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Real Estate and Other Activities (Tables)
 12 Months Ended
Dec. 31, 2022
Real Estate [Abstract]  
Net Assets Acquired

For the years ended December 31, 2022, 2021, and 2020, we acquired or invested in the following net assets (in thousands):

 

 

 

2022

 

 

2021

 

 

2020

 

Land and land improvements

 

$

135,301

 

 

$

642,312

 

 

$

365,281

 

Buildings

 

 

487,698

 

 

 

2,381,654

 

 

 

2,547,313

 

Intangible lease assets — subject to amortization
   (weighted-average useful life of 21.3 years in 2022,
   34.5 years in 2021, and 27.5 years in 2020)

 

 

45,394

 

 

 

262,385

 

 

 

642,699

 

Investment in financing leases

 

 

—

 

 

 

—

 

 

 

114,797

 

Mortgage loans(1)(2)

 

 

159,735

 

 

 

1,113,300

 

 

 

176,840

 

Investments in unconsolidated real estate joint ventures

 

 

399,456

 

 

 

—

 

 

 

233,593

 

Investments in unconsolidated operating entities

 

 

131,105

 

 

 

1,033,096

 

 

 

205,000

 

Other loans

 

 

—

 

 

 

—

 

 

 

103,195

 

Other assets

 

 

—

 

 

 

—

 

 

 

1,328

 

Liabilities assumed

 

 

(25,727

)

 

 

(82,508

)

 

 

(140,866

)

 

 

$

1,332,962

 

 

$

5,350,239

 

 

$

4,249,180

 

Loans repaid(1)

 

 

—

 

 

 

(1,103,410

)

 

 

(834,743

)

Total net assets acquired

 

$

1,332,962

 

 

$

4,246,829

 

 

$

3,414,437

 

 

(1)
The 2021 column includes an £800 million mortgage loan advanced to the Priory Group (“Priory”) in the first quarter of 2021 and converted to fee simple ownership of 35 properties in the second quarter of 2021 as described below. The 2020 column includes approximately $740 million of loans advanced to Steward in 2017 and exchanged for the fee simple real estate of two hospitals as described below, as well as approximately $100 million of loans advanced to Ernest Health, Inc. (“Ernest”) in 2012 and exchanged for the fee simple real estate of four hospitals as described below.
(2)
In the 2022 second quarter, we increased our mortgage loan to Prospect Medical Holdings, Inc. ("Prospect") that was originated in 2019 and that is secured by a first lien on a California hospital. The loan bears interest at a current market rate plus a component of additional interest upon repayment.
Summary of Status on Current Development Projects

See table below for a status summary of our current development projects (in thousands):

Property

 

Commitment

 

 

Costs
Incurred as of
December 31, 2022

 

 

Estimated Rent
Commencement
Date

Ernest (Stockton, California)

 

$

47,700

 

 

$

45,739

 

 

1Q 2023

IMED (Spain)

 

 

50,411

 

 

 

13,037

 

 

2Q 2023

Ernest (South Carolina)

 

 

22,400

 

 

 

7,541

 

 

2Q 2023

IMED (Spain)

 

 

45,408

 

 

 

33,801

 

 

3Q 2023

Springstone (Texas)

 

 

34,600

 

 

 

1,962

 

 

1Q 2024

IMED (Spain)

 

 

36,734

 

 

 

8,320

 

 

3Q 2024

Steward (Texas)

 

 

169,408

 

 

 

57,020

 

 

1Q 2026

 

 

$

406,661

 

 

$

167,420

 

 

 
Summary of Operating Results from Properties

The properties sold during 2022 do not meet the definition of discontinued operations. However, the following represents the operating results from these properties for the periods presented (in thousands):

 

 

 

For the Year Ended December 31,

 

 

 

2022

 

 

2021

 

 

2020

 

Revenues(1)

 

$

17,831

 

 

$

180,549

 

 

$

174,362

 

Real estate depreciation and amortization(2)

 

 

(4,683

)

 

 

(28,579

)

 

 

(38,059

)

Property-related expenses

 

 

(1,588

)

 

 

(5,065

)

 

 

(12,509

)

Other income(3)

 

 

536,813

 

 

 

181

 

 

 

1,228

 

Income from real estate dispositions, net

 

$

548,373

 

 

$

147,086

 

 

$

125,022

 
(1)
Includes approximately $42 million of straight-line rent and other write-offs associated with the non-Macquarie disposal transactions for the year ended December 31, 2022.
(2)
Lower in 2022 as we stopped depreciating the properties making up the Macquarie Transaction once deemed held for sale in September 2021.
(3)
Includes $536.8 million of gains (net of $125 million write-off of straight-line rent receivables related to the Macquarie Transaction) for the year ended December 31, 2022.
Amortization Expense from Existing Lease Intangible Assets

We recorded amortization expense related to intangible lease assets of $55.9 million, $56.0 million, and $42.4 million in 2022, 2021, and 2020, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands):

 

For the Year Ended December 31:

 

 

 

2023

 

$

56,740

 

2024

 

 

56,683

 

2025

 

 

56,535

 

2026

 

 

56,266

 

2027

 

 

55,932

 
Summary of Total Future Minimum Lease Payments to be Received

The following table summarizes total future minimum lease payments to be received, excluding operating expense reimbursements, from tenants under noncancelable leases as of December 31, 2022 (amounts in thousands):

 

 

 

Total Under
Operating Leases

 

 

Total Under
Financing Leases

 

 

Total

 

2023

 

$

984,353

 

 

$

161,079

 

 

$

1,145,432

 

2024

 

 

1,001,456

 

 

 

164,357

 

 

 

1,165,813

 

2025

 

 

1,016,367

 

 

 

167,701

 

 

 

1,184,068

 

2026

 

 

1,031,717

 

 

 

171,112

 

 

 

1,202,829

 

2027

 

 

1,048,409

 

 

 

174,591

 

 

 

1,223,000

 

Thereafter

 

 

25,851,987

 

 

 

4,376,304

 

 

 

30,228,291

 

 

 

$

30,934,289

 

 

$

5,215,144

 

 

$

36,149,433

 
Components of Total Investment in Financing Leases The components of our total investment in financing leases consisted of the following (in thousands):

 

 

 

As of December 31, 2022

 

 

As of December 31, 2021

 

Minimum lease payments receivable

 

$

880,253

 

 

$

1,183,855

 

Estimated unguaranteed residual values

 

 

203,818

 

 

 

203,818

 

Less: Unearned income and allowance for credit loss

 

 

(731,915

)

 

 

(918,584

)

Net investment in direct financing leases

 

 

352,156

 

 

 

469,089

 

Other financing leases (net of allowance for credit loss)

 

 

1,339,167

 

 

 

1,584,238

 

Total investment in financing leases

 

$

1,691,323

 

 

$

2,053,327

 
Summary of Investments in Unconsolidated Operating Entities

The following is a summary of our investments in unconsolidated real estate joint ventures by operator (amounts in thousands):

 

Operator

 

Ownership Percentage

 

As of December 31, 2022

 

 

As of December 31, 2021

 

MEDIAN

 

50%

 

$

482,735

 

 

$

517,648

 

Swiss Medical Network

 

70%

 

 

454,083

 

 

 

476,193

 

Steward (Macquarie Transaction)

 

50%

 

 

417,701

 

 

 

—

 

Policlinico di Monza

 

50%

 

 

86,245

 

 

 

95,468

 

HM Hospitales

 

45%

 

 

57,139

 

 

 

63,618

 

Total

 

 

 

$

1,497,903

 

 

$

1,152,927

 

The following is a summary of our investments in unconsolidated operating entities (amounts in thousands):

 

Operator

 

As of December 31,
2022

 

 

As of December 31,
2021

 

Steward (loan investment)

 

$

362,831

 

 

$

360,164

 

International joint venture

 

 

231,402

 

 

 

219,387

 

Springstone

 

 

200,827

 

 

 

187,450

 

Priory

 

 

156,575

 

 

 

42,315

 

Swiss Medical Network

 

 

157,145

 

 

 

159,208

 

Steward (equity investment)

 

 

125,862

 

 

 

139,000

 

Prospect

 

 

112,777

 

 

 

112,283

 

Aevis Victoria SA ("Aevis")

 

 

72,904

 

 

 

61,271

 

Aspris Children's Services ("Aspris")

 

 

16,023

 

 

 

8,356

 

Caremax

 

 

8,526

 

 

 

—

 

Total

 

$

1,444,872

 

 

$

1,289,434