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Real Estate and Other Activities (Tables)
 3 Months Ended
Mar. 31, 2024
Real Estate [Abstract]  
Net Assets Acquired

We acquired or invested in the following net assets (in thousands):

 

 

 

For the Three Months
Ended March 31,

 

 

 

2024

 

 

2023

 

 

 

 

 

 

 

 

Land and land improvements

 

$

—

 

 

$

9,313

 

Buildings

 

 

—

 

 

 

11,652

 

Intangible lease assets — subject to amortization (weighted-average useful
   life of 28.8 years for 2023)

 

 

—

 

 

 

1,935

 

Investments in unconsolidated operating entities

 

 

—

 

 

 

50,000

 

 

 

$

—

 

 

$

72,900

 

Loans repaid(1)

 

 

—

 

 

 

(22,900

)

Total net assets acquired

 

$

—

 

 

$

50,000

 
(1)
The 2023 column includes a $23 million mortgage loan that was converted to fee simple ownership of one property as described under Lifepoint Transaction below.
Summary of Status on Current Development Projects

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

 

Property

 

Commitment

 

 

Costs
Incurred as of
March 31, 2024

 

 

Estimated Rent
Commencement
Date

IMED Hospitales ("IMED") (Spain)

 

$

37,790

 

 

$

21,586

 

 

4Q 2024

IMED (Spain)

 

 

51,802

 

 

 

19,299

 

 

1Q 2025

 

 

$

89,592

 

 

$

40,885

 

 

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

 

 

 

As of March 31,
   2024

 

 

As of December 31,
   2023

 

Minimum lease payments receivable

 

$

606,537

 

 

$

611,669

 

Estimated unguaranteed residual values

 

 

203,818

 

 

 

203,818

 

Less: Unearned income and allowance for credit loss

 

 

(565,116

)

 

 

(571,059

)

Net investment in direct financing leases

 

 

245,239

 

 

 

244,428

 

Other financing leases (net of allowance for credit loss)

 

 

987,939

 

 

 

987,202

 

Total investment in financing leases

 

$

1,233,178

 

 

$

1,231,630

 
Summary of Investments in Unconsolidated Operating Entities

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

 

Operator

 

Ownership Percentage

As of March 31,
   2024

 

 

As of December 31,
   2023

 

MEDIAN

 

50%

$

471,303

 

 

$

471,336

 

Swiss Medical Network

 

70%

 

441,636

 

 

 

472,434

 

Steward (Macquarie partnership)

 

50%

 

405,781

 

 

 

394,052

 

Policlinico di Monza

 

50%

 

78,752

 

 

 

80,562

 

HM Hospitales

 

45%

 

53,010

 

 

 

56,071

 

Total

 

 

$

1,450,482

 

 

$

1,474,455

 

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

 

 

Operator

 

As of March 31,
   2024

 

 

As of December 31,
   2023

 

PHP Holdings

 

$

498,632

 

 

$

699,535

 

Swiss Medical Network

 

 

173,647

 

 

 

186,113

 

Aevis Victoria SA ("Aevis")

 

 

65,120

 

 

 

77,345

 

Priory Group ("Priory")

 

 

40,394

 

 

 

163,837

 

Aspris Children's Services ("Aspris")

 

 

15,977

 

 

 

15,986

 

Caremax

 

 

368

 

 

 

1,148

 

Steward (loan investment)

 

 

—

 

 

 

361,591

 

International joint venture

 

 

—

 

 

 

225,960

 

Steward (equity investment)

 

 

—

 

 

 

35,696

 

Lifepoint Behavioral

 

 

—

 

 

 

11,429

 

Total

 

$

794,138

 

 

$

1,778,640

 
Summary of Activity in Credit Loss reserves

The following table summarizes the activity in our credit loss reserves (in thousands):

 

 

 

For the Three Months
Ended March 31,

 

 

 

2024

 

 

2023

 

Balance at beginning of the year

 

$

96,001

 

 

$

121,146

 

Provision for credit loss, net

 

 

362,187

 

(1)

 

986

 

Expected credit loss reserve related to financial instruments
     sold, repaid, or satisfied

 

 

(1,596

)

 

 

(160

)

Balance at end of the period

 

$

456,592

 

 

$

121,972

 
(1)
Reflects the charge related to the $362 million loan to Steward, as further described under "Steward Health Care System" subheading of this Note 3.
Schedule of Concentrations of Credit Risk See below for our concentration details (dollars in thousands):

Total Assets by Operator

 

 

 

As of March 31, 2024

 

 

As of December 31, 2023

 

Operators

 

Total Assets (1)

 

 

Percentage of
Total Assets

 

 

Total Assets (1)

 

 

Percentage of
Total Assets

 

Steward

 

$

3,218,969

 

 

 

18.6

%

 

$

3,518,537

 

 

 

19.2

%

Circle Health Ltd ("Circle")

 

 

2,088,232

 

 

 

12.1

%

 

 

2,119,392

 

 

 

11.6

%

Priory

 

 

1,250,626

 

 

 

7.2

%

 

 

1,391,005

 

 

 

7.6

%

Prospect

 

 

1,093,094

 

 

 

6.3

%

 

 

1,092,974

 

 

 

6.0

%

Lifepoint Behavioral

 

 

813,498

 

 

 

4.7

%

 

 

813,527

 

 

 

4.4

%

Other operators

 

 

7,018,904

 

 

 

40.6

%

 

 

7,352,012

 

 

 

40.2

%

Other assets

 

 

1,817,633

 

(2)

 

10.5

%

 

 

2,017,397

 

 

 

11.0

%

Total

 

$

17,300,956

 

 

 

100.0

%

 

$

18,304,844

 

 

 

100.0

%
(1)
Total assets by operator are generally comprised of real estate assets, mortgage loans, investments in unconsolidated real estate joint ventures, investments in unconsolidated operating entities, and other loans.
(2)
Includes our investment in PHP Holdings of approximately $500 million as part of the Prospect Transaction as further described above in this same Note 3.

 

Total Assets by U.S. State and Country (1)

 

 

As of March 31, 2024

 

 

As of December 31, 2023

 

U.S. States and Other Countries

 

Total Assets

 

 

Percentage of
Total Assets

 

 

Total Assets

 

 

Percentage of
Total Assets

 

Texas

 

$

1,434,667

 

 

 

8.3

%

 

$

1,891,482

 

 

 

10.3

%

Florida

 

 

1,271,192

 

 

 

7.3

%

 

 

1,348,210

 

 

 

7.4

%

California

 

 

1,248,995

 

 

 

7.2

%

 

 

1,252,674

 

 

 

6.8

%

Utah

 

 

818,704

 

 

 

4.7

%

 

 

824,048

 

 

 

4.5

%

Massachusetts

 

 

759,268

 

 

 

4.4

%

 

 

732,550

 

 

 

4.0

%

All other states

 

 

3,695,029

 

 

 

21.4

%

 

 

3,726,145

 

 

 

20.4

%

Other domestic assets

 

 

1,229,695

 

 

 

7.1

%

 

 

1,397,170

 

 

 

7.6

%

Total U.S.

 

$

10,457,550

 

 

 

60.4

%

 

$

11,172,279

 

 

 

61.0

%

United Kingdom

 

$

4,079,869

 

 

 

23.6

%

 

$

4,261,944

 

 

 

23.3

%

Germany

 

 

726,940

 

 

 

4.2

%

 

 

734,630

 

 

 

4.0

%

Switzerland

 

 

680,403

 

 

 

3.9

%

 

 

735,891

 

 

 

4.0

%

Spain

 

 

250,043

 

 

 

1.5

%

 

 

252,529

 

 

 

1.4

%

All other countries

 

 

518,213

 

 

 

3.0

%

 

 

527,344

 

 

 

2.9

%

Other international assets

 

 

587,938

 

 

 

3.4

%

 

 

620,227

 

 

 

3.4

%

Total international

 

$

6,843,406

 

 

 

39.6

%

 

$

7,132,565

 

 

 

39.0

%

Grand total

 

$

17,300,956

 

 

 

100.0

%

 

$

18,304,844

 

 

 

100.0

%

Total Assets by Facility Type (1)

 

 

As of March 31, 2024

 

 

As of December 31, 2023

 

Facility Types

 

Total Assets

 

 

Percentage of
Total Assets

 

 

Total Assets

 

 

Percentage of
Total Assets

 

General acute care hospitals

 

$

11,115,957

 

 

 

64.3

%

 

$

11,764,151

 

 

 

64.3

%

Behavioral health facilities

 

 

2,432,850

 

 

 

14.1

%

 

 

2,576,983

 

 

 

14.1

%

Inpatient rehabilitation hospitals

 

 

1,436,694

 

 

 

8.3

%

 

 

1,445,399

 

 

 

7.9

%

Long-term acute care hospitals

 

 

269,235

 

 

 

1.5

%

 

 

270,849

 

 

 

1.5

%

Freestanding ER/urgent care facilities

 

 

228,587

 

 

 

1.3

%

 

 

230,065

 

 

 

1.2

%

Other assets

 

 

1,817,633

 

 

 

10.5

%

 

 

2,017,397

 

 

 

11.0

%

Total

 

$

17,300,956

 

 

 

100.0

%

 

$

18,304,844

 

 

 

100.0

%
(1)
For geographic and facility type concentration metrics in the tables above, we allocate our investments in operating entities pro rata based on the gross book value of the real estate. Such pro rata allocations are subject to change from period to period.