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Real Estate Investments, Net (Tables)
 12 Months Ended
Dec. 31, 2021
Real Estate [Abstract]  
Summary of Investment in Owned Properties
The following table summarizes the Company’s investment in owned properties at December 31, 2021 and 2020 (dollars in thousands):
 
December 31, 2021December 31, 2020
Land$251,787 $205,356 
Buildings and improvements1,622,019 1,477,849 
Integral equipment, furniture and fixtures104,722 97,836 
Identified intangible assets1,257 2,352 
Real estate investments1,979,785 1,783,393 
Accumulated depreciation and amortization(389,814)(335,294)
Real estate investments, net$1,589,971 $1,448,099 
Schedule of Total Future Contractual Minimum Rental Income As of December 31, 2021, the Company’s total future contractual minimum rental income for all of its tenants, excluding operating expense reimbursements, was (dollars in thousands):
YearAmount
2022$192,897 
2023192,693 
2024191,347 
2025191,319 
2026191,424 
Thereafter1,138,179 
$2,097,859 
Schedule of Tenant Purchase Options
Certain of the Company’s operators hold purchase options allowing them to acquire properties they currently lease from the Company. A summary of these purchase options is presented below (dollars in thousands):
Asset TypePropertiesLease ExpirationNext Option Open Date
Option Type(1)
Current Cash Rent(2)
ALF7October 20341/1/2022
(3)
A$3,383 
SNF11November 20301/1/2022
(3)
C4,944 
SNF1March 20294/1/2022
B / C(4)
779 
SNF / Campus2October 20321/1/2023B1,028 
SNF4November 203412/1/2024B3,796 
ALF2October 20341/1/2026A1,598 
(1) Option type includes:
A - Fixed base price plus a specified share on any appreciation.
B - Fixed base price.
C - Fixed capitalization rate on lease revenue.
(2) Based on annualized cash revenue for contracts in place at December 31, 2021.
(3) Option window is open for six months.
(4) Purchase option reflects two option types.
Schedule of Rental Income
The following table summarizes components of the Company’s rental income (dollars in thousands):
For the Year Ended December 31,
202120202019
Rental Income
Contractual rent due(1)
$190,100 $171,309 $166,056 
Straight-line rent32 77 1,385 
Adjustment for collectibility(2)
— — (11,774)
Recovery of previously reversed rent(3)
— 1,047 — 
Lease termination revenue(3)
63 1,179 — 
Total$190,195 $173,612 $155,667 

(1)Includes initial cash rent and tenant operating expense reimbursements, as adjusted for applicable rental escalators and rent increases due to capital expenditures funded by the Company. For tenants on a cash basis, this represents the lesser of the amount that would be recognized on a straight-line basis or cash that has been received.
(2)During the year ended December 31, 2019, and in accordance with ASC 842, the Company evaluated the collectibility of lease payments through maturity and determined that it was not probable that the Company would collect substantially all of the contractual obligations from five operators through maturity. As such, the Company reversed
$7.8 million of contractual rent, $3.5 million of straight-line rent and $0.5 million of property tax reimbursements during the year ended December 31, 2019.
(3)During the year ended December 31, 2020, the Company recovered $1.0 million in rental income related to affiliates of Metron Integrated Health Systems (“Metron”) that was previously written off. In addition, in connection with the agreement to terminate its lease agreements with Metron and to sell the facilities to a third-party, the Company received certain lease termination payments from Metron. During the years ended December 31, 2021 and 2020, the Company recognized approximately $0.1 million and $1.2 million in lease termination revenue, respectively.
Schedule of Real Estate Acquisitions
The following table summarizes the Company’s acquisitions for the years ended December 31, 2021, 2020 and 2019 (dollar amounts in thousands):
Type of Property
Purchase Price(1)
Initial Annual Cash Rent(2)
Number of Properties
Number of Beds/Units(3)
December 31, 2021
Skilled nursing$57,973 $4,499 (4)4 509 
Multi-service campuses125,708 8,604 (5)4 640 
Assisted living12,395 — (6)2 98 
Total$196,076 $13,103 10 1,247 
December 31, 2020
Skilled nursing$75,545 $6,453 6 715 
Multi-service campuses6,876 555 1 184 
Assisted living7,396 590 1 62 
Total$89,817 $7,598 8 961 
December 31, 2019
Skilled nursing$254,760 $22,909 17 2,099 
Multi-service campuses59,344 5,203 4 762 
Assisted living12,596 1,031 1 96 
Total$326,700 $29,143 22 2,957 
(1)    Purchase price includes capitalized acquisition costs.
(2)    Initial annual cash rent excludes ground lease income.
(3)    The number of beds/units includes operating beds at acquisition date.
(4)    Initial annual cash rent represents initial cash rent for the first twelve months excluding any impact of straight-line rent.
(5)    Initial annual cash rent represents the first twelve months of rent upon commencement of the Company’s long-term net leases, which occurred during the three months ended June 30, 2021, upon the tenant’s receipt of licensing approval and increases to $9.4 million in the second year with CPI-based annual escalators thereafter.
(6)    Initial annual cash rent is zero until transfer of operations upon receipt of licensing approval.