Table of Contents

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 10-Q

(Mark One)

QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended June 30, 2021March 31, 2022

or

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from                           to                           

OMEGA HEALTHCARE INVESTORS, INC.

(Exact name of registrant as specified in its charter)

Maryland

1-11316

38-3041398

(State or other jurisdiction of incorporation or
organization)

(Commission file number)

(IRS Employer Identification No.)

303 International Circle, Suite 200, Hunt Valley, MD 21030

(Address of principal executive offices)

(410) 427-1700

(Registrant’s telephone number, including area code)

Securities registered pursuant to Section 12(b) of the Securities Exchange Act of 1934

Title of each class

Trading Symbol(s)

Name of each exchange on which registered

Common Stock, $.10 par value

OHI

New York Stock Exchange

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports) and (2) has been subject to such filing requirements for the past 90 days.

Yes      No  

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).

Yes      No  

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.

Large accelerated filer

Accelerated filer

Non-accelerated filer

Smaller reporting company

Emerging growth company

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).

Yes  

No

As of July 29, 2021,April 28, 2022, there were 238,875,381235,216,880 shares of common stock outstanding.

Table of Contents

OMEGA HEALTHCARE INVESTORS, INC.

FORM 10-Q

June 30, 2021March 31, 2022

TABLE OF CONTENTS

Page
No.

PART I

Financial Information

Item 1.

Financial Statements of Omega Healthcare Investors, Inc.:

Consolidated Balance Sheets

2

June 30, 2021March 31, 2022 (unaudited) and December 31, 20202021

2

Consolidated Statements of Operations (unaudited)

Three and Six months ended June 30,March 31, 2022 and 2021 and 2020

3

Consolidated Statements of Comprehensive Income (unaudited)

Three and Six months ended June 30,March 31, 2022 and 2021 and 2020

4

Consolidated Statements of Changes in Equity (unaudited)

Three and Six months ended June 30,March 31, 2022 and 2021 and 2020

5

Consolidated Statements of Cash Flows (unaudited)

SixThree months ended June 30,March 31, 2022 and 2021 and 2020

76

Notes to Consolidated Financial Statements

June 30, 2021March 31, 2022 (unaudited)

87

Item 2.

Management’s Discussion and Analysis of Financial Condition and Results of Operations

3130

Item 3.

Quantitative and Qualitative Disclosures About Market Risk

4745

Item 4.

Controls and Procedures

4745

PART II

Other Information

Item 1.

Legal Proceedings

4846

Item 1A.

Risk Factors

4846

Item 2.

Unregistered Sales of Equity Securities and Use of Proceeds

50

Item 5.

Other Information

5048

Item 6.

Exhibits

5249

Table of Contents

PART I – FINANCIAL INFORMATION

Item 1 - Financial Statements

OMEGA HEALTHCARE INVESTORS, INC.

CONSOLIDATED BALANCE SHEETS

(in thousands, except per share amounts)

    

June 30, 

    

December 31, 

    

2021

    

2020

(Unaudited)

ASSETS

Real estate properties

 

  

 

  

Real estate investments

$

9,228,332

 

$

8,702,154

Less accumulated depreciation

 

(2,139,100)

 

 

(1,996,914)

Real estate investments – net

 

7,089,232

 

 

6,705,240

Investments in direct financing leases – net

 

10,807

 

 

10,764

Mortgage notes receivable – net

 

857,162

 

 

885,313

7,957,201

7,601,317

Other investments – net

 

458,664

 

 

467,442

Investments in unconsolidated joint ventures

 

197,912

 

 

200,638

Assets held for sale

 

35,335

 

 

81,452

Total investments

 

8,649,112

 

 

8,350,849

Cash and cash equivalents

 

100,824

 

 

163,535

Restricted cash

 

3,736

 

 

4,023

Contractual receivables – net

 

10,948

 

 

10,408

Other receivables and lease inducements

229,509

234,666

Goodwill

 

651,697

 

 

651,737

Other assets

 

113,228

 

 

82,231

Total assets

$

9,759,054

 

$

9,497,449

LIABILITIES AND EQUITY

 

  

 

 

  

Revolving credit facility

$

 

$

101,158

Secured borrowings

 

365,831

 

 

369,524

Senior notes and other unsecured borrowings – net

 

4,906,734

 

 

4,698,570

Accrued expenses and other liabilities

 

266,818

 

 

280,824

Deferred income taxes

 

9,645

 

 

10,766

Total liabilities

 

5,549,028

 

 

5,460,842

Equity:

 

  

 

  

Preferred stock $1.00 par value authorized – 20,000 shares, issued and outstanding - none

Common stock $.10 par value authorized – 350,000 shares, issued and outstanding – 237,570 shares as of June 30, 2021 and 231,199 as of December 31, 2020

 

23,756

 

23,119

Additional paid-in capital

 

6,377,238

 

6,152,887

Cumulative net earnings

 

2,839,236

 

2,594,735

Cumulative dividends paid

 

(5,232,692)

 

(4,916,097)

Accumulated other comprehensive income (loss)

 

4,523

 

(12,768)

Total stockholders’ equity

 

4,012,061

 

3,841,876

Noncontrolling interest

 

197,965

 

194,731

Total equity

 

4,210,026

 

4,036,607

Total liabilities and equity

$

9,759,054

 

$

9,497,449

    

March 31, 

    

December 31, 

    

2022

    

2021

(Unaudited)

ASSETS

Real estate assets

 

  

 

  

Buildings and improvements

$

7,477,855

 

$

7,448,126

Land

937,235

916,328

Furniture and equipment

516,410

511,271

Construction in progress

77,633

74,062

Total real estate assets

9,009,133

8,949,787

Less accumulated depreciation

 

(2,212,183)

 

 

(2,160,696)

Real estate assets – net

 

6,796,950

 

 

6,789,091

Investments in direct financing leases – net

 

10,849

 

 

10,873

Mortgage notes receivable – net

 

819,577

 

 

835,086

7,627,376

7,635,050

Other investments – net

 

506,942

 

 

469,884

Investments in unconsolidated joint ventures

 

192,238

 

 

194,687

Assets held for sale

 

92,762

 

 

261,151

Total investments

 

8,419,318

 

 

8,560,772

Cash and cash equivalents

 

491,247

 

 

20,534

Restricted cash

 

3,534

 

 

3,877

Contractual receivables – net

 

13,172

 

 

11,259

Other receivables and lease inducements

269,992

251,815

Goodwill

 

651,024

 

 

651,417

Other assets

 

166,318

 

 

138,804

Total assets

$

10,014,605

 

$

9,638,478

LIABILITIES AND EQUITY

 

  

 

 

  

Revolving credit facility

$

354,888

 

$

Secured borrowings

 

379,644

 

 

362,081

Senior notes and other unsecured borrowings – net

 

4,893,839

 

 

4,891,455

Accrued expenses and other liabilities

 

256,390

 

 

276,716

Total liabilities

 

5,884,761

 

 

5,530,252

Equity:

 

  

 

  

Preferred stock $1.00 par value authorized – 20,000 shares, issued and outstanding – none

Common stock $.10 par value authorized – 350,000 shares, issued and outstanding – 238,206 shares as of March 31, 2022 and 239,061 shares as of December 31, 2021

 

23,820

 

23,906

Additional paid-in capital

 

6,401,207

 

6,427,566

Cumulative net earnings

 

3,201,081

 

3,011,474

Cumulative dividends paid

 

(5,714,595)

 

(5,553,908)

Accumulated other comprehensive income (loss)

 

6,318

 

(2,200)

Total stockholders’ equity

 

3,917,831

 

3,906,838

Noncontrolling interest

 

212,013

 

201,388

Total equity

 

4,129,844

 

4,108,226

Total liabilities and equity

$

10,014,605

 

$

9,638,478

See notes to consolidated financial statements.

2

Table of Contents

OMEGA HEALTHCARE INVESTORS, INC.

CONSOLIDATED STATEMENTS OF OPERATIONS

Unaudited

(in thousands, except per share amounts)

r

 

Three Months Ended

Six Months Ended

 

 

Three Months Ended

    

June 30, 

    

June 30, 

    

March 31, 

    

2021

    

2020

    

2021

    

2020

    

    

2022

    

2021

Revenues

Rental income

$

220,955

$

221,532

 

$

458,716

$

443,032

$

216,883

$

237,761

Income from direct financing leases

 

257

 

259

 

 

515

 

517

 

256

 

258

Mortgage interest income

 

24,021

 

21,680

 

 

47,646

 

41,365

 

20,549

 

23,625

Other investment income

 

11,813

 

10,932

 

 

23,465

 

21,584

 

10,594

 

11,652

Miscellaneous income

 

374

 

1,992

 

 

846

 

2,921

 

1,033

 

472

Total revenues

 

257,420

 

256,395

 

 

531,188

 

509,419

 

249,315

 

273,768

Expenses

 

  

 

  

 

 

  

 

  

 

  

 

  

Depreciation and amortization

 

85,799

 

83,586

 

 

170,648

 

166,229

 

82,752

 

84,849

General and administrative

 

15,200

 

13,969

 

 

31,352

 

29,892

 

16,385

 

16,152

Real estate taxes

3,001

3,655

5,730

7,321

3,603

2,729

Acquisition, merger and transition related costs

 

 

251

 

 

1,814

 

26

 

1,513

 

1,814

Impairment on real estate properties

 

8,822

 

11,988

 

 

37,511

 

15,627

 

3,511

 

28,689

Recovery on direct financing leases

 

(164)

 

(752)

 

 

(717)

 

(752)

 

 

(553)

Provision for credit losses

 

3,536

 

15

 

 

2,512

 

1,501

Provision (recovery) for credit losses

 

1,824

 

(1,024)

Interest expense

 

58,879

 

55,252

 

 

117,400

 

110,454

 

58,145

 

58,521

Total expenses

 

175,073

 

167,964

 

 

366,250

 

330,298

 

167,733

 

191,177

Other income (expense)

 

 

  

 

 

 

  

 

 

  

Other income (expense) – net

 

540

 

142

 

 

771

 

(662)

Other (expense) income – net

 

(455)

 

231

Loss on debt extinguishment

 

(395)

 

 

 

(30,065)

 

 

(6)

 

(29,670)

Gain on assets sold – net

4,123

12,843

104,465

14,681

113,637

100,342

Total other income

 

4,268

 

12,985

 

 

75,171

 

14,019

 

113,176

 

70,903

Income before income tax expense and income from unconsolidated joint ventures

 

86,615

 

101,416

 

 

240,109

 

193,140

 

194,758

 

153,494

Income tax expense

 

(939)

 

(858)

 

 

(1,897)

 

(1,863)

 

(1,225)

 

(958)

Income from unconsolidated joint ventures

 

1,187

 

1,402

 

 

13,017

 

2,962

 

1,623

 

11,830

Net income

 

86,863

 

101,960

 

 

251,229

 

194,239

 

195,156

 

164,366

Net income attributable to noncontrolling interest

 

(2,340)

 

(2,653)

 

 

(6,728)

 

(5,017)

 

(5,549)

 

(4,388)

Net income available to common stockholders

$

84,523

$

99,307

 

$

244,501

$

189,222

$

189,607

$

159,978

Earnings per common share available to common stockholders:

 

  

 

  

 

 

  

 

  

 

  

 

  

Basic:

 

  

 

  

 

 

  

 

 

  

 

  

Net income available to common stockholders

$

0.36

$

0.44

 

$

1.04

$

0.83

$

0.79

$

0.69

Diluted:

 

  

 

  

 

 

  

 

  

 

  

 

  

Net income

$

0.36

$

0.43

 

$

1.04

$

0.83

$

0.79

$

0.69

See notes to consolidated financial statements.

3

Table of Contents

OMEGA HEALTHCARE INVESTORS, INC.

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME

Unaudited

(in thousands)

Three Months Ended

Six Months Ended

Three Months Ended

    

June 30, 

    

June 30, 

    

March 31, 

    

2021

    

2020

    

2021

    

2020

    

    

2022

    

2021

Net income

$

86,863

$

101,960

$

251,229

$

194,239

$

195,156

$

164,366

Other comprehensive income (loss):

 

 

  

 

 

  

 

 

  

Foreign currency translation

 

940

 

(972)

 

2,126

 

(19,743)

 

(10,809)

 

1,186

Cash flow hedges

 

(20,167)

 

513

 

15,634

 

(7,331)

 

19,578

 

35,801

Total other comprehensive income (loss)

 

(19,227)

 

(459)

 

17,760

 

(27,074)

Total other comprehensive income

 

8,769

 

36,987

Comprehensive income

 

67,636

 

101,501

 

268,989

 

167,165

 

203,925

 

201,353

Comprehensive income attributable to noncontrolling interest

 

(1,820)

 

(2,641)

 

(7,197)

 

(4,320)

 

(5,800)

 

(5,377)

Comprehensive income attributable to common stockholders

$

65,816

$

98,860

$

261,792

$

162,845

$

198,125

$

195,976

See notes to consolidated financial statements.

4

Table of Contents

OMEGA HEALTHCARE INVESTORS, INC.

CONSOLIDATED STATEMENTS OF CHANGES IN EQUITY

Three Months Ended June 30,March 31, 2022 and 2021 and 2020

Unaudited

(in thousands, except per share amounts)

Accumulated

Common

Additional

Cumulative

Other

Total

Stock

Paid-in

Net

Cumulative

Comprehensive

Stockholders’

Noncontrolling

Total

    

Par Value

    

Capital

    

Earnings

    

Dividends Paid

    

Income (Loss)

    

Equity

    

Interest

    

Equity

Balance at March 31, 2021

$

23,338

$

6,226,543

$

2,754,713

$

(5,074,432)

$

23,230

$

3,953,392

$

194,938

$

4,148,330

Stock related compensation

5,847

5,847

5,847

Issuance of common stock

418

151,180

151,598

151,598

Common dividends declared ($0.67 per share)

(158,260)

(158,260)

(158,260)

Vesting/exercising of Omega OP Units

(6,603)

(6,603)

6,603

Conversion and redemption of Omega OP Units to common stock

271

271

(271)

Omega OP Units distributions

(5,125)

(5,125)

Other comprehensive loss

(18,707)

(18,707)

(520)

(19,227)

Net income

84,523

84,523

2,340

86,863

Balance at June 30, 2021

$

23,756

$

6,377,238

$

2,839,236

$

(5,232,692)

$

4,523

$

4,012,061

$

197,965

$

4,210,026

Balance at March 31, 2020

$

22,686

$

5,997,561

$

2,525,323

$

(4,458,207)

$

(65,788)

$

4,021,575

$

197,070

$

4,218,645

Stock related compensation

4,623

4,623

4,623

Issuance of common stock

5

(200)

(195)

(195)

Common dividends declared ($0.67 per share)

(152,621)

(152,621)

(152,621)

Vesting/exercising of Omega OP Units

(2,825)

(2,825)

2,825

Conversion and redemption of Omega OP Units to common stock

3

813

816

(816)

Omega OP Units distributions

(4,561)

(4,561)

Other comprehensive loss

(447)

(447)

(12)

(459)

Net income

99,307

99,307

2,653

101,960

Balance at June 30, 2020

$

22,694

$

5,999,972

$

2,624,630

$

(4,610,828)

$

(66,235)

$

3,970,233

$

197,159

$

4,167,392

Accumulated

Common

Additional

Cumulative

Cumulative

Other

Total

Stock

Paid-in

Net

Dividends

Comprehensive

Stockholders’

Noncontrolling

Total

    

Par Value

    

Capital

    

Earnings

    

Paid

    

Income (Loss)

    

Equity

    

Interest

    

Equity

Balance at December 31, 2021

$

23,906

$

6,427,566

$

3,011,474

$

(5,553,908)

$

(2,200)

$

3,906,838

$

201,388

$

4,108,226

Stock related compensation

6,905

6,905

6,905

Issuance of common stock

12

1,135

1,147

1,147

Repurchase of common stock

(98)

(27,223)

(27,321)

(27,321)

Common dividends declared ($0.67 per share)

(160,687)

(160,687)

(160,687)

Vesting/exercising of Omega OP Units

(7,176)

(7,176)

7,176

Omega OP Units distributions

(5,276)

(5,276)

Capital contribution from noncontrolling interest holder in consolidated JV

2,925

2,925

Other comprehensive income

8,518

8,518

251

8,769

Net income

189,607

189,607

5,549

195,156

Balance at March 31, 2022

$

23,820

$

6,401,207

$

3,201,081

$

(5,714,595)

$

6,318

$

3,917,831

$

212,013

$

4,129,844

Balance at December 31, 2020

$

23,119

$

6,152,887

$

2,594,735

$

(4,916,097)

$

(12,768)

$

3,841,876

$

194,731

$

4,036,607

Stock related compensation

5,433

5,433

5,433

Issuance of common stock

219

72,908

73,127

73,127

Common dividends declared ($0.67 per share)

(158,335)

(158,335)

(158,335)

Vesting/exercising of Omega OP Units

(4,767)

(4,767)

4,767

Conversion and redemption of Omega OP Units to common stock

82

82

(82)

Omega OP Units distributions

(9,855)

(9,855)

Other comprehensive income

35,998

35,998

989

36,987

Net income

159,978

159,978

4,388

164,366

Balance at March 31, 2021

$

23,338

$

6,226,543

$

2,754,713

$

(5,074,432)

$

23,230

$

3,953,392

$

194,938

$

4,148,330

See notes to consolidated financial statements.

5

Table of Contents

OMEGA HEALTHCARE INVESTORS, INC.

CONSOLIDATED STATEMENTS OF CHANGES IN EQUITY

Six Months Ended June 30, 2021 and 2020

Unaudited

(in thousands, except per share amounts)

Accumulated

Common

Additional

Cumulative

Other

Total

Stock

Paid-in

Net

Cumulative

Comprehensive

Stockholders’

Noncontrolling

Total

    

Par Value

    

Capital

    

Earnings

    

Dividends Paid

    

Loss

    

Equity

    

Interest

    

Equity

Balance at December 31, 2020

$

23,119

$

6,152,887

$

2,594,735

$

(4,916,097)

$

(12,768)

$

3,841,876

$

194,731

$

4,036,607

Stock related compensation

11,282

11,282

11,282

Issuance of common stock

637

224,086

224,723

224,723

Common dividends declared ($1.34 per share)

(316,595)

(316,595)

(316,595)

Vesting/exercising of Omega OP units

(11,370)

(11,370)

11,370

Conversion and redemption of Omega OP Units to common stock

353

353

(353)

Omega OP Units distributions

(14,980)

(14,980)

Other comprehensive income

17,291

17,291

469

17,760

Net income

244,501

244,501

6,728

251,229

Balance at June 30, 2021

$

23,756

$

6,377,238

$

2,839,236

$

(5,232,692)

$

4,523

$

4,012,061

$

197,965

$

4,210,026

Balance at December 31, 2019

$

22,663

$

5,992,733

$

2,463,436

$

(4,303,546)

$

(39,858)

$

4,135,428

$

201,166

$

4,336,594

Cumulative effect of accounting change

(28,028)

(28,028)

(757)

(28,785)

22,663

5,992,733

2,435,408

(4,303,546)

(39,858)

4,107,400

200,409

4,307,809

Stock related compensation

9,258

9,258

9,258

Issuance of common stock

28

2,265

2,293

2,293

Common dividends declared ($1.34 per share)

(307,282)

(307,282)

(307,282)

Vesting/exercising of Omega OP units

(5,433)

(5,433)

5,433

Conversion and redemption of Omega OP Units to common stock

3

1,149

1,152

(1,152)

Omega OP Units distributions

(11,851)

(11,851)

Other comprehensive loss

(26,377)

(26,377)

(697)

(27,074)

Net income

189,222

189,222

5,017

194,239

Balance at June 30, 2020

$

22,694

$

5,999,972

$

2,624,630

$

(4,610,828)

$

(66,235)

$

3,970,233

$

197,159

$

4,167,392

See notes to consolidated financial statements.

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OMEGA HEALTHCARE INVESTORS, INC.

CONSOLIDATED STATEMENTS OF CASH FLOWS

Unaudited (in thousands)

    

June 30, 

    

2021

    

2020

    

Cash flows from operating activities

 

  

 

  

 

Net income

$

251,229

$

194,239

Adjustment to reconcile net income to net cash provided by operating activities:

 

 

  

Depreciation and amortization

 

170,648

 

166,229

Impairment on real estate properties

 

37,511

 

15,627

Recovery on direct financing leases

 

(717)

 

(752)

Provision for rental income

 

20,151

 

1,205

Provision for credit losses

 

2,512

 

1,501

Amortization of deferred financing costs and loss on debt extinguishment

 

36,038

 

4,922

Accretion of direct financing leases

 

24

 

12

Stock-based compensation expense

 

11,207

 

9,258

Gain on assets sold – net

 

(104,465)

 

(14,681)

Amortization of acquired in-place leases – net

 

(7,344)

 

(4,798)

Effective yield payable (receivable) on mortgage notes

 

641

 

(146)

Interest paid-in-kind

(3,546)

(3,838)

Income from unconsolidated joint ventures

(928)

(1,739)

Change in operating assets and liabilities – net:

 

 

  

Contractual receivables

 

(541)

 

5,812

Straight-line rent receivables

 

(25,696)

 

(5,764)

Lease inducements

 

2,849

 

(24,245)

Other operating assets and liabilities

 

(11,246)

 

(13,398)

Net cash provided by operating activities

 

378,327

 

329,444

Cash flows from investing activities

 

 

Acquisition of real estate

 

(604,939)

 

(25,935)

Refund of acquisition deposit

 

2,500

 

Net proceeds from sale of real estate investments

 

201,183

 

56,117

Investments in construction in progress

 

(19,297)

 

(46,750)

Proceeds from sale of direct financing lease and related trust

717

14,897

Placement of mortgage loans

 

(13,436)

 

(52,653)

Collection of mortgage principal

 

42,952

 

2,549

Investments in unconsolidated joint ventures

(10,484)

(1,971)

Distributions from unconsolidated joint ventures in excess of earnings

 

15,507

 

482

Capital improvements to real estate investments

 

(13,312)

 

(24,374)

Receipts from insurance proceeds

 

3,493

 

346

Investments in other investments

 

(48,554)

 

(67,692)

Proceeds from other investments

 

56,527

 

48,244

Net cash used in investing activities

 

(387,143)

 

(96,740)

Cash flows from financing activities

 

  

 

  

Proceeds from long-term borrowings

 

2,090,128

 

762,466

Payments of long-term borrowings

 

(1,989,561)

 

(669,704)

Payments of financing related costs

 

(48,076)

 

Receipts from dividend reinvestment plan

 

77,286

 

3,747

Taxes paid on vested restricted stock

 

(3,269)

 

(3,369)

Net proceeds from issuance of common stock

 

150,706

 

1,797

Dividends paid

 

(316,520)

 

(307,164)

Distributions to Omega OP Unit Holders

 

(14,980)

 

(11,851)

Net cash used in financing activities

 

(54,286)

 

(224,078)

Effect of foreign currency translation on cash, cash equivalents and restricted cash

 

104

 

(441)

(Decrease) increase in cash, cash equivalents and restricted cash

 

(62,998)

 

8,185

Cash, cash equivalents and restricted cash at beginning of period

 

167,558

 

33,380

Cash, cash equivalents and restricted cash at end of period

$

104,560

$

41,565

    

Three Months Ended March 31, 

    

2022

    

2021

    

Cash flows from operating activities

 

  

 

  

 

Net income

$

195,156

$

164,366

Adjustment to reconcile net income to net cash provided by operating activities:

 

 

  

Depreciation and amortization

 

82,752

 

84,849

Impairment on real estate properties

 

3,511

 

28,689

Recovery on direct financing leases

 

 

(553)

Provision for rental income

 

3,151

 

2,750

Provision (recovery) for credit losses

 

1,824

 

(1,024)

Amortization of deferred financing costs and loss on debt extinguishment

 

3,199

 

32,423

Accretion of direct financing leases

 

19

 

12

Stock-based compensation expense

 

6,860

 

5,396

Gain on assets sold – net

 

(113,637)

 

(100,342)

Amortization of acquired in-place leases – net

 

(1,608)

 

(6,221)

Effective yield payable on mortgage notes

 

463

 

311

Interest paid-in-kind

(2,196)

(1,754)

(Income) loss from unconsolidated joint ventures

(677)

72

Change in operating assets and liabilities – net:

 

 

  

Contractual receivables

 

(1,912)

 

(1,020)

Straight-line rent receivables

 

(24,137)

 

(13,459)

Lease inducements

 

1,932

 

1,168

Other operating assets and liabilities

 

(22,498)

 

(19,688)

Net cash provided by operating activities

 

132,202

 

175,975

Cash flows from investing activities

 

 

Acquisition of real estate

 

(113,157)

 

(594,504)

Acquisition deposit - net

 

 

2,500

Net proceeds from sale of real estate investments

 

332,552

 

188,253

Investments in construction in progress

 

(4,667)

 

(9,806)

Proceeds from sale of direct financing lease and related trust

553

Placement of mortgage loans

 

(2,801)

 

(4,717)

Collection of mortgage principal

 

22,913

 

1,065

Investments in unconsolidated joint ventures

(10,443)

Distributions from unconsolidated joint ventures in excess of earnings

 

61

 

7,489

Capital improvements to real estate investments

 

(13,548)

 

(4,012)

Receipts from insurance proceeds

 

22

 

3,017

Investments in other investments

 

(100,225)

 

(27,636)

Proceeds from other investments

 

56,188

 

51,911

Net cash provided by (used in) investing activities

 

177,338

 

(396,330)

Cash flows from financing activities

 

  

 

  

Proceeds from long-term borrowings

 

420,208

 

1,905,128

Payments of long-term borrowings

 

(66,896)

 

(1,667,707)

Payments of financing related costs

 

(6)

 

(33,836)

Net proceeds from issuance of common stock

 

1,147

 

73,127

Repurchase of common stock

 

(27,321)

 

Dividends paid

 

(160,641)

 

(158,298)

Noncontrolling members’ contributions to consolidated joint venture

22

Distributions to Omega OP Unit Holders

 

(5,276)

 

(9,855)

Net cash provided by financing activities

 

161,237

 

108,559

Effect of foreign currency translation on cash, cash equivalents and restricted cash

 

(407)

 

136

Increase (decrease) in cash, cash equivalents and restricted cash

 

470,370

 

(111,660)

Cash, cash equivalents and restricted cash at beginning of period

 

24,411

 

167,558

Cash, cash equivalents and restricted cash at end of period

$

494,781

$

55,898

See notes to consolidated financial statements.

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OMEGA HEALTHCARE INVESTORS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

Unaudited

June 30, 2021March 31, 2022

NOTE 1 – BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES

Business Overview and Organization

Omega Healthcare Investors, Inc. (“Omega”Parent”) was incorporated in the State ofis a Maryland on March 31, 1992 and has elected to be taxed as a real estate investment trust (“REIT”) for federal income tax purposes. Omega is structured as an umbrella partnership REIT (“UPREIT”) under which all of Omega’s assets are owned directly or indirectly by, and all of Omega’s operations are conducted directly or indirectly through,corporation that, together with its operating partnership subsidiary, OHI Healthcare Properties Limited Partnership (“Omega OP”). Unless stated otherwise or the context otherwise requires, the terms “Omega”,consolidated subsidiaries (collectively, “Omega,” the “Company,” “we,” “our” and“our,” or “us” refer to Omega Healthcare Investors, Inc. and its consolidated subsidiaries, including Omega OP, references to “Parent” refer to Omega Healthcare Investors, Inc. without regard to its consolidated subsidiaries, and references to “Omega OP” mean OHI Healthcare Properties Limited Partnership and its consolidated subsidiaries.

Omega has 1 reportable segment consisting of investments) invests in healthcare-related real estate properties located in the United States (“U.S.”) and the United Kingdom (“U.K.”). Our core business is to provide financing and capital to the long-term healthcare industry with a particular focus on skilled nursing facilities (“SNFs”), assisted living facilities (“ALFs”), and to a lesser extent, independent living facilities (“ILFs”), rehabilitation and acute care facilities (“specialty facilities”) and medical office buildings. Our core portfolio consists of long-term “triple net” leases and mortgage agreements. All ofloans with healthcare operating companies and affiliates (collectively, our leases are “triple-net” leases, which require the operators (we use the term “operator” to refer“operators”). In addition to our tenants and mortgagors and their affiliates who manage and/or operate our properties) to pay all property-related expenses. Our mortgage revenue derives from fixed rate mortgage loans, which are secured by first mortgage liens on the underlying real estate and personal property of the mortgagor. Our other investment income derives from fixed and variable ratecore investments, we selectively make loans to our operators and/or their principals to fundfor working capital and capital expenditures. These loans,From time to time, we also acquire equity interests in joint ventures or entities that support the long-term healthcare industry and our operators.

Omega has elected to be taxed as a real estate investment trust (“REIT”) for federal income tax purposes and is structured as an umbrella partnership REIT (“UPREIT”) under which may be either unsecuredall of Omega’s assets are owned directly or securedindirectly by, the collateraland all of the borrower,Omega’s operations are classified as other investments.

conducted directly or indirectly through, its operating partnership subsidiary, OHI Healthcare Properties Limited Partnership (collectively with its subsidiaries, “Omega OP”). Omega has exclusive control over Omega OP’s day-to-day management pursuant to the partnership agreement governing Omega OP. As of June 30, 2021,March 31, 2022, Parent owned approximately 97% of the issued and outstanding units of partnership interest in Omega OP (“Omega OP Units”), and other investors owned approximately 3% of the outstanding Omega OP Units.

Basis of Presentation and Principles of Consolidation

The accompanying unaudited consolidated financial statements have been prepared in accordance with the instructions to Form 10-Q and do not include all of the information and notes required by U.S. generally accepted accounting principles (“GAAP”) for complete financial statements. In our opinion, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation have been included. The results of operations for the interim periods reported herein are not necessarily indicative of results to be expected for the full year. These unaudited consolidated financial statements should be read in conjunction with the financial statements and the footnotes thereto included in our latest Annual Report on Form 10-K filed with the Securities and Exchange Commission on February 22, 2021.17, 2022.

Omega’s consolidated financial statements include the accounts of (i) Parent, (ii) Omega OP, (iii) all direct and indirect wholly owned subsidiaries of Omega and (iv) other entities in which Omega or Omega OP has a majority voting interest and control. All intercompany transactions and balances have been eliminated in consolidation, and Omega’s net earnings are reduced by the portion of net earnings attributable to noncontrolling interests.

Segments

We conduct our operations and report financial results as 1 business segment. The presentation of financial results as 1 reportable segment is consistent with the way we operate our business and is consistent with the manner in which our Chief Operating Decision Maker (CODM), our Chief Executive Officer, evaluates performance and makes resource and operating decisions for the business.  

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Reclassification

Certain line items on our Consolidated Balance Sheets, Consolidated Statements of Operations, Consolidated Statements of Changes in Equity, Consolidated Balance Sheets and Consolidated Statements of Cash Flows have been reclassified to conform to the current period presentation.

Impact ofRisks and Uncertainties including COVID-19

The Company is subject to certain risks and uncertainties affecting the healthcare industry, including those stemming from the novel coronavirus (“COVID-19”) global pandemic described below, which has disproportionately impacted the senior care sector, as well as those stemming from healthcare legislation and changing regulation by federal, state and local governments. Additionally, we are subject to risks and uncertainties as a result of changes affecting operators of nursing home facilities due to the actions of governmental agencies and insurers to limit the rising cost of healthcare services.

In additionRecent Accounting Pronouncements

ASU – 2022-02, Financial Instruments – Credit Losses (Topic 326): Troubled Debt Restructurings and Vintage Disclosures

On March 31, 2022, the FASB issued ASU 2022-02, which eliminates the recognition and measurement guidance for troubled debt restructurings (“TDRs”) and requires additional disclosures for certain loan modifications. ASU 2022-02 also requires entities to experiencing outbreaksdisclose gross write-offs of positive casesfinancing receivables and deathsnet investments in leases by year of residentsorigination. The TDR guidance can be adopted using either a prospective or modified retrospective transition approach and employees during the pandemic,additional disclosure requirements are made prospectively. ASU 2022-02 would be effective for Omega’s first quarter of 2023, and early adoption is permitted. We are still evaluating the impact that adopting ASU 2022-02 will have on our operators have been requiredconsolidated financial statements.

ASU – 2020-04, Financial Instruments – Reference Rate Reform (Topic 848)

On March 12, 2020, the FASB issued ASU 2020-04, which contains optional practical expedients for a limited period of time to and continue to, adapt their operations rapidly throughoutease the pandemic to manage the spread of the COVID-19 virus as well as the implementation of new treatments and vaccines, and to implement new requirements relating to infection control, staffing levels, personal protective equipment (“PPE”), quality of care, visitation protocols, and reporting, among other regulations, throughout the pandemic while facing staffing shortages that have accelerated during the pandemic and that may impede the delivery of care. It remains uncertain when and to what extent vaccination programspotential burden in accounting for COVID-19, which have been implemented in most of our facilities, will continue to mitigate(or recognizing the effects of) reference rate reform on financial reporting for contracts, hedging relationships, and other transactions that reference the London Interbank Offered Rate (“LIBOR”). The guidance may be elected over time until December 31, 2022, as reference rate reform activities occur. The Company has several derivative instruments (See Note 16 – Derivatives and Hedging), a $1.45 billion senior unsecured multicurrency revolving credit facility, and a $50 million senior unsecured term loan facility (See Note 15 – Borrowing Activities and Arrangements) that reference LIBOR. We also have a $25.0 million senior secured debtor-in-possession (“DIP”) facility loan with an operator that references LIBOR (See Note 6 – Other Investments), but it matures in 2022 prior to LIBOR being discontinued. During the first quarter of COVID-19 in our facilities, or how effective existing vaccines2020, we elected to apply the hedge accounting expedients related to probability and the assessments of effectiveness for future LIBOR indexed cash flows to assume that the index upon which future hedged transactions will be against variants ofbased matches the COVID-19 virus;index on the impactcorresponding derivatives. Application of these programs will depend in part onexpedients preserves the continued speed, distribution, efficacy and deliverypresentation of the vaccine in ourderivatives consistent with past presentation. Our credit facilities as well as participation levels in vaccination programs among the residents and employees of our operators. In additionthat reference LIBOR contain customary LIBOR replacement language, including, but not limited to, the risks associated with managing the spread of the virus, delivery of the vaccines and care of their patients and residents, many of our operators reported incurring, and may continue to incur, significant cost increases as a result of the COVID-19 pandemic, with dramatic increases for facilities with positive cases. We believe these increases primarily stem from elevated labor costs, in part due to staffing shortages, including the increased use of overtime and bonus pay and reliance on agency staffing, as well as a significant increase in both the cost and usage of PPE, testing equipment and processes and supplies, as well as implementation of new infection control protocols and vaccination programs. In addition, many of our operators have reported experiencing declines, in some cases that are material, in occupancy levels as a result of the pandemic. While these declines on average appear to be stabilizing and even marginally improving in recent months, it remains unclear when demand and occupancy levels will return to pre-COVID-19 levels. We believe these occupancy declines may be in part due to staffing shortages, which in some cases have required operators to limit admissions, as well as COVID-19 related fatalities at our facilities, the delay of SNF placement and/or utilization of alternative care settings for those with lower level of care needs, the suspension and/or postponement of elective hospital procedures, fewer discharges from hospitals to SNFs and higher hospital readmittances from SNFs. We continue to monitor the impact of occupancy declines at many of our operators, and it remains uncertain whether and when demand, staffing and occupancy levels will return to pre-COVID-19 levels.

While substantial government support has been allocated to SNFs and to a lesser extent to ALFs, further government support will likely be needed to continue to offset these impacts and it is unclear whether and to what extent such government support has been and will continue to be sufficient and timely to offset these impacts. Further, to the extent the impacts of the pandemic continue or accelerate and are not offset by continued government relief that is sufficient and timely, we anticipate that the operating results of certain of our operators would be materially and adversely affected, some may be unwilling or unable to pay their contractual obligations to us in full or on a timely basis and we may be unable to restructure such obligations on terms as favorable to us as those currently in place. Even if operators are able to avail themselves of government relief to offset some of these costs, they may face challenges in complying with the terms and conditions of government support and may face longer-term adverse impacts to their personnel and business operations from the COVID-19 pandemic, including potential patient litigation and decreased demand for their services, loss of business due to an interruption in their operations, workforce challenges, new regulatory restrictions, or other liabilities related to gathering restrictions, quarantines, reopening plans, vaccine distribution or delivery, spread of infection or other related factors.

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The extent of the COVID-19 pandemic’s effect on our and our operators’ operational and financial performance will depend on future developments, including the ability to control the spread of the outbreak generally and in our facilities and the delivery and efficacy of and participation in vaccination programs and other treatments for COVID-19, government funds and other support for the senior care sector and the efficacy of other policies and measures that may mitigate the impact of the pandemic, as well as the future demand for needs-based skilled nursing care and senior living facilities, all of which are uncertain and difficult to predict. Due to these uncertainties, we are not able at this time to estimate the effect of these factors on our business, but the adverse impact on our business, results of operations, financial condition and cash flows could be material.

Derivative Instruments

Cash flow hedges

During our normal course of business, we may use certain types of derivative instruments for the purpose of managing interest rate and currency risk. As a matter of policy, we do not use derivatives for trading or speculative purposes. To qualify for hedge accounting, derivative instruments used for risk management purposes must effectively reduce the risk exposure that they are designed to hedge. In addition, at the inception of a qualifying cash flow hedging relationship, the underlying transaction or transactions, must be, and are expected to remain, probable of occurring in accordance with our related assertions. The Company recognizes all derivative instruments, including embedded derivatives required to be bifurcated, as assets or liabilities in the Consolidated Balance Sheets at their fair value which is determined using a market approach and Level 2 inputs. Changes in the fair value of derivative instruments that are not designated in hedging relationships or that do not meet the criteria of hedge accounting are recognized in earnings. For derivatives designated in qualifying cash flow hedging relationships, the gain or loss on the derivative is recognized in accumulated other comprehensive income (“AOCI”) as a separate component of equity and a proportionate amount of gain or loss is allocated to noncontrolling interest, if applicable. We formally document all relationships between hedging instruments and hedged items, as well as our risk-management objectives and strategy for undertaking various hedge transactions. This process includes designating all derivatives that are part of a hedging relationship to specific forecasted transactions as well as recognized liabilities or assets on the Consolidated Balance Sheets. We also assess and document, both at inception of the hedging relationship and on a quarterly basis thereafter, whether the derivatives are highly effective in offsetting the designated risks associated with the respective hedged items. If it is determined that a derivative ceases to be highly effective as a hedge, or that it is probable the underlying forecasted transaction will not occur, we discontinue hedge accounting prospectively and record the appropriate adjustment to earningsrates based on the current fair value ofsecured overnight financing rate. The Company is evaluating: (i) how the derivative. At June 30, 2021transition away from LIBOR will impact the Company, (ii) whether any additional optional expedients provided by the standards will be adopted, and December 31, 2020, $0.5 million and $1.0 million, respectively, of qualifying cash flow hedges were recorded at fair value in accrued expenses and other liabilities(iii) the impact that adopting ASU 2020-04 will have on our Consolidated Balance Sheets. At June 30, 2021 and December 31, 2020, $34.1 million and $17.0 million, respectively, of qualifying cash flow hedges were recorded at fair value in other assets on our Consolidated Balance Sheets.  

Net investment hedges

We are exposed to fluctuations in the British Pound (“GBP”) against its functional currency, the U.S. Dollar (“USD”), relating to our investments in healthcare-related real estate located in the U.K. For derivatives that are designated and qualify as net investment hedges, the gain or loss on the derivative is reported in AOCI as part of the cumulative translation adjustment in our Consolidated Balance Sheets. For nonderivativeconsolidated financial instruments that are designated and qualify as net investment hedges, the foreign currency transaction gain or loss on the nonderivative financial instrument is reported in AOCI as a part of the cumulative translation adjustment in our Consolidated Balance Sheets. Amounts are reclassified out of AOCI into earnings when the hedged net investment is either sold or substantially liquidated. From the issuance date of our GBP borrowings through the prepayment date in March 2021, we used a nonderivative, GBP-denominated term loan and line of credit totaling £174 million to hedge a portion of our net investments in foreign operations. During March 2021 and concurrent with the prepayment of our GBP-denominated term loan and line of credit, we entered into 4 foreign currency forwards that mature on March 8, 2024 to hedge a portion of our net investments in foreign real estate, effectively replacing the terminated net investment hedge. At June 30, 2021, $0.3 million of qualifying net investment hedges were recorded at fair value in other assets on our Consolidated Balance Sheets.  statements.

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NOTE 2 – PROPERTIES AND INVESTMENTS

Leased Property

A summary of our investments in real estate properties subject to operating leases is as follows:

    

June 30, 

December 31, 

    

2021

    

2020

    

(in thousands)

Buildings

$

7,424,693

$

6,961,509

Land

 

941,672

 

883,765

Furniture and equipment

 

533,169

 

518,664

Site improvements

 

328,765

 

308,087

Construction in progress

 

33

 

30,129

Total real estate investments

 

9,228,332

 

8,702,154

Less accumulated depreciation

 

(2,139,100)

 

(1,996,914)

Real estate investments – net

$

7,089,232

$

6,705,240

REAL ESTATE ASSETS

At June 30, 2021,March 31, 2022, our leased real estate properties included 728674 SNFs, 132163 ALFs, 3520 ILFs, 16 specialty facilities and 2 medical office buildings.

Three Months Ended June 30,

Six Months Ended June 30,

2021

2020

2021

2020

(in thousands)

(in thousands)

Rental income – operating leases

$

218,247

$

217,620

$

453,309

$

435,960

Variable lease income – operating leases

2,708

3,912

5,407

7,072

Total rental income

$

220,955

$

221,532

$

458,716

$

443,032

The following table summarizes the significantCompany’s rental income from operating leases:

Three Months Ended March 31,

2022

2021

(in thousands)

Rental income – operating leases

$

213,597

$

235,062

Variable lease income – operating leases

3,286

2,699

Total rental income

$

216,883

$

237,761

Our variable lease income primarily represents the reimbursement of real estate taxes and ground lease expenses by operators that Omega pays directly.

Asset Acquisitions

The following table summarizes the asset acquisitions that occurred during the first sixthree months of 2021:2022:

Number of

Total

Initial 

Number of

Total Real Estate

Initial 

    

 Facilities

    

Country/

    

Investment

    

Annual

    

 Facilities

    

    

Assets Acquired

    

Annual

Period

SNF

ALF

Specialty

State

(in millions)

Cash Yield(1) 

SNF

ALF

Specialty

Country/State

(in millions)

Cash Yield(1) 

Q1

 

17

7

 

AZ, CA, FL, IL, NJ, OR, PA, TN, TX, VA, WA

$

511.3

(2)

8.43

%

 

1

 

U.K.

$

8.7

(2)

8.0

%

Q1

6

FL

83.1

9.25

%

1

U.K.

5.0

8.0

%

Q1

27

U.K.

86.6

(2)

8.0

%

Q1

1

MD

8.2

(3)

9.5

%

Total

 

6

17

7

 

  

$

594.4

 

 

1

29

 

  

$

108.5

 

(1)The initialInitial annual cash yield reflects the initial annual contractual cash rent divided by the purchase price.
(2)OnThe total consideration paid for this 1 facility U.K. acquisition and the 27-facility U.K. acquisition was $8.2 million and $100.0 million, respectively. In connection with these acquisitions, we allocated $0.5 million of the purchase consideration to a deferred tax liability related to this 1 facility U.K. acquisition, and $13.4 million to a deferred tax asset related to the 27-facility U.K. acquisition. See Note 13 – Taxes for additional information.
(3)Total consideration for the 1 facility Maryland acquisition was paid on December 30, 2021, but the closing of the acquisition did not occur until January 20, 2021, we acquired 24 facilities from Healthpeak Properties, Inc. The acquisition involved the assumption of an in-place master lease with Brookdale Senior Living Inc.1, 2022.

DuringNOTE 3 – ASSETS HELD FOR SALE, DISPOSITIONS AND IMPAIRMENTS

Periodically we sell facilities to reduce our exposure to certain operators, geographies and non-strategic assets or due to the second quarterexercise of 2021,a tenant purchase option.

In March 2022, we acquired 1 parcel of land (not reflectedreclassified 7 facilities leased to Guardian Healthcare (“Guardian”) to held for sale in connection with the transactions outlined in the table above)restructuring agreement that was executed in April 2022 with Guardian, as discussed further in Note 4 – Contractual Receivables and Other Receivables and Lease Inducements. We also entered into agreements to sell 7 of these held for approximately $10.4sale facilities in March and April 2022 for estimated gross proceeds of $36.5 million. As of March 31, 2022, the remaining 19 facilities in held for sale are all under sales agreements which provide for estimated proceeds of $83.1 million, subject to terms and conditions of such agreements.

The following is a summary of our assets held for sale:

March 31, 

December 31,

2022

  

2021

Number of facilities held for sale

26

41

Amount of assets held for sale (in thousands)

$

92,762

$

261,151

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Asset Sales and Impairments

During the first quarter of 2021,three months ended March 31, 2022, we sold 2427 facilities, subject to operating leases, for approximately $188.3$332.6 million in net cash proceeds, recognizing a net gain of approximately $100.3$113.6 million. In addition, we recorded impairments on 4NaN of these facilities of approximately $28.7 million (3 were subsequently reclassifiedwas sold to assets held for salethe joint venture that was consolidated in the first quarter of 2021).

During2022, as discussed further in Note 8 – Variable Interest Entities. The proceeds and gain primarily relate to the second quartersale of 2021, we sold 6the 22 facilities subject to operating leasesthat were previously leased and operated by Gulf Coast Health Care LLC (together with certain affiliates “Gulf Coast”) and were included in assets held for approximately $12.9 million insale as of December 31, 2021. The net cash proceeds recognizingfrom the sale, including related costs accrued for as of the end of the first quarter, were $304.0 million, and we recognized a net gain of approximately $4.1$113.5 million. In addition,We elected to exit these facilities following Gulf Coast commencing the Chapter 11 bankruptcy process in October 2021. The agreement includes an earnout clause pursuant to which the buyer is obligated to pay an additional $18.7 million to Omega if certain financial metrics are achieved at the facilities in the three years following the sale. As we have determined it is not probable that we will receive any additional funds, we have not recorded any income related to the earnout clause.

NaN of the facilities sold during the three months ended March 31, 2022 were previously leased to Guardian and were sold for $3.0 million in gross proceeds, which resulted in a net gain of approximately $0.5 million, in connection with on-going restructuring negotiations and were included in held for sale as of December 31, 2021.

Real Estate Impairments

During the three months ended March 31, 2022, we recorded impairments on 3 facilities of approximately $8.8$3.5 million (all 3on 2 facilities that were subsequently reclassified to assetsclassified as held for sale induring the second quarter of 2021).

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Our recorded impairments were primarilyfor which the result of decisions to exit certain non-strategic facilities and/or operators. We reducedcarrying values exceeded the net book value of the impaired facilities to their estimated fair values or, with respect to the facilities reclassified to held for sale, to their estimated fair values less costs to sell. To estimate the fair value of the facilities determined to be held for sale for the impairments noted above, we utilized a market approach whichthat considered binding sale agreements (a Level 1 input) and/or non-binding offers from unrelated third parties and/or broker quotes (a Level 3 input).

NOTE 34 – CONTRACTUAL RECEIVABLES AND OTHER RECEIVABLES AND LEASE INDUCEMENTS

Contractual receivables relate to the amounts currently owed to us under the terms of our lease and loan agreements. Effective yield interest receivables relate to the difference between the interest income recognized on an effective yield basis over the term of the loan agreement and the interest currently due to us according to the contractual agreement. Straight-line rent receivables relate to the difference between the rental revenue recognized on a straight-line basis and the amounts currently due to us according to the contractual agreement. Lease inducements result from value provided by us to the lessee, at the inception, modification or renewal of the lease, and are amortized as a reduction of rental income over the non-cancellable lease term.

A summary of our net receivables and lease inducements by type is as follows:

    

March 31, 

December 31, 

    

2022

    

2021

    

(in thousands)

Contractual receivables – net

$

13,172

$

11,259

Effective yield interest receivables

$

9,127

$

9,590

Straight-line rent receivables

 

169,028

 

148,455

Lease inducements

 

91,837

 

93,770

Other receivables and lease inducements

$

269,992

$

251,815

    

June 30, 

December 31, 

    

2021

    

2020

    

(in thousands)

Contractual receivables – net

$

10,948

$

10,408

Effective yield interest receivables

$

11,554

$

12,195

Straight-line rent receivables

 

138,449

 

139,046

Lease inducements

 

79,506

 

83,425

Other receivables and lease inducements

$

229,509

$

234,666

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Agemo Holdings, LLC

DuringAgemo Holdings, LLC (“Agemo”) continued to not pay contractual rent and interest due under its lease and loan agreements during the first and second quartersquarter of 2021,2022. As we wrote-off approximately $2.7 million and $17.4 million, respectively, of straight-line rent receivables to rental income as a result of transitioning 1 facility and placing 2 operatorsalready placed Agemo on a cash basis dueof revenue recognition during the third quarter of 2020, 0 revenue was recorded during the three months ended March 31, 2022. See Note 6 – Other Investments for additional details on our loans with Agemo. For the three months ended March 31, 2021, Agemo generated approximately 4.6%, respectively, of our total revenues (excluding the impact of write-offs in the first quarter of 2021).

During the three months ended March 31, 2022, the Agemo lease was amended to changes in our evaluationallow for the extension of the collectibilityrent deferral through April 2022, which represents an additional deferral of futureapproximately $1.6 million of rent. Additionally, in the first quarter of 2022, we extended the forbearance period from February 28, 2022 to April 30, 2022. The forbearance period was subsequently extended to May 31, 2022.

Guardian Healthcare

Guardian Healthcare (“Guardian”) continued to not make contractual rent and interest payments dueunder its lease and loan agreements during the first quarter of 2022. As we already placed Guardian on a cash basis of revenue recognition in the fourth quarter of 2021, 0 revenue was recorded during the three months ended March 31, 2022. In the first quarter of 2022, we transitioned 8 facilities previously leased to Guardian to 2 other operators as part of the planned restructuring. Additionally, we also sold 2 facilities previously leased to Guardian and 3 facilities previously subject to the Guardian mortgage loan in the first quarter of 2022 as part of on-going restructuring activities. In April 2022, we agreed to a formal restructuring agreement, master lease amendment and mortgage loan amendment with Guardian. As part of the restructuring agreement and amendments, Omega and Guardian agreed to the following:

Extend the lease and loan terms to December 31, 2031 and allow Guardian the option to extend the maturity date for both the lease and loan through September 30, 2034,
sell 6 facilities subject to the master lease agreement to other operators in exchange for a reduction in base rent equal to 9.5% of the agreed upon fair value of these facilities,
require Guardian to purchase 1 leased facility for $3.5 million before June 30, 2022, with a corresponding reduction in base rent equal to 9.5% of the proceeds,
reduce the combined rent and mortgage interest to an aggregate $24.0 million following the completion of sale of the 6 leased facilities and Guardian repurchase of the 1 leased facility are completed and
allow for the deferral of up to $18.0 million of aggregate rent and interest, effective retrospectively, from October 1, 2021 through April 1, 2022 based on the existence of certain financial conditions, with repayment required after September 30, 2024 based on certain financial metrics and in full by the current lease termination date of December 31, 2031, or the earlier termination of the lease for any reason.

Guardian elected to utilize the allowed deferral in the restructuring agreement for unpaid contractual rent and interest during the period from October 2021 through March 2022 and for a portion of rent and interest in April 2022. In April 2022, Guardian made a partial payment after exhausting the maximum allowable deferral of $18.0 million under the leaserestructuring agreement. Guardian is required to make contractual rent and interest payments going forward under the restructuring agreements.

Based As discussed in Note 3 – Assets Held for Sale, Dispositions and Impairments, the 7 leased facilities expected to be sold based on the terms within the restructuring agreement are included in assets held for sale as of March 31, 2022. As of March 31, 2022, we have $7.4 million of letters of credit from Guardian as collateral which could be applied against our uncollected rent and interest receivables. See Note 5 – Mortgage Notes Receivable for additional details on our evaluation ofmortgage with Guardian. For the collectibility of future rent payments due under the lease agreements for the 2 operators discussed above, we do not believe it is probable that we will be able to collect substantially all rents due. These 2 operatorsthree months ended March 31, 2021, Guardian generated approximately 3%3.2% of our total revenues (excluding the impact of straight-line write-offs in the first quarter of 2021).

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Other operator updates

From January through March 2022, an operator representing 3.8% and 3.3%, respectively, of total revenue (excluding the impact of write-offs) for the three months ended March 31, 2022 and 2021, did not pay its contractual amounts due under its lease agreement. In March 2022, the lease with this operator was amended to allow for a short-term rent deferral for January through March 2022. The deferred rent balance accrues interest monthly at a rate of 5% per annum. This operator paid the contractual amount due under its lease agreement in April 2022. The operator is required to repay the deferred rent balance and accrued interest by December 31, 2022. Omega holds a $1.0 million letter of credit and a $150.0 thousand security deposit from this operator.

We also have a $20.0 million revolving credit facility with this operator, and the operator paid contractual interest under the facility from January through April 2022. As of March 31, 2022, the total outstanding principal due under the credit facility was $16.0 million. In April 2022, this operator borrowed an additional $1.8 million under the credit facility. The credit facility is secured by a first lien on the accounts receivable of the operator.

In March 2022, another operator, representing 2.3% and 2.1%, respectively, of total revenue (excluding the impact of write-offs) for the three months ended March 31, 2022 and 2021, did not pay its contractual amounts due under its lease agreement. In April 2022, the lease with this operator was amended to allow the operator to apply its $2.0 million security deposit toward payment of March 2022 rent and to allow for a short-term rent deferral for April, 2022 with regular rent payments required to resume in May 2022.

During the first quarter of 2022, we allowed three other operators, representing an aggregate 2.5% and 2.7%, respectively, of total revenue (excluding the impact of write-offs) for the three months ended March 31, 2022 and 2021 to apply $1.3 million of their security deposits to pay rent to accommodate short term liquidity issues, with regular rent payments required to resume shortly thereafter. As of April 30, 2022, all of these operators are current on their lease obligations. These operators also are required to begin replenishing their security deposits in 2023.  

Other straight-line receivables and write-offs

During the first quarter of 2022, we wrote-off straight-line rent receivable write-offs in 2021) for the six months ended June 30, 2021 and 2020. For the six months ended June 30, 2021, we have been unablebalances of $3.2 million through rental income as a result of transitioning 6 facilities to collect approximately $3.5 million of contractual rents due from these operators.  We have applied $2.5 million of one of the operator’s security deposit funds against their uncollected receivables, which represents one month of contractual rent under the lease agreement. We have subordinated debt to a third party with an outstanding principal balance of $20 million that matures in December 2021 (see Note 13 – Borrowing Arrangements in our Annual Report on another existing operator.  

Form 10-K for the year ended December 31, 2020). However, that indebtedness (interest and, under some circumstances, principal) is subject to offset if contractual rent is not paid when due by one of the subject operators.

NOTE 45 – MORTGAGE NOTES RECEIVABLE

As of June 30, 2021,March 31, 2022, mortgage notes receivable relate to 7 fixed rate mortgage notes on 6360 facilities. The mortgage notes are secured by first mortgage liens on the borrowers’ underlying real estate and personal property. The mortgage notes receivable relate to facilities located in 76 states that are operated by 6 independent healthcare operating companies. We monitor compliance with the terms of our mortgages and when necessary have initiated collection, foreclosure and other proceedings with respect to certain outstanding mortgage notes.

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The principal amounts outstanding of mortgage notes receivable, net of allowances, were as follows:

June 30, 

December 31, 

March 31, 

December 31, 

    

2021

    

2020

    

    

2022

    

2021

    

(in thousands)

(in thousands)

Mortgage note due 2027; interest at 10.81%

$

112,500

$

112,500

Mortgage notes due 2029; interest at 10.59%(1)

 

655,133

  

670,015

Mortgage note due 2027; interest at 11.02%

$

82,017

$

103,762

Mortgage notes due 2029; interest at 10.81%(1)

 

656,007

  

653,564

Other mortgage notes outstanding(2)

 

122,409

  

136,043

 

150,779

  

151,361

Mortgage notes receivable, gross

 

890,042

  

918,558

 

888,803

  

908,687

Allowance for credit losses on mortgage notes receivable

 

(32,880)

  

(33,245)

 

(69,226)

  

(73,601)

Total mortgages — net

$

857,162

$

885,313

Total mortgage notes receivable — net

$

819,577

$

835,086

(1)Approximates the weighted average interest rate on 4645 facilities as of June 30, 2021. As of June 30, 2021, the carrying amount includes 2 mortgages that mature in 2021, a construction mortgage with an outstanding principal balance of $13.9 million and a facility mortgage with an outstanding principal balance of $21.3 million, with the remaining loan balance maturing in 2029. During the second quarter of 2021, 1 construction mortgage with an original maturity date of 2021 was extended to 2029 and converted into a facility mortgage.  March 31, 2022.
(2)Other mortgagesmortgage notes outstanding have a weighted average interest rate of 9.38%8.84% per annum as of June 30, 2021March 31, 2022 and maturity dates ranging from 2023 through 2032.

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Mortgage Note due 2027

As discussed in Note 4 – Contractual Receivables and Other Receivables and Lease Inducements, Guardian continued to not pay contractual rent and interest to us during the first quarter of 2022. During the first quarter of 2022, we continued our on-going negotiations to restructure and amend Guardian’s lease and loan agreements. As part of the restructuring negotiations, on February 15, 2022, Guardian completed the sale of 3 facilities, subject to the Guardian mortgage loan with Omega. Concurrent with the sale, Omega agreed to release the mortgage liens on these facilities in exchange for a partial paydown of $21.7 million. In connection with the partial paydown, we recorded a $5.1 million recovery for credit losses in the first quarter of 2022 related to the Guardian mortgage loan. Following the mortgage paydown and recovery, Omega has reserves of $42.0 million against the loan that reduces the loan carrying value to the estimated fair value of the collateral of $40.0 million. As of March 31, 2022, the mortgage loan is secured by 3 SNFs and 1 ALF located in Pennsylvania. In April 2022, we agreed to a formal restructuring agreement and amendments to the master lease and mortgage loan with Guardian. See Note 4 – Contractual Receivables and Other Receivables and Lease Inducements.

NOTE 56 – OTHER INVESTMENTS

Our other investments consist of fixed and variable rate loans to our operators and/or their principals to fund working capital and capital expenditures. These loans may be either unsecured or secured by the collateral of the borrower. A number of the secured loans are collateralized by a leasehold mortgage on, or an assignment or pledge of the membership interest in, the related properties, corporate guarantees and/or personal guarantees. We deem these to be “real estate related loans” that are included as qualifying assets under our quarterly REIT asset tests. As of March 31, 2022, we had 37 loans with 18 different operators. A summary of our other investments is as follows:

    

June 30, 

December 31, 

    

March 31, 

December 31, 

    

2021

    

2020

    

2022

    

2021

(in thousands)

(in thousands)

Other investment notes due 2024; interest at 13.13% (1)

$

87,145

  

$

83,636

Other investment notes due 2024; interest at 13.15% (1)

$

92,613

  

$

90,752

Other investment notes due 2030; interest at 7.00%

 

212,633

  

201,613

Other investment note due 2023; interest at 12.00%

 

37,797

40,232

Other investment notes outstanding (2)

 

19,599

  

22,076

Real estate related loans - other investments, gross

362,642

354,673

Other investment notes due 2024-2025; interest at 8.12% (1)

56,987

  

56,987

55,791

  

55,791

Other investment note due 2023; interest at 12.00%

 

42,603

49,973

Other investment notes due 2030; interest at 7.00%

 

174,988

  

147,148

Other investment notes outstanding (2)

 

132,401

  

161,155

Other investment notes outstanding (3)

 

164,491

  

128,814

Non-real estate related loans - other investments, gross

220,282

184,605

Total other investments, gross

494,124

498,899

582,924

539,278

Allowance for credit losses on other investments

(35,460)

(31,457)

(75,982)

(69,394)

Total other investments — net

$

458,664

$

467,442

Total other investments - net

$

506,942

$

469,884

(1)ApproximateApproximates the weighted average interest rate as of June 30, 2021.March 31, 2022.
(2)Other investment notes that are real estate related loans have a weighted average interest rate of 8.37%11.20% as of June 30, 2021 andMarch 31, 2022 with maturity dates ranging from 20212022 through 2028.2023 (with $10.4 million maturing in 2022).
(3)Other investment notes that are non-real estate related loans have a weighted average interest rate of 8.08% as of March 31, 2022 with maturity dates ranging from 2022 through 2032 (with $70.5 million maturing in 2022).

OtherInterest revenue on other investment notes due 2024

On March 6, 2018, we amended certain termsloans is included within other investment income on the Consolidated Statement of Operations. A summary of our $48.0 million secured term loan with Genesis Healthcare, Inc. (“Genesis”). The $48.0 million term loan bears interest at a fixed rate of 14% per annum, of which 9% per annumother investments income by real estate and non-real estate loans, as defined above, is paid-in-kind and was initially scheduled to mature on July 29, 2020. The maturity date of this loan was extended during the first quarter of 2021 to January 1, 2024. This term loan (and the $16.0 million term loan discussed below) is secured by a first priority lien on and security interest in certain collateral of Genesis. As of June 30, 2021, approximately $68.2 million is outstanding on this term loan.    as follows:

Also on March 6, 2018, we provided Genesis an additional $16.0 million secured term loan bearing interest at a fixed rate of 10% per annum, of which 5% per annum is paid-in-kind, and was initially scheduled to mature on July 29, 2020. The maturity date of this loan was extended during the first quarter of 2021 to January 1, 2024. As of June 30, 2021, approximately $18.9 million is outstanding on this term loan.

Three Months Ended March 31,

2022

    

2021

(in thousands)

Real estate related loans - interest income

$

8,379

  

$

7,706

Non-real estate related loans - interest income

 

2,215

  

3,946

Total other investment income

$

10,594

$

11,652

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Other investment notes due 2024-2025

As discussed in Note 4 – Contractual Receivables and Other Receivables and Lease Inducements, Agemo continued to not pay contractual rent and interest to us during the first quarter of 2022. We have continued to monitor the fair value of the collateral associated with Agemo’s $25.0 million secured working capital loan (the “Agemo WC Loan”) on a quarterly basis. In the first quarter of 2022, we recorded an additional provision for credit losses of $4.7 million related to the Agemo WC Loan as a result of a reduction in the fair value of the underlying collateral assets supporting the current carrying values. The reduction in fair value of the collateral assets was driven by a reduction in Agemo’s working capital accessible to Omega as collateral, after considering other liens on the assets.

Other investment notes outstanding

Term Loan $25 million

On March 25, 2022, we entered into a $25.0 million term loan with LaVie Care Centers, LLC (“LaVie,” f/k/a Consulate Health Care) that bears interest at a fixed rate of 8.5% per annum and matures on March 31, 2032. The term loan requires quarterly principal payments of $1.3 million commencing January 1, 2028 and is secured by a second priority lien on the accounts receivable of the operator. As of March 31, 2022, the outstanding principal under this term loan was $25.0 million.

NOTE 67 – ALLOWANCE FOR CREDIT LOSSES

TheA rollforward of our allowance for credit losses on loansfor the three months ended March 31, 2022 is measured using relevant information about past events, including historical credit loss experience, current conditions, and reasonable and supportable forecasts that affect the collectibility of the remaining cash flows over the contractual term of the loans. We elected to disaggregate our financial assets within the scope of Accounting Standards Codification 326 based on the type of financial instrument. These segments were further disaggregated based on our internal credit ratings. We assess our internal credit ratings on a quarterly basis. Our internal credit ratings consider several factors including the collateral and/or security, the performance of borrowers underlying facilities, if applicable, available credit support (e.g., guarantees), borrowings with third parties, and other ancillary business ventures and real estate operations of the borrower. Our internal ratings range between 1 and 7. An internal rating of 1 reflects the lowest likelihood of loss and a 7 reflects the highest likelihood of loss.  as follows:

We have a limited history of incurred losses and consequently have elected to employ external data to perform our expected credit loss calculation. We have elected a probability of default (“PD”) and loss given default (“LGD”) methodology. Our model’s historic inputs consider PD and LGD data for residential care facilities published by the Federal Housing Administration along with Standards & Poor’s one-year global corporate default rates. Our historical loss rates revert to historical averages after 36 periods. Our model’s current conditions and supportable forecasts consider internal credit ratings, current and projected U.S. unemployment rates published by the U.S. Bureau of Labor Statistics and the Federal Reserve Bank of St. Louis and the weighted average life to maturity of the underlying financial asset. As of June 30, 2021, $10.2 million of contractual interest receivable is recorded in contractual receivables – net and $11.6 million of effective yield interest receivables is recorded in other receivables and lease inducements on our Consolidated Balance Sheets, both of which are excluded from our allowance for credit losses.

Periodically, the Company may identify an individual loan for impairment. A loan is considered impaired when, based on current information and events, it is probable that we will be unable to collect all amounts due as scheduled according to the contractual terms of the loan agreements. Our assessment of collectibility considers several factors, including, among other things, payment history, the financial strength of the borrower and any guarantors, historical operations and operating trends, current and future economic conditions, expectations of performance (which includes known substantial doubt about an operator’s ability to continue as a going concern) and the value of the underlying collateral of the agreement, if any. Consistent with this definition, all loans on non-accrual status may be deemed impaired. To the extent circumstances improve and the risk of collectibility is diminished, we will return these loans to full accrual status. When we identify a loan impairment, the loan is written down to the present value of the expected future cash flows. In cases where expected future cash flows are not readily determinable, the loan is written down to the fair value of the underlying collateral. We may base our valuation on a loan’s observable market price, if any, or the fair value of collateral, net of sales costs, if the repayment of the loan is expected to be provided solely by the sale of the collateral.

Rating

Financial Statement Line Item

Allowance for Credit Loss as of December 31, 2021

Provision (recovery) for Credit Loss for the three months ended March 31, 2022

Write-offs charged against allowance for the three months ended March 31, 2022

Allowance for Credit Loss as of March 31, 2022

(in thousands)

2

Mortgage Notes Receivable

$

15

$

47

$

$

62

3

Mortgage Notes Receivable

1,973

126

2,099

4

Mortgage Notes Receivable

19,461

610

20,071

5

Mortgage Notes Receivable

135

(23)

112

6

Mortgage Notes Receivable

52,017

(5,135)

(1)

46,882

Sub-total

73,601

(4,375)

69,226

3

Investment in Direct Financing Leases

530

5

535

Sub-total

530

5

535

2

Other Investments

29

53

82

3

Other Investments

4,600

1,063

5,663

4

Other Investments

1,172

1,499

2,671

5

Other Investments

7,861

4,704

(2)

12,565

6

Other Investments

55,732

(731)

(3)

55,001

Sub-total

69,394

6,588

75,982

2

Off-Balance Sheet Note Commitments

7

3

10

3

Off-Balance Sheet Note Commitments

458

(132)

326

4

Off-Balance Sheet Note Commitments

216

(78)

138

4

Off-Balance Sheet Mortgage Commitments

117

(106)

11

6

Off-Balance Sheet Note Commitments

143

(81)

62

Sub-total

941

(394)

547

Total

$

144,466

$

1,824

$

$

146,290

(1)This amount relates to a recovery recorded on the Guardian mortgage loan during the first quarter of 2022. See Note 5 – Mortgage Notes Receivable for additional information on the recovery recorded.
(2)This provision includes an additional $4.7 million allowance recorded on the Agemo WC Loan during the first quarter of 2022. See Note 6 – Other Investments for additional information on the Agemo WC Loan impairment.
(3)During the three months ended March 31, 2022, we received $0.7 million of interest and fee payments from Gulf Coast under the $25.0 million senior secured DIP facility, the outstanding principal of which was fully reserved against in the fourth quarter of 2021. The DIP loan is on non-accrual status, and the payments received in the first quarter of 2022 have been applied against the outstanding principal using the cost recovery method. In the first quarter of 2022, we recorded a recovery for credit loss equal to the amount of payments applied against the principal.

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A rollforward of our allowance for credit losses for the six months ended June 30, 2021 is as follows:

Segment

Financial Statement Line Item

Allowance for Credit Loss as of December 31, 2020

Provision (recovery) for Credit Loss for the three months ended June 30, 2021

Write-offs charged against allowance for the three months ended June 30, 2021

Provision (recovery) for Credit Loss for the six months ended June 30, 2021

Write-offs charged against allowance for the six months ended June 30, 2021

Allowance for Credit Loss as of June 30, 2021

(in thousands)

Segment A-4

Mortgage Notes Receivable

$

26,865

$

793

$

-

$

(120)

$

-

$

26,745

Segment B-3

Mortgage Notes Receivable

954

61

-

23

-

977

Segment C-5

Mortgage Notes Receivable

433

(108)

-

(215)

-

218

Segment E-6

Mortgage Notes Receivable

4,905

-

-

-

-

4,905

Segment F-2

Mortgage Notes Receivable

88

(8)

-

(53)

-

35

Sub-total

33,245

738

-

(365)

-

32,880

Segment A-3

Investment in Direct Financing Leases

694

(62)

-

(68)

-

626

Sub-total

694

(62)

-

(68)

-

626

Segment A-4

Other Investments

24,397

4,076

(1)

-

4,489

(1)

-

28,886

Segment B-3

Other Investments

5,113

(483)

-

(266)

-

4,847

Segment C-2

Other Investments

94

(18)

-

(58)

-

36

Segment D-5

Other Investments

1,853

(57)

-

(67)

(95)

1,691

Sub-total

31,457

3,518

-

4,098

(95)

35,460

Segment A-4

Off-Balance Sheet Mortgage Commitments

24

(31)

-

7

-

31

Segment B-3

Off-Balance Sheet Note Commitments

2,305

(585)

-

(1,123)

-

1,182

Segment C-2

Off-Balance Sheet Note Commitments

116

(42)

-

(37)

-

79

Sub-total

2,445

(658)

-

(1,153)

-

1,292

Total

$

67,841

$

3,536

$

-

$

2,512

$

(95)

$

70,258

(1)This provision primarily relates to a $4.5 million reserve recorded on a term loan during the second quarter of 2021.

A rollforward of our allowance for credit losses for the six months ended June 30, 2020 is as follows:

Segment

Financial Statement Line Item

Allowance for Credit Loss at December 31, 2019

Allowance for Credit Loss on January 1, 2020

Provision (recovery) for Credit Loss for the three months ended June 30, 2020

Write-offs charged against allowance for the three months ended June 30, 2020

Provision (recovery) for Credit Loss for the six months ended June 30, 2020

Write-offs charged against allowance for the six months ended June 30, 2020

Allowance for Credit Loss as of June 30, 2020

(in thousands)

Segment A-4

Mortgage Notes Receivable

$

-

$

19,293

$

2,704

$

-

$

3,774

-

$

23,067

Segment B-3

Mortgage Notes Receivable

-

901

(106)

-

(74)

-

827

Segment C-5

Mortgage Notes Receivable

-

829

(396)

-

(409)

-

420

Segment E-6

Mortgage Notes Receivable

4,905

363

(93)

-

(27)

-

5,241

Segment F-2

Mortgage Notes Receivable

-

-

133

-

133

-

133

Sub-total

4,905

21,386

2,242

-

3,397

-

29,688

Segment A-3

Investment in Direct Financing Leases

217

611

(26)

(217)

(5)

(217)

606

Sub-total

217

611

(26)

(217)

(5)

(217)

606

Segment A-4

Other Investments

-

3,158

(983)

-

(826)

-

2,332

Segment B-3

Other Investments

-

1,434

(441)

-

(412)

-

1,022

Segment C-2

Other Investments

-

195

(61)

-

(71)

-

124

Segment D-5

Other Investments

-

1,901

(705)

-

(545)

-

1,356

Sub-total

-

6,688

(2,190)

-

(1,854)

-

4,834

Segment A-4

Off-Balance Sheet Commitments

-

100

(11)

-

(37)

-

63

Sub-total

-

100

(11)

-

(37)

-

63

Total

$

5,122

$

28,785

$

15

$

(217)

$

1,501

$

(217)

$

35,191

15

Table of Contents

A rollforward of our allowance for credit losses for the three months ended March 31, 2021 is as follows:

Rating

Financial Statement Line Item

Allowance for Credit Loss at December 31, 2020

Provision (recovery) for Credit Loss for the three months ended March 31, 2021

Write-offs charged against allowance for the three months ended March 31, 2021

Allowance for Credit Loss as of March 31, 2021

(in thousands)

2

Mortgage Notes Receivable

$

88

$

(45)

$

$

43

3

Mortgage Notes Receivable

954

(38)

916

4

Mortgage Notes Receivable

26,865

(913)

25,952

5

Mortgage Notes Receivable

433

(107)

326

6

Mortgage Notes Receivable

4,905

4,905

Sub-total

33,245

(1,103)

32,142

3

Investment in Direct Financing Leases

694

(6)

688

Sub-total

694

(6)

688

2

Other Investments

94

(40)

54

3

Other Investments

5,113

217

5,330

4

Other Investments

24,397

413

24,810

5

Other Investments

1,853

(10)

(95)

1,748

Sub-total

31,457

580

(95)

31,942

2

Off-Balance Sheet Note Commitments

116

5

121

3

Off-Balance Sheet Note Commitments

2,305

(538)

1,767

4

Off-Balance Sheet Mortgage Commitments

24

38

62

Sub-total

2,445

(495)

1,950

Total

$

67,841

$

(1,024)

$

(95)

$

66,722

A summary of our amortized cost basis by year of origination and credit quality indicator is as follows:

Rating

Financial Statement Line Item

2021

2020

2019

2018

2017

2016

2015 & older

Revolving Loans

Balance as of June 30, 2021

Financial Statement Line Item

2022

2021

2020

2019

2018

2017

2016 & older

Revolving Loans

Balance as of March 31, 2022

(in thousands)

(in thousands)

1

Mortgage Notes Receivable

$

-

$

-

$

-

$

-

$

-

$

-

$

66,251

$

-

$

66,251

Mortgage notes receivable

$

$

$

$

$

$

$

65,054

$

$

65,054

2

Mortgage Notes Receivable

-

21,325

-

-

-

-

-

-

21,325

Mortgage notes receivable

21,325

21,325

3

Mortgage Notes Receivable

6,420

-

-

-

-

-

35,964

-

42,384

Mortgage notes receivable

72,420

72,420

4

Mortgage Notes Receivable

4,307

89,373

18,883

44,374

46,431

38,830

504,110

-

746,308

Mortgage notes receivable

19,204

89,397

5,084

44,274

46,349

430,373

634,681

5

Mortgage Notes Receivable

-

-

-

-

-

-

7,397

-

7,397

Mortgage notes receivable

6,929

6,929

6

Mortgage Notes Receivable

-

-

-

-

-

-

6,377

-

6,377

Mortgage notes receivable

88,394

88,394

Sub-total

10,727

110,698

18,883

44,374

46,431

38,830

620,099

-

890,042

Sub-total

91,624

110,722

5,084

44,274

46,349

590,750

888,803

3

Investment in Direct Financing Leases

-

-

-

-

-

-

11,433

-

11,433

Investment in direct financing leases

11,384

11,384

Sub-total

-

-

-

-

-

-

11,433

-

11,433

Sub-total

11,384

11,384

2

Other Investments

-

-

-

-

-

-

2,082

10,820

12,902

Other investments

32,800

32,800

3

Other Investments

6,000

-

20,805

28,602

-

-

3,493

184,588

243,488

Other investments

17,341

26,224

2,482

249,893

295,940

4

Other Investments

-

-

11,560

116,608

-

75,590

-

5,000

208,758

Other investments

25,000

4,749

8,525

92,613

38,797

169,684

5

Other Investments

-

-

23,351

5,625

-

-

-

-

28,976

Other investments

29,498

29,498

6

Other investments

19,296

4,463

31,243

55,002

Sub-total

6,000

-

55,716

150,835

-

75,590

5,575

200,408

494,124

Sub-total

25,000

24,045

25,866

152,798

72,522

282,693

582,924

Total

$

16,727

$

110,698

$

74,599

$

195,209

$

46,431

$

114,420

$

637,107

$

200,408

$

1,395,599

$

25,000

$

115,669

$

110,722

$

30,950

$

197,072

$

46,349

$

674,656

$

282,693

$

1,483,111

Interest Receivable on Mortgage and Other Investment Loans

We have elected the practical expedient to exclude interest receivable from our allowance for credit losses. As of March 31, 2022, $11.3 million of contractual interest receivable is recorded in contractual receivables – net, and $9.1 million of effective yield interest receivables is recorded in other receivables and lease inducements on our Consolidated Balance Sheets, both of which are excluded from our allowance for credit losses. We write-off interest receivable to provision for credit losses in the period we determine the interest is no longer considered collectible.

15

Table of Contents

During the first quarter of 2022, we did 0t recognize any interest income related to loans on non-accrual status as of March 31, 2022.

NOTE 78 – VARIABLE INTEREST ENTITIES

As of June 30, 2021 and December 31, 2020, Agemo Holdings, LLC (“Agemo”) and Maplewood Real Estate Holdings, LLC (“Maplewood”) are bothUnconsolidated Variable Interest Entities

We hold variable interests in several variable interest entities (“VIEs”). As of June 30, 2021, we have through our investing and financing activities, which are not consolidated, any VIEs, as we have concluded that we are not the primary beneficiary. This conclusion is based on the fact thatbeneficiary of these entities as we do not have the power to direct the activities of any VIEs that most significantly impact theirthe VIE’s economic performance andand/or the variable interest we dohold does not have the obligationobligate us to absorb losses or provide us with the right to receive benefits offrom the VIEs thatVIE which could potentially be significant to the entities. significant.

Below is a summary of our assets, liabilities and collateral associated with these operatorsunconsolidated VIEs as of June 30, 2021March 31, 2022 and December 31, 2020:2021:

June 30, 2021

December 31, 2020

Agemo

Maplewood

Agemo

Maplewood

(in thousands)

(in thousands)

Assets

Real estate investments – net

$

338,291

750,953

$

371,010

$

750,488

Assets held for sale

14,710

Other investments

 

34,253

174,988

34,253

 

147,148

Contractual receivables

 

475

1,021

346

 

887

Straight-line rent receivables

 

(49,119)

 

(56,664)

Lease inducement

66,987

69,666

Total Assets

 

387,729

 

944,830

405,609

911,525

Liabilities

Net in-place lease liability

(318)

(331)

Security deposit

(343)

(4,609)

Contingent liability

(43,915)

(43,915)

Total Liabilities

 

(343)

 

(48,842)

(44,246)

Collateral

 

  

 

  

  

  

Letters of credit

 

(9,253)

(9,253)

 

Personal guarantee

 

(8,000)

(40,000)

(8,000)

 

(40,000)

Other collateral

 

(353,001)

(750,953)

(371,010)

 

(750,488)

Total Collateral

 

(370,254)

 

(790,953)

(388,263)

(790,488)

Maximum exposure to loss

$

17,132

$

105,035

$

17,346

$

76,791

March 31, 

December 31, 

2022

2021

(in thousands)

Assets

Real estate assets – net

$

1,136,095

$

1,144,851

Assets held for sale

191,016

Other investments – net

 

236,334

230,768

Contractual receivables – net

 

1,310

1,227

Straight-line rent receivables

 

(37,888)

(41,512)

Lease inducement

62,967

64,307

Other assets

732

Total assets

 

1,399,550

 

1,590,657

Liabilities

Net in-place lease liability

(299)

(305)

Security deposit

(4,743)

(4,715)

Contingent liability

(43,915)

(43,915)

Other liabilities

(732)

Total liabilities

 

(49,689)

 

(48,935)

Collateral

 

  

 

  

Letters of credit

 

Personal guarantee

 

(48,000)

(48,000)

Other collateral(1)

 

(1,136,095)

(1,335,867)

Total collateral

 

(1,184,095)

(1,383,867)

Maximum exposure to loss

$

165,766

$

157,855

16

(1)Amount excludes accounts receivable that Omega has a security interest in as collateral under the two working capital loans with operators that are unconsolidated VIEs. The fair value of the accounts receivable available to Omega was $23.7 million and $29.2 million as of March 31, 2022 and December 31, 2021, respectively.

In determining our maximum exposure to loss from the VIE,unconsolidated VIEs, we considered the underlying carrying value of the real estate subject to leases with the operator and other collateral, if any, supporting our other investments, which may include accounts receivable, security deposits, letters of credit or personal guarantees, if any, as well as other liabilities recognized with respect to these operators.

In May 2018, we reached an out-of-court restructuring agreement with Agemo that, among other terms, provided for the deferral of rent up to $6.3 million per annum through April 2021. During the second quarter of 2021, the Agemo lease was amended to allow for the deferral of four additional months of rent, representing $2.1 million, through August 2021. As a result of concerns of our ability to collect all future rent payments, the Company had begun recognizing rental income related to Agemo on a cash basis in September 2020 and had written off all remaining contractual rent receivables, straight-line rent receivables, and lease inducements. Our conclusion on collectibility was based on information the Company received from Agemo regarding substantial doubt as to their ability to continue as a going concern.

The table below reflects our total revenues from Agemo and Maplewood for the three and six months ended June 30, 2021 and 2020:

��

Three Months Ended June 30,

Six Months Ended June 30,

2021

2021

2020

2020

2021

2021

2020

2020

Agemo

Maplewood

Agemo

Maplewood

Agemo

Maplewood

Agemo

Maplewood

(in thousands)

(in thousands)

Revenue

 

  

 

  

 

  

 

  

 

  

 

  

 

  

 

  

Rental income

$

12,282

$

19,093

$

14,814

$

10,041

$

23,774

$

38,125

$

30,101

$

20,182

Other investment income

 

1,178

 

3,052

 

1,297

 

1,202

 

2,335

 

5,840

 

2,538

 

2,404

Total (1)

$

13,460

$

22,145

$

16,111

$

11,243

$

26,109

$

43,965

$

32,639

$

22,586

(1)For the three months ended June 30, 2021 and 2020, we received cash from Agemo of approximately $14.0 million and $13.1 million, respectively, pursuant to our lease and other investment agreements. For the six months ended June 30, 2021 and 2020, we received cash from Agemo of approximately $28.0 million and $26.8 million, respectively, pursuant to our lease and other investment agreements. For the three months ended June 30, 2021 and 2020, we received cash from Maplewood of approximately $19.7 million and $17.2 million, respectively, pursuant to our lease and other investment agreements. For the six months ended June 30, 2021 and 2020, we received cash from Maplewood of approximately $39.0 million and $33.9 million, respectively, pursuant to our lease and other investment agreements.

1716

The table below reflects our total revenues from the operators that are considered unconsolidated VIEs for the three months ended March 31, 2022 and 2021:

Three Months Ended March 31,

2022

2021

(in thousands)

Revenue

 

  

  

Rental income

$

20,863

$

30,524

Other investment income

 

3,766

 

3,945

Total

$

24,629

$

34,469

Consolidated VIEs

During the first quarter of 2022, we entered into a joint venture, which owns 2 ALFs, for a $3.2 million cash contribution, representing 52.4% of the outstanding equity of the joint venture. Concurrent with entering the joint venture, we sold 1 of the ALFs to the joint venture for $7.7 million in net proceeds. The joint venture is a VIE and we have concluded that we are the primary beneficiary of this VIE based on a combination of the ability to direct the activities that most significantly impact the joint venture’s economic performance and the rights to receive residual returns or the obligation to absorb losses arising from the joint venture. Accordingly, this joint venture has been consolidated. Omega is not required to make any additional capital contributions to the joint venture, and it is expected to be funded from the ongoing operations of the underlying properties. As of March 31, 2022, this joint venture has $25.6 million of total assets and $19.6 million of total liabilities, which are included in our Consolidated Balance Sheets. As a result of consolidating the joint venture, in the first quarter of 2022, we recorded a $2.9 million noncontrolling interest to reflect the contributions of the minority interest holder of the joint venture. No gain or loss was recognized on the initial consolidation of the VIE or upon the sale of the ALF to the joint venture.

NOTE 89 – INVESTMENTS IN JOINT VENTURES

Unconsolidated Joint Ventures

Omega owns an interest in a number of joint ventures that are accounted for under the equity method. These entities and their subsidiaries are not consolidated by the Company because it does not control, through voting rights or other means, the joint venture. The following is a summary of our investments in unconsolidated joint ventures (dollars in thousands):

Carrying Amount

Carrying Amount

Ownership

Initial Investment

Facility

Facilities at

June 30, 

December 31, 

Ownership

Initial Investment

Facility

Facilities at

March 31, 

December 31, 

Entity

%

Date

Investment(1)

Type

6/30/2021

2021

    

2020

%

Date

Investment(1)

Type

3/31/2022

2022

    

2021

Second Spring Healthcare Investments(2)

15%

11/1/2016

$

50,032

SNF

$

10,916

  

$

17,700

15%

11/1/2016

$

50,032

SNF

$

11,565

  

$

11,355

Second Spring II LLC(3)

15%

3/10/2021

10,330

SNF

1

2,279

  

15%

3/10/2021

10,330

SNF

5

  

8

Lakeway Realty, L.L.C.

51%

5/17/2019

73,834

Specialty facility

1

71,831

72,318

51%

5/17/2019

73,834

Specialty facility

1

71,014

71,286

Cindat Joint Venture

49%

12/18/2019

105,688

ALF

66

112,656

110,360

49%

12/18/2019

105,688

ALF

65

109,381

111,792

OMG Senior Housing, LLC

50%

12/6/2019

Specialty facility

1

 

  

50%

12/6/2019

Specialty facility

1

 

  

OH CHS SNP, Inc.

9%

12/20/2019

900

N/A

N/A

230

260

9%

12/20/2019

900

N/A

N/A

273

246

$

240,784

$

197,912

$

200,638

$

240,784

$

192,238

$

194,687

(1)Our initial investment includes our transaction costs, if any.
(2)During the first quarter of 2021, this joint venture sold 16 SNFs to an unrelated third party for approximately $328 million in net proceeds and recognized a gain on sale of approximately $102.2 million ($14.9 million of which represents the Company’s share of the gain). During the first quarter of 2021, this joint venture also sold 5 SNFs to Second Spring II LLC for approximately $70.8 million in net proceeds.
(3)We acquired a 15% interest in Second Spring II LLC for approximately $10.3 million. During the first quarter of 2021, this joint venture acquired 5 SNFs from Second Spring Healthcare Investments for approximately $70.8 million. During the second quarter of 2021, this joint venture sold 4 SNFs to an unrelated third party for approximately $50 million in net proceeds and recognized a loss on sale of approximately $0.3 million ($0.1 million of which represents the Company’s share of the loss).

17

The following table reflects our income (loss) from unconsolidated joint ventures for the three and six months ended June 30, 2021March 31, 2022 and 2020:2021:

Three Months Ended June 30,

Six Months Ended June 30,

Three Months Ended March 31,

Entity

2021

    

2020

2021

    

2020

2022

    

2021

���

(in thousands)

(in thousands)

Second Spring Healthcare Investments(1)

$

293

$

712

$

11,704

$

1,281

$

285

$

11,411

Second Spring II LLC

(299)

(756)

(2)

(457)

Lakeway Realty, L.L.C.

641

  

613

1,286

  

1,223

661

  

645

Cindat Joint Venture

 

646

  

244

 

1,132

  

891

 

735

  

486

OMG Senior Housing, LLC

 

(103)

  

(118)

 

(204)

  

(279)

 

(83)

  

(101)

OH CHS SNP, Inc.

 

9

  

(49)

 

(145)

  

(154)

 

27

  

(154)

Total

$

1,187

$

1,402

$

13,017

$

2,962

$

1,623

$

11,830

(1)The income from this unconsolidated joint venture for the sixthree months ended June 30,March 31, 2021 includes a $14.9 million gain on sale of real estate investments.

Asset Management Fees

We receive asset management fees from certain joint ventures for services provided. For each of the three months ended June 30,March 31, 2022 and 2021, and 2020, we recognized approximately $0.3$0.2 million and $0.5 million, respectively, of asset management fees. For each of the six months ended June 30, 2021 and 2020, we recognized approximately $0.5 million and $0.7 million, respectively, of asset management fees. These fees are included in miscellaneous income in the accompanying Consolidated Statements of Operations.

18

NOTE 9 – ASSETS HELD FOR SALE

The following is a summary of our assets held for sale:

Facilities Held For Sale

Number of Facilities

(in thousands)

December 31, 2020

22

$

81,452

Facilities sold/other(1)

(21)

(81,252)

Facilities added(2)

5

7,722

March 31, 2021

6

$

7,922

Facilities sold/other(1)

(5)

(1,795)

Facilities added(2)(3)

8

29,208

June 30, 2021(3)

9

$

35,335

(1)In the first quarter of 2021, we sold 21 facilities for approximately $187.6 million in net cash proceeds recognizing a net gain on sale of approximately $100.3 million. In the second quarter of 2021, we sold 4 facilities for approximately $3.5 million in net cash proceeds recognizing a net gain on sale of approximately $1.9 million. NaN facility classified as held for sale at March 31, 2021 was no longer considered held for sale during the second quarter of 2021 and was reclassified to leased property at approximately $0.2 million which represents the facility’s carrying value.
(2)In the first quarter of 2021, we recorded approximately $16.9 million of impairment expense to reduce 3 facilities’ book value to their estimated fair value less costs to sell before they were reclassified to assets held for sale. In the second quarter of 2021, we recorded approximately $8.8 million of impairment expense to reduce 3 facilities’ book value to their estimated fair value less costs to sell before they were reclassified to assets held for sale.
(3)Number of facilities excludes one parcel of land.    

NOTE 10 – GOODWILL AND OTHER INTANGIBLES

The following is a summary of our goodwill as of June 30,March 31, 2022 and December 31, 2021:

    

(in thousands)

Balance as of December 31, 2020

$

651,737

Add: foreign currency translation

 

(40)

Balance as of June 30, 2021

$

651,697

    

(in thousands)

Balance as of December 31, 2021

$

651,417

Foreign currency translation

 

(393)

Balance as of March 31, 2022

$

651,024

The following is a summary of our intangibles as of June 30, 2021March 31, 2022 and December 31, 2020:2021:

    

June 30, 

December 31,

    

March 31, 

December 31,

    

2021

    

2020

    

2022

    

2021

(in thousands)

(in thousands)

Assets:

 

  

  

 

  

  

Above market leases

$

22,410

$

22,822

$

5,929

$

5,929

Accumulated amortization

 

(20,638)

  

 

(20,882)

 

(4,365)

  

 

(4,313)

Net above market leases

$

1,772

$

1,940

$

1,564

$

1,616

Liabilities:

 

  

 

 

  

 

Below market leases

$

139,069

$

139,515

$

71,072

$

66,324

Accumulated amortization

 

(108,508)

  

 

(100,996)

 

(45,060)

  

 

(38,091)

Net below market leases

$

30,561

$

38,519

$

26,012

$

28,233

Above market leases, net of accumulated amortization, are included in other assets on our Consolidated Balance Sheets. Below market leases, net of accumulated amortization, are included in accrued expenses and other liabilities on our Consolidated Balance Sheets. The net amortization related to the above and below market leases is included in our Consolidated Statements of Operations as an adjustment to rental income.  

1918

For the three months ended June 30,March 31, 2022 and 2021, and 2020, our net amortization related to intangibles was $1.1$1.6 million and $3.5 million, respectively. For the six months ended June 30, 2021 and 2020, our net amortization related to intangibles was $7.3 million and $4.8$6.2 million, respectively. The estimated net amortization related to these intangibles for the remainder of 20212022 and the subsequent four years is as follows: remainder of 2021 – $2.2 million; 2022 – $4.2$3.0 million; 2023 – $4.0$3.9 million; 2024 – $3.8 million; 2025 – $3.5 million and 20252026 – $3.6$2.8 million. As of June 30, 2021,March 31, 2022, the weighted average remaining amortization period of above market lease assets is approximately ten years and below market lease liabilities is approximately eightseven years.

NOTE 11 – CONCENTRATION OF RISK

As of June 30, 2021,March 31, 2022, our portfolio of real estate investments (including properties associated with mortgages, direct financing leases, and assets held for sale)sale and consolidated joint ventures) consisted of 970962 healthcare facilities, located in 42 states and the U.K. and operated by 65 third-party operators. Our investment in these facilities, net of impairments and allowances, totaled approximately $10.1$9.9 billion at June 30, 2021,March 31, 2022, with approximately 97% of our real estate investments related to long-term healthcare facilities. Our portfolio is made up of (i) 729675 SNFs, 132163 ALFs, 3520 ILFs, 16 specialty facilities and 2 medical office buildings, (ii) fixed rate mortgages on 5856 SNFs, 32 ALFs and 2 specialty facilities, and (iii) 926 facilities that are held for sale. At June 30, 2021,March 31, 2022, we also held other investments of approximately $458.7$506.9 million, consisting primarily of secured loans to third-party operators of our facilities and $197.9$192.2 million of investments in 6 unconsolidated joint ventures.

At June 30, 2021March 31, 2022 we had investments with 1 operator/2 operators or managermanagers that approximated or exceeded 10% of our total investments: Consulate Health Care (“Consulate”Maplewood Senior Living (along with affiliates, “Maplewood”). Consulate also and LaVie. Maplewood generated approximately 10%9.0% and 7.5% of our total revenues for the three and six months ended June 30,March 31, 2022 and 2021, respectively. LaVie generated approximately 11.3% and 2020,9.1% of our total revenues for the three months ended March 31, 2022 and 2021, respectively.

At June 30, 2021,March 31, 2022, the three states in which we had our highest concentration of investments were Florida (15%(13%), Texas (10%) and Michigan (6%(7%).

NOTE 12 – STOCKHOLDERS’ EQUITY

Dividends$500 Million Stock Repurchase Program

The BoardOn January 27, 2022, the Company authorized the repurchase of Directors has declared cash dividends on common stock as set forth below:

Record

Payment

Dividend per

Date

    

Date

    

Common Share

February 8, 2021

February 16, 2021

$

0.67

May 3, 2021

May 17, 2021

0.67

August 2, 2021

August 13, 2021

0.67

Dividend Reinvestment and Common Stock Purchase Plan

The table below presents information regarding the shares issued under the Dividend Reinvestment and Common Stock Purchase Plan for the three and six months ended June 30, 2020 and 2021:

Shares issued

Gross Proceeds

Period Ended

(in millions)

(in millions)

Three Months Ended

June 30, 2020

-

$

-

Three Months Ended

June 30, 2021

1.6

61.8

Six Months Ended

June 30, 2020

0.1

3.7

Six Months Ended

June 30, 2021

2.0

77.3

20

At-The-Market Offering Programs

During the third quarter of 2015, Omega entered into Equity Distribution Agreements with several financial institutionsup to sell $500.0$500 million of shares ofour outstanding common stock from time to time through an “at-the-market” (“ATM”) offering program (the “2015 ATM Program”).

March 2025. The Company is authorized to repurchase shares of its common stock in open market and privately negotiated transactions, pursuant to Rule 10b5-1 trading plans or in any other manner as determined by the Company’s management and in accordance with applicable law. The timing and amount of stock repurchases will be determined, in management’s discretion, based on a variety of factors, including but not limited to market conditions, other capital management needs and opportunities and corporate and regulatory considerations. The Company has no obligation to repurchase any amount of its common stock, and such repurchases, if any, may be discontinued at any time. During the secondfirst quarter of 2021, we terminated2022, the 2015 ATM Program and entered into a new ATM Equity Offering Sales Agreement pursuant to which shares of common stock having an aggregate gross sales price of up to $1.0 billion (the “2021 ATM Program”) may be sold from time to time (i) by Omega through several financial institutions acting as a sales agent or directly to the financial institutions as principals, or (ii) by several financial institutions acting as forward sellers on behalf of any forward purchasers pursuant to a forward sale agreement. Under the 2021 ATM Program, compensation for sales of the shares will not exceed 2% of the gross sales price per share for shares sold through each financial institution. The use of forward sales under the 2021 ATM Program generally allows Omega to lock in a price on the sale of shares of common stock when sold by the forward sellers but defer receiving the net proceeds from such sales until theCompany repurchased 980,530 shares of our outstanding common stock are issued at settlementan average price of $27.84 per share. Under Maryland law, shares repurchased become authorized but unissued shares. The Company reduced the common stock at par value and to the extent the cost acquired exceeds par value, it is recorded through additional paid-in capital on a later date. We did not utilize the forward provisions under the 2021 ATM Program during the three months ended June 30, 2021.our Consolidated Balance Sheets and Consolidated Statements of Changes in Equity.

Dividends

The table below presents information regarding the shares issued under the 2021 and 2015 ATM Programs for the three and six months ended June 30, 2020 and 2021:following is a summary of our declared cash dividends on common stock:

Shares issued

Average Net Price

Gross Proceeds

Commissions

Net Proceeds

Period Ended

(in millions)

Per Share(1)

(in millions)

Three Months Ended

June 30, 2020

-

$

-

$

-

$

-

$

-

Three Months Ended

June 30, 2021

2.5

36.23

92.4

1.9

90.5

Six Months Ended

June 30, 2020

0.1

36.18

2.0

0.2

1.8

Six Months Ended

June 30, 2021

4.1

36.60

153.8

3.2

150.6

(1)Represents the average price per share after commissions.

Record

Payment

Dividend per

Date

    

Date

    

Common Share

February 7, 2022

February 15, 2022

$

0.67

May 2, 2022

May 13, 2022

0.67

2119

Dividend Reinvestment and Common Stock Purchase Plan

The following is a summary of the shares issued under the Dividend Reinvestment and Common Stock Purchase Plan for the three months ended March 31, 2022 and 2021 (in millions):

Three Months Ended

Shares issued

Gross Proceeds

March 31, 2021

0.4

$

15.5

March 31, 2022

0.1

2.3

At-The-Market Offering Programs

The following is a summary of the shares issued under our former $500 million 2015 At-The-Market Offering Program (“2015 ATM Program”) and our current $1.0 billion 2021 At-The-Market Offering Program (“2021 ATM Program”) for the three months ended March 31, 2022 and 2021 (in millions except average price per share):

Average Net Price

Three Months Ended

Shares issued

Per Share(1)

Gross Proceeds

Commissions

Net Proceeds

March 31, 2021

1.6

$

37.16

$

61.4

$

1.3

$

60.1

March 31, 2022

(1)Represents the average price per share after commissions.

We did not utilize the forward provisions under the 2021 ATM Program during the first quarter of 2022.

Accumulated Other Comprehensive Income (Loss)

The following is a summary of our accumulated other comprehensive income (loss), net of tax where applicable:

    

As of and for the 

    

As of and for the 

Three Months Ended

Six Months Ended

As of and for the 

June 30, 

June 30, 

Three Months Ended March

    

2021

    

2020

    

2021

    

2020

    

    

2022

    

2021

(in thousands)

(in thousands)

Foreign Currency Translation:

 

  

    

  

  

    

  

  

    

  

Beginning balance

$

(14,231)

$

(67,058)

$

(18,427)

$

(35,100)

$

(24,012)

$

(18,427)

Translation gain (loss)

 

601

 

(1,738)

 

4,131

 

(33,626)

Realized gain (loss)

 

22

 

1

 

688

 

(69)

Translation (loss) gain

 

(14,630)

 

3,530

Realized (loss) gain

 

(26)

 

666

Ending balance

 

(13,608)

 

(68,795)

 

(13,608)

 

(68,795)

 

(38,668)

 

(14,231)

Derivative Instruments:

 

 

 

 

 

  

 

  

Cash flow hedges:

 

 

 

 

 

  

 

  

Beginning balance

 

53,519

 

(10,213)

 

17,718

 

(2,369)

 

30,407

 

17,718

Unrealized (loss) gain

 

(20,900)

 

1,704

 

14,291

 

(5,823)

Realized gain (loss)(1)

 

733

(1,190)

 

1,343

(1,507)

Unrealized gain

 

18,612

 

35,191

Realized gain(1)

 

966

 

610

Ending balance

 

33,352

 

(9,699)

 

33,352

 

(9,699)

 

49,985

 

53,519

Net investment hedges:

 

 

 

 

 

  

 

  

Beginning balance

 

(16,341)

 

8,767

 

(13,331)

 

(4,420)

 

(9,588)

 

(13,331)

Unrealized gain (loss)

 

317

 

766

 

(2,693)

 

13,953

 

3,847

 

(3,010)

Ending balance

 

(16,024)

 

9,533

 

(16,024)

 

9,533

 

(5,741)

 

(16,341)

Total accumulated other comprehensive income (loss) before noncontrolling interest

 

3,720

 

(68,961)

 

3,720

 

(68,961)

Total accumulated other comprehensive income before noncontrolling interest

 

5,576

 

22,947

Add: portion included in noncontrolling interest

 

803

 

2,726

 

803

 

2,726

 

742

 

283

Total accumulated other comprehensive income (loss) for Omega

$

4,523

$

(66,235)

$

4,523

$

(66,235)

Total accumulated other comprehensive income for Omega

$

6,318

$

23,230

(1)Recorded in interest expense on the Consolidated Statements of Operations.

20

NOTE 13 – TAXES

Omega was organized, has operated and intends to continue to operate in a manner that enables Omega to qualify for taxation as a REIT under Sections 856 through 860 of the Code. On a quarterly and annual basis, we perform several analyses to test our compliance within the REIT taxation rules. If we fail to meet the requirements for qualification as a REIT in any tax year, we will be subject to federal income tax on our taxable income at regular corporate rates and may not be able to qualify as a REIT for the four subsequent years, unless we qualify for certain relief provisions that are available in the event we fail to satisfy any of the requirements.

We are also subject to federal taxation of 100% of the net income derived from the sale or other disposition of property, other than foreclosure property, that we held primarily for sale to customers in the ordinary course of a trade or business. We believe that we do not hold assets for sale to customers in the ordinary course of business and that none of the assets currently held for sale or that have been sold would be considered a prohibited transaction within the REIT taxation rules.

As a REIT under the Code, we generally will not be subject to federal income taxes on the REIT taxable income that we distribute to stockholders, subject to certain exceptions. In 2020, 2019, and 2018,2021, we distributed dividends in excess of our taxable income.  

We currently own stock in entities that have elected to be taxed as a REIT.certain subsidiary REITs. These subsidiary REITssubsidiaries are required to individually satisfy all of the rules for qualification as a REIT.

22

TableIf we fail to meet the requirements for qualification as a REIT for any of Contentsthese subsidiaries, it may cause Omega to fail the requirements for qualification as a REIT also.

We have elected to treat certain of our active subsidiaries as taxable REIT subsidiaries (“TRSs”). Our domestic TRSs are subject to federal, state and local income taxes at the applicable corporate rates. Our foreign TRSs are subject to foreign income taxes and may be subject to current-year income inclusion relating to ownership of a controlled foreign corporation for U.S. income tax purposes.

As of June 30, 2021,March 31, 2022, 1 of our domestic TRSs that is subject to income taxes at the applicable corporate rates had a net operating loss (“NOL”) carry-forward of approximately $6.5$10.3 million. Our domestic NOL carry-forward was fully reserved as of June 30, 2021,March 31, 2022, with a valuation allowance due to uncertainties regarding realization. Under current law, NOL carry-forwards generated up through December 31, 2017 may be carried forward for no more than 20 years, and NOL carry-forwards generated in taxable years ended after December 31, 2017, may be carried forward indefinitely. We do not anticipate that such changes will materially impact the computation of Omega’s taxable income, or the taxable income of any Omega entity, including our TRSs.

As discussed in Note 2 – Real Estate Assets, in connection with the acquisition of one U.K. entity in the first quarter of 2022, we acquired foreign net operating losses of $55.0 million resulting in a NOL deferred tax asset of $13.4 million. The NOLs have no expiration date and may be available to offset future taxable income. We believe these foreign NOLs are realizable under a “more likely than not” measurement and have not recorded a valuation allowance against the deferred tax asset.

21

The following is a summary of deferred tax assets and liabilities (which are recorded in other assets and accrued expenses and other liabilities, respectively, in our Consolidated Balance Sheets):

March 31, 

December 31, 

    

2022

    

2021

(in thousands)

Deferred tax assets:

 

  

    

  

U.S. Federal net operating loss carryforward

$

2,156

$

2,221

Foreign net operating loss carryforward

13,374

15,530

2,221

Deferred tax liability:

 

  

 

  

Foreign deferred tax liability (1)

 

(7,883)

 

(8,200)

Valuation allowance on deferred tax asset

 

(2,156)

 

(2,221)

Net deferred tax asset (liability)

$

5,491

$

(8,200)

(1)The deferred tax liability primarily resulted from inherited basis differences resulting from our acquisition of entities in the U.K. Subsequent adjustments to these accounts result from GAAP to tax differences related to depreciation, indexation and revenue recognition.

The following is a summary of our provision for income taxes:

Three Months Ended

    

Six Months Ended

Three Months Ended

    

June 30, 

 

June 30, 

    

March 31, 

2021

    

2020

     

2021

     

2020

2022

    

2021

(in millions)

(in millions)

Provision for federal, state and local income taxes

$

0.3

 

$

0.2

 

$

0.6

 

$

0.6

$

0.3

 

$

0.3

Provision for foreign income taxes

0.6

 

0.7

 

1.3

 

1.3

0.9

 

0.7

Total provision for income taxes (1)

$

0.9

$

0.9

$

1.9

$

1.9

$

1.2

$

1.0

(1)The above amounts do not include gross receipts or franchise taxes payable to certain states and municipalities.

NOTE 14 – STOCK-BASED COMPENSATION

The following is a summary of our stock-basedStock-based compensation expense was $6.9 million and $5.4 million for the three and six months ended June 30,March 31, 2022 and 2021, respectively. Stock-based compensation expense is included within general and 2020, respectively.

    

Three Months Ended

    

Six Months Ended

 

June 30, 

 

June 30, 

 

    

2021

    

2020

     

2021

     

2020

    

 

(in thousands)

Stock-based compensation expense

 

$

5,811

 

$

4,623

 

$

11,207

 

$

9,258

 

administrative expenses on our Consolidated Statements of Operations.

We granted 22,05131,685 time-based restricted stock units (“RSUs”) and 142,719170,294 time-based profits interest units (“PIUs”) during the first quarter of 20212022 to certain officers and key employees, and those units vest on December 31, 20232024 (three years after the grant date), subject to continued employment and vesting in certain other events.

We also granted 1,232,178 performance based1,545,070 performance-based PIUs during the first quarter of 20212022 to certain officers and key employees, which are earned based on the level of performance over the performance period (normally three years) and vest quarterly in the fourth year, subject to continued employment and vesting in certain other events.

Time-based and performance-based grants made to named executive officers and key employees that meet certain conditions under the Company’s retirement policy (length of service, age, etc.) vest on an accelerated basis pursuant to the 2018 Stock Incentive Plan.

2322

NOTE 15 – BORROWING ACTIVITIES AND ARRANGEMENTS

The following is a summary of our borrowings:

    

    

    

Annual

    

    

Interest Rate 

as of 

June 30, 

June 30, 

December 31, 

Net Proceeds

    

Maturity

    

2021

    

2021

    

2020

(in millions)

    

    

    

(in thousands)

Secured borrowings

 

  

 

  

 

  

 

  

 

  

HUD mortgages(1)(2)

2046-2052

3.01

%

$

363,556

$

367,249

Term loan(3)

 

 

2022

 

3.75

%

2,275

2,275

Total secured borrowings

365,831

369,524

Unsecured borrowings

 

 

  

 

  

 

  

 

  

Revolving borrowings:

 

 

2017 Revolving credit facility(4)

 

 

N/A

 

N/A

 

 

101,158

Revolving credit facility(4)

 

 

2025

 

1.30

%  

 

 

Total revolving borrowings

101,158

Senior notes and other unsecured borrowings:

2023 notes(4)(5)

$

692.0

 

2023

 

4.375

%  

 

350,000

 

700,000

2024 notes(4)

394.3

 

2024

 

4.950

%  

 

400,000

 

400,000

2025 notes(4)

397.7

 

2025

 

4.500

%  

 

400,000

 

400,000

2026 notes(4)

594.4

 

2026

 

5.250

%  

 

600,000

 

600,000

2027 notes(4)

683.0

 

2027

 

4.500

%  

 

700,000

 

700,000

2028 notes(4)

540.8

 

2028

 

4.750

%  

 

550,000

 

550,000

2029 notes(4)

487.8

 

2029

 

3.625

%

 

500,000

 

500,000

2031 notes(4)

680.5

2031

3.375

%

700,000

700,000

2033 notes(4)(6)

689.3

2033

3.250

%

700,000

Subordinated debt(2)

 

 

2021

 

9.000

%  

 

20,000

 

20,000

Sterling term loan(4)(7)

 

 

N/A

 

N/A

 

 

136,700

2017 OP term loan(8)

 

 

N/A

 

N/A

 

 

50,000

OP term loan(8)

 

 

2025

 

3.29

%  

 

50,000

 

Deferred financing costs – net

 

 

  

 

  

 

(29,326)

 

(26,421)

Discount – net

 

  

 

  

 

  

 

(33,940)

 

(31,709)

Total senior notes and other unsecured borrowings – net

 

  

 

  

 

  

 

4,906,734

 

4,698,570

Total unsecured borrowings – net

 

  

 

  

 

  

 

4,906,734

 

4,799,728

Total secured and unsecured borrowings – net(9)(10)

 

  

 

  

 

  

$

5,272,565

$

5,169,252

    

    

Annual

    

Interest Rate 

as of 

March 31, 

March 31, 

December 31, 

    

Maturity

    

2022

    

2022

    

2021

    

    

    

(in thousands)

Secured borrowings:

 

  

 

  

 

  

 

  

HUD mortgages(1)(2)

2046-2052

3.01

%

$

357,910

$

359,806

2022 term loan(3)

 

2022

 

4.00

%

2,275

2,275

2024 term loan(4)

 

2024

 

6.00

%

19,459

Total secured borrowings

379,644

362,081

Unsecured borrowings:

 

  

 

  

 

  

 

  

Revolving credit facility(5)(6)

 

2025

 

1.82

%  

 

354,888

 

Senior notes and other unsecured borrowings:

2023 notes(5)

 

2023

 

4.375

%  

 

350,000

 

350,000

2024 notes(5)

 

2024

 

4.950

%  

 

400,000

 

400,000

2025 notes(5)

 

2025

 

4.500

%  

 

400,000

 

400,000

2026 notes(5)

 

2026

 

5.250

%  

 

600,000

 

600,000

2027 notes(5)

 

2027

 

4.500

%  

 

700,000

 

700,000

2028 notes(5)

 

2028

 

4.750

%  

 

550,000

 

550,000

2029 notes(5)

 

2029

 

3.625

%

 

500,000

 

500,000

2031 notes(5)

2031

3.375

%

700,000

700,000

2033 notes(5)

2033

3.250

%

700,000

700,000

OP term loan(7)(8)

 

2025

 

1.91

%  

 

50,000

 

50,000

Deferred financing costs – net

 

  

 

  

 

(25,804)

 

(26,980)

Discount – net

 

  

 

  

 

(30,357)

 

(31,565)

Total senior notes and other unsecured borrowings – net

 

  

 

  

 

4,893,839

 

4,891,455

Total unsecured borrowings – net

 

  

 

  

 

5,248,727

 

4,891,455

Total secured and unsecured borrowings – net(9)(10)

 

  

 

  

$

5,628,371

$

5,253,536

(1)Reflects the weighted average annual contractual interest rate on the mortgages at June 30, 2021.March 31, 2022. Secured by real estate assets with a net carrying value of $558.0$537.8 million as of June 30, 2021.March 31, 2022.
(2)Wholly owned subsidiaries of Omega OP are the obligor on these borrowings.
(3)Borrowing is the debt of a consolidated joint venture.
(4)Borrowing is the debt of the consolidated joint venture discussed in Note 8 – Variable Interest Entities which was formed in the first quarter of 2022. The borrowing is secured by 2 ALFs which are owned by the joint venture.
(5)Guaranteed by Omega OP.
(5)In March 2021, we used a portion of the proceeds from the 2033 Senior Notes offering to fund the tender offer to purchase $350 million of the 4.375% Senior Notes due 2023. In connection with this transaction, we recorded approximately $29.7 million in related fees, premiums, and expenses which were recorded as Loss on debt extinguishment in our Consolidated Statement of Operations.
(6)We usedAs of March 31, 2022, borrowings under Omega’s $1.45 billion senior unsecured multicurrency revolving credit facility consisted of $110.0 million U.S. dollars (“USD”) and £186.0 million British Pounds Sterling (“GBP”). The interest rate presented reflects the proceeds from this offering to pay down outstanding borrowingsweighted average interest rate on the 2017 Revolving Credit Facility, repayborrowings under the Sterling term loan,revolving credit facility denominated in USD and fund the tender offer to purchase $350 million of the 4.375% Senior Notes due 2023 and the payment of accrued interest and related fees, premiums and expenses.GBP.
(7)Actual borrowing is in GBP and remeasured to USD. The Sterling term loan was settled in March 2021 using proceeds from the 3.250% 2033 Senior Notes offering.
(8)Omega OP is the obligor on this borrowing.
(8)The interest rate swaps, that were cash flow hedges of Omega OP’s $50.0 million senior unsecured term loan facility (the “OP term loan”) interest payments and that effectively fixed the interest rate at 3.29%, matured on February 10, 2022.
(9)All borrowings are direct borrowings of Parent unless otherwise noted.
(10)Certain of our other secured and unsecured borrowings are subject to customary affirmative and negative covenants, including financial covenants. As of June 30, 2021March 31, 2022 and December 31, 2020,2021, we were in compliance with all affirmative and negative covenants, including financialapplicable covenants for our secured and unsecured borrowings.

2423

Unsecured Borrowings

Revolving Credit Facility

On April 30, 2021, Omega entered into a credit agreement (the “2021 Omega Credit Agreement”) providing us with a new $1.45 billion senior unsecured multicurrency revolving credit facility (the “Revolving Credit Facility”), replacing our previous $1.25 billion senior unsecured 2017 multicurrency revolving credit facility (the “2017 Revolving Credit Facility”). The 2021 Omega Credit Agreement contains an accordion feature permitting us, subject to compliance with customary conditions, to increase the maximum aggregate commitments thereunder to $2.5 billion, by requesting an increase in the aggregate commitments under the Revolving Credit Facility or by adding term loan tranches.

The Revolving Credit Facility bears interest at LIBOR (or in the case of loans denominated in GBP, the Sterling overnight index average reference rate plus an adjustment of 0.1193% per annum) plus an applicable percentage (with a range of 95 to 185 basis points) based on our credit ratings. The Revolving Credit Facility matures on April 30, 2025, subject to Omega’s option to extend such maturity date for 2 six-month periods. The Revolving Credit Facility may be drawn in Euros, GBP, Canadian Dollars (collectively, “Alternative Currencies”) or USD, with a $1.15 billion tranche available in USD and a $300 million tranche available in Alternative Currencies. For purposes of the Revolving Credit Facility, references to LIBOR include the Canadian dealer offered rates for amounts offered in Canadian Dollars and any other Alternative Currency rate approved in accordance with the terms of the 2021 Omega Credit Agreement for amounts offered in any other non-London interbank offered rate quoted currency, as applicable.

We incurred $12.9 million of deferred costs in connection with the 2021 Omega Credit Agreement.

OP Term Loan

On April 30, 2021, Omega OP entered into a credit agreement (the “2021 Omega OP Credit Agreement”) providing it with a new $50 million senior unsecured term loan facility (the “OP Term Loan”). The OP Term Loan replaces the $50 million senior unsecured term loan obtained in 2017 (the “2017 OP Term Loan”) and the related credit agreement. The OP Term Loan bears interest at LIBOR plus an applicable percentage (with a range of 85 to 185 basis points) based on our credit ratings. The OP Term Loan matures on April 30, 2025, subject to Omega OP’s option to extend such maturity date for 2, six-month periods.

We incurred $0.4 million of deferred costs in connection with the 2021 Omega OP Credit Agreement.

$400 Million Forward Starting Swaps

On March 27, 2020, we entered into 5 forward starting swaps totaling $400 million. We designated the forward starting swaps as cash flow hedges of interest rate risk associated with interest payments on a forecasted issuance of fixed rate long-term debt, initially expected to occur within the next five years. The swaps are effective on August 1, 2023 and expire on August 1, 2033 and were issued at a fixed rate of approximately 0.8675%. In March 2021, in conjunction with the issuance of $700 million aggregate principal amount of our 3.25% Senior Notes due 2033, we discontinued hedge accounting for these 5 forward starting swaps. Amounts reported in AOCI related to these discontinued cash flow hedging relationships will be reclassified to interest expense over a ten-year term. Simultaneously, we re-designated these swaps in new cash flow hedging relationships of interest rate risk associated with interest payments on another forecasted issuance of long-term debt. We are hedging our exposure to the variability in future cash flows for forecasted transactions over a maximum period of 46 months (excluding forecasted transactions related to the payment of variable interest on existing financial instruments).

25

£174 Million Foreign Exchange Forward Starting Swaps

From the issuance date of our GBP borrowings through the prepayment date in March 2021, we used a nonderivative, GBP-denominated term loan and line of credit totaling £174 million to hedge a portion of our net investments in foreign operations. During March 2021 and concurrent with the settlement of our GBP-denominated term loan and repayment of our GBP-denominated borrowings under our line of credit, we entered into 4 foreign currency forwards, that mature on March 8, 2024, to hedge a portion of our net investments in foreign operations, effectively replacing the terminated net investment hedge. For these derivatives that are designated and qualify as net investment hedges, the gain or loss on the derivative is reported in AOCI as part of the cumulative translation adjustment. Amounts are reclassified out of AOCI into earnings when the hedged net investment is either sold or substantially liquidated.  

NOTE 16 – DERIVATIVES AND HEDGING

We are exposed to, among other risks, the impact of changes in foreign currency exchange rates as a result of our investments in the U.K. and interest rate risk related to our capital structure. As a matter of policy, we do not use derivatives for trading or speculative purposes. Our risk management program is designed to manage the exposure and volatility arising from these risks, and utilizes foreign currency forward contracts, interest rate swaps and debt issued in foreign currencies to offset a portion of these risks. As of March 31, 2022, we have 5 forward starting swaps with $400.0 million in notional value designated as cash flow hedges and 4 forward currency forwards with £174.0 million in notional value designated as net investment hedges.

NaN of our interest rate swaps that were entered into in May 2019 with aggregate notional amounts of $50.0 million matured on February 10, 2022. These interest rate swap contracts were designated as hedges against our exposure to changes in interest payment cash flow fluctuations in the variable interest rates on the OP term loan.

The location and the fair value of derivative instruments designated as hedges, at the respective balance sheet dates, were as follows:

March 31, 

December 31, 

2022

    

2021

Cash flow hedges:

(in thousands)

Other assets

$

53,394

$

32,849

Accrued expenses and other liabilities

$

$

96

Net investment hedges:

Other assets

$

10,601

$

6,754

The fair value of the interest rate swaps and foreign currency forwards is derived from observable market data such as yield curves and foreign exchange rates and represents a Level 2 measurement on the fair value hierarchy.

NOTE 1617 – FINANCIAL INSTRUMENTS

The net carrying amount of cash and cash equivalents, restricted cash, contractual receivables, other assets and accrued expenses and other liabilities reported in the Consolidated Balance Sheets approximates fair value because of the short maturity of these instruments (Level 1).

24

At June 30, 2021March 31, 2022 and December 31, 2020,2021, the net carrying amounts and fair values of our other financial instruments were as follows:

June 30, 2021

December 31, 2020

March 31, 2022

December 31, 2021

    

Carrying

    

Fair

    

Carrying

    

Fair

    

Carrying

    

Fair

    

Carrying

    

Fair

    

Amount

    

Value

    

Amount

    

Value

    

Amount

    

Value

    

Amount

    

Value

(in thousands)

(in thousands)

Assets:

Investments in direct financing leases – net

$

10,807

$

10,807

    

$

10,764

$

10,764

$

10,849

$

10,849

    

$

10,873

$

10,873

Mortgage notes receivable – net

 

857,162

897,342

885,313

924,353

 

819,577

841,432

835,086

869,715

Other investments – net

 

458,664

466,690

467,442

474,552

 

506,942

516,639

469,884

476,664

Total

$

1,326,633

$

1,374,839

$

1,363,519

$

1,409,669

$

1,337,368

$

1,368,920

$

1,315,843

$

1,357,252

Liabilities:

 

  

 

  

 

  

 

  

 

  

 

  

 

  

 

  

2017 Revolving credit facility

$

$

    

$

101,158

$

101,158

Revolving credit facility

    

$

354,888

$

354,888

    

$

$

Term loan

2,275

2,275

2,275

2,275

Sterling term loan

 

136,453

136,700

2017 OP term loan

 

49,896

50,000

OP Term loan

 

49,616

50,000

2022 term loan

2,275

2,275

2,275

2,275

2024 term loan

 

19,459

19,750

OP term loan

 

49,686

50,000

49,661

50,000

4.375% notes due 2023 – net

 

348,816

379,284

696,981

770,635

 

349,242

355,534

349,100

365,243

4.95% notes due 2024 – net

 

397,219

442,023

396,714

441,194

 

397,978

408,984

397,725

427,184

4.50% notes due 2025 – net

 

397,305

444,675

396,924

444,652

 

397,875

406,980

397,685

427,440

5.25% notes due 2026 – net

 

596,790

697,838

596,437

697,993

 

597,319

622,896

597,142

667,524

4.50% notes due 2027 – net

 

691,642

790,201

690,909

794,294

 

692,739

714,903

692,374

766,003

4.75% notes due 2028 – net

 

543,404

627,615

542,899

633,950

 

544,160

559,916

543,908

607,249

3.625% notes due 2029 – net

490,076

538,108

489,472

532,248

490,983

472,485

490,681

519,430

3.375% notes due 2031 – net

682,697

721,067

681,802

731,541

684,040

641,347

683,592

705,810

3.25% notes due 2033 – net

689,128

698,804

689,817

610,575

689,587

683,151

HUD mortgages – net

363,556

396,266

367,249

409,004

357,910

344,769

359,806

394,284

Subordinated debt – net

 

20,041

20,799

20,083

21,599

Total

$

5,272,565

$

5,808,955

$

5,169,252

$

5,767,243

$

5,628,371

$

5,565,302

$

5,253,536

$

5,615,593

Fair value estimates are subjective in nature and are dependent on a number of important assumptions, including estimates of future cash flows, risks, discount rates and relevant comparable market information associated with each financial instrument (see Note 2 – Summary of Significant Accounting Policies in our Annual Report on Form 10-K for the year ended December 31, 2020)2021). The use of different market assumptions and estimation methodologies may have a material effect on the reported estimated fair value amounts.

26

The following methods and assumptions were used in estimating fair value disclosures for financial instruments.

Direct financing leases:  The fair value of the investments in direct financing leases are estimated using a discounted cash flow analysis, using interest rates being offered for similar leases to borrowers with similar credit ratings (Level 3).
Mortgage notes receivable: The fair value of the mortgage notes receivables are estimated using a discounted cash flow analysis, using interest rates being offered for similar loans to borrowers with similar credit ratings (Level 3).
Other investments: Other investments are primarily comprised of notes receivable. The fair values of notes receivable are estimated using a discounted cash flow analysis, using interest rates being offered for similar loans to borrowers with similar credit ratings (Level 3).
Revolving line of credit secured borrowingfacility, OP term loan, 2022 term loan and 2024 term loan: The carrying amount of these approximate fair value because the borrowings are interest rate adjusted. Differences between carrying value and the fair value in the table above are due to the inclusion of our borrowings under variable rate agreements are estimated using a present value technique based on expected cash flows discounted usingdeferred financing costs in the current market rates (Level 3).carrying value.
Senior notes: The fair value of the senior unsecured notes and subordinatedpayable was estimated based on (Level 1) publicly available trading prices. 

25

Subordinated debt: The fair value of our borrowings under fixed ratethese agreements are estimated using a present value technique based on inputs from trading activity provided by a third-party (Level 2).
HUD mortgages: The fair value of our borrowings under HUD debt agreements are estimated using an expected present value technique based on quotes obtained by HUD debt brokers (Level 2).

NOTE 1718 – COMMITMENTS AND CONTINGENCIES

Litigation

Shareholder Litigation

The Company and certain of its officers, C. Taylor Pickett, Robert O. Stephenson, and Daniel J. Booth, are defendants in a purported securities class action lawsuit pending in the U.S. District Court for the Southern District of New York (the “Securities Class Action”). Brought by lead plaintiff Royce Setzer and additional plaintiff Earl Holtzman, the Securities Class Action purports to assert claims for violations of Section 10(b) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”) and Rule 10b-5 promulgated thereunder, as well as Section 20(a) of the Exchange Act, and seeks an unspecified amount of monetary damages, interest, fees and expenses of attorneys and experts, and other relief. The Securities Class Action alleges that the defendants violated the Exchange Act by making materially false and/or misleading statements, and by failing to disclose material adverse facts about the Company’s business, operations, and prospects, including the financial and operating results of one of the Company’s operators, the ability of such operator to make timely rent payments, and the impairment of certain of the Company’s leases and the uncollectibility of certain receivables. The initial complaint was dismissed with prejudice by the U.S. District Court, but the dismissal was overturned by the U.SU.S. Court of Appeals for the Second Circuit in 2020. Thereafter, the plaintiffs filed a Second Consolidated Amended Complaint in August 2020. In November 2020, the Company and the officers named in the Securities Class Action filed a Motion to Dismiss the Second Consolidated Amended Complaint, which is fully briefedComplaint. On September 28, 2021, the Court issued an order denying the motion to dismiss insofar as it requested dismissal of the entire action on grounds of loss causation, and pending beforegranting it insofar as it sought dismissal of any claims arising out of defendants’ statements in February 2017. Because the District Court.dismissed claims were the basis for defendants’ efforts to begin the alleged class period in February 2017, the decision means that the alleged class period runs from May 3, 2017 to October 31, 2017.

Certain derivative actions have also been brought against the officers named in the Securities Class Action, and certain current and former directors of the Company, alleging claims relating to the matters at issue in the Securities Class Action. These derivative actions are currently stayed pending certain developments in the Securities Class Action.

27

In 2018, Stourbridge Investments LLC, a purported stockholder of the Company, filed a derivative action purportedly on behalf of the Company in the U.S. District Court for the Southern District of New York, alleging violations of Section 14(a) of the Exchange Act and state-law claims including breach of fiduciary duty. The complaint alleges, among other things, that the named defendants are responsible for the Company’s failure to disclose the financial condition of Orianna Health Systems, the alleged non-disclosures that are also the subject of the Securities Class Action described above. The plaintiff did not make a demand on the Company to bring the action prior to filing it, but rather alleges that demand would have been futile. The case has been stayed pending the entry of judgment or a voluntary dismissal with prejudice in the Securities Class Action.

In 2019, purported stockholder Phillip Swan by his counsel, and stockholders Tom Bradley and Sarah Smith by their counsel, filed derivative actions in the Baltimore City Circuit Court of Maryland, purportedly on behalf of the Company, asserting claims for breach of fiduciary duty, waste of corporate assets and unjust enrichment against the named defendants. Those actions have been consolidated and stayed in the Maryland court pending completion of fact discovery in the Securities Class Action. Prior to filing suit, each of these stockholders had made demands on the Board of Directors in 2018 that the Company bring such lawsuits. After an investigation and due consideration, and in the exercise of its business judgment, the Board of Directors determined that it is not in the best interests of the Company to commence litigation against any current or former officers or directors based on the matters raised in the demands.

26

In addition, in late 2020, Robert Wojcik, a purported shareholder of the Company, filed a derivative action in the U.S. District Court for the District of Maryland, purportedly on behalf of the Company, asserting violations of Section 14(a) of the Exchange Act, Sections 10(b) and 21D of the Exchange Act, as well as claims for breach of fiduciary duty, unjust enrichment, abuse of control, gross mismanagement, and waste of corporate assets. Wojcik also did not make a demand on the Company prior to filing suit. The case has been stayed pending the entry of judgment or a voluntary dismissal with prejudice in the Securities Class Action.

The Company believes that the claims asserted against it in these lawsuits are without merit and intends to vigorously defend against them.

Other

Gulf Coast Subordinated Debt

In August 2021, we filed suit in the Circuit Court for Baltimore County (the “Court”) against the holders of certain Subordinated Debt associated with our Gulf Coast master lease agreement, following an assertion by the holders that our prior exercise of offset rights in connection with Gulf Coast’s non-payment of rent had resulted in defaults under the terms of the Subordinated Debt. The suit seeks a declaratory judgment to, among other items, declare that the aggregate amount of unpaid rent due from Gulf Coast under the master lease agreement exceeds all amounts which otherwise would be due and owing by a subsidiary of Omega (“Omega Obligor”) under the Subordinated Debt, and that all principal and interest due and owing under the Subordinated Debt may be (and was) offset in full as of December 31, 2021. In October 2021, the defendants in the case filed a motion to dismiss for lack of personal jurisdiction. A hearing was held on such motion on February 25, 2022, but the decision was taken under advisement. While Omega believes Omega Obligor is entitled to the enforcement of the offset rights sought in the action, the outcome of litigation is unpredictable, and Omega cannot predict the outcome of the declaratory judgment action, irrespective of whether it is litigated in the Court or, if the motion to dismiss for lack of personal jurisdiction is granted, in another court.

Lakeway Realty, L.L.C.

In September 2016, MedEquities received a Civil Investigative Demand (“CID”) from the U.S. Department of Justice (“DOJ”), which indicates that it is conducting an investigation regarding alleged violations of the False Claims Act, Stark Law and Anti-Kickback Statute in connection with claims that may have been submitted to Medicare and other federal payors for services rendered to patients at Lakeway Hospital or by providers with financial relationships with Lakeway Hospital. As a result of the acquisition of MedEquities, the Company owns a 51% interest in an unconsolidated partnership that owns Lakeway Hospital, (the “LakewayLakeway Realty, L.L.C.”). The CID requested certain documents and information related to the acquisition and ownership of Lakeway Hospital through Lakeway Realty, L.L.C. The Company has learned that the DOJ is investigating MedEquities’ conduct in connection with its investigation of financial relationships related to Lakeway Hospital, including allegations by the DOJ that these relationships violate and continue to violate the Anti-Kickback Statute and, as a result, related claims submitted to federal payors violated and continue to violate the False Claims Act. The Company is cooperating fully with the DOJ in connection with the CID and has produced all of the information that has been requested to date.  

On September 29, 2020, the Department of Justice announced it had reached a settlement of a False Claims Act case with Lakeway Regional Medical Center wherein Lakeway Regional Medical Center agreed to pay $1.1 million for inducing certain physicians to refer patients by offering a low risk and high return investment in the form of a joint venture to purchase and then lease back the hospital to Lakeway Regional Medical Center. A MedEquities subsidiary was a party to this transaction but was not included in settlement discussions.discussions, and we understand that the settlement did not fully resolve the investigation referenced in the CID. The documents relating to the settlement are not publicly available.

The Company believes that the acquisition, ownership and leasing of Lakeway Hospital through the Lakeway Partnership was and is in compliance with all applicable laws. However, due to the uncertainties surrounding this matter and its ultimate outcome, we are unable to determine whether it is probable that any loss has been incurred.

2827

In addition, we are subject to various other legal proceedings, claims and other actions arising out of the normal course of business. While any legal proceeding or claim has an element of uncertainty, management believes that the outcome of each lawsuit, claim or legal proceeding that is pending or threatened, or all of them combined, will not have a material adverse effect on our consolidated financial position or results of operations.

Indemnification Agreements

In connection with certain facility transitions, we have agreed to indemnify certain operators in certain events.  As of June 30, 2021,March 31, 2022, our maximum funding commitment under these indemnification agreements was approximately $8.6$5.6 million. Claims under these indemnification agreements may be made within 18 months to 72 months of the transition date. These indemnification agreements were provided to certain operators in connection with facility transitions and generally would be applicable in the event that the prior operators do not perform under their transition agreements. The Company does not expect to fund a material amount under these indemnification agreements.

Commitments

We have committed to fund the construction of new leased and mortgaged facilities, capital improvements and other commitments. We expect the funding of these commitments to be completed over the next several years. Our remaining commitments at June 30, 2021,March 31, 2022, are outlined in the table below (in thousands):

Total commitments

    

$

539,528

    

$

752,891

Amounts funded to date (1)

 

(415,281)

 

(532,002)

Remaining commitments (2)

$

124,247

$

220,889

(1)Includes finance costs.
(2)This amount excludes our remaining commitments to fund under our other investments of approximately $67.6$41.2 million.

NOTE 1819 – EARNINGS PER SHARE

The following tables set forth the computation of basic and diluted earnings per share:

    

Three Months Ended

    

Six Months Ended

    

June 30, 

    

June 30, 

Three Months Ended March

    

2021

    

2020

    

2021

    

2020

    

    

2022

    

2021

(in thousands, except per share amounts)

(in thousands, except per share amounts)

Numerator:

 

  

    

  

  

    

  

  

    

  

Net income

$

86,863

$

101,960

$

251,229

$

194,239

$

195,156

$

164,366

Deduct: net income attributable to noncontrolling interests

 

(2,340)

 

(2,653)

 

(6,728)

 

(5,017)

 

(5,549)

 

(4,388)

Net income available to common stockholders

$

84,523

$

99,307

$

244,501

$

189,222

$

189,607

$

159,978

Denominator:

 

  

 

  

 

  

 

  

 

  

 

  

Denominator for basic earnings per share

 

236,229

 

227,411

 

234,401

 

227,336

 

239,527

 

232,572

Effect of dilutive securities:

 

 

  

 

 

  

 

 

  

Common stock equivalents

 

1,130

 

1,030

 

1,037

 

1,146

 

963

 

944

Noncontrolling interest – Omega OP Units

 

6,549

 

6,082

 

6,470

 

6,033

 

7,066

 

6,391

Denominator for diluted earnings per share

 

243,908

 

234,523

 

241,908

 

234,515

 

247,556

 

239,907

Earnings per share - basic:

 

  

 

  

 

  

 

  

 

  

 

  

Net income available to common stockholders

$

0.36

$

0.44

$

1.04

$

0.83

$

0.79

$

0.69

Earnings per share – diluted:

 

 

 

 

 

  

 

  

Net income

$

0.36

$

0.43

$

1.04

$

0.83

$

0.79

$

0.69

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NOTE 1920 – SUPPLEMENTAL DISCLOSURE TO CONSOLIDATED STATEMENTS OF CASH FLOWS

The following are supplemental disclosures to the consolidated statementsConsolidated Statements of cash flowsCash Flows for the sixthree months ended June 30, 2021March 31, 2022 and 2020:2021:

    

Six Months Ended June 30, 

    

Three Months Ended March 31, 

    

2021

    

2020

    

    

2022

    

2021

    

 

(in thousands)

 

(in thousands)

Reconciliation of cash and cash equivalents and restricted cash:

Cash and cash equivalents

$

100,824

$

37,022

$

491,247

$

51,376

Restricted cash

 

3,736

 

4,543

 

3,534

 

4,522

Cash, cash equivalents and restricted cash at end of period

$

104,560

$

41,565

$

494,781

$

55,898

Supplemental information:

 

 

 

 

Interest paid during the period, net of amounts capitalized

$

105,634

$

112,035

$

60,478

$

67,538

Taxes paid during the period

$

3,072

$

4,497

$

1,716

$

1,509

Non cash investing activities

 

  

 

  

Non cash proceeds from sale of real estate investments

$

$

83,910

Non cash placement of mortgages

$

(1,000)

$

(86,936)

Non cash proceeds from other investments

$

1,000

$

3,026

Non-cash investing activities:

 

  

 

  

Non-cash acquisition of real estate

$

(11,133)

$

Non cash financing activities

 

  

 

  

Non cash borrowing of other long-term borrowings

$

$

6,459

Non-cash financing activities:

 

  

 

  

Non-cash contribution from noncontrolling interest holder in consolidated joint venture

$

2,903

$

Change in fair value of cash flow hedges

$

17,869

$

(7,329)

$

24,489

$

36,672

Remeasurement of debt denominated in a foreign currency

$

3,010

$

(13,953)

$

(320)

$

3,010

NOTE 20 – SUBSEQUENT EVENTS

On July 1, 2021, we financed 6 SNFs in Ohio and amended an existing $6.4 million mortgage to include the 6 facilities in a consolidated $72.4 million mortgage for 8 Ohio facilities bearing interest at an initial rate of 10.5% per annum. In conjunction with this transaction, we also acquired 3 Maryland facilities that were previously subject to a mortgage issued by Omega bearing interest at 13.75% per annum with a principal balance of $36.0 million. The purchase price for these 3 facilities was equal to the remaining mortgage principal amount, and the 3 acquired Maryland facilities were subsequently leased back to the seller for a term expiring on December 31, 2032, assuming Omega exercises the options under the agreement. The base rent in the initial year is approximately $5.0 million and includes annual escalators of 2.5%. On July 1, 2021, we also entered into a $12.0 million revolving credit facility agreement with this operator for working capital expenses for the 8 Ohio facilities discussed above with a maturity date of June 30, 2022. The credit facility bears interest at 10% per annum.

On July 14, 2021, we acquired 2 U.K. facilities for $9.5 million and entered into a lease with an existing operator with an initial term expiring on April 23, 2027. The base rent in the initial year is approximately $0.8 million and includes annual escalators of 2.5%.

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Item 2 – Management’s Discussion and Analysis of Financial Condition and Results of Operations

Forward-Looking Statements and Factors Affecting Future Results

Unless stated otherwise indicated or except where the context otherwise requires, the terms “Omega”, the “Company,“we,“we,”“us” and “our” and “us”other similar terms in this Quarterly Report on Form 10-Q refer to Omega Healthcare Investors, Inc. and its consolidated subsidiaries including Omega OP, references to “Parent” refer to Omega Healthcare Properties, Inc. without regard to its consolidated subsidiaries, and references to “Omega OP” mean OHI Healthcare Properties Limited Partnership and its consolidated subsidiaries..

Forward-Looking Statements and Factors Affecting Future Results

The following discussion should be read in conjunction with the financial statements and notes thereto appearing elsewhere in this document. This document contains “forward-looking statements” within the meaning of the federal securities laws. These statements relate to our expectations, beliefs, intentions, plans, objectives, goals, strategies, future events, performance and underlying assumptions and other statements other than statements of historical facts. In some cases, you can identify forward-looking statements by the use of forward-looking terminology including, but not limited to, terms such as “may,” “will,” “anticipates,” “expects,” “believes,” “intends,” “should” or comparable terms or the negative thereof. These statements are based on information available on the date of this filing and only speak as to the date hereof and no obligation to update such forward-looking statements should be assumed.

Our actual results may differ materially from those reflected in the forward-looking statements contained herein as a result of a variety of factors, including, among other things:

(i)(1)those items discussed under “Risk Factors” in Part I, Item 1A to our annual reportAnnual Report on Form 10-K;
(ii)(2)uncertainties relating to the business operations of the operators of our assets, including those relating to reimbursement by third-party payors, regulatory matters and occupancy levels;
(iii)(3)the impact of the novel coronavirus (“COVID-19”)COVID-19 pandemic on our business and the business of our operators, including without limitation, the extent and duration of the COVID-19 pandemic, increased costs, staffing shortages and decreased occupancy levels experienced by operators of skilled nursing facilities (“SNFs”) and assisted living facilities (“ALFs”) in connection therewith, the ability of operators to comply with new infection control and vaccine protocols, the long-term impact of vaccination on facility infection rates, and the extent to which continued government support may be available to operators to offset such costs and the conditions related thereto;
(iv)(4)the ability of any of Omega’sour operators in bankruptcy to reject unexpired lease obligations, modify the terms of Omega’sour mortgages and impede theour ability of Omega to collect unpaid rent or interest during the pendency of a bankruptcy proceeding and retain security deposits for the debtor’s obligations, and other costs and uncertainties associated with operator bankruptcies;
(v)(5)our ability to re-lease, otherwise transition, or sell underperforming assets or assets held for sale on a timely basis and on terms that allow us to realize the carrying value of these assets;
(vi)(6)the availability and cost of capital to us;
(vii)(7)changes in our credit ratings and the ratings of our debt securities;
(viii)(8)competition in the financing of healthcare facilities;
(ix)(9)competition in the long-term healthcare industry and shifts in the perception of various types of long-term care facilities, including SNFs and ALFs;
(x)(10)additional regulatory and other changes in the healthcare sector;
(xi)(11)changes in the financial position of our operators;
(xii)(12)the effect of economic and market conditions generally and, particularly, in the healthcare industry;
(xiii)(13)changes in interest rates;rates and the impact of inflation;
(xiv)(14)the timing, amount and yield of any additional investments;
(xv)(15)changes in tax laws and regulations affecting real estate investment trusts (“REITs”);
(xvi)(16)the potential impact of changes in the SNF and ALF markets or local real estate conditions on our ability to dispose of assets held for sale for the anticipated proceeds or on a timely basis, or to redeploy the proceeds therefrom on favorable terms;
(xvii)(17)our ability to maintain our status as a REIT; and
(xviii)(18)the effect of other factors affecting our business or the businesses of our operators that are beyond our or their control, including natural disasters, other health crises or pandemics and governmental action; particularly in the healthcare industry.

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Overview

Omega was incorporated in the State ofHealthcare Investors, Inc. (“Parent”) is a Maryland on March 31, 1992 andcorporation that, together with its consolidated subsidiaries (collectively, “Omega,” or “Company,” “we,” “our,” or “us”) has elected to be taxed as a REIT for federal income tax purposes. Omega is structured as an umbrella partnership REIT (“UPREIT”) under which all of Omega’s assets are owned directly or indirectly by, and all of Omega’s operations are conducted directly or indirectly through, its operating partnership subsidiary, Omega OP.OHI Healthcare Properties Limited Partnership (collectively with its subsidiaries, “Omega OP”). As of June 30, 2021, OmegaMarch 31, 2022, Parent owned approximately 97% of the issued and outstanding units of partnership interest in Omega OP (“Omega OP Units”), and other investors owned approximately 3% of the outstanding Omega OP Units.

Omega has one reportable segment consisting of investments in healthcare-related real estate properties located in the United States (“U.S.”) and the United Kingdom (“U.K.”). Our core business is to provide financing and capital to the long-term healthcare industry with a particular focus on SNFs, and ALFs, and to a lesser extent, independent living facilities (“ILFs”), rehabilitation and acute care facilities (“specialty facilities”) and medical office buildings. Our core portfolio consists of our long-term leases and mortgage agreements.loans with healthcare operating companies and affiliates (collectively, our “operators”). All of our leases are “triple-net” leases, which require the operators (we use the term “operator” to refer to our tenants and mortgagors and their affiliates who manage and/or operate our properties) to pay all property-related expenses. Our mortgage revenue derives from fixed rate mortgage loans, whichmortgages are secured by first mortgage liens on the underlying real estate and personal property of the mortgagor. Our other investment income derives from fixed and variable rateoperators. In addition to our core investments, we selectively make loans to our operators and/or their principals to fundfor working capital and capital expenditures. These loans, which may be either unsecured or secured by the collateral of the borrower, are classified as other investments. From time to time, we also acquire equity interests in joint ventures or entities that support the long-term healthcare industry and our operators.

COVID-19 Pandemic Update

ForThe COVID-19 pandemic has continued to significantly and adversely impact SNFs and long-term care providers due to the year ended December 31, 2020higher rates of virus transmission and fatality among the elderly and frail populations that these facilities serve. As a result, many of our operators have been and may continue to be significantly impacted by the pandemic. Agemo Holdings, LLC (“Agemo”), Guardian Healthcare (“Guardian”) and Gulf Coast Health Care LLC (together with certain affiliates, “Gulf Coast”), three operators that failed to make contractual payments under their lease and loan agreements for periods of 2021, continued to not make payments during the first quarter of 2021, we collected substantially all2022. During the first quarter of the contractual rents and mortgage interest payments owed to us from our2022, two new operators, (other than operators under a forbearance agreement prior to the pandemic). However, in June 2021, we were informed byrepresenting an operator, which represents approximately 3%aggregate of our6.1% of total revenue for the six months ended June 30, 2021 and 2020 (excluding the impact of write-offs) for the straight-line write-offsthree months ended March 31, 2022, missed contractual rent payments during the period, and we have agreed to short term deferrals with these two operators, as well as allowed one of these operators to apply its security deposit to pay rent, as discussed further in 2021), that it would be unable“Collectibility Issues” below. Additionally, we allowed three other operators, representing an aggregate 2.5% of total revenue (excluding the impact of write-offs) for the three months ended March 31, 2022, to apply $1.3 million of their security deposits to pay rent to us in the foreseeable future. As of June 30, 2021, we have been unable to collect approximately $2.5 million of contractual rents due from this operator, which represents one month of contractual rent under the lease agreement, and have applied $2.5 million of the operator’s security deposit funds against their uncollected receivables. As such, we placed the operator on a cash basis for revenue recognition based on our evaluation of the collectibility of futureaccommodate short term liquidity issues, with regular rent payments due under its lease agreement, and in connection with this, we wrote off approximately $17.4 million of straight-line receivablesrequired to rental income during the quarter. resume shortly thereafter.

We believe this operator wasthese operators were impacted by, among other things, reduced revenue as a result of lower occupancy and increased expenses both as a result ofresulting from the COVID-19 pandemic. As discussed in Note 2 – Contractual Receivablespandemic and Other Receivables, we also placed a smaller operator on a cash basis inuncertainties regarding the first quarter due to collectability concerns as a resultcontinuing availability of the impacts of the COVID-19 pandemic. With respect to our other operators, we collected substantially all contractual rents and mortgage interest payments due to us from our operators during the second quarter of 2021; however, wesufficient government support. We remain cautious as the COVID-19 pandemic continues to have a significant impact on our operators and their financial conditions, particularly given continued uncertainty regarding the availability of sufficient government support and trend of reduced federal support to our operators beginning in 2021, the persistence of staffing shortages that continue to impact our operators’ occupancy levels and profitability, andthe impact of governmental vaccine mandates for staff on these ongoing staffing shortages, other factors that may impact virus transmission in our facilities, including genetic mutations of the virus into new variants, the commencement in April 2021 for many of our operators of the repayment of accelerated payments of Medicare funds that were previously received as Advanced Medicare payments in 2020.2020 and the commencement in December 2021 of repayment of deferred FICA obligations.

As of April 27, 2022, our operators have reported a decline in cases of COVID-19 involving employees and residents from the high caseload experienced in January 2022 driven by the Omicron variant. Our operators reported, as of April 27, 2022, cases of COVID-19 within 151, or 16.1%, of our 939 operating facilities as of December 31, 2021, which includes cases involving employees and residents.

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As of July 27, 2021, our operators reported cases of COVID-19 within 153, or 16%, of our 949 operating facilities as of December 31, 2020, which includes cases involving employees and residents. This represents a meaningful decline in cases from the 614 facilities with cases, or 64% of our 959 operating facilities, that our operators reported as of December 22, 2020, and from the 212 facilities with cases, or 22%, of our 949 operating facilities, that our operators reported as of April 27, 2021. We caution that we have not independently validated any such facility virus incidence information, itwhich may be reported on an inconsistent basis by our operators, and we can provide no assurance regarding itsthe information’s accuracy or that there have not been any changes since the time the informationit was obtained from our operators; we also undertake no duty to update this information. While we believe the declines in reported cases noted above is due in large partIt remains uncertain to what extent vaccination programs for COVID-19 which have been implemented in most of our facilities, it remains uncertain when and to what extent these vaccination programsany booster doses will continue to mitigate the effects of COVID-19 in our facilities, or how effective existing vaccines will be againstparticularly with regard to new variants of the COVID-19 virus.virus, the impact of governmental vaccine mandates for staff on ongoing staffing shortages in our facilities and other factors that impact virus transmission in our facilities. The impact of these programs will depend in part on the continued speed, distribution, efficacy and delivery of the vaccine and booster doses in our facilities, as well ascompliance with staff vaccination requirements and participation levels in vaccination programs among the residents and employees of our operators. Our operators have continued to report considerable variationand in participation levels among both employees and residents,the communities in which we believe may change over time with additional vaccination education efforts.they operate.

In addition to experiencing outbreaks of positive cases and deaths of residents and employees during the pandemic, our operators have been required to, and continue to, adapt their operations rapidly throughout the pandemic to manage the spread of the COVID-19 virus as well as the implementation of new treatments and vaccines, and to implement new requirements relating to infection control, staffing levels, personal protective equipment (“PPE”), testing mandates, quality of care, visitation protocols and reporting, among other regulations, throughout the pandemic while facing staffing shortages that have accelerated during the pandemic and that may impede the delivery of care. Many of our operators have reported incurring significant cost increases as a result of the COVID-19 pandemic, with dramatic increases for facilities with positive cases. These increases have been offset to some extent by increases in reimbursements due to increased skilling in place, which has been necessitated by pandemic-related protocols and may decrease when such protocols subside. We believe these increases primarily stem from elevated labor costs, including increased use of overtime and bonus pay and reliance on agency staffing due to staffing shortages, as well as a significant increase in both the cost and usage of PPE, testing equipment and processes and supplies, as well as implementation of new infection control protocols and vaccination programs. In addition, many

The federal government announced in August and September 2021 that it would be requiring SNF and healthcare workers to be vaccinated against COVID-19 and issued an emergency implementing regulation effective November 5, 2021 requiring covered healthcare facilities to ensure eligible staff have received a first vaccine dose as of ourDecember 5, 2021 and a second dose of a two-dose vaccine as of January 4, 2022, with certain permitted exemptions in alignment with federal law, which were subsequently extended by the U.S. Centers for Medicare and Medicaid Services by between one to two months depending on the applicable state. Our operators have reported experiencingincreases in staff vaccination rates during the first quarter of 2022; however, we expect that such mandates may exacerbate ongoing staffing shortages in skilled nursing and senior housing facilities. In addition, operators who do not achieve full compliance with the requirements may face potential survey issues and penalties. At this time, there is significant uncertainty regarding the impact of such developments.

In addition, our facilities, on average, have experienced declines, in some cases that are material, in occupancy levels as a result of the pandemic. While these declinesOccupancy in our facilities has generally improved on average appearsince early 2021, with a slight reduction in growth in late 2021 and early 2022 due to be stabilizing and even marginally improving in recent months, itthe impact of new variants; however, average occupancy has not returned to pre-pandemic levels. It remains unclear when and the extent to which demand and occupancy levels will return to pre-COVID-19 levels. We believe these challenges to occupancy declinesrecovery may be in part due to staffing shortages, which in some cases have required operators to limit admissions, as well as COVID-19 related fatalities at the facilities, the delay of SNF placement and/or utilization of alternative care settings for those with lower level of care needs, the suspension and/or postponement of elective hospital procedures, fewer discharges from hospitals to SNFs and higher hospital readmittances from SNFs.

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While substantial government support, primarily through the federal CARES Act in the U.S. and distribution of PPE, vaccines and testing equipment by federal and state governments, has beenwas allocated to SNFs and to a lesser extent to ALFs in 2020, federal relief efforts were limited in 2021 as have been relief efforts in certain states. We believe further government support will likely be needed to continue to offset these impacts.impacts, which may take the form of stimulus or reimbursement rate adjustments to reflect sustained cost changes experienced by operators. It is unclear whether and to what extent such government support will continue to be sufficient and timely to offset these impacts. In particular, while $25.5 billion in federal funding for healthcare providers impacted by COVID-19 was announced in September 2021 with distributions beginning in late 2021, it remains unclear asthe extent to whetherwhich these funds or remaining unallocated funds under the Public Health and Social Services Emergency Fund (“Provider Relief Fund”) will be distributed to our operators in any meaningful way, whether additional funds will be added to the Provider Relief Fund or otherwise allocated to health carehealthcare operators or our operators, or whether additional Medicaid funds under the recently enacted American Rescue Plan Act of 2021 (the “American Rescue Plan Act”) or other Medicare or Medicaid reimbursement rates changes in the U.S. will ultimately support reimbursement to our operators. Further, to the extent the cost and occupancy impacts on our operators continue or accelerate and are not offset by continued government relief that is sufficient and timely, we anticipate that the operating results of certain of ouradditional operators wouldmay be materially and adversely affected, some may be unwilling or unable to pay their contractual obligations to us in full or on a timely basis and we may be unable to restructure such obligations on terms as favorable to us as those currently in place. Citing in part the impact of the COVID-19 pandemic and uncertainties regarding the continuing availability of sufficient government support, during the third and fourth quarters of 2020, four of our operators indicated in their financial statements substantial doubt regarding their ability to continue as going concerns.

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There are a number of uncertainties we face as we consider the potentialcontinuing impact of COVID-19 on our business, including how long census disruption and elevated COVID-19 costs will last, the impact of vaccination programs, including booster doses, and participation levels in those programs in reducing the spread of COVID-19 in our facilities, the impact of genetic mutations of the virus into new variants on our facilities, the impact of vaccine mandates on ongoing staffing shortages in our facilities, and the extent to which funding support from the federal government and the states will continue to offset these incremental costs as well as lost revenues. Notwithstanding vaccination programs, we expect that heightened clinical protocols for infection control within facilities will continue for some period; however, we do not know if future reimbursement rates or equipment provided by governmental agencies will be sufficient to cover the increased costs of enhanced infection control and monitoring.

While we continue to believe that longer term demographics will drive increasing demand for needs-based skilled nursing care, we expect the uncertainties to our business described above to persist at least for the near term until we can gain more information as to the level of costs our operators will continue to experience and for how long, and the level of additional governmental support that will be available to them, the potential support our operators may request from us and the future demand for needs-based skilled nursing care and senior living facilities. We continue to monitor the impactrate of occupancy declinesrecovery at many of our operators, and it remains uncertain whether and when demand, staffing availability and occupancy levels will return to pre-COVID-19 levels.

We continue to monitor the impacts of other regulatory changes, as discussed below, including any significant limits on the scope of services reimbursed and on reimbursement rates and fees, which could have a material adverse effect on an operator’s results of operations and financial condition, which could adversely affect the operator’s ability to meet its obligations to us.

Other Trends and Conditions

In addition to the impacts of COVID-19 discussed above, our operators have been and are likely to continue to be adversely affected by labor shortages and increased labor costs. In addition, our operations have also been and are likely to continue to be impacted by increased competition for the acquisition of facilities in the U.S., which has decreased the number of investment opportunities that would be accretive to our portfolio. As part of our continuous evaluation of our portfolio and in connection with certain operator restructuring transactions, we expect to continue to opportunistically sell assets, or portfolios of assets, from time to time.

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Government Regulation and Reimbursement

The following information supplements and updates, and should be read in conjunction with, the information contained under the caption Item 1. Business – Government Regulation and Reimbursement in our Annual Report on Form 10-K for the year ended December 31, 2020.2021.

The healthcare industry is heavily regulated. Our operators, which are primarily based in the U.S., are subject to extensive and complex federal, state and local healthcare laws and regulations; we also have several U.K.-based operators thatwhich are impacted bysubject to a variety of laws and regulations in their jurisdiction. These laws and regulations are subject to frequent and substantial changes resulting from the adoption of new legislation, rules and regulations, and administrative and judicial interpretations of existing law. The ultimate timing or effect of these changes, which may be applied retroactively, cannot be predicted. Changes in laws and regulations impacting our operators, in addition to regulatory non-compliance by our operators, can have a significant effect on the operations and financial condition of our operators, which in turn may adversely impact us. There is the potential that we may be subject directly to healthcare laws and regulations because of the broad nature of some of these regulations, such as the Anti-kickback Statute and False Claims Act, among others.

The U.S. Department of Health and Human Services (“HHS”) declared a public health emergency on January 31, 2020 following the World Health Organization's decision to declare COVID-19 a public health emergency of international concern. This declaration, which has been extended through October 17, 2021,July 15, 2022, allows HHS to provide temporary regulatory waivers and new reimbursement rules designed to equip providers with flexibility to respond to the COVID-19 pandemic by suspending various Medicare patient coverage criteria and documentation and care requirements, including, for example, suspension of the three-day prior hospital stay coverage requirement and expanding the list of approved services which may be provided via telehealth. These regulatory actions couldhave contributed, and may continue to contribute, to a change in census volumes and skilled nursing mix that may not otherwise have occurred. It remains uncertain when federal and state regulators will resume enforcement of those regulations which are waived or otherwise not being enforced during the public health emergency due to the exercise of enforcement discretion.  

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These temporary changes to regulations and reimbursement, as well as emergency legislation, including the CARES Act enacted on March 27, 2020 and discussed below, continue to have a significant impact on the operations and financial condition of our operators. The extent of the COVID-19 pandemic’s effect on the Company’s and our operators’ operational and financial performance will depend on future developments, including the sufficiency and timeliness of additional governmental relief, the duration, spread and intensity of the outbreak, the impact of genetic mutations of the virus into new variants, the impact of vaccine distributions and booster doses on our operators and their populations, the impact of vaccine mandates on staffing shortages at our operators, as well as the difference in how the pandemic may impact SNFs in contrast to ALFs, all of which developments and impacts are uncertain and difficult to predict. Due to these uncertainties, we are not able at this time to estimate the effect of these factors on our business; however, the adverse impact on our business, results of operations, financial condition and cash flows could be material.  

A significant portion of our operators’ revenue is derived from government-funded reimbursement programs, consisting primarily of Medicare and Medicaid. As federal and state governments continue to focus on healthcare reform initiatives, efforts to reduce costs by government payors will likely continue. Significant limits on the scope of services reimbursed and/or reductions of reimbursement rates could therefore have a material adverse effect on our operators’ results of operations and financial condition. Additionally, new and evolving payor and provider programs that are tied to quality and efficiency could adversely impact our tenants’ and operators’ liquidity, financial condition or results of operations, and there can be no assurance that payments under any of these government health carehealthcare programs are currently, or will be in the future, sufficient to fully reimburse the property operators for their operating and capital expenses. In addition to quality and value based reimbursement reforms, the U.S. Centers for Medicare and Medicaid Services (“CMS”) has implemented a number of initiatives focused on the reporting of certain facility specific quality of care indicators that could affect our operators, including publicly released quality ratings for all of the nursing homes that participate in Medicare or Medicaid under the CMS “Five Star Quality Rating System.” Facility rankings, ranging from five stars (“much above average”) to one star (“much below average”) are updated on a monthly basis. SNFs are required to provide information for the CMS Nursing Home Compare website regarding staffing and quality measures. These rating changes have impacted referrals to SNFs, and it is possible that changes to this system or other ranking systems could lead to future reimbursement policies that reward or penalize facilities on the basis of the reported quality of care parameters.  

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The following is a discussion of certain U.S. laws and regulations generally applicable to our operators, and in certain cases, to us.

Reimbursement Changes Related to COVID-19:

U.S. Federal Stimulus Funds through the CARES Act and Provider Relief Fund, Appropriating $178 billion to Health Care Providers. Financial Assistance for Healthcare Providers. In response to the pandemic, Congress has enacted a series of economic stimulus and relief measures throughout 2020.measures. On March 18, 2020, the Families First Coronavirus Response Act was enacted in the U.S., providing a temporary 6.2% increase to each qualifying state and territory’s Medicaid Federal Medical Assistance Percentage (“FMAP”) effective January 1, 2020. The temporary FMAP increase will extend through the last day of the calendar quarter in which the public health emergency terminates. States will make individual determinations about how this additional Medicaid reimbursement will be applied to SNFs, if at all.

In a further response to the pandemic, the CARES Act authorized approximately $178 billion to be distributed through the Provider Relief Fund to reimburse eligible healthcare providers for health carehealthcare related expenses or lost revenues that arewere attributable to coronavirus. As part of the $178 billion, in May 2020, HHS announced that approximately $9.5 billion in targeted distributions would be made available to eligible SNFs, approximately $2.5 billion of which were composed of performance-based incentive payments tied to a facility’s infection rate. Further, in September 2021, HHS announced the release of $25.5 billion in provider funding, including $17 billion of the $178 billion previously authorized through the CARES Act and $8.5 billion for rural providers, including those with Medicaid and Medicare patients, through the American Rescue Plan Act. The Provider Relief Fund is administered under the broad authority and discretion of HHS and recipients are not required to repay distributions received to the extent they are used in compliance with applicable requirements. Also in September 2021, the Centers for Disease Control and Prevention (“CDC”) announced it would allocate $500 million to staffing, training and deployment of state-based nursing home and long-term care “strike teams” to assist facilities with known or suspected COVID-19 outbreaks.

HHS began distributing Provider Relief Fund grants in April 2020 and has made grants available to various provider groups in three general phases. In May 2020, HHS announced that approximately $9.5 billion in targeted distributions would be made available to eligible skilled nursing facilities, approximately $2.5 billion of which were composed of performance-based incentive payments tied to a facility’s infection rate. Approximately $8.5 billion in additional funds were added to the Provider Relief Fund through the American Rescue Plan Act enacted on March 11, 2021; however, these funds are limited to rural providers and suppliers.  

As of March 15, 2021, based on data published by HHS, it appears that less than $29 billion of the Provider Relief Fund remains unallocated. HHS continues to evaluate and provide allocations of, and issue regulations and guidance regarding, grants made under the CARES Act and related legislation. There are substantial uncertainties regarding the extent to which our operators will receive funds which have not been allocated, whether additional funds will be allocated to the Provider Relief Fund, health care providers or senior care providers and whether additional payments will be distributed to providers, the financial impact of receiving any of these funds on their operations or financial condition, and whether operators will be able to meet the compliance requirements associated with the funds. HHS continues to evaluate and provide allocations of, and issue regulation and guidance regarding, grants made under the CARES Act. There are substantial uncertainties regarding the extent to which our operators will receive additional funding from HHS.

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The CARES Act and related legislation also made other forms of financial assistance available to healthcare providers, which have the potential to impact our operators to varying degrees. This assistance includes Medicare and Medicaid payment adjustments and an expansion of the Medicare Accelerated and Advance Payment Program, which made available accelerated payments of Medicare funds in order to increase cash flow to providers. These payments are loans that providers are scheduled to repay beginning one year from the issuance date of each provider’s or supplier’s accelerated or advance payment, with repayment made through automatic recoupment of 25% of Medicare payments otherwise owed to the provider or supplier for eleven months, followed by an increase to 50% for another six months, after which any outstanding balance would be repaid subject to an interest rate of 4%. We believe these repayments commenced for many of our operators in April 2021 and have adversely impacted, and will continue to adversely impact, operating cash flows of these operators.

Additionally, the Centers for Medicare and Medicaid Services (“CMS”)CMS suspended Medicare sequestration payment adjustments, which would have otherwise reduced payments to Medicare providers by 2%, from May 1, 2020 through December 31, 2021,2020, but also extended sequestration through 2030. The Bipartisan-Bicameral Omnibus COVID Relief Deal that passed in December 2020 further extended the suspension of the Medicare sequestration until March 31, 2021, and it most recently has been further extended from December 31, 2021 through March 31, 2022, resulting in a 1% cut in Medicare reimbursement for the three months starting April 1, 2022 and the full 2% sequester resuming July 1, 2022. While not limited to healthcare providers, the CARES Act additionally provided payroll tax relief for employers, allowing them to defer payment of employer Social Security taxes that are otherwise owed for wage payments made after March 27, 2020 through December 31, 2020 to December 31, 2021 with respect to 50% of the payroll taxes owed, with the remaining 50% deferred until December 31, 2022.

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Quality of Care Initiatives and Additional Requirements Related to COVID-19:

COVID-19.

In addition to COVID-19 reimbursement changes, several regulatory initiatives announced in 2020 and the first quarter of 2021 focused on addressing quality of care in long-term care facilities, including those related to COVID-19 testing and infection control protocols, vaccine protocols, staffing levels, reporting requirements, and visitation policies, as well as increased inspection of nursing homes. For example,In August 2021, CMS announced it was developing an emergency regulation requiring staff vaccinations within the nation’s more than 15,000 Medicare and Medicaid-participating nursing homes, and in September 2021, CMS further announced that the scope of the regulation will be expanded to include workers in hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies. In addition, recent updates to the Nursing Home Care website and the Five Star Quality Rating System include revisions to the inspection process, adjustment of staffing rating thresholds, and the implementation of new quality measures.measures and the inclusion of a staff turnover percentage (over a 12-month period). Additionally, the Biden Administration announced a focus on implementing minimum staffing requirements and increased inspections as part of the nursing home reforms announced in the 2022 State of the Union Address. Although the American Rescue Plan Act did not allocate specific funds to SNF or assisted living facilityALF providers, approximately $200 million was allocated to quality improvement organizations to provide infection control and vaccination uptake support to SNFs.SNFs and $500 million has been allocated by the CDC to staffing, training and deployment of state-based nursing home and long-term care “strike teams” to assist facilities with known or suspected COVID-19 outbreaks.

On June 16, 2020, the U.S. House of Representatives Select Subcommittee on the Coronavirus Crisis announced the launch of an investigation into the COVID-19 response of nursing homes and the use of federal funds by nursing homes during the pandemic. The Select Subcommittee continued to be active throughout the remainder of 2020 and the first quarter of 2021. In March 2021, the Oversight Subcommittee of the House Ways and Means Committee held a hearing on examining the impact of private equity in the U.S. health carehealthcare system, including the impact on quality of care provided within the skilled nursing industry. The Biden Administration additionally announced in March 2022 a focus on reviewing private equity investment specifically in the skilled nursing sector. These hearings,initiatives, as well as additional calls for government review of the role of private equity in the U.S. healthcare industry, could result in legislation imposing additional requirements on our operators.

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Reimbursement Generally:

Medicaid.Medicaid.  The American Rescue Plan Act contains several provisions designed to increase coverage, expand benefits, and adjust federal financing for state Medicaid programs. For example, the American Rescue Plan Act increases the FMAP by 10 percentage points for state home and community-based services expenditures beginning April 1, 2021 through March 30, 2022 in an effort to assist seniors and people with disabilities to receive services safely in the community rather than in nursing homes and other congregate care settings. As a condition for receiving the FMAP increase, states must enhance, expand, or strengthen their Medicaid home and community-based services program during this period. These potential enhancements to Medicaid reimbursement funding may be offset in certain states by state budgetary concerns, the ability of the state to allocate matching funds and to comply with the new requirements, the potential for increased enrollment in Medicaid due to unemployment and declines in family incomes resulting from the COVID-19 pandemic, and the potential allocation of state Medicaid funds available for reimbursement away from SNFs in favor of home and community-based programs. These challenges may particularly impact us in states where we have a larger presence, including Florida and Texas. In Texas in particular, several of our operators have historically experienced lower operating margins on their SNFs, as compared to other states, as a result of lower Medicaid reimbursement rates and higher labor costs. Our operators in Texas may also be adversely impacted by the expected expiration upon expiration of the federally declared public health emergency, of an add-on by the state to the daily reimbursement rate for Medicaid patients duringthat will terminate upon expiration of the pandemic.federally declared public health emergency. In Florida, while added support to our operators during the pandemic has generally been limited, andapproximately $100 million in additional FMAP funds for nursing homes was approved by the State in November 2021, with the funds to be distributed through increased Medicaid payment rates over a three-month period. In addition, on April 6, 2022, the State of Florida enacted staffing reforms for SNFs that may provide additional flexibility to our operators in the state may be additionally adversely impactedmeeting minimum staffing requirements by the scheduled expiration in December 2021 of a three-year temporary Medicaid reimbursement rate increase by the state.using supplemental staff. Since our operators’ profit margins on Medicaid patients are generally relatively low, more than modest reductions in Medicaid reimbursement or an increase in the percentage of Medicaid patients has in the past and may in the future adversely affect our operators’ results of operations and financial condition, which in turn could adversely impact us.

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Medicare.Medicare.  On July 29, 2021, CMS issued a final rule regarding the government fiscal year 2022 Medicare payment rates and quality payment programs for SNFs, with aggregate Medicare Part A payments projected to increase by $410 million, or 1.2%, for fiscal year 2022 compared to fiscal year 2021. This estimated reimbursement increase is attributable to a 2.7% market basket increase factor less a 0.8 percentage point forecast error adjustment and a 0.7 percentage point productivity adjustment, and a $1.2 million decrease due to the proposed reduction to the SNF prospective payment system rates to account for the recent blood-clotting factors exclusion. The annual update is reduced by two percentage points for SNFs that fail to submit required quality data to CMS under the SNF Quality Reporting Program. CMS has indicated that these impact figures did not incorporate the SNF Value-Based Program reductions that are estimated to be $184.25 million in fiscal year 2022. While Medicare reimbursement rate setting, which takes effect annually each October, has historically included forecasted inflationary adjustments, the degree to which those forecasts accurately reflect current inflation rates remains uncertain. Additionally, it remains uncertain whether these adjustments will ultimately be offset by non-inflationary factors, including any adjustments related to the impact of various payment models, such as those described below.

Payments to providers continue to be increasingly tied to quality and efficiency. The Patient Driven Payment Model (“PDPM”), which was designed by CMS to improve the incentives to treat the needs of the whole patient, became effective October 1, 2019. CMS intended PDPM to be revenue-neutral to operators, with future Medicare reimbursement reductions possible if that was not the case. In April 2022, CMS put out a proposal for comment, which included an adjustment to obtain that revenue neutrality as early as the 2023 rate setting period; however, that proposal may change significantly prior to adoption. Prior to COVID-19, we believed that certain of our operators could realize efficiencies and cost savings from increased concurrent and group therapy under PDPM and some had reported early positive results. Given the ongoing impacts of COVID-19, many operators are and may continue to be restricted from pursuing concurrent and group therapy and unable to realize these benefits. Additionally, our operators continue to adapt to the reimbursement changes and other payment reforms resulting from the value basedvalue-based purchasing programs applicable to SNFs under the 2014 Protecting Access to Medicare Act, which became effective on October 1, 2018.Act. These reimbursement changes have had and may, together with any further reimbursement changes to PDPM or value-based purchasing models, in the future have an adverse effect on the operations and financial condition of some operators and could adversely impact the ability of operators to meet their obligations to us.    

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TableOn May 27, 2020, CMS added physical therapy, occupational therapy and speech-language pathology to the list of Contentsapproved telehealth Providers for the Medicare Part B programs provided by a SNF as a part of the COVID-19 1135 waiver provisions. The COVID-19 1135 waiver provisions also allow for the facility to bill an originating site fee to CMS for telehealth services provided to Medicare Part B beneficiary residents of the facility when the services are provided by a physician from an alternate location, effective March 6, 2020 through the end of the public health emergency.

Other Regulation:

Department of Justice and Other Enforcement Actions:

Actions.  SNFs are under intense scrutiny for ensuring the quality of care being rendered to residents and appropriate billing practices conducted by the facility. The Department of Justice (“DOJ”) has historically used the False Claims Act to civilly pursue nursing homes that bill the federal government for services not rendered or care that is grossly substandard. For example, California prosecutors announced in March 2021 an investigation into a skilled nursing provider that is affiliated with one of our operators, alleging the chain manipulated the submission of staffing level data in order to improve its Five Star rating. In 2020, the DOJ launched a National Nursing Home Initiative to coordinate and enhance civil and criminal enforcement actions against nursing homes with grossly substandard deficiencies. Such enforcement activities are unpredictable and may develop over lengthy periods of time. An adverse resolution of any of these enforcement activities or investigations incurred by our operators may involve injunctive relief and/or substantial monetary penalties, either or both of which could have a material adverse effect on their reputation, business, results of operations and cash flows.

Critical Accounting Policies37

2022 and EstimatesRecent Highlights

Our financial statements are prepared in accordance with generally accepted accounting principles (“GAAP”) in the U.S. Our preparationInvestments

We acquired $108.5 million of real estate assets which included 30 facilities during the three months ended March 31, 2022. The initial cash yield (the initial annual contractual cash rent divided by the purchase price) on these asset acquisitions was between 8% and 9.5%.
We invested $18.2 million under our construction-in-progress and capital improvement programs during the three months ended March 31, 2022.
In the first quarter of 2022, we advanced $2.8 million under existing mortgage loans.

Dispositions and Impairments

In the first quarter of 2022, we sold 27 facilities for approximately $332.6 million in net cash proceeds, recognizing a net gain of approximately $113.6 million. One of these facilities was sold to the joint venture that was consolidated in the first quarter of 2022. The proceeds and gain primarily relate to the sale of 22 facilities that were previously leased and operated by Gulf Coast Health Care LLC (together with certain affiliates “Gulf Coast”) and were included in assets held for sale as of December 31, 2021. The net cash proceeds from the sale, including certain costs accrued as of the end of the first quarter, were $304.0 million, and we recognized a net gain of approximately $113.5 million.
In the first quarter of 2022, we recorded impairments on real estate properties of approximately $3.5 million on two facilities primarily as a result of reclassifying facilities to held for sale.
In March 2022, we reclassified seven facilities leased to Guardian Healthcare (“Guardian”) to held for sale in connection with the planned restructuring. We also entered into agreements to sell seven of these held for facilities in March and April 2022 for estimated gross proceeds of $36.5 million. As of March 31, 2022, the remaining 19 facilities in held for sale are all under sales agreements which provide for estimated proceeds of $83.1 million, subject to terms and conditions of such agreements.

Financing Activities

In January 2022, our Board authorized the repurchase of up to $500 million of our outstanding common stock, from time to time, through March 2025. During the first quarter of 2022, the Company repurchased 980,530 shares of our outstanding common stock at an average price of $27.84 per share. In April 2022, the Company repurchased 3.9 million of our outstanding common stock for $106.1 million.

Other Highlights

During the first quarter of 2022, we made $25.8 million of new other investment loans with a weighted average interest rate of 8.5%. Of the $25.8 million, $25 million relates to a term loan entered into with LaVie Care Centers, LLC (“LaVie,” f/k/a Consulate Health Care) that bears interest at a fixed rate of 8.5% per annum and matures on March 31, 2032. During the first quarter of 2022, we also advanced $72.2 million under existing other investment loans. Of the $72.2 million, $47.4 million related to a revolving working capital loan which also had repayments of $48.1 million during the first quarter of 2022.
In 2022, Omega was again included in the Bloomberg Gender-Equality Index (GEI) – one of only 418 companies worldwide, and fewer than 15 U.S. REITs, to be included in the 2022 index.

38

Collectibility Issues

During the first quarter of 2022, Agemo Holdings, LLC (“Agemo”) continued to not pay contractual rent and interest due under its lease and loan agreements. As Agemo was already placed on a cash basis of revenue recognition during the third quarter of 2020, no revenue was recorded during the three months ended March 31, 2022. In the first quarter of 2022, we recorded a provision for credit losses of $4.7 million related to the $25.0 million secured working capital loan as a result of a reduction in the fair value of the underlying collateral assets supporting the current carrying values.
During the first quarter of 2022, Guardian Healthcare (“Guardian”) continued to not make contractual rent and interest payments under its lease and loan agreements. As Guardian was already placed on a cash basis of revenue recognition in the fourth quarter of 2021, no revenue was recorded during the three months ended March 31, 2022. We recorded a $5.1 million recovery for credit losses in the first quarter of 2022 on the Guardian mortgage loan in connection with a $21.7 million principal repayment on the loan from the proceeds of the sale of three of the mortgage facilities. We also transitioned or sold 10 facilities that were previously leased to Guardian in the first quarter of 2022 in connection with on-going restructuring activities. In April 2022, we agreed to a formal restructuring agreement, master lease amendment and mortgage loan amendment with Guardian. As part of the restructuring agreement and amendments, Omega and Guardian agreed to, among other things, allow for the deferral of up to $18.0 million of aggregate rent and interest, effective retrospectively, with repayment required after September 30, 2024 and to reduce the combined rent and mortgage interest to an aggregate $24.0 million following the completion of the sale of those seven facilities. Guardian made a partial payment in April 2022 after exhausting the maximum allowable deferral of $18.0 million under the restructuring agreement.
From January through March 2022, an operator, representing 3.8% and 3.3%, respectively, of total revenue (excluded the impact of write-offs) for the three months ended March 31, 2022 and 2021, did not pay its contractual amounts due under its lease agreement. In March 2022, the lease with this operator was amended to allow for a short-term rent deferral for January through March 2022. This operator paid the contractual amount due under its lease agreement in April 2022. Omega holds a $1.0 million letter of credit and a $150 thousand security deposit from this operator. The operator remains current on its loan obligations, which are secured by a first lien on the accounts receivable of the operator.
In March 2022, another operator representing 2.3% and 2.1%, respectively, of total revenue (excluding the impact of write-offs) for the three months ended March 31, 2022 and 2021, did not pay its contractual amounts due under its lease agreement. In April 2022, the lease with this operator was amended to allow the operator to apply its $2.0 million security deposit in order to pay March 2022 rent and to allow for a short-term rent deferral for April 2022, with regular rent payments required to resume in May 2022.
During the first quarter of 2022, we allowed three other operators, each representing 2.5% and 2.7%, respectively, of total revenue (excluding the impact of write-offs) for the three months ended March 31, 2022 and 2021 to apply $1.3 million of their security deposits to pay rent in order to accommodate short term liquidity issues, with regular rent payments required to resume shortly thereafter. As of April 30, 2022, all of these operators are current on their lease obligations. These operators are required to begin replenishing their security deposits in 2023.
During the first quarter of 2022, we wrote off straight-line rent receivable balances of $3.2 million through rental income as a result of transitioning six facilities to another existing operator.

Dividends

On April 21, 2022, the Board of Directors declared a cash dividend for the quarter ended March 31, 2022 of $0.67 per share.

39

Results of Operations

The following is our discussion of the consolidated results of operations, financial position and liquidity and capital resources, which should be read in conjunction with our unaudited consolidated financial statements and accompanying notes.

Three Months Ended June 30,March 31, 2022 and 2021 and 2020

Revenues

Our revenues for the three months ended June 30, 2021March 31, 2022 totaled $257.4$249.3 million, an increasea decrease of approximately $1.0$24.5 million over the same period in 2020. The $1.02021. Included below is a description of the material changes in revenues for three months ended March 31, 2022 compared to the same period in 2021:

Rental income was $216.9 million, a decrease of $20.9 million over the same period in 2021. The decrease was primarily the result of (i) a $17.4 million decrease relating to two cash basis operators, Agemo and Guardian, from which we received no rental payments and recorded no revenue for in the first quarter of 2022; (ii) a $7.3 million decrease as a result of recognizing no rental income associated with the 24 facilities previously leased to Gulf Coast in the first quarter of 2022, as 23 of the facilities were temporarily transitioned to another operator in December 2021 that was not required to pay contractual rent during the transition period, as a part of the chapter 11 bankruptcy process; and (iii) a $4.6 million decrease resulting from the acceleration of certain in-place lease liabilities due to facility transitions. The overall decrease in rental income was partially offset by (i) a $6.4 million increase due to additional rental income in the first quarter of 2022 from acquisitions and construction in progress facilities being placed in service and (ii) a net increase of $1.8 million due to lease extensions, facility transitions and sales.
Mortgage interest income was $20.5 million, a decrease of $3.1 million over the same period in 2021. The decrease was primarily the result of recognizing no interest income in the first quarter of 2022 on the Guardian mortgage loan with $82.0 million of principal outstanding as of March 31, 2022. The loan was placed on non-accrual status in the fourth quarter of 2021, with all payments received (none in the first quarter of 2022) applied directly to principal under the cost recovery method.

Expenses

Our expenses for the three months ended March 31, 2022 totaled $167.7 million, increase was primarilya decrease of approximately $23.4 million over the resultsame period in 2021. Included below is a description of (i) a $30.4 million increasethe material changes in rental income resulting from facility acquisitions, facilities placedexpenses for three months ended March 31, 2022 compared to the same period in service, and facility transitions and (ii) a $3.2 million increase in mortgage interest income and other investment income primarily related to new and refinanced mortgages or notes and additional funding to existing operators offset by principal payments. These increases were partially offset by (i) a $21.5 million decrease in rental income primarily resulting from placing certain operators on a cash basis for revenue recognition, (ii) a $2.4 million decrease in rental income resulting from the acceleration of certain in-place lease liabilities, (iii) a $6.8 million decrease in rental income resulting from facility sales and facility transitions and (iv) a $1.6 million decrease in miscellaneous income which is primarily related to an operator’s late fees and reduced management fees.2021:

Our depreciation and amortization expense was $82.8 million, a $2.1 million decrease over the same period in 2021. The decrease primarily relates to facility sales and facilities reclassified to assets held for sale, such as the 22 Gulf Coast facilities that were sold in the first quarter of 2022, partially offset by facility acquisitions and capital additions.
Our impairment on real estate properties was $3.5 million, a decrease of $25.2 million over the same period in 2021. The 2022 impairments were recognized in connection with reclassifying two facilities to held for sale in the first quarter to reduce their net book value to the estimated fair value less costs to sell. The 2021 impairments related to four facilities, three of which were recognized in connection with reclassifying the facilities to assets held for sale.

3840

Expenses

Expenses for the three months ended June 30, 2021 totaled $175.1 million, an increase of approximately $7.1 million over the same period in 2020. The $7.1 million increase was primarily due to: (i) a $3.5 million increase in provision for credit losses primarily resulting from a $4.5 million reserve related to a term loan, (ii) a $3.6 million increase in interest expense primarily resulting from the issuance during the fourth quarter of 2020 of the $700 million of Senior Notes due 2031 and the issuance during the first quarter of 2021 of the $700 million of Senior Notes due 2033, partially offset by the retirement of term loans in the fourth quarter of 2020 and (iii) a $2.2 million increase in depreciation expense primarily resulting from facility acquisitions and capital additions, offset by facility sales and facilities reclassified to assets held for sale. These increases were partially offset by a $3.2 million decrease in impairment on real estate properties related to three facilities in the second quarter of 2021 compared to 10 facilities during the same period in 2020.

Our provision for credit losses was $1.8 million, a $2.8 million increase over the same period in 2021. The increase was primarily as a result of additional reserves taken against a loan outstanding to Agemo (see Item 2 – Management’s Discussion and Analysis of Financial Condition and Results of Operations – Collectibility Issues), increases in loan balances and increases in loss rates in the first quarter of 2022 compared to the same period in 2021 partially offset by recoveries for cash collections and paydowns received on the Guardian mortgage (see Item 2 – Management’s Discussion and Analysis of Financial Condition and Results of Operations – Collectibility Issues).

Other Income (Expense)

For the three months ended June 30, 2021,March 31, 2022, total other income was $4.3$113.2 million, a decreasean increase of approximately $8.7$42.3 million over the same period in 2020.2021. The decrease was mainly due to an $8.7 million decrease in gain on assets sold related to the sale of six facilities in the second quarter of 2021 compared to the sale of 15 facilities during the same period in 2020.

Six Months Ended June 30, 2021 and 2020

Revenues

Our revenues for the six months ended June 30, 2021 totaled $531.2 million, an increase of approximately $21.8 million over the same period in 2020. The $21.8 million increase was primarily the result of (i) a $54.7 million increase in rental income resulting from facility acquisitions, facilities placed in service, and facility transitions and (ii) an $8.2 million increase in mortgage interest income and other investment income primarily related to new and refinanced mortgages or notes and additional funding to existing operators. These increases were partially offset by (i) a $29.4 million decrease in rental income resulting from operators placed on a cash basis for revenue recognition, (ii) a $5.3 million decrease in rental income resulting from facility sales and facility transitions, and (iii) a $2.1 million decrease in miscellaneous income which is primarily related to an operator’s late fees and reduced management fees.

Expenses

Expenses for the six months ended June 30, 2021 totaled $366.3 million, an increase of approximately $36.0 million over the same period in 2020. The $36.0 million increase was primarily due to: (i) a $21.9$29.7 million increaseloss on debt extinguishment in impairment on real estate properties related to seven facilities compared to 13 facilities during the same period in 2020, (ii) a $6.9 million increase in interest expense primarily resulting from the issuance during the fourth quarter of 2020 of the $700 million of Senior Notes due 2031 and the issuance during the first quarter of 2021 of the $700 million of Senior Notes due 2033, partially offset by the retirement of term loans in the fourth quarter of 2020, (iii) a $4.4 million increase in depreciation expense primarily resulting from facility acquisitions and capital additions, offset by facility sales and facilities reclassified to assets held for sale (discussed in further detail below), (iv) a $1.8 million increase in acquisition, merger and transition related costs primarily resulting from the Daybreak transition, and (v) a $1.0 million increase in provision for credit losses primarily resulting from a $4.5 million reserve related to a term loan, increases in loan balances and increases in average time to maturity offset by decreases in loss rates compared to the same period in 2020.

Other Income (Expense)

For the six months ended June 30, 2021, total other income was $75.2 million, an increase of approximately $61.2 million over the same period in 2020. The increase was mainly due to a $89.8 million increase in gain on assets sold related to the sale of 30 facilities compared to the sale of 21 facilities during the same period in 2020 offset by a $30.1 million increase in loss on debt extinguishment primarily related to fees, premiums and expenses related to the purchase of $350 million of the 4.375% Senior Notes due 2023 during the first quarter of 2021 and (ii) $13.3 million increase in gain on assets sold related to the sale of 27 facilities in the first quarter of 2022 compared to the sale of 24 facilities during the same period in 2021.

39

National Association of Real Estate Investment Trusts Funds From Operations

OurWe use funds from operations (“Nareit FFO”) for, a non-GAAP financial measure, as one of several criteria to measure the three months ended June 30, 2021 was $180.8 million compared to $186.5 million for the same period in 2020. Our Nareit FFO for the six months ended June 30, 2021 was $351.1 million compared to $367.5 million for the same period in 2020.

operating performance of our business. We calculate and report Nareit FFO in accordance with the definition of Funds from Operations and interpretive guidelines issued by the National Association of Real Estate Investment Trusts (“Nareit”), and, consequently,. Nareit FFO is defined as net income (computed in accordance with GAAP), adjusted for the effects of asset dispositions and certain non-cash items, primarily depreciation and amortization and impairment on real estate assets, and after adjustments for unconsolidated partnerships and joint ventures and changes in the fair value of warrants. Adjustments for unconsolidated partnerships and joint ventures are calculated to reflect funds from operations on the same basis. Revenue recognized based on the application of security deposits and letters of credit or based on the ability to offset against other financial instruments is included within Nareit FFO. We believe that Nareit FFO is an important supplemental measure of our operating performance. Because the historical cost accounting convention used forAs real estate assets requires depreciation (except on land), are depreciated under GAAP, such accounting presentation implies that the value of real estate assets diminishes predictably over time, while real estate values instead have historically risen or fallen with market conditions. Nareit FFO was designed by the real estate industry to address this issue. Nareit FFO herein is not necessarily comparable to Nareit FFO of other REITs that do not use the same definition or implementation guidelines or interpret the standards differently from us.

Nareit FFO is a non-GAAP financial measure. We use Nareit FFO as one of several criteria to measure the operating performance of our business. We further believe that by excluding the effect of depreciation, amortization, impairment on real estate assets and gains or losses from sales of real estate, all of which are based on historical costs and which may be of limited relevance in evaluating current performance, Nareit FFO can facilitate comparisons of operating performance between periods and between other REITs. We offer this measure to assist the users of our financial statements in evaluating our financial performance under GAAP, and Nareit FFO should not be considered a measure of liquidity, an alternative to net income or an indicator of any other performance measure determined in accordance with GAAP. Investors and potential investors in our securities should not rely on this measure as a substitute for any GAAP measure, including net income. The following table presents our Nareit FFO results for the three and six months ended June 30, 2021 and 2020:

Three Months Ended

Six Months Ended

June 30, 

June 30, 

    

2021

    

2020

2021

    

2020

    

(in thousands)

Net income

$

86,863

$

101,960

$

251,229

$

194,239

Deduct gain from real estate dispositions

(4,123)

(12,843)

(104,465)

(14,681)

Add back loss (deduct gain) from real estate dispositions - unconsolidated joint ventures

 

177

 

(1,838)

 

(14,747)

 

(1,955)

 

82,917

 

87,279

 

132,017

 

177,603

Elimination of non-cash items included in net income:

 

 

  

 

 

  

Depreciation and amortization

 

85,799

 

83,586

 

170,648

 

166,229

Depreciation – unconsolidated joint ventures

 

3,067

 

3,550

 

6,428

 

7,182

Add back impairments on real estate properties

8,822

11,988

37,511

15,627

Add back impairments on real estate properties - unconsolidated joint ventures

252

4,430

(Deduct) add back unrealized (gain) loss on warrants

 

(29)

65

43

840

Nareit FFO

$

180,828

$

186,468

$

351,077

$

367,481

40

Portfolio and Recent Developments

The following table summarizes the significant asset acquisitions that occurred during the first six months of 2021:

Number of

Total

Initial 

    

 Facilities

    

Country/

    

Investment

    

Annual

Period

SNF

ALF

Specialty

State

(in millions)

Cash Yield(1) 

Q1

 

17

7

 

AZ, CA, FL, IL, NJ, OR, PA, TN, TX, VA, WA

$

511.3

(2)

8.43

%

Q1

6

FL

83.1

9.25

%

Total

 

6

17

7

 

  

$

594.4

 

(1)The initial annual cash yield reflects the initial cash rent divided by the purchase price.
(2)On January 20, 2021, we acquired 24 facilities from Healthpeak Properties, Inc. The acquisition involved the assumption of an in-place master lease with Brookdale Senior Living Inc.

During the second quarter of 2021, we acquired one parcel of land (not reflected in the table above) for approximately $10.4 million.

Other Recent Developments

On July 1, 2021, the Company financed six SNFs in Ohio and amended an existing $6.4 million mortgage to include the six facilities in a consolidated $72.4 million mortgage for eight Ohio facilities bearing interest at an initial rate of 10.5% per annum. In conjunction with this transaction, the Company also acquired three Maryland facilities that were previously subject to a mortgage issued by the Company bearing interest at 13.75% per annum with a principal balance of $36.0 million. The purchase price for these three facilities was equal to the remaining mortgage principal amount, and the three acquired Maryland facilities were subsequently leased back to the seller for a term expiring on December 31, 2032, assuming Omega exercises the options under the agreement. The base rent in the initial year is approximately $5.0 million and includes annual escalators of 2.5%. On July 1, 2021, the Company also entered into a $12.0 million revolving credit facility agreement with this operator for working capital expenses for the eight Ohio facilities discussed above with a maturity date of June 30, 2022. The credit facility bears interest at 10% per annum.

On July 14, 2021, the Company acquired two U.K. facilities for $9.5 million and entered into a lease with an existing operator with an initial term expiring on April 23, 2027. The base rent in the initial year is approximately $0.8 million and includes annual escalators of 2.5%.

Asset Sales, Impairments, Contractual Receivables and Other Receivables and Lease Inducements

Asset Sales

During the first quarter of 2021, we sold 24 facilities subject to operating leases for approximately $188.3 million in net cash proceeds, recognizing a net gain of approximately $100.3 million.

During the second quarter of 2021, we sold six facilities subject to operating leases for approximately $12.9 million in net cash proceeds, recognizing a net gain of approximately $4.1 million. As of June 30, 2021, we have nine facilities and one parcel of land, totaling $35.3 million, classified as assets held for sale. We expect to sell these facilities over the next twelve months.

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ImpairmentsThe following table presents our Nareit FFO results for the three months ended March 31, 2022 and 2021:

Three Months Ended

March 31, 

    

2022

    

2021

(in thousands)

Net income

$

195,156

$

164,366

Deduct gain from real estate dispositions

(113,637)

(100,342)

Deduct gain from real estate dispositions - unconsolidated joint ventures

 

 

(14,924)

 

81,519

 

49,100

Elimination of non-cash items included in net income:

 

 

  

Depreciation and amortization

 

82,752

 

84,849

Depreciation – unconsolidated joint ventures

 

2,896

 

3,361

Add back impairments on real estate properties

3,511

28,689

Add back impairments on real estate properties - unconsolidated joint ventures

4,178

Add back unrealized loss on warrants

 

72

Nareit FFO

$

170,678

$

170,249

DuringLiquidity and Capital Resources

Sources and Uses

Our primary sources of cash include rental income and interest receipts, existing availability under our revolving credit facility, proceeds from our DRSPP and the first quarter of$1.0 billion 2021 we recorded impairments onAt-The-Market Offering Program (“2021 ATM Program”), facility sales, and proceeds from mortgage and other investment payoffs. We anticipate that these sources will be adequate to fund our cash flow needs through the next twelve months, which include common stock dividends, debt service payments (including principal and interest), real estate propertiesinvestments (including facility acquisitions, capital improvement programs and other capital expenditures), mortgage and other investment loan advances and normal recurring G&A expenses (primarily consisting of approximately $28.7 million on four facilities (three were subsequently reclassifiedemployee payroll and benefits and expenses relating to assets held for sale in the first quarter of 2021). During the second quarter of 2021, we recorded impairments on real estate properties of approximately $8.8 million on three facilities (all three were subsequently reclassified to assets held for sale in the second quarter of 2021). Our recorded impairments were primarily the result of decisions to exit certain non-strategic facilities and/or operators. We reduced the net book value of the impaired facilities to their estimated fair values or, with respect to the facilities reclassified to held for sale, to their estimated fair values less costs to sell. To estimate the fair value of the facilities, we utilized a market approach which considered binding sale agreements (a Level 1 input) and/or non-binding offers from unrelated third parties and/or broker quotes (a Level 3 input)for legal, consulting and audit services).

Contractual Receivables, Other ReceivablesCapital Structure

At March 31, 2022, we had total assets of $10.0 billion, total equity of $4.1 billion and Lease Inducementstotal debt of $5.7 billion in our consolidated financial statements, with such debt representing approximately 57.9% of total capitalization.

A summaryDebt

At March 31, 2022, the weighted-average annual interest rate of our net receivables by type isdebt was 3.96%. Additionally, as follows:

    

June 30, 

December 31, 

    

2021

    

2020

    

(in thousands)

Contractual receivables – net

$

10,948

$

10,408

Effective yield interest receivables

$

11,554

$

12,195

Straight-line rent receivables

 

138,449

 

139,046

Lease inducements

 

79,506

 

83,425

Other receivables and lease inducements

$

229,509

$

234,666

During the first and second quarters of 2021, we wrote-off approximately $2.7March 31, 2022, 92% of our debt with outstanding principal balances has fixed interest payments.

Two of our interest rate swaps that were entered into in May 2019 with aggregate notional amounts of $50.0 million and $17.4 million, respectively, of straight-line rent receivables to rental incomematured on February 10, 2022. These interest rate swap contracts were designated as a result of transitioning one facility and placing two operators on a cash basis duehedges against our exposure to changes in interest payment cash flow fluctuations in the variable interest rates on the OP term loan.

As of March 31, 2022, we had long-term credit ratings of Baa3 from Moody’s and BBB- from S&P Global and Fitch. Credit ratings impact our evaluationability to access capital and directly impact our cost of capital as well. For example, our revolving credit facility accrues interest and fees at a rate per annum equal to LIBOR plus a margin that depends upon our credit rating. A downgrade in credit ratings by Moody’s and S&P Global may have a negative impact on the collectibility of future rent payments due under the lease agreements.interest rates and fees for our revolving credit facility.

Based on our evaluation of the collectibility of future rent payments due under the lease agreements for the two operators discussed above, we do not believe it is probable that we will be able to collect substantially all rents due. These two operators generated approximately 3%Certain of our total revenues (excluding the impactother secured and unsecured borrowings are subject to customary affirmative and negative covenants, including financial covenants. As of straight-line rent  receivable write-offs in 2021) for the six months ended June 30, 2021March 31, 2022 and 2020. For the six months ended June 30,December 31, 2021, we have been unable to collect approximately $3.5 million of contractual rents due from these operators. We have applied $2.5 million of one of the operator’s security deposit funds against their uncollected receivables, which represents one month of contractual rent under the lease agreement. We have subordinated debt to a third partywere in compliance with an outstanding principal balance of $20 million that matures in December 2021 (see Note 13 – Borrowing Arrangements inall affirmative and negative covenants, including financial covenants, for our Annual Report on Form 10-K for the year ended December 31, 2020). However, that indebtedness (interestsecured and under some circumstances, principal) is subject to offset if contractual rent is not paid when due by one of the subject operators.

Other Investments

Genesis

On March 6, 2018, we amended certain terms of our $48.0 million secured term loan with Genesis Healthcare, Inc. (“Genesis”). The $48.0 million term loan bears interest at a fixed rate of 14% per annum, of which 9% per annum is paid-in-kind and was initially scheduled to mature on July 29, 2020. The maturity date of this loan was extended during the first quarter of 2021 to January 1, 2024. This term loan (and the $16.0 million term loan discussed below) is secured by a first priority lien on and security interest in certain collateral of Genesis. As of June 30, 2021, approximately $68.2 million is outstanding on this term loan.    unsecured borrowings.

42

Also on March 6, 2018, we provided Genesis an additional $16.0 million secured term loan bearing interest at a fixed rate of 10% per annum, of which 5% per annum is paid-in-kind, and was initially scheduled to mature on July 29, 2020. The maturity date of this loan was extended during the first quarter of 2021 to January 1, 2024. As of June 30, 2021, approximately $18.9 million is outstanding on this term loan.

Daybreak

During the first quarter of 2021, we transitioned 14 Daybreak Ventures, LLC (“Daybreak”) facilities to existing operators and sold two Daybreak facilities. During the second quarter of 2021, we sold the two remaining Daybreak facilities. The total annual rent or rent equivalents achieved through transitioning the Daybreak portfolio equal $16.6 million. On April 6, 2021, we terminated the Daybreak master lease and exited that relationship.

We continue to closely monitor the performance of all of our operators, as well as industry trends and developments generally.

Liquidity and Capital Resources

At June 30, 2021, we had total assets of $9.8 billion, total equity of $4.2 billion and debt of $5.3 billion, representing approximately 55.9% of total capitalization.

Financing Activities and Borrowing Arrangements

Revolving Credit Facility

On April 30, 2021, Omega entered into a credit agreement (the “2021 Omega Credit Agreement”) providing us with a new $1.45 billion senior unsecured multicurrency revolving credit facility (the “Revolving Credit Facility”), replacing our previous $1.25 billion senior unsecured 2017 multicurrency revolving credit facility (the “2017 Revolving Credit Facility”). The 2021 Omega Credit Agreement contains an accordion feature permitting us, subject to compliance with customary conditions, to increase the maximum aggregate commitments thereunder to $2.5 billion, by requesting an increase in the aggregate commitments under the Revolving Credit Facility or by adding term loan tranches.

The Revolving Credit Facility bears interest at LIBOR (or in the case of loans denominated in GBP, the Sterling overnight index average reference rate plus an adjustment of 0.1193% per annum) plus an applicable percentage (with a range of 95 to 185 basis points) based on our credit ratings. The Revolving Credit Facility matures on April 30, 2025, subject to Omega’s option to extend such maturity date for two six-month periods. The Revolving Credit Facility may be drawn in Euros, GBP, Canadian Dollars (collectively, “Alternative Currencies”) or U.S. Dollars (“USD”), with a $1.15 billion tranche available in USD and a $300 million tranche available in Alternative Currencies. For purposes of the Revolving Credit Facility, references to LIBOR include the Canadian dealer offered rates for amounts offered in Canadian Dollars and any other Alternative Currency rate approved in accordance with the terms of the 2021 Omega Credit Agreement for amounts offered in any other non-London interbank offered rate quoted currency, as applicable.

We incurred $12.9 million of deferred costs in connection with the 2021 Omega Credit Agreement.

OP Term Loan

On April 30, 2021, Omega OP entered into a credit agreement (the “2021 Omega OP Credit Agreement”) providing it with a new $50 million senior unsecured term loan facility (the “OP Term Loan”). The OP Term Loan replaces the $50 million senior unsecured term loan obtained in 2017 (the “2017 OP Term Loan”) and the related credit agreement. The OP Term Loan bears interest at LIBOR plus an applicable percentage (with a range of 85 to 185 basis points) based on our credit ratings. The OP Term Loan matures on April 30, 2025, subject to Omega OP’s option to extend such maturity date for two, six-month periods.

We incurred $0.4 million of deferred costs in connection with the 2021 Omega OP Credit Agreement.

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$700 Million 3.250% Senior Notes due 2033

In March 2021, we issued $700 million aggregate principal amount of our 3.250% Senior Notes due 2033 (the “2033 Senior Notes”). The 2033 Senior Notes mature on April 15, 2033. The 2033 Senior Notes were sold at an issue price of 99.304% of their face value before the underwriters’ discount. We used the proceeds from this offering to pay down outstanding borrowings on the Revolving Line of Credit, repay the Sterling term loan, and fund the tender offer to purchase $350 million of the 4.375% Senior Notes due 2023 and the payment of accrued interest and related fees, premiums and expenses. In connection with this transaction, we recorded approximately $29.7 million in related fees, premiums, and expenses which were recorded as Loss on debt extinguishment in our Consolidated Statement of Operations.

$400 Million Forward Starting Swaps

On March 27, 2020, we entered into five forward starting swaps totaling $400 million. We designated the forward starting swaps as cash flow hedges of interest rate risk associated with interest payments on a forecasted issuance of fixed rate long-term debt, initially expected to occur within the next five years. The swaps are effective on August 1, 2023 and expire on August 1, 2033 and were issued at a fixed rate of approximately 0.8675%. In March 2021, in conjunction with the issuance of $700 million aggregate principal amount of our 3.25% Senior Notes due 2033, we discontinued hedge accounting for these five forward starting swaps. Amounts reported in Accumulated Other Comprehensive Income (“AOCI”) related to these discontinued cash flow hedging relationships will be reclassified to interest expense over a ten year term. Simultaneously, we re-designated these swaps in new cash flow hedging relationships of interest rate risk associated with interest payments on another forecasted issuance of long-term debt. We are hedging our exposure to the variability in future cash flows for forecasted transactions over a maximum period of 46 months (excluding forecasted transactions related to the payment of variable interest on existing financial instruments).

£174 Million Foreign Exchange Forward Starting Swaps

From the issuance date of our GBP borrowings through the prepayment date in March 2021, we used a nonderivative, GBP-denominated term loan and line of credit totaling £174 million to hedge a portion of our net investments in foreign operations. During March 2021 and concurrent with the settlement of our GBP-denominated term loan and repayment of our GBP-denominated borrowings under our line of credit, we entered into four foreign currency forwards that mature on March 8, 2024 to hedge a portion of our net investments in foreign operations, effectively replacing the terminated net investment hedge. For these derivatives that are designated and qualify as net investment hedges, the gain or loss on the derivative is reported in AOCI as part of the cumulative translation adjustment. Amounts are reclassified out of AOCI into earnings when the hedged net investment is either sold or substantially liquidated.

Supplemental Guarantor Information

Parent has issued approximately $4.9 billion aggregate principal of senior notes outstanding at June 30, 2021March 31, 2022 that were registered under the Securities Act of 1933, as amended. The senior notes are guaranteed by Omega OP.

The SEC adopted amendments to Rule 3-10 of Regulation S-X and created Rule 13-01 to simplify disclosure requirements related to certain registered securities, such as our senior notes. As a result of these amendments, registrants are permitted to provide certain alternative financial and non-financial disclosures, to the extent material, in lieu of separate financial statements for subsidiary issuers and guarantors of registered debt securities. Accordingly, separate consolidated financial statements of Omega OP have not been presented. Parent and Omega OP, on a combined basis, have no material assets, liabilities or operations other than financing activities (including borrowings under the outstanding senior notes, the Revolving Credit Facilityrevolving credit facility and the OP Term Loan)term loan) and their investments in non-guarantor subsidiaries.

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Omega OP is currently the sole guarantor of our senior notes. The guarantees by Omega OP of our senior notes are full and unconditional and joint and several with respect to the payment of the principal and premium and interest on our senior notes. The guarantees of Omega OP are senior unsecured obligations of Omega OP that rank equal with all existing and future senior debt of Omega OP and are senior to all subordinated debt. However, the guarantees are effectively subordinated to any secured debt of Omega OP. As of June 30, 2021,March 31, 2022, there were no significant restrictions on the ability of Omega OP to make distributions to Omega.

At-The-Market Offering ProgramsEquity

During the third quarter of 2015, Omega entered into Equity Distribution Agreements with several financial institutions to sell $500.0At March 31, 2022, we had approximately 238.2 million of shares of common stock from time to time through an “at-the-market” (“ATM”) offering program (the “2015 ATM Program”).  

During the second quarteroutstanding, and our shares had a market value of 2021, the we terminated the 2015 ATM Program and entered into$7.4 billion. The following is a new ATM Equity Offering Sales Agreement pursuant to which sharessummary of common stock having an aggregate gross sales price of up to $1.0 billion (the “2021 ATM Program”) may be sold from time to time (i) by Omega through several financial institutions acting as a sales agent or directly to the financial institutions as principals, or (ii) by several financial institutions acting as forward sellers on behalf of any forward purchasers pursuant to a forward sale agreement. Under the 2021 ATM Program, compensation for sales of the shares will not exceed 2% of the gross sales price per share for shares sold through each financial institution. The use of forward salesactivity under the 2021 ATM Program generally allows Omega to lock in a price on the sale of shares of common stock when sold by the forward sellers but defer receiving the net proceeds from such sales until the shares of our common stock are issued at settlement on a later date. We did not utilize the forward provisions under the 2021 ATM Programequity programs during the three months ended June 30, 2021.March 31, 2022:

The table below presents information regarding the shares issued under the 2021 and 2015 ATM Programs for the three and six months ended June 30, 2020 and 2021:

Shares issued

Average Net Price

Gross Proceeds

Commissions

Net Proceeds

Period Ended

(in millions)

Per Share(1)

(in millions)

Three Months Ended

June 30, 2020

-

$

-

$

-

$

-

$

-

Three Months Ended

June 30, 2021

2.5

36.23

92.4

1.9

90.5

Six Months Ended

June 30, 2020

0.1

36.18

2.0

0.2

1.8

Six Months Ended

June 30, 2021

4.1

36.60

153.8

3.2

150.6

In January 2022, our Board authorized the repurchase of up to $500 million of our outstanding common stock, from time to time, through March 2025. During the first quarter of 2022, the Company repurchased 980,530 shares of our outstanding common stock at an average price of $27.84 per share.
(1)RepresentsWe did not issue any shares of common stock under our 2021 ATM Program during the average price per share after commissions.three months ended March 31, 2022.

Dividend Reinvestment and Common Stock Purchase Plan

The table below presents information regarding the shares issued under the Dividend Reinvestment and Common Stock Purchase Plan for the three and six months ended June 30, 2020 and 2021:

Shares issued

Gross Proceeds

Period Ended

(in millions)

(in millions)

Three Months Ended

June 30, 2020

-

$

-

Three Months Ended

June 30, 2021

1.6

61.8

Six Months Ended

June 30, 2020

0.1

3.7

Six Months Ended

June 30, 2021

2.0

77.3

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Commitments

We have committed to fund the construction of new leased and mortgaged facilities, capital improvements and other commitments. We expect the funding of these commitments to be completed over the next several years. Our remaining commitments at June 30, 2021, are outlined in the table below (in thousands):

Total commitments

    

$

539,528

Amounts funded to date (1)

 

(415,281)

Remaining commitments (2)

$

124,247

(1)Includes finance costs.We did not utilize the forward provisions under the 2021 ATM Program during the three months ended March 31, 2022. We have $929.9 million of sales remaining under the 2021 ATM Program as of March 31, 2022.
(2)This amount excludes our remaining commitments to fundWe issued 79.9 thousand shares of common stock under our other investmentsDRSPP during the three months ended March 31, 2022. Aggregate gross proceeds from these sales were $2.3 million during the first quarter of approximately $67.6 million.  2022.

Dividends

As a REIT, we are required to distribute dividends (other than capital gain dividends) to our stockholders in an amount at least equal to (A) the sum of (i) 90% of our “REIT taxable income” (computed without regard to the dividends paid deduction and our net capital gain), and (ii) 90% of the net income (after tax), if any, from foreclosure property, minus (B) the sum of certain items of non-cash income. In addition, if we dispose of any built-in gain asset during a recognition period, we will be required to distribute at least 90% of the built-in gain (after tax), if any, recognized on the disposition of such asset. Such distributions must be paid in the taxable year to which they relate, or in the following taxable year if declared before we timely file our tax return for such year and paid on or before the first regular dividend payment after such declaration. In addition, such distributions are required to be made pro rata, with no preference to any share of stock as compared with other shares of the same class, and with no preference to one class of stock as compared with another class except to the extent that such class is entitled to such a preference. To the extent that we do not distribute all of our net capital gain or do distribute at least 90%, but less than 100% of our “REIT taxable income” as adjusted, we will be subject to tax thereon at regular ordinary and capital gain corporate tax rates.  

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For the sixthree months ended June 30, 2021,March 31, 2022, we paid dividends of approximately $316.5$160.6 million to our common stockholders. On February 16, 2021,15, 2022, we paid dividends of $0.67 per outstanding common share to the common stockholders of record as of the close of business on February 8, 2021.  On May 17,7, 2022.

Material Cash Requirements

During the three months ended March 31, 2022, there were no significant changes to our material cash requirements from those disclosed in the section “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our 2021 Annual Report.

As of March 31, 2022, we paid dividendshad $220.9 million of $0.67 per outstanding common sharecommitments to fund the construction of new leased and mortgaged facilities, capital improvements and other commitments. Additionally, we have commitments to fund $41.2 million of advancements under existing other investment loans. These commitments are expected to be funded over the next several years and are dependent upon the operators’ election to use the commitments.

Other Arrangements

We own interests in certain unconsolidated joint ventures as described in Note 9 to the common stockholdersConsolidated Financial Statements – Investments in Joint Ventures. Our risk of record as of the close of business on May 3, 2021.  

Liquidity

We believeloss is generally limited to our liquidity and various sources of available capital, including cash from operations, our existing availability under our credit facilities, existing equity sales programs, facility sales and expected proceeds from mortgage and other investment payoffs are adequate to finance operations, meet recurring debt service requirements and fund future investments through the next twelve months.

We regularly review our liquidity needs, the adequacy of cash flow from operations, and other expected liquidity sources to meet these needs. We believe our principal short-term liquidity needs are to fund:

normal recurring expenses;
debt service payments;
capital improvement programs;
common stock dividends; and
growth through acquisitions of additional properties.

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The primary source of liquidity is our cash flows from operations. Operating cash flows have historically been determined by: (i) the number of facilities we lease or have mortgages on; (ii) rental and mortgage rates; (iii) our debt service obligations; (iv) general and administrative expenses and (v) our operators’ ability to pay amounts owed. The timing, source and amount of cash flows provided by or used in financing activities and in investing activities are sensitive to the capital markets environment, especially to changes in interest rates. Changes in the capital markets environment may impactjoint venture and any outstanding loans receivable. We use derivative instruments to hedge interest rate and foreign currency exchange rate exposure as discussed in Note 15 – Derivatives and Hedging in our Annual Report on Form 10-K for the availability of cost-effective capital and affect our plans for acquisition and disposition activity.year ended December 31, 2021.

Cash Flow Summary

Cash, cash equivalents and restricted cash totaled $104.6$494.8 million as of June 30, 2021, a decreaseMarch 31, 2022, an increase of $63.0$470.4 million as compared to the balance at December 31, 2020.2021. The following is a discussion of changes in cash, cash equivalents and restricted cash due to operating, investing and financing activities, which are presented in our Consolidated Statements of Cash Flows.

Operating Activities – Operating activities generated $378.3$132.2 million of net cash flow for the sixthree months ended June 30, 2021,March 31, 2022, as compared to $329.4$176.0 million for the same period in 2020, an increase2021, a decrease of $48.9$43.8 million, which is primarily driven by an increasea decrease of $45.9$30.2 million of net income, adjusted for non-cash items, primarily due to a year over year reduction in rental income and mortgage revenue growthrelated to three operators, as a resultdiscussed in our material changes analysis under Results of facility acquisitions and transitions, investments in mortgages and other investments.Operations above. A $3.0$13.6 million change in the net movements of the operating assets and liabilities, primarily driven by a reductionan increase in lease inducements provided to our operators,receivables, also contributed to the overall increasedecrease in cash provided by operating activities.

Investing Activities – Net cash flow from investing activities was an outflowinflow of $387.1$177.3 million for the sixthree months ended June 30, 2021,March 31, 2022, as compared to an outflow of $96.7$396.3 million for the same period in 2020.2021. The $290.4$573.6 million change in cash flow from investing activities related primarily to (i) a $579.0$481.3 million increasedecrease in real estate acquisitions anddriven by the acquisition of 24 senior living facilities from Healthpeak Properties, Inc. for $511.3 million in the first quarter of 2021, (ii) a $8.5 million increase in investments in unconsolidated joint ventures, offset by (i) a $145.1$144.3 million increase in proceeds from the sales of real estate investments (ii)largely driven by the sale of 22 facilities previously leased to Gulf Coast for net proceeds of $310.3 million in the first quarter of 2022, (iii) a $79.6$23.8 million increase in mortgagesmortgage collections, net of placements driven by a $21.7 million partial principal paydown on the Guardian mortgage loan in the first quarter of 2022 and (iv) a $10.4 million decrease in investments in unconsolidated joint ventures driven by our $10.3 million investment in Second Spring II LLC in the first quarter of 2021, offset by (i) a $68.3 million increase in new other investments, net of other investments proceeds driven by the new $25.0 million term loan to LaVie and additional draws on existing loans, (ii) a $7.4 million decrease in distributions from unconsolidated joint venture in excess of earnings primarily related to the Second Spring Healthcare Investments joint venture due to significant facility sales in the first quarter of 2021, (iii) a $38.5$4.4 million decreaseincrease in investment in construction in progress and capital expenditures, (iv) a $27.4$3.0 million increase in other investment proceeds, net of new investments, (v) a $3.1 million increasedecrease in receipts from insurance proceeds and (vi)(v) a $2.5 million refund of andecrease in acquisition related deposit in the first quarterdeposits.

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Financing Activities – Net cash flow from financing activities was an outflowinflow of $54.3$161.2 million for the sixthree months ended June 30, 2021,March 31, 2022, as compared to an outflowinflow of $224.1$108.6 million for the same period in 2020.2021. The $169.8$52.6 million change in cash provided byflow from financing activities was primarily related to (i) a $148.9 million increase in cash proceeds from the issuance of common stock in 2021, as compared to the same period in 2020, (ii) a $73.5 million increase in net proceeds from our dividend reinvestment plan in 2021, as compared to the same period in 2020 and (iii) $7.8$115.9 million increase in proceeds from other long-term borrowings, net of repayments offset by (i)as we had increased borrowings on our revolving credit facility in connection with funding acquisitions and loans, (ii) a $48.1$33.8 million increasedecrease in payment of financing related costs due to fees and premiums paid in the first quarter of 2021 related to the early redemption of $350 million of principal of the 4.375% senior notes due 2023 and (iii) a $4.6 million decrease in distributions to Omega OP Unit holders. The overall increase in financing inflows was partially offset by (i) a $72.0 million decrease in cash proceeds from the issuance of common stock in 2022 due to decreased issuances under our DRSPP and our ATM Programs, as compared to the same period in 2021, (ii) $27.3 million of repurchases of shares of common stock in the first quarter of 2022 and (iii) a $9.4$2.3 million increase in dividends paid.

Critical Accounting Policies and Estimates

Our financial statements are prepared in accordance with generally accepted accounting principles (“GAAP”) in the U.S. Our preparation of the financial statements requires us to make estimates and assumptions about future events that affect the amounts reported in our financial statements and accompanying footnotes. Future events and their effects cannot be determined with absolute certainty. Therefore, the determination of estimates requires the exercise of judgment. Actual results inevitably will differ from those estimates, and such differences may be material to the consolidated financial statements. We have described our accounting policies in Note 2 – Summary of Significant Accounting Policies to our Annual Report on Form 10-K for the year ended December 31, 2021. There have been no material changes to our critical accounting policies or estimates since December 31, 2021.

Item 3 – Quantitative and Qualitative Disclosures about Market Risk

During the quarter ended June 30, 2021,March 31, 2022, there were no material changes in our primary market risk exposures or how those exposures are managed from the information disclosed under Item 7A of our Annual Report on Form 10-K for the year ended December 31, 2020.2021.

Item 4 – Controls and Procedures

Disclosure controls and procedures (as defined in Rule 13a-15(e) under the Securities Exchange Act of 1934, as amended (the “Exchange Act”)) are controls and other procedures of an issuer that are designed to ensure that information required to be disclosed by the issuer in the reports that it files or submits under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms. Disclosure controls and procedures include, without limitation, controls and procedures designed to ensure that information required to be disclosed by an issuer in the reports that it files or submits under the Exchange Act is accumulated and communicated to the issuer’s management, including its principal executive and principal financial officers, or persons performing similar functions, as appropriate to allow timely decisions regarding required disclosure.

47

In connection with the preparation of our Form 10-Q as of and for the quarter ended June 30, 2021,March 31, 2022, management evaluated the effectiveness of the design and operation of the disclosure controls and procedures of the Company as of June 30, 2021.March 31, 2022. Based on this evaluation, our Chief Executive Officer and Chief Financial Officer concluded that disclosure controls and procedures of the Company were effective at a reasonable assurance level as of June 30, 2021.March 31, 2022.

Internal Control Over Financial Reporting

There were no changes in the Company’s internal control over financial reporting during the quarter ended June 30, 2021March 31, 2022 identified in connection with the evaluation of our disclosure controls and procedures described above that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

45

PART II – OTHER INFORMATION

Item 1 – Legal Proceedings

See Note 1718 – Commitments and Contingencies into the Consolidated Financial Statements - Part I, Item 1 hereto, which is hereby incorporated by reference in response to this item.Item.

Item 1A – Risk Factors

In addition to the risk factors previously disclosed in Item 1A contained in Part I of our Annual Report on Form 10-K for the year ended December 31, 2020,2021, investors should carefully consider the following additional risk factor, which should be read in conjunction with the risk factors set forth in such Form 10-K and Form 10-Q and the other information contained in this report and our other filings with the Securities and Exchange Commission.  

The COVID-19 pandemic and measures intended to prevent its spread could have a material adverse effect on our business, results of operations, cash flows and financial condition.

The COVID-19 pandemic has continued to significantly and adversely impacted,impact, and may continue to so impact SNFs and long termlong-term care providers generally, withdue to higher rates of virus transmission and fatality among the elderly and frail populations these facilities serve. As a result, many of our operators have been, and may continue to be, significantly impacted by the pandemic. In June 2021, we were informed by an operator, which represents approximately 3%See Item 2 – Management’s Discussion and Analysis of Financial Condition and Results of Operations – Overview.

Continued uncertainty exists relating to our revenue for the six months ended June 30, 2021 and 2020 (excluding the impact of the straight-line write-offs in 2021), that it would be unableother operators’ ability to pay rentmeet their payments obligations generally or meet their payment obligations to us, in the foreseeable future. As of June 30, 2021, we have been unableincluding due to collect approximately $2.5 million of contractual rents due from this operator, which represents one month of contractual rent under the lease agreement, and have applied $2.5 million of the operator’s security deposit funds against their uncollected receivables. As such, we placed the operator on a cash basis for revenue recognition based on our evaluation of the collectibility of future rent payments due under its lease agreement, and in connection with this, we wrote off approximately $17.4 million of straight-line receivables to rental income during the quarter. We believe this operator was impacted by, among other things, reduced revenue as a result of lower occupancy and increased expenses, both as a result of the COVID-19 pandemic. Continuedcontinued uncertainty regarding the availability of sufficient government support, the persistence of staffing shortages that have impacted, and may continue to impact, our operators’ occupancy levels and profitability, the impact of governmental vaccine mandates for staff on ongoing staffing shortages, and other factors that may impact virus transmission in our facilities, including the impact of genetic mutations of the virus into new variants, as well as the commencement in April 2021 for many of our operators of the repayment of accelerated payments of Medicare funds that were previously received as Advanced Medicare payments in 2020, could resultand the commencement in otherDecember 2021 of repayment of deferred FICA obligations. To the extent our operators having difficulty meeting their payments obligations generally or meetingare unable to meet their payment obligations, to us. In the latter such event, we may record additional impairment charges with respect to straight-line rent receivables associated with any such operator or with respect to outstanding loans and our financial condition could be adversely impacted. See “Our assets, including our real estate and loans, are subject to impairment charges, and our valuation and reserve estimates are based on assumptions and may be subject to adjustment” in Item 1A contained in Part I of our Annual Report on Form 10-K for the year ended December 31, 2020.2021.

48

Our operators have been, and continue to be, impacted by the pandemic in numerous ways. In addition to experiencing outbreaks of positive cases and deaths of residents and employees during the pandemic, our operators have been required to, and continue to, adapt their operations rapidly throughout the pandemic to manage the spread of the COVID-19 virus as well as the implementation of new treatments and vaccines, and to implement new requirements relating to infection control, staffing levels, PPE, quality of care, visitation protocols, and reporting, among other regulations, throughout the pandemic while facing staffing shortages that have accelerated during from the pandemic and that may impede the delivery of care. ItSignificant uncertainty remains regarding the impact of vaccine mandates for SNF and healthcare workers on ongoing staffing shortages in our facilities, which have caused some operators to limit admissions.  In addition, it remains uncertain when and to what extent vaccination programs for COVID-19, which have been implemented in most of our facilities, will continue to mitigate the effects of COVID-19 in our facilities, or how effective existing vaccines and booster doses will be against the variants of the COVID-19 virus; the impact of these programs will depend in part on the continued speed, distribution, efficacy and delivery of the vaccine and booster doses in our facilities, compliance with staff vaccination requirements as well as participation levels in vaccination programs among the residents and employees of our operators. Our operators have continued to report considerable variation in participation levels among both employees and residents, which we believe may change over time with additional vaccination education efforts.efforts for residents and implementation of vaccine mandates for staff.

46

In addition to the risks associated with managing the spread of the virus, delivery of the vaccines and care of their patients and residents, many of our operators reported incurring, and may continue to incur, significant cost increases as a result of the COVID-19 pandemic, with dramatic increases for facilities with positive cases. We believe these increases primarily stem from elevated labor costs, in part as a result of staffing shortages, including the increased use of overtime and bonus pay and reliance on agency staffing, as well as a significant increase in both the cost and usage of PPE, testing equipment and processes and supplies, as well as implementation of new infection control protocols and delivery of the vaccine. In addition, many of our operators have reported experiencingexperienced declines in occupancy levels as a result of the pandemic. We believe these declines may be in part due to staffing shortages, which in some cases have required operators to limit admissions, as well as COVID-19-induced fatalities at the facilities, the delay of SNF placement and/or utilization of alternative care settings for those with lower level of care needs, the suspension or postponement of elective hospital procedures, fewer discharges from hospitals to SNFs and higher hospital readmittances from SNFs. We continue to monitor the impact of occupancy declineslevels at many of our operators, and it remains uncertain whether and when demand and occupancy levels will return to pre-COVID-19 levels.

While substantial government support, primarily through the federal CARES Act in the U.S. and distribution of PPE and testing equipment by federal and state governments, has been allocated toFederal relief efforts for SNFs and to a lesser extent to ALFs have been limited since 2021 as have been relief efforts in certain states, and further government support will likely be needed to continue to offset these impacts and itimpacts. It is unclear whether and to what extent such government support, which may take the form of stimulus or reimbursement rate adjustments to reflect sustained cost changes experienced by operators, has been and will continue to be sufficient and timely to offset these impacts. In particular, it remains unclear as to whether unallocated funds under the Provider Relief Fundrelief will be distributed to our operators in any meaningful way whether additional funds will be added to the Provider Relief Fund or otherwise allocated to health care operators or our operators, or whether additional Medicaid or Medicare funds under the federal American Rescue Plan Act will ultimately support reimbursement to our operators. Further, to the extent the impacts of the pandemic continue or accelerate and are not offset by continued government relief that is sufficient and timely, we anticipate that the operating results of certain of our operators would be materially and adversely affected, some may be unwilling or unable to pay their contractual obligations to us in full or on a timely basis and we may be unable to restructure such obligations on terms as favorable to us as those currently in place. Even if operators are able to avail themselves of government relief to offset some of these costs, they may face challenges in complying with the terms and conditions of government support and may face longer-term adverse impacts to their personnel and business operations from the COVID-19 pandemic, including potential patient litigation and decreased demand for their services, loss of business due to an interruption in their operations, workforce challenges, new regulatory restrictions, or other liabilities related to gathering restrictions, quarantines, reopening plans, vaccine distribution or delivery, spread of infection or other related factors.

Numerous state and local governments and the federal government have initiated efforts that may also affect landlords’ and/or mortgagees’ ability to collect payments due or enforce remedies for the failure to pay amounts due. Additionally, a growing number of professional liability and employment related claims have been filed or are threatened to be filed against long-term care providers related to the COVID-19 pandemic. While such claims may be subject to liability protection provisions within various state executive orders or legislation and/or federal legislation, an adverse resolution of any of legal proceeding or investigations against our operators may involve injunctive relief and/or substantial monetary penalties, either or both of which could have a material adverse effect on our reputation, business, results of operations and cash flows.

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The COVID-19 pandemic has from time to time also caused, and may continue to cause, severe economic, market and other disruptions worldwide. The pandemic has led governments and other authorities in the U.S., U.K. and around the world to impose measures intended to control its spread, including but not limited to, restrictions on freedom of movement and business operations which may remain in place or be reinstated along with continuing uncertainty around the potential duration of the pandemic. We cannot assure you that conditions in the bank lending, capital and other financial markets will not deteriorate or fluctuate as a result of the COVID-19 pandemic, or that our access to capital and other sources of funding will not become constrained, which could adversely affect the availability and terms of future borrowings, renewals or refinancing. In addition, our employees may be impacted directly or indirectly by the pandemic and we may be required to make changes to our internal controls as a result of changes in our business processes or personnel; any such changes may increase our operational and financial reporting risks.

47

The extent of the COVID-19 pandemic’s effect on our and our operators’ operational and financial performance will depend on future developments, including the ability to control the spread of the outbreak generally and in our facilities, and the delivery and efficacy of and participation in vaccination programs and other treatments for COVID-19, government funds and other support for the senior care sector and the efficacy of other policies and measures that may mitigate the impact of the pandemic, as well as the future demand for needs-based skilled nursing care and senior living facilities, all of which are uncertain and difficult to predict. Due to these uncertainties, we are not able at this time to estimate the effect of these factors on our business, but the adverse impact on our business, results of operations, financial condition and cash flows could be material.  

Inflation could adversely impact our operators and our results of operations.

Inflation, both real or anticipated as well as any resulting governmental policies, could adversely affect the economy and the costs of labor, goods and services to our operators or borrowers. Our long-term leases and loans typically contain provisions such as rent and interest escalators that are designed to mitigate the adverse impact of inflation on Omega’s results of operations. However, these provisions may have limited effectiveness at mitigating the risk of high levels of inflation due to contractual limits on escalation which exist on substantially all of our escalation provisions. Our leases are triple-net and typically require the operator to pay all property operating expenses and, therefore, increases in property-level expenses at our leased properties generally do not directly affect us. However, increased operating costs resulting from inflation could have an adverse impact on our operators and borrowers if increases in their operating expenses exceed increases in their revenue, which may adversely affect our operators’ or borrowers’ ability to pay rent or other obligations owed to us.

An increase in our operators’ expenses and a failure of their revenues to increase at least with inflation could adversely impact our operators’ and our financial condition and our results of operations.

Item 2 – Unregistered Sales of Equity Securities and Use of Proceeds

During the quarter ended June 30, 2021,March 31, 2022, Omega issued an aggregate of 7,539did not issue any shares of Omega common stock in exchange for an equivalent number of Omega OP Units tendered to Omega OP for redemption in accordance with the provisions of its partnership agreement. The Company issued these shares of Omega common stock in reliance on an exemption from registration under Section 4(a)(2) of the Securities Act of 1933, as amended, based upon factual representations received from the limited partners who received the Omega common stock.Units.

Issuer Purchases of Equity Securities

On January 27, 2022, the Company authorized the repurchase of up to $500 million of our outstanding common stock from time to time through March 2025. The Company is authorized to repurchase shares of its common stock in open market and privately negotiated transactions or in any other manner as determined by the Company’s management and in accordance with applicable law. The timing and amount of stock repurchases will be determined, in management’s discretion, based on a variety of factors, including but not limited to market conditions, other capital management needs and opportunities, and corporate and regulatory considerations. The Company has no obligation to repurchase any amount of its common stock, and such repurchases, if any, may be discontinued at any time.

During the secondfirst quarter of 2021,2022, we did not purchase anyrepurchased shares of our outstanding common stock.

Item 5 – Other Information

 On July 22, 2021, the Board of Directors revised the Company’s compensation program for non-employee directors to consist of the following components effectivestock as of June 4, 2021:follows:

annual cash retainer of $75,000 payable in quarterly installments of $18,750 on or about August 15, November 15, February 15 and May 15; provided, however, that each director may elect each year to receive the retainer in common stock (or at the director’s option, a number of profits interest units with equivalent value) to be included in the annual equity grant described below;
annual grant as of the date of the annual meeting of a number of shares of restricted common stock determined by dividing $150,000 by the fair market value per share of common stock on the date of grant (or at the director’s option, a number of profits interest units with equivalent value), vesting based on the director’s continuing service until the date of the next succeeding annual meeting of stockholders (subject to 100% acceleration upon death, disability, change in control or any other event that in the discretion of the Compensation Committee of the Board of Directors is deemed to be an appropriate basis for acceleration);
Chair of the Board of Directors: $120,000 annual payment, of which 50% will be added to, and treated as part of, the annual equity grant;

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Additional annual cash payments for committee service:

Committee

Chair

Member

Audit Committee

$25,000

$12,500

Compensation Committee

$20,000

$9,000

Nominating and Corporate Governance Committee

$20,000

$7,500

Investment Committee

$20,000

$7,500

$1,500 per meeting for attendance at each meeting of the Board of Directors or committee of the Board of Directors in excess of the following number of meetings during the year of a director’s term:

Board/Committee

Number of Meetings

Board of Directors

10

Audit Committee

6

Compensation Committee

6

Nominating and Corporate Governance Committee

5

Investment Committee

5

The non-employee directors may elect to have all annual cash retainers (i.e., the annual cash retainer paid quarterly, the Chair of the Board of Directors cash fee, the committee chair fee and the committee member fees described above): (a) paid in cash, (b) added to the annual equity grant that is normally subject to one-year vesting, or (c) deferred and paid in cash in the future.

Maximum 

Total Number of 

Number (or 

Shares 

Approximate 

Purchased as 

Dollar Value) of 

Part of Publicly 

Shares that may 

Total Number 

Announced 

yet be Purchased 

of Shares 

Average Price 

Plans or 

Under these Plans 

Period

    

Purchased

    

Paid per Share

    

Programs

    

or Programs

January 1, 2022 to January 31, 2022

 

$

 

$

February 1, 2022 to February 28, 2022

 

 

 

 

March 1, 2022 to March 31, 2022

 

980,530

 

27.84

 

980,530

 

472,698,431

Total

 

980,530

$

27.84

 

980,530

$

472,698,431

5148

Item 6–Exhibits

Exhibit No.

3.1

Amended and Restated Bylaws of Omega Healthcare Investors, Inc. as of April 8, 2021 (incorporated by reference to Exhibit 3.1 on the Company’s Form 8-K, filed on April 14, 2021).

10.1

Credit Agreement, dated as of April 30, 2021, among Omega Healthcare Investors, Inc., certain subsidiaries of Omega Healthcare Investors, Inc. identified therein as guarantors, the lenders named therein and Bank of America, N.A., as administrative agent for such lenders (incorporated by reference to Exhibit 10.1 to the Company’s Form 8-K filed on May 4, 2021).

10.2

Credit Agreement, dated as of April 30, 2021, among OHI Healthcare Properties Limited Partnership, the lenders named therein and Bank of America, N.A., as administrative agent for such lenders (incorporated by reference to Exhibit 10.2 to the Company’s Form 8-K filed on May 4, 2021).

22.1

Subsidiary guarantors of guaranteed securities (incorporated by reference to Exhibit 22.1 to the Company’s Form 10-Q for the quarter ended March 31, 2021).

31.1

Rule 13a-14(a)/15d-14(a) Certification of Chief Executive Officer of Omega Healthcare Investors, Inc.*

31.2

Rule 13a-14(a)/15d-14(a) Certification of Chief Financial Officer of Omega Healthcare Investors, Inc.*

32.1

Section 1350 Certification of the Chief Executive Officer of Omega Healthcare Investors, Inc.*

32.2

Section 1350 Certification of the Chief Financial Officer of Omega Healthcare Investors, Inc.*

101

The following financial statements from the Company’s Quarterly Report on Form 10-Q for the quarter ended June 30, 2021,March 31, 2022, formatted in Inline XBRL: (i) Consolidated Balance Sheets, (ii) Consolidated Statements of Operations, (iii) Consolidated Statements of Comprehensive Income, (iv) Consolidated Statements of Changes in Equity, (v) Consolidated Statements of Cash Flows, and (vi) Notes to Consolidated Financial Statements, tagged as blocks of text and including detailed tags.

104

Cover Page Interactive Data File - the cover page XBRL tags are embedded within the Inline XBRL document (included in Exhibit 101).

*  Exhibits that are filed herewith.

5249

SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

OMEGA HEALTHCARE INVESTORS, INC.

Registrant

Date:  AugustMay 3, 20212022

By:

/S/ C. TAYLOR PICKETT

C. Taylor Pickett

Chief Executive Officer

Date:    AugustMay 3, 20212022

By:

/S/ ROBERT O. STEPHENSON

Robert O. Stephenson

Chief Financial Officer

5350