XML 56 R33.htm IDEA: XBRL DOCUMENT v3.25.4
Real Estate and Other Activities (Tables)
 12 Months Ended
Dec. 31, 2025
Real Estate [Abstract]  
Net Assets Acquired

For the years ended December 31, 2025, 2024, and 2023, we acquired or invested in the following net assets (in thousands):

 

 

2025

 

 

2024

 

 

2023

 

Land and land improvements

 

$

25,231

 

 

$

—

 

 

$

28,916

 

Buildings

 

 

48,742

 

 

 

—

 

 

 

114,966

 

Intangible lease assets — subject to amortization
   (weighted-average useful life of 19.9 years in 2025 and 24.8 years in 2023)

 

 

5,101

 

 

 

—

 

 

 

16,305

 

Investments in unconsolidated real estate joint ventures

 

 

63,015

 

 

 

107,908

 

 

 

—

 

Investments in unconsolidated operating entities

 

 

—

 

 

 

—

 

 

 

50,000

 

Other loans

 

 

—

 

 

 

—

 

 

 

25,000

 

Liabilities assumed

 

 

—

 

 

 

(2,290

)

 

 

—

 

 

$

142,089

 

 

$

105,618

 

 

$

235,187

 

Loans repaid(1)

 

 

—

 

 

 

—

 

 

 

(22,900

)

Total net assets acquired

 

$

142,089

 

 

$

105,618

 

 

$

212,287

 

 

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

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

 

Property

 

Commitment

 

 

Costs
Paid as of
December 31, 2025

 

 

Cost Remaining

 

IMED Hospitales ("IMED") (Spain)

 

$

67,054

 

 

$

39,954

 

 

$

27,100

 

Healthcare Systems of America (Florida)

 

 

43,500

 

 

 

2,064

 

 

 

41,436

 

IMED (Spain)

 

 

43,495

 

 

 

39,797

 

 

 

3,698

 

Lifepoint Behavioral (Arizona)

 

 

10,659

 

 

 

8,281

 

 

 

2,378

 

Other (Various)

 

 

554

 

 

 

210

 

 

 

344

 

 

$

165,262

 

 

$

90,306

 

 

$

74,956

 
Amortization Expense from Existing Lease Intangible Assets

We recorded amortization expense related to intangible lease assets of $30.4 million, $205.6 million (including $170 million for accelerating the amortization of the in-place lease intangibles associated with two master leases, including the Steward master lease that was terminated effective September 18, 2024), and $332.5 million (including $286 million for accelerating the amortization of the in-place lease intangibles related to re-leasing the Utah properties to CommonSpirit as described in this same Note 3), in 2025, 2024, and 2023, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands):

 

For the Year Ended December 31:

 

 

 

2026

 

$

32,165

 

2027

 

 

31,847

 

2028

 

 

31,684

 

2029

 

 

29,840

 

2030

 

 

29,173

 
Summary of Total Future Contractual Minimum Lease Payments to be Received

The following table summarizes total future contractual minimum lease payments, excluding operating expense reimbursements, tenant recoveries, and other lease-related adjustments to revenue (i.e., straight-line rents, deferred revenues, or reserves/write-offs), from tenants under noncancelable leases as of December 31, 2025 (amounts in thousands):

 

 

 

Total Under
Operating Leases

 

 

Total Under
Financing Leases

 

 

Total

 

2026

 

$

842,559

 

 

$

34,726

 

 

$

877,285

 

2027

 

 

933,571

 

 

 

35,477

 

 

 

969,048

 

2028

 

 

942,705

 

 

 

36,243

 

 

 

978,948

 

2029

 

 

946,839

 

 

 

37,025

 

 

 

983,864

 

2030

 

 

952,310

 

 

 

37,822

 

 

 

990,132

 

Thereafter

 

 

20,829,144

 

 

 

840,542

 

 

 

21,669,686

 

 

$

25,447,128

 

 

$

1,021,835

 

 

$

26,468,963

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

 

 

 

As of December 31, 2025

 

 

As of December 31, 2024

 

Minimum lease payments receivable

 

$

570,150

 

 

$

591,142

 

Estimated unguaranteed residual values

 

 

203,818

 

 

 

203,818

 

Less: Unearned income and allowance for credit loss

 

 

(523,746

)

 

 

(547,770

)

Net investment in direct financing leases

 

 

250,222

 

 

 

247,190

 

Other financing leases (net of allowance for credit loss)

 

 

171,462

 

 

 

810,580

 

Total investment in financing leases

 

$

421,684

 

 

$

1,057,770

 
Schedule of Real Estate and Other Impairment Charges, Net

Due to the events discussed above, we recorded various impairment charges during 2024 and 2023, which included the following (in millions):

 

 

For the Years Ended December 31,

 

 

 

Description

 

2024

 

 

2023

 

 

Income Statement
Classification

Reserve for unpaid rent and interest and straight-line
   rent receivables

 

$

—

 

 

$

413

 

 

Total revenues

Working capital and other loans(1)

 

 

787

 

 

 

—

 

 

Real estate and other
impairment charges, net

Investment in Massachusetts partnership(2)

 

 

445

 

 

 

30

 

 

Earnings (loss) from
equity interests

Real estate(2)

 

 

277

 

 

 

100

 

 

Real estate and other
impairment charges, net

Equity investment and other(1)

 

 

54

 

 

 

171

 

 

Real estate and other
impairment charges, net

Total

 

$

1,563

 

 

$

714

 

 

 
(1)
For our non-real estate investments in Steward, we compared our carrying value of all such investments to the fair value of the underlying collateral, which had no value after the global settlement and our release of claims against Steward as discussed above.
(2)
The three Space Coast properties and certain excess properties previously leased to Steward were deemed held for sale in the 2024 third quarter. We recognized a real estate impairment charge of approximately $180 million to adjust our net book value to align with fair value less cost to sell based on expected proceeds, including from a binding agreement for the Space Coast properties. For the other real estate held for use, we made a comparison of the projected undiscounted future cash flows with the net book value of each asset. For those properties where the carrying value was deemed not recoverable, we recorded an impairment charge to reduce the carrying value to its estimated fair value. For the real estate in the Massachusetts partnership, there was no fair value as we transitioned those properties to the mortgage lender to satisfy the mortgage debt. For the remaining properties (less than 10 in total in 2024 and 2023), we, along with assistance from a third-party, independent valuation firm, estimated fair value using a combination of cost, market, and income approaches using Level 3 inputs. The cost approach used comparable sales to value the land and cost manuals to value the improvements. The value derived from the market approach was based on sale prices of similar properties. For the income approach, we divided the expected operating income (rent revenue less expenses, if any) from the property by a market capitalization rate (range from 8% to 10%).
Summary of Investments in Unconsolidated Operating Entities

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

 

Operator

 

Ownership Percentage

 

As of December 31, 2025

 

 

As of December 31, 2024

 

Swiss Medical Network

 

70%

 

$

611,347

 

 

$

483,770

 

MEDIAN

 

50%

 

 

486,695

 

 

 

431,964

 

CommonSpirit (Utah partnership)

 

25%

 

 

162,278

 

 

 

113,202

 

Policlinico di Monza

 

50%

 

 

86,091

 

 

 

77,592

 

HM Hospitales

 

45%

 

 

53,366

 

 

 

49,869

 

Total

 

 

 

$

1,399,777

 

 

$

1,156,397

 

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

 

Operator

 

As of December 31,
2025

 

 

As of December 31,
2024

 

Swiss Medical Network

 

$

197,497

 

 

$

172,453

 

Aevis Victoria SA ("Aevis")

 

 

64,859

 

 

 

63,409

 

Priory

 

 

43,913

 

 

 

38,739

 

Aspris Children's Services ("Aspris")

 

 

15,910

 

 

 

15,950

 

PHP Holdings

 

 

—

 

 

 

149,027

 

Total

 

$

322,179

 

 

$

439,578

 
Summary of Financial Information on Combined Basis for Our Investments in Unconsolidated Real Estate Joint Ventures

The following tables present summary financial information on a combined basis for our investments in unconsolidated real estate joint ventures (amounts in thousands):

 

 

 

For the Year Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Revenue

 

$

357,823

 

 

$

348,404

 

 

$

315,108

 

Net income (loss)

 

$

313,593

 

 

$

(739,393

)

 

$

14,701

 

 

 

 

As of December 31,

 

 

 

2025

 

 

2024

 

Assets

 

$

5,614,938

 

 

$

4,872,918

 

Liabilities

 

$

2,831,599

 

 

$

2,599,078

 

The summary above by year reflects the financial information of all five of our current investments, except for the Utah Partnership that was formed in April 2024 with reporting starting in the 2024 third quarter. In addition, we have included financial information for the Macquarie partnership in 2023 and through the 2024 second quarter - see discussion under "Leasing Operations (Lessor)" in this same Note 3 for more details on this investment and its conclusion.
Schedule of Concentrations of Credit Risk See below for our concentration details (dollars in thousands):

Total Assets by Operator

 

 

 

As of December 31, 2025

 

 

As of December 31, 2024

 

Operators

 

Total Assets (1)

 

 

Percentage of
Total Assets

 

 

Total Assets (1)

 

 

Percentage of
Total Assets

 

Circle

 

$

2,121,848

 

 

 

14.1

%

 

$

2,026,778

 

 

 

14.2

%

Priory

 

 

1,301,888

 

 

 

8.7

%

 

 

1,233,462

 

 

 

8.6

%

Healthcare Systems of America

 

 

1,200,996

 

 

 

8.0

%

 

 

1,187,006

 

 

 

8.3

%

Swiss Medical Network

 

 

873,703

 

 

 

5.8

%

 

 

719,632

 

 

 

5.1

%

Lifepoint Behavioral

 

 

809,492

 

 

 

5.4

%

 

 

813,584

 

 

 

5.7

%

Other operators

 

 

6,688,287

 

 

 

44.6

%

 

 

6,624,256

 

 

 

46.3

%

Other assets

 

 

2,005,561

 

 

 

13.4

%

 

 

1,689,876

 

 

 

11.8

%

Total

 

$

15,001,775

 

 

 

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.

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

 

 

 

As of December 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

 

$

1,427,391

 

 

 

9.5

%

 

$

1,394,296

 

 

 

9.8

%

California

 

 

977,890

 

 

 

6.5

%

 

 

935,470

 

 

 

6.4

%

Florida

 

 

834,940

 

 

 

5.6

%

 

 

840,876

 

 

 

5.9

%

Ohio

 

 

330,189

 

 

 

2.2

%

 

 

327,577

 

 

 

2.3

%

Arizona

 

 

328,873

 

 

 

2.2

%

 

 

379,801

 

 

 

2.7

%

All other states

 

 

2,480,182

 

 

 

16.5

%

 

 

2,636,587

 

 

 

18.5

%

Other domestic assets

 

 

1,072,900

 

 

 

7.2

%

 

 

951,486

 

 

 

6.6

%

Total U.S.

 

$

7,452,365

 

 

 

49.7

%

 

$

7,466,093

 

 

 

52.2

%

United Kingdom

 

$

4,184,188

 

 

 

27.9

%

 

$

3,985,672

 

 

 

27.9

%

Switzerland

 

 

873,703

 

 

 

5.8

%

 

 

719,632

 

 

 

5.0

%

Germany

 

 

751,806

 

 

 

5.0

%

 

 

672,343

 

 

 

4.7

%

Spain

 

 

302,323

 

 

 

2.0

%

 

 

247,996

 

 

 

1.7

%

Finland

 

 

220,813

 

 

 

1.5

%

 

 

199,721

 

 

 

1.4

%

All other countries

 

 

283,916

 

 

 

1.9

%

 

 

264,747

 

 

 

1.9

%

Other international assets

 

 

932,661

 

 

 

6.2

%

 

 

738,390

 

 

 

5.2

%

Total international

 

$

7,549,410

 

 

 

50.3

%

 

$

6,828,501

 

 

 

47.8

%

Grand total

 

$

15,001,775

 

 

 

100.0

%

 

$

14,294,594

 

 

 

100.0

%

Total Assets by Facility Type (1)

 

 

 

As of December 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

 

$

8,769,909

 

 

 

58.5

%

 

$

8,493,331

 

 

 

59.4

%

Behavioral health facilities

 

 

2,445,418

 

 

 

16.3

%

 

 

2,376,460

 

 

 

16.7

%

Post acute care facilities

 

 

1,671,616

 

 

 

11.1

%

 

 

1,617,596

 

 

 

11.3

%

Freestanding ER/urgent care facilities

 

 

109,271

 

 

 

0.7

%

 

 

117,331

 

 

 

0.8

%

Other assets

 

 

2,005,561

 

 

 

13.4

%

 

 

1,689,876

 

 

 

11.8

%

Total

 

$

15,001,775

 

 

 

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 a revenue basis, concentration for the year ended December 31, 2025 as compared to the two prior years is as follows:

The following shows those tenants that represented 10% or more of our total revenues by year (in thousands):

 

2025

 

Operator

 

Total Revenues

 

 

Percentage of
Total Revenues

 

Circle

 

$

212,719

 

 

 

21.9

%

Priory

 

 

105,986

 

 

 

10.9

%

 

2024

 

Operator

 

Total Revenues

 

 

Percentage of
Total Revenues

 

Circle

 

$

205,582

 

 

 

20.7

%

Priory

 

 

101,675

 

 

 

10.2

%

 

2023

 

Operator

 

Total Revenues

 

 

Percentage of
Total Revenues

 

Circle

 

$

194,390

 

 

 

22.3

%

Priory

 

 

107,557

 

 

 

12.3

%
Total Revenues by Geographic Location

 

 

 

For the Years Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Geographic Location

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

Total U.S.

 

$

517,878

 

 

 

53.3

%

 

$

561,673

 

 

 

56.4

%

 

$

407,329

 

 

 

46.7

%

United Kingdom

 

 

373,279

 

 

 

38.4

%

 

 

359,991

 

 

 

36.2

%

 

 

352,594

 

 

 

40.4

%

All other countries

 

 

80,865

 

 

 

8.3

%

 

 

73,883

 

 

 

7.4

%

 

 

111,876

 

 

 

12.9

%

Grand total

 

$

972,022

 

 

 

100.0

%

 

$

995,547

 

 

 

100.0

%

 

$

871,799

 

 

 

100.0

%

 

 

Total Revenues by Facility Type

 

 

 

For the Years Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Facility Types

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

General acute care hospitals

 

$

586,648

 

 

 

60.3

%

 

$

628,622

 

 

 

63.1

%

 

$

541,888

 

 

 

62.2

%

Behavioral health facilities

 

 

214,437

 

 

 

22.1

%

 

 

209,668

 

 

 

21.1

%

 

 

213,292

 

 

 

24.5

%

Post acute care facilities

 

 

162,954

 

 

 

16.8

%

 

 

139,859

 

 

 

14.0

%

 

 

92,787

 

 

 

10.6

%

Freestanding ER/urgent care
   facilities

 

 

7,983

 

 

 

0.8

%

 

 

17,398

 

 

 

1.8

%

 

 

23,832

 

 

 

2.7

%

Total

 

$

972,022

 

 

 

100.0

%

 

$

995,547

 

 

 

100.0

%

 

$

871,799

 

 

 

100.0

%