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Real Estate Investments, Net (Tables) | 12 Months Ended
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Dec. 31, 2023
Real Estate [Abstract] |
Summary of Investment in Owned Properties Held for Use | The following table summarizes the Company’s investment in owned properties, and properties held in consolidated joint ventures, held for use at December 31, 2023 and 2022 (dollars in thousands):
| December 31, 2023 |  | December 31, 2022
Land | $ | 279,276 |  |  | $ | 238,738 |
Buildings and improvements | 1,620,014 |  |  | 1,483,133 |
Integral equipment, furniture and fixtures | 100,504 |  |  | 97,199 |
Identified intangible assets | 5,283 |  |  | 2,832 |
Real estate investments | 2,005,077 |  |  | 1,821,902 |
Accumulated depreciation and amortization | (437,958) |  |  | (400,492) |
Real estate investments, net | $ | 1,567,119 |  |  | $ | 1,421,410 |
Schedule of Total Future Contractual Minimum Rental Income | As of December 31, 2023, the Company’s total future contractual minimum rental income for all of its tenants, excluding operating expense reimbursements, assets held for sale and assets being repurposed, was as follows (dollars in thousands):
Year | Amount
2024 | $ | 200,650 |
2025 | 201,648 |
2026 | 200,530 |
2027 | 197,378 |
2028 | 195,140 |
Thereafter | 970,806 |
| $ | 1,966,152 |
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 Type(1) | Properties |  | Lease Expiration | Option Period Open Date(2) |  | Option Type(3) | Current Cash Rent(4)
SNF | 1 |  | March 2029 | 4/1/2022 | (5) | A / B(7) | $ | 832 |
SNF / Campus | 1 | (8) | October 2032 | 1/1/2024 | (6) | A | 947 |
SNF | 4 |  | November 2034 | 12/1/2024 | (5) | A | 3,988 |
(1)Excludes a purchase option on an 11 building SNF portfolio classified as held for sale as of December 31, 2023 and representing $5.1 million of current cash rent. Tenant is currently not eligible to elect the option. (2)The Company has not received notice of exercise for the option periods that are currently open. (3)Option type includes: A - Fixed base price. B - Fixed capitalization rate on lease revenue. (4)Based on annualized cash revenue for contracts in place as of December 31, 2023. (5)Option window is open until the expiration of the lease term. (6)Option window is open for six months from the option period open date. (7)Purchase option reflects two option types. (8)Excludes one property classified as held for sale as of December 31, 2023 and subsequently sold in the first quarter of 2024.
Schedule of Rental Income | The following table summarizes components of the Company’s rental income (dollars in thousands):
| For the Year Ended December 31,
| 2023 |  | 2022 |  | 2021
Rental Income |  |  |  |  |
Contractual rent due(1) | $ | 198,244 |  |  | $ | 188,906 |  |  | $ | 190,100 |
Straight-line rent | (29) |  |  | 17 |  |  | 32 |
Amortization of below-market lease intangible | 384 |  |  | — |  |  | — |
Adjustment for collectibility(2) | — |  |  | (1,417) |  |  | — |
Lease termination revenue(3) | — |  |  | — |  |  | 63 |
Total | $ | 198,599 |  |  | $ | 187,506 |  |  | $ | 190,195 |
(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. Tenant operating expense reimbursements for the years ended December 31, 2023, 2022 and 2021 were $5.5 million, $2.8 million, and $3.6 million, respectively. (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)In connection with the agreement to terminate its lease agreements with Metron Integrated Health Systems (“Metron”) and to sell the facilities to a third-party, the Company received certain lease termination payments from Metron.
Schedule of Real Estate Acquisitions | The following table summarizes the Company’s acquisitions for the years ended December 31, 2023, 2022 and 2021 (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, 2023 |  |  |  |  |  |  |
Skilled nursing(4) (5) | $ | 169,181 |  |  | $ | 13,764 |  |  | 10 |  |  | 1,256 |
Multi-service campuses(5) | 25,276 |  |  | 1,916 |  |  | 1 |  |  | 168 |
Assisted living | 39,318 |  |  | 3,495 |  |  | 4 |  |  | 241 |
Total | $ | 233,775 |  |  | $ | 19,175 |  |  | 15 |  |  | 1,665 |
December 31, 2022 |  |  |  |  |  |  |
Skilled nursing | $ | 8,918 |  |  | $ | 815 |  |  | 1 |  |  | 135 |
Multi-service campuses | 13,003 |  |  | 1,235 |  |  | 1 |  |  | 130 |
Total | $ | 21,921 |  |  | $ | 2,050 |  |  | 2 |  |  | 265 |
December 31, 2021 |  |  |  |  |  |  |
Skilled nursing | $ | 57,973 |  |  | $ | 4,499 |  |  | 4 |  |  | 509 |
Multi-service campuses | 125,708 |  |  | 8,604 |  | (6) | 4 |  |  | 640 |
Assisted living | 12,395 |  |  | — |  | (7) | 2 |  |  | 98 |
Total | $ | 196,076 |  |  | $ | 13,103 |  |  | 10 |  |  | 1,247 |
(1)Purchase price includes capitalized acquisition costs. (2)Initial annual cash rent represents initial cash rent for the first twelve months excluding the impact of straight-line rent or rent abatement in the first one to three months, if applicable. (3)The number of beds/units includes operating beds at acquisition date. (4)Includes three SNFs held through joint ventures. See Note 11, Variable Interest Entities, for additional information. One SNF is currently leased under a short-term lease and a new long-term lease has been entered into with one of the Company’s existing operators and it is expected that this lease will become effective once regulatory approval is obtained. Initial annual cash rent does not consider a rent deferral of $420,000 in the first year upon commencement of the long-term lease to be repaid in 15 installments beginning in year 2. The two other SNFs held through a joint venture are under separate leases with an initial annual rent of $2.0 million. The leases provide for a rent reset in which the joint venture may propose rent, capped at 10% of gross revenues, effective January 1, 2027. If the proposed rent reset is not accepted, the joint venture has the option to replace the current tenant. (5)One acquisition including three SNFs and one multi-service campus provides for annual fixed increases from $6.8 million in year one to $7.6 million in year two and $8.9 million in year three. (6)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. (7)Initial annual cash rent is zero until transfer of operations upon receipt of licensing approval.

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