Fair Value of Financial Instruments (Tables)

12 Months Ended

Dec. 31, 2021

Fair Value Disclosures [Abstract]

Summary of Fair Value Information of Financial Instruments

The following table summarizes fair value estimates for our financial instruments (in thousands):

	December 31, 2021						December 31, 2020
Asset (Liability)	Book Value			Fair Value			Book Value			Fair Value
Interest and rent receivables	$	56,229		$	56,564		$	46,208		$	45,381
Loans(1)		991,609			991,954			751,341			756,608
Debt, net		(11,282,770	)		(11,526,388	)		(8,865,458	)		(9,226,564	)

(1) Excludes the acquisition loan and mortgage loan made in October 2021 to Springstone and the acquisition loan made in May 2020 to our international joint venture, along with the related subsequent investment in the real estate of three hospitals in Colombia (see Note 3 for further details), as these assets are accounted for under the fair value option method.

Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis

At December 31, 2021 and 2020, the amounts recorded under the fair value option method were as follows (in thousands):

	As of December 31, 2021				As of December 31, 2020
Asset (Liability)	Fair Value		Original Cost		Fair Value		Original Cost		Asset Type Classification
Mortgage loans	$	143,068	$	143,068	$	136,332	$	136,332	Mortgage loans
Equity investment and other loans		409,638		409,638		218,775		218,775	Equity investments/Other loans

Schedule of Effects of Movement in DLOM by Sensitivity Analysis by Using Basis Point Variations

The DLOM on our Springstone and international joint venture equity investments was 40% at December 31, 2021. In arriving at the DLOM, we started with a DLOM range based on the results of studies supporting valuation discounts for other transactions or structures without a public market. To select the appropriate DLOM within the range, we then considered many qualitative factors, including the percent of control, the nature of the underlying investee’s business along with our rights as an investor pursuant to the operating agreement, the size of investment, expected holding period, number of shareholders, access to capital marketplace, etc. To illustrate the effect of movements in the DLOM, we performed a sensitivity analysis below by using basis point variations (dollars in thousands):

Basis Point Change in Marketability Discount	Estimated Increase (Decrease) in Fair Value
+ 100 basis points	$	(41	)
- 100 basis points		41