American Healthcare REIT, Inc 10-Q for FY2022 Q3

American Healthcare REIT, Inc. (AHR)

10-Q 2022-11-14 For: 2022-09-30

Added on April 10, 2026

About this 10-Q

American Healthcare REIT, Inc filed this 10-Q on November 14, 2022, covering the quarter ended September 30, 2022 (FY2022 Q3).

Headline figures

Quarter ended September 30, 2022, as reported in this filing, compared with the same period a year earlier where the filing states it.

Revenue: $368.31M; up 28.4% from $286.88M a year earlier
Net loss: $13.51M; compared with a net loss of $5.24M a year earlier
Diluted EPS: -$0.05; compared with -$0.03 a year earlier

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Maryland						47-2887436
(State or other jurisdiction of incorporation or organization)						(I.R.S. Employer Identification No.)

18191 Von Karman Avenue, Suite 300 Irvine, California						92612
(Address of principal executive offices)						(Zip Code)


			Page
PART I — FINANCIAL INFORMATION

Item 1. Financial Statements (Unaudited)			3
Condensed Consolidated Balance Sheets as of September 30, 2022 and December 31, 2021			3
Condensed Consolidated Statements of Operations and Comprehensive Loss for the Three and Nine Months Ended September 30, 2022 and 2021			5
Condensed Consolidated Statements of Equity for the Three and Nine Months Ended September 30, 2022 and 2021			6
Condensed Consolidated Statements of Cash Flows for the Nine Months Ended September 30, 2022 and 2021			9
Notes to Condensed Consolidated Financial Statements			12
Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations			45
Item 3. Quantitative and Qualitative Disclosures About Market Risk			64
Item 4. Controls and Procedures			66

PART II — OTHER INFORMATION

Item 1. Legal Proceedings			67
Item 1A. Risk Factors			67
Item 2. Unregistered Sales of Equity Securities and Use of Proceeds			70
Item 3. Defaults Upon Senior Securities			71
Item 4. Mine Safety Disclosures			71
Item 5. Other Information			71
Item 6. Exhibits			72
Signatures			73


	September 30, 2022		December 31, 2021
ASSETS
Real estate investments, net	$	3,526,591,000	$	3,514,686,000
Debt security investment, net	82,067,000		79,315,000
Cash and cash equivalents	79,421,000		81,597,000
Restricted cash	44,877,000		43,889,000
Accounts and other receivables, net	136,028,000		122,778,000

Identified intangible assets, net	237,969,000		248,871,000
Goodwill	254,888,000		209,898,000

Operating lease right-of-use assets, net	262,489,000		158,157,000
Other assets, net	134,316,000		121,148,000
Total assets	$	4,758,646,000	$	4,580,339,000

LIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND EQUITY
Liabilities:
Mortgage loans payable, net(1)	$	1,159,159,000	$	1,095,594,000
Lines of credit and term loans, net(1)	1,292,043,000		1,226,634,000
Accounts payable and accrued liabilities(1)	235,515,000		187,254,000
Accounts payable due to affiliates(1)	—		866,000

Identified intangible liabilities, net	11,249,000		12,715,000
Financing obligations(1)	20,827,000		33,653,000
Operating lease liabilities(1)	260,380,000		145,485,000
Security deposits, prepaid rent and other liabilities(1)	54,098,000		48,567,000
Total liabilities	3,033,271,000		2,750,768,000

Commitments and contingencies (Note 12)

Redeemable noncontrolling interests (Note 13)	85,869,000		72,725,000

Equity:
Stockholders’ equity:
Preferred stock, $0.01 par value per share; 200,000,000 shares authorized; none issued and outstanding	—		—
Class T common stock, $0.01 par value per share; 200,000,000 shares authorized; 77,895,942 and 77,176,406 shares issued and outstanding as of September 30, 2022 and December 31, 2021, respectively	770,000		763,000
Class I common stock, $0.01 par value per share; 800,000,000 shares authorized; 186,275,548 and 185,855,625 shares issued and outstanding as of September 30, 2022 and December 31, 2021, respectively	1,863,000		1,859,000
Additional paid-in capital	2,532,047,000		2,531,940,000
Accumulated deficit	(1,064,270,000)		(951,303,000)
Accumulated other comprehensive loss	(3,130,000)		(1,966,000)
Total stockholders’ equity	1,467,280,000		1,581,293,000
Noncontrolling interests (Note 14)	172,226,000		175,553,000
Total equity	1,639,506,000		1,756,846,000
Total liabilities, redeemable noncontrolling interests and equity	$	4,758,646,000	$	4,580,339,000


	Three Months Ended September 30,				Nine Months Ended September 30,
	2022		2021		2022		2021
Revenues and grant income:
Resident fees and services	$	368,306,000	$	286,882,000	$	1,013,505,000	$	816,260,000
Real estate revenue	51,323,000		29,668,000		154,371,000		90,333,000
Grant income	6,533,000		936,000		22,716,000		10,264,000
Total revenues and grant income	426,162,000		317,486,000		1,190,592,000		916,857,000
Expenses:
Property operating expenses	337,487,000		256,821,000		920,706,000		752,389,000
Rental expenses	14,850,000		8,188,000		44,800,000		24,362,000
General and administrative	9,626,000		9,008,000		31,673,000		23,608,000
Business acquisition expenses	231,000		3,633,000		2,161,000		7,631,000
Depreciation and amortization	40,422,000		26,334,000		122,704,000		78,414,000
Total expenses	402,616,000		303,984,000		1,122,044,000		886,404,000

Other income (expense):
Interest expense:
Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments)	(27,524,000)		(18,885,000)		(71,194,000)		(57,740,000)
Gain in fair value of derivative financial instruments	—		1,860,000		500,000		5,456,000
Gain (loss) on dispositions of real estate investments	2,113,000		276,000		2,796,000		(101,000)
Impairment of real estate investments	(21,851,000)		—		(39,191,000)		(3,335,000)
(Loss) income from unconsolidated entities	(344,000)		384,000		1,680,000		(2,288,000)
Gain on re-measurement of previously held equity interest	19,567,000		—		19,567,000		—
Foreign currency loss	(3,695,000)		(1,394,000)		(8,689,000)		(741,000)
Other income	670,000		348,000		2,399,000		811,000
Total net other expense	(31,064,000)		(17,411,000)		(92,132,000)		(57,938,000)
Loss before income taxes	(7,518,000)		(3,909,000)		(23,584,000)		(27,485,000)
Income tax expense	(126,000)		(127,000)		(499,000)		(785,000)
Net loss	(7,644,000)		(4,036,000)		(24,083,000)		(28,270,000)
Net (income) loss attributable to noncontrolling interests	(5,861,000)		(1,201,000)		(9,688,000)		3,508,000
Net loss attributable to controlling interest	$	(13,505,000)	$	(5,237,000)	$	(33,771,000)	$	(24,762,000)
Net loss per Class T and Class I common share attributable to controlling interest — basic and diluted	$	(0.05)	$	(0.03)	$	(0.13)	$	(0.14)
Weighted average number of Class T and Class I common shares outstanding — basic and diluted	263,279,232		179,641,677		262,940,706		179,632,818

Net loss	$	(7,644,000)	$	(4,036,000)	$	(24,083,000)	$	(28,270,000)
Other comprehensive loss:
Foreign currency translation adjustments	(477,000)		(207,000)		(1,164,000)		(96,000)
Total other comprehensive loss	(477,000)		(207,000)		(1,164,000)		(96,000)
Comprehensive loss	(8,121,000)		(4,243,000)		(25,247,000)		(28,366,000)
Comprehensive (income) loss attributable to noncontrolling interests	(5,861,000)		(1,201,000)		(9,688,000)		3,508,000
Comprehensive loss attributable to controlling interest	$	(13,982,000)	$	(5,444,000)	$	(34,935,000)	$	(24,858,000)


	Three Months Ended September 30, 2022
	Stockholders’ Equity
	Class T and Class I Common Stock
	Number of Shares	Amount		Additional Paid-In Capital		Accumulated Deficit		Accumulated Other Comprehensive Loss		Total Stockholders’ Equity		Noncontrolling Interests		Total Equity
BALANCE — June 30, 2022	264,364,596	$	2,635,000	$	2,541,504,000	$	(1,024,328,000)	$	(2,653,000)	$	1,517,158,000	$	172,602,000	$	1,689,760,000


Issuance of common stock under the DRIP	395,174	4,000		3,667,000		—		—		3,671,000		—		3,671,000
Issuance of nonvested restricted common stock	19,858	—		—		—		—		—		—		—
Amortization of nonvested restricted common stock and stock units	—	—		914,000		—		—		914,000		—		914,000


Stock based compensation	—	—		—		—		—		—		20,000		20,000
Repurchase of common stock	(608,138)	(6,000)		(5,644,000)		—		—		(5,650,000)		—		(5,650,000)

Distributions to noncontrolling interests	—	—		—		—		—		—		(3,516,000)		(3,516,000)

Reclassification of noncontrolling interests to mezzanine equity	—	—		—		—		—		—		(20,000)		(20,000)
Adjustment to value of redeemable noncontrolling interests	—	—		(8,394,000)		—		—		(8,394,000)		(2,367,000)		(10,761,000)
Distributions declared ($0.10 per share)	—	—		—		(26,437,000)		—		(26,437,000)		—		(26,437,000)
Net (loss) income	—	—		—		(13,505,000)		—		(13,505,000)		5,507,000		(7,998,000)		(1)
Other comprehensive loss	—	—		—		—		(477,000)		(477,000)		—		(477,000)
BALANCE — September 30, 2022	264,171,490	$	2,633,000	$	2,532,047,000	$	(1,064,270,000)	$	(3,130,000)	$	1,467,280,000	$	172,226,000	$	1,639,506,000


☒			QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended September 30, 2022


☐			TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from to


	Three Months Ended September 30, 2021
	Stockholders’ Equity
	Class T and Class I Common Stock
	Number of Shares	Amount		Additional Paid-In Capital		Accumulated Deficit		Accumulated Other Comprehensive Loss		Total Stockholders’ Equity		Noncontrolling Interests		Total Equity
BALANCE — June 30, 2021	179,658,367	$	1,798,000	$	1,730,002,000	$	(886,983,000)	$	(1,897,000)	$	842,920,000	$	163,551,000	$	1,006,471,000




Amortization of nonvested restricted common stock	—	—		13,000		—		—		13,000		—		13,000





Distributions to noncontrolling interests	—	—		—		—		—		—		(9,005,000)		(9,005,000)


Adjustment to value of redeemable noncontrolling interests	—	—		62,000		—		—		62,000		27,000		89,000
Distributions declared ($0.05 per share)	—	—		—		(9,774,000)		—		(9,774,000)		—		(9,774,000)
Net (loss) income	—	—		—		(5,237,000)		—		(5,237,000)		1,084,000		(4,153,000)		(1)
Other comprehensive loss	—	—		—		—		(207,000)		(207,000)		—		(207,000)
BALANCE — September 30, 2021	179,658,367	$	1,798,000	$	1,730,077,000	$	(901,994,000)	$	(2,104,000)	$	827,777,000	$	155,657,000	$	983,434,000


	Nine Months Ended September 30, 2022
	Stockholders’ Equity
	Class T and Class I Common Stock
	Number of Shares	Amount		Additional Paid-In Capital		Accumulated Deficit		Accumulated Other Comprehensive Loss		Total Stockholders’ Equity		Noncontrolling Interests		Total Equity
BALANCE — December 31, 2021	263,032,031	$	2,622,000	$	2,531,940,000	$	(951,303,000)	$	(1,966,000)	$	1,581,293,000	$	175,553,000	$	1,756,846,000

Offering costs — common stock	—	—		(2,000)		—		—		(2,000)		—		(2,000)
Issuance of common stock under the DRIP	2,820,674	28,000		26,090,000		—		—		26,118,000		—		26,118,000
Issuance of nonvested restricted common stock	74,758	1,000		(1,000)		—		—		—		—		—
Amortization of nonvested restricted common stock and stock units	—	—		2,705,000		—		—		2,705,000		—		2,705,000


Stock based compensation	—	—		—		—		—		—		62,000		62,000
Repurchase of common stock	(1,755,973)	(18,000)		(16,215,000)		—		—		(16,233,000)		—		(16,233,000)

Distributions to noncontrolling interests	—	—		—		—		—		—		(10,568,000)		(10,568,000)

Adjustment to noncontrolling interest in connection with the Merger	—	—		(1,173,000)		—		—		(1,173,000)		1,173,000		—
Reclassification of noncontrolling interests to mezzanine equity	—	—		—		—		—		—		(62,000)		(62,000)
Adjustment to value of redeemable noncontrolling interests	—	—		(11,297,000)		—		—		(11,297,000)		(3,297,000)		(14,594,000)
Distributions declared ($0.30 per share)	—	—		—		(79,196,000)		—		(79,196,000)		—		(79,196,000)
Net (loss) income	—	—		—		(33,771,000)		—		(33,771,000)		9,365,000		(24,406,000)		(1)
Other comprehensive loss	—	—		—		—		(1,164,000)		(1,164,000)		—		(1,164,000)
BALANCE — September 30, 2022	264,171,490	$	2,633,000	$	2,532,047,000	$	(1,064,270,000)	$	(3,130,000)	$	1,467,280,000	$	172,226,000	$	1,639,506,000


	Nine Months Ended September 30, 2021
	Stockholders’ Equity
	Class T and Class I Common Stock
	Number of Shares	Amount		Additional Paid-In Capital		Accumulated Deficit		Accumulated Other Comprehensive Loss		Total Stockholders’ Equity		Noncontrolling Interests		Total Equity
BALANCE — December 31, 2020	179,658,367	$	1,798,000	$	1,730,589,000	$	(864,271,000)	$	(2,008,000)	$	866,108,000	$	168,375,000	$	1,034,483,000

Offering costs — common stock	—	—		(1,000)		—		—		(1,000)		—		(1,000)


Amortization of nonvested restricted common stock	—	—		66,000		—		—		66,000		—		66,000
Stock based compensation	—	—		—		—		—		—		(14,000)		(14,000)




Distributions to noncontrolling interests	—	—		—		—		—		—		(9,360,000)		(9,360,000)


Adjustment to value of redeemable noncontrolling interests	—	—		(577,000)		—		—		(577,000)		(233,000)		(810,000)
Distributions declared ($0.07 per share)	—	—		—		(12,961,000)		—		(12,961,000)		—		(12,961,000)
Net loss	—	—		—		(24,762,000)		—		(24,762,000)		(3,111,000)		(27,873,000)		(1)
Other comprehensive loss	—	—		—		—		(96,000)		(96,000)		—		(96,000)
BALANCE — September 30, 2021	179,658,367	$	1,798,000	$	1,730,077,000	$	(901,994,000)	$	(2,104,000)	$	827,777,000	$	155,657,000	$	983,434,000


	Private and Other Payors		Medicare		Medicaid		Total
Beginning balance — January 1, 2022	$	42,056,000	$	35,953,000	$	16,922,000	$	94,931,000
Ending balance — September 30, 2022	51,209,000		45,609,000		23,578,000		120,396,000
Increase	$	9,153,000	$	9,656,000	$	6,656,000	$	25,465,000


	Total
Beginning balance — January 1, 2022	$	14,673,000
Ending balance — September 30, 2022	19,001,000
Increase	$	4,328,000


	September 30, 2022		December 31, 2021
Building, improvements and construction in process	$	3,595,437,000	$	3,505,786,000
Land and improvements	334,496,000		334,562,000
Furniture, fixtures and equipment	218,052,000		198,224,000
	4,147,985,000		4,038,572,000
Less: accumulated depreciation	(621,394,000)		(523,886,000)
	$	3,526,591,000	$	3,514,686,000


	2022 Acquisitions
Building and improvements	$	49,645,000
Land and improvements	8,173,000




Total assets acquired	$	57,818,000


	2022 Acquisitions
Operating lease right-of-use assets	$	153,777,000
Building and improvements	80,533,000
Goodwill	44,990,000
Accounts receivable, net	19,472,000
In-place leases	10,330,000
Land	8,755,000
Cash and restricted cash	9,723,000
Certificates of need	3,567,000
Furniture, fixtures and equipment	1,936,000
Other assets	1,787,000
Total assets acquired	334,870,000
Operating lease liabilities	(161,121,000)
Mortgage loan payable	(45,300,000)
Security deposits and other liabilities	(15,994,000)
Accounts payable and accrued liabilities	(15,060,000)
Financing obligations	(65,000)
Total liabilities assumed	(237,540,000)
Net assets acquired	$	97,330,000


	Nine Months Ended September 30,
	2022		2021
Distributions to noncontrolling interests in total equity	$	(9,821,000)	$	(9,356,000)
Contributions from redeemable noncontrolling interests	273,000		—
Distributions to redeemable noncontrolling interests	(1,918,000)		(550,000)
Repurchase of redeemable noncontrolling interests and stock warrants	—		(88,000)
Payment of offering costs	(666,000)		—
Security deposits	(628,000)		21,000
Net cash provided by financing activities	7,969,000		138,271,000
NET CHANGE IN CASH, CASH EQUIVALENTS AND RESTRICTED CASH	$	(1,129,000)	$	(802,000)
EFFECT OF FOREIGN CURRENCY TRANSLATION ON CASH, CASH EQUIVALENTS AND RESTRICTED CASH	(59,000)		(96,000)
CASH, CASH EQUIVALENTS AND RESTRICTED CASH — Beginning of period	125,486,000		152,190,000
CASH, CASH EQUIVALENTS AND RESTRICTED CASH — End of period	$	124,298,000	$	151,292,000

RECONCILIATION OF CASH, CASH EQUIVALENTS AND RESTRICTED CASH
Beginning of period:
Cash and cash equivalents	$	81,597,000	$	113,212,000
Restricted cash	43,889,000		38,978,000
Cash, cash equivalents and restricted cash	$	125,486,000	$	152,190,000

End of period:
Cash and cash equivalents	$	79,421,000	$	109,650,000
Restricted cash	44,877,000		41,642,000
Cash, cash equivalents and restricted cash	$	124,298,000	$	151,292,000

SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION
Cash paid for:
Interest	$	60,328,000	$	49,895,000
Income taxes	$	653,000	$	1,037,000
SUPPLEMENTAL DISCLOSURE OF NONCASH INVESTING AND FINANCING ACTIVITIES
Accrued developments and capital expenditures	$	25,096,000	$	17,262,000


Capital expenditures from financing obligations	$	—	$	1,409,000
Tenant improvement overage	$	605,000	$	568,000


	Three Months Ended September 30,
	2022						2021
	Integrated Senior Health Campuses		SHOP(1)		Total		Integrated Senior Health Campuses		SHOP(1)		Total
Over time	$	265,705,000	$	38,740,000	$	304,445,000	$	213,823,000	$	20,975,000	$	234,798,000
Point in time	63,046,000		815,000		63,861,000		51,520,000		564,000		52,084,000
Total resident fees and services	$	328,751,000	$	39,555,000	$	368,306,000	$	265,343,000	$	21,539,000	$	286,882,000


	Nine Months Ended September 30,
	2022						2021
	Integrated Senior Health Campuses		SHOP(1)		Total		Integrated Senior Health Campuses		SHOP(1)		Total
Over time	$	729,079,000	$	113,848,000	$	842,927,000	$	606,811,000	$	60,473,000	$	667,284,000
Point in time	168,266,000		2,312,000		170,578,000		147,573,000		1,403,000		148,976,000
Total resident fees and services	$	897,345,000	$	116,160,000	$	1,013,505,000	$	754,384,000	$	61,876,000	$	816,260,000


	Three Months Ended September 30,
	2022						2021
	Integrated Senior Health Campuses		SHOP(1)		Total		Integrated Senior Health Campuses		SHOP(1)		Total
Private and other payors	$	151,296,000	$	36,228,000	$	187,524,000	$	122,467,000	$	21,258,000	$	143,725,000
Medicare	112,547,000		—		112,547,000		84,616,000		—		84,616,000
Medicaid	64,908,000		3,327,000		68,235,000		58,260,000		281,000		58,541,000
Total resident fees and services	$	328,751,000	$	39,555,000	$	368,306,000	$	265,343,000	$	21,539,000	$	286,882,000


	September 30, 2022		December 31, 2021
Intangible assets subject to amortization:
In-place leases, net of accumulated amortization of $34,036,000 and $28,120,000 as of September 30, 2022 and December 31, 2021, respectively (with a weighted average remaining life of 7.4 years and 8.2 years as of September 30, 2022 and December 31, 2021, respectively)	$	74,761,000	$	81,538,000
Above-market leases, net of accumulated amortization of $5,419,000 and $2,082,000 as of September 30, 2022 and December 31, 2021, respectively (with a weighted average remaining life of 9.2 years and 9.7 years as of September 30, 2022 and December 31, 2021, respectively)	31,736,000		35,106,000
Customer relationships, net of accumulated amortization of $747,000 and $635,000 as of September 30, 2022 and December 31, 2021, respectively (with a weighted average remaining life of 13.9 years and 14.7 years as of September 30, 2022 and December 31, 2021, respectively)	2,093,000		2,205,000
Internally developed technology and software, net of accumulated amortization of $399,000 as of December 31, 2021 (with a weighted average remaining life of 0.7 years as of December 31, 2021)	—		70,000
Intangible assets not subject to amortization:
Certificates of need	98,592,000		99,165,000
Trade names	30,787,000		30,787,000
	$	237,969,000	$	248,871,000


Year	Amount
2022	$	8,233,000
2023	21,162,000
2024	13,640,000
2025	11,001,000
2026	9,831,000
Thereafter	44,723,000
	$	108,590,000


	September 30, 2022		December 31, 2021
Deferred rent receivables	$	45,921,000	$	41,061,000
Prepaid expenses, deposits, other assets and deferred tax assets, net	33,367,000		22,484,000
Lease commissions, net of accumulated amortization of $5,938,000 and $4,911,000 as of September 30, 2022 and December 31, 2021, respectively	19,032,000		16,120,000

Inventory	18,875,000		18,929,000
Investments in unconsolidated entities	9,431,000		15,615,000
Deferred financing costs, net of accumulated amortization of $5,011,000 and $8,469,000 as of September 30, 2022 and December 31, 2021, respectively	4,795,000		3,781,000
Lease inducement, net of accumulated amortization of $2,105,000 and $1,842,000 as of September 30, 2022 and December 31, 2021, respectively (with a weighted average remaining life of 8.2 years and 8.9 years as of September 30, 2022 and December 31, 2021, respectively)	2,895,000		3,158,000
	$	134,316,000	$	121,148,000


	September 30, 2022		December 31, 2021
Total fixed-rate debt	$	805,284,000	$	845,504,000
Total variable-rate debt	371,960,000		270,712,000
Total fixed- and variable-rate debt	1,177,244,000		1,116,216,000
Less: deferred financing costs, net	(8,001,000)		(8,680,000)
Add: premium	267,000		397,000
Less: discount	(10,351,000)		(12,339,000)
Mortgage loans payable, net	$	1,159,159,000	$	1,095,594,000


Instrument	Notional Amount		Index	Interest Rate	Maturity Date	Fair Value December 31, 2021
Swap	$	250,000,000	one month LIBOR	2.10%	01/25/22	$	332,000
Swap	$	130,000,000	one month LIBOR	1.98%	01/25/22	162,000
Swap	$	100,000,000	one month LIBOR	0.20%	01/25/22	6,000
						$	500,000


Approval Date by our Board	Estimated Per Share NAV (Unaudited)



10/03/19	$	9.40
03/18/21	$	8.55
03/24/22	$	9.29


	Three Months Ended September 30, 2021		Nine Months Ended September 30, 2021
Asset management fees(1)	$	5,424,000	$	16,187,000
Property management fees(2)	674,000		2,009,000
Development fees(3)	214,000		854,000
Operating expenses(4)	44,000		160,000
Construction management fees(5)	38,000		118,000
Lease fees(6)	25,000		410,000
Acquisition fees(7)	19,000		1,363,000
	$	6,438,000	$	21,101,000


Fee	December 31, 2021
Lease commissions	$	245,000
Development fees	229,000
Construction management fees	152,000
Operating expenses	100,000
Asset and property management fees	83,000
Acquisition fees	57,000



	$	866,000


	Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total



Liabilities:
Warrants	$	—	$	—	$	678,000	$	678,000
Total liabilities at fair value	$	—	$	—	$	678,000	$	678,000


	September 30, 2022				December 31, 2021
	Carrying Amount(1)		Fair Value		Carrying Amount(1)		Fair Value
Financial Assets:

Debt security investment	$	82,067,000	$	92,831,000	$	79,315,000	$	93,920,000
Financial Liabilities:
Mortgage loans payable	$	1,159,159,000	$	1,022,541,000	$	1,095,594,000	$	1,075,729,000
Lines of credit and term loans	$	1,287,248,000	$	1,294,231,000	$	1,222,853,000	$	1,226,636,000


		Three Months Ended September 30,
Lease Cost	Classification	2022		2021
Operating lease cost(1)	Property operating expenses, rental expenses or general and administrative expenses	$	9,322,000	$	5,530,000
Finance lease cost:
Amortization of leased assets	Depreciation and amortization	310,000		332,000
Interest on lease liabilities	Interest expense	43,000		81,000
Sublease income	Resident fees and services revenue or other income	(156,000)		(57,000)
Total lease cost		$	9,519,000	$	5,886,000


Lease Term and Discount Rate	September 30, 2022		December 31, 2021
Weighted average remaining lease term (in years):
Operating leases	12.8		16.9
Finance leases	2.5		3.6
Weighted average discount rate:
Operating leases	5.60	%	5.52	%
Finance leases	7.62	%	7.68	%


	Nine Months Ended September 30,
Supplemental Disclosure of Cash Flows Information	2022		2021

Operating cash outflows related to finance leases	$	183,000	$	273,000
Financing cash outflows related to finance leases	$	40,000	$	159,000

Right-of-use assets obtained in exchange for operating lease liabilities	$	—	$	125,000


	Integrated Senior Health Campuses		SHOP		Medical Office Buildings		Senior Housing — Leased		Skilled Nursing Facilities		Hospitals		Three Months Ended September 30, 2022
Revenues and grant income:
Resident fees and services	$	328,751,000	$	39,555,000	$	—	$	—	$	—	$	—	$	368,306,000
Real estate revenue	—		—		37,128,000		5,143,000		6,633,000		2,419,000		51,323,000
Grant income	5,796,000		737,000		—		—		—		—		6,533,000
Total revenues and grant income	334,547,000		40,292,000		37,128,000		5,143,000		6,633,000		2,419,000		426,162,000
Expenses:
Property operating expenses	299,197,000		38,290,000		—		—		—		—		337,487,000
Rental expenses	—		—		14,155,000		160,000		437,000		98,000		14,850,000
Segment net operating income	$	35,350,000	$	2,002,000	$	22,973,000	$	4,983,000	$	6,196,000	$	2,321,000	$	73,825,000
Expenses:
General and administrative													$	9,626,000
Business acquisition expenses													231,000
Depreciation and amortization													40,422,000
Other income (expense):

Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments)													(27,524,000)

Gain on dispositions of real estate investments													2,113,000
Impairment of real estate investments													(21,851,000)
Loss from unconsolidated entities													(344,000)
Gain on re-measurement of previously held equity interest													19,567,000
Foreign currency loss													(3,695,000)
Other income													670,000
Total net other expense													(31,064,000)
Loss before income taxes													(7,518,000)
Income tax expense													(126,000)


Net loss													$	(7,644,000)


	September 30, 2022		December 31, 2021
Integrated senior health campuses	$	2,167,850,000	$	1,896,608,000
Medical office buildings	1,392,302,000		1,412,247,000
SHOP	576,181,000		625,164,000
Skilled nursing facilities	248,141,000		252,869,000
Senior housing — leased	245,429,000		255,555,000
Hospitals	106,859,000		109,834,000
Other	21,884,000		28,062,000
Total assets	$	4,758,646,000	$	4,580,339,000


	September 30, 2022		December 31, 2021
Real estate investments, net:
United States	$	3,487,451,000	$	3,466,019,000
International	39,140,000		48,667,000
	$	3,526,591,000	$	3,514,686,000


	September 30,
	2022					2021
	Number of Buildings/ Campuses	Aggregate Contract Purchase Price		Leased %		Number of Buildings/ Campuses	Aggregate Contract Purchase Price		Leased %
Integrated senior health campuses	121	$	1,894,235,000	(1)		120	$	1,769,757,000	(1)
Medical office buildings	105	1,378,995,000		89.6	%	62	641,585,000		90.3	%
SHOP	47	706,871,000		(2)		20	433,891,000		(2)
Senior housing — leased	20	179,285,000		100	%	9	89,535,000		100	%
Skilled nursing facilities	17	249,200,000		100	%	6	119,500,000		100	%
Hospitals	2	139,780,000		100	%	2	139,780,000		100	%
Total/weighted average(3)	312	$	4,548,366,000	92.6	%	219	$	3,194,048,000	92.7	%


	Payments Due by Period
	2022		2023-2024		2025-2026		Thereafter		Total
Principal payments — fixed-rate debt	$	12,679,000	$	105,743,000	$	183,849,000	$	503,013,000	$	805,284,000
Interest payments — fixed-rate debt	6,183,000		46,192,000		37,958,000		198,377,000		288,710,000
Principal payments — variable-rate debt	111,000		680,794,000		414,469,000		569,521,000		1,664,895,000
Interest payments — variable-rate debt (based on rates in effect as of September 30, 2022)	21,838,000		122,717,000		76,107,000		5,847,000		226,509,000
Ground and other lease obligations	9,137,000		72,225,000		70,201,000		244,392,000		395,955,000
Financing obligations	984,000		5,366,000		3,048,000		16,243,000		25,641,000
Total	$	50,932,000	$	1,033,037,000	$	785,632,000	$	1,537,393,000	$	3,406,994,000


	AHR				GAHR III
	Nine Months Ended September 30, 2022				Nine Months Ended September 30, 2021
Distributions paid in cash	$	35,391,000			$	12,961,000
Distributions reinvested	26,118,000				—
	$	61,509,000			$	12,961,000
Sources of distributions:
Cash flows from operations	$	61,509,000	100	%	$	—	—	%
Proceeds from borrowings	—		—		12,961,000		100

	$	61,509,000	100	%	$	12,961,000	100	%


	Expected Maturity Date
	2022			2023			2024			2025			2026			Thereafter			Total			Fair Value
Assets
Debt security held-to-maturity	$	—		$	—		$	—		$	93,433,000		$	—		$	—		$	93,433,000		$	92,831,000
Weighted average interest rate on maturing fixed-rate debt security	—		%	—		%	—		%	4.24		%	—		%	—		%	4.24		%	—
Liabilities
Fixed-rate debt — principal payments	$	12,679,000		$	34,321,000		$	71,422,000		$	28,892,000		$	154,957,000		$	503,013,000		$	805,284,000		$	644,045,000
Weighted average interest rate on maturing fixed-rate debt	4.03		%	3.78		%	3.52		%	3.34		%	2.98		%	3.00		%	3.10		%	—
Variable-rate debt — principal payments	$	111,000		$	522,729,000		$	158,065,000		$	277,000		$	414,192,000		$	569,521,000		$	1,664,895,000		$	1,672,727,000
Weighted average interest rate on maturing variable-rate debt (based on rates in effect as of September 30, 2022)	6.52		%	5.68		%	5.60		%	5.07		%	4.79		%	4.75		%	5.13		%	—