ARS 1 a2024annualreport-web.htm ARS a2024annualreport-web


 
ANNUAL REPORT TO SHAREHOLDERS | 2 2024 was a productive and eventful year for Healthcare Realty. We increased occupancy, made key leadership changes, reduced debt, launched new strategic joint ventures, and refined the quality of our portfolio through asset sales. The great strides we’ve made in all these areas have strengthened the opportunity to elevate the growth rate of our outpatient medical real estate platform and deliver long-term value to our shareholders. Letter to Shareholders LEADERSHIP CHANGES Last year, the Board of Directors determined that the time was right to bring a new direction to the company’s leadership, offering a fresh perspective for our next chapter of growth. In November, Todd Meredith stepped down as CEO. Connie Moore, a member of our Board of Directors, was asked to serve as Interim President and CEO, bringing to the role her many years of REIT leadership experience as the former CEO of BRE Properties, Inc. A committee was formed to oversee the search for a permanent President and CEO, in collaboration with a leading executive search firm. That process, which we are approaching with great diligence and care, is well underway now. We look forward to introducing our new CEO in the coming months. Other 2024 leadership shifts include moving Rob Hull to Executive VP – Chief Operating Officer, Ryan Crowley to Executive VP – Chief Investment Officer, Julie Wilson to Executive VP – Chief Administrative Officer, and Austen Helfrich to Executive VP – Chief Financial Officer. We also appointed four new members to the Board of Directors, each with deep industry expertise and a commitment to enhancing performance: Tom Bohjalian (who was appointed Independent Chair of the Board), Dave Henry, Glenn Rufrano, and Don Wood. We are confident that the reenergized team at the helm has set Healthcare Realty on a solid course to build upon its 32-year history as the dominant, pure play medical outpatient REIT. STRONG MARKET FUNDAMENTALS The outpatient medical sector continues to be one of the most durable real estate property types. The aging U.S. population and the ongoing trend toward greater reliance on outpatient settings for healthcare delivery continue to increase demand for well-located medical outpatient building (MOB) space. Between 2023 and 2033, the over-65 population is projected to increase by 23.6%, further accelerating demand. Meanwhile, new MOB development starts have declined steadily since mid-2022 due to ongoing financing constraints, creating further upward pressure on demand for existing space and on achievable lease rates. CONTINUED LEASING MOMENTUM Healthcare Realty is well-positioned to capitalize on the opportunities created by the backdrop of these strong fundamentals. Our industry-leading portfolio of MOBs, coupled with providing best-in- class service to our physician and health system tenants, generated tremendous leasing velocity in 2024. We exceeded our expectations for new leasing activity and occupancy improvement


 
ANNUAL REPORT TO SHAREHOLDERS | 1 across the portfolio. Our leasing team executed a single-year company-record number of new leases last year, totaling nearly two million square feet. Combined with an 83.4% tenant retention rate for the year (up 400 basis points from 2023), this activity resulted in a 149-basis-point multi- tenant occupancy gain for the year, at the top end of our projected range. Our healthy pipeline of signed-not-occupied (SNO) leases represents over 160 basis points of additional embedded occupancy, laying the foundation for this steady upward trajectory to continue in 2025. PORTFOLIO REFINEMENT In 2024, we focused on further refinement of our portfolio, selling 37 non-core properties totaling 1.9 million square feet, generating proceeds of $491 million. Nearly half of the assets we sold were located outside of the nation’s top 50 MSAs. The result is that our portfolio is concentrated in high-growth markets; now, nearly 90% of our portfolio is within the top 50 MSAs. This refinement also improves our opportunity to direct resources toward properties where we can achieve greater operating efficiencies within a cluster of properties in the higher growth markets. We anticipate additional property sales in 2025, aimed at further aligning our portfolio to generate stronger NOI growth over the long term. CAPITAL ALLOCATION Other highlights of 2024 included the launch of our joint venture with KKR and the expansion of our joint venture with Nuveen. These JVs enabled us to monetize largely stabilized assets, providing a significant and cost-effective capital source. In total, we contributed 30 properties totaling 2.2 million square feet to the JVs, generating proceeds of approximately $770 million. We used $510 million of these funds to repurchase 31 million shares of the company’s stock at an average price of $16.56 per share. We also made great strides toward our debt reduction goals by fully repaying a $350 million unsecured term loan that was set to mature in 2025. We ended the year with leverage at 6.4 times net debt to adjusted EBITDA – below the 6.5 times leverage we had forecast. Our focus on operational efficiency has also produced results, reducing controllable operating expenses by 100 basis points. Normalized FFO per share in 2024 was $1.56, at the high end of our revised range. After closing out 2024 with strong performance, Healthcare Realty is well-positioned to meet our high expectations for 2025. With a strengthened capital position, significant scale in high-growth markets, deep health system relationships, and demographic trends supporting increased demand for our industry-leading portfolio, we are excited about the opportunity to build on our success and deliver long-term value to shareholders. Sincerely, Thomas N. Bohjalian Independent Chair of the Board of Directors Constance B. Moore Interim President and CEO


 
ANNUAL REPORT TO SHAREHOLDERS | 2 Company Overview Healthcare Realty is a publicly-traded Real Estate Investment Trust (REIT) that owns and operates outpatient medical facilities throughout the United States. As the first REIT to specialize in medical outpatient buildings, the Company has built a leading medical real estate portfolio affiliated with market-leading healthcare systems. A Differentiated, Secular Growth Strategy $10.8B Enterprise Value 1992 Founded 651 Properties S&P 400 Member BBB/Baa2 S&P/Moody's $4.3B Cumulative Cash Dividends Paid 38M Square Feet Owned HR NYSE Ticker 73% On/Adjacent to Campus Only pure-play public medical outpatient REIT Highly durable and resilient property sector with track record of NOI growth across cycles Strong secular demographic tailwinds driven by aging population Beneficiary of health system strategies to drive outpatient visits and increase market share Best-in-class scale with top health systems Leading leasing performance with additional occupancy upside potential As of December 31, 2024


 
ANNUAL REPORT TO SHAREHOLDERS | 3 TOP MARKETS TOTAL SF % OF NOI 1 Dallas 3,802,883 9.0% 2 Houston 2,241,583 4.5% 3 Denver 1,790,590 4.1% 4 Charlotte 1,702,275 4.9% 5 Los Angeles 1,637,235 3.5% 6 Phoenix 1,613,390 3.3% 7 Seattle 1,592,501 5.9% 8 Indianapolis 1,497,832 2.7% 9 Atlanta 1,380,220 3.8% 10 Nashville 1,350,563 2.8% 11 Raleigh 1,178,954 2.9% 12 Miami 1,033,584 2.8% 13 Tampa 876,079 2.7% 14 Austin 787,454 2.1% 15 Boston 776,106 3.7% Other (50 Markets) 15,183,925 41.30% Total 38,445,174 100.0% Premier Outpatient Medical Platform >1M SF <1M SF Superior scale, growth, and demographics SCALE WITH TOP 100 HEALTH SYSTEMS Ranked by net patient revenue from Modern Healthcare’s financial database EXPOSURE TO TOP 25 MSAs % of GLA HR HR PEER AVG PEER AVG 26M SF 64% 19M SF 56%


 
ANNUAL REPORT TO SHAREHOLDERS | 4 Management Team Constance B. Moore Interim President and Chief Executive Officer Rob Hull Executive Vice President and Chief Operating Officer Ryan Crowley Executive Vice President and Chief Investment Officer Andrew Loope Executive Vice President, General Counsel and Secretary Austen Helfrich Executive Vice President and Chief Financial Officer Julie Wilson Executive Vice President and Chief Administrative Officer


 
ANNUAL REPORT TO SHAREHOLDERS | 5 Board of Directors Constance B. Moore Interim President and Chief Executive Officer, Healthcare Realty Trust James J. Kilroy President and Portfolio Manager, Willis Investment Counsel Nancy H. Agee Chief Executive Officer, Carilion Clinic Jay P. Leupp Managing Partner and Senior Portfolio Manager, Terra Firma Asset Management Peter F. Lyle Executive Vice President, Medical Management Associates Ajay Gupta Chief Executive Officer, Physical Rehabilitation Network Thomas N. Bohjalian Chair of the Board, Retired Executive Vice President, Senior Portfolio Manager and Head of U.S. Real Estate and Trading, Cohen & Steers Glenn J. Rufrano Executive Chairman, PREIT; Retired Chief Executive Officer, VEREIT Christann M. Vasquez Retired Healthcare Executive, Ascension Texas David B. Henry Retired Vice Chairman and CEO, Kimco Realty Donald C. Wood President and Chief Executive Officer, Federal Realty Investment Trust


 
ANNUAL REPORT TO SHAREHOLDERS | 6 DIRECT DEPOSIT OF DIVIDENDS Direct deposit of dividends is offered as a convenience to shareholders of record. For information, write Computershare Investor Services, P.O. Box 43078, Providence, Rhode Island 02940-3078, or call 1.888.801.0107. Information may also be obtained at the transfer agent’s website www.computershare.com. FORM 10-K The Company has filed an Annual Report on Form 10-K for the year ended December 31, 2024, with the Securities and Exchange Commission. Shareholders may obtain a copy of this report, without charge, by writing: Investor Relations, Healthcare Realty Trust Incorporated, 3310 West End Avenue, Suite 700, Nashville, Tennessee 37203. Or, via e-mail: communications@healthcarerealty.com. CERTIFICATIONS The Company’s chief executive officer and chief financial officer have filed the certifications required by Section 302 of the Sarbanes-Oxley Act of 2002 with the Securities and Exchange Commission as exhibits to the Company’s Annual Report on Form 10-K. In addition, the Company’s chief executive officer certified to the New York Stock Exchange in 2024 that he was not aware of any violation by the Company of the New York Stock Exchange’s corporate governance listing standards. ANNUAL SHAREHOLDERS MEETING The annual meeting of shareholders will be held on May 20, 2025, at 10:00 a.m. Central Time at 3310 West End Avenue, Suite 700, Nashville, Tennessee 37203. CORPORATE ADDRESS Healthcare Realty Trust Incorporated 3310 West End Avenue, Suite 700 Nashville, Tennessee 37203 Phone: 615.269.8175 Fax: 615.269.8461 www.healthcarerealty.com communications@healthcarerealty.com INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM BDO USA, P.C. 414 Union Street, Suite 1800 Nashville, Tennessee 37219 TRANSFER AGENT Computershare Investor Services P.O. Box 43078 Providence, Rhode Island 02940-3078 1.888.801.0107 www.computershare.com CUSIP NUMBERS Class A Common Stock: 42226K105 Senior Notes due 2025: 421946AJ3 Senior Notes due 2026: 42225UAD6 Senior Notes due 2027: 42225UAF1 Senior Notes due 2028: 421946AK0 Senior Notes due 2030: 42225UAG9 Senior Notes due 2030: 421946AL8 Senior Notes due 2031: 421946AM6 Senior Notes due 2031: 42225UAH7


 
2024 Form 10-K PART I Item 1 Business 1 Item 1A Risk Factors 7 Item 1B Unresolved Staff Comments 22 Item 1C Cybersecurity 22 Item 2 Properties 23 Item 3 Legal Proceedings 23 Item 4 Mine Safety Disclosures 23 PART II Item 5 Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities 23 Item 6 [Reserved] 25 Item 7 Management’s Discussion and Analysis of Financial Condition and Results of Operations 26 Item 7A Quantitative and Qualitative Disclosures About Market Risk 49 Item 8 Financial Statements and Supplementary Data 50 Item 9 Changes in and Disagreements with Accountants on Accounting and Financial Disclosure 94 Item 9A Controls and Procedures 94 Item 9B Other Information 97 Item 9C Disclosure Regarding Foreign Jurisdictions that Prevent Inspections 97 PART III Item 10 Directors, Executive Officers and Corporate Governance 98 Item 11 Executive Compensation 99 Item 12 Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters 99 Item 13 Certain Relationships and Related Transactions, and Director Independence 99 Item 14 Principal Accountant Fees and Services 100 Item 15 Exhibits and Financial Statement Schedules 100 Item 16 Form 10-K Summary 104 SIGNATURES AND SCHEDULES 104 HEALTHCARE REALTY TRUST


 
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 _______________ Form 10-K (Mark One) ☒ ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the fiscal year ended: December 31, 2024 OR ☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the transition period from             to Commission File Number: 001-35568 HEALTHCARE REALTY TRUST INCORPORATED (Exact name of Registrant as specified in its charter) Maryland 20-4738467 (State or other jurisdiction of Incorporation or organization) (I.R.S. Employer Identification No.) 3310 West End Avenue Suite 700 Nashville, Tennessee 37203 (Address of principal executive offices) (615) 269-8175 (Registrant’s telephone number, including area code) Securities Registered Pursuant to Section 12(b) of the Act: Title of Each Class Trading Symbol Name of Each Exchange on Which Registered Class A Common Stock, $0.01 par value per share HR New York Stock Exchange Securities Registered Pursuant to Section 12(g) of the Act: None (Title of Class) Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes  ☒    No ☐ Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act. Yes ☐    No  ☒ Indicate by check mark whether the Registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes  ☒    No ☐ Indicate by check mark whether the Registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes ☒    No ☐ Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and "emerging growth company" in Rule 12b-2 of the Exchange Act.: Large accelerated filer ☒ Accelerated filer ☐ Non-accelerated filer ☐ Smaller reporting company ☐ Emerging growth company ☐ If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐ Indicate by check mark whether the registrant has filed a report on and attestation to management's assessment of the effectiveness of its internal control over financial reporting under Section 404(b) of the Sarbanes-Oxley Act (15- U.S.C. 7262(b)) by the registered public accounting firm that prepared or issued its audit report.  ☒   If securities are registered pursuant to Section 12(b) of the Act, indicate by check mark whether the financial statements of the registrant included in the filing reflect the correction of an error to previously issued financial statements. ☐ Indicate by check mark whether any of those error corrections are restatements that required a recovery analysis of incentive-based compensation received by any of the Registrant’s executive officers during the relevant recovery period pursuant to §240.10D-1(b). ☐ Indicate by check mark whether the Registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act.) Yes ☐    No ☒ The aggregate market value of the shares of common stock of the Registrant (based upon the closing price of these shares on the New York Stock Exchange on June 30, 2024, held by non-affiliates on June 30, 2024 was $5,955,657,463. As of February 14, 2025, there were 350,820,406 shares of the Registrant’s common stock outstanding. DOCUMENTS INCORPORATED BY REFERENCE Portions of the Registrant’s definitive Proxy Statement relating to the Annual Meeting of Stockholders to be held on May 20, 2025 are incorporated by reference into Part III of this Report.


 
PART I Item 1. Business Healthcare Realty Trust Incorporated is a self-managed and self-administered real estate investment trust (“REIT”) that owns, leases, manages, acquires, finances, develops and redevelops income-producing real estate properties associated primarily with the delivery of outpatient healthcare services throughout the United States. The Company operates so as to qualify as a REIT for federal income tax purposes. As a REIT, the Company is not subject to corporate federal income tax with respect to taxable income distributed to its stockholders. See “Item 1A. Risk Factors” for a discussion of risks associated with qualifying as a REIT. On July 20, 2022, pursuant to that certain Agreement and Plan of Merger dated as of February 28, 2022, by and among Healthcare Realty Trust Incorporated, a Maryland corporation (now known as HRTI, LLC, a Maryland limited liability company) (“Legacy HR”), Healthcare Trust of America, Inc., a Maryland corporation (now known as Healthcare Realty Trust Incorporated) (“Legacy HTA”), Healthcare Trust of America Holdings, LP, a Delaware limited partnership (now known as Healthcare Realty Holdings, L.P.) (the “OP”), and HR Acquisition 2, LLC, a Maryland limited liability company (“Merger Sub”), Merger Sub merged with and into Legacy HR, with Legacy HR continuing as the surviving entity and a wholly-owned subsidiary of Legacy HTA (the “Merger”). The combined company operates under the name “Healthcare Realty Trust Incorporated” and its shares of class A common stock, $0.01 par value per share, trade on the New York Stock Exchange under the ticker symbol “HR”. For purposes of this Annual Report on Form 10-K, references to “Healthcare Realty Trust”, the “Company”, “we”, “us”, and “our” are to Legacy HTA after giving effect to the Merger and, unless the context requires otherwise, to its consolidated subsidiaries, including the OP. Additionally, any references to the “Company” for periods prior to the Merger are to Legacy HR. Real Estate Properties The Company had gross investments of approximately $11.8 billion in 589 consolidated real estate properties, construction in progress, redevelopments, financing receivables, financing lease right-of-use assets, land held for development and corporate property as of December 31, 2024. The Company had a weighted average ownership interest of approximately 31% in 63 real estate properties held in unconsolidated joint ventures as of December 31, 2024. The Company provided leasing and property management services to 92% of its portfolio nationwide as of December 31, 2024. The Company’s real estate property investments by geographic area are detailed in Note 3 to the Consolidated Financial Statements. The following table details the Company's owned properties by facility type as of December 31, 2024:   December 31, 2024 Dollars and square feet in thousands INVESTMENT SQUARE FEET NUMBER OF PROPERTIES OCCUPANCY 1 Medical office/outpatient 2 $ 10,656,096 31,919 565 87.4 % Inpatient 438,074 934 15 95.3 % Office 426,690 1,357 6 97.4 % 11,520,860 34,210 586 88.0 % Construction in progress 31,978 101 1 Land held for development 52,408 Investments in financing receivables, net 3,4 123,671 160 1 100.0 % Financing lease right-of-use assets 4 77,343 45 1 68.5 % Corporate property 4,450 Total real estate investments 11,810,710 34,516 589 88.0 % Unconsolidated joint ventures 5 473,122 4,030 63 89.8 % Total investments $ 12,283,832 38,546 652 88.2 % 1 The occupancy column represents the percentage of total rentable square feet leased (including month-to-month and holdover leases). There were three properties excluded from the table above that were classified as held for sale as of December 31, 2024. 2 Includes two real estate properties held in consolidated joint ventures. 1


 
3 Investments in financing receivables, net includes an investment of $116.3 million in a single-tenant net lease property in San Diego, CA related to a sale- leaseback transaction. 4 Financing lease right-of-use assets includes a multi-tenant lease property in Columbus, OH related to a sale-leaseback transaction totaling $15.6 million, of which $8.2 million was accounted for as an imputed lease arrangement as required under ASC 842, Leases. The remaining $7.4 million was accounted for as a financing arrangement and is included in investments in financing receivables, net. 5 Represents the Company's equity investment in unconsolidated joint ventures. Square feet have not been adjusted by the Company's ownership percentage. Financial Concentrations The Company’s real estate portfolio is leased to a diverse tenant base. For the year ended December 31, 2024, the Company did not have any tenants that accounted for 10% or more of the Company’s consolidated revenues. See Note 3 to the Consolidated Financial Statements for additional information regarding the Company's gross investments by geographic market. Expiring Leases As of December 31, 2024, the weighted average remaining years to expiration pursuant to the Company’s leases was approximately 4.2 years, with expirations through 2052. The table below details the Company’s lease expirations as of December 31, 2024, excluding the Company's unconsolidated joint ventures, financing receivables, assets held for sale and right-of-use assets. EXPIRATION YEAR NUMBER OF LEASES LEASED SQUARE FEET PERCENTAGE OF LEASED SQUARE FEET 2025 (1) 1,418 5,264,353 17.5 % 2026 1,029 3,947,479 13.1 % 2027 1,071 4,553,597 15.1 % 2028 814 3,400,507 11.3 % 2029 804 3,548,010 11.8 % 2030 351 2,213,933 7.4 % 2031 315 1,606,677 5.3 % 2032 290 1,891,102 6.3 % 2033 179 765,997 2.5 % 2034 197 1,109,560 3.7 % Thereafter 197 1,803,299 6.0 % 6,665 30,104,514 100.0 % 1 Includes 109 leases totaling 257,954 square feet that expired prior to December 31, 2024, and were on month-to-month terms. See "Trends and Matters Impacting Operating Results" as part of Management's Discussion and Analysis of Financial Condition and Results of Operations included in Part II, Item 7 of this report for additional information regarding the Company's leases and leasing efforts. Liquidity The Company believes that its liquidity and sources of capital are adequate to satisfy its cash requirements. The Company expects to meet its liquidity needs through cash on hand, cash flows from operations, asset sales and joint venture contributions, equity and debt issuances in the public or private markets and borrowings under commercial credit facilities. Business Strategy The Company owns and operates properties that facilitate the delivery of healthcare services in primarily outpatient settings. To execute its strategy, the Company engages in a broad spectrum of integrated services including leasing, management, acquisition, financing, development and redevelopment of such properties. The Company seeks to generate stable, growing income and lower the long-term risk profile of its portfolio of properties by focusing on facilities primarily located on or near the campuses of acute care hospitals associated with leading health systems. The Company seeks to reduce financial and operational risk by owning properties in high-growth markets with a broad tenant mix that includes over 30 physician specialties, as well as surgery, imaging, cancer, and diagnostic centers. 2


 
2024 Investment Activity In 2024, the Company completed no property acquisitions. In 2024, the Company's investment in unconsolidated joint ventures increased by $172.7 million, as a result of the Company's contribution of medical outpatient properties to two joint ventures in which it holds a 20% interest. The Company disposed of 67 properties in 2024 for sales prices totaling $1.5 billion, including 30 properties contributed into two unconsolidated joint ventures in which the Company maintains a non-controlling interest. These transactions yielded net cash proceeds of $1.2 billion, net of $67.3 million of closing costs and related adjustments and $172.7 million of retained joint venture interests. The weighted average capitalization rate for these sales was 6.6%. The Company calculates the capitalization rate for dispositions as the in-place cash net operating income divided by the sales price. In 2024, the Company funded $150.6 million toward development and redevelopment of properties. See the Company's discussion regarding the 2024 joint venture and disposition activity in Note 5 to the Consolidated Financial Statements and development activity in Note 15 to the Consolidated Financial Statements. Also, please refer to the Company's discussion in "Trends and Matters Impacting Operating Results" as part of Item 7. Management's Discussion and Analysis of Financial Condition and Results of Operations included in Part II of this report. Competition The Company competes for the acquisition and development of real estate properties with private investors, healthcare providers, other REITs, real estate partnerships and financial institutions, among others. The business of acquiring and developing new healthcare facilities is highly competitive and is subject to price, construction and operating costs, and other competitive pressures. Some of the Company's competitors may have lower costs of capital. The financial performance of all of the Company’s properties is subject to competition from similar properties. The extent to which the Company’s properties are utilized depends upon several factors, including the number of physicians using or referring patients to an associated healthcare facility, healthcare employment, competitive systems of healthcare delivery, and the area’s population, size and composition. Private, federal and state health insurance programs and other laws and regulations may also have an effect on the utilization of the properties. Government Regulation The facilities owned by the Company are utilized by medical tenants which are required to comply with extensive regulation and legislation at the federal, state and local levels, including, but not limited to, the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively, the "Affordable Care Act"), the Bipartisan Budget Act of 2015, the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”), and laws intended to combat fraud, waste and abuse such as the Anti-Kickback Statute, Stark Law and False Claims Act, and laws intended to protect the privacy and security of patient information, such as the Health Insurance Portability and Accountability Act of 1996. Medical tenants are subject to state and federal laws and regulations that establish, among other things, requirements for participation in government-sponsored reimbursement programs, including the Medicare and Medicaid programs. The Company's leases generally require the tenant to comply with all applicable laws relating to the tenant's use and occupation of the leased premises. Although lease payments to the Company are not directly affected by these laws and regulations, changes in these programs or the loss by a tenant of its license or ability to participate in government-sponsored reimbursement programs could have a material adverse effect on the tenant's ability to make lease payments to the Company. Government healthcare programs have increased over time as a significant percentage of the U.S. population’s health insurance coverage. The Medicare and Medicaid programs are highly regulated and subject to frequent evaluation and change. Changes from year to year in reimbursement methodology, rates and other regulatory requirements may cause the profitability of providing care to Medicare and Medicaid patients to decline, which could adversely affect tenants' ability to make lease payments to the Company. 3


 
The Centers for Medicare and Medicaid Services continued to adjust Medicare payment rates in 2024 to implement site-neutral payment policies. These changes have lowered Medicare payments for services delivered in off-campus hospital outpatient departments in an effort to lessen reimbursement disparity in off-campus medical office and outpatient facilities. The Company’s medical office buildings that are located on hospital campuses could become more valuable as hospital tenants will keep their higher Medicare rates for on-campus outpatient services. However, the Company has not seen a material impact from site-neutral Medicare payment policy, positively or negatively. The Company cannot predict the amount of benefit or loss from these measures or if other federal health policy will ultimately require cuts to reimbursement rates for services provided in other settings. The Company cannot predict the degree to which these changes, or changes to federal healthcare programs in general, may affect the economic performance of some or all of the Company's tenants, positively or negatively. Since 2018, physicians have been required to report patient data on quality and performance measures that began to affect their Medicare payments in 2020. Implementation of MACRA, and the ongoing debate over the most effective payment system to use to promote value-based reimbursement, along with its budget-neutrality rule that requires any increases in payments to be offset by decreases, present the industry and its individual participants with uncertainty and financial risk. The Company cannot predict the degree to which any such changes may affect the economic performance of the Company's tenants or, indirectly, the Company. Legislative Developments Taxation of Dividends The Tax Cuts and Jobs Act of 2017 (“TCJA”) generally allows a deduction for individuals equal to 20% of certain income from pass-through entities, including ordinary dividends distributed by a REIT (excluding capital gain dividends and qualified dividend income). In addition, the deduction for ordinary REIT dividends is not subject to the wage and tax basis limitations applicable to the deduction for other qualifying pass-through income. The TCJA was a far-reaching and complex revision to the existing U.S. federal income tax laws. Many of the provisions of this act, such as the 20% deduction mentioned above, will expire at the end of 2025, unless extended by legislative action. Healthcare Each year, legislative proposals for health policy are introduced in Congress and state legislatures, and regulatory changes are proposed and enacted by government agencies. These proposals, individually or in the aggregate, could significantly change the delivery of healthcare services and limit the ability of the Company and other REITs to own and lease certain healthcare facilities, either nationally or at the state level, if implemented. Examples of significant legislation or regulatory action recently proposed, enacted, or in the process of implementation include: • federal legislative proposals that would prohibit payments from federal healthcare programs to healthcare providers that sell assets to REITs or use assets as collateral for loans from REITs; • state legislation and legislative proposals that (i) prohibit licensure of certain healthcare facilities leased from REITs, (ii) require additional government oversight and approval of healthcare provider transactions involving a change in control or sales of assets, including real estate, and (iii) impose public reporting requirements on ownership and control of healthcare provider entities; • the expansion or reduction of, or the decision in some states not to expand, Medicaid benefits and health insurance exchange subsidies established by the Affordable Care Act, whereby individuals and small businesses purchase health insurance with assistance from federal subsidies; • various state legislature proposals for state-funded single-payer health insurance and a limit on allowable rates of reimbursement to healthcare providers; • the implementation of quality control, cost containment, and value-based payment system reforms for Medicaid and Medicare, such as expansion of pay-for-performance criteria, bundled provider payments, accountable care organizations, comparative effectiveness research, and lower payments for hospital readmissions; • ongoing evaluation of and transition toward value-based reimbursement models for Medicare payments to physicians as designated under MACRA; 4


 
• annual regulatory updates to Medicare policy for healthcare providers that can broadly change reimbursement methodology under budget-neutral guidelines, with the effect of lowering payments for some services and increasing payments for others, having a varying impact, positively or negatively, on providers; • ongoing efforts to equalize Medicare payment rates across different facility-type settings, according to Section 603 of the Bipartisan Budget Act of 2015, which lowered Medicare payment rates, effective January 1, 2017, for services provided in off-campus, provider-based outpatient departments to the same level of rates for physician office settings; • the continued adoption by providers of federal standards for the Medicare Promoting Interoperability Program; • reforms to the physician self-referral laws, commonly referred to as the Stark Law, as adjusted in 2020 in order to promote the transition toward value-based, coordinated care among providers, although clear intent to boost referrals could still yield provider penalties; • consideration of broad reforms to Medicare and Medicaid impacting eligibility and reimbursement; • more stringent regulatory criteria by which federal antitrust agencies evaluate the potential for anti- competitive practices as a result of mergers and acquisitions of health systems and physicians; • state and federal regulations requiring increased scrutiny of healthcare-related transactions, particularly those involving REITs and private equity firms; • regulations requiring the publication of hospital prices for certain services, as well as hospitals’ negotiated rates with insurers for these services; • limits on price increases in pharmaceutical drugs and the cost to Medicare beneficiaries, including the potential for setting prices according to an international standard; and • the prohibition of “surprise billing,” or high payment rates charged to consumers for out-of-network physician services. The Company cannot predict whether any proposals, rulings, or legislation will be fully implemented, adopted, repealed, or amended, or what effect, whether positive or negative, such developments might have on the Company's business. Such proposals, rulings, or legislation could have a material adverse effect on the Company's business and results of operations. Environmental Matters Under various federal, state and local environmental laws, ordinances and regulations, an owner of real property (such as the Company) may be liable for the costs of removal or remediation of certain hazardous or toxic substances at, under, or disposed of in connection with such property, as well as certain other potential costs (including government fines and injuries to persons and adjacent property) relating to hazardous or toxic substances. Most, if not all, of these laws, ordinances and regulations contain stringent enforcement provisions including, but not limited to, the authority to impose substantial administrative, civil, and criminal fines and penalties upon violators. Such laws often impose liability without regard to whether the owner knew of, or was responsible for, the presence or disposal of such substances, and liability may be imposed on the owner in connection with the activities of a tenant or operator of the property. The cost of any required remediation, removal, fines or personal or property damages and the owner’s liability therefore could exceed the value of the property and/or the aggregate assets of the owner. In addition, the presence of such substances, or the failure to properly dispose of or remediate such substances, may adversely affect the owner’s ability to sell or lease such property or to borrow using such property as collateral. A property can also be negatively impacted either through physical contamination, or by virtue of an adverse effect on value, from contamination that has or may have emanated from other properties. Operations of the properties owned, developed or managed by the Company are and will continue to be subject to numerous federal, state, and local environmental laws, ordinances and regulations, including those relating to the following: the generation, segregation, handling, packaging and disposal of medical wastes; air quality requirements related to operations of generators, incineration devices, or sterilization equipment; facility siting and construction; 5


 
disposal of non-medical wastes and ash from incinerators; and underground storage tanks. Certain properties owned, developed or managed by the Company contain, and others may contain or at one time may have contained, underground storage tanks that are or were used to store waste oils, petroleum products or other hazardous substances. Such underground storage tanks can be the source of releases of hazardous or toxic materials. Operations of nuclear medicine departments at some properties also involve the use and handling, and subsequent disposal of, radioactive isotopes and similar materials, activities which are closely regulated by the Nuclear Regulatory Commission and state regulatory agencies. In addition, several of the Company's properties were built during the period that asbestos was commonly used in building construction and other such facilities may be acquired by the Company in the future. The presence of such materials could result in significant costs in the event that any asbestos- containing materials requiring immediate removal and/or encapsulation are located in or on any facilities or in the event of any future renovation activities. The Company has had environmental site assessments conducted on substantially all of the properties that it currently owns. These site assessments are limited in scope and provide only an evaluation of potential environmental conditions associated with the property, not compliance assessments of ongoing operations. While it is the Company’s policy to seek indemnification from tenants relating to environmental liabilities or conditions, even where leases do contain such provisions, there can be no assurance that the tenant will be able to fulfill its indemnification obligations. In addition, the terms of the Company’s leases do not give the Company control over the operational activities of its tenants or healthcare operators, nor will the Company monitor the tenants or healthcare operators with respect to environmental matters. Human Capital Resources We believe our employees are a critical component to the achievement of our business objectives and recognition as a trusted owner and operator of medical office properties. As of December 31, 2024, the Company employed 550 people. Our employees are comprised of accountants, maintenance engineers, property managers, leasing personnel, architects, administrative staff, an investments team, and the corporate management team. By supporting, recognizing, and investing in our employees, we believe that we are able to attract and retain the highest quality talent. We are committed to fostering, cultivating, and preserving a culture of diversity and inclusion. We embrace employee differences in race, color, religion, sex, sexual orientation, national origin, age, disability, veteran status, and other characteristics that make our employees unique. To retain talented employees who contribute to the Company’s strategic objectives, we offer an attractive set of employee benefits, including: • Health benefits and 401(k) eligibility starting on the first day of employment; • Dollar-for-dollar match on 401(k) contributions up to $2,800, encouraging higher employee savings; • 100% of long-term disability and life insurance premiums paid; and • Tuition reimbursement up to $3,000 annually for any employee pursuing higher education. Additional information regarding employee and community engagement is available in the 2024 Corporate Responsibility Report, which is posted on the Company's website (www.healthcarerealty.com). Environment, Social, and Governance (“ESG”) Our goal is to create long-term value for all stakeholders, including our employees and investors who expect responsible financial and environmental stewardship, and for our healthcare system partners who rely on the Company to provide well-operated facilities that allow them to effectively serve and care for their local communities. We seek to help healthcare professionals deliver the best care by providing the highest level of service in the most desirable outpatient settings. Our ESG objectives include full integration of our sustainability strategy, improved transparency and reporting, enhanced operational frameworks, and continued stakeholder engagement. As we implement our strategy and pursue our objectives, the Company’s actions are guided by our Sustainability Principles and Policies, to ensure continuous improvement and long-term success. Our Sustainability Principles and Policies include: 6


 
a. Integration: Embed and integrate leading environmental, social and governance practices designed to enhance portfolio performance into the Company’s daily operations. b. Impact: Drive positive impact across the Company while mitigating risk and creating long-term value for stakeholders, including our tenants, investors, employees, and the communities in which we live, work and invest. c. Integrity: Conduct business with integrity, respect and excellence, earning the right to be a preferred provider of outpatient medical properties. The Company’s Board of Directors is committed to overseeing the integration of our ESG principles throughout the Company. In addition, the Company's incentive program for named executive officers includes ESG performance measures. To more effectively track and communicate the Company’s ESG performance, we have adopted various frameworks and methodologies, including participation in the annual GRESB Assessment; reporting disclosures in alignment with the Sustainability Accounting Standards Board; establishing goals and key performance indicators under the Sustainable Development Goals, and we are working toward expanding our climate risk and resiliency strategies in alignment with the Task Force on Climate-Related Disclosure. More information regarding the Company’s Sustainability Principles and Policies and ESG performance can be found in the Company’s 2024 Corporate Responsibility Report on its website (www.healthcarerealty.com). Available Information The Company makes available to the public free of charge through its website the Company’s Proxy Statement, Annual Report on Form 10-K, Quarterly Reports on Form 10-Q, Current Reports on Form 8-K, and amendments to those reports filed or furnished pursuant to Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), as soon as reasonably practicable after the Company electronically files such reports with, or furnishes such reports to, the Securities and Exchange Commission ("SEC"). The Company’s website address is www.healthcarerealty.com. Corporate Governance Principles The Company has adopted Corporate Governance Principles relating to the conduct and operations of the Board of Directors. The Corporate Governance Principles are posted on the Company’s website (www.healthcarerealty.com) and are available in print to any stockholder who requests a copy. Committee Charters The Board of Directors has an Audit Committee, Compensation and Human Capital Committee, and Nominating and Corporate Governance Committee. The Board of Directors has adopted written charters for each committee, which are posted on the Company’s website (www.healthcarerealty.com) and are available in print to any stockholder who requests a copy. Executive Officers Information regarding the executive officers of the Company is set forth in Part III, Item 10 of this report and is incorporated herein by reference. Item 1A. Risk Factors The following are some of the risks and uncertainties that could negatively affect the Company’s consolidated financial condition, results of operations, business and prospects. These risk factors are grouped into three categories: risks relating to the Company’s business and operations; risks relating to the Company’s capital structure and financings; and risks relating to government regulations. These risks, as well as the risks described in Item 1 under the headings “Competition,” “Government Regulation,” “Legislative Developments,” and “Environmental Matters,” and in Item 7 under the heading “Disclosure Regarding Forward-Looking Statements,” should be carefully considered before making an investment decision regarding the 7


 
Company. The risks and uncertainties described in Item 1 and below are not the only ones facing the Company, and there may be additional risks that the Company does not presently know of or that the Company currently considers not likely to have a material impact. If any of the events underlying the following risks actually occurred, the Company’s business, consolidated financial condition, operating results and cash flows, including distributions to the Company's stockholders, could suffer, and the trading price of its common stock could decline. Risks relating to our business and operations The Company's expected results may not be achieved. The Company's expected results may not be achieved, and actual results may differ materially from expectations. This may be the result of various factors, including, but not limited to: changes in the economy; the availability and cost of capital at favorable rates; increases in property taxes, utilities and other operating expenses; changes to facility-related healthcare regulations; changes in interest rates; competition for quality assets; negative developments in the operating results or financial condition of the Company's tenants, including, but not limited to, their ability to pay rent; the Company's ability to reposition or sell facilities with profitable results; the Company's ability to re-lease space at similar rates as vacancies occur; the Company's ability to timely reinvest proceeds from the sale of assets at similar yields; government regulations affecting tenants' Medicare and Medicaid reimbursement rates and operational requirements; unanticipated difficulties and/or expenditures relating to future acquisitions and developments; changes in rules or practices governing the Company's financial reporting; and other financial, legal and operational matters. The Company may from time to time decide to sell properties and may be required under purchase options to sell certain properties. The Company may not be able to reinvest the proceeds from sales at rates of return equal to the return received on the properties sold. Uncertain market conditions could result in the Company selling properties at unfavorable prices or at losses in the future. The Company’s revenues depend on the ability of its tenants under its leases to generate sufficient income from their operations to make rental payments to the Company. The Company’s revenues are subject to the financial strength of its tenants and associated health systems. The Company has no operational control over the business of these tenants and associated health systems who face a wide range of economic, competitive, government reimbursement and regulatory pressures and constraints, including the loss of licensure or certification. Any slowdown in the economy, decline in the availability of financing from the capital markets, and changes in healthcare regulations may adversely affect the businesses of the Company’s tenants to varying degrees. Such conditions may further impact such tenants’ abilities to meet their obligations to the Company and, in certain cases, could lead to restructurings, disruptions, or bankruptcies of such tenants. The Company leases to government tenants from time to time that may be subject to annual budget appropriations. If a government tenant fails to receive its annual budget appropriation, it might not be able to make its lease payments to the Company. In addition, defaults under leases with federal government tenants are governed by federal statute and not by state eviction or rent deficiency laws. These conditions could adversely affect the Company’s revenues and could increase allowances for losses and result in impairment charges, which could decrease net income attributable to common stockholders and equity and reduce cash flows from operations. The Company's results of operations have been and will continue to be impacted negatively by the Steward Health and Prospect Medical bankruptcies. As previously disclosed, on May 6, 2024, Steward Health announced that it had filed petitions for relief under Chapter 11 of the U.S. Bankruptcy Code in the U.S. Bankruptcy Court for the Southern District of Texas. Prior to the bankruptcy filing, Steward leased approximately 593,000 square feet of space from the Company, accounting for approximately 2.0% of the Company’s rental revenue. Leases for six buildings in Massachusetts totaling approximately 244,000 square feet were assumed in connection with the sale of Steward’s Massachusetts hospitals on or about September 30, 2024. In October 2024, the Company received $2.2 million for prior rent owed under these assumed leases. Leases for approximately 349,000 square feet in buildings in Florida and Massachusetts were rejected by Steward. The total annual revenue associated with the rejected leases was approximately $13.0 million. 8


 
The Company will pursue claims for outstanding rent of approximately $2.3 million against Steward in the bankruptcy court. However, there can be no assurance that the Company will recover unpaid rent from Steward be able to timely relet space related to rejected leases at similar rental rates, or otherwise offset lost revenue from Steward Health. On January 11, 2025, Prospect Medical Holdings filed petitions for relief under Chapter 11 of the U.S. Bankruptcy Code in the U.S. Bankruptcy Court for the Northern District of Texas. Prospect leases approximately 80,912 square feet of space from the Company, accounting for approximately $2.9 million of annual rental revenue. The Company moved to cash basis accounting for these leases and recorded a revenue reduction of $0.7 million in the fourth quarter. There can be no assurance that the Company will recover unpaid rent from Prospect or be able to timely relet space related to any rejected leases. Owning real estate and indirect interests in real estate is subject to inherent risks. The Company’s operating performance and the value of its real estate assets are subject to the risk that if its properties do not generate revenues sufficient to meet its operating expenses, including debt service, the Company’s cash flow and ability to pay dividends to stockholders will be adversely affected. The Company may incur impairment charges on its real estate properties or other assets. The Company performs an impairment review on its real estate properties every year. In addition, the Company assesses the potential for impairment of identifiable intangible assets and long-lived assets, including real estate properties and goodwill, whenever events occur or a change in circumstances indicates that the recorded value might not be fully recoverable. The decision to sell a property also requires the Company to assess the potential for impairment. The Company incurred impairment charges of $249.9 million in 2024, associated with completed or planned disposition activity. Additionally, the Company recorded a goodwill impairment of $250.5 million in 2024. The Company may determine in future periods that an impairment has occurred in the value of one or more of its real estate properties or other assets. In such an event, the Company may be required to recognize an impairment which could have a material adverse effect on the Company’s consolidated financial condition and results of operations. The Company has properties subject to purchase options that expose it to reinvestment risk and reduction in expected investment returns. The Company had approximately $111.4 million, or 0.94%, of real estate property investments that were subject to purchase options held by lessees that were exercisable as of December 31, 2024. Other properties have purchase options that will become exercisable after 2024. Properties with purchase options exercisable in 2024 produced aggregate net operating income of approximately $10.6 million in 2024. The exercise of these purchase options exposes the Company to reinvestment risk and a reduction in investment return. Certain properties subject to purchase options may be purchased at rates of return above the rates of return the Company expects to achieve with new investments. If the Company is unable to reinvest the sale proceeds at rates of return equal to the return received on the properties that are sold, it may experience a decline in lease revenues and profitability and a corresponding material adverse effect on the Company’s consolidated financial condition and results of operations. For more specific information concerning the Company’s purchase options, see “Purchase Options” in the “Trends and Matters Impacting Operating Results” as a part of Item 7. Management's Discussion and Analysis of Financial Condition and Results of Operations included in Part II of this report. If the Company is unable to promptly re-let its properties, if the rates upon such re-letting are significantly lower than the previous rates or if the Company is required to undertake significant expenditures or make significant leasing concessions to attract new tenants, then the Company’s business, consolidated financial condition and results of operations would be adversely affected. A portion of the Company’s leases will expire over the course of any year. For more specific information concerning the Company’s expiring leases, see "Expiring Leases" in Item 1 and in the "Trends and Matters Impacting Operating Results" as part of Item 7. Management's Discussion and Analysis of Financial Condition and Results of Operations included in Part II of this report. The Company may not be able to re-let space on terms that are favorable to the Company or at all. Further, the Company may be required to make significant capital expenditures to renovate or reconfigure space or make significant leasing concessions to attract new tenants. 9


 
Certain of the Company’s properties are special purpose healthcare facilities and may not be easily adaptable to other uses. Some of the Company’s properties are specialized medical facilities. If the Company or the Company’s tenants terminate the leases for these properties or the Company’s tenants lose their regulatory authority to operate such properties, the Company may not be able to locate suitable replacement tenants to lease the properties for their specialized uses. Alternatively, the Company may be required to spend substantial amounts to adapt the properties to other uses. Any loss of revenues and/or additional capital expenditures occurring as a result may have a material adverse effect on the Company’s consolidated financial condition and results of operations. The Company has, and in the future may have more, exposure to fixed rent escalators, which could lag behind inflation and the growth in operating expenses such as real estate taxes, utilities, insurance, and maintenance expense. The Company receives a significant portion of its revenues by leasing assets subject to fixed rent escalations. Approximately 96% of leases have increases that are based upon fixed percentages and approximately 4% of leases have increases based on the Consumer Price Index ("CPI"). To the extent fixed percentage increases lag behind inflation and operating expense growth, the Company's performance, growth, and profitability would be negatively impacted. As of December 31, 2024, the Company had weighted average annual fixed rent escalators of 2.82% with its wholly-owned and consolidated properties. The Company’s real estate investments are illiquid and the Company may not be able to sell properties strategically targeted for disposition. Because real estate investments are relatively illiquid, the Company’s ability to adjust its portfolio promptly in response to economic or other conditions is limited. Certain significant expenditures generally do not change in response to economic or other conditions, including debt service (if any), real estate taxes, and operating and maintenance costs. This combination of variable revenue and relatively fixed expenditures may result in reduced earnings and could have an adverse effect on the Company’s financial condition. In addition, the Company may not be able to sell properties targeted for disposition, including properties held for sale, due to adverse market conditions. This may negatively affect, among other things, the Company’s ability to sell properties on favorable terms, execute its operating strategy, repay debt, or pay dividends. The Company is subject to risks associated with the development and redevelopment of properties. The Company expects development and redevelopment of properties will continue to be a key component of its growth plans. The Company is subject to certain risks associated with the development and redevelopment of properties including the following: • The construction of properties generally requires various government and other approvals that may not be received when expected, or at all, which could delay or preclude commencement of construction; • The development, construction or expansion of healthcare facilities in certain states may require a certificate of need approval prior to commencing such projects or allowing tenants to occupy and operate on the property; • Opportunities that the Company pursued but later abandoned could result in the expensing of pursuit costs, which could impact the Company’s consolidated results of operations; • Construction costs could exceed original estimates, which could impact the building’s profitability to the Company; • Operating expenses could be higher than forecasted; • Time required to initiate and complete the construction of a property and to lease up a completed property may be greater than originally anticipated, thereby adversely affecting the Company’s cash flow and liquidity; • Occupancy rates and rents of a completed development or redevelopment property may not be sufficient to make the property profitable to the Company; and • Favorable capital sources to fund the Company’s development and redevelopment activities may not be available when needed. 10


 
The Company may make material acquisitions and undertake developments and redevelopments that may involve the expenditure of significant funds and may not perform in accordance with management’s expectations. The Company regularly pursues potential transactions to acquire, develop or redevelop real estate assets. Future acquisitions could require the Company to issue equity securities, incur debt or other contingent liabilities or amortize expenses related to other intangible assets, any of which could adversely impact the Company’s consolidated financial condition or results of operations. In addition, equity or debt financing required for such acquisitions may not be available at favorable times or rates. The Company’s acquired, developed, redeveloped and existing real estate properties may not perform in accordance with management’s expectations because of many factors including the following: • The Company’s purchase price for acquired facilities may be based upon a series of market or building-specific judgments which may be incorrect; • The costs of any maintenance or improvements for properties might exceed estimated costs; • The Company may incur unexpected costs in the acquisition, construction or maintenance of real estate assets that could impact its expected returns on such assets; and • Leasing may not occur at all, within expected time frames or at expected rental rates. Further, the Company can give no assurance that acquisition, development and redevelopment opportunities that meet management’s investment criteria will be available when needed or anticipated. The Company is exposed to risks associated with geographic concentration. As of December 31, 2024, the Company had investment concentrations of greater than 5% of its total investments in the Dallas, TX (8.5%), Houston, TX (5.4%), and Seattle, WA (5.2%) markets. These concentrations increase the exposure to adverse conditions that might affect these markets, including natural disasters, local economic conditions, local real estate market conditions, increased competition, state and local regulation (including property taxes) and other localized events or conditions. Many of the Company’s leases are dependent on the viability of associated health systems. Revenue concentrations relating to these leases expose the Company to risks related to the financial condition of the associated health systems. Most of the Company’s properties on or adjacent to hospital campuses are largely dependent on the viability of the health system’s campus where they are located, whether or not the hospital or health system is a tenant in such properties. The viability of these health systems depends on factors such as the quality and mix of healthcare services provided, competition, payor mix, demographic trends in the surrounding community, market position and growth potential. If one of these hospitals is unable to meet its financial obligations, is unable to compete successfully, or is forced to close or relocate, the Company’s properties on or near such hospital campus could be adversely impacted. Many of the Company’s properties are held under ground leases. These ground leases contain provisions that may limit the Company’s ability to lease, sell, or finance these properties. As of December 31, 2024, the Company had 215 properties that were held under ground leases, representing an aggregate gross investment of approximately $5.0 billion. The weighted average remaining term of the Company's ground leases is approximately 63.6 years, including renewal options. The Company’s ground lease agreements with hospitals and health systems typically contain restrictions that limit building occupancy to physicians on the medical staff of an affiliated hospital and prohibit tenants from providing services that compete with the services provided by the affiliated hospital. Ground leases may also contain consent requirements or other restrictions on sale or assignment of the Company’s leasehold interest, including rights of first offer and first refusal in favor of the lessor. These ground lease provisions may limit the Company’s ability to lease, sell, or obtain mortgage financing secured by such properties which, in turn, could adversely affect the income from operations or the proceeds received from a sale. As a ground lessee, the Company is also exposed to the risk of reversion of the property upon expiration of the ground lease term, or an earlier breach by the Company of the ground lease, which may have a material adverse effect on the Company’s consolidated financial condition and results of operations. 11


 
The Company may experience uninsured or underinsured losses. The Company carries comprehensive liability insurance and property insurance covering its owned and managed properties. A portion of the property insurance is provided by a wholly-owned captive insurance company. In addition, tenants under single-tenant leases are required to carry property insurance covering the Company’s interest in the buildings. Some types of losses may be uninsurable or too expensive to insure against. Insurance companies, including the captive insurance company, limit or exclude coverage against certain types of losses, such as losses due to named windstorms, terrorist acts, earthquakes, toxic mold, and losses without direct physical loss, such as business interruptions occurring from pandemics. Accordingly, the Company may not have sufficient insurance coverage against certain types of losses and may experience decreases in the insurance coverage available. Should an uninsured loss or a loss in excess of insured limits occur, the Company could lose all or a portion of the capital it has invested in a property, as well as the anticipated future revenue from the property. In such an event, the Company might remain obligated for any mortgage debt or other financial obligation related to the property. Further, if any of the Company's insurance carriers were to become insolvent, the Company would be forced to replace the existing coverage with another suitable carrier, and any outstanding claims would be at risk for collection. In such an event, the Company cannot be certain that the Company would be able to replace the coverage at similar or otherwise favorable terms. The Company has obtained title insurance policies for each of its properties, typically in an amount equal to its purchase price. However, the coverage provided by this insurance may be for amounts less than the current or future values of our properties. In such an event, if there is a title defect relating to any of the Company's properties, it could lose some of the capital invested in and anticipated profits from such property. The Company cannot give assurance that material losses in excess of insurance proceeds will not occur in the future. Damage from catastrophic weather and other natural events, whether caused by climate change or otherwise, could result in losses to the Company. Many of our properties are located in areas susceptible to revenue loss, cost increase, or damage caused by severe weather conditions or natural disasters such as wildfires, hurricanes, earthquakes, tornadoes and floods. The Company could experience losses to the extent that such damages exceed insurance coverage, cause an increase in insurance premiums, and/or a decrease in demand for properties located in such areas. In the event that climate change causes such catastrophic weather or other natural events to increase broadly or in localized areas, such costs and damages could increase above historic expectations. In addition, changes in federal and state legislation and regulation on climate change could result in increased capital expenditures to improve energy efficiency of our existing properties and could require the Company to spend more on development and redevelopment properties without a corresponding increase in revenue. 12


 
The Company faces risks associated with security breaches through cyber attacks, cyber intrusions, or otherwise, as well as other significant disruptions of its information technology networks and related systems. The Company faces risks associated with security breaches, whether through cyber attacks or cyber intrusions over the Internet, malware, computer viruses, attachments to emails, persons inside the Company, or persons with access to systems inside the Company, and other significant disruptions of the Company's information technology ("IT") networks and related systems. The risk of a security breach or disruption, particularly through cyber attack or cyber intrusion, including by computer hackers, foreign governments and cyber terrorists, has generally increased as the number, intensity, and sophistication of attempted attacks and intrusions from around the world have increased. The Company's IT networks and related systems are essential to the operation of its business and its ability to perform day-to-day operations (including managing building systems) and, in some cases, may be critical to the operations of certain of our tenants. Although the Company makes efforts to maintain the security and integrity of these types of IT networks and related systems, it has experienced breaches. While breaches to date have not had a material impact, and we have implemented various measures to manage the risk of a security breach or disruption, there can be no assurance that these security measures will be effective or that future attempted security breaches or disruptions would not be successful or damaging. A security breach or other significant disruption involving the Company's IT network and related systems could: • disrupt the proper functioning of the Company's networks and systems and therefore the Company's operations and/or those of certain tenants; • result in misstated financial reports, violations of loan covenants, missed reporting deadlines, and/or missed permitting deadlines; • result in the Company's inability to properly monitor its compliance with the rules and regulations regarding the Company's qualification as a REIT; • result in loss, theft, or misappropriation of Company funds, or funds held by tenants or other parties; • result in the unauthorized access to, and destruction, loss, theft, misappropriation or release of proprietary, confidential, sensitive, or otherwise valuable information of the Company or others, which others could use to compete against the Company or which could expose it to damage claims by third parties for disruption, destructive, or otherwise harmful purposes or outcomes; • result in the Company's inability to maintain the building systems relied upon by its tenants for the efficient use of their leased space; • require significant management attention and resources to remedy any damages that result; • subject the Company to claims for breach of contract, damages, credits, penalties, or termination of leases or other agreements; or • damage the Company's reputation among its tenants and investors generally. Although the Company carries cyber risk insurance, losses could exceed insurance coverage available and any or all of the foregoing could have a material adverse effect on the Company's consolidated financial condition and results of operations. The Company has structured and may in the future structure acquisitions of property in exchange for limited partnership units of the OP on terms that could limit its liquidity or flexibility. The Company has acquired and may in the future acquire properties by issuing limited partnership units of the OP in exchange for a property owner contributing property to the Company. If the Company continues to enter into such transactions in order to induce the contributors of such properties to accept units of the OP rather than cash in exchange for their properties, it may be necessary for the Company to provide additional incentives. For instance, the OP's limited partnership agreement provides that any holder of units may exchange limited partnership units on a one-for-one basis for shares of common stock or, at the Company's option, cash equal to the value of an equivalent number of shares of the Company's common stock. The Company may, however, enter into additional contractual arrangements with contributors of property under which it would agree to repurchase a contributor’s units for shares of the Company's common stock or cash, at the option of the contributor, at set times. If the contributor required the Company to repurchase units for cash pursuant to such a provision, it would limit the Company's liquidity and, thus, 13


 
its ability to use cash to make other investments, satisfy other obligations or make distributions to stockholders. Moreover, if the Company were required to repurchase units for cash at a time when it did not have sufficient cash to fund the repurchase, the Company might be required to sell one or more of its properties to raise funds to satisfy this obligation. Furthermore, the Company might agree that if distributions the contributor received as a limited partner in the OP did not provide the contributor with an established return level, then upon redemption of the contributor’s units the Company would pay the contributor an additional amount necessary to achieve that return. Such a provision could further negatively impact our liquidity and flexibility. Finally, in order to allow a contributor of a property to defer taxable gain on the contribution of property to the OP, the Company might agree not to sell a contributed property for a defined period of time or until the contributor exchanged the contributor’s units for cash or shares. Such an agreement would prevent the Company from selling those properties, or require the Company to indemnify the contributor for taxes if the Company did sell the properties. Healthcare Realty Trust is a holding company with no direct operations and, as such, it relies on funds received from the OP to pay liabilities, and the interests of its stockholders will be structurally subordinated to all liabilities and obligations of the OP and its subsidiaries. Substantially all of Healthcare Realty Trust's assets are held through the OP, which holds substantially all of its assets through subsidiaries. Healthcare Realty Trust does not have, apart from its interest in the OP, any independent operations. Substantially all of Healthcare Realty Trust's cash flow is dependent upon cash distributions from the OP. As a result, Healthcare Realty Trust relies on distributions from the OP to pay any dividends that may be declared on its shares of Class A common stock. Healthcare Realty Trust also relies on distributions from the OP to meet its other obligations, including any tax liability on taxable income allocated to it from the OP. In addition, because Healthcare Realty Trust is a holding company, stockholder claims will be structurally subordinated to all existing and future liabilities and obligations (whether or not for borrowed money) of the OP and its subsidiaries. In the event of a bankruptcy, liquidation, or reorganization of Healthcare Realty Trust, its assets and those of the OP and its subsidiaries will be available to satisfy the claims of stockholders only after all of Healthcare Realty Trust's and the OP’s and its subsidiaries’ liabilities and obligations have been paid in full. The Company cannot assure you that it will be able to continue paying dividends at or above the rates previously paid. The stockholders of the Company may not receive dividends at the same rate they received previously for various reasons, including the following: (i) the Company may not have enough cash to pay such dividends due to changes in the Company's cash requirements, capital spending plans, cash flow or financial position; (ii) decisions on whether, when and in what amounts to make any future distributions will remain at all times entirely at the discretion of the Board of Directors, which reserves the right to change the Company's current dividend practices at any time and for any reason; (iii) reduction of outstanding indebtedness; and (iv) the amount of dividends that the Company's subsidiaries may distribute to the Company may be subject to restrictions imposed by state law, restrictions that may be imposed by state regulators, and restrictions imposed by the terms of any current or future indebtedness that these subsidiaries may incur. Stockholders of the Company do not have a contractual or other legal right to dividends that have not been authorized by the Board of Directors. Pandemics, and measures intended to prevent their spread or mitigate their severity could have a material adverse effect on the Company's business, results of operations, cash flows and financial condition. Pandemics can have repercussions across regional and global economies and financial markets. For example, during the COVID-19 pandemic, all of the states and cities in which the Company owns properties, manages properties, and/ or has development or redevelopment projects instituted quarantines, restrictions on travel, “shelter in place” rules, restrictions on the types of businesses that may continue to operate, and/or restrictions on the types of construction projects that may continue. As a result, a number of the Company's tenants temporarily closed their offices or clinical space or operated on a reduced basis in response to government requirements or recommendations. Pandemics can cause and have caused severe economic, market and other disruptions worldwide. There can be no assurance that a similar situation in the future would not affect the Company's access to capital and other sources of funding, which could adversely affect the availability and terms of future borrowings, renewals or refinancings. In addition, the deterioration of economic conditions, including supply chain constraints, that could result from another 14


 
pandemic may ultimately decrease occupancy levels and average rent per square foot across the Company's portfolio as tenants reduce or defer their spending. The effect of any new variants of existing viruses or of another pandemic in the future on the Company's operational and financial performance will depend on future developments, including the duration, spread and intensity of the outbreak, the availability and effectiveness of vaccines, and the effect of government requirements or recommendations, all of which are uncertain and difficult to predict. The Company's success depends, in part, on its ability to attract and retain talented employees. The loss of any one of the Company's key personnel or the inability to maintain appropriate staffing could adversely impact the Company's business. The success of the Company's business depends, in part, on the leadership and performance of its executive and senior management team and key employees and the ability to maintain appropriate staffing levels across the Company. Failure to attract, retain and motivate highly qualified employees, or failure to develop and implement a viable succession plan, could result in loss of institutional knowledge or important skill sets. Further, an ineffective culture could significantly impact the Company's performance and adversely affect its business. Rising labor costs, increased competition for talent, and a tight labor market may make it difficult for the Company to hire skilled and unskilled employees to meet staffing needs. The Company's former Chief Executive Officer departed the Company in the second half of 2024. The Company's board of directors is currently conducting a search for a chief executive officer. While the board is actively engaged in the process and is utilizing a reputable national search firm, there can be no assurances as to the timing of the appointment of a CEO. Uncertainty concerning the appointment of a CEO could affect the Company's stock performance and its ability to attract, retain, and motivate key personnel needed to execute operational priorities. Risks relating to our capital structure and financings The Company has incurred significant debt obligations and may incur additional debt and increase leverage in the future. As of December 31, 2024, the Company had approximately $4.9 billion of outstanding indebtedness excluding discounts, premiums and debt issuance costs. Covenants under the Fourth Amended and Restated Revolving Credit and Term Loan Agreement dated as of July 20, 2022, among Healthcare Realty Trust, the OP, and Wells Fargo Bank, National Association, as Administrative Agent, and the other lenders that are party thereto, as amended ("Unsecured Credit Facility"), and the indentures governing the OP's senior notes permit the Company to incur substantial, additional debt, and the Company may borrow additional funds, which may include secured borrowings or additional instances of notes by the OP that are fully guaranteed by Healthcare Realty Trust. The Company has approximately $1.5 billion of combined debt maturities in 2025 and 2026. A high level of indebtedness would require the Company to dedicate a substantial portion of its cash flows from operations to service debt, thereby reducing the funds available to implement the Company's business strategy and to make distributions to stockholders. A high level of indebtedness could also: • limit the Company’s ability to adjust rapidly to changing market conditions in the event of a downturn in general economic conditions or in the real estate and/or healthcare industries; • impair the Company’s ability to obtain additional debt financing or require potentially dilutive equity to fund obligations and carry out its business strategy; and • result in a downgrade of the rating of the Company’s debt securities by one or more rating agencies, which would increase the costs of borrowing under the Unsecured Credit Facility and the cost of issuance of new debt securities, among other things. In addition, from time to time, the Company secures mortgage financing or assumes mortgages to partially fund its investments. If the Company is unable to meet its mortgage payments, then the encumbered properties could be foreclosed upon or transferred to the mortgagee with a consequent loss of income and asset value. A foreclosure on one or more of the Company's properties could have a material adverse effect on the Company’s consolidated financial condition and results of operations. The Company may not be able to repay, refinance, or extend any or all of our debt at maturity or upon any acceleration. If any refinancing is done at higher interest rates, the increased interest expense could adversely affect the Company's financial condition and results of operations. Any such refinancing could also impose tighter financial 15


 
ratios and other covenants that restrict the Company's ability to take actions that could otherwise be in its best interest, such as funding new development activity, making opportunistic acquisitions, or paying dividends. Covenants in the Company’s debt instruments limit its operational flexibility, and a breach of these covenants could materially affect the Company’s consolidated financial condition and results of operations. The terms of the Unsecured Credit Facility, the indentures governing the OP’s outstanding senior notes (which are fully and unconditionally guaranteed by Healthcare Realty Trust) and other debt instruments that the Company may enter into in the future are subject to customary financial and operational covenants. These provisions include, among other things: a limitation on the incurrence of additional indebtedness; limitations on mergers, investments, acquisitions, redemptions of capital stock, and transactions with affiliates; and maintenance of specified financial ratios. The Company’s continued ability to incur debt and operate its business is subject to compliance with these covenants, which limit operational flexibility. Breaches of these covenants could result in defaults under applicable debt instruments, even if payment obligations are satisfied. Financial and other covenants that limit the Company’s operational flexibility, as well as defaults resulting from a breach of any of these covenants in its debt instruments, could have a material adverse effect on the Company’s consolidated financial condition and results of operations. If lenders under the Unsecured Credit Facility fail to meet their funding commitments, the Company’s operations and consolidated financial position would be negatively impacted. Access to external capital on favorable terms is critical to the Company’s success in growing and maintaining its portfolio. If financial institutions within the Unsecured Credit Facility were unwilling or unable to meet their respective funding commitments to the Company, any such failure would have a negative impact on the Company’s operations, consolidated financial condition and ability to meet its obligations, including the payment of dividends to stockholders. The unavailability of equity and debt capital, volatility in the credit markets, increases in interest rates, or changes in the Company’s debt ratings could have an adverse effect on the Company’s ability to meet its debt payments, make dividend payments to stockholders or engage in acquisition and development activity. A REIT is required by the Internal Revenue Code of 1986, as amended (the “Internal Revenue Code”), to make dividend distributions, thereby retaining less of its capital for growth. As a result, a REIT typically requires new capital to invest in real estate assets. However, there may be times when the Company will have limited access to capital from the equity and/or debt markets. Changes in the Company’s debt ratings could have a material adverse effect on its interest costs and financing sources. The Company’s debt rating can be materially influenced by a number of factors including, but not limited to, acquisitions, investment decisions, and capital management activities. In recent years, the capital and credit markets have experienced volatility and at times have limited the availability of funds. The Company’s ability to access the capital and credit markets may be limited by these or other factors, which could have an impact on its ability to refinance maturing debt, fund dividend payments and operations, acquire healthcare properties and complete development and redevelopment projects. If the Company is unable to refinance or extend principal payments due at maturity of its various debt instruments, its cash flow may not be sufficient to repay maturing debt or make dividend payments to stockholders. If the Company defaults in paying any of its debts or satisfying its debt covenants, it could experience cross-defaults among debt instruments, the debts could be accelerated, and the Company could be forced to liquidate assets for less than the values it would otherwise receive. Further, the Company obtains credit ratings from various credit-rating agencies based on their evaluation of the Company's credit. These agencies' ratings are based on a number of factors, some of which are not within the Company's control. In addition to factors specific to the Company's financial strength and performance, the rating agencies also consider conditions affecting REITs generally. The Company's credit ratings could be downgraded. If the Company's credit ratings are downgraded or other negative action is taken, the Company could be required, among other things, to pay additional interest and fees on borrowings under the Unsecured Credit Facility. Increases in interest rates could have a material adverse effect on the Company's cost of capital. During 2024, the Federal Reserve mainly kept interest rates constant and in the latter part of the year actually decreased rates by a total of 100 basis points with the easing of inflation. However, if inflation climbs again, the Federal Reserve may again raise interest rates. Any increases in interest rates will increase interest costs on any new debt and existing variable rate debt. Such increases in the cost of capital could adversely impact our ability to 16


 
finance operations, acquire and develop properties, and refinance existing debt. Additionally, increased interest rates may also result in less liquid property markets, limiting our ability to sell existing assets. The Company's swap agreements may not effectively reduce its exposure to changes in interest rates.  The Company enters into swap agreements from time to time to manage some of its exposure to interest rate volatility. These swap agreements involve risks, such as the risk that counterparties may fail to honor their obligations under these arrangements. In addition, these arrangements may not be effective in reducing the Company’s exposure to changes in interest rates. When the Company uses forward-starting interest rate swaps, there is a risk that it will not complete the long-term borrowing against which the swap is intended to hedge. If such events occur, the Company’s consolidated financial condition and results of operations may be adversely affected. See Note 11 to the Consolidated Financial Statements for additional information on the Company's interest rate swaps. The Company has entered into joint venture agreements that limit its flexibility with respect to jointly owned properties and expects to enter into additional such agreements in the future. As of December 31, 2024, the Company had investments of $473.1 million in unconsolidated joint ventures with unrelated third parties comprised of 63 properties and seven parking garages. In addition, the Company had investments of $97.6 million in two consolidated joint ventures with developments that were completed in the fourth quarter of 2024. The Company may acquire, develop, or redevelop additional properties in joint ventures with unrelated third parties. In such investments, the Company is subject to risks that may not be present in its other forms of ownership, including: • joint venture partners could have financing and investment goals or strategies that are different than those of the Company, including terms and strategies for such investment and what levels of debt place on the venture; • the parties to a joint venture could reach an impasse on certain decisions, which could result in unexpected costs, including costs associated with litigation or arbitration; • a joint venture partner's actions might have the result of subjecting the property or the Company to liabilities in excess of those contemplated; • joint venture partners could have investments that are competitive with the Company's properties in certain markets; • interests in joint ventures are often illiquid and the Company may have difficulty exiting such an investment, or may have to exit at less than fair market value; • joint venture partners may be structured differently than the Company for tax purposes and there could be conflicts relating to the Company's REIT status; and • joint venture partners could become insolvent, fail to fund capital contributions, or otherwise fail to fulfill their obligations as a partner, which could require the Company to invest more capital into such ventures than anticipated. The U.S. federal income tax treatment of the cash that the Company might receive from cash settlement of a forward equity agreement is unclear and could jeopardize the Company's ability to meet the REIT qualification requirements. The Company has utilized and, in the future, may utilize forward equity agreements to secure pricing for equity capital needed at a later time. The Company currently has no forward equity agreements outstanding. In the event that we enter into forward equity agreements in the future and elect to settle any such forward equity agreement for cash and the settlement price is below the applicable forward equity price, we would be entitled to receive a cash payment from the relevant forward purchaser. Under Section 1032 of the Internal Revenue Code, generally, no gains and losses are recognized by a corporation in dealing in its own shares, including pursuant to a "securities futures contract" (as defined in the Internal Revenue Code, by reference to the Exchange Act). Although we believe that any amount received by us in exchange for our stock would qualify for the exemption under Section 1032 of the Internal Revenue Code, because it is not entirely clear whether a forward equity agreement qualifies as a "securities futures contract," the U.S. federal income tax treatment of any cash settlement payment we receive is uncertain. In the event that we recognize a significant gain from the cash settlement of a forward equity agreement, we might be unable to satisfy the gross income requirements applicable to REITs under the Internal Revenue Code. In that case, we may be able to rely upon the relief provisions under the Internal Revenue Code in order to avoid the loss of our REIT status. 17


 
Even if the relief provisions apply, we will be subject to a 100% tax on the greater of (i) the excess of 75% of our gross income (excluding gross income from prohibited transactions) over the amount of such income attributable to sources that qualify under the 75% test or (ii) the excess of 95% of our gross income (excluding gross income from prohibited transactions) over the amount of such gross income attributable to sources that qualify under the 95% test, multiplied in either case by a fraction intended to reflect our profitability. In the event that these relief provisions were not available, we could lose our REIT status under the Internal Revenue Code. In case of our bankruptcy or insolvency, any forward equity agreements will automatically terminate, and the Company would not receive the expected proceeds from any forward sale of shares of its common stock. If we file for or consent to a proceeding seeking a judgment in bankruptcy or insolvency or any other relief under any bankruptcy or insolvency law or other similar law affecting creditors’ rights, or we or a regulatory authority with jurisdiction over us presents a petition for our winding-up or liquidation, and we consent to such a petition, any forward equity agreements that are then in effect will automatically terminate. If any such forward equity agreement so terminates under these circumstances, we would not be obligated to deliver to the relevant forward purchaser any shares of common stock not previously delivered, and the relevant forward purchaser would be discharged from its obligation to pay the applicable forward equity price per share in respect of any shares of common stock not previously settled under the applicable forward equity agreement. Therefore, to the extent that there are any shares of common stock with respect to which any forward equity agreement has not been settled at the time of the commencement of any such bankruptcy or insolvency proceedings, we would not receive the relevant forward equity price per share in respect of those shares of common stock. Risks relating to government regulations The Company's property taxes could increase due to reassessment or property tax rate changes. Real property taxes on the Company's properties may increase as its properties are reassessed by taxing authorities or as property tax rates change. For example, a current California law commonly referred to as Proposition 13 generally limits annual real estate tax increases on California properties to 2% of assessed value at the date of acquisition. Accordingly, the assessed value and resulting property tax the Company pays is less than it would be if the properties were assessed at current values. The Company owns 31 properties in California, representing 7.1% of its total revenue. From time to time, proposals have been made to reduce the beneficial impact of Proposition 13, particularly with respect to commercial property, which would include medical office buildings. Most recently, an initiative qualified for California’s November 2020 statewide ballot that would generally limit Proposition 13’s protections to residential real estate. If this initiative had passed, it would have ended the beneficial effect of Proposition 13 for the Company's properties, and property tax expense could have increase substantially, adversely affecting the Company's cash flow from operations and net income. While this initiative did not pass, the Company cannot predict whether other changes to Proposition 13 may be proposed or adopted in the future. Trends in the healthcare service industry may negatively affect the demand for the Company’s properties, lease revenues and the values of its investments. The healthcare service industry may be affected by the following: • transition to value-based care and reimbursement of providers; • competition among healthcare providers; • consolidation among healthcare providers, health insurers, hospitals and health systems; • a rise in government-funded health insurance coverage; • pressure on providers' operating profit margins from lower reimbursement rates, lower admissions growth, and higher expense growth; • availability of capital; • credit downgrades; • liability insurance expense; • rising pharmaceutical drug expense; • regulatory and government reimbursement uncertainty related to the Medicare and Medicaid programs; • a trend toward government regulation of pharmaceutical pricing; 18


 
• government regulation of hospitals' and health insurers' pricing transparency; • federal court decisions on cases challenging the legality of the Affordable Care Act, in whole or in part; • site-neutral rate-setting for Medicare services across different care settings; • disruption in patient volume and revenue from pandemics, such as COVID-19; • trends in the method of delivery of healthcare services, such as telehealth; • heightened health information technology security standards and the meaningful use of electronic health records by healthcare providers; • potential tax law changes affecting providers; and • state and federal regulations that provide for heightened scrutiny of healthcare transactions involving REITs and private equity firms. These trends, among others, can adversely affect the economic performance of some or all of the tenants and, in turn, negatively affect the lease revenues and the value of the Company’s property investments. The costs of complying with governmental laws and regulations may adversely affect the Company's results of operations. All real property and the operations conducted on real property are subject to federal, state, and local laws and regulations relating to environmental protection and human health and safety. Some of these laws and regulations may impose joint and several liability on tenants, owners, or operators for the costs to investigate or remediate contaminated properties, regardless of fault or whether the acts causing the contamination were legal. In addition, the presence of hazardous substances, or the failure to properly remediate these substances, may hinder the Company's ability to sell, rent, or pledge such property as collateral for future borrowings. Compliance with new laws or regulations or stricter interpretation of existing laws may require the Company to incur significant expenditures. For example, enacted or proposed legislation to address climate change could increase utility and other costs of operating the Company's properties. Future laws or regulations may impose significant environmental liability. Additionally, operations of tenants or other parties in the vicinity of the Company's properties, such as the presence of underground storage tanks, may affect the Company's properties. There are various local, state, and federal fire, health, life-safety, and similar regulations with which the Company may be required to comply and that may subject us to liability in the form of fines or damages for noncompliance. Any expenditures, fines, or damages that the Company must pay would adversely affect its results of operations. Discovery of previously undetected environmentally hazardous conditions may adversely affect the Company's financial condition and results of operations. Under various federal, state, and local environmental laws and regulations, a current or previous property owner or operator may be liable for the cost to remove or remediate hazardous or toxic substances on such property. These costs could be significant. Such laws often impose liability whether or not the owner or operator knew of, or was responsible for, the presence of such hazardous or toxic substances. Environmental laws also may impose restrictions on the manner in which property may be used or businesses may be operated, and these restrictions may require significant expenditures or prevent the Company from entering into leases with prospective tenants that may be impacted by such laws. Environmental laws provide for sanctions for noncompliance and may be enforced by governmental agencies or private parties. Certain environmental laws and common law principles could be used to impose liability for the release of and exposure to hazardous substances, including asbestos-containing materials. Third parties may seek recovery from real property owners or operators for personal injury or property damage associated with exposure to released hazardous substances. The cost of defending against claims of liability, of complying with environmental regulatory requirements, of remediating any contaminated property, or of paying personal injury claims could adversely affect the Company's financial condition and results of operations. Qualifying as a REIT involves highly technical and complex provisions of the Internal Revenue Code. Qualification as a REIT involves the application of highly technical and complex provisions of the Internal Revenue Code for which only limited judicial and administrative authorities exist. Even a technical or inadvertent violation could jeopardize the Company’s REIT qualification. The Company’s continued qualification as a REIT will depend on the Company’s satisfaction of certain asset, income, organizational, distribution, stockholder ownership and other 19


 
requirements on a continuing basis. In addition, the Company’s ability to satisfy the requirements to qualify as a REIT depends in part on the actions of third parties over which the Company has no control or only limited influence, including in cases where the Company owns an equity interest in an entity that is classified as a partnership for U.S. federal income tax purposes. If the Company fails to remain qualified as a REIT, the Company will be subject to significant adverse consequences, including adversely affecting the value of its common stock. The Company intends to operate in a manner that will allow it to continue to qualify as a REIT for federal income tax purposes. Although the Company believes that it qualifies as a REIT, it cannot provide any assurance that it will continue to qualify as a REIT for federal income tax purposes. The Company’s continued qualification as a REIT will depend on the satisfaction of certain asset, income, organizational, distribution, stockholder ownership and other requirements on a continuing basis. The Company’s ability to satisfy the asset tests depends upon the characterization and fair market values of its assets. The Company’s compliance with the REIT income and quarterly asset requirements also depends upon the Company’s ability to successfully manage the composition of the Company’s income and assets on an ongoing basis. Accordingly, there can be no assurance that the Internal Revenue Service (“IRS”) will not contend that the Company has operated in a manner that violates any of the REIT requirements. If the Company were to fail to qualify as a REIT in any taxable year, the Company would be subject to federal income tax on its taxable income at regular corporate rates and possibly increased state and local taxes (and the Company might need to borrow money or sell assets in order to pay any such tax). Further, dividends paid to the Company’s stockholders would not be deductible by the Company in computing its taxable income. Any resulting corporate tax liability could be substantial and would reduce the amount of cash available for distribution to the Company’s stockholders, which in turn could have an adverse impact on the value of the Company’s common stock. In addition, in such an event the Company would no longer be required to pay dividends to maintain REIT status, which could adversely affect the value of the Company’s common stock. Unless the Company were entitled to relief under certain provisions of the Internal Revenue Code, the Company also would continue to be disqualified from taxation as a REIT for the four taxable years following the year in which the Company failed to qualify as a REIT. Even if the Company remains qualified for taxation as a REIT, the Company is subject to certain federal, state and local taxes on its income and assets, including taxes on any undistributed taxable income, and state or local income, franchise, property and transfer taxes. These tax liabilities would reduce the Company’s cash flow and could adversely affect the value of the Company’s common stock. For more specific information on state income taxes paid, see Note 16 to the Consolidated Financial Statements. The Company’s articles of incorporation, as well as provisions of the MGCL, contain limits and restrictions on transferability of the Company’s common stock which may have adverse effects on the value of the Company’s common stock. In order to qualify as a REIT, no more than 50% of the value of the Company’s outstanding shares may be owned, directly or indirectly, by five or fewer individuals (as defined in the Internal Revenue Code to include certain entities) during the last half of a taxable year. To assist in complying with this REIT requirement, the Company’s articles of incorporation contain provisions restricting share transfers where the transferee would, after such transfer, own more than 9.8% either in number or value of the outstanding stock of the Company. If, despite this prohibition, stock is acquired increasing a transferee’s ownership to over 9.8% in value of the outstanding stock, the stock in excess of this 9.8% in value is deemed to be held in trust for transfer at a price that does not exceed what the purported transferee paid for the stock, and, while held in trust, the stock is not entitled to receive dividends or to vote. In addition, under these circumstances, the Company has the right to redeem such stock. In addition, certain provisions of the MGCL applicable to the Company may have the effect of inhibiting or deterring a third party from making a proposal to acquire the Company or of delaying or preventing a change of control under circumstances that otherwise could provide Company stockholders with the opportunity to realize a premium over the then-prevailing market price of such shares, including: • provisions under Subtitle 8 of Title 3 of the MGCL that permit the Board of Directors, without stockholders’ approval and regardless of what is currently provided in the Company's Articles of Incorporation or bylaws, to implement certain takeover defenses; 20


 
• “business combination” provisions that, subject to limitations, prohibit certain business combinations, asset transfers and equity security issuances or reclassifications between the Company and an “interested stockholder” (defined generally as any person who beneficially owns, directly or indirectly, 10% or more of the voting power of the Company's outstanding voting stock or an affiliate or associate of the Company who, at any time within the two-year period immediately prior to the date in question, was the beneficial owner, directly or indirectly, of 10% or more of the Company's then outstanding stock) or an affiliate of an interested stockholder for five years after the most recent date on which the stockholder becomes an interested stockholder, and thereafter may impose supermajority voting requirements unless certain minimum price conditions are satisfied; and • “control share” provisions that provide that holders of “control shares” of the Company (defined as shares which, when aggregated with other shares controlled by the stockholder, entitle the stockholder to exercise one of three increasing ranges of voting power in electing directors) acquired in a “control share acquisition” (defined as the direct or indirect acquisition of ownership or control of issued and outstanding “control shares”) have no voting rights except to the extent approved by Company stockholders by the affirmative vote of at least two-thirds of all the votes entitled to be cast on the matter, excluding all interested shares. Pursuant to a resolution adopted by the Board of Directors, the Company is prohibited from classifying the Board of Directors under Subtitle 8 unless stockholders entitled to vote generally in the election of directors approve a proposal to repeal such resolution by the affirmative of a majority of the votes cast on the matter. In the case of the business combination provisions of the MGCL, the Board of Directors has adopted a resolution providing that any business combination between the Company and any other person is exempted from this statute, provided that such business combination is first approved by the Board of Directors. This resolution, however, may be altered or repealed in whole or in part at any time. In the case of the control share provisions of the MGCL, the Company has opted out of these provisions pursuant to a provision in its bylaws. The Company may, however, by amendment to its bylaws, opt into the control share provisions of the MGCL. The Company may also choose to adopt other takeover defenses in the future. Any such actions could deter a transaction that may otherwise be in the interest of Company stockholders. These restrictions on the transfer of the Company’s shares could have adverse effects on the value of the Company’s common stock. Complying with the REIT requirements may cause the Company to forego otherwise attractive opportunities. To qualify as a REIT for federal income tax purposes, the Company must continually satisfy tests concerning, among other things, the sources of its income, the nature of its assets, the amounts it distributes to its stockholders and the ownership of its stock. The Company may be unable to pursue investments that would be otherwise advantageous to the Company in order to satisfy the source-of-income or distribution requirements for qualifying as a REIT. Thus, compliance with the REIT requirements may hinder the Company’s ability to make certain attractive investments. The prohibited transactions tax may limit the Company's ability to sell properties. A REIT's net gain from prohibited transactions is subject to a 100% tax. In general, prohibited transactions are sales or other dispositions of property held primarily for sale to customers in the ordinary course of business. The Company may be subject to the prohibited transaction tax equal to 100% of net gain upon the disposition of real property. Although a safe harbor to the characterization of the sale of real property by a REIT as a prohibited transaction is available, there can be no assurance that the Company can comply in all cases with the safe harbor or that it will avoid owning property that may be characterized as held primarily for sale to customers in the ordinary course of business. Consequently, the Company may choose not to engage in certain sales of its properties or may conduct such sales through a taxable REIT subsidiary, which would be subject to federal and state income taxation. New legislation or administrative or judicial action, in each instance potentially with retroactive effect, could make it more difficult or impossible for the Company to qualify as a REIT. The present federal income tax treatment of REITs may be modified, possibly with retroactive effect, by legislative, judicial or administrative action at any time, which could affect the federal income tax treatment of an investment in the Company. The federal income tax rules that affect REITs are constantly under review by persons involved in the legislative process, the IRS and the U.S. Treasury Department, which results in statutory changes as well as frequent 21


 
revisions to regulations and interpretations. Revisions in federal tax laws and interpretations thereof could cause the Company to change its investments and commitments and affect the tax considerations of an investment in the Company. There can be no assurance that new legislation, regulations, administrative interpretations or court decisions will not change the tax laws significantly with respect to the Company’s qualification as a REIT or with respect to the federal income tax consequences of qualification. New and increased transfer tax rates may reduce the value of the Company’s properties. In recent years, several cities in which the Company owns assets have increased transfer tax rates. These include Boston, Los Angeles, San Francisco, Seattle, and Washington, D.C. In 2022, Los Angeles increased its transfer tax rate from 0.45% to 5.5% on sales of real properties greater than $10 million in value, effective April 1, 2023. In 2020, San Francisco increased it transfer tax rate to 6% for sales in excess of $25 million in value. Also in 2020, the State of Washington increased its transfer tax rate from 1.28% to 3% on sales in excess of $3 million in value; the combined state and local transfer tax rate in Seattle/King County, Washington is 3.5% on sales above $3 million. As state and municipal governments seek new ways to raise revenue, other jurisdictions may implement new real estate transfer taxes or increase existing transfer tax rates. Increases in such tax rates can impose significant additional transaction costs on sales of commercial real estate and may reduce the value of the Company’s properties for sale by the amount of the new or increased tax. Item 1B. Unresolved Staff Comments None. Item 1C. Cybersecurity The Company annually reviews its overall risk profile with the Audit Committee and full Board of Directors. Assessing, identifying and managing material risks from cybersecurity threats are integrated into the Company’s overall risk management processes. The Audit Committee of the Company’s Board of Directors has oversight in the management of risks associated with cybersecurity. The Audit Committee is briefed regularly on cybersecurity matters, including meeting with the Company’s Chief Technology Officer at least annually and receiving a memorandum quarterly regarding cybersecurity. In addition, the Audit Committee discusses cybersecurity with other members of management and the internal audit staff at each quarterly meeting. The Audit Committee reports to the full Board of Directors quarterly regarding cybersecurity. Management of the Company plays an integral role in assessing and managing risks from cybersecurity threats. The Company has a dedicated technology services department, led by the Company’s Chief Technology Officer. The Company also has an in-house internal audit staff that is involved in risk management of cybersecurity threats. The Company solicits input from key employees regarding the overall risk environment, including cybersecurity threats. The Company requires all employees to complete cybersecurity training semi-annually and periodically facilitates penetration tests on the Company's systems. The Company’s Chief Technology Officer reports to the Company’s Executive Vice President and Chief Administrative Officer. In addition, as discussed in more detail below, any cybersecurity incident is reported to the Company’s legal department. Although the Company’s Executive Vice President and Chief Administrative Officer and the members of its legal department do not have a technology services background, we believe that the Company’s Chief Technology Officer and technology services team possess the requisite background and experience to effectively manage the Company’s cybersecurity needs. The Company's Chief Technology Officer has extensive information technology and program management experience from service in the government and private and public Fortune 100 companies. He has expanded the Company's cybersecurity program over the last several years resulting in a robust enterprise security posture focused on preventing cybersecurity incidents, while simultaneously increasing the Company's system resilience in an effort to minimize the business impact if an incident should occur. 22


 
The Company also engages with third parties on an as-needed basis to advise and assist in managing cybersecurity risks. When the Company utilizes third-party services that include web-based platforms or data collection stored on third-party servers, it reviews the service provider’s SOC1 attestation reports on internal controls and inquires regarding controls and procedures utilized by such third parties with respect to cybersecurity of the Company’s data. The Company has in place a cybersecurity incident response plan. Procedures for addressing cybersecurity incidents include reporting incidents up to senior management, including the Company’s legal department for analysis. If a cybersecurity incident were determined to be material by the Company's legal department, the Company’s Audit Committee would be informed promptly and the Company’s disclosure committee would address appropriate public disclosures. As noted above, management regularly reports to the Audit Committee regarding the current cyber threat environment and the controls and procedures meant to address such risks. The Company carries cyber risk insurance, but there can be no assurance that losses from a cybersecurity incident would not exceed the insurance coverage. Although the Company has not experienced a cybersecurity incident that materially affected or, to the Company’s knowledge, is reasonably likely to materially affect the Company, including its business strategy, results of operations or financial condition, the Company has, from time to time, experienced threats to and breaches of its data and systems. The Company faces risks associated with security breaches through cyber attacks, cyber intrusions, or otherwise, as well as other significant disruptions of its information technology networks and related systems. These risks are described in more detail under Item 1A. Risk Factors. Item 2. Properties In addition to the properties described in Item 1. “Business,” in Note 3 to the Consolidated Financial Statements, and in Schedule III of Item 15 of this Annual Report on Form 10-K, the Company leases office space from unrelated third parties from time to time. The Company owns its corporate headquarters located at 3310 West End Avenue in Nashville, Tennessee. Item 3. Legal Proceedings The Company is not aware of any pending or threatened litigation that, if resolved against the Company, would have a material adverse effect on the Company's consolidated financial position, results of operations, or cash flows. Item 4. Mine Safety Disclosures Not applicable. PART II Item 5. Market for Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities Shares of the Company’s common stock are traded on the New York Stock Exchange under the symbol “HR.” As of December 31, 2024, there were 2,009 stockholders of record. Future dividends will be declared and paid at the discretion of the Board of Directors. The Company’s ability to pay dividends is dependent upon its ability to generate funds from operations and cash flows, and to make accretive new investments. 23


 
Equity Compensation Plan Information The following table provides information as of December 31, 2024, about the Company’s common stock that may be issued as restricted stock and upon the exercise of options, warrants and rights under the Company’s existing compensation plans, including the Amended and Restated 2006 Incentive Plan. PLAN CATEGORY NUMBER OF SECURITIES TO BE ISSUED upon exercise of outstanding options, warrants, and rights WEIGHTED AVERAGE EXERCISE PRICE of outstanding options, warrants, and rights NUMBER OF SECURITIES REMAINING AVAILABLE  for future issuance under equity  compensation plans (excluding securities reflected in the first column) Equity compensation plans approved by security holders — — 6,140,496 Equity compensation plans not approved by security holders — — — Total — — 6,140,496 Issuer Purchases of Equity Securities During the year ended December 31, 2024, the Company withheld and canceled shares of Company common stock to satisfy employee tax withholding obligations payable upon the vesting of non-vested shares, as follows: PERIOD TOTAL NUMBER OF SHARES PURCHASED AVERAGE PRICE PAID per share TOTAL NUMBER OF SHARES purchased as part of publicly announced plans or programs MAXIMUM NUMBER OF SHARES that may yet be purchased under the plans or programs February 1 - February 28 8,228 $ 16.31 — — October 1 - October 31 93,965 17.16 December 1 - December 31 383,016 18.14 — — Total 485,209 $ 17.92 Authorization to Repurchase Common Stock During 2024, the Company repurchased shares of its common stock under repurchase authorizations as follows: PERIOD TOTAL NUMBER OF SHARES PURCHASED (1) (2) AVERAGE PRICE PAID per share TOTAL NUMBER OF SHARES purchased as part of publicly announced plans or programs (2) MAXIMUM NUMBER (or Approximate DOLLAR VALUE) OF SHARES that may yet be purchased under the plans or programs (1) Prior Authorizations April 1 - April 30 2,966,764 $ 14.07 2,966,764 May 1 - May 31 7,536,692 15.94 7,536,692 June 1 - June 30 6,738,781 16.44 6,738,781 July 1 - July 31 1,296,985 16.82 1,296,985 August 1 - August 31 3,055,197 17.56 3,055,197 September 1 - September 30 4,140,669 17.97 4,140,669 October 1 - October 31 1,380,000 17.54 1,380,000 October 29, 2024 Authorized Shares $ 300,000,000 November 1 - November 30 1,554,958 17.22 1,554,958 273,224,084 December 1 - December 31 2,124,204 17.07 2,124,204 236,957,114 Total 30,794,250 $ 16.56 30,794,250 $ 236,957,114 1 On May 31, 2023, the Company's Board of Directors authorized the repurchase of up to $500.0 million of outstanding shares of the Company's common stock either in the open market or through privately negotiated transactions, subject to market conditions, regulatory constraints, and other customary conditions. On April 30, 2024, the Company's Board of Directors authorized the repurchase of up to $500.0 million of outstanding shares of the Company's common stock, superseding the previous stock repurchase authorization. On October 29, 2024, the Company's Board of Directors authorized the repurchase of up to $300.0 million of outstanding shares of the Company's common stock, superseding the previous stock repurchase authorization. The stock repurchase authorization expires on October 28, 2025, and the Company may suspend or terminate repurchases at any time without prior notice. The Company is not obligated under this authorization to repurchase any specific number of shares. 2 Repurchases of common stock in April 2024 were made under the May 31, 2023 $500.0 million stock repurchase authorization. May 2024 through October 2024 were repurchased under the April 30, 2024 $500.0 million stock repurchase authorization. November and December 2024 repurchases were repurchased under the October 29, 2024 $300.0 million stock repurchase authorization. As of December 31, 2024, the Company was authorized to repurchase an additional $237.0 million of the Company's common stock. 24


 
Stock Performance Graph The following graph provides a comparison of the Company's cumulative total shareholder return with the Russell 3000 Index and cumulative total returns of FTSE NAREIT All Equity REITs Index for the period from December 31, 2019 through December 31, 2024. The comparison assumes $100 was invested on December 31, 2019, in the Company's common stock and in each of the indexes and assumes reinvestment of dividends, as applicable. The Company's data for periods prior to the closing of the Merger is the stock performance of Legacy HR. Item 6. [Reserved] Stock Performance Graph The following graph provides a comparison of the Company's cumulative total shareholder return with the Russell 3000 Index and cumulative total returns of FTSE NAREIT All Equity REITs Index for the period from December 31, 2019 through December 31, 2024. The comparison assumes $100 was invested on December 31, 2019, in the Company's common stock and i each of the indexes and assumes reinvestment of dividends, as applicable. The Co pany's data for periods prior to the closing of the Merger is the stock performance of Legacy HR. Item 6. [Reserved] Stock Performance Graph The following graph provides a comparison of the Company's cumulative total shareholder return with the Russell 3000 Index and cumulative total returns of FTSE NAREIT All Equity REITs Index for the period from December 31, 2019 through December 31, 2024. The comparison assumes $100 was invested on December 31, 2019, in the Company's common stock and in each of the indexes and assumes reinvestment of dividends, as applicable. The Company's data for periods prior to the closing of the Merger is the stock performance of Legacy HR. Item 6. [Reserved] 25


 
Item 7. Management's Discussion and Analysis of Financial Condition and Results of Operations Disclosure Regarding Forward-Looking Statements This report and other materials the Company has filed or may file with the SEC, as well as information included in oral statements or other written statements made, or to be made, by senior management of the Company, contain, or will contain, disclosures that are “forward-looking statements.” Forward-looking statements include all statements that do not relate solely to historical or current facts and can be identified by the use of words such as “may,” “will,” “expect,” “believe,” “anticipate,” “target,” “intend,” “plan,” “estimate,” “project,” “continue,” “should,” “could” and other comparable terms. These forward-looking statements are based on the current plans and expectations of management and are subject to a number of risks and uncertainties that could materially affect the Company’s current plans and expectations and future financial condition and results. Such risks and uncertainties as more fully discussed in Item 1A “Risk Factors” of this report and in other reports filed by the Company with the SEC from time to time include, among other things, the following: Risks relating to our business and operations • The Company's expected results may not be achieved; • The Company’s revenues depend on the ability of its tenants under its leases to generate sufficient income from their operations to make rental payments to the Company; • The Company's results of operations have been and will continue to be impacted negatively by the Steward Health and Prospect Medical bankruptcies; • Owning real estate and indirect interests in real estate is subject to inherent risks; • The Company may incur impairment charges on its real estate properties or other assets; • The Company has properties subject to purchase options that expose it to reinvestment risk and reduction in expected investment returns; • If the Company is unable to promptly re-let its properties, if the rates upon such re-letting are significantly lower than the previous rates or if the Company is required to undertake significant expenditures or make significant leasing concessions to attract new tenants, then the Company’s business, consolidated financial condition and results of operations would be adversely affected; • Certain of the Company’s properties are special purpose healthcare facilities and may not be easily adaptable to other uses; • The Company has, and in the future may have more, exposure to fixed rent escalators, which could lag behind inflation and the growth in operating expenses such as real estate taxes, utilities, insurance, and maintenance expense; • The Company’s real estate investments are illiquid and the Company may not be able to sell properties strategically targeted for disposition; • The Company is subject to risks associated with the development and redevelopment of properties; • The Company may make material acquisitions and undertake developments and redevelopments that may involve the expenditure of significant funds and may not perform in accordance with management’s expectations; • The Company is exposed to risks associated with geographic concentration; • Many of the Company’s leases are dependent on the viability of associated health systems. Revenue concentrations relating to these leases expose the Company to risks related to the financial condition of the associated health systems; • Many of the Company’s properties are held under ground leases. These ground leases contain provisions that may limit the Company’s ability to lease, sell, or finance these properties; • The Company may experience uninsured or underinsured losses; • Damage from catastrophic weather and other natural events, whether caused by climate change or otherwise, could result in losses to the Company; 26


 
• The Company faces risks associated with security breaches through cyber attacks, cyber intrusions, or otherwise, as well as other significant disruptions of its information technology networks and related systems; • The Company has structured and may in the future structure acquisitions of property in exchange for limited partnership units of the OP on terms that could limit its liquidity or flexibility; • Healthcare Realty Trust is a holding company with no direct operations and, as such, it relies on funds received from the OP to pay liabilities, and the interests of its stockholders will be structurally subordinated to all liabilities and obligations of the OP and its subsidiaries • The Company cannot assure you that it will be able to continue paying dividends at or above the rates previously paid; • Pandemics, and measures intended to prevent their spread or mitigate their severity could have a material adverse effect on the Company's business, results of operations, cash flows and financial condition; and • The Company's success depends, in part, on its ability to attract and retain talented employees. The loss of any one of the Company's key personnel or the inability to maintain appropriate staffing could adversely impact the Company's business. Risks relating to our capital structure and financings • The Company has incurred significant debt obligations and may incur additional debt and increase leverage in the future; • Covenants in the Company’s debt instruments limit its operational flexibility, and a breach of these covenants could materially affect the Company’s consolidated financial condition and results of operations; • If lenders under the Unsecured Credit Facility fail to meet their funding commitments, the Company’s operations and consolidated financial position would be negatively impacted; • The unavailability of equity and debt capital, volatility in the credit markets, increases in interest rates, or changes in the Company’s debt ratings could have an adverse effect on the Company’s ability to meet its debt payments, make dividend payments to stockholders or engage in acquisition and development activity; • Increases in interest rates could have a material adverse effect on the Company's cost of capital; • The Company's swap agreements may not effectively reduce its exposure to changes in interest rates; • The Company has entered into joint venture agreements that limit its flexibility with respect to jointly owned properties and expects to enter into additional such agreements in the future; • The U.S. federal income tax treatment of the cash that the Company might receive from cash settlement of a forward equity agreement is unclear and could jeopardize the Company's ability to meet the REIT qualification requirements; and • In case of our bankruptcy or insolvency, any forward equity agreements will automatically terminate, and the Company would not receive the expected proceeds from any forward sale of shares of its common stock. Risks relating to government regulations • The Company's property taxes could increase due to reassessment or property tax rate changes; • Trends in the healthcare service industry may negatively affect the demand for the Company’s properties, lease revenues and the values of its investments; • The costs of complying with governmental laws and regulations may adversely affect the Company's results of operations; • Qualifying as a REIT involves highly technical and complex provisions of the Internal Revenue Code; • If the Company fails to remain qualified as a REIT, the Company will be subject to significant adverse consequences, including adversely affecting the value of its common stock; • The Company’s articles of incorporation, as well as provisions of the MGCL, contain limits and restrictions on transferability of the Company’s common stock which may have adverse effects on the value of the Company’s common stock; 27


 
• Complying with the REIT requirements may cause the Company to forego otherwise attractive opportunities; • The prohibited transactions tax may limit the Company's ability to sell properties; • New legislation or administrative or judicial action, in each instance potentially with retroactive effect, could make it more difficult or impossible for the Company to qualify as a REIT; and • New and increased transfer tax rates may reduce the value of the Company’s properties. The Company undertakes no obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events or otherwise. Stockholders and investors are cautioned not to unduly rely on such forward-looking statements when evaluating the information presented in the Company’s filings and reports, including, without limitation, estimates and projections regarding the performance of development projects the Company is pursuing. Overview The Company owns and operates properties that facilitate the delivery of healthcare services in primarily outpatient settings. To execute its strategy, the Company engages in a broad spectrum of integrated services including leasing, management, acquisition, financing, development and redevelopment of such properties. The Company seeks to generate stable, growing income and lower the long-term risk profile of its portfolio of properties by focusing on facilities primarily located on or near the campuses of acute care hospitals associated with leading health systems. The Company seeks to reduce financial and operational risk by owning properties in high-growth markets with a broad tenant mix that includes over 30 physician specialties, as well as surgery, imaging, cancer, and diagnostic centers. As described in Item 1. Business above and elsewhere in this report, on July 20, 2022, Legacy HR and Legacy HTA completed a merger between the companies in which Legacy HR merged with and into a wholly-owned subsidiary of Legacy HTA, with Legacy HR continuing as the surviving entity and a wholly-owned subsidiary of Legacy HTA. Immediately following the Merger, Legacy HTA changed its name to “Healthcare Realty Trust Incorporated.” For accounting purposes, the Merger was treated as a “reverse acquisition” in which Legacy HR was considered the acquirer. Accordingly, the information discussed in this section reflects, for periods prior to the closing of the Merger, the financial condition and results of operations of Legacy HR, and for periods from the closing of the Merger, that of the Company. This section is organized into the following sections: • Liquidity and Capital Resources; • Trends and Matters Impacting Operating Results; • Results of Operations; • Non-GAAP Financial Measures and Key Performance Indicators; and • Application of Critical Accounting Policies to Accounting Estimates. Liquidity and Capital Resources The Company monitors its liquidity and capital resources and considers several indicators in its assessment of capital markets for financing acquisitions and other operating activities. The Company considers, among other factors, its leverage ratios and lending covenants, dividend payout percentages, interest rates, underlying treasury rates, debt market spreads and cost of equity capital to compare its operations to its peers and to help identify areas in which the Company may need to focus its attention. Sources and Uses of Cash The Company's revenues are derived from its real estate property portfolio based on contractual arrangements with its tenants. These sources of revenue represent the Company's primary source of liquidity to fund its dividends and its operating expenses, including interest incurred on debt, principal payments on debt, general and administrative costs, capital expenditures and other expenses incurred in connection with managing its existing portfolio and investing in additional properties. To the extent additional investments are not funded by these sources, the 28


 
Company will fund its investment activity generally through equity or debt issuances either in the public or private markets, asset sales and joint venture contributions or through proceeds from the Unsecured Credit Facility. The Company expects to continue to meet its liquidity needs, including capital for additional investments, tenant improvement allowances, operating and finance lease payments, paying dividends, and funding debt service, through cash on hand, cash flows from operations and the cash flow sources addressed above. See Note 4 to the Consolidated Financial Statements for additional discussion of operating and financing lease payment obligations. See "Trends and Matters Impacting Operating Results" for additional information regarding the Company's sources and uses of cash. The Company also had unencumbered real estate assets with a gross book value of approximately $11.7 billion at December 31, 2024, of which a portion could serve as collateral for secured mortgage financing. The Company believes that its liquidity and sources of capital are adequate to satisfy its cash requirements. The Company cannot, however, be certain that these sources of funds will be available at a time and upon terms acceptable to the Company in sufficient amounts to meet its liquidity needs. The Company has exposure to variable interest rates and its common stock price is impacted by the volatility in the stock markets. However, the Company’s leases, which provide its main source of income and cash flow, have terms of approximately one to 20 years and have lease rates that generally increase on an annual basis at fixed rates or based on consumer price indices. Operating Activities Cash flows provided by operating activities for the two years ended December 31, 2024 and 2023 were $501.6 million and $499.8 million, respectively. Several items impact cash flows from operating activities including, but not limited to, cash generated from property operations, interest payments and the timing related to the payment of invoices and other expenses and receipt of tenant rent. The Company may, from time to time, sell properties and redeploy cash from property sales into new investments. To the extent revenues related to the properties being sold exceed income from these new investments, the Company's consolidated results of operations and cash flows could be adversely affected. See "Trends and Matters Impacting Operating Results" for additional information regarding the Company's operating activities. Investing Activities A summary of the significant transactions impacting investing activities for the year ended December 31, 2024 is listed below. See Note 5 to the Consolidated Financial Statements for more detail on these activities. The Company had no real estate acquisition activity for the year ended December 31, 2024. Investment in Unconsolidated Joint Ventures In 2024, the Company's investment in unconsolidated joint ventures increased by $172.7 million, as a result of the Company's contribution of medical outpatient properties to two joint ventures in which it holds a 20% interest. Capital Funding In 2024, the Company incurred capital expenditures totaling $303.9 million for the following: • $150.6 million toward development and redevelopment of properties; • $52.4 million toward first generation tenant improvements and planned capital expenditures for acquisitions; • $68.4 million toward second generation tenant improvements; and • $32.5 million toward capital expenditures. See "Trends and Matters Impacting Operating Results" below for more detail. Real Estate Notes Receivable On June 24, 2024, the Company's two mezzanine loans in Texas with a total principal balance of $54.1 million matured. On July 15, 2024, the senior lender on the construction mortgage loans associated with the underlying project initiated foreclosure proceedings to the borrower. In the third quarter of 2024, the Company recorded an allowance for credit loss of $46.8 million to cover the entire carrying amount for these loans. The Company had 29


 
previously placed the mezzanine loans on non-accrual status in 2023. In the fourth quarter of 2024, the underlying project was sold, and the Company received $4.0 million as consideration for its mezzanine loan interests. The Company no longer has a mezzanine loan position in connection with the project. In 2024, the Company placed one of its real estate notes receivable with a principal balance of $31.2 million on non- accrual status. The Company determined that the risk of credit loss was no longer remote and recorded a credit loss reserve of $16.8 million including $0.5 million of accrued interest in 2024. In January 2025, the underlying real estate collateral was sold and the Company received $14.9 million towards the principal balance of this loan. See Note 1 to the Consolidated Financial Statements accompanying this report for more information about real estate notes receivable and allowance for credit losses. Dispositions The following table details the Company's asset sales and joint venture contributions for the year ended December 31, 2024: Dollars in thousands DATE DISPOSED SALE PRICE CLOSING COSTS & CREDITS COMPANY- FINANCED MORTGAGE NOTES NET CONSIDERATION NET REAL ESTATE INVESTMENT OTHER GAIN/ (IMPAIR- MENT) SQUARE FOOTAGE Albany, NY 4/1/24 $ 725 $ (60) $ — $ 665 $ 765 $ (82) $ (18) 14,800 San Angelo, TX 4/12/24 5,085 (128) — 4,957 4,917 66 (26) 24,580 Houston, TX 5/20/24 250 (9) — 241 713 (520) 48 37,040 Multiple 1 5/23/24 284,348 (14,270) — 270,078 254,176 25,836 (9,934) 556,274 Denver, CO 5/30/24 19,000 (628) — 18,372 18,522 165 (315) 37,130 Austin, TX 1 6/6/24 54,858 (1,575) — 53,283 27,964 623 24,696 129,879 Minneapolis, MN 6/21/24 1,082 (144) — 938 303 43 592 50,291 Raleigh, NC 2 6/28/24 99,518 (2,835) — 96,683 86,810 906 8,967 309,424 Albany, NY 8/2/24 6,300 (847) — 5,453 5,528 486 (561) 180,000 Charlotte, NC 8/6/24 26,670 (395) — 26,275 14,853 613 10,809 90,633 Charleston, SC 8/13/24 14,500 (589) — 13,911 11,488 1 2,422 46,711 Multiple 1 8/23/24 118,000 (8,615) — 109,385 113,956 548 (5,119) 266,782 Multiple 3 8/27/24 177,250 (7,085) — 170,165 169,545 5,363 (4,743) 473,003 Austin, TX 9/13/24 42,281 (1,257) — 41,024 14,561 425 26,038 76,246 Raleigh, NC 9/26/24 1,813 (27) — 1,786 1,694 50 42 5,934 Houston, TX 4 10/3/24 12,000 (1,001) (9,630) 1,369 11,266 295 (563) 140,012 Greensboro, NC 10/9/24 12,514 (21) — 12,493 10,152 296 2,045 35,373 Des Moines, IA 10/15/24 31,750 (1,320) — 30,430 13,869 1,662 14,899 95,486 Albany, NY 10/15/24 9,500 (521) — 8,979 7,823 1,193 (37) 80,676 Salt Lake City, UT 5 10/24/24 30,712 (8,962) — 21,750 26,899 (9,406) 4,257 112,192 Miami, FL 10/25/24 36,789 (706) — 36,083 35,925 (209) 367 102,186 Miami, FL 6 10/25/24 17,767 (718) — 17,049 14,650 (210) 2,609 60,761 Cleveland, OH 12/10/24 1,000 (157) — 843 1,454 57 (668) 31,152 Boise, ID 7 12/12/24 18,350 (2,003) — 16,347 17,562 345 (1,560) 83,078 Multiple 1 12/18/24 310,250 (6,767) — 303,483 321,437 6,616 (24,570) 766,622 Atlanta, GA 12/20/24 15,900 (1,318) — 14,582 13,344 635 603 42,921 Los Angeles, CA 7 12/20/24 64,000 (4,805) — 59,195 47,322 1,676 10,197 162,554 Tampa, FL 12/27/24 37,500 (402) — 37,098 41,556 (1,962) (2,496) 95,896 Wichita Falls, TX 12/27/24 600 (130) — 470 2,530 14 (2,074) 25,133 Total dispositions $ 1,450,312 $ (67,295) $ (9,630) $ 1,373,387 $ 1,291,584 $ 35,525 $ 55,907 4,132,769 1 The Company contributed the following medical outpatient properties to a joint venture in which the Company retained 20% ownership: one in each of Raleigh, NC, New York, NY, Philadelphia, PA, Atlanta, GA, Austin, TX, Miami, FL, Denver, CO, Memphis, TN, Indianapolis, IN, and Honolulu, HI; two MOBs in Los Angeles; three MOBs in Houston, TX and Dallas, TX; and five in Seattle, WA. Sale price and square footage reflect the total sale price paid by the joint venture and total square footage of the property. The net proceeds to the Company related to these dispositions totaled $584.9 million. 2 The Company sold seven MOBs in Greensboro, NC and two non-clustered single-tenant MOBs in Raleigh, NC to a single buyer in a single transaction. 30


 
3 The Company contributed the following medical outpatient properties to a joint venture in which the Company retained 20% ownership: one in each of Dallas, TX, San Antonio, TX and Atlanta, GA; and two MOBs in each of Nashville, TN and Denver, CO. Sale price and square footage reflect the total sale price paid by the joint venture and total square footage of the property. The net proceeds to the Company related to these dispositions totaled $148.9 million. 4 The Company provided seller financing of approximately $9.6 million in connection with this sale. 5 The Company sold an MOB that was included in a consolidated joint venture in which the Company held a 63% ownership interest. Proceeds include the Company's pro-rata share of the purchase price as well as amounts due to the Company by the joint venture. 6 Includes two properties. 7 Includes three properties. Subsequent Dispositions On February 7, 2025, the Company disposed of a 30,304 square foot medical outpatient building in Boston, Massachusetts for $4.5 million. On February 14, 2025, the Company disposed of two medical outpatient buildings in Denver, Colorado, with a combined total of 69,715 square feet for an aggregate purchase price of $8.6 million. Financing Activities Common Stock Repurchases During 2024, the Company repurchased 30.8 million shares of its common stock at an average price of $16.56 per share for a total of $509.8 million. As of December 31, 2024, the Company had $237.0 million of authorized share repurchases remaining. Debt Activity Below is a summary of the significant debt financing activity for the year ended December 31, 2024. See Note 10 to the Consolidated Financial Statements for additional information on financing activities. Mortgage Activity The following table details the mortgage note repayment activity for the year ended December 31, 2024: (dollars in millions) TRANSACTION DATE PRINCIPAL BORROWING (REPAYMENT) ENCUMBERED SQUARE FEET CONTRACTUAL INTEREST RATE Mortgages repaid at maturity: West Hills, CA 1/6/2024 $ (11.3) 63,012 4.77 % Atlanta, GA 2/1/2024 (5.6) 40,324 4.12 % Minnesota 9/1/2024 (7.0) 64,143 4.15 % Total repayments $ (23.9) 167,479 4.44 % Term Loans During 2024, the Company repaid its $350 million Unsecured Term Loan, due 2025 and recognized approximately $0.2 million of accelerated amortization expense included in the loss on extinguishment of debt. Subsequent Activity On January 7, 2025, the Company made a partial repayment of $25 million on its $200 million Unsecured Term Loan due 2025. On January 14, 2025 the Company made a partial repayment of $10 million on its $300 million Unsecured Term Loan due 2025. Interest Rate Swaps As of December 31, 2024, the Company had outstanding interest rate derivatives totaling approximately $1.1 billion to hedge one-month Secured Overnight Financing Rate (“SOFR”). The following details the amount and rate of each swap as of such date (dollars in thousands): 31


 
EXPIRATION AMOUNT WEIGHTED AVERAGE RATE May 2026 $ 275,000 3.74 % June 2026 150,000 3.83 % December 2026 150,000 3.84 % June 2027 200,000 4.27 % December 2027 300,000 3.93 % Total $ 1,075,000 3.92 % The following table details the Company's debt balances as of December 31, 2024: PRINCIPAL BALANCE CARRYING BALANCE 1 WEIGHTED YEARS TO MATURITY 2 CONTRACTUAL RATE EFFECTIVE RATE Senior Notes due 2025 $ 250,000 $ 249,868 0.3 3.88 % 4.12 % Senior Notes due 2026 3 600,000 586,824 1.6 3.50 % 4.94 % Senior Notes due 2027 3 500,000 488,104 2.5 3.75 % 4.76 % Senior Notes due 2028 300,000 298,029 3.0 3.63 % 3.85 % Senior Notes due 2030 3 650,000 586,028 5.1 3.10 % 5.30 % Senior Notes due 2030 299,500 297,190 5.2 2.40 % 2.72 % Senior Notes due 2031 299,785 296,343 6.2 2.05 % 2.25 % Senior Notes due 2031 3 800,000 667,233 6.2 2.00 % 5.13 % Total Senior Notes Outstanding 3,699,285 3,469,619 2.97 % 4.44 % $1.5 billion unsecured credit facility 4 — — 2.8 SOFR + 0.94% 5.30 % $200 million unsecured term loan 200,000 199,896 1.4 SOFR + 1.04% 5.59 % $150 million unsecured term loan 150,000 149,790 1.4 SOFR + 1.04% 5.59 % $300 million unsecured term loan 3 300,000 299,981 1.8 SOFR + 1.04% 5.59 % $200 million unsecured term loan 3 200,000 199,641 2.5 SOFR + 1.04% 5.59 % $300 million unsecured term loan 300,000 298,708 3.0 SOFR + 1.04% 5.59 % Mortgage notes payable 45,279 45,136 1.3 4.04 % 4.17 % Total Outstanding Notes and Bonds Payable $ 4,894,564 $ 4,662,771 3.59 % 4.72 % 1 Balances are reflected net of discounts and debt issuance costs and include premiums. 2 Includes extension options. 3 Debt instruments assumed as part of the Merger with Legacy HTA on July 20, 2022. The amounts shown represent fair value adjustments. 4 As of December 31, 2024, the Company had no outstanding borrowings under the Unsecured Credit Facility with a remaining borrowing capacity of $1.5 billion. Debt Covenant Information The Company’s various debt agreements contain certain representations, warranties, and financial and other covenants customary in such debt agreements. Among other things, these provisions require the Company to maintain certain financial ratios and impose certain limits on the Company’s ability to incur indebtedness and create liens or encumbrances. As of December 31, 2024, the Company was in compliance with the financial covenant provisions under all of its various debt instruments. As of December 31, 2024, 68.4% of the Company’s principal balances were due after 2026, including extension options. Also, as of December 31, 2024, the Company's incurrence of total debt as defined in the senior notes [debt divided by (total assets less intangibles and accounts receivable)] was approximately 38.0% (cannot be greater than 60%) and debt service coverage [interest expense divided by (net income plus interest expense, taxes, depreciation and amortization, gains and impairments)] was approximately 3.1 times (cannot be less than 1.5 times). The Company plans to manage its capital structure to maintain compliance with its debt covenants consistent with its current profile. Downgrades in ratings by the rating agencies could have a material adverse impact on the Company’s cost and availability of capital, which could in turn have a material adverse impact on consolidated results of operations, liquidity and/or financial condition. 32


 
Supplemental Guarantor Information The OP has issued unsecured notes described in Note 10 to the Company's Consolidated Financial Statements included in this report. All unsecured notes are fully and unconditionally guaranteed by the Company, and the OP is 98.7% owned by the Company. Effective January 4, 2021, the Securities and Exchange Commission (the “SEC”) adopted amendments to the financial disclosure requirements which permit subsidiary issuers of obligations guaranteed by the parent to omit separate financial statements if the consolidated financial statements of the parent company have been filed, the subsidiary obligor is a consolidated subsidiary of the parent company, the guaranteed security is debt or debt-like, and the security is guaranteed fully and unconditionally by the parent. Accordingly, as permitted under Rule 13-01(a)(4)(vi) of Regulation S-X, the Company has excluded the summarized financial information for the OP because the assets, liabilities, and results of operations of the OP are not materially different than the corresponding amounts in the Company's Consolidated Financial Statements and management believes such summarized financial information would be repetitive and would not provide incremental value to investors. Trends and Matters Impacting Operating Results Management monitors factors and trends important to the Company and the REIT industry in order to gauge their potential impact on the operations of the Company. Discussed below are some of the factors and trends that management believes may impact the future operations of the Company. Economic and Market Conditions Rising interest rates and increased volatility in the capital markets have increased the Company’s cost and availability of debt and equity capital. Limited availability and increases in the cost of capital could adversely impact the Company’s ability to finance operations and acquire and develop properties. To the extent the Company’s tenants experience increased costs or financing difficulties due to the economic and market conditions, they may be unable or unwilling to make payments or perform their obligations when due. Additionally, increased interest rates may also result in less liquid property markets, limiting the Company’s ability to sell existing assets or obtain joint venture capital. Acquisitions and Dispositions In 2024, the Company completed no property acquisitions. The Company disposed of 67 properties in 2024 for sales prices totaling $1.5 billion, including 30 properties contributed into two joint ventures in which the Company maintains a non-controlling interest. These transactions yielded net cash proceeds of $1.2 billion, net of $67.3 million of closing costs and related adjustments and $172.7 million of retained joint venture interests. The weighted average capitalization rate for these properties was 6.6%. The Company calculates the capitalization rate for dispositions as the in-place cash net operating income divided by the sales price. See the Company's discussion of its 2024 disposition activity in Note 5 to the Consolidated Financial Statements. Development and Redevelopment Activity The table below details the Company’s activity related to its active development and redevelopment projects as of December 31, 2024. The information included in the table below represents management’s estimates and expectations at December 31, 2024, which are subject to change. The Company’s disclosures regarding certain projections or estimates may not reflect actual results. 33


 
ESTIMATED REMAINING FUNDINGS ESTIMATED TOTAL INVESTMENT APPROXIMATE SQUARE FEET Dollars in thousands NUMBER OF PROPERTIES TOTAL FUNDED DURING THE YEAR TOTAL AMOUNT FUNDED Development Activity Raleigh, NC 1 $ 11,602 $ 44,994 $ 7,606 $ 52,600 122,991 Phoenix, AZ 1 33,609 54,950 3,050 58,000 101,086 Fort Worth, TX 1 30,076 30,076 18,124 48,200 101,000 Total $ 75,287 $ 130,020 $ 28,780 $ 158,800 325,077 Redevelopment Activity Washington, DC 3 $ 5,075 $ 15,853 $ 1,704 $ 17,557 259,290 Houston, TX 3 7,878 13,561 16,439 30,000 314,861 Charlotte, NC 2 13,519 17,409 1,291 18,700 169,135 Washington, DC 1 4,212 8,995 1,083 10,078 57,323 White Plains, NY 1 4,601 4,601 14,799 19,400 65,851 Raleigh, NC 1 768 768 10,032 10,800 40,400 Total $ 36,053 $ 61,187 $ 45,348 $ 106,535 906,860 For previously completed development and redevelopment projects, during 2024, the Company funded an additional $39.2 million related to ongoing tenant improvements. The Company maintains discussions with health systems and developers regarding long-term future new development opportunities. In addition, the Company continually evaluates its portfolio for accretive redevelopment opportunities. Security Deposits and Letters of Credit As of December 31, 2024, the Company held approximately $33.4 million in letters of credit and security deposits for the benefit of the Company in the event the obligated tenant fails to perform under the terms of its respective lease. Generally, the Company may, at its discretion and upon notification to the tenant, draw upon these instruments if there are any defaults under the leases. Expiring Leases The Company expects that approximately 15% of the leases in its portfolio will expire each year. In-place leases have a weighted average lease term of 8.3 years and a weighted average remaining lease term of 4.2 years. Demand for well-located real estate with complementary practice types and services remains consistent, and the Company's 2024 quarterly tenant retention statistics ranged from 81% to 85%. In 2025, the Company has 1,359 leases totaling 4.3 million square feet in its multi-tenant portfolio that are scheduled to expire. See additional information regarding expiring single-tenant leases under the heading "Single-Tenant Leases" below. The Company seeks contractual rent increases for in-place leases. As of December 31, 2024 and 2023, the Company's contractual rental rate growth averaged 2.83% and 2.82%, respectively, for in-place leases. In addition, the Company continued to see strong quarterly weighted average rental rate growth for renewing leases ("cash leasing spread"). In 2024, cash leasing spreads averaged 3.3%. In a further effort to maximize revenue growth and reduce its exposure to key expenses such as taxes and utilities, the Company carefully manages its balance of lease types. Gross leases, wherein the Company has full exposure to all operating expenses, comprise 9% of its lease portfolio. Modified gross or base year leases, in which the Company and tenant both pay a share of operating expenses, comprise 28% of the Company's leased portfolio. Net leases, in which tenants pay substantially all operating expenses, total 59% of the leased portfolio. Absolute net leases, in which tenants pay substantially all of the building's operating and capital expenses, comprise 4%. 34


 
Steward Health As previously disclosed, on May 6, 2024, Steward Health announced that it had filed petitions for relief under Chapter 11 of the U.S. Bankruptcy Code in the U.S. Bankruptcy Court for the Southern District of Texas. Prior to the bankruptcy filing, Steward leased approximately 593,000 square feet of space from the Company. Leases for six buildings in Massachusetts totaling approximately 244,000 square feet were assumed in connection with the sale of Steward’s Massachusetts hospitals on or about September 30, 2024. In October 2024, the Company received $2.2 million for prior rent owed under these assumed leases. Leases for approximately 349,000 square feet in buildings in Florida and Massachusetts were rejected by Steward. The total annual revenue associated with the rejected leases was approximately $13.0 million. The Company made significant progress re-leasing space previously occupied by Steward Health, with leases representing over 80% of the rejected Steward Health square feet. Prospect Medical On January 11, 2025, Prospect Medical Holdings filed petitions for relief under Chapter 11 of the U.S. Bankruptcy Code in the U.S. Bankruptcy Court for the Northern District of Texas. Prospect leases approximately 80,912 square feet of space from the Company, accounting for approximately $2.9 million of annual revenue. The Company moved to cash basis accounting for these leases and recorded a reserve of $0.7 million in the fourth quarter. While it is early in the bankruptcy proceedings and the Company is in discussions with Prospect regarding its leases with the Company, there can be no assurance that the Company will recover unpaid rent from Prospect. Capital Expenditures Capital expenditures are long-term investments made to maintain and improve the physical and aesthetic attributes of the Company's owned properties. Examples of such improvements include, but are not limited to, material changes to, or the full replacement of, major building systems (exterior facade, building structure, roofs, elevators, mechanical systems, electrical systems, energy management systems, upgrades to existing systems for improved efficiency) and common area improvements (furniture, signage and artwork, bathroom fixtures and finishes, exterior landscaping, parking lots or garages). These additions are capitalized into the gross investment of a property and then depreciated over their estimated useful lives, typically ranging from 7 to 20 years. Capital expenditures specifically do not include recurring maintenance expenses, whether direct or indirect, related to the upkeep and maintenance of major building systems or common area improvements.  Capital expenditures also do not include improvements related to a specific tenant suite, unless the improvement is part of a major building system or common area improvement. The Company invested $32.5 million, or $0.94 per square foot, in capital expenditures in 2024 and $47.7 million, or $1.24 per square foot, in capital expenditures in 2023. As a percentage of cash net operating income, 2024 and 2023 capital expenditures were 4.1% and 5.8%, respectively. For a reconciliation of cash net operating income, see "Same Store Cash NOI" in the "Non-GAAP Financial Measures and Key Performance Indicators" section as part of Item 7. Management's Discussion and Analysis of Financial Condition and Results of Operations included in Part II of this report. Tenant Improvements The Company may invest in tenant improvements for the purpose of refurbishing or renovating tenant space. The Company categorizes these expenditures into first and second generation tenant improvements. As of December 31, 2024, the Company had commitments of approximately $212.8 million that are expected to be spent on tenant improvements throughout the portfolio, excluding development properties currently under construction. First Generation Tenant Improvements & Planned Capital Expenditures for Acquisitions First generation tenant improvements and planned capital expenditures for acquisition spending totaled $52.4 million and $38.7 million for the years ended December 31, 2024 and 2023, respectively. First generation tenant improvements include build out costs related to suite space in shell condition. Planned capital expenditures for acquisitions include expected near-term fundings that were contemplated as part of the acquisition. Second Generation Tenant Improvements Second generation tenant improvements spending totaled $68.4 million in 2024, or 8.7% of total cash net operating income. In 2023, this spending totaled $63.5 million, or 7.7% of total cash net operating income. 35


 
If the cost of a tenant improvement project exceeds a tenant improvement allowance, the Company generally offers the tenant the option to finance the excess over the lease term with interest or to reimburse the overage to the Company in a lump sum. In either case, such overages are amortized by the Company as rental income over the term of the lease. Interest earned on tenant overages is included in other operating income in the Company's Consolidated Statements of Operations. The first and second generation tenant overage amount amortized to rent, including interest, totaled approximately $7.8 million in 2024, $8.4 million in 2023, and $7.5 million in 2022. Second generation tenant improvement commitments in 2024 for renewals averaged $2.14 per square foot per lease year, ranging quarterly from $1.80 to $2.39. In 2023, these commitments averaged $1.78 per square foot per lease year, ranging quarterly from $1.64 to $1.89. In 2022, these commitments averaged $1.76 per square foot per lease year, ranging quarterly from $1.46 to $1.90. Second generation tenant improvement commitments in 2024 for new leases averaged $7.22 per square foot per lease year, ranging quarterly from $6.93 to $7.34. In 2023, these commitments averaged $5.69 per square foot per lease year, ranging quarterly from $4.44 to $7.11. In 2022, these commitments averaged $5.74 per square foot per lease year, ranging quarterly from $4.84 to $7.07. Leasing Commissions In certain markets, the Company may pay leasing commissions to real estate brokers who represent either the Company or prospective tenants, with commissions generally equating to 4% to 6% of the gross lease value for new leases and 2% to 4% of the gross lease value for renewal leases. In addition, the Company pays its leasing employees incentive compensation when leases are executed that meet certain leasing thresholds. External leasing commissions are amortized to property operating expense, and internal leasing costs are amortized to general and administrative expense in the Company's Consolidated Statements of Operations. In 2024, the Company paid leasing commissions of approximately $47.1 million, or $1.37 per square foot. In 2023, the Company paid leasing commissions of approximately $35.9 million, or $0.93 per square foot. In 2022, the Company paid leasing commissions of approximately $22.9 million, or $0.57 per square foot. As a percentage of total cash net operating income, leasing commissions paid for 2024, 2023 and 2022 were 6.0%, 4.3% and 4.0%, respectively. The amount of leasing commissions amortized over the term of the applicable leases totaled $21.2 million, $13.8 million and $11.0 million for the years ended December 31, 2024, 2023 and 2022, respectively. Rent Abatements Rent abatements, which generally take the form of deferred rent, are sometimes used to help induce a potential tenant to lease space in the Company's properties. Such abatements, when made, are amortized by the Company on a straight-line basis against rental income over the lease term. Rent abatements for 2024 totaled approximately $16.0 million, or $0.46 per square foot. Rent abatements for 2023 totaled approximately $14.3 million, or $0.37 per square foot. Rent abatements for 2022 totaled approximately $14.8 million, or $0.37 per square foot. Single-Tenant Leases As of December 31, 2024, the Company had a total of 110 single-tenant buildings, with a weighted average lease term of 11.6 years and a weighted average remaining lease term of 5.5 years. Twenty-two single-tenant buildings have leases that expire in 2025. Five of these leases have been renewed. The Company is in negotiations with tenants in fifteen of these buildings and expects the leases to be renewed or the building to be backfilled. The Company expects the tenants of two of these single-tenant buildings to vacate the buildings upon lease expiration. The annual base rent for leases that are not expected to renew or be backfilled in 2025 is $4.1 million. Operating Leases As of December 31, 2024, the Company was obligated to make rental payments under operating lease agreements consisting primarily of ground leases related to 142 real estate investments, excluding those ground leases the Company has prepaid. As of December 31, 2024, the Company had 215 properties totaling 16.1 million square feet that were held under ground leases with a remaining weighted average term of 63.6 years, including renewal options. 36


 
These ground leases typically have initial terms of 50 to 75 years with one or more renewal options extending the terms to 75 to 100 years, with expiration dates through 2119. Purchase Options The Company had approximately $111.4 million in real estate properties as of December 31, 2024 that were subject to exercisable purchase options. The Company has approximately $1.1 billion in real estate properties that are subject to purchase options that will become exercisable after 2024. Additional information about the amount and basis for determination of the purchase price is detailed in the table below (dollars in thousands): YEAR EXERCISABLE NUMBER OF PROPERTIES GROSS REAL ESTATE INVESTMENT AS OF DECEMBER 31, 2024 1 Current 2 6 $ 111,399 2025 5 99,970 2026 6 173,761 2027 4 112,305 2028 5 136,814 2029 3 82,026 2030 — — 2031 4 106,839 2032 2 23,848 2033 — — 2034 — — 2035 and thereafter 3 9 326,103 Total 44 $ 1,173,065 1 Purchase option prices are based on fair market value components that are determined by an appraisal process, except for three properties totaling $45.4 million with stated prices or prices based on fixed capitalization rates. 2 These purchase options have been exercisable for an average of 15.1 years. 3 Includes two medical outpatient properties that are recorded in the line item Investment in financing receivable, net on the Company's Consolidated Balance Sheet. Debt Management The Company maintains a flexible capital structure that allows it to fund new investments and operate its existing portfolio. The Company has approximately $45.3 million of mortgage notes payable, maturing in 2025 and 2026, most of which were assumed when the Company acquired properties. The Company will repay mortgages with cash on hand or borrowings under the Unsecured Credit Facility. The Company had $1.5 billion of outstanding debt that matures in 2025 and 2026. See additional information in “Liquidity and Capital Resources - Financing Activities” above. 37


 
Impact of Inflation The Company is subject to the risk of inflation as most of its revenues are derived from long-term leases. Most of the Company's leases provide for fixed increases in base rents or increases based on the Consumer Price Index and require the tenant to pay all or some portion of increases in operating expenses. The Company believes that these provisions mitigate the impact of inflation. However, there can be no assurance that the Company's ability to increase rents or recover operating expenses will keep pace with inflation. The Company's leases have a weighted average lease term remaining of approximately 4.2 years. As of December 31, 2024, 95.6% of the Company's leases provide for fixed base rent increases and 4.4% provide for Consumer Price Index-based rent increases. New Accounting Pronouncements See Note 1 to the Consolidated Financial Statements for information on new accounting standards including both standards that the Company adopted during the year and those that have not yet been adopted. The Company continues to evaluate the impact of the new standards that have not yet been adopted. Other Items Impacting Operations General and administrative expenses will fluctuate quarter-to-quarter. In the first quarter of each year, general and administrative expense include increases for certain expenses such as payroll taxes and healthcare savings account fundings. The Company expects these customary expenses to increase by approximately $0.9 million in the first quarter of 2025. Approximately $0.8 million is not expected to recur in subsequent quarters in 2025. Results of Operations Year Ended December 31, 2024 Compared to Year Ended December 31, 2023 The Company’s consolidated results of operations for 2024 compared to 2023 were impacted by acquisitions, developments, dispositions, gain on sales and impairment charges recorded on real estate properties, and capital markets transactions. Revenues Rental income decreased $76.4 million, or 5.8%, as a result of the following: • Dispositions in 2023 and 2024 resulted in a decrease of $96.3 million. • Acquisitions and developments in 2023 and 2024 contributed $2.3 million. • Leasing activity, including contractual rent increases contributed $24.5 million. • Reversed revenue related to the Steward bankruptcy resulted in a decrease of $6.2 million, including straight- line rent of $2.7 million. • Reversed revenue related to the Prospect Medical bankruptcy resulted in a decrease of $0.7 million. Other operating income increased $1.7 million, or 9.8%, from the prior year primarily as a result of income from management fees. Expenses Property operating expenses decreased $27.0 million, or 5.4%, from the prior year primarily as a result of the following activity: • Dispositions in 2023 and 2024 resulted in a decrease of $35.9 million. • Acquisitions and developments in 2023 and 2024 resulted in an increase of $0.8 million. • Increases in portfolio operating expenses as follows: ◦ Administrative, primarily leasing commissions, of $5.1 million; ◦ Utilities of $2.7 million; ◦ Property taxes of $1.9 million; ◦ Security expense of $0.3 million; and ◦ Janitorial expense of $0.2 million. • Decreases in portfolio operating expenses were due to maintenance and repair expenses of $1.3 million and compensation expense of $0.8 million. 38


 
General and administrative expenses increased approximately $24.7 million, or 42.3%, from the prior year primarily as a result of the following activity: • Increase in restructuring and severance-related charges of $28.3 million • Decrease in payroll and payroll related expenses of approximately $2.4 million. • Increase in cash compensation expense of $1.4 million. • Increase in non-cash compensation incentive expense of $0.9 million. • Other decreases including travel, legal and other administrative costs of $3.5 million. There were no merger-related costs for the year ended December 31, 2024. Merger-related costs for the year ended December 31, 2023, included legal and consulting fees, which were offset by a refund related to state transfer taxes. Depreciation and amortization expense decreased $55.6 million, or 7.6%, from the prior year primarily as a result of the following activity: • Dispositions in 2023 and 2024 resulted in a decrease of $56.6 million. • Acquisitions and developments in 2023 and 2024 resulted in an increase of $0.9 million. • Various building and tenant improvement expenditures resulted in an increase of $39.0 million. • Assets that became fully depreciated resulted in a decrease of $38.9 million. Other Income (Expense) Other income (expense), as an expense increased $361.2 million, or 107.4%, from the prior year mainly due to the following activity: Gain on Sales of Real Estate Properties Gains on the sale of real estate properties and other assets for the years ended December 31, 2024 and 2023 totaled $109.8 million and $77.5 million, respectively. Interest Expense Interest expense decreased $16.2 million for the year ended December 31, 2024 compared to the prior year. The components of interest expense are as follows: CHANGE Dollars in thousands 2024 2023 $ % Contractual interest $ 196,392 $ 208,305 $ (11,913) (5.7) % Net discount/premium accretion 41,050 38,941 2,109 5.4 % Debt issuance costs amortization 4,769 5,588 (819) (14.7) % Amortization of interest rate swap settlement 168 168 — — % Amortization of treasury hedge settlement 427 427 — — % Fair value derivative 187 4,412 (4,225) (95.8) % Interest cost capitalization (4,295) (2,961) (1,334) 45.1 % Interest on lease liabilities 3,727 3,704 23 0.6 % Total interest expense $ 242,425 $ 258,584 $ (16,159) (6.2) % Contractual interest decreased $11.9 million, or 5.7%, primarily as a result of the following activity: • The Unsecured Term Loans accounted for an decrease of approximately $4.8 million, primarily due to the repayment of the $350 million Unsecured Term Loan, due 2025. • The Unsecured Credit Facility accounted for a decrease of approximately $11.4 million. • Active interest rate derivatives accounted for a decrease of $2.5 million, while expired interest rate derivatives accounted for an increase of $8.2 million. • Mortgage note repayments, net of assumptions, accounted for a decrease of approximately $1.4 million. 39


 
Impairment of Real Estate Assets and Credit Loss Reserves Impairment of real estate assets in 2024 totaling approximately $249.9 million is associated with completed or planned disposition activity. Additionally, the Company recorded $59.5 million of credit loss reserves on its mortgage note receivables and a $4.1 million fair value adjustment for an equity investment in other assets. Impairment of real estate assets in 2023 totaling approximately $149.7 million is associated with completed or planned disposition activity. Additionally, the Company recorded $5.2 million of credit loss reserves on its mortgage notes receivable. Impairment of Goodwill During the first quarter of 2024, the Company determined that the carrying value of its single reporting unit exceeded estimated fair value and therefore recorded a $250.5 million full impairment of its goodwill, which is recorded as a non-cash charge in “Impairment of goodwill” in the consolidated statements of operations. See Note 1 to the Condensed Consolidated Financial Statements accompanying this report for more details. Equity income (loss) from unconsolidated joint ventures The Company recognizes its proportionate share of losses from its unconsolidated joint ventures. The losses are primarily attributable to non-cash depreciation expense. See Note 5 for more details regarding the Company's unconsolidated joint ventures. Year Ended December 31, 2023 Compared to Year Ended December 31, 2022 The Company's discussion regarding the comparison of the year ended December 31, 2023 compared to the year ended December 31, 2022 was previously disclosed beginning on page 37 of the Company's Annual Report on Form 10-K for the year ended December 31, 2023 filed with the SEC on February 16, 2024, and is incorporated herein by reference. Non-GAAP Financial Measures and Key Performance Indicators Management considers certain non-GAAP financial measures and key performance indicators to be useful supplemental measures of the Company's operating performance. A non-GAAP financial measure is generally defined as one that purports to measure financial performance, financial position or cash flows, but excludes or includes amounts that would not be so adjusted in the most comparable measure determined in accordance with GAAP. Set forth below are descriptions of the non-GAAP financial measures management considers relevant to the Company's business and useful to investors, as well as reconciliations of these measures to the most directly comparable GAAP financial measures. The non-GAAP financial measures and key performance indicators presented herein are not necessarily identical to those presented by other real estate companies due to the fact that not all real estate companies use the same definitions. These measures should not be considered as alternatives to net income, as indicators of the Company's financial performance, or as alternatives to cash flow from operating activities as measures of the Company's liquidity, nor are these measures necessarily indicative of sufficient cash flow to fund all of the Company's needs. Management believes that in order to facilitate a clear understanding of the Company's historical consolidated operating results, these measures should be examined in conjunction with net income and cash flows from operations as presented in the Consolidated Financial Statements and other financial data included elsewhere in this Annual Report on Form 10-K. Funds from Operations ("FFO"), Normalized FFO and Funds Available for Distribution ("FAD") FFO and FFO per share are operating performance measures adopted by the National Association of Real Estate Investment Trusts (“NAREIT”). NAREIT defines FFO as the most commonly accepted and reported measure of a REIT’s operating performance equal to “net income (computed in accordance with GAAP), excluding gains (or losses) from sales of property, plus depreciation and amortization, impairment, and after adjustments for unconsolidated partnerships and joint ventures.” In addition to FFO, the Company presents Normalized FFO and FAD. Normalized FFO is presented by adding to FFO acquisition-related costs, acceleration of debt issuance costs, debt extinguishment costs and other Company- defined normalizing items to evaluate operating performance. FAD is presented by adding to Normalized FFO non- real estate depreciation and amortization, deferred financing fees amortization, share-based compensation expense 40


 
and provision for bad debts, net; and subtracting straight-line rent income, net of expense, and maintenance capital expenditures, including second generation tenant improvements, capital expenditures and leasing commissions paid. The Company's definition of these terms may not be comparable to that of other real estate companies as they may have different methodologies for computing these amounts. FFO, Normalized FFO, and FAD should not be considered as an alternative to net income as an indicator of the Company's financial performance or to cash flow from operating activities as an indicator of the Company's liquidity. FFO, Normalized FFO, and FAD should be reviewed in connection with GAAP financial measures. Management believes FFO, Normalized FFO, FFO per share, Normalized FFO per share and FAD ("Non-GAAP Measures") provide an understanding of the operating performance of the Company’s properties without giving effect to certain significant non-cash items, primarily gains on sales of real estate, impairments and depreciation and amortization expense. Historical cost accounting for real estate assets in accordance with GAAP assumes that the value of real estate assets diminishes predictably over time. However, real estate values instead have historically risen or fallen with market conditions. The Company believes that by excluding the effect of depreciation, amortization, impairments and gains or losses from sales of real estate, all of which are based on historical costs, and which may be of limited relevance in evaluating current performance, Non-GAAP Measures can facilitate comparisons of operating performance between periods. The Company reports Non-GAAP Measures because these measures are observed by management to also be the predominant measures used by the REIT industry and by industry analysts to evaluate REITs. For these reasons, management deems it appropriate to disclose and discuss these Non-GAAP Measures. However, none of these measures represent cash generated from operating activities determined in accordance with GAAP and are not necessarily indicative of cash available to fund cash needs. Further, these measures should not be considered as an alternative to net income as an indicator of the Company’s operating performance or as an alternative to cash flow from operating activities as a measure of liquidity. 41


 
The table below reconciles net income attributable to common stockholders to FFO, Normalized FFO and FAD attributable to common stockholders for the years ended December 31, 2024, 2023, and 2022. YEAR ENDED DECEMBER 31, Amounts in thousands, except per share data 2024 2023 2022 Net (loss) income attributable to common stockholders $ (654,485) $ (278,261) $ 40,897 Net (loss) income attributable to common stockholders per diluted share 1 $ (1.81) $ (0.74) $ 0.15 Gain on sales of real estate assets (104,684) (77,546) (270,271) Impairment of real estate properties 249,909 149,717 54,427 Real estate depreciation and amortization 690,988 738,526 459,211 Non-controlling loss from operating partnership units (9,149) (3,426) (5) Unconsolidated JV depreciation and amortization 20,678 18,116 12,722 FFO adjustments $ 847,742 $ 825,387 $ 256,084 FFO adjustments per common share - diluted $ 2.29 $ 2.15 $ 1.01 FFO attributable to common stockholders $ 193,257 $ 547,126 $ 296,981 FFO attributable to common stockholders per common share - diluted $ 0.52 $ 1.43 $ 1.17 — Transaction costs 3,122 2,026 3,229 Merger-related costs 2 — (1,952) 103,380 Lease intangible amortization (2,054) 860 1,028 Non-routine legal costs/forfeited earnest money received 1,077 175 771 Debt financing costs 237 (62) 3,145 Restructuring and severance-related charges 29,852 1,445 — Credit losses and gains (losses) on other assets, net 3 59,707 8,599 — Impairment of goodwill 250,530 — — Merger-related fair value of debt instruments 40,667 42,885 21,248 Unconsolidated JV normalizing items 4 390 389 330 Normalized FFO adjustments $ 383,528 $ 54,365 $ 133,131 Normalized FFO adjustments per common share - diluted $ 1.04 $ 0.14 $ 0.52 Normalized FFO attributable to common stockholders $ 576,785 $ 601,491 $ 430,112 Normalized FFO attributable to common stockholders per common share - diluted $ 1.56 $ 1.57 $ 1.69 Non-real estate depreciation and amortization 1,478 2,566 2,217 Non-cash interest amortization, net 5 5,101 4,968 5,129 Rent reserves, net 714 3,163 516 Straight-line rent, net (27,254) (32,592) (20,124) Stock-based compensation 14,036 13,791 14,294 Unconsolidated JV non-cash items 6 (923) (1,034) (1,206) Normalized FFO adjusted for non-cash items $ 569,937 $ 592,353 $ 430,938 2nd generation tenant improvements (69,445) (66,081) (33,620) Leasing commissions paid (47,450) (36,391) (22,929) Building capital (33,934) (49,343) (48,913) FAD $ 419,108 $ 440,538 $ 325,476 FFO weighted average common shares outstanding - diluted 7 369,767 383,381 254,622 1 Potential common shares are not included in diluted earnings per share when a loss exists as the effect would be antidilutive. 2 Includes costs incurred related to the Merger. For the year ended December 31, 2023, Merger-related costs are net of a refund of $17.8 million for transfer taxes paid during the year ended December 31, 2022. 3 For the year ended December 31, 2024, includes $59.6 million in credit loss reserves, net of recoveries on four notes receivable included in "Impairment of real estate properties and credit loss reserves" on the Statement of Operations, $5.1 million gain on sale of other assets included in "Gains on sales of real estate and other assets" on the Statement of Operations, $4.1 million loss on other asset included in "Impairment of real estate properties and credit loss reserves" on the Statement of Operations, and a $1.1 million straight line rent reversal included in "Rental income" on the Statement of Operations. For the year ended December 31, 2023, includes a $5.2 million credit allowance for a mezzanine loan included in "Impairment of real estate properties and credit loss reserves" on the Statement of Operations and $3.4 million reserve included in “Rental Income” on the Statement of Operations for previously deferred rent and straight line rent for three skilled nursing facilities. 4 Includes the Company's proportionate share of lease intangible amortization related to unconsolidated joint ventures. 5 Includes the amortization of deferred financing costs, discounts and premiums, and non-cash financing receivable amortization. 6 Includes the Company's proportionate share of straight-line rent, net related to unconsolidated joint ventures. 42


 
7 The Company utilizes the treasury stock method which includes the dilutive effect of nonvested share-based awards outstanding of 556,201, 397,168, and 748,385 for the years ended December 31, 2024, 2023, and 2022, respectively. Cash Net Operating Income ("NOI") and Same Store Cash NOI Cash NOI and Same Store Cash NOI are key performance indicators. Management considers these to be supplemental measures that allow investors, analysts and Company management to measure unlevered property- level operating results. The Company defines Cash NOI as rental income, interest from financing receivables less property operating expenses. Cash NOI excludes non-cash items such as above and below market lease intangibles, straight-line rent, lease inducements, financing receivable amortization, tenant improvement amortization and leasing commission amortization. The Company also excludes cash lease termination fees. Cash NOI is historical and not necessarily indicative of future results. Same Store Cash NOI compares Cash NOI for stabilized properties. Stabilized properties are properties that have been included in operations for the duration of the year-over-year comparison period presented. Accordingly, stabilized properties exclude properties that were recently acquired or disposed of, properties classified as held for sale or intended for sale, properties undergoing redevelopment, and newly-redeveloped or developed properties. The Company utilizes the redevelopment classification for properties where management has approved a change in strategic direction for such properties through the application of additional resources including an amount of capital expenditures significantly above routine maintenance and capital improvement expenditures. Any recently acquired property will be included in the same store pool once the Company has owned the property for eight full quarters. Newly-developed or redeveloped properties will be included in the same store pool eight full quarters after substantial completion. The following table reflects the Company's Same Store Cash NOI for the years ended December 31, 2024 and 2023. NUMBER OF PROPERTIES GROSS INVESTMENT at December 31, 2024 SAME STORE CASH NOI for the year ended December 31 Dollars in thousands 2024 2023 Same store properties 556 $ 10,810,884 $ 670,867 $ 652,420 Joint venture same store properties 29 $ 322,639 $ 17,595 $ 16,869 The following tables reconcile net loss to Same Store NOI and the same store property metrics to the total owned real estate portfolio for the years ended December 31, 2024 and 2023: Reconciliation of Same Store Cash NOI 43


 
SAME STORE RECONCILIATION YEAR ENDED DECEMBER 31, Dollars in thousands 2024 2023 Net loss $ (663,904) $ (282,083) Other expense 697,381 336,227 General and administrative expense 83,121 58,405 Depreciation and amortization expense 675,152 730,709 Other expenses 1 23,446 13,413 Straight-line rent, net (26,115) (32,592) Joint venture properties 24,219 19,176 Other revenue 2 (31,967) (17,249) Cash NOI 781,333 826,006 Cash NOI not included in same store (92,871) (156,717) Same store cash NOI 688,462 669,289 Same store joint venture properties (17,595) (16,869) Same store cash NOI (excluding JVs) $ 670,867 $ 652,420 1. Includes transaction costs, Merger-related costs, rent reserves, above and below market ground lease intangible amortization, leasing commission amortization and ground lease straight-line rent expense. 2. Includes management fee income, interest, above and below market lease intangible amortization, lease inducement amortization, lease terminations and tenant improvement overage amortization. Reconciliation of Same Store Properties AS OF DECEMBER 31, 2024 Dollars and square feet in thousands PROPERTY COUNT GROSS INVESTMENT 1 SQUARE FEET OCCUPANCY Same store properties 556 $ 10,810,884 31,850 89.8 % Joint venture same store properties 29 322,639 1,636 89.2 % Wholly owned and joint venture acquisitions 33 172,330 2,388 94.3 % Wholly owned and joint venture development completions 5 191,113 553 57.7 % Wholly owned and joint venture redevelopments 25 545,331 1,874 63.0 % Planned Dispositions 3 50,245 144 58.3 % Total 651 $ 12,092,542 38,445 88.2 % Joint venture properties 65 556,897 4,253 87.4 % Total wholly-owned real estate properties 586 $ 11,535,645 34,192 88.3 % 1 Excludes assets held for sale, construction in progress, land held for development, corporate property and financing lease right-of-use assets unrelated to an imputed lease arrangement as a result of a sale leaseback transaction. Application of Critical Accounting Policies to Accounting Estimates The Company’s Consolidated Financial Statements are prepared in accordance with GAAP and the rules and regulations of the SEC. In preparing the Consolidated Financial Statements, management is required to exercise judgment and make assumptions that impact the carrying amount of assets and liabilities and the reported amounts of revenues and expenses reflected in the Consolidated Financial Statements. Management routinely evaluates the estimates and assumptions used in the preparation of its Consolidated Financial Statements. These regular evaluations consider historical experience and other reasonable factors and use the seasoned judgment of management personnel. Management has reviewed the Company’s critical accounting policies with the Audit Committee of the Board of Directors. Management believes the following paragraphs in this section describe the application of critical accounting policies and estimates by management to arrive at the critical accounting estimates reflected in the Consolidated Financial 44


 
Statements. The Company’s accounting policies are more fully discussed in Note 1 to the Consolidated Financial Statements. Principles of Consolidation The Company’s Consolidated Financial Statements include the accounts of the Company, its wholly owned subsidiaries, joint ventures, and partnerships where the Company controls the operating activities. All material intercompany accounts and transactions have been eliminated. Capitalization of Costs GAAP generally allows for the capitalization of various types of costs. The rules and regulations on capitalizing costs and the subsequent depreciation or amortization of those costs versus expensing them in the period incurred vary depending on the type of costs and the reason for capitalizing the costs. Direct costs of a development project generally include construction costs, professional services such as architectural and legal costs, travel expenses, and land acquisition costs as well as other types of fees and expenses. These costs are capitalized as part of the basis of an asset to which such costs relate. Indirect costs include capitalized interest and overhead costs. Indirect costs are capitalized during construction and on the unoccupied space in a property for up to one year after the property is ready for its intended use. Capitalized interest is calculated using the weighted average interest rate of the Company's unsecured debt or the interest rate on project specific debt, if applicable. The Company’s overhead costs are based on overhead load factors that are charged to a project based on direct time incurred. The Company computes the overhead load factors annually for its acquisition and development departments, which have employees who are involved in the projects. The overhead load factors are computed to absorb that portion of indirect employee costs (payroll and benefits, training, and similar costs) that are attributable to the productive time the employee incurs working directly on projects. The employees in the Company’s development departments who work on these projects maintain and report their hours, by project. Employee costs that are administrative, such as vacation time, sick time, or general and administrative time, are expensed in the period incurred. Acquisition-related costs include finder’s fees, advisory, legal, accounting, valuation, other professional or consulting fees, and certain general and administrative costs. Acquisition-related costs are expensed in the period incurred for acquisitions accounted for as a business combination under Accounting Standards Codification Topic 805, Business Combinations. These costs associated with asset acquisitions are capitalized in accordance with GAAP. Management’s judgment is also exercised in determining whether costs that have been previously capitalized to a project should be reserved for or written off if or when the project is abandoned or circumstances otherwise change that would call the project’s viability into question. The Company follows a standard and consistently applied policy of classifying pursuit activity as well as reserving for these types of costs based on their classification. The Company classifies its pursuit projects into two categories relating to development. The first category includes pursuits of developments that have a remote chance of producing new business. Costs for these projects are expensed in the period incurred. The second category includes those pursuits of developments that are either probable or highly probable to result in a project or contract. Since the Company believes it is probable that these pursuits will result in a project or contract, it capitalizes these costs in full and records no reserve. Each quarter, all capitalized pursuit costs are again reviewed for viability or a change in classification, and a management decision is made as to whether any additional reserve is deemed necessary. If necessary and considered appropriate, management would record an additional reserve at that time. Capitalized pursuit costs, net of the reserve, are carried in other assets in the Company’s Consolidated Balance Sheets, and any reserve recorded is charged to acquisition and pursuit costs on the Consolidated Statements of Operations. All pursuit costs will ultimately be written off to expense or capitalized as part of the constructed real estate asset. As of December 31, 2024 and 2023, the Company's Consolidated Balance Sheets include capitalized pursuit costs relating to potential developments totaling $4.9 million and $6.2 million, respectively. The Company expensed costs related to the pursuit of acquisitions and dispositions totaling $1.7 million, $0.8 million and $1.0 million for the years ended December 31, 2024, 2023 and 2022, respectively. In addition, the Company expensed costs related to the 45


 
pursuit of developments totaling $1.1 million, $0.8 million, and $2.2 million for the years ended December 31, 2024, 2023 and 2022, respectively. Valuation of Long-Lived Assets Held and Used, Unconsolidated Joint Ventures, Intangible Assets and Goodwill Long-Lived Assets Held and Used The Company assesses the potential for impairment of identifiable intangible assets and long-lived assets, primarily real estate properties, whenever events occur or a change in circumstances indicates that the carrying value might not be recoverable. Important factors that could cause management to review for impairment include significant underperformance of an asset relative to historical or expected operating results; significant changes in the Company's use of assets or the strategy for its overall business; plans to sell an asset before its useful life has ended; the expiration of a significant portion of leases in a property; or significant negative economic trends or negative industry trends for the Company or its operators. In addition, the Company reviews for possible impairment of those assets subject to purchase options and those impacted by casualties, such as tornadoes and hurricanes. In addition, at least annually, the Company assesses whether there were indicators, including property operating performance, changes in anticipated holding period and general market conditions, that the value of the Company’s investments, including unconsolidated joint ventures, may have been impaired. The investment’s value would have been impaired only if management’s estimate of the fair value of the Company’s investment was less than its carrying value. To the extent impairment had occurred, a loss would have been recognized for the excess of its carrying amount over its fair value. The Company may, from time to time, be approached by a third party with an interest in purchasing one or more of the Company's operating real estate properties that were otherwise not for sale. Alternatively, the Company may explore disposing of an operating real estate property but without specific intent to sell the property and without the property meeting the criteria to be classified as held for sale (see discussion below). In such cases, the Company and a potential buyer typically negotiate a letter of intent followed by a purchase and sale agreement that includes a due diligence timeline for completion of customary due diligence procedures. Anytime throughout this period the transaction could be terminated by the parties. The Company views the execution of a purchase and sale agreement as a circumstance that warrants an impairment assessment and must include its best estimates of the impact of a potential sale in the recoverability test discussed in more detail below. A property value is considered impaired only if management's estimate of current and projected (undiscounted and unleveraged) operating cash flows of the property is less than the net carrying value of the property. These estimates of future cash flows include only those that are directly associated with and that are expected to arise as a direct result of the use and eventual disposition of the property based on its estimated remaining useful life. These estimates, including the useful life determination which can be affected by any potential sale of the property, are based on management's assumptions about its use of the property. Therefore, significant judgment is involved in estimating the current and projected cash flows. When the Company executes a purchase and sale agreement for a held and used property, the Company performs the cash flow estimation described above. This assessment gives consideration to all available information, including an assessment of the likelihood the potential transaction will be consummated under the terms and conditions set forth in the purchase and sale agreement. Management will re-evaluate the recoverability of the property if and when significant changes occur as the transaction proceeds toward closing. Normally sale transactions will close within 15 to 30 days after the due diligence period expires. Upon expiration of the due diligence period, management will again re-evaluate the recoverability of the property, updating its assessment based on the status of the potential sale. Whenever management determines that the carrying value of an asset that has been tested may not be recoverable, then an impairment charge would be recognized to the extent the current carrying value exceeds the current fair value of the asset. Significant judgment is also involved in making a determination of the estimated fair value of the asset. The Company also performs an annual goodwill impairment review. The Company's reviews are typically performed as of December 31 of each year. However, during the first quarter of 2024, the Company experienced a sustained decline in the price per share of its common stock, which was identified as an indicator of goodwill impairment. As a 46


 
result, a goodwill evaluation was performed. As of the measurement date, the Company's current operations are carried out through a single reporting unit that had a carrying value of approximately $12.0 billion. The Company determined that the carrying value exceeded estimated fair value and therefore an impairment of goodwill was recorded. The Company recorded a $250.5 million full impairment of its goodwill, which is recorded as a non-cash charge in “Impairment of goodwill” in the Consolidated Statements of Operations. In 2023, a review indicated that no impairment had occurred with respect to the Company's goodwill asset of $250.5 million. Long-Lived Assets to be Disposed of by Planned Sale From time-to-time management affirmatively decides to sell certain real estate properties under a plan of sale. The Company reclassifies the property or disposal group as held for sale when all the following criteria for a qualifying plan of sale are met: • Management, having the authority to approve the action, commits to a plan to sell the property or disposal group; • The property or disposal group is available for immediate sale (i.e., a seller currently has the intent and ability to transfer the property or disposal group to a buyer) in its present condition, subject only to conditions that are usual and customary for sales of such properties or disposal groups; • An active program to locate a buyer and other actions required to complete the plan to sell have been initiated; • The sale of the property or disposal group is probable (i.e., likely to occur) and the transfer is expected to qualify for recognition as a completed sale within one year, with certain exceptions; • The property or disposal group is being actively marketed for sale at a price that is reasonable in relation to its current fair value; and • Actions necessary to complete the plan indicate that it is unlikely significant changes to the plan will be made or that the plan will be withdrawn. A property or disposal group classified as held for sale is initially measured at the lower of its carrying amount or fair value less estimated costs to sell. An impairment charge is recognized for any initial adjustment of the property's or disposal group's carrying amount to its fair value less estimated costs to sell in the period the held for sale criteria are met. The fair value less estimated costs to sell the property (disposal group) should be assessed each reporting period it remains classified as held for sale. Depreciation ceases as long as a property is classified as held for sale. If circumstances arise that were previously considered unlikely and a subsequent decision not to sell a property classified as held for sale were to occur, the property is reclassified as held and used. The property is measured at the time of reclassification at the lower of its (a) carrying amount before it was classified as held for sale, adjusted for any depreciation expense or impairment losses that would have been recognized had the property been continuously classified as held and used or (b) fair value at the date of the subsequent decision not to sell. The effect of any required adjustment is reflected in income from continuing operations at the date of the decision not to sell. The Company recorded impairment charges totaling $249.9 million for the year ended December 31, 2024 related to real estate properties and other long-lived assets. The impairment charges related to 51 properties sold and 13 additional properties associated with planned disposition activity in 2025. The Company recorded impairment charges of $149.7 million in 2023. Valuation of Asset Acquisitions As described in more detail in Note 1 to the Consolidated Financial Statements, when the Company acquires real estate properties with in-place leases, the cost of the acquisition must be allocated between the acquired tangible real estate assets “as if vacant” and any acquired intangible assets. Such intangible assets could include above- (or below-) market in-place leases and at-market in-place leases, which could include the opportunity costs associated with absorption period rentals, direct costs associated with obtaining new leases such as tenant improvements, leasing commissions and customer relationship assets. With regard to the elements of estimating the “as if vacant” values of the property and the intangible assets, including the absorption period, occupancy increases during the absorption period, tenant improvement amounts, and leasing commission percentages, the Company uses the same absorption period and occupancy assumptions for similar property types. Any remaining excess purchase price is then allocated 47


 
to the tangible and intangible assets based on their relative fair values. The identifiable tangible and intangible assets are then subject to depreciation and amortization. Depreciation of Real Estate Assets and Amortization of Related Intangible Assets As of December 31, 2024, the Company had gross investments of approximately $10.5 billion in depreciable real estate assets and related intangible assets. When real estate assets and related intangible assets are acquired or placed in service, they must be depreciated or amortized. Management’s judgment involves determining which depreciation method to use, estimating the economic life of the building and improvement components of real estate assets, and estimating the value of intangible assets acquired when real estate assets are purchased that have in- place leases. With respect to the building components, there are several depreciation methods available under GAAP. Some methods record relatively more depreciation expense on an asset in the early years of the asset’s economic life, and relatively less depreciation expense on the asset in the later years of its economic life. The straight-line method of depreciating real estate assets is the method the Company follows because, in the opinion of management, it is the method that most accurately and consistently allocates the cost of the asset over its estimated life. The Company assigns a useful life to its owned properties based on many factors, including the age and condition of the property when acquired. Revenue Recognition The Company's primary source of revenue is rental income derived from non-cancelable leases. When a lease is executed, the terms and conditions of the lease are assessed to determine the appropriate accounting classification. As of December 31, 2024, with the exception of one finance lease, all of the Company's leases, where the Company is the lessor, are classified as operating leases. Operating leases are recognized on the straight-line basis over the term of the related lease, including periods where a tenant is provided a rent concession. Operating expense recoveries, which include reimbursements for building specific operating expenses, are recognized as revenue in the period in which the related expenses are incurred. The Company generally expects that collectability is probable at lease commencement. If the assessment of collectability changes after the lease commencement date and Rental income is not considered probable, Rental income is recognized on a cash basis and all previously recognized uncollectible Rental income is reversed in the period in which it is determined not to be probable of collection. In addition to the lease-specific collectability assessment performed under Topic 842, the Company may also apply a general reserve ("provision for bad debt"), as a reduction to Rental income, for its portfolio of operating lease receivables. The Company also recognizes certain revenue based on the guidance in Topic 606 and is based on the five-step model to account for revenue arising from contracts with customers. The Company's primary source of revenue associated with Topic 606 relates to parking revenue and management fee income. Derivative Instruments Hedge accounting generally provides for the matching of the timing of gain or loss recognition on the derivative instrument with the recognition of the changes in the fair-value of the hedged asset or liability that are attributable to the hedged risk in a fair value hedge or the earnings effect of the hedged forecasted transaction in a cash flow hedge. The accounting for a derivative requires that the Company make judgments in determining the nature of the derivatives and their effectiveness, including ones regarding the likelihood that a forecasted transaction will take place. These judgments could materially affect our consolidated financial statements. The Company may enter into a derivative instrument to manage interest rate risk from time to time. When a derivative instrument is initiated, the Company will assess its intended use of the derivative instrument and may elect a hedging relationship and apply hedge accounting. As required by the accounting literature, the Company will formally document the hedging relationship for all derivative instruments prior to or contemporaneous with entering into the derivative instrument. 48


 
Item 7A. Quantitative and Qualitative Disclosures About Market Risk The Company is exposed to market risk in the form of changing interest rates on its debt. Management uses regular monitoring of market conditions and analysis techniques to manage this risk. As of December 31, 2024, $3.5 billion of the Company’s $4.7 billion carrying value of debt bore interest at fixed rates, excluding the interest rate swaps. The following table provides information regarding the sensitivity of certain of the Company’s financial instruments, as described above, to market conditions and changes resulting from changes in interest rates. For purposes of this analysis, sensitivity is demonstrated based on hypothetical 10% changes in the underlying market interest rates.       IMPACT ON EARNINGS AND CASH FLOW Dollars in thousands OUTSTANDING PRINCIPAL BALANCE as of Dec. 31, 2024 CALCULATED ANNUAL INTEREST ASSUMING 10% INCREASE  in market interest rates ASSUMING 10% DECREASE in market interest rates Variable Rate Debt Unsecured Credit Facility $ — $ — $ — $ — Unsecured Term Loan due 2025 200,000 11,180 (1,118) 1,118 Unsecured Term Loan due 2025 300,000 16,770 (1,677) 1,677 Unsecured Term Loan due 2026 150,000 8,385 (839) 839 Unsecured Term Loan due 2027 200,000 11,180 (1,118) 1,118 Unsecured Term Loan due 2028 300,000 16,770 (1,677) 1,677 $ 1,150,000 $ 64,285 $ (6,429) $ 6,429 The Company has outstanding interest rate swaps to help mitigate its risk related to variable rate debt. As of December 31, 2024, the Company had $1.1 billion of interest rate swaps at a weighted average rate of 3.92%. See Note 11 to the Consolidated Financial Statements for more information regarding the Company's interest rate swaps.     FAIR VALUE Dollars in thousands CARRYING VALUE as of Dec. 31, 2024 1 DEC. 31, 2024 1 ASSUMING 10% INCREASE  in market interest rates ASSUMING 10% DECREASE in market interest rates DEC. 31, 2023 Fixed Rate Debt Senior Notes due 2025 $ 249,868 $ 250,605 $ 250,515 $ 250,679 $ 244,233 Senior Notes due 2026 586,824 595,052 594,141 595,919 581,556 Senior Notes due 2027 488,104 494,909 493,756 496,037 483,590 Senior Notes due 2028 298,029 290,349 289,532 291,144 282,200 Senior Notes due 2030 586,028 590,648 587,926 593,321 577,702 Senior Notes due 2030 297,190 258,718 257,480 259,924 249,124 Senior Notes due 2031 296,343 244,270 242,884 245,622 235,894 Senior Notes due 2031 667,233 659,624 655,870 663,292 649,347 Mortgage Notes Payable 45,136 44,251 44,196 44,305 69,058 Total Fixed Rate Debt $ 3,514,755 $ 3,428,426 $ 3,416,300 $ 3,440,243 $ 3,372,704 1 Balances are presented net of discounts and debt issuance costs and including premiums. The fair value presented is based on Level 2 inputs defined as model-derived valuations in which significant inputs and significant value drivers are observable in active markets. 49


 
Item 8. Financial Statements and Supplementary Data Report of Independent Registered Public Accounting Firm Stockholders and Board of Directors Healthcare Realty Trust Incorporated Nashville, Tennessee Opinion on the Consolidated Financial Statements We have audited the accompanying consolidated balance sheets of Healthcare Realty Trust Incorporated (the “Company”) as of December 31, 2024 and 2023, the related consolidated statements of operations, comprehensive income (loss), equity and redeemable non-controlling interests, and cash flows for each of the three years in the period ended December 31, 2024, and the related notes and financial statement schedules listed in the accompanying index (collectively referred to as the “consolidated financial statements”). In our opinion, the consolidated financial statements present fairly, in all material respects, the financial position of the Company at December 31, 2024 and 2023, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 2024, in conformity with accounting principles generally accepted in the United States of America. We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) (“PCAOB”), the Company's internal control over financial reporting as of December 31, 2024, based on criteria established in Internal Control – Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (“COSO”) and our report dated February 19, 2025 expressed an unqualified opinion thereon. Basis for Opinion These consolidated financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on the Company’s consolidated financial statements based on our audits. We are a public accounting firm registered with the PCAOB and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB. We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement, whether due to error or fraud. Our audits included performing procedures to assess the risks of material misstatement of the consolidated financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the consolidated financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements. We believe that our audits provide a reasonable basis for our opinion. Critical Audit Matters The critical audit matters communicated below are matters arising from the current period audit of the consolidated financial statements that were communicated or required to be communicated to the audit committee and that: (1) relate to accounts or disclosures that are material to the consolidated financial statements and (2) involved our especially challenging, subjective, or complex judgments. The communication of critical audit matters does not alter in any way our opinion on the consolidated financial statements, taken as a whole, and we are not, by communicating the critical audit matters below, providing separate opinions on the critical audit matters or on the accounts or disclosures to which they relate. Asset Impairment – Plans to Sell a Real Estate Property Before its Useful Life Has Ended The Company recorded total real estate investments, net, of approximately $9.3 billion as of December 31, 2024. As described in Note 1 to the Company's consolidated financial statements, the Company assesses the potential for impairment of long-lived assets, including real estate properties, whenever events occur, or a change in circumstances indicates, that the carrying value might not be fully recoverable. Indicators of impairment may include, among others, plans to sell an asset before its useful life has ended. 50


 
We identified management’s assessment of plans to sell an asset before its useful life has ended as an indicator of potential impairment for real estate properties as a critical audit matter. Assessing the likelihood of the sale of an asset before its useful life has ended requires a high degree of judgment. Auditing management's judgment around these elements was especially challenging due to the nature and extent of audit effort required to address this matter. The primary procedures we performed to address this critical audit matter included: • Testing the design and operating effectiveness of controls over management’s assessment of the likelihood of plans to sell an asset before its useful life has ended. • Assessing the likelihood of plans to sell an asset before its useful life has ended using a combination of retrospective review, inquiry with management outside of the accounting department, and obtaining third party evidence. Impairment of Goodwill As described in Note 1 to the Company’s consolidated financial statements, the Company recorded a $250.5 million impairment of its goodwill in the Consolidated Statement of Operations for the year ended December 31, 2024. The Company evaluates goodwill for impairment annually as of December 31 or whenever events or changes in circumstances indicate that an impairment may exist. During 2024, the Company experienced a sustained decline in the price per share of its common stock, which was identified as an indicator of goodwill impairment. As a result, the Company performed a quantitative assessment, and the fair value of the Company’s single reporting unit was estimated using a combination of discounted cash flow models and earnings multiples techniques. The determination of fair value using the discounted cash flow model technique requires the use of estimates and assumptions, including revenue and expense growth rates, capitalization rate and discount rate. The determination of fair value using the earnings multiples technique requires assumptions to be made in relation to maintainable earnings and market multiples. We identified the evaluation of goodwill for impairment as a critical audit matter. Significant judgments are required to be made by management to determine the fair value for the single reporting unit, especially the assumptions of the discount rate used in the discounted cash flow model and the market multiples used in the earnings multiples technique. Auditing management’s assumptions used in the impairment assessment of goodwill involved especially challenging and subjective auditor judgment due to the nature and extent of audit effort required to address this matter and the extent of specialized skill or knowledge needed. The primary procedures we performed to address this critical audit matter included: • Testing the design and operating effectiveness of controls over management’s determination of the fair value of the single reporting unit, including controls over the discount rate and market multiples used in the goodwill impairment assessment. • Utilizing professionals with specialized skills and knowledge to assist in assessing the reasonableness of the discount rate and market multiples used in the goodwill impairment assessment. /s/ BDO USA, P.C. We have served as the Company's auditor since 2005. Nashville, Tennessee February 19, 2025 51


 
Healthcare Realty Trust Incorporated Consolidated Balance Sheets Amounts in thousands, except per share data ASSETS   DECEMBER 31, 2024 2023 Real estate properties Land $ 1,143,468 $ 1,343,265 Buildings and improvements 9,707,066 10,881,373 Lease intangibles 664,867 836,302 Personal property 9,909 12,718 Investment in financing receivables, net 123,671 122,602 Financing lease right-of-use assets 77,343 82,209 Construction in progress 31,978 60,727 Land held for development 52,408 59,871 Total real estate investments 11,810,710 13,399,067 Less accumulated depreciation (2,483,656) (2,226,853) Total real estate investments, net 9,327,054 11,172,214 Cash and cash equivalents 68,916 25,699 Assets held for sale, net 12,897 8,834 Operating lease right-of-use assets 261,438 275,975 Investments in unconsolidated joint ventures 473,122 311,511 Goodwill — 250,530 Other assets, net 507,496 592,368 Total assets $ 10,650,923 $ 12,637,131 LIABILITIES, REDEEMABLE NON-CONTROLLING INTERESTS, AND STOCKHOLDERS' EQUITY DECEMBER 31, 2024 2023 Liabilities Notes and bonds payable $ 4,662,771 $ 4,994,859 Accounts payable and accrued liabilities 222,510 211,994 Liabilities of properties held for sale 1,283 295 Operating lease liabilities 224,499 229,714 Financing lease liabilities 72,346 74,503 Other liabilities 161,640 202,984 Total liabilities 5,345,049 5,714,349 Commitments and contingencies (See Footnote 15) Redeemable non-controlling interests 4,778 3,868 Stockholders' equity Preferred stock, $0.01 par value; 200,000 shares authorized; none issued and outstanding — — Common stock, $0.01 par value; 1,000,000 shares authorized; 350,532 and 380,964 shares issued and outstanding at December 31, 2024 and 2023, respectively. 3,505 3,810 Additional paid-in capital 9,118,229 9,602,592 Accumulated other comprehensive loss (1,168) (10,741) Cumulative net income attributable to common stockholders 374,309 1,028,794 Cumulative dividends (4,260,014) (3,801,793) Total stockholders’ equity 5,234,861 6,822,662 Non-controlling interest 66,235 96,252 Total equity 5,301,096 6,918,914 Total liabilities, redeemable non-controlling interests, and stockholders' equity $ 10,650,923 $ 12,637,131 See accompanying notes. 52


 
Healthcare Realty Trust Incorporated Consolidated Statements of Operations Amounts in thousands, except per share data   YEAR ENDED DECEMBER 31, 2024 2023 2022 Revenues Rental income $ 1,232,776 $ 1,309,184 $ 907,451 Interest income 16,383 17,134 11,480 Other operating 19,157 17,451 13,706 1,268,316 1,343,769 932,637 Expenses Property operating 473,444 500,437 344,038 General and administrative 83,121 58,405 52,734 Transaction costs 3,122 2,026 3,229 Merger-related costs — (1,952) 103,380 Depreciation and amortization 675,152 730,709 453,082 1,234,839 1,289,625 956,463 Other income (expense) Gain on sales of real estate properties and other assets 109,753 77,546 270,271 Interest expense (242,425) (258,584) (146,691) (Loss) gain on extinguishment of debt (237) 62 (2,401) Impairment of real estate properties and credit loss reserves (313,547) (154,912) (54,427) Impairment of goodwill (250,530) — — Equity loss from unconsolidated joint ventures (135) (1,682) (687) Interest and other (expense) income, net (260) 1,343 (1,546) (697,381) (336,227) 64,519 Net (loss) income (663,904) (282,083) 40,693 Net loss attributable to non-controlling interests 9,419 3,822 204 Net (loss) income attributable to common stockholders $ (654,485) $ (278,261) $ 40,897 Basic earnings per common share $ (1.81) $ (0.74) $ 0.15 Diluted earnings per common share $ (1.81) $ (0.74) $ 0.15 Weighted average common shares outstanding - basic 365,553 378,928 252,356 Weighted average common shares outstanding - diluted 365,553 378,928 253,873 See accompanying notes. 53


 
Healthcare Realty Trust Incorporated Consolidated Statements of Comprehensive Income (Loss) Amounts in thousands   YEAR ENDED DECEMBER 31, 2024 2023 2022 Net (loss) income $ (663,904) $ (282,083) $ 40,693 Other comprehensive (loss) income Interest rate swaps Reclassification adjustment for (gains) losses included in net income (interest expense) (13,137) (14,488) 1,527 Gains arising during the period on interest rate swaps 22,809 1,463 10,630 9,672 (13,025) 12,157 Comprehensive (loss) income (654,232) (295,108) 52,850 Less: Comprehensive loss attributable to non-controlling interests 9,337 3,966 168 Comprehensive (loss) income attributable to common stockholders $ (644,895) $ (291,142) $ 53,018 See accompanying notes. 54


 
Healthcare Realty Trust Incorporated Consolidated Statements of Equity and Redeemable Non-Controlling Interests Amounts in thousands, except per share data Common Stock Additional Paid-In Capital Accumulated Other Comprehensive Income (Loss) Cumulative Net Income Cumulative Dividends Total Stockholders’ Equity Non- controlling Interests Total Equity Redeemable Non- controlling Interests Balance at December 31, 2021 $ 1,505 $ 3,972,917 $ (9,981) $ 1,266,158 $ (3,045,483) $ 2,185,116 $ — $ 2,185,116 $ — Issuance of stock, net of costs 6 22,901 — — — 22,907 — 22,907 — Merger consideration transferred 2,289 5,574,174 — — — 5,576,463 110,702 5,687,165 — Common stock redemption (1) (2,791) — — — (2,792) — (2,792) — Share-based compensation 7 20,339 — — — 20,346 — 20,346 — Redemption of non-controlling interest — 97 — — — 97 (97) — — Net income (loss) — — — 40,897 — 40,897 (204) 40,693 — Reclassification adjustments for losses included in net income (interest expense) — — 1,531 — — 1,531 (4) 1,527 — Gain on interest rate swaps and treasury locks — — 10,590 — — 10,590 40 10,630 — Contributions from redeemable non-controlling interests — — — — — — — — 2,014 Dividends to common stockholders ($1.24 per share) — — — — (284,079) (284,079) (1,695) (285,774) — Balance at December 31, 2022 3,806 9,587,637 2,140 1,307,055 (3,329,562) 7,571,076 108,742 7,679,818 2,014 Issuance of stock, net of costs — 130 — — — 130 — 130 — Common stock redemption (1) (2,234) — — — (2,235) — (2,235) — Conversion of OP Units to common stock 2 2,774 — — — 2,776 (2,776) — — Share-based compensation 3 14,285 — — — 14,288 — 14,288 — Net loss — — — (278,261) — (278,261) (3,822) (282,083) — Reclassification adjustments for gains included in net income (interest expense) — — (14,315) — — (14,315) (173) (14,488) — Gain on interest rate swaps and treasury locks — — 1,434 — — 1,434 29 1,463 — Contributions from redeemable non-controlling interests — — — — — — — — 1,889 Adjustments to redemption value of redeemable non- controlling interests — — — — — — — — (35) Dividends to common stockholders ($1.24 per share) — — — — (472,231) (472,231) (5,748) (477,979) — Balance at December 31, 2023 3,810 9,602,592 (10,741) 1,028,794 (3,801,793) 6,822,662 96,252 6,918,914 3,868 Issuance of stock, net of costs — 104 — — — 104 — 104 — Common stock redemption (5) (8,692) — — — (8,697) — (8,697) — Conversion of OP Units to common stock 3 3,409 — — — 3,412 (3,412) — — 55


 
Share-based compensation 5 31,819 — — — 31,824 — 31,824 — Common stock repurchases (308) (510,115) — — — (510,423) — (510,423) — Redemption of non-controlling interest — — — — — — (11,930) (11,930) — Net (loss) gain — — — (654,485) — (654,485) (9,436) (663,921) 17 Reclassification adjustments for gains included in net income (interest expense) — — (12,954) — — (12,954) (183) (13,137) — Gains arising during the period on interest rate swaps — — 22,527 — — 22,527 282 22,809 — Contributions from redeemable non-controlling interests — — — — — — — — 13 Adjustments to redemption value of redeemable non- controlling interests — (888) — — — (888) — (888) 880 Dividends to common stockholders ($1.24 per share) — — — — (458,221) (458,221) (5,338) (463,559) — Balance at December 31, 2024 $ 3,505 $ 9,118,229 $ (1,168) $ 374,309 $ (4,260,014) $ 5,234,861 $ 66,235 $ 5,301,096 $ 4,778 See accompanying notes. 56


 
Healthcare Realty Trust Incorporated Consolidated Statements of Cash Flows Amounts in thousands   YEAR ENDED DECEMBER 31, OPERATING ACTIVITIES 2024 2023 2022 Net (loss) income $ (663,904) $ (282,083) $ 40,693 Adjustments to reconcile net income to net cash provided by operating activities: Depreciation and amortization 675,152 730,709 453,082 Other amortization 47,165 45,181 24,695 Share-based compensation 31,824 14,288 20,346 Amortization of straight-line rent receivable (lessor) (29,996) (38,676) (23,498) Amortization of straight-line rent on operating leases (lessee) 3,880 6,084 3,374 Gain on sales of real estate properties and other assets (109,753) (77,546) (270,271) Loss (gain) on extinguishment of debt 237 (62) 2,401 Impairment of real estate properties and credit loss reserves 313,547 154,912 54,427 Impairment of goodwill 250,530 — — Equity loss from unconsolidated joint ventures 135 1,682 687 Distributions from unconsolidated joint ventures 10,498 17,880 1,881 Non-cash interest from financing and real estate notes receivable (1,833) (1,654) (2,257) Changes in operating assets and liabilities: Other assets, including right-of-use-assets (34,547) (55,946) (26,098) Accounts payable and accrued liabilities 5,199 (18,775) 24,191 Other liabilities 3,483 3,826 (30,906) Net cash provided by operating activities 501,617 499,820 272,747 INVESTING ACTIVITIES Acquisitions of real estate — (49,171) (402,529) Development of real estate (70,338) (41,058) (37,862) Additional long-lived assets (248,981) (231,026) (163,544) Funding of mortgages and notes receivable (5,505) (26,803) (23,325) Investments in unconsolidated joint ventures — (3,824) (99,967) Investment in financing receivable (511) (1,801) (1,002) Proceeds from sales of real estate properties and additional long-lived assets 1,221,083 701,434 1,201,068 Contributions from redeemable non-controlling interests 13 1,389 — Proceeds from notes receivable repayments 5,162 — 1,688 Cash assumed in Merger, including restricted cash for special dividend payment — — 1,159,837 Net cash provided by investing activities 900,923 349,140 1,634,364 FINANCING ACTIVITIES Net borrowings (repayments) on unsecured credit facility — (385,000) 40,000 Borrowings on term loans — — 666,500 Repayment on term loan (350,000) — (1,141,500) Repayments of notes and bonds payable (25,473) (19,143) (20,042) Redemption of notes and bonds payable — — (2,184) Dividends paid (457,853) (472,242) (283,713) Special dividend paid in relation to the Merger — — (1,123,648) Net proceeds from issuance of common stock 104 130 22,902 Common stock redemptions (8,881) (2,298) (3,192) Common stock repurchases (510,423) — — Distributions to non-controlling interest holders (5,473) (5,123) (1,695) Redemption of non-controlling interest (744) — — Debt issuance and assumption costs (563) (529) (12,753) Payments made on finance leases (17) (17) — Net cash used in financing activities (1,359,323) (884,222) (1,859,325) Increase (decrease) in cash and cash equivalents 43,217 (35,262) 47,786 Cash and cash equivalents cash at beginning of period 25,699 60,961 13,175 Cash and cash equivalents at end of period $ 68,916 $ 25,699 $ 60,961 57


 
See accompanying notes. Healthcare Realty Trust Incorporated Consolidated Statements of Cash Flows, cont. Amounts in thousands YEAR ENDED DECEMBER 31, Supplemental Cash Flow Information 2024 2023 2022 Interest paid $ 202,503 $ 216,033 $ 112,692 Mortgage notes payable assumed in connection with acquisition of real estate, net $ — $ 5,284 $ — Invoices accrued for construction, tenant improvements and other capitalized costs $ 39,969 $ 31,469 $ 48,292 Capitalized interest $ 4,295 $ 2,961 $ 1,410 Mortgage notes receivable taken in connection with sale of real estate $ 9,630 $ 51,000 $ — Non-controlling interest in sale of real estate $ 11,185 $ — $ — Contribution of real estate properties into unconsolidated joint venture $ 172,666 $ — $ — Real estate notes receivable assumed in Merger (adjusted to fair value) $ — $ — $ 74,819 Unsecured credit facility and term loans assumed in Merger (adjusted to fair value) $ — $ — $ 1,758,650 Senior notes assumed in Merger (adjusted to fair value) $ — $ — $ 2,232,650 Consideration transferred in relation to the Merger $ — $ — $ 5,576,463 See accompanying notes. 58


 
1. Summary of Significant Accounting Policies Business Overview Healthcare Realty Trust Incorporated is a real estate investment trust ("REIT") that owns, leases, manages, acquires, finances, develops and redevelops income-producing real estate properties associated primarily with the delivery of outpatient healthcare services throughout the United States of America. Except as otherwise provided in the Notes to the Company’s Consolidated Financial Statements, references herein to the "Company" mean Healthcare Realty Trust Incorporated and its consolidated subsidiaries, including Healthcare Realty Holdings, L.P. (formerly known as Healthcare Trust of America Holdings, LP) (the "OP"), after giving effect to the Merger discussed in more detail in Note 2 below. As of December 31, 2024, the Company had gross real estate investments of approximately $11.8 billion in 589 consolidated real estate properties, construction in progress, redevelopments, financing receivables, financing lease right-of-use assets, land held for development and corporate property, excluding held for sale assets. The Company’s real estate properties are located in 33 states and total approximately 34.2 million square feet. In addition, as of December 31, 2024, the Company had a weighted average ownership interest of approximately 31% in 63 real estate properties held in unconsolidated joint ventures. See Note 5 below for more details regarding the Company's joint ventures. Square footage and property count disclosures in these Notes to the Company's Consolidated Financial Statements are unaudited. Principles of Consolidation The Company’s Consolidated Financial Statements include the accounts of the Company, its wholly owned subsidiaries, and joint ventures and partnerships where the Company controls the operating activities. GAAP requires the Company to identify entities for which control is achieved through means other than voting rights and to determine which business enterprise is the primary beneficiary of variable interest entities (“VIEs”). ASC Topic 810 broadly defines a VIE as an entity in which either (i) the equity investors as a group, if any, lack the power through voting or similar rights to direct the activities of such entity that most significantly impact such entity’s economic performance or (ii) the equity investment at risk is insufficient to finance that entity’s activities without additional subordinated financial support. The Company identifies the primary beneficiary of a VIE as the enterprise that has both of the following characteristics: (i) the power to direct the activities of the VIE that most significantly impact the entity’s economic performance and (ii) the obligation to absorb losses or receive benefits of the VIE that could potentially be significant to the entity. The Company consolidates its investment in a VIE when it determines that it is the VIE’s primary beneficiary, with any minority interests reflected as non-controlling interests or redeemable non- controlling interests in the accompanying Consolidated Financial Statements. The Company may change its original assessment of a VIE upon subsequent events such as the modification of contractual arrangements that affect the characteristics or adequacy of the entity’s equity investments at risk, the disposition of all or a portion of an interest held by the primary beneficiary, or changes in facts and circumstances that impact the power to direct activities of the VIE that most significantly impacts economic performance. The Company performs this analysis on an ongoing basis. For property holding entities not determined to be VIEs, the Company consolidates such entities in which it owns 100% of the equity or has a controlling financial interest evidenced by ownership of a majority voting interest. All intercompany balances and transactions are eliminated in consolidation. For entities in which the Company owns less than 100% of the equity interest, the Company consolidates the entity if it has the direct or indirect ability to control the entities’ activities based upon the terms of the respective entities’ ownership agreements. The OP is 98.7% owned by the Company. Holders of operating partnership units (“OP Units”) are considered to be non-controlling interest holders in the OP and their ownership interests are reflected as equity on the accompanying Consolidated Balance Sheets. Further, a portion of the earnings and losses of the OP are allocated to non-controlling interest holders based on their respective ownership percentages. Upon conversion of OP Units to common stock, any difference between the fair value of the common stock issued and the carrying value of the OP Units converted to common stock is recorded as a component of equity. As of December 31, 2024, there were approximately 4.6 million, or 1.3%, of OP Units issued and outstanding held by non-controlling interest holders. Additionally, the Company is the primary beneficiary of this VIE. Accordingly, the Company consolidates its interests in the OP. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS 59


 
As of December 31, 2024, the Company had three consolidated VIEs in addition to the OP, consisting of joint venture investments in which the Company is the primary beneficiary of the VIE based on the combination of operational control and the rights to receive residual returns or the obligation to absorb losses arising from the joint ventures. Accordingly, such joint ventures have been consolidated, and the table below summarizes the balance sheets of consolidated VIEs, excluding the OP, in the aggregate as of December 31, 2024 and 2023: DECEMBER 31, (dollars in thousands) 2024 2023 Assets: Total real estate investments, net $ 103,933 $ 85,752 Cash and cash equivalents 159 2,144 Other assets, net 4,053 2,704 Total assets $ 108,145 $ 90,600 Liabilities: Notes and bonds payable $ 60,170 $ — Accounts payable and accrued liabilities 2,786 17,835 Other liabilities 45 — Total liabilities $ 63,001 $ 17,835 As of December 31, 2024, the Company had five unconsolidated VIEs consisting of four notes receivables and one joint venture. The Company does not have the power or economic interests to direct the activities of these VIEs on a stand-alone basis, and therefore it was determined that the Company was not the primary beneficiary. As a result, the Company accounts for the four notes receivables as amortized cost and a joint venture arrangement under the equity method. See below for additional information regarding the Company's unconsolidated VIEs: (dollars in thousands) ORIGINATION DATE LOCATION SOURCE CARRYING AMOUNT MAXIMUM EXPOSURE TO LOSS 2021 Houston, TX 1 Note receivable $ 14,900 $ 14,900 2021 Charlotte, NC 1 Note receivable 7,441 7,441 2022 Texas 2 Equity method 56,586 56,586 2024 Texas 3 Note receivable 9,689 16,729 2024 Texas 3 Note receivable 1 4,500 1 Assumed mortgage note receivable in connection with the Merger. 2 Includes investments in seven properties. 3 Company provided seller financing and entered into a mortgage loan and a mezzanine loan in connection with a property disposition. As of December 31, 2024, the Company's unconsolidated joint venture arrangements were accounted for using the equity method of accounting as the Company exercised significant influence over but did not control these entities. See Note 5 for more details regarding the Company's unconsolidated joint ventures. Use of Estimates in the Consolidated Financial Statements Preparation of the Consolidated Financial Statements in accordance with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect amounts reported in the Consolidated Financial Statements and accompanying notes. Actual results may differ from those estimates and assumptions. Management makes significant estimates regarding revenue recognition, purchase price allocations to record investments in real estate, impairments, collectability of tenant receivables, and fair value measurements, as applicable. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 60


 
Segment Reporting The Company owns, leases, acquires, manages, finances, develops and redevelops outpatient and other healthcare- related properties. The Company is managed as one reporting unit, rather than multiple reporting units, for internal reporting purposes and for internal decision-making and discloses its operating results in a single reportable segment. The Company's chief operating decision makers (“CODM”), represented by the Company's Chief Executive Officer, the Chief Financial Officer and the Chief Operating Officer, review financial information and assess the consolidated operations of the Company in order to make strategic decisions such as allocation of capital expenditures and other significant expenses. See Note 18 for additional information on segment reporting. Real Estate Properties Real estate properties are recorded at cost or at fair value if acquired in a transaction that is a business combination under ASC Topic 805, Business Combinations. Cost or fair value at the time of acquisition is allocated among land, buildings, tenant improvements, lease and other intangibles, and personal property as applicable. During 2024 and 2023, the Company eliminated against accumulated depreciation approximately $112.3 million and $51.7 million , respectively, of fully amortized real estate intangibles that were initially recorded as a component of certain real estate acquisitions. During 2024 approximately $3.0 million of fully depreciated tenant and capital improvements that were no longer in service were eliminated against accumulated depreciation. There were no such transactions during 2023. Depreciation expense of real estate properties for the three years ended December 31, 2024, 2023 and 2022 was $507.1 million, $518.6 million and $320.8 million, respectively. Depreciation and amortization of real estate assets in place as of December 31, 2024, is provided for on a straight-line basis over the asset’s estimated useful life: Land improvements 2.0 to 39.0 years Buildings and improvements 3.3 to 49.0 years Lease intangibles (including ground lease intangibles) 1.0 to 99.0 years Personal property 3.0 to 10.0 years The Company capitalizes direct costs, including costs such as construction costs and professional services, and indirect costs, including capitalized interest and overhead costs, associated with the development and construction of real estate assets while substantive activities are ongoing to prepare the assets for their intended use. Capitalized interest cost is calculated using the weighted average interest rate of the Company's unsecured debt or the interest rate on project specific debt, if applicable. The Company continues to capitalize interest on the unoccupied portion of the properties in stabilization for up to one year after the buildings have been placed into service, at which time the capitalization of interest must cease. Asset Impairment The Company assesses the potential for impairment of identifiable, definite-lived, intangible assets and long-lived assets, including real estate properties, whenever events occur or a change in circumstances indicates that the carrying value might not be fully recoverable. Indicators of impairment may include significant underperformance of an asset relative to historical or expected operating results; significant changes in the Company’s use of assets or the strategy for its overall business; plans to sell an asset before its useful life has ended; the expiration of a significant portion of leases in a property; or significant negative economic trends or negative industry trends for the Company or its tenants. In addition, the Company reviews for possible impairment, those assets subject to purchase options and those impacted by casualty losses, such as tornadoes and hurricanes. A property value is considered impaired only if management's estimate of current and projected (undiscounted and unleveraged) operating cash flows of the property is less than the net carrying value of the property. These estimates of future cash flows include only those that are directly associated with and that are expected to arise as a direct result of the use and eventual disposition of the property. These estimates, including the useful life determination which can be affected by any potential sale of the property, are based on management's assumptions about its use of the property. Therefore, significant judgment is involved in estimating the current and projected cash flows. If management determines that the carrying value of the Company’s assets may not be fully recoverable NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 61


 
based on the existence of any of the factors above, or others, management would measure and record an impairment charge based on the estimated fair value of the property or the estimated fair value less costs to sell the property. See Note 7 for additional information on impairment. Acquisitions of Real Estate Properties with In-Place Leases The Company's acquisitions of real estate properties typically do not meet the definition of a business and are accounted for as asset acquisitions. Acquisitions of real estate properties with in-place leases are accounted for at relative fair value. When a building with in-place leases is acquired, the cost of the acquisition must be allocated between the tangible real estate assets "as-if-vacant" and the intangible real estate assets related to in-place leases based on their estimated fair values. Land fair value is estimated by using an assessment of comparable transactions and other relevant data. The Company considers whether any of the in-place lease rental rates are above- or below-market. An asset (if the actual rental rate is above-market) or a liability (if the actual rental rate is below-market) is calculated and recorded in an amount equal to the present value of the future cash flows that represent the difference between the actual lease rate and the estimated market rate. If an in-place lease is identified as a below-market rental rate, the Company would also evaluate any renewal options associated with that lease to determine if the intangible should include those periods. The values related to above- or below-market in-place lease intangibles are amortized over the remaining term of the leases upon acquisition to rental income where the Company is the lessor and to property operating expense where the Company is the lessee. The Company also estimates an absorption period, which can vary by property, assuming the building is vacant and must be leased up to the actual level of occupancy when acquired. During that absorption period, the owner would incur direct costs, such as tenant improvements, and would suffer lost rental income. Likewise, the owner would have acquired a measurable asset in that, assuming the building was vacant, certain fixed costs would be avoided because the actual in-place lessees would reimburse a certain portion of fixed costs through expense reimbursements during the absorption period. These assets (above- or below-market lease, tenant improvement, leasing costs avoided, rental income lost, and expenses recovered through in-place lessee reimbursements) are estimated and recorded in amounts equal to the present value of estimated future cash flows. The actual purchase price is allocated based on the various relative asset fair values described above. The building and tenant improvement components of the purchase price are depreciated over the estimated useful life of the building or the weighted average remaining term of the in-place leases. The at-market, in-place lease intangibles are amortized to depreciation and amortization expense over the weighted average remaining term of the leases, and customer relationship assets are amortized to depreciation and amortization expense over terms applicable to each acquisition. Any goodwill recorded through a business combination would be reviewed for impairment at least annually and is not amortized. See Note 9 for more details on the Company’s intangible assets. Fair Value Measurements Fair value is defined as the price that would be received to sell an asset, or paid to transfer a liability, in an orderly transaction between market participants. In calculating fair value, a company must maximize the use of observable market inputs, minimize the use of unobservable market inputs and disclose in the form of an outlined hierarchy the details of such fair value measurements. A hierarchy of valuation techniques is defined to determine whether the inputs to a fair value measurement are considered to be observable or unobservable in a marketplace. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect the Company’s market assumptions. This hierarchy requires the use of observable market data when available. These inputs have created the following fair value hierarchy: • Level 1 – quoted prices for identical instruments in active markets; • Level 2 – quoted prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are not active, and model-derived valuations in which significant inputs and significant value drivers are observable in active markets; and NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 62


 
• Level 3 – fair value measurements derived from valuation techniques in which one or more significant inputs or significant value drivers are unobservable. Executed purchase and sale agreements, which are binding agreements, are categorized as level one inputs. Fair Value of Derivative Financial Instruments Derivative financial instruments are recorded at fair value on the Company's Consolidated Balance Sheets as other assets or other liabilities. The valuation of derivative instruments requires the Company to make estimates and judgments that affect the fair value of the instruments. Fair values of derivatives are estimated by pricing models that consider the forward yield curves and discount rates. The fair value of the Company's forward starting interest rate swap contracts are estimated by pricing models that consider foreign trade rates and discount rates. Such amounts and the recognition of such amounts are subject to significant estimates that may change in the future. For derivatives designated in qualifying cash flow hedging relationships, the change in fair value of the effective portion of the derivatives is recognized in accumulated other comprehensive income (loss). Gains and losses are reclassified from accumulated other comprehensive income (loss) into earnings once the underlying hedged transaction is recognized in earnings. As of December 31, 2024 and 2023, the Company had $1.2 million and $10.7 million recorded in accumulated other comprehensive loss, respectively, related to forward starting interest rate swaps entered into and settled during 2015 and 2020 and a hedge of the Company's variable rate debt. See Note 11 for additional information. Cash, Cash Equivalents and Restricted Cash Cash and cash equivalents includes short-term investments with original maturities of three months or less when purchased. Restricted cash includes cash held in escrow in connection with proceeds from the sales of certain real estate properties. The Company did not have any restricted cash for the years ended December 31, 2024 or 2023. Cash and cash equivalents are held in bank accounts and overnight investments. The Company maintains its bank deposits with large financial institutions in amounts that often exceed federally-insured limits. The Company has not experienced any losses in such accounts. Goodwill and Other Intangible Assets Goodwill and intangible assets with indefinite lives are not amortized, but are tested at least annually for impairment. Intangible assets with finite lives are amortized over their respective lives to their estimated residual values and are reviewed for impairment only when impairment indicators are present. Identifiable intangible assets of the Company are comprised of enterprise goodwill, in-place lease intangible assets, customer relationship intangible assets, and debt issuance costs. In-place lease and customer relationship intangible assets are amortized on a straight-line basis over the applicable lives of the assets. Debt issuance costs are amortized over the term of the debt instrument on the effective interest method or the straight-line method when the effective interest method is not applicable. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 63


 
Goodwill is not amortized but is typically evaluated for impairment annually as of December 31 or whenever events or changes in circumstances indicate that an impairment may exist. However, during the first quarter of 2024, the Company experienced a sustained decline in the price per share of its common stock, which was identified as an indicator of goodwill impairment. As a result, a goodwill evaluation was performed. The Company performed a quantitative assessment, and the fair value of the Company’s single reporting unit was estimated using a combination of discounted cash flow models and earnings multiples techniques. The determination of fair value using the discounted cash flow model technique requires the use of estimates and assumptions related to revenue and expense growth rates, capitalization rates, discount rates, capital expenditures and working capital levels. The determination of fair value using the earnings multiples technique requires assumptions to be made in relation to maintainable earnings and market multiples. These forecasts and assumptions are highly subjective, and while we believe our assumptions are reasonable, changes in these assumptions may have a material impact on our financial results. The Company determined that the carrying value exceeded estimated fair value, and therefore the Company recorded a $250.5 million full impairment of its goodwill, which is recorded as a non-cash charge in “Impairment of goodwill” in the Consolidated Statements of Operations. See Note 9 for more detail on the Company’s intangible assets. Contingent Liabilities From time to time, the Company may be subject to loss contingencies arising from legal proceedings and similar matters. Additionally, while the Company maintains comprehensive liability and property insurance with respect to each of its properties, the Company may be exposed to unforeseen losses related to uninsured or underinsured damages. The Company continually monitors any matters that may present a contingent liability, and, on a quarterly basis, management reviews the Company’s reserves and accruals in relation to each of them, adjusting provisions as necessary in view of changes in available information. Liabilities for contingencies are first recorded when a loss is determined to be both probable and can be reasonably estimated. Changes in estimates regarding the exposure to a contingent loss are reflected as adjustments to the related liability in the periods when they occur. Because of uncertainties inherent in the estimation of contingent liabilities, it is possible that the Company’s provision for contingent losses could change materially in the near term. To the extent that any significant losses, in addition to amounts recognized, are at least reasonably possible, such amounts will be disclosed in the notes to the Consolidated Financial Statements. Share-Based Compensation The Company has various employee and director share-based awards outstanding. These awards include non-vested common stock or other stock-based awards, including units in the OP, pursuant to the Company's Amended and Restated 2006 Incentive Plan, dated April 29, 2021 ( the "Incentive Plan"). The Company recognizes share-based payments to employees and directors in the Consolidated Statements of Operations on a straight-line basis over the requisite service period based on the fair value of the award on the measurement date. The Company recognizes the impact of forfeitures as they occur. See Note 13 for details on the Company’s share-based awards. Accumulated Other Comprehensive (Loss) Income Certain items must be included in comprehensive (loss) income, including items such as foreign currency translation adjustments, minimum pension liability adjustments, changes in the fair value of derivative instruments and unrealized gains or losses on available-for-sale securities. As of December 31, 2024, the Company’s accumulated other comprehensive (loss) income consists of the loss for changes in the fair value of active derivatives designated as cash flow hedges and the loss on the unamortized settlement of forward starting swaps and treasury hedges. See Note 11 for more details on the Company's derivative financial instruments. Revenue from Contracts with Customers (Topic 606) The Company recognizes certain revenue under the core principle of Topic 606. This requires an entity to recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. Lease revenue is not within the scope of Topic 606. To achieve the core principle, the Company applies the five-step model specified in the guidance. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 64


 
Revenue that is accounted for under Topic 606 is segregated on the Company’s Consolidated Statements of Operations in the Other operating line item. This line item includes parking income, management fee income and other miscellaneous income. Below is a detail of the amounts by category: YEAR ENDED DECEMBER 31, in thousands 2024 2023 2022 Type of Revenue Parking income $ 9,329 $ 9,903 $ 8,513 Management fee income/other 1 9,828 7,548 5,193 $ 19,157 $ 17,451 $ 13,706 1 Includes the recovery of certain expenses under the financing receivable as outlined in the management agreement. The Company’s two major types of revenue that are accounted for under Topic 606 are all accounted for as the performance obligation is satisfied. The performance obligations that are identified for each of these items are satisfied over time and the Company recognizes revenue monthly based on this principle. In most cases, the revenue is due and payable on a monthly basis. The Company had a receivable balance of $1.9 million, $1.9 million and $1.5 million for the years ended December 31, 2024, 2023 and 2022, respectively. Management fee income includes property management services provided to third parties and certain of the properties in the Company's unconsolidated joint ventures and is generally calculated, accrued and billed monthly based on a percentage of cash collections of tenant receivables for the month or a stated amount per square foot. Management fee income also includes amounts paid to the Company for its asset management services for certain of its unconsolidated joint ventures. Internal management fee income, where the Company manages its owned properties, is eliminated in consolidation. Rental Income Rental income related to non-cancelable operating leases is recognized as earned over the life of the lease agreements on a straight-line basis. The Company's lease agreements generally include provisions for stated annual increases or increases based on a Consumer Price Index ("CPI"). Rental income from properties under multi-tenant office lease arrangements and rental income from properties with single-tenant lease arrangements are included in rental income on the Company's Consolidated Statements of Operations. For lessors, the standard requires a lessor to classify leases as either sales-type, direct-financing or operating. A lease will be treated as a sale if it is considered to transfer control of the underlying asset to the lessee. A lease will be classified as direct-financing if risks and rewards are conveyed without the transfer of control. Otherwise, the lease is treated as an operating lease. Nonlease components, such as common area maintenance, are generally accounted for under Topic 606 and separated from the lease payments. However, the Company elected the lessor practical expedient allowing the Company to not separate these components when certain conditions are met. The combined component is accounted for under Accounting Standards Codification, Topic 842. The components of rental income are as follows: YEAR ENDED DECEMBER 31, in thousands 2024 2023 2022 Property operating income $ 1,202,780 $ 1,270,508 $ 883,953 Straight-line rent 29,996 38,676 23,498 Rental income $ 1,232,776 $ 1,309,184 $ 907,451 Federal Income Taxes The Company believes it has qualified to be taxed as a REIT and intends at all times to continue to qualify as a REIT under Sections 856 through 860 of the Internal Revenue Code. The Company must distribute at least 90% per annum of its real estate investment trust taxable income to its stockholders and meet other requirements to continue to qualify as a real estate investment trust. As a REIT, the Company is generally not subject to federal income tax on net income it distributes to its stockholders, but may be subject to certain state and local taxes and fees. See Note 16 for further discussion. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 65


 
If the Company fails to qualify as a REIT in any taxable year, it will be subject to U.S. federal income taxes on its taxable income and will not be permitted to qualify for treatment as a REIT for U.S. federal income tax purposes for four years following the year during which the qualification is lost unless the IRS grants it relief under certain statutory provisions. Such an event could have a material adverse effect on its business, financial condition, results of operations and net cash available for dividend distributions to its stockholders. The Company conducts substantially all of its operations through the OP. As a partnership, the OP generally is not liable for federal income taxes. The income and loss from the operations of the OP is included in the tax returns of its partners, including the Company, who are responsible for reporting their allocable share of the partnership income and loss. Accordingly, no provision for income tax has been made in the accompanying consolidated financial statements. The Company classifies interest and penalties related to uncertain tax positions, if any, in the Consolidated Financial Statements as a component of general and administrative expenses. No such amounts were recognized during the three years ended December 31, 2024. Federal tax returns for the years 2021, 2022, 2023 and 2024 are currently subject to examination by taxing authorities. State Income Taxes The Company must pay certain state income taxes and the provisions for such taxes are generally included in general and administrative expenses on the Company’s Consolidated Statements of Operations. See Note 16 for further discussion. Sales and Use Taxes The Company must pay sales and use taxes to certain state tax authorities based on rents collected from tenants in properties located in those states. The Company is generally reimbursed for these taxes by the tenant. The Company accounts for the payments to the taxing authority and subsequent reimbursement from the tenant on a net basis in rental income in the Company’s Consolidated Statements of Operations. Assets Held for Sale Long-lived assets held for sale are reported at the lower of their carrying amount or their fair value less estimated cost to sell. Further, depreciation of these assets ceases at the time the assets are classified as held for sale. Losses resulting from the sale of such properties are characterized as impairment losses in the Consolidated Statements of Operations. See Note 6 for more detail on assets held for sale. Earnings per Share The Company uses the two-class method of computing net earnings per common share. Earnings per common share is calculated by considering share-based payment awards that contain nonforfeitable rights to dividends or dividend equivalents as participating securities. Undistributed earnings (excess net income over dividend payments) are allocated on a pro rata basis to common shareholders and restricted shareholders. Undistributed losses (dividends in excess of net income) do not get allocated to restricted stockholders as they do not have the contractual obligation to share in losses. The amount of undistributed losses that applies to the restricted stockholders is allocated to the common stockholders. Basic earnings per common share is calculated using weighted average shares outstanding less issued and outstanding non-vested shares of common stock. Diluted earnings per common share is calculated using weighted average shares outstanding plus the dilutive effect of the outstanding stock options from the Legacy HR Employee Stock Purchase Plan using the treasury stock method and the average stock price during the period. Additionally, net income (loss) allocated to OP units has been included in the numerator and common stock related to redeemable OP units have been included in the denominator for the purpose of computing diluted earnings per share. See Note 14 for the calculations of earnings per share. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 66


 
Redeemable Non-Controlling Interests The Company accounts for redeemable equity securities in accordance with Accounting Standards Update ("ASU") 2009-04 Liabilities (Topic 480): Accounting for Redeemable Equity Instruments, which requires that equity securities contingently redeemable at the option of the holder, not solely within our control, be classified outside permanent stockholders’ equity. The Company classifies redeemable equity securities as redeemable non-controlling interests in the accompanying Consolidated Balance Sheet. Accordingly, the Company records the carrying amount at the greater of the initial carrying amount (increased or decreased for the non-controlling interest’s share of net income or loss and distributions) or the redemption value. We measure the redemption value and record an adjustment to the carrying value of the equity securities as a component of redeemable non-controlling interest. As of December 31, 2024, the Company had redeemable non-controlling interests of $4.8 million. Investments in Leases - Financing Receivables, Net In accordance with ASC Topic 842: Leases, for transactions in which the Company enters into a contract to acquire an asset and leases it back to the seller (i.e., a sale-leaseback transaction), control of the asset is not considered to have transferred when the seller-lessee has a purchase option. As a result, the Company does not recognize the underlying real estate asset but instead recognizes a financial asset in accordance with ASC Topic 310: Receivables. See below for additional information regarding the Company's financing receivables as of December 31, 2024. (dollars in thousands) ORIGINATION DATE LOCATION INTEREST RATE CARRYING VALUE as of DECEMBER 31, 2024 CARRYING VALUE as of DECEMBER 31, 2023 May 2021 Poway, CA 5.71% $ 116,304 $ 115,239 November 2021 Columbus, OH 6.48% 7,367 7,363 $ 123,671 $ 122,602 Real Estate Notes Receivable Real estate notes receivable consists of mezzanine and other real estate loans, which are generally collateralized by a pledge of the borrower’s ownership interest in the respective real estate owner, a mortgage or deed of trust, and/or corporate guarantees. Real estate notes receivable are intended to be held-to-maturity and are recorded at amortized cost, net of unamortized loan origination costs and fees and allowance for credit losses. As of December 31, 2024, real estate notes receivable, net, which are included in Other assets, net on the Company's Consolidated Balance Sheets totaled $127.6 million. (dollars in thousands) ORIGINATION MATURITY STATED INTEREST RATE MAXIMUM LOAN COMMITMENT OUTSTANDING as of DECEMBER 31, 2024 INTEREST RECEIVABLE (OTHER ASSETS) ALLOWANCE FOR CREDIT LOSSES FAIR VALUE DISCOUNT AND FEES CARRYING VALUE as of DECEMBER 31, 2024 Mezzanine loans Arizona 12/21/2023 12/20/2026 9.00 % $ 6,000 $ 6,000 $ 38 $ — $ — $ 6,038 Texas 1 10/03/2024 10/02/2029 11.00 % 4,500 1 — — — 1 10,500 6,001 38 — — 6,039 Mortgage loans Texas 2 6/30/2021 12/02/2024 7.00 % 31,150 31,150 551 (16,801) — 14,900 North Carolina 3 12/22/2021 12/22/2024 8.00 % 6,000 6,000 1,441 — — 7,441 Florida 5/17/2022 2/27/2026 6.00 % 65,000 37,661 195 — (24) 37,832 California 3/30/2023 3/29/2026 6.00 % 45,000 45,000 185 — — 45,185 Florida 12/28/2023 12/28/2026 9.00 % 7,700 6,538 — — — 6,538 Texas 1 10/03/2024 10/02/2029 7.50 % 16,729 9,629 60 — — 9,689 171,579 135,978 2,432 (16,801) (24) 121,585 $ 182,079 $ 141,979 $ 2,470 $ (16,801) $ (24) $ 127,624 1 In 2024, the Company provided seller financing of $9.6 million in connection with the sale of a real estate property in Houston, TX. The Company has also committed mezzanine loan funding of up to $4.5 million in connection with this sale. 2 In 2024, the Company determined that an allowance for credit loss of $16.8 million was needed on this mortgage loan, which included approximately $16.3 million of principal and approximately $0.5 million of interest. In January 2025, the underlying collateral for this loan was sold and the Company received $14.9 million towards the principal balance of this loan. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 67


 
3 Outstanding principal and interest due upon maturity. As of the date of these financial statements, the outstanding principal and interest on this loan has not been repaid. The Company has evaluated the collectibility of the amount outstanding and has determined that the underlying collateral has a value that exceeds the carrying value of as of December 31, 2024, and is working with borrower on satisfaction of the mortgage loan. Allowance for Credit Losses Pursuant to ASC Topic 326, Financial Instruments - Credit Losses, the Company adopted a policy to evaluate current expected credit losses at the inception of loans qualifying for treatment under ASC Topic 326. The Company utilizes a probability of default method approach for estimating current expected credit losses and evaluates the liquidity and creditworthiness of its borrowers on a quarterly basis to determine whether any updates to the future expected losses recognized upon inception are necessary. The Company’s evaluation considers industry and economic conditions, credit enhancements, liquidity, and other factors. The determination of the credit allowance is based on a quarterly evaluation of all outstanding loans, including general economic conditions and estimated collectability of loan payments. The Company evaluates the collectability of loan receivables based on a combination of credit quality indicators, including, but not limited to, payment status, historical loan charge-offs, financial strength of the borrower and guarantors, and nature, extent, and value of the underlying collateral. A loan is considered to have deteriorated credit quality when, based on current information and events, it is probable that the Company will be unable to collect all amounts due as scheduled according to the contractual terms of the loan agreement. For those loans identified as having deteriorated credit quality, the amount of credit loss is determined on an individual basis. Placement on non-accrual status may be required. Consistent with this definition, all loans on non-accrual status are deemed to have deteriorated credit quality. To the extent circumstances improve and the risk of collectability is diminished, the loan may return to income accrual status. While a loan is on non-accrual status, any cash receipts are applied against the outstanding principal balance. In 2023, the Company determined that the risk of credit loss on two of its mezzanine loans was no longer remote and recorded a credit loss reserve of $5.2 million. In 2024, the Company determined that an additional allowance of $46.8 million was needed on these two mezzanine loans to cover the entire carrying amount for these loans. In fourth quarter of 2024, the underlying project was sold and the Company received $4.0 million as consideration for its mezzanine loan interests. Additionally, in 2024 the Company determined the risk of credit loss on one of its mortgage notes receivable was no longer remote and recorded a credit loss reserve of $16.8 million, including $0.5 million of accrued interest. The Company utilized the level 1 fair value hierarchy, which included an executed purchase and sale agreement on the underlying collateral of the mortgage loan, to determine the amount of credit loss reserve. The following table summarizes the Company's allowance for credit losses on real estate notes receivable: Dollars in thousands TWELVE MONTHS ENDED DECEMBER 31, 2024 TWELVE MONTHS ENDED DECEMBER 31, 2023 Allowance for credit losses, beginning of period $ 5,196 $ — Credit loss reserves 1 59,563 5,196 Recoveries 1 (4,000) — Write-off 1 (43,958) — Allowance for credit losses, end of period $ 16,801 $ 5,196 1. On June 24, 2024, the Company's two mezzanine loans in Texas with a total principal balance of $54.1 million matured. On July 15, 2024, the senior lender on the construction loan associated with the underlying project provided notice of foreclosure proceedings to the borrower. In 2024, the Company recorded an allowance for credit loss of $46.8 million to cover the entire carrying amount for these loans. In the fourth quarter of 2024, the capital for the underlying project was restructured and the Company received $4.0 million as consideration for its interest. As of December 31, 2024, the Company no longer has a mezzanine position in connection with these projects. Interest Income Income from Lease Finance Receivables The Company recognized the related income from two financing receivables totaling $8.4 million, $8.3 million and $8.1 million, respectively, for the years ended December 31, 2024, 2023 and 2022, based on an imputed interest rate over the terms of the applicable lease. As a result, the interest recognized from the financing receivable in any particular period will not equal the cash payments from the lease agreement in that period. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 68


 
Acquisition costs incurred in connection with entering into the financing receivable are treated as loan origination fees. These costs are classified with the financing receivable and are included in the balance of the net investment. Amortization of these amounts will be recognized as a reduction to Interest income over the life of the lease. Income from Real Estate Notes Receivable For the years ended December 31, 2024, 2023 and 2022, the Company recognized interest income of $8.0 million, $8.8 million and $3.4 million, respectively, related to real estate notes receivable. The Company recognizes interest income on an accrual basis unless the Company has determined that collectability of contractual amounts is not reasonably assured, at which point the note is placed on non-accrual status and interest income is recognized on a cash basis. In 2023, the Company placed two of its real estate notes receivable on non-accrual status. In 2024, the Company placed one of its real estate notes receivable with a principal balance, net of credit loss, of $14.9 million on non-accrual status. Accordingly, the Company did not recognize any interest income for these loans subsequent to the transition to non-accrual status. New Accounting Pronouncements On November 27, 2023, the Financial Accounting Standards Board ("FASB") issued ASU 2023-07, Segment Reporting (Topic 280). Some of the main provisions of this update to segment reporting include; (i) a requirement to disclose significant segment expenses, on an annual and interim basis, that are regularly provided to the CODM and included within each reported measure of segment profit or loss; (ii) a requirement to disclose the title and position of the CODM and an explanation of how the CODM uses the reported measures of segment profit or loss in assessing segment performance and deciding how to allocate resources, and (iii) a requirement that an entity that has a single reportable segment provide all the disclosures required by the amendments in this update. The Company adopted this ASU, effective for the year ended December 31, 2024. The adoption has no impact on the Company’s financial position, results of operations or cash flows, but has resulted in new footnote disclosure. See Note 18 for details on Segment Reporting. On November 4, 2024, the FASB issued ASU 2024-03, Disaggregation of Income Statement Expenses, that will require entities to provide more detailed information in the notes to the financial statements related to certain expense captions on the face of the income statement. The ASU aims to increase transparency and provide investors with more detailed information about the nature of expenses reported on the face of the income statement. The new standard does not change the requirements for the presentation of expenses on the face of the income statement. Under this ASU, entities are required to disaggregate, in a tabular format, expense captions presented on the face of the income statement — excluding earnings or losses from equity method investments — if they include any of the following expense categories: purchases of inventory, employee compensation, depreciation, intangible asset amortization, and depreciation or depletion. For any remaining items within each relevant expense caption, entities must provide a qualitative description of the nature of those expenses. The new ASU is effective for annual reporting periods beginning after December 15, 2026 and interim reporting periods beginning after December 15, 2027. Early adoption is permitted. The Company does not expect that the adoption of this ASU will have a material impact on its consolidated financial statements and compliance of these new disclosure requirements will begin with the Company's Annual Report on Form 10-K for the year ended December 31, 2027. Note 2. Merger with HTA On July 20, 2022 (the “Closing Date”), pursuant to the Agreement and Plan of Merger dated as of February 28, 2022 (the “Merger Agreement”), by and among Healthcare Realty Trust Incorporated (now known as HRTI, LLC) (“Legacy HR”), Healthcare Trust of America, Inc. (now known as Healthcare Realty Trust Incorporated) (“Legacy HTA”), the OP, and HR Acquisition 2, LLC (“Merger Sub”), Merger Sub merged with and into Legacy HR, with Legacy HR continuing as the surviving entity and a wholly-owned subsidiary of Legacy HTA (the “Merger”). On the Closing Date, each outstanding share of Legacy HR common stock, $0.01 par value per share (the “Legacy HR Common Stock”), was cancelled and converted into the right to receive one share of Legacy HTA class A common stock at a fixed ratio of 1.00 to 1.00. Per the terms of the Merger Agreement, Legacy HTA declared a special dividend of $4.82 (the “Special Dividend”) for each outstanding share of Legacy HTA class A common stock, $0.01 par value per NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 69


 
share ( the “Legacy HTA Common Stock”), and the OP declared a corresponding distribution to the holders of its partnership units, payable to Legacy HTA stockholders and OP unitholders of record on July 19, 2022. Immediately following the Merger, Legacy HR converted to a Maryland limited liability company and changed its name to HRTI, LLC and Legacy HTA changed its name to “Healthcare Realty Trust Incorporated”. In addition, the equity interests of Legacy HR were contributed by Legacy HTA by means of a contribution and assignment agreement to the OP, and Legacy HR became a wholly-owned subsidiary of the OP. The Company operates under the name “Healthcare Realty Trust Incorporated” and its shares of class A common stock, $0.01 par value per share, trade on the New York Stock Exchange under the ticker symbol “HR”. For accounting purposes, the Merger was treated as a “reverse acquisition” in which Legacy HTA was considered the legal acquirer and Legacy HR was considered the accounting acquirer based on various factors, including, but not limited to: (i) the composition of the board of directors of the combined company following the Merger, (ii) the composition of senior management of the combined company following the Merger, and (iii) the premium transferred to the Legacy HTA stockholders. As a result, the historical financial statements of the accounting acquirer, Legacy HR, became the historical financial statements of the Company. The acquisition was accounted for using the acquisition method of accounting in accordance with ASC 805, Business Combinations, which requires, among other things, the assets acquired and the liabilities assumed and non- controlling interests, if any, to be recognized at their acquisition date fair value. The implied consideration transferred on the Closing Date is as follows: Fair value of Legacy HTA restricted stock awards attributable to pre-Merger services(c) 7,406 Consideration transferred $ 5,576,463 Dollars in thousands, except for per share data Shares of Legacy HTA Common Stock outstanding as of July 20, 2022 as adjusted(a) 228,520,990 Exchange ratio 1.00 Implied shares of Legacy HR Common Stock issued 228,520,990 Adjusted closing price of Legacy HR Common Stock on July 20, 2022(b) $ 24.37 Value of implied Legacy HR Common Stock issued $ 5,569,057 (a) The number of shares of Legacy HTA Common Stock presented above was based on 228,857,717 total shares of Legacy HTA Common Stock outstanding as of the Closing Date, less 192 Legacy HTA fractional shares that were cancelled in lieu of cash and less 336,535 shares of Legacy HTA restricted stock (net of 215,764 shares of Legacy HTA restricted stock withheld). For accounting purposes, these shares were converted to Legacy HR Common Stock, at an exchange ratio of 1.00 share of Legacy HR Common Stock per share of Legacy HTA Common Stock. (b) For accounting purposes, the fair value of Legacy HR Common Stock issued to former holders of Legacy HTA Common Stock was based on the per share closing price of Legacy HR Common Stock on July 20, 2022. (c) Represents the fair value of Legacy HTA restricted shares which fully vested prior to the closing of the Merger or became fully vested as a result of the closing of the Merger and which are attributable to pre-combination services. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 70


 
Final Purchase Price Allocation The following table summarizes the estimated fair values of the assets acquired and liabilities assumed at the Closing Date: Dollars in thousands PRELIMINARY AMOUNTS RECOGNIZED ON THE CLOSING DATE CUMULATIVE MEASUREMENT PERIOD ADJUSTMENTS AMOUNTS RECOGNIZED ON THE CLOSING DATE (as adjusted) ASSETS Real estate investments Land $ 985,926 $ 18,359 $ 1,004,285 Buildings and improvements 6,960,418 (119,135) 6,841,283 Lease intangible assets(a) 831,920 1,839 833,759 Financing lease right-of-use assets 9,874 3,146 13,020 Construction in progress 10,071 (6,744) 3,327 Land held for development 46,538 — 46,538 Total real estate investments $ 8,844,747 $ (102,535) $ 8,742,212 Assets held for sale, net 707,442 (7,946) 699,496 Investments in unconsolidated joint ventures 67,892 — 67,892 Cash and cash equivalents 26,034 11,403 37,437 Restricted cash 1,123,647 (1,247) 1,122,400 Operating lease right-of-use assets 198,261 16,370 214,631 Other assets, net (b) (c) 209,163 (3,840) 205,323 Total assets acquired $ 11,177,186 $ (87,795) $ 11,089,391 LIABILITIES Notes and bonds payable $ 3,991,300 $ — $ 3,991,300 Accounts payable and accrued liabilities 1,227,570 17,374 1,244,944 Liabilities of assets held for sale 28,677 (3,939) 24,738 Operating lease liabilities 173,948 10,173 184,121 Financing lease liabilities 10,720 (855) 9,865 Other liabilities 203,210 (8,909) 194,301 Total liabilities assumed $ 5,635,425 $ 13,844 $ 5,649,269 Net identifiable assets acquired $ 5,541,761 $ (101,639) $ 5,440,122 Non-controlling interest $ 110,702 $ — $ 110,702 Goodwill $ 145,404 $ 101,639 $ 247,043 (a) The weighted average amortization period for the acquired lease intangible assets is approximately 6 years. (b) Includes $15.9 million of contractual accounts receivable, which approximates fair value. (c) Includes $78.7 million of gross contractual real estate notes receivable, the fair value of which was $74.8 million, and the Company expected to collect substantially all of the real estate notes receivable proceeds as of the Closing Date. The cumulative measurement period adjustments recorded through June 30, 2023 are final and primarily resulted from updated valuations related to the Company’s real estate assets and liabilities and additional information obtained by the Company related to the properties acquired in the Merger and their respective tenants, and resulted in an increase to goodwill of $101.6 million. Based on the final purchase price allocation of fair value, approximately $247.0 million was allocated to goodwill. Goodwill represents the excess of the purchase price over the fair value of the net tangible and intangible assets acquired and liabilities assumed. The recognized goodwill was attributable to expected synergies and benefits arising from the Merger, including anticipated general and administrative cost savings and potential economies of scale benefits in both tenant and vendor relationships following the closing of the Merger. None of the goodwill recognized was deductible for tax purposes. During 2024, the Company experienced a sustained decline in the price per share of its common stock, which was identified as an indicator of goodwill impairment. As a result, a goodwill evaluation was performed and the Company recorded a full impairment of its goodwill, which was recorded as a non-cash charge in “Impairment of goodwill” in the Consolidated Statements of Operations. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 71


 
Merger-related Costs The Company incurred Merger-related costs of $(2.0) million and $103.4 million, respectively, for the years ended December 31, 2023 and 2022, which were included within Merger-related costs in results of operations. The Merger- related costs primarily consisted of legal, consulting, severance, and banking services and for the year ended December 31, 2023, including a refund of $17.8 million for transfer taxes paid during the year ended December 31, 2023. No Merger-related costs were incurred for the year ended December 31, 2024. 3. Property Investments The Company invests in healthcare-related properties located throughout the United States. The Company provides management, leasing, development and redevelopment services, and capital for the construction of new facilities as well as for the acquisition of existing properties. The following table summarizes the Company’s consolidated investments at December 31, 2024. Dollars in thousands NUMBER OF PROPERTIES LAND BUILDINGS AND IMPROVEMENTS LEASE INTANGIBLES PERSONAL PROPERTY TOTAL ACCUMULATED DEPRECIATION Dallas, TX 39 $ 73,030 $ 864,625 $ 40,948 $ 547 $ 979,150 $ (245,493) Seattle, WA 24 45,272 547,743 5,178 679 598,872 (184,304) Charlotte, NC 31 32,980 462,173 25,947 133 521,233 (134,075) Houston, TX 26 61,201 510,255 46,286 46 617,788 (106,416) Denver, CO 26 55,309 390,453 32,602 605 478,969 (106,457) Atlanta, GA 24 39,895 365,592 20,769 102 426,358 (86,861) Boston, MA 16 120,818 279,881 39,509 14 440,222 (60,469) Los Angeles, CA 15 49,770 265,617 3,486 401 319,274 (131,477) Phoenix, AZ 35 29,177 492,016 31,915 427 553,535 (84,116) Raleigh, NC 25 57,906 366,150 29,224 13 453,293 (55,468) Nashville, TN 11 38,057 339,417 9,840 4,422 391,736 (128,686) Miami, FL 14 22,890 265,974 17,785 176 306,825 (75,640) Tampa, FL 18 30,586 313,381 26,109 33 370,109 (53,946) Indianapolis, IN 39 50,874 274,524 23,329 13 348,740 (50,188) New York, NY 14 63,377 163,038 25,963 — 252,378 (26,533) Austin, TX 11 21,601 217,862 18,568 37 258,068 (46,372) Washington, DC 9 5,265 220,493 3,799 48 229,605 (59,598) Chicago, IL 6 13,804 217,359 7,626 81 238,870 (45,205) San Francisco, CA 6 49,181 181,860 9,915 52 241,008 (59,302) Orlando, FL 7 9,793 170,755 16,815 1 197,364 (29,866) Other (45 markets) 190 272,682 2,797,898 229,254 2,079 3,301,913 (713,184) 586 1,143,468 9,707,066 664,867 9,909 11,525,310 (2,483,656) Investment in financing receivables, net 1 — — — 123,671 — Financing lease right-of-use assets 1 — — — — 77,343 — Construction in progress 1 — — — — 31,978 — Land held for development — — — — — 52,408 — Total real estate investments 589 $ 1,143,468 $ 9,707,066 $ 664,867 $ 9,909 $ 11,810,710 $ (2,483,656) 4. Leases Lessor Accounting Under ASC 842 The Company’s properties generally are leased pursuant to non-cancelable, fixed-term operating leases with expiration dates through 2052. Some leases provide tenants with fixed rent renewal terms while others have market rent renewal terms. Some leases provide the lessee, during the term of the lease, with an option or right of first refusal to purchase the leased property. The Company’s single-tenant net leases generally require the lessee to pay NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 72


 
minimum rent and all taxes (including property tax), insurance, maintenance and other operating costs associated with the leased property. The Company's leases typically have escalators that are either based on a stated percentage or an index such as the CPI. In addition, most of the Company's leases include nonlease components, such as reimbursement of operating expenses as additional rent, or include the reimbursement of expected operating expenses as part of the lease payment. The Company adopted an accounting policy to combine lease and nonlease components. Rent escalators based on indices and reimbursements of operating expenses that are not included in the lease rate are considered variable lease payments. Variable payments are recognized in the period earned. Lease income for the Company's operating leases recognized for the years ended December 31, 2024, 2023 and 2022 was $1.2 billion, $1.3 billion and $907.5 million, respectively. Future minimum lease payments under the non-cancelable operating leases, excluding any reimbursements, as of December 31, 2024 were as follows: In thousands 2025 $ 816,029 2026 744,399 2027 634,752 2028 522,433 2029 418,455 2030 and thereafter 1,544,358 $ 4,680,426 Revenue Concentrations The Company’s real estate portfolio is leased to a diverse tenant base. The Company did not have any customers that account for 10% or more of the Company's revenues for the years ended December 31, 2024, 2023 and 2022. Purchase Option Provisions Certain of the Company’s leases include purchase option provisions. The provisions vary by agreement but generally allow the lessee to purchase the property covered by the agreement at fair market value or an amount equal to the Company’s gross investment. The Company expects that the purchase price from its purchase options will be greater than its net investment in the properties at the time of potential exercise by the lessee. The Company had gross investments of approximately $111.1 million in six real estate properties as of December 31, 2024 that were subject to purchase options that were exercisable. Lessee Accounting Under ASC 842 As of December 31, 2024, the Company was obligated, as the lessee, under operating lease agreements consisting primarily of the Company’s ground leases. Contracts evaluated and treated as leases are those that convey the right to control the use of identified assets for a period of time in exchange for consideration. ASC 842 requires the recording of these leases based on the aggregate future cash flows, discounted utilizing the implicit rate in the lease, or, if not readily determinable, based upon the lessee's incremental borrowing rate, to which the Company utilizes market inputs that are both similar to the Company's credit profile and corresponding term of the leases. As of December 31, 2024, the Company had 215 properties totaling 16.1 million square feet that were held under ground leases. Some of the ground leases include fixed rent renewal terms and others have market rent renewal terms. The ground leases typically have initial terms of 40 to 99 years with expiration dates through 2119. Any rental increases related to the Company’s ground leases are generally either stated or based on the CPI. The Company had 73 prepaid ground leases as of December 31, 2024. The amortization of the prepaid rent, included in the operating lease right-of- use asset, represented approximately $1.4 million, $1.3 million and $1.1 million for the years ended December 31, 2024, 2023 and 2022, respectively. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 73


 
The Company’s future lease payments (primarily for its 142 non-prepaid ground leases) as of December 31, 2024 were as follows: In thousands OPERATING FINANCING 2025 $ 12,410 $ 2,070 2026 12,540 2,106 2027 12,743 2,145 2028 12,879 2,177 2029 12,944 2,209 2030 and thereafter 657,744 383,172 Total undiscounted lease payments $ 721,260 $ 393,879 Discount (496,761) (321,533) Lease liabilities $ 224,499 $ 72,346 The following table provides details of the Company's total lease expense for the years ended December 31, 2024 and 2023: YEAR ENDED DECEMBER 31 In thousands 2024 2023 Operating lease cost Operating lease expense $ 18,076 $ 20,623 Variable lease expense 4,939 8,979 Finance lease cost Amortization of right-of-use assets 1,533 1,564 Interest on lease liabilities 3,727 3,718 Total lease expense $ 28,275 $ 34,884 Other information Operating cash flows outflows related to operating leases $ 15,545 $ 19,222 Operating cash flows outflows related to financing leases $ 2,107 $ 2,122 Financing cash flows outflows related to financing leases $ 17 $ 17 Right-of-use assets obtained in exchange for new operating lease liabilities $ 3,855 $ 1,758 Weighted-average remaining lease term (excluding renewal options) - operating leases 44.1 45.8 Weighted-average remaining lease term (excluding renewal options) - finance leases 57.8 57.9 Weighted-average discount rate - operating leases 5.7 % 5.7 % Weighted-average discount rate - finance leases 5.0 % 5.0 % 5. Acquisitions, Dispositions and Mortgage Repayments 2024 Acquisition Activity The Company had no real estate acquisition activity for the year ended December 31, 2024. Unconsolidated Joint Ventures As of December 31, 2024, the Company had a weighted average ownership interest of approximately 31% in 63 real estate properties held in unconsolidated joint ventures. The Company recognizes distributions from unconsolidated joint ventures utilizing the nature of distribution approach and classifies the distributions based on the nature of the underlying activity that generated the distribution. The distributions from unconsolidated joint ventures for the years ended December 31, 2024 and 2023 were classified as operating activities. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 74


 
The Company's investment in and loss recognized for the years ended December 31, 2024 and 2023 related to its unconsolidated joint ventures accounted for under the equity method are shown in the table below: DECEMBER 31, Dollars in thousands 2024 2023 Investments in unconsolidated joint ventures, beginning of period $ 311,511 $ 327,248 New investments during the period 172,244 3,824 Equity loss recognized during the period (135) (1,682) Owner distributions (10,498) (17,879) Investments in unconsolidated joint ventures, end of period $ 473,122 $ 311,511 2023 Acquisition Activity The following table details the Company's real estate acquisition activity for the year ended December 31, 2023: Dollars in thousands DATE ACQUIRED PURCHASE PRICE MORTGAGE NOTES PAYABLE, NET CASH CONSIDERATION 1 REAL ESTATE OTHER 2 SQUARE FOOTAGE Tampa, FL 3/10/23 $ 31,500 $ — $ 30,499 $ 30,596 $ (97) 115,867 Colorado Springs, CO 7/28/23 11,450 (5,284) 6,024 11,416 (108) 42,770 Total real estate acquisitions $ 42,950 $ (5,284) $ 36,523 $ 42,012 $ (205) 158,637 1. Cash consideration excludes prorations of revenue and expense due to/from seller at the time of the acquisition. 2. Includes other assets acquired, liabilities assumed, and intangibles recognized at acquisition. The following table summarizes the estimated relative fair values of the assets acquired and liabilities assumed in the real estate acquisitions for 2023 as of the acquisition date: ESTIMATED FAIR VALUE in millions ESTIMATED USEFUL LIFE in years Building $ 27.5 17.0 - 30.0 Tenant Improvements 3.4 5.1 - 5.9 Land 5.5 0 Land Improvements 1.1 6.0 - 10.0 Intangibles At-market lease intangibles 4.5 5.1 - 5.9 Above-market lease intangibles (lessor) 0.2 1.8 - 4.9 Below-market lease intangibles (lessor) (0.2) 6.4 - 13.9 Mortgage notes payable assumed, including fair value adjustments (5.3) Other assets acquired 0.1 Accounts payable, accrued liabilities and other liabilities assumed (0.3) Total cash paid $ 36.5 NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 75


 
2024 Real Estate Asset Dispositions The following table details the Company's dispositions and joint venture dispositions for the year ended December 31, 2024: Dollars in thousands DATE DISPOSED SALE PRICE CLOSING COSTS & CREDITS COMPANY- FINANCED MORTGAGE NOTES NET CONSIDERATION NET REAL ESTATE INVESTMENT OTHER GAIN/ (IMPAIR- MENT) SQUARE FOOTAGE Albany, NY 4/1/24 $ 725 $ (60) $ — $ 665 $ 765 $ (82) $ (18) 14,800 San Angelo, TX 4/12/24 5,085 (128) — 4,957 4,917 66 (26) 24,580 Houston, TX 5/20/24 250 (9) — 241 713 (520) 48 37,040 Multiple 1 5/23/24 284,348 (14,270) — 270,078 254,176 25,836 (9,934) 556,274 Denver, CO 5/30/24 19,000 (628) — 18,372 18,522 165 (315) 37,130 Austin, TX 1 6/6/24 54,858 (1,575) — 53,283 27,964 623 24,696 129,879 Minneapolis, MN 6/21/24 1,082 (144) — 938 303 43 592 50,291 Raleigh, NC 2 6/28/24 99,518 (2,835) — 96,683 86,810 906 8,967 309,424 Albany, NY 8/2/24 6,300 (847) — 5,453 5,528 486 (561) 180,000 Charlotte, NC 8/6/24 26,670 (395) — 26,275 14,853 613 10,809 90,633 Charleston, SC 8/13/24 14,500 (589) — 13,911 11,488 1 2,422 46,711 Multiple 1 8/23/24 118,000 (8,615) — 109,385 113,956 548 (5,119) 266,782 Multiple 3 8/27/24 177,250 (7,085) — 170,165 169,545 5,363 (4,743) 473,003 Austin, TX 9/13/24 42,281 (1,257) — 41,024 14,561 425 26,038 76,246 Raleigh, NC 9/26/24 1,813 (27) — 1,786 1,694 50 42 5,934 Houston, TX 4 10/3/24 12,000 (1,001) (9,630) 1,369 11,266 295 (563) 140,012 Greensboro, NC 10/9/24 12,514 (21) — 12,493 10,152 296 2,045 35,373 Des Moines, IA 10/15/24 31,750 (1,320) — 30,430 13,869 1,662 14,899 95,486 Albany, NY 10/15/24 9,500 (521) — 8,979 7,823 1,193 (37) 80,676 Salt Lake City, UT 5 10/24/24 30,712 (8,962) — 21,750 26,899 (9,406) 4,257 112,192 Miami, FL 10/25/24 36,789 (706) — 36,083 35,925 (209) 367 102,186 Miami, FL 6 10/25/24 17,767 (718) — 17,049 14,650 (210) 2,609 60,761 Cleveland, OH 12/10/24 1,000 (157) — 843 1,454 57 (668) 31,152 Boise, ID 7 12/12/24 18,350 (2,003) — 16,347 17,562 345 (1,560) 83,078 Multiple 1 12/18/24 310,250 (6,767) — 303,483 321,437 6,616 (24,570) 766,622 Atlanta, GA 12/20/24 15,900 (1,318) — 14,582 13,344 635 603 42,921 Los Angeles, CA 7 12/20/24 64,000 (4,805) — 59,195 47,322 1,676 10,197 162,554 Tampa, FL 12/27/24 37,500 (402) — 37,098 41,556 (1,962) (2,496) 95,896 Wichita Falls, TX 12/27/24 600 (130) — 470 2,530 14 (2,074) 25,133 Total dispositions $ 1,450,312 $ (67,295) $ (9,630) $ 1,373,387 $ 1,291,584 $ 35,525 $ 55,907 4,132,769 1. The Company contributed the following medical outpatient properties to a joint venture in which the Company retained 20% ownership: one in each of Raleigh, NC, New York, NY, Philadelphia, PA, Atlanta, GA, Austin, TX, Miami, FL, Denver, CO, Memphis, TN, Indianapolis, IN, and Honolulu, HI; two MOBs in Los Angeles; three MOBs in Houston, TX and Dallas, TX; and five in Seattle, WA. Sale price and square footage reflect the total sale price paid by the joint venture and total square footage of the property. The net proceeds to the Company related to these dispositions totaled $584.9 million. 2. The Company sold seven MOBs in Greensboro, NC and two non-clustered single-tenant MOBs in Raleigh, NC to a single buyer in a single transaction. 3. The Company contributed the following medical outpatient properties to a joint venture in which the Company retained 20% ownership: two in each of Nashville, TN and Denver, CO; one in each of Dallas, TX, San Antonio, TX and Atlanta, GA. Sale price and square footage reflect the total sale price paid by the joint venture and total square footage of the property. The net proceeds to the Company related to these dispositions totaled $148.9 million. 4. The Company provided seller financing of approximately $9.6 million in connection with this sale. 5. The Company sold an MOB that was included in a consolidated joint venture in which the Company held a 63% ownership interest. Proceeds include the Company's pro-rata share of the purchase price as well as amounts due to the Company by the joint venture. 6. Includes two properties. 7. Includes three properties. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 76


 
2023 Real Estate Asset Dispositions The following table details the Company's dispositions for the year ended December 31, 2023: Dollars in thousands Type1 DATE DISPOSED SALE PRICE CLOSING COSTS & CREDITS COMPANY- FINANCED NOTES NET CONSIDERATION NET REAL ESTATE INVESTMENT OTHER 2 GAIN/ (IMPAIR- MENT) SQUARE FOOTAGE Tampa/Miami, FL3 MOB 1/12/23 $ 93,250 $ (5,875) $ — $ 87,375 $ 87,302 $ (888) $ 961 224,037 Dallas, TX 4 MOB 1/30/23 19,210 (141) — 19,069 18,986 43 40 36,691 St. Louis, MO MOB 2/10/23 350 (18) — 332 398 — (66) 6,500 Los Angeles, CA MOB 3/23/23 21,000 (526) — 20,474 20,610 52 (188) 37,165 Los Angeles, CA 5 MOB 3/30/23 75,000 (8,079) (45,000) 21,921 88,624 (803) (20,900) 147,078 Los Angeles, CA 6 Land 5/12/23 3,300 (334) — 2,966 3,268 — (302) — Albany, NY MOB 6/30/23 10,000 (1,229) — 8,771 2,613 (1,040) 7,198 40,870 Houston, TX MOB 8/2/23 8,320 (285) — 8,035 4,567 194 3,274 57,170 Atlanta, GA MOB 8/22/23 25,140 (66) — 25,074 23,226 (536) 2,386 55,195 Dallas, TX Inpatient 9/15/23 115,000 (1,504) — 113,496 64,183 6,094 43,219 161,264 Houston, TX MOB 9/18/23 250 (24) — 226 1,998 — (1,772) 52,040 Chicago, IL MOB 9/27/23 59,950 (870) — 59,080 74,710 (380) (15,250) 104,912 Evansville, IN 7 MOB 11/13/23 18,500 (63) — 18,437 17,807 (149) 779 260,520 Houston, TX Hospital 12/1/23 4,100 (6) — 4,094 3,486 — 608 83,223 Charleston, SC 8 Office 12/15/23 6,200 (401) — 5,799 3,415 — 2,384 15,014 Dallas, TX MOB 12/20/23 43,295 (764) — 42,531 33,882 (3,782) 12,431 77,827 Los Angeles, CA Office 12/21/23 19,000 (1,311) — 17,689 17,787 — (98) 104,377 Tucson, AZ 9,10 MOB 12/22/23 43,230 (3,770) (6,000) 33,460 39,786 (26) (300) 215,471 Miami, FL MOB 12/22/23 18,250 (756) — 17,494 17,354 643 (503) 48,000 Sebring, FL MOB 12/27/23 9,500 (81) — 9,419 10,438 (512) (507) 38,949 Boston, MA MOB 12/28/23 117,197 (2,079) — 115,118 107,803 9,828 (2,513) 161,254 Florida 11 SNF 12/29/23 77,000 (8,678) (7,700) 60,622 65,839 (294) 2,777 354,500 Total dispositions $ 787,042 $ (36,860) $ (58,700) $ 691,482 $ 708,082 $ 8,444 $ 33,658 2,282,057 1. MOB = medical outpatient building; SNF = skilled nursing facility. 2. Includes straight-line rent receivables, leasing commissions and lease inducements. 3. Includes two properties sold in two separate transactions to the same buyer on the same date. 4. The Company sold this property to a joint venture in which it retained a 40% interest. Sales price and square footage reflect the total sales price paid by the joint venture and total square footage of the property. 5. The Company entered into a mortgage loan agreement with the buyer for $45.0 million. 6. The Company sold a land parcel totaling 0.34 acres. 7. Includes five properties sold in three separate transactions to the same buyer on the same date. 8. The Company sold a corporate office in Charleston, SC that was 100% occupied by the Company. 9. Includes 12 properties sold in one transaction to the same buyer. 10. The Company entered into a mezzanine loan with the buyer for $6.0 million. 11. Includes three properties sold in one transaction to the same buyer. The Company entered into a separate note receivable for $7.7 million related to this sale. 6. Held for Sale The Company had three properties classified as assets held for sale as of December 31, 2024. The net real estate assets held for sale includes the impact of $24.1 million of impairment charges for the year ended December 31, 2024. The Company had one property classified as assets held for sale as of December 31, 2023. The net real estate assets held for sale included the impact of $5.9 million of impairment charges for the year ended December 31, 2023. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 77


 
The table below reflects the assets and liabilities classified as held for sale as of December 31, 2024 and 2023. DECEMBER 31, Dollars in thousands 2024 2023 Balance Sheet data Land $ 10,859 $ 1,850 Buildings and improvements 3,410 6,779 Lease intangibles 3,286 1,017 17,555 9,646 Accumulated depreciation (5,275) (913) Real estate assets held for sale, net 12,280 8,733 Other assets, net 617 101 Assets held for sale, net $ 12,897 $ 8,834 Accounts payable and accrued liabilities $ 694 $ 23 Other liabilities 589 272 Liabilities of properties held for sale $ 1,283 $ 295 Subsequent Dispositions On February 7, 2025, the Company disposed of a 30,304 square foot medical office building in Boston, Massachusetts for $4.5 million. On February 14, 2025, the Company disposed of two medical office buildings in Denver, Colorado, with a combined total of 69,715 square feet for an aggregate purchase price of $8.6 million. These properties were classified as held for sale as of December 31, 2024. 7. Impairment Charges - Long-Lived Assets An asset is impaired when undiscounted cash flows expected to be generated by the asset are less than the carrying value of the asset. The Company must assess the potential for impairment of its long-lived assets, including real estate properties, whenever events occur or there is a change in circumstances, such as the sale of a property or the decision to sell a property, which indicate that the recorded value might not be fully recoverable. The Company recorded impairment charges totaling $249.9 million on 51 properties sold and 13 additional properties as a result of completed and planned disposition activity for the year ended December 31, 2024. The Company recorded impairment charges on 31 properties sold and six additional properties associated with planned disposition activity for the year ended December 31, 2023, totaling $149.7 million. Both level 1 and level 3 fair value techniques were used to derive these impairment charges. As of December 31, 2024, nine real estate properties totaling $61.2 million were measured at fair value using level three fair value hierarchy. The level 3 fair value techniques included brokerage estimates, letters of intent, and unexecuted purchase and sale agreements, less estimated closing costs, and are nonbinding in nature. 8. Other Assets Other assets consist primarily of real estate notes receivable, straight-line rent receivables, prepaid assets, intangible assets, accounts receivable and additional long-lived assets. Items included in "Other assets, net" on the Company’s Consolidated Balance Sheets as of December 31, 2024 and 2023 are detailed in the table below: NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 78


 
Dollars in thousands December 31, 2024 December 31, 2023 Prepaid assets $ 154,957 $ 116,455 Real estate notes receivable, net 127,624 173,614 Straight-line rent receivables 124,970 116,866 Accounts receivable, net 1 36,495 63,203 Above-market intangible assets, net 32,230 66,695 Interest rate swap assets 5,263 4,634 Project costs 4,903 6,187 Additional long-lived assets, net 4,197 20,717 Net investment in lease 2,168 2,112 Investment in securities 2 1,936 6,011 Debt issuance costs, net 1,758 3,867 Customer relationship intangible assets, net 1,011 1,066 Other 9,984 10,941 $ 507,496 $ 592,368 1 The amounts for December 31, 2024 and 2023 are net of allowance for doubtful accounts of $9.5 million and $8.4 million, respectively. 2 This amount represents the value of the Company's preferred stock investment in a data analytics platform. In 2024, a fair value measurement impairment of $4.1 million was recorded on this investment and is included in "Impairment of real estate properties and credit loss reserves" on the Statement of Operations. 9. Intangible Assets and Liabilities The Company has several types of intangible assets and liabilities included in its Consolidated Balance Sheets, including goodwill, debt issuance costs, above-, below-, and at-market lease intangibles, and customer relationship intangibles. For additional details on the Company's debt issuance costs, see Note 10 to the Consolidated Financial Statements. The Company’s intangible assets and liabilities, including assets held for sale and certain debt issuance costs, as of December 31, 2024 and 2023 consisted of the following:   GROSS BALANCE at December 31, ACCUMULATED AMORTIZATION at December 31, WEIGHTED AVG. REMAINING LIFE in years BALANCE SHEET CLASSIFICATIONDollars in millions 2024 2023 2024 2023 Goodwill $ — $ 250.5 $ — $ — N/A Goodwill Credit facility debt issuance costs 6.9 6.9 5.2 3.1 0.9 Other assets, net Above-market lease intangibles (lessor) 74.8 98.0 42.3 31.3 4.0 Other assets, net Customer relationship intangibles (lessor) 2.1 2.1 1.1 1.1 18.6 Other assets, net Below-market lease intangibles (lessor) (98.3) (112.5) (53.1) (35.7) 5.3 Other liabilities At-market lease intangibles 668.2 837.3 353.9 301.7 5.9 Real estate properties $ 653.7 $ 1,082.3 $ 349.4 $ 301.5 5.8 For the years ended December 31, 2024, 2023 and 2022, the Company recognized approximately $167.7 million, $214.8 million, and $133.6 million of intangible amortization, respectively. The following table represents expected amortization over the next five years of the Company’s intangible assets and liabilities in place as of December 31, 2024: Dollars in millions FUTURE AMORTIZATION OF INTANGIBLES, NET 2025 $ 114.3 2026 68.4 2027 43.3 2028 24.7 2029 14.9 NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 79


 
10. Notes and Bonds Payable   DECEMBER 31, 1 MATURITY DATES CONTRACTUAL INTEREST RATES EFFECTIVE INTEREST RATES PRINCIPAL PAYMENTS INTEREST PAYMENTSDollars in thousands 2024 2023 $1.5B Unsecured Credit Facility 2 — — 10/25 SOFR + 0.95% 5.30 % At maturity Monthly $350M Unsecured Term Loan 3 — 349,798 7/25 SOFR + 1.04% 5.59 % At maturity Monthly $200M Unsecured Term Loan 4 199,896 199,903 5/25 SOFR + 1.04% 5.59 % At maturity Monthly $150M Unsecured Term Loan 149,790 149,643 6/26 SOFR + 1.04% 5.59 % At maturity Monthly $300M Unsecured Term Loan 5 299,981 299,958 10/25 SOFR + 1.04% 5.59 % At maturity Monthly $200M Unsecured Term Loan 199,641 199,502 7/27 SOFR + 1.04% 5.59 % At maturity Monthly $300M Unsecured Term Loan 298,708 298,288 1/28 SOFR + 1.04% 5.59 % At maturity Monthly Senior Notes due 2025 249,868 249,484 5/25 3.88 % 4.12 % At maturity Semi-annual Senior Notes due 2026 586,824 579,017 8/26 3.50 % 4.94 % At maturity Semi-annual Senior Notes due 2027 488,104 483,727 7/27 3.75 % 4.76 % At maturity Semi-annual Senior Notes due 2028 298,029 297,429 1/28 3.63 % 3.85 % At maturity Semi-annual Senior Notes due 2030 586,028 575,443 2/30 3.10 % 5.30 % At maturity Semi-annual Senior Notes due 2030 297,190 296,780 3/30 2.40 % 2.72 % At maturity Semi-annual Senior Notes due 2031 296,343 295,832 3/31 2.05 % 2.25 % At maturity Semi-annual Senior Notes due 2031 667,233 649,521 3/31 2.00 % 5.13 % At maturity Semi-annual Mortgage notes payable 45,136 70,534 12/25-12/26 3.60%-4.77% 3.57%-6.88% Monthly Monthly $ 4,662,771 $ 4,994,859 1 Balance is presented net of discounts and issuance costs and inclusive of premiums, where applicable. 2 As of December 31, 2024, the Company had $1.5 billion available to be drawn on its $1.5 billion Unsecured Credit Facility. 3 In 2024, the Company repaid the $350 million Unsecured Term Loan and recognized approximately $0.2 million of accelerated amortization expense included in the loss on extinguishment of debt. 4 In April 2024, the Company exercised its option to extend the maturity date for one year to May 2025 for a fee of approximately $0.3 million. On January 7, 2025 the company made a partial repayment of $25 million on the initial $200 million Unsecured Term Loan. 5 On January 14, 2025, the company made a partial repayment of $10 million on the initial $300 million Unsecured Term Loan. The Company’s various debt agreements contain certain representations, warranties, and financial and other covenants customary in such loan agreements. Among other things, these provisions require the Company to maintain certain financial ratios and impose certain limits on the Company’s ability to incur indebtedness and create liens or encumbrances. As of December 31, 2024, the Company was in compliance with its financial covenant provisions under its various debt instruments. Senior Notes The following table summarizes the Company’s aggregate Senior notes principal balance as of December 31, 2024 and 2023.   DECEMBER 31, Dollars in thousands 2024 2023 Senior notes principal balance $ 3,699,285 $ 3,699,285 Unaccreted discount (224,759) (265,852) Debt issuance costs (4,907) (6,200) Senior notes carrying amount $ 3,469,619 $ 3,427,233 NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 80


 
Term Loans The following table summarizes the Company’s aggregate term loan principal balances as of December 31, 2024 and 2023.   DECEMBER 31, Dollars in thousands 2024 2023 Term loan principal balances 1 $ 1,150,000 $ 1,500,000 Debt issuance costs (1,984) (2,908) Term Loans carrying amount $ 1,148,016 $ 1,497,092 1. In 2024, the Company repaid the $350 million Unsecured Term Loan and recorded approximately $0.2 million of accelerated amortization expense included in the loss of extinguishment of debt. Mortgage Notes Payable The following table summarizes the Company’s aggregate mortgage notes principal balance as of December 31, 2024 and 2023.   DECEMBER 31, Dollars in thousands 2024 2023 Mortgage notes payable principal balance $ 45,278 $ 70,752 Unamortized premium 140 285 Unaccreted discount (134) (237) Debt issuance costs (148) (266) Mortgage notes payable carrying amount $ 45,136 $ 70,534 Mortgage Activity On January 6, 2024, the Company repaid in full at maturity a mortgage note payable bearing interest at a rate of 4.77% per annum with an outstanding principal of $11.3 million. The mortgage note encumbered a 63,012 square foot property in California. On February 1, 2024, the Company repaid in full at maturity a mortgage note payable bearing interest at a rate of 4.12% per annum with an outstanding principal of $5.6 million. The mortgage note encumbered a 40,324 square foot property in Georgia. On September 1, 2024, the Company repaid in full at maturity a mortgage note payable bearing interest at a rate of 4.15% per annum with an outstanding principal balance of $7.0 million. The mortgage note encumbered a 64,143 square foot property in Minnesota. The following table details the Company’s mortgage notes payable, with related collateral.   ORIGINAL BALANCE EFFECTIVE INTEREST RATE 6 MATURITY DATE COLLATERAL 7 PRINCIPAL AND INTEREST PAYMENTS 8 INVESTMENT IN COLLATERAL at December 31, BALANCE at December 31, Dollars in millions 2024 2024 2023 Life Insurance Co. 1 13.3 4.13 % 1/24 MOB Monthly/10-yr amort. — — 11.3 Life Insurance Co. 2 6.8 3.96 % 2/24 MOB Monthly/7-yr amort. — — 5.6 Financial Services 3 9.7 4.32 % 9/24 MOB Monthly/10-yr amort. — — 7.2 Life Insurance Co. 4 16.5 3.57 % 12/25 MOB,OFC Monthly/7-yr amort. 39.7 15.4 15.9 Financial Services 11.5 3.71 % 1/26 MOB Monthly/10-yr amort. 42.3 7.4 7.8 Life Insurance Co. 5 6.0 6.88 % 4/26 MOB Monthly/7-yr amort. 11.8 5.2 5.2 Life Insurance Co. 19.2 4.08 % 12/26 MOB Monthly/10-yr amort. 46.0 17.1 17.5 $ 139.8 $ 45.1 $ 70.5 1 The unamortized portion of the $0.8 million premium recorded on this note upon acquisition is included in the balance above. 2 The unamortized portion of the $0.2 million premium recorded on this note upon acquisition is included in the balance above. 3 The unamortized portion of the $0.1 million premium recorded on this note upon acquisition is included in the balance above. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 81


 
4 The unamortized portion of the $0.7 million premium recorded on this note upon acquisition is included in the balance above. 5 The unaccreted portion of the $0.3 million discount recorded on this note upon acquisition is included in the balance above. 6 The contractual interest rates for the four outstanding mortgage notes ranged from 3.6% to 4.5% as of December 31, 2024. 7 MOB-Medical outpatient building; OFC-Office 8 Payable in monthly installments of principal and interest with the final payment due at maturity (unless otherwise noted). Other Long-Term Debt Information Future maturities of the Company’s notes and bonds payable as of December 31, 2024, were as follows: Dollars in thousands PRINCIPAL MATURITIES NET ACCRETION/ AMORTIZATION 1 DEBT ISSUANCE COSTS 2 NOTES AND BONDS PAYABLE % 2025 $ 766,375 $ (43,163) $ (2,020) $ 721,192 15.5 % 2026 778,904 (41,837) (1,650) 735,417 15.8 % 2027 700,000 (36,192) (1,519) 662,289 14.2 % 2028 600,000 (35,179) (707) 564,114 12.1 % 2029 — (37,025) (674) (37,699) (0.8) % 2030 and thereafter 2,049,286 (31,357) (471) 2,017,458 43.2 % $ 4,894,565 $ (224,753) $ (7,041) $ 4,662,771 100.0 % 1 Includes discount accretion and premium amortization related to the Company’s Senior Notes and two mortgage notes payable. 2 Excludes approximately $1.8 million in debt issuance costs related to the Company's Unsecured Credit Facility included in other assets, net 11. Derivative Financial Instruments Risk Management Objective of Using Derivatives The Company is exposed to certain risks arising from both its business operations and economic conditions. The Company principally manages its exposures to a wide variety of business and operational risks through management of its core business activities. The Company manages economic risks, including interest rate, liquidity, and credit risk, primarily by managing the amount, sources, and duration of its assets and liabilities and the use of derivative financial instruments. Specifically, the Company enters into derivative financial instruments to manage exposures that arise from business activities that result in the receipt or payment of future known and uncertain cash amounts, the value of which are determined by interest rates. The Company’s derivative financial instruments are used to manage differences in the amount, timing, and duration of the Company’s known or expected cash receipts and its known or expected cash payments principally related to the Company’s borrowings. Cash Flow Hedges of Interest Rate Risk The Company’s objectives in using interest rate derivatives are to add stability to interest expense and to manage its exposure to interest rate movements. To accomplish this objective, the Company primarily uses interest rate swaps as part of its interest rate risk management strategy. Interest rate swaps designated as cash flow hedges involve the receipt of variable amounts from a counterparty in exchange for the Company making fixed-rate payments over the life of the agreements without exchange of the underlying notional amount. During 2024, 2023, and 2022, such derivatives were used to hedge the variable cash flows associated with existing variable-rate debt. For derivatives designated and that qualify as cash flow hedges of interest rate risk, the gain or loss on the derivative is recorded in accumulated other comprehensive income (loss) and subsequently reclassified into interest expense in the same period(s) during which the hedged transaction affects earnings. Amounts reported in accumulated other comprehensive income (loss) related to derivatives will be reclassified to interest expense as interest payments are made on the Company’s variable-rate debt. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 82


 
As of December 31, 2024, the Company had interest rate derivatives that were designated as cash flow hedges of interest rate risk. The table below presents the notional value and weighted average rates of the Company's derivative financial instruments as of December 31, 2024 and 2023: NOTIONAL VALUE AS OF WEIGHTED AVERAGE RATE NOTIONAL VALUE AS OF WEIGHTED AVERAGE RATE EXPIRATION DECEMBER 31, 2024 EXPIRATION DECEMBER 31, 2023 January 2024 $ 200,000 1.21 % May 2026 $ 275,000 3.74 % May 2026 275,000 3.74 % June 2026 150,000 3.83 % June 2026 150,000 3.83 % December 2026 150,000 3.84 % December 2026 150,000 3.84 % June 2027 200,000 4.27 % June 2027 200,000 4.27 % December 2027 300,000 3.93 % December 2027 300,000 3.93 % $ 1,075,000 3.92 % $ 1,275,000 3.49 % Tabular Disclosure of Fair Values of Derivative Instruments on the Balance Sheet The table below presents the fair value of the Company's derivative financial instruments as well as their classification on the Consolidated Balance Sheets as of December 31, 2024 and 2023. AS OF DECEMBER 31, 2024 AS OF DECEMBER 31, 2023 Dollars in thousands BALANCE SHEET LOCATION FAIR VALUE BALANCE SHEET LOCATION FAIR VALUE Interest rate swaps 2019 Other Assets $ 2,493 Other Assets $ 4,214 Interest rate swaps 2022 Other Assets 2,250 Interest rate swaps 2022 Other Liabilities (853) Other Liabilities (5,067) Interest rate swaps 2023 Other Assets 521 Other Assets 411 Interest rate swaps 2023 Other Liabilities (3,310) Other Liabilities (7,357) Total derivatives designated as hedging instruments $ 1,101 $ (7,799) Tabular Disclosure of the Effect of Fair Value and Cash Flow Hedge Accounting on Accumulated Other Comprehensive Income (Loss) The table below presents the effect of cash flow hedge accounting on Accumulated other comprehensive income (loss) ("AOCI") as of December 31, 2024 and 2023 related to the Company's outstanding interest rate swaps. AMOUNT OF GAIN/(LOSS) RECOGNIZED IN AOCI ON DERIVATIVE for the year ended December 31, AMOUNT OF (GAIN)/LOSS RECLASSIFIED FROM AOCI INTO INCOME for the year ended December 31, Dollars in thousands 2024 2023 2024 2023 Interest rate swaps 2019 $ — $ 1,995 Interest expense $ — $ (6,964) Interest rate swaps 2022 15,237 4,583 Interest expense (10,317) (6,289) Interest rate swaps 2023 7,572 (5,115) Interest expense (3,416) (1,829) Settled treasury hedges — — Interest expense 428 426 Settled interest rate swaps — — Interest expense 168 168 Total $ 22,809 $ 1,463 Total $ (13,137) $ (14,488) The Company estimates that an additional $1.4 million will be reclassified from accumulated other comprehensive loss as a net decrease to interest expense over the next 12 months. Tabular Disclosure Offsetting Derivatives The table below presents a gross presentation, the effects of offsetting, and a net presentation of the Company's derivatives as of December 31, 2024. The net amounts of derivative liabilities can be reconciled to the tabular disclosure of fair value. The tabular disclosure of fair value provides the location that derivative liabilities are presented on the Company's Consolidated Balance Sheets. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 83


 
Offsetting of Derivative Assets GROSS AMOUNTS of recognized assets GROSS AMOUNTS OFFSET in the Consolidated Balance Sheets NET AMOUNTS OF ASSETS presented in the Consolidated Balance Sheets GROSS AMOUNTS NOT OFFSET in the Consolidated Balance Sheets FINANCIAL INSTRUMENTS CASH COLLATERAL NET AMOUNT Derivatives $ 5,264 $ — $ 5,264 $ (5,264) $ — $ — Offsetting of Derivative Liabilities GROSS AMOUNTS of recognized liabilities GROSS AMOUNTS OFFSET in the Consolidated Balance Sheets NET AMOUNTS OF LIABILITIES presented in the Consolidated Balance Sheets GROSS AMOUNTS NOT OFFSET in the Consolidated Balance Sheets FINANCIAL INSTRUMENTS CASH COLLATERAL NET AMOUNT Derivatives $ (4,163) $ — $ (4,163) $ 5,264 $ — $ 1,101 Credit-risk-related Contingent Features The Company has agreements with each of its derivative counterparties that contain a provision where the Company could be declared in default on its derivative obligations if repayment of the underlying indebtedness is accelerated by the lender due to the Company's default on the indebtedness. The Company has agreements with each of its derivative counterparties that contain a provision where if the Company either defaults or is capable of being declared in default on any of its indebtedness, then the Company could also be declared in default on its derivative obligations. As of December 31, 2024, the fair value of derivatives in a net liability position including accrued interest but excluding any adjustment for nonperformance risk related to these agreements was $2.9 million. As of December 31, 2024, the Company has not posted any collateral related to these agreements and was not in breach of any agreement provisions. 12. Stockholders’ Equity Common Stock The Company had no preferred shares outstanding and had common shares outstanding for the years ended December 31, 2024, 2023, and 2022 as follows:    YEAR ENDED DECEMBER 31, 2024 2023 2022 Balance, beginning of year 380,964,433 380,589,894 150,457,433 Issuance of common stock 8,623 8,627 229,618,304 Conversion of OP units to common stock 194,767 190,544 — Shares repurchased (30,794,250) — — Non-vested share-based awards, net of withheld shares and forfeitures 158,433 175,368 514,157 Balance, end of year 350,532,006 380,964,433 380,589,894 Dividends Declared During 2024, the Company declared and paid common stock dividends aggregating $1.24 per share ($0.31 per share per quarter). On February 18, 2025, the Company declared a quarterly common stock dividend in the amount of $0.31 per share payable on March 19, 2025, to stockholders of record on March 3, 2025. Authorization to Repurchase Common Stock During 2024, the Company repurchased 30.8 million shares of its common stock at an average price of $16.56 per share for a total of $509.8 million. As of December 31, 2024, the Company had $237.0 million of authorized share repurchases remaining. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 84


 
Accumulated Other Comprehensive (Loss) Income The following table represents the changes in accumulated other comprehensive (loss) income during the years ended December 31, 2024 and 2023: INTEREST RATE SWAPS as of December 31, Dollars in thousands 2024 2023 Beginning balance $ (10,741) $ 2,140 Other comprehensive income (loss) before reclassifications 22,527 1,434 Amounts reclassified from accumulated other comprehensive (loss) income (12,954) (14,315) Net current-period other comprehensive income (loss) 9,573 (12,881) Ending balance $ (1,168) $ (10,741) The following table represents the details regarding the reclassifications from accumulated other comprehensive (loss) income during the year ended December 31, 2024 (dollars in thousands): DETAILS ABOUT ACCUMULATED OTHER COMPREHENSIVE INCOME (LOSS) COMPONENTS AMOUNT RECLASSIFIED from accumulated other comprehensive income (loss) AFFECTED LINE ITEM in the statement where net income is presented Amounts reclassified from accumulated other comprehensive income (loss) related to settled interest rate swaps $ 596 Interest Expense Amounts reclassified from accumulated other comprehensive income (loss) related to current interest rate swaps (13,733) Interest Expense $ (13,137) 13. Stock and Other Incentive Plans Stock Incentive Plan The Company's Incentive Plan permits the grant of incentive awards to its employees and directors in any of the following forms: options, stock appreciation rights, restricted stock, restricted or deferred stock units, performance awards, dividend equivalents, or other stock-based awards, including units in the OP. The Incentive Plan replaced the Legacy HR Incentive Plan as of the Merger date. Unvested awards under the Legacy HR Incentive Plan were assumed according to their existing terms by the Company in connection with the Merger. As of the Merger date, 9,647,839 share-based awards were available for grant under the Incentive Plan. As of December 31, 2024 and 2023, the Company had share-based awards available for grant under the Incentive Plan of 6,140,496 and 8,102,861 shares, respectively. Non-vested shares issued to employees under the Incentive Plan are generally subject to fixed vesting periods varying from three to eight years beginning on the date of issue. If a recipient voluntarily terminates his or her relationship with the Company or is terminated for cause before the end of the vesting period, the shares are forfeited, at no cost to the Company. Once the shares have been issued, the recipient has the right to receive dividends and the right to vote the shares through the vesting period. Compensation expense, included in general and administrative expense, recognized during the years ended December 31, 2024, 2023 and 2022 from the amortization of the value of shares over the vesting period issued to employees and directors was $31.8 million, $14.6 million and $13.9 million, respectively. In 2024, the Company accelerated the amortization of certain outstanding awards, including in connection with the termination without cause of its CEO and CFO, totaling $17.8 million. The following table represents expected amortization of the Company's non-vested shares issued as of December 31, 2024: Dollars in millions FUTURE AMORTIZATION of non-vested shares 2025 $ 8.4 2026 5.5 2027 3.2 2028 1.3 2029 and thereafter 0.4 Total $ 18.8 NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 85


 
Executive Incentive Plan The Compensation Committee has adopted an executive incentive plan pursuant to the Incentive Plan (the "Executive Incentive Plan") to provide specific award criteria with respect to incentive awards made under the Incentive Plan subject to the discretion of the Compensation Committee. Under the terms of the Executive Incentive Plan, the Company's named executive officers and certain other members of senior management may earn incentive awards in the form of cash, non-vested stock, restricted stock units ("RSUs"), and units in the OP ("OP Units"). For 2024, 2023 and 2022, compensation expense, included in general and administrative expense, resulting from the amortization of the Executive Incentive Plan non-vested share, RSU, and OP Unit grants to officers was approximately $16.8 million, $9.0 million, and $9.8 million, respectively. In 2024, the Company accelerated the amortization of certain outstanding non-vested stock and RSU awards, including in connection with the termination without cause of its CEO and CFO, totaling $8.5 million. Details of equity awards that have been issued under this plan are as follows: • During the first quarter of 2024, the Company granted non-vested stock awards to its named executive officers and other members of senior management with an aggregate grant date fair value of $4.3 million, which consisted of an aggregate of 283,320 non-vested shares with a vesting period of five years. • During the second quarter of 2024, the Company granted non-vested stock to other members of senior management with an aggregate grant date fair value of $0.1 million, which consisted of an aggregate of 9,350 non-vested shares with a vesting period of five years. • On February 13, 2024, the Company granted an aggregate of 208,055 RSUs to members of senior management, with an aggregate grant date fair value of $3.5 million. These awards are subject to a three-year performance period and if the performance criteria is met, the awards are then subject to employment for two additional years with ratable vesting of 50% in year four and 50% in year five. The expense will be recognized on the straight-line basis over the five-year vesting period. ◦ Approximately 36% of the RSUs vest based on relative total shareholder return ("TSR") and were valued using independent specialists. The Company utilized a Monte Carlo simulation to calculate the weighted average grant date fair value of $19.10 for the relative TSR component for the February grants using the following assumptions: Volatility 28.0 % Dividend assumption Accrued Expected term 3 years Risk-free rate 4.44 % Stock price (per share) $15.22 ▪ The remaining 64% of the RSU awards are subject to certain operating performance conditions. With respect to the operating performance conditions of the February 2024 grants, the grant date fair value was $15.22 based on the Company's share price on the date of grant. The Company records amortization expense based on the probability of achieving certain operating performance conditions, which is evaluated throughout the performance period. ▪ The combined weighted average grant date fair value of the February 2024 RSUs was $16.61 per share. ◦ On April 30, 2024, the Company granted an aggregate of 21,816 RSUs to members of senior management, with an aggregate grant date fair value of $0.3 million. These awards are subject to a three-year performance period and if the performance criteria is met, the awards are then subject to employment for two additional years with ratable vesting of 50% in year four and 50% in year five. The expense will be recognized on the straight-line basis over the five-year vesting period. • Approximately 36% of the RSUs vest based on relative TSR and were valued using independent specialists. The Company utilized a Monte Carlo simulation to calculate the weighted average grant date fair value of $14.94 for the relative TSR component for the April grants using the following assumptions: NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 86


 
Volatility 29.0 % Dividend assumption Accrued Expected term 3 years Risk-free rate 4.85 % Stock price (per share) $14.23 ◦ The remaining 64% of the RSU awards are subject to certain operating performance conditions. With respect to the operating performance conditions of the April 2024 grants, the grant date fair value was $14.23 based on the Company's share price on the date of grant. The Company records amortization expense based on the probability of achieving certain operating performance conditions, which is evaluated throughout the performance period. ◦ The combined weighted average grant date fair value of the April 2024 RSUs was $14.48 per share. LTIP Series C Units On February 13, 2024, the Company granted an aggregate of 906,044 LTIP Series C units ("LTIP-C units) in the OP to its named executive officers with an aggregate grant date fair value of $7.5  million. LTIP-C units are granted notionally at the maximum value of the award. These awards are subject to a three-year performance period and if the performance criteria is met, the awards are then subject to two additional years of employment with ratable vesting of 50% in year four and 50% in year five. The expense will be recognized on the straight-line basis over the five-year vesting period. • Approximately 36% of the LTIP-C units vest based on relative TSR and were valued using independent specialists. The Company utilized a Monte Carlo simulation to calculate the weighted average grant date fair value of $9.62 for the relative TSR component for the February 2024 grant using the following assumptions: Volatility 28.0 % Dividend assumption Accrued Expected term 3 years Risk-free rate 4.44 % Stock price (per share) $15.22 • The remaining 64% of the LTIP-C units vest based upon certain operating performance conditions. With respect to the operating performance conditions of the February 13, 2024 grant, the grant date fair value was $15.22 based on the Company's share price on the date of grant. The Company records amortization expense based on the probability of achieving certain operating performance conditions, which is evaluated throughout the performance period. • The combined weighted average grant date fair value of the February 2024 LTIP-C units was $13.22 per share. For 2024, compensation expense resulting from the amortization of LTIP-C units awarded to officers was approximately $8.8 million. The Company accelerated the amortization of certain outstanding LTIP-C awards, including in connection with the termination without cause of its CEO and CFO, totaling $7.2 million. Officer Incentive Program In 2024 the Company granted a performance-based award to certain non-executive officers totaling approximately $0.7 million, which was granted in the form of 48,490 non-vested shares. The shares have vesting periods ranging from three to eight years with a weighted average vesting period of approximately five years. For 2024, 2023 and 2022, compensation expense resulting from the amortization of these non-vested share grants awarded to officers was approximately $0.5 million, $0.6 million, and $0.9 million, respectively. The Company accelerated the amortization of certain outstanding awards, including in connection with the termination without cause of its CEO and CFO, totaling $0.1 million. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 87


 
Salary Deferral Plan The Company's salary deferral plan allows certain of its officers to elect to defer up to 50% of their base salary in the form of non-vested shares subject to long-term vesting. The number of shares will be increased through a Company match depending on the length of the vesting period selected by the officer. The officer's vesting period choices are: three years for a 30% match; five years for a 50% match; and eight years for a 100% match. During 2024, 2023 and 2022, the Company issued 29,902 shares, 31,792 shares and 17,381 shares, respectively, to its officers through the salary deferral plan. For 2024, 2023 and 2022, compensation expense resulting from the amortization of non-vested share grants to officers was approximately $1.1 million, $0.9 million, and $0.9 million, respectively. Non-employee Directors Incentive Plan The Company grants non-vested share-based awards to its non-employee directors under the Incentive Plan. The directors’ awards typically have a one-year vesting period and are subject to forfeiture prior to such date upon termination of the director’s service, at no cost to the Company. For each of the years 2024, 2023 and 2022, compensation expense resulting from the amortization of non-vested share-based grants to directors was approximately $2.4 million, $2.1 million, and $1.5 million, respectively. • During the second quarter of 2024, the Company granted non-vested stock awards to certain of its independent directors, with a grant date fair value of $0.9 million, which consisted of an aggregate of 58,910 non-vested shares, with a one-year vesting period. • During the second quarter of 2024, the Company also granted LTIP-D units in the OP to certain of its independent directors, with a grant fair value of $0.8 million, which consisted of an aggregate of 45,982 non- vested units, with a one-year vesting period. Other Grants The Company granted an aggregate of 51,884 non-vested shares to other members of senior management, with an aggregate grant date fair value of $0.9 million and a three-year vesting period. In 2024, the Company granted 69,022 non-vested shares to its interim Chief Executive Officer with a grant date fair value of $1.2 million with vesting the earlier of the appointment of a permanent CEO or one-year. The Company issued one-time non-vested share grants related to executive management transition in 2016. For 2024, 2023, and 2022, compensation expense resulting from the amortization of these non-vested share grants to officers was approximately $2.2 million, $0.8 million, and $0.8 million. The Company accelerated the amortization of these outstanding awards, including in connection with the termination without cause of its CEO and CFO, totaling $1.6 million. The following table represents the summary of non-vested share-based awards (including restricted stock, RSUs, LTIP-C units and LTIP-D units) under the Incentive Plans and related information for the years ended December 31, 2024, 2023, and 2022:  NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 88


 
YEAR ENDED DECEMBER 31, Dollars in thousands, except per share data 2024 2023 2022 Share-based awards, beginning of year 2,615,562 2,090,060 1,562,028 Granted 1 1,732,484 1,164,359 952,407 Vested (2,284,767) (403,266) (418,949) Change in awards based on performance assessment 2 (47,202) (205,668) — Forfeited (216,340) (29,923) (5,426) Share-based awards, end of year 1,799,737 2,615,562 2,090,060 Weighted-average grant date fair value of Share-based awards, beginning of year $ 25.56 $ 30.35 $ 31.10 Share-based awards granted during the year $ 15.49 $ 18.70 $ 29.64 Share-based awards vested during the year $ 21.43 $ 28.38 $ 31.52 Share-based awards change in performance assessment during the year $ 20.21 $ 29.05 $ — Stock-based awards forfeited during the year $ 16.87 $ 31.16 $ 31.48 Share-based awards, end of year $ 22.30 $ 25.56 $ 30.35 Grant date fair value of shares granted during the year $ 26,844 $ 22,171 $ 28,225 1 LTIP-C units are issued at the maximum possible value of the award and are reflected as such in this table until the performance period has been satisfied and the exact number of awards are determinable. 2 The Company's RSUs that are based on operating performance metrics are evaluated on the probability of those performance metrics being achieved. During 2023, the Company determined that the operating performance goals related to the RSUs issued in 2022 are not probable of being achieved and reversed all of the outstanding amortization expense for that grant. In addition, the Company lowered the probability of achieving the operating performance goals related to the RSUs issued in 2023. The vesting periods for the non-vested shares granted during 2024 ranged from one to eight years with a weighted- average amortization period remaining as of December 31, 2024 of approximately 3.9 years. During 2024, 2023 and 2022, the Company withheld 485,209 shares, 126,085 shares and 137,892 shares, respectively, of common stock from its officers to pay estimated withholding taxes related to the vesting of shares. 401(k) Plan The Company maintains a 401(k) plan that allows eligible employees to defer salary, subject to certain limitations imposed by the Internal Revenue Code. The Company provides a matching contribution up to $2,800 per employee, subject to certain limitations. The Company’s matching contributions were approximately $1.4 million for 2024, $1.5 million for 2023 and $1.2 million for 2022. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 89


 
14. Earnings Per Share The Company uses the two-class method of computing net earnings per common share. The Company's non-vested share-based awards are considered participating securities pursuant to the two-class method. The table below sets forth the computation of basic and diluted earnings per common share for the years ended December 31, 2024, 2023, and 2022.   YEAR ENDED DECEMBER 31, Dollars in thousands, except per share data 2024 2023 2022 Weighted average common shares outstanding Weighted average common shares outstanding 367,444,706 380,850,967 254,296,810 Non-vested shares (1,891,650) (1,923,096) (1,940,607) Weighted average common shares outstanding - basic 365,553,056 378,927,871 252,356,203 Weighted average common shares outstanding - basic 365,553,056 378,927,871 252,356,203 Dilutive effect of OP Units — — 1,451,599 Dilutive effect of employee stock purchase plan — — 65,519 Weighted average common shares outstanding - diluted 365,553,056 378,927,871 253,873,321 Net (loss) income $ (663,904) $ (282,083) $ 40,693 Income allocated to participating securities (3,122) (2,504) (2,437) Net loss attributable to non-controlling interest 9,419 3,822 204 Adjustment to loss attributable to non-controlling interest for legally outstanding restricted units (2,798) (851) — Net (loss) income applicable to common stockholders - basic $ (660,405) $ (281,616) $ 38,460 Net income attributable to OP Units — — 81 Net income applicable to common stockholders - diluted $ (660,405) $ (281,616) $ 38,541 Basic earnings per common share - net income $ (1.81) $ (0.74) $ 0.15 Diluted earnings per common share - net income $ (1.81) $ (0.74) $ 0.15 The effect of OP units convertible into 3,652,553 shares and options to purchase 4,751 shares under the Company's Employee Stock Purchase Plan for the year ended December 31, 2024 were excluded from the calculation of diluted loss per common share because the effect was anti-dilutive as a result of the loss from continuing operations incurred during the year. 15. Commitments and Contingencies Tenant Improvements The Company may provide a tenant improvement allowance in new or renewal leases for the purpose of refurbishing or renovating tenant space. As of December 31, 2024, the Company had commitments of approximately $212.8 million that are expected to be spent on tenant improvements throughout the portfolio, excluding development properties currently under construction. Land Held for Development Land held for development includes parcels of land owned by the Company, upon which the Company intends to develop and own outpatient healthcare facilities. The Company's land held for development included 15 parcels as of December 31, 2024 and 17 parcels as of December 31, 2023. The Company’s investments in land held for development totaled approximately $52.4 million as of December 31, 2024 and $59.9 million as of December 31, 2023. The current land held for development is located adjacent to certain of the Company's existing medical office buildings in Colorado, Connecticut, Florida, Georgia, Massachusetts, New York, Tennessee, Texas, and Washington. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 90


 
Security Deposits and Letters of Credit As of December 31, 2024, the Company held approximately $33.4 million in letters of credit and security deposits for the benefit of the Company in the event the obligated tenant fails to perform under the terms of its respective lease. Generally, the Company may, at its discretion and upon notification to the tenant, draw upon these instruments if there are any defaults under the leases. 16. Other Data Taxable Income (unaudited) The Company has elected to be taxed as a REIT, as defined under the Internal Revenue Code. To qualify as a REIT, the Company must meet a number of organizational and operational requirements, including a requirement that it currently distribute at least 90% of its taxable income to its stockholders. As a REIT, the Company generally will not be subject to federal income tax on taxable income it distributes currently to its stockholders. Accordingly, no provision for federal income taxes has been made in the accompanying Consolidated Financial Statements. If the Company fails to qualify as a REIT for any taxable year, then it will be subject to federal income taxes at regular corporate rates, including any applicable alternative minimum tax, and may not be able to qualify as a REIT for four subsequent taxable years. Even if the Company qualifies as a REIT, it may be subject to certain state and local taxes on its income and property and to federal income and excise tax on its undistributed taxable income. Earnings and profits (as defined under the Internal Revenue Code), the current and accumulated amounts of which determine the taxability of distributions to stockholders, vary from net income attributable to common stockholders and taxable income because of different depreciation recovery periods, depreciation methods, and other items. While Legacy HR was considered the accounting acquirer in the Merger for GAAP purposes, Legacy HR’s separate tax existence ceased with the Merger and Legacy HTA continues as the tax successor. On a tax basis, the Company’s gross real estate assets totaled approximately $11.1 billion, $12.6 billion and $13.0 billion as of December 31, 2024, 2023 and 2022, respectively. Characterization of Distributions (unaudited) Distributions in excess of earnings and profits generally constitute a return of capital. The table below gives the characterization of the distributions of the Company’s common stock for the years ended December 31, 2024, 2023 and 2022. For the years ended December 31, 2024, 2023 and 2022, there were no preferred shares outstanding. As such, no dividends were distributed related to preferred shares for those periods. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 91


 
YEAR ENDED DECEMBER 31,   2024 2023 2022   PER SHARE PER SHARE PER SHARE Tax Treatment of Dividends Pre-Merger Healthcare Trust of America Ordinary income 1 $ — $ — $ 0.5862 Return of capital — — 4.0162 Capital gain — — 1.2216 Common stock distributions $ — $ — $ 5.8240 Tax Treatment of Dividends Pre-Merger Healthcare Realty Ordinary income 1 $ — $ — $ 0.2655 Return of capital — — 0.5555 Capital gain — — — Common stock distributions $ — $ — $ 0.8210 Tax Treatment of Dividends Post-Merger Healthcare Realty Ordinary income 1 $ 0.4335 $ 0.5482 $ 0.0422 Return of capital 0.7558 0.5031 0.2889 Capital gain 0.0507 0.1887 0.0879 Common stock distributions $ 1.2400 $ 1.2400 $ 0.4190 1 Reporting year ordinary income is also Code Section 199A eligible per the The Tax Cut and Jobs Act of 2017. State Income Taxes The Company must pay certain state income taxes, which are typically included in general and administrative expense on the Company’s Consolidated Statements of Operations. The State of Texas gross margins tax on gross receipts from operations is disclosed in the table below as an income tax. State income tax expense and state income tax payments for the years ended December 31, 2024, 2023 and 2022 are detailed in the table below:  YEAR ENDED DECEMBER 31, Dollars in thousands 2024 2023 2022 State income tax expense Texas gross margins tax $ 1,674 $ 1,206 $ 1,693 Other 126 133 151 Total state income tax expense $ 1,800 $ 1,339 $ 1,844 State income tax payments, net of refunds and collections $ 1,787 $ 1,324 $ 1,834 17. Fair Value of Financial Instruments The following methods and assumptions were used to estimate the fair value of each class of financial instrument for which it is practical to estimate that value. • Cash, cash equivalents and restricted cash - The carrying amount approximates fair value (level 1 inputs) due to the short-term maturity of these investments. • Real estate notes receivable - Real estate notes receivable is recorded in other assets on the Company's Condensed Consolidated Balance Sheets. Fair value is estimated using cash flow analyses, based on current interest rates for similar types of arrangements using level 2 inputs in the hierarchy. However, the fair value of one note receivable was determined utilizing the fair value of the receivable's collateral, which was determined based on an executed purchase and sale agreement of the underlying collateral, and therefore was classified as level 1 inputs in the hierarchy. • Borrowings under the Unsecured Credit Facility and the Term Loans due 2024 and 2026 - The carrying amount approximates fair value because the borrowings are based on variable market interest rates. • Senior Notes and Mortgage notes payable - The fair value of notes and bonds payable is estimated using cash flow analyses, based on the Company’s current interest rates for similar types of borrowing arrangements. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 92


 
• Interest rate swap agreements - Interest rate swap agreements are recorded in other assets/liabilities on the Company's Consolidated Balance Sheets at fair value. Fair value is estimated by utilizing pricing models, level 2 inputs, which consider forward yield curves and discount rates. See Note 11 for additional information. The table below details the fair value and carrying values for our other financial instruments as of December 31, 2024 and 2023.    December 31, 2024 December 31, 2023 Dollars in millions CARRYING VALUE FAIR VALUE CARRYING VALUE FAIR VALUE Notes and bonds payable 1, 2 $ 4,662.8 $ 4,578.4 $ 4,994.9 $ 4,872.7 Real estate notes receivable $ 127.2 $ 122.4 $ 173.6 $ 172.5 1 Level 2 – model-derived valuations in which significant inputs and significant value drivers are observable in active markets. 2 Fair value for senior notes includes accrued interest as of December 31, 2024. 18. Segment Reporting The Company’s current business strategy with a single reportable segment related to its medical outpatient properties. Within this portfolio, the Company owns, leases, acquires, invests in joint ventures, manages, finances, develops and redevelops its properties and reports the operating results in the accompanying Consolidated Financial Statements. The CODM assess performance and allocate resources based on consolidated net income (loss) as reported on the Company's Statements of Operations. The Company uses net income to monitor expected versus actual results to assess the segment's performance. The measure of the Company's reportable segment assets is reported on the Company's Consolidated Balance Sheets as total assets. Pursuant to ASU 2023-07, Segment Reporting (Topic 280), public entities are required to disclose more detailed information about significant reportable segment expenses that are regularly provided to the CODM. The table below details the significant expenses for the years ended December 31, 2024, 2023 and 2022. YEAR ENDED DECEMBER 31, Dollars in thousands 2024 2023 2022 Significant Segment Expenses: Property taxes $ 126,692 $ 137,634 $ 98,101 Personnel 92,935 94,775 79,222 Utilities 97,889 101,840 65,999 Maintenance 110,962 117,969 80,527 Totals $ 428,478 $ 452,218 $ 323,849 NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 93


 
The following schedule reconciles net income to segment expenses. YEAR ENDED DECEMBER 31, Dollars in thousands 2024 2023 2022 Revenue $ 1,268,316 $ 1,343,769 $ 932,637 Property taxes (126,692) (137,634) (98,101) Personnel (92,935) (94,775) (79,222) Utilities (97,889) (101,840) (65,999) Maintenance (110,962) (117,969) (80,527) Other segment expenses (128,087) (106,624) (72,923) Transaction costs (3,122) (2,026) (3,229) Merger-related costs — 1,952 (103,380) Depreciation and amortization (675,152) (730,709) (453,082) Gain on sales of real estate properties and other assets 109,753 77,546 270,271 Interest expense (242,425) (258,584) (146,691) (Loss) gain on extinguishment of debt (237) 62 (2,401) Impairment of real estate properties and credit loss reserves (313,547) (154,912) (54,427) Impairment of goodwill (250,530) — — Equity loss from unconsolidated joint ventures (135) (1,682) (687) Interest and other (expense) income, net (260) 1,343 (1,546) Net (loss) income $ (663,904) $ (282,083) $ 40,693 Other segment expenses are primarily related to administrative costs, travel, legal, technology, and insurance. 19. Related-Party Transactions In the ordinary course of conducting its business, the Company enters into agreements with affiliates in relation to the management and leasing of its real estate assets, including real estate assets owned through joint ventures. Item 9. Changes in and Disagreements with Accountants on Accounting and Financial Disclosure None. Item 9A. Controls and Procedures Disclosure Controls and Procedures The Company maintains disclosure controls and procedures designed to ensure that information required to be disclosed in the Company’s reports under the Securities Exchange Act of 1934, as amended (the “Exchange Act”), is recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms. These disclosure controls and procedures include, without limitation, controls and procedures designed to ensure that the information required to be disclosed is accumulated and communicated to management, including the Chief Executive Officer and Chief Financial Officer, to allow for timely decisions regarding required disclosure. The Company’s management, with the participation of the Company’s Interim Chief Executive Officer and Chief Financial Officer, has evaluated the effectiveness of the Company’s disclosure controls and procedures (as such term is defined in Rules 13a-15(e) and 15d-15(e) under the Exchange Act) as of the end of the period covered by this Annual Report on Form 10-K. Based on such evaluation, the Company’s Interim Chief Executive Officer and Chief Financial Officer have concluded that, as of the end of such period, the Company’s disclosure controls and procedures are effective in recording, processing, summarizing and reporting, on a timely basis, information required to be disclosed by the Company in the reports that it files or submits under the Exchange Act. NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS, cont. 94


 
Changes in Internal Control over Financial Reporting There have not been any changes in the Company’s internal control over financial reporting (as such term is defined in Rules 13a-15(f) and 15d-15(f) under the Exchange Act) during the year ended December  31, 2024 that have materially affected, or are reasonably likely to materially affect, the Company’s internal control over financial reporting. Management’s Annual Report on Internal Control Over Financial Reporting The Company's management is responsible for establishing and maintaining adequate internal control over financial reporting as defined in Rules 13a-15(f) and 15d-15(f) under the Exchange Act. The Company’s internal control over financial reporting is designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with accounting principles generally accepted in the United States of America. The Company’s internal control over financial reporting includes those policies and procedures that: (i) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the Company; (ii) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with accounting principles generally accepted in the United States of America, and that receipts and expenditures of the Company are being made only in accordance with authorizations of management and directors of the Company; and (iii) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use or disposition of the Company’s assets that could have a material effect on the financial statements. Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate. Management assessed the effectiveness of the Company’s internal control over financial reporting as of December 31, 2024 using the principles and other criteria set forth by the Committee of Sponsoring Organizations of the Treadway Commission (COSO) in Internal Control-Integrated Framework (2013). Based on that assessment, management concluded that the Company’s internal control over financial reporting was effective as of December 31, 2024. The Company’s independent registered public accounting firm, BDO USA, P.C., has also issued an attestation report on the effectiveness of the Company’s internal control over financial reporting included herein. 95


 
Report of INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM Stockholders and Board of Directors Healthcare Realty Trust Incorporated Nashville, Tennessee Opinion on Internal Control over Financial Reporting We have audited Healthcare Realty Trust Incorporated’s (the “Company’s”) internal control over financial reporting as of December 31, 2024, based on criteria established in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (the “COSO criteria”). In our opinion, the Company maintained, in all material respects, effective internal control over financial reporting as of December 31, 2024, based on the COSO criteria. We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) (“PCAOB”), the consolidated balance sheets of the Company as of December 31, 2024 and 2023, the related consolidated statements of operations, comprehensive income (loss), equity and redeemable non-controlling interests, and cash flows for each of the three years in the period ended December 31, 2024, and the related notes and financial statement schedules and our report dated February 19, 2025 expressed an unqualified opinion thereon. Basis for Opinion The Company’s management is responsible for maintaining effective internal control over financial reporting and for its assessment of the effectiveness of internal control over financial reporting, included in the accompanying Item 9A, Management’s Annual Report on Internal Control over Financial Reporting. Our responsibility is to express an opinion on the Company’s internal control over financial reporting based on our audit. We are a public accounting firm registered with the PCAOB and are required to be independent with respect to the Company in accordance with U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB. We conducted our audit of internal control over financial reporting in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether effective internal control over financial reporting was maintained in all material respects. Our audit included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness exists, and testing and evaluating the design and operating effectiveness of internal control based on the assessed risk. Our audit also included performing such other procedures as we considered necessary in the circumstances. We believe that our audit provides a reasonable basis for our opinion. Definition and Limitations of Internal Control over Financial Reporting A company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company’s internal control over financial reporting includes those policies and procedures that (1) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; (2) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management and directors of the company; and (3) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the financial statements. Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate. /s/ BDO USA, P.C. Nashville, Tennessee February 19, 2025 96


 
Item 9B. Other Information During the year ended December 31, 2024, no director or officer of the Company adopted or terminated a "Rule 10b5-1 trading agreement" or "non-Rule 10b5-1 trading agreement," as each term is defined in Item 408(a) of Regulation S- K. Item 9C. Disclosure Regarding Foreign Jurisdictions that Prevent Inspections Not applicable. 97


 
PART III Item 10. Directors, Executive Officers and Corporate Governance Directors Information with respect to the Company’s directors, set forth in the Company’s Proxy Statement relating to the Annual Meeting of Shareholders to be held on May 20, 2025, under the caption “Election of Directors,” is incorporated herein by reference. Executive Officers The executive officers of the Company are:  NAME AGE POSITION Constance B. Moore 69 Interim President and Chief Executive Officer Austen B. Helfrich 38 Executive Vice President and Chief Financial Officer Andrew E. Loope 56 Executive Vice President, General Counsel and Secretary Ryan E. Crowley 41 Executive Vice President and Chief Investment Officer Robert E. Hull 52 Executive Vice President and Chief Operating Officer Julie F. Wilson 53 Executive Vice President and Chief Administrative Officer Ms. Moore was appointed Interim President and Chief Executive Officer effective November 11, 2024 as a result of the departure of former President and Chief Executive Officer Todd J. Meredith. She was elected to the board of directors of the Company in March 2022 shortly before the Merger. She has served as a director of Civeo Corporation and TriPointe Homes since 2014. From 2017 to 2021, she served as a director of Columbia Property Trust, including one year as chair of its board of directors. In 2009, she served as chair of Nareit. She served as President and CEO of BRE Properties, Inc., a publicly-traded REIT, from 2005 until 2014. Mr. Helfrich was appointed as Executive Vice President and Chief Financial Officer effective December 8, 2024 and has been employed by the Company since 2019. He served as the Company’s Interim Chief Financial Officer from October 1, 2024 until December 8, 2024, and prior to that served as the Company’s First Vice President, Portfolio Strategy, most recently leading the asset sales and joint venture efforts.  Prior to joining the Company, Mr. Helfrich worked at Point72 where he was responsible for investing in the healthcare services sector. He also worked at Columbus Hill Capital Management and Citigroup's investment banking division. Mr. Loope was appointed as Executive Vice President, General Counsel, and Secretary effective January 1, 2025 after serving as Senior Vice President, Corporate Counsel, and Secretary. Prior to joining the Company in 2008, Mr. Loope was an attorney in the corporate and securities group of the law firm Waller Lansden Dortch & Davis, LLP (now Holland & Knight LLP) in Nashville, Tennessee. Mr. Crowley was appointed as Executive Vice President and Chief Investment Officer effective October 1, 2024 and has been employed by the Company since 2006. He served as Senior Vice President, Investments from November 2021 until September 30, 2024. Prior to that, he served as First Vice President, Investments. Mr. Hull was appointed Executive Vice President and Chief Operating Officer effective October 1, 2024 and has been employed by the company since 2004. He Served as Executive Vice President - Investments from January 1, 2017 until September 30, 2024. He served as Senior Vice President - Investments from March 2011 until January 2017, managing the Company's development and acquisition activity. Prior to that, Mr. Hull served in various capacities on the Company's investments team. Before joining the Company, Mr. Hull worked in the senior living and commercial banking industries. Ms. Wilson was appointed Executive Vice President and Chief Administrative Officer effective October 1, 2024 and has been employed with the Company since 2001. She served as Executive Vice President - Operations from July 1, 2021 until September 30, 2024. She previously served as Senior Vice President - Leasing and Management from March 2008 until July 2021. Prior to that, Ms. Wilson worked in the leasing, property management and investments 98


 
groups. Before joining the Company in 2001, Ms. Wilson worked in investment banking and commercial real estate brokerage. Code of Ethics The Company has adopted a Code of Business Conduct and Ethics (the “Code of Ethics”) that applies to its principal executive officer, principal financial officer, principal accounting officer and controller, or persons performing similar functions, as well as all directors, officers and employees of the Company. The Code of Ethics is posted on the Company’s website (www.healthcarerealty.com) and is available in print free of charge to any stockholder who requests a copy. Interested parties may address a written request for a printed copy of the Code of Ethics to: Investor Relations, Healthcare Realty Trust Incorporated, 3310 West End Avenue, Suite 700, Nashville, Tennessee 37203. The Company intends to satisfy the disclosure requirement regarding any amendment to, or a waiver of, a provision of the Code of Ethics for the Company’s principal executive officer, principal financial officer, principal accounting officer or controller, or persons performing similar functions by posting such information on the Company’s website. Insider Trading Policy The Company has adopted an insider trading policy governing the buying, selling, or other transfers of its securities by its directors, officers, and employees that the Company believes is reasonably designed to promote compliance with federal and state securities laws and any listing standards applicable to the Company. It is the Company’s policy to comply with all applicable securities laws and regulations (including appropriate approvals by the Company’s board of directors, if required) when engaging in transactions in the Company’s securities. Section 16(a) Compliance Information with respect to compliance with Section 16(a) of the Exchange Act set forth in the Company’s Proxy Statement relating to the Annual Meeting of Shareholders to be held on May 20, 2025, under the caption “Security Ownership of Certain Beneficial Owners and Management – Delinquent Section 16(a) Reports,” is incorporated herein by reference. Stockholder Recommendation of Director Candidates Information with respect to the Company’s policy relating to stockholder recommendations of director candidates is set forth in the Company’s Proxy Statement relating to the Annual Meeting of Stockholders to be held on May 20, 2025, under the caption “Stockholder Recommendation or Nomination of Director Candidates,” and is incorporated herein by reference. Audit Committee Information relating to the Company’s Audit Committee, its members and the Audit Committee’s financial experts, set forth in the Company’s Proxy Statement relating to the Annual Meeting of Shareholders to be held on May 20, 2025, under the caption “Committee Membership,” is incorporated herein by reference. Item 11. Executive Compensation Information relating to executive compensation, set forth in the Company’s Proxy Statement relating to the Annual Meeting of Shareholders to be held on May 20, 2025, under the captions “Compensation Discussion and Analysis,” “Executive Compensation,” “Compensation Committee Interlocks and Insider Participation,” “Compensation Committee Report” and “Director Compensation,” is incorporated herein by reference, except with respect to the disclosure under the heading "Executive Compensation - Pay Versus Performance." Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters Information relating to the security ownership of management and certain beneficial owners, set forth in the Company’s Proxy Statement relating to the Annual Meeting of Shareholders to be held on May 20, 2025 under the caption “Security Ownership of Certain Beneficial Owners and Management,” is incorporated herein by reference. 99


 
Information relating to securities authorized for issuance under the Company’s equity compensation plans, set forth in Item 5 of this report under the caption “Equity Compensation Plan Information,” is incorporated herein by reference. Item 13. Certain Relationships and Related Transactions, and Director Independence Information relating to certain relationships and related transactions, and director independence, set forth in the Company’s Proxy Statement relating to the Annual Meeting of Shareholders to be held on May 20, 2025 under the captions “Certain Relationships and Related Transactions” and “Corporate Governance – Independence of Directors,” is incorporated herein by reference. Item 14. Principal Accountant Fees and Services Our independent registered public accounting firm is BDO USA, P.C., Nashville, TN, PCAOB ID#243. Information relating to the fees paid to the Company’s accountants, set forth in the Company’s Proxy Statement relating to the Annual Meeting of Shareholders to be held on May 20, 2025, under the caption “Ratification of Appointment of Independent Registered Public Accounting Firm,” is incorporated herein by reference. Item 15. Exhibits and Financial Statement Schedules Index to Historical Financial Statements, Financial Statement Schedules and Exhibits 1. Financial Statements The following financial statements of Healthcare Realty Trust Incorporated are included in Item 8 of this Annual Report on Form 10-K. • Consolidated Balance Sheets – December 31, 2024 and December 31, 2023. • Consolidated Statements of Operations for the years ended December 31, 2024, December 31, 2023 and December 31, 2022. • Consolidated Statements of Comprehensive Income (Loss) for the years ended December 31, 2024, December 31, 2023 and December 31, 2022. • Consolidated Statements of Equity and Redeemable Non-Controlling Interests for the years ended December 31, 2024, December 31, 2023 and December 31, 2022. • Consolidated Statements of Cash Flows for the years ended December 31, 2024, December 31, 2023 and December 31, 2022. • Notes to Consolidated Financial Statements. 2. Financial Statement Schedules Schedule II — Valuation and Qualifying Accounts for the years ended December 31, 2024, 2023, and 2022 106 Schedule III — Real Estate and Accumulated Depreciation as of December 31, 2024 107 Schedule IV — Mortgage Loans on Real Estate Assets as of December 31, 2024 112 All other schedules are omitted because they are either not applicable, not required or because the information is included in the consolidated financial statements or notes thereto. 100


 
3. Exhibits EXHIBIT NUMBER DESCRIPTION OF EXHIBITS 2.1 Agreement and Plan of Merger, dated as of February 28, 2022, by and among Healthcare Realty Trust Incorporated (now known as HRTI, LLC), Healthcare Trust of America, Inc. (now known as Healthcare Realty Trust Incorporated), Healthcare Trust of America Holdings, L.P. (now known as Healthcare Realty Holdings, L.P.), and HR Acquisition 2, LLC. 1 3.1 Fifth Articles of Amendment and Restatement of the Company, as amended.2 3.2 Fourth Amended and Restated Bylaws of the Company.3 3.3 Certificate of Limited Partnership of Healthcare Realty Holdings, L.P., as amended.4 3.4 Second Amended and Restated Agreement of Limited Partnership of Healthcare Realty Holdings, L.P.4 4.1 Description of Registrant's securities registered pursuant to Section 12 of the Securities Exchange Act of 1934. 5 4.2 2026 Notes Indenture, dated as of July 12, 2016 among Healthcare Trust of America Holdings, LP (now Healthcare Realty Holdings, L.P.), Healthcare Trust of America, Inc. (now Healthcare Realty Trust Incorporated), and U.S. Bank National Association, as trustee, including the form of 3.50% Senior Notes due 2026 and the guarantee thereof.6 4.3 2027 Notes Indenture, dated as of June 8, 2017 among Healthcare Trust of America Holdings, LP (now Healthcare Realty Holdings, L.P.), Healthcare Trust of America, Inc. (now Healthcare Realty Trust Incorporated), and U.S. Bank National Association, as trustee, including the form of 3.75% Senior Notes due 2027 and the guarantee thereof.7 4.4 2030 Notes Indenture, dated as of September 16, 2019 among Healthcare Trust of America Holdings, LP (now Healthcare Realty Holdings, L.P.), Healthcare Trust of America, Inc. (now Healthcare Realty Trust Incorporated), and U.S. Bank National Association, as trustee, including the form of 3.10% Senior Notes due 2030 and the guarantee thereof.8 4.5 2031 Notes Indenture, dated as of September 28, 2020 among Healthcare Trust of America Holdings, LP (now Healthcare Realty Holdings, L.P.), Healthcare Trust of America, Inc. (now Healthcare Realty Trust Incorporated), and U.S. Bank National Association, as trustee, including the form of 2.00% Senior Notes due 2031 and the guarantee thereof.9 4.6 Indenture, dated as of July 22, 2022, by and among Healthcare Realty Holdings, L.P., Healthcare Realty Trust Incorporated, and U.S. Bank Trust Company, National Association.4 4.7 Supplemental Indenture No. 1, dated as of July 22, 2022, by and among Healthcare Realty Holdings, L.P., Healthcare Realty Trust Incorporated, and U.S. Bank Trust Company, National Association.4 4.8 Supplemental Indenture No. 2, dated as of July 22, 2022, by and among Healthcare Realty Holdings, L.P., Healthcare Realty Trust Incorporated, and U.S. Bank Trust Company, National Association.4 4.9 Supplemental Indenture No. 3, dated as of July 22, 2022, by and among Healthcare Realty Holdings, L.P., Healthcare Realty Trust Incorporated, and U.S. Bank Trust Company, National Association.4 4.10 Supplemental Indenture No. 4, dated as of July 22, 2022, by and among Healthcare Realty Holdings, L.P., Healthcare Realty Trust Incorporated, and U.S. Bank Trust Company, National Association.4 4.11 Tenth Supplemental Indenture, dated as of July 22, 2022, by and between HRTI, LLC and Truist Bank. 4 4.12 3.875% Senior Notes due 2025.4 4.13 3.625% Senior Notes due 2028 (No. 2028-1).4 4.14 3.625% Senior Notes due 2028 (No. 2028-2).4 4.15 2.400% Senior Notes due 2030 (No. 2030-1).4 4.16 2.400% Senior Notes due 2030 (No. 2030-2).4 4.17 2.050% Senior Notes due 2031.4 4.18 Guarantee of 2025 Note.4 4.19 Guarantee of 2028 Note.4 4.20 Guarantee of 2030 Note.4 4.21 Guarantee of 2031 Note.4 10.1 Fourth Amended and Restated Revolving Credit and Term Loan Agreement, dated as of July 20, 2022, by and among Healthcare Trust of America Holdings, LP (now known as Healthcare Realty Holdings, L.P.), Healthcare Trust of America, Inc. (now known as Healthcare Realty Trust Incorporated), the lenders named therein, and Wells Fargo Bank, National Association.4 10.2 Third Amended and Restated Employment Agreement, dated February 16, 2016, by and between Todd J. Meredith and Healthcare Realty Trust Incorporated (now known as HRTI, LLC).10 101


 
10.3 Amendment No. 1 to Third Amended and Restated Employment Agreement, dated February 12, 2020, between Todd J. Meredith and Healthcare Realty Trust Incorporated (now known as HRTI, LLC).11 10.4 Amendment No. 2 to Third Amended and Restated Employment Agreement, dated February 18, 2022, between Todd J. Meredith and Healthcare Realty Trust Incorporated (now known as HRTI, LLC).12 10.5 Amended and Restated Employment Agreement, dated January 1, 2017, between Robert E. Hull and Healthcare Realty Trust Incorporated (now known as HRTI, LLC).10 10.6 Amendment No. 1 to Amended and Restated Employment Agreement, dated February 12, 2020, between Robert E. Hull and Healthcare Realty Trust Incorporated (now known as HRTI, LLC).11 10.7 Amendment No. 2 to Amended and Restated Employment Agreement, dated February 18, 2022, between Robert E. Hull and Healthcare Realty Trust Incorporated (now known as HRTI, LLC).12 10.8 Amended and Restated Employment Agreement, dated February 2, 2016, between J. Christopher Douglas and Healthcare Realty Trust Incorporated (now known as HRTI, LLC).13 10.9 Amendment No. 1 to Amended and Restated Employment Agreement, dated February 12, 2020, between J. Christopher Douglas and Healthcare Realty Trust Incorporated (now known as HRTI, LLC).11 10.1 Amendment No. 2 to Amended and Restated Employment Agreement, dated February 18, 2022, between J. Christopher Douglas and Healthcare Realty Trust Incorporated (now known as HRTI, LLC).12 10.11 Amended and Restated Employment Agreement, dated July 1, 2021, between Julie F. Wilson and Healthcare Realty Trust Incorporated (now known as HRTI, LLC).14 10.12 Executive Incentive Program, dated August 1, 2022.15 10.13 Form of LTIP Award Agreement (Executive Version).16 10.14 Form of LTIP Award Agreement (Director Version).16 10.15 Form of Indemnification Agreement for Directors.17 10.16 Form of Restricted Stock Award Certificate.18 10.17 The Company's Amended and Restated 2006 Incentive Plan, dated April 29, 2021.19 10.18 Form of LTIP Award Agreement.20 10.19 Amendment No. 3 to Amended and Restated Employment Agreement, dated October 1, 2024, between Robert E. Hull and Healthcare Realty Trust Incorporated.21 10.20 Amendment No. 1 to Amended and Restated Employment Agreement, dated October 1, 2024, between Julie F. Wilson and Healthcare Realty Trust Incorporated.21 10.21 Amended and Restated Employment Agreement, dated October 1, 2024, between Ryan E. Crowley and Healthcare Realty Trust Incorporated.21 10.22 Letter Agreement dated December 8, 2024, between Constance B. Moore and Healthcare Realty Trust Incorporated.22 10.23 Amended and Restated Employment Agreement, dated December 8, 2024, between Austen B. Helfrich and Healthcare Realty Trust Incorporated.23 10.24 Amended and Restated Employment Agreement, dated December 8, 2024, between Andrew E. Loope and Healthcare Realty Trust Incorporated.23 10.25 Agreement dated as of December 8, 2024 by and among Healthcare Realty Trust Incorporated and Starboard Value LP and certain of its affiliated entities and natural persons named therein.23 10.26 Fourth Amended and Restated Employment Agreement, dated as of December 31, 2024, between John M. Bryant, Jr. and Healthcare Realty Trust Incorporated. (filed herewith) 19 Insider Trading Policy (filed herewith) 21 Subsidiaries of the Registrant. (filed herewith) 22 Subsidiary Issuers of Guaranteed Securities. (filed herewith) 23 Consent of BDO USA, P.C., independent registered public accounting firm. (filed herewith) 31.1 Certification of the Chief Executive Officer of the Company pursuant to Rule 13a-14 of the Securities Exchange Act of 1934, as amended, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002. (filed herewith) 31.2 Certification of the Chief Financial Officer of the Company pursuant to Rule 13a-14 of the Securities Exchange Act of 1934, as amended, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002. (filed herewith) 32 Certifications pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002. (filed herewith) 97 Healthcare Realty Policy for the Recovery of Erroneously Awarded Compensation. 101.INS This instance document does not appear in the interactive data file because its XBRL tags are embedded within the inline XBRL document. 101.SCH XBRL Taxonomy Extension Schema Document. (filed herewith) 102


 
101.CAL XBRL Taxonomy Extension Calculation Linkbase Document. (filed herewith) 101.LAB XBRL Taxonomy Extension Labels Linkbase Document. (filed herewith) 101.DEF XBRL Taxonomy Extension Definition Linkbase Document. (filed herewith) 101.PRE XBRL Taxonomy Extension Presentation Linkbase Document. (filed herewith) 104 Cover Page Interactive Data File (formatted as Inline XBRL document and contained in Exhibit 101). 1 Filed as an exhibit to Legacy HTA’s (File No. 001-35568) Form 8-K filed with the SEC on March 1, 2022 and hereby incorporated by reference. 2 Filed as an exhibit to the Company's (File No. 001-35568) Form 10-Q for the quarter ended June 30, 2023 filed with the SEC on August 8, 2023 and hereby incorporated by reference. 3 Filed as an exhibit to Legacy HTA's (File No. 001-35568) Form 8-K filed with the SEC on April 29, 2020 and hereby incorporated by reference. 4 Filed as an exhibit to the Company's (File No. 001-35568) Form 8-K filed with the SEC on July 26, 2022 and hereby incorporated by reference. 5 Filed as an exhibit to the Company's Form 10-Q for the period ended September 30, 2023, filed with the SEC on November 3, 2023, and hereby incorporated by reference. 6 Filed as an exhibit to Legacy HTA's (File No. 001-35568) Form 8-K filed with the SEC on July 12, 2016 and hereby incorporated by reference. 7 Filed as an exhibit to Legacy HTA's (File No. 001-35568) Form 8-K filed with the SEC on June 13, 2017 and hereby incorporated by reference. 8 Filed as an exhibit to Legacy HTA's (File No. 001-35568) Form 8-K filed with the SEC on September 16, 2019 and hereby incorporated by reference. 9 Filed as an exhibit to Legacy HTA's (File No. 001-35568) Form 8-K filed with the SEC on September 28, 2020 and hereby incorporated by reference. 10 Filed as an exhibit to Legacy HR's (File No. 001-11852) Form 10-K for the year ended December 31, 2015 filed with the SEC on February 16, 2016 and hereby incorporated by reference. 11 Filed as an exhibit to Legacy HR's (File No. 001-11852) Form 10-K for the year ended December 31, 2019 filed with the SEC on February 12, 2020 and hereby incorporated by reference. 12 Filed as an exhibit to Legacy HR's (File No. 001-11852) Form 10-K for the year ended December 31, 2021 filed with the SEC on February 22, 2022 and hereby incorporated by reference. 13 Filed as an exhibit to Legacy HR's (File No. 001-11852) Form 8-K filed with the SEC on February 2, 2016 and hereby incorporated by reference. 14 Filed as an exhibit to Legacy HR's (File No. 001-11852) Form 10-Q for the quarter ended June 30, 2021 filed with the SEC on August 4, 2021 and hereby incorporated by reference. 15 Filed as an exhibit to the Company's (File No. 001-35568) Form 8-K filed with the SEC on August 5, 2022 and hereby incorporated by reference. 16 Filed as an exhibit to Legacy HTA's (File No. 001-35568) Form 8-K filed with the SEC on May 18, 2012 and hereby incorporated by reference. 17 Filed as an exhibit to Legacy HTA's (File No. 001-35568) Form 8-K filed with the SEC on December 22, 2010 and hereby incorporated by reference. 18 Filed as an exhibit to Legacy HTA's (File No. 001-35568) Form 10-K for the year ended December 31, 2016 filed with the SEC on February 21, 2017 and hereby incorporated by reference. 19 Included as Appendix A to Legacy HTA's (File No. 001-35568) Definitive Proxy Statement on Schedule 14A filed with the SEC on April 30, 2021 and hereby incorporated by reference. 20 Filed as an exhibit to the Company's (File No. 001-35568) Form 10-K for the year ended December 31, 2022 filed with the SEC on March 1, 2023 and hereby incorporated by reference. 21 Filed as an exhibit to the Company's (File No. 001-35568) Form 10-Q for the quarter ended September 20, 2024 filed with the SEC on October 30, 2024 and hereby incorporated by reference. 22 Filed as an exhibit to the Company's (File No. 001-35568) Form 8-K/A filed with the SEC on December 9, 2024 and hereby incorporated by reference. 23 Filed as an exhibit to the Company's (File No. 001-35568) Form 8-K filed with the SEC on December 9, 2024 and hereby incorporated by reference. Executive Compensation Plans and Arrangements The following is a list of all executive compensation plans and arrangements filed as exhibits to this Annual Report on Form 10-K: 1. Third Amended and Restated Employment Agreement, dated February 16, 2016, between Todd J. Meredith and Healthcare Realty Trust Incorporated (now known as HRTI, LLC) (filed as Exhibit 10.2) 2. Amendment No. 1 to Third Amended and Restated Employment Agreement, dated February 12, 2020, between Todd J. Meredith and Healthcare Realty Trust Incorporated (now known as HRTI, LLC) (filed as Exhibit 10.3) 3. Amendment No. 2 to Third Amended and Restated Employment Agreement, dated February 22, 2022, between Todd J. Meredith and Healthcare Realty Trust Incorporated (now known as HRTI, LLC) (filed as Exhibit 10.4) 4. Amended and Restated Employment Agreement, dated January 1, 2017, between Robert E. Hull and Healthcare Realty Trust Incorporated (now known as HRTI, LLC) (filed as Exhibit 10.5) 5. Amendment No. 1 to Amended and Restated Employment Agreement, dated February 12, 2020, between Robert E. Hull and Healthcare Realty Trust Incorporated (now known as HRTI, LLC) (filed as Exhibit 10.6) 6. Amendment No. 2 to Amended and Restated Employment Agreement, dated February 22, 2022, between Robert E. Hull and Healthcare Realty Trust Incorporated (now known as HRTI, LLC) (filed as Exhibit 10.7) 7. Amended and Restated Employment Agreement, dated February 2, 2016, between J. Christopher Douglas and Healthcare Realty Trust Incorporated (now known as HRTI, LLC) (filed as Exhibit 10.8) 103


 
8. Amendment No. 1 to Amended and Restated Employment Agreement, dated February 12, 2020, between J. Christopher Douglas and Healthcare Realty Trust Incorporated (now known as HRTI, LLC) (filed as Exhibit 10.9) 9. Amendment No. 2 to Amended and Restated Employment Agreement, dated February 22, 2022, between J. Christopher Douglas and Healthcare Realty Trust Incorporated (now known as HRTI, LLC) (filed as Exhibit 10.10) 10. Amended and Restated Employment Agreement between Healthcare Realty Trust Incorporated (now known as HRTI, LLC) and Julie F. Wilson, dated July 1, 2021 (filed as Exhibit 10.11) 11. Executive Incentive Program, dated August 1, 2022 (filed as Exhibit 10.12) 12. Form of LTIP Award Agreement (Executive Version) (filed as Exhibit 10.13) 13. Form of LTIP Award Agreement (Director Version) (filed as Exhibit 10.14) 14. Form of Restricted Stock Award Certificate (filed as Exhibit 10.16) 15. The Company's Amended and Restated 2006 Incentive Plan, dated April 29, 2021 (filed as Exhibit 10.17) 16. Form of LTIP Award Agreement (filed as Exhibit 10.18) 17. Amendment No. 3 to Amended and Restated Employment Agreement, dated October 1, 2024, between Robert E. Hull and Healthcare Realty Trust Incorporated (filed as Exhibit 10.19) 18. Amendment No. 1 to Amended and Restated Employment Agreement, dated October 1, 2024, between Julie F. Wilson and Healthcare Realty Trust Incorporated (filed as Exhibit 10.20) 19. Amended and Restated Employment Agreement, dated October 1, 2024, between Ryan E. Crowley and Healthcare Realty Trust Incorporated (filed as Exhibit 10.21) 20. Letter Agreement dated December 8, 2024, between Constance B. Moore and Healthcare Realty Trust Incorporated (filed as Exhibit 10.22) 21. Amended and Restated Employment Agreement, dated December 8, 2024, between Austen B. Helfrich and Healthcare Realty Trust Incorporated (filed as Exhibit 10.23) 22. Amended and Restated Employment Agreement, dated December 8, 2024, between Andrew E. Loope and Healthcare Realty Trust Incorporated (filed as Exhibit 10.24) 23. Fourth Amended and Restated Employment Agreement, dated as of December 31, 2024, between John M. Bryant, Jr. and Healthcare Realty Trust Incorporated (filed herewith) Item 16. Form 10-K Summary None. SIGNATURES AND SCHEDULES Signatures Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this Report to be signed on its behalf by the undersigned, thereunto duly authorized. 104


 
HEALTHCARE REALTY TRUST INCORPORATED By: /s/ CONSTANCE B. MOORE Constance B. Moore Interim President, Chief Executive Officer, and Director February 19, 2025 Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed by the following persons on behalf of the registrant and in the capacities and on the dates indicated. SIGNATURE TITLE DATE /s/ Constance B. Moore Interim President, Chief Executive Officer and Director February 19, 2025 Constance B. Moore (Principal Executive Officer) /s/ Austen B. Helfrich Executive Vice President and Chief Financial Officer February 19, 2025 Austen B. Helfrich (Principal Financial Officer) /s/ Amanda L. Callaway Senior Vice President and Chief Accounting February 19, 2025 Amanda L. Callaway Officer (Principal Accounting Officer) /s/ Nancy H. Agee Director February 19, 2025 Nancy H. Agee /s/ Thomas N. Bohjalian Director February 19, 2025 Thomas N. Bohjalian /s/ Ajay Gupta Director February 19, 2025 Ajay Gupta /s/ David B. Henry Director February 19, 2025 David B. Henry /s/ James J. Kilroy Director February 19, 2025 James J. Kilroy /s/ Jay P. Leupp Director February 19, 2025 Jay P. Leupp /s/ Peter F. Lyle Director February 19, 2025 Peter F. Lyle /s/ Glenn J. Rufrano Director February 19, 2025 Glenn J. Rufrano /s/ Christann M. Vasquez Director February 19, 2025 Christann M. Vasquez /s/ Donald C. Wood Director February 19, 2025 Donald C. Wood 105


 
Schedule II – Valuation and Qualifying Accounts for the years ended December 31, 2024, 2023 and 2022 Dollars in thousands ADDITIONS AND DEDUCTIONS DESCRIPTION BALANCE AT BEGINNING OF PERIOD CHARGED/ (CREDITED) TO COSTS AND EXPENSES CHARGED TO OTHER ACCOUNTS UNCOLLECTIBLE ACCOUNTS WRITTEN-OFF BALANCE AT END OF PERIOD 2024 Accounts receivable allowance $ 8,404 $ 2,094 $ — $ 962 $ 9,536 2023 Accounts receivable allowance $ 3,954 $ 5,119 $ — $ 669 $ 8,404 2022 Accounts receivable allowance $ 654 $ 3,306 $ — $ 6 $ 3,954 106


 
Schedule III – Real Estate and Accumulated Depreciation as of December 31, 2024 Dollars in thousands LAND 1 BUILDINGS, IMPROVEMENTS, LEASE INTANGIBLES AND CIP 1             MARKET NUMBER OF PROP. INITIAL INVESTMENT COST CAPITALIZED subsequent to acquisition TOTAL INITIAL INVESTMENT COST CAPITALIZED subsequent to acquisition TOTAL PERSONAL PROPERTY 2, 3, 5, 6 TOTAL PROPERTY 1, 3, 6 ACCUMULATED DEPRECIATION 4 ENCUMBRANCES 5 DATE ACQUIRED DATE CONST. Dallas, TX 39 $ 59,646 $ 13,383 $ 73,029 $ 734,249 $ 171,324 $ 905,573 $ 547 $ 979,149 $ 245,493 $ — 2003-2022 1974-2015 Seattle, WA 24 41,251 4,021 45,272 457,146 95,775 552,921 679 598,872 184,304 — 2008-2022 1974-2018 Charlotte, NC 31 25,635 7,345 32,980 433,524 54,597 488,121 133 521,234 134,075 — 2008-2020 1961-2018 Houston, TX 26 50,389 10,812 61,201 528,854 27,686 556,540 46 617,787 106,416 — 2007-2022 1980-2018 Denver, CO 26 49,621 9,918 59,539 373,784 56,284 430,068 605 490,212 109,752 — 2007-2022 1977-2020 Atlanta, GA 24 31,501 8,394 39,895 369,109 17,252 386,361 102 426,358 86,861 — 2007-2022 1974-2014 Boston, MA 16 117,857 9,590 127,447 336,494 (17,422) 319,072 14 446,533 62,449 — 2012-2016 1860-2011 Los Angeles, CA 15 47,027 2,743 49,770 201,800 67,303 269,103 401 319,274 131,477 17,113 1994-2020 1964-2003 Phoenix, AZ 35 21,120 8,057 29,177 469,183 54,748 523,931 427 553,535 84,116 — 2007-2017 1971-2008 Raleigh, NC 25 47,773 10,134 57,907 372,169 23,205 395,374 13 453,294 55,468 — 2010-2022 1977-2020 Nashville, TN 11 35,670 2,387 38,057 240,744 108,513 349,257 4,422 391,736 128,686 7,391 2004-2022 1960-2022 Miami, FL 14 19,100 3,789 22,889 245,413 38,346 283,759 176 306,824 75,640 — 1994-2020 1954-2009 Tampa, FL 18 23,491 7,095 30,586 319,520 19,969 339,489 33 370,108 53,946 — 1994-2023 1975-2015 Indianapolis, IN 39 42,629 8,245 50,874 274,723 23,130 297,853 13 348,740 50,188 — 2007-2019 1988-2013 New York, NY 14 58,719 4,658 63,377 179,119 9,882 189,001 — 252,378 26,533 — 2014-2019 1920-2000 Austin, TX 11 16,719 4,882 21,601 216,066 20,364 236,430 37 258,068 46,372 — 2013-2022 1986-2015 Washington, DC 9 3,756 1,509 5,265 187,304 36,987 224,291 48 229,604 59,598 — 2004-2021 1959-2011 Chicago, IL 6 11,250 2,554 13,804 204,996 19,989 224,985 81 238,870 45,205 — 2004-2019 1970-2017 San Francisco, CA 6 48,443 737 49,180 164,562 27,213 191,775 52 241,007 59,302 — 2015-2022 1912-2014 Orlando, FL 7 6,734 3,059 9,793 180,641 6,929 187,570 1 197,364 29,866 — 1998-2017 1994-2009 Other (45 markets) 190 214,962 57,722 272,684 2,793,299 233,856 3,027,155 2,079 3,301,918 713,184 20,633 1993-2023 Total real estate 586 973,293 181,034 1,154,327 9,282,699 1,095,930 10,378,629 9,909 11,542,865 2,488,931 45,137 Land held for develop. — 52,408 — 52,408 — — — — 52,408 — Construction in Progress — — — — 31,978 — 31,978 — 31,978 — — Financing lease right- of-use assets — — — — — — — — 77,343 — — Investment in financing receivables, net — — — — — — — — 123,671 — — Total properties 586 $ 1,025,701 $ 181,034 $ 1,206,735 $ 9,314,677 $ 1,095,930 $ 10,410,607 $ 9,909 $ 11,828,265 $ 2,488,931 $ 45,137 1 Includes three asset held for sale as of December 31, 2024 with gross real estate investments of approximately $17.6 million. 2 Total properties as of December 31, 2024 have an estimated aggregate total cost of $11.1 billion for federal income tax purposes. 3 Depreciation is provided for on a straight-line basis on buildings and improvements over 3.3 to 49.0 years, lease intangibles over 1.0 to 99.0 years, personal property over 3.0 to 10.0 years, and land improvements over 2.0 to 39.0 years. 4 Includes unamortized premium of $0.1 million and unaccreted discount of $0.1 million and debt issuance costs of $0.1 million as of December 31, 2024. 5 Includes merger of Healthcare Trust of America, Inc. buildings, acquired in 2022. 6 Rollforward of Total Property and Accumulated Depreciation, including assets held for sale, for the year ended December 31, 2024, 2023 and 2022 follows:   YEAR ENDED DEC. 31, 2024 YEAR ENDED DEC. 31, 2023 YEAR ENDED DEC. 31, 2022 Dollars in thousands TOTAL PROPERTY ACCUMULATED DEPRECIATION TOTAL PROPERTY ACCUMULATED DEPRECIATION TOTAL PROPERTY ACCUMULATED DEPRECIATION Beginning balance $ 13,408,713 $ 2,227,766 $ 14,076,475 $ 1,645,271 $ 5,104,942 $ 1,338,743 Additions during the period Real estate acquired — — 54,024 2,322 9,780,070 241,285 Other improvements 53,748 549,160 28,521 668,069 219,783 205,703 Land held for development — — — 49,416 — Construction in progress 69,598 — 49,901 — 31,586 — Investment in financing receivable, net 1,541 — 2,366 — (66,509) — Financing lease right-of-use assets, net (4,865) — (1,616) — 52,249 — Corporate Properties — — — — 3,640 236 Retirement/dispositions Real estate (1,700,470) (287,995) (800,958) (87,896) (1,098,702) (140,696) Ending balance $ 11,828,265 $ 2,488,931 $ 13,408,713 $ 2,227,766 $ 14,076,475 $ 1,645,271 107


 
Schedule IV – Mortgage Loans on Real Estate Assets as of December 31, 2024 Dollars in thousands Final Maturity Date Payment Terms Prior Liens Face Amount Carrying Amount Principal Amount of Loans Subject to Delinquent Principal or Interest Mortgage loan on real estate located in: Texas 7.00 % 12/2/2024 (1) $ — $ 31,150 $ 14,900 $ 31,150 North Carolina 8.00 % 12/22/2024 (2) — 6,000 7,441 7,441 Florida 6.00 % 2/27/2026 (3) — 37,661 37,832 — California 6.00 % 3/29/2026 (4) — 45,000 45,185 — Florida 9.00 % 12/28/2026 (5) — 6,538 6,538 — Texas 7.50 % 10/02/2029 (4) — 9,629 9,689 — Mezzanine loans on real estate located in: Arizona 9.00 % 12/20/2026 (4) — 6,000 6,038 — Texas 11.00 % 10/02/2029 (4) — 1 1 — Total real estate notes receivable $ — $ 141,979 $ 127,624 $ 38,591 1 Twelve-month prefunded interest reserve, with principal sum and interest on unpaid principal due on the maturity date. Loan on non-accrual status as of December 31, 2024. 2 Capitalized interest through maturity, with outstanding principal and accrued interest due on the maturity date. 3 Construction loan up to $65 million with periodic disbursements. Interest only payments due with principal and any unpaid interest due on the maturity date. 4 Interest only payments due with principal and any unpaid interest due on the maturity date. 5 Monthly installment payments of principal and interest in the amount of $152,069. The following shows changes in the carrying amounts of mortgage loans on real estate assets during the years ended December 31, 2024, 2023 and 2022: Year Ended December 31, 2024 2023 2022 Balance as of the beginning of the year $ 173,614 $ 99,643 $ — Additions: Fair value real estate notes assumed — — 74,819 New real estate notes 9,630 58,700 23,325 Draws on existing real estate notes 5,505 19,103 Capitalized interest — — 1,499 Accretion of fees and other items 3,600 1,364 — Deductions: Collection of real estate loans (5,162) — — Deferred fees and other items — — — Allowance for credit loss (59,563) (5,196) — Balance as of the end of the year $ 127,624 $ 173,614 $ 99,643 All other schedules for which provision is made in the applicable accounting regulations of the Securities and Exchange Commission are omitted because they are not required under the related instructions or are not applicable, or because the required information is shown in the consolidated financial statements or notes thereto. 108