National Health Investors (NHI) 10-Q 6 Aug 24 2024 Q2 Quarterly report Financial data

Cover

Cover - shares	6 Months Ended
	Jun. 30, 2024	Aug. 01, 2024
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2024
Document Transition Report	false
Entity File Number	001-10822
Entity Registrant Name	National Health Investors, Inc.
Entity Incorporation, State or Country Code	MD
Entity Tax Identification Number	62-1470956
Entity Address, Address Line One	222 Robert Rose Drive
Entity Address, City or Town	Murfreesboro
Entity Address, State or Province	TN
Entity Address, Postal Zip Code	37129
City Area Code	(615)
Local Phone Number	890-9100
Title of 12(b) Security	Common Stock, $0.01 par value
Trading Symbol	NHI
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		43,442,849
Amendment Flag	false
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q2
Entity Central Index Key	0000877860
Current Fiscal Year End Date	--12-31

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands		Jun. 30, 2024	Dec. 31, 2023
Real estate properties:
Land		$ 181,173	$ 180,749
Buildings and improvements		2,622,633	2,593,696
Construction in progress		8,347	5,913
Real estate properties, gross		2,812,153	2,780,358
Less accumulated depreciation		(705,829)	(673,276)
Real estate properties, net		2,106,324	2,107,082
Mortgage and other notes receivable, net of reserve of $15,921 and $15,476, respectively		240,850	245,271
Cash and cash equivalents		14,766	22,347
Straight-line rent receivable		85,321	84,713
Assets held for sale, net		5,669	5,004
Other assets, net		23,982	24,063
Total Assets	[1]	2,476,912	2,488,480
Liabilities and Stockholders’ Equity:
Debt		1,136,035	1,135,051
Accounts payable and accrued expenses		33,200	34,304
Dividends payable		39,098	39,069
Deferred income		5,107	6,009
Total Liabilities	[1]	1,213,440	1,214,433
Commitments and contingencies
Redeemable noncontrolling interest		9,169	9,656
National Health Investors, Inc. Stockholders’ Equity:
Common stock		434	434
Capital in excess of par value		1,606,199	1,603,757
Retained earnings		2,533,047	2,466,844
Cumulative dividends		(2,895,263)	(2,817,083)
Total National Health Investors, Inc. Stockholders’ Equity		1,244,417	1,253,952
Noncontrolling interests		9,886	10,439
Total Equity		1,254,303	1,264,391
Total Liabilities and Equity		$ 2,476,912	$ 2,488,480
[1] The condensed consolidated balance sheets include the following amounts related to our consolidated Variable Interest Entities (“VIE”s): $507.9 million and $513.2 million of Real estate properties, net; $8.3 million and $10.9 million of Cash and cash equivalents; $9.8 million and $9.7 million of Straight-line rent receivable; $9.3 million and $9.4 million of Other assets, net; and $4.3 million and $4.7 million of Accounts payable and accrued expenses, in each case as of June 30, 2024 and December 31, 2023, respectively.

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Mortgage and other notes receivable, net of reserve	$ 15,921	$ 15,476
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	100,000,000	100,000,000
Common stock, shares issued (in shares)	43,442,849	43,442,849
Common stock, shares outstanding (in shares)	43,409,841	43,409,841
Real estate properties, net	$ 2,106,324	$ 2,107,082
Cash and cash equivalents	14,766	22,347
Straight-line rent receivable	85,321	84,713
Other assets, net	23,982	24,063
Accounts payable and accrued expenses	(33,200)	(34,304)
Variable Interest Entity, Primary Beneficiary
Real estate properties, net	507,900	513,200
Cash and cash equivalents	8,300	10,900
Straight-line rent receivable	9,800	9,700
Other assets, net	9,300	9,400
Accounts payable and accrued expenses	$ (4,300)	$ (4,700)

Condensed Consolidated Statemen

Condensed Consolidated Statements Of Income - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Revenues:
Rental income	$ 65,760	$ 60,952	$ 127,947	$ 126,250
Resident fees and services	13,390	11,793	26,645	23,493
Interest income and other	5,820	5,131	11,890	10,521
Total revenues	84,970	77,876	166,482	160,264
Expenses:
Depreciation	17,490	17,730	34,995	35,347
Interest	14,854	14,194	29,723	28,221
Senior housing operating expenses	10,437	9,682	20,751	19,481
Legal	165	174	400	297
Franchise, excise and other taxes	47	258	(139)	441
General and administrative	4,870	4,306	10,510	9,959
Taxes and insurance on leased properties	2,802	3,212	5,535	5,830
Loan and realty losses (gains)	1,106	186	1,116	(232)
Total operating expenses	51,771	49,742	102,891	99,344
Gains on sales of real estate, net	1,517	11,366	1,617	12,763
Gain on operations transfer, net	0	20	0	20
Loss on early retirement of debt	0	(73)	0	(73)
Gains from equity method investment	236	0	402	0
Net income	34,952	39,447	65,610	73,630
Add: net loss attributable to noncontrolling interests	304	332	593	633
Net income attributable to stockholders	35,256	39,779	66,203	74,263
Less: net income attributable to unvested restricted stock awards	(29)	(19)	(61)	(19)
Net income attributable to common stockholders - basic	$ 35,227	$ 39,760	$ 66,142	$ 74,244
Weighted average common shares outstanding:
Basic (in shares)	43,397,080	43,388,753	43,392,961	43,388,748
Diluted (in shares)	43,563,654	43,388,753	43,494,103	43,390,092
Earnings per common share - basic (in dollars per share)	$ 0.81	$ 0.92	$ 1.52	$ 1.71
Earnings per common share - diluted (in dollars per share)	$ 0.81	$ 0.92	$ 1.52	$ 1.71

Condensed Consolidated Statem_2

Condensed Consolidated Statements Of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
Cash flows from operating activities:
Net income	$ 65,610	$ 73,630
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	34,995	35,347
Amortization of debt issuance costs, debt discounts and prepaids	3,018	2,082
Amortization of commitment fees and note receivable discounts	191	(234)
Amortization of lease incentives	1,446	1,075
Straight-line rent adjustments	(905)	(4,972)
Non-cash rental income	0	(2,500)
Non-cash interest income on mortgage and other notes receivable	(25)	(784)
Gains on sales of real estate, net	(1,617)	(12,763)
Gains from equity method investment	(402)	0
Loss on early retirement of debt	0	73
Loan and realty losses (gains)	1,116	(232)
Payment of lease incentive	0	(10,000)
Non-cash share-based compensation	2,842	2,874
Changes in operating assets and liabilities:
Other assets, net	(2,822)	(2,632)
Accounts payable and accrued expenses	(1,275)	776
Deferred income	(606)	(196)
Net cash provided by operating activities	101,566	81,544
Cash flows from investing activities:
Investments in mortgage and other notes receivable	(26,604)	(12,174)
Collections of mortgage and other notes receivable	8,347	9,493
Fees received on mortgage note	82	0
Acquisitions of real estate	(9,866)	(38,081)
Proceeds from sales of real estate	4,658	48,619
Investments in renovations of existing real estate	(5,039)	(2,910)
Investments in equipment	(1,524)	(1,467)
Distributions from equity method investment	402	2,500
Net cash (used in) provided by investing activities	(29,544)	5,980
Cash flows from financing activities:
Proceeds from revolving credit facility	120,000	231,000
Payments on revolving credit facility	(120,500)	(77,000)
Borrowings on term loan	0	200,000
Payments on term loans	(222)	(365,203)
Debt issuance costs	0	(2,747)
Distributions to noncontrolling interests	(533)	(638)
Dividends paid to stockholders	(78,151)	(78,100)
Taxes related to net settlement of equity awards	(400)	0
Proceeds from noncontrolling interest	70	2,922
Net cash used in financing activities	(79,736)	(89,766)
Decrease in cash and cash equivalents and restricted cash	(7,714)	(2,242)
Cash and cash equivalents and restricted cash, beginning of period	24,617	21,516
Cash and cash equivalents and restricted cash, end of period	16,903	19,274
Supplemental disclosure of cash flow information:
Interest paid, net of amounts capitalized	28,322	25,971
Supplemental disclosure of non-cash investing and financing activities:
Real estate acquired in exchange for mortgage note receivable	22,184	14,200
Increase in notes receivable from sales of real estate	0	699
Change in accounts payable related to renovations of existing real estate	(87)	244
Change in accounts payable related to distributions to noncontrolling interests	18	75
Right of use asset in exchange for lease liability	115	0
Reclassification of prepaid equity issuance costs to capital in excess of par value	$ 0	$ 275

Condensed Consolidated Statem_3

Condensed Consolidated Statement Of Equity - USD ($) $ in Thousands	Total	Total National Health Investors, Inc. Stockholders’ Equity	Common Stock	Capital in Excess of Par Value	Retained Earnings	Cumulative Dividends	Noncontrolling Interests
Beginning balance (in shares) at Dec. 31, 2022			43,388,742
Beginning balance at Dec. 31, 2022	$ 1,280,081	$ 1,270,225	$ 434	$ 1,599,427	$ 2,331,190	$ (2,660,826)	$ 9,856
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Shares issued on stock options exercised (in shares)	5,166
Ending balance (in shares) at Jun. 30, 2023			43,409,841
Ending balance at Jun. 30, 2023	$ 1,280,203	1,268,968	$ 434	1,602,026	2,405,453	(2,738,945)	11,235
Beginning balance (in shares) at Dec. 31, 2023	43,409,841		43,409,841
Beginning balance at Dec. 31, 2023	$ 1,264,391	1,253,952	$ 434	1,603,757	2,466,844	(2,817,083)	10,439
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Shares issued on stock options exercised (in shares)	122,174
Ending balance (in shares) at Jun. 30, 2024	43,409,841		43,442,849
Ending balance at Jun. 30, 2024	$ 1,254,303	$ 1,244,417	$ 434	$ 1,606,199	$ 2,533,047	$ (2,895,263)	$ 9,886

Condensed Consolidated Statem_4

Condensed Consolidated Statement Of Equity (Parenthetical) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2024	Mar. 31, 2024	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2024	Jun. 30, 2023
Statement of Stockholders' Equity [Abstract]
Distributions		$ 6	$ 3		$ 9
Net loss attributable to redeemable noncontrolling interest	$ 253	$ 225	$ 270	$ 305	$ 478
Dividends to common stockholders (in dollars per share)	$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 1.80	$ 1.80

Organization and Nature of Busi

Organization and Nature of Business	6 Months Ended
	Jun. 30, 2024
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, and mortgage and other notes receivables in independent living facilities (“ILFs”), assisted living facilities (“ALFs”), entrance-fee communities (“EFCs”), senior living campuses (“SLCs”), skilled nursing facilities (“SNFs”) and a hospital (“HOSP”). As of June 30, 2024, we had gross real estate investments of approximately $2.5 billion in 161 healthcare real estate properties located in 31 states and leased pursuant primarily to triple-net leases to 25 tenants consisting of 95 senior housing communities, 65 SNFs and one HOSP, excluding two properties classified as assets held for sale. Our portfolio of ten mortgages alon g with other notes receivable totaled $256.8 million, excluding an allowance for expected credit losses of $15.9 million, as of June 30, 2024. Our SHOP segment is comprised of two ventures that own the operations of ILFs. For this segment, as of June 30, 2024, we had gross investments of approximately $351.1 million in 15 ILFs located in eight states with a combined 1,732 units that are operated on behalf of the Company by independent managers pursuant to the terms of separate management agreements. The third-party managers, or related parties of the managers, own equity interests in the respective ventures. Units, beds and property count disclosures in these footnotes to the condensed consolidated financial statements are outside the scope of our independent registered accounting firm’s review.

Basis of Presentation and Signi

Basis of Presentation and Significant Accounting Policies	6 Months Ended
	Jun. 30, 2024
Accounting Policies [Abstract]
Basis of Presentation and Significant Accounting Policies	Basis of Presentation and Significant Accounting Policies Basis of Presentation The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with United States generally accepted accounting principles (“GAAP”) for interim financial statements. In our opinion, the accompanying unaudited condensed consolidated financial statements reflect all adjustments consisting of normal recurring adjustments necessary for a fair presentation. Interim results of operations are not necessarily indicative of the results that may be achieved for a full year. The condensed consolidated financial statements and related notes do not include all information and footnotes required by GAAP for annual reports. These interim condensed consolidated financial statements should be read in conjunction with our audited consolidated financial statements and notes thereto as of and for the year ended December 31, 2023, included in our Annual Report on Form 10-K for the year ended December 31, 2023 filed with the Securities and Exchange Commission (the “SEC”). Principles of Consolidation The condensed 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. 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 16 for further discussion of our SHOP ventures. We also consolidate two real estate partner ships formed with our partners, Discovery Senior Housing Investor XXIV, LLC, a related party of Discovery, and LCS Timber Ridge LLC (“LCS”), 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 condensed consolidated financial statements. Reference Note 16 for further discussion of these consolidated real estate partnerships. We use the equity method of accounting when we own an interest in an entity over which we can exert significant influence 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 their economic performance. See Note 16 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, contributions, 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 Condensed Consolidated Balance Sheets and included in our computation of earnings per share. As of June 30, 2024, the Merrill SHOP venture noncontrolling interest was classified in mezzanine equity, as discussed further in Note 10. The noncontrolling interests associated with our two consolidated real estate partnerships and our Discovery member SHOP venture were classified in equity as of June 30, 2024. Cash and Cash Equivalents and Restricted Cash Cash equivalents consist of all highly liquid investments with original maturities 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 Condensed Consolidated Statements of Cash Flows ( $ in thousands ): June 30, 2024 June 30, 2023 Beginning 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 End of period: Cash and cash equivalents $ 14,766 $ 17,411 Restricted cash (included in Other assets, net) 2,137 1,863 Cash, cash equivalents, and restricted cash $ 16,903 $ 19,274 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 mortgage and other notes receivable consist primarily of secured loans on facilities. Our financial instruments, principally our investments in mortgage and other 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 mortgage and other 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. 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 assets may not be recoverable. The need to recognize an impairment charge is based on estimated undiscounted future cash flows compared to the carrying amount. If recognition of an impairment charge is necessary, it is measured as the amount by which the carrying amount of the property exceeds the estimated fair value of the long-lived asset. 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 collectable 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 base year or base quarter. We recognize contingent rent annually or quarterly 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 and are excluded from the schedule of minimum lease payments. 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 of substantially all lease payments 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. Reference Note 3 for further discussion. 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 Accounting Standards Codification (“ASC”) 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 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 June 30, 2024, we had two mortgage notes receivable and a mezzanine loan totaling an aggregate of $26.5 million due from affiliates of two operators/borrowers, including Bickford Senior Living (“Bickford”) , designated as non-performing. 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. 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 taxable REIT subsidiaries (“TRSs”). TRSs are subject to federal, state, and local income taxes. Accordingly, a provision for income taxes has been made in the condensed consolidated financial statements. Segments We operate our business through two reportable segments: Re al 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 15 for additional information. 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 average number of shares of common stock outstanding during the period. Diluted earnings per common share reflects the effect of dilutive securities. Recent Accounting Pronouncements

Investment Activity

Investment Activity	6 Months Ended
	Jun. 30, 2024
Real Estate [Abstract]
Investment Activity	Investment Activity Asset Acquisitions In June 2024, we acquired a 110-unit ALF located in Sussex, Wisconsin, from Encore Senior Living (“Encore”). The acquisition price was $32.1 million, including $0.1 million in closing costs, and the cancellation of an outstanding construction note receivable held by us of $22.2 million including interest. We added the facility to an existing master lease with Encore for a term of 15 years at an initial lease rate of 8.25%, and annual escalators of 2.21%. Of the total purchase price $1.3 million was allocated to land and $30.8 million was allocated to buildings and improvements. Asset Dispositions During the three and six months ended June 30, 2024, we completed the sale of two ALFs located in Louisiana, previously leased to one of our tenants on cash basis of accounting for revenue recognition, for net cash proceeds of $4.7 million, resulting in a gain of approximately $1.4 million. Tenant Concentration The following table contains information regarding concentration in our Real Estate Investments portfolio of tenants or affiliates of tenants that exceed 10% of total revenues as of and for the six months ended June 30, 2024 and 2023, excluding $2.6 million for our corporate office, a credit loss reserve of $15.9 million and $351.1 million in real estate assets in the SHOP segment ( $ in thousands ): As of June 30, 2024 Revenues 1 Asset Class Gross Real Estate 2 Notes Receivable Six Months Ended June 30, 2024 2023 Senior Living Communities, LLC (“Senior Living”) EFC $ 573,631 $ 45,375 $ 26,406 16% $ 25,658 16% National HealthCare Corporation (“NHC”) SNF 133,770 — 20,836 13% 18,983 12% Bickford ALF 426,798 16,697 20,691 12% 19,977 12% All others, net Various 1,339,754 194,699 66,369 40% 66,323 41% Escrow funds received from tenants for property operating expenses Various — — 5,535 3% 5,830 4% $ 2,473,953 $ 256,771 139,837 136,771 Resident fees and services 3 26,645 16% 23,493 15% $ 166,482 $ 160,264 1 Includes interest income on notes receivable and rental income from properties classified as assets held for sale. 2 Amounts include any properties classified as held for sale. 3 There is no tenant concentration in “Resident fees and services” because these agreements are with individual residents. At June 30, 2024, the two states in which we had an investment concentration of 10% or more were South Carolina (12.0%) and Texas (10.6%). Senior Living As of June 30, 2024, we leased ten retirement communities to Senior Living. In the second quarter of 2024, two of the leases were amended to extend the maturity dates by two years and to provide up to $10.0 million of capital improvements on various properties, none of which was funded as of June 30, 2024. Rental revenue will increase at a lease rate of 8.5% applied to the amount expended. We recognized straight-line rent revenue of $(0.5) million and $(0.6) million from Senior Living for the six months ended June 30, 2024 and 2023, respectively. NHC As of June 30, 2024, we leased three ILFs and 32 SNFs to NHC, a publicly held company, under a master lease (four of which were subleased to other parties for whom the lease payments were guaranteed to us by NHC). Straight-line rent revenue of $0.1 million and $(0.6) million was recognized from NHC for the six months ended June 30, 2024 and 2023, respectively. NHC Percentage Rent - Under the terms of our master lease agreement with NHC, rent escalates by 4% of the increase, if any, in each of the facility’s revenue over a base year and is referred to as “percentage rent.” The following table summarizes the percentage rent income from NHC ( $ in thousands ): Six Months Ended June 30, 2024 2023 Current year $ 2,759 $ 1,931 Prior year final certification 1 1,656 630 Total percentage rent income $ 4,415 $ 2,561 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 the members of our Board of Directors, including our chairman, are also members of NHC’s board of directors. Bickford As of June 30, 2024, we leased 39 facilities, including one property reclassified to assets held for sale in the second quarter of 2024, to Bickford under four leases. In 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. Effective April 1, 2024, the combined rent for the Bickford leased portfolio was reset to $34.5 million per year with nominal increases through April 1, 2026, at which time the rent will be reset to a fair market value based on the Consumer Price Index (“CPI”). Base rent will escalate annually thereafter based on either a fixed percentage or CPI subject to a floor of 2% and a ceiling of 3%. As part of the lease amendments, we agreed to fund up to $8.0 million of capital improvements on various properties, of which less than $0.1 million was funded as of June 30, 2024. Rental revenue will increase at a lease rate of 8.0% applied to the amount expended. During the three and six months ended June 30, 2024, Bickford repaid $1.3 million and $2.8 million, respectively, of its outstanding pandemic-related rent deferrals. During the three and six months ended June 30, 2023, Bickford repaid $0.4 million and $0.6 million, respectively, of its outstanding pandemic-related rent deferrals, in addition to the reduction in rent deferrals of $2.5 million recognized in connection with the acquisition of an ALF located in Chesapeake, Virginia from Bickford through a note receivable conversion. As of June 30, 2024, Bickford’s outstanding pandemic-related rent deferrals were $15.2 million. Assets Held for Sale and Impairments of Long-Lived Assets The following is a summary of our assets held for sale in our Real Estate Investments portfolio ( $ in thousands ): As of As of June 30, 2024 December 31, 2023 Number of facilities 2 1 Real estate, net $5,669 $5,004 Rental income associated with assets he ld for sale as of June 30, 2024 totaled $0.5 million and $0.9 million for the three and six months ended June 30, 2024, respectively, and $0.4 million and $1.0 million for the three and six months ended June 30, 2023, respectively. During the three and six months ended June 30, 2024, we recorded impairment charges of approximately $0.7 million on one property reclassified to assets held for sale in the second quarter of 2024 in our Real Estate Investments segment. During the three and six months ended June 30, 2023, we recorded impairment charges of approximately $0.1 million on two properties and approximately $0.5 million on three properties, respectively, in our Real Estate Investments segment. The impairment charges were determined in connection with the preparation of the financial statements for the applicable quarterly period and are included in “ Loan and realty losses (gains) ” in the Condensed Consolidated Statements of Income for the three and six months ended June 30, 2024 and 2023. We reduce the carrying value of impaired properties to their estimated fair value or, with respect to the properties classified as assets 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). In March 2024, we executed a purchase and sale agreement with a tenant to acquire its leased SLC for a purchase price of $38.5 million, subject to the tenant’s ability to secure financing for the purchase. The purchase and sale agreement expires in December 2024. Until the tenant provides notification that it has obtained financing, the property continues to be classified as held and used and leased pursuant to the existing triple-net lease that generates approximately $2.8 million in annual rent and expires in July 2027. The property had a net investment of $19.4 million as of June 30, 2024. Cash Basis Operators We have three tenants on the cash basis of accounting for revenue recognition for their leasing arrangements based on our assessment of each tenant’s ability to satisfy its contractual obligations. Cash rents received from these tenants for the three and six months ended June 30, 2024 and 2023 were as follows ( $ in thousands ): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Bickford 1 $ 9,946 $ 8,119 $ 19,310 $ 15,927 All others 2 5,142 2,318 7,544 6,516 Total rental income from cash basis operators $ 15,088 $ 10,437 $ 26,854 $ 22,443 1 Excludes $2.5 million of rental income related to the reduction of pandemic-related rent deferrals recognized in connection with the acquisition of an ALF from Bickford in the first quarter of 2023. 2 In the second quarter of 2024, we received a $2.5 million lump sum payment from an operator for partial repayment of pandemic-related rent deferrals. Tenant Transition In June 2024, we transitioned a leased SNF located in Wisconsin to a new operator. The new lease contains a purchase option to acquire the property at the end of the initial lease term in 2031 or during the renewal period at a fixed minimum internal rate of return on our investment. In the first quarter of 2024, we wrote off to “ Rental income ” the straight-line rent receivable of approximately $0.8 million associated with the terminated lease. Tenant Purchase Options Certain of our leases contain purchase options allowing tenants to acquire the leased properties at a fixed base price plus a specified share in any appreciation, fixed base price, or a fixed minimum internal rate of return on our investment. At June 30, 2024, tenants had purchase options on four properties with an aggregate net investment of $78.5 million that will become exercisable between 2027 and 2031. Rental income from these properties with tenant purchase options was $2.0 million and $3.8 million for the three and six months ended June 30, 2024, respectively. Rental income from these properties with tenant purchase options was $1.8 million and $3.6 million for three and six months ended June 30, 2023, respectively. We cannot reasonably estimate at this time the probability that any purchase options will be exercised in the future. Consideration to be received from the exercise of any tenant purchase option is expected to exceed our net investment in the leased property or properties. Future Minimum Base Rent Future minimum lease payments to be received by us under our operating leases at June 30, 2024, were as follows ( $ in thousands ): Remainder of 2024 $ 118,344 2025 239,272 2026 245,826 2027 198,986 2028 193,384 2029 176,362 Thereafter 677,813 $ 1,849,987 Variable Lease Payments Most of our 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 are indeterminable at the inception of the lease. The table below indicates the rental income recognized as a result of fixed and variable lease escalators ( $ in thousands ): Three Months Ended Six Months Ended June 30, June 30, 2024 2023 2024 2023 Lease payments based on fixed escalators $ 60,110 $ 53,538 $ 116,702 $ 112,827 Lease payments based on variable escalators 2,358 2,103 6,251 3,696 Straight-line rent, net of write-offs 1,213 2,875 905 4,972 Escrow funds received from tenants for property operating expenses 2,802 3,212 5,535 5,830 Amortization of lease incentives (723) (776) (1,446) (1,075) Rental income $ 65,760 $ 60,952 $ 127,947 $ 126,250

Mortgage and Other Notes Receiv

Mortgage and Other Notes Receivable	6 Months Ended
	Jun. 30, 2024
Accounts, Notes, Loans and Financing Receivable, Gross, Allowance, and Net [Abstract]
Mortgage and Other Notes Receivable	Mortgage and Other Notes Receivable At June 30, 2024, our investments in mortgage notes receivable totaled $164.4 million secured by real estate and other assets of the borrowers ( e.g ., Uniform Commercial Code liens on personal property) related to 18 facilities and in other notes receivable totaled $92.4 million, substantially all of which were guaranteed by significant parties to the notes or by cross-collateralization of properties with the same owner. These balances exclude a credit loss reserve of $15.9 million at June 30, 2024. Our loans designated as non-performing as of June 30, 2024 and December 31, 2023 include a mortgage note receivable of $2.0 million and $2.1 million, respectively, due from Bickford and a mortgage note receivable of $10.0 million and a mezzanine loan of $14.5 million due from affiliates of one operator/borrower. This operator/borrower is also one of the tenants on the cash basis of accounting for revenue recognition for its leases. Interest income recognized, representing cash received, from these non-performing loans was $0.5 million and $0.9 million, respectively, for the three and six months ended June 30, 2024. Interest income recognized for the three and six months ended June 30, 2023 was $0.4 million and $0.9 million, respectively. All other loans were on full accrual basis as of June 30, 2024. The credit loss reserve related to non-performing loans totaled $12.4 million and $11.9 million at June 30, 2024 and December 31, 2023, respectively. Compass Senior Living , LLC In June 2024, we funded $9.5 million on a mortgage note receivable secured by two facilities with Compass Senior Living, LLC. The five-year loan agreement provides for an annual interest rate of 8.5% with an option for the Company to purchase one or both facilities after July 2026. Carriage Crossing Senior Living Bloomington In February 2024, we funded $15.0 million on a mortgage note receivable with Carriage Crossing Senior Living Bloomington (“Carriage Crossing”), with an additional $2.0 million available to be funded contingent upon the performance of facility operations until March 31, 2027. The five-year loan agreement provides for an annual interest rate of 8.75% 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. In the second quarter of 2024, approximately $2.1 million of principal was repaid upon the sale by the fund of two of the underlying properties. As of June 30, 2024, $18.0 million was outstanding on the loan associated with seven medical office buildings with a combined purchase price of approximately $76.4 million. For the three and six months ended June 30, 2024, we recognized interest income of $0.5 million and $1.0 million, respectively. Interest income recognized for the three and six months ended June 30, 2023 was $0.5 million and $0.9 million, respectively. Bickford Construction and Mortgage Loans As of June 30, 2024, we had one fully funded construction loan of $14.7 million to Bickford. The construction loan is secured by a first mortgage lien on substantially all of the related 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 agreement, 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 . At June 30, 2024, we held a $12.5 million second mortgage as a component of the purchase price consideration 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 $0.3 million and $0.6 million for both the three and six months ended June 30, 2024 and 2023, 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 Condensed Consolidated Balance Sheets as of June 30, 2024 and December 31, 2023. During the three and six months ended June 30, 2024 and 2023, Bickford repaid $0.1 million and $0.2 million, respectively, of principal on this note receivable which is reflected in “ Gains on sale of real estate, net ” in the Condensed Consolidated Statements of Income. Senior Living 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 needs and to finance construction projects within its portfolio, including building additional units. Beginning January 1, 2025, availability under the revolver will reduce to $15.0 million. The revolver matures in December 2031 at the time of the Senior Living lease maturity. At June 30, 2024, the $12.8 million outstanding under the revolver bore 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 for the acquisition of a 248-unit continuing care retirement community (“CCRC”) in Columbia, South Carolina. The mortgage loan matures July of 2025 with a one-year extension and bears interest at an annual 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, March 31, 2024, 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. We consider the guidance in ASC 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 June 30, 2024 is presented below for the amortized cost, net by year of origination ( $ in thousands ): 2024 2023 2022 2021 2020 Prior Total Mortgages more than 1.5x $ 9,407 $ — $ 70,351 $ — $ — $ 35,100 $ 114,858 between 1.0x and 1.5x 14,862 930 — — — 6,423 22,215 less than 1.0x — 620 — — — 14,700 15,320 24,269 1,550 70,351 — — 56,223 152,393 Mezzanine more than 1.5x — 512 — 14,049 — — 14,561 between 1.0x and 1.5x — 223 — 21,621 — — 21,844 less than 1.0x — — — — — 25,000 25,000 — 735 — 35,670 — 25,000 61,405 Non-performing between 1.0x and 1.5x — — — — — 24,500 24,500 less than 1.0x — — — — 1,997 — 1,997 — — — — 1,997 24,500 26,497 Revolver more than 1.5x 16,476 16,476 Credit loss reserve (15,921) $ 240,850 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 underlying 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 periods. The allowance for expected credit losses is presented in the following table for the six months ended June 30, 2024 ( $ in thousands ): Balance at January 1, 2024 $ 15,476 Provision for expected credit losses 445 Balance at June 30, 2024 $ 15,921

Senior Housing Operating Portfo

Senior Housing Operating Portfolio Structure	6 Months Ended
	Jun. 30, 2024
Senior Housing Operating Portfolio Structure [Abstract]
Senior Housing Operating Portfolio Structure	Senior Housing Operating Portfolio Structure Our SHOP segment is comprised of two ventures that own the operations of 15 ILFs. These ventures 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 ventures were capitalized with preferred and common equity interests, with the Company owning 100% of the preferred equity and a controlling common equity interest in each venture. The managers, or related parties of the managers, own a non-controlling common equity interest in their respective ventures. Each venture is discussed in more detail below. Merrill Managed Portfolio We have six ILFs located in California and Washington in a consolidated venture with Merrill, which owns a 20% common equity interest in the venture . The operating agreement for the venture provides for contingent distributions to the members based on the attainment of certain yiel ds 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. The noncontrolling interest associated with the venture was determined to be contingently redeemable and is classified in mezzanine equity as of June 30, 2024 and December 31, 2023, as discussed further in Note 10. Discovery Managed Portfolio We have nine ILFs located in Arkansas, Georgia, Ohio, Oklahoma, New Jersey, and South Carolina in a consolidated venture with the Discovery member, which owns a 2% common equity interest in the venture. In the second quarter of 2024, the members contributed an additional $3.5 million to fund additional capital expenditures, of which the Discovery member contributed approximately $0.1 million in cash in accordance with its common equity interest percentage in the venture. Th e 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 noncontrolling interest associated with the venture is included in “ Equity ” on the Condensed Consolidated Balance Sheets as of June 30, 2024 and December 31, 2023. 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	6 Months Ended
	Jun. 30, 2024
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 25.0% equity interest. This investment is held by our 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 the 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 June 30, 2024, 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 Condensed Consolidated Balance Sheet as of June 30, 2024. Excess unrecognized equity method losses for this investment for the three and six months ended June 30, 2024 were $0.6 million and $1.2 million, respectively, and $0.7 million and $1.3 million for the three and six months ended June 30, 2023, respectively. Cumulative unrecognized losses for this investment were $10.7 million through June 30, 2024. We recognized gains of approximately $0.2 million and $0.4 million, representing cash distributions received related to our investment in Timber Ridge OpCo for the three and six months ended June 30, 2024, respectively. The Timber Ridge property is subject to early resident mortgages secured by a Deed of Trust and Indenture of Trust (the “Deed and Indenture”). As part of our acquisition, NHI-LCS JV I, LLC (“Timber Ridge PropCo”) acquired the Timber Ridge 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 agreements, during the term of the lease (seven years with two five-year renewal options), Timber Ridge OpCo is to indemnify Timber Ridge PropCo for any repayment by Timber Ridge PropCo of these early resident mortgage liabilities under the guarantee. As a result of the subordination agreement and the resident loan assumption agreements, no liability has been recorded as of June 30, 2024. The balance secured by the Deed and Indenture was $11.8 million at June 30, 2024.

Other Assets

Other Assets	6 Months Ended
	Jun. 30, 2024
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Other Assets	Other Assets Other assets, net consist of the following ( $ in thousands ): June 30, 2024 December 31, 2023 SHOP accounts receivable, net of allowance of $382 and $343, and other assets $ 2,725 $ 1,620 Real estate investments accounts receivable and prepaid expenses 3,688 3,296 Lease incentive payments, net 9,224 10,669 Regulatory escrows 6,208 6,208 Restricted cash 2,137 2,270 $ 23,982 $ 24,063 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	6 Months Ended
	Jun. 30, 2024
Debt Instruments [Abstract]
Debt	Debt Debt consisted of the following ( $ in thousands ): June 30, 2024 December 31, 2023 Revolving credit facility - unsecured $ 244,500 $ 245,000 Bank term loans - unsecured 200,000 200,000 2031 Senior Notes - unsecured, net of discount of $2,117 and $2,278 397,883 397,722 Private placement notes - unsecured 225,000 225,000 Fannie Mae term loans - secured, non-recourse 76,031 76,241 Unamortized loan costs (7,379) (8,912) $ 1,136,035 $ 1,135,051 Aggregate principal maturities of debt as of June 30, 2024 were as follows ( $ in thousands ): Remainder of 2024 $ 75,425 2025 325,606 2026 244,500 2027 100,000 2028 — 2029 — Thereafter 400,000 1,145,531 Less: discount (2,117) Less: unamortized loan costs (7,379) $ 1,136,035 Unsecured revolving credit facility and bank term loan Our $700.0 million unsecured revolving credit facility (the “2022 Credit Facility”) 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 Facility 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 (x) the agent’s prime rate, (y) the federal funds rate on such day plus 0.50% or (z) the adjusted Term SOFR for a one-month tenor in effect on such day plus 1.0%. In addition, the 2022 Credit Facility requires a facility fee equal to 0.125% to 0.30%, based on our credit rating. At June 30, 2024, we had $455.5 million available to draw on the 2022 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 June 30, 2024, we were in compliance with these ratios. We have a $200.0 million term loan (the “2025 Term Loan”) that matures June 2025 and bears 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 . 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 in 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. The 2031 Senior Notes are subject to affirmative and negative covenants, including financial covenants with which we were in compliance at June 30, 2024. Private Placement Notes Our unsecured private placement notes as of June 30, 2024, 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 unsecured 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 more. Fannie Mae Term Loans As of June 30, 2024, 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. 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 September 2024, bears interest at a rate of 4.60%, and has a remaining balance of $15.9 million at June 30, 2024. Collectively, the Fannie Mae debt is secured by properties having a net book value of $99.1 million at June 30, 2024. Interest Expense The following table summarizes interest expense ($ in thousands ): Three Months Ended Six Months Ended June 30, June 30, 2024 2023 2024 2023 Interest expense on debt at contractual rates $ 14,029 $ 13,612 $ 28,116 $ 27,052 Capitalized interest (48) (22) (87) (41) Amortization of debt issuance costs, debt discount and other 873 604 1,694 1,210 Total interest expense $ 14,854 $ 14,194 $ 29,723 $ 28,221

Commitments. Contingencies and

Commitments. Contingencies and Uncertainties	6 Months Ended
	Jun. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments, Contingencies and Uncertainties	Commitments, Contingencies and Uncertainties In the normal course of business, we enter into a variety of commitments, typically consisting of funding revolving credit arrangements, construction and mezzanine loans to our operators to conduct expansions and acquisitions for their own account, and commitments for the funding of construction for expansion or renovation to our existing properties under lease. In our leasing operations, we offer to our tenants and to sellers of newly acquired properties a variety of inducements that originate contractually as contingencies but which may become commitments upon the satisfaction of the contingent event. Contingent payments earned will be included in the respective lease bases when funded. As of June 30, 2024, we had working capital, mortgage, construction and mezzanine loan commitments to six operators or borrowers for an aggregate of $110.5 million, of which we had funded $64.9 million toward these commitments. Loan funded amounts do not reflect the effects of discounts or commitment fees. As of June 30, 2024, we had $33.5 million of development commitments for construction and renovation of six properties of which we had funded $14.0 million toward these commitments. One of our consolidated real estate partnerships, NHI-REIT of DSL PropCo, LLC, 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 June 30, 2024. As of June 30, 2024, we had an aggregate of $6.9 million in remaining contingent lease inducement commitments in three lease agreements which are generally based on the performance of facility operations and may or may not be met by the tenant. 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 loan commitments reflected in “ Accounts payable and accrued expenses ” on the Condensed Consolidated Balance Sheets as of June 30, 2024 and December 31, 2023 is presented in the following table for the six months ended June 30, 2024 ( $ in thousands ): Balance at January 1, 2024 $ 279 Provision for expected credit losses 17 Balance at June 30, 2024 $ 296 Litigation Our facilities are subject to claims and suits in the ordinary course of business. Such claims may include, among other things, professional liability and general liability claims, as well as regulatory proceedings related to our SHOP segment. 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. 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 material adverse effect on our financial condition, results of operations or cash flows.

Redeemable Noncontrolling Inter

Redeemable Noncontrolling Interests	6 Months Ended
	Jun. 30, 2024
Noncontrolling Interest [Abstract]
Redeemable Noncontrolling Interests	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 Condensed Consolidated Balance Sheets as of June 30, 2024 and December 31, 2023. 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 June 30, 2024. 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 in each period. The following table presents the change in “ Redeemable noncontrolling interest” for the six months ended June 30, 2024 ( $ in thousands ): Six Months Ended June 30, 2024 Balance at January 1, $ 9,656 Net loss (478) Distributions (9) Balance at June 30, $ 9,169

Equity and Dividends

Equity and Dividends	6 Months Ended
	Jun. 30, 2024
Equity [Abstract]
Equity and Dividends	Equity and Dividends Share Repurchase Plan On February 16, 2024, our Board of Directors renewed our stock repurchase program (the “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 Repurchase Plan is effective for a period of one year and does not require us to repurchase any specific number of shares. The Repurchase Plan 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, and repurchases 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. No common stock was repurchased under the Repurchase Plan during six months ended June 30, 2024. At-the-Market (ATM) Equity Program We maintain an ATM equity program which allows us to sell our common stock directly into the market and have entered into an ATM equity offering sales agreement pursuant to which the Company may sell, from time to time, up to an aggregate sales price of $500.0 million of the Company’s common stock. The ATM equity program has a forward sale provision which allows us to sell shares of common stock to forward purchasers at a predetermined price at a future date. No shares were sold under the ATM equity program during the six months ended June 30, 2024. Dividends The following table summarizes dividends declared by the Board of Directors or paid during the six months ended June 30, 2024 and 2023: Six Months Ended June 30, 2024 Date of Declaration Date of Record Date Paid/Payable Quarterly Dividend November 3, 2023 December 29, 2023 January 26, 2024 $0.90 February 16, 2024 March 28, 2024 May 3, 2024 $0.90 May 3, 2024 June 28, 2024 August 2, 2024 $0.90 Six Months Ended June 30, 2023 Date of Declaration Date of Record Date Paid/Payable Quarterly Dividend November 6, 2022 December 30, 2022 January 27, 2023 $0.90 February 17, 2023 March 31, 2023 May 5, 2023 $0.90 May 5, 2023 June 30, 2023 August 4, 2023 $0.90

Share-Based Compensation

Share-Based Compensation	6 Months Ended
	Jun. 30, 2024
Share-Based Payment Arrangement [Abstract]
Stock-Based Compensation	Share-Based Compensation The Company’s outstanding stock incentive awards have been granted under two incentive plans – the 2012 Stock Incentive Plan and the 2019 Stock Incentive Plan, as amended and restated (the “2019 Plan”). During the six months ended June 30, 2024, we granted options to purchase 431,000 shares of common stock under the 2019 Plan. In February 2024, 15,000 shares of restricted stock were issued to executive officers with a grant date fair value of $57.76 per share based on the market value of our common stock on the date of grant. The restricted stock vests 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. During the second quarter of 2024, 3,970 net shares of restricted stock vested. As of June 30, 2024, there were 31,800 non-vested shares of restricted stock outstanding. The weighted average fair value of options granted during the six months ended June 30, 2024 and 2023 was $7.36 and $10.56 per option, respectively. The fair value of each grant is estimated on the date of grant using the Black-Scholes option-pricing model with the following weighted average assumptions: 2024 2023 Dividend yield 6.4% 7.0% Expected volatility 26.1% 39.7% Expected lives 2.9 years 2.9 years Risk-free interest rate 4.49% 4.65% The following table summarizes our outstanding stock options: Weighted Average Number Weighted Average Remaining of Shares Exercise Price Contractual Life (Years) Options outstanding, January 1, 2023 2,216,175 $70.97 Options granted 385,500 $54.73 Options exercised (5,166) $53.41 Options forfeited (61,168) $66.44 Options expired (88,170) $64.33 Options outstanding, June 30, 2023 2,447,171 $68.80 Exercisable at June 30, 2023 2,078,827 $71.40 Options outstanding, January 1, 2024 2,447,171 $68.80 Options granted 431,000 $57.76 Options exercised (122,174) $54.03 Options expired (301,837) $79.96 Options outstanding, June 30, 2024 2,454,160 $66.23 2.46 Exercisable at June 30, 2024 2,113,466 $67.74 2.16 At June 30, 2024, the intrinsic value of stock options outstanding and exercisable was $16.5 million and $12.8 million, respectively. The following is a summary of share-based compensation expense, net of any forfeitures, included in “ General and administrative expenses ” in the Condensed Consolidated Statements of Income ( $ in thousands ): Three Months Ended Six Months Ended June 30, June 30, 2024 2023 2024 2023 Share-based compensation components: Restricted stock expense $ 186 $ 72 $ 344 $ 72 Stock option expense 501 697 2,498 2,802 Total share-based compensation expense $ 687 $ 769 $ 2,842 $ 2,874 As of June 30, 2024, unrecognized compensation expense totaling $2.9 million associated with stock-based awards was expected to be recognized over the following periods: remainder of 2024 - $1.3 million, 2025 - $1.1 million, 2026 - $0.3 million, 2027 - $0.1 million, and thereafter - $0.1 million.

Earnings Per Common Share

Earnings Per Common Share	6 Months Ended
	Jun. 30, 2024
Earnings Per Share [Abstract]
Earnings Per Common Share	Earnings Per Common Share The following table summarizes the average number of common shares and the net income used in the calculation of basic and diluted earnings per common share ($ in thousands, except share and per share amounts) : Three Months Ended Six Months Ended June 30, June 30, 2024 2023 2024 2023 Net income $ 34,952 $ 39,447 $ 65,610 $ 73,630 Add: net loss attributable to noncontrolling interests 304 332 593 633 Net income attributable to stockholders 35,256 39,779 66,203 74,263 Less: net income attributable to unvested restricted stock awards (29) (19) (61) (19) Net income attributable to common stockholders - basic $ 35,227 $ 39,760 $ 66,142 $ 74,244 BASIC: Weighted average common shares outstanding 43,397,080 43,388,753 43,392,961 43,388,748 DILUTED: Weighted average common shares outstanding 43,397,080 43,388,753 43,392,961 43,388,748 Stock options 166,574 — 101,142 1,344 Weighted average dilutive common shares outstanding 43,563,654 43,388,753 43,494,103 43,390,092 Earnings per common share - basic $ 0.81 $ 0.92 $ 1.52 $ 1.71 Earnings per common share - diluted $ 0.81 $ 0.92 $ 1.52 $ 1.71 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 261,255 903,425 376,965 776,771 Regular dividends declared per common share $ 0.90 $ 0.90 $ 1.80 $ 1.80

Fair Value of Financial Instrum

Fair Value of Financial Instruments	6 Months Ended
	Jun. 30, 2024
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 June 30, 2024 and December 31, 2023 in the Condensed Consolidated Balance Sheets are as follows ($ in thousands ): Carrying Amount Fair Value Measurement June 30, 2024 December 31, 2023 June 30, 2024 December 31, 2023 Level 2 Variable rate debt $ 440,376 $ 439,693 $ 444,500 $ 445,000 Fixed rate debt $ 695,659 $ 695,358 $ 615,417 $ 616,852 Level 3 Mortgage and other notes receivable, net $ 240,850 $ 245,271 $ 231,437 $ 237,646 Fixed rate debt. Fixed rate debt is classified as Level 2 and its fair value is based on quoted prices for similar instruments or calculated utilizing model derived valuations in which significant inputs are observable in active markets. Variable rate debt. Variable rate debt is classified as Level 2 and the fair values of our borrowings under our revolving credit facility and other variable rate debt are reasonably estimated at their notional amounts due to the predominance of floating interest rates, which generally reflect market conditions. 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.

Segment Reporting

Segment Reporting	6 Months Ended
	Jun. 30, 2024
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 leases, 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 leased primarily 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. 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 three or six months ended June 30, 2024 and 2023. Capital expenditures for the six months ended June 30, 2024 were approximately $35.0 million for the Real Estate Investments segment and $3.7 million for the SHOP segment. Capital expenditures for the six months ended June 30, 2023 were approximately $56.2 million for the Real Estate Investments segment and $3.0 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. Summary information for the reportable segments during the three and six months ended June 30, 2024 and 2023 is as follows ( $ in thousands ): For the three months ended June 30, 2024: Real Estate Investments SHOP Non-segment/Corporate Total Rental income $ 65,760 $ — $ — $ 65,760 Resident fees and services — 13,390 — 13,390 Interest income and other 5,744 — 76 5,820 Total revenues 71,504 13,390 76 84,970 Senior housing operating expenses — 10,437 — 10,437 Taxes and insurance on leased properties 2,802 — — 2,802 NOI 68,702 2,953 76 71,731 Depreciation 14,992 2,490 8 17,490 Interest 761 — 14,093 14,854 Legal — — 165 165 Franchise, excise and other taxes — — 47 47 General and administrative — — 4,870 4,870 Loan and realty losses 1,106 — — 1,106 Gains on sales of real estate, net (1,517) — — (1,517) Gains from equity method investment (236) — — (236) Net income (loss) $ 53,596 $ 463 $ (19,107) $ 34,952 Total assets $ 2,197,656 $ 268,187 $ 11,069 $ 2,476,912 For the three months ended June 30, 2023: Real Estate Investments SHOP Non-segment/Corporate Total Rental income $ 60,952 $ — $ — $ 60,952 Resident fees and services — 11,793 — 11,793 Interest income and other 5,083 — 48 5,131 Total revenues 66,035 11,793 48 77,876 Senior housing operating expenses — 9,682 — 9,682 Taxes and insurance on leased properties 3,212 — — 3,212 NOI 62,823 2,111 48 64,982 Depreciation 15,477 2,239 14 17,730 Interest 766 — 13,428 14,194 Legal — — 174 174 Franchise, excise and other taxes — — 258 258 General and administrative — — 4,306 4,306 Loan and realty losses 186 — — 186 Gains on sales of real estate, net (11,366) — — (11,366) Gain on operations transfer, net (20) — — (20) Loss on early retirement of debt — — 73 73 Net income (loss) $ 57,780 $ (128) $ (18,205) $ 39,447 Total assets $ 2,217,124 $ 271,359 $ 10,012 $ 2,498,495 For the six months ended June 30, 2024: Real Estate Investments SHOP Non-segment/Corporate Total Rental income $ 127,947 $ — $ — $ 127,947 Resident fees and services — 26,645 — 26,645 Interest income and other 11,685 — 205 11,890 Total revenues 139,632 26,645 205 166,482 Senior housing operating expenses — 20,751 — 20,751 Taxes and insurance on leased properties 5,535 — — 5,535 NOI 134,097 5,894 205 140,196 Depreciation 30,050 4,927 18 34,995 Interest 1,524 — 28,199 29,723 Legal — — 400 400 Franchise, excise and other taxes — — (139) (139) General and administrative — — 10,510 10,510 Loan and realty losses 1,116 — — 1,116 Gains on sales of real estate, net (1,617) — — (1,617) Gains from equity method investment (402) — — (402) Net income (loss) $ 103,426 $ 967 $ (38,783) $ 65,610 For the six months ended June 30, 2023: Real Estate Investments SHOP Non-segment/Corporate Total Rental income $ 126,250 $ — $ — $ 126,250 Resident fees and services — 23,493 — 23,493 Interest income and other 10,391 — 130 10,521 Total revenues 136,641 23,493 130 160,264 Senior housing operating expenses — 19,481 — 19,481 Taxes and insurance on leased properties 5,830 — — 5,830 NOI 130,811 4,012 130 134,953 Depreciation 30,854 4,466 27 35,347 Interest 1,525 — 26,696 28,221 Legal — — 297 297 Franchise, excise and other taxes — — 441 441 General and administrative — — 9,959 9,959 Loan and realty losses (232) — — (232) Gains on sales of real estate, net (12,763) — — (12,763) Loss on operations transfer, net (20) — — (20) Loss on early retirement of debt — — 73 73 Net income (loss) $ 111,447 $ (454) $ (37,363) $ 73,630

Variable Interest Entities

Variable Interest Entities	6 Months Ended
	Jun. 30, 2024
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 $259.5 million and $260.7 million of real estate properties, net, $6.0 million and $7.7 million of cash and cash equivalents, and $2.7 million and $1.7 million of other assets, net, as of June 30, 2024 and December 31, 2023, respectively. Liabilities of the consolidated SHOP ventures for which creditors do not have recourse to the general credit of the Company are $4.3 million and $4.7 million as of June 30, 2024 and December 31, 2023, respectively. Reference Notes 5 and 10 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 as of June 30, 2024 and December 31, 2023 include approximately $248.4 million and $252.5 million of real estate properties, net, $9.8 million and $9.7 million in straight-line rent receivable, $2.3 million and $3.2 million of cash and cash equivalents and $6.6 million and $7.8 million of other assets, net, 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 to our condensed consolidated financial statements cross-referenced below ( $ in thousands ). Date Name Source of Exposure Carrying Amount Maximum Exposure to Loss Note Reference 2014 Senior Living Various 1 $ 85,238 $ 102,488 Notes 3, 4 2016 Senior Living Management Notes $ 24,500 $ 24,500 — 2018 Bickford Notes and development commitments $ 16,823 $ 37,263 Notes 3, 4 2019 Encore Various 2 $ 34,579 $ 57,243 — 2020 Timber Ridge OpCo Various 3 $ 16 $ 5,016 Notes 6, 7 2020 Watermark Retirement Notes and straight-line rent receivable $ 10,590 $ 11,864 — 2021 Montecito Medical Real Estate Notes and funding commitment $ 18,201 $ 50,211 Note 4 2021 Vizion Health Notes and straight-line rent receivable $ 15,833 $ 15,833 — 2021 Navion Senior Solutions Various 4 $ 7,975 $ 11,278 — 2023 Kindcare Senior Living Notes 5 $ 766 $ 766 — 1 Notes, straight-line rent receivable, and development commitment 2 Note, straight-line rent receivable, and lease receivables 3 Loan commitment, equity method investment, straight-line rent receivable and unamortized lease incentive 4 Development commitments, straight-line rent receivable, and unamortized lease incentive 5 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 condensed consolidated financial statements.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ 35,256	$ 39,779	$ 66,203	$ 74,263

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Jun. 30, 2024
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 (Policies)	6 Months Ended
	Jun. 30, 2024
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with United States generally accepted accounting principles (“GAAP”) for interim financial statements. In our opinion, the accompanying unaudited condensed consolidated financial statements reflect all adjustments consisting of normal recurring adjustments necessary for a fair presentation. Interim results of operations are not necessarily indicative of the results that may be achieved for a full year. The condensed consolidated financial statements and related notes do not include all information and footnotes required by GAAP for annual reports. These interim condensed consolidated financial statements should be read in conjunction with our audited consolidated financial statements and notes thereto as of and for the year ended December 31, 2023, included in our Annual Report on Form 10-K for the year ended December 31, 2023 filed with the Securities and Exchange Commission (the “SEC”).
Principles of Consolidation	Principles of Consolidation The condensed consolidated financial statements include the accounts of the Company, 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. 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 16 for further discussion of our SHOP ventures. We also consolidate two real estate partner ships formed with our partners, Discovery Senior Housing Investor XXIV, LLC, a related party of Discovery, and LCS Timber Ridge LLC (“LCS”), 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 condensed consolidated financial statements. Reference Note 16 for further discussion of these consolidated real estate partnerships. We use the equity method of accounting when we own an interest in an entity over which we can exert significant influence 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 their economic performance. See Note 16 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, contributions, 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 Condensed Consolidated Balance Sheets and included in our computation of earnings per share. As of June 30, 2024, the Merrill SHOP venture noncontrolling interest was classified in mezzanine equity, as discussed further in Note 10.
Cash and Cash Equivalents and Restricted Cash	Cash and Cash Equivalents and Restricted Cash Cash equivalents consist of all highly liquid investments with original maturities 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).
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 mortgage and other notes receivable consist primarily of secured loans on facilities. Our financial instruments, principally our investments in mortgage and other 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 mortgage and other 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.
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 assets may not be recoverable. The need to recognize an impairment charge is based on estimated undiscounted future cash flows compared to the carrying amount. If recognition of an impairment charge is necessary, it is measured as the amount by which the carrying amount of the property exceeds the estimated fair value of the long-lived asset.
Revenue Recognition	Revenue Recognition Rental Income - Our leases generally provide for rent escalators throughout the term of the lease. Base rental income is recognized using the straight-line method over the term of the lease to the extent that lease payments are considered collectable 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 base year or base quarter. We recognize contingent rent annually or quarterly 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 and are excluded from the schedule of minimum lease payments. 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 of substantially all lease payments 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. Reference Note 3 for further discussion. 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 Accounting Standards Codification (“ASC”) 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 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
Income Taxes	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. A failure to qualify under the applicable REIT qualification rules and regulations would have a material adverse impact on our financial position, results of operations and cash flows.
Segments	Segments We operate our business through two reportable segments: Re al 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 15 for additional information.
Earnings Per Share	Earnings Per Share
Recent Accounting Pronouncements	Recent Accounting Pronouncements

Basis of Presentation and Sig_3

Basis of Presentation and Significant Accounting Policies (Tables)	6 Months Ended
	Jun. 30, 2024
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 Condensed Consolidated Statements of Cash Flows ( $ in thousands ): June 30, 2024 June 30, 2023 Beginning 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 End of period: Cash and cash equivalents $ 14,766 $ 17,411 Restricted cash (included in Other assets, net) 2,137 1,863 Cash, cash equivalents, and restricted cash $ 16,903 $ 19,274
Schedule of Restrictions on Cash and Cash Equivalents	The following table sets forth our “ Cash and cash equivalents and restricted cash ” reported within the Company’s Condensed Consolidated Statements of Cash Flows ( $ in thousands ): June 30, 2024 June 30, 2023 Beginning 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 End of period: Cash and cash equivalents $ 14,766 $ 17,411 Restricted cash (included in Other assets, net) 2,137 1,863 Cash, cash equivalents, and restricted cash $ 16,903 $ 19,274

Investment Activity (Tables)

Investment Activity (Tables)	6 Months Ended
	Jun. 30, 2024
Real Estate [Abstract]
Schedule of Tenant Concentrations	The following table contains information regarding concentration in our Real Estate Investments portfolio of tenants or affiliates of tenants that exceed 10% of total revenues as of and for the six months ended June 30, 2024 and 2023, excluding $2.6 million for our corporate office, a credit loss reserve of $15.9 million and $351.1 million in real estate assets in the SHOP segment ( $ in thousands ): As of June 30, 2024 Revenues 1 Asset Class Gross Real Estate 2 Notes Receivable Six Months Ended June 30, 2024 2023 Senior Living Communities, LLC (“Senior Living”) EFC $ 573,631 $ 45,375 $ 26,406 16% $ 25,658 16% National HealthCare Corporation (“NHC”) SNF 133,770 — 20,836 13% 18,983 12% Bickford ALF 426,798 16,697 20,691 12% 19,977 12% All others, net Various 1,339,754 194,699 66,369 40% 66,323 41% Escrow funds received from tenants for property operating expenses Various — — 5,535 3% 5,830 4% $ 2,473,953 $ 256,771 139,837 136,771 Resident fees and services 3 26,645 16% 23,493 15% $ 166,482 $ 160,264 1 Includes interest income on notes receivable and rental income from properties classified as assets held for sale. 2 Amounts include any properties classified as held for sale. 3 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 ): Six Months Ended June 30, 2024 2023 Current year $ 2,759 $ 1,931 Prior year final certification 1 1,656 630 Total percentage rent income $ 4,415 $ 2,561 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 Assets Held for Sale and Long-Lived Assets	The following is a summary of our assets held for sale in our Real Estate Investments portfolio ( $ in thousands ): As of As of June 30, 2024 December 31, 2023 Number of facilities 2 1 Real estate, net $5,669 $5,004
Schedule of Cash Rents Received	Cash rents received from these tenants for the three and six months ended June 30, 2024 and 2023 were as follows ( $ in thousands ): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Bickford 1 $ 9,946 $ 8,119 $ 19,310 $ 15,927 All others 2 5,142 2,318 7,544 6,516 Total rental income from cash basis operators $ 15,088 $ 10,437 $ 26,854 $ 22,443 1 Excludes $2.5 million of rental income related to the reduction of pandemic-related rent deferrals recognized in connection with the acquisition of an ALF from Bickford in the first quarter of 2023. 2 In the second quarter of 2024, we received a $2.5 million lump sum payment from an operator for partial repayment of pandemic-related rent deferrals.
Schedule of Future Minimum Base Rent	Future minimum lease payments to be received by us under our operating leases at June 30, 2024, were as follows ( $ in thousands ): Remainder of 2024 $ 118,344 2025 239,272 2026 245,826 2027 198,986 2028 193,384 2029 176,362 Thereafter 677,813 $ 1,849,987
Schedule of Fixed and Variable Lease Payments	The table below indicates the rental income recognized as a result of fixed and variable lease escalators ( $ in thousands ): Three Months Ended Six Months Ended June 30, June 30, 2024 2023 2024 2023 Lease payments based on fixed escalators $ 60,110 $ 53,538 $ 116,702 $ 112,827 Lease payments based on variable escalators 2,358 2,103 6,251 3,696 Straight-line rent, net of write-offs 1,213 2,875 905 4,972 Escrow funds received from tenants for property operating expenses 2,802 3,212 5,535 5,830 Amortization of lease incentives (723) (776) (1,446) (1,075) Rental income $ 65,760 $ 60,952 $ 127,947 $ 126,250

Mortgage and Other Notes Rece_2

Mortgage and Other Notes Receivable (Tables)	6 Months Ended
	Jun. 30, 2024
Accounts, Notes, Loans and Financing Receivable, Gross, Allowance, and Net [Abstract]
Schedule of Financing Receivable Credit Quality Indicators	The credit quality indicator as of June 30, 2024 is presented below for the amortized cost, net by year of origination ( $ in thousands ): 2024 2023 2022 2021 2020 Prior Total Mortgages more than 1.5x $ 9,407 $ — $ 70,351 $ — $ — $ 35,100 $ 114,858 between 1.0x and 1.5x 14,862 930 — — — 6,423 22,215 less than 1.0x — 620 — — — 14,700 15,320 24,269 1,550 70,351 — — 56,223 152,393 Mezzanine more than 1.5x — 512 — 14,049 — — 14,561 between 1.0x and 1.5x — 223 — 21,621 — — 21,844 less than 1.0x — — — — — 25,000 25,000 — 735 — 35,670 — 25,000 61,405 Non-performing between 1.0x and 1.5x — — — — — 24,500 24,500 less than 1.0x — — — — 1,997 — 1,997 — — — — 1,997 24,500 26,497 Revolver more than 1.5x 16,476 16,476 Credit loss reserve (15,921) $ 240,850
Schedule of Financing Receivable, Allowance for Credit Loss	The allowance for expected credit losses is presented in the following table for the six months ended June 30, 2024 ( $ in thousands ): Balance at January 1, 2024 $ 15,476 Provision for expected credit losses 445 Balance at June 30, 2024 $ 15,921

Other Assets (Tables)

Other Assets (Tables)	6 Months Ended
	Jun. 30, 2024
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Schedule of Other Assets	Other assets, net consist of the following ( $ in thousands ): June 30, 2024 December 31, 2023 SHOP accounts receivable, net of allowance of $382 and $343, and other assets $ 2,725 $ 1,620 Real estate investments accounts receivable and prepaid expenses 3,688 3,296 Lease incentive payments, net 9,224 10,669 Regulatory escrows 6,208 6,208 Restricted cash 2,137 2,270 $ 23,982 $ 24,063

Debt (Tables)

Debt (Tables)	6 Months Ended
	Jun. 30, 2024
Debt Instruments [Abstract]
Schedule of Debt	Debt consisted of the following ( $ in thousands ): June 30, 2024 December 31, 2023 Revolving credit facility - unsecured $ 244,500 $ 245,000 Bank term loans - unsecured 200,000 200,000 2031 Senior Notes - unsecured, net of discount of $2,117 and $2,278 397,883 397,722 Private placement notes - unsecured 225,000 225,000 Fannie Mae term loans - secured, non-recourse 76,031 76,241 Unamortized loan costs (7,379) (8,912) $ 1,136,035 $ 1,135,051
Schedule of Maturities of Long-term Debt	Aggregate principal maturities of debt as of June 30, 2024 were as follows ( $ in thousands ): Remainder of 2024 $ 75,425 2025 325,606 2026 244,500 2027 100,000 2028 — 2029 — Thereafter 400,000 1,145,531 Less: discount (2,117) Less: unamortized loan costs (7,379) $ 1,136,035
Schedule of Unsecured Term Loans	Our unsecured private placement notes as of June 30, 2024, 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 ): Three Months Ended Six Months Ended June 30, June 30, 2024 2023 2024 2023 Interest expense on debt at contractual rates $ 14,029 $ 13,612 $ 28,116 $ 27,052 Capitalized interest (48) (22) (87) (41) Amortization of debt issuance costs, debt discount and other 873 604 1,694 1,210 Total interest expense $ 14,854 $ 14,194 $ 29,723 $ 28,221

Commitments. Contingencies an_2

Commitments. Contingencies and Uncertainties (Tables)	6 Months Ended
	Jun. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
Schedule of Off Balance Sheet, Credit Loss, Liability, Roll Forward	The liability for expected credit losses on our unfunded loan commitments reflected in “ Accounts payable and accrued expenses ” on the Condensed Consolidated Balance Sheets as of June 30, 2024 and December 31, 2023 is presented in the following table for the six months ended June 30, 2024 ( $ in thousands ): Balance at January 1, 2024 $ 279 Provision for expected credit losses 17 Balance at June 30, 2024 $ 296

Redeemable Noncontrolling Int_2

Redeemable Noncontrolling Interest (Tables)	6 Months Ended
	Jun. 30, 2024
Noncontrolling Interest [Abstract]
Schedule of Redeemable Noncontrolling Interest	The following table presents the change in “ Redeemable noncontrolling interest” for the six months ended June 30, 2024 ( $ in thousands ): Six Months Ended June 30, 2024 Balance at January 1, $ 9,656 Net loss (478) Distributions (9) Balance at June 30, $ 9,169

Equity and Dividends (Tables)

Equity and Dividends (Tables)	6 Months Ended
	Jun. 30, 2024
Equity [Abstract]
Schedule of Dividends Declared	The following table summarizes dividends declared by the Board of Directors or paid during the six months ended June 30, 2024 and 2023: Six Months Ended June 30, 2024 Date of Declaration Date of Record Date Paid/Payable Quarterly Dividend November 3, 2023 December 29, 2023 January 26, 2024 $0.90 February 16, 2024 March 28, 2024 May 3, 2024 $0.90 May 3, 2024 June 28, 2024 August 2, 2024 $0.90 Six Months Ended June 30, 2023 Date of Declaration Date of Record Date Paid/Payable Quarterly Dividend November 6, 2022 December 30, 2022 January 27, 2023 $0.90 February 17, 2023 March 31, 2023 May 5, 2023 $0.90 May 5, 2023 June 30, 2023 August 4, 2023 $0.90

Share-Based Compensation (Table

Share-Based Compensation (Tables)	6 Months Ended
	Jun. 30, 2024
Share-Based Payment Arrangement [Abstract]
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions	The fair value of each grant is estimated on the date of grant using the Black-Scholes option-pricing model with the following weighted average assumptions: 2024 2023 Dividend yield 6.4% 7.0% Expected volatility 26.1% 39.7% Expected lives 2.9 years 2.9 years Risk-free interest rate 4.49% 4.65%
Schedule of Stock Option Activity	The following table summarizes our outstanding stock options: Weighted Average Number Weighted Average Remaining of Shares Exercise Price Contractual Life (Years) Options outstanding, January 1, 2023 2,216,175 $70.97 Options granted 385,500 $54.73 Options exercised (5,166) $53.41 Options forfeited (61,168) $66.44 Options expired (88,170) $64.33 Options outstanding, June 30, 2023 2,447,171 $68.80 Exercisable at June 30, 2023 2,078,827 $71.40 Options outstanding, January 1, 2024 2,447,171 $68.80 Options granted 431,000 $57.76 Options exercised (122,174) $54.03 Options expired (301,837) $79.96 Options outstanding, June 30, 2024 2,454,160 $66.23 2.46 Exercisable at June 30, 2024 2,113,466 $67.74 2.16
Schedule of Disclosure of Share-Based Compensation Arrangements by Share-Based Payment Award	The following is a summary of share-based compensation expense, net of any forfeitures, included in “ General and administrative expenses ” in the Condensed Consolidated Statements of Income ( $ in thousands ): Three Months Ended Six Months Ended June 30, June 30, 2024 2023 2024 2023 Share-based compensation components: Restricted stock expense $ 186 $ 72 $ 344 $ 72 Stock option expense 501 697 2,498 2,802 Total share-based compensation expense $ 687 $ 769 $ 2,842 $ 2,874

Earnings Per Common Share (Tabl

Earnings Per Common Share (Tables)	6 Months Ended
	Jun. 30, 2024
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	The following table summarizes the average number of common shares and the net income used in the calculation of basic and diluted earnings per common share ($ in thousands, except share and per share amounts) : Three Months Ended Six Months Ended June 30, June 30, 2024 2023 2024 2023 Net income $ 34,952 $ 39,447 $ 65,610 $ 73,630 Add: net loss attributable to noncontrolling interests 304 332 593 633 Net income attributable to stockholders 35,256 39,779 66,203 74,263 Less: net income attributable to unvested restricted stock awards (29) (19) (61) (19) Net income attributable to common stockholders - basic $ 35,227 $ 39,760 $ 66,142 $ 74,244 BASIC: Weighted average common shares outstanding 43,397,080 43,388,753 43,392,961 43,388,748 DILUTED: Weighted average common shares outstanding 43,397,080 43,388,753 43,392,961 43,388,748 Stock options 166,574 — 101,142 1,344 Weighted average dilutive common shares outstanding 43,563,654 43,388,753 43,494,103 43,390,092 Earnings per common share - basic $ 0.81 $ 0.92 $ 1.52 $ 1.71 Earnings per common share - diluted $ 0.81 $ 0.92 $ 1.52 $ 1.71 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 261,255 903,425 376,965 776,771 Regular dividends declared per common share $ 0.90 $ 0.90 $ 1.80 $ 1.80

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	6 Months Ended
	Jun. 30, 2024
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 June 30, 2024 and December 31, 2023 in the Condensed Consolidated Balance Sheets are as follows ($ in thousands ): Carrying Amount Fair Value Measurement June 30, 2024 December 31, 2023 June 30, 2024 December 31, 2023 Level 2 Variable rate debt $ 440,376 $ 439,693 $ 444,500 $ 445,000 Fixed rate debt $ 695,659 $ 695,358 $ 615,417 $ 616,852 Level 3 Mortgage and other notes receivable, net $ 240,850 $ 245,271 $ 231,437 $ 237,646

Segment Reporting (Tables)

Segment Reporting (Tables)	6 Months Ended
	Jun. 30, 2024
Segment Reporting [Abstract]
Schedule of Segment Reporting Information, by Segment	Summary information for the reportable segments during the three and six months ended June 30, 2024 and 2023 is as follows ( $ in thousands ): For the three months ended June 30, 2024: Real Estate Investments SHOP Non-segment/Corporate Total Rental income $ 65,760 $ — $ — $ 65,760 Resident fees and services — 13,390 — 13,390 Interest income and other 5,744 — 76 5,820 Total revenues 71,504 13,390 76 84,970 Senior housing operating expenses — 10,437 — 10,437 Taxes and insurance on leased properties 2,802 — — 2,802 NOI 68,702 2,953 76 71,731 Depreciation 14,992 2,490 8 17,490 Interest 761 — 14,093 14,854 Legal — — 165 165 Franchise, excise and other taxes — — 47 47 General and administrative — — 4,870 4,870 Loan and realty losses 1,106 — — 1,106 Gains on sales of real estate, net (1,517) — — (1,517) Gains from equity method investment (236) — — (236) Net income (loss) $ 53,596 $ 463 $ (19,107) $ 34,952 Total assets $ 2,197,656 $ 268,187 $ 11,069 $ 2,476,912 For the three months ended June 30, 2023: Real Estate Investments SHOP Non-segment/Corporate Total Rental income $ 60,952 $ — $ — $ 60,952 Resident fees and services — 11,793 — 11,793 Interest income and other 5,083 — 48 5,131 Total revenues 66,035 11,793 48 77,876 Senior housing operating expenses — 9,682 — 9,682 Taxes and insurance on leased properties 3,212 — — 3,212 NOI 62,823 2,111 48 64,982 Depreciation 15,477 2,239 14 17,730 Interest 766 — 13,428 14,194 Legal — — 174 174 Franchise, excise and other taxes — — 258 258 General and administrative — — 4,306 4,306 Loan and realty losses 186 — — 186 Gains on sales of real estate, net (11,366) — — (11,366) Gain on operations transfer, net (20) — — (20) Loss on early retirement of debt — — 73 73 Net income (loss) $ 57,780 $ (128) $ (18,205) $ 39,447 Total assets $ 2,217,124 $ 271,359 $ 10,012 $ 2,498,495 For the six months ended June 30, 2024: Real Estate Investments SHOP Non-segment/Corporate Total Rental income $ 127,947 $ — $ — $ 127,947 Resident fees and services — 26,645 — 26,645 Interest income and other 11,685 — 205 11,890 Total revenues 139,632 26,645 205 166,482 Senior housing operating expenses — 20,751 — 20,751 Taxes and insurance on leased properties 5,535 — — 5,535 NOI 134,097 5,894 205 140,196 Depreciation 30,050 4,927 18 34,995 Interest 1,524 — 28,199 29,723 Legal — — 400 400 Franchise, excise and other taxes — — (139) (139) General and administrative — — 10,510 10,510 Loan and realty losses 1,116 — — 1,116 Gains on sales of real estate, net (1,617) — — (1,617) Gains from equity method investment (402) — — (402) Net income (loss) $ 103,426 $ 967 $ (38,783) $ 65,610 For the six months ended June 30, 2023: Real Estate Investments SHOP Non-segment/Corporate Total Rental income $ 126,250 $ — $ — $ 126,250 Resident fees and services — 23,493 — 23,493 Interest income and other 10,391 — 130 10,521 Total revenues 136,641 23,493 130 160,264 Senior housing operating expenses — 19,481 — 19,481 Taxes and insurance on leased properties 5,830 — — 5,830 NOI 130,811 4,012 130 134,953 Depreciation 30,854 4,466 27 35,347 Interest 1,525 — 26,696 28,221 Legal — — 297 297 Franchise, excise and other taxes — — 441 441 General and administrative — — 9,959 9,959 Loan and realty losses (232) — — (232) Gains on sales of real estate, net (12,763) — — (12,763) Loss on operations transfer, net (20) — — (20) Loss on early retirement of debt — — 73 73 Net income (loss) $ 111,447 $ (454) $ (37,363) $ 73,630

Variable Interest Entities (Tab

Variable Interest Entities (Tables)	6 Months Ended
	Jun. 30, 2024
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 to our condensed consolidated financial statements cross-referenced below ( $ in thousands ). Date Name Source of Exposure Carrying Amount Maximum Exposure to Loss Note Reference 2014 Senior Living Various 1 $ 85,238 $ 102,488 Notes 3, 4 2016 Senior Living Management Notes $ 24,500 $ 24,500 — 2018 Bickford Notes and development commitments $ 16,823 $ 37,263 Notes 3, 4 2019 Encore Various 2 $ 34,579 $ 57,243 — 2020 Timber Ridge OpCo Various 3 $ 16 $ 5,016 Notes 6, 7 2020 Watermark Retirement Notes and straight-line rent receivable $ 10,590 $ 11,864 — 2021 Montecito Medical Real Estate Notes and funding commitment $ 18,201 $ 50,211 Note 4 2021 Vizion Health Notes and straight-line rent receivable $ 15,833 $ 15,833 — 2021 Navion Senior Solutions Various 4 $ 7,975 $ 11,278 — 2023 Kindcare Senior Living Notes 5 $ 766 $ 766 — 1 Notes, straight-line rent receivable, and development commitment 2 Note, straight-line rent receivable, and lease receivables 3 Loan commitment, equity method investment, straight-line rent receivable and unamortized lease incentive 4 Development commitments, straight-line rent receivable, and unamortized lease incentive 5 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	6 Months Ended
	Jun. 30, 2024 USD ($) segment	Jun. 30, 2024 property	Jun. 30, 2024 state	Jun. 30, 2024 tenant	Jun. 30, 2024 mortgage	Jun. 30, 2024 unit	Jun. 30, 2024 jointVenture	Dec. 31, 2023 USD ($)
Real Estate Properties [Line Items]
Number of reportable segments | segment	2
Number of facilities		2
Number of health care properties related to mortgage notes receivables		18			10
Loans and leases receivable, gross | $	$ 256,771
Credit loss reserve | $	15,921							$ 15,476
Real Estate Investments
Real Estate Properties [Line Items]
Real estate investment property, portfolio assets | $	2,500,000
Properties		161
Number of states in which entity operates | state			31
Number of lessees | tenant				25
Senior Housing Community | Real Estate Investments
Real Estate Properties [Line Items]
Properties		95
Skilled Nursing Facility
Real Estate Properties [Line Items]
Properties		32
Skilled Nursing Facility | Real Estate Investments
Real Estate Properties [Line Items]
Properties		65
Hospital | Real Estate Investments
Real Estate Properties [Line Items]
Properties		1
Independent Living Facility
Real Estate Properties [Line Items]
Properties		3
Number of states in which entity operates | state			8
Number of joint ventures | jointVenture							2
Independent Living Facility | SHOP
Real Estate Properties [Line Items]
Real estate investment property, portfolio assets | $	$ 351,100
Properties		15
Number of units in real estate property | unit						1,732

Basis of Presentation and Sig_4

Basis of Presentation and Significant Accounting Policies (Narrative) (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2024 USD ($) operator segment property jointVenture mortgage realEstatePartnership
Property, Plant and Equipment [Line Items]
Number of real estate partnerships | realEstatePartnership	2
Loans and leases receivable, gross | $	$ 256,771
Number of reportable segments | segment	2
Non-performing
Property, Plant and Equipment [Line Items]
Mortgage note receivables | mortgage	2
Number of operators/borrowers | operator	2
Non-performing | Mortgage Receivable And Mezzanine Loan
Property, Plant and Equipment [Line Items]
Loans and leases receivable, gross | $	$ 26,500
Minimum
Property, Plant and Equipment [Line Items]
Residency agreement, term	30 days
Maximum
Property, Plant and Equipment [Line Items]
Residency agreement, term	1 year
Independent Living Facility
Property, Plant and Equipment [Line Items]
Number of joint ventures | jointVenture	2
Properties | property	3
Independent Living Facility | SHOP
Property, Plant and Equipment [Line Items]
Properties | property	15

Basis of Presentation and Sig_5

Basis of Presentation and Significant Accounting Policies (Schedule of Cash and Cash Equivalents and Restricted Cash) (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023	Jun. 30, 2023	Dec. 31, 2022
Accounting Policies [Abstract]
Cash and cash equivalents	$ 14,766	$ 22,347	$ 17,411	$ 19,291
Restricted cash (included in Other assets, net)	2,137	2,270	1,863	2,225
Cash, cash equivalents, and restricted cash	$ 16,903	$ 24,617	$ 19,274	$ 21,516

Investment Activity (Asset Acqu

Investment Activity (Asset Acquisitions) (Details) - Encore $ in Millions	1 Months Ended
	Jun. 30, 2024 USD ($) unit
Real Estate [Line Items]
Annual lease escalator	2.21%
Encore
Real Estate [Line Items]
Number of units in real estate property | unit	110
Acquisition price	$ 32.1
Asset purchase transaction costs	0.1
Full payment of an outstanding construction note receivable	$ 22.2
Master lease, term	15 years
Asset acquisition, initial lease rate	8.25%
Encore | Land
Real Estate [Line Items]
Acquisition price	$ 1.3
Encore | Building Improvements
Real Estate [Line Items]
Acquisition price	$ 30.8

Investment Activity (Asset Disp

Investment Activity (Asset Dispositions) (Details) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024 USD ($) tenant property	Jun. 30, 2023 USD ($)	Jun. 30, 2024 USD ($) property tenant	Jun. 30, 2023 USD ($)
Real Estate [Line Items]
Gains on sales of real estate, net	$ 1,517	$ 11,366	$ 1,617	$ 12,763
Assisted Living Facilities | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Real Estate [Line Items]
Properties | property	2		2
Number of tenants leased on cash basis | tenant	1		1
Amount of real estate sold in cash consideration			$ 4,700
Gains on sales of real estate, net			$ 1,400

Investment Activity (Tenant Con

Investment Activity (Tenant Concentration Narrative) (Details) $ in Thousands

3 Months Ended

6 Months Ended

Apr. 01, 2024 USD ($)

Jun. 30, 2024 USD ($)

Jun. 30, 2023 USD ($)

Jun. 30, 2024 USD ($)

Jun. 30, 2023 USD ($)

Jun. 30, 2024 property

Jun. 30, 2024 state

Jun. 30, 2024

Jun. 30, 2024 lease

Jun. 30, 2024 boardMember

Jun. 30, 2024 facility

Jun. 30, 2024 leaseAgreement

Dec. 31, 2023 USD ($)

Real Estate [Line Items]

Cost of corporate office

$ 2,600

$ 2,600

$ 2,600

$ 2,600

Credit loss reserve

(15,921)

(15,921)

$ (15,476)

Straight-line rent, net of write-offs

905

4,972

Number of board of directors | boardMember

2

Rental income

$ 65,760

60,952

127,947

126,250

Bickford Senior Living Acquisition

Real Estate [Line Items]

Asset acquisition, rent deferral deduction

2,500

Lease Extended Until 2026

Real Estate [Line Items]

Lease escalator minimum

2%

Annual lease cap

3%

Senior Living Communities, LLC (“Senior Living”)

Real Estate [Line Items]

Real estate properties | property

10

Lease comprising properties | lease

2

Leases extended maturity

2 years

Payments for capital improvements

10,000

Lease rate

0.085

Straight-line rent, net of write-offs

500

600

Rental income

26,406

25,658

National HealthCare Corporation (“NHC”)

Real Estate [Line Items]

Straight-line rent, net of write-offs

100

600

Rental income

$ 20,836

18,983

National HealthCare Corporation (“NHC”) | NHC - 1991 Lease

Real Estate [Line Items]

Percentage rent rate

4%

Bickford

Real Estate [Line Items]

Properties

1

39

Number of leases | leaseAgreement

4

Rental income

$ 20,691

19,977

Maximum capital improvements commitment

$ 8,000

Minimum capital improvements commitment

100

Annual rent increase

8%

Rent deferral

$ 15,200

15,200

Bickford | Bickford Senior Living Acquisition

Real Estate [Line Items]

Payments for rent

1,300

$ 400

$ 2,800

$ 600

Bickford | Lease Extended Until 2026

Real Estate [Line Items]

Rental income

$ 34,500

Revenue as % of Total, Exceeds 10%

Real Estate [Line Items]

Number of states in which entity operates | state

2

Geographic Concentration Risk | South Carolina | Investment Consideration Benchmark

Real Estate [Line Items]

Concentration risk percentage

12%

Geographic Concentration Risk | Texas | Investment Consideration Benchmark

Real Estate [Line Items]

Concentration risk percentage

10.60%

Independent Living Facility

Real Estate [Line Items]

Number of states in which entity operates | state

8

Properties | property

3

Independent Living Facility | SHOP

Real Estate [Line Items]

Real estate investment property, portfolio assets

$ 351,100

$ 351,100

Properties | property

15

Skilled Nursing Facility

Real Estate [Line Items]

Properties | property

32

Skilled Nursing Facility | National HealthCare Corporation (“NHC”) | Subleased Facilities

Real Estate [Line Items]

Properties | property

4

Investment Activity (Schedule o

Investment Activity (Schedule of Tenant Concentrations) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023
Tenant Concentration [Line Items]
Gross Real Estate	$ 2,812,153		$ 2,812,153		$ 2,780,358
Total Gross Real Estate	2,473,953		2,473,953
Total notes receivable	256,771		256,771
Revenues	65,760	$ 60,952	127,947	$ 126,250
Escrow funds received from tenants for property operating expenses			5,535	5,830
Resident fees and services	13,390	11,793	26,645	23,493
Total revenues	84,970	$ 77,876	$ 166,482	$ 160,264
Percentage of continuing revenue			16%	15%
Senior Living Communities, LLC (“Senior Living”)
Tenant Concentration [Line Items]
Gross Real Estate	573,631		$ 573,631
Notes Receivable	45,375		45,375
Revenues			$ 26,406	$ 25,658
Percentage of continuing revenue			16%	16%
National HealthCare Corporation (“NHC”)
Tenant Concentration [Line Items]
Gross Real Estate	133,770		$ 133,770
Notes Receivable	0		0
Revenues			$ 20,836	$ 18,983
Percentage of continuing revenue			13%	12%
Bickford
Tenant Concentration [Line Items]
Gross Real Estate	426,798		$ 426,798
Notes Receivable	16,697		16,697
Revenues			$ 20,691	$ 19,977
Percentage of continuing revenue			12%	12%
All others, net
Tenant Concentration [Line Items]
Gross Real Estate	1,339,754		$ 1,339,754
Notes Receivable	$ 194,699		194,699
Revenues			$ 66,369	$ 66,323
Percentage of continuing revenue			40%	41%
Tenants With Escrow Funds
Tenant Concentration [Line Items]
Percentage of continuing revenue			3%	4%
More than 10% Operators
Tenant Concentration [Line Items]
Revenues			$ 139,837	$ 136,771

Investment Activity (Schedule_2

Investment Activity (Schedule of NHC Percentage Rent) (Details) - National HealthCare Corporation (“NHC”) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
Real Estate [Line Items]
Rent income from NHC	$ 4,415	$ 2,561
Current year
Real Estate [Line Items]
Rent income from NHC	2,759	1,931
Prior year final certification
Real Estate [Line Items]
Rent income (loss) from NHC	$ 1,656	$ 630

Investment Activity (Schedule_3

Investment Activity (Schedule of Assets Held for Sale and Long-Lived Assets) (Details) $ in Thousands	Jun. 30, 2024 USD ($) property	Dec. 31, 2023 USD ($) property
Real Estate [Line Items]
Number of facilities	2
Disposal Group, Held-for-sale, Not Discontinued Operations | Real Estate Investments
Real Estate [Line Items]
Number of facilities	2	1
Real estate, net | $	$ 5,669	$ 5,004

Investment Activity (Assets Hel

Investment Activity (Assets Held for Sale and Long-Lived Assets Narrative) (Details) $ in Thousands	1 Months Ended	3 Months Ended		6 Months Ended
	Mar. 31, 2024 USD ($)	Jun. 30, 2024 USD ($) property	Jun. 30, 2023 USD ($) property	Jun. 30, 2024 USD ($) property	Jun. 30, 2023 USD ($) property
Real Estate [Line Items]
Rental income		$ 65,760	$ 60,952	$ 127,947	$ 126,250
Asset Held For Sale In 2023
Real Estate [Line Items]
Rental income					1,000
Real Estate Investments
Real Estate [Line Items]
Impairment of real estate		$ 700	$ 100	$ 700	$ 500
Number of real estate properties, impaired, sold or classified as held for sale | property		1	2	1	3
Disposal Group, Held-for-sale, Not Discontinued Operations
Real Estate [Line Items]
Rental income		$ 500	$ 400	$ 900
Disposal Group, Held-for-sale, Not Discontinued Operations | Senior Living Campuses | 2024 Disposal Group
Real Estate [Line Items]
Purchase price		38,500		38,500
Lease income, annual rent	$ 2,800
Net real estate balance		$ 19,400		$ 19,400

Investment Activity (Cash Basis

Investment Activity (Cash Basis Operators Narrative) (Details)	6 Months Ended
	Jun. 30, 2024 operator
Cash Basis Lessees
Real Estate [Line Items]
Number of cash basis operators	3

Investment Activity (Schedule_4

Investment Activity (Schedule of Cash Rents Received) (Details) - USD ($) $ in Thousands	3 Months Ended			6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2024	Jun. 30, 2023
Real Estate [Line Items]
Total rental income from cash basis operators	$ 65,760	$ 60,952		$ 127,947	$ 126,250
Cash Basis Lessees
Real Estate [Line Items]
Total rental income from cash basis operators	15,088	10,437		26,854	22,443
Lump sum payment	2,500
Cash Basis Lessees | Bickford
Real Estate [Line Items]
Total rental income from cash basis operators	9,946	8,119		19,310	15,927
Asset acquisition, rent deferral deduction			$ 2,500
Cash Basis Lessees | All others
Real Estate [Line Items]
Total rental income from cash basis operators	$ 5,142	$ 2,318		$ 7,544	$ 6,516

Investment Activity (Tenant Tra

Investment Activity (Tenant Transition Narrative) (Details) $ in Millions	3 Months Ended
	Mar. 31, 2024 USD ($)
Skilled Nursing Facilities
Real Estate [Line Items]
Straight-line rent adjustments	$ (0.8)

Investment Activity (Tenant Pur

Investment Activity (Tenant Purchase Options Narrative) (Details) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024 USD ($) property	Jun. 30, 2023 USD ($)	Jun. 30, 2024 USD ($) property	Jun. 30, 2023 USD ($)	Dec. 31, 2023 USD ($)
Real Estate [Line Items]
Real estate properties, net	$ 2,106,324		$ 2,106,324		$ 2,107,082
Rental income	$ 65,760	$ 60,952	$ 127,947	$ 126,250
Lease Option
Real Estate [Line Items]
Properties | property	4		4
Lease Option, Between 2027 and 2028
Real Estate [Line Items]
Real estate properties, net	$ 78,500		$ 78,500
Rental income	$ 2,000	$ 1,800	$ 3,800	$ 3,600

Investment Activity (Schedule_5

Investment Activity (Schedule of Future Minimum Lease Payments) (Details) $ in Thousands	Jun. 30, 2024 USD ($)
Real Estate [Abstract]
Remainder of 2024	$ 118,344
2025	239,272
2026	245,826
2027	198,986
2028	193,384
2029	176,362
Thereafter	677,813
Future minimum lease payments	$ 1,849,987

Investment Activity (Schedule_6

Investment Activity (Schedule of Fixed and Variable Lease Payments) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Fixed and Variable Lease Payments [Line Items]
Rental income	$ 65,760	$ 60,952	$ 127,947	$ 126,250
Straight-line rent adjustments			(905)	(4,972)
Lease payments based on fixed escalators
Fixed and Variable Lease Payments [Line Items]
Rental income	60,110	53,538	116,702	112,827
Lease payments based on variable escalators
Fixed and Variable Lease Payments [Line Items]
Rental income	2,358	2,103	6,251	3,696
Straight-line rent, net of write-offs
Fixed and Variable Lease Payments [Line Items]
Straight-line rent adjustments	(1,213)	(2,875)	(905)	(4,972)
Escrow funds received from tenants for property operating expenses
Fixed and Variable Lease Payments [Line Items]
Rental income	2,802	3,212	5,535	5,830
Amortization of lease incentives
Fixed and Variable Lease Payments [Line Items]
Amortization of lease incentives	$ (723)	$ (776)	$ (1,446)	$ (1,075)

Mortgage and Other Notes Rece_3

Mortgage and Other Notes Receivable (Narrative) (Details) $ in Thousands	1 Months Ended		3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2024 USD ($) facility	Feb. 29, 2024 USD ($) extensionOption	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)	Jun. 30, 2024 USD ($) property	Jun. 30, 2023 USD ($)	Dec. 31, 2023 USD ($)	Jun. 30, 2024 property	Jun. 30, 2024 mortgage	Jun. 30, 2024 unit	Jun. 30, 2024 operator	Jun. 30, 2024 facility	Jun. 30, 2024	Jun. 30, 2024 loan	Dec. 31, 2021 property
Accounts, Notes, Loans and Financing Receivable [Line Items]
Number of health care properties related to mortgage notes receivables								18	10
Mortgage and other notes receivable, net of reserve	$ 15,921		$ 15,921		$ 15,921		$ 15,476
Financing receivable, excluding accrued interest, after allowance for credit loss	(240,850)		(240,850)		(240,850)		(245,271)
Loans and leases agreement					110,500
Number of underlying properties | property								2
Interest income and other			5,820	$ 5,131	11,890	$ 10,521
Increase rate in the amount of loss from a default													20%
Effective adjustment rate													44%
Compass Senior Living , LLC
Accounts, Notes, Loans and Financing Receivable [Line Items]
Loans and leases agreement	$ 9,500
Number of mortgage facilities | facility	2
Term of loan agreement	5 years
Financing receivable, stated interest rate	8.50%
Carriage Crossing Senior Living
Accounts, Notes, Loans and Financing Receivable [Line Items]
Loans and leases agreement		$ 15,000
Term of loan agreement		5 years
Financing receivable, stated interest rate		8.75%
Contingent incentive payments		$ 2,000
Number of loan extensions | extensionOption		2
Financing receivable, renewal term		1 year
Montecito Medical Real Estate
Accounts, Notes, Loans and Financing Receivable [Line Items]
Mortgage and other notes receivable, net	$ 18,000		18,000		18,000
Interest income and other			500	500	1,000	900
Loans and leases agreement					50,000
Principal repaid					2,100
Bickford
Accounts, Notes, Loans and Financing Receivable [Line Items]
Mortgage and other notes receivable, net	16,697		16,697		16,697
Properties								1				39
Interest income and other			300	600	300	600
Repayments of term loan			100	200	100	200
Senior Living Communities, LLC (“Senior Living”)
Accounts, Notes, Loans and Financing Receivable [Line Items]
Mortgage and other notes receivable, net	45,375		45,375		$ 45,375
Financing receivable, renewal term					1 year
Revolving amount line of credit	20,000		20,000		$ 20,000
Revolving note receivable amount outstanding	(12,800)		(12,800)		$ (12,800)
Loans receivable facility bears interest rate					8%
Purchase option at a stated minimum price	38,300		38,300		$ 38,300
Mezzanine
Accounts, Notes, Loans and Financing Receivable [Line Items]
Mortgage and other notes receivable, net of reserve	10,000		10,000		10,000
Non-performing
Accounts, Notes, Loans and Financing Receivable [Line Items]
Mortgage and other notes receivable, net of reserve	12,400		12,400		12,400		11,900
Mortgage notes receivable, designated as nonperforming					2,000		$ 2,100
Number of operators/borrowers | operator											2
Interest income and other			500	$ 400	900	$ 900
Non-performing | Mezzanine
Accounts, Notes, Loans and Financing Receivable [Line Items]
Financing receivable, excluding accrued interest, after allowance for credit loss	(14,500)		(14,500)		(14,500)
Number of operators/borrowers | operator											1
Secured By Real Estate
Accounts, Notes, Loans and Financing Receivable [Line Items]
Mortgage and other notes receivable, net	164,400		164,400		164,400
Not Secured By Real Estate
Accounts, Notes, Loans and Financing Receivable [Line Items]
Mortgage and other notes receivable, net	92,400		92,400		$ 92,400
Property Held by Fund | Montecito Medical Real Estate
Accounts, Notes, Loans and Financing Receivable [Line Items]
Number of medical office buildings | property					7
Combined purchase price of medical office buildings					$ 76,400
Fully Funded | Bickford
Accounts, Notes, Loans and Financing Receivable [Line Items]
Loans and leases agreement					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]
Mortgage increase from sale of real estate					12,500
Negotiations to sale | Bickford
Accounts, Notes, Loans and Financing Receivable [Line Items]
Properties | property															6
After 2021 | Senior Living Communities, LLC (“Senior Living”)
Accounts, Notes, Loans and Financing Receivable [Line Items]
Revolving amount line of credit	$ 15,000		$ 15,000		15,000
July 2019 Transaction | Senior Living Communities, LLC (“Senior Living”)
Accounts, Notes, Loans and Financing Receivable [Line Items]
Loans and leases agreement					$ 32,700
Annual interest rate from master credit agreement													7.25%
June 2019 Transaction | Senior Living Communities, LLC (“Senior Living”)
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	Jun. 30, 2024	Dec. 31, 2023
Financing Receivable, Credit Quality Indicator [Line Items]
Credit loss reserve	$ (15,921)	$ (15,476)
Financing receivable, after allowance for credit loss	240,850	$ 245,271
Mortgages
Financing Receivable, Credit Quality Indicator [Line Items]
2024	24,269
2023	1,550
2022	70,351
2021	0
2020	0
Prior	56,223
Total	152,393
Mezzanine
Financing Receivable, Credit Quality Indicator [Line Items]
2024	0
2023	735
2022	0
2021	35,670
2020	0
Prior	25,000
Total	61,405
Non-performing
Financing Receivable, Credit Quality Indicator [Line Items]
2024	0
2023	0
2022	0
2021	0
2020	1,997
Prior	24,500
Total	26,497
Revolver
Financing Receivable, Credit Quality Indicator [Line Items]
Total	16,476
more than 1.5x | Mortgages
Financing Receivable, Credit Quality Indicator [Line Items]
2024	9,407
2023	0
2022	70,351
2021	0
2020	0
Prior	35,100
Total	114,858
more than 1.5x | Mezzanine
Financing Receivable, Credit Quality Indicator [Line Items]
2024	0
2023	512
2022	0
2021	14,049
2020	0
Prior	0
Total	14,561
more than 1.5x | Revolver
Financing Receivable, Credit Quality Indicator [Line Items]
Total	16,476
between 1.0x and 1.5x | Mortgages
Financing Receivable, Credit Quality Indicator [Line Items]
2024	14,862
2023	930
2022	0
2021	0
2020	0
Prior	6,423
Total	22,215
between 1.0x and 1.5x | Mezzanine
Financing Receivable, Credit Quality Indicator [Line Items]
2024	0
2023	223
2022	0
2021	21,621
2020	0
Prior	0
Total	21,844
between 1.0x and 1.5x | Non-performing
Financing Receivable, Credit Quality Indicator [Line Items]
2024	0
2023	0
2022	0
2021	0
2020	0
Prior	24,500
Total	24,500
less than 1.0x | Mortgages
Financing Receivable, Credit Quality Indicator [Line Items]
2024	0
2023	620
2022	0
2021	0
2020	0
Prior	14,700
Total	15,320
less than 1.0x | Mezzanine
Financing Receivable, Credit Quality Indicator [Line Items]
2024	0
2023	0
2022	0
2021	0
2020	0
Prior	25,000
Total	25,000
EBITDARM Coverage less than 1.0x | Non-performing
Financing Receivable, Credit Quality Indicator [Line Items]
2024	0
2023	0
2022	0
2021	0
2020	1,997
Prior	0
Total	$ 1,997

Mortgage and Other Notes Rece_5

Mortgage and Other Notes Receivable (Schedule of Financing Receivables By Allowance for Credit Loss) (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2024 USD ($)
Financing Receivable, Allowance for Credit Loss [Roll Forward]
Balance at January 1, 2024	$ 15,476
Provision for expected credit losses	445
Balance at June 30, 2024	$ 15,921

Senior Housing Operating Port_2

Senior Housing Operating Portfolio Structure (Details)	3 Months Ended	6 Months Ended
	Jun. 30, 2024 USD ($) property jointVenture	Jun. 30, 2024 USD ($) property jointVenture
Senior Housing Operating Portfolio Formation Activities [Line Items]
Cash contributed for its common equity interest in the venture | $	$ 100,000
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]
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]
Management fee		5%
Common equity interest in venture		2%
Cash contributed for its common equity interest in the venture | $	$ 3,500,000
SHOP | New Venture
Senior Housing Operating Portfolio Formation Activities [Line Items]
Ownership percentage	100%	100%
Independent Living Facility
Senior Housing Operating Portfolio Formation Activities [Line Items]
Number of joint ventures | jointVenture	2	2
Properties	3	3
Independent Living Facility | Merrill Gardens Managed Portfolio
Senior Housing Operating Portfolio Formation Activities [Line Items]
Properties	6	6
Independent Living Facility | Discovery Managed Portfolio
Senior Housing Operating Portfolio Formation Activities [Line Items]
Properties	9	9
Independent Living Facility | SHOP
Senior Housing Operating Portfolio Formation Activities [Line Items]
Properties	15	15

Equity Method Investment (Detai

Equity Method Investment (Details) $ in Thousands	1 Months Ended		3 Months Ended		6 Months Ended
	Feb. 28, 2023 USD ($)	Jan. 31, 2020 USD ($)	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)	Jun. 30, 2024 USD ($) extensionOption	Jun. 30, 2023 USD ($)
Schedule of Equity Method Investments [Line Items]
Cumulative unrecognized equity method losses			$ (5,000)		$ (5,000)
Unrecognized equity method losses			(600)	$ (700)	(1,200)	$ (1,300)
Gains from equity method investment			$ 236	$ 0	$ 402	$ 0
Operating lease term			7 years		7 years
Number of renewal options | extensionOption					2
Renewal term			5 years		5 years
Balance secured by the deed and indenture			$ 11,800		$ 11,800
Timber Ridge OpCo
Schedule of Equity Method Investments [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		5,000
Timber Ridge OpCo
Schedule of Equity Method Investments [Line Items]
Mortgage and other notes receivable, net			0		0
Gains from equity method investment			200		400
Timber Ridge OpCo | Cumulative Amount
Schedule of Equity Method Investments [Line Items]
Cumulative unrecognized equity method losses			$ 10,700		$ 10,700
Timber Ridge OpCo | Noncontrolling Interests | Real Estate Operating Company
Schedule of Equity Method Investments [Line Items]
Investments in affiliates		$ 900
LCS Timber Ridge | Real Estate Operating Company
Schedule of Equity Method Investments [Line Items]
Equity interest in affiliates		25%

Other Assets (Details)

Other Assets (Details) - USD ($) $ in Thousands	1 Months Ended	6 Months Ended
	Feb. 28, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023	Dec. 31, 2022
Segment Reporting Information [Line Items]
Lease incentive payments, net		$ 9,224		$ 10,669
Regulatory escrows		6,208		6,208
Restricted cash		2,137	$ 1,863	2,270	$ 2,225
Other assets		23,982		24,063
Payment of lease incentive		0	$ 10,000
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		2,725		1,620
Allowance		382		343
Real Estate Investments
Segment Reporting Information [Line Items]
Accounts receivable and prepaid expenses		$ 3,688		$ 3,296

Debt (Schedule of Debt) (Detail

Debt (Schedule of Debt) (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Revolving credit facility - unsecured	$ 244,500	$ 245,000
Unamortized loan costs	(7,379)	(8,912)
Debt	1,136,035	1,135,051
Debt instrument, unamortized discount	(2,117)
Bank term loans - unsecured
Debt Instrument [Line Items]
Bank term loans - unsecured	200,000	200,000
2031 Senior Notes
Debt Instrument [Line Items]
Bank term loans - unsecured	397,883	397,722
Debt instrument, unamortized discount	(2,117)	(2,278)
Private placement notes - unsecured
Debt Instrument [Line Items]
Bank term loans - unsecured	225,000	225,000
Fannie Mae term loans - secured, non-recourse
Debt Instrument [Line Items]
Fannie Mae term loans - secured, non-recourse	$ 76,031	$ 76,241

Debt (Schedule of Maturities of

Debt (Schedule of Maturities of Long-term Debt) (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Debt Instruments [Abstract]
Remainder of 2024	$ 75,425
2025	325,606
2026	244,500
2027	100,000
2028	0
2029	0
Thereafter	400,000
Long-term debt, gross	1,145,531
Less: discount	(2,117)
Less: unamortized loan costs	(7,379)	$ (8,912)
Debt	$ 1,136,035	$ 1,135,051

Debt (Narrative) (Details)

Debt (Narrative) (Details) $ in Millions	1 Months Ended	6 Months Ended
	Jan. 31, 2021 USD ($)	Jun. 30, 2024 USD ($) property extensionOption
Debt Instrument [Line Items]
Debt leverage limit		50%
Fannie Mae term loans - secured, non-recourse
Debt Instrument [Line Items]
Interest rate		3.79%
Long-term debt		$ 60.1
Term of debt		10 years
Net book value		$ 99.1
Debt Instrument, Name, Fannie Mae Term Loans
Debt Instrument [Line Items]
Properties | property		11
FNMA Berkadia Note
Debt Instrument [Line Items]
Interest rate		4.60%
Long-term debt		$ 15.9
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]
Facility fee percentage		0.125%
Maximum
Debt Instrument [Line Items]
Facility fee percentage		0.30%
Secured Debt | 2025 Term Loan
Debt Instrument [Line Items]
Aggregate principle amount issued		$ 200
Secured Debt | Secured Overnight Financing Rate (SOFR) | 2025 Term Loan
Debt Instrument [Line Items]
Basis spread on variable rate		0.10%
Senior Notes | 2031 Senior Notes
Debt Instrument [Line Items]
Aggregate principle amount issued	$ 400
Interest rate	3%
Percentage of issue price on face value	99.196%
Proceeds from issuance of senior notes	$ 392.3
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]
Unsecured revolving credit facility		$ 700
Debt instrument, number of extension options | extensionOption		2
Debt instrument, extension period		6 months
Unused balance of the unsecured revolving credit facility		$ 455.5

Debt (Schedule of Unsecured Ter

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

Debt (Schedule of Interest Expe

Debt (Schedule of Interest Expense) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Debt Instruments [Abstract]
Interest expense on debt at contractual rates	$ 14,029	$ 13,612	$ 28,116	$ 27,052
Capitalized interest	(48)	(22)	(87)	(41)
Amortization of debt issuance costs, debt discount and other	873	604	1,694	1,210
Total interest expense	$ 14,854	$ 14,194	$ 29,723	$ 28,221

Commitments. Contingencies an_3

Commitments. Contingencies and Uncertainties (Narrative) (Details) $ in Millions	6 Months Ended
	Jun. 30, 2024 USD ($) leaseAgreement operator property
Commitment and Contingencies [Line Items]
Loans and leases agreement	$ 110.5
Development commitments for construction and renovation	33.5
Amount funded toward the development commitments	14
Amount funded on real estate investments	1
Contingent lease inducement commitments and contingent consideration of acquisitions	6.9
Discovery PropCo
Commitment and Contingencies [Line Items]
Development commitments for construction and renovation	$ 2
Loans Receivable
Commitment and Contingencies [Line Items]
Number of operators/tenants | operator	6
Notes Receivable Remain Unfunded
Commitment and Contingencies [Line Items]
Mortgage and other notes receivable, net	$ 64.9
Development Commitment
Commitment and Contingencies [Line Items]
Number of operators/tenants | property	6
Lease Inducement
Commitment and Contingencies [Line Items]
Number of leases | leaseAgreement	3

Commitments. Contingencies an_4

Commitments. Contingencies and Uncertainties (Schedule of Off Balance Sheet Credit Loss Liability Roll Forward Schedule) (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2024 USD ($)
Off Balance Sheet, Credit Loss [Roll Forward]
Provision for expected credit losses	$ 17
Ending balance	296
Accounting Standards Update 2016-13
Off Balance Sheet, Credit Loss [Roll Forward]
Beginning balance	$ 279

Redeemable Noncontrolling Int_3

Redeemable Noncontrolling Interest (Details) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2024	Mar. 31, 2024	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2024
Redeemable Noncontrolling Interests [Roll Forward]
Beginning balance		$ 9,656			$ 9,656
Net loss	$ 253	225	$ 270	$ 305	478
Distributions		$ (6)	$ (3)		(9)
Ending balance	$ 9,169				$ 9,169

Equity and Dividends (Narrative

Equity and Dividends (Narrative) (Details) - USD ($) $ / shares in Units, $ in Millions			3 Months Ended				6 Months Ended
	Aug. 02, 2024	Feb. 16, 2024	Jun. 30, 2024	Mar. 31, 2024	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023
Dividends Payable [Line Items]
Authorized repurchase amount		$ 160
Common stock, par value (in dollars per share)		$ 0.01	$ 0.01				$ 0.01		$ 0.01
Effective period of stock repurchase plan		1 year
Common stock repurchased (in shares)							0
At-the market shelf registration, equity offering sales agreement, aggregate sales price			$ 500				$ 500
Issuance of common stock (in shares)			0		0		0	0
Dividends to common stockholders (in dollars per share)			$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 1.80	$ 1.80
Subsequent Event
Dividends Payable [Line Items]
Dividends to common stockholders (in dollars per share)	$ 0.90

Equity and Dividends (Schedule

Equity and Dividends (Schedule of Dividends Declared) (Details) - $ / shares	May 03, 2024	Feb. 16, 2024	Nov. 03, 2023	May 05, 2023	Feb. 17, 2023	Nov. 06, 2022
Equity [Abstract]
Quarterly dividend (in dollars per share)	$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 0.90

Share-Based Compensation (Narra

Share-Based Compensation (Narrative) (Details) $ / shares in Units, $ in Millions	1 Months Ended	3 Months Ended	6 Months Ended
	Feb. 29, 2024 $ / shares shares	Jun. 30, 2024 USD ($) plan shares	Jun. 30, 2024 USD ($) plan $ / shares shares	Jun. 30, 2023 $ / shares shares	Dec. 31, 2023 USD ($)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of incentive plans | plan		2	2
Options granted (in shares) | shares				385,500
Weighted average fair value of options granted (in US dollars per share) | $ / shares			$ 7.36	$ 10.56
Aggregate intrinsic value of stock options outstanding		$ 16.5	$ 16.5		$ 12.8
Unrecognized compensation cost		$ 2.9	$ 2.9
2019 Stock Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares) | shares			431,000
Restricted stock expense | Executive Officer | 2019 Stock Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares issued in period (in shares) | shares	15,000
Shares issued in period (in dollars per shares) | $ / shares	$ 57.76
Stock option plan, award vesting period	5 years
Restricted stock vested shares (in shares) | shares		3,970
Restricted stock non-vested shares (in shares) | shares		31,800	31,800
Restricted stock expense | Executive Officer | 2019 Stock Incentive Plan | Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rights, percentage	20%
Restricted stock expense | Executive Officer | 2019 Stock Incentive Plan | Tranche Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rights, percentage	20%
Restricted stock expense | Executive Officer | 2019 Stock Incentive Plan | Tranche Three
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rights, percentage	20%
Restricted stock expense | Executive Officer | 2019 Stock Incentive Plan | Tranche Four
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rights, percentage	20%
Restricted stock expense | Executive Officer | 2019 Stock Incentive Plan | Tranche Five
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rights, percentage	20%
Expected To Be Recognized Remainder Of 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost		$ 1.3	$ 1.3
Expected To Be Recognized During 2024
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost		1.1	1.1
Expected To Be Recognized During 2025
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost		0.3	0.3
Expected To Be Recognized During 2026
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost		0.1	0.1
Expected To Be Recognized During Thereafter
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost		$ 0.1	$ 0.1

Share-Based Compensation (Sched

Share-Based Compensation (Schedule of Stock Option Valuation Assumptions) (Details)	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
Share-Based Payment Arrangement [Abstract]
Dividend yield	6.40%	7%
Expected volatility	26.10%	39.70%
Expected lives	2 years 10 months 24 days	2 years 10 months 24 days
Risk-free interest rate	4.49%	4.65%

Share-Based Compensation (Sch_2

Share-Based Compensation (Schedule of Stock Option Activity) (Details) - $ / shares	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding [Roll Forward]
Options outstanding beginning balance (in shares)	2,447,171	2,216,175
Options granted (in shares)		385,500
Options exercised (in shares)	(122,174)	(5,166)
Options forfeited (in shares)		(61,168)
Options expired (in shares)	(301,837)
Options outstanding, ending balance (in shares)	2,454,160	2,447,171
Stock Options Weighted Average Exercise Price
Options outstanding (in dollars per share)	$ 68.80	$ 70.97
Options granted (in dollars per share)		54.73
Options exercised (in US dollars per share)	54.03	53.41
Options forfeited (in dollars per share)		66.44
Options expired (in dollars per share)	79.96
Options outstanding (in dollars per share)	$ 66.23	$ 68.80
Stock Options Additional Disclosures
Options exercisable (in shares)	2,113,466	2,078,827
Options exercisable (in dollars per share)	$ 67.74	$ 71.40
Options outstanding (in years)	2 years 5 months 15 days
Options exercisable (in years)	2 years 1 month 28 days
2019 Stock Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding [Roll Forward]
Options granted (in shares)	431,000
Options expired (in shares)		(88,170)
Stock Options Weighted Average Exercise Price
Options granted (in dollars per share)	$ 57.76
Options expired (in dollars per share)		$ 64.33

Share-Based Compensation (Sch_3

Share-Based Compensation (Schedule of Share-Based Payments) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Non-cash share-based compensation	$ 687	$ 769	$ 2,842	$ 2,874
Restricted stock expense
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Non-cash share-based compensation	186	72	344	72
Stock option expense
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Non-cash share-based compensation	$ 501	$ 697	$ 2,498	$ 2,802

Earnings Per Common Share (Deta

Earnings Per Common Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2024	Mar. 31, 2024	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2024	Jun. 30, 2023
Earnings Per Share [Abstract]
Net income	$ 34,952		$ 39,447		$ 65,610	$ 73,630
Add: net loss attributable to noncontrolling interests	304		332		593	633
Net income attributable to stockholders	35,256		39,779		66,203	74,263
Less: net income attributable to unvested restricted stock awards	(29)		(19)		(61)	(19)
Net income attributable to common stockholders - basic	$ 35,227		$ 39,760		$ 66,142	$ 74,244
BASIC:
Weighted average common shares outstanding (in shares)	43,397,080		43,388,753		43,392,961	43,388,748
DILUTED:
Weighted average common shares outstanding (in shares)	43,397,080		43,388,753		43,392,961	43,388,748
Stock options (in shares)	166,574		0		101,142	1,344
Weighed average dilutive common shares outstanding (in shares)	43,563,654		43,388,753		43,494,103	43,390,092
Earnings per common share - basic (in dollars per share)	$ 0.81		$ 0.92		$ 1.52	$ 1.71
Earnings per common share - diluted (in dollars per share)	$ 0.81		$ 0.92		$ 1.52	$ 1.71
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)	261,255		903,425		376,965	776,771
Regular dividends declared per common share (in dollars per share)	$ 0.90	$ 0.90	$ 0.90	$ 0.90	$ 1.80	$ 1.80

Fair Value of Financial Instr_3

Fair Value of Financial Instruments (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Level 3 | Carrying Amount
Fair Value of Financial Instruments [Line Items]
Mortgage and other notes receivable, net	$ 240,850	$ 245,271
Level 3 | Fair Value Measurement
Fair Value of Financial Instruments [Line Items]
Mortgage and other notes receivable, net	231,437	237,646
Variable rate debt | Level 2 | Carrying Amount
Fair Value of Financial Instruments [Line Items]
Debt instrument, fair value disclosure	440,376	439,693
Variable rate debt | Level 2 | Fair Value Measurement
Fair Value of Financial Instruments [Line Items]
Debt instrument, fair value disclosure	444,500	445,000
Fixed rate debt | Level 2 | Carrying Amount
Fair Value of Financial Instruments [Line Items]
Debt instrument, fair value disclosure	695,659	695,358
Fixed rate debt | Level 2 | Fair Value Measurement
Fair Value of Financial Instruments [Line Items]
Debt instrument, fair value disclosure	$ 615,417	$ 616,852

Segment Reporting (Narrative) (

Segment Reporting (Narrative) (Details) $ in Millions	6 Months Ended
	Jun. 30, 2024 USD ($) operatingSegment	Jun. 30, 2023 USD ($)
Segment Reporting Information [Line Items]
Number of operating segments | operatingSegment	2
Real Estate Investments
Segment Reporting Information [Line Items]
Capital expenditures	$ 35	$ 56.2
SHOP
Segment Reporting Information [Line Items]
Capital expenditures	$ 3.7	$ 3

Segment Reporting (Schedule of

Segment Reporting (Schedule of Segment Reporting Information, by Segment) (Details) - USD ($) $ in Thousands	3 Months Ended			6 Months Ended
	Jun. 30, 2024		Jun. 30, 2023	Jun. 30, 2024		Jun. 30, 2023	Dec. 31, 2023	[1]
Segment Reporting Information [Line Items]
Rental income	$ 65,760		$ 60,952	$ 127,947		$ 126,250
Resident fees and services	13,390		11,793	26,645		23,493
Interest income and other	5,820		5,131	11,890		10,521
Total revenues	84,970		77,876	166,482		160,264
Senior housing operating expenses	10,437		9,682	20,751		19,481
Taxes and insurance on leased properties	2,802		3,212	5,535		5,830
NOI	71,731		64,982	140,196		134,953
Depreciation	17,490		17,730	34,995		35,347
Interest	14,854		14,194	29,723		28,221
Legal	165		174	400		297
Franchise, excise and other taxes	47		258	(139)		441
General and administrative	4,870		4,306	10,510		9,959
Loan and realty losses (gains)	1,106		186	1,116		(232)
Gains on sales of real estate, net	(1,517)		(11,366)	(1,617)		(12,763)
Gain on operations transfer, net	0		(20)	0		(20)
Loss on early retirement of debt	0		73	0		73
Gains from equity method investment	(236)		0	(402)		0
Net income	34,952		39,447	65,610		73,630
Total assets	2,476,912	[1]	2,498,495	2,476,912	[1]	2,498,495	$ 2,488,480
Operating Segments | Real Estate Investments
Segment Reporting Information [Line Items]
Rental income	65,760		60,952	127,947		126,250
Resident fees and services	0		0	0		0
Interest income and other	5,744		5,083	11,685		10,391
Total revenues	71,504		66,035	139,632		136,641
Senior housing operating expenses	0		0	0		0
Taxes and insurance on leased properties	2,802		3,212	5,535		5,830
NOI	68,702		62,823	134,097		130,811
Depreciation	14,992		15,477	30,050		30,854
Interest	761		766	1,524		1,525
Legal	0		0	0		0
Franchise, excise and other taxes	0		0	0		0
General and administrative	0		0	0		0
Loan and realty losses (gains)	1,106		186	1,116		(232)
Gains on sales of real estate, net	(1,517)		(11,366)	(1,617)		(12,763)
Gain on operations transfer, net			(20)			(20)
Loss on early retirement of debt			0			0
Gains from equity method investment	(236)			(402)
Net income	53,596		57,780	103,426		111,447
Total assets	2,197,656		2,217,124	2,197,656		2,217,124
Operating Segments | SHOP
Segment Reporting Information [Line Items]
Rental income	0		0	0		0
Resident fees and services	13,390		11,793	26,645		23,493
Interest income and other	0		0	0		0
Total revenues	13,390		11,793	26,645		23,493
Senior housing operating expenses	10,437		9,682	20,751		19,481
Taxes and insurance on leased properties	0		0	0		0
NOI	2,953		2,111	5,894		4,012
Depreciation	2,490		2,239	4,927		4,466
Interest	0		0	0		0
Legal	0		0	0		0
Franchise, excise and other taxes	0		0	0		0
General and administrative	0		0	0		0
Loan and realty losses (gains)	0		0	0		0
Gains on sales of real estate, net	0		0	0		0
Gain on operations transfer, net			0			0
Loss on early retirement of debt			0			0
Gains from equity method investment	0			0
Net income	463		(128)	967		(454)
Total assets	268,187		271,359	268,187		271,359
Non-segment/Corporate
Segment Reporting Information [Line Items]
Rental income	0		0	0		0
Resident fees and services	0		0	0		0
Interest income and other	76		48	205		130
Total revenues	76		48	205		130
Senior housing operating expenses	0		0	0		0
Taxes and insurance on leased properties	0		0	0		0
NOI	76		48	205		130
Depreciation	8		14	18		27
Interest	14,093		13,428	28,199		26,696
Legal	165		174	400		297
Franchise, excise and other taxes	47		258	(139)		441
General and administrative	4,870		4,306	10,510		9,959
Loan and realty losses (gains)	0		0	0		0
Gains on sales of real estate, net	0		0	0		0
Gain on operations transfer, net			0			0
Loss on early retirement of debt			73			73
Gains from equity method investment	0			0
Net income	(19,107)		(18,205)	(38,783)		(37,363)
Total assets	$ 11,069		$ 10,012	$ 11,069		$ 10,012
[1] The condensed consolidated balance sheets include the following amounts related to our consolidated Variable Interest Entities (“VIE”s): $507.9 million and $513.2 million of Real estate properties, net; $8.3 million and $10.9 million of Cash and cash equivalents; $9.8 million and $9.7 million of Straight-line rent receivable; $9.3 million and $9.4 million of Other assets, net; and $4.3 million and $4.7 million of Accounts payable and accrued expenses, in each case as of June 30, 2024 and December 31, 2023, respectively.

Variable Interest Entities (Nar

Variable Interest Entities (Narrative) (Details) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2024 USD ($) realEstatePartnership	Dec. 31, 2023 USD ($)	Jun. 30, 2023 USD ($)	Dec. 31, 2022 USD ($)
Variable Interest Entity [Line Items]
Real estate properties, net	$ 2,106,324	$ 2,107,082
Cash and cash equivalents	$ 14,766	22,347	$ 17,411	$ 19,291
Number of real estate partnerships | realEstatePartnership	2
Other assets, net	$ 23,982	24,063
Subsidiaries
Variable Interest Entity [Line Items]
Real estate properties, net	248,400	252,500
Cash and cash equivalents	2,300	3,200
Straight line receivables	9,800	9,700
Other assets, net	6,600	7,800
SHOP
Variable Interest Entity [Line Items]
Real estate properties, net	259,500	260,700
Cash and cash equivalents	6,000	7,700
Prepaid expense	2,700	1,700
Credit liabilities of SHOP	$ 4,300	$ 4,700

Variable Interest Entities (Sch

Variable Interest Entities (Schedule of Variable Interest Entities) (Details) $ in Thousands	Jun. 30, 2024 USD ($) loan
Variable Interest Entity [Line Items]
Number of mezzanine loans | loan	2
Senior Living | Straight-Line Rent Receivable
Variable Interest Entity [Line Items]
Carrying Amount	$ 85,238
Maximum Exposure to Loss	102,488
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	16,823
Maximum Exposure to Loss	37,263
Encore | Notes Receivable
Variable Interest Entity [Line Items]
Carrying Amount	34,579
Maximum Exposure to Loss	57,243
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	16
Maximum Exposure to Loss	5,016
Watermark Retirement | Notes Receivable
Variable Interest Entity [Line Items]
Carrying Amount	10,590
Maximum Exposure to Loss	11,864
Montecito Medical Real Estate | Notes Receivable
Variable Interest Entity [Line Items]
Carrying Amount	18,201
Maximum Exposure to Loss	50,211
Vizion Health | Notes Receivable
Variable Interest Entity [Line Items]
Carrying Amount	15,833
Maximum Exposure to Loss	15,833
Navion Senior Solutions | Notes Receivable
Variable Interest Entity [Line Items]
Carrying Amount	7,975
Maximum Exposure to Loss	11,278
Kindcare Senior Living | Notes Receivable
Variable Interest Entity [Line Items]
Carrying Amount	766
Maximum Exposure to Loss	$ 766

Uncategorized Items - nhi-20240

Label	Element	Value
Net Income (Loss), Excluding Gain (Loss) Attributable to Redeemable Noncontrolling Interest	nhi_NetIncomeLossExcludingGainLossAttributableToRedeemableNoncontrollingInterest	$ 34,488,000
Net Income (Loss), Excluding Gain (Loss) Attributable to Redeemable Noncontrolling Interest	nhi_NetIncomeLossExcludingGainLossAttributableToRedeemableNoncontrollingInterest	30,882,000
Net Income (Loss), Excluding Gain (Loss) Attributable to Redeemable Noncontrolling Interest	nhi_NetIncomeLossExcludingGainLossAttributableToRedeemableNoncontrollingInterest	35,206,000
Net Income (Loss), Excluding Gain (Loss) Attributable to Redeemable Noncontrolling Interest	nhi_NetIncomeLossExcludingGainLossAttributableToRedeemableNoncontrollingInterest	39,717,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	39,050,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	39,069,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	39,082,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	39,098,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(3,838,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(1,005,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(6,250,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	1,127,000
Adjustments to Additional Paid in Capital, Stock Issued, Issuance Costs	us-gaap_AdjustmentsToAdditionalPaidInCapitalStockIssuedIssuanceCosts	275,000
APIC, Share-Based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	2,155,000
APIC, Share-Based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	687,000
APIC, Share-Based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	769,000
APIC, Share-Based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	2,105,000
Share-Based Payment Arrangement, Decrease for Tax Withholding Obligation	us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation	400,000
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	303,000
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	290,000
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	273,000
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	205,000
Noncontrolling Interest, Increase from Subsidiary Equity Issuance	us-gaap_NoncontrollingInterestIncreaseFromSubsidiaryEquityIssuance	2,000,000
Noncontrolling Interest, Increase from Subsidiary Equity Issuance	us-gaap_NoncontrollingInterestIncreaseFromSubsidiaryEquityIssuance	70,000
Noncontrolling Interest [Member]
Net Income (Loss), Excluding Gain (Loss) Attributable to Redeemable Noncontrolling Interest	nhi_NetIncomeLossExcludingGainLossAttributableToRedeemableNoncontrollingInterest	(50,000)
Net Income (Loss), Excluding Gain (Loss) Attributable to Redeemable Noncontrolling Interest	nhi_NetIncomeLossExcludingGainLossAttributableToRedeemableNoncontrollingInterest	(65,000)
Net Income (Loss), Excluding Gain (Loss) Attributable to Redeemable Noncontrolling Interest	nhi_NetIncomeLossExcludingGainLossAttributableToRedeemableNoncontrollingInterest	(62,000)
Net Income (Loss), Excluding Gain (Loss) Attributable to Redeemable Noncontrolling Interest	nhi_NetIncomeLossExcludingGainLossAttributableToRedeemableNoncontrollingInterest	4,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(283,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	1,731,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(270,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(352,000)
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	205,000
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	303,000
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	290,000
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders	us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders	273,000
Noncontrolling Interest, Increase from Subsidiary Equity Issuance	us-gaap_NoncontrollingInterestIncreaseFromSubsidiaryEquityIssuance	2,000,000
Noncontrolling Interest, Increase from Subsidiary Equity Issuance	us-gaap_NoncontrollingInterestIncreaseFromSubsidiaryEquityIssuance	70,000
Retained Earnings, Appropriated [Member]
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	39,082,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	39,069,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	39,098,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	39,050,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(39,098,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(39,050,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(39,069,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	$ (39,082,000)
Common Stock [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Exercises in Period	us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised	99
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Exercises in Period	us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised	18,238
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	$ 0
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	0
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	0
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	$ 0
Stock Issued During Period, Shares, Restricted Stock Award, Gross	us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardGross	15,000
Stock Issued During Period, Shares, Restricted Stock Award, Gross	us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardGross	21,000
Stock Issued During Period, Shares, Period Increase (Decrease)	us-gaap_StockIssuedDuringPeriodSharesPeriodIncreaseDecrease	0
Stock Issued During Period, Shares, Period Increase (Decrease)	us-gaap_StockIssuedDuringPeriodSharesPeriodIncreaseDecrease	21,099
Stock Issued During Period, Shares, Period Increase (Decrease)	us-gaap_StockIssuedDuringPeriodSharesPeriodIncreaseDecrease	15,000
Stock Issued During Period, Shares, Period Increase (Decrease)	us-gaap_StockIssuedDuringPeriodSharesPeriodIncreaseDecrease	18,008
Share-Based Payment Arrangement, Shares Withheld for Tax Withholding Obligation	us-gaap_SharesPaidForTaxWithholdingForShareBasedCompensation	230
Retained Earnings [Member]
Net Income (Loss), Excluding Gain (Loss) Attributable to Redeemable Noncontrolling Interest	nhi_NetIncomeLossExcludingGainLossAttributableToRedeemableNoncontrollingInterest	$ 35,256,000
Net Income (Loss), Excluding Gain (Loss) Attributable to Redeemable Noncontrolling Interest	nhi_NetIncomeLossExcludingGainLossAttributableToRedeemableNoncontrollingInterest	39,779,000
Net Income (Loss), Excluding Gain (Loss) Attributable to Redeemable Noncontrolling Interest	nhi_NetIncomeLossExcludingGainLossAttributableToRedeemableNoncontrollingInterest	34,484,000
Net Income (Loss), Excluding Gain (Loss) Attributable to Redeemable Noncontrolling Interest	nhi_NetIncomeLossExcludingGainLossAttributableToRedeemableNoncontrollingInterest	30,947,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	35,256,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	34,484,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	39,779,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	30,947,000
Additional Paid-in Capital [Member]
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	287,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	1,830,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	769,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	2,155,000
Adjustments to Additional Paid in Capital, Stock Issued, Issuance Costs	us-gaap_AdjustmentsToAdditionalPaidInCapitalStockIssuedIssuanceCosts	275,000
APIC, Share-Based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	769,000
APIC, Share-Based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	2,105,000
APIC, Share-Based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	2,155,000
APIC, Share-Based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	687,000
Share-Based Payment Arrangement, Decrease for Tax Withholding Obligation	us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation	400,000
Parent [Member]
Net Income (Loss), Excluding Gain (Loss) Attributable to Redeemable Noncontrolling Interest	nhi_NetIncomeLossExcludingGainLossAttributableToRedeemableNoncontrollingInterest	35,256,000
Net Income (Loss), Excluding Gain (Loss) Attributable to Redeemable Noncontrolling Interest	nhi_NetIncomeLossExcludingGainLossAttributableToRedeemableNoncontrollingInterest	39,779,000
Net Income (Loss), Excluding Gain (Loss) Attributable to Redeemable Noncontrolling Interest	nhi_NetIncomeLossExcludingGainLossAttributableToRedeemableNoncontrollingInterest	34,484,000
Net Income (Loss), Excluding Gain (Loss) Attributable to Redeemable Noncontrolling Interest	nhi_NetIncomeLossExcludingGainLossAttributableToRedeemableNoncontrollingInterest	30,947,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	39,082,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	39,069,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	39,098,000
Dividends, Common Stock, Cash	us-gaap_DividendsCommonStockCash	39,050,000
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(3,555,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(2,736,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	(5,980,000)
Stockholders' Equity, Period Increase (Decrease)	us-gaap_StockholdersEquityPeriodIncreaseDecrease	1,479,000
Adjustments to Additional Paid in Capital, Stock Issued, Issuance Costs	us-gaap_AdjustmentsToAdditionalPaidInCapitalStockIssuedIssuanceCosts	275,000
APIC, Share-Based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	2,105,000
APIC, Share-Based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	2,155,000
APIC, Share-Based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	769,000
APIC, Share-Based Payment Arrangement, Increase for Cost Recognition	us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue	687,000
Share-Based Payment Arrangement, Decrease for Tax Withholding Obligation	us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation	$ 400,000