Real Estate and Other Activities (Tables)

3 Months Ended

Mar. 31, 2026

Real Estate [Abstract]

Net Assets Acquired

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

	For the Three Months Ended March 31,
	2026		2025
Land and land improvements	$	2,163	$	19,905
Buildings and other		24,340		19,409
Intangible lease assets — subject to amortization    (weighted-average useful life of 25.1 years in 2026)		2,819		—
Total net assets acquired	$	29,322	$	39,314

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, 2026		Cost Remaining
IMED Hospitales ("IMED") (Spain)	$	65,952	$	49,820	$	16,132
IMED (Spain)		42,780		42,594		186
HSA (Florida)		43,500		4,421		39,079
NOR (California)		24,333		289		24,044
Other (Various)		554		210		344
	$	177,119	$	97,334	$	79,785

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,    2026			As of December 31,    2025
Minimum lease payments receivable	$	564,783		$	570,150
Estimated unguaranteed residual values		203,818			203,818
Less: Unearned income and allowance for credit loss		(517,683	)		(523,746	)
Net investment in direct financing leases		250,918			250,222
Other financing leases (net of allowance for credit loss)		130,671			171,462
Total investment in financing leases	$	381,589		$	421,684

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,    2026		As of December 31,    2025
Swiss Medical Network	70%	$	609,795	$	611,347
MEDIAN	50%		474,120		486,695
CommonSpirit (Utah partnership)	25%		169,269		162,278
Policlinico di Monza	50%		85,503		86,091
HM Hospitales	45%		51,698		53,366
Total		$	1,390,385	$	1,399,777

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

Operator	As of March 31,    2026		As of December 31,    2025
Swiss Medical Network	$	195,838	$	197,497
Aevis Victoria SA ("Aevis")		63,346		64,859
Priory Group ("Priory")		45,844		43,913
Aspris Children's Services ("Aspris")		15,900		15,910
Total	$	320,928	$	322,179

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,
	2026			2025
Balance at beginning of the year	$	553,297		$	511,473
Provision for credit loss, net (1)		14,554			65,982
Expected credit loss reserve written off or related to financial      instruments sold, repaid, or satisfied (2)		(525,079	)		—
Balance at end of the period	$	42,772		$	577,455

(1)The amount in 2025 is primarily related to Prospect. See "Leasing Operations (Lessor)" in this Note 3 for further discussion.

(2)The amount in 2026 is primarily related to write-offs of previously reserved Prospect mortgages and other financing leases. See "Leasing Operations (Lessor)" in this Note 3 for further discussion.

Schedule of Concentrations of Credit Risk

See below for our concentration details (dollars in thousands):

Total Assets by Operator

	As of March 31, 2026					As of December 31, 2025
Operators	Total Assets (1)		Percentage of Total Assets			Total Assets (1)		Percentage of Total Assets
Circle Health Ltd ("Circle")	$	2,069,009		14.0	%	$	2,121,848		14.1	%
Priory		1,273,725		8.6	%		1,301,888		8.7	%
HSA		1,209,459		8.2	%		1,200,996		8.0	%
Swiss Medical Network		868,978		5.9	%		873,703		5.8	%
Lifepoint Behavioral		806,344		5.5	%		809,492		5.4	%
Other operators		6,624,284		44.9	%		6,688,287		44.6	%
Other assets		1,910,878		12.9	%		2,005,561		13.4	%
Total	$	14,762,677		100.0	%	$	15,001,775		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 March 31, 2026					As of December 31, 2025
U.S. States and Other Countries	Total Assets		Percentage of Total Assets			Total Assets		Percentage of Total Assets
Texas	$	1,403,311		9.5	%	$	1,427,391		9.5	%
California		1,024,998		7.0	%		977,890		6.5	%
Florida		832,712		5.6	%		834,940		5.6	%
Arizona		329,471		2.2	%		328,873		2.2	%
Ohio		317,842		2.2	%		330,189		2.2	%
All other states		2,422,158		16.4	%		2,480,182		16.5	%
Other domestic assets		1,046,367		7.1	%		1,072,900		7.2	%
Total U.S.	$	7,376,859		50.0	%	$	7,452,365		49.7	%
United Kingdom	$	4,084,982		27.7	%	$	4,184,188		27.9	%
Switzerland		868,978		5.9	%		873,703		5.8	%
Germany		761,421		5.1	%		751,806		5.0	%
Spain		306,718		2.1	%		302,323		2.0	%
All other countries		499,208		3.4	%		504,729		3.4	%
Other international assets		864,511		5.8	%		932,661		6.2	%
Total international	$	7,385,818		50.0	%	$	7,549,410		50.3	%
Grand total	$	14,762,677		100.0	%	$	15,001,775		100.0	%

Total Assets by Facility Type (1)

	As of March 31, 2026					As of December 31, 2025
Facility Types	Total Assets		Percentage of Total Assets			Total Assets		Percentage of Total Assets
General acute care hospitals	$	8,673,783		58.8	%	$	8,769,909		58.5	%
Behavioral health facilities		2,407,964		16.3	%		2,445,418		16.3	%
Post acute care facilities		1,668,629		11.3	%		1,671,616		11.1	%
Freestanding ER/urgent care facilities		101,423		0.7	%		109,271		0.7	%
Other assets		1,910,878		12.9	%		2,005,561		13.4	%
Total	$	14,762,677		100.0	%	$	15,001,775		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, 2026.

On a revenue basis, concentration in 2026 compared to the same periods of 2025 is as follows:

Total Revenues by Geographic Location

	For the Three Months Ended March 31,
	2026					2025
Geographic Location	Total Revenues		Percentage of Total Revenues			Total Revenues		Percentage of Total Revenues
Total U.S.	$	134,861		53.5	%	$	116,840		52.2	%
United Kingdom		96,396		38.2	%		88,653		39.6	%
All other countries		20,808		8.3	%		18,306		8.2	%
Grand total	$	252,065		100.0	%	$	223,799		100.0	%

Total Revenues by Facility Type

	For the Three Months Ended March 31,
	2026					2025
Facility Types	Total Revenues		Percentage of Total Revenues			Total Revenues		Percentage of Total Revenues
General acute care hospitals	$	156,194		62.0	%	$	135,019		60.3	%
Behavioral health facilities		55,575		22.0	%		51,520		23.0	%
Post acute care facilities		38,370		15.2	%		35,256		15.8	%
Freestanding ER/urgent care facilities		1,926		0.8	%		2,004		0.9	%
Total	$	252,065		100.0	%	$	223,799		100.0	%

The following shows those tenants that represented 10% or more of our total revenues for the three months ended March 31, 2026 and 2025:

	For the Three Months Ended March 31,
	2026					2025
Operators	Total Revenues		Percentage of Total Revenues			Total Revenues		Percentage of Total Revenues
Circle	$	54,961		21.8	%	$	50,711		22.7	%
Priory		27,496		10.9	%		24,941		11.1	%
Other operators		169,608		67.3	%		148,147		66.2	%
Total	$	252,065		100.0	%	$	223,799		100.0	%