LTC Properties (LTC) 10-Q 28 Oct 21 2021 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2021	Oct. 21, 2021
Document and Entity Information
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Sep. 30, 2021
Entity File Number	1-11314
Entity Registrant Name	LTC PROPERTIES INC
Entity Incorporation, State or Country Code	MD
Entity Tax Identification Number	71-0720518
Entity Address, Address Line One	2829 Townsgate Road, Suite 350
Entity Address, City or Town	Westlake Village
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	91361
City Area Code	805
Local Phone Number	981-8655
Title of 12(b) Security	Common stock, $.01 par value
Trading Symbol	LTC
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		39,374,044
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q3
Entity Central Index Key	0000887905
Amendment Flag	false

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($)	Sep. 30, 2021	Dec. 31, 2020
Investments:
Land	$ 123,239,000	$ 127,774,000
Buildings and improvements	1,283,859,000	1,324,227,000
Accumulated depreciation and amortization	(365,182,000)	(349,643,000)
Real property investments, net	1,041,916,000	1,102,358,000
Mortgage loans receivable, net of loan loss reserve: 2021-$2,608; 2020-$2,592	258,829,000	257,251,000
Real estate investments, net	1,300,745,000	1,359,609,000
Notes receivable, net of loan loss reserve: 2021-$186; 2020-$146	18,675,000	14,465,000
Investments in unconsolidated joint ventures	19,340,000	11,340,000
Investments, net	1,338,760,000	1,385,414,000
Other assets:
Cash and cash equivalents	45,459,000	7,772,000
Debt issue costs related to bank borrowings	688,000	1,324,000
Interest receivable	37,476,000	32,746,000
Straight-line rent receivable	24,298,000	24,452,000
Lease incentives	2,726,000	2,462,000
Prepaid expenses and other assets	3,681,000	5,316,000
Total assets	1,453,088,000	1,459,486,000
LIABILITIES
Bank borrowings	134,400,000	89,900,000
Senior unsecured notes, net of debt issue costs: 2021-$551; 2020-$658	527,429,000	559,482,000
Accrued interest	3,172,000	4,216,000
Accrued expenses and other liabilities	35,157,000	30,082,000
Total liabilities	700,158,000	683,680,000
Stockholders' equity:
Common stock: $0.01 par value; 60,000 shares authorized; shares issued and outstanding: 2021-39,374; 2020-39,242	394,000	392,000
Capital in excess of par value	854,921,000	852,780,000
Cumulative net income	1,431,798,000	1,388,775,000
Cumulative distributions	(1,542,596,000)	(1,474,545,000)
Total LTC Properties, Inc. stockholders' equity	744,517,000	767,402,000
Non-controlling interests	8,413,000	8,404,000
Total equity	752,930,000	775,806,000
Total liabilities and equity	$ 1,453,088,000	$ 1,459,486,000

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) shares in Thousands, $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Mortgage loans receivable, loan loss reserve	$ 2,608	$ 2,592
Notes receivable, loan loss reserve	$ 189	$ 146
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized	60,000	60,000
Common stock, shares issued	39,374	39,242
Common stock, shares outstanding	39,374	39,242
Senior Unsecured Notes
Debt issue costs, net	$ 551	$ 658

CONSOLIDATED STATEMENTS OF INCO

CONSOLIDATED STATEMENTS OF INCOME AND COMPREHENSIVE INCOME - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Revenues:
Rental income	$ 29,320	$ 30,010	$ 91,097	$ 88,320
Interest income from mortgage loans	7,924	7,890	23,779	23,487
Interest and other income	228	273	1,005	1,257
Total revenues	37,472	38,173	115,881	113,064
Expenses:
Interest expense	6,610	7,361	20,442	22,617
Depreciation and amortization	9,462	9,766	28,847	29,232
Impairment charges		941		941
Provision (recovery) for credit losses	68	(2)	59	(1)
Transaction costs	4,046	63	4,271	197
Property tax expense	3,932	3,351	11,713	11,685
General and administrative expenses	5,318	4,814	15,688	14,494
Total expenses	29,436	26,294	81,020	79,165
Other operating income:
Gain on sale of real estate, net	2,702	30	7,392	44,073
Operating income	10,738	11,909	42,253	77,972
Gain from property insurance proceeds		373		373
Loss on unconsolidated joint ventures				(620)
Income from unconsolidated joint ventures	376	56	1,041	287
Net income	11,114	12,338	43,294	78,012
Income allocated to non-controlling interests	(92)	(121)	(271)	(292)
Net income attributable to LTC Properties, Inc.	11,022	12,217	43,023	77,720
Income allocated to participating securities	(113)	(103)	(346)	(339)
Net income available to common stockholders	$ 10,909	$ 12,114	$ 42,677	$ 77,381
Earnings per common share:
Basic (in dollars per share)	$ 0.28	$ 0.31	$ 1.09	$ 1.97
Diluted (in dollars per share)	$ 0.28	$ 0.31	$ 1.09	$ 1.97
Weighted average shares used to calculate earnings per common share:
Basic (in shares)	39,177	39,061	39,149	39,218
Diluted (in shares)	39,177	39,112	39,149	39,269
Dividends declared and paid per common share	$ 0.57	$ 0.57	$ 1.71	$ 1.71
Comprehensive Income:
Net income	$ 11,114	$ 12,338	$ 43,294	$ 78,012
Comprehensive income	$ 11,114	$ 12,338	$ 43,294	$ 78,012

CONSOLIDATED STATEMENTS OF EQUI

CONSOLIDATED STATEMENTS OF EQUITY - USD ($) shares in Thousands, $ in Thousands	Parent	Common Stock	Capital in Excess of Par Value	Cumulative Net Income	Cumulative Distributions	Non-controlling Interests	Total
Balance at beginning of period at Dec. 31, 2019	$ 776,943	$ 398	$ 867,346	$ 1,293,482	$ (1,384,283)	$ 8,483	$ 785,426
Balance (in shares) at Dec. 31, 2019		39,752
Equity activity
Common stock cash distributions	(22,581)				(22,581)		(22,581)
Vesting of performance-based stock units, including the payment of distributions	(586)				(586)		(586)
Vesting of performance-based stock units, including the payment of distributions (in shares)		82
Issuance of restricted stock		$ 1	(1)
Issuance of restricted stock (in shares)		76
Repurchase of common stock	(18,012)	$ (6)	(18,006)				(18,012)
Repurchase of common stock (in shares)		(616)
Stock-based compensation expense	1,777		1,777				1,777
Net income	63,633			63,633		89	63,722
Non-controlling interest distributions						(146)	(146)
Other	(3,545)	$ (1)	(3,544)				(3,545)
Other (in shares)		(76)
Balance at end of period at Mar. 31, 2020	797,629	$ 392	847,572	1,357,115	(1,407,450)	8,426	806,055
Balance (in shares) at Mar. 31, 2020		39,218
Balance at beginning of period at Dec. 31, 2019	776,943	$ 398	867,346	1,293,482	(1,384,283)	8,483	785,426
Balance (in shares) at Dec. 31, 2019		39,752
Equity activity
Net income							78,012
Balance at end of period at Sep. 30, 2020	770,417	$ 392	851,000	1,371,202	(1,452,177)	8,404	778,821
Balance (in shares) at Sep. 30, 2020		39,242
Balance at beginning of period at Mar. 31, 2020	797,629	$ 392	847,572	1,357,115	(1,407,450)	8,426	806,055
Balance (in shares) at Mar. 31, 2020		39,218
Equity activity
Common stock cash distributions	(22,359)				(22,359)		(22,359)
Issuance of restricted stock	(7)		(7)				(7)
Issuance of restricted stock (in shares)		25
Stock-based compensation expense	1,761		1,761				1,761
Net income	1,870			1,870		82	1,952
Non-controlling interest distributions						(97)	(97)
Balance at end of period at Jun. 30, 2020	778,894	$ 392	849,326	1,358,985	(1,429,809)	8,411	787,305
Balance (in shares) at Jun. 30, 2020		39,243
Equity activity
Common stock cash distributions	(22,368)				(22,368)		(22,368)
Stock-based compensation expense	1,693		1,693				1,693
Net income	12,217			12,217		121	12,338
Non-controlling interest distributions						(128)	(128)
Other	(19)		(19)				(19)
Other (in shares)		(1)
Balance at end of period at Sep. 30, 2020	770,417	$ 392	851,000	1,371,202	(1,452,177)	8,404	778,821
Balance (in shares) at Sep. 30, 2020		39,242
Equity activity
Common stock cash distributions	(22,368)				(22,368)		(22,368)
Issuance of restricted stock	(1)		(1)				(1)
Stock-based compensation expense	1,781		1,781				1,781
Net income	17,573			17,573		92	17,665
Non-controlling interest distributions						(92)	(92)
Balance at end of period at Dec. 31, 2020	767,402	$ 392	852,780	1,388,775	(1,474,545)	8,404	775,806
Balance (in shares) at Dec. 31, 2020		39,242
Equity activity
Common stock cash distributions	(22,405)				(22,405)		(22,405)
Vesting of performance-based stock units, including the payment of distributions	(764)	$ 1	(1)		(764)		(764)
Vesting of performance-based stock units, including the payment of distributions (in shares)		109
Stock-based compensation expense	1,852		1,852				1,852
Net income	13,762			13,762		88	13,850
Non-controlling interest distributions						(88)	(88)
Cash paid for taxes in lieu of common shares	(3,470)		(3,470)				(3,470)
Cash paid for taxes in lieu of common shares (in shares)		(84)
Other	(10)	$ 1	(11)				(10)
Other (in shares)		95
Balance at end of period at Mar. 31, 2021	756,367	$ 394	851,150	1,402,537	(1,497,714)	8,404	764,771
Balance (in shares) at Mar. 31, 2021		39,362
Balance at beginning of period at Dec. 31, 2020	767,402	$ 392	852,780	1,388,775	(1,474,545)	8,404	775,806
Balance (in shares) at Dec. 31, 2020		39,242
Equity activity
Net income							43,294
Balance at end of period at Sep. 30, 2021	744,517	$ 394	854,921	1,431,798	(1,542,596)	8,413	752,930
Balance (in shares) at Sep. 30, 2021		39,374
Balance at beginning of period at Mar. 31, 2021	756,367	$ 394	851,150	1,402,537	(1,497,714)	8,404	764,771
Balance (in shares) at Mar. 31, 2021		39,362
Equity activity
Common stock cash distributions	(22,439)				(22,439)		(22,439)
Stock-based compensation expense	1,958		1,958				1,958
Net income	18,239			18,239		91	18,330
Non-controlling interest distributions						(91)	(91)
Cash paid for taxes in lieu of common shares	(103)		(103)				(103)
Cash paid for taxes in lieu of common shares (in shares)		(3)
Other	(46)		(46)				(46)
Other (in shares)		15
Balance at end of period at Jun. 30, 2021	753,976	$ 394	852,959	1,420,776	(1,520,153)	8,404	762,380
Balance (in shares) at Jun. 30, 2021		39,374
Equity activity
Common stock cash distributions	(22,443)				(22,443)		(22,443)
Stock-based compensation expense	1,975		1,975				1,975
Net income	11,022			11,022		92	11,114
Non-controlling interests contributions						9	9
Non-controlling interest distributions						(92)	(92)
Other	(13)		(13)				(13)
Balance at end of period at Sep. 30, 2021	$ 744,517	$ 394	$ 854,921	$ 1,431,798	$ (1,542,596)	$ 8,413	$ 752,930
Balance (in shares) at Sep. 30, 2021		39,374

CONSOLIDATED STATEMENTS OF EQ_2

CONSOLIDATED STATEMENTS OF EQUITY (Parenthetical) - $ / shares	3 Months Ended
	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020
CONSOLIDATED STATEMENTS OF EQUITY
Common Stock cash distributions	$ 0.57	$ 0.57	$ 0.57	$ 0.57	$ 0.57	$ 0.57	$ 0.57

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended					9 Months Ended		12 Months Ended
	Sep. 30, 2021	Mar. 31, 2021	Dec. 31, 2020	Sep. 30, 2020	Mar. 31, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
OPERATING ACTIVITIES:
Net income	$ 11,114	$ 13,850	$ 17,665	$ 12,338	$ 63,722	$ 43,294	$ 78,012
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization						28,847	29,232
Stock-based compensation expense						5,785	5,231
Impairment charges							941
Gain on sale of real estate, net	(2,702)			(30)		(7,392)	(44,073)
Loss on unconsolidated joint ventures							620
Income from unconsolidated joint ventures						(1,041)	(287)
Income distributions from unconsolidated joint ventures							249
Straight-line rental income	44			(228)		(619)	(1,701)
Adjustment for collectibility of rental income and lease incentives				5,472		758	23,214
Lease incentives funded						(650)	(50)
Amortization of lease incentives	158			108		386	317
Provision (recovery) for credit losses	68			(2)		59	(1)
Other non-cash items, net						782	772
Increase in interest receivable						(4,730)	(4,662)
Decrease in accrued interest payable						(1,044)	(1,683)
Net change in other assets and liabilities						5,146	(502)
Net cash provided by operating activities						69,581	85,629
INVESTING ACTIVITIES:
Investment in real estate properties							(13,581)
Investment in real estate developments							(13,384)
Investment in real estate capital improvements						(4,839)	(3,955)
Capitalized interest							(354)
Proceeds from sale of real estate, net						43,628	72,141
Investment in real estate mortgage loans receivable						(2,081)	(4,176)
Principal payments received on mortgage loans receivable						625	565
Investments in unconsolidated joint ventures						(5,676)	(6,398)
Proceeds from liquidation of investments in unconsolidated joint ventures							17,758
Advances and originations under notes receivable						(6,453)	(1,366)
Principal payments received on notes receivable						2,553	4,732
Net cash provided by investing activities						27,757	51,982
FINANCING ACTIVITIES:
Bank borrowings						92,500	24,000
Repayment of bank borrowings						(48,000)	(28,000)
Principal payments on senior unsecured notes						(32,160)	(25,160)
Stock repurchase plan							(18,012)
Distributions paid to stockholders						(68,051)	(67,894)
Contribution from non-controlling interests						9
Distributions paid to non-controlling interests						(271)	(371)
Financing costs paid						(35)	(35)
Cash paid for taxes in lieu of shares upon vesting of restricted stock and performance-based stock units						(3,573)	(3,564)
Other						(70)	(8)
Net cash used in financing activities						(59,651)	(119,044)
(Decrease) increase in cash, cash equivalents and restricted cash						37,687	18,567
Cash, cash equivalents and restricted cash, beginning of period		$ 7,772	22,811		$ 4,244	7,772	4,244	$ 4,244
Cash, cash equivalents and restricted cash, end of period	$ 45,459		$ 7,772	$ 22,811		45,459	22,811	$ 7,772
Supplemental disclosure of cash flow information:
Interest paid						20,708	23,531
Non-cash investing and financing transactions:
Reclassification of notes receivable to lease incentives							$ 300
Preferred return reserve related to investments in unconsolidated joint ventures (See Note 3)						2,324
Mortgage loan receivable reserve withheld at origination (See Note 2)						142
Notes receivable reserve withheld at origination (See Note 4)						$ 353

General

General	9 Months Ended
	Sep. 30, 2021
General
General	1. Genera l LTC Properties, Inc., a health care real estate investment trust (“REIT”), was incorporated on May 12, 1992 in the State of Maryland and commenced operations on August 25, 1992. We invest primarily in seniors housing and health care properties primarily through sale-leasebacks, mortgage financing, joint ventures and structured finance solutions including preferred equity and mezzanine lending. We conduct and manage our business as one operating segment, rather than multiple operating segments, for internal reporting and internal decision-making purposes. Our primary objectives are to create, sustain and enhance stockholder equity value and provide current income for distribution to stockholders through real estate investments in seniors housing and health care properties managed by experienced operators. Our primary seniors housing and health care property classifications include skilled nursing centers (“SNF”), assisted living communities (“ALF”), independent living communities (“ILF”), memory care communities (“MC”) and combinations thereof. We also invest in other (“OTH”) types of properties, such as land parcels, projects under development (“UDP”) and behavioral health care hospitals. We have prepared consolidated financial statements included herein without audit and in the opinion of management have included all adjustments necessary for a fair presentation of the consolidated financial statements pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”). Certain information and note disclosures normally included in financial statements prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) have been condensed or omitted pursuant to rules and regulations governing the presentation of interim financial statements. The accompanying consolidated financial statements include the accounts of our company and its wholly-owned subsidiaries. All significant intercompany accounts and transactions have been eliminated in consolidation. The results of operations for the three and nine months ended September 30, 2021 and 2020 are not necessarily indicative of the results for a full year. No provision has been made for federal or state income taxes. Our company qualifies as a REIT under Sections 856 through 860 of the Internal Revenue Code of 1986, as amended. As such, we generally are not taxed on income that is distributed to our stockholders. New Accounting Pronouncements In March 2020, the Financial Accounting Standards Board (“FASB”) issued guidance which provides temporary optional expedients and exceptions to the U.S. GAAP guidance on contract modifications and hedge accounting to ease the financial reporting burdens of the expected market transition from LIBOR and other interbank offered rates to alternative reference rates. The guidance is effective upon issuance and generally may be elected over time through December 31, 2022. The Company has not adopted any of the optional expedients or exceptions through September 30, 2021 but will continue to evaluate the possible adoption (including potential impact) of any such expedients or exceptions during the effective period as circumstances evolve.

Real Estate Investments

Real Estate Investments	9 Months Ended
	Sep. 30, 2021
Real Estate Investments
Real Estate Investments	2. Real Estate Investments Assisted living communities, independent living communities, memory care communities and combinations thereof are included in the assisted living property classification (collectively “ALF”). Any reference to the number of properties or facilities, number of units, number of beds, number of operators and yield on investments in real estate are unaudited and outside the scope of our independent registered public accounting firm’s review of our consolidated financial statements in accordance with the standards of the Public Company Accounting Oversight Board. Owned Properties. Our owned properties are leased pursuant to non-cancelable operating leases generally with an initial term of 10 to 15 years . Each lease is a triple net lease which requires the lessee to pay all taxes, insurance, maintenance and repairs, capital and non-capital expenditures and other costs necessary in the operations of the facilities. Many of the leases contain renewal options. The leases provide for fixed minimum base rent during the initial and renewal periods. The majority of our leases contain provisions for specified annual increases over the rents of the prior year that are generally computed in one of four ways depending on specific provisions of each lease: (i) a specified percentage increase over the prior year’s rent, generally between 2.0% and 2.5% ; (ii) a calculation based on the Consumer Price Index; (iii) as a percentage of facility net patient revenues in excess of base amounts; or (iv) specific dollar increases. Our leases that contain fixed annual rental escalations and/or have annual rental escalations are contingent upon changes in the Consumer Price Index. Certain leases have annual rental escalations that are contingent upon changes in the gross operating revenues of the property. This revenue is not recognized until the appropriate contingencies have been resolved. The following table summarizes our investments in owned properties at September 30, 2021 (dollar amounts in thousands) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Average ​ ​ ​ ​ ​ Percentage ​ Number ​ Number of ​ Investment ​ ​ Gross ​ of ​ of ​ SNF ​ ALF ​ per Type of Property ​ Investment ​ Investment ​ Properties (1) ​ Beds ​ Units ​ Bed/Unit Assisted Living ​ $ 843,015 ​ 59.9 % 102 ​ — ​ 5,798 ​ $ 145.40 ​ Skilled Nursing ​ ​ 552,723 ​ 39.3 % 50 ​ 6,154 ​ 212 ​ $ 86.82 ​ Other (2) ​ ​ 11,360 ​ 0.8 % 1 ​ 118 ​ — ​ ​ — ​ Total ​ $ 1,407,098 ​ 100.0 % 153 ​ 6,272 ​ 6,010 ​ ​ ​ ​ (1) We own properties in 26 states that are leased to 31 different operators. ​ (2) Includes three parcels of land held-for-use, and one behavioral health care hospital. ​ Senior Care Centers, LLC and affiliates and subsidiaries (“Senior Care”) filed for Chapter 11 bankruptcy in December 2018. During 2019, while in bankruptcy, Senior Care assumed LTC’s master lease and, in March 2020, Senior Care emerged from bankruptcy. Concurrent with their emergence from bankruptcy, in accordance with the order confirming Senior Care’s plan of reorganization, Abri Health Services, LLC (“Abri Health”) was formed as the parent company of reorganized Senior Care and became co-tenant and co-obligor with reorganized Senior Care under our master lease. In March 2021, Senior Care and Abri Health (collectively, “Lessee”) failed to pay rent and additional obligations owed under the master lease. Accordingly, we sent a notice of default and applied proceeds from letters of credit to certain obligations owed under the master lease. Furthermore, we sent the Lessee a notice of termination of the master lease to be effective April 17, 2021. On April 16, 2021, the Lessee filed for Chapter 11 bankruptcy. In August 2021, the United States Bankruptcy Court approved a settlement agreement between the Lessee and LTC. The settlement provides for, among other things, a one-time payment of $3,250,000 from LTC to the affiliates of the Lessee which we expensed as transaction costs during the three months ended September 30, 2021 and subsequently paid in October 2021. Future minimum base rents receivable under the remaining non-cancelable terms of operating leases excluding the effects of straight-line rent receivable, amortization of lease incentives and renewal options are as follows (in thousands): ​ ​ ​ ​ ​ ​ Cash ​ ​ Rent (1) 4Q 2021 ​ $ 27,175 ​ 2022 ​ 119,023 ​ 2023 ​ 104,210 ​ 2024 ​ 105,332 ​ 2025 ​ 87,144 ​ Thereafter ​ 329,267 ​ (1) Represents contractual cash rent, except for certain master leases which are based on estimated cash payments and the Senior Care and Abri Health master lease. See Footnote 12 for further discussion about this lease. We monitor the collectability of our receivable balances, including deferred rent receivable balances, on an ongoing basis. We write-off uncollectible operator receivable balances, including straight line rent receivable and lease incentives balances, as a reduction to rental income in the period such balances are no longer probable of being collected. Therefore, recognition of rental income is limited to the lesser of the amount of cash collected or rental income reflected on a “straight-line” basis for those customer receivable balances deemed uncollectible. As of September 30, 2021, we have 20 operators that are being accounted for on a “cash-basis” representing approximately 51% of our rental income for the three months ended September 30, 2021. We wrote-off straight-line rent receivable and lease incentives balances of $758,000 and $23,214,000 for the nine months ended September 30, 2021 and 2020, respectively. We continue to take into account the current financial condition of our operators, including consideration of the impact of COVID-19, in our estimation of our uncollectible accounts and deferred rents receivable at September 30, 2021. We are closely monitoring the collectability of such rents and will adjust future estimations as appropriate as further information becomes known. ​ The following table summarizes components of our rental income for the three and nine months ended September 30, 2021 and 2020 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ ​ September 30, ​ September 30, ​ Rental Income ​ ​ 2021 ​ ​ 2020 ​ ​ 2021 ​ ​ 2020 ​ Base cash rental income ​ $ 25,934 (1) $ 32,006 ​ $ 80,967 (1) $ 98,357 ​ Variable cash rental income ​ ​ 3,588 (2) ​ 3,356 (2) ​ 10,655 (2) ​ 11,793 (2) Straight-line rent ​ ​ (44) (3) ​ 228 ​ ​ 619 (3) ​ 1,701 ​ Adjustment for collectability of rental income and lease incentives ​ ​ — ​ ​ (5,472) (4) ​ (758) (4) ​ (23,214) (4) Amortization of lease incentives ​ ​ (158) ​ ​ (108) ​ ​ (386) ​ ​ (317) ​ Total ​ $ 29,320 ​ $ 30,010 ​ $ 91,097 ​ $ 88,320 ​ (1) Decreased primarily due to non-payment of lease obligations from Senior Lifestyle Corporation (“Senior Lifestyle”), unpaid lease obligations from Senior Care and Abri Health, abated and deferred rent and reduced rent from a property sale. This decrease was partially offset by increased rent from re-leasing 18 properties previously leased to Senior Lifestyle, completion of development projects and contractual rent increases. ​ (2) The variable rental income for the three and nine months ended September 30, 2021, includes reimbursement of real estate taxes by our lessees of $3,588 and $10,655 , respectively. The variable rental income for the three and nine months ended September 30, 2020 includes contingent rental income of $4 and $108 , respectively and reimbursement of real estate taxes by our lessees of $3,352 and $11,685 , respectively. ​ (3) Decreased due to more leases accounted for on a cash basis. ​ (4) Represents straight-line rent receivable and lease incentives write-offs. Some of our lease agreements provide purchase options allowing the lessees to purchase the properties they currently lease from us. The following table summarizes information about purchase options included in our lease agreements (dollar amounts in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Type ​ Number ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ of ​ of ​ ​ Gross ​ ​ Carrying ​ Option ​ State ​ Property ​ Properties ​ ​ Investments ​ ​ Value ​ Window ​ California ​ ALF/MC ​ 2 ​ $ 38,895 ​ $ 34,895 ​ 2024-2029 ​ California ​ ALF ​ 2 ​ ​ 31,682 ​ ​ 17,166 ​ 2021-TBD (1) Colorado ​ ALF ​ 1 ​ ​ 6,764 ​ ​ 5,378 ​ 2022-2026 ​ Florida ​ MC ​ 1 ​ ​ 15,201 ​ ​ 13,069 ​ 2028-2029 ​ Kentucky and Ohio ​ MC ​ 2 ​ ​ 30,421 ​ ​ 26,798 ​ 2028-2029 ​ Nebraska ​ ALF ​ 3 ​ ​ 7,633 ​ ​ 3,248 ​ TBD (2) Texas ​ MC ​ 2 ​ ​ 25,265 ​ ​ 23,250 ​ 2021-2027 ​ South Carolina ​ ALF/MC ​ 1 ​ ​ 11,680 ​ ​ 9,777 ​ 2028-2029 ​ Total ​ ​ ​ ​ ​ $ 167,541 ​ $ 133,581 ​ ​ ​ (1) The option window ending date will be either 24 months or 48 months after the option window commences, based on certain contingencies. ​ (2) Subject to the properties achieving certain coverage ratios. On March 11, 2020, the World Health Organization declared the outbreak of COVID-19 as a pandemic, and on March 13, 2020, the United States declared a national emergency with regard to COVID-19. At September 30, 2021, in conjunction with the continued levels of uncertainty related to the adverse effects of COVID-19, we assessed the probability of collecting substantially all of our lease payments through maturity and concluded that we did not have sufficient information available to evaluate the impact of COVID-19 on the collectibility of our lease payments. The extent to which COVID-19 could impact our operators and the collectibility of our future lease payments will depend on the future developments including the financial impact significance, government support and subsidies and the duration of the pandemic. In recognition of the pandemic impact affecting our operators, we have agreed to rent abatements totaling $2,639,000 and rent deferrals, net of repayments, for certain operators totaling $3,371,000 during the nine months ended September 30, 2021. The $6,010,000 in rent abatements and deferrals, net of repayments, during the nine months ended September 30, 2021, represented approximately 5.0% of our contractual rent for the nine months ended September 30, 2021. Additionally, we reduced 2021 rent and interest escalations by 50% to support eligible operators during the continuing COVID-19 crisis. The rent and interest escalation reductions were given in the form of a rent and interest credit in recognition of operators’ increased costs due to COVID-19. We have elected to recognize the rent credits given to the eligible operators where we accrue rent on a straight-line basis over the remaining life of those respective leases. During the nine months ended September 30, 2021, we recognized a decrease of $496,000 of GAAP revenue and $1,337,000 of cash revenue. Acquisitions and Developments: The following table summarizes our acquisitions for the nine months ended September 30, 2021 and 2020 (dollar amounts in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total ​ Number ​ Number ​ ​ ​ ​ Purchase ​ Transaction ​ Acquisition ​ of ​ of Year ​ Type of Property ​ Price ​ Costs ​ Costs ​ Properties ​ Beds/Units 2021 ​ n/a ​ $ — ​ $ — ​ $ — — ​ — ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2020 ​ Skilled Nursing (1) ​ $ 13,500 ​ $ 81 ​ $ 13,581 ​ 1 ​ 140 (1) We acquired a SNF located in Texas. During he following in development and improvement projects (in thousands) : ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended September 30, ​ ​ 2021 ​ 2020 Type of Property ​ Developments ​ Improvements ​ ​ Developments ​ Improvements ​ Assisted Living Communities ​ $ — ​ $ 4,560 ​ ​ $ 4,491 ​ $ 3,941 ​ Skilled Nursing Centers ​ ​ — ​ ​ 279 ​ ​ ​ 8,893 ​ ​ 14 ​ Total ​ $ — ​ $ 4,839 ​ ​ $ 13,384 ​ $ 3,955 ​ ​ Completed Developments. (dollar amounts in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Number ​ Type ​ Number ​ ​ ​ ​ ​ ​ ​ ​ ​ of ​ of ​ of ​ ​ ​ ​ Total Year ​ Type of Project ​ Properties ​ Property ​ Beds/Units ​ State ​ Investment 2020 ​ Development ​ 1 ​ ALF/MC ​ 78 ​ Oregon ​ $ 18,447 ​ ​ Development ​ 1 ​ SNF ​ 90 ​ Missouri ​ ​ 13,272 Total ​ ​ ​ 2 ​ ​ ​ 168 ​ ​ ​ $ 31,719 ​ Properties Sold. (dollar amounts in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Type ​ Number ​ Number ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ of ​ of ​ of ​ ​ Sales ​ ​ Carrying ​ ​ Net ​ Year ​ State ​ Properties ​ Properties ​ Beds/Units ​ ​ Price ​ ​ Value ​ ​ Gain (loss) (1) ​ 2021 ​ n/a ​ n/a ​ — ​ — ​ $ — ​ $ — ​ $ 292 (2) (3) ​ ​ Florida ​ ALF ​ 1 ​ — ​ ​ 2,000 ​ ​ 2,626 ​ ​ (858) ​ ​ ​ Nebraska ​ ALF ​ 1 ​ 40 ​ ​ 900 ​ ​ 1,079 ​ ​ (198) ​ ​ ​ Washington ​ SNF ​ 1 ​ 123 ​ ​ 7,700 ​ ​ 4,528 ​ ​ 2,562 ​ ​ ​ Wisconsin ​ ALF ​ 3 ​ 263 ​ ​ 35,000 ​ ​ 28,295 ​ ​ 5,594 ​ Total 2021 ​ ​ ​ ​ ​ 6 ​ 426 ​ $ 45,600 ​ $ 36,528 ​ $ 7,392 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2020 ​ n/a ​ n/a ​ — ​ — ​ $ — ​ $ — ​ $ 108 (2) (3) ​ ​ Arizona ​ SNF ​ 1 ​ 194 ​ ​ 12,550 ​ ​ 2,229 ​ ​ 10,292 ​ ​ ​ Colorado ​ SNF ​ 3 ​ 275 ​ ​ 15,000 ​ ​ 4,271 ​ ​ 10,364 ​ ​ ​ Iowa ​ SNF ​ 7 ​ 544 ​ ​ 14,500 ​ ​ 4,886 ​ ​ 9,029 (3) ​ ​ Kansas ​ SNF ​ 3 ​ 250 ​ ​ 9,750 ​ ​ 7,438 ​ ​ 1,993 ​ ​ ​ Texas ​ SNF ​ 7 ​ 1,148 ​ ​ 23,000 ​ ​ 10,260 ​ ​ 12,287 ​ Total 2020 ​ ​ ​ ​ ​ 21 ​ 2,411 ​ $ 74,800 ​ $ 29,084 ​ $ 44,073 ​ ( (1) Calculation of net gain (loss) includes cost of sales. ​ (2) We recognized additional gain due to the reassessment adjustment of the holdbacks related to properties sold during 2019 and 2020, under the expected value model per ASC Topic 606, Contracts with Customers (“ASC 606”). ​ (3) One of the transactions includes a holdback of $838 which is held in an interest-bearing account with an escrow holder on behalf of the buyer for potential specific losses. During 2020, we received $150 of the holdback. The remaining holdback expires in March 2022. Using the expected value model per ASC 606, we estimated and recorded the holdback value of $471 at closing. ​ Mortgage Loans. (dollar amounts in thousands) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Type ​ Percentage ​ Number of ​ Investment ​ ​ ​ ​ ​ ​ Gross ​ of ​ of ​ ​ ​ ​ ​ SNF ​ per Interest Rate (1) ​ Maturity ​ State ​ Investment ​ Property ​ Investment ​ Loans (2) ​ Properties (3) ​ Beds ​ Bed/Unit 7.5% ​ 2022 ​ MO ​ $ 1,780 ​ OTH (4) 0.7 % 1 ​ — (4) — ​ $ n/a 10.1% ​ 2043 ​ MI ​ ​ 185,859 ​ SNF ​ 71.1 % 1 ​ 15 ​ 1,875 ​ $ 99.12 9.3% ​ 2045 ​ MI ​ ​ 39,148 ​ SNF ​ 15.0 % 1 ​ 4 ​ 501 ​ $ 78.14 9.6% ​ 2045 ​ MI ​ 19,750 ​ SNF ​ 7.5 % 1 ​ 2 ​ 205 ​ $ 96.34 9.6% ​ 2045 ​ MI ​ ​ 14,900 ​ SNF ​ 5.7 % 1 ​ 1 ​ 146 ​ $ 102.05 Total ​ ​ ​ ​ ​ $ 261,437 ​ ​ ​ 100.0 % 5 (5) 22 (5) 2,727 ​ $ 95.87 (1) The majority of the mortgage loans provide for 2.25% annual increases in the interest rate after a certain time period. ​ (2) Some loans contain certain guarantees, provide for certain facility fees and the majority of the mortgage loans have a 30-year term. ​ (3) The properties securing these mortgage loans are operated by the same operator except for (4) below. ​ (4) Represents a mortgage loan secured by a parcel of land for the future development of a 91 -bed post-acute SNF. ​ (5) Subsequent to September 30, 2021, we funded a $27,047 mortgage loan secured by a 189 -bed SNF in Louisiana with a regional operator new to us. The mortgage loan has a three -year term, with one 12-month extension option and a yield of 7.5% . Additionally, we funded a $12,530 mortgage loan secured by a 68 -unit ALF and MC community in Florida operated by a regional operator new to us. The mortgage loan term is approximately 4 years at a 7.75% yield and includes an additional $4,177 loan commitment for the construction of a memory care addition to the property to be funded at a later date subject to satisfaction of various conditions. The following table summarizes our mortgage loan activity for the nine months ended September 30, 2021 and 2020 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended September 30, ​ ​ ​ 2021 ​ ​ 2020 ​ Originations and funding under mortgage loans receivable ​ $ 2,223 (1) ​ $ 4,176 ​ Scheduled principal payments received ​ ​ (625) ​ ​ ​ (565) ​ Mortgage loan premium amortization ​ ​ (4) ​ ​ ​ (3) ​ Provision for loan loss reserve ​ ​ (16) ​ ​ ​ (36) ​ Net increase in mortgage loans receivable ​ $ 1,578 ​ ​ $ 3,572 ​ (1) We originated a $1,780 mortgage loan secured by a parcel of land for the future development of a 91 -bed post-acute SNF in Missouri and withheld a reserve of $142 . The mortgage loan term is one year at a yield of 7.5% . We apply , Measurement of Credit Losses on Financial Instruments . As of September 30, 2021, the accrued interest receivable of $37,476,000 was not included in the measurement of expected credit losses on the mortgage loan receivable and notes receivable (see Note 4). We elected not to measure an allowance for expected credit losses on the related accrued interest receivable using the expected credit loss standard. Rather, we have elected to write-off accrued interest receivable by reversing interest income and/or recognizing credit loss expense as incurred. We review the collectability of the accrued interest receivable quarterly as part of our review of the mortgage loan or notes receivables including the performance of the underlying collateral. For the nine months ended September 30, 2021 and 2020, the Company did not write-off any accrued interest receivable.

Investment in Unconsolidated Jo

Investment in Unconsolidated Joint Ventures	9 Months Ended
	Sep. 30, 2021
Investment in Unconsolidated Joint Ventures
Investment in Unconsolidated Joint Ventures	3. Investment in Unconsolidated Joint Ventures We had a preferred equity investment in an unconsolidated joint venture (“JV”) that owned four communities located in Arizona, providing independent living, assisted living and memory care services. During 2020, the JV sold the four properties comprising the JV and received liquidation proceeds totaling $17,848,000. As a result of this transaction, we incurred $620,000 of losses during the nine months ended September 30, 2020 and an additional $138,000 during the fourth quarter of 2020. During 2020, we provided preferred capital contribution commitments to two joint ventures (“JVs”). We determined that each of these JVs meets the accounting criteria to be considered a variable interest entity (“VIE”). We are not the primary beneficiary of the JVs as we do not have the power to direct the activities that most significantly affect the JVs’ economic performance. However, we do have significant influence over the JVs. Therefore, we have accounted for the JVs using the equity method of accounting. The following table provides information regarding these preferred equity investments (dollar amounts in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Type ​ Type ​ Total ​ ​ Contractual ​ ​ Number ​ ​ ​ ​ ​ ​ of ​ of ​ Preferred ​ ​ Cash ​ ​ of ​ ​ Carrying ​ State ​ Properties ​ Investment ​ Return ​ ​ Portion ​ ​ Beds/ Units ​ ​ Value ​ Washington ​ UDP ​ Preferred Equity (1) 12 % ​ 7 % ​ — ​ $ 6,340 (1) Washington ​ UDP ​ Preferred Equity (2) 12 % ​ 8 % ​ — ​ ​ 13,000 (2) Total ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ — ​ $ 19,340 ​ (1) Invested $6,340 of preferred equity in an entity that will develop and own a 95 -unit ALF and MC in Washington and withheld $1,425 as a reserve. Our investment represents 15.5% of the estimated total investment. The preferred equity investment earns an initial cash rate of 7% increasing to 9% in year four until the internal rate of return (“IRR”) is 8% . After achieving an 8% IRR, the cash rate drops to 8% until achieving an IRR ranging between 12% to 14% . ​ (2) Invested $13,000 of preferred equity in an entity that will develop and own a 267 -unit ILF and ALF in Washington and withheld $3,777 as a reserve. Our investment represents 11.6% of the estimated total investment. The preferred equity investment earns an initial cash rate of 8% until achieving an IRR ranging between 12% and 14% . ​ The following table summarizes our capital contributions, income recognized, and cash interest received related to our investments in unconsolidated joint ventures for the nine months ended September 30, 2021 and 2020 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Type ​ ​ ​ ​ ​ of ​ ​ Capital ​ ​ Income ​ ​ Cash Interest ​ Year ​ Properties ​ ​ Contribution ​ ​ Recognized ​ ​ Earned ​ 2021 ​ UDP (1) $ — ​ $ 337 ​ $ 300 ​ ​ ​ UDP (2) ​ 8,000 (2) ​ 704 ​ ​ 616 ​ Total ​ ​ ​ $ 8,000 ​ $ 1,041 ​ $ 916 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2020 ​ ALF/MC/ILF (3) $ 58 (3) $ 231 ​ $ 231 ​ ​ ​ UDP (1) ​ 6,340 (1) ​ 56 ​ ​ 18 ​ Total ​ ​ ​ $ 6,398 ​ $ 287 ​ $ 249 ​ (1) During 2020, we provided a total preferred equity investment of $6,340 to a JV for the development of a 95 -unit ALF and MC. ​ (2) During 2021, we funded the remaining $8,000 related to a $13,000 preferred equity investment commitment in an entity that will develop and own a 267 -unit ILF and ALF in Washington. Additionally, we withheld $2,324 from the $8,000 funding for a total reserve of $3,777 related to this preferred equity investment. ​ (3) Relates to our preferred equity investment in Arizona discussed above. During 2020, the properties comprising the JV were sold.

Notes Receivable

Notes Receivable	9 Months Ended
	Sep. 30, 2021
Notes Receivable.
Notes Receivable	4. Notes Receivable Notes receivable consists of mezzanine loans and other loan arrangements. The following table is a summary of our notes receivable components as of September 30, 2021 and December 31, 2020 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2021 ​ December 31, 2020 Mezzanine loans $ 11,816 (1) $ 8,445 ​ Other loans ​ 7,048 (2) ​ 6,166 ​ Notes receivable loan loss reserve ​ (189) ​ ​ (146) ​ Total $ 18,675 ​ $ 14,465 ​ (1) During the three months ended September 30, 2021, we originated a $4,355 mezzanine loan and held back a $353 interest reserve. The mezzanine loan has a three -year term with two 12 -month extensions. The initial rate is 8.0% for the first 18 months increasing to 10.5% thereafter with an internal rate of return (“IRR”) of 10.5% . ​ (2) Subsequent to September 30, 2021, we provided HMG Healthcare, LLC (“HMG”) a $25,000 secured working capital loan maturing in September 2022 to facilitate the transition of the 11 properties from Senior Care and Abri Health. ​ The following table summarizes our notes receivable activity for the nine months ended September 30, 2021 and 2020 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended September 30, ​ ​ 2021 ​ ​ 2020 ​ Advances under notes receivable $ 6,453 (1) $ 1,366 ​ Interest reserve withheld ​ 353 ​ ​ — ​ Principal payments received under notes receivable ​ (2,553) ​ ​ (4,732) ​ Reclassified to lease incentives ​ — ​ ​ (300) (2) Notes receivable reserve ​ 43 ​ ​ 36 ​ Net increase (decrease) in notes receivable $ 4,296 ​ $ (3,630) ​ (1) Funding under working capital notes and mezzanine loans with interest ranging between 5% and 8% and maturities between 2022 and 2030. ​ (2) Represents interim working capital loans related to development projects which matured upon completion of the development projects and commencement of the master leases .

Lease Incentives

Lease Incentives	9 Months Ended
	Sep. 30, 2021
Lease Incentives
Lease Incentives	5. Lease Incentives Our lease incentive balances at September 30, 2021 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2021 ​ ​ December 31, 2020 Non-contingent lease incentives ​ $ 2,726 ​ $ 2,462 ​ The following table summarizes our lease incentives activity for the nine months ended September 30, 2021 and 2020 (in thousands) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended September 30, ​ ​ ​ 2021 ​ 2020 ​ ​ ​ ​ Funding ​ ​ Amortization ​ ​ Funding ​ ​ Amortization ​ ​ Reclassification ​ Non-contingent lease incentives ​ $ 650 ​ $ (386) ​ $ 50 ​ $ (317) ​ $ 115 (1) (1) We reclassified a $300 interim working capital loan as lease incentive. See Note 4. Notes Receivable for further discussion. Additionally, we wrote-off $185 of lease incentive related to a master lease for which we determined it was not probable we will collect substantially all of the contractual lease obligations through maturity. See Note 2. Real Estate Investments for further discussion. Non-contingent lease incentives represent payments made to our lessees for various reasons including entering into a new lease or lease amendments and extensions. Contingent lease incentives represent potential contingent earn-out payments that may be made to our lessees in the future, as part of our lease agreements. From time to time, we may commit to provide contingent payments to our lessees, upon our properties achieving certain rent coverage ratios. Once the contingent payment becomes probable and estimable, the contingent payment is recorded as a lease incentive. Lease incentives are amortized as a yield adjustment to rental income over the remaining life of the lease.

Debt Obligations

Debt Obligations	9 Months Ended
	Sep. 30, 2021
Debt Obligations
Debt Obligations	6. Debt Obligations Bank Borrowings. We have an unsecured credit agreement that provides for a revolving aggregate commitment of the lenders of up to $600,000,000 with the opportunity to increase the commitment size of the credit agreement up to a total of $1,000,000,000 . The unsecured credit agreement matures on June 27, 2022 and provides for a one-year extension option at our discretion, subject to customary conditions. Based on our leverage at September 30, 2021, the facility provides for interest annually at LIBOR plus 115 basis points and a facility fee of 20 basis points. At September 30, 2021, we were in compliance with all covenants. Senior Unsecured Notes. The debt obligations by component as of September 30, 2021 and December 31, 2020 are as follows ( dollar amounts in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At September 30, 2021 ​ At December 31, 2020 ​ ​ ​ Applicable ​ ​ ​ Available ​ ​ ​ Available ​ ​ ​ Interest ​ Outstanding ​ for ​ Outstanding ​ for ​ Debt Obligations ​ Rate (1) ​ Balance ​ Borrowing ​ Balance ​ Borrowing ​ Bank borrowings ​ 1.23% ​ $ 134,400 ​ $ 465,600 ​ $ 89,900 ​ $ 510,100 ​ Senior unsecured notes, net of debt issue costs ​ 4.34% ​ ​ 527,429 ​ ​ — ​ ​ 559,482 ​ ​ — ​ Total ​ 3.71% ​ $ 661,829 ​ $ 465,600 ​ $ 649,382 ​ $ 510,100 ​ (1) Represents weighted average of interest rate as of September 30, 2021. Our borrowings and repayments are as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended September 30, ​ ​ 2021 ​ 2020 ​ Debt Obligations ​ ​ Borrowings ​ ​ Repayments ​ Borrowings ​ Repayments ​ Bank borrowings ​ $ 92,500 ​ $ (48,000) ​ $ 24,000 ​ $ (28,000) ​ Senior unsecured notes ​ ​ — ​ ​ (32,160) ​ ​ — ​ ​ (25,160) ​ Total ​ $ 92,500 ​ $ (80,160) ​ $ 24,000 ​ $ (53,160) ​ ​

Equity

Equity	9 Months Ended
	Sep. 30, 2021
Equity
Equity	7. Equity Non-controlling Interests. As of September 30, 2021, we have the following consolidated VIEs (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Gross ​ ​ ​ ​ Investment ​ ​ ​ Property ​ ​ ​ ​ Consolidated ​ ​ Non-Controlling ​ Year ​ Purpose ​ Type ​ State ​ ​ Assets ​ ​ Interests ​ 2019 ​ Owned real estate ​ ALF/MC ​ VA ​ $ 16,895 ​ $ 919 ​ 2018 ​ Owned real estate ​ ILF ​ OR ​ ​ 14,400 ​ ​ 2,857 ​ 2018 ​ Owned real estate and development ​ ALF/MC ​ OR ​ ​ 18,447 ​ ​ 1,091 ​ 2017 ​ Owned real estate and development ​ ILF/ALF/MC ​ WI ​ ​ 22,007 ​ ​ 2,305 ​ 2017 ​ Owned real estate ​ ALF/MC ​ SC ​ ​ 11,680 ​ ​ 1,241 ​ Total ​ ​ ​ ​ ​ ​ ​ $ 83,429 ​ $ 8,413 ​ ​ Common Stock. Equity Distribution Agreements. Accordingly, at September 30, 2021, we had $200,000,000 available under the Equity Distribution Agreements. During the nine months ended September 30, 2021 and 2020, we acquired 87,249 shares and 76,574 shares, respectively, of common stock held by employees who tendered owned shares to satisfy tax withholding obligations. Stock Repurchase Plan. Available Shelf Registration. Distributions. (in thousands) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended September 30, ​ ​ ​ 2021 ​ 2020 ​ ​ ​ ​ Declared ​ Paid ​ Declared ​ Paid ​ ​ Common Stock (1) ​ $ 68,051 (2) $ 68,051 (2) $ 67,894 (3) $ 67,894 (3) ​ (1) Represents $0.19 per share per month for the nine months ended September 30, 2021 and 2020. ​ (2) Includes $764 of distributions that were paid as a result of the vesting of performance-based stock units. ​ (3) Includes $586 of distributions that were paid as a result of the vesting of performance-based stock units. In October 2021, we declared a monthly cash dividend of $0.19 per share on our common stock for the months of October , November and December 2021, payable on October 29, November 30, and December 31, 2021, respectively, to stockholders of record on October 21, November 19, and December 23, 2021, respectively. Stock-Based Compensation 2015 Plan are set by our compensation committee at its discretion. At September 30, 2021, we had 15,000 stock options outstanding and exercisable. During the nine months ended September 30, 2021 and 2020, no stock options were granted or exercised. The following table summarizes our restricted stock activity for the nine months ended September 30, 2021 and 2020 : ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended September 30, ​ ​ ​ 2021 ​ 2020 ​ Outstanding, January 1 ​ ​ 180,440 ​ ​ 163,569 ​ Granted ​ ​ 110,348 ​ ​ 101,348 ​ Vested ​ ​ (93,366) ​ ​ (84,477) ​ Outstanding, September 30 ​ ​ 197,422 ​ ​ 180,440 ​ ​ During the nine months ended September 30, 2021 and 2020, we granted 71,892 and 66,027 , respectively, of performance-based stock units. Additionally, during the nine months ended September 30, 2021 and 2020, the number of performance-based stock units that vested were 108,720 and 81,574 , respectively. During the nine months ended September 30, 2021 and 2020, we granted restricted stock and performance-based stock units as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ No. of ​ Price per ​ ​ ​ Year ​ Shares/Units ​ Share ​ Vesting Period ​ 2021 ​ 95,293 ​ $ 42.27 ​ ratably over 3 years ​ ​ ​ 71,892 ​ $ 42.27 ​ TSR targets (1) ​ ​ ​ 12,055 ​ $ 39.40 ​ May 26, 2022 ​ ​ ​ 3,000 ​ $ 43.14 ​ April 1, 2022 ​ ​ ​ 182,240 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2020 ​ 76,464 ​ $ 48.95 ​ ratably over 3 years ​ ​ ​ 66,027 ​ $ 49.98 ​ TSR targets (1) ​ ​ ​ 9,884 ​ $ 38.45 ​ May 27, 2021 ​ ​ ​ 15,000 ​ $ 38.45 ​ ratably over 3 years ​ ​ ​ 167,375 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ (1) Vesting is based on achieving certain total shareholder return (“TSR”) targets in 4 years with acceleration opportunity in 3 years . ​ Compensation expense recognized related to the vesting of restricted common stock and performance-based stock units for the nine months ended September 30, 2021 and 2020 were $5,785,000 and $5,231,000 , respectively. At September 30, 2021, the remaining compensation expense to be recognized related to the future service period of unvested outstanding restricted common stock and performance-based stock units are as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ Remaining ​ ​ Compensation Vesting Date ​ Expense 2021 ​ $ 1,974 2022 ​ ​ 5,447 2023 ​ ​ 2,855 2024 ​ ​ 303 Total ​ $ 10,579 ​ ​

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2021
Commitments and Contingencies
Commitments and Contingencies	8. Commitments and Contingencies At September 30, 2021, we had commitments as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total ​ ​ ​ ​ ​ Investment ​ 2021 ​ Commitment ​ Remaining ​ ​ Commitment ​ Funding ​ Funded ​ Commitment Real estate properties Note 2. Real Estate Investments ​ $ 19,670 (1) $ 3,770 ​ $ 10,228 ​ $ 9,442 Accrued incentives and earn-out liabilities (Note 5. Lease Incentives) ​ ​ 9,130 ​ ​ 50 ​ ​ 50 ​ ​ 9,080 Mortgage loans ( Note 2. Real Estate Investments ​ ​ 21,000 (2) ​ 318 ​ ​ 3,699 ​ ​ 17,301 Notes receivable ( Note 4. Notes Receivable ​ ​ 1,925 ​ ​ 643 ​ ​ 1,247 ​ ​ 678 Total ​ $ 51,725 ​ $ 4,781 ​ $ 15,224 ​ $ 36,501 (1) Represents commitments to purchase land and improvements, if applicable, and to develop, re-develop, renovate or expand seniors housing and health care properties. ​ (2) Represents $3,000 of commitments to expand and renovate seniors housing and health care properties securing mortgage loans and $18,000 of commitments which are contingent upon the borrower achieving certain coverage ratios. Also, some of our lease agreements provide purchase options allowing the lessee to purchase the properties they currently lease from us. See Note 2. Real Estate Investments We are a party from time to time to various general and professional liability claims and lawsuits asserted against the lessees or borrowers of our properties, which in our opinion are not singularly or in the aggregate material to our results of operations or financial condition. These types of claims and lawsuits may include matters involving general or professional liability, which we believe under applicable legal principles are not our responsibility as a non-possessory landlord or mortgage holder. We believe that these matters are the responsibility of our lessees and borrowers pursuant to general legal principles and pursuant to insurance and indemnification provisions in the applicable leases or mortgages. We intend to continue to vigorously defend such claims. ​

Major Operators

Major Operators	9 Months Ended
	Sep. 30, 2021
Major Operators
Major Operators	9. Major Operators We have one operator that derives 10% or more of our combined rental revenue and interest income from mortgage loans. The following table sets forth information regarding our major operator as of September 30, 2021: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Number of ​ Number of ​ Percentage of ​ ​ ​ ​ ​ ​ ​ SNF ​ ALF ​ Total ​ ​ Total ​ ​ Operator ​ SNF ​ ALF ​ Beds ​ Units ​ Revenue (1) ​ ​ Assets (2) ​ ​ Prestige Healthcare (3) ​ 24 ​ — ​ 2,845 ​ 93 ​ 21.4 % ​ 18.3 % ​ (1) Includes rental income from owned properties and interest income from mortgage loans as of September 30, 2021. ​ (2) Represents the net carrying value of the mortgage loans and properties we own divided by the Total assets on the Consolidated Balance Sheets. ​ (3) The majority of the revenue derived from this operator relates to interest income from mortgage loans. Our financial position and ability to make distributions may be adversely affected if Prestige Healthcare or any of our lessees and borrowers face financial difficulties, including any bankruptcies, inability to emerge from bankruptcy, insolvency or general downturn in business of any such operator, impact upon services or occupancy levels due to COVID-19, or in the event any such operator does not renew and/or extend its relationship with us.

Earnings per Share

Earnings per Share	9 Months Ended
	Sep. 30, 2021
Earnings per Share
Earnings per Share	10. Earnings per Share The following table sets forth the computation of basic and diluted net income per share ( in thousands, except per share amounts ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ ​ September 30, ​ September 30, ​ ​ ​ 2021 ​ 2020 ​ 2021 ​ 2020 ​ ​ Net income ​ $ 11,114 ​ $ 12,338 ​ $ 43,294 ​ $ 78,012 ​ ​ Less income allocated to non-controlling interests ​ (92) ​ (121) ​ (271) ​ (292) ​ ​ Less income allocated to participating securities: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Non-forfeitable dividends on participating securities ​ ​ (113) ​ ​ (103) ​ ​ (346) ​ ​ (294) ​ ​ Income allocated to participating securities ​ ​ — ​ ​ — ​ ​ — ​ ​ (45) ​ ​ Total net income allocated to participating securities ​ ​ (113) ​ ​ (103) ​ ​ (346) ​ ​ (339) ​ ​ Net income available to common stockholders ​ ​ 10,909 ​ ​ 12,114 ​ ​ 42,677 ​ ​ 77,381 ​ ​ Effect of dilutive securities: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Participating securities (1) ​ ​ — ​ ​ — ​ ​ — ​ ​ — ​ ​ Net income for diluted net income per share ​ $ 10,909 ​ $ 12,114 ​ $ 42,677 ​ $ 77,381 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Shares for basic net income per share ​ ​ 39,177 ​ ​ 39,061 ​ ​ 39,149 ​ ​ 39,218 ​ ​ Effect of dilutive securities: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Stock options (1) ​ ​ — ​ ​ — ​ ​ — ​ ​ — ​ ​ Performance-based stock units ​ ​ — (2) ​ 51 ​ ​ — (2) ​ 51 ​ ​ Participating securities (1) ​ ​ — ​ ​ — ​ ​ — ​ ​ — ​ ​ Total effect of dilutive securities ​ ​ — ​ ​ 51 ​ ​ — ​ ​ 51 ​ ​ Shares for diluted net income per share ​ ​ 39,177 ​ ​ 39,112 ​ ​ 39,149 ​ ​ 39,269 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Basic net income per share ​ $ 0.28 ​ $ 0.31 ​ $ 1.09 ​ $ 1.97 ​ ​ Diluted net income per share ​ $ 0.28 ​ $ 0.31 ​ $ 1.09 ​ $ 1.97 ​ ​ (1) For the three and nine months ended September 30, 2021, and 2020, the stock options and participating securities have been excluded from the computation of diluted net income per share as such inclusion would be anti-dilutive. ​ (2) For the three and nine months ended September 30, 2021, no performance-based stock units would be earned based on TSR targets.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2021
Fair Value Measurements
Fair Value Measurements	11. Fair Value Measurements In accordance with the accounting guidance regarding the fair value option for financial assets and financial liabilities, entities are permitted to choose to measure certain financial assets and liabilities at fair value, with the change in unrealized gains and losses reported in earnings. We did not elect the fair value option for any of our financial assets and financial liabilities. The carrying amount of cash and cash equivalents, prepaid expenses and other assets, accrued interest, accrued expenses and other liabilities approximates fair value because of the short-term maturity of these instruments. We do not invest our cash in auction rate securities. The carrying value and fair value of our financial instruments as of September 30, 2021 and December 31, 2020 assuming election of fair value for our financial assets and financial liabilities were as follows ( in thousands ): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At September 30, 2021 ​ At December 31, 2020 ​ ​ ​ Carrying ​ Fair ​ Carrying ​ Fair ​ ​ ​ Value ​ Value ​ Value ​ Value ​ Mortgage loans receivable, net of loan loss reserve ​ $ 258,829 ​ $ 298,677 (1) $ 257,251 ​ $ 299,751 (1) Notes receivable, net of loan loss reserve ​ 18,675 ​ 18,552 (2) 14,465 ​ 13,893 (2) Bank borrowings ​ 134,400 ​ ​ 134,400 (3) ​ 89,900 ​ ​ 89,900 (3) Senior unsecured notes, net of debt issue costs ​ 527,429 ​ ​ 556,841 (4) ​ 559,482 ​ ​ 560,140 (4) (1) Our investment in mortgage loans receivable is classified as Level 3. The fair value is determined using a widely accepted valuation technique, discounted cash flow analysis on the expected cash flows. The discount rate is determined using our assumption on market conditions adjusted for market and credit risk and current returns on our investments. The discount rate used to value our future cash inflows of the mortgage loans receivable at September 30, 2021 and December 31, 2020 was 10.1% and 10.0% , respectively. ​ (2) Our investments in notes receivable are classified as Level 3. The discount rate is determined using our assumption on market conditions adjusted for market and credit risk and current returns on our investments. The discount rate used to value our future cash flows of the notes receivable at September 30, 2021 and December 31, 2020, were 6.5% and 6.6% , respectively. ​ (3) Our bank borrowings bear interest at a variable interest rate. The estimated fair value of our bank borrowings approximated their carrying values at September 30, 2021 and December 31, 2020 based upon prevailing market interest rates for similar debt arrangements. ​ (4) Our obligation under our senior unsecured notes is classified as Level 3 and thus the fair value is determined using a widely accepted valuation technique, discounted cash flow analysis on the expected cash flows. The discount rate is measured based upon management’s estimates of rates currently prevailing for comparable loans available to us, and instruments of comparable maturities. At September 30, 2021, the discount rate used to value our future cash outflow of our senior unsecured notes was 3.00% for those maturing before year 2030 and 3.25% for those maturing at or beyond year 2030. At December 31, 2020, the discount rate used to value our future cash outflow of our senior unsecured notes was 3.25% for those maturing before year 2026 and 3.50% for those maturing at or beyond year 2026. ​

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2021
Subsequent Events
Subsequent Events	12. Subsequent Events Subsequent to September 30, 2021 the following events occurred: Real Estate Investments: We transitioned 11 properties previously leased to Senior Care and Abri Health to HMG under a one -year master lease with rent based on cash flows, and payment subject to a deferral of up to six months. We intend to add these 11 properties to their current master lease after establishing a stabilized rent during the first lease year. We also funded the following mortgage loans: ● A $27,047,000 mortgage loan secured by a 189 -bed skilled nursing center in Louisiana with a regional operator new to us. The mortgage loan has a three -year term with one 12 -month extension option and a yield of 7.5% ; and ● A $12,530,000 mortgage loan secured by a 68 -unit assisted living and memory care community in Florida operated by a regional operator new to us. The mortgage loan term is approximately 4 years at a 7.75% yield and includes an additional $4,177,000 loan commitment for the construction of a memory care addition to the property to be funded at a later date subject to satisfaction of various conditions. Notes Receivable: We provided HMG a $25,000,000 secured working capital loan maturing in September 2022 to facilitate the transition of the 11 properties from Senior Care and Abri Health. Equity: We declared a monthly cash dividend of $0.19 per share on our common stock for the months of October , November and December 2021, payable on October 29, November 30, and December 31, 2021, respectively to stockholders of record on October 21, November 19, and December 23, 2021, respectively.

General (Policies)

General (Policies)	9 Months Ended
	Sep. 30, 2021
General
Basis of Presentation	We have prepared consolidated financial statements included herein without audit and in the opinion of management have included all adjustments necessary for a fair presentation of the consolidated financial statements pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”). Certain information and note disclosures normally included in financial statements prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) have been condensed or omitted pursuant to rules and regulations governing the presentation of interim financial statements. The accompanying consolidated financial statements include the accounts of our company and its wholly-owned subsidiaries.
Reclassifications	All significant intercompany accounts and transactions have been eliminated in consolidation. The results of operations for the three and nine months ended September 30, 2021 and 2020 are not necessarily indicative of the results for a full year.
Income taxes	No provision has been made for federal or state income taxes. Our company qualifies as a REIT under Sections 856 through 860 of the Internal Revenue Code of 1986, as amended. As such, we generally are not taxed on income that is distributed to our stockholders.
New Accounting Pronouncements	New Accounting Pronouncements In March 2020, the Financial Accounting Standards Board (“FASB”) issued guidance which provides temporary optional expedients and exceptions to the U.S. GAAP guidance on contract modifications and hedge accounting to ease the financial reporting burdens of the expected market transition from LIBOR and other interbank offered rates to alternative reference rates. The guidance is effective upon issuance and generally may be elected over time through December 31, 2022. The Company has not adopted any of the optional expedients or exceptions through September 30, 2021 but will continue to evaluate the possible adoption (including potential impact) of any such expedients or exceptions during the effective period as circumstances evolve.

Real Estate Investments (Tables

Real Estate Investments (Tables)	9 Months Ended
	Sep. 30, 2021
Real Estate Investments
Summary of investments in owned properties	The following table summarizes our investments in owned properties at September 30, 2021 (dollar amounts in thousands) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Average ​ ​ ​ ​ ​ Percentage ​ Number ​ Number of ​ Investment ​ ​ Gross ​ of ​ of ​ SNF ​ ALF ​ per Type of Property ​ Investment ​ Investment ​ Properties (1) ​ Beds ​ Units ​ Bed/Unit Assisted Living ​ $ 843,015 ​ 59.9 % 102 ​ — ​ 5,798 ​ $ 145.40 ​ Skilled Nursing ​ ​ 552,723 ​ 39.3 % 50 ​ 6,154 ​ 212 ​ $ 86.82 ​ Other (2) ​ ​ 11,360 ​ 0.8 % 1 ​ 118 ​ — ​ ​ — ​ Total ​ $ 1,407,098 ​ 100.0 % 153 ​ 6,272 ​ 6,010 ​ ​ ​ ​ (1) We own properties in 26 states that are leased to 31 different operators. ​ (2) Includes three parcels of land held-for-use, and one behavioral health care hospital.
Schedule of future minimum base rents receivable	Future minimum base rents receivable under the remaining non-cancelable terms of operating leases excluding the effects of straight-line rent receivable, amortization of lease incentives and renewal options are as follows (in thousands): ​ ​ ​ ​ ​ ​ Cash ​ ​ Rent (1) 4Q 2021 ​ $ 27,175 ​ 2022 ​ 119,023 ​ 2023 ​ 104,210 ​ 2024 ​ 105,332 ​ 2025 ​ 87,144 ​ Thereafter ​ 329,267 ​ (1) Represents contractual cash rent, except for certain master leases which are based on estimated cash payments and the Senior Care and Abri Health master lease. See Footnote 12 for further discussion about this lease.
Summary of components of our rental income	The following table summarizes components of our rental income for the three and nine months ended September 30, 2021 and 2020 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ ​ September 30, ​ September 30, ​ Rental Income ​ ​ 2021 ​ ​ 2020 ​ ​ 2021 ​ ​ 2020 ​ Base cash rental income ​ $ 25,934 (1) $ 32,006 ​ $ 80,967 (1) $ 98,357 ​ Variable cash rental income ​ ​ 3,588 (2) ​ 3,356 (2) ​ 10,655 (2) ​ 11,793 (2) Straight-line rent ​ ​ (44) (3) ​ 228 ​ ​ 619 (3) ​ 1,701 ​ Adjustment for collectability of rental income and lease incentives ​ ​ — ​ ​ (5,472) (4) ​ (758) (4) ​ (23,214) (4) Amortization of lease incentives ​ ​ (158) ​ ​ (108) ​ ​ (386) ​ ​ (317) ​ Total ​ $ 29,320 ​ $ 30,010 ​ $ 91,097 ​ $ 88,320 ​ (1) Decreased primarily due to non-payment of lease obligations from Senior Lifestyle Corporation (“Senior Lifestyle”), unpaid lease obligations from Senior Care and Abri Health, abated and deferred rent and reduced rent from a property sale. This decrease was partially offset by increased rent from re-leasing 18 properties previously leased to Senior Lifestyle, completion of development projects and contractual rent increases. ​ (2) The variable rental income for the three and nine months ended September 30, 2021, includes reimbursement of real estate taxes by our lessees of $3,588 and $10,655 , respectively. The variable rental income for the three and nine months ended September 30, 2020 includes contingent rental income of $4 and $108 , respectively and reimbursement of real estate taxes by our lessees of $3,352 and $11,685 , respectively. ​ (3) Decreased due to more leases accounted for on a cash basis. ​ (4) Represents straight-line rent receivable and lease incentives write-offs.
Summary of information about purchase options included in our lease agreements	Some of our lease agreements provide purchase options allowing the lessees to purchase the properties they currently lease from us. The following table summarizes information about purchase options included in our lease agreements (dollar amounts in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Type ​ Number ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ of ​ of ​ ​ Gross ​ ​ Carrying ​ Option ​ State ​ Property ​ Properties ​ ​ Investments ​ ​ Value ​ Window ​ California ​ ALF/MC ​ 2 ​ $ 38,895 ​ $ 34,895 ​ 2024-2029 ​ California ​ ALF ​ 2 ​ ​ 31,682 ​ ​ 17,166 ​ 2021-TBD (1) Colorado ​ ALF ​ 1 ​ ​ 6,764 ​ ​ 5,378 ​ 2022-2026 ​ Florida ​ MC ​ 1 ​ ​ 15,201 ​ ​ 13,069 ​ 2028-2029 ​ Kentucky and Ohio ​ MC ​ 2 ​ ​ 30,421 ​ ​ 26,798 ​ 2028-2029 ​ Nebraska ​ ALF ​ 3 ​ ​ 7,633 ​ ​ 3,248 ​ TBD (2) Texas ​ MC ​ 2 ​ ​ 25,265 ​ ​ 23,250 ​ 2021-2027 ​ South Carolina ​ ALF/MC ​ 1 ​ ​ 11,680 ​ ​ 9,777 ​ 2028-2029 ​ Total ​ ​ ​ ​ ​ $ 167,541 ​ $ 133,581 ​ ​ ​ (1) The option window ending date will be either 24 months or 48 months after the option window commences, based on certain contingencies. ​ (2) Subject to the properties achieving certain coverage ratios.
Summary of acquisitions	Acquisitions and Developments: The following table summarizes our acquisitions for the nine months ended September 30, 2021 and 2020 (dollar amounts in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total ​ Number ​ Number ​ ​ ​ ​ Purchase ​ Transaction ​ Acquisition ​ of ​ of Year ​ Type of Property ​ Price ​ Costs ​ Costs ​ Properties ​ Beds/Units 2021 ​ n/a ​ $ — ​ $ — ​ $ — — ​ — ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2020 ​ Skilled Nursing (1) ​ $ 13,500 ​ $ 81 ​ $ 13,581 ​ 1 ​ 140 (1) We acquired a SNF located in Texas.
Schedule of development and improvement projects	During he following in development and improvement projects (in thousands) : ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended September 30, ​ ​ 2021 ​ 2020 Type of Property ​ Developments ​ Improvements ​ ​ Developments ​ Improvements ​ Assisted Living Communities ​ $ — ​ $ 4,560 ​ ​ $ 4,491 ​ $ 3,941 ​ Skilled Nursing Centers ​ ​ — ​ ​ 279 ​ ​ ​ 8,893 ​ ​ 14 ​ Total ​ $ — ​ $ 4,839 ​ ​ $ 13,384 ​ $ 3,955 ​
Schedule of completed developments	Completed Developments. (dollar amounts in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Number ​ Type ​ Number ​ ​ ​ ​ ​ ​ ​ ​ ​ of ​ of ​ of ​ ​ ​ ​ Total Year ​ Type of Project ​ Properties ​ Property ​ Beds/Units ​ State ​ Investment 2020 ​ Development ​ 1 ​ ALF/MC ​ 78 ​ Oregon ​ $ 18,447 ​ ​ Development ​ 1 ​ SNF ​ 90 ​ Missouri ​ ​ 13,272 Total ​ ​ ​ 2 ​ ​ ​ 168 ​ ​ ​ $ 31,719
Schedule of property sold	Properties Sold. (dollar amounts in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Type ​ Number ​ Number ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ of ​ of ​ of ​ ​ Sales ​ ​ Carrying ​ ​ Net ​ Year ​ State ​ Properties ​ Properties ​ Beds/Units ​ ​ Price ​ ​ Value ​ ​ Gain (loss) (1) ​ 2021 ​ n/a ​ n/a ​ — ​ — ​ $ — ​ $ — ​ $ 292 (2) (3) ​ ​ Florida ​ ALF ​ 1 ​ — ​ ​ 2,000 ​ ​ 2,626 ​ ​ (858) ​ ​ ​ Nebraska ​ ALF ​ 1 ​ 40 ​ ​ 900 ​ ​ 1,079 ​ ​ (198) ​ ​ ​ Washington ​ SNF ​ 1 ​ 123 ​ ​ 7,700 ​ ​ 4,528 ​ ​ 2,562 ​ ​ ​ Wisconsin ​ ALF ​ 3 ​ 263 ​ ​ 35,000 ​ ​ 28,295 ​ ​ 5,594 ​ Total 2021 ​ ​ ​ ​ ​ 6 ​ 426 ​ $ 45,600 ​ $ 36,528 ​ $ 7,392 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2020 ​ n/a ​ n/a ​ — ​ — ​ $ — ​ $ — ​ $ 108 (2) (3) ​ ​ Arizona ​ SNF ​ 1 ​ 194 ​ ​ 12,550 ​ ​ 2,229 ​ ​ 10,292 ​ ​ ​ Colorado ​ SNF ​ 3 ​ 275 ​ ​ 15,000 ​ ​ 4,271 ​ ​ 10,364 ​ ​ ​ Iowa ​ SNF ​ 7 ​ 544 ​ ​ 14,500 ​ ​ 4,886 ​ ​ 9,029 (3) ​ ​ Kansas ​ SNF ​ 3 ​ 250 ​ ​ 9,750 ​ ​ 7,438 ​ ​ 1,993 ​ ​ ​ Texas ​ SNF ​ 7 ​ 1,148 ​ ​ 23,000 ​ ​ 10,260 ​ ​ 12,287 ​ Total 2020 ​ ​ ​ ​ ​ 21 ​ 2,411 ​ $ 74,800 ​ $ 29,084 ​ $ 44,073 ​ ( (1) Calculation of net gain (loss) includes cost of sales. ​ (2) We recognized additional gain due to the reassessment adjustment of the holdbacks related to properties sold during 2019 and 2020, under the expected value model per ASC Topic 606, Contracts with Customers (“ASC 606”). ​ (3) One of the transactions includes a holdback of $838 which is held in an interest-bearing account with an escrow holder on behalf of the buyer for potential specific losses. During 2020, we received $150 of the holdback. The remaining holdback expires in March 2022. Using the expected value model per ASC 606, we estimated and recorded the holdback value of $471 at closing. ​
Summary of investments in mortgage loans secured by first mortgages	Mortgage Loans. (dollar amounts in thousands) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Type ​ Percentage ​ Number of ​ Investment ​ ​ ​ ​ ​ ​ Gross ​ of ​ of ​ ​ ​ ​ ​ SNF ​ per Interest Rate (1) ​ Maturity ​ State ​ Investment ​ Property ​ Investment ​ Loans (2) ​ Properties (3) ​ Beds ​ Bed/Unit 7.5% ​ 2022 ​ MO ​ $ 1,780 ​ OTH (4) 0.7 % 1 ​ — (4) — ​ $ n/a 10.1% ​ 2043 ​ MI ​ ​ 185,859 ​ SNF ​ 71.1 % 1 ​ 15 ​ 1,875 ​ $ 99.12 9.3% ​ 2045 ​ MI ​ ​ 39,148 ​ SNF ​ 15.0 % 1 ​ 4 ​ 501 ​ $ 78.14 9.6% ​ 2045 ​ MI ​ 19,750 ​ SNF ​ 7.5 % 1 ​ 2 ​ 205 ​ $ 96.34 9.6% ​ 2045 ​ MI ​ ​ 14,900 ​ SNF ​ 5.7 % 1 ​ 1 ​ 146 ​ $ 102.05 Total ​ ​ ​ ​ ​ $ 261,437 ​ ​ ​ 100.0 % 5 (5) 22 (5) 2,727 ​ $ 95.87 (1) The majority of the mortgage loans provide for 2.25% annual increases in the interest rate after a certain time period. ​ (2) Some loans contain certain guarantees, provide for certain facility fees and the majority of the mortgage loans have a 30-year term. ​ (3) The properties securing these mortgage loans are operated by the same operator except for (4) below. ​ (4) Represents a mortgage loan secured by a parcel of land for the future development of a 91 -bed post-acute SNF. ​ (5) Subsequent to September 30, 2021, we funded a $27,047 mortgage loan secured by a 189 -bed SNF in Louisiana with a regional operator new to us. The mortgage loan has a three -year term, with one 12-month extension option and a yield of 7.5% . Additionally, we funded a $12,530 mortgage loan secured by a 68 -unit ALF and MC community in Florida operated by a regional operator new to us. The mortgage loan term is approximately 4 years at a 7.75% yield and includes an additional $4,177 loan commitment for the construction of a memory care addition to the property to be funded at a later date subject to satisfaction of various conditions.
Schedule of mortgage loan activity	The following table summarizes our mortgage loan activity for the nine months ended September 30, 2021 and 2020 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended September 30, ​ ​ ​ 2021 ​ ​ 2020 ​ Originations and funding under mortgage loans receivable ​ $ 2,223 (1) ​ $ 4,176 ​ Scheduled principal payments received ​ ​ (625) ​ ​ ​ (565) ​ Mortgage loan premium amortization ​ ​ (4) ​ ​ ​ (3) ​ Provision for loan loss reserve ​ ​ (16) ​ ​ ​ (36) ​ Net increase in mortgage loans receivable ​ $ 1,578 ​ ​ $ 3,572 ​ (1) We originated a $1,780 mortgage loan secured by a parcel of land for the future development of a 91 -bed post-acute SNF in Missouri and withheld a reserve of $142 . The mortgage loan term is one year at a yield of 7.5% .

Investment in Unconsolidated _2

Investment in Unconsolidated Joint Ventures (Tables)	9 Months Ended
	Sep. 30, 2021
Investment in Unconsolidated Joint Ventures
Summary of the preferred equity investments	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Type ​ Type ​ Total ​ ​ Contractual ​ ​ Number ​ ​ ​ ​ ​ ​ of ​ of ​ Preferred ​ ​ Cash ​ ​ of ​ ​ Carrying ​ State ​ Properties ​ Investment ​ Return ​ ​ Portion ​ ​ Beds/ Units ​ ​ Value ​ Washington ​ UDP ​ Preferred Equity (1) 12 % ​ 7 % ​ — ​ $ 6,340 (1) Washington ​ UDP ​ Preferred Equity (2) 12 % ​ 8 % ​ — ​ ​ 13,000 (2) Total ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ — ​ $ 19,340 ​ (1) Invested $6,340 of preferred equity in an entity that will develop and own a 95 -unit ALF and MC in Washington and withheld $1,425 as a reserve. Our investment represents 15.5% of the estimated total investment. The preferred equity investment earns an initial cash rate of 7% increasing to 9% in year four until the internal rate of return (“IRR”) is 8% . After achieving an 8% IRR, the cash rate drops to 8% until achieving an IRR ranging between 12% to 14% . ​ (2) Invested $13,000 of preferred equity in an entity that will develop and own a 267 -unit ILF and ALF in Washington and withheld $3,777 as a reserve. Our investment represents 11.6% of the estimated total investment. The preferred equity investment earns an initial cash rate of 8% until achieving an IRR ranging between 12% and 14% .
Summary of capital contributions, income recognized and cash interest received from investments in unconsolidated joint ventures	​ The following table summarizes our capital contributions, income recognized, and cash interest received related to our investments in unconsolidated joint ventures for the nine months ended September 30, 2021 and 2020 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Type ​ ​ ​ ​ ​ of ​ ​ Capital ​ ​ Income ​ ​ Cash Interest ​ Year ​ Properties ​ ​ Contribution ​ ​ Recognized ​ ​ Earned ​ 2021 ​ UDP (1) $ — ​ $ 337 ​ $ 300 ​ ​ ​ UDP (2) ​ 8,000 (2) ​ 704 ​ ​ 616 ​ Total ​ ​ ​ $ 8,000 ​ $ 1,041 ​ $ 916 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2020 ​ ALF/MC/ILF (3) $ 58 (3) $ 231 ​ $ 231 ​ ​ ​ UDP (1) ​ 6,340 (1) ​ 56 ​ ​ 18 ​ Total ​ ​ ​ $ 6,398 ​ $ 287 ​ $ 249 ​ (1) During 2020, we provided a total preferred equity investment of $6,340 to a JV for the development of a 95 -unit ALF and MC. ​ (2) During 2021, we funded the remaining $8,000 related to a $13,000 preferred equity investment commitment in an entity that will develop and own a 267 -unit ILF and ALF in Washington. Additionally, we withheld $2,324 from the $8,000 funding for a total reserve of $3,777 related to this preferred equity investment. ​ (3) Relates to our preferred equity investment in Arizona discussed above. During 2020, the properties comprising the JV were sold.

Notes Receivable (Tables)

Notes Receivable (Tables)	9 Months Ended
	Sep. 30, 2021
Notes Receivable.
Summary of mezzanine loans and other loan arrangements	Notes receivable consists of mezzanine loans and other loan arrangements. The following table is a summary of our notes receivable components as of September 30, 2021 and December 31, 2020 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2021 ​ December 31, 2020 Mezzanine loans $ 11,816 (1) $ 8,445 ​ Other loans ​ 7,048 (2) ​ 6,166 ​ Notes receivable loan loss reserve ​ (189) ​ ​ (146) ​ Total $ 18,675 ​ $ 14,465 ​ (1) During the three months ended September 30, 2021, we originated a $4,355 mezzanine loan and held back a $353 interest reserve. The mezzanine loan has a three -year term with two 12 -month extensions. The initial rate is 8.0% for the first 18 months increasing to 10.5% thereafter with an internal rate of return (“IRR”) of 10.5% . ​ (2) Subsequent to September 30, 2021, we provided HMG Healthcare, LLC (“HMG”) a $25,000 secured working capital loan maturing in September 2022 to facilitate the transition of the 11 properties from Senior Care and Abri Health.
Summary of notes receivable activity	The following table summarizes our notes receivable activity for the nine months ended September 30, 2021 and 2020 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended September 30, ​ ​ 2021 ​ ​ 2020 ​ Advances under notes receivable $ 6,453 (1) $ 1,366 ​ Interest reserve withheld ​ 353 ​ ​ — ​ Principal payments received under notes receivable ​ (2,553) ​ ​ (4,732) ​ Reclassified to lease incentives ​ — ​ ​ (300) (2) Notes receivable reserve ​ 43 ​ ​ 36 ​ Net increase (decrease) in notes receivable $ 4,296 ​ $ (3,630) ​ (1) Funding under working capital notes and mezzanine loans with interest ranging between 5% and 8% and maturities between 2022 and 2030. ​ (2) Represents interim working capital loans related to development projects which matured upon completion of the development projects and commencement of the master leases .

Lease Incentives (Tables)

Lease Incentives (Tables)	9 Months Ended
	Sep. 30, 2021
Lease Incentives
Summary of lease incentives by component	Our lease incentive balances at September 30, 2021 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2021 ​ ​ December 31, 2020 Non-contingent lease incentives ​ $ 2,726 ​ $ 2,462
Summary of lease incentive activity	The following table summarizes our lease incentives activity for the nine months ended September 30, 2021 and 2020 (in thousands) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended September 30, ​ ​ ​ 2021 ​ 2020 ​ ​ ​ ​ Funding ​ ​ Amortization ​ ​ Funding ​ ​ Amortization ​ ​ Reclassification ​ Non-contingent lease incentives ​ $ 650 ​ $ (386) ​ $ 50 ​ $ (317) ​ $ 115 (1) (1) We reclassified a $300 interim working capital loan as lease incentive. See Note 4. Notes Receivable for further discussion. Additionally, we wrote-off $185 of lease incentive related to a master lease for which we determined it was not probable we will collect substantially all of the contractual lease obligations through maturity. See Note 2. Real Estate Investments for further discussion.

Debt Obligations (Tables)

Debt Obligations (Tables)	9 Months Ended
	Sep. 30, 2021
Debt Obligations
Schedule of Debt Obligations	The debt obligations by component as of September 30, 2021 and December 31, 2020 are as follows ( dollar amounts in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At September 30, 2021 ​ At December 31, 2020 ​ ​ ​ Applicable ​ ​ ​ Available ​ ​ ​ Available ​ ​ ​ Interest ​ Outstanding ​ for ​ Outstanding ​ for ​ Debt Obligations ​ Rate (1) ​ Balance ​ Borrowing ​ Balance ​ Borrowing ​ Bank borrowings ​ 1.23% ​ $ 134,400 ​ $ 465,600 ​ $ 89,900 ​ $ 510,100 ​ Senior unsecured notes, net of debt issue costs ​ 4.34% ​ ​ 527,429 ​ ​ — ​ ​ 559,482 ​ ​ — ​ Total ​ 3.71% ​ $ 661,829 ​ $ 465,600 ​ $ 649,382 ​ $ 510,100 ​ (1) Represents weighted average of interest rate as of September 30, 2021.
Schedule of borrowings and repayments	Our borrowings and repayments are as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended September 30, ​ ​ 2021 ​ 2020 ​ Debt Obligations ​ ​ Borrowings ​ ​ Repayments ​ Borrowings ​ Repayments ​ Bank borrowings ​ $ 92,500 ​ $ (48,000) ​ $ 24,000 ​ $ (28,000) ​ Senior unsecured notes ​ ​ — ​ ​ (32,160) ​ ​ — ​ ​ (25,160) ​ Total ​ $ 92,500 ​ $ (80,160) ​ $ 24,000 ​ $ (53,160) ​

Equity (Tables)

Equity (Tables)	9 Months Ended
	Sep. 30, 2021
Equity
Schedule of consolidated VIEs	As of September 30, 2021, we have the following consolidated VIEs (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Gross ​ ​ ​ ​ Investment ​ ​ ​ Property ​ ​ ​ ​ Consolidated ​ ​ Non-Controlling ​ Year ​ Purpose ​ Type ​ State ​ ​ Assets ​ ​ Interests ​ 2019 ​ Owned real estate ​ ALF/MC ​ VA ​ $ 16,895 ​ $ 919 ​ 2018 ​ Owned real estate ​ ILF ​ OR ​ ​ 14,400 ​ ​ 2,857 ​ 2018 ​ Owned real estate and development ​ ALF/MC ​ OR ​ ​ 18,447 ​ ​ 1,091 ​ 2017 ​ Owned real estate and development ​ ILF/ALF/MC ​ WI ​ ​ 22,007 ​ ​ 2,305 ​ 2017 ​ Owned real estate ​ ALF/MC ​ SC ​ ​ 11,680 ​ ​ 1,241 ​ Total ​ ​ ​ ​ ​ ​ ​ $ 83,429 ​ $ 8,413 ​ ​
Schedule of cash dividends declared and paid	Distributions. (in thousands) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended September 30, ​ ​ ​ 2021 ​ 2020 ​ ​ ​ ​ Declared ​ Paid ​ Declared ​ Paid ​ ​ Common Stock (1) ​ $ 68,051 (2) $ 68,051 (2) $ 67,894 (3) $ 67,894 (3) ​ (1) Represents $0.19 per share per month for the nine months ended September 30, 2021 and 2020. ​ (2) Includes $764 of distributions that were paid as a result of the vesting of performance-based stock units. ​ (3) Includes $586 of distributions that were paid as a result of the vesting of performance-based stock units.
Schedule of restricted stock activity	The following table summarizes our restricted stock activity for the nine months ended September 30, 2021 and 2020 : ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended September 30, ​ ​ ​ 2021 ​ 2020 ​ Outstanding, January 1 ​ ​ 180,440 ​ ​ 163,569 ​ Granted ​ ​ 110,348 ​ ​ 101,348 ​ Vested ​ ​ (93,366) ​ ​ (84,477) ​ Outstanding, September 30 ​ ​ 197,422 ​ ​ 180,440 ​
Schedule of restricted stock granted	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ No. of ​ Price per ​ ​ ​ Year ​ Shares/Units ​ Share ​ Vesting Period ​ 2021 ​ 95,293 ​ $ 42.27 ​ ratably over 3 years ​ ​ ​ 71,892 ​ $ 42.27 ​ TSR targets (1) ​ ​ ​ 12,055 ​ $ 39.40 ​ May 26, 2022 ​ ​ ​ 3,000 ​ $ 43.14 ​ April 1, 2022 ​ ​ ​ 182,240 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2020 ​ 76,464 ​ $ 48.95 ​ ratably over 3 years ​ ​ ​ 66,027 ​ $ 49.98 ​ TSR targets (1) ​ ​ ​ 9,884 ​ $ 38.45 ​ May 27, 2021 ​ ​ ​ 15,000 ​ $ 38.45 ​ ratably over 3 years ​ ​ ​ 167,375 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ (1) Vesting is based on achieving certain total shareholder return (“TSR”) targets in 4 years with acceleration opportunity in 3 years .
Schedule of restricted common stock and performance-based stock unit scheduled to vest and remaining compensation expense	At September 30, 2021, the remaining compensation expense to be recognized related to the future service period of unvested outstanding restricted common stock and performance-based stock units are as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ Remaining ​ ​ Compensation Vesting Date ​ Expense 2021 ​ $ 1,974 2022 ​ ​ 5,447 2023 ​ ​ 2,855 2024 ​ ​ 303 Total ​ $ 10,579

Commitments and Contingencies (

Commitments and Contingencies (Tables)	9 Months Ended
	Sep. 30, 2021
Commitments and Contingencies
Schedule of commitments	At September 30, 2021, we had commitments as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total ​ ​ ​ ​ ​ Investment ​ 2021 ​ Commitment ​ Remaining ​ ​ Commitment ​ Funding ​ Funded ​ Commitment Real estate properties Note 2. Real Estate Investments ​ $ 19,670 (1) $ 3,770 ​ $ 10,228 ​ $ 9,442 Accrued incentives and earn-out liabilities (Note 5. Lease Incentives) ​ ​ 9,130 ​ ​ 50 ​ ​ 50 ​ ​ 9,080 Mortgage loans ( Note 2. Real Estate Investments ​ ​ 21,000 (2) ​ 318 ​ ​ 3,699 ​ ​ 17,301 Notes receivable ( Note 4. Notes Receivable ​ ​ 1,925 ​ ​ 643 ​ ​ 1,247 ​ ​ 678 Total ​ $ 51,725 ​ $ 4,781 ​ $ 15,224 ​ $ 36,501 (1) Represents commitments to purchase land and improvements, if applicable, and to develop, re-develop, renovate or expand seniors housing and health care properties. ​ (2) Represents $3,000 of commitments to expand and renovate seniors housing and health care properties securing mortgage loans and $18,000 of commitments which are contingent upon the borrower achieving certain coverage ratios.

Major Operators (Tables)

Major Operators (Tables)	9 Months Ended
	Sep. 30, 2021
Major Operators
Schedule of concentration of risk by major operators	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Number of ​ Number of ​ Percentage of ​ ​ ​ ​ ​ ​ ​ SNF ​ ALF ​ Total ​ ​ Total ​ ​ Operator ​ SNF ​ ALF ​ Beds ​ Units ​ Revenue (1) ​ ​ Assets (2) ​ ​ Prestige Healthcare (3) ​ 24 ​ — ​ 2,845 ​ 93 ​ 21.4 % ​ 18.3 % ​ (1) Includes rental income from owned properties and interest income from mortgage loans as of September 30, 2021. ​ (2) Represents the net carrying value of the mortgage loans and properties we own divided by the Total assets on the Consolidated Balance Sheets. ​ (3) The majority of the revenue derived from this operator relates to interest income from mortgage loans.

Earnings per Share (Tables)

Earnings per Share (Tables)	9 Months Ended
	Sep. 30, 2021
Earnings per Share
Schedule of basic and diluted net income per share	The following table sets forth the computation of basic and diluted net income per share ( in thousands, except per share amounts ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ ​ September 30, ​ September 30, ​ ​ ​ 2021 ​ 2020 ​ 2021 ​ 2020 ​ ​ Net income ​ $ 11,114 ​ $ 12,338 ​ $ 43,294 ​ $ 78,012 ​ ​ Less income allocated to non-controlling interests ​ (92) ​ (121) ​ (271) ​ (292) ​ ​ Less income allocated to participating securities: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Non-forfeitable dividends on participating securities ​ ​ (113) ​ ​ (103) ​ ​ (346) ​ ​ (294) ​ ​ Income allocated to participating securities ​ ​ — ​ ​ — ​ ​ — ​ ​ (45) ​ ​ Total net income allocated to participating securities ​ ​ (113) ​ ​ (103) ​ ​ (346) ​ ​ (339) ​ ​ Net income available to common stockholders ​ ​ 10,909 ​ ​ 12,114 ​ ​ 42,677 ​ ​ 77,381 ​ ​ Effect of dilutive securities: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Participating securities (1) ​ ​ — ​ ​ — ​ ​ — ​ ​ — ​ ​ Net income for diluted net income per share ​ $ 10,909 ​ $ 12,114 ​ $ 42,677 ​ $ 77,381 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Shares for basic net income per share ​ ​ 39,177 ​ ​ 39,061 ​ ​ 39,149 ​ ​ 39,218 ​ ​ Effect of dilutive securities: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Stock options (1) ​ ​ — ​ ​ — ​ ​ — ​ ​ — ​ ​ Performance-based stock units ​ ​ — (2) ​ 51 ​ ​ — (2) ​ 51 ​ ​ Participating securities (1) ​ ​ — ​ ​ — ​ ​ — ​ ​ — ​ ​ Total effect of dilutive securities ​ ​ — ​ ​ 51 ​ ​ — ​ ​ 51 ​ ​ Shares for diluted net income per share ​ ​ 39,177 ​ ​ 39,112 ​ ​ 39,149 ​ ​ 39,269 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Basic net income per share ​ $ 0.28 ​ $ 0.31 ​ $ 1.09 ​ $ 1.97 ​ ​ Diluted net income per share ​ $ 0.28 ​ $ 0.31 ​ $ 1.09 ​ $ 1.97 ​ ​ (1) For the three and nine months ended September 30, 2021, and 2020, the stock options and participating securities have been excluded from the computation of diluted net income per share as such inclusion would be anti-dilutive. ​ (2) For the three and nine months ended September 30, 2021, no performance-based stock units would be earned based on TSR targets.

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2021
Fair Value Measurements
Schedule of carrying value and fair value of the entity's financial instruments	The carrying value and fair value of our financial instruments as of September 30, 2021 and December 31, 2020 assuming election of fair value for our financial assets and financial liabilities were as follows ( in thousands ): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At September 30, 2021 ​ At December 31, 2020 ​ ​ ​ Carrying ​ Fair ​ Carrying ​ Fair ​ ​ ​ Value ​ Value ​ Value ​ Value ​ Mortgage loans receivable, net of loan loss reserve ​ $ 258,829 ​ $ 298,677 (1) $ 257,251 ​ $ 299,751 (1) Notes receivable, net of loan loss reserve ​ 18,675 ​ 18,552 (2) 14,465 ​ 13,893 (2) Bank borrowings ​ 134,400 ​ ​ 134,400 (3) ​ 89,900 ​ ​ 89,900 (3) Senior unsecured notes, net of debt issue costs ​ 527,429 ​ ​ 556,841 (4) ​ 559,482 ​ ​ 560,140 (4) (1) Our investment in mortgage loans receivable is classified as Level 3. The fair value is determined using a widely accepted valuation technique, discounted cash flow analysis on the expected cash flows. The discount rate is determined using our assumption on market conditions adjusted for market and credit risk and current returns on our investments. The discount rate used to value our future cash inflows of the mortgage loans receivable at September 30, 2021 and December 31, 2020 was 10.1% and 10.0% , respectively. ​ (2) Our investments in notes receivable are classified as Level 3. The discount rate is determined using our assumption on market conditions adjusted for market and credit risk and current returns on our investments. The discount rate used to value our future cash flows of the notes receivable at September 30, 2021 and December 31, 2020, were 6.5% and 6.6% , respectively. ​ (3) Our bank borrowings bear interest at a variable interest rate. The estimated fair value of our bank borrowings approximated their carrying values at September 30, 2021 and December 31, 2020 based upon prevailing market interest rates for similar debt arrangements. ​ (4) Our obligation under our senior unsecured notes is classified as Level 3 and thus the fair value is determined using a widely accepted valuation technique, discounted cash flow analysis on the expected cash flows. The discount rate is measured based upon management’s estimates of rates currently prevailing for comparable loans available to us, and instruments of comparable maturities. At September 30, 2021, the discount rate used to value our future cash outflow of our senior unsecured notes was 3.00% for those maturing before year 2030 and 3.25% for those maturing at or beyond year 2030. At December 31, 2020, the discount rate used to value our future cash outflow of our senior unsecured notes was 3.25% for those maturing before year 2026 and 3.50% for those maturing at or beyond year 2026.

General (Details)

General (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2021USD ($)segment
General
Number of operating segments | segment	1
Provision for federal or state income taxes | $	$ 0

Real Estate Investments - Owned

Real Estate Investments - Owned Properties (Details) - Real Estate Investment	3 Months Ended	9 Months Ended
	Sep. 30, 2021USD ($)itempropertystate	Sep. 30, 2021USD ($)itempropertystate$ / item
Real Estate [Line Items]
Gross Investment | $	$ 1,407,098,000	$ 1,407,098,000
Percentage of Investment	100.00%	100.00%
Number of properties | property	153	153
Number of states | state	26	26
Number of operators	31	31
Payment to affiliates | $	$ 3,250,000
Operating leases
Number of ways to compute annual rent increases		4
Minimum
Operating leases
Initial lease term	10 years	10 years
Specified annual increase over the prior year's rent (as a percent)		2.00%
Maximum
Operating leases
Initial lease term	15 years	15 years
Specified annual increase over the prior year's rent (as a percent)		2.50%
SNF Beds
Real Estate [Line Items]
Number of beds/units	6,272	6,272
ALF Units
Real Estate [Line Items]
Number of beds/units	6,010	6,010
ALF
Real Estate [Line Items]
Gross Investment | $	$ 843,015,000	$ 843,015,000
Percentage of Investment	59.90%	59.90%
Number of properties | property	102	102
Investment per Bed/Unit | $ / item		145.40
ALF | ALF Units
Real Estate [Line Items]
Number of beds/units	5,798	5,798
SNF
Real Estate [Line Items]
Gross Investment | $	$ 552,723,000	$ 552,723,000
Percentage of Investment	39.30%	39.30%
Number of properties | property	50	50
Investment per Bed/Unit | $ / item		86.82
SNF | SNF Beds
Real Estate [Line Items]
Number of beds/units	6,154	6,154
SNF | ALF Units
Real Estate [Line Items]
Number of beds/units	212	212
Other
Real Estate [Line Items]
Gross Investment | $	$ 11,360,000	$ 11,360,000
Percentage of Investment	0.80%	0.80%
Number of properties | property	1	1
Number of parcels of land		3
Other | SNF Beds
Real Estate [Line Items]
Number of beds/units	118	118
Hospital
Real Estate [Line Items]
Number of properties | property	1	1

Real Estate Investments - Base

Real Estate Investments - Base Rents (Details) $ in Thousands	Sep. 30, 2021USD ($)
Future minimum base rents receivable
4Q 2021	$ 27,175
2022	119,023
2023	104,210
2024	105,332
2025	87,144
Thereafter	$ 329,267

Real Estate Investments - Lease

Real Estate Investments - Lease (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2021USD ($)property	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)propertyitem	Sep. 30, 2020USD ($)	Dec. 31, 2020USD ($)
Real estate investments
Number of operators | item			20
Rental income on cash basis	51
Write-off of straight-line rent and lease incentives balances			$ 758,000	$ 23,214,000
Carrying value	$ 1,041,916,000		1,041,916,000		$ 1,102,358,000
Income and Expenses, Lessor [Abstract]
Base cash rental income	25,934,000	$ 32,006,000	80,967,000	98,357,000
Variable cash rental income	3,588,000	3,356,000	10,655,000	11,793,000
Straight-Line Rent	(44,000)	228,000	619,000	1,701,000
Adjustment for collectability of rental income and lease incentives		(5,472,000)	(758,000)	(23,214,000)
Amortization of Lease Incentives	(158,000)	(108,000)	(386,000)	(317,000)
Total Rental Income	29,320,000	30,010,000	91,097,000	88,320,000
Real estate taxes reimbursed	3,588,000	3,352,000	10,655,000	11,685,000
Contingent rental income		$ 4,000		$ 108,000
Rent deferrals	3,371,000		3,371,000
Rent abatements			2,639,000
Rent abatements and deferrals			$ 6,010,000
Percentage of contractual rent			5.00%
Percentage of reduction in rent and interest escalations			50.00%
Decrease of revenue			$ (496,000)
Decrease in cash			(1,337,000)
Purchase Option in Lease Arrangements
Real estate investments
Gross Investment	167,541,000		167,541,000
Carrying value	$ 133,581,000		$ 133,581,000
ALF | Purchase Option in Lease Arrangements | California
Real estate investments
Number of properties | property	2		2
Gross Investment	$ 31,682,000		$ 31,682,000
Carrying value	$ 17,166,000		$ 17,166,000
ALF | Purchase Option in Lease Arrangements | California | Minimum
Real estate investments
Purchase option ending period			24 months
ALF | Purchase Option in Lease Arrangements | California | Maximum
Real estate investments
Purchase option ending period			48 months
ALF | Purchase Option in Lease Arrangements | Colorado
Real estate investments
Number of properties | property	1		1
Gross Investment	$ 6,764,000		$ 6,764,000
Carrying value	$ 5,378,000		$ 5,378,000
ALF | Purchase Option in Lease Arrangements | Nebraska
Real estate investments
Number of properties | property	3		3
Gross Investment	$ 7,633,000		$ 7,633,000
Carrying value	$ 3,248,000		$ 3,248,000
MC | Purchase Option in Lease Arrangements | Florida
Real estate investments
Number of properties | property	1		1
Gross Investment	$ 15,201,000		$ 15,201,000
Carrying value	$ 13,069,000		$ 13,069,000
MC | Purchase Option in Lease Arrangements | Kentucky and Ohio
Real estate investments
Number of properties | property	2		2
Gross Investment	$ 30,421,000		$ 30,421,000
Carrying value	$ 26,798,000		$ 26,798,000
MC | Purchase Option in Lease Arrangements | Texas
Real estate investments
Number of properties | property	2		2
Gross Investment	$ 25,265,000		$ 25,265,000
Carrying value	$ 23,250,000		$ 23,250,000
ALF and MC | Purchase Option in Lease Arrangements | California
Real estate investments
Number of properties | property	2		2
Gross Investment	$ 38,895,000		$ 38,895,000
Carrying value	$ 34,895,000		$ 34,895,000
ALF and MC | Purchase Option in Lease Arrangements | South Carolina
Real estate investments
Number of properties | property	1		1
Gross Investment	$ 11,680,000		$ 11,680,000
Carrying value	$ 9,777,000		$ 9,777,000
Real Estate Investment
Real estate investments
Number of properties | property	153		153
Gross Investment	$ 1,407,098,000		$ 1,407,098,000
Real Estate Investment | ALF
Real estate investments
Number of properties | property	102		102
Gross Investment	$ 843,015,000		$ 843,015,000

Real Estate Investments - Acqui

Real Estate Investments - Acquisitions and Developments (Details) - 2020 Acquisitions - SNF	9 Months Ended
	Sep. 30, 2020USD ($)item
Real estate investments
Purchase Price	$ 13,500,000
Transaction Costs	81,000
Total Acquisition Costs	$ 13,581,000
Number of properties acquired	1
Number of beds/units acquired | item	140

Real Estate Investments - Types

Real Estate Investments - Types of property Development and Improvement (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Real estate investments
Invested in projects	$ 4,781
Developments | Development and Improvement Commitments
Real estate investments
Invested in projects		$ 13,384
Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects	4,839	3,955
ALF | Developments | Development and Improvement Commitments
Real estate investments
Invested in projects		4,491
ALF | Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects	4,560	3,941
SNF | Developments | Development and Improvement Commitments
Real estate investments
Invested in projects		8,893
SNF | Improvements | Development and Improvement Commitments
Real estate investments
Invested in projects	$ 279	$ 14

Real Estate Investments - Devel

Real Estate Investments - Development and Improvement Projects (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2020USD ($)propertyitem
Completed development and improvement projects
Number of Properties | property	2
Number of Beds/Units | item	168
Total Investment | $	$ 31,719
SNF | Developments | Real Estate Development Commitments | Real Estate Investment Completed Projects
Completed development and improvement projects
Number of Properties | property	1
Number of Beds/Units | item	90
Total Investment | $	$ 13,272
ALF and MC | Developments | Real Estate Development Commitments | Real Estate Investment Completed Projects
Completed development and improvement projects
Number of Properties | property	1
Number of Beds/Units | item	78
Total Investment | $	$ 18,447

Real Estate Investments - Prope

Real Estate Investments - Property Sales (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)itemproperty	Sep. 30, 2020USD ($)itemproperty	Dec. 31, 2020USD ($)
Disposals and other
Carrying value	$ 1,041,916		$ 1,041,916		$ 1,102,358
Net Gain (loss)	2,702	$ 30	$ 7,392	$ 44,073
Impairment charges		941		$ 941
Properties sold
Disposals and other
Number of properties sold | property			6	21
Number of beds or units in property sold | item			426	2,411
Sales price			$ 45,600	$ 74,800
Carrying value	36,528	29,084	36,528	29,084
Net Gain (loss)			7,392	44,073
Net Gain (loss)			$ 292	108
Holdback amount		838		$ 838
Properties sold | SNF | Arizona
Disposals and other
Number of properties sold | property				1
Number of beds or units in property sold | item				194
Sales price				$ 12,550
Carrying value		2,229		2,229
Net Gain (loss)				$ 10,292
Properties sold | SNF | Colorado
Disposals and other
Number of properties sold | property				3
Number of beds or units in property sold | item				275
Sales price				$ 15,000
Carrying value		4,271		4,271
Net Gain (loss)				$ 10,364
Properties sold | SNF | Iowa
Disposals and other
Number of properties sold | property				7
Number of beds or units in property sold | item				544
Sales price				$ 14,500
Carrying value		4,886		4,886
Net Gain (loss)				9,029
Holdback amount					$ 150
Realizable holdback amount				$ 471
Properties sold | SNF | Kansas
Disposals and other
Number of properties sold | property				3
Number of beds or units in property sold | item				250
Sales price				$ 9,750
Carrying value		7,438		7,438
Net Gain (loss)				$ 1,993
Properties sold | SNF | Texas
Disposals and other
Number of properties sold | property				7
Number of beds or units in property sold | item				1,148
Sales price				$ 23,000
Carrying value		$ 10,260		10,260
Net Gain (loss)				$ 12,287
Properties sold | SNF | Washington
Disposals and other
Number of properties sold | property			1
Number of beds or units in property sold | item			123
Sales price			$ 7,700
Carrying value	4,528		4,528
Net Gain (loss)			$ 2,562
Properties sold | ALF | Florida
Disposals and other
Number of properties sold | property			1
Sales price			$ 2,000
Carrying value	2,626		2,626
Net Gain (loss)			$ (858)
Properties sold | ALF | Nebraska
Disposals and other
Number of properties sold | property			1
Number of beds or units in property sold | item			40
Sales price			$ 900
Carrying value	1,079		1,079
Net Gain (loss)			$ (198)
Properties sold | ALF | Wisconsin
Disposals and other
Number of properties sold | property			3
Number of beds or units in property sold | item			263
Sales price			$ 35,000
Carrying value	$ 28,295		28,295
Net Gain (loss)			$ 5,594

Real Estate Investments - Pro_2

Real Estate Investments - Properties held-for-sale (Details) $ in Thousands	Oct. 29, 2021property	Sep. 30, 2021USD ($)	Dec. 31, 2020USD ($)
Real estate investments
Accumulated depreciation | $		$ 365,182	$ 349,643
Subsequent Event
Real estate investments
Number of beds/units | property	11

Real Estate Investments - Mortg

Real Estate Investments - Mortgage Loan (Details)	Oct. 29, 2021USD ($)propertyitem	Sep. 30, 2021USD ($)itemproperty	Sep. 30, 2021USD ($)itemloanproperty$ / item
Real Estate [Line Items]
Loan Term			1 year
Subsequent Event
Real Estate [Line Items]
Number of beds/units | property	11
Mortgage loans with 7.5% Interest Maturing 2022 | ALF and MC | Combination ALF and MC community | Florida | Subsequent Event
Real Estate [Line Items]
Number of beds/units | property	68
Mortgages With 7.75% Interest | ALF and MC | Combination ALF and MC community
Real Estate [Line Items]
Interest rate (as a percent)	7.75%
Mortgage Loans
Real Estate [Line Items]
Gross Investment		$ 261,437,000	$ 261,437,000
Percentage of Investment		100.00%	100.00%
Number of Loans | loan			5
Number of properties | property		22	22
Investment per Bed/Unit | $ / item			95.87
Specified basis points for annual increase in interest rate (as a percent)			2.25%
Loan Term			30 years
Mortgage Loans | SNF Beds
Real Estate [Line Items]
Number of beds/units | item		2,727	2,727
Mortgage Loans | SNF | Subsequent Event
Real Estate [Line Items]
Gross Investment	$ 27,047,000
Percentage of Investment	7.50%
Number of beds/units | property	189
Mortgage Loans | ALF and MC | Combination ALF and MC community | Subsequent Event
Real Estate [Line Items]
Number of beds/units | property	68
Mortgage Loans | Mortgage loans with 7.5% Interest Maturing 2022 | SNF
Real Estate [Line Items]
Interest rate (as a percent)		7.50%
Gross Investment		$ 1,780,000	$ 1,780,000
Number of beds/units | item		91	91
Amount With held in Reserve		$ 142,000	$ 142,000
Mortgage Loans | Mortgage loans with 7.5% Interest Maturing 2022 | OTH
Real Estate [Line Items]
Interest rate (as a percent)			7.50%
Gross Investment		$ 1,780,000	$ 1,780,000
Percentage of Investment		0.70%	0.70%
Number of Loans | loan			1
Mortgage Loans | Mortgage loans with 7.5% Interest Maturing 2022 | OTH | SNF Beds
Real Estate [Line Items]
Number of beds/units | item		91	91
Mortgage Loans | Mortgage loans with 7.5% Interest Maturing 2022 | ALF and MC
Real Estate [Line Items]
Gross Investment	$ 12,530
Mortgage Loans | Mortgages With 7.75% Interest | SNF | Subsequent Event
Real Estate [Line Items]
Loan Term	12 months
Mortgage Loans | Mortgages With 7.75% Interest | ALF and MC | Subsequent Event
Real Estate [Line Items]
Gross Investment	$ 12,530,000
Percentage of Investment	7.75%
Loan Term	4 years
Loan Commitments	$ 4,177,000
Mortgage Loans | Mortgages With 7.5 Percent Interest | SNF
Real Estate [Line Items]
Extension term	12 months
Mortgage Loans | Mortgages With 7.5 Percent Interest | SNF | Subsequent Event
Real Estate [Line Items]
Interest rate (as a percent)	7.50%
Gross Investment	$ 27,047,000
Loan Term	3 years
Extension term number of options | item	1
Mortgage Loans | Mortgages With 7.5 Percent Interest | SNF | SNF Beds | LAOS | Subsequent Event
Real Estate [Line Items]
Number of beds/units | property	189
Mortgage Loans | Mortgage loans with 10.1% Interest Maturing 2043 | SNF
Real Estate [Line Items]
Interest rate (as a percent)			10.10%
Gross Investment		$ 185,859,000	$ 185,859,000
Percentage of Investment		71.10%	71.10%
Number of Loans | loan			1
Number of properties | property		15	15
Investment per Bed/Unit | $ / item			99.12
Mortgage Loans | Mortgage loans with 10.1% Interest Maturing 2043 | SNF | SNF Beds
Real Estate [Line Items]
Number of beds/units | item		1,875	1,875
Mortgage Loans | Mortgage loans with 9.3% Interest Maturing 2045 | SNF
Real Estate [Line Items]
Interest rate (as a percent)			9.30%
Gross Investment		$ 39,148,000	$ 39,148,000
Percentage of Investment		15.00%	15.00%
Number of Loans | loan			1
Number of properties | property		4	4
Investment per Bed/Unit | $ / item			78.14
Mortgage Loans | Mortgage loans with 9.3% Interest Maturing 2045 | SNF | SNF Beds
Real Estate [Line Items]
Number of beds/units | item		501	501
Mortgage Loans | Mortgage loans with 9.6% Interest Maturing 2045, A | SNF
Real Estate [Line Items]
Interest rate (as a percent)			9.60%
Gross Investment		$ 19,750,000	$ 19,750,000
Percentage of Investment		7.50%	7.50%
Number of Loans | loan			1
Number of properties | property		2	2
Investment per Bed/Unit | $ / item			96.34
Mortgage Loans | Mortgage loans with 9.6% Interest Maturing 2045, A | SNF | SNF Beds
Real Estate [Line Items]
Number of beds/units | item		205	205
Mortgage Loans | Mortgage loans with 9.6% Interest Maturing 2045, B | SNF
Real Estate [Line Items]
Interest rate (as a percent)			9.60%
Gross Investment		$ 14,900,000	$ 14,900,000
Percentage of Investment		5.70%	5.70%
Number of Loans | loan			1
Number of properties | property		1	1
Investment per Bed/Unit | $ / item			102.05
Mortgage Loans | Mortgage loans with 9.6% Interest Maturing 2045, B | SNF | SNF Beds
Real Estate [Line Items]
Number of beds/units | item		146	146

Real Estate Investments - Mor_2

Real Estate Investments - Mortgage Loans Activity (Details) - USD ($)	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Mortgage Loans
Originations and funding under mortgage loans receivable	$ 2,223,000	$ 4,176,000
Scheduled principal payments received	(625,000)	(565,000)
Mortgage loan premium amortization	(4,000)	(3,000)
Provision for loan loss reserve	(16,000)	(36,000)
Net (decrease) increase in mortgage loans receivable	1,578,000	3,572,000
Interest receivable	37,476,000		$ 32,746,000
Write-off of accrued interest receivable	$ 0	$ 0

Investment in Unconsolidated _3

Investment in Unconsolidated Joint Ventures - Investment (Details)	3 Months Ended	9 Months Ended		12 Months Ended
	Dec. 31, 2020USD ($)itemproperty	Sep. 30, 2021USD ($)propertyitem	Sep. 30, 2020USD ($)	Dec. 31, 2020USD ($)itemproperty	Oct. 29, 2021property
Investment in Unconsolidated Joint Ventures
Carrying Value	$ 11,340,000	$ 19,340,000		$ 11,340,000
Income Recognized		$ 1,041,000	$ 287,000
Cash Interest Received			249,000
Liquidation proceeds			17,758,000
Subsequent Event
Investment in Unconsolidated Joint Ventures
Number of beds/units | property					11
Joint Venture
Investment in Unconsolidated Joint Ventures
Number of properties owned by joint venture for sale | property	4			4
Liquidation proceeds				$ 17,848,000
Amount of gains (losses) on liquidation	$ 138,000		(620,000)
Joint Venture | Preferred Equity Investment | Arizona
Investment in Unconsolidated Joint Ventures
Number of properties owned by joint venture | property		4
Joint Venture | Not primary beneficiary
Investment in Unconsolidated Joint Ventures
Capital Contributions		$ 8,000,000	6,398,000
Income Recognized		1,041,000	287,000
Cash Interest Received		916,000	249,000
Preferred Equity Investment | Joint Venture | Not primary beneficiary
Investment in Unconsolidated Joint Ventures
Carrying Value		19,340,000
Combination ALF, MC, ILF | Preferred Equity Investment | Joint Venture | Not primary beneficiary
Investment in Unconsolidated Joint Ventures
Capital Contributions			58,000
Income Recognized			231,000
Cash Interest Received			231,000
Combination ALF/MC | Preferred Equity Investment | Joint Venture | Not primary beneficiary
Investment in Unconsolidated Joint Ventures
Number of beds/units | item	95			95
Capital Contributions			6,340,000	$ 6,340,000
Income Recognized		337,000	56,000
Cash Interest Received		$ 300,000	$ 18,000
Combination ALF/MC | Preferred Equity Investment | Joint Venture | Not primary beneficiary | Washington
Investment in Unconsolidated Joint Ventures
Preferred return percentage		12.00%
Contractual cash portion		7.00%
Number of beds/units | item		95
Carrying Value		$ 6,340,000
Reserve withheld		$ 1,425,000
Percentage of Investment		15.50%
Combination ALF/MC | Preferred Equity Investment | Joint Venture | Not primary beneficiary | Washington | Internal Rate of Return is Until Eight Percent
Investment in Unconsolidated Joint Ventures
Percentage of cash return		8.00%
Combination ALF/MC | Preferred Equity Investment | Joint Venture | Not primary beneficiary | Washington | Internal Rate of Return is Until Eight Percent | Minimum
Investment in Unconsolidated Joint Ventures
Percentage of cash return		7.00%
Combination ALF/MC | Preferred Equity Investment | Joint Venture | Not primary beneficiary | Washington | Internal Rate of Return is Until Eight Percent | Maximum
Investment in Unconsolidated Joint Ventures
Percentage of cash return		9.00%
Combination ALF/MC | Preferred Equity Investment | Joint Venture | Not primary beneficiary | Washington | The Internal Rate of Return is Between Twelve and Fourteen Percent | Minimum
Investment in Unconsolidated Joint Ventures
Percentage of cash return		12.00%
Combination ALF/MC | Preferred Equity Investment | Joint Venture | Not primary beneficiary | Washington | The Internal Rate of Return is Between Twelve and Fourteen Percent | Maximum
Investment in Unconsolidated Joint Ventures
Percentage of cash return		14.00%
Combination ILF/ALF | Joint Venture | Not primary beneficiary | Preferred Equity Investment | Washington
Investment in Unconsolidated Joint Ventures
Reserve withheld		$ 2,324
Combination ILF/ALF | Preferred Equity Investment | Joint Venture | Not primary beneficiary
Investment in Unconsolidated Joint Ventures
Capital Contributions		8,000,000
Income Recognized		704,000
Cash Interest Received		$ 616,000
Combination ILF/ALF | Preferred Equity Investment | Joint Venture | Not primary beneficiary | Washington
Investment in Unconsolidated Joint Ventures
Preferred return percentage		12.00%
Contractual cash portion		8.00%
Number of beds/units | item		267
Carrying Value		$ 13,000,000
Reserve withheld		$ 3,777,000
Percentage of Investment		11.60%
Additional preferred capital contributions in joint venture committed		$ 8,000,000
Amount of joint venture investment		13,000,000
Reserve for preferred equity investment		$ 3,777
Combination ILF/ALF | Preferred Equity Investment | Joint Venture | Not primary beneficiary | Washington | Internal Rate of Return is Until Eight Percent
Investment in Unconsolidated Joint Ventures
Percentage of cash return		8.00%
Combination ILF/ALF | Preferred Equity Investment | Joint Venture | Not primary beneficiary | Washington | The Internal Rate of Return is Between Twelve and Fourteen Percent | Minimum
Investment in Unconsolidated Joint Ventures
Percentage of Investment		12.00%
Combination ILF/ALF | Preferred Equity Investment | Joint Venture | Not primary beneficiary | Washington | The Internal Rate of Return is Between Twelve and Fourteen Percent | Maximum
Investment in Unconsolidated Joint Ventures
Percentage of Investment		14.00%
Combination ILF/ALF | Preferred Equity Investment | Joint Venture | Not primary beneficiary | Preferred Equity Investment | Washington
Investment in Unconsolidated Joint Ventures
Additional preferred capital contributions in joint venture committed		$ 8,000

Notes Receivable - Components (

Notes Receivable - Components (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Notes receivable activities
Notes receivable loan loss reserve	$ (189)	$ (146)
Total	18,675	14,465
Mezzanine loan
Notes receivable activities
Mezzanine loan	11,816	8,445
Other loans
Notes receivable activities
Mezzanine loan	$ 7,048	$ 6,166

Notes Receivable - Notes Receiv

Notes Receivable - Notes Receivable Activity (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Notes receivable activities
Advances under notes receivable	$ 6,453	$ 1,366
Interest reserve withheld	353
Principal payments received under notes receivable	(2,553)	(4,732)
Reclassified to lease incentives		(300)
Notes receivable reserve	43	36
Net increase (decrease) in notes receivable	$ 4,296	$ (3,630)

Notes Receivable - New Loan Com

Notes Receivable - New Loan Commitment (Details)	1 Months Ended	3 Months Ended	9 Months Ended
	Oct. 31, 2021USD ($)property	Sep. 30, 2021USD ($)loan	Sep. 30, 2021USD ($)loan	Dec. 31, 2020USD ($)
Notes receivable activities
Loan Term			1 year
Minimum
Notes receivable activities
Interest rate (as a percent)			5.00%
Maximum
Notes receivable activities
Interest rate (as a percent)			8.00%
Mezzanine loan
Notes receivable activities
Financing Receivable, Gross		$ 11,816,000	$ 11,816,000	$ 8,445,000
Mezzanine loan | Loan with 8.0% for the first 18 months increasing to 10.5% thereafter with an internal rate of return ("IRR") of 10.5%.
Notes receivable activities
Financing Receivable, Gross		4,355	4,355
Interest reserve withheld		$ 353	$ 353
Loan Term		3 years
Extension term number of options | loan		2	2
Extension term		12 months
Mezzanine loan | Loan with 8.0% for the first 18 months increasing to 10.5% thereafter with an internal rate of return ("IRR") of 10.5%. | Internal Rate Of Return To 10.5 Thereafter
Notes receivable activities
Interest rate (as a percent)		10.50%
Mezzanine loan | Loan with 8.0% for the first 18 months increasing to 10.5% thereafter with an internal rate of return ("IRR") of 10.5%. | Internal Rate Of Return is 8.0%
Notes receivable activities
Interest rate (as a percent)		8.00%
Mezzanine loan | Loan with 8.0% for the first 18 months increasing to 10.5% thereafter with an internal rate of return ("IRR") of 10.5%. | Internal Rate Of Return of 10.5%
Notes receivable activities
Interest rate (as a percent)		10.50%
HMG Healthcare, LLC | Subsequent Event | Secured loan maturing in September 2022
Notes receivable activities
Financing Receivable, Gross	$ 25,000
Number of properties in transition | property	11

Lease Incentives (Details)

Lease Incentives (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Lease Incentives
Non-contingent lease incentives	$ 2,726		$ 2,462
Non-contingent lease incentives, funding	650	$ 50
Non-contingent lease incentives, Amortization	$ (386)	(317)
Lease adjustment		115
Reclassified to lease incentives		300
Non-contingent lease incentives, Write off		$ 185

Debt Obligations - Bank Borrowi

Debt Obligations - Bank Borrowings (Details) - Bank Borrowings - USD ($)	9 Months Ended
	Sep. 30, 2021	Dec. 31, 2018
Debt Obligations
Maximum available under facility	$ 1,000,000,000	$ 600,000,000
Additional extension period option	1 year
Unused commitment fee (as a percent)	0.20%
LIBOR
Debt Obligations
Basis spread over base rate (as a percent)	1.15%

Debt Obligations - Component (D

Debt Obligations - Component (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Dec. 31, 2020
Debt Obligations
Applicable Interest Rate (as a percent)	3.71%
Outstanding Balance	$ 661,829	$ 649,382
Available for borrowing	$ 465,600	510,100
Minimum
Debt Obligations
Interest rate (as a percent)	5.00%
Maximum
Debt Obligations
Interest rate (as a percent)	8.00%
Bank Borrowings
Debt Obligations
Applicable Interest Rate (as a percent)	1.23%
Outstanding Balance	$ 134,400	89,900
Available for borrowing	$ 465,600	510,100
Senior Unsecured Notes
Debt Obligations
Applicable Interest Rate (as a percent)	4.34%
Outstanding Balance	$ 527,429	$ 559,482
Senior Unsecured Notes | Minimum
Debt Obligations
Interest rate (as a percent)	3.85%
Senior Unsecured Notes | Maximum
Debt Obligations
Interest rate (as a percent)	5.03%

Debt Obligations - Borrowings a

Debt Obligations - Borrowings and Repayments (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Borrowings
Bank borrowings	$ 92,500	$ 24,000
Total	92,500	24,000
Repayments
Bank borrowings	(48,000)	(28,000)
Senior unsecured notes	(32,160)	(25,160)
Total	(80,160)	(53,160)
Outstanding Balance	661,829		$ 649,382
Available for borrowing	465,600		510,100
Bank Borrowings
Borrowings
Bank borrowings	92,500	24,000
Repayments
Bank borrowings	(48,000)	(28,000)
Outstanding Balance	134,400		89,900
Available for borrowing	465,600		510,100
Senior Unsecured Notes
Repayments
Senior unsecured notes	(32,160)	$ (25,160)
Outstanding Balance	$ 527,429		$ 559,482

Equity - Noncontrolling Interes

Equity - Noncontrolling Interest (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Noncontrolling interest
Gross Consolidated Assets	$ 1,453,088	$ 1,459,486
Non-controlling interests	8,413	$ 8,404
Partnership
Noncontrolling interest
Gross Consolidated Assets	83,429
Non-controlling interests	8,413
Virginia | 2019 Acquisitions | Partnership | ALF and MC
Noncontrolling interest
Gross Consolidated Assets	16,895
Non-controlling interests	919
Oregon | 2018 Acquisitions | Partnership | ALF and MC
Noncontrolling interest
Gross Consolidated Assets	18,447
Non-controlling interests	1,091
Oregon | 2018 Acquisitions | Partnership | ILF
Noncontrolling interest
Gross Consolidated Assets	14,400
Non-controlling interests	2,857
Wisconsin | 2017 Acquisitions | Partnership | ILF/ALF/MC
Noncontrolling interest
Gross Consolidated Assets	22,007
Non-controlling interests	2,305
South Carolina | 2017 Acquisitions | Partnership | ALF and MC
Noncontrolling interest
Gross Consolidated Assets	11,680
Non-controlling interests	$ 1,241

Equity - Common Stock (Details)

Equity - Common Stock (Details) - Common Stock - USD ($)	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Equity
Number of shares repurchased	87,249	76,574
Equity Distribution Agreements
Equity
Maximum offering capacity under shelf registration statement	$ 200,000,000
Shares common stock sold	0
Amount available under effective shelf registration statement	$ 200,000,000

Equity - Stock Repurchase Plan

Equity - Stock Repurchase Plan (Details) - USD ($)	12 Months Ended
	Dec. 31, 2020	Mar. 12, 2020
Equity
Shares authorized for repurchase		5,000,000
Number of shares purchased	615,827
Average price per share	$ 29.25
Total purchase price of shares	$ 18,012,000

Equity - Distributions (Details

Equity - Distributions (Details) - USD ($) $ / shares in Units, $ in Thousands

1 Months Ended

3 Months Ended

9 Months Ended

Dec. 31, 2021

Nov. 30, 2021

Oct. 31, 2021

Sep. 30, 2021

Jun. 30, 2021

Mar. 31, 2021

Dec. 31, 2020

Sep. 30, 2020

Jun. 30, 2020

Mar. 31, 2020

Sep. 30, 2021

Sep. 30, 2020

Dividend Distributions

Paid

$ 68,051

$ 67,894

Common Stock cash distributions

$ 0.57

$ 0.57

$ 0.57

$ 0.57

$ 0.57

$ 0.57

$ 0.57

Dividends declared and paid per common share

$ 0.57

$ 0.57

$ 1.71

$ 1.71

Subsequent Event | Dividend Payable, July 30, 2021

Dividend Distributions

Dividends declared and paid per common share

$ 0.19

Subsequent Event | Dividend Payable, August 31, 2021

Dividend Distributions

Dividends declared and paid per common share

$ 0.19

Subsequent Event | Dividend Payable, September 30, 2021

Dividend Distributions

Dividends declared and paid per common share

$ 0.19

Common Stock

Dividend Distributions

Declared

$ 68,051

$ 67,894

$ 68,051

$ 67,894

Paid

$ 68,051

$ 67,894

Common Stock cash distributions

$ 0.19

$ 0.19

Common Stock | Subsequent Event | Dividend Payable, July 30, 2021

Dividend Distributions

Dividends declared and paid per common share

0.19

Common Stock | Subsequent Event | Dividend Payable, August 31, 2021

Dividend Distributions

Dividends declared and paid per common share

$ 0.19

$ 0.19

Common Stock | Subsequent Event | Dividend Payable, September 30, 2021

Dividend Distributions

Dividends declared and paid per common share

$ 0.19

Common Stock | Performance-based stock units

Dividend Distributions

Paid

$ 764

$ 586

Equity - Stock-Based Compensati

Equity - Stock-Based Compensation (Details)	9 Months Ended
	Sep. 30, 2021shares	Sep. 30, 2020shares
Stock Based Compensation Plans
Options outstanding (in shares)	15,000
Options exercisable (in shares)	15,000
Stock options granted (in shares)	0	0
2015 Plan
Stock Based Compensation Plans
Ratio of shares subject to award granted	1
2021 Plan
Stock Based Compensation Plans
Total shares reserved for issuance of common stock related to the conversion of preferred stock	1,900,000

Equity - Restricted Stock and p

Equity - Restricted Stock and performance-based stock units (Details) - shares	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Restricted stock and performance-based stock units
Restricted stock and performance based stock units activity
Granted (in shares)	182,240	167,375
Performance-based stock units
Restricted stock and performance based stock units activity
Granted (in shares)	71,892	66,027
Vested (in shares)	(108,720)	(81,574)
Outstanding at the end of the period (in shares)	0
Restricted stock
Restricted stock and performance based stock units activity
Outstanding at the beginning of the period (in shares)	180,440	163,569
Granted (in shares)	110,348	101,348
Vested (in shares)	(93,366)	(84,477)
Outstanding at the end of the period (in shares)	197,422	180,440

Equity - Restricted Stock (Deta

Equity - Restricted Stock (Details) - USD ($)	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Restricted stock
Restricted stock awards
Number of shares granted	110,348	101,348
Number of vesting of performance-based stock units (in shares)	93,366	84,477
Performance-based stock units
Restricted stock awards
Number of shares granted	71,892	66,027
Number of vesting of performance-based stock units (in shares)	108,720	81,574
Restricted stock and performance-based stock units
Restricted stock awards
Number of shares granted	182,240	167,375
Compensation expense related to share-based award	$ 5,785,000	$ 5,231,000
Nonvested awards
Remaining compensation expense	10,579,000
2021 | Restricted stock and performance-based stock units
Nonvested awards
Remaining compensation expense	1,974,000
2022 | Restricted stock and performance-based stock units
Nonvested awards
Remaining compensation expense	5,447,000
2023 | Restricted stock and performance-based stock units
Nonvested awards
Remaining compensation expense	2,855,000
2023 | Restricted stock and performance-based stock units
Nonvested awards
Remaining compensation expense	$ 303,000
Grant Date Price 42.27 | Three year vesting | Restricted stock and performance-based stock units
Restricted stock awards
Number of shares granted	95,293
Granted (in dollars per share)	$ 42.27
Vesting period	3 years
Grant Date Price 42.27 | TSR Targets | Restricted stock and performance-based stock units
Restricted stock awards
Number of shares granted	71,892
Granted (in dollars per share)	$ 42.27
Vesting period	4 years
Grant Date Price 42.27 | Accelerated TSR Targets | Restricted stock and performance-based stock units
Restricted stock awards
Vesting period	3 years
Grant Date Price $48.95 | Three year vesting | Restricted stock and performance-based stock units
Restricted stock awards
Number of shares granted		76,464
Granted (in dollars per share)		$ 48.95
Vesting period		3 years
Grant Date Price $49.98 | TSR Targets | Restricted stock and performance-based stock units
Restricted stock awards
Number of shares granted		66,027
Granted (in dollars per share)		$ 49.98
Vesting period		4 years
Grant Date Price $49.98 | Accelerated TSR Targets | Restricted stock and performance-based stock units
Restricted stock awards
Vesting period		3 years
Grant Date Price $39.40 | Vesting Date, May 26, 2021 | Restricted stock and performance-based stock units
Restricted stock awards
Number of shares granted	12,055
Granted (in dollars per share)	$ 39.40
Grant Date Price $43.14 | Three year vesting | Restricted stock and performance-based stock units
Restricted stock awards
Number of shares granted	3,000
Granted (in dollars per share)	$ 43.14
Grant Date Price $38.45 | Three year vesting | Restricted stock and performance-based stock units
Restricted stock awards
Number of shares granted		15,000
Granted (in dollars per share)		$ 38.45
Vesting period		3 years
Grant Date Price $38.45 | Vesting Date, May 27, 2021 | Restricted stock and performance-based stock units
Restricted stock awards
Number of shares granted		9,884
Granted (in dollars per share)		$ 38.45

Commitments and Contingencies -

Commitments and Contingencies - Summary of Commitments (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2021USD ($)
Commitments and Contingencies
Investment Commitment	$ 51,725
2021 Funding	4,781
Total Commitment funded	15,224
Remaining commitment	36,501
Real estate properties
Commitments and Contingencies
Investment Commitment	19,670
2021 Funding	3,770
Total Commitment funded	10,228
Remaining commitment	9,442
Accrued incentives and earn-out liabilities
Commitments and Contingencies
Investment Commitment	9,130
2021 Funding	50
Total Commitment funded	50
Remaining commitment	9,080
Mortgage loans
Commitments and Contingencies
Investment Commitment	21,000
2021 Funding	318
Total Commitment funded	3,699
Remaining commitment	17,301
Commitments To Expand and Renovate Properties
Commitments and Contingencies
Investment Commitment	3,000
Contingent Funding Commitments
Commitments and Contingencies
Investment Commitment	18,000
Notes receivable
Commitments and Contingencies
Investment Commitment	1,925
2021 Funding	643
Total Commitment funded	1,247
Remaining commitment	$ 678

Major Operators (Details)

Major Operators (Details)	9 Months Ended
	Sep. 30, 2021itemproperty
Major Operators
Number of major operators	1
Prestige Healthcare | SNF
Major Operators
Number of beds | property	24
Number of beds/units	2,845
Prestige Healthcare | ALF
Major Operators
Number of beds/units	93
Total Revenue | Operator Concentration Risk | Prestige Healthcare
Major Operators
Concentration risk (as a percent)	21.40%
Total Assets | Credit Concentration Risk | Prestige Healthcare
Major Operators
Concentration risk (as a percent)	18.30%

Earnings per Share (Details)

Earnings per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended							9 Months Ended
	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Sep. 30, 2021	Sep. 30, 2020
Net income	$ 11,114	$ 18,330	$ 13,850	$ 17,665	$ 12,338	$ 1,952	$ 63,722	$ 43,294	$ 78,012
Less income allocated to non-controlling interests	(92)				(121)			(271)	(292)
Less income allocated to participating securities:
Non-forfeitable dividends on participating securities	(113)				(103)			(346)	(294)
Income allocated to participating securities									(45)
Total net income allocated to participating securities	(113)				(103)			(346)	(339)
Net income available to common stockholders	10,909				12,114			42,677	77,381
Net income for diluted net income per share	$ 10,909				$ 12,114			$ 42,677	$ 77,381
Reconciliation of shares
Shares for basic net income per share	39,177,000				39,061,000			39,149,000	39,218,000
Effect of dilutive securities:
Total effect of dilutive securities (in shares)					51,000				51,000
Shares for diluted net income per share	39,177,000				39,112,000			39,149,000	39,269,000
Basic net income per share (in dollars per share)	$ 0.28				$ 0.31			$ 1.09	$ 1.97
Diluted net income per share (in dollars per share)	$ 0.28				$ 0.31			$ 1.09	$ 1.97
Performance-based stock units
Effect of dilutive securities:
Stock options and performance-based stock units (in shares)					51,000				51,000
Performance-based stock units would be earned based on TSR targets	0							0

Fair Value Measurements (Detail

Fair Value Measurements (Details) $ in Thousands	Sep. 30, 2021USD ($)item	Dec. 31, 2020USD ($)item
Fair value measurements
Mortgage loans receivable, net of loan loss reserve	$ 258,829	$ 257,251
Mortgage loans receivable, net of loan loss reserve	18,675	14,465
Senior unsecured notes, net of debt issue costs	$ 527,429	$ 559,482
Level 3 | Senior Unsecured Notes maturing before 2030 | Discount Rate
Fair value measurements
Future cash outflows discount rate (as a percent) | item	0.0300
Level 3 | Senior Unsecured Notes maturing 2030 and after | Discount Rate
Fair value measurements
Future cash outflows discount rate (as a percent) | item	0.0325
Level 3 | Senior Unsecured Notes maturing before 2026 | Discount Rate
Fair value measurements
Future cash outflows discount rate (as a percent) | item		0.0325
Level 3 | Senior Unsecured Notes maturing 2026 and after | Discount Rate
Fair value measurements
Future cash outflows discount rate (as a percent) | item		0.0350
Level 3 | Mortgage Loans Receivable | Discount Rate
Fair value measurements
Future cash inflows discount rate (as a percent)	0.101	0.100
Level 3 | Notes Receivable | Discount Rate
Fair value measurements
Future cash inflows discount rate (as a percent) | item	0.065	0.066
Carrying Value
Fair value measurements
Mortgage loans receivable, net of loan loss reserve	$ 258,829	$ 257,251
Mortgage loans receivable, net of loan loss reserve	18,675	14,465
Bank borrowings	134,400	89,900
Senior unsecured notes, net of debt issue costs	527,429	559,482
Fair Value
Fair value measurements
Mortgage loans receivable, net of loan loss reserve	18,552	13,893
Bank borrowings	134,400	89,900
Fair Value | Level 3
Fair value measurements
Mortgage loans receivable, net of loan loss reserve	298,677	299,751
Senior unsecured notes, net of debt issue costs	$ 556,841	$ 560,140

Subsequent Events (Details)

Subsequent Events (Details)	Oct. 29, 2021USD ($)property	Dec. 31, 2021$ / shares	Nov. 30, 2021$ / shares	Oct. 31, 2021$ / shares	Sep. 30, 2021USD ($)property$ / shares	Sep. 30, 2020$ / shares	Sep. 30, 2021USD ($)property$ / shares	Sep. 30, 2020USD ($)$ / shares	Dec. 31, 2020USD ($)
Real Estate Investments
Mortgage Loans on Real Estate, Amortization Period							1 year
First lease year					$ 119,023,000		$ 119,023,000
Second lease year					104,210,000		104,210,000
Third lease year					105,332,000		105,332,000
Debt:
Amount borrowed							92,500,000	$ 24,000,000
Outstanding Balance					661,829,000		661,829,000		$ 649,382,000
Available for borrowing					465,600,000		465,600,000		510,100,000
Repayment paid							48,000,000	$ 28,000,000
Unsecured revolving line of credit					$ 134,400,000		$ 134,400,000		89,900,000
Equity
Dividends declared and paid per common share | $ / shares					$ 0.57	$ 0.57	$ 1.71	$ 1.71
Mortgage Loans
Real Estate Investments
Real Estate Investment Property, at Cost					$ 261,437,000		$ 261,437,000
Mortgage Loans on Real Estate, Amortization Period							30 years
Real Estate Investments, Percentage					100.00%		100.00%
Number of properties | property					22		22
Bank Borrowings
Debt:
Amount borrowed							$ 92,500,000	$ 24,000,000
Outstanding Balance					$ 134,400,000		134,400,000		89,900,000
Available for borrowing					$ 465,600,000		465,600,000		$ 510,100,000
Repayment paid							$ 48,000,000	$ 28,000,000
Subsequent Event
Real Estate Investments
Number of Units in Real Estate Property | property	11
Subsequent Event | Dividend Payable, July 30, 2021
Equity
Dividends declared and paid per common share | $ / shares				$ 0.19
Subsequent Event | Dividend Payable, August 31, 2021
Equity
Dividends declared and paid per common share | $ / shares			$ 0.19
Subsequent Event | Dividend Payable, September 30, 2021
Equity
Dividends declared and paid per common share | $ / shares		$ 0.19
Subsequent Event | HMG Healthcare, LLC | Master lease agreement
Real Estate Investments
Number of Properties Transitioned | property	11
Agreement Term	1 year
Real Estate Investment Property, at Cost	$ 25,000,000
Subsequent Event | Common Stock | Dividend Payable, July 30, 2021
Equity
Dividends declared and paid per common share | $ / shares				0.19
Subsequent Event | Common Stock | Dividend Payable, August 31, 2021
Equity
Dividends declared and paid per common share | $ / shares			$ 0.19	$ 0.19
Subsequent Event | Common Stock | Dividend Payable, September 30, 2021
Equity
Dividends declared and paid per common share | $ / shares		$ 0.19
Subsequent Event | SNF | Mortgage Loans
Real Estate Investments
Real Estate Investment Property, at Cost	$ 27,047,000
Number of Units in Real Estate Property | property	189
Real Estate Investments, Percentage	7.50%
Lease term	3 years
Subsequent Event | SNF | Mortgage Loans | Mortgages With 7.75% Interest
Real Estate Investments
Mortgage Loans on Real Estate, Amortization Period	12 months
Subsequent Event | ALF and MC | Mortgage Loans | Combination ALF and MC community
Real Estate Investments
Number of Units in Real Estate Property | property	68
Subsequent Event | ALF and MC | Mortgage Loans | Mortgages With 7.75% Interest
Real Estate Investments
Real Estate Investment Property, at Cost	$ 12,530,000
Mortgage Loans on Real Estate, Amortization Period	4 years
Real Estate Investments, Percentage	7.75%
Loan Commitments	$ 4,177,000