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Real Estate and Other Activities (Tables)
 3 Months Ended
Mar. 31, 2025
Real Estate [Abstract]  
Summary of Status on Current Development and Capital Additions Projects

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

 

Property

 

Commitment

 

 

Costs
Paid as of
March 31, 2025

 

 

Cost Remaining

 

Lifepoint Behavioral (Kansas)

 

$

20,183

 

 

$

13,992

 

 

$

6,191

 

Surgery Partners (Idaho)

 

 

15,993

 

 

 

9,960

 

 

 

6,033

 

Lifepoint Behavioral (Arizona)

 

 

10,659

 

 

 

1,651

 

 

 

9,008

 

IMED Hospitales (Spain)

 

 

51,925

 

 

 

24,651

 

 

 

27,274

 

IMED Hospitales (Spain)

 

 

37,879

 

 

 

31,152

 

 

 

6,727

 

 

 

$

136,639

 

 

$

81,406

 

 

$

55,233

 
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,
   2025

 

 

As of December 31,
   2024

 

Minimum lease payments receivable

 

$

585,894

 

 

$

591,142

 

Estimated unguaranteed residual values

 

 

203,818

 

 

 

203,818

 

Less: Unearned income and allowance for credit loss

 

 

(541,748

)

 

 

(547,770

)

Net investment in direct financing leases

 

 

247,964

 

 

 

247,190

 

Other financing leases (net of allowance for credit loss)

 

 

756,264

 

 

 

810,580

 

Total investment in financing leases

 

$

1,004,228

 

 

$

1,057,770

 
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,
   2025

 

 

As of December 31,
   2024

 

Swiss Medical Network

 

70%

$

498,227

 

 

$

483,770

 

Median Kliniken S.á.r.l ("MEDIAN")

 

50%

 

445,068

 

 

 

431,964

 

CommonSpirit (Utah partnership)

 

25%

 

119,178

 

 

 

113,202

 

Policlinico di Monza

 

50%

 

76,512

 

 

 

77,592

 

HM Hospitales

 

45%

 

50,253

 

 

 

49,869

 

Total

 

 

$

1,189,238

 

 

$

1,156,397

 

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

 

Operator

 

As of March 31,
   2025

 

 

As of December 31,
   2024

 

Swiss Medical Network

 

$

177,079

 

 

$

172,453

 

PHP Holdings

 

 

131,027

 

 

 

149,027

 

Aevis Victoria SA ("Aevis")

 

 

53,569

 

 

 

63,409

 

Priory

 

 

40,460

 

 

 

38,739

 

Aspris Children's Services ("Aspris")

 

 

15,939

 

 

 

15,950

 

Total

 

$

418,074

 

 

$

439,578

 
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,

 

 

 

2025

 

 

2024

 

Balance at beginning of the year

 

$

511,473

 

 

$

96,001

 

Provision for credit loss, net (1)

 

 

65,982

 

 

 

362,187

 

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

 

 

—

 

 

 

(1,596

)

Balance at end of the period

 

$

577,455

 

 

$

456,592

 
(1)
Includes charges and reserves related to our investments in cash basis tenants. The amount in 2025 is primarily related to Prospect; whereas, the amount in 2024 includes the charge related to the $362 million loan to Steward.
Schedule of Concentrations of Credit Risk See below for our concentration details (dollars in thousands):

Total Assets by Operator

 

 

 

As of March 31, 2025

 

 

As of December 31, 2024

 

Operators

 

Total Assets (1)

 

 

Percentage of
Total Assets

 

 

Total Assets (1)

 

 

Percentage of
Total Assets

 

Circle Health Ltd ("Circle")

 

$

2,078,387

 

 

 

14.0

%

 

$

2,026,778

 

 

 

14.2

%

Priory

 

 

1,266,776

 

 

 

8.5

%

 

 

1,233,462

 

 

 

8.6

%

Healthcare Systems of America

 

 

1,205,404

 

 

 

8.1

%

 

 

1,187,006

 

 

 

8.3

%

Lifepoint Behavioral

 

 

817,661

 

 

 

5.5

%

 

 

813,584

 

 

 

5.7

%

Swiss Medical Network

 

 

728,874

 

 

 

4.9

%

 

 

719,632

 

 

 

5.1

%

Other operators

 

 

6,664,260

 

 

 

44.9

%

 

 

6,624,256

 

 

 

46.3

%

Other assets (2)

 

 

2,092,518

 

 

 

14.1

%

 

 

1,689,876

 

 

 

11.8

%

Total

 

$

14,853,880

 

 

 

100.0

%

 

$

14,294,594

 

 

 

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 $131 million and $150 million as of March 31, 2025, and December 31, 2024, respectively - see tenant update described previously in this same Note 3.

 

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

 

 

As of March 31, 2025

 

 

As of December 31, 2024

 

U.S. States and Other Countries

 

Total Assets

 

 

Percentage of
Total Assets

 

 

Total Assets

 

 

Percentage of
Total Assets

 

Texas

 

$

1,426,400

 

 

 

9.6

%

 

$

1,394,296

 

 

 

9.8

%

California

 

 

932,742

 

 

 

6.3

%

 

 

935,470

 

 

 

6.4

%

Florida

 

 

850,384

 

 

 

5.7

%

 

 

840,876

 

 

 

5.9

%

Arizona

 

 

383,582

 

 

 

2.6

%

 

 

379,801

 

 

 

2.7

%

Ohio

 

 

334,589

 

 

 

2.2

%

 

 

327,577

 

 

 

2.3

%

All other states

 

 

2,593,144

 

 

 

17.5

%

 

 

2,636,587

 

 

 

18.5

%

Other domestic assets

 

 

1,353,075

 

 

 

9.1

%

 

 

951,486

 

 

 

6.6

%

Total U.S.

 

$

7,873,916

 

 

 

53.0

%

 

$

7,466,093

 

 

 

52.2

%

United Kingdom

 

$

4,088,987

 

 

 

27.5

%

 

$

3,985,672

 

 

 

27.9

%

Switzerland

 

 

728,874

 

 

 

4.9

%

 

 

719,632

 

 

 

5.0

%

Germany

 

 

694,425

 

 

 

4.7

%

 

 

672,343

 

 

 

4.7

%

Spain

 

 

259,033

 

 

 

1.7

%

 

 

247,996

 

 

 

1.7

%

All other countries

 

 

469,202

 

 

 

3.2

%

 

 

464,468

 

 

 

3.3

%

Other international assets

 

 

739,443

 

 

 

5.0

%

 

 

738,390

 

 

 

5.2

%

Total international

 

$

6,979,964

 

 

 

47.0

%

 

$

6,828,501

 

 

 

47.8

%

Grand total

 

$

14,853,880

 

 

 

100.0

%

 

$

14,294,594

 

 

 

100.0

%

 

Total Assets by Facility Type (1)

 

 

As of March 31, 2025

 

 

As of December 31, 2024

 

Facility Types

 

Total Assets

 

 

Percentage of
Total Assets

 

 

Total Assets

 

 

Percentage of
Total Assets

 

General acute care hospitals

 

$

8,601,253

 

 

 

57.9

%

 

$

8,493,331

 

 

 

59.4

%

Behavioral health facilities

 

 

2,419,999

 

 

 

16.3

%

 

 

2,376,460

 

 

 

16.7

%

Post acute care facilities

 

 

1,623,653

 

 

 

10.9

%

 

 

1,617,596

 

 

 

11.3

%

Freestanding ER/urgent care facilities

 

 

116,457

 

 

 

0.8

%

 

 

117,331

 

 

 

0.8

%

Other assets

 

 

2,092,518

 

 

 

14.1

%

 

 

1,689,876

 

 

 

11.8

%

Total

 

$

14,853,880

 

 

 

100.0

%

 

$

14,294,594

 

 

 

100.0

%
(1)
For geographic and facility type concentration metrics in the tables above, we allocate our investments in unconsolidated 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.

On an individual property basis, our largest investment in any single property was less than 2% of our total assets as of March 31, 2025.

On a revenue basis, concentration for the quarter ended March 31, 2025 compared to the same period of 2024 is as follows:

Total Revenues by Operator

The following shows those tenants that represented 10% or more of our total revenues for the period:

 

 

 

For the Three Months Ended March 31,

 

 

 

2025

 

 

2024

 

Operators

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

Circle

 

$

50,711

 

 

 

22.7

%

 

$

51,012

 

 

 

18.8

%

Priory

 

 

24,941

 

 

 

11.1

%

 

 

25,882

 

 

 

9.5

%

CommonSpirit

 

 

—

 

 

 

0.0

%

 

 

29,353

 

 

 

10.8

%

Other operators

 

 

148,147

 

 

 

66.2

%

 

 

165,069

 

 

 

60.9

%

Total

 

$

223,799

 

 

 

100.0

%

 

$

271,316

 

 

 

100.0

%

Total Revenues by Geographic Location

 

 

 

For the Three Months Ended March 31,

 

 

 

2025

 

 

2024

 

Geographic Location

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

Total U.S.

 

$

116,840

 

 

 

52.2

%

 

$

163,456

 

 

 

60.2

%

United Kingdom

 

 

88,653

 

 

 

39.6

%

 

 

89,907

 

 

 

33.1

%

All other countries

 

 

18,306

 

 

 

8.2

%

 

 

17,953

 

 

 

6.7

%

Grand total

 

$

223,799

 

 

 

100.0

%

 

$

271,316

 

 

 

100.0

%

Total Revenues by Facility Type

 

 

 

For the Three Months Ended March 31,

 

 

 

2025

 

 

2024

 

Facility Types

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

General acute care hospitals

 

$

135,019

 

 

 

60.3

%

 

$

178,710

 

 

 

65.9

%

Behavioral health facilities

 

 

51,520

 

 

 

23.0

%

 

 

52,327

 

 

 

19.3

%

Post acute care facilities

 

 

35,256

 

 

 

15.8

%

 

 

34,545

 

 

 

12.7

%

Freestanding ER/urgent care facilities

 

 

2,004

 

 

 

0.9

%

 

 

5,734

 

 

 

2.1

%

Total

 

$

223,799

 

 

 

100.0

%

 

$

271,316

 

 

 

100.0

%