 North Branch, MN — 595 3,053 — 595 3,053 3,648 1,165 3/10/2010 Mahtomedi, MN — 515 8,825 — 515 8,825 9,340 999 12/27/2019 Charlotte, NC — 650 17,663 2,000 650 19,663 20,313 4,642 7/1/2015 Durham, NC — 860 7,752 994 860 8,746 9,606 1,183 12/15/2017 Hendersonville, NC (2 facilities) — 3,120 12,980 — 3,120 12,980 16,100 2,661 3/16/2017 Lincoln, NE 8,418 380 10,904 — 380 10,904 11,284 3,116 6/28/2013 Omaha, NE (2 facilities) 2,455 1,110 15,437 851 1,110 16,288 17,398 4,099 Various Las Vegas, NV — 1,951 16,184 — 1,951 16,184 18,135 447 2/14/2023 Arlington, OH — 570 7,917 — 570 7,917 8,487 1,965 4/30/2018 Columbus, OH — 530 6,776 — 530 6,776 7,306 1,757 4/30/2018 Lancaster, OH — 530 20,530 — 530 20,530 21,060 5,224 7/31/2015 Middletown, OH — 940 15,548 — 940 15,548 16,488 4,059 10/31/2014 Rocky River, OH — 650 4,189 — 650 4,189 4,839 871 4/30/2018 Worthington, OH — — 18,869 1,476 — 20,345 — 20,345 3,996 4/30/2018 McMinnville, OR — 390 9,183 — 390 9,183 9,573 1,959 8/31/2016 Portland, OR — 930 25,270 — 930 25,270 26,200 4,622 8/31/2015 Erie, PA — 1,030 15,206 914 1,030 16,120 — 17,150 2,418 4/30/2018 Reading, PA — 1,027 11,179 — 1,027 11,179 12,206 1,536 5/31/2019 Manchester, TN — 534 6,068 — 534 6,068 6,602 522 6/3/2021 Chesapeake, VA — 1,746 15,542 — 1,746 15,542 17,288 436 2/9/2023 Fredericksburg, VA — 1,615 9,271 — 1,615 9,271 10,886 2,238 9/20/2016 Midlothian, VA — 1,646 8,635 — 1,646 8,635 10,281 2,155 10/31/2016 Suffolk, VA — 1,022 9,320 — 1,022 9,320 10,342 2,064 3/25/2016 Virginia Beach, VA — 2,052 15,148 — 2,052 15,148 17,200 451 11/10/2022 NATIONAL HEALTH INVESTORS, INC. SCHEDULE III - REAL ESTATE AND ACCUMULATED DEPRECIATION December 31, 2023 ($ in thousands) Costs Initial Cost to Company (C) Capitalized Date Buildings & Subsequent to Buildings & Accumulated Acquired/ Encumbrances (A) Land Improvements Acquisition Land Improvements (D) Total (E) Depreciation (B) Constructed Bellevue, WI — 504 11,796 — 504 11,796 12,300 1,192 9/30/2020 Oshkosh, WI — 542 12,758 — 542 12,758 13,300 608 4/29/2022 60,139 53,043 700,582 8,627 53,043 709,209 762,252 148,912 Independent Living Facilities Vero Beach, FL — 550 37,450 2,543 550 350 39,993 40,543 5,343 2/1/2019 Columbus, IN — 348 6,124 — 348 6,124 6,472 812 5/31/2019 St. Charles, MO — 344 3,181 — 344 3,181 3,525 2,778 10/17/1991 Tulsa, OK 16,102 1,980 32,620 502 1,980 33,122 35,102 5,698 12/1/2017 Chattanooga, TN — 9 1,567 1 9 1,568 1,577 1,473 10/17/1991 Johnson City, TN — 55 4,077 — 55 4,077 4,132 3,375 10/17/1991 Chehalis, WA — 1,980 7,710 7,445 1,980 15,155 17,135 2,686 1/15/2016 16,102 5,266 92,729 10,491 5,266 103,220 108,486 22,165 Senior Living Campuses Michigan City, IN — 974 22,667 — 974 22,667 23,641 2,973 5/31/2019 Portage, IN — 661 21,959 — 661 21,959 22,620 2,887 5/31/2019 Needham, MA — 5,500 45,157 1,451 5,500 46,608 52,108 7,268 1/15/2019 Salisbury, MD — 1,876 44,084 471 1,876 44,555 46,431 6,081 5/31/2019 Roscommon, MI — 44 6,005 1 44 6,006 6,050 1,525 8/31/2015 Mt. Airy, NC — 1,370 7,470 150 1,370 7,620 8,990 1,992 12/17/2014 McMinnville, OR — 410 26,667 — 410 26,667 27,077 5,375 8/31/2016 Silverdale, WA — 1,750 23,860 2,167 1,750 26,027 27,777 8,021 8/16/2012 — 12,585 197,869 4,240 12,585 202,109 214,694 36,122 NATIONAL HEALTH INVESTORS, INC. SCHEDULE III - REAL ESTATE AND ACCUMULATED DEPRECIATION December 31, 2023 ($ in thousands) Costs Initial Cost to Company (C) Capitalized Date Buildings & Subsequent to Buildings & Accumulated Acquired/ Encumbrances (A) Land Improvements Acquisition Land Improvements (D) Total (E) Depreciation (B) Constructed Entrance-Fee Communities Bridgeport, CT — 4,320 23,494 5,809 4,320 29,303 33,623 6,582 6/2/2016 North Branford, CT — 7,724 64,430 — 7,724 64,430 72,154 13,231 11/3/2016 Southbury, CT — 10,320 17,143 6,178 10,320 23,321 33,641 4,806 6/2/2016 Fernandina Beach, FL — 1,430 63,420 1,522 1,430 64,942 66,372 16,255 12/17/2014 St. Simons Island, GA — 8,770 38,070 963 8,770 39,033 47,803 9,930 12/17/2014 Winston-Salem, NC — 8,700 73,920 507 8,700 74,427 83,127 18,517 12/17/2014 Greenville, SC — 5,850 90,760 — 5,850 90,760 96,610 22,216 12/17/2014 Myrtle Beach, SC — 3,910 82,140 542 3,910 82,682 86,592 20,703 12/17/2014 Pawleys Island, SC — 1,480 38,620 460 1,480 39,080 40,560 10,088 12/17/2014 Spartanburg, SC — 900 49,190 1,021 900 50,211 51,111 12,615 12/17/2014 Issaquah, WA — 4,370 130,522 — 4,370 130,522 134,892 14,679 01/31/2020 — 57,774 671,709 17,002 57,774 688,711 746,485 149,622 Hospitals Tulsa, OK — 1,470 38,780 250 1,470 39,030 40,500 2,691 5/28/2021 — 1,470 38,780 250 1,470 39,030 40,500 2,691 Total real estate investments properties 76,241 164,588 2,217,812 48,013 164,588 2,265,825 2,430,413 586,139 Senior Housing Operating Independent Living Facilities Fort Smith, AR — 590 22,447 486 590 22,933 23,523 6,080 4/01/2022 Rogers, AR — 1,470 25,282 697 1,470 25,979 27,449 6,839 4/01/2022 Fresno, CA — 420 10,899 404 420 11,303 11,723 3,052 4/01/2022 Modesto, CA — 1,170 22,673 727 1,170 23,400 24,570 6,067 4/01/2022 Pinole, CA — 1,020 18,066 722 1,020 18,788 19,808 4,881 4/01/2022 Roseville, CA — 630 31,343 928 630 32,271 32,901 8,391 4/01/2022 West Covina, CA — 940 20,280 1,545 940 21,825 22,765 5,525 4/01/2022 Athens, GA — 910 31,940 1,085 910 33,025 33,935 8,601 4/01/2022 Columbus, GA — 570 8,639 663 570 9,302 9,872 2,515 4/01/2022 Voorhees, NJ — 670 23,710 1,292 670 25,002 25,672 6,417 4/01/2022 Gahanna, OH — 920 22,919 423 920 23,342 24,262 6,244 4/01/2022 NATIONAL HEALTH INVESTORS, INC. SCHEDULE III - REAL ESTATE AND ACCUMULATED DEPRECIATION December 31, 2023 ($ in thousands) Costs Initial Cost to Company (C) Capitalized Date Buildings & Subsequent to Buildings & Accumulated Acquired/ Encumbrances (A) Land Improvements Acquisition Land Improvements (D) Total (E) Depreciation (B) Constructed Broken Arrow, OK — 2,660 18,477 518 2,660 18,995 21,655 5,082 4/01/2022 Greenville, SC — 560 16,547 939 560 17,486 18,046 4,597 4/01/2022 Myrtle Beach, SC — 1,310 26,229 1,434 1,310 27,663 28,973 7,115 4/01/2022 Vancouver, WA — 1,030 19,183 2,027 1,030 21,210 22,240 5,254 4/01/2022 Total senior housing operating properties — 14,870 318,634 13,890 14,870 332,524 347,394 86,660 Corporate office — 1,291 677 583 1,291 1,260 2,551 477 $ 76,241 $ 180,749 $ 2,537,123 $ 62,486 $ 180,749 $ 2,599,609 $ 2,780,358 $ 673,276 NOTES TO SCHEDULE III - REAL ESTATE AND ACCUMULATED DEPRECIATION (A) See the notes to the consolidated financial statements. (B) Depreciation is calculated using estimated useful lives up to 40 years for all completed facilities. (C) Subsequent to NHC’s transfer of the original real estate properties in 1991, we purchased from NHC $33.9 million of additions to those properties. As the additions were purchased from NHC rather than developed by us, the $33.9 million has been included as Initial Cost to Company. (D) Includes construction in progress. (E) At December 31, 2023, the tax basis of the Company’s net real estate assets was $2.1 billion. NATIONAL HEALTH INVESTORS, INC. SCHEDULE III - REAL ESTATE AND ACCUMULATED DEPRECIATION FOR THE YEARS ENDED DECEMBER 31, 2023, 2022, AND 2021 ($ in thousands) December 31, 2023 2022 2021 Investment in Real Estate: Balance at beginning of period $ 2,729,898 $ 2,894,548 $ 3,265,070 Additions through cash expenditures 49,556 10,993 50,346 Change in accounts payable related to investments in real estate construction & equipment 325 (69) (388) Change in other assets related to investments in real estate 454 200 — Right of use asset in exchange for lease liability 101 — — Operating equipment received in lease termination — 1,287 — Real estate acquired in exchange for non-cash rental income 2,500 3,000 — Real estate acquired in exchange for mortgage notes receivable 14,200 23,071 — Sale of properties for cash (19,326) (104,691) (276,429) Properties classified as held for sale (11,970) (84,761) (137,651) Property reclassified as held for use 15,793 7,851 — Impairment of property (1,173) (21,531) (6,400) Balance at end of period $ 2,780,358 $ 2,729,898 $ 2,894,548 Accumulated Depreciation: Balance at beginning of period $ 611,688 $ 576,668 $ 597,638 Addition charged to costs and expenses 69,973 70,880 80,798 Amortization of right-of-use asset 38 36 36 Sale of properties (4,851) (25,643) (70,063) Properties classified as held for sale (6,965) (11,092) (31,741) Property reclassified as held for use 3,393 839 — Balance at end of period $ 673,276 $ 611,688 $ 576,668

Schedule IV - Mortgage Loans on

Schedule IV - Mortgage Loans on Real Estate Schedule IV - Mortgage Loans on Real Estate	12 Months Ended
	Dec. 31, 2023
Schedule IV - Mortgage Loans on Real Estate [Abstract]
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate	NATIONAL HEALTH INVESTORS, INC. SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE December 31, 2023 Monthly Amount Subject To Interest Maturity Payment Prior Original Carrying Delinquent Principal Rate Date Terms Liens Face Amount Amount or Interest ( $ in thousands ) First Mortgages: Skilled nursing facilities: Lexington, VA 8.0% 2032-12-31 $21,000 $ 3,089 $ 1,326 Brookneal, VA 8.0% 2031-12-31 $21,000 $ 2,780 $ 1,261 Austin/San Antonio, TX 7.25% 2027-11-30 Interest Only $ 42,500 $ 42,380 Assisted living facilities: Oviedo, FL 8.25% 2025-07-31 Interest Only $ 10,000 $ 10,000 Indianapolis, IN 7.0% 2022-12-31 Interest Only $ 6,423 $ 6,423 Wabash, IN 7.0% 2025-12-31 Interest Only $ 4,000 $ 2,094 Entrance-fee communities: Columbia, SC 7.25% 2024-12-31 Interest Only $ 32,700 $ 32,700 Second Mortgages: Winter Park, FL 12.0% 2025/10/31 Interest Only $ 1,550 $ 1,550 Construction Loans: Canton, MI 9.0% 2023-12-31 Interest Only $ 14,700 $ 14,700 Fitchburg, WI 8.50% 2026-01-28 Interest Only $ 28,525 $ 27,662 Sussex, WI 8.50% 2024-12-31 Interest Only $ 22,200 $ 22,337 $ 162,433 $ — At December 31, 2023, the tax basis of our mortgage loans on real estate was $175.2 million. Balloon payments on our interest only mortgage receivables are equivalent to the carrying amounts listed above except for unamortized commitment fees of $32.5 thousand. See the notes to our consolidated financial statements for more information on our mortgage loan receivables. NATIONAL HEALTH INVESTORS, INC. SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE FOR THE YEARS ENDED DECEMBER 31, 2023, 2022, AND 2021 ($ in thousands) December 31, 2023 2022 2021 Reconciliation of mortgage loans on real estate Balance at beginning of period $ 164,576 $ 230,927 $ 259,491 Additions: New mortgage loans 15,083 67,978 33,160 Amortization of loan discount and commitment fees 428 907 741 Total Additions 15,511 68,885 33,901 Deductions: Loan commitment fees received — 497 — Mortgage notes receivable related to investments in real estate 14,200 23,071 — Collection of principal, less recoveries of previous write-downs 3,454 111,668 62,465 Total Deductions 17,654 135,236 62,465 Balance at end of period $ 162,433 $ 164,576 $ 230,927

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Pay vs Performance Disclosure
Net income attributable to stockholders	$ 135,654	$ 66,403	$ 111,804

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Dec. 31, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Basis of Presentation and Sig_2

Basis of Presentation and Significant Accounting Policies (Policy)	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Principles of Consolidation	Principles of Consolidation - The consolidated financial statements include the accounts of the Company, and 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.
Variable Interest Entity	A VIE is broadly defined as an entity with one or more of the following characteristics: (a) the total equity investment at risk is insufficient to finance the entity’s activities without additional subordinated financial support; (b) as a group, the holders of the equity investment at risk lack (i) the ability to make decisions about the entity’s activities through voting or similar rights, (ii) the obligation to absorb the expected losses of the entity, or (iii) the right to receive the expected residual returns of the entity; or (c) the equity investors have voting rights that are not proportional to their economic interests, and substantially all of the entity’s activities either involve, or are conducted on behalf of, an investor that has disproportionately few voting rights. We evaluate our arrangements with VIEs to identify entities for which control is achieved through means other than voting rights and to determine which business enterprise is the primary beneficiary of the VIE. In accordance with FASB guidance, management must evaluate each of the Company’s contractual relationships which creates a variable interest in other entities. If the Company has a variable interest and the entity is a VIE, then management must determine whether the Company is the primary beneficiary of the VIE. If it is determined that the Company is the primary beneficiary, NHI would consolidate the VIE. We identify the primary beneficiary of a VIE as the enterprise that has both: (i) the power to direct the activities of the VIE that most significantly impact the entity’s economic performance; and (ii) the obligation to absorb losses or the right to receive benefits of the VIE that could be significant to the entity. We perform this analysis on an ongoing basis. If the Company has determined that an entity is not a VIE, the Company assesses the need for consolidation under all other provisions of Accounting Standards Codification (“ASC”) Topic 810, Consolidation . These provisions provide for consolidation of majority-owned entities where a majority voting interest held by the Company demonstrates control of such entities in the absence of any legal constraints. Effective April 1, 2022 and at December 31, 2023, our consolidated total assets and liabilities include two consolidated ventures comprising our SHOP activities, each formed with a separate partner - Merrill Gardens, L.L.C. (“Merrill”) and DSHI NHI Holiday LLC (the “Discovery member”), a related party of Discovery Senior Living (“Discovery”). We consider both ventures to be VIEs as the members of each, as a group, lack the characteristics of a controlling financial interest. We are deemed to be the primary beneficiary of each VIE because we have the ability to control the activities that most significantly impact each VIE’s economic performance. Reference Notes 5 and 17 for further discussion of our SHOP ventures. We also consolidate two real estate partnerships formed with our partners, Discovery Senior Housing Investor XXIV, LLC, a related party of Discovery, beginning in June 2019, and LCS Timber Ridge LLC (“LCS”), beginning in January 2020, to invest in senior housing facilities. We consider both partnerships to be VIEs as either the members, as a group, lack the characteristics of a controlling financial interest or the total equity at risk is insufficient to finance activities without additional subordinated financial support. NHI directs the activities that most significantly impact economic performance of these partnerships, 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. Reference Note 17 for further discussion of these real estate partnerships. 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. We have concluded that the Company is not the primary beneficiary for certain investments where we lack either directly or through related parties the power to direct the activities that most significantly impact the investments’ economic performance. Accordingly, we account for our transactions with these entities and their subsidiaries at either amortized cost or net realizable value for straight-line rents receivable, excluding our investments accounted for under the equity method. See Note 17 for information on unconsolidated VIEs.
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 December 31, 2023 and 2022, the Merrill SHOP venture noncontrolling interest was classified in mezzanine equity, as discussed further in Note 10.
Use of Estimates	Use of Estimates - The preparation of consolidated financial statements in conformity with accounting principles generally accepted in the U.S. requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the financial statements, and the reported amounts of revenues and expenses during the reporting period. Significant assumptions and estimates include purchase price allocations to record investments in real estate, impairment of real estate, and allowance for credit losses. Actual results could differ from those estimates.
Earnings Per Share	Earnings Per Share - Our unvested restricted stock awards contain non-forfeitable rights to dividends, and accordingly, these awards are deemed to be participating securities. Therefore, the Company applies the two-class method to calculate basic and diluted earnings. Under the two-class method, we allocate net income attributable to stockholders to common stockholders and holders of unvested restricted stock by using the weighted-average shares of each class outstanding for quarter-to-date and year-to-date periods, based on their respective participation rights to dividends declared and undistributed earnings. Basic earnings per common share is computed by dividing net income attributable to common stockholders by the weighted number of shares of common stock outstanding during the period. Diluted earnings per common share reflects the effect of dilutive securities. We apply the treasury stock method to any convertible debt instruments, the effect of which is that conversion will not be assumed for purposes of computing diluted earnings per share unless the average share price of our common stock for the period exceeds the conversion price per share. Diluted earnings per share for the year ended December 31, 2021 includes the potential dilutive impact of our convertible debt that was repaid in 2021. Reclassifications - In prior years, the Company presented " Cumulative dividends in excess of net income " as a single line item on the Consolidated Balance Sheets and the Consolidated Statements of Equity. Beginning January 1, 2023, the Company separated this line item into two components, " Retained earnings " and " Cumulative dividends, " and reclassified prior year information to conform to the current period presentation.
Fair Value Measurements	Fair Value Measurements - Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants at the measurement date. A three-level fair value hierarchy is required to prioritize the inputs used to measure fair value. This hierarchy requires entities to maximize the use of observable inputs and minimize the use of unobservable inputs. The three levels of inputs used to measure fair value are as follows: Level 1 - Quoted prices in active markets for identical assets or liabilities. Level 2 - Observable inputs other than quoted prices included in Level 1, such as quoted prices for similar assets and liabilities in active markets; quoted prices for identical or similar assets and liabilities in markets that are not active; or other inputs that are observable or can be corroborated by observable market data. Level 3 - Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities. This includes certain pricing models, discounted cash flow methodologies and similar techniques that use significant unobservable inputs. If the fair value measurement is based on inputs from different levels of the hierarchy, the level within which the entire fair value measurement falls is the lowest level input that is significant to the fair value measurement in its entirety. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability. When an event or circumstance alters our assessment of the observability and thus the appropriate classification of an input to a fair value measurement which we deem to be significant to the fair value measurement as a whole, we will transfer that fair value measurement to the appropriate level within the fair value hierarchy.
Real Property Owned	Real Property Owned - Real estate properties are recorded at cost or, if acquired through business combination, at fair value, including the fair value of contingent consideration, if any. Cost or fair value at the time of acquisition is allocated among land, buildings, improvements, personal property and lease and other intangibles. For properties acquired in transactions accounted for as asset purchases, the purchase price, which includes transaction costs, is allocated based on the relative fair values of the assets acquired. Cost includes the amount of contingent consideration, if any, deemed to be probable at the acquisition date. Contingent consideration is deemed to be probable to the extent that a significant reversal in amounts recognized is not likely to occur when the uncertainty associated with the contingent consideration is subsequently resolved. Cost also includes capitalized interest during construction periods. We use the straight-line method of depreciation for buildings over their estimated useful lives of 40 years, and improvements, including any equipment related to the SHOP segment, over their estimated useful lives ranging from 5 to 25 years. For contingent consideration arising from business combinations, the liability is adjusted to estimated fair value at each reporting date through earnings. Expenditures for repairs and maintenance are expensed as incurred.
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 or significant deterioration of the underlying cash flows of the long-lived assets, indicate that the carrying amount of the long-lived asset 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 of the property exceeds the estimated fair value of the long-lived asset.
Leases	Leases - All of our leases within the Real Estate Investment segment are classified as operating leases and generally have an initial leasehold term of 10 to 15 years followed by one or more five-year tenant renewal options. The leases are “triple-net leases” under which the tenant is responsible for the payment of all taxes, utilities, insurance premiums, repairs and other charges relating to the operation of the properties, including required levels of capital expenditures each year. The tenant is obligated at its expense to keep all improvements, fixtures and other components of the properties covered by “all risk” insurance in an amount equal to at least the full replacement cost thereof, and to maintain specified minimal personal injury and property damage insurance. The leases also require the tenant to indemnify and hold us harmless from all claims resulting from the use, occupancy and related activities of each property by the tenant, and to indemnify us against all costs related to any release, discovery, clean-up and removal of hazardous substances or materials, or other environmental responsibility with respect to each facility. While we do not incorporate residual value guarantees, the lease provisions and considerations discussed above impact our expectation of realizable value from our properties upon the expiration of their lease terms. The residual value of our real estate under lease is still subject to various market, asset, and tenant-specific risks and characteristics. As the classification of our leases is dependent on the fair value of estimated cash flows at lease commencement, management’s projected residual values represent significant assumptions in our accounting for operating leases. Similarly, the exercise of renewal options is also subject to these same risks, making a tenant’s lease term another significant variable in a lease’s cash flows. Initial direct costs that are incremental to entering into a lease are capitalized in accordance with the provisions of ASC Topic 842. FASB Lease Modifications Related to Effects of the COVID-19 Pandemic
Financial Instruments - Credit Losses	Financial Instruments - Credit Losses - We estimate and record an allowance for credit losses upon origination of the loan, based on expected credit losses over the term of the loan and update this estimate each reporting period. We calculate the estimated credit losses on mortgages by pooling these loans into two groups – investments in existing or new mortgages and construction mortgages. Mezzanine, revolving lines of credit and loans designated as non-performing are evaluated at the individual loan level. We estimate the allowance for credit losses by utilizing a loss model that relies on future expected credit losses, rather than incurred losses. This loss model incorporates our historical experience, adjusted for current conditions and our forecasts, using the probability of default and loss given default method. Incorporated into the construction mortgage loss model is an estimate of the probability that NHI will acquire the property. Using the resulting estimate, a portion of the outstanding construction mortgage balance which we currently expect will be reduced by our acquisition of the underlying property when construction is complete, is deducted from the construction mortgage balance included in the expected loss calculation. Mezzanine loans, revolving lines of credit and loans designated as non-performing are also based on the loss model to recognize expected future credit losses and are applied to each individual loan using borrower specific information. We also perform a qualitative assessment beyond model estimates and apply adjustments as necessary. The credit loss estimate is based on the net amortized cost balance of our mortgage and other notes receivables as of the balance sheet date. Calculation of the allowance for credit losses involves significant judgment. It is possible that actual credit losses will differ materially from our current estimates. Write-offs are deducted from the allowance for credit losses when we judge the principal to be uncollectible.
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 exchange agreement pursuant to Section 1031 of the Internal Revenue Code of 1986, as amended (the “Internal Revenue Code”) or in accordance with agency agreements governing our mortgages).
Assets Held for Sale	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. If a property subsequently no longer meets the criteria to be classified as held for sale, it is reclassified as held and used and measured at the lower of i) its original carrying amount before the asset was classified as held for sale, adjusted for any depreciation expense not recognized while it was classified as held for sale, and ii) its fair value.
Concentration of Credit Risks	Concentration of Credit Risks - Our credit risks primarily relate to cash and cash equivalents and investments in mortgage and other notes receivable. Cash and cash equivalents are primarily held in bank accounts and overnight investments. We maintain our bank deposit accounts with large financial institutions in amounts that may exceed federally insured limits. We have not experienced any losses in such accounts. Our mortgages and other notes receivable consist primarily of secured loans on facilities. Our financial instruments, principally our investments in notes receivable, are subject to the possibility of loss of the carrying values as a result of the failure of other parties to perform according to their contractual obligations which may make the instruments less valuable. We obtain collateral in the form of mortgage liens and other protective rights for notes receivable and continually monitor these rights in order to reduce such possibilities of loss. We evaluate the need to provide for reserves for potential losses on our financial instruments based on management’s periodic review of our portfolio on an instrument-by-instrument basis.
Deferred Loan Costs and Deferred Income	Deferred Loan Costs - Costs incurred to acquire debt are capitalized and amortized by the straight-line method, which approximates the effective-interest method, over the term of the related debt. Deferred Income - Deferred income primarily includes rents received in advance from tenants and residents and non-refundable commitment fees received by us, which are amortized into income over the expected period of the related loan or lease. In the event that our financing commitment to a potential borrower or tenant expires, the related commitment fees are recognized into income immediately. Commitment fees may be charged based on the terms of the lease agreements and the creditworthiness of the parties.
Rental Income	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. Under certain leases, we receive additional contingent rent, which is calculated on the increase in revenues of the tenant over a target threshold. We recognize contingent rent periodically based on the actual revenues of the tenant once the target threshold has been achieved. Lease payments that depend on a factor directly related to future use of the property, such as an increase in annual revenues over a base year, are considered to be contingent rent payments and are excluded from the determination of minimum lease payments. If rental income calculated on a straight-line basis exceeds the cash rent due under a lease, the difference is recorded as an increase to straight-line rents receivable in the Consolidated Balance Sheets and an increase in rental income in the Consolidated Statements of Income. If rental income on a straight-line basis is calculated to be less than cash received, there is a decrease in the same accounts. Property operating expenses that are reimbursed by our operators are recorded as “ Rental income” in the Consolidated Statements of Income. Accordingly, we record a corresponding expense, reflected in “ Taxes and insurance on leased properties” in the Consolidated Statements of Income. Rental income includes reimbursement of property operating expenses for the years ended December 2023, 2022 and 2021, totaling $11.5 million, $9.8 million and $11.6 million, respectively. Rental income is reduced for the non-cash amortization of payments made upon the eventual settlement of commitments and contingencies originally identified and recorded as lease inducements. We record lease inducements to the extent that it is probable that a significant reversal of amounts recognized will not occur when the uncertainty associated with the contingent consideration is subsequently resolved. The Company reviews its operating lease receivables for collectability 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 collectability 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. As of December 31, 2023, we had three tenants, including Bickford Senior Living (“Bickford”), on the cash basis of revenue recognition for their lease arrangements. During the year ended December 31, 2022, we placed three operators on the cash basis of rental income recognition. During the year ended December 31, 2021, we placed Holiday Retirement (“Holiday”) on cash basis for its master lease which was terminated in 2022 upon the formation of the SHOP ventures. Reference Note 3 for further discussion of cash basis tenants. Resident Fees and Services - Resident fee and services revenue associated with our SHOP activities is recognized as the related performance obligations are satisfied and includes resident room charges, community fees and other resident charges. Residency agreements are generally short term (30 days to one year), and entitle the resident to certain room and care services for a monthly fee billed in advance. Revenue for certain related services is billed monthly in arrears. The Company has elected the lessor practical expedient within ASC Topic 842, Leases, not to separate the lease and nonlease components within our resident agreements as the timing and pattern of transfer to the resident are the same. The Company has determined that the nonlease component is the predominant component within the contract and will recognize revenue under ASC Topic 606, Revenue Recognition from Contracts with Customers .
Interest Income from Mortgage and Other Notes Receivable	Interest Income from Mortgage and Other Notes Receivable - Interest income is recognized based on the interest rates and principal amounts outstanding on the notes receivable. We identify a mortgage note as non-performing based on various criteria including timeliness of required payments, compliance with other provisions under the related note agreement, and an evaluation of the borrower’s current financial condition for indicators that it is probable it cannot pay its contractual amounts. A non-performing loan is returned to accrual status at such time as the note becomes contractually current and management believes all future principal and interest will be received according to the contractual terms of the note. As of December 31, 2023, we had two mortgage notes receivable and a mezzanine loan totaling an aggregate of $26.6 million with affiliates of two operators/borrowers, including Bickford, designated as non-performing.
Derivatives	Derivatives - In the normal course of business, we are subject to risk from adverse fluctuations in interest rates. Occasionally, we may choose to manage this risk through the use of derivative financial instruments, primarily interest rate swaps. Counterparties to these contracts are major financial institutions. We are exposed to credit loss in the event of nonperformance by these counterparties. We do not use derivative instruments for trading or speculative purposes. Our objective in managing exposure to market risk is to limit the impact on cash flows relating to the change in market interest rates on our variable rate debt. To qualify for hedge accounting, our interest rate swaps must effectively reduce the risk exposure that they are designed to hedge. In addition, at inception of a qualifying cash flow hedging relationship, the underlying transaction or transactions must be, and be expected to remain, probable of occurring in accordance with our related assertions. All of our hedges are cash flow hedges. We recognize all derivative instruments, including embedded derivatives required to be bifurcated, as assets or liabilities at their fair value in the Consolidated Balance Sheets. Changes in the fair value of derivative instruments that are not designated as hedges or that do not meet the criteria of hedge accounting are recognized in earnings. For derivatives designated in qualifying cash flow hedging relationships, the change in fair value of the effective portion of the derivatives is recognized in accumulated other comprehensive income (loss), whereas the change in fair value of any ineffective portion is recognized in earnings. Gains and losses are reclassified from accumulated other comprehensive income (loss) into earnings once the underlying hedged transaction is recognized in earnings.
Income Tax	Income Taxes - We intend at all times to qualify as a REIT under Sections 856 through 860 of the Internal Revenue Code. 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 equal to or in excess of 90% of our taxable income. 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. Certain activities that we undertake may be conducted by subsidiary entities that have elected to be treated as 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. Earnings and profits, which determine the taxability of dividends to stockholders, differ from net income reported for financial reporting purposes due primarily to differences in the basis of assets, estimated useful lives used to compute depreciation expense, gains on sales of real estate, non-cash compensation expense and recognition of commitment fees. Our tax returns filed for years beginning in 2020 are subject to examination by taxing authorities. We classify interest and penalties related to uncertain tax positions, if any, in our Consolidated Statements of Income as a component of income tax expense.
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 primarily 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 independent managers pursuant to the terms of separate management agreements. Reference Notes 5 and 16 for additional information.
Recent Accounting Pronouncements	Recent Accounting Pronouncements -

Basis of Presentation and Sig_3

Basis of Presentation and Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Schedule of Cash and Cash Equivalents	The following table sets forth our “ Cash and cash equivalents and restricted cash ” reported within the Company’s Consolidated Statements of Cash Flows ( $ in thousands ): As of December 31, 2023 2022 Beginning of period: Cash and cash equivalents $ 19,291 $ 37,412 Restricted cash (included in Other assets, net ) 2,225 2,073 Cash, cash equivalents, and restricted cash $ 21,516 $ 39,485 End of period: Cash and cash equivalents $ 22,347 $ 19,291 Restricted cash (included in Other assets, net ) 2,270 2,225 Cash, cash equivalents, and restricted cash $ 24,617 $ 21,516
Restrictions on Cash and Cash Equivalents	The following table sets forth our “ Cash and cash equivalents and restricted cash ” reported within the Company’s Consolidated Statements of Cash Flows ( $ in thousands ): As of December 31, 2023 2022 Beginning of period: Cash and cash equivalents $ 19,291 $ 37,412 Restricted cash (included in Other assets, net ) 2,225 2,073 Cash, cash equivalents, and restricted cash $ 21,516 $ 39,485 End of period: Cash and cash equivalents $ 22,347 $ 19,291 Restricted cash (included in Other assets, net ) 2,270 2,225 Cash, cash equivalents, and restricted cash $ 24,617 $ 21,516

Investment Activity (Tables)

Investment Activity (Tables)	12 Months Ended
	Dec. 31, 2023
Real Estate [Abstract]
Schedule of Business Acquisitions, by Acquisition	During the year ended December 31, 2023, we completed the following real estate acquisitions within our Real Estate Investments segment ( $ in thousands ): Operator Date Properties Asset Class Land Building and Improvements Total Silverado Senior Living Q1 2023 2 ALF $ 3,894 $ 33,599 $ 37,493 Bickford Q1 2023 1 ALF 1,746 15,542 17,288 $ 5,640 $ 49,141 $ 54,781 During the year ended December 31, 2022, we completed the following real estate acquisitions within our Real Estate Investments segment ( $ in thousands ): Operator Date Properties Asset Class Land Building and Improvements Total Encore Senior Living Q2 2022 1 ALF $ 542 $ 12,758 $ 13,300 Bickford Q4 2022 1 ALF 2,052 15,148 17,200 $ 2,594 $ 27,906 $ 30,500
Schedule of Asset Disposition	During the year ended December 31, 2023, we completed the following real estate property dispositions within our Real Estate Investments segment ( $ in thousands ): Operator Date Properties Asset Class Net Proceeds Net Real Estate Investment Gain Impairment 2 BAKA Enterprises, LLC 1,3 Q1 2023 1 ALF $ 7,478 $ 7,505 $ — $ 27 Bickford 1 Q1 2023 1 ALF 2,553 1,421 1,132 — Chancellor Health Care 1,3 Q2 2023 1 ALF 2,355 1,977 378 — Milestone Retirement 1,3,4 Q2 2023 2 ALF 3,803 3,934 — 131 Chancellor Health Care 1,3 Q2 2023 1 ALF 7,633 6,140 1,493 — Milestone Retirement 1,3,4 Q2 2023 1 ALF 1,602 1,452 150 — Chancellor Health Care Q2 2023 1 ALF 23,724 14,476 9,248 — Chancellor Health Care 1,3 Q3 2023 1 ALF 2,923 2,292 631 — Senior Living Management 1,4 Q4 2023 2 ALF 5,522 4,770 752 — Senior Living Management 1,3 Q4 2023 1 ALF 1,515 1,100 415 — 12 $ 59,108 $ 45,067 $ 14,199 $ 158 1 Assets were previously classified as “ Assets held for sale ” in the Consolidated Balance Sheet at December 31, 2022. 2 Impairments are included in “ Loan and realty losses, net ” in the Consolidated Statements of Income for the year ended December 31, 2023. 3 Total aggregate impairment charges previously recognized on these properties were $0.3 million and $17.4 million for the years ended December 31, 2023 and 2022, respectively. 4 The Company provided aggregate financing of approximately $2.2 million, net of discounts, on these transactions in the form of notes receivable, which is included net proceeds. During the year ended December 31, 2022, we completed the following real estate property dispositions within our Real Estate Investments segment ( $ 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 2 Q2 2022 1 ILF 2,990 3,020 — 30 Chancellor Health Care 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 38,444 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 — 22 $ 168,989 $ 143,038 $ 28,342 $ 2,391 1 Impairments are included in “ Loan and realty losses, net ” in the Consolidated Statement of Income for the year ended December 31, 2022. 2 Total impairment charges recognized on these properties were $28.5 million for the year ended December 31, 2022.
Schedule of Disclosure of Long Lived Assets Held-for-sale	The following is a summary of our assets held for sale ( $ in thousands ): For the Year Ended December 31, 2023 2022 Number of facilities 1 13 Real estate, net $5,004 $43,302
Schedule of Tenant Concentrations	The following table contains information regarding tenant concentration, excluding $2.6 million for our corporate office, $347.4 million for the SHOP segment, and a credit loss reserve of $15.5 million, based on the percentage of revenues for the years ended December 31, 2023, 2022 and 2021 related to tenants or affiliates of tenants, that exceed 10% of total revenue ( $ in thousands ): As of December 31, 2023 Revenues 1 Asset Gross Real Notes Year Ended December 31, Class Estate 2 Receivable 2023 2022 2021 Senior Living Communities EFC $ 573,631 $ 48,950 $ 51,274 16% $ 51,183 18% $ 50,726 17% NHC SNF 133,770 — 37,335 12% 36,893 13% 37,735 12% Bickford 3 ALF 429,043 16,795 38,688 12% N/A N/A 34,599 12% All others, net Various 1,293,969 195,002 132,216 41% 144,534 52% 164,017 55% Escrow funds received from tenants for property operating expenses Various — — 11,513 4% 9,788 4% 11,638 4% $ 2,430,413 $ 260,747 271,026 242,398 298,715 Resident fees and services 4 48,809 15% 35,796 13% — —% $ 319,835 $ 278,194 $ 298,715 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 Revenues included in All others, net for years when less than 10%. 4 There is no tenant concentration in resident fees and services because these agreements are with individual residents.
Schedule of NHC Percentage Rent	The following table summarizes the percentage rent income from NHC ( $ in thousands ): Year Ended December 31, 2023 2022 2021 Current year $ 3,862 $ 3,332 $ 3,536 Prior year final certification 1 630 (206) (5) Total percentage rent income $ 4,492 $ 3,126 $ 3,531 1 For purposes of the percentage rent calculation described in the master lease agreement, NHC’s annual revenue by facility for a given year is certified to NHI by March 31st of the following year.
Schedule of Supplemental Balance Sheet Information Related to Lease	Supplemental balance sheet information related to the lease is as follows ( $ in thousands ): As of December 31, 2023 2022 Buildings and improvements - right of use asset $ 1,562 $ 1,599 Accounts payable and accrued expenses - lease liability $ 1,705 $ 1,724
Schedule of Lessor, Operating Lease, Payment to be Received, Fiscal Year Maturity	Future Minimum Lease Payments Future minimum lease payments to be received by us under our operating leases, including cash basis tenants, at December 31, 2023 are as follows ( $ in thousands ): Year Ending December 31, Amount 2024 $ 232,059 2025 237,981 2026 244,581 2027 198,598 2028 192,179 Thereafter 684,840 $ 1,790,238
Schedule of Fixed and Variable Lease Payments	Variable Lease Payments Most of our existing leases contain annual escalators in rent payments. 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 ): Year Ended December 31, 2023 2022 2021 Lease payments based on fixed escalators and deferral repayments $ 225,565 $ 226,873 $ 241,172 Lease payments based on variable escalators 7,709 5,275 4,662 Straight-line rent income, net of write-offs 6,961 (16,681) 14,603 Escrow funds received from tenants for property operating expenses 11,513 9,788 11,638 Amortization and write-off of lease incentives (2,521) (7,555) (1,026) Rental income $ 249,227 $ 217,700 $ 271,049

Mortgage and Other Notes Rece_2

Mortgage and Other Notes Receivable (Tables)	12 Months Ended
	Dec. 31, 2023
Mortgage and Other Notes Receivable [Abstract]
Schedule of Financing Receivable Credit Quality Indicators	The credit quality indicator as of December 31, 2023, is presented below for the amortized cost, net by year of origination of ( $ in thousands ): 2023 2022 2021 2020 2019 Prior Total Mortgages more than 1.5x $ — $ 70,042 $ — $ 22,337 $ 32,700 $ 2,587 $ 127,666 between 1.0x and 1.5x 1,550 — — — — 14,700 16,250 less than 1.0x — — — — 6,423 — 6,423 1,550 70,042 — 22,337 39,123 17,287 150,339 Mezzanine more than 1.5x 720 — 14,933 — — — 15,653 between 1.0x and 1.5x — — 23,934 — — — 23,934 less than 1.0x — — — — — 25,000 25,000 720 — 38,867 — — 25,000 64,587 Non-performing less than 1.0x — — — 2,095 — 24,500 26,595 — — — 2,095 — 24,500 26,595 Revolver between 1.0x and 1.5x 19,226 19,226 Credit loss reserve (15,476) $ 245,271
Schedule of Financing Receivable, Allowance for Credit Loss, Roll Forward	The allowance for expected credit losses is presented in the following table for the year ended December 31, 2023 ( $ in thousands ): Balance at January 1, 2023 $ 15,338 Provision for expected credit losses 138 Balance at December 31, 2023 $ 15,476

Other Assets (Tables)

Other Assets (Tables)	12 Months Ended
	Dec. 31, 2023
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Schedule of Other Assets	Other assets, net consist of the following ( $ in thousands ): December 31, 2023 December 31, 2022 SHOP accounts receivable, net of allowance of $343 and $375, and other assets $ 1,620 $ 1,341 Real estate investments accounts receivable and prepaid expenses 3,296 3,621 Lease incentive payments, net 10,669 3,190 Regulatory escrows 6,208 6,208 Restricted cash 2,270 2,225 $ 24,063 $ 16,585

Debt (Tables)

Debt (Tables)	12 Months Ended
	Dec. 31, 2023
Debt Instruments [Abstract]
Schedule of Long-term Debt Instruments	Debt consists of the following ( $ in thousands ): December 31, December 31, 2022 Revolving credit facility - unsecured $ 245,000 $ 42,000 Bank term loans - unsecured 200,000 240,000 2031 Senior Notes - unsecured, net of discount of $2,278 and $2,600 397,722 397,400 Private placement notes - unsecured 225,000 400,000 Fannie Mae term loans - secured, non-recourse 76,241 76,649 Unamortized loan costs (8,912) (8,538) $ 1,135,051 $ 1,147,511
Schedule of Maturities of Long-term Debt	Aggregate principal maturities of debt as of December 31, 2023 for each of the next five years and thereafter are included in the table below. These maturities do not include the impact of any debt incurred or repaid subsequent to December 31, 2023 ( $ in thousands ): For The Year Ending December 31, Amount 2024 $ 75,425 2025 325,816 2026 245,000 2027 100,000 2028 — Thereafter 400,000 1,146,241 Less: discount (2,278) Less: unamortized loan costs (8,912) $ 1,135,051
Schedule of Unsecured Term Loans	Our remaining unsecured private placement notes as of December 31, 2023, payable interest-only, are summarized below ( $ in thousands ): Amount Inception Maturity Fixed Rate $ 75,000 September 2016 September 2024 3.93 % 50,000 November 2015 November 2025 4.33 % 100,000 January 2015 January 2027 4.51 % $ 225,000
Schedule of Interest Expense	The following table summarizes interest expense ( $ in thousands ): Year Ended December 31, 2023 2022 2021 Interest expense on debt at contractual rates $ 55,603 $ 42,487 $ 40,866 Losses reclassified from accumulated other comprehensive income into interest expense — — 7,286 Capitalized interest (90) (46) (40) Amortization of debt issuance costs, debt discount and other 2,647 2,476 2,698 Total interest expense $ 58,160 $ 44,917 $ 50,810

Commitments, Contingencies an_2

Commitments, Contingencies and Uncertainties (Tables)	12 Months Ended
	Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Schedule of Loan Commitments	The tables below summarize our existing, known commitments and contingencies as of December 31, 2023 according to the nature of their impact on our leasehold or loan portfolios ($ in thousands) : Asset Class Type Total Funded Remaining Loan Commitments: Encore Senior Living SHO Construction $ 50,725 $ (49,846) $ 879 Senior Living SHO Revolving Credit 20,000 (16,250) 3,750 Timber Ridge OpCo SHO Working Capital 5,000 — 5,000 Watermark Retirement SHO Working Capital 5,000 (2,976) 2,024 Montecito Medical Real Estate MOB Mezzanine Loan 50,000 (20,255) 29,745 $ 130,725 $ (89,327) $ 41,398
Schedule of 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 Consolidated Balance Sheets as of December 31, 2023 and 2022 is presented in the following table for the year ended December 31, 2023 ( $ in thousands ): Balance at December 31, 2022 $ 683 Provision for expected credit losses (404) Balance at December 31, 2023 $ 279
Schedule of Lease Commitments	Asset Class Type Total Funded Remaining Development Commitments: Woodland Village SHO Renovation $ 7,515 $ (7,425) $ 90 Navion Senior Solutions SHO Renovation 3,500 (2,059) 1,441 Vizion Health SHO Renovation 2,000 (250) 1,750 SHOP ILF Renovation 1,500 (1,221) 279 $ 14,515 $ (10,955) $ 3,560
Schedule of Loss Contingencies by Contingency	As of December 31, 2023, we had the following contingent lease inducement commitments which are generally based on the performance of facility operations and may or may not be met by the tenant ( $ in thousands ): Asset Class Total Funded Remaining Contingencies (Lease Inducements): IntegraCare SHO $ 750 — $ 750 Navion Senior Solutions SHO 4,850 (2,700) 2,150 Discovery SHO 4,000 — 4,000 Ignite Medical Resorts SNF 2,000 — 2,000 $ 11,600 $ (2,700) $ 8,900

Redeemable Noncontrolling Int_2

Redeemable Noncontrolling Interest (Tables)	12 Months Ended
	Dec. 31, 2023
Noncontrolling Interest [Abstract]
Schedule of Redeemable Noncontrolling Interest	The following table presents the change in “ Redeemable noncontrolling interest ” for the years ended December 31, 2023 and 2022 ( $ in thousands ): Year Ended December 31, 2023 2022 Balance at January 1, $ 9,825 $ — Initial carrying amount — 11,738 Reclassification of Discovery member noncontrolling interest — (1,030) Contributions 922 — Net loss (1,091) (843) Distributions — (40) Balance at December 31, $ 9,656 $ 9,825

Equity and Dividends (Tables)

Equity and Dividends (Tables)	12 Months Ended
	Dec. 31, 2023
Equity [Abstract]
Schedule of Dividends Declared	The following table summarizes dividends declared or paid by the Board of Directors during the years ended December 31, 2023 and 2022: Year Ended December 31, 2023 Date of Declaration Date of Record Date Paid/Payable Quarterly Dividend February 17, 2023 March 31, 2023 May 5, 2023 $0.90 May 5, 2023 June 30, 2023 August 4, 2023 $0.90 August 4, 2023 September 29, 2023 November 3, 2023 $0.90 November 3, 2023 December 29, 2023 January 26, 2024 $0.90 Year Ended December 31, 2022 Date of Declaration Date of Record Date Paid/Payable Quarterly Dividend 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 November 6, 2022 December 30, 2022 January 27, 2023 $0.90

Share-Based Compensation (Table

Share-Based Compensation (Tables)	12 Months Ended
	Dec. 31, 2023
Share-Based Payment Arrangement [Abstract]
Schedule of 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 Consolidated Statements of Income ( $ in thousands ): December 31, 2023 December 31, 2022 December 31, 2021 Shared-based compensation components: Restricted stock expense $ 310 $ — $ — Stock option expense 4,295 8,613 8,415 Total share-based compensation expense $ 4,605 $ 8,613 $ 8,415
Schedule of Stock Option 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: December 31, 2023 December 31, 2022 December 31, 2021 Dividend yield 6.9% 7.0% 6.7% Expected volatility 39.0% 49.3% 48.1% Expected lives 2.9 years 2.9 years 2.9 years Risk-free interest rate 4.56% 1.75% 0.33%
Schedule of Stock Option Activity	The following tables summarize our outstanding stock options: Weighted Average Number Weighted Average Remaining of Shares Exercise Price Contractual Life (Years) Outstanding December 31, 2020 1,033,838 $83.54 Options granted under 2012 Plan 12,500 $69.20 Options granted under 2019 Plan 639,500 $69.20 Options exercised under 2012 Plan (20,000) $60.52 Options forfeited under 2019 Plan (13,333) $90.79 Outstanding December 31, 2021 1,652,505 $78.10 Options granted under 2019 Plan 718,000 $53.62 Options exercised under 2019 Plan (56,832) $53.41 Options forfeited (23,000) $62.33 Options expired (74,498) $77.93 Outstanding December 31, 2022 2,216,175 $70.97 Options granted under 2019 Plan 385,500 $54.73 Options exercised (5,166) $53.41 Options forfeited (61,168) $66.44 Options expired (88,170) $64.33 Options outstanding, December 31, 2023 2,447,171 $68.80 2.26 Exercisable at December 31, 2023 2,078,827 $71.40 2.00 Remaining Grant Number Exercise Contractual Date of Shares Price Life in Years 2/21/2019 301,837 $ 79.96 0.14 2/21/2020 516,000 $ 90.79 1.15 5/1/2020 7,500 $ 53.76 1.33 2/25/2021 616,000 $ 69.20 2.16 2/25/2022 610,834 $ 53.41 3.16 6/1/2022 25,000 $ 59.43 3.42 2/24/2023 370,000 $ 54.73 4.15 Options outstanding, December 31, 2023 2,447,171
Schedule of Nonvested Share Activity	The following table summarizes our outstanding non-vested stock options: Number of Shares Weighted Average Grant Date Fair Value Non-vested December 31, 2022 515,020 $12.51 Options granted under 2019 Plan 385,500 $11.33 Options vested under 2012 Plan (4,168) $14.33 Options vested under 2019 Plan (505,007) $12.37 Non-vested options forfeited under 2019 Plan (23,001) $11.80 Non-vested December 31, 2023 368,344 $11.48

Earnings Per Common Share (Tabl

Earnings Per Common Share (Tables)	12 Months Ended
	Dec. 31, 2023
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 ): Year Ended December 31, 2023 2022 2021 Net income $ 134,381 $ 65,501 $ 111,967 Add: net loss (income) attributable to noncontrolling interests 1,273 902 $ (163) Net income attributable to stockholders 135,654 66,403 111,804 Less: net income attributable to unvested restricted stock awards (57) — — Net income attributable to common stockholders $ 135,597 $ 66,403 $ 111,804 BASIC: Weighted average common shares outstanding 43,388,794 44,774,708 45,714,221 DILUTED: Weighted average common shares outstanding 43,388,794 44,774,708 45,714,221 Stock options 672 19,528 4,823 Convertible debt — — 10,453 Weighted average dilutive common shares outstanding 43,389,466 44,794,236 45,729,497 Earnings per common share - basic $ 3.13 $ 1.48 $ 2.45 Earnings per common share - diluted $ 3.13 $ 1.48 $ 2.44 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 802,506 564,803 383,716 Regular dividends declared per common share $ 3.60 $ 3.60 $ 3.8025

Fair Value of Financial instr_2

Fair Value of Financial instruments (Tables)	12 Months Ended
	Dec. 31, 2023
Fair Value Disclosures [Abstract]
Schedule of Fair Value Measurements, Nonrecurring	Carrying amounts and fair values of financial instruments that are not carried at fair value at December 31, 2023 and December 31, 2022 in the Consolidated Balance Sheets are as follows ( $ in thousands ): Carrying Amount Fair Value Measurement 2023 2022 2023 2022 Level 2 Variable rate debt $ 439,693 $ 277,699 $ 445,000 $ 282,000 Fixed rate debt $ 695,358 $ 869,812 $ 616,852 $ 773,994 Level 3 Mortgage and other notes receivable, net $ 245,271 $ 233,141 $ 237,646 $ 227,611

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2023
Income Tax Disclosure [Abstract]
Schedule of Dividends Paid, Per Share	Dividend payments to common stockholders for the last three years are characterized for tax purposes as follows on a per share basis: (Unaudited) December 31, 2023 December 31, 2022 December 31, 2021 Ordinary income $ 2.40807 $ 2.61966 $ 2.87799 Capital gain 0.24805 — 0.43890 Return of capital 0.94388 0.98034 0.48562 Dividends paid per common share $ 3.60 $ 3.60 $ 3.8025

Segment Reporting (Tables)

Segment Reporting (Tables)	12 Months Ended
	Dec. 31, 2023
Segment Reporting [Abstract]
Schedule of Segment Reporting Information, by Segment	Summary information for the reportable segments during the year ended December 31, 2023 and 2022 is as follows ( $ in thousands ): For the year ended December 31, 2023: Real Estate Investments SHOP Non-segment/Corporate Total Rental income $ 249,227 $ — $ — $ 249,227 Resident fees and services — 48,809 — 48,809 Interest income and other 21,448 — 351 21,799 Total revenues 270,675 48,809 351 319,835 Senior housing operating expenses — 39,587 — 39,587 Taxes and insurance on leased properties 11,513 — — 11,513 NOI 259,162 9,222 351 268,735 Depreciation 60,764 9,158 51 69,973 Interest 3,071 — 55,089 58,160 Legal — — 507 507 Franchise, excise and other taxes — — 449 449 General and administrative — — 19,314 19,314 Loan and realty losses, net 1,376 — — 1,376 Gains on sales of real estate, net (14,721) — — (14,721) Loss on operations transfer, net (20) — — (20) Other income (202) — — (202) Loss on early retirement of debt — — 73 73 Gains from equity method investment (555) — — (555) Net income (loss) $ 209,449 $ 64 $ (75,132) $ 134,381 Total assets $ 2,202,647 $ 270,051 $ 15,782 $ 2,488,480 For the year ended December 31, 2022: Real Estate Investments SHOP Non-segment/Corporate Total Rental income $ 217,700 $ — $ — $ 217,700 Resident fees and services — 35,796 — 35,796 Interest income and other 24,383 — 315 24,698 Total revenues 242,083 35,796 315 278,194 Senior housing operating expenses — 28,193 — 28,193 Taxes and insurance on leased properties 9,788 — — 9,788 NOI 232,295 7,603 315 240,213 Depreciation 64,407 6,408 65 70,880 Interest 3,089 — 41,828 44,917 Legal — — 2,555 2,555 Franchise, excise and other taxes — — 844 844 General and administrative — — 22,768 22,768 Loan and realty losses, net 61,911 — — 61,911 Gains on sales of real estate, net (28,342) — — (28,342) Gain on operations transfer, net 710 — — 710 Gain on note receivable payoff (1,113) — — (1,113) Loss on early retirement of debt — — 151 151 Gains from equity method investment (569) — — (569) Net income (loss) $ 132,202 $ 1,195 $ (67,896) $ 65,501 Total assets $ 2,225,176 $ 274,135 $ 8,113 $ 2,507,424

Variable Interest Entities (Tab

Variable Interest Entities (Tables)	12 Months Ended
	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of Variable Interest Entities	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 cross-referenced below ( $ in thousands ). Date Name Source of Exposure Carrying Amount Maximum Exposure to Loss Note Reference 2014 Senior Living Notes and straight-line receivable $ 89,406 $ 93,156 Notes 3, 4 2016 Senior Living Management Notes $ 24,500 $ 24,500 — 2018 Bickford Notes and funding commitment $ 16,909 $ 29,550 Notes 3, 4 2019 Encore Senior Living Various 1 $ 56,578 $ 57,432 — 2020 Timber Ridge OpCo Various 2 $ 1,348 $ 6,348 Notes 6, 7 2020 Watermark Retirement Notes and straight-line receivable $ 9,551 $ 11,574 — 2021 Montecito Medical Real Estate Notes and funding commitment $ 20,509 $ 50,254 Note 4 2021 Vizion Health Notes and straight-line receivable $ 16,481 $ 16,481 — 2021 Navion Senior Solutions Various 3 $ 7,992 $ 7,992 — 2023 Kindcare Senior Living Notes 4 $ 751 $ 751 — 1 Notes, straight-line rents receivable, and lease receivables 2 Loan commitment, equity method investment, straight-line rents receivable and unamortized lease incentive 3 Notes, loan commitments, straight-line rents receivable, and unamortized lease incentive 4 Represents two mezzanine loans originated from the sales of real estate

Organization and Nature of Bu_2

Organization and Nature of Business (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($) segment	Dec. 31, 2023 property	Dec. 31, 2023 state	Dec. 31, 2023 tenant	Dec. 31, 2023 facility	Dec. 31, 2023 mortgage	Dec. 31, 2023 jointVenture	Dec. 31, 2023 unit	Dec. 31, 2022 USD ($) property	Apr. 01, 2022 property
Real Estate [Line Items]
Number of reportable segments | segment	2
Number of lessees | tenant				3
Number of properties		1							13
Number of health care properties related to mortgage notes receivables		16				8
Loans an leases receivable, gross | $	$ 260,747
Credit loss reserve | $	15,476								$ 15,338
Number of joint ventures | jointVenture							2
Real Estate Investments
Real Estate [Line Items]
Real estate investment property, portfolio assets | $	2,400,000
Properties		163
Number of states in which entity operates | state			31
Number of lessees | tenant				25
Senior Housing Community | Real Estate Investments
Real Estate [Line Items]
Properties		97
Skilled Nursing Facilities
Real Estate [Line Items]
Properties | facility					32
Skilled Nursing Facilities | Real Estate Investments
Real Estate [Line Items]
Properties | facility					65
Hospitals | Real Estate Investments
Real Estate [Line Items]
Properties		1
Independent Living Facilities
Real Estate [Line Items]
Properties		3
Number of states in which entity operates | state			8
Number of joint ventures | jointVenture							2
Independent Living Facilities | SHOP
Real Estate [Line Items]
Real estate investment property, portfolio assets | $	$ 347,400
Properties		15								15
Number of units in real estate property | unit								1,733

Basis of Presentation and Sig_4

Basis of Presentation and Significant Accounting Policies (Narrative) (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($) facility jointVenture operator property mortgage tenant segment realEstatePartnership	Dec. 31, 2022 USD ($) operator	Dec. 31, 2021 USD ($)	Apr. 01, 2022 property
Property, Plant and Equipment [Line Items]
Number of joint ventures | jointVenture	2
Number of real estate partnerships | realEstatePartnership	2
Property, plant and equipment, useful life	40 years
Impairment of property	$ 1,173	$ 21,531	$ 6,400
Lessor, operating lease, renewal term	5 years
Rental income	$ 249,227	$ 217,700	271,049
Number of lessees | tenant	3
Loans an leases receivable, gross	$ (260,747)
Number of reportable segments | segment	2
Independent Living Facilities
Property, Plant and Equipment [Line Items]
Number of joint ventures | jointVenture	2
Properties | property	3
Non-performing
Property, Plant and Equipment [Line Items]
Mortgage note receivables | mortgage	2
Number of operators/borrowers | operator	1
Non-performing | Mortgage Receivable And Mezzanine Loan
Property, Plant and Equipment [Line Items]
Loans an leases receivable, gross	$ (26,600)
Number of operators/borrowers | operator	2
Bickford
Property, Plant and Equipment [Line Items]
Rental income	$ 38,688		34,599
Number of operators | operator		3
Properties | facility	39
Escrow funds received from tenants for property operating expenses
Property, Plant and Equipment [Line Items]
Rental income	$ 11,513	$ 9,788	11,600
Real Estate Investments
Property, Plant and Equipment [Line Items]
Impairment of property	$ 1,600	$ 51,600	$ 51,800
Number of lessees | tenant	25
Properties | property	163
SHOP | Independent Living Facilities
Property, Plant and Equipment [Line Items]
Properties | property	15			15
Minimum
Property, Plant and Equipment [Line Items]
Lessor, operating lease, contract term	10 years
Residency agreement, term	30 days
Maximum
Property, Plant and Equipment [Line Items]
Lessor, operating lease, contract term	15 years
Residency agreement, term	1 year
Building
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	40 years
Building Improvements | Minimum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	5 years
Building Improvements | Maximum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	25 years

Basis of Presentation and Sig_5

Basis of Presentation and Significant Accounting Policies (Cash Equivalents and Restricted Cash) (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Accounting Policies [Abstract]
Cash and cash equivalents	$ 22,347	$ 19,291	$ 37,412
Restricted cash (included in Other assets, net)	2,270	2,225	2,073
Cash and cash equivalents and restricted cash, total	$ 24,617	$ 21,516	$ 39,485	$ 46,343

Investment Activity - Asset Acq

Investment Activity - Asset Acquisition Schedule (Details) $ in Thousands	3 Months Ended			12 Months Ended
	Mar. 31, 2023 USD ($) property	Dec. 31, 2022 USD ($) property	Jun. 30, 2022 USD ($) property	Dec. 31, 2022 USD ($)
Silverado Senior Living
Real Estate [Line Items]
Properties | property	2
Total	$ 37,493
Silverado Senior Living | Land
Real Estate [Line Items]
Total	3,894
Silverado Senior Living | Building and Improvements
Real Estate [Line Items]
Total	$ 33,599
Encore Senior Living
Real Estate [Line Items]
Properties | property			1
Total			$ 13,300
Encore Senior Living | Land
Real Estate [Line Items]
Total			542
Encore Senior Living | Building and Improvements
Real Estate [Line Items]
Total			$ 12,758
Bickford
Real Estate [Line Items]
Properties | property	1	1
Total	$ 17,288	$ 17,200
Bickford | Land
Real Estate [Line Items]
Total	1,746	2,052
Bickford | Building and Improvements
Real Estate [Line Items]
Total	15,542	$ 15,148
Current Period Real Estate Acquisition
Real Estate [Line Items]
Total	54,781
Current Period Real Estate Acquisition | Land
Real Estate [Line Items]
Total	5,640
Current Period Real Estate Acquisition | Building and Improvements
Real Estate [Line Items]
Total	$ 49,141
Prior Period Real Estate Acquisition
Real Estate [Line Items]
Total				$ 30,500
Prior Period Real Estate Acquisition | Land
Real Estate [Line Items]
Total				2,594
Prior Period Real Estate Acquisition | Building and Improvements
Real Estate [Line Items]
Total				$ 27,906

Investment Activity (Asset Acqu

Investment Activity (Asset Acquisition) (Details) $ in Millions	1 Months Ended			3 Months Ended
	Feb. 28, 2023 USD ($) property unit	Nov. 30, 2022 USD ($) bedOrUnitInTheProperty	Apr. 30, 2022 USD ($) bedOrUnitInTheProperty	Mar. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Real Estate [Line Items]
Proceeds from sale and collection of notes receivable	$ 14.2		$ 9.1
Silverado Senior Living
Real Estate [Line Items]
Initial lease rate	7.50%
Number of units in real estate property | property	2
Term of master lease	20 years
Annual lease escalator	2%
Silverado Senior Living, Summerlin, NE
Real Estate [Line Items]
Number of units in real estate property | unit	60
Acquisition price	$ 37.5
Silverado Senior Living, Frederick, MD
Real Estate [Line Items]
Number of units in real estate property | unit	60
Bickford Senior Living Acquisition
Real Estate [Line Items]
Asset acquisition, rent deferral deduction				$ 2.5	$ 3
Encore Senior Living
Real Estate [Line Items]
Initial lease rate			7.25%
Number of units in real estate property | bedOrUnitInTheProperty			53
Acquisition price			$ 13.3
Term of master lease			15 years
Annual lease escalator			2.50%
Bickford | Bickford
Real Estate [Line Items]
Initial lease rate	8%	8%
Number of units in real estate property	64	60
Acquisition price	$ 17.3	$ 17.2
Term of master lease		10 years 6 months
Cancellation of outstanding construction note receivable	0.5	$ 14
Asset purchase transaction costs	$ 0.1	0.2
Asset acquisition, rent deferral deduction		$ 3

Investment Activity (2023 Asset

Investment Activity (2023 Asset Dispositions) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Real Estate [Line Items]
Rental income	$ 249,227	$ 217,700	$ 271,049
Disposal Group, Disposed of by Sale, Not Discontinued Operations | 2023 Asset Dispositions
Real Estate [Line Items]
Rental income	$ 3,300	$ 700	$ 6,100

Investment Activity (2022 Asset

Investment Activity (2022 Asset Dispositions) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Real Estate [Line Items]
Rental income	$ 249,227	$ 217,700	$ 271,049
Disposal Group, Disposed of by Sale, Not Discontinued Operations | 2022 Asset Dispositions
Real Estate [Line Items]
Rental income		$ 7,000	$ 10,900

Investment Activity (Dispositio

Investment Activity (Dispositions Table) (Details) $ in Thousands	3 Months Ended							12 Months Ended
	Dec. 31, 2023 USD ($) property facility	Sep. 30, 2023 USD ($) property	Jun. 30, 2023 USD ($) property	Mar. 31, 2023 USD ($) property	Sep. 30, 2022 USD ($) property	Jun. 30, 2022 USD ($) property	Mar. 31, 2022 USD ($) property	Dec. 31, 2023 USD ($) property facility	Dec. 31, 2022 USD ($) property	Dec. 31, 2021 USD ($)
Real Estate [Line Items]
Net Proceeds								$ 57,031	$ 168,958	$ 238,864
Gain								14,721	28,342	32,498
Impairment								$ 1,173	$ 21,531	$ 6,400
Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property	12							12	22
Net Proceeds								$ 59,108	$ 168,989
Net Real Estate Investment	$ 45,067							45,067	143,038
Gain								14,199	28,342
Impairment								158	2,391
BAKA Enterprises, LLC
Real Estate [Line Items]
Total impairment charges on real estate	$ 300							$ 300	17,400
BAKA Enterprises, LLC | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property				1
Net Proceeds				$ 7,478
Net Real Estate Investment				7,505
Gain				0
Impairment				$ 27
Bickford | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property				1
Net Proceeds				$ 2,553
Net Real Estate Investment				1,421
Gain				1,132
Impairment				$ 0
Chancellor Health Care 1 | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property			1
Net Proceeds			$ 2,355
Net Real Estate Investment			1,977
Gain			378
Impairment			$ 0
Milestone Retirement 1 | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property			2
Net Proceeds			$ 3,803
Net Real Estate Investment			3,934
Gain			0
Impairment			$ 131
Chancellor Health Care 2 | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property			1
Net Proceeds			$ 7,633
Net Real Estate Investment			6,140
Gain			1,493
Impairment			$ 0
Milestone Retirement 2 | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property			1
Net Proceeds			$ 1,602
Net Real Estate Investment			1,452
Gain			150
Impairment			$ 0
Chancellor Health Care 3 | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property			1
Net Proceeds			$ 23,724
Net Real Estate Investment			14,476
Gain			9,248
Impairment			$ 0
Chancellor Health Care 4 | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property		1
Net Proceeds		$ 2,923
Net Real Estate Investment		2,292
Gain		631
Impairment		$ 0
Senior Living Management 1 | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property	2							2
Net Proceeds	$ 5,522
Net Real Estate Investment	4,770							$ 4,770
Gain	752
Impairment	$ 0
Senior Living Management 2 | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property	1							1
Net Proceeds	$ 1,515
Net Real Estate Investment	1,100							$ 1,100
Gain	415
Impairment	$ 0
Hospital Corporation of America | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property							1
Net Proceeds							$ 4,868
Net Real Estate Investment							1,904
Gain							2,964
Impairment							$ 0
Vitality Senior Living | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property							1
Net Proceeds							$ 8,302
Net Real Estate Investment							8,285
Gain							17
Impairment							$ 0
Holiday Vero Beach | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property						1
Net Proceeds						$ 2,990
Net Real Estate Investment						3,020
Gain						0
Impairment						$ 30
Chancellor Health Care | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property						2
Net Proceeds						$ 7,305
Net Real Estate Investment						7,357
Gain						0
Impairment						$ 52
Bickford
Real Estate [Line Items]
Properties | facility	39							39
Mortgage and other notes receivable, net	$ 16,795							$ 16,795
Bickford | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property						3
Net Proceeds						$ 25,959
Net Real Estate Investment						28,268
Gain						0
Impairment						$ 2,309
Comfort Care | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property						4
Net Proceeds						$ 40,000
Net Real Estate Investment						38,444
Gain						1,556
Impairment						$ 0
Helix Healthcare | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property						1
Net Proceeds						$ 19,500
Net Real Estate Investment						10,535
Gain						8,965
Impairment						$ 0
Discovery Senior Living College Park | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property					2
Net Proceeds					$ 16,379
Net Real Estate Investment					15,159
Gain					1,220
Impairment					$ 0
NHC
Real Estate [Line Items]
Mortgage and other notes receivable, net	0							0
NHC | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property					7
Net Proceeds					$ 43,686
Net Real Estate Investment					30,066
Gain					13,620
Impairment					$ 0
Senior Living Management 1 and Milestone Retirement 1 & 2
Real Estate [Line Items]
Mortgage and other notes receivable, net	$ 2,200							$ 2,200
Vitality, Holiday, Chancellor, and Bickford
Real Estate [Line Items]
Total impairment charges on real estate									$ 28,500

Investment Activity (Held for S

Investment Activity (Held for Sale Schedule) (Details) $ in Thousands	Dec. 31, 2023 USD ($) property	Dec. 31, 2022 USD ($) property
Real Estate [Abstract]
Number of facilities | property	1	13
Real estate, net | $	$ 5,004	$ 43,302

Investment Activity (Assets Hel

Investment Activity (Assets Held for Sale and Long-Lived Assets) (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($) property	Dec. 31, 2022 USD ($) property	Dec. 31, 2021 USD ($)
Real Estate [Line Items]
Rental income	$ 249,227	$ 217,700	$ 271,049
Impairment of property	$ 1,173	21,531	6,400
Real estate properties, impaired, sold or classified as held for sale | property	3
Real estate assets held for development and sale	$ 500
Real Estate Investments
Real Estate [Line Items]
Impairment of property	$ 1,600	$ 51,600	51,800
Real estate properties, impaired, sold or classified as held for sale | property	4	19
Asset Held For Sale In 2023
Real Estate [Line Items]
Rental income	$ 1,700	$ 900	$ 1,100
Asset Held For Sale In 2022
Real Estate [Line Items]
Rental income	$ 2,100	$ 5,600

Investment Activity (Tenant Con

Investment Activity (Tenant Concentration) (Details)	1 Months Ended	3 Months Ended		6 Months Ended	12 Months Ended
	Nov. 30, 2022 USD ($) bedOrUnitInTheProperty	Mar. 31, 2023 USD ($)	Dec. 31, 2022 USD ($) bedOrUnitInTheProperty	Jun. 30, 2022 USD ($) property	Dec. 31, 2023 USD ($) lease property unit boardMember masterLease facility state bedOrUnitInTheProperty shares	Dec. 31, 2022 USD ($) bedOrUnitInTheProperty	Dec. 31, 2021 USD ($)	Feb. 28, 2023 unit	Sep. 01, 2022 property	Apr. 01, 2022 property masterLease	Jun. 30, 2021 facility
Real Estate [Line Items]
Nonportfolio assets, original cost					$ 2,600,000
Credit loss reserve			$ (15,338,000)		(15,476,000)	$ (15,338,000)
Straight-line rent income, net of write-offs					$ 6,961,000	(16,681,000)	$ 14,603,000
Lessor, operating lease, renewal term					5 years
Number of board of directors members also members of NHC board of directors | boardMember					2
Lease incentive payments, net			3,190,000		$ 10,669,000	3,190,000
Rental income					$ 249,227,000	217,700,000	271,049,000
Bickford Senior Living Acquisition
Real Estate [Line Items]
Properties | property					2
Asset acquisition, rent deferral deduction		$ 2,500,000	3,000,000
Lease Extended Until 2028
Real Estate [Line Items]
Lease escalator minimum					8%
Senior Living Communities
Real Estate [Line Items]
Straight-line rent income, net of write-offs					$ 1,200,000	400,000	2,500,000
Rental income					51,274,000	51,183,000	50,726,000
NHC
Real Estate [Line Items]
Straight-line rent income, net of write-offs					$ 1,200,000	500,000	0
Number of real estate properties sold | property									7
Number of master leases | masterLease					2
Lessor, operating lease, renewal term					5 years
Lessor equity shares owned, significant lessee (in shares) | shares					1,630,642
Rental income					$ 37,335,000	36,893,000	37,735,000
NHC | NHC - 1991 Lease
Real Estate [Line Items]
Percentage rent rate					4%
Bickford
Real Estate [Line Items]
Properties | facility					39
Straight-line rent income, net of write-offs						18,200,000	1,700,000
Number of leases | lease					4
Write off of financing receivable					$ 18,100,000
Proceeds from rent collection					33,400,000	27,600,000	29,500,000
Rental income					38,688,000		34,599,000
Asset acquisition, rent deferral deduction					18,000,000
Amortization of rate deferral					6,000,000
Bickford | Bickford
Real Estate [Line Items]
Number of units in real estate property	60							64
Payments for rent					200,000	2,300,000
Asset acquisition, rent deferral deduction	$ 3,000,000
Bickford | Lease Extended Until 2028
Real Estate [Line Items]
Properties | property				11						28
Number of master leases | masterLease										3
Rental income					28,300,000
Cash Basis Lessees
Real Estate [Line Items]
Lease incentive payments, net			$ 7,100,000		7,100,000	7,100,000
Rental income					48,300,000	21,400,000	$ 68,800,000
Straight line rent adjustments					26,000,000
Cash Basis Lessees | Bickford Senior Living Acquisition
Real Estate [Line Items]
Asset acquisition, rent deferral deduction					$ 2,500,000	$ 3,000,000
Holiday Acquisition Holdings
Real Estate [Line Items]
Properties | facility											17
NHC - 1991 Lease | Senior Living Communities
Real Estate [Line Items]
Properties | property					10
Number of units in real estate property | unit					2,216
Revenue as % of Total, Exceeds 10%
Real Estate [Line Items]
Number of states in which entity operates | bedOrUnitInTheProperty			2		2	2
Geographic Concentration Risk | SOUTH CAROLINA | Investment Consideration Benchmark
Real Estate [Line Items]
Percentage of continuing revenue					12.10%	12.10%
Geographic Concentration Risk | TEXAS | Investment Consideration Benchmark
Real Estate [Line Items]
Percentage of continuing revenue					10.70%	10.70%
Independent Living Facilities
Real Estate [Line Items]
Number of states in which entity operates | state					8
Properties | property					3
Independent Living Facilities | SHOP
Real Estate [Line Items]
Real estate investment property, portfolio assets					$ 347,400,000
Properties | property					15					15
Number of units in real estate property | unit					1,733
Skilled Nursing Facilities
Real Estate [Line Items]
Properties | facility					32
Skilled Nursing Facilities | NHC | Subleased Facilities
Real Estate [Line Items]
Properties | property					4
Facilities Transitioned To Other Operators | Bickford
Real Estate [Line Items]
Lessor, operating lease, contract term				10 years
Facilities Transitioned To Other Operators | Holiday Acquisition Holdings
Real Estate [Line Items]
Properties | property				1						1
Assisted Living Facilities | Bickford
Real Estate [Line Items]
Straight line rent adjustments				$ 700,000

Investment Activity (Schedule o

Investment Activity (Schedule of Tenant Concentrations) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Real Estate [Line Items]
Gross Real Estate	$ 2,780,358	$ 2,729,898
Total gross real estate	2,430,413
Total notes receivable	260,747
Revenues	249,227	217,700	$ 271,049
Escrow funds received from tenants for property operating expenses	11,513	9,788	11,638
Resident fees and services	48,809	35,796	0
Total revenues	$ 319,835	$ 278,194	$ 298,715
Percentage of continuing revenue	15%	13%	0%
Escrow funds received from tenants for property operating expenses
Real Estate [Line Items]
Revenues	$ 11,513	$ 9,788	$ 11,600
Senior Living Communities
Real Estate [Line Items]
Gross Real Estate	573,631
Notes Receivable	48,950
Revenues	$ 51,274	$ 51,183	$ 50,726
Percentage of continuing revenue	16%	18%	17%
NHC
Real Estate [Line Items]
Gross Real Estate	$ 133,770
Notes Receivable	0
Revenues	$ 37,335	$ 36,893	$ 37,735
Percentage of continuing revenue	12%	13%	12%
Bickford
Real Estate [Line Items]
Gross Real Estate	$ 429,043
Notes Receivable	16,795
Revenues	$ 38,688		$ 34,599
Percentage of continuing revenue	12%		12%
All others, net
Real Estate [Line Items]
Gross Real Estate	$ 1,293,969
Notes Receivable	195,002
Revenues	$ 132,216	$ 144,534	$ 164,017
Percentage of continuing revenue	41%	52%	55%
Tenants With Escrow Funds
Real Estate [Line Items]
Percentage of continuing revenue	4%	4%	4%
More than 10% Operators
Real Estate [Line Items]
Revenues	$ 271,026	$ 242,398	$ 298,715

Investment Activity (Schedule_2

Investment Activity (Schedule of NHC Percentage Rent) (Details) - NHC - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Net Investment Income [Line Items]
Rent income from NHC	$ 4,492	$ 3,126	$ 3,531
Current year
Net Investment Income [Line Items]
Rent income from NHC	3,862	3,332	3,536
Prior year final certification
Net Investment Income [Line Items]
Rent income (loss) from NHC	$ 630	$ (206)	$ (5)

Investment Activity (Other Port

Investment Activity (Other Portfolio Activity) (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($) property	Dec. 31, 2022 USD ($) operator	Dec. 31, 2021 USD ($)
Real Estate [Line Items]
Rental income	$ (249,227)	$ (217,700)	$ (271,049)
Lease incentive payments, net	10,669	3,190
Property, plant and equipment, net	$ 2,107,082	2,118,210
Lease Option
Real Estate [Line Items]
Properties | property	3
Lease Option, Between 2027 and 2028
Real Estate [Line Items]
Rental income	$ (7,200)	$ (7,000)	(6,900)
Property, plant and equipment, net	58,400
Cash Basis Lessees
Real Estate [Line Items]
Number of operators converted to cash basis accounting | operator		3
Rental income	(48,300)	$ (21,400)	$ (68,800)
Straight line rent adjustments	26,000
Lease incentive payments, net	7,100	7,100
Prior rent deferrals	$ 2,800	$ 300

Investment Activity (Lease Cost

Investment Activity (Lease Costs) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Real Estate [Abstract]
Operating lease	$ 0.1	$ 0.1	$ 0.1
Future minimum lease payments, 2024	0.1
Future minimum lease payments, 2025	0.1
Future minimum lease payments, 2026	0.1
Future minimum lease payments, 2027	0.1
Future minimum lease payments, 2028	0.1
Future minimum lease payments, thereafter	2.5
Imputed interest	$ 1.3
Discount rate	4.70%

Investment Activity (Schedule_3

Investment Activity (Schedule of Supplemental Balance Sheet Information Related to Lease) (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Assets:
Buildings and improvements - right of use asset	$ 1,562	$ 1,599
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Buildings and improvements	Buildings and improvements
Liabilities [Abstract]
Accounts payable and accrued expenses - lease liability	$ 1,705	$ 1,724
Operating Lease, Liability, Statement of Financial Position [Extensible Enumeration]	Accounts payable and accrued expenses	Accounts payable and accrued expenses

Investment Activity (Rent Conce

Investment Activity (Rent Concessions) (Details) - Lease Payment Deferral and Abatement - COVID-19 - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Real Estate [Line Items]
Pandemic deferrals		$ 9.3	$ 26.4
Bickford
Real Estate [Line Items]
Pandemic deferrals	$ 4	$ 18.3

Investment Activity (Future Min

Investment Activity (Future Minimum Lease Payments) (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Real Estate [Abstract]
2024	$ 232,059
2025	237,981
2026	244,581
2027	198,598
2028	192,179
Thereafter	684,840
Operating leases, future minimum payments due	$ 1,790,238

Investment Activity (Schedule_4

Investment Activity (Schedule of Fixed and Variable Lease Payments) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Schedule of Fixed and Variable Lease Payments [Line Items]
Rental income	$ 249,227	$ 217,700	$ 271,049
Straight-line rent income, net of write-offs	6,961	(16,681)	14,603
Lease payments based on fixed escalators and deferral repayments
Schedule of Fixed and Variable Lease Payments [Line Items]
Rental income	225,565	226,873	241,172
Lease payments based on variable escalators
Schedule of Fixed and Variable Lease Payments [Line Items]
Rental income	7,709	5,275	4,662
Straight-line rent income, net of write-offs
Schedule of Fixed and Variable Lease Payments [Line Items]
Straight-line rent income, net of write-offs	6,961	(16,681)	14,603
Escrow funds received from tenants for property operating expenses
Schedule of Fixed and Variable Lease Payments [Line Items]
Rental income	11,513	9,788	11,600
Amortization and write-off of lease incentives
Schedule of Fixed and Variable Lease Payments [Line Items]
Amortization and write-off of lease incentives	$ (2,521)	$ (7,555)	$ (1,026)

Mortgage and Other Notes Rece_3

Mortgage and Other Notes Receivable (Narrative) (Details) $ in Thousands

1 Months Ended

3 Months Ended

12 Months Ended

Nov. 30, 2022 USD ($) facility extensionOption

Jan. 31, 2022 USD ($) property extensionOption

Sep. 30, 2023 USD ($)

Jun. 30, 2022 USD ($)

Dec. 31, 2023 USD ($) property

Dec. 31, 2022 USD ($) property

Dec. 31, 2021 USD ($)

Dec. 31, 2023 property

Dec. 31, 2023 facility

Dec. 31, 2023 mortgage

Dec. 31, 2023 unit

Dec. 31, 2023 operator

Dec. 31, 2023

Dec. 31, 2023 extensionOption

Dec. 31, 2023 renewalOption

Dec. 31, 2023 loan

Sep. 21, 2023 USD ($)

Sep. 20, 2023 USD ($)

Sep. 30, 2021 property

Jun. 30, 2021 property

Accounts, Notes, Loans and Financing Receivable [Line Items]

Number of health care properties related to mortgage notes receivables

16

8

Credit loss reserve

$ 15,476

$ 15,338

Financing receivable, excluding accrued interest, after allowance for credit loss

(245,271)

(233,141)

Total

130,725

Increase in mortgage note receivable from sale of real estate

2,249

0

$ 0

Interest income and other

21,799

24,698

27,666

Collection of mortgage and other notes receivable

13,465

119,212

67,790

Probability of default, increase, current conditions adjustment

20%

Estimated credit losses, current conditions adjustment, combined

44%

Encore Senior Living

Accounts, Notes, Loans and Financing Receivable [Line Items]

Mortgage and other notes receivable, net

27,700

14,200

Total

$ 28,500

Loan term

5 years

4 years

Notes receivable, interest rate, master credit agreement

8.50%

Number of additional lease renewal options | extensionOption

2

Note receivable renewal term

1 year

Capital Funding Group

Accounts, Notes, Loans and Financing Receivable [Line Items]

Financing receivable, stated interest rate

7.25%

Number of additional lease renewal options | extensionOption

2

Note receivable renewal term

1 year

Payments to acquire receivables

$ 42,500

Number of collateral properties | facility

5

Montecito Medical Real Estate

Accounts, Notes, Loans and Financing Receivable [Line Items]

Mortgage and other notes receivable, net

20,300

20,300

Interest income and other

1,800

1,800

200

Total

$ 50,000

Loan term

5 years

Notes receivable, interest rate, master credit agreement

9.50%

Number of additional lease renewal options | renewalOption

2

Note receivable renewal term

1 year

Investment interest rate

7.50%

Incremental percentage increase in the stated rate of a note receivable

2.50%

Deferred interest rate, additional interest rate accrued

4.50%

Payments for loans

$ 300

Bickford

Accounts, Notes, Loans and Financing Receivable [Line Items]

Mortgage and other notes receivable, net

16,795

Contingent incentive payments

2,000

Properties | facility

39

Interest income and other

1,200

1,300

900

Repayments of debt

(300)

(300)

LCS Sagewood

Accounts, Notes, Loans and Financing Receivable [Line Items]

Increase (decrease) in notes receivables

(61,200)

Life-Care Services - Sagewood

Accounts, Notes, Loans and Financing Receivable [Line Items]

Interest income and other

5,200

10,200

Collection of mortgage and other notes receivable

$ 111,300

Proceeds repayment fee and accrued interest on receivable

$ 1,100

Senior Living Communities

Accounts, Notes, Loans and Financing Receivable [Line Items]

Mortgage and other notes receivable, net

$ 48,950

Number of additional lease renewal options | extensionOption

2

Note receivable renewal term

1 year

Revolving amount line of credit

$ 20,000

Revolving note receivable amount outstanding

$ (16,300)

Loans receivable, description, variable rate basis, reference rate

8%

Purchase option, minimum amount

$ 38,300

Non-performing

Accounts, Notes, Loans and Financing Receivable [Line Items]

Number of operators/borrowers | operator

1

Collections of mortgage and other notes receivable

$ (2,100)

Interest income and other

1,800

1,700

2,100

Mezzanine

Accounts, Notes, Loans and Financing Receivable [Line Items]

Credit loss reserve

10,000

Mezzanine | Non-performing

Accounts, Notes, Loans and Financing Receivable [Line Items]

Financing receivable, excluding accrued interest, after allowance for credit loss

(14,500)

Secured By Real Estate

Accounts, Notes, Loans and Financing Receivable [Line Items]

Mortgage and other notes receivable, net

162,400

164,600

Not Secured By Real Estate

Accounts, Notes, Loans and Financing Receivable [Line Items]

Mortgage and other notes receivable, net

$ 98,300

$ 83,900

Capital Funding Group, Inc.

Accounts, Notes, Loans and Financing Receivable [Line Items]

Financing receivable, excluding accrued interest, after allowance for credit loss

$ (25,000)

$ (8,100)

Financing receivable, stated interest rate

10%

Current Period Investment | Encore Senior Living

Accounts, Notes, Loans and Financing Receivable [Line Items]

Number of units in real estate property | property

108

Property Held by Fund | Montecito Medical Real Estate

Accounts, Notes, Loans and Financing Receivable [Line Items]

Properties | property

9

9

Combined purchase price of medical office buildings

$ 86,700

$ 86,700

Fully Funded | Bickford

Accounts, Notes, Loans and Financing Receivable [Line Items]

Total

14,700

Number of construction loans | loan

1

Disposal Group, Disposed of by Sale, Not Discontinued Operations | Bickford

Accounts, Notes, Loans and Financing Receivable [Line Items]

Note receivable interest rate

10%

Disposal Group, Disposed of by Sale, Not Discontinued Operations | Bickford Note Investment | Unlikely to be Collected Financing Receivable

Accounts, Notes, Loans and Financing Receivable [Line Items]

Increase in mortgage note receivable from sale of real estate

12,700

$ 13,000

Negotiations to sale | Bickford

Accounts, Notes, Loans and Financing Receivable [Line Items]

Properties | property

6

6

Commitment Fees

Accounts, Notes, Loans and Financing Receivable [Line Items]

Commitment fee

$ 400

After 2021 | Senior Living Communities

Accounts, Notes, Loans and Financing Receivable [Line Items]

Revolving amount line of credit

15,000

July 2019 Transaction | Senior Living

Accounts, Notes, Loans and Financing Receivable [Line Items]

Total

$ 32,700

Loan term

5 years

Notes receivable, interest rate, master credit agreement

7.25%

June 2019 Transaction | Senior Living Communities

Accounts, Notes, Loans and Financing Receivable [Line Items]

Number of units in real estate property | unit

248

Mortgage and Other Notes Rece_4

Mortgage and Other Notes Receivable (Schedule of Financing Receivables By Credit Quality Indicator) (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Financing Receivable, Credit Quality Indicator [Line Items]
Credit loss reserve	$ (15,476)	$ (15,338)
Financing receivable, after allowance for credit loss	245,271	$ 233,141
Mortgages
Financing Receivable, Credit Quality Indicator [Line Items]
2023	1,550
2022	70,042
2021	0
2020	22,337
2019	39,123
Prior	17,287
Total	150,339
Mortgages | more than 1.5x
Financing Receivable, Credit Quality Indicator [Line Items]
2023	0
2022	70,042
2021	0
2020	22,337
2019	32,700
Prior	2,587
Total	127,666
Mortgages | between 1.0x and 1.5x
Financing Receivable, Credit Quality Indicator [Line Items]
2023	1,550
2022	0
2021	0
2020	0
2019	0
Prior	14,700
Total	16,250
Mortgages | less than 1.0x
Financing Receivable, Credit Quality Indicator [Line Items]
2023	0
2022	0
2021	0
2020	0
2019	6,423
Prior	0
Total	6,423
Mezzanine
Financing Receivable, Credit Quality Indicator [Line Items]
2023	720
2022	0
2021	38,867
2020	0
2019	0
Prior	25,000
Total	64,587
Mezzanine | more than 1.5x
Financing Receivable, Credit Quality Indicator [Line Items]
2023	720
2022	0
2021	14,933
2020	0
2019	0
Prior	0
Total	15,653
Mezzanine | between 1.0x and 1.5x
Financing Receivable, Credit Quality Indicator [Line Items]
2023	0
2022	0
2021	23,934
2020	0
2019	0
Prior	0
Total	23,934
Mezzanine | less than 1.0x
Financing Receivable, Credit Quality Indicator [Line Items]
2023	0
2022	0
2021	0
2020	0
2019	0
Prior	25,000
Total	25,000
Non-performing
Financing Receivable, Credit Quality Indicator [Line Items]
2023	0
2022	0
2021	0
2020	2,095
2019	0
Prior	24,500
Total	26,595
Non-performing | EBITDARM Coverage less than 1.0x
Financing Receivable, Credit Quality Indicator [Line Items]
2023	0
2022	0
2021	0
2020	2,095
2019	0
Prior	24,500
Total	26,595
Revolver
Financing Receivable, Credit Quality Indicator [Line Items]
Total	19,226
Revolver | between 1.0x and 1.5x
Financing Receivable, Credit Quality Indicator [Line Items]
Total	$ 19,226

Mortgage and Other Notes Rece_5

Mortgage and Other Notes Receivable (Schedule of Financing Receivable, Allowance for Credit Loss, Roll Forward) (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($)
Financing receivable, allowance for credit loss
Beginning balance	$ 15,338
Provision for expected credit losses	138
Ending balance	$ 15,476

Senior Housing Operating Port_2

Senior Housing Operating Portfolio Formation Activities (Details)	3 Months Ended		12 Months Ended
	Dec. 31, 2023 USD ($) jointVenture unit property bedOrUnitInTheProperty	Jun. 30, 2023 USD ($)	Dec. 31, 2023 USD ($) jointVenture unit property bedOrUnitInTheProperty	Apr. 01, 2022 property
Senior Housing Operating Portfolio Formation Activities [Line Items]
Number of joint ventures | jointVenture	2		2
Annual fixed preferred return	$ 10,200,000		$ 10,200,000
Cash contributed for its common equity interest in the venture	2,600,000	$ 4,600,000
Minimum
Senior Housing Operating Portfolio Formation Activities [Line Items]
Management fee multiplier	$ 1,000		1,000
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
Interest in joint venture percentage			20%
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%
Common equity interest in venture			2%
SHOP | New Venture
Senior Housing Operating Portfolio Formation Activities [Line Items]
Ownership percentage	100%		100%
Independent Living Facilities
Senior Housing Operating Portfolio Formation Activities [Line Items]
Properties | property	3		3
Number of joint ventures | jointVenture	2		2
Independent Living Facilities | Merrill Gardens Managed Portfolio
Senior Housing Operating Portfolio Formation Activities [Line Items]
Properties | bedOrUnitInTheProperty	6		6
Independent Living Facilities | Discovery Managed Portfolio
Senior Housing Operating Portfolio Formation Activities [Line Items]
Properties | unit	9		9
Independent Living Facilities | SHOP
Senior Housing Operating Portfolio Formation Activities [Line Items]
Properties | property	15		15	15

Equity Method Investment (Narra

Equity Method Investment (Narrative) (Details) $ in Thousands	1 Months Ended		12 Months Ended
	Feb. 28, 2023 USD ($)	Jan. 31, 2020 USD ($)	Dec. 31, 2023 USD ($) extensionOption	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Excess unrecognized equity method losses			$ (5,000)
Excess unrecognized equity method losses			2,700	$ (4,200)
Gains (losses) from equity method investment			$ 555	569	$ (1,545)
Operating lease term			7 years
Operating lease, number of renewal options | extensionOption			2
Balance secured by deed and indenture			$ 11,800
Timber Ridge OpCo
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Financing receivable of revolving credit facility			5,000
Amortization and write-off of lease incentives	$ 2,500
Maximum Exposure to Loss			5,000
Timber Ridge OpCo
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Mortgage and other notes receivable, net			0
Gains (losses) from equity method investment			600	$ 600	$ (1,500)
Timber Ridge OpCo | Cumulative Amount
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Excess unrecognized equity method losses			$ (9,100)
Timber Ridge OpCo | Noncontrolling Interests | Real Estate Operating Company
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Consideration for interest in combined venture		$ 900
LCS Timber Ridge | Real Estate Operating Company
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Equity interest acquired		25%

Other Assets (Details)

Other Assets (Details) - USD ($) $ in Thousands	1 Months Ended	12 Months Ended
	Feb. 28, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Segment Reporting Information [Line Items]
Lease incentive payments, net		$ 10,669	$ 3,190
Regulatory escrows		6,208	6,208
Restricted cash (included in Other assets, net)		2,270	2,225	$ 2,073
Other assets		24,063	16,585
Payment of lease incentive		10,000	1,200	$ 1,042
Timber Ridge OpCo
Segment Reporting Information [Line Items]
Payment of lease incentive	$ 10,000
SHOP
Segment Reporting Information [Line Items]
Accounts receivable and prepaid expenses		1,620	1,341
Allowance		343	375
Real Estate Investments
Segment Reporting Information [Line Items]
Accounts receivable and prepaid expenses		$ 3,296	$ 3,621

Debt (Schedule of Debt) (Detail

Debt (Schedule of Debt) (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Revolving credit facility - unsecured	$ 245,000	$ 42,000
Unamortized loan costs	(8,912)	(8,538)
Debt	1,135,051	1,147,511
Debt instrument, unamortized discount	(2,278)
Bank term loans - unsecured
Debt Instrument [Line Items]
Bank term loans - unsecured	200,000	240,000
2031 Senior Notes - unsecured, net of discount of $2,278 and $2,600
Debt Instrument [Line Items]
Bank term loans - unsecured	397,722	397,400
Debt instrument, unamortized discount	(2,278)	(2,600)
Private placement notes - unsecured
Debt Instrument [Line Items]
Bank term loans - unsecured	225,000	400,000
Fannie Mae term loans - secured, non-recourse
Debt Instrument [Line Items]
Fannie Mae term loans - secured, non-recourse	$ 76,241	$ 76,649

Debt (Schedule of Long Term Deb

Debt (Schedule of Long Term Debt Maturities) (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Debt Instruments [Abstract]
2024	$ 75,425
2025	325,816
2026	245,000
2027	100,000
2028	0
Thereafter	400,000
HUD mortgage loans, balance	1,146,241
Debt instrument, unamortized discount	(2,278)
Less: unamortized loan costs	8,912	$ 8,538
Debt	$ 1,135,051	$ 1,147,511

Debt (Narrative) (Details)

Debt (Narrative) (Details) $ in Thousands

1 Months Ended

3 Months Ended

12 Months Ended

Mar. 31, 2022 USD ($) extensionOption

Jun. 30, 2023 USD ($)

Mar. 31, 2022 USD ($)

Dec. 31, 2021 USD ($) loan

Jan. 31, 2021 USD ($)

Mar. 31, 2015

Mar. 31, 2023 USD ($)

Dec. 31, 2023 USD ($) property

Dec. 31, 2022 USD ($)

Dec. 31, 2021 USD ($)

Mar. 30, 2022 USD ($)

Jan. 01, 2021

Debt Instrument [Line Items]

Debt issuance costs, gross

$ 2,700

Fannie Mae financing

$ 220,000

Deferred financing costs

$ 0

$ 0

$ 1,462

Proceeds from issuance of senior notes

$ 0

$ 0

396,784

Debt leverage limit, coupon change, trigger

50%

Interest Rate Swaps, Maturity Date, After June 2020

Debt Instrument [Line Items]

Interest rate, stated percentage

1.92%

$300M Term Loan

Debt Instrument [Line Items]

Long-term debt

$ 300,000

$ 300,000

Repayments of debt

$ 60,000

$75M Term Loan

Debt Instrument [Line Items]

Repayments of debt

75,000

$ 20,000

Deferred debt issuance cost

$ 100

$100M Term Loan

Debt Instrument [Line Items]

Basis spread on variable rate

1.85%

Deferred financing costs

$ 200

1,900

Basis point floor

1.35%

0.50%

Term loans, outstanding balance

$ 100,000

Deferred debt issuance cost

500

Private placement notes - unsecured

Debt Instrument [Line Items]

Repayments of debt

175,000

Fannie Mae Term Loans

Debt Instrument [Line Items]

Long-term debt

$ 60,100

Fannie Mae term loans - secured, non-recourse

Debt Instrument [Line Items]

Debt instrument, term

10 years

Deferred financing costs

1,500

Interest rate, stated percentage

3.79%

Properties | property

11

Number of Fannie Mae term loans | loan

2

Fannie Mae term loans, balance

$ 17,900

Fannie Mae term loans, accrued interest

100

Net book value of real estate pledged toward mortgage

$ 100,900

FNMA Berkadia Note

Debt Instrument [Line Items]

Long-term debt

$ 16,100

Interest rate, stated percentage

4.60%

Interest Rate Swaps, Maturity Date, After June 2020

Debt Instrument [Line Items]

Derivative, notional amount

$ 400,000

$ 400,000

Secured Overnight Financing Rate (SOFR)

Debt Instrument [Line Items]

Basis spread on variable rate

1%

Fed Funds Effective Rate Overnight Index Swap Rate

Debt Instrument [Line Items]

Basis spread on variable rate

0.50%

Minimum

Debt Instrument [Line Items]

Line of credit facility, commitment fee percentage

0.125%

Maximum

Debt Instrument [Line Items]

Line of credit facility, commitment fee percentage

0.30%

Senior Notes | 2031 Senior Notes - unsecured, net of discount of $2,278 and $2,600

Debt Instrument [Line Items]

Aggregate principal amount, senior notes

$ 400,000

Interest rate, stated percentage

3%

Percentage of issue price on face value

99.196%

Proceeds from issuance of senior notes

$ 392,300

Revolving Credit Facility | Minimum | Secured Overnight Financing Rate (SOFR)

Debt Instrument [Line Items]

Basis spread on variable rate

0.725%

Revolving Credit Facility | Minimum | Base Rate

Debt Instrument [Line Items]

Basis spread on variable rate

0%

Revolving Credit Facility | Maximum | Secured Overnight Financing Rate (SOFR)

Debt Instrument [Line Items]

Basis spread on variable rate

1.40%

Revolving Credit Facility | Maximum | Base Rate

Debt Instrument [Line Items]

Basis spread on variable rate

0.40%

Revolving Credit Facility | Unsecured Debt

Debt Instrument [Line Items]

Line of credit facility, maximum borrowing capacity

$ 700,000

$ 200,000

$ 700,000

$ 550,000

Debt instrument, number of extension options | extensionOption

2

Debt instrument, extension period

6 months

Debt issuance costs, gross

$ 4,500

Debt instrument, term

2 years

Basis point floor

0.10%

0.10%

4.36%

Unused balance of the unsecured revolving credit facility

$ 455,000

Revolving Credit Facility | Unsecured Debt | Secured Overnight Financing Rate (SOFR)

Debt Instrument [Line Items]

Basis spread on variable rate

0.10%

1.05%

Adjusts basis spread on variable rate

1.25%

Line of credit facility, interest rate at period end

5.34%

Debt Debt (Schedule of Unsecure

Debt Debt (Schedule of Unsecured Term Loans) (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Private placement notes - unsecured
Debt Instrument [Line Items]
Amount	$ 225,000	$ 400,000
September 2024
Debt Instrument [Line Items]
Amount	$ 75,000
Fixed Rate	3.93%
November 2025
Debt Instrument [Line Items]
Amount	$ 50,000
Fixed Rate	4.33%
January 2027
Debt Instrument [Line Items]
Amount	$ 100,000
Fixed Rate	4.51%

Debt Debt (Schedule of Interest

Debt Debt (Schedule of Interest Expense) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Debt Instruments [Abstract]
Interest expense on debt at contractual rates	$ 55,603	$ 42,487	$ 40,866
comprehensive income into interest expense	0	0	7,286
Capitalized interest	(90)	(46)	(40)
Amortization of debt issuance costs, debt discount and other	2,647	2,476	2,698
Total interest expense	$ 58,160	$ 44,917	$ 50,810

Commitments, Contingencies an_3

Commitments, Contingencies and Uncertainties (Schedule of Loan Commitments) (Details) - USD ($) $ in Thousands	1 Months Ended	12 Months Ended
	Jan. 31, 2022	Dec. 31, 2023	Dec. 31, 2022
Net Investment Income [Line Items]
Total		$ 130,725
Remaining		41,398
Encore Senior Living
Net Investment Income [Line Items]
Total	$ 28,500
Funded		(27,700)	$ (14,200)
Senior Living
Net Investment Income [Line Items]
Funded		(48,950)
Montecito Medical Real Estate
Net Investment Income [Line Items]
Total		50,000
Funded		(20,300)	$ (20,300)
Development Commitment | Encore Senior Living
Net Investment Income [Line Items]
Total		50,725
Funded		(49,846)
Remaining		879
Revolving Credit Facility | Senior Living
Net Investment Income [Line Items]
Total		20,000
Funded		(16,250)
Remaining		3,750
Working Capital | Timber Ridge OpCo
Net Investment Income [Line Items]
Total		5,000
Funded		0
Remaining		5,000
Working Capital | Watermark Retirement
Net Investment Income [Line Items]
Total		5,000
Funded		(2,976)
Remaining		2,024
Mezzanine | Montecito Medical Real Estate
Net Investment Income [Line Items]
Total		50,000
Funded		(20,255)
Remaining		29,745
Notes Receivable, Amount Funded
Net Investment Income [Line Items]
Funded		$ (89,327)

Commitments, Contingencies an_4

Commitments, Contingencies and Uncertainties (Off Balance Sheet Credit Loss Liability Roll Forward Schedule) (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($)
Off Balance Sheet, Credit Loss [Roll Forward]
Provision for expected credit losses	$ (404)
Balance at December 31, 2023	279
Accounting Standards Update 2016-13
Off Balance Sheet, Credit Loss [Roll Forward]
Balance at December 31, 2022	$ 683

Commitments, Contingencies an_5

Commitments, Contingencies and Uncertainties (Schedule of Development Commitments) (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Net Investment Income [Line Items]
Total	$ 14,515
Funded	(10,955)
Remaining	3,560
Woodland Village | Capital Improvement Commitment
Net Investment Income [Line Items]
Total	7,515
Funded	(7,425)
Remaining	90
Navion Senior Solutions | Capital Improvement Commitment
Net Investment Income [Line Items]
Total	3,500
Funded	(2,059)
Remaining	1,441
Vizion Health | Capital Improvement Commitment
Net Investment Income [Line Items]
Total	2,000
Funded	(250)
Remaining	1,750
SHOP | Development Commitment
Net Investment Income [Line Items]
Total	1,500
Funded	(1,221)
Remaining	$ 279

Commitments, Contingencies an_6

Commitments, Contingencies and Uncertainties (Narratives) (Details) $ in Thousands			12 Months Ended
	Apr. 01, 2022 USD ($) property jointVenture	Mar. 04, 2022 USD ($)	Dec. 31, 2023 USD ($) jointVenture facility	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)	Jun. 30, 2022 property	Mar. 31, 2022 USD ($)	Sep. 30, 2021 property	Jun. 30, 2021 facility property
Loss Contingencies [Line Items]
Total			$ 14,515
Contingent funding commitment, amount funded			2,700
Proceeds from sales of real estate			$ 57,031	$ 168,958	$ 238,864
Litigation settlement, amount awarded from other party	$ 6,900	$ 6,900
Number of joint ventures | jointVenture			2
Loss on operations transfer, net			$ (20)	$ 710	0
Discovery PropCo
Loss Contingencies [Line Items]
Contingent funding commitment, amount funded			1,000
Discovery PropCo | Capital Addition Purchase Commitments
Loss Contingencies [Line Items]
Total			$ 2,000
Bickford
Loss Contingencies [Line Items]
Properties | facility			39
Bickford | Assessed not probable to occur
Loss Contingencies [Line Items]
Asset disposition, contingent consideration, note receivable					$ 4,500
Bickford | Assessed not probable to occur | Notes Receivable
Loss Contingencies [Line Items]
Note receivable interest rate								10%
Loan term			5 years
Bickford | Negotiations to sale
Loss Contingencies [Line Items]
Properties | property								6	6
Bickford | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Loss Contingencies [Line Items]
Proceeds from sales of real estate			$ 52,100
Proceeds from sale of real estate			52,900
Repayments of secured debt			$ 800
Note receivable interest rate			10%
Holiday Acquisition Holdings
Loss Contingencies [Line Items]
Properties | facility									17
Lease deposit liabilities							$ 8,800
Number of joint ventures | jointVenture	2
Holiday Acquisition Holdings | Facilities Transitioned To Other Operators
Loss Contingencies [Line Items]
Properties | property	1					1
Holiday Acquisition Holdings | Facilities Transitioned to SHOP Partnership Ventures
Loss Contingencies [Line Items]
Properties | property	15
Holiday Acquisition Holdings | Asset Held For Sale In 2022
Loss Contingencies [Line Items]
Properties | property	1

Commitments, Contingencies an_7

Commitments, Contingencies and Uncertainties (Schedule of Contingencies) (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Loss Contingencies [Line Items]
Total	$ 11,600
Funded	(2,700)
Remaining	8,900
IntegraCare
Loss Contingencies [Line Items]
Total	750
Funded	0
Remaining	750
Navion Senior Solutions
Loss Contingencies [Line Items]
Total	4,850
Funded	(2,700)
Remaining	2,150
Discovery
Loss Contingencies [Line Items]
Total	4,000
Funded	0
Remaining	4,000
Ignite Medical Resorts
Loss Contingencies [Line Items]
Total	2,000
Funded	0
Remaining	$ 2,000

Redeemable Noncontrolling Int_3

Redeemable Noncontrolling Interest (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Redeemable Noncontrolling Interests [Roll Forward]
Beginning balance	$ 9,825	$ 0
Initial carrying amount	0	11,738
Reclassification of redeemable noncontrolling interest	0	(1,030)
Contributions	922	0
Net loss	(1,091)	(843)
Distributions	0	(40)
Ending balance	$ 9,656	$ 9,825

Equity and Dividends (Narrative

Equity and Dividends (Narrative) (Details) - USD ($) $ / shares in Units, $ in Thousands										12 Months Ended
	Feb. 16, 2024	Nov. 03, 2023	Aug. 04, 2023	May 05, 2023	Feb. 17, 2023	Nov. 06, 2022	Aug. 05, 2022	May 06, 2022	Feb. 16, 2022	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Mar. 31, 2020
Dividends Payable [Line Items]
Stock repurchased during period (in shares)											2,468,354
Average price of shares repurchased (in usd per share)											$ 61.56
Common stock, par value (in usd per share)										$ 0.01	$ 0.01
At-the market shelf registration, equity offering sales agreement, aggregate sales price													$ 500,000
Issuance of common stock, net (in shares)										0	0	661,951
Common stock issued, price per share (in usd per share)												$ 73.62
Proceeds from equity offering, net										$ 0	$ 0	$ 47,904
Regular dividends declared per common share (in usd per share)		$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 3.60	$ 3.60	$ 3.8025
Subsequent Event
Dividends Payable [Line Items]
Authorized repurchase amount	$ 160,000
Common stock, par value (in usd per share)	$ 0.01
Stock repurchase plan effective period	1 year
Regular dividends declared per common share (in usd per share)	$ 0.90

Equity and Dividends - Schedule

Equity and Dividends - Schedule of Dividends Declared (Details) - $ / shares									12 Months Ended
	Nov. 03, 2023	Aug. 04, 2023	May 05, 2023	Feb. 17, 2023	Nov. 06, 2022	Aug. 05, 2022	May 06, 2022	Feb. 16, 2022	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Equity [Abstract]
Regular dividends declared per common share (in usd per share)	$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 3.60	$ 3.60	$ 3.8025

Share-Based Compensation (Narra

Share-Based Compensation (Narrative) (Details) $ / shares in Units, $ in Millions	1 Months Ended	12 Months Ended
	May 31, 2023 $ / shares shares	Dec. 31, 2023 USD ($) plan $ / shares shares	Dec. 31, 2022 USD ($) $ / shares	Dec. 31, 2021 USD ($) $ / shares	Apr. 30, 2023 shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of incentive plans | plan		2
Weighted average fair value of options granted (in usd per share) | $ / shares		$ 10.56	$ 11.92	$ 14.54
Unrecognized compensation cost		$ 1.8
Intrinsic value of stock options outstanding		1.9
Intrinsic value of stock options exercisable		1.3
Aggregate intrinsic value of stock options exercised		$ 0.1	$ 0.1	$ 0.2
Aggregate intrinsic value of stock options exercised, per share amounts (in usd per share) | $ / shares		$ 1.23	$ 6.13	$ 9.27
Restricted stock expense | 2019 Stock Option Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock option plan, award vesting period	5 years
Restricted stock expense | 2019 Stock Option Plan | Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rights, percentage	20%
Restricted stock expense | 2019 Stock Option Plan | Tranche Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rights, percentage	20%
Restricted stock expense | 2019 Stock Option Plan | Tranche Three
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rights, percentage	20%
Restricted stock expense | 2019 Stock Option Plan | Tranche Four
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rights, percentage	20%
Restricted stock expense | 2019 Stock Option Plan | Tranche Five
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rights, percentage	20%
Restricted stock expense | 2019 Stock Option Plan | Executive Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock option plan, award vesting period	5 years
Shares issued in period (in dollars per shares) | shares	21,000
Stock option plan, award vesting period | $ / shares	$ 49.30
Restricted stock expense | 2019 Stock Option Plan | Executive Officer | Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rights, percentage	20%
Restricted stock expense | 2019 Stock Option Plan | Executive Officer | Tranche Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rights, percentage	20%
Restricted stock expense | 2019 Stock Option Plan | Executive Officer | Tranche Three
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rights, percentage	20%
Restricted stock expense | 2019 Stock Option Plan | Executive Officer | Tranche Four
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rights, percentage	20%
Restricted stock expense | 2019 Stock Option Plan | Executive Officer | Tranche Five
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rights, percentage	20%
Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percent of fair market value		100%
Share-based compensation arrangement by share-based payment award, expiration period		10 years
Non-qualified Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percent of fair market value		100%
2019 Stock Option Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted average fair value of options granted (in usd per share) | $ / shares		$ 11.33
2019 Stock Award Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock option plan, award vesting period		5 years
Share-based compensation arrangement by share-based payment award, expiration period		10 years
Shares available for grants (in shares) | shares		4,089,168
Common Stock | 2019 Stock Option Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares authorized (in shares) | shares	6,000,000				3,000,000
Expected To Be Recognized During 2024
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost		$ 1.3
Expected To Be Recognized During 2025
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost		0.3
Expected To Be Recognized During Thereafter
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	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total share-based compensation expense	$ 4,605	$ 8,613	$ 8,415
Restricted stock expense
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total share-based compensation expense	310	0	0
Stock option expense
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total share-based compensation expense	$ 4,295	$ 8,613	$ 8,415

Share-Based Compensation (Sch_2

Share-Based Compensation (Schedule of Stock Option Valuation Assumptions) (Details)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-Based Payment Arrangement [Abstract]
Dividend yield	6.90%	7%	6.70%
Expected volatility	39%	49.30%	48.10%
Expected lives	2 years 10 months 24 days	2 years 10 months 24 days	2 years 10 months 24 days
Risk-free interest rate	4.56%	1.75%	0.33%

Share-Based Compensation (Sch_3

Share-Based Compensation (Schedule Of Stock Option Activity) (Details) - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Number of Shares
Options outstanding, beginning (in shares)	2,216,175	1,652,505	1,033,838
Options exercised (in shares)	(5,166)
Options forfeited (in shares)	(61,168)
Options expired (in shares)	(88,170)	(74,498)
Options outstanding, December 31 (in shares)	2,447,171	2,216,175	1,652,505
Options exercisable, December 31 (in shares)	2,078,827
Weighted Average Grant Date Fair Value
Outstanding, January 1 (in usd per share)	$ 70.97	$ 78.10	$ 83.54
Exercised (in usd per share)	53.41
Forfeited (in usd per share)		77.93
Options expired (in US dollars per share)	64.33
Outstanding, December 31 (in usd per share)	68.80	$ 70.97	$ 78.10
Exercisable, December 31 (in usd per share)	$ 71.40
Weighted Average Remaining Contractual Life (Years)
Options outstanding, December 31, 2023	2 years 3 months 3 days
Exercisable at December 31, 2023	2 years
2012 Plan
Number of Shares
Options granted (in shares)			12,500
Options exercised (in shares)			(20,000)
Options forfeited (in shares)		(23,000)
Weighted Average Grant Date Fair Value
Granted (in usd per share)			$ 69.20
Exercised (in usd per share)			$ 60.52
Forfeited (in usd per share)	$ 66.44	$ 62.33
2019 Stock Option Plan
Number of Shares
Options granted (in shares)	385,500	718,000	639,500
Options exercised (in shares)		(56,832)
Options forfeited (in shares)			(13,333)
Weighted Average Grant Date Fair Value
Granted (in usd per share)	$ 54.73	$ 53.62	$ 69.20
Exercised (in usd per share)		$ 53.41
Forfeited (in usd per share)			$ 90.79
Grant Date 2-21-2019
Number of Shares
Options outstanding, December 31 (in shares)	301,837
Weighted Average Grant Date Fair Value
Outstanding, December 31 (in usd per share)	$ 79.96
Weighted Average Remaining Contractual Life (Years)
Options outstanding, December 31, 2023	1 month 20 days
Grant Date 2-21-2020
Number of Shares
Options outstanding, December 31 (in shares)	516,000
Weighted Average Grant Date Fair Value
Outstanding, December 31 (in usd per share)	$ 90.79
Weighted Average Remaining Contractual Life (Years)
Options outstanding, December 31, 2023	1 year 1 month 24 days
Grant Date 5-1-2020
Number of Shares
Options outstanding, December 31 (in shares)	7,500
Weighted Average Grant Date Fair Value
Outstanding, December 31 (in usd per share)	$ 53.76
Weighted Average Remaining Contractual Life (Years)
Options outstanding, December 31, 2023	1 year 3 months 29 days
Grant date 2-25-2021
Number of Shares
Options outstanding, December 31 (in shares)	616,000
Weighted Average Grant Date Fair Value
Outstanding, December 31 (in usd per share)	$ 69.20
Weighted Average Remaining Contractual Life (Years)
Options outstanding, December 31, 2023	2 years 1 month 28 days
Grant date 2-25-2022
Number of Shares
Options outstanding, December 31 (in shares)	610,834
Weighted Average Grant Date Fair Value
Outstanding, December 31 (in usd per share)	$ 53.41
Weighted Average Remaining Contractual Life (Years)
Options outstanding, December 31, 2023	3 years 1 month 28 days
Grant date 6-1-2022
Number of Shares
Options outstanding, December 31 (in shares)	25,000
Weighted Average Grant Date Fair Value
Outstanding, December 31 (in usd per share)	$ 59.43
Weighted Average Remaining Contractual Life (Years)
Options outstanding, December 31, 2023	3 years 5 months 1 day
Grant date2-24-2023
Number of Shares
Options outstanding, December 31 (in shares)	370,000
Weighted Average Grant Date Fair Value
Outstanding, December 31 (in usd per share)	$ 54.73
Weighted Average Remaining Contractual Life (Years)
Options outstanding, December 31, 2023	4 years 1 month 24 days

Share-Based Compensation (Sch_4

Share-Based Compensation (Schedule of Non-Vested Share Activity) (Details) - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Number of Shares
Non-vested stock options, period start (in shares)	515,020
Non-vested stock options, period end (in shares)	368,344	515,020
Weighted Average Grant Date Fair Value
Non-vested stock options, period start (in usd per share)	$ 11.48	$ 12.51
Weighted average fair value of options granted (in usd per share)	10.56	$ 11.92	$ 14.54
Non-vested stock options, period end (in usd per share)	$ 12.51
2012 Plan
Number of Shares
Options granted (in shares)			12,500
Options vested (in shares)	(4,168)
Weighted Average Grant Date Fair Value
Weighted average grant date fair value per share, options vested (in usd per share)	$ 14.33
2019 Stock Option Plan
Number of Shares
Options granted (in shares)	385,500	718,000	639,500
Options vested (in shares)	(505,007)
Non-vested options forfeited (in shares)	(23,001)
Weighted Average Grant Date Fair Value
Weighted average fair value of options granted (in usd per share)	$ 11.33
Weighted average grant date fair value per share, options vested (in usd per share)	12.37
Weighted average grant date fair value per share, options forfeited (in shares)	$ 11.80

Earnings Per Common Share (Sche

Earnings Per Common Share (Schedule of Calculation of Basic and Diluted Earnings Per Share) (Details) - USD ($) $ / shares in Units, $ in Thousands									12 Months Ended
	Nov. 03, 2023	Aug. 04, 2023	May 05, 2023	Feb. 17, 2023	Nov. 06, 2022	Aug. 05, 2022	May 06, 2022	Feb. 16, 2022	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Earnings Per Share [Abstract]
Net income									$ 134,381	$ 65,501	$ 111,967
Add: net loss (income) attributable to noncontrolling interests									1,273	902	(163)
Net income attributable to stockholders									135,654	66,403	111,804
Less: net income attributable to unvested restricted stock awards									(57)	0	0
Net income attributable to common stockholders									$ 135,597	$ 66,403	$ 111,804
BASIC:
Weighted average common shares outstanding (in shares)									43,388,794	44,774,708	45,714,221
DILUTED:
Weighted average common shares outstanding (in shares)									43,388,794	44,774,708	45,714,221
Stock options (in shares)									672	19,528	4,823
Convertible debt (in shares)									0	0	10,453
Weighted average dilutive common shares outstanding (in shares)									43,389,466	44,794,236	45,729,497
Net income attributable to common stockholders - basic (in usd per share)									$ 3.13	$ 1.48	$ 2.45
Net income attributable to common stockholders - diluted (in usd per share)									$ 3.13	$ 1.48	$ 2.44
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)									802,506	564,803	383,716
Regular dividends declared per common share (in usd per share)	$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 3.60	$ 3.60	$ 3.8025

Fair Value of Financial Instr_3

Fair Value of Financial Instruments (Fair Value Measurements, Nonrecurring) (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Carrying Amount | Level 2 | Variable rate debt
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt instrument, fair value disclosure	$ 439,693	$ 277,699
Carrying Amount | Level 2 | Fixed rate debt
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt instrument, fair value disclosure	695,358	869,812
Carrying Amount | Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Mortgage and other notes receivable, net	245,271	233,141
Fair Value Measurement | Level 2 | Variable rate debt
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt instrument, fair value disclosure	445,000	282,000
Fair Value Measurement | Level 2 | Fixed rate debt
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt instrument, fair value disclosure	616,852	773,994
Fair Value Measurement | Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Mortgage and other notes receivable, net	$ 237,646	$ 227,611

Income Taxes (Narrative) (Detai

Income Taxes (Narrative) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Operating Loss Carryforwards [Line Items]
Deferred tax asset	$ 2.2	$ 1.5
State income tax payments	0.1	0.1	$ 0.1
State and Local Jurisdiction
Operating Loss Carryforwards [Line Items]
Income tax expense (benefit)	$ 0.1	$ 0.1	$ 0.1

Income Taxes (Schedule of Divid

Income Taxes (Schedule of Dividends Paid, Per Share) (Details) - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Examination [Line Items]
Dividends paid per common share (in usd per share)	$ 3.60	$ 3.60	$ 3.8025
Ordinary income
Income Tax Examination [Line Items]
Dividends paid per common share (in usd per share)	2.40807	2.61966	2.87799
Capital gain
Income Tax Examination [Line Items]
Dividends paid per common share (in usd per share)	0.24805	0	0.43890
Return of capital
Income Tax Examination [Line Items]
Dividends paid per common share (in usd per share)	$ 0.94388	$ 0.98034	$ 0.48562

Segment Reporting (Narrative) (

Segment Reporting (Narrative) (Details) $ in Millions	12 Months Ended
	Dec. 31, 2023 USD ($) jointVenture property operatingSegment	Dec. 31, 2022 USD ($)	Apr. 01, 2022 jointVenture property	Jun. 30, 2021 facility
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 | $	$ 9.3	$ 3.3
Real Estate Investments
Segment Reporting Information [Line Items]
Properties | property	163
Capital expenditures | $	$ 56.9	$ 30.8
Holiday Acquisition Holdings
Segment Reporting Information [Line Items]
Properties | facility				17
Number of joint ventures | jointVenture			2
Independent Living Facilities
Segment Reporting Information [Line Items]
Properties | property	3
Number of joint ventures | jointVenture	2
Independent Living Facilities | 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		12 Months Ended
		Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Segment Reporting Information [Line Items]
Rental income		$ 249,227	$ 217,700	$ 271,049
Resident fees and services		48,809	35,796	0
Interest income and other		21,799	24,698	27,666
Total revenues		319,835	278,194	298,715
Senior housing operating expenses		39,587	28,193	0
Taxes and insurance on leased properties		11,513	9,788	11,638
NOI		268,735	240,213
Depreciation		69,973	70,880	80,798
Interest		58,160	44,917	50,810
Legal		507	2,555	908
Franchise, excise and other taxes		449	844	788
General and administrative		19,314	22,768	18,431
Loan and realty losses, net		1,376	61,911	52,766
Gains on sales of real estate, net		(14,721)	(28,342)	(32,498)
Loss on operations transfer, net		(20)	710	0
Other income		(202)	0	(350)
Gain on note receivable payoff		0	(1,113)	0
Loss on early retirement of debt		73	151	1,912
Gains from equity method investment		(555)	(569)	1,545
Net income (loss)		134,381	65,501	$ 111,967
Total assets	[1]	2,488,480	2,507,424
Operating Segments | Real Estate Investments
Segment Reporting Information [Line Items]
Rental income		249,227	217,700
Resident fees and services		0	0
Interest income and other		21,448	24,383
Total revenues		270,675	242,083
Senior housing operating expenses		0	0
Taxes and insurance on leased properties		11,513	9,788
NOI		259,162	232,295
Depreciation		60,764	64,407
Interest		3,071	3,089
Legal		0	0
Franchise, excise and other taxes		0	0
General and administrative		0	0
Loan and realty losses, net		1,376	61,911
Gains on sales of real estate, net		(14,721)	(28,342)
Loss on operations transfer, net		(20)	710
Other income		(202)
Gain on note receivable payoff			(1,113)
Loss on early retirement of debt		0	0
Gains from equity method investment		(555)	(569)
Net income (loss)		209,449	132,202
Total assets		2,202,647	2,225,176
Operating Segments | SHOP
Segment Reporting Information [Line Items]
Rental income		0	0
Resident fees and services		48,809	35,796
Interest income and other		0	0
Total revenues		48,809	35,796
Senior housing operating expenses		39,587	28,193
Taxes and insurance on leased properties		0	0
NOI		9,222	7,603
Depreciation		9,158	6,408
Interest		0	0
Legal		0	0
Franchise, excise and other taxes		0	0
General and administrative		0	0
Loan and realty losses, net		0	0
Gains on sales of real estate, net		0	0
Loss on operations transfer, net		0	0
Other income		0
Gain on note receivable payoff			0
Loss on early retirement of debt		0	0
Gains from equity method investment		0	0
Net income (loss)		64	1,195
Total assets		270,051	274,135
Non-segment/Corporate
Segment Reporting Information [Line Items]
Rental income		0	0
Resident fees and services		0	0
Interest income and other		351	315
Total revenues		351	315
Senior housing operating expenses		0	0
Taxes and insurance on leased properties		0	0
NOI		351	315
Depreciation		51	65
Interest		55,089	41,828
Legal		507	2,555
Franchise, excise and other taxes		449	844
General and administrative		19,314	22,768
Loan and realty losses, net		0	0
Gains on sales of real estate, net		0	0
Loss on operations transfer, net		0	0
Other income		0
Gain on note receivable payoff			0
Loss on early retirement of debt		73	151
Gains from equity method investment		0	0
Net income (loss)		(75,132)	(67,896)
Total assets		$ 15,782	$ 8,113
[1] The consolidated balance sheets include the following amounts related to our consolidated Variable Interest Entities (VIEs): $513.2 million and $519.8 million of Real estate properties, net; $10.9 million and $10.3 million of Cash and cash equivalents; $9.7 million and $7.1 million of Straight-line rents receivable; $9.4 million and $1.3 million of Other assets, net; and $4.7 million and $3.3 million of Accounts payable and accrued expenses as of December 31, 2023 and 2022, respectively.

Variable Interest Entities - Na

Variable Interest Entities - Narrative (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($) realEstatePartnership	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Property, Plant and Equipment [Line Items]
Property, plant and equipment, net	$ 2,107,082	$ 2,118,210
Cash and cash equivalents	$ 22,347	19,291	$ 37,412
Number of real estate partnerships | realEstatePartnership	2
Other assets, net	$ 24,063	16,585
Subsidiaries
Property, Plant and Equipment [Line Items]
Property, plant and equipment, net	252,500	259,200
Cash and cash equivalents	3,200	3,400
Accounts receivable, net	9,700	7,100
Other assets, net	7,800	100
SHOP
Property, Plant and Equipment [Line Items]
Property, plant and equipment, net	260,700	260,600
Cash and cash equivalents	7,700	6,900
Prepaid expense	900	700
Accounts receivable, net	800	700
Credit liabilities of SHOP	$ (4,700)	$ (3,300)

Variable Interest Entities - Sc

Variable Interest Entities - Schedule of Variable Interest Entities (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Senior Living Communities | Straight-Line Rent Receivable
Variable Interest Entity [Line Items]
Carrying Amount	$ 89,406
Maximum Exposure to Loss	93,156
Senior Living Management | Straight-Line Rent Receivable
Variable Interest Entity [Line Items]
Carrying Amount	24,500
Maximum Exposure to Loss	24,500
Bickford | Straight-Line Rent Receivable
Variable Interest Entity [Line Items]
Carrying Amount	16,909
Maximum Exposure to Loss	29,550
Encore Senior Living | Notes Receivable
Variable Interest Entity [Line Items]
Carrying Amount	56,578
Maximum Exposure to Loss	57,432
Timber Ridge OpCo
Variable Interest Entity [Line Items]
Maximum Exposure to Loss	5,000
Timber Ridge OpCo | Notes Receivable
Variable Interest Entity [Line Items]
Carrying Amount	1,348
Maximum Exposure to Loss	6,348
Watermark Retirement | Notes Receivable
Variable Interest Entity [Line Items]
Carrying Amount	9,551
Maximum Exposure to Loss	11,574
Montecito Medical Real Estate | Notes Receivable
Variable Interest Entity [Line Items]
Carrying Amount	20,509
Maximum Exposure to Loss	50,254
Vizion Health | Notes Receivable
Variable Interest Entity [Line Items]
Carrying Amount	16,481
Maximum Exposure to Loss	16,481
Navion Senior Solutions | Notes Receivable
Variable Interest Entity [Line Items]
Carrying Amount	7,992
Maximum Exposure to Loss	7,992
Kindcare Senior Living | Notes Receivable
Variable Interest Entity [Line Items]
Carrying Amount	751
Maximum Exposure to Loss	$ 751

Schedule III - Real Estate an_2

Schedule III - Real Estate and Accumulated Depreciation Schedule III - Real Estate and Accumulated Depreciation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 76,241
Initial cost to company, land	180,749
Initial cost to company, building and improvements	2,537,123
Cost capitalized subsequent to acquisition	62,486
Land	180,749
Building and improvements, amount	2,599,609
Investment in real estate, gross	2,780,358	$ 2,729,898	$ 2,894,548	$ 3,265,070
Accumulated depreciation	$ 673,276	$ 611,688	$ 576,668	$ 597,638
Property, plant and equipment, useful life	40 years
Investment in real estate, federal income tax basis	$ 2,100,000
Real estate investment properties
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	76,241
Initial cost to company, land	164,588
Initial cost to company, building and improvements	2,217,812
Cost capitalized subsequent to acquisition	48,013
Land	164,588
Building and improvements, amount	2,265,825
Investment in real estate, gross	2,430,413
Accumulated depreciation	586,139
Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	34,450
Initial cost to company, building and improvements	516,143
Cost capitalized subsequent to acquisition	7,403
Land	34,450
Building and improvements, amount	523,546
Investment in real estate, gross	557,996
Accumulated depreciation	226,627
Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	60,139
Initial cost to company, land	53,043
Initial cost to company, building and improvements	700,582
Cost capitalized subsequent to acquisition	8,627
Land	53,043
Building and improvements, amount	709,209
Investment in real estate, gross	762,252
Accumulated depreciation	148,912
Independent Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	16,102
Initial cost to company, land	5,266
Initial cost to company, building and improvements	92,729
Cost capitalized subsequent to acquisition	10,491
Land	5,266
Building and improvements, amount	103,220
Investment in real estate, gross	108,486
Accumulated depreciation	22,165
Senior Living Campuses
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	12,585
Initial cost to company, building and improvements	197,869
Cost capitalized subsequent to acquisition	4,240
Land	12,585
Building and improvements, amount	202,109
Investment in real estate, gross	214,694
Accumulated depreciation	36,122
Entrance-Fee Communities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	57,774
Initial cost to company, building and improvements	671,709
Cost capitalized subsequent to acquisition	17,002
Land	57,774
Building and improvements, amount	688,711
Investment in real estate, gross	746,485
Accumulated depreciation	149,622
Hospitals
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,470
Initial cost to company, building and improvements	38,780
Cost capitalized subsequent to acquisition	250
Land	1,470
Building and improvements, amount	39,030
Investment in real estate, gross	40,500
Accumulated depreciation	2,691
Senior Housing Operating
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	14,870
Initial cost to company, building and improvements	318,634
Cost capitalized subsequent to acquisition	13,890
Land	14,870
Building and improvements, amount	332,524
Investment in real estate, gross	347,394
Accumulated depreciation	86,660
Corporate office
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,291
Initial cost to company, building and improvements	677
Cost capitalized subsequent to acquisition	583
Land	1,291
Building and improvements, amount	1,260
Investment in real estate, gross	2,551
Accumulated depreciation	477
Subsequent Property Additions Purchased From NHC
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Initial cost to company, building and improvements	33,900
Anniston, AL | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	70
Initial cost to company, building and improvements	4,477
Cost capitalized subsequent to acquisition	0
Land	70
Building and improvements, amount	4,477
Investment in real estate, gross	4,547
Accumulated depreciation	$ 3,795
Date acquired, constructed	Oct. 17, 1991
Moulton, AL | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	25
Initial cost to company, building and improvements	688
Cost capitalized subsequent to acquisition	0
Land	25
Building and improvements, amount	688
Investment in real estate, gross	713
Accumulated depreciation	$ 688
Date acquired, constructed	Oct. 17, 1991
Avondale, AZ | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	453
Initial cost to company, building and improvements	6,678
Cost capitalized subsequent to acquisition	0
Land	453
Building and improvements, amount	6,678
Investment in real estate, gross	7,131
Accumulated depreciation	$ 4,642
Date acquired, constructed	Aug. 13, 1996
Brooksville, FL | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,217
Initial cost to company, building and improvements	16,166
Cost capitalized subsequent to acquisition	0
Land	1,217
Building and improvements, amount	16,166
Investment in real estate, gross	17,383
Accumulated depreciation	$ 5,624
Date acquired, constructed	Feb. 01, 2010
Crystal River, FL | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	912
Initial cost to company, building and improvements	12,117
Cost capitalized subsequent to acquisition	0
Land	912
Building and improvements, amount	12,117
Investment in real estate, gross	13,029
Accumulated depreciation	$ 4,216
Date acquired, constructed	Feb. 01, 2010
Dade City, FL | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	605
Initial cost to company, building and improvements	8,042
Cost capitalized subsequent to acquisition	0
Land	605
Building and improvements, amount	8,042
Investment in real estate, gross	8,647
Accumulated depreciation	$ 2,798
Date acquired, constructed	Feb. 01, 2010
Hudson, FL (2 facilities) | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,290
Initial cost to company, building and improvements	22,392
Cost capitalized subsequent to acquisition	0
Land	1,290
Building and improvements, amount	22,392
Investment in real estate, gross	23,682
Accumulated depreciation	13,323
Merritt Island, FL | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	701
Initial cost to company, building and improvements	8,869
Cost capitalized subsequent to acquisition	0
Land	701
Building and improvements, amount	8,869
Investment in real estate, gross	9,570
Accumulated depreciation	$ 7,832
Date acquired, constructed	Oct. 17, 1991
New Port Richey, FL | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	228
Initial cost to company, building and improvements	3,023
Cost capitalized subsequent to acquisition	0
Land	228
Building and improvements, amount	3,023
Investment in real estate, gross	3,251
Accumulated depreciation	$ 1,052
Date acquired, constructed	Feb. 01, 2010
Plant City, FL | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	405
Initial cost to company, building and improvements	8,777
Cost capitalized subsequent to acquisition	0
Land	405
Building and improvements, amount	8,777
Investment in real estate, gross	9,182
Accumulated depreciation	$ 7,687
Date acquired, constructed	Oct. 17, 1991
Stuart, FL | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	787
Initial cost to company, building and improvements	9,048
Cost capitalized subsequent to acquisition	0
Land	787
Building and improvements, amount	9,048
Investment in real estate, gross	9,835
Accumulated depreciation	$ 8,146
Date acquired, constructed	Oct. 17, 1991
Trenton, FL | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	851
Initial cost to company, building and improvements	11,312
Cost capitalized subsequent to acquisition	0
Land	851
Building and improvements, amount	11,312
Investment in real estate, gross	12,163
Accumulated depreciation	$ 3,935
Date acquired, constructed	Feb. 01, 2010
Glasgow, KY | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	33
Initial cost to company, building and improvements	2,110
Cost capitalized subsequent to acquisition	0
Land	33
Building and improvements, amount	2,110
Investment in real estate, gross	2,143
Accumulated depreciation	$ 2,069
Date acquired, constructed	Oct. 17, 1991
Desloge, MO | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	178
Initial cost to company, building and improvements	3,804
Cost capitalized subsequent to acquisition	0
Land	178
Building and improvements, amount	3,804
Investment in real estate, gross	3,982
Accumulated depreciation	$ 3,804
Date acquired, constructed	Oct. 17, 1991
Joplin, MO | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	175
Initial cost to company, building and improvements	4,034
Cost capitalized subsequent to acquisition	0
Land	175
Building and improvements, amount	4,034
Investment in real estate, gross	4,209
Accumulated depreciation	$ 3,381
Date acquired, constructed	Oct. 17, 1991
Kennett, MO | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	180
Initial cost to company, building and improvements	4,928
Cost capitalized subsequent to acquisition	0
Land	180
Building and improvements, amount	4,928
Investment in real estate, gross	5,108
Accumulated depreciation	$ 4,814
Date acquired, constructed	Oct. 17, 1991
Maryland Heights, MO | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	150
Initial cost to company, building and improvements	4,790
Cost capitalized subsequent to acquisition	0
Land	150
Building and improvements, amount	4,790
Investment in real estate, gross	4,940
Accumulated depreciation	$ 4,675
Date acquired, constructed	Oct. 17, 1991
St. Charles, MO | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	420
Initial cost to company, building and improvements	5,512
Cost capitalized subsequent to acquisition	0
Land	420
Building and improvements, amount	5,512
Investment in real estate, gross	5,932
Accumulated depreciation	$ 5,512
Date acquired, constructed	Oct. 17, 1991
St. Charles, MO | Independent Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	344
Initial cost to company, building and improvements	3,181
Cost capitalized subsequent to acquisition	0
Land	344
Building and improvements, amount	3,181
Investment in real estate, gross	3,525
Accumulated depreciation	$ 2,778
Date acquired, constructed	Oct. 17, 1991
Albany, OR | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	190
Initial cost to company, building and improvements	10,415
Cost capitalized subsequent to acquisition	0
Land	190
Building and improvements, amount	10,415
Investment in real estate, gross	10,605
Accumulated depreciation	$ 2,959
Date acquired, constructed	Mar. 31, 2014
Creswell, OR | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	470
Initial cost to company, building and improvements	8,946
Cost capitalized subsequent to acquisition	0
Land	470
Building and improvements, amount	8,946
Investment in real estate, gross	9,416
Accumulated depreciation	$ 2,439
Date acquired, constructed	Mar. 31, 2014
Forest Grove, OR | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	540
Initial cost to company, building and improvements	11,848
Cost capitalized subsequent to acquisition	0
Land	540
Building and improvements, amount	11,848
Investment in real estate, gross	12,388
Accumulated depreciation	$ 3,286
Date acquired, constructed	Mar. 31, 2014
Anderson, SC | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	308
Initial cost to company, building and improvements	4,643
Cost capitalized subsequent to acquisition	0
Land	308
Building and improvements, amount	4,643
Investment in real estate, gross	4,951
Accumulated depreciation	$ 4,504
Date acquired, constructed	Oct. 17, 1991
Greenwood, SC | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	174
Initial cost to company, building and improvements	3,457
Cost capitalized subsequent to acquisition	0
Land	174
Building and improvements, amount	3,457
Investment in real estate, gross	3,631
Accumulated depreciation	$ 3,291
Date acquired, constructed	Oct. 17, 1991
Laurens, SC | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	42
Initial cost to company, building and improvements	3,426
Cost capitalized subsequent to acquisition	0
Land	42
Building and improvements, amount	3,426
Investment in real estate, gross	3,468
Accumulated depreciation	$ 3,185
Date acquired, constructed	Oct. 17, 1991
Orangeburg, SC | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	300
Initial cost to company, building and improvements	3,714
Cost capitalized subsequent to acquisition	0
Land	300
Building and improvements, amount	3,714
Investment in real estate, gross	4,014
Accumulated depreciation	$ 1,478
Date acquired, constructed	Sep. 25, 2008
Athens, TN | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	38
Initial cost to company, building and improvements	1,463
Cost capitalized subsequent to acquisition	0
Land	38
Building and improvements, amount	1,463
Investment in real estate, gross	1,501
Accumulated depreciation	$ 1,377
Date acquired, constructed	Oct. 17, 1991
Chattanooga, TN | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	143
Initial cost to company, building and improvements	2,309
Cost capitalized subsequent to acquisition	0
Land	143
Building and improvements, amount	2,309
Investment in real estate, gross	2,452
Accumulated depreciation	$ 2,300
Date acquired, constructed	Oct. 17, 1991
Chattanooga, TN | Independent Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	9
Initial cost to company, building and improvements	1,567
Cost capitalized subsequent to acquisition	1
Land	9
Building and improvements, amount	1,568
Investment in real estate, gross	1,577
Accumulated depreciation	$ 1,473
Date acquired, constructed	Oct. 17, 1991
Dickson, TN | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	90
Initial cost to company, building and improvements	3,541
Cost capitalized subsequent to acquisition	0
Land	90
Building and improvements, amount	3,541
Investment in real estate, gross	3,631
Accumulated depreciation	$ 3,294
Date acquired, constructed	Oct. 17, 1991
Franklin, TN | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	47
Initial cost to company, building and improvements	1,130
Cost capitalized subsequent to acquisition	0
Land	47
Building and improvements, amount	1,130
Investment in real estate, gross	1,177
Accumulated depreciation	$ 1,130
Date acquired, constructed	Oct. 17, 1991
Hendersonville, TN | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	363
Initial cost to company, building and improvements	3,837
Cost capitalized subsequent to acquisition	0
Land	363
Building and improvements, amount	3,837
Investment in real estate, gross	4,200
Accumulated depreciation	$ 3,438
Date acquired, constructed	Oct. 17, 1991
Johnson City, TN | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	85
Initial cost to company, building and improvements	1,918
Cost capitalized subsequent to acquisition	0
Land	85
Building and improvements, amount	1,918
Investment in real estate, gross	2,003
Accumulated depreciation	$ 1,917
Date acquired, constructed	Oct. 17, 1991
Johnson City, TN | Independent Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	55
Initial cost to company, building and improvements	4,077
Cost capitalized subsequent to acquisition	0
Land	55
Building and improvements, amount	4,077
Investment in real estate, gross	4,132
Accumulated depreciation	$ 3,375
Date acquired, constructed	Oct. 17, 1991
Lewisburg, TN (2 facilities) | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	46
Initial cost to company, building and improvements	994
Cost capitalized subsequent to acquisition	0
Land	46
Building and improvements, amount	994
Investment in real estate, gross	1,040
Accumulated depreciation	$ 994
Date acquired, constructed	Oct. 17, 1991
McMinnville, TN | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	73
Initial cost to company, building and improvements	3,618
Cost capitalized subsequent to acquisition	0
Land	73
Building and improvements, amount	3,618
Investment in real estate, gross	3,691
Accumulated depreciation	$ 3,283
Date acquired, constructed	Oct. 17, 1991
Milan, TN | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	41
Initial cost to company, building and improvements	1,826
Cost capitalized subsequent to acquisition	0
Land	41
Building and improvements, amount	1,826
Investment in real estate, gross	1,867
Accumulated depreciation	$ 1,712
Date acquired, constructed	Oct. 17, 1991
Pulaski, TN | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	53
Initial cost to company, building and improvements	3,921
Cost capitalized subsequent to acquisition	0
Land	53
Building and improvements, amount	3,921
Investment in real estate, gross	3,974
Accumulated depreciation	$ 3,536
Date acquired, constructed	Oct. 17, 1991
Lawrenceburg, TN | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	98
Initial cost to company, building and improvements	2,900
Cost capitalized subsequent to acquisition	0
Land	98
Building and improvements, amount	2,900
Investment in real estate, gross	2,998
Accumulated depreciation	$ 2,509
Date acquired, constructed	Oct. 17, 1991
Dunlap, TN | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	35
Initial cost to company, building and improvements	3,679
Cost capitalized subsequent to acquisition	0
Land	35
Building and improvements, amount	3,679
Investment in real estate, gross	3,714
Accumulated depreciation	$ 3,182
Date acquired, constructed	Oct. 17, 1991
Smithville, TN | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	35
Initial cost to company, building and improvements	3,816
Cost capitalized subsequent to acquisition	0
Land	35
Building and improvements, amount	3,816
Investment in real estate, gross	3,851
Accumulated depreciation	$ 3,389
Date acquired, constructed	Oct. 18, 1991
Somerville, TN | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	26
Initial cost to company, building and improvements	677
Cost capitalized subsequent to acquisition	0
Land	26
Building and improvements, amount	677
Investment in real estate, gross	703
Accumulated depreciation	$ 678
Date acquired, constructed	Oct. 19, 1991
Sparta, TN | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	80
Initial cost to company, building and improvements	1,602
Cost capitalized subsequent to acquisition	0
Land	80
Building and improvements, amount	1,602
Investment in real estate, gross	1,682
Accumulated depreciation	$ 1,547
Date acquired, constructed	Oct. 20, 1991
Austin, TX | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	606
Initial cost to company, building and improvements	9,895
Cost capitalized subsequent to acquisition	0
Land	606
Building and improvements, amount	9,895
Investment in real estate, gross	10,501
Accumulated depreciation	$ 2,232
Date acquired, constructed	Apr. 01, 2016
Canton, TX | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	420
Initial cost to company, building and improvements	12,330
Cost capitalized subsequent to acquisition	0
Land	420
Building and improvements, amount	12,330
Investment in real estate, gross	12,750
Accumulated depreciation	$ 4,014
Date acquired, constructed	Apr. 18, 2013
Corinth, TX | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,075
Initial cost to company, building and improvements	13,935
Cost capitalized subsequent to acquisition	0
Land	1,075
Building and improvements, amount	13,935
Investment in real estate, gross	15,010
Accumulated depreciation	$ 4,745
Date acquired, constructed	Apr. 18, 2013
Ennis, TX | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	986
Initial cost to company, building and improvements	9,025
Cost capitalized subsequent to acquisition	0
Land	986
Building and improvements, amount	9,025
Investment in real estate, gross	10,011
Accumulated depreciation	$ 3,305
Date acquired, constructed	Oct. 31, 2011
Euless, TX | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,241
Initial cost to company, building and improvements	12,629
Cost capitalized subsequent to acquisition	0
Land	1,241
Building and improvements, amount	12,629
Investment in real estate, gross	13,870
Accumulated depreciation	$ 3,070
Date acquired, constructed	Apr. 01, 2016
Fort Worth, TX | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,380
Initial cost to company, building and improvements	14,370
Cost capitalized subsequent to acquisition	0
Land	1,380
Building and improvements, amount	14,370
Investment in real estate, gross	15,750
Accumulated depreciation	$ 2,738
Date acquired, constructed	May 10, 2018
Garland, TX | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,440
Initial cost to company, building and improvements	14,310
Cost capitalized subsequent to acquisition	0
Land	1,440
Building and improvements, amount	14,310
Investment in real estate, gross	15,750
Accumulated depreciation	$ 2,721
Date acquired, constructed	May 10, 2018
Gladewater, TX | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	70
Initial cost to company, building and improvements	17,840
Cost capitalized subsequent to acquisition	0
Land	70
Building and improvements, amount	17,840
Investment in real estate, gross	17,910
Accumulated depreciation	$ 3,835
Date acquired, constructed	Apr. 01, 2016
Greenville, TX | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,800
Initial cost to company, building and improvements	13,948
Cost capitalized subsequent to acquisition	0
Land	1,800
Building and improvements, amount	13,948
Investment in real estate, gross	15,748
Accumulated depreciation	$ 4,886
Date acquired, constructed	Oct. 31, 2011
Houston, TX (3 facilities) | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	2,808
Initial cost to company, building and improvements	42,511
Cost capitalized subsequent to acquisition	0
Land	2,808
Building and improvements, amount	42,511
Investment in real estate, gross	45,319
Accumulated depreciation	15,482
Katy, TX | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	610
Initial cost to company, building and improvements	13,893
Cost capitalized subsequent to acquisition	0
Land	610
Building and improvements, amount	13,893
Investment in real estate, gross	14,503
Accumulated depreciation	$ 3,159
Date acquired, constructed	Apr. 01, 2016
Kyle, TX | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,096
Initial cost to company, building and improvements	12,279
Cost capitalized subsequent to acquisition	0
Land	1,096
Building and improvements, amount	12,279
Investment in real estate, gross	13,375
Accumulated depreciation	$ 4,346
Date acquired, constructed	Jun. 11, 2012
Marble Falls, TX | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	480
Initial cost to company, building and improvements	14,989
Cost capitalized subsequent to acquisition	0
Land	480
Building and improvements, amount	14,989
Investment in real estate, gross	15,469
Accumulated depreciation	$ 3,331
Date acquired, constructed	Apr. 01, 2016
McAllen, TX | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,175
Initial cost to company, building and improvements	8,259
Cost capitalized subsequent to acquisition	0
Land	1,175
Building and improvements, amount	8,259
Investment in real estate, gross	9,434
Accumulated depreciation	$ 2,045
Date acquired, constructed	Apr. 01, 2016
New Braunfels, TX | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,430
Initial cost to company, building and improvements	13,666
Cost capitalized subsequent to acquisition	0
Land	1,430
Building and improvements, amount	13,666
Investment in real estate, gross	15,096
Accumulated depreciation	$ 3,174
Date acquired, constructed	Feb. 24, 2017
San Antonio, TX (3 facilities) | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	2,370
Initial cost to company, building and improvements	40,054
Cost capitalized subsequent to acquisition	0
Land	2,370
Building and improvements, amount	40,054
Investment in real estate, gross	42,424
Accumulated depreciation	11,730
Waxahachie, TX | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,330
Initial cost to company, building and improvements	14,349
Cost capitalized subsequent to acquisition	0
Land	1,330
Building and improvements, amount	14,349
Investment in real estate, gross	15,679
Accumulated depreciation	$ 2,879
Date acquired, constructed	Jan. 17, 2018
Bristol, VA | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	176
Initial cost to company, building and improvements	2,511
Cost capitalized subsequent to acquisition	0
Land	176
Building and improvements, amount	2,511
Investment in real estate, gross	2,687
Accumulated depreciation	$ 2,511
Date acquired, constructed	Oct. 17, 1991
Oak Creek, WI | Skilled Nursing Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	2,000
Initial cost to company, building and improvements	14,903
Cost capitalized subsequent to acquisition	7,403
Land	2,000
Building and improvements, amount	22,306
Investment in real estate, gross	24,306
Accumulated depreciation	$ 3,003
Date acquired, constructed	Dec. 07, 2018
Rainbow City, AL | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	670
Initial cost to company, building and improvements	11,330
Cost capitalized subsequent to acquisition	0
Land	670
Building and improvements, amount	11,330
Investment in real estate, gross	12,000
Accumulated depreciation	$ 3,211
Date acquired, constructed	Oct. 31, 2013
Sacramento, CA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	660
Initial cost to company, building and improvements	10,840
Cost capitalized subsequent to acquisition	0
Land	660
Building and improvements, amount	10,840
Investment in real estate, gross	11,500
Accumulated depreciation	$ 2,962
Date acquired, constructed	Jun. 01, 2014
Pueblo West, CO | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	169
Initial cost to company, building and improvements	7,431
Cost capitalized subsequent to acquisition	0
Land	169
Building and improvements, amount	7,431
Investment in real estate, gross	7,600
Accumulated depreciation	$ 984
Date acquired, constructed	Jul. 23, 2019
Greensboro, GA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	672
Initial cost to company, building and improvements	4,849
Cost capitalized subsequent to acquisition	631
Land	672
Building and improvements, amount	5,480
Investment in real estate, gross	6,152
Accumulated depreciation	$ 1,694
Date acquired, constructed	Sep. 15, 2011
Ames, IA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 3,193
Initial cost to company, land	360
Initial cost to company, building and improvements	4,670
Cost capitalized subsequent to acquisition	0
Land	360
Building and improvements, amount	4,670
Investment in real estate, gross	5,030
Accumulated depreciation	$ 1,377
Date acquired, constructed	Jun. 28, 2013
Burlington, IA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 3,901
Initial cost to company, land	200
Initial cost to company, building and improvements	8,374
Cost capitalized subsequent to acquisition	0
Land	200
Building and improvements, amount	8,374
Investment in real estate, gross	8,574
Accumulated depreciation	$ 2,477
Date acquired, constructed	Jun. 28, 2013
Cedar Falls, IA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	260
Initial cost to company, building and improvements	4,700
Cost capitalized subsequent to acquisition	30
Land	260
Building and improvements, amount	4,730
Investment in real estate, gross	4,990
Accumulated depreciation	$ 1,428
Date acquired, constructed	Jun. 28, 2013
Ft. Dodge, IA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 4,008
Initial cost to company, land	100
Initial cost to company, building and improvements	7,208
Cost capitalized subsequent to acquisition	0
Land	100
Building and improvements, amount	7,208
Investment in real estate, gross	7,308
Accumulated depreciation	$ 2,090
Date acquired, constructed	Jun. 28, 2013
Iowa City, IA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	297
Initial cost to company, building and improvements	2,725
Cost capitalized subsequent to acquisition	33
Land	297
Building and improvements, amount	2,758
Investment in real estate, gross	3,055
Accumulated depreciation	$ 1,040
Date acquired, constructed	Jun. 30, 2010
Marshalltown, IA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 5,714
Initial cost to company, land	240
Initial cost to company, building and improvements	6,208
Cost capitalized subsequent to acquisition	0
Land	240
Building and improvements, amount	6,208
Investment in real estate, gross	6,448
Accumulated depreciation	$ 1,829
Date acquired, constructed	Jun. 28, 2013
Urbandale, IA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 8,113
Initial cost to company, land	540
Initial cost to company, building and improvements	4,292
Cost capitalized subsequent to acquisition	0
Land	540
Building and improvements, amount	4,292
Investment in real estate, gross	4,832
Accumulated depreciation	$ 1,305
Date acquired, constructed	Jun. 28, 2013
Caldwell, ID | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	320
Initial cost to company, building and improvements	9,353
Cost capitalized subsequent to acquisition	0
Land	320
Building and improvements, amount	9,353
Investment in real estate, gross	9,673
Accumulated depreciation	$ 2,558
Date acquired, constructed	Mar. 31, 2014
Aurora, IL | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,195
Initial cost to company, building and improvements	11,713
Cost capitalized subsequent to acquisition	0
Land	1,195
Building and improvements, amount	11,713
Investment in real estate, gross	12,908
Accumulated depreciation	$ 2,743
Date acquired, constructed	May 09, 2017
Bolingbrook, IL | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,290
Initial cost to company, building and improvements	14,677
Cost capitalized subsequent to acquisition	0
Land	1,290
Building and improvements, amount	14,677
Investment in real estate, gross	15,967
Accumulated depreciation	$ 2,783
Date acquired, constructed	Mar. 16, 2017
Bourbonnais, IL | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 7,974
Initial cost to company, land	170
Initial cost to company, building and improvements	16,594
Cost capitalized subsequent to acquisition	0
Land	170
Building and improvements, amount	16,594
Investment in real estate, gross	16,764
Accumulated depreciation	$ 4,743
Date acquired, constructed	Jun. 28, 2013
Crystal Lake, IL (2 facilities) | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,060
Initial cost to company, building and improvements	30,043
Cost capitalized subsequent to acquisition	170
Land	1,060
Building and improvements, amount	30,213
Investment in real estate, gross	31,273
Accumulated depreciation	5,917
Gurnee, IL | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,244
Initial cost to company, building and improvements	13,856
Cost capitalized subsequent to acquisition	0
Land	1,244
Building and improvements, amount	13,856
Investment in real estate, gross	15,100
Accumulated depreciation	$ 1,781
Date acquired, constructed	Sep. 10, 2019
Moline, IL | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 3,896
Initial cost to company, land	250
Initial cost to company, building and improvements	5,630
Cost capitalized subsequent to acquisition	0
Land	250
Building and improvements, amount	5,630
Investment in real estate, gross	5,880
Accumulated depreciation	$ 1,674
Date acquired, constructed	Jun. 28, 2013
Oswego, IL | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	390
Initial cost to company, building and improvements	20,957
Cost capitalized subsequent to acquisition	212
Land	390
Building and improvements, amount	21,169
Investment in real estate, gross	21,559
Accumulated depreciation	$ 4,251
Date acquired, constructed	Jun. 01, 2016
Quincy, IL | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 6,055
Initial cost to company, land	360
Initial cost to company, building and improvements	12,403
Cost capitalized subsequent to acquisition	0
Land	360
Building and improvements, amount	12,403
Investment in real estate, gross	12,763
Accumulated depreciation	$ 3,596
Date acquired, constructed	Jun. 28, 2013
Rockford, IL | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 6,412
Initial cost to company, land	390
Initial cost to company, building and improvements	12,575
Cost capitalized subsequent to acquisition	0
Land	390
Building and improvements, amount	12,575
Investment in real estate, gross	12,965
Accumulated depreciation	$ 3,664
Date acquired, constructed	Jun. 28, 2013
South Barrington, IL | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,610
Initial cost to company, building and improvements	13,456
Cost capitalized subsequent to acquisition	0
Land	1,610
Building and improvements, amount	13,456
Investment in real estate, gross	15,066
Accumulated depreciation	$ 2,604
Date acquired, constructed	Mar. 16, 2017
St. Charles, IL | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	820
Initial cost to company, building and improvements	22,188
Cost capitalized subsequent to acquisition	252
Land	820
Building and improvements, amount	22,440
Investment in real estate, gross	23,260
Accumulated depreciation	$ 4,547
Date acquired, constructed	Jun. 01, 2016
Tinley Park, IL | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,622
Initial cost to company, building and improvements	11,354
Cost capitalized subsequent to acquisition	0
Land	1,622
Building and improvements, amount	11,354
Investment in real estate, gross	12,976
Accumulated depreciation	$ 2,765
Date acquired, constructed	Jun. 23, 2016
Attica, IN | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	284
Initial cost to company, building and improvements	7,891
Cost capitalized subsequent to acquisition	0
Land	284
Building and improvements, amount	7,891
Investment in real estate, gross	8,175
Accumulated depreciation	$ 874
Date acquired, constructed	May 01, 2020
Carmel, IN | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	463
Initial cost to company, building and improvements	7,055
Cost capitalized subsequent to acquisition	0
Land	463
Building and improvements, amount	7,055
Investment in real estate, gross	7,518
Accumulated depreciation	$ 2,346
Date acquired, constructed	Nov. 12, 2014
Crawfordsville, IN | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	300
Initial cost to company, building and improvements	1,961
Cost capitalized subsequent to acquisition	0
Land	300
Building and improvements, amount	1,961
Investment in real estate, gross	2,261
Accumulated depreciation	$ 921
Date acquired, constructed	Jun. 28, 2013
Crown Point, IN | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	574
Initial cost to company, building and improvements	7,336
Cost capitalized subsequent to acquisition	353
Land	574
Building and improvements, amount	7,689
Investment in real estate, gross	8,263
Accumulated depreciation	$ 2,473
Date acquired, constructed	Oct. 30, 2013
Greenwood, IN | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	791
Initial cost to company, building and improvements	7,020
Cost capitalized subsequent to acquisition	227
Land	791
Building and improvements, amount	7,247
Investment in real estate, gross	8,038
Accumulated depreciation	$ 2,418
Date acquired, constructed	Nov. 07, 2013
Linton, IN | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	60
Initial cost to company, building and improvements	6,015
Cost capitalized subsequent to acquisition	0
Land	60
Building and improvements, amount	6,015
Investment in real estate, gross	6,075
Accumulated depreciation	$ 668
Date acquired, constructed	May 01, 2020
Bastrop, LA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	325
Initial cost to company, building and improvements	2,456
Cost capitalized subsequent to acquisition	0
Land	325
Building and improvements, amount	2,456
Investment in real estate, gross	2,781
Accumulated depreciation	$ 880
Date acquired, constructed	Apr. 30, 2011
Bossier City, LA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	500
Initial cost to company, building and improvements	3,344
Cost capitalized subsequent to acquisition	0
Land	500
Building and improvements, amount	3,344
Investment in real estate, gross	3,844
Accumulated depreciation	$ 1,230
Date acquired, constructed	Apr. 30, 2011
Minden, LA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	280
Initial cost to company, building and improvements	1,698
Cost capitalized subsequent to acquisition	0
Land	280
Building and improvements, amount	1,698
Investment in real estate, gross	1,978
Accumulated depreciation	$ 606
Date acquired, constructed	Apr. 30, 2011
West Monroe, LA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	770
Initial cost to company, building and improvements	5,627
Cost capitalized subsequent to acquisition	0
Land	770
Building and improvements, amount	5,627
Investment in real estate, gross	6,397
Accumulated depreciation	$ 1,953
Date acquired, constructed	Apr. 30, 2011
Frederick, MD | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,942
Initial cost to company, building and improvements	17,415
Cost capitalized subsequent to acquisition	0
Land	1,942
Building and improvements, amount	17,415
Investment in real estate, gross	19,357
Accumulated depreciation	$ 486
Date acquired, constructed	Feb. 04, 2023
Battle Creek, MI | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	398
Initial cost to company, building and improvements	3,093
Cost capitalized subsequent to acquisition	197
Land	398
Building and improvements, amount	3,290
Investment in real estate, gross	3,688
Accumulated depreciation	$ 1,357
Date acquired, constructed	Oct. 19, 2009
Lansing, MI | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,020
Initial cost to company, building and improvements	9,684
Cost capitalized subsequent to acquisition	174
Land	1,020
Building and improvements, amount	9,858
Investment in real estate, gross	10,878
Accumulated depreciation	$ 2,022
Date acquired, constructed	Oct. 19, 2009
Okemos, MI | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	340
Initial cost to company, building and improvements	8,082
Cost capitalized subsequent to acquisition	0
Land	340
Building and improvements, amount	8,082
Investment in real estate, gross	8,422
Accumulated depreciation	$ 3,123
Date acquired, constructed	Nov. 19, 2009
Shelby, MI | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,588
Initial cost to company, building and improvements	13,512
Cost capitalized subsequent to acquisition	0
Land	1,588
Building and improvements, amount	13,512
Investment in real estate, gross	15,100
Accumulated depreciation	$ 1,610
Date acquired, constructed	Jan. 27, 2020
Champlin, MN | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	980
Initial cost to company, building and improvements	4,475
Cost capitalized subsequent to acquisition	0
Land	980
Building and improvements, amount	4,475
Investment in real estate, gross	5,455
Accumulated depreciation	$ 1,664
Date acquired, constructed	Mar. 10, 2010
Hugo, MN | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	400
Initial cost to company, building and improvements	3,945
Cost capitalized subsequent to acquisition	113
Land	400
Building and improvements, amount	4,058
Investment in real estate, gross	4,458
Accumulated depreciation	$ 1,440
Date acquired, constructed	Mar. 10, 2010
Maplewood, MN | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,700
Initial cost to company, building and improvements	6,544
Cost capitalized subsequent to acquisition	0
Land	1,700
Building and improvements, amount	6,544
Investment in real estate, gross	8,244
Accumulated depreciation	$ 2,433
Date acquired, constructed	Mar. 10, 2010
North Branch, MN | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	595
Initial cost to company, building and improvements	3,053
Cost capitalized subsequent to acquisition	0
Land	595
Building and improvements, amount	3,053
Investment in real estate, gross	3,648
Accumulated depreciation	$ 1,165
Date acquired, constructed	Mar. 10, 2010
Mahtomedi, MN | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	515
Initial cost to company, building and improvements	8,825
Cost capitalized subsequent to acquisition	0
Land	515
Building and improvements, amount	8,825
Investment in real estate, gross	9,340
Accumulated depreciation	$ 999
Date acquired, constructed	Dec. 27, 2019
Charlotte, NC | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	650
Initial cost to company, building and improvements	17,663
Cost capitalized subsequent to acquisition	2,000
Land	650
Building and improvements, amount	19,663
Investment in real estate, gross	20,313
Accumulated depreciation	$ 4,642
Date acquired, constructed	Jul. 01, 2015
Durham, NC | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	860
Initial cost to company, building and improvements	7,752
Cost capitalized subsequent to acquisition	994
Land	860
Building and improvements, amount	8,746
Investment in real estate, gross	9,606
Accumulated depreciation	$ 1,183
Date acquired, constructed	Dec. 15, 2017
Hendersonville, NC (2 facilities) | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	3,120
Initial cost to company, building and improvements	12,980
Cost capitalized subsequent to acquisition	0
Land	3,120
Building and improvements, amount	12,980
Investment in real estate, gross	16,100
Accumulated depreciation	$ 2,661
Date acquired, constructed	Mar. 16, 2017
Lincoln, NE | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 8,418
Initial cost to company, land	380
Initial cost to company, building and improvements	10,904
Cost capitalized subsequent to acquisition	0
Land	380
Building and improvements, amount	10,904
Investment in real estate, gross	11,284
Accumulated depreciation	$ 3,116
Date acquired, constructed	Jun. 28, 2013
Omaha, NE (2 facilities) | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 2,455
Initial cost to company, land	1,110
Initial cost to company, building and improvements	15,437
Cost capitalized subsequent to acquisition	851
Land	1,110
Building and improvements, amount	16,288
Investment in real estate, gross	17,398
Accumulated depreciation	4,099
Las Vegas, NV | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	0
Initial cost to company, land	1,951
Initial cost to company, building and improvements	16,184
Cost capitalized subsequent to acquisition	0
Land	1,951
Building and improvements, amount	16,184
Investment in real estate, gross	18,135
Accumulated depreciation	$ 447
Date acquired, constructed	Feb. 14, 2023
Arlington, OH | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	570
Initial cost to company, building and improvements	7,917
Cost capitalized subsequent to acquisition	0
Land	570
Building and improvements, amount	7,917
Investment in real estate, gross	8,487
Accumulated depreciation	$ 1,965
Date acquired, constructed	Apr. 30, 2018
Columbus, OH | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	530
Initial cost to company, building and improvements	6,776
Cost capitalized subsequent to acquisition	0
Land	530
Building and improvements, amount	6,776
Investment in real estate, gross	7,306
Accumulated depreciation	$ 1,757
Date acquired, constructed	Apr. 30, 2018
Lancaster, OH | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	530
Initial cost to company, building and improvements	20,530
Cost capitalized subsequent to acquisition	0
Land	530
Building and improvements, amount	20,530
Investment in real estate, gross	21,060
Accumulated depreciation	$ 5,224
Date acquired, constructed	Jul. 31, 2015
Middletown, OH | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	940
Initial cost to company, building and improvements	15,548
Cost capitalized subsequent to acquisition	0
Land	940
Building and improvements, amount	15,548
Investment in real estate, gross	16,488
Accumulated depreciation	$ 4,059
Date acquired, constructed	Oct. 31, 2014
Rocky River, OH | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	650
Initial cost to company, building and improvements	4,189
Cost capitalized subsequent to acquisition	0
Land	650
Building and improvements, amount	4,189
Investment in real estate, gross	4,839
Accumulated depreciation	$ 871
Date acquired, constructed	Apr. 30, 2018
Worthington, OH | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	0
Initial cost to company, building and improvements	18,869
Cost capitalized subsequent to acquisition	1,476
Land	0
Building and improvements, amount	20,345
Investment in real estate, gross	20,345
Accumulated depreciation	$ 3,996
Date acquired, constructed	Apr. 30, 2018
McMinnville, OR | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	390
Initial cost to company, building and improvements	9,183
Cost capitalized subsequent to acquisition	0
Land	390
Building and improvements, amount	9,183
Investment in real estate, gross	9,573
Accumulated depreciation	$ 1,959
Date acquired, constructed	Aug. 31, 2016
McMinnville, OR | Senior Living Campuses
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	410
Initial cost to company, building and improvements	26,667
Cost capitalized subsequent to acquisition	0
Land	410
Building and improvements, amount	26,667
Investment in real estate, gross	27,077
Accumulated depreciation	$ 5,375
Date acquired, constructed	Aug. 31, 2016
Portland, OR | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	930
Initial cost to company, building and improvements	25,270
Cost capitalized subsequent to acquisition	0
Land	930
Building and improvements, amount	25,270
Investment in real estate, gross	26,200
Accumulated depreciation	$ 4,622
Date acquired, constructed	Aug. 31, 2015
Erie, PA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,030
Initial cost to company, building and improvements	15,206
Cost capitalized subsequent to acquisition	914
Land	1,030
Building and improvements, amount	16,120
Investment in real estate, gross	17,150
Accumulated depreciation	$ 2,418
Date acquired, constructed	Apr. 30, 2018
Reading, PA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,027
Initial cost to company, building and improvements	11,179
Cost capitalized subsequent to acquisition	0
Land	1,027
Building and improvements, amount	11,179
Investment in real estate, gross	12,206
Accumulated depreciation	$ 1,536
Date acquired, constructed	May 31, 2019
Manchester, TN | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	534
Initial cost to company, building and improvements	6,068
Cost capitalized subsequent to acquisition	0
Land	534
Building and improvements, amount	6,068
Investment in real estate, gross	6,602
Accumulated depreciation	$ 522
Date acquired, constructed	Jun. 03, 2021
Chesapeake, VA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,746
Initial cost to company, building and improvements	15,542
Cost capitalized subsequent to acquisition	0
Land	1,746
Building and improvements, amount	15,542
Investment in real estate, gross	17,288
Accumulated depreciation	$ 436
Date acquired, constructed	Feb. 09, 2023
Fredericksburg, VA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,615
Initial cost to company, building and improvements	9,271
Cost capitalized subsequent to acquisition	0
Land	1,615
Building and improvements, amount	9,271
Investment in real estate, gross	10,886
Accumulated depreciation	$ 2,238
Date acquired, constructed	Sep. 20, 2016
Midlothian, VA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,646
Initial cost to company, building and improvements	8,635
Cost capitalized subsequent to acquisition	0
Land	1,646
Building and improvements, amount	8,635
Investment in real estate, gross	10,281
Accumulated depreciation	$ 2,155
Date acquired, constructed	Oct. 31, 2016
Suffolk, VA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,022
Initial cost to company, building and improvements	9,320
Cost capitalized subsequent to acquisition	0
Land	1,022
Building and improvements, amount	9,320
Investment in real estate, gross	10,342
Accumulated depreciation	$ 2,064
Date acquired, constructed	Mar. 25, 2016
Virginia Beach, VA | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	2,052
Initial cost to company, building and improvements	15,148
Cost capitalized subsequent to acquisition	0
Land	2,052
Building and improvements, amount	15,148
Investment in real estate, gross	17,200
Accumulated depreciation	$ 451
Date acquired, constructed	Nov. 10, 2022
Bellevue, WI | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	504
Initial cost to company, building and improvements	11,796
Cost capitalized subsequent to acquisition	0
Land	504
Building and improvements, amount	11,796
Investment in real estate, gross	12,300
Accumulated depreciation	$ 1,192
Date acquired, constructed	Sep. 30, 2020
Oshkosh, WI | Assisted Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	542
Initial cost to company, building and improvements	12,758
Cost capitalized subsequent to acquisition	0
Land	542
Building and improvements, amount	12,758
Investment in real estate, gross	13,300
Accumulated depreciation	$ 608
Date acquired, constructed	Apr. 29, 2022
Vero Beach, FL | Independent Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	550
Initial cost to company, building and improvements	37,450
Cost capitalized subsequent to acquisition	2,543
Land	550
Building and improvements, amount	39,993
Investment in real estate, gross	40,543
Accumulated depreciation	$ 5,343
Date acquired, constructed	Feb. 01, 2019
Columbus, IN | Independent Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	348
Initial cost to company, building and improvements	6,124
Cost capitalized subsequent to acquisition	0
Land	348
Building and improvements, amount	6,124
Investment in real estate, gross	6,472
Accumulated depreciation	$ 812
Date acquired, constructed	May 31, 2019
Tulsa, OK | Independent Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 16,102
Initial cost to company, land	1,980
Initial cost to company, building and improvements	32,620
Cost capitalized subsequent to acquisition	502
Land	1,980
Building and improvements, amount	33,122
Investment in real estate, gross	35,102
Accumulated depreciation	$ 5,698
Date acquired, constructed	Dec. 01, 2017
Tulsa, OK | Hospitals
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,470
Initial cost to company, building and improvements	38,780
Cost capitalized subsequent to acquisition	250
Land	1,470
Building and improvements, amount	39,030
Investment in real estate, gross	40,500
Accumulated depreciation	$ 2,691
Date acquired, constructed	May 28, 2021
Chehalis, WA | Independent Living Facilities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,980
Initial cost to company, building and improvements	7,710
Cost capitalized subsequent to acquisition	7,445
Land	1,980
Building and improvements, amount	15,155
Investment in real estate, gross	17,135
Accumulated depreciation	$ 2,686
Date acquired, constructed	Jan. 15, 2016
Michigan City, IN | Senior Living Campuses
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	974
Initial cost to company, building and improvements	22,667
Cost capitalized subsequent to acquisition	0
Land	974
Building and improvements, amount	22,667
Investment in real estate, gross	23,641
Accumulated depreciation	$ 2,973
Date acquired, constructed	May 31, 2019
Portage, IN | Senior Living Campuses
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	661
Initial cost to company, building and improvements	21,959
Cost capitalized subsequent to acquisition	0
Land	661
Building and improvements, amount	21,959
Investment in real estate, gross	22,620
Accumulated depreciation	$ 2,887
Date acquired, constructed	May 31, 2019
Needham, MA | Senior Living Campuses
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	5,500
Initial cost to company, building and improvements	45,157
Cost capitalized subsequent to acquisition	1,451
Land	5,500
Building and improvements, amount	46,608
Investment in real estate, gross	52,108
Accumulated depreciation	$ 7,268
Date acquired, constructed	Jan. 15, 2019
Salisbury, MD | Senior Living Campuses
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,876
Initial cost to company, building and improvements	44,084
Cost capitalized subsequent to acquisition	471
Land	1,876
Building and improvements, amount	44,555
Investment in real estate, gross	46,431
Accumulated depreciation	$ 6,081
Date acquired, constructed	May 31, 2019
Roscommon, MI | Senior Living Campuses
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	44
Initial cost to company, building and improvements	6,005
Cost capitalized subsequent to acquisition	1
Land	44
Building and improvements, amount	6,006
Investment in real estate, gross	6,050
Accumulated depreciation	$ 1,525
Date acquired, constructed	Aug. 31, 2015
Mt. Airy, NC | Senior Living Campuses
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,370
Initial cost to company, building and improvements	7,470
Cost capitalized subsequent to acquisition	150
Land	1,370
Building and improvements, amount	7,620
Investment in real estate, gross	8,990
Accumulated depreciation	$ 1,992
Date acquired, constructed	Dec. 17, 2014
Silverdale, WA | Senior Living Campuses
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,750
Initial cost to company, building and improvements	23,860
Cost capitalized subsequent to acquisition	2,167
Land	1,750
Building and improvements, amount	26,027
Investment in real estate, gross	27,777
Accumulated depreciation	$ 8,021
Date acquired, constructed	Aug. 16, 2012
Bridgeport, CT | Entrance-Fee Communities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	4,320
Initial cost to company, building and improvements	23,494
Cost capitalized subsequent to acquisition	5,809
Land	4,320
Building and improvements, amount	29,303
Investment in real estate, gross	33,623
Accumulated depreciation	$ 6,582
Date acquired, constructed	Jun. 02, 2016
North Branford, CT | Entrance-Fee Communities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	7,724
Initial cost to company, building and improvements	64,430
Cost capitalized subsequent to acquisition	0
Land	7,724
Building and improvements, amount	64,430
Investment in real estate, gross	72,154
Accumulated depreciation	$ 13,231
Date acquired, constructed	Nov. 03, 2016
Southbury, CT | Entrance-Fee Communities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	10,320
Initial cost to company, building and improvements	17,143
Cost capitalized subsequent to acquisition	6,178
Land	10,320
Building and improvements, amount	23,321
Investment in real estate, gross	33,641
Accumulated depreciation	$ 4,806
Date acquired, constructed	Jun. 02, 2016
Fernandina Beach, FL | Entrance-Fee Communities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,430
Initial cost to company, building and improvements	63,420
Cost capitalized subsequent to acquisition	1,522
Land	1,430
Building and improvements, amount	64,942
Investment in real estate, gross	66,372
Accumulated depreciation	$ 16,255
Date acquired, constructed	Dec. 17, 2014
St. Simons Island, GA | Entrance-Fee Communities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	8,770
Initial cost to company, building and improvements	38,070
Cost capitalized subsequent to acquisition	963
Land	8,770
Building and improvements, amount	39,033
Investment in real estate, gross	47,803
Accumulated depreciation	$ 9,930
Date acquired, constructed	Dec. 17, 2014
Winston-Salem, NC | Entrance-Fee Communities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	8,700
Initial cost to company, building and improvements	73,920
Cost capitalized subsequent to acquisition	507
Land	8,700
Building and improvements, amount	74,427
Investment in real estate, gross	83,127
Accumulated depreciation	$ 18,517
Date acquired, constructed	Dec. 17, 2014
Greenville, SC | Entrance-Fee Communities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	5,850
Initial cost to company, building and improvements	90,760
Cost capitalized subsequent to acquisition	0
Land	5,850
Building and improvements, amount	90,760
Investment in real estate, gross	96,610
Accumulated depreciation	$ 22,216
Date acquired, constructed	Dec. 17, 2014
Greenville, SC | Senior Housing Operating
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	560
Initial cost to company, building and improvements	16,547
Cost capitalized subsequent to acquisition	939
Land	560
Building and improvements, amount	17,486
Investment in real estate, gross	18,046
Accumulated depreciation	$ 4,597
Date acquired, constructed	Apr. 01, 2022
Myrtle Beach, SC | Entrance-Fee Communities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	3,910
Initial cost to company, building and improvements	82,140
Cost capitalized subsequent to acquisition	542
Land	3,910
Building and improvements, amount	82,682
Investment in real estate, gross	86,592
Accumulated depreciation	$ 20,703
Date acquired, constructed	Dec. 17, 2014
Myrtle Beach, SC | Senior Housing Operating
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,310
Initial cost to company, building and improvements	26,229
Cost capitalized subsequent to acquisition	1,434
Land	1,310
Building and improvements, amount	27,663
Investment in real estate, gross	28,973
Accumulated depreciation	$ 7,115
Date acquired, constructed	Apr. 01, 2022
Pawleys Island, SC | Entrance-Fee Communities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,480
Initial cost to company, building and improvements	38,620
Cost capitalized subsequent to acquisition	460
Land	1,480
Building and improvements, amount	39,080
Investment in real estate, gross	40,560
Accumulated depreciation	$ 10,088
Date acquired, constructed	Dec. 17, 2014
Spartanburg, SC | Entrance-Fee Communities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	900
Initial cost to company, building and improvements	49,190
Cost capitalized subsequent to acquisition	1,021
Land	900
Building and improvements, amount	50,211
Investment in real estate, gross	51,111
Accumulated depreciation	$ 12,615
Date acquired, constructed	Dec. 17, 2014
Issaquah, WA | Entrance-Fee Communities
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	4,370
Initial cost to company, building and improvements	130,522
Cost capitalized subsequent to acquisition	0
Land	4,370
Building and improvements, amount	130,522
Investment in real estate, gross	134,892
Accumulated depreciation	$ 14,679
Date acquired, constructed	Jan. 31, 2020
Fort Smith, AR | Senior Housing Operating
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	590
Initial cost to company, building and improvements	22,447
Cost capitalized subsequent to acquisition	486
Land	590
Building and improvements, amount	22,933
Investment in real estate, gross	23,523
Accumulated depreciation	$ 6,080
Date acquired, constructed	Apr. 01, 2022
Rogers, AR | Senior Housing Operating
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,470
Initial cost to company, building and improvements	25,282
Cost capitalized subsequent to acquisition	697
Land	1,470
Building and improvements, amount	25,979
Investment in real estate, gross	27,449
Accumulated depreciation	$ 6,839
Date acquired, constructed	Apr. 01, 2022
Fresno, CA | Senior Housing Operating
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	420
Initial cost to company, building and improvements	10,899
Cost capitalized subsequent to acquisition	404
Land	420
Building and improvements, amount	11,303
Investment in real estate, gross	11,723
Accumulated depreciation	$ 3,052
Date acquired, constructed	Apr. 01, 2022
Modesto, CA | Senior Housing Operating
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,170
Initial cost to company, building and improvements	22,673
Cost capitalized subsequent to acquisition	727
Land	1,170
Building and improvements, amount	23,400
Investment in real estate, gross	24,570
Accumulated depreciation	$ 6,067
Date acquired, constructed	Apr. 01, 2022
Pinole, CA | Senior Housing Operating
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,020
Initial cost to company, building and improvements	18,066
Cost capitalized subsequent to acquisition	722
Land	1,020
Building and improvements, amount	18,788
Investment in real estate, gross	19,808
Accumulated depreciation	$ 4,881
Date acquired, constructed	Apr. 01, 2022
Roseville, CA | Senior Housing Operating
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	630
Initial cost to company, building and improvements	31,343
Cost capitalized subsequent to acquisition	928
Land	630
Building and improvements, amount	32,271
Investment in real estate, gross	32,901
Accumulated depreciation	$ 8,391
Date acquired, constructed	Apr. 01, 2022
West Covina, CA | Senior Housing Operating
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	940
Initial cost to company, building and improvements	20,280
Cost capitalized subsequent to acquisition	1,545
Land	940
Building and improvements, amount	21,825
Investment in real estate, gross	22,765
Accumulated depreciation	$ 5,525
Date acquired, constructed	Apr. 01, 2022
Athens, GA | Senior Housing Operating
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	910
Initial cost to company, building and improvements	31,940
Cost capitalized subsequent to acquisition	1,085
Land	910
Building and improvements, amount	33,025
Investment in real estate, gross	33,935
Accumulated depreciation	$ 8,601
Date acquired, constructed	Apr. 01, 2022
Columbus, GA | Senior Housing Operating
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	570
Initial cost to company, building and improvements	8,639
Cost capitalized subsequent to acquisition	663
Land	570
Building and improvements, amount	9,302
Investment in real estate, gross	9,872
Accumulated depreciation	$ 2,515
Date acquired, constructed	Apr. 01, 2022
Voorhees, NJ | Senior Housing Operating
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	670
Initial cost to company, building and improvements	23,710
Cost capitalized subsequent to acquisition	1,292
Land	670
Building and improvements, amount	25,002
Investment in real estate, gross	25,672
Accumulated depreciation	$ 6,417
Date acquired, constructed	Apr. 01, 2022
Gahanna, OH | Senior Housing Operating
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	920
Initial cost to company, building and improvements	22,919
Cost capitalized subsequent to acquisition	423
Land	920
Building and improvements, amount	23,342
Investment in real estate, gross	24,262
Accumulated depreciation	$ 6,244
Date acquired, constructed	Apr. 01, 2022
Broken Arrow, OK | Senior Housing Operating
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	2,660
Initial cost to company, building and improvements	18,477
Cost capitalized subsequent to acquisition	518
Land	2,660
Building and improvements, amount	18,995
Investment in real estate, gross	21,655
Accumulated depreciation	$ 5,082
Date acquired, constructed	Apr. 01, 2022
Vancouver, WA | Senior Housing Operating
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 0
Initial cost to company, land	1,030
Initial cost to company, building and improvements	19,183
Cost capitalized subsequent to acquisition	2,027
Land	1,030
Building and improvements, amount	21,210
Investment in real estate, gross	22,240
Accumulated depreciation	$ 5,254
Date acquired, constructed	Apr. 01, 2022

Schedule III - Real Estate an_3

Schedule III - Real Estate and Accumulated Depreciation Schedule III - Real Estate and Accumulated Depreciation (Summary) (Details) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Investment in Real Estate:
Balance at beginning of period	$ 2,729,898	$ 2,894,548	$ 3,265,070
Additions through cash expenditures	49,556	10,993	50,346
Change in accounts payable related to investments in real estate construction & equipment	325	(69)	(388)
Change in other assets related to investments in real estate	454	200	0
Right of use asset in exchange for lease liability	101	0	0
Operating equipment received in lease termination	0	1,287	0
Real estate acquired in exchange for non-cash rental income	2,500	3,000	0
Real estate acquired in exchange for mortgage notes receivable	14,200	23,071	0
Sale of properties for cash	(19,326)	(104,691)	(276,429)
Properties classified as held for sale	(11,970)	(84,761)	(137,651)
Property reclassified as held for use	15,793	7,851	0
Impairment of property	(1,173)	(21,531)	(6,400)
Balance at end of period	2,780,358	2,729,898	2,894,548
Accumulated Depreciation:
Balance at beginning of period	611,688	576,668	597,638
Addition charged to costs and expenses	69,973	70,880	80,798
Amortization of right-of-use asset	38	36	36
Sale of properties	(4,851)	(25,643)	(70,063)
Properties classified as held for sale	(6,965)	(11,092)	(31,741)
Property reclassified as held for use	3,393	839	0
Balance at end of period	$ 673,276	$ 611,688	$ 576,668

Schedule IV - Mortgage Loans _2

Schedule IV - Mortgage Loans on Real Estate Schedule IV - Mortgage Loans on Real Estate (Details) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Carrying amount	$ 162,433,000	$ 164,576,000	$ 230,927,000	$ 259,491,000
Amount of delinquent loans	0
Federal income tax basis	175,200,000
Origination fee, and premium (discount)	$ 32,500
Second Mortgages | Winter Park, FL
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Interest	12%
Maturity	Oct. 31, 2025
Payment	Interest Only
Face Amount	$ 1,550,000
Carrying amount	$ 1,550,000
Construction Loans | Canton, MI
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Interest	9%
Maturity	Dec. 31, 2023
Payment	Interest Only
Face Amount	$ 14,700,000
Carrying amount	$ 14,700,000
Construction Loans | Fitchburg, WI
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Interest	8.50%
Maturity	Jan. 28, 2026
Payment	Interest Only
Face Amount	$ 28,525,000
Carrying amount	$ 27,662,000
Construction Loans | Sussex, WI
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Interest	8.50%
Maturity	Dec. 31, 2024
Payment	Interest Only
Face Amount	$ 22,200,000
Carrying amount	$ 22,337,000
Skilled Nursing Facilities | First Mortgages | Lexington, VA
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Interest	8%
Maturity	Dec. 31, 2032
Mortgage and other notes receivable, periodic payments	$ 21,000
Face Amount	3,089,000
Carrying amount	$ 1,326,000
Skilled Nursing Facilities | First Mortgages | Brookneal, VA
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Interest	8%
Maturity	Dec. 31, 2031
Mortgage and other notes receivable, periodic payments	$ 21,000
Face Amount	2,780,000
Carrying amount	$ 1,261,000
Skilled Nursing Facilities | First Mortgages | Austin/San Antonio, TX
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Interest	7.25%
Maturity	Nov. 30, 2027
Payment	Interest Only
Face Amount	$ 42,500,000
Carrying amount	$ 42,380,000
Assisted Living Facilities | First Mortgages | Oviedo, FL
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Interest	8.25%
Maturity	Jul. 31, 2025
Payment	Interest Only
Face Amount	$ 10,000,000
Carrying amount	$ 10,000,000
Assisted Living Facilities | First Mortgages | Indianapolis, IN
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Interest	7%
Maturity	Dec. 31, 2022
Payment	Interest Only
Face Amount	$ 6,423,000
Carrying amount	$ 6,423,000
Assisted Living Facilities | First Mortgages | Wabash, IN
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Interest	7%
Maturity	Dec. 31, 2025
Payment	Interest Only
Face Amount	$ 4,000,000
Carrying amount	$ 2,094,000
Entrance-Fee Communities | First Mortgages | Columbia, SC
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Line Items]
Interest	7.25%
Maturity	Dec. 31, 2024
Payment	Interest Only
Face Amount	$ 32,700,000
Carrying amount	$ 32,700,000

Schedule IV - Mortgage Loans _3

Schedule IV - Mortgage Loans on Real Estate Schedule IV - Mortgage Loans on Real Estate (Roll-Forward) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Reconciliation of mortgage loans on real estate
Balance at beginning of period	$ 164,576	$ 230,927	$ 259,491
Additions:
New mortgage loans	15,083	67,978	33,160
Amortization of loan discount and commitment fees	428	907	741
Total Additions	15,511	68,885	33,901
Deductions:
Loan commitment fees received	0	497	0
Mortgage notes receivable related to investments in real estate	14,200	23,071	0
Collection of principal, less recoveries of previous write-downs	3,454	111,668	62,465
Total Deductions	17,654	135,236	62,465
Balance at end of period	$ 162,433	$ 164,576	$ 230,927