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Real Estate Investments, Net (Tables)
 12 Months Ended
Dec. 31, 2022
Real Estate [Abstract]  
Summary of Investment in Owned Properties Held for Use
The following table summarizes the Company’s investment in owned properties held for use at December 31, 2022 and 2021 (dollars in thousands):
 
December 31, 2022December 31, 2021
Land$238,738 $251,787 
Buildings and improvements1,483,133 1,622,019 
Integral equipment, furniture and fixtures97,199 104,722 
Identified intangible assets2,832 1,257 
Real estate investments1,821,902 1,979,785 
Accumulated depreciation and amortization(400,492)(389,814)
Real estate investments, net$1,421,410 $1,589,971 
Schedule of Total Future Contractual Minimum Rental Income As of December 31, 2022, the Company’s total future contractual minimum rental income for all of its tenants, excluding operating expense reimbursements, was as follows (dollars in thousands):
YearAmount
2023$190,704 
2024190,463 
2025190,621 
2026190,727 
2027187,719 
Thereafter984,665 
$1,934,899 
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 Expiration
Next Option Open Date(1)
Option Type(2)
Current Cash Rent(3)
SNF11November 20301/1/2023
(4)
B5,092 
SNF1March 20294/1/2022
(5)
A / B(6)
805 
SNF / Campus2October 20321/1/2023
(4)
A1,097 
SNF4November 203412/1/2024
(5)
A3,891 
(1) The Company has not received notice of exercise for the option periods that are currently open.
(2) Option type includes:
A - Fixed base price.
B - Fixed capitalization rate on lease revenue.
(3) Based on annualized cash revenue for contracts in place at December 31, 2022.
(4) Option window is open for six months.
(5) Option window is open until the expiration of the lease term.
(6) 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,
202220212020
Rental Income
Contractual rent due(1)
$188,906 $190,100 $171,309 
Straight-line rent17 32 77 
Adjustment for collectibility(2)
(1,417)— — 
Recoveries(3)
— — 1,047 
Lease termination revenue(4)
— 63 1,179 
Total$187,506 $190,195 $173,612 
(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, 2022, 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 existing and former operators. As such, the Company reversed $0.7 million of operating expense reimbursements, $0.2 million of contractual rent and $0.5 million of straight-line rent during the year ended December 31, 2022. If lease payments are subsequently deemed probable of collection, the Company will reestablish the receivable which will result in an increase in rental income for such recoveries.
(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.
(4)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, 2022, 2021 and 2020 (dollar amounts in thousands):
Type of Property
Purchase Price(1)
Initial Annual Cash RentNumber of Properties
Number of Beds/Units(2)
December 31, 2022
Skilled nursing$8,918 $815 1 135 
Multi-service campuses13,003 1,235 1 130 
Total$21,921 $2,050 2 265 
December 31, 2021
Skilled nursing$57,973 $4,499 (3)4 509 
Multi-service campuses125,708 8,604 (4)4 640 
Assisted living12,395 — (5)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 
(1)    Purchase price includes capitalized acquisition costs.
(2)    The number of beds/units includes operating beds at acquisition date.
(3)    Initial annual cash rent represents initial cash rent for the first twelve months excluding any impact of straight-line rent.
(4)    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.
(5)    Initial annual cash rent is zero until transfer of operations upon receipt of licensing approval.