During the years ended December 31, 2019, 2018 and 2017, the Company operated in three reportable business segments for management and internal financial reporting purposes: MOBs, triple-net leased healthcare facilities, and SHOPs.

The Company evaluates performance and makes resource allocations based on its three business segments. The medical office building segment primarily consists of MOBs leased to healthcare-related tenants under long-term leases, which may require such tenants to pay a pro rata share of property-related expenses. The triple-net leased healthcare facilities segment primarily consists of investments in seniors housing properties, hospitals, inpatient rehabilitation facilities and skilled nursing facilities under long-term leases, under which tenants are generally responsible to directly pay property-related expenses. The SHOP segment consists of direct investments in seniors housing properties, primarily providing assisted living, independent living and memory care services, which are operated through engaging independent third-party operators. There were no intersegment sales or transfers during the periods presented.

As described in more detail below, on April 1, 2019 the Company transitioned (i.e. this asset is now operating as a SHOP asset and is not leased to a third party) one property located in Wellington, Florida (the “Transition Property”) from its triple-net leased healthcare facilities segment to its Seniors Housing — Operating Properties segment. See Note 3 — Real Estate Investments, Net for further information about this property and the transition. When such transfers between segments occur, we reclassify the operating results of the transferred properties to their current segment for both the current and all historical periods in order to present a consistent group of property results. The results of operations from the Transition Property are presented within the Seniors Housing — Operating Properties segment for the year ended December 31, 2019, 2018 and 2017.

In 2018, we had also transitioned (i.e. this asset is now operating as a SHOP asset and is not leased to a third party) a property located in Lutz, Florida from our triple-net leased healthcare facilities segment to our SHOP segment. The results of this property had previously been reclassified in our Same Store operating results in 2018 and, according, require no additional adjustment in 2019.

The Company evaluates the performance of the combined properties in each segment based on net operating income (“NOI”). NOI is defined as total revenues from tenants, less property operating and maintenance expense. NOI excludes all other items of expense and income included in the financial statements in calculating net income (loss). The Company uses NOI to assess and compare property level performance and to make decisions concerning the operation of the properties. The Company believes that NOI is useful as a performance measure because, when compared across periods, NOI reflects the impact on operations from trends in occupancy rates, rental rates, operating expenses and acquisition activity on an unleveraged basis, providing perspective not immediately apparent from net income (loss).

NOI excludes certain components from net income (loss) in order to provide results that are more closely related to a property’s results of operations. For example, interest expense is not necessarily linked to the operating performance of a real estate asset and is often incurred at the corporate level. In addition, depreciation and amortization, because of historical cost accounting and useful life estimates, may distort operating performance at the property level. NOI presented by the Company may not be comparable to NOI reported by other REITs that define NOI differently. The Company believes that in order to facilitate a clear understanding of the Company’s operating results, NOI should be examined in conjunction with net income (loss) as presented in the Company’s consolidated financial statements. NOI should not be considered as an alternative to net income (loss) as an indication of the Company’s performance or to cash flows as a measure of the Company’s liquidity or ability to pay distributions.



	Year Ended December 31, 2019
(In thousands)	Medical Office Buildings		Triple-Net Leased Healthcare Facilities ⁽¹⁾		Seniors Housing — Operating Properties ⁽¹⁾		Consolidated
Revenue from tenants	$	100,379	$	14,564	$	259,971	$	374,914
Property operating and maintenance	31,813		2,800		199,572		234,185
NOI	$	68,566	$	11,764	$	60,399	140,729
Impairment charges							(55,969		)
Operating fees to related parties							(23,414		)
Acquisition and transaction related							(362		)
General and administrative							(20,530		)
Depreciation and amortization							(81,032		)
Gain on sale of real estate investments							8,790
Interest expense							(56,059		)
Interest and other income							7
Loss on non designated derivatives							(68		)
Income tax expense							(399		)
Net loss attributable to non-controlling interests							393
Preferred dividends							(173		)
Net loss attributable to common stockholders							$	(88,087	)



	Year Ended December 31, 2018
(In thousands)	Medical Office Buildings		Triple-Net Leased Healthcare Facilities ⁽¹⁾		Seniors Housing — Operating Properties ⁽¹⁾		Consolidated
Revenue from tenants	$	99,103	$	19,617	$	243,686	$	362,406
Property operating and maintenance	30,295		7,197		183,505		220,997
NOI	68,808		12,420		60,181		141,409
Impairment charges							(20,655		)
Operating fees to related parties							(23,071		)
Acquisition and transaction related							(302		)
General and administrative							(17,275		)
Depreciation and amortization							(83,212		)
Loss on sale of real estate investments							(70		)
Interest expense							(49,471		)
Interest and other income							23
Loss on sale of non-designated derivatives							(157		)
Income tax expense							(197		)
Net loss attributable to non-controlling interests							216
Net loss attributable to common stockholders							$	(52,762	)



	Year Ended December 31, 2017
(In thousands)	Medical Office Buildings		Triple-Net Leased Healthcare Facilities ⁽¹⁾		Seniors Housing — Operating Properties ⁽¹⁾		Consolidated
Revenue from tenants	$	82,850	$	22,169	$	206,154	$	311,173
Property operating and maintenance	24,137		12,789		149,351		186,277
NOI	58,713		9,380		56,803		124,896
Impairment charges							(18,993		)
Operating fees to related parties							(22,257		)
Acquisition and transaction related							(2,986		)
General and administrative							(15,673		)
Depreciation and amortization							(77,641		)
Gain on sale of real estate investment							438
Interest expense							(30,264		)
Interest and other income							306
Loss on non-designated derivatives							(198		)
Gain on asset acquisition							307
Income tax expense							(647		)
Net loss attributable to non-controlling interests							164
Net loss attributable to common stockholders							$	(42,548	)



	December 31,
(In thousands)	2019		2018
ASSETS
Investments in real estate, net:
Medical office buildings	$	891,477	$	878,703
Triple-net leased healthcare facilities ⁽¹⁾	305,250		289,686
Construction in progress⁽²⁾	—		90,829
Seniors housing — operating properties ⁽¹⁾	856,864		911,952
Total investments in real estate, net	2,053,591		2,171,170
Cash and cash equivalents	95,691		77,264
Restricted cash	15,908		14,094
Assets held for sale	70,839		52,397
Derivative assets, at fair value	392		4,633
Straight-line rent receivable, net	21,182		17,351
Operating lease right-of-use asset	14,351		—
Prepaid expenses and other assets	39,707		28,785
Deferred costs, net	13,642		11,752
Total assets	$	2,325,303	$	2,377,446



	Year Ended December 31,
(In thousands)	2019		2018		2017
Medical office buildings	$	5,309	$	7,582	$	4,037
Triple-net leased healthcare facilities	396		1,152		154
Seniors housing — operating properties ⁽¹⁾	11,014		4,176		4,810
Total capital expenditures	$	16,719	$	12,910	$	9,001