Table of Contents

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, DC 20549

FORM 10-Q

þ

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

For the quarterly period ended September 30, 2017

2020

OR

¨

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

For the transition period from ___________ to ___________.

Commission file number: 001-37815

Global Medical REIT Inc.

 (Exact(Exact name of registrant as specified in its charter)

Maryland
46-4757266

Maryland

46-4757266

(State or other jurisdiction of incorporation or
organization)

(I.R.S. Employer Identification No.)

 4800 Montgomery Lane,2 Bethesda Metro Center, Suite 450440

Bethesda, MD

 

20814

(Address of principal executive offices)

(Zip Code)

Registrant’s telephone number, including area code:(202) (202) 524-6851

N/A

N/A

(Former name, former address and former fiscal year, if changed since last report)

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

Title of each class:

Trading Symbol:

Name of each exchange on which registered:

Common Stock, par value $0.001 per share

GMRE

NYSE

Series A Preferred Stock, Par value $0.001 per share

GMRE PrA

NYSE

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. þYes¨ No

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).Yes þ   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

¨

þ

Non-accelerated filer (Do not check if a smaller reporting company)

¨

Smaller reporting company

þ

Emerging growth company

þ

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¨Noþ

Indicate the number of shares outstanding of each of the issuer’s classes of common equity,stock, as of the latest practicable date.

The number of shares of the registrant’s common stock outstanding at November 1, 2020 was 48,188,327.

Table of Contents

TABLE OF CONTENTS

PART I   FINANCIAL INFORMATION

Class
Outstanding November 3, 2017

Common Stock, $0.001 par value per share

21,630,675

TABLE OF CONTENTSItem 1.

Financial Statements (Unaudited)

PART I FINANCIAL INFORMATION

Item 1.

Financial Statements3
Condensed Consolidated Balance Sheets – September 30, 2017 (unaudited)2020 and December 31, 20162019

3

Condensed Consolidated Statements of Operations (unaudited) – Three and Nine Months Ended September 30, 20172020 and 20162019

4

Condensed Consolidated Statements of Comprehensive (Loss) Income – Three and Nine Months Ended September 30, 2020 and 2019

5

Condensed Consolidated Statements of Equity – Three and Nine Months Ended September 30, 2020 and 2019

6

Condensed Consolidated Statements of Cash Flows (unaudited) – Nine Months Ended September 30, 20172020 and 20162019

5

8

Notes to the Unaudited Condensed Consolidated Financial Statements

6

9

Item 2.

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

23

37

Item 3.

Quantitative and Qualitative Disclosures About Market Risk

34

52

Item 4.

Controls and Procedures

34

52

PART II OTHER INFORMATION

Item 1.

Legal Proceedings

34

53

Item 1A.

Risk Factors

34

53

Item 2.

Unregistered Sales of Equity Securities and Use of Proceeds

35

55

Item 3.

Defaults Upon Senior Securities

35

55

Item 4.

Mine Safety Disclosures

35

55

Item 5.

Other Information

35

55

Item 6.

Exhibits

36

56

Signatures

37
Exhibit Index38

58

-2-

Table of Contents

Item 1.Financial Statements

GLOBAL MEDICAL REIT INC.

Condensed Consolidated Balance Sheets

(unaudited and in thousands, except par values)

  As of 
  

September 30,

2017

  December 31, 2016 
Assets  (unaudited)     
Investment in real estate:        
   Land $36,839,127  $17,785,001 
   Building  349,041,480   179,253,398 
   Site improvements  3,992,974   1,465,273 
   Tenant improvements  5,095,651   1,186,014 
   Acquired lease intangible assets  27,308,632   7,187,041 
   422,277,864   206,876,727 
   Less: accumulated depreciation and amortization  (10,142,823)  (3,366,680)
Investment in real estate, net  412,135,041   203,510,047 
Cash  6,776,501   19,671,131 
Restricted cash  2,040,026   941,344 
Tenant receivables  616,741   212,435 
Escrow deposits  1,297,665   1,212,177 
Deferred assets  2,923,494   704,537 
Deferred financing costs, net  2,977,981   927,085 
Other assets  160,214   140,374 
Total assets $428,927,663  $227,319,130 
         
Liabilities and Stockholders’ Equity        
Liabilities:        
Revolving credit facility $126,100,000  $27,700,000 
Notes payable, net of unamortized discount of $963,184 and $1,061,602 at
September 30, 2017 and December 31, 2016, respectively
  38,511,716   38,413,298 
Notes payable to related parties  -   421,000 
Accounts payable and accrued expenses  2,433,549   573,997 
Dividends payable  4,767,037   3,604,037 
Security deposits and other  2,206,145   719,592 
Due to related parties, net  802,286   580,911 
Acquired lease intangible liability, net  1,080,123   277,917 
   Total liabilities  175,900,856   72,290,752 
Stockholders' equity:        
Preferred stock, $0.001 par value, 10,000,000 shares authorized; 3,105,000 and no shares issued and outstanding at September 30, 2017 and December 31, 2016, respectively (liquidation preference of $77,625,000 and $0, respectively)  74,959,003   - 
Common stock, $0.001 par value, 500,000,000 shares authorized; 21,630,675 and 17,605,675 shares issued and outstanding at September 30, 2017 and December 31, 2016, respectively  21,631   17,606 
Additional paid-in capital  207,268,720   171,997,396 
Accumulated deficit  (29,914,472)  (16,986,624)
     Total Global Medical REIT Inc. stockholders' equity  252,334,882   155,028,378 
Noncontrolling interest  691,925   - 
    Total equity  253,026,807   155,028,378 
Total liabilities and stockholders' equity $428,927,663  $227,319,130 

As of

    

September 30, 2020

    

December 31, 2019

    

Assets

Investment in real estate:

Land

$

116,123

$

95,381

Building

 

793,559

 

693,533

Site improvements

 

13,268

 

9,912

Tenant improvements

 

46,965

 

33,909

Acquired lease intangible assets

 

91,465

 

72,794

 

1,061,380

 

905,529

Less: accumulated depreciation and amortization

 

(83,893)

 

(56,503)

Investment in real estate, net

 

977,487

 

849,026

Cash and cash equivalents

 

2,052

 

2,765

Restricted cash

 

5,210

 

4,420

Tenant receivables

 

6,702

 

4,957

Due from related parties

121

50

Escrow deposits

 

3,792

 

3,417

Deferred assets

 

18,928

 

14,512

Derivative asset

2,194

Goodwill

5,903

Other assets

 

5,356

 

3,593

Total assets

$

1,025,551

$

884,934

Liabilities and Equity

Liabilities:

Credit Facility, net of unamortized debt issuance costs of $3,875 and $3,832 at September 30, 2020 and December 31, 2019, respectively

$

454,325

$

347,518

Notes payable, net of unamortized debt issuance costs of $898 and $667 at September 30, 2020 and December 31, 2019, respectively

 

65,060

 

38,650

Accounts payable and accrued expenses

 

8,329

 

5,069

Dividends payable

 

11,843

 

11,091

Security deposits and other

 

5,571

 

6,351

Due to related party

 

 

1,648

Derivative liability

 

19,505

 

8,685

Other liability

 

3,090

 

2,405

Acquired lease intangible liability, net

 

8,621

 

3,164

Total liabilities

 

576,344

 

424,581

Commitments and Contingencies

Equity:

Preferred stock, $0.001 par value, 10,000 shares authorized; 3,105 issued and outstanding at September 30, 2020 and December 31, 2019, respectively (liquidation preference of $77,625 at September 30, 2020 and December 31, 2019, respectively)

 

74,959

 

74,959

Common stock, $0.001 par value, 500,000 shares authorized; 48,188 shares and 43,806 shares issued and outstanding at September 30, 2020 and December 31, 2019, respectively

 

48

 

44

Additional paid-in capital

 

487,114

 

433,330

Accumulated deficit

 

(107,943)

 

(71,389)

Accumulated other comprehensive loss

 

(19,651)

 

(6,674)

Total Global Medical REIT Inc. stockholders' equity

 

434,527

 

430,270

Noncontrolling interest

 

14,680

 

30,083

Total equity

 

449,207

 

460,353

Total liabilities and equity

$

1,025,551

$

884,934

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

- 3 --3-

Table of Contents

GLOBAL MEDICAL REIT INC.

Condensed Consolidated Statements of Operations

(unaudited)(unaudited and in thousands, except per share amounts)

  

Three Months Ended

September 30,

  

Nine Months Ended

September 30,

 
  2017  2016  2017  2016 
             
Revenue                
Rental revenue $7,921,913  $1,932,425  $19,217,710  $4,994,172 
Expense recoveries  443,816   -   1,141,455   - 
Other income  23,134   70,225   111,502   93,196 
   Total revenue  8,388,863   2,002,650   20,470,667   5,087,368 
                 
Expenses                
Acquisition fees  651,645   -   2,130,187   - 
Acquisition fees – related party  -   -   -   754,000 
General and administrative  989,526   1,720,651   4,418,115   2,962,730 
Operating expenses  464,514   1,025   1,234,247   15,685 
Management fees – related party  803,804   627,147   2,059,325   807,147 
Depreciation expense  2,175,668   585,449   5,372,308   1,528,281 
Amortization expense  523,487   -   1,326,395   - 
Interest expense  2,174,683   1,051,204   5,265,262   3,443,113 
   Total expenses  7,783,327   3,985,476   21,805,839   9,510,956 
                 
   Net income (loss) $605,536  $(1,982,826) $(1,335,172) $(4,423,588)
      Less: Preferred stock dividends  (258,750)  -   (258,750)  - 
        Less: Net loss attributable to noncontrolling interest  34,482   -   34,482   - 
     Net income (loss) attributable to common stockholders $381,268  $(1,982,826) $(1,559,440) $(4,423,588)
                 
Net income (loss) attributable to common stockholders per share – basic and diluted $0.02  $(0.11) $(0.08) $(0.68)
                 
Weighted average shares outstanding – basic and diluted  21,522,251   17,371,743   18,938,367   6,514,230 

Three Months Ended September 30, 

Nine Months Ended September 30, 

    

2020

    

2019

    

2020

    

2019

    

Revenue

Rental revenue

$

25,055

$

18,117

$

68,623

$

50,093

Other income

 

42

 

78

 

178

 

182

Total revenue

 

25,097

 

18,195

 

68,801

 

50,275

Expenses

General and administrative

 

4,027

 

1,681

 

7,509

 

4,928

Operating expenses

 

3,619

 

1,362

 

8,256

 

3,826

Management fees – related party

 

 

1,621

 

4,024

 

4,539

Depreciation expense

 

6,954

 

5,006

 

19,383

 

13,481

Amortization expense

 

2,563

 

1,500

 

6,832

 

3,757

Interest expense

 

4,864

 

4,549

 

13,616

 

12,707

Management internalization expense

12,580

14,005

Preacquisition expense

 

70

 

168

 

267

 

224

Total expenses

 

34,677

 

15,887

 

73,892

 

43,462

Net (loss) income

$

(9,580)

$

2,308

$

(5,091)

$

6,813

Less: Preferred stock dividends

 

(1,455)

 

(1,455)

 

(4,366)

 

(4,366)

Less: Net loss (income) attributable to noncontrolling interest

 

767

 

(83)

 

647

 

(246)

Net (loss) income attributable to common stockholders

$

(10,268)

$

770

$

(8,810)

$

2,201

Net (loss) income attributable to common stockholders per share – basic and diluted

$

(0.22)

$

0.02

$

(0.19)

$

0.07

Weighted average shares outstanding – basic and diluted

 

46,908

 

35,512

 

45,503

 

32,514

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

- 4 --4-

Table of Contents

GLOBAL MEDICAL REIT INC.

Condensed Consolidated Statements of Cash FlowsComprehensive (Loss) Income

(unaudited and in thousands)

  Nine Months Ended September 30, 
  2017  2016 
Operating activities (unaudited) 
Net loss $(1,335,172) $(4,423,588)
Adjustments to reconcile net loss to net cash provided by (used in) operating activities:        
Depreciation expense  5,372,308   1,528,281 
Amortization of deferred financing costs  840,214   215,449 
Amortization of acquired lease intangible assets  1,326,395   - 
Amortization of above (below) market leases, net  13,970   - 
Stock-based compensation expense  1,480,724   830,827 
Advisory expense settled in OP Units  77,497   - 
Changes in operating assets and liabilities:        
Restricted cash  (1,144,705)  (438,189)
Tenant receivables  (404,306)  (177,369)
Deferred assets  (2,218,957)  (222,324)
Other assets  (21,890)  - 
Accounts payable and accrued expenses  1,622,426   (267,627)
Security deposits and other  1,486,553   597,593 
Accrued management fees due to related party  183,096   297,147 
Net cash provided by (used in) operating activities  7,278,153   (2,059,800)
         
Investing activities        
Purchase of land, buildings, and other tangible and intangible assets and liabilities  (213,535,461)  (68,690,495)
Escrow deposits for purchase of properties  (60,000)  394,310 
Loans repayments from (made to) related party  38,428   (39,000)
Pre-acquisition costs for purchase of properties  51,459   - 
Net cash used in investing activities  (213,505,574)  (68,335,185)
         
Financing activities        
Net proceeds received from preferred stock offering  75,146,720   - 
Net proceeds received from common equity offerings  33,794,625   137,358,367 
Change in restricted cash  46,023   80,040 
Escrow deposits required by third party lenders  (25,488)  (843,636)
Loans (repaid to) from related party  (149)  29,986 
Repayment of convertible debenture, due to related party  -   (10,000,000)
Proceeds from notes payable from acquisitions  -   41,320,900 
Payments on notes payable from acquisitions  -   (24,011,168)
Proceeds from note payable from related party  -   450,000 
Repayment of note payable from related party  (421,000)  (450,000)
Proceeds from revolving credit facility, net  98,400,000   - 
Payments of deferred financing costs  (2,792,692)  (1,090,079)
Dividends paid to stockholders  (10,815,248)  (285,703)
Net cash provided by financing activities  193,332,791   142,558,707 
Net (decrease) increase in cash and cash equivalents  (12,894,630)  72,163,722 
Cash and cash equivalents—beginning of period  19,671,131   9,184,270 
Cash and cash equivalents—end of period $6,776,501  $81,347,992 
Supplemental cash flow information:        
Cash payments for interest $3,928,208  $3,696,467 
Noncash financing and investing activities:        
Accrued dividends payable $4,767,037  $3,592,786 
Conversion of convertible debenture due to majority stockholder to common stock $-  $30,030,134 
Accrued preferred stock offering costs $187,717  $- 
Reclassification of common stock offering costs to additional paid-in capital $443,499  $1,681,259 
Reclassification of preferred stock offering costs to preferred stock balance $220,809  $- 
Accrued capitalized offering costs $49,409  $- 
OP Units issued for noncash transaction $1,000,000  $- 

Three Months Ended September 30, 

Nine Months Ended September 30, 

    

2020

    

2019

    

2020

    

2019

    

Net (loss) income

$

(9,580)

$

2,308

$

(5,091)

$

6,813

Other comprehensive income (loss):

Increase (decrease) in fair value of interest rate swap agreements

 

2,003

 

(1,303)

 

(12,977)

 

(6,875)

Total other comprehensive income (loss)

 

2,003

 

(1,303)

 

(12,977)

 

(6,875)

Comprehensive (loss) income

 

(7,577)

 

1,005

 

(18,068)

 

(62)

Less: Preferred stock dividends

 

(1,455)

 

(1,455)

 

(4,366)

 

(4,366)

Less: Comprehensive loss attributable to noncontrolling interest

 

628

 

44

 

1,555

 

442

Comprehensive loss attributable to common stockholders

$

(8,404)

$

(406)

$

(20,879)

$

(3,986)

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

- 5 --5-

Table of Contents

GLOBAL MEDICAL REIT INC.

Condensed Consolidated Statements of Equity

(unaudited and in thousands)

For the Nine Months Ended September 30, 2020:

Global

Accumulated

Medical

Additional

Other

REIT Inc.

Non-

Common Stock

Preferred Stock

Paid-in

Accumulated

Comprehensive

Stockholders’

controlling

Total

    

Shares

    

Amount

    

Shares

    

Amount

    

Capital

    

Deficit

    

Loss

    

Equity

    

Interest

    

Equity

Balances, December 31, 2019

 

43,806

$

44

 

3,105

$

74,959

$

433,330

$

(71,389)

$

(6,674)

$

430,270

$

30,083

$

460,353

Net loss

 

0

 

0

 

0

 

0

 

0

 

(4,444)

 

0

 

(4,444)

 

(647)

 

(5,091)

Issuance of shares of common stock, net

 

3,169

 

3

 

0

 

0

 

38,234

0

0

38,237

 

0

 

38,237

LTIP Units and OP Units redeemed for common stock

 

1,213

 

1

 

0

 

0

 

15,550

 

0

 

0

 

15,551

 

(15,551)

 

0

Change in fair value of interest rate swap agreements

 

0

 

0

 

0

 

0

 

0

 

0

 

(12,977)

 

(12,977)

 

0

 

(12,977)

Stock-based compensation expense

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

3,391

 

3,391

Dividends to common stockholders ($0.60 per share)

 

0

 

0

 

0

 

0

 

0

 

(27,744)

 

0

 

(27,744)

 

0

 

(27,744)

Dividends to preferred stockholders ($1.40625 per share)

 

0

 

0

 

0

 

0

 

0

 

(4,366)

 

0

 

(4,366)

 

0

 

(4,366)

Dividends to noncontrolling interest

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

(2,596)

 

(2,596)

Balances, September 30, 2020

 

48,188

$

48

 

3,105

$

74,959

$

487,114

$

(107,943)

$

(19,651)

$

434,527

$

14,680

$

449,207

For the Three Months Ended September 30, 2020:

Global

Accumulated

Medical

Additional

Other

REIT Inc.

Non-

Common Stock

Preferred Stock

Paid-in

Accumulated

Comprehensive

Stockholders’

controlling

Total

    

Shares

    

Amount

    

Shares

    

Amount

    

Capital

    

Deficit

    

Loss

    

Equity

    

Interest

    

Equity

Balances, June 30, 2020

 

46,252

$

46

 

3,105

$

74,959

$

462,607

$

(88,037)

$

(21,654)

$

427,921

$

14,788

$

442,709

Net loss

 

0

 

0

 

0

 

0

 

0

 

(8,813)

 

0

 

(8,813)

 

(767)

 

(9,580)

Issuance of shares of common stock, net

1,930

2

0

0

24,431

0

0

24,433

0

24,433

LTIP Units and OP Units redeemed for common stock

6

0

0

0

76

0

0

76

(76)

0

Change in fair value of interest rate swap agreements

0

0

0

0

0

0

2,003

2,003

0

2,003

Stock-based compensation expense

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

1,572

 

1,572

Dividends to common stockholders ($0.20 per share)

 

0

 

0

 

0

 

0

 

0

 

(9,638)

 

0

 

(9,638)

 

0

 

(9,638)

Dividends to preferred stockholders ($0.46875 per share)

 

0

 

0

 

0

 

0

 

0

 

(1,455)

 

0

 

(1,455)

 

0

 

(1,455)

Dividends to noncontrolling interest

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

(837)

 

(837)

Balances, September 30, 2020

 

48,188

$

48

 

3,105

$

74,959

$

487,114

$

(107,943)

$

(19,651)

$

434,527

$

14,680

$

449,207

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

-6-

Table of Contents

GLOBAL MEDICAL REIT INC.

Condensed Consolidated Statement of Equity - Continued

(unaudited and in thousands)

For the Nine Months Ended September 30, 2019:

Global

Accumulated

Medical

Additional

Other

REIT Inc.

Non-

Common Stock

Preferred Stock

Paid-in

Accumulated

Comprehensive

Stockholders’

controlling

Total

    

Shares

    

Amount

    

Shares

    

Amount

    

Capital

    

Deficit

    

Loss

    

Equity

    

Interest

    

Equity

Balances, December 31, 2018

 

25,944

$

26

 

3,105

$

74,959

$

243,038

$

(45,007)

$

(3,721)

$

269,295

$

30,455

$

299,750

Net income

 

0

 

0

 

0

 

0

 

0

 

6,567

 

0

 

6,567

 

246

 

6,813

Issuance of shares of common stock, net

10,284

10

0

0

96,767

0

0

96,777

0

96,777

LTIP Units and OP Units redeemed for common stock

62

0

0

0

630

0

0

630

(630)

0

Change in fair value of interest rate swap agreements

 

0

 

0

 

0

 

0

 

0

 

0

 

(6,875)

 

(6,875)

 

0

 

(6,875)

Stock-based compensation expense

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

2,493

 

2,493

Dividends to common stockholders ($0.60 per share)

 

0

 

0

 

0

 

0

 

0

 

(21,040)

 

0

 

(21,040)

 

0

 

(21,040)

Dividends to preferred stockholders ($1.40625 per share)

 

0

 

0

 

0

 

0

 

0

 

(4,366)

 

0

 

(4,366)

 

0

 

(4,366)

Dividends to noncontrolling interest

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

(2,615)

 

(2,615)

OP Units issued to third parties

0

0

0

0

0

0

0

0

506

506

Balances, September 30, 2019

 

36,290

$

36

 

3,105

$

74,959

$

340,435

$

(63,846)

$

(10,596)

$

340,988

$

30,455

$

371,443

For the Three Months Ended September 30, 2019:

Global

Accumulated

Medical

Additional

Other

REIT Inc.

Non-

Common Stock

Preferred Stock

Paid-in

Accumulated

Comprehensive

Stockholders’

controlling

Total

    

Shares

    

Amount

    

Shares

    

Amount

    

Capital

    

Deficit

    

Loss

    

Equity

    

Interest

    

Equity

Balances, June 30, 2019

 

34,653

$

35

 

3,105

$

74,959

$

322,872

$

(57,397)

$

(9,293)

$

331,176

$

30,427

$

361,603

Net income

 

0

 

0

 

0

 

0

 

0

 

2,225

 

0

 

2,225

 

83

 

2,308

Issuance of shares of common stock, net

1,632

1

0

0

17,509

0

0

17,510

0

17,510

LTIP Units and OP Units redeemed for common stock

5

0

0

0

54

0

0

54

(54)

0

Change in fair value of interest rate swap agreements

0

0

0

0

0

0

(1,303)

(1,303)

0

(1,303)

Stock-based compensation expense

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

868

 

868

Dividends to common stockholders ($0.20 per share)

 

0

 

0

 

0

 

0

 

0

 

(7,219)

 

0

 

(7,219)

 

0

 

(7,219)

Dividends to preferred stockholders ($0.46875 per share)

 

0

 

0

 

0

 

0

 

0

 

(1,455)

 

0

 

(1,455)

 

0

 

(1,455)

Dividends to noncontrolling interest

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

(869)

 

(869)

Balances, September 30, 2019

 

36,290

$

36

 

3,105

$

74,959

$

340,435

$

(63,846)

$

(10,596)

$

340,988

$

30,455

$

371,443

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

-7-

Table of Contents

GLOBAL MEDICAL REIT INC.

Condensed Consolidated Statements of Cash Flows

(unaudited and in thousands)

Nine Months Ended September 30, 

    

2020

    

2019

    

Operating activities

Net (loss) income

$

(5,091)

$

6,813

Adjustments to reconcile net (loss) income to net cash provided by operating activities:

Depreciation expense

 

19,383

 

13,481

Amortization of acquired lease intangible assets

 

6,813

 

3,757

Amortization of above market leases, net

 

472

 

634

Amortization of debt issuance costs and other

 

1,030

 

1,000

Stock-based compensation expense

 

3,391

 

2,493

Capitalized preacquisition costs charged to expense

167

162

Reserve for uncollectible receivables

727

Other

 

45

 

82

Changes in operating assets and liabilities:

Tenant receivables

 

(2,472)

 

(1,232)

Deferred assets

 

(4,416)

 

(3,955)

Other assets

 

(322)

 

(154)

Accounts payable and accrued expenses

 

1,169

 

911

Security deposits and other

 

(780)

 

2,210

Accrued management fees due to related party

 

(1,727)

 

479

Net cash provided by operating activities

 

18,389

 

26,681

Investing activities

Purchase of land, buildings, and other tangible and intangible assets and liabilities

 

(136,813)

 

(181,440)

Internalization - cash paid for acquisition of Former Advisor, net of cash acquired of $559

(5,093)

Escrow deposits for purchase of properties

 

700

 

(897)

Loan repayments from related parties

 

10

 

Capital expenditures on existing real estate investments

 

(416)

 

(337)

Net cash used in investing activities

 

(141,612)

 

(182,674)

Financing activities

Net proceeds received from common equity offerings

 

38,137

 

96,799

Escrow deposits required by third party lenders

 

(1,034)

 

(216)

Proceeds from note payable

14,800

Repayment of notes payable

 

(233)

 

(101)

Proceeds from Credit Facility

 

158,400

 

164,450

Repayment of Credit Facility

 

(51,550)

 

(77,500)

Payment of debt issuance costs

 

(1,266)

 

(924)

Dividends paid to common stockholders, and OP Unit and LTIP Unit holders

 

(29,588)

 

(21,167)

Dividends paid to preferred stockholders

 

(4,366)

 

(4,365)

Net cash provided by financing activities

 

123,300

 

156,976

Net increase in cash and cash equivalents and restricted cash

 

77

 

983

Cash and cash equivalents and restricted cash—beginning of period

 

7,185

 

4,843

Cash and cash equivalents and restricted cash—end of period

$

7,262

$

5,826

Supplemental cash flow information:

Cash payments for interest

$

12,339

$

11,687

Noncash financing and investing activities:

Accrued dividends payable

$

11,843

$

9,470

Interest rate swap agreements fair value change recognized in other comprehensive loss

$

12,977

$

6,875

OP Units and LTIP Units redeemed for common stock

$

15,551

$

630

CMBS loan assumed in connection with a facility acquisition

$

12,074

$

Accrued common stock offering costs

$

169

$

22

Recognition of lease liability related to right of use asset

$

727

$

3,143

OP Units issued primarily for property acquisition

$

$

506

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

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Table of Contents

GLOBAL MEDICAL REIT INC.

Notes to the Unaudited Condensed Consolidated Financial Statements

(in thousands, except per share amounts or as otherwise indicated)

Note 1 – Organization

Global Medical REIT Inc. (the “Company”) is a Maryland corporation engaged primarily in the acquisition of licensed, state-of-the-art, purpose-built healthcare facilities and the leasing of thesethose facilities to strong clinical operatorshealthcare systems and physician groups with leading market share. The Company is externally managed and advised by Inter-American Management, LLC (the “Advisor”), a Delaware limited liability company and affiliate of the Company. ZH International Holdings Limited (formerly known as Heng Fai Enterprises, Ltd.) a Hong Kong limited liability company that is engaged in real estate development, investments, management and sales, hospitality management and investments, and REIT management, is an 85% owner of the Advisor and the Company’s Chief Executive Office is a 15% owner of the Advisor. ZH international Holdings Limited owns ZH USA, LLC, a related party and the Company’s former (pre initial public offering) majority stockholder.

The Company holds its facilities and conducts its operations through a Delaware limited partnership subsidiary named Global Medical REIT L.P. (the “Operating Partnership”). The Company serves as the sole general partner of the Operating Partnership through a wholly-ownedwholly owned subsidiary of the Company named Global Medical REIT GP LLC, (the “GP”), a Delaware limited liability company, which owns an approximate 0.01% interest in the Operating Partnership.company. As of September 30, 2017,2020, the Company was the 97.64%93.05% limited partner of the Operating Partnership, with 1.82%an aggregate of 6.95% of the Operating Partnership owned by holders of long-term incentive plan units (“LTIP”LTIP Units”) units and 0.53% owned by third party holders ofthird-party limited partners who contributed properties or services to the Operating Partnership Unitsin exchange for common limited partnership units (“OP Units”). The Operating Partnership holdsAs described below, until July 9, 2020, the Company’s healthcare facilities through separate wholly-ownedCompany was externally managed and advised by Inter-American Management LLC, a Delaware limited liability company subsidiariesand affiliate of the Company (the “Former Advisor”).

On July 9, 2020, the Company acquired all of the outstanding shares of capital stock of Inter-American Group Holdings Inc. (“IAGH”), the parent company of the Former Advisor, for total consideration, after a working capital adjustment, of $17,746 (the “Internalization”). The Internalization was completed pursuant to a stock purchase agreement, dated as of July 9, 2020 (the "Stock Purchase Agreement"), by and among the Company, Zensun Enterprises Limited (“Zensun”) and Mr. Jeffrey Busch. Prior to the Internalization, IAGH was owned by Zensun (85%) and Mr. Busch (15%) (collectively, the “Sellers”).

 A special committee (the "Special Committee") comprised entirely of independent and disinterested members of the Company’s board of directors (the "Board"), after consultation with its independent legal and financial advisors, determined that were formed for each healthcare facility acquisition.the Internalization was advisable to, and in the best interests of, the Company and the Company’s stockholders and recommended that the Board authorize and approve the Internalization. Upon such recommendation from the Special Committee, the Board authorized and approved the Internalization. Approval by the Company’s stockholders was not required.

 

TheUpon completion of the Internalization, the employees of the Former Advisor became employees of the Company elected to be taxed as a REIT for U.S. federal income tax purposes commencing with its taxable year ended December 31, 2016.and the functions previously performed by the Former Advisor were internalized by the Company.  As an internally managed company, the Company will no longer pay the Former Advisor any fees arising from the Management Agreement (as defined in Note 6 – “Related Party Transactions”).

Note 2 – Summary of Significant Accounting Policies

Basis of presentation

The accompanying condensed consolidated financial statements are unaudited and areinclude the accounts of the Company, including the Operating Partnership and its wholly owned subsidiaries. The accompanying condensed consolidated financial statements have been prepared in accordance with accounting principlesU.S. generally accepted in the United States of Americaaccounting principles (“GAAP”) and the rules and regulations of the United StatesU.S. Securities and Exchange Commission (“SEC”). Certain information and footnote disclosures required for annual consolidated financial statements have been condensed or excluded pursuant to SEC rules and regulations. Accordingly, the accompanying condensed consolidated financial statements do not include all of the information and footnotes required by GAAP for complete consolidated financial statements and should be read in conjunction with the audited consolidated financial statements and notes thereto for the fiscal year ended December 31, 2016.2019. In the opinion of management, all adjustments of a normal and recurring nature necessary for a fair presentation of the condensed consolidated financial statements for the interim periods have been made.

Principles of Consolidation

The accompanying condensed consolidated financial statements include the accounts of the Company, including the Operating Partnership and its wholly-owned subsidiaries, and the interests in the Operating Partnership held by LTIP unit holders and OP Unit holders.wholly owned subsidiaries. The Company presents the portion of any equity it does not own but controls (and thus consolidates) as noncontrolling interest. Noncontrolling interest in the Company includes the LTIP unitsUnits that have been granted to directors, employeesofficers and affiliatesemployees of the Company and the OP Units held by third parties. Refer to Note 5 – “Stockholders’ Equity”“Equity” and Note 7 – “Stock-Based Compensation” and for additional information regarding the OP Units and LTIP units.Units.

-9-

Table of Contents

The Company classifies noncontrolling interest as a component of consolidated equity on its Condensed Consolidated Balance Sheets, separate from the Company’s total stockholders’ equity. The Company’s net income or loss is allocated to noncontrolling interests based on the respective ownership or voting percentage in the Operating Partnership associated with such noncontrolling interests and is removed from consolidated income or loss on the Condensed Consolidated Statements of Operations in order to derive net income or loss attributable to common stockholders. The noncontrolling ownership percentage is calculated by dividing the aggregate number of LTIP unitsUnits and OP Units held by the total number of units and shares outstanding. Any future issuances of additional LTIP units or OP Units would change the noncontrolling ownership interest.

Use of Estimates

The preparation of the condensed consolidated financial statements in conformity with GAAP requires the Company to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and footnotes. Actual results could differ from those estimates.

Investment in Real Estate

The Company determines when an acquisition meets the definition of a business or alternatively should be accounted for as an asset acquisition in accordance with Accounting Standard Codification (“ASC”) Topic 805 “Business Combinations” (“ASC Topic 805”), which requires that, when substantially all of the fair value of an acquisition is concentrated in a single identifiable asset or a group of similar identifiable assets, the asset or group of similar identifiable assets does not meet the definition of a business and therefore is required to be accounted for as an asset acquisition. Transaction costs are capitalized for asset acquisitions and expensed as incurred for business combinations. All our facility acquisitions for the nine months ended September 30, 2020 and 2019 have been accounted for as asset acquisitions because substantially all the fair value of the gross assets the Company acquired were concentrated in a single asset or group of similar identifiable assets.

- 6 -For asset acquisitions that are “owner occupied” (meaning that the seller either is the tenant or controls the tenant), the purchase price, including capitalized acquisition costs, will be allocated to land and building based on their relative fair values with no value allocated to intangible assets or liabilities. For asset acquisitions that are not “owner occupied,” the Company will allocate the purchase price to tangible assets and any intangible assets acquired or liabilities assumed based on their relative fair values. Fair value is determined based upon the guidance of ASC Topic 820, “Fair Value Measurements and Disclosures,” and generally are determined using Level 2 inputs, such as rent comparables, sales comparables, and broker indications. Although Level 3 Inputs are utilized, they are minor in comparison to the Level 2 data used for the primary assumptions. The determination of fair value involves the use of significant judgment and estimates. We make estimates to determine the fair value of the tangible and intangible assets acquired and liabilities assumed using information obtained from multiple sources, including preacquisition due diligence, and we routinely utilize the assistance of a third-party appraiser.

Revenue Recognition

The Company’s operations primarily consist of rental revenue earned from tenants under leasing arrangements which provide for minimum rent and escalations. The leases have been accounted for as operating leases. For operating leases with contingent rental escalators, revenue is recorded based on the contractual cash rental payments due during the period. Revenue from leases with fixed annual rental escalators are recognized on a straight-line basis over the initial lease term, subject to a collectability assessment, with the difference between the contractual rental receipts and the straight-line amounts recorded as a “deferred rent receivable.” Additionally, the Company recognizes “expense recoveries” revenue, which represents revenue recognized related to tenant reimbursement of real estate taxes, insurance, and certain other operating expenses (“tenant reimbursements”). The Company recognizes these reimbursements and related expenses on a gross basis in its Condensed Consolidated Statements of Operations.

-10-

Cash and Cash Equivalents and Restricted Cash

The Company considers all demand deposits, cashier’s checks, money market accounts, and certificates of deposit with a maturity of three months or less to be cash equivalents. Amounts included in restricted cash balance as of September 30, 2017 and December 31, 2016 was $2,040,026 and $941,344, respectively. The restricted cash balance as of September 30, 2017 consisted of $337,242 of cash required by a third-party lender to be held by the Company as a reserve for debt service, $1,619,659 inrepresent (1) certain security deposits received from facility tenants at the inception of their leases,leases; (2) cash required to be held by a third-party lender as a reserve for debt service; and $83,125 in(3) funds held by the Company from certainrelated to tenant reimbursements. The following table provides a reconciliation of its tenantsthe Company’s cash and cash equivalents and restricted cash that sums to the Company collected to pay specific tenant expenses, such as real estate taxes and insurance,total of those amounts at the end of the periods presented on the tenant’s behalf. The restricted cash balance asCompany’s accompanying Condensed Consolidated Statements of December 31, 2016 consisted of $383,265 of cash required by a third party lender to be held by the Company as a reserve for debt service, a security deposit of $319,500, and $238,579 in funds held by the Company from certain of its tenants that the Company collected to pay specific tenant expenses, such as real estate taxes and insurance.Cash Flows:

As of September 30, 

    

2020

    

2019

Cash and cash equivalents

 

$

2,052

 

$

2,815

Restricted cash

5,210

3,011

Total cash and cash equivalents and restricted cash

 

$

7,262

 

$

5,826

Tenant Receivables

The tenant receivable balance as of September 30, 20172020 and December 31, 20162019 was $616,741$6,702 and $212,435,$4,957, respectively. The balance as of September 30, 20172020 consisted of $113,400$2,573 in funds owed from the Company’s tenants for rent that the Company had earned but had not yet received, and $503,341 in funds owed by certain$1,211 of loans that were made to two of the Company’s tenants, for amounts the Company collects to pay specificand $2,918 of tenant expenses, such as real estate taxes and insurance, on the tenants’ behalf.reimbursements. The balance as of December 31, 20162019 consisted primarily of $50,922$1,428 in funds owed from the Company’s tenants for rent that the Company had earned but had not yet received, and $161,513 in funds owed by certain$1,062 of loans that were made to two of the Company’s tenants, $2,342 of tenant reimbursements, as well as $125 in miscellaneous receivables.

The Company adopted the provisions of ASU 2016-13, “Financial Instruments - Credit Losses (Topic 326)” (“ASU 2016-03”) effective January 1, 2020.  Receivables arising from operating leases are not within the scope of Subtopic 326-20. Instead, impairment of these receivables should be accounted for amounts the Company collects to pay specific tenant expenses, such as real estate taxes and insurance,in accordance with ASC Topic 842 “Leases” (“ASC Topic 842”).  The adoption of ASU 2016-03 did not have a material impact on the tenants’ behalf.Company’s condensed consolidated financial statements or related disclosures.

The Company assesses the likelihood of losses resulting from tenant defaults, or the inability of tenants to make contractual rent and tenant recovery payments at each reporting date. The Company also monitors the liquidity and creditworthiness of its tenants and operators on a continuous basis. If the likelihood of a tenant paying its lease payments is determined to no longer be probable, all tenant receivables, including deferred rent, are written off against revenue and any future revenue for that tenant is recognized only upon receipt of cash. In addition, a portfolio level reserve is established on those leases that are probable of collection to ensure that the tenant lease receivables are not overstated.

Escrow Deposits

The escrow balance as of September 30, 2020 and December 31, 2019 was $3,792 and $3,417, respectively. Escrow deposits include funds held in escrow to be used for the acquisition of properties in the future and for the payment of taxes, insurance, and other amounts as stipulated by the Company’s Cantor Loan and the Dumfries Loan, as hereinafter defined. The escrow balance as of September 30, 2017 and December 31, 2016 was $1,297,665 and $1,212,177, respectively

Deferred Assets

The deferred assets balance as of September 30, 20172020 and December 31, 20162019 was $2,923,494$18,928 and $704,537,$14,512, respectively. The balance as of September 30, 20172020 consisted of $2,776,735$18,848 in deferred rent receivables resulting from the recognition of revenue from leases with fixed annual rental escalations on a straight linestraight-line basis and the balance$80 of $146,759 represented other deferred costs. The December 31, 2016 balance of $704,537 consisted of deferred rent receivables.

Other Assets

Other assets primarily consists of capitalized costs related to the Company’s property acquisitions. Costs that are incurred prior to the completion of the acquisition of a property are capitalized if all of the following conditions are met: (a) the costs are directly identifiable with the specific property, (b) the costs would be capitalized if the property were already acquired, and (c) acquisition of the property is probable. These costs are included with the value of the acquired property upon completion of the acquisition. The costs are charged to expense when it is probable that the acquisition will not be completed. The other assets balance was $160,214 as of September 30, 2017, which consisted of $138,324 in capitalized costs related to property acquisitions and $21,890 in a prepaid asset. The balance as of December 31, 20162019 consisted of $14,204 in deferred rent receivables resulting from the recognition of revenue from leases with fixed annual rental escalations on a straight-line basis and $308 of other deferred costs.

Other Assets

The other assets balance as of September 30, 2020 and December 31, 2019 was $140,374,$5,356 and $3,593, respectively. The balance as of September 30, 2020 consisted solely of $3,669 for a right of use asset (refer to Note 8 – “Leases” for additional details), $669 in capitalized

-11-

preacquisition costs, $661 in prepaid assets, and $357 for net capitalized software costs related to property acquisitions.

and miscellaneous assets. The balance as of December 31, 2019 consisted of $3,077 for a right of use asset, $223 in capitalized preacquisition costs, and $293 in a prepaid asset.

Security Deposits and Other

The security deposits and other liability balance as of September 30, 20172020 and December 31, 20162019 was $2,206,145$5,571 and $719,592,$6,351, respectively. The balance as of September 30, 20172020 consisted of security deposits of $1,619,679$4,066 and a tenant impound liability of $586,466$1,505 related to amounts owed for specific tenant expenses, such as real estate taxes and insurance. The balance as of December 31, 20162019 consisted of security deposits of $319,500$4,968 and a tenant impound liability of $400,092$1,383 related to amounts owed for specific tenant expenses, such as real estate taxes and insurance.

Derivative Instruments - Interest Rate Swaps

Net Income (Loss) Attributable to Common Stockholders Per Share

The Company uses the treasury stock method to compute diluted net income or loss attributable to common stockholders per share. Basic net income or loss per share of common stock is computed by dividing net income or loss attributable to common stockholders by the weighted average number of shares of common stock outstanding for the period. Diluted net income or loss per share of common stock is computed by dividing net income or loss attributable to common stockholders by the sum of the weighted average number of shares of common stock outstanding plus any potential dilutive shares for the period.  The Company considered the requirements of the two-class method when computing earnings per share and determined that there would be no difference in its reported results if the two-class method was utilized.

- 7 -

Reclassification

The Company reclassified the line item “Acquired Lease Intangible Assets, Net” on its Consolidated Balance Sheets as of December 31, 2016, to present the gross intangible assets acquired as part of its business combination transactions as a separate line item within the category “Investment in Real Estate” and also reclassified the related accumulated amortization balance on the intangible assets acquired to the line item “Accumulated Depreciation and Amortization.” This reclassification was made to conform to the Company’s presentation of those balances asAs of September 30, 2017.2020 and December 31, 2019, the Company’s liability balance related to interest rate swap derivative instruments that were designated as cash flow hedges of interest rate risk was $19,505 and $6,491, respectively. In accordance with the Company’s risk management strategy, the purpose of the interest rate swaps is to manage interest rate risk for certain of the Company’s variable-rate debt. The interest rate swaps involve the Company’s receipt of variable-rate amounts from three counterparties in exchange for the Company making fixed-rate payments over the life of the agreement. The Company accounts for derivative instruments in accordance with the provisions of ASC Topic 815, “Derivatives and Hedging.” Refer to Note 4 – “Credit Facility, Notes Payable and Derivative Instruments” for additional details.

Management Internalization Expense

As described in Note 1 – “Organization,” the Internalization transaction closed on July 9, 2020. The Company’stotal amount of consideration for the Internalization, after a working capital adjustment, was $17,746.

In accordance with ASC Topic 805, the portion of the consideration paid for the Internalization that was attributed to the settlement of a preexisting contractual relationship (the Management Agreement) of $12,094 was recognized as “Management Internalization Expense” in the accompanying Condensed Consolidated Statements of Operations for the three and nine months ended September 30, 20172020 and 2016 includes the $5,903 of excess consideration paid over the fair value of underlying identifiable net liabilities of the business acquired of $251 was recorded as “Goodwill” in the accompanying Condensed Consolidated Balance Sheets. The Company also incurred $486 and $1,911 of expense related to the Internalization for the three and nine months ended September 30, 2020, respectively, which are also included in the “Management Internalization Expense” line item “Operating Expenses” which primarilyfor the three and nine months ended September 30, 2020.  The Company’s Condensed Consolidated Statement of Operations for the nine months ended September 30, 2020, includes both reimbursable property operating0 revenue and $1,666 of net loss related to the operations of the business acquired subsequent to its acquisition.

The table below presents the unaudited revenue and net income attributable to common stockholders on a pro forma basis as if the transaction occurred on January 1, 2019. Pro forma net income attributable to common stockholders for the nine months ended September 30, 2020, excludes non-recurring expenses thatincurred related to the Company pays on behalfsettlement of certainthe preexisting contractual agreement of its tenants, including real estate taxes$12,094, and insurance, non-reimbursable property operatingother Internalization expenses, and other operating expenses. Reimbursementsincludes compensation expense for the employees that were previously employed by the Former Advisor. The pro forma results are not necessarily indicative of tenant operating expenses are recordedthe results that would have occurred if the business combination had occurred on a gross basis (i.e., the Company recognizes an equivalent increase in revenue (expense recoveries) and expense (operating expenses)). Priorfirst day of the periods presented, nor does the pro forma information purport to represent the third quarterresults of 2017,operations for future periods.

Nine Months Ended

Nine Months Ended

    

September 30, 2020

September 30, 2019

(unaudited, in thousands)

Pro forma total revenue

$

68,801

$

50,275

Pro forma net income attributable to common stockholders

$

4,469

$

3,080

Goodwill

Goodwill represents the excess of consideration paid over the fair value of underlying identifiable net assets of businesses acquired. During the three months ended September 30, 2020, the Company recorded property operating$5,903 of Goodwill related to the Internalization. Goodwill has an indeterminate life and is not amortized, but is tested for impairment on an annual basis, or more frequently if events or

-12-

changes in circumstances indicate that the asset might be impaired. The Company has one reporting unit.  The following table summarizes the consideration paid, the fair value of the assets and liabilities assumed, and the resulting Goodwill balance:

Total consideration paid

$ 17,746

Internalization expense - settlement of a preexisting contractual relationship

12,094

Recognized amounts of identifiable assets acquired and liabilities assumed:

Cash

559

Software intangible

263

Fixed assets

87

Prepaids and other assets

101

Accrued wages and expenses

(883)

Income tax liability

(378)

Total identifiable net liabilities

(251)

Goodwill

$ 5,903

The amount attributable to the settlement of a preexisting contractual relationship was based on the fair value of the Management Agreement. The fair value was determined using the multi-period excess earnings method (“MPEEM”), a form of the income approach. The MPEEM is based on the principle that the value of an intangible asset is equal to the present value of the incremental after-tax cash flows attributable only to that asset. To quantify the cash flows attributable solely to the subject intangible asset, contributory asset charges are typically applied to account for the use of and/or required return on these assets. In applying the MPEEM, the earnings expected to be generated by the Management Agreement were forecasted over the estimated duration of the intangible asset. The earnings were then adjusted by taxes and the required return for the use of the contributory assets.  The after-tax excess cash flows were then present valued to estimate the value of the Management Agreement as of July 9, 2020.

Cash paid for the acquisition of the Former Advisor, after consideration of the settlement of preexisting contractual relationship of $12,094 and net of cash acquired of $559 was $5,093 and is included as an “Investing” activity in the “GeneralCompany’s Condensed Consolidated Statement of Cash Flows for the nine months ended September 30, 2020.

Recent Accounting Pronouncements

Lease Modifications

Due to the business disruptions and Administrative” expense line item. Accordingly for prior periods these expenseschallenges severely affecting the global economy caused by the COVID-19 pandemic, many lessors may be required to provide rent deferrals and other lease concessions to lessees. While the lease modification guidance in ASC Topic 842 addresses routine changes to lease terms resulting from negotiations between the lessee and the lessor, this guidance did not contemplate concessions being so rapidly executed to address the sudden liquidity constraints of some lessees arising from the COVID-19 pandemic. In April 2020, the Financial Accounting Standards Board (“FASB”) staff issued a question and answer document (the “Lease Modification Q&A”) focused on the application of lease accounting guidance to lease concessions provided as a result of the COVID-19 pandemic. Under existing lease guidance, the Company would have to determine, on a lease-by-lease basis, if a lease concession was the result of a new arrangement reached with the tenant (treated within the lease modification accounting framework) or if a lease concession was under the enforceable rights and obligations within the existing lease agreement (precluded from applying the lease modification accounting framework). The Lease Modification Q&A allows the Company, if certain criteria have been reclassified frommet, to bypass the “Generallease-by-lease analysis, and Administrative” expense line item intoinstead elect to either apply the “Operating Expenses” line item withinlease modification accounting framework or not, with such election applied consistently to leases with similar characteristics and similar circumstances. The Company has elected to apply such relief and will avail itself of the election to avoid performing a lease-by-lease analysis for the lease concessions that were (1) granted as relief due to the COVID-19 pandemic and (2) result in the cash flows remaining substantially the same or less. The Lease Modification Q&A has no material impact on the Company’s Consolidated Statementscondensed consolidated financial statements as of Operations.and for the three and nine months ended September 30, 2020. However, its future impact on the Company is dependent upon the extent of lease concessions granted to tenants as a result of the COVID-19 pandemic in future periods and the elections made by the Company at the time of entering such concessions.

-13-

Reference Rate Reform

During the nine months ended September 30, 2020, the FASB issued Accounting Standards Update (“ASU”) 2020-04, Reference Rate Reform (Topic 848) (“ASU 2020-04”). ASU 2020-04 contains practical expedients for reference rate reform-related activities that impact debt, leases, derivatives and other contracts. The guidance in ASU 2020-04 is optional and may be elected over time as reference rate reform activities occur. During the nine months ended September 30, 2020, the Company has 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 based matches the index on the corresponding derivatives. Application of these expedients preserves the presentation of derivatives consistent with past presentation. The Company continues to evaluate the impact of the guidance and may apply other elections as applicable as additional changes in the market occur.

Note 3 – Property Portfolio

Summary of Properties Acquired

During the Nine Months Ended September 30, 2020

During the nine months ended September 30, 2017,2020 the Company completed 1610 acquisitions. For each acquisition, substantially all the fair value was concentrated in a single identifiable asset or group of similar identifiable assets and, therefore, each acquisition represents an asset acquisition. Accordingly, transaction costs for these acquisitions were capitalized.

A rollforward of the gross investment in land, building, improvements, and improvementsacquired lease intangible assets as of September 30, 2017,2020 resulting from these acquisitions is as follows:

  Land  Building  Site & Tenant Improvements  Acquired Lease Intangibles  Gross Investment in Real Estate 
Balances as of January 1, 2017 $17,785,001  $179,253,398  $2,651,287  $7,187,041  $206,876,727 
Facility Acquired – Date Acquired:                    
   Cape Coral – 1/10/17  353,349   7,016,511   -   -   7,369,860 
   Lewisburg – 1/12/17  471,184   5,819,137   504,726   504,953   7,300,000 
   Las Cruces – 2/1/17  397,148   4,618,258   -   -   5,015,406 
   Prescott – 2/9/17  790,637   3,821,417   -   -   4,612,054 
   Clermont – 3/1/17  -   4,361,028   205,922   867,678   5,434,628 
   Sandusky – 3/10/17  409,204   3,997,607   -   -   4,406,811 
   Great Bend – 3/31/17  836,929   23,800,758   -   -   24,637,687 
   Oklahoma City – 3/31/17  2,086,885   37,713,709   1,876,730   7,822,676   49,500,000 
   Sandusky – 4/21/17  97,804   978,035   -   -   1,075,839 
   Brockport – 6/27/17  412,838   6,885,477   491,427   1,294,763   9,084,505 
   Flower Mound – 6/27/17  580,763   2,922,164   381,859   406,757   4,291,543 
   Sherman facility – 6/30/17  1,600,711   25,011,110   -   -   26,611,821 
   Sandusky facility – 8/15/17  55,734   1,214,999   -   -   1,270,733 
   Lubbock facility – 8/18/17  1,302,651   5,041,964   947,227   908,158   8,200,000 
   Germantown – 8/30/17  2,700,468   8,078,246   656,111   4,505,425   15,940,250 
   Austin – 9/25/17  6,957,821   28,507,662   1,373,336   3,811,181   40,650,000 
Total Additions1:  19,054,126   169,788,082   6,437,338   20,121,591   215,401,137 
Balances as of September 30, 2017 $36,839,127  $349,041,480  $9,088,625  $27,308,632  $422,277,864 

1The Lubbock facility acquisition included approximately $1,000,000 of OP Units issued as part of the total consideration. Additionally, an aggregate of $865,676 of intangible liabilities were acquired from the acquisitions that occurred during the nine months ended September 30, 2017, resulting in total gross investments funded using cash of $213,535,461.

    

    

Site

    

Tenant

    

Acquired Lease

    

Gross Investment in

    

Land

    

Building

    

Improvements

    

Improvements

    

Intangible Assets

    

Real Estate

Balances as of December 31, 2019

$

95,381

$

693,533

$

9,912

$

33,909

$

72,794

$

905,529

Facility Acquired – Date Acquired:

 

  

 

  

 

  

 

  

 

  

 

  

High Point – 2/13/20

 

1,749

 

20,367

 

440

 

869

 

1,656

 

25,081

Clinton – 2/27/20

 

664

 

6,551

 

342

 

1,578

 

2,484

 

11,619

West Allis – 3/4/20

 

974

 

7,687

 

137

 

98

 

461

 

9,357

Grand Rapids – 3/20/20

 

2,947

 

17,341

 

470

 

450

 

1,582

 

22,790

Dumfries – 4/27/20

2,597

10,047

289

4,815

4,292

22,040

Centerville – 7/16/20

4,202

160

208

501

5,071

Fairfax – 7/17/20

6,731

6,642

381

2,979

3,012

19,745

Rosedale – 7/31/20

2,856

16,204

567

1,443

2,821

23,891

Lancaster – 9/18/20

696

4,269

110

116

1,114

6,305

Winston-Salem – 9/30/20

1,524

6,407

254

307

748

9,240

Capitalized costs(1)

4

309

206

193

712

Total Additions:

 

20,742

 

100,026

 

3,356

 

13,056

 

18,671

 

155,851

Balances as of September 30, 2020

$

116,123

$

793,559

$

13,268

$

46,965

$

91,465

$

1,061,380

(1)Represents capital projects that were completed and placed in service during the nine months ended September 30, 2020 related to the Company’s existing facilities.

Depreciation expense was $2,175,668$6,954 and $5,372,308$19,383 for the three and nine months ended September 30, 2017,2020, respectively, and $585,449$5,006 and $1,528,281$13,481 for the three and nine months ended September 30, 2016,2019, respectively.

- 8 -

A summary descriptionAs of September 30, 2020, the Company had aggregate capital improvement commitments and obligations to improve, expand, and maintain the Company’s existing facilities of approximately $20,164. Many of these amounts are subject to contingencies that make it difficult to predict when they will be utilized, if at all. In accordance with the terms of the fourCompany’s leases, capital improvement obligations in the next twelve months could total up to approximately $9,233.

The following is a summary of the acquisitions that were completed during the threenine months ended September 30, 2017 is as follows:2020.

-14-

High Point Facility

On September 25, 2017, the Company closed on the acquisition of the Central Texas Rehabilitation Hospital (the “Rehab Hospital”) and approximately 1.27 acres of land adjacent to the Rehab Hospital that has been planned to accommodate the development of a long-term, acute care hospital (the “Developable Land,” and together with the Rehab Hospital, the “Austin Facility”), for an aggregate purchase price of $40.65 million. Norvin Austin Rehab LLC (the “Austin Seller”), was the seller of the Austin Facility.

Upon the closing of the acquisition of the Austin Facility, the Company assumed the Austin Seller’s interest, as lessor, in the absolute triple-net lease (the “Austin Facility Lease”) with CTRH, LLC.

Accounting Treatment

The Company accounted for the acquisition of the Austin Facility as a business combination in accordance with the provisions of Accounting Standards Codification (“ASC”) Topic 805 - Business Combinations. The following table presents the preliminary purchase price allocation for the assets acquired as part of the acquisition:

Land and site improvements $7,222,455 
Building and tenant improvements  29,616,364 
Above market lease intangible  245,686 
In-place leases  1,680,282 
Leasing costs  1,885,213 
   Total purchase price $40,650,000 

The above allocation is preliminary and subject to revision within the measurement period, not to exceed one year from the date of the acquisition.

Germantown Facility

On August 30, 2017,February 13, 2020, the Company purchased a medical office building located in Germantown, TennesseeHigh Point, North Carolina (the “Germantown“High Point Facility”) from Brierbrook Partners, LLC (“Brierbrook”) for a purchase price of $15.94 million andapproximately $25.1 million. Upon closing, the Company assumed Brierbrook’s interest, as lessor, in threethe existing absolute triple-net leaseslease of the Germantown Facility.

Accounting Treatment

The Company accounted forHigh Point Facility with Wake Forest Health Network, LLC, as tenant. At acquisition, the acquisitionlease had approximately three years remaining in the current term, exclusive of the Germantown Facility as a business combination in accordance with the provisions of ASC Topic 805 - Business Combinations.tenant renewal option. The following table presents the preliminary purchase price allocation fordetails of the tangible and intangible assets acquired as part of the acquisition:and liabilities assumed:

Land and site improvements $3,049,683 

    

$

2,189

Building and tenant improvements  8,385,142 

 

21,236

Above market lease intangible  3,284,388 
In-place leases  586,812 

 

1,207

Leasing costs  634,225 

 

449

Total purchase price $15,940,250 

$

25,081

The above allocation is preliminary and subject to revision within the measurement period, not to exceed one year from the date of the acquisition.Clinton Facility

Lubbock Facility

On August 18, 2017,February 27, 2020, the Company purchased a medical office building located in Lubbock, TexasClinton, Iowa (the “Lubbock“Clinton Facility”) from Cardiac Partners Development, LP, for a purchase price of $8.2 million and entered into a new triple-netapproximately $11.6 million. Upon closing, the Company assumed the existing lease of the LubbockClinton Facility with Lubbock Heart Hospital, LLC,MercyOne Clinton Medical Center, as tenant.

- 9 -

Accounting Treatment

The Company accounted for At acquisition, the acquisitionlease had approximately four years remaining in the initial term, exclusive of the Lubbock Facility as a business combination in accordance with the provisions of ASC Topic 805 - Business Combinations.tenant renewal option. The following table presents the preliminary purchase price allocation fordetails of the tangible and intangible assets acquired as part of the acquisition:and liabilities assumed:

Land and site improvements $1,566,487 

    

$

1,006

Building and tenant improvements  5,725,355 

 

8,129

In-place leases  414,189 

 

2,115

Leasing costs  493,969 

 

369

Total purchase price $8,200,000 

$

11,619

The above allocation is preliminary and subject to revision within the measurement period, not to exceed one year from the date of the acquisition.

SanduskyWest Allis Facility (Ballville Property)

On August 15, 2017,March 4, 2020, the Company purchased a medical office building located in Ballville, OhioWest Allis, Wisconsin (the “Ballville Property”“West Allis Facility”) from NOMS Property, LLC, for a purchase price of $1.3approximately$9.1 million. Upon closing, the Company assumed the existing lease of the West Allis Facility with Ascension Columbia St. Mary’s Hospital Milwaukee, as tenant. At acquisition, the lease had approximately four years remaining in the initial term, exclusive of renewal options. The following table presents the details of the tangible and intangible assets acquired and liabilities assumed:

Land and site improvements

    

$

1,111

Building and tenant improvements

 

7,785

In-place leases

 

263

Leasing costs

 

198

Below-market lease intangibles

 

(264)

Total purchase price

$

9,093

Grand Rapids Facilities

On March 20, 2020, the Company purchased a four-building medical office portfolio located in the greater Grand Rapids, Michigan area (the “Grand Rapids Facilities”) for a total purchase price of approximately $22.7 million. Upon closing, the Company assumed 11 existing leases at the Grand Rapids Facilities (the “Grand Rapids Leases”). At acquisition, the Grand Rapids Leases had a weighted-average remaining term of five years, exclusive of tenant renewal options. The following table presents the details of the tangible and intangible assets acquired and liabilities assumed:

Land and site improvements

    

$

3,417

Building and tenant improvements

 

17,791

In-place leases

 

761

Above-market lease intangibles

 

685

-15-

Leasing costs

 

136

Below-market lease intangibles

 

(125)

Total purchase price

$

22,665

Dumfries Facility

On April 27, 2020, the Company purchased a medical office building located in Dumfries, Virginia (the “Dumfries Facility”) for a purchase price of approximately $19.6 million. Upon closing, the Company assumed the existing lease of the Dumfries Facility with Spectrum Healthcare Resources, Inc., as tenant. At acquisition, the lease had approximately nine and a half years left in the initial term, exclusive of tenant renewal options. The following table presents the details of the tangible and intangible assets acquired and liabilities assumed:

Land and site improvements

    

$

2,886

Building and tenant improvements

 

14,862

In-place leases

 

3,255

Leasing costs

 

1,037

Below-market lease intangibles

 

(2,419)

Total purchase price

$

19,621

In connection with this acquisition, the Company assumed an existing $12.1 million commercial mortgage-backed securities (“CMBS”) loan with an interest rate of 4.68% and a term of four years.

Centerville Facility

On July 16, 2020, the Company purchased a medical office building located in Centerville, Iowa (the “Centerville Facility”) and the seller’s interest, as ground lessee, in an existing ground lease, for a purchase price of approximately $5.1 million. The ground lease has a remaining term of approximately 49 years.  Upon closing, the Company assumed the existing lease of the Centerville Facility with Mercy Medical Center-Centerville One St. Joseph Drive, as tenant. At acquisition, the lease had approximately 10.5 years remaining in the initial term, exclusive of renewal options. The following table presents the details of the tangible and intangible assets acquired and liabilities assumed:

Land and site improvements

    

$

160

Building and tenant improvements

 

4,410

In-place leases

 

216

Leasing costs

 

285

Total purchase price

$

5,071

Fairfax Facility

On July 17, 2020, the Company purchased a medical office building located in Fairfax, Virginia (the “Fairfax Facility”) for a purchase price of approximately $17.9 million. Upon closing, the Company assumed the existing lease of the Fairfax Facility with Spectrum Healthcare Resources, Inc., as tenant. At acquisition, the lease had approximately 9.1 years remaining in the initial term, exclusive of renewal options. The following table presents the details of the tangible and intangible assets acquired and liabilities assumed:

Land and site improvements

    

$

7,112

Building and tenant improvements

 

9,621

In-place leases

 

2,314

Leasing costs

 

698

Below-market lease intangibles

 

(1,866)

Total purchase price

$

17,879

-16-

Rosedale Facilities

On July 31, 2020, the Company purchased certain condominium units within a medical office building and a medical office building, both located in Rosedale, Maryland (the “Rosedale Facilities”) for a total purchase price of approximately $23.1 million.  Upon closing, the Company assumed 8 leases with 6 tenants at the Rosedale Facilities (the “Rosedale Leases”).  At acquisition, the Rosedale Leases had a weighted-average remaining lease term of approximately 6.6 years,  exclusive of renewal options.  The following table presents the details of the tangible and intangible assets acquired and liabilities assumed:

Land and site improvements

    

$

3,423

Building and tenant improvements

 

17,647

In-place leases

 

1,063

Leasing costs

 

892

Above-market lease intangibles

866

Below-market lease intangibles

 

(785)

Total purchase price

$

23,106

In connection with this acquisition, the Company entered into a third-party loan in the amount of $14.8 million with an annual interest rate of 3.85% and a term of five years.

Lancaster Facility

On September 18, 2020, the Company purchased a medical office building located in Lancaster, Texas (the “Lancaster Facility”) for a purchase price of approximately $6.3 million.  Upon closing, the Company assumed the existing lease at the Lancaster Facility with Biomat USA, Inc., as tenant. At acquisition, the lease had approximately eight and a half years left in the initial term, exclusive of a tenant renewal option.  The following table presents the details of the tangible and intangible assets acquired and liabilities assumed:

Land and site improvements

    

$

806

Building and tenant improvements

 

4,385

In-place leases

 

244

Leasing costs

 

283

Above-market lease intangibles

 

587

Total purchase price

$

6,305

Winston-Salem Facility

On September 30, 2020, the Company purchased a medical office building located in Winston-Salem, North Carolina (the “Winston-Salem Facility”) for a total purchase price of approximately $8.5 million. Upon closing, the Company assumed 5 existing leases at the Winston-Salem Facility (the “Winston-Salem Leases”). At acquisition, the Winston-Salem Leases had a weighted-average remaining term of approximately four years, exclusive of a tenant renewal option. The following table presents the details of the tangible and intangible assets acquired and liabilities assumed:

Land and site improvements

    

$

1,778

Building and tenant improvements

 

6,714

In-place leases

 

581

Leasing costs

 

167

Below-market lease intangibles

 

(725)

Total purchase price

$

8,515

Summary of Properties Acquired During the Year Ended December 31, 2019

During the year ended December 31, 2019 the Company completed 18 acquisitions. For each acquisition, substantially all of the fair value was concentrated in a single identifiable asset or group of similar identifiable assets and, therefore, each acquisition represents an asset acquisition. Accordingly, transaction costs for these acquisitions were capitalized.

-17-

A rollforward of the gross investment in land, building, improvements, and acquired lease intangible assets as of December 31, 2019 resulting from these acquisitions is as follows:

Site 

Tenant

Acquired Lease

Gross Investment in 

    

Land

    

Building

Improvements

    

Improvements

    

Intangible Assets

    

Real Estate

Balances as of December 31, 2018

$

63,710

$

518,451

    

$

6,880

$

15,357

$

43,152

$

647,550

Facility Acquired – Date Acquired:

Zachary – 2/28/19

 

0

 

3,336

 

103

409

 

835

 

4,683

Gilbert and Chandler – 3/19/19

 

4,616

 

11,643

 

0

 

0

 

16,259

Las Vegas – 4/15/19

2,479

15,277

244

2,205

2,297

22,502

Oklahoma Northwest – 4/15/19

2,364

19,501

143

3,044

3,155

28,207

Mishawaka – 4/15/19

1,924

10,084

74

1,798

2,223

16,103

Surprise – 4/15/19

1,738

18,737

228

4,119

3,860

28,682

San Marcos – 7/12/19

2,322

6,934

126

404

2,188

11,974

Lansing – 8/1/19

1,202

7,681

185

667

1,633

11,368

Bannockburn – 8/5/19

763

3,566

132

1,134

1,382

6,977

Aurora – 8/6/19

1,521

7,446

308

603

2,679

12,557

Livonia – 8/14/19

980

7,629

201

442

1,340

10,592

Gilbert – 8/23/19

2,408

2,027

62

362

733

5,592

Morgantown – 9/26/19

883

5,286

373

506

902

7,950

Beaumont – 10/1/19

3,022

24,836

399

1,036

4,446

33,739

Bastrop – 10/25/19

1,975

8,436

64

276

1,314

12,065

Panama City – 10/31/19

1,559

8,682

220

1,036

1,479

12,976

Jacksonville – 11/15/19

1,023

7,846

0

0

8,869

Greenwood – 12/17/19

892

4,956

0

0

5,848

ASC Topic 842 Reclassification

0

0

0

(824)

(824)

Capitalized costs(1)

0

1,179

170

511

0

1,860

Total Additions:

 

31,671

 

175,082

 

3,032

18,552

29,642

 

257,979

Balances as of December 31, 2019

$

95,381

$

693,533

$

9,912

$

33,909

$

72,794

$

905,529

(1)

Represents capital projects that were completed and placed in service during the year ended December 31, 2019 related to the Company’s existing facilities.

The following is a summary of the acquisitions completed during the year ended December 31, 2019.

Zachary Facility

On February 28, 2019, the Company assumed the following leasehold interests in the real property located in Zachary, Louisiana for a purchase price of approximately $4.6 million: (i) the interest, as ground lessee, in an existing ground lease of the facility, with approximately 46 years remaining in the initial term with no extension options; and (ii) the interest, as landlord, in an existing lease of the facility with LTAC Hospital of Feliciana, LLC, as tenant. At acquisition, the lease had approximately 16 years remaining in the initial term, exclusive of tenant renewal options. The following table presents the details of the tangible and intangible assets acquired and liabilities assumed:

Land and site improvements

    

$

103

Building and tenant improvements

3,745

In-place leases

305

Above-market lease intangibles

117

Leasing costs

413

Below-market lease intangibles

(34)

Total purchase price

$

4,649

-18-

Gilbert and Chandler Facilities

On March 19, 2019, the Company purchased the following facilities located in Gilbert, Arizona and Chandler, Arizona for a total purchase price of approximately $16.3 million: (i) 2 medical office buildings located in Gilbert, Arizona and (ii) 2 medical office suites located in Chandler, Arizona (collectively, the “Gilbert and Chandler Facilities”). Upon the closing of the acquisition, the Company assumed the seller’s interest, as lessor, in 2 existing leases and entered into an amendment3 new leases, as lessor, at the Gilbert and Chandler Facilities. At acquisition, the Gilbert and Chandler leases had a weighted average remaining lease term of 10.5 years, exclusive of tenant renewal options.

IRF Portfolio

On April 15, 2019, the Company purchased four in-patient rehabilitation facilities located in Las Vegas, Nevada; Surprise, Arizona; Oklahoma City, Oklahoma; and Mishawaka, Indiana (collectively, the “IRF Portfolio”) for a total purchase price of approximately $94.6 million. Upon the closing of the existing triple-net master lease dated October 7, 2016 (the “NOMS Lease”), betweenacquisition, the Company assumed the sellers’ interest, as lessor, in 4 existing leases at the properties (collectively, the “IRF Portfolio Leases”) with (i) Encompass Health (Las Vegas, Nevada facility); (ii) a joint venture between Cobalt Rehabilitation and Northern Ohio Medical Specialists, LLC (“NOMS”Tenet Healthcare (the Surprise, Arizona facility); (iii) a joint venture between Mercy Health and Kindred Healthcare (the Oklahoma City, Oklahoma facility); and (iv) St. Joseph’s Health System (the Mishawaka, Indiana facility). At acquisition, the IRF Portfolio leases had a weighted average remaining lease term of approximately 8.3 years, exclusive of tenant renewal options. The following table presents the details of the tangible and intangible assets acquired and liabilities assumed:

    

    

    

Oklahoma

    

Las Vegas

Surprise

City

Mishawaka

Land and site improvements

$

2,723

$

1,966

$

2,507

$

1,998

Building and tenant improvements

 

17,482

 

22,856

 

22,545

 

11,882

In-place leases

 

1,778

 

1,845

 

1,890

 

1,465

Above-market lease intangibles

 

0

 

938

 

367

 

236

Leasing costs

 

519

 

1,077

 

898

 

522

Below-market lease intangibles

 

(863)

 

0

 

0

 

0

Total purchase price

$

21,639

$

28,682

$

28,207

$

16,103

San Marcos Facility

On July 12, 2019, the Company purchased a medical office building located in San Marcos, California (the “San Marcos Facility”) for a purchase price of approximately $12.0 million. Upon closing, the Company assumed the existing lease of the San Marcos Facility with California Cancer Associates for Research and Excellence, Inc., as tenant. At acquisition, the lease had eight years remaining in the initial term, exclusive of tenant renewal options.  The following table presents the details of the tangible and intangible assets acquired and liabilities assumed:

Land and site improvements

    

$

2,448

Building and tenant improvements

 

7,338

In-place leases

 

698

Above-market lease intangibles

 

1,101

Leasing costs

 

389

Total purchase price

$

11,974

-19-

Lansing Facilities

On August 1, 2019, the Company purchased the following real property and buildings thereon located in Lansing, Michigan for a total purchase price of approximately $11.1 million: (i) 3390 East Jolly Road; (ii) 3955 Patient Care Drive; and (iii) 3400 East Jolly Road (collectively, the “Lansing Facilities”). Upon closing, the Company assumed sellers’ interest, as lessor, in 4 existing leases and entered into 2 new leases at the Lansing Facilities (the “Lansing Leases”).  At acquisition, the Lansing Leases had a weighted-average remaining term of 8.5 years, exclusive of tenant renewal options.  The following table presents the details of the tangible and intangible assets acquired and liabilities assumed:

Land and site improvements

    

$

1,387

Building and tenant improvements

 

8,348

In-place leases

 

953

Above-market lease intangibles

 

130

Leasing costs

 

550

Below-market lease intangibles

 

(248)

Total purchase price

$

11,120

Bannockburn Facility

On August 5, 2019, the Company purchased an office building located in Bannockburn, Illinois (the “Bannockburn Facility”) for a purchase price of approximately $6.8 million. Upon closing, the Company assumed seller’s interest, as lessor, in 14 existing leases at the Bannockburn Facility (the “Bannockburn Leases”).  At acquisition, the Bannockburn Leases had a weighted-average remaining term of 6.3 years, exclusive of tenant renewal options. The following table presents the details of the tangible and intangible assets acquired and liabilities assumed:

Land and site improvements

    

$

895

Building and tenant improvements

 

4,700

In-place leases

 

796

Above-market lease intangibles

 

250

Leasing costs

 

336

Below-market lease intangibles

 

(144)

Total purchase price

$

6,833

Aurora Facility

On August 6, 2019, the Company purchased a medical office building located in Aurora, Illinois (the “Aurora Facility”) for a purchase price of approximately $12.6 million. Upon closing, the Company assumed the existing lease of the Aurora Facility with Dreyer Clinic Inc., as tenant whereby(the “Dreyer Lease”). At acquisition, the Ballville Property was added toDreyer Lease had approximately six years remaining in the NOMS Lease and leased to NOMS.

Unaudited Pro Forma Financial Information for the Three and Nine Months Ended September 30, 2017 and September 30, 2016

initial term, exclusive of tenant renewal options.  The following table illustratespresents the unaudited pro forma consolidated revenue, net income (loss),details of the tangible and income (loss) per share as if the facilities thatintangible assets acquired and liabilities assumed:

Land and site improvements

    

$

1,829

Building and tenant improvements

 

8,049

In-place leases

 

1,417

Above-market lease intangibles

 

861

Leasing costs

 

401

Total purchase price

$

12,557

-20-

Livonia Facility

On August 14, 2019, the Company acquired duringpurchased a medical office building located in Livonia, Michigan (the “Livonia Facility”) for a purchase price of approximately $10.4 million. Upon closing, the nine months ended September 30, 2017 that were accounted for as business combinationsCompany assumed 10 existing leases at the Livonia Facility (the Austin, Germantown, Lubbock, Flower Mound, Brockport, OCOM, Clermont and Lewisburg facilities)“Livonia Leases”).  At acquisition, the Livonia Leases had occurred on January 1, 2016.a weighted-average remaining term of 3.2 years, exclusive of tenant renewal options.  The following summarytable presents the details of pro forma financial informationthe tangible and intangible assets acquired and liabilities assumed:

Land and site improvements

    

$

1,181

Building and tenant improvements

 

8,071

In-place leases

 

1,252

Above-market lease intangibles

 

53

Leasing costs

 

35

Below-market lease intangibles

 

(236)

Total purchase price

$

10,356

Gilbert Facility

On August 23, 2019, the Company purchased certain condominium units within 2 medical office buildings located in Gilbert, Arizona (the “Gilbert Facility”) for a total purchase price of approximately $5.6 million. Upon closing, the Company leased the Gilbert Facility to Covenant Surgical Partners, Inc., a Delaware corporation (the “Covenant Lease”). At acquisition, the Covenant Lease had approximately 10 years remaining in the initial term, exclusive of tenant renewal options.  The following table presents the details of the tangible and intangible assets acquired and liabilities assumed:

Land and site improvements

    

$

2,470

Building and tenant improvements

 

2,389

In-place leases

 

121

Above-market lease intangibles

 

300

Leasing costs

 

312

Total purchase price

$

5,592

Morgantown Facility

On September 26, 2019, the Company purchased a parcel of land and an office building that is being constructed thereon located in Morgantown, West Virginia (the “Morgantown Facility”) for a total purchase price of approximately $8.0 million. Upon closing, the threeCompany assumed the existing lease of the Morgantown Facility with Urgent Care MSO, LLC, as tenant (the “Urgent Care Lease”). At acquisition, the Urgent Care Lease had approximately ten years remaining in the initial term, exclusive of tenant renewal options. The following table presents the details of the tangible and nine months ended September 30, 2017intangible assets acquired and 2016:liabilities assumed:

  Three Months Ended September 30,  Nine Months Ended September 30, 
  2017  2016  2017  2016 
  (unaudited)  (unaudited) 
             
Revenue $9,425,057  $4,909,852  $25,736,802  $13,808,974 
Net income (loss) $653,952  $(2,047,241) $(1,053,239) $(4,616,832)
Net income (loss) attributable to common stockholders $428,546  $(2,047,241) $(1,284,133) $(4,616,832)
  Income (loss) attributable to common stockholders per share – basic  and diluted $0.02  $(0.12) $(0.07) $(0.71)
Weighted average shares outstanding – basic and diluted  21,522,251   17,371,743   18,938,367   6,514,230 

Land and site improvements

    

$

1,256

Building and tenant improvements

 

5,792

In-place leases

 

457

Leasing costs

 

445

Total purchase price

$

7,950

-21-

Beaumont Facility

On October 1, 2019, the Company purchased a medical office building located in Beaumont, Texas (the “Beaumont Facility”) for a total purchase price of approximately $33.7 million. Upon closing, the Company assumed the existing lease of the Beaumont Facility with The Medical Center of Southeast Texas, LP, as tenant (the “Medical Center Lease”). At acquisition, the Medical Center Lease had 10 years remaining in the initial term, exclusive of tenant renewal options. The following table presents the details of the tangible and intangible assets acquired and liabilities assumed:

Land and site improvements

    

$

3,421

Building and tenant improvements

25,872

In-place leases

3,304

Leasing costs

1,142

  Total purchase price

$

33,739

Bastrop Facility

On October 25, 2019, the Company purchased a medical emergency center located in Bastrop, Texas (the “Bastrop Facility”) for a total purchase price of approximately $12.1 million. Upon closing, the Company assumed the existing lease of the Bastrop Facility with St. David’s Healthcare Partnership, L.P., LLP, as tenant (the “St. David’s Lease”). At acquisition, the St. David’s Lease had approximately five years remaining in the initial term, exclusive of tenant renewal options. The following table presents the details of the tangible and intangible assets acquired and liabilities assumed:

Land and site improvements

    

$

2,039

Building and tenant improvements

8,712

In-place leases

990

Leasing costs

324

  Total purchase price

$

12,065

Panama City Facilities

On October 31, 2019, the Company purchased: (i) a medical office building located in Panama City, Florida (the “Panama City Facility”); (ii) a medical office building located in Panama City Beach, Florida (the “PCB Facility”); and (iii) a medical office building located in Chipley, Florida (the “Chipley Facility”) for a total purchase price of approximately $13.0 million. Upon closing, the Company assumed the existing leases with SCP Eye Care Services, LLC, as tenant (the “SCP Leases”), at the Panama City Facility, the PCB Facility and the Chipley Facility. At acquisition, the SCP Leases had approximately 15 years remaining in the initial term, exclusive of tenant renewal options. The following table presents the details of the tangible and intangible assets acquired and liabilities assumed:

Land and site improvements

    

$

1,779

Building and tenant improvements

 

9,718

In-place leases

 

405

Leasing costs

 

1,074

  Total purchase price

$

12,976

-22-

Jacksonville Facilities

On November 15, 2019, the Company purchased a condominium unit located in Ponte Vedra, Florida (the “Ponte Vedra Facility”) and a medical office building located in Jacksonville, Florida (the “Riverside Facility”) for a total purchase price of approximately $8.9 million. Upon closing, the Company entered into new leases of the Ponte Vedra Facility and the Riverside Facility to Southeast Orthopedic Specialists, Inc., as tenant, with each lease having an initial term of 15 years, exclusive of tenant renewal options. The following table presents the details of the tangible assets acquired:

Land and site improvements

    

$

1,023

Building and tenant improvements

7,846

  Total purchase price

$

8,869

Greenwood Facility

On December 17, 2019, the Company purchased a medical office building located in Greenwood, Indiana (the “Greenwood Facility”) for a purchase price of approximately $5.8 million. Upon closing, the Company assumed the existing leases of the Greenwood Facility with (i) Indiana Eye Clinic, LLC, as tenant, (ii) Glasshouse Optical, Inc., as tenant, and (iii) The Ambulatory Surgery Center at the Indiana Eye Clinic, LLC, as tenant. At acquisition, each lease had approximately 13 years remaining in the initial terms, exclusive of tenant renewal options. The following table presents the details of the tangible assets acquired:

Land and site improvements

    

$

892

Building and tenant improvements

4,956

  Total purchase price

$

5,848

Intangible Assets and Liabilities

The following is a summary of the carrying amount of intangible assets and liabilities as of September 30, 2017:the dates presented:

 As of September 30, 2017 
 Cost  

Accumulated

Amortization

  Net 

As of September 30, 2020

Accumulated

    

Cost

    

Amortization

    

Net

Assets       

In-place leases $14,590,650  $(1,056,983) $13,533,667 

$

51,451

$

(12,647)

$

38,804

Above market ground lease  487,978   (3,972)  484,006 
Above market leases  4,363,022   (73,911)  4,289,111 

 

14,384

 

(3,565)

 

10,819

Leasing costs  7,866,982   (311,734)  7,555,248 

 

25,630

 

(5,475)

 

20,155

 $27,308,632  $(1,446,600) $25,862,032 
            
Liabilities            

$

91,465

$

(21,687)

$

69,778

Liability

Below market leases $1,145,030  $(64,907) $1,080,123 

$

10,045

$

(1,424)

$

8,621

As of December 31, 2019

    

    

Accumulated

    

Cost

Amortization

Net

Assets

 

  

 

  

 

  

In-place leases

$

39,429

$

(7,851)

$

31,578

Above market leases

 

12,246

 

(2,366)

 

9,880

Leasing costs

 

21,119

 

(3,458)

 

17,661

$

72,794

$

(13,675)

$

59,119

Liability

 

 

 

Below market leases

$

3,861

$

(697)

$

3,164

- 10 -

-23-

The following is a summaryTable of the carrying amount of intangible assets and liabilities as of December 31, 2016:Contents

  As of December 31, 2016 
  Cost  

Accumulated

Amortization

  Net 
Assets         
In-place leases $5,826,556  $(34,789) $5,791,767 
Above market leases  74,096   (443)  73,653 
Leasing costs  1,286,389   (7,533)  1,278,856 
  $7,187,041  $(42,765) $7,144,276 
             
Liabilities            
Below market leases $279,354  $(1,437) $277,917 

The following is a summary of the acquired lease intangible amortization:

Three Months Ended

Nine Months Ended

September 30, 

September 30, 

    

2020

    

2019

    

2020

    

2019

    

Amortization expense related to in-place leases

$

1,800

$

1,033

$

4,796

$

2,562

Amortization expense related to leasing costs

$

744

$

467

���

$

2,017

$

1,195

Decrease in rental revenue related to above market leases

$

421

$

343

$

1,199

$

895

Increase in rental revenue related to below market leases

$

352

$

114

$

727

$

261

As of September 30, 2020, scheduled future aggregate net amortization of the acquired lease intangible assets and liabilities for each year ended December 31 is listed below:

    

Net (Decrease)

    

Increase

Net Increase

in Revenue

in Expenses

2020 (three months remaining)

$

(22)

$

2,644

2021

 

(91)

 

9,970

2022

 

(107)

 

9,554

2023

 

(145)

 

8,633

2024

 

51

 

7,343

Thereafter

 

(1,884)

 

20,815

Total

$

(2,198)

$

58,959

As of September 30, 2020, the weighted average amortization periods for asset lease intangibles and liability lease intangibles were 5.5 years and 5.1.years, respectively.

Note 4 – Credit Facility, Notes Payable and Derivative Instruments

Credit Facility

The Company, the Operating Partnership, as borrower, and certain of its subsidiaries (such subsidiaries, the “Subsidiary Guarantors”) are parties to a $600 million syndicated credit facility with BMO Harris Bank N.A. (“BMO”), as administrative agent (the “Credit Facility”). The Credit Facility consists of a $350 million term-loan component (the “Term Loan”) and a $250 million revolver component (the “Revolver”). The Credit Facility also contains a $50 million accordion. The term of the Company’s Credit Facility expires in August 2022, subject to a one-year extension option. Amounts outstanding under the Credit Facility bear interest at a floating rate that is based on LIBOR plus a specified margin based on the Company’s leverage.

The Subsidiary Guarantors and the Company are guarantors of the obligations under the Credit Facility. The amount available to borrow from time to time under the Credit Facility is limited according to a quarterly borrowing base valuation of certain properties owned by the Subsidiary Guarantors.

The Operating Partnership is subject to a number of financial covenants under its Credit Facility, including, among other things, (i) a maximum consolidated leverage ratio as of the end of each fiscal quarter of less than 0.60:1.00, (ii) a minimum fixed charge coverage ratio of 1.50:1.00, (iii) a minimum net worth of $203.8 million plus 75% of all net proceeds raised through equity offerings subsequent to March 31, 2018 and (iv) a ratio of total secured recourse debt to total asset value of not greater than 0.10:1.00. Additionally, beginning at the end of fourth quarter of 2020, the Company’s distributions to common stockholders will be limited to an amount equal to 95% of its AFFO. As of September 30, 2020, the Company was in compliance with all of the financial and non-financial covenants contained in the Credit Facility.

-24-

During the nine months ended September 30, 2020, the Company borrowed $158,400 under the Credit Facility and repaid $51,550, for a net amount borrowed of $106,850. During the nine months ended September 30, 2019, the Company borrowed $164,450 under the Credit Facility and repaid $77,500 for a net amount borrowed of $86,950. Interest expense incurred on the Credit Facility was $3,743 and $10,805, for the three and nine months ended September 30, 2017. The Company had no intangible assets or liabilities as of September 30, 20162020, respectively, and therefore no amortization was incurred during$3,716 and $10,268 for the three and nine months ended September 30, 2016.

  Three Months Ended
September 30, 2017
  Nine Months Ended
September 30, 2017
 
Amortization expense related to in-place leases $388,409  $1,022,194 
Amortization expense related to leasing costs $135,078  $304,201 
Decrease of rental revenue related to above market ground lease $1,702  $3,972 
Decrease of rental revenue related to above market leases $55,757  $73,468 
Increase of rental revenue related to below market leases $32,443  $63,470 

2019, respectively.

As of September 30, 2017, scheduled future aggregate net amortization of acquired lease intangible assets2020 and liabilities for each fiscal year ended December 31, 2019, the Company had the following outstanding borrowings under the Credit Facility:

    

September 30, 2020

    

December 31, 2019

Revolver

$

108,200

$

51,350

Term Loan

 

350,000

 

300,000

Less: Unamortized debt issuance costs

 

(3,875)

 

(3,832)

Credit Facility, net

$

454,325

$

347,518

Costs incurred related to the Credit Facility, net of accumulated amortization, are listed below:

  Net Decrease in Revenue  Net Increase in Expenses 
2017 $(113,108) $650,590 
2018  (452,433)  2,602,359 
2019  (452,433)  2,602,359 
2020  (452,433)  2,602,359 
2021  (455,278)  1,987,746 
Thereafter  (1,767,309)  10,643,502 
Total $(3,692,994) $21,088,915 

Asnetted against the Company’s “Credit Facility, net of unamortized debt issuance costs” balance in the accompanying Condensed Consolidated Balance Sheets. The Company paid $925 and $924 related to modifications to the Credit Facility as well as fees related to adding properties to the borrowing base during the nine months ended September 30, 2020 and 2019, respectively. Amortization expense incurred was $341 and $882 for the three and nine months ended September 30, 2020, respectively, and $303 and $863 for the three and nine months ended September 30, 2019, respectively, and is included in the “Interest Expense” line item in the accompanying Condensed Consolidated Statements of Operations.

In July 2017, the weighted average amortization periodFinancial Conduct Authority (the “FCA”), which regulates LIBOR, announced its intention to stop compelling banks to submit rates for asset lease intangiblesthe calculation of LIBOR after 2021. As a result, the Federal Reserve Board and liability lease intangibles were 8.12 yearsthe Federal Reserve Bank of New York organized the Alternative Reference Rates Committee (the “ARRC”), which identified the Secured Overnight Financing Rate (the “SOFR”) as its preferred alternative to USD-LIBOR in derivatives and 8.32 years, respectively.other financial contracts. The Credit Facility provides that, on or about the LIBOR cessation date (subject to an early opt-in election), LIBOR shall be replaced as a benchmark rate in the Credit Facility with a new benchmark rate to be agreed upon by the Company and BMO, with such adjustments to cause the new benchmark rate to be economically equivalent to LIBOR.  The Company is not able to predict when LIBOR will cease to be available or when there will be sufficient liquidity in the SOFR markets.

The Company has interest rate swap agreements that are indexed to LIBOR and is monitoring and evaluating the related risks. These risks arise in connection with transitioning contracts to a new alternative rate, including any resulting value transfer that may occur. The value of loans, securities, or derivative instruments tied to LIBOR could also be impacted if LIBOR is limited or discontinued. For some instruments, the method of transitioning to an alternative rate may be challenging, as they may require negotiation with the respective counterparty.

Note 4 – If a contract is not transitioned to an alternative rate and LIBOR is discontinued, the impact on our interest rate swap agreements is likely to vary by agreement. If LIBOR is discontinued or if the methods of calculating LIBOR change from their current form, interest rates on our current or future indebtedness may be adversely affected.

While the Company expects LIBOR to be available in substantially its current form until the end of 2021, it is possible that LIBOR will become unavailable prior to that point. This could result, for example, if sufficient banks decline to make submissions to the LIBOR administrator. In that case, the risks associated with the transition to an alternative reference rate will be accelerated and potentially magnified.

-25-

Notes Payable, Related to Acquisitions and Revolving Credit Facility

Summary of Notes Payable Related to Acquisitions, Net of Debt Discount

Issuance Costs

The Company’s notes payable, related to acquisitions, net, includes twofour loans: (1) the Rosedale Loan, (2) the Dumfries Loan, (3) the Cantor Loan, and (2)(4) the West Mifflin Note, described in detail below. The following table sets forth the aggregate balances of these loans as of September 30, 20172020 and December 31, 2016.2019.

  September 30, 2017  December 31, 2016 
Notes payable related to acquisitions, gross $39,474,900  $39,474,900 
   Less: Unamortized debt discount  (963,184)  (1,061,602)
Notes payable related to acquisitions, net $38,511,716  $38,413,298 

    

September 30, 2020

    

December 31, 2019

Notes payable, gross

$

66,349

$

39,475

Less: Unamortized debt issuance costs

 

(898)

 

(667)

Cumulative principal repayments

 

(391)

 

(158)

Notes payable, net

$

65,060

$

38,650

- 11 -

Costs incurredThe Company paid $341 in debt issuance and related to securingcosts during the Company’s fixed-rate debt instruments have been capitalized as a debt discount, net of accumulated amortization, and are netted against the Company’s Notes Payable balance in the accompanying Consolidated Balance Sheets.nine months ended September 30, 2020. Amortization expense incurred related to the debt discount was $32,806issuance costs $42 and $98,418$110 for the three and nine months ended September 30, 2017,2020, respectively, and $62,604$32 and $215,449$98 for the three and nine months ended September 30, 2016,2019, respectively, and is included in the “Interest Expense” line item in the accompanying Condensed Consolidated Statements of Operations.

CantorRosedale Loan

On MarchJuly 31, 2016,2020, in connection with its acquisition of the Rosedale Facilities, the Company, through certain of its wholly-owned subsidiaries, as borrowers, entered into a $32,097,400 portfolio commercial mortgage-backed securitiesterm loan with a principal balance of $14,800 (“the Rosedale Loan”). The Rosedale Loan has an annual interest rate of 3.90% and matures on July 31, 2025 with principal and interest payable monthly based on a 25-year amortization schedule. The Company, at its option, may prepay the loan, subject to a prepayment fee.

The Company made principal payments of $20 during the nine months ended September 30, 2020. The loan balance as of September 30, 2020 was $14,780. Interest expense incurred on this loan was $104 for the three and nine months ended September 30, 2020.

As of September 30, 2020, scheduled principal payments due for each year ended December 31 were as follows:

2020 (three months remaining)

    

$

89

2021

 

361

2022

 

376

2023

 

391

2024

405

Thereafter

 

13,158

Total

$

14,780

Dumfries Loan

On April 27, 2020, in connection with its acquisition of the Dumfries Facility, the Company, through a wholly-owned subsidiary, assumed a CMBS loan with a principal amount of $12,074 (“the Dumfries Loan”). The Dumfries Loan has an annual interest rate of 4.68% and matures on June 1, 2024 with principal and interest payable monthly based on a ten-year amortization schedule. The Company, at its option, may prepay the loan, subject to a prepayment premium.

The Company made principal payments of $108 during the nine months ended September 30, 2020. The loan balance as of September 30, 2020 was $11,966. Interest expense incurred on this loan was $140 and $186 for the three and nine months ended September 30, 2020, respectively.

-26-

As of September 30, 2020, scheduled principal payments due for each year ended December 31 were as follows:

2020 (three months remaining)

    

$

67

2021

 

275

2022

 

288

2023

 

302

2024

 

11,034

Total

$

11,966

Cantor Loan

On March 31, 2016, through certain of its wholly owned subsidiaries (the “GMR Loan Subsidiaries”), the Company entered into a $32,097 CMBS loan (the “Cantor Loan”) with Cantor Commercial Real Estate Lending, LP (“CCRE”). The subsidiaries are GMR Melbourne, LLC, GMR Westland, LLC, GMR Memphis, LLC, and GMR Plano, LLC (“GMR Loan Subsidiaries”). The Cantor Loan has cross-default and cross-collateral terms. The Company used the proceeds of the Cantor Loan to acquire the Marina Towers (Melbourne, FL) and the Surgical Institute of Michigan (Westland, MI) properties and to refinance the Star Medical (Plano, TX) assets by paying off the existing principal amount of the loan with East West bank in the amount of $9,223,500.

The Cantor Loan has a maturity date of April 6, 2026 and accruesan annual interest atrate of 5.22%. The first five years of the term requireCantor Loan requires interest-only payments through March 31, 2021 and thereafter principal and interest only payments and after that payments will include interest and principal, amortized overbased on a 30-year amortization schedule. Prepayment can only occur within four months prior to the maturity date, except that after thesubject to earlier of (a) two years after the loan is placed in a securitized mortgage pool, or (ii) May 6, 2020, thedefeasance.

The Cantor Loan can be fully and partially defeased upon payment of amounts due under the Cantor Loan and payment of a defeasance amount that is sufficient to purchase U.S. government securities equal to the scheduled payments of principal, interest, fees, and any other amounts due related to a full or partial defeasance under the Cantor Loan.

The Company is securing the payment of the Cantor Loan withsecured by the assets including property, facilities, and rents, held byof the GMR Loan Subsidiaries and has agreed to guarantee certain customary recourse obligations, including findings of fraud, gross negligence, or breach of environmental covenants by GMR Loan Subsidiaries. The GMR Loan Subsidiaries will besuch subsidiaries are required to maintain a monthly debt service coverage ratio of 1.35:1.00 for all of the collateral properties in the aggregate.1.00.

No principal payments were made on the Cantor Loan during the three and nine months ended September 30, 2017. The note balance as of September 30, 20172020 and December 31, 20162019 was $32,097,400.$32,097. Interest expense incurred on this note was $428,180$425 and $1,270,578$1,326 for the three and nine months ended September 30, 2017, respectively.Interest expense incurred on this note was $428,1792020, respectively, and $851,704$429 and $1,271 for the three and nine months ended September 30, 2016,2019, respectively.

As of September 30, 2017,2020, scheduled principal payments due for each fiscal year ended December 31 are listed belowwere as follows:

2017 $- 
2018  - 
2019  - 
2020  - 
2021  - 
Thereafter  32,097,400 
    Total $32,097,400 

2020 (three months remaining)

    

$

2021

    

 

282

2022

 

447

2023

 

471

2024

 

492

Thereafter

 

30,405

Total

$

32,097

West Mifflin Note

In order to finance a portion of the purchase price for the West Mifflin facility, onOn September 25, 2015, the Company, (through its wholly ownedthrough a wholly-owned subsidiary, GMR Pittsburgh LLC, as borrower)borrower, entered into a Term Loan and Security Agreement$7,378 term loan with Capital One. On September 25, 2020, the Company and Capital One (the “West Mifflin Note”)amended the terms of the loan to borrow $7,377,500.extend the maturity date to September 25, 2021 and increase the interest rate to 4.25% per annum. The West Mifflin Note bears interest at 3.72% per annum and all unpaid interest and principal is due on September 25, 2020. Interest is paid in arrears and interest payments began on November 1, 2015, and onfacility serves as collateral for the first day of each calendar month thereafter. Principal payments begin on November 1, 2018 and on the first day of each calendar month thereafter based on an amortization schedule with the principal balance due on the maturity date.loan. The Company, at its option, may prepay the West Mifflin Note at any time, in whole (but not in part) on at least thirty calendar days but not more than sixty calendar days advance written notice. The West Mifflin Note has an early termination fee of two percent if prepaid prior to September 25, 2018. The West Mifflin Notenote requires a quarterly fixed charge coverage ratio of at least 1:1, a quarterly minimum debt yield of 0.09:1.00, and annualized Operatoroperator EBITDAR (as defined in the note) measured on a quarterly basis of not less than $6,000,000.$6,000. The Operatoroperator is Associates in Ophthalmology, Ltd. and Associates Surgery Centers, LLC. No

The Company made principal payments were madeof $105 during the nine months ended September 30, 2020. The note balance as of September 30, 2020 and December 31, 2019 was $7,115 and $7,220, respectively. Interest expense incurred on this note was $68 and $203 for the three and nine months ended September 30, 2020, respectively, and $69 and $207 for the three and nine months ended September 30, 2019, respectively.

-27-

Derivative Instruments - Interest Rate Swaps

As of September 30, 2020, the Company had the following 6 interest rate swaps that are used to manage its interest rate risk and fix the LIBOR component of certain of its floating rate debt on a weighted average basis at 1.91%:

Counterparty

Notional Amount

Fixed LIBOR Rate

Maturity

Wells Fargo Bank, N.A.

$

50 million

0.16%

August 2023

BMO

100 million

2.88%

August 2023

BMO

90 million

1.21%

August 2024

Truist Bank

40 million

1.21%

August 2024

Truist Bank

40 million

2.93%

August 2024

Citizens Bank, National Association

30 million

2.93%

August 2024

Total/Weighted Average

$

350 million

1.91%

In accordance with the provisions of ASC Topic 815, the Company records the swaps either as an asset or a liability measured at its fair value at each reporting period. When hedge accounting is applied, the change in the fair value of derivatives designated and that qualify as cash flow hedges is (i) recorded in accumulated other comprehensive loss in the equity section of the Company’s Condensed Consolidated Balance Sheets and (ii) subsequently reclassified into earnings as interest expense for the period that the hedged forecasted transactions affect earnings. If specific hedge accounting criteria are not met, changes in the Company’s derivative instruments’ fair value are recognized currently as an adjustment to net income.

The Company’s interest rate swaps are not traded on an exchange. The Company’s interest rate swaps are recorded at fair value based on a variety of observable inputs including contractual terms, interest rate curves, yield curves, measure of volatility, and correlations of such inputs. The Company measures its derivatives at fair value on a recurring basis based on the expected size of future cash flows on a discounted basis and incorporating a measure of non-performance risk. The fair values are based on Level 2 inputs within the framework of ASC Topic 820, “Fair Value Measurement.” The Company considers its own credit risk, as well as the credit risk of its counterparties, when evaluating the fair value of its derivative instruments.

The fair value of the Company’s interest rate swaps was a net liability of $19,505 and $6,491 as of September 30, 2020 and December 31, 2019, respectively. The gross balances are included in the “Derivative Asset’ and “Derivative Liability” line items on the Company’s Condensed Consolidated Balance Sheets as of September 30, 2020 and December 31, 2019, respectively.

The table below details the components of the loss presented on the accompanying Condensed Consolidated Statements of Comprehensive (Loss) Income recognized on the Company’s interest rate swaps designated as cash flow hedges for the three and nine months ended September 30, 2020 and 2019:

Three Months Ended September 30, 

Nine Months Ended September 30, 

    

    

2020

    

2019

    

2020

    

2019

    

 

Amount of (gain) loss recognized in other comprehensive loss

$

(451)

$

1,603

$

16,313

$

7,559

Amount of loss reclassified from accumulated other comprehensive (loss) income into interest expense

 

(1,552)

 

(300)

 

(3,336)

 

(684)

Total change in accumulated other comprehensive loss

$

(2,003)

$

1,303

$

12,977

$

6,875

During the next twelve months, the Company estimates that an additional $6,135 will be reclassified as an increase to interest expense. Additionally, during the three and nine months ended September 30, 2017. The West Mifflin Note balance as of September 30, 2017 and December 31, 2016 was $7,377,500.Interest expense incurred on the West Mifflin Note was $70,136 and $208,882 for the three and nine months ended September 30, 2017, respectively, and $70,136 and $209,645 for the three and nine months ended September 30, 2016, respectively.

- 12 -

As of September 30, 2017, scheduled principal payments due for each fiscal year ended December 31 are listed below as follows:

2017 $- 
2018  22,044 
2019  136,007 
2020  7,219,449 
    Total $7,377,500 

Revolving Credit Facility

As of September 30, 2017 and December 31, 2016,2020, the Company had $126,100,000 and $27,700,000 of outstanding borrowings under its revolving credit facility, respectively. As described below, the maximum amount that the Company can borrow under the facility is $250,000,000.

On December 2, 2016, the Company, the Operating Partnership, as borrower, and certain subsidiaries (GMR Asheville LLC, GMR Watertown LLC, GMR Sandusky LLC, GMR East Orange LLC, GMR Omaha LLC, and GMR Reading LLC) (such subsidiaries, the “Subsidiary Guarantors”) of the Operating Partnership entered into a senior revolving credit facility (the “Credit Facility”) with BMO Harris Bank N.A., as Administrative Agent (“BMO”), which initially provided up to $75,000,000 in revolving credit commitments for the Operating Partnership. The initial Credit Facility included an accordion feature that provided the Operating Partnership with additional capacity, subject to the satisfaction of customary terms and conditions, of up to $125,000,000, for arecorded total initial facility size of up to $200,000,000. On March 3, 2017, the Company, the Operating Partnership, as borrower, and the Subsidiary Guarantors of the Operating Partnership entered into an amendment to the Credit Facility with BMO, which increased the commitment amount to $200,000,000 plus an accordion feature that allows for up to an additional $50,000,000 of principal amount subject to certain conditions, for a total facility size of $250,000,000 (the “Revolving Credit Facility”). On September 28, 2017, the Company obtained commitments from certain of its lenders on the Revolving Credit Facility for the entire $50,000,000 accordion. The Subsidiary Guarantors and the Company are guarantors of the obligations under the Revolving Credit Facility. The amount available to borrow from time to time under the Revolving Credit Facility is limited according to a quarterly borrowing base valuation of certain properties owned by the Subsidiary Guarantors. The initial termination date of the Revolving Credit Facility is December 2, 2019, which could be extended for one year in the case that no event of default occurs.

Amounts outstanding under the Revolving Credit Facility bear annual interest at a floating rate that is based, at the Operating Partnership’s option, on (i) adjusted LIBOR plus 2.00% to 3.00% or (ii) a base rate plus 1.00% to 2.00%, in each case, depending upon the Company’s consolidated leverage ratio. In addition, the Operating Partnership is obligated to pay a quarterly fee equal to a rate per annum equal to (x) 0.20% if the average daily unused commitments are less than 50% of the commitments then in effect and (y) 0.30% if the average daily unused commitments are greater than or equal to 50% of the commitments then in effect and determined based on the average daily unused commitments during such previous quarter.

The Operating Partnership is subject to ongoing compliance with a number of customary affirmative and negative covenants, including limitations with respect to liens, indebtedness, distributions, mergers, consolidations, investments, restricted payments and asset sales. The Operating Partnership must also maintain (i) a maximum consolidated leverage ratio, commencing with the fiscal quarter ending December 31, 2016 and as of the end of each fiscal quarter thereafter, of less than (y) 0.65:1.00 for each fiscal quarter ending prior to October 1, 2019 and (z) thereafter, 0.60:1.00, (ii) a minimum fixed charge coverage ratio of 1.50:1.00, (iii) a minimum net worth of $119,781,219 plus 75% of all net proceeds raised through subsequent equity offerings and (iv) a ratio of total secured recourse debt to total asset value of not greater than 0.10:1.00.

During the nine months ended September 30, 2017, the Company borrowed $205,400,000 under the Revolving Credit Facility and repaid $107,000,000 using funds primarily from the follow-on common stock offering and the preferred offering for a net amount borrowed of $98,400,000. For the three and nine months ended September 30, 2017, interest incurred on the Revolving Credit Facility was $1,335,730 and $2,945,588, respectively. No interest expense was incurred for the three and nine months ended September 30, 2016 as the Revolving Credit Facility was not in place.

- 13 -

Deferred Financing Costs, Net

Costs incurred related to securing the Company’s Revolving Credit Facility have been capitalized as a deferred financing asset, net of accumulated amortization, in the accompanying Consolidated Balance Sheets. A rollforward of the deferred financing cost balance as of September 30, 2017, is as follows:

Balance as of January 1, 2017, net $927,085 
Additions – Revolving Credit Facility1  2,792,692 
Deferred financing cost amortization expense  (741,796)
Balance as of September 30, 2017, net $2,977,981 

1This amount includes $1,223,359 of costs incurred in connection with the Company’s Revolving Credit Facility that were erroneously expensed and included in the “General and Administrative Expense” line item within the Company’s Consolidated Statement of Operations for the three months ended March 31, 2017.  During the six-month period ended June 30, 2017, the Company corrected this error by removing the $1,223,359 from expense and capitalizing it as “Deferred Financing Costs, Net” on the Company’s Consolidated Balance Sheet as of June 30, 2017. See Note 2 – “Summary of Significant Accounting Policies.”

Amortization expense incurred related to the Revolving Credit Facility deferred financing costs were $307,831 and $741,796 for the three and nine months ended September 30, 2017, respectively, and is included in the “Interest Expense” line item in the accompanyingits Condensed Consolidated Statements of Operations. There was no amortization expense incurred on the Revolving Credit Facility during the threeOperations of $4,864 and nine months ended September 30, 2016, as the Revolving Credit Facility was not in place.

$13,616.

Weighted-Average Interest Rate and Term

The Company’s weighted average interest rate and term of itsthe Company’s debt was 3.84%3.34% and 3.433.06 years respectively, at September 30, 2017,2020, compared to 4.29%3.90% and 6.043.76 years respectively, atas of December 31, 2016.2019.

-28-

Note 5 – Stockholders’ Equity

Preferred Stock

General

On September 15, 2017, the Company closed onThe Company’s charter authorizes the issuance of 3,105,00010,000 shares of itspreferred stock, par value $0.001 per share. As of September 30, 2020 and December 31, 2019, there were 3,105 shares of Series A Cumulative Redeemable Preferred Stock $0.001 par value per share, with an initial(“Series A Preferred Stock”), issued and outstanding. The Series A Preferred Stock has a liquidation preference of $25 per share (“Series A share.

Preferred Stock”), inclusive of 405,000 shares issued in connection withstock dividend activity for the underwriters’ exercise of their over-allotment option. The Company may, at its option, redeem the Series A Preferred Stock for cash in whole or in part, from time to time, at any time on or after September 15, 2022, at a cash redemption price of $25 per share. The Series A Preferred Stock will have no voting rights, except for limited voting rights if the Company fails to pay dividends for six quarterly periods. The issuance resulted in aggregate gross proceeds of $77,625,000. After deducting underwriting discounts and advisory fees of $2,445,188, and expenses paid or to be paid by the Company that were directly attributable to the offering of $220,809 (which are both treated as a reduction of the “Preferred Stock” balance on the accompanying Consolidated Balance Sheets), the Company’s preferred stock balance as ofnine months ended September 30, 2017 was $74,959,003. Net proceeds received from2020 is summarized in the transaction were $75,146,720, which the Company used primarily to repay borrowings on its Revolving Credit Facility. following table:

    

    

Applicable

    

    

Quarterly

    

Dividends

Date Announced

Record Date

Quarter

Payment Date

Dividend

per Share

December 13, 2019

 

January 15, 2020

 

Q4 2019

 

January 31, 2020

$

1,455

$

0.46875

March 4, 2020

 

April 15, 2020

 

Q1 2020

 

April 30, 2020

$

1,455

$

0.46875

June 12, 2020

 

July 15, 2020

 

Q2 2020

 

July 31, 2020

$

1,455

$

0.46875

September 3, 2020

 

October 15, 2020

 

Q3 2020

 

October 31, 2020

$

1,455

(1)

$

0.46875

(1)

Two months of this amount, equal to $970, was accrued at September 30, 2020.

The Company assessed the characteristicsholders of the Series A Preferred Stock in accordance with the provisions of ASC Topic 480 – “Distinguishing Liabilities from Equity,” and concluded that the Series A Preferred Stock is classified as permanent equity.

Preferred Stock Dividends

Holders of the Company’s Series A Preferred Stock will beare entitled to receive dividend payments only when, as and if declared by the Board of Directors of the Company (the “Board”)(or(or a duly authorized committee of the Board). Any such dividendsDividends will accrue or be payable in cash from the original issue date, on a cumulative basis, quarterly in arrears on each dividend payment date. Additionally, dividends will be payabledate at a fixed rate per annum equal to 7.50% of the liquidation preference of $25$25.00 per share (equivalent to $1.875 per share on an annual basis). Dividends on the Series A Preferred Stock will be cumulative and will accrue whether or not:not (i) funds are legally available for the payment of those dividends, (ii) the Company has earnings or (iii) those dividends are authorized.

declared by the Board. The quarterly dividend payment dates on the Series A Preferred Stock are January 31, April 30, July 31 and October 31 of each year, commencing on October 31, 2017. The initial dividend is scheduled to beyear. During each of the nine-month periods ended September 30, 2020 and 2019, the Company paid on October 31, 2017 to holderspreferred dividends of record as of October 15, 2017,$4,366 and will be a pro rata dividend from, and including, the original issue date to, and including, October 30, 2017, in the pro rata amount of $0.2396 per share for a total dividend amount of $743,598. Refer to Note 11 – “Subsequent Events” for additional information regarding this dividend payment.

- 14 -

$4,365 respectively.

Common Stock

General

The Company has 500,000 authorized shares of common stock, $0.001 par value. As of September 30, 2020 and December 31, 2019, there were 48,188 and 43,806 outstanding shares of common stock, respectively.

On June 30, 2017,August 17, 2020, the Company closedand the Operating Partnership entered into a public underwritten offering of its common shares and on July 20, 2017Sales Agreement with certain sales agents, pursuant to which the Company closed on the over-allotment option grantedmay offer and sell, from time to the underwriters. These transactions resulted in an aggregate of 4,025,000 sharestime, up to $150,000 of its common stock being issued(the “ATM Program”). During the three months ended September 30, 2020, the Company generated gross proceeds of $25,050 through ATM Program equity issuances of 1,930 shares of the Company’s common stock at a publican average offering price of $9$12.98 per share, resulting in aggregateshare. During the nine months ended September 30, 2020, the Company generated gross proceeds of $36,225,000. After deducting underwriting discounts and advisory fees$39,221 through ATM Program equity issuances of $1,986,876, and expenses paid by the Company that were directly attributable to the offering of $443,499 (both of which are treated as a reduction3,170 shares of the Company’s additional paid-in capital balance), the Company received net proceeds from the transactions of $33,794,625.

Dividends

Since July 2016, the Company’s Board had declared cash dividends on its common stock asat an average offering price of $12.37 per share.

Common stock dividend activity for the nine months ended September 30, 2020 is summarized in the following table.table:

Date Announced Record Date Applicable
Quarter
 Payment Date Dividend Amount1  Dividends per Share 
             
September 14, 2016 September 27, 2016 Q3 2016 October 11, 2016 $3,592,786  $0.20 
December 14, 2016 December 27, 2016 Q4 2016 January 10, 2017 $3,604,037  $0.20 
March 20, 2017 March 27, 2017 Q1 2017 April 10, 2017 $3,603,485  $0.20 
June 16, 2017 June 27, 2017 Q2 2017 July 10, 2017 $3,607,726  $0.20 
September 8, 2017 September 26, 2017 Q3 2017 October 9, 2017 $4,416,1642 $0.20 

    

    

Applicable

    

    

Dividend

    

Dividends

Date Announced

Record Date

Quarter

Payment Date

Amount(1)

per Share

December 13, 2019

 

December 26, 2019

 

Q4 2019

 

January 9, 2020

$

9,541

$

0.20

March 4, 2020

 

March 25, 2020

 

Q1 2020

 

April 9, 2020

$

9,610

$

0.20

June 12, 2020

 

June 25, 2020

 

Q2 2020

 

July 9, 2020

$

9,861

$

0.20

September 3, 2020

 

September 24, 2020

 

Q3 2020

 

October 8, 2020

$

10,357

$

0.20

(1)

1

Includes dividendsdistributions on granted LTIP unitsUnits and OP Units issued to third parties.Units.

2This amount was accrued as of September 30, 2017 and paid on October 9, 2017. For additional details refer to Note 11 – “Subsequent Events.”

During the nine months ended September 30, 2017,2020 and 2019, the Company paid total dividends on its common stock, LTIP Units and OP Units in the aggregate amount of $10,815,248, consisting$29,588 and $21,167, respectively.

-29-

In accordance with the terms of the Company’s 2017 Annual Equity Bonus and Long-Term Equity Award Plan as disclosed in Note 7 – “Stock-Based Compensation,” asAs of September 30, 20172020 and December 31, 2019, the Company had an accrued a dividend balance of $0.20 per LTIP unit$516 and $580 for each of the three quarters of 2017dividends payable on the aggregate annual and long-term LTIP unitsUnits that are subject to retroactive receipt of dividends on the amount of LTIPsLTIP Units ultimately earned. During the nine months ended September 30, 2020, $512 of dividends were accrued and $576 of dividends were paid related to these units. During the nine months ended September 30, 2019, $265 of dividends were accrued and $85 of dividends were paid related to these units.

The aggregate amount of the accrualdividends paid to the Company’s stockholders is determined by the Board and is dependent on a number of factors, including funds available for payment of dividends, the Company’s financial condition and capital expenditure requirements except that, in accordance with the Company’s organizational documents and Maryland law, the Company may not make dividend distributions that would: (i) cause it to be unable to pay its debts as they become due in the usual course of September 30, 2017 was $92,123.

business; (ii) cause its total assets to be less than the sum of its total liabilities plus senior liquidation preferences; or (iii) jeopardize its ability to maintain its qualification as a REIT.

OP Units

During the nine months ended September 30, 2020, three OP Unit holders redeemed an aggregate of 1,185 OP Units for shares of the Company’s common stock with an aggregate redemption value of $15,245. During the year ended December 31, 2019, the Company issued an aggregate of 49 OP Units with a value of $506 in connection with a facility acquisition. Additionally, during the year ended December 31, 2019, two OP Unit holders redeemed an aggregate of 51 OP Units for shares of the Company’s common stock with an aggregate redemption value of $519. As of September 30, 2017,2020 and December 31, 2019, there were 117,9411,958 and 3,143 OP Units issued and held by third partiesoutstanding, respectively, with an aggregate value of approximately $1,077,497. 109,608 of the$12,636 and $27,881, respectively. The OP Units were issued in connection with the acquisition of a facilityUnit value at issuance and were valued at the measurement date of August 18, 2017 usingredemption is based on the Company’s closing stockshare price on thatthe date of $9.14 per share, resultingthe respective transaction and is included as a component of noncontrolling interest equity in a valuethe Company’s Condensed Consolidated Balance Sheets as of $1,000,000. Additionally, 8,333 OP Units were issuedSeptember 30, 2020 and December 31, 2019. The Company has sufficient shares of common stock authorized pursuant to a third party advisory agreement. Theseits charter to cover the redemption of outstanding OP Units were valued at the measurement date of August 1, 2017 using the Company’s closing stock price on that date of $9.30 per share resulting in a value of $77,497. The advisory agreement is for the period from June 27, 2017 through December 31, 2017 for a total fee of $250,000 payable in shares of Company common stock, LTIP Units, or OP Units, in three equal installments on August 1, 2017, October 1, 2017, and December 1, 2017.  The number of units issued pursuant to the advisory agreement is determined based on the higher of $10 per share or the average closing price per share of the Company’s common stock as reported on the NYSE on the last 10 trading days of the calendar month preceding each payment date.

Units.

Note 6 – Related Party Transactions

Initial Management Agreement

On November 10, 2014,Prior to the Company entered into a management agreement, with an effective date of April 1, 2014, with the Advisor. Under the terms of this initial management agreement, the Advisor was responsible for designing and implementing the Company’s business strategy and administering its business activities and day-to-day operations. For performing these services,Internalization, the Company was obligated to pay the Advisor a base management fee equalsubject to the greaterManagement Agreement, the material terms of (a) 2.0% per annum ofwhich are summarized in the section titled “Business — Our Advisor and our Management Agreement,” contained in the Company’s net asset value (the valueAnnual Report on Form 10-K for the year ended December 31, 2019 filed with the SEC on March 9, 2020.

Management Fees and Accrued Management Fees

For the three months ended September 30, 2020 no management fees were incurred and expensed by the Company. For the  nine months ended September 30, 2020, and prior to the Internalization, management fees of $4,024 were incurred and expensed by the Company’s assets less the value of the Company’s liabilities), or (b) $30,000 per calendar month. InCompany in accordance with the terms of the initial management agreement, during the nine-month period ended September 30, 2016, the Company incurred $807,147 of base management fees and repaid $510,000 of cumulative management fees accrued and outstanding. Additionally, during the nine-month period ended September 30, 2016, the Company incurred $754,000 in acquisition fees that were paid to the Advisor for acquisitions that were completed during that period.

- 15 -

Amended Management Agreement

Upon completion of the Company’s initial public offering on July 1, 2016, the Company and the Advisor entered into an amended and restated management agreement (the “Amended Management Agreement”). Certain material terms of the Amended Management Agreement are summarized below:

Term and Termination

The Amended Management Agreement has an initial term of three years expiring on the third anniversary of the closing date of the initial public offering but will automatically renew for an unlimited number of successive one-year periods thereafter, unless the agreement is not renewed or is terminated in accordance with its terms. If the Board decides to terminate or not renew the Amended Management Agreement, the Company will generally be required to pay the Advisor a termination fee equal to three times the sum of the average annual base management fee and the average annual incentive compensation with respect to the previous eight fiscal quarters ending on the last day of the fiscal quarter prior to termination. Subsequent to the initial term, the Company may terminate the Amended Management Agreement only under certain circumstances.

Base Management Fee

The Company pays its Advisor a base management fee in an amount equal to 1.5% of its stockholders’ equity per annum, calculated quarterly for the most recently completed fiscal quarter and payable in quarterly installments in arrears.

For purposes of calculating the base management fee, the Company’s stockholders’ equity means: (a) the sum of (1) the Company stockholders’ equity as of March 31, 2016, (2) the aggregate amount of the conversion price (including interest) for the conversion of the Company’s outstanding convertible debentures into common stock and OP Units upon completion of the initial public offering, and (3) the net proceeds from (or equity value assigned to) all issuances of equity and equity equivalent securities (including common stock, common stock equivalents, preferred stock, LTIP units and OP Units issued by the Company or the Operating Partnership) in the initial public offering, or in any subsequent offering (allocated on a pro rata daily basis for such issuances during the fiscal quarter of any such issuance), less (b) any amount that the Company pays to repurchase shares of its common stock or equity securities of the Operating Partnership. Stockholders’ equity also excludes (1) any unrealized gains and losses and other non-cash items (including depreciation and amortization) that have impacted stockholders’ equity as reported in the Company’s financial statements prepared in accordance with GAAP, and (2) one-time events pursuant to changes in GAAP, and certain non-cash items not otherwise described above, in each case after discussions between the Advisor and its independent directors and approval by a majority of the Company’s independent directors. As a result, the Company’s stockholders’ equity, for purposes of calculating the base management fee, could be greater or less than the amount of stockholders’ equity shown on its financial statements.

The base management fee of the Advisor shall be calculated within 30 days after the end of each quarter and such calculation shall be promptly delivered to the Company. The Company is obligated to pay the quarterly installment of the base management fee calculated for that quarter in cash within five business days after delivery to the Company of the written statement of the Advisor setting forth the computation of the base management fee for such quarter.

Incentive Compensation Fee

The Company pays its Advisor an incentive fee with respect to each calendar quarter (or part thereof that the management agreement is in effect) in arrears. The incentive fee is an amount, not less than zero, equal to the difference between (1) the product of (x) 20% and (y) the difference between (i) the Company’s AFFO (as defined below) for the previous 12-month period, and (ii) the product of (A) the weighted average of the issue price of equity securities issued in the initial public offering and in future offerings and transactions, multiplied by the weighted average number of all shares of common stock outstanding on a fully-diluted basis (including any restricted stock units, any restricted shares of common stock, OP Units, LTIP units, and shares of common stock underlying awards granted under the 2016 Equity Incentive Plan (the “2016 Plan”) or any future plan in the previous 12-month period, and (B) 8%, and (2) the sum of any incentive fee paid to the Advisor with respect to the first three calendar quarters of such previous 12-month period; provided, however, that no incentive fee is payable with respect to any calendar quarter unless AFFO is greater than zero for the four most recently completed calendar quarters, or the number of completed calendar quarters since the closing date of the offering, whichever is less. For purposes of calculating the incentive fee during the first 12 months after completion of the offering, AFFO will be determined by annualizing the applicable period following completion of the offering.

- 16 -

Per the terms of the Amended Management Agreement, AFFO is calculated by adjusting the Company’s funds from operations, or FFO, by adding back acquisition and disposition costs, stock based compensation expenses, amortization of deferred financing costs and any other non-recurring or non-cash expenses, which are costs that do not relate to the operating performance of the Company’s properties, and subtracting loss on extinguishment of debt, straight line rent adjustment, recurring tenant improvements, recurring leasing commissions and recurring capital expenditures. To date the Company has not incurred or paid an incentive fee.

Management Fee Expense Incurred and Accrued Management Fees

Agreement. For the three and nine months ended September 30, 2017,2019, management fees of $803,804$1,621 and $2,059,325,$4,539, respectively, were incurred and expensed by the Company and duringCompany. As a result of the nine months endedInternalization, there were no accrued management fees due to the Former Advisor as of September 30, 2017, the Company paid2020. Accrued management fees due to the Advisor inwere $1,727 as of December 31, 2019. No incentive management fee was incurred by the amount of $1,876,229. ForCompany during the three and nine months ended September 30, 2020 or 2019.

-30-

Related Party Balances

A rollforward of the due from related parties and due to related party balance, net, as of September 30, 2020 is as follows:

    

Due From

    

    

    

Related Parties

Due to Related Party, Net

Other

Funds for

Management

Funds due

Due to

Various

Fees due to

from

Related

Purposes

Advisor

Advisor

Party, net

Balance as of January 1, 2020

$

50

 

$

(1,727)

 

79

$

(1,648)

Management fee expense incurred

 

 

 

(4,024)

 

 

 

(4,024)

Management fees paid to Advisor

 

 

 

5,751

 

 

 

5,751

Loans to Advisor

 

 

 

 

 

(79)

 

(79)

Loan to related parties

 

71

 

 

 

 

 

Balance as of September 30, 2020

$

121

 

$

0

 

0

$

0

Note 7 – Stock-Based Compensation

2016 management fees of $627,147 and $807,147, respectively, were incurred and expensed byEquity Incentive Plan

The 2016 Equity Incentive Plan, as amended (the “Plan”), is intended to assist the Company and duringits affiliates in recruiting and retaining employees, members of the Board, executive officers of the Company, and individuals who provide services to the Company and its affiliates.

The Plan is intended to permit the grant of both qualifying and non-qualified options and the grant of stock appreciation rights, restricted stock, unrestricted stock, awards of restricted stock units, performance awards and other equity-based awards (including LTIP Units). Based on the grants outstanding as of September 30, 2020, there are 521 shares of common stock that remain available to be granted under the Plan. Units subject to awards under the Plan that are forfeited, cancelled, lapsed, settled in cash or otherwise expired (excluding shares withheld to satisfy exercise prices or tax withholding obligations) are available for grant.

Time-Based Grants

During the nine months ended September 30, 2016 the Company paid management fees2020, pursuant to the Advisor in the amount of $510,000. As of September 30, 2017 and December 31, 2016, accrued management fees of $803,805 and $620,709, respectively, were due to the Advisor.

Allocated General and Administrative Expenses

Effective May 8, 2017, the Company and the Advisor entered into an agreement pursuant to which, for a period of one year commencing on May 8, 2017, the Company has agreed to reimburse the Advisor for $125,000 of the annual salary of the General Counsel and Secretary of the Company, such reimbursement to be paid in arrears in 12 equal monthly installments beginning after the end of the month of May 2017 so long as the General Counsel and Secretary continues to be primarily dedicated to the Company in his capacity as its General Counsel and Secretary. In the future, the Company may receive additional allocations of general and administrative expenses from the Advisor that are either clearly applicable to or were reasonably allocated to the operations of the Company. Other than via the terms of the reimbursement agreement, there were no allocated general and administrative expenses from the Advisor for the three and nine months ended September 30, 2017 or September 30, 2016.

Note Payable to Majority Stockholder

In prior years the Company received funds from its former majority stockholder ZH USA, LLC in the form of a non-interest bearing, due on demand note payable, which is classified as“Note payable to related parties” on the accompanying Consolidated Balance Sheets. The Company repaid this loan in full during the nine months ended September 30, 2017 and accordingly the balance of this note was zero and $421,000 as of September 30, 2017 and December 31, 2016, respectively.

Due to Related Parties, Net

A rollforward of the due (to) from related parties balance, net, as of September 30, 2017, is as follows:

  Due to Advisor –Mgmt. Fees  Due to Advisor – Other Funds  Due (to) from Other Related Party  Total Due (To) From Related Parties, Net 
Balance as of January 1, 2017 $(620,709)  (586)  40,384   (580,911)
Management fee expense incurred1  (2,059,325)  -   -   (2,059,325)
Management fees paid to Advisor1  1,876,229   -   -   1,876,229 
Loan repaid to Advisor2  -   149   -   149 
Loan repaid to other related party3  -   -   (38,428)  (38,428)
Balance as of September 30, 2017 $(803,805)  (437)  1,956   (802,286)

1Net amount accrued of $183,096 consists of $2,059,325 in management fee expense incurred, net of $1,876,229 of accrued management fees that were paid to the Advisor.  This represents a cash flow operating activity.
2Amount represents the partial repayment of expenses that were previously paid by the Advisor on the Company’s behalf.  This represents a cash flow financing activity.
3Amount represents the net repayment of previous loans made by the Company to related parties.  This represents a cash flow investing activity.

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Note 7 – Stock-Based Compensation

2017 Program – Performance Based Awards

On February 28, 2017, the Board approved the recommendationsrecommendation of the Compensation Committee of the Board (the “Compensation Committee”) with respect to, the awardingBoard approved the following LTIP Unit activity:

On March 3, 2020, determined that 190 LTIP Units were earned in accordance with the terms of the previously disclosed 2017 long-term performance award agreements. The grant and vesting of these units are as follows:
ØOn March 3, 2020, there were 155 units granted that vested 50% on March 3, 2020, the determination date, and 50% vest on March 3, 2021.
ØOn May 12, 2020, there were 14 units granted that vested 50% on May 12, 2020, the determination date, and 50% vest on May 12, 2021.
ØOn August 23, 2020, there were 21 units granted that vested 50% on August 23, 2020, the determination date, and 50% vest on August 23, 2021.
On March 3, 2020, determined that 147 LTIP Units were earned in accordance with the terms of the previously disclosed 2019 annual award agreements. These units vested 50% on March 3, 2020, the determination date, and 50% vest on March 3, 2021.
On March 3, 2020, granted 43 LTIP Units in connection with the 2020 Long-Term Incentive Plan. These grants were valued based on the Company’s closing common stock price on the March 3, 2020 date of grant of $14.34 and vest in equal one-thirdincrements on each of March 3, 2021, March 3, 2022, and March 3, 2023.
On July 9, 2020, granted 402 LTIP Units to the Company’s executives in connection with the Internalization. These grants were valued based on the Company’s closing stock price on July 8, 2020 of $10.46 and vest in equal one-fourthincrements on each of July 9, 2021, July 9, 2022, July 9, 2023, and July 9, 2024.

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On July 24, 2020, granted 108 LTIP Units to the Company’s non-executive employees in connection with the Internalization. These grants were valued based on the Company’s closing stock price on July 23, 2020 of $12.05 and vest in equal one-fourthincrements on each of July 24, 2021, July 24, 2022, July 24, 2023, and July 24, 2024.
On September 2, 2020, granted 19 LTIP Units to the Company’s independent directors. These grants were valued based on the average of the Company’s closing stock price for the ten days prior to the date of grant and vest on September 2, 2021.

Additionally, during the nine months ended September 30, 2020, there were 28 LTIP Units redeemed for shares of the Company’s common stock.

A detail of the Company’s outstanding time based LTIP Units as of September 30, 2020 is as follows:

Vested units

811

Unvested units

828

LTIP Units outstanding as of September 30, 2020

1,639

Performance Based Awards

The Board has approved annual performance-based equity incentive award targets in the form of LTIP units (the “Annualawards (“Annual Awards”) and long-term performance-based LTIP awards (the “Long-Term(“Long-Term Awards”) to the executive officers of the Company and other employees of the Company’s external manager who perform services forCompany.  As described below, the Company (the “2017 Program”). Additionally,Annual Awards have one-year performance periods and the Board approvedLong-Term Awards have three-year performance periods. In addition to meeting specified performance metrics, vesting in both the recommendations of the Compensation Committee with respect to awarding Annual Awards and the Long-Term Awards is subject to two executive officersservice requirements.

A detail of the Company whose employment commenced on August 23, 2017 and May 8, 2017, respectively. None of the LTIP units awardedCompany’s Long-Term Awards under the 2017, Program have been earned by the participants as of September 30, 2017.

The 2017 Program is a part of the Company’s 2016 Plan2018 and therefore2019 programs, and the Annual Awards and Long-Term Awards were awarded pursuant to the 2016 Plan. The purpose of the 2016 Plan is to attract and retain qualified persons upon whom, in large measure, the Company’s sustained progress, growth and profitability depend, to motivate the participants to achieve long-term company goals and to more closely align the participants’ interests with those of the Company’s other stockholders by providing them with a proprietary interest in the Company’s growth and performance. The Company’s executive officers, employees, employees of its advisor and its affiliates, consultants and non-employee directors are eligible to participate in the 2016 Plan.

The LTIP unit award targets under the 2017 Program and subsequent activity during the nine months ended2020 program as of September 30, 2017,2020 is as follows:

  Annual  Long-Term  Total 
          
Awards on February 28, 2017  97,243   147,081   244,324 
Awards on August 23, 2017 and May 8, 2017  8,224   17,754   25,978 
Total 2017 Program LTIP units awarded as of September 30, 2017  105,467   164,835   270,302 
2017 Program LTIP units forfeited  (19,338)  (58,668)  (78,006)
     Net 2017 Program LTIP awards as of September 30, 2017  86,129   106,167   192,296 

As of September 30, 2017, all 192,296 LTIP unit target awards as of September 30, 2017 were to non-employees. The number of target LTIP units comprising each Annual Award was based on the closing price of the Company’s common stock reported on the New York Stock Exchange (“NYSE”) on the dates of grant (August 23, 2017, May 8, 2017, and February 28, 2017) and the number of target LTIP units comprising each Long-Term Award was based on the fair value of the Long-Term Awards as determined by an independent valuation consultant, in each case rounded to the next whole LTIP unit in order to eliminate fractional units.

2018 Long-Term Awards

 

110

2019 Long-Term Awards

82

2020 Annual Awards (1)

196

2020 Long-Term Awards (2)

70

Total target performance awards as of September 30, 2020

458

(1)Approved by the Board on March 17, 2020. The number of target LTIP Units was based on the closing price of the Company’s common stock reported on the New York Stock Exchange (“NYSE”) on that date.
(2)Approved by the Board on March 3, 2020. The number of target LTIP Units was based on the fair value of the Long-Term Awards as determined by an independent valuation consultant.

Annual Awards. The Annual Awards are subject to the terms and conditions of LTIP Annual Award Agreements (“LTIP Annual Award Agreements”) between the Company and each grantee.

The Compensation Committee and Board established various operating performance goals for calendarthe year 2017,ended December 31, 2020, as set forth in Exhibit A to the 2020 LTIP Annual Award Agreements (the “Performance Goals”), that will be used to determine the actual number of LTIP unitsUnits earned by each grantee under each LTIP Annual Award Agreement. During the three months ended September 30, 2017, management made a determination that the Annual Award payout trend asgrantee. As of September 30, 2017 was 55%,2020, management estimated that the Performance Goals would be met at a 110% level and, accordingly, applied 55% toestimated that 110% of the net2020 program target Annual Awards as of September 30, 2017 (86,129 units) to estimate the Annual Awardswere expected to be earned at the end of the performance period (47,371 units).period. Cumulative stock basedstock-based compensation expense during the three and nine months ended September 30, 2017 was adjusted to reflect the reduction in the Annual Award target to 55%.2020 reflects management’s estimate that 110% of these awards will be earned. As soon as reasonably practicable following the last dayfirst anniversary of the 2017 fiscal year,Annual Awards grant date, the Compensation Committee and Board will determine the extent to which the Company has achieved each of the Performance Goals (expressed as a percentage) and, based on such determination, will calculate the number of LTIP unitsUnits that each grantee is entitled to receive under the grantee’s Annual Award based on the performance percentages described in the grantee’s LTIP Annual Award Agreement.receive. Each grantee may earn up to 150% of the number of his/her target LTIP units covered by the grantee’sUnits. Any 2020 Annual Award. Any targetAward LTIP unitsUnits that are not earned will be forfeited and cancelled.

The Company expensesVesting. LTIP Units that are earned as of the fair valueend of all unit awardsthe applicable performance period will be subject to vesting, subject to continued employment through each vesting date, in accordance withtwo installments as follows: 50% of the fair value recognition requirements of ASC Topic 718, Compensation-Stock Compensation, for “employees,” and ASC Topic 505, Equity, for “non-employees.”

As the Annual Awards were granted to non-employees, in accordance with the provisions of ASC Topic 505, the Annual Awards utilize the grant date fair value for expense recognition; however, the accounting after the measurement date requires a fair value re-measurement each reporting period until the awards vest. Since these are performance based awards with no market condition, the closing priceearned LTIP Units will become vested on the valuation date in 2021 that the Board approves the number of LTIP Units to be awarded pursuant to the performance components set forth in the 2020 LTIP Annual Award Agreements and revaluation date50% of the earned LTIP Units become vested on the one year anniversary of the initial

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vesting date. Vesting may be accelerated under certain circumstances such as a “change-in-control” transaction or a “qualified termination” event.

Distributions. Distributions equal to the dividends declared and paid by the Company will accrue during the applicable performance period on the maximum number of LTIP Units that the grantee could earn and will be used for expense recognition purposes.

- 18 -

paid with respect to all of the earned LTIP Units at the conclusion of the applicable performance period, in cash or by the issuance of additional LTIP Units at the discretion of the Compensation Committee.

Long-Term AwardsAwards.. The Long-Term Awards are subject to the terms and conditions of their related LTIP Long-Term Award Agreements (“LTIP(collectively the “LTIP Long-Term Award Agreements”) between the Company and each grantee. The number of LTIP unitsUnits that each grantee is entitled to earn under the LTIP Long-Term Award Agreements will be determined following the conclusion of a three-year performance period based on the Company’s total shareholderstockholder return (“TSR”), which is determined based on a combination of appreciation in stock price and dividends paid during the performance period (“TSR”).period. Each grantee may earn up to 200% of the number of target LTIP unitsUnits covered by the grantee’s Long-Term Award. Any target LTIP unitsUnits that are not earned will be forfeited and cancelled. The number of LTIP unitsUnits earned under the Long-Term Awards will be determined as soon as reasonably practicable following the end of the applicable three-year performance period based on the Company’s TSR on an absolute basis (as to 75% of the Long-Term Award) and relative to the SNL Healthcare REIT Index (as to 25% of the Long-Term Award).

Vesting. LTIP Units that are earned as of the end of the applicable three-year performance period will be subject to forfeiture restrictions that will lapse (“vesting”), subject to continued employment through each vesting date as follows; 50% of the earned LTIP Units will vest upon the third anniversary of the respective grant dates and the remaining 50% will vest on the fourth anniversary of the respective grant dates. Vesting may be accelerated under certain circumstances such as a “change-in-control” transaction or a “qualified termination” event.

Distributions. Pursuant to the LTIP Long-Term Award Agreements, distributions equal to the dividends declared and paid by the Company will accrue during the applicable performance period on the maximum number of LTIP Units that the grantee could earn and will be paid with respect to all of the earned LTIP Units at the conclusion of the applicable performance period, in cash or by the issuance of additional LTIP Units at the discretion of the Compensation Committee.

Stock-Based Compensation Expense

Under the provisions of ASU 2018-07, the Company’s prospective compensation expense for all unvested LTIP Units, Annual Awards, and Long-Term Awards is recognized using the adoption date fair value of the awards, with no remeasurement required. Compensation expense for future LTIP Unit grants, Annual Awards, and Long-Term Awards is based on the grant date fair value of the units/awards, with no subsequent remeasurement required.

As the Long-Term Awards were granted to non-employees and involvedinvolve market-based performance conditions, in accordance with the provisions of ASC Topic 505, the Long-Term Awards utilizeCompany utilizes a Monte Carlo simulation to provide a grant date fair value for expense recognition; however, the accounting after the measurement date requires a fair value re-measurement each reporting period until the awards vest. The fair value re-measurement will be performed by calculating a Monte Carlo produced fair value at the conclusion of each reporting period until vesting.

recognition. The Monte Carlo simulation is a generally accepted statistical technique used, in this instance, to simulate a range of possible future stock prices for the Company and the members of the SNL Healthcare REIT Index (the “Index”) over the Performance Period (February 28, 2017 to February 27, 2020; May 8, 2017 to May 7, 2020; and August 23, 2017 to August 22, 2020, respectively).Periods. The purpose of this modeling is to use a probabilistic approach for estimating the fair value of the performance share award for purposes of accounting under ASC Topic 718. ASC Topic 505 does not provide guidance on how to derive a fair value, so the valuation defaults to that described in ASC Topic 718.

The assumptions used in the Monte Carlo simulation include beginning average stock price, valuation date stock price, expected volatilities, correlation coefficients, risk-free rate of interest, and expected dividend yield. The beginning average stock price is the beginning average stock price for the Company and each member of the Index for the five trading days leading up to the grant date.date of the Long-Term Award. The valuation date stock price is the average closing stock price offor the Company and each member of the peer companies in the Index on the grant date for the grant date fair value, and15 trading days leading up to the closing stock price on September 30, 2017 for revaluation.valuation date. The expected volatilities are modeled using the historical volatilities for the Company and the members of the Index. The correlation coefficients are calculated using the same data as the historical volatilities. The risk-free rate of interest is taken from the U.S. Treasury website and relates to the expected life of the remaining performance period on valuation or revaluation. Lastly, the dividend yield assumption is 0.0%, which is mathematically equivalent to reinvesting dividends in the issuing entity, which is part of the Company’s award agreement assumptions.

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Vesting.LTIP units thatTable of Contents

Below are earned asdetails regarding certain of the end ofassumptions for the applicable performance period will be subject to forfeiture restrictions that will lapse (“vesting”), subject to continued employment through each vesting date, in two installments as follows: 50% of the earned LTIP units will vest upon being earned as of the end of the applicable performance period and the remaining 50% will vest on the first anniversary of the date on which such LTIP units are earned.Long-Term Awards using Monte Carlo simulations:

2020 Long-Term

2019 Long-Term

2018 Long-Term

2017 Long-Term

    

Awards

    

Awards

    

Awards

    

Awards

Fair value

$

13.47

$

10.07

$

8.86

 

$

8.86

Target awards

 

70

 

82

 

110

 

96

Volatility

 

28.75

%  

 

31.7

%  

 

33.8

%  

33.8% - 35.4%

Risk-free rate

 

0.72

%  

 

2.5

%  

 

2.6

%  

2.4% - 2.6%

Dividend assumption

 

reinvested

 

reinvested

 

reinvested

 

reinvested

Expected term in years

 

3

 

3

 

2.7

 

1.7 – 2.7

Distributions.Pursuant to both the LTIP Annual Award Agreements and LTIP Long-Term Award Agreements, distributions equal to the dividends declared and paid by the Company will accrue during the applicable performance period on the maximum number of LTIP units that the grantee could earn and will be paid with respect to all of the earned LTIP units at the conclusion of the applicable performance period, in cash or by the issuance of additional LTIP units at the discretion of the Compensation Committee

2016 Plan – Time Based Grants (excludes 2017 Program - Performance Based Awards)

The LTIP units granted under the 2016 Plan (excluding 2017 Program awards) during the nine months ended September 30, 2017, are as follows:

Total 2016 Plan LTIP units granted as of January 1, 2017414,504
Additional LTIP units granted27,179
Total 2016 Plan LTIP units granted as of September 30, 2017441,683
2016 Plan LTIP units forfeited(38,733)
   Net 2016 Plan LTIP units granted and outstanding as of September 30, 2017402,950

Of the 27,179 LTIP units that were granted during the nine months ended September 30, 2017, there was a total of 11,204 LTIP units granted to two executives of the Company (employees of the Advisor) on August 23, 2017 and May 8, 2017 and the remaining 15,975 LTIP units were granted to the Company’s independent directors on May 18, 2017.

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Of the 402,950 LTIP units that were granted under the 2016 Plan (net of forfeitures), 60,400 units vested immediately on July 1, 2016 upon completion of the Company’s initial public offering, 68,900 LTIP units vested on December 1, 2016, 13,750 units that were granted to the independent directors vested on July 1, 2017, and an additional 72,488 LTIP units vested immediately as a result of individuals (primarily executives) leaving the Company, resulting in a total of 215,538 vested LTIP units as of September 30, 2017.

The remaining unvested 187,412 LTIP units, net of forfeitures, (the “Service LTIPs”) consists of 171,437 units granted to employees of the Advisor and its affiliates deemed to be non-employees in accordance with ASC Topic 505 and vest over periods of 36 months to 53 months, from the grant date, dependent on the population granted to, as well as 15,975 units granted to the Company’s independent directors on May 18, 2017 (who were treated as employees in accordance with ASC Topic 718), and vest over a period of 12 months from the grant date.

Under the 2016 Plan a total of 1,232,397 shares of common stock are available to be granted or issued in respect of other equity-based awards such as LTIP units. Based on the grants and target awards outstanding as of September 30, 2017, there are 637,151 shares that remain available to be granted or issued under the 2016 Plan as of September 30, 2017. Shares subject to awards under the 2017 Program and the 2016 Plan that are forfeited, cancelled, lapsed, settled in cash or otherwise expired (excluding shares withheld to satisfy exercise prices or tax withholding obligations) are available for grant.

Detail of Compensation Expense Recognized For The Three and Nine Months Ended September 30, 2017

The Company incurred stock compensation expense of $340,287$1,572 and $1,480,724$3,391, for the three and nine months ended September 30, 2017,2020, respectively, and $868 and $2,493, for the three and nine months ended September 30, 2019, respectively, related to the grants awarded under the 2017 Program and the 2016 Plan. Compensation expense is classified asincluded within “General and Administrative” expense in the Company’s accompanyingCondensed Consolidated Statements of Operations. A detail

As of September 30, 2020, total unamortized compensation expense related to these awards of approximately $8.6 million is expected to be recognized over a weighted average remaining period of 2.2 years.

Note 8 – Leases

The Company operates as both a lessor and a lessee. As a lessor, the Company is required under ASC Topic 842 to account for leases using an approach that is substantially similar to ASC Topic 840’s guidance for operating leases and other leases such as sales-type leases and direct financing leases. In addition, ASC Topic 842 requires lessors to capitalize and amortize only incremental direct leasing costs. As a lessee, the Company is required under the new standard to apply a dual approach, classifying leases, such as ground leases, as either finance or operating leases based on the principle of whether or not the lease is effectively a financed purchase. This classification determines whether lease expense is recognized based on an effective interest method or on a straight-line basis over the term of the lease. ASC Topic 842 also requires lessees to record a right of use asset and a lease liability for all leases with an initial term of greater than a year regardless of their classification. The Company has also elected the practical expedient not to recognize right of use assets and lease liabilities for leases with a term of a year or less.

Information as Lessor Under ASC Topic 842

To generate positive cash flow, as a lessor, the Company leases its facilities to tenants in exchange for fixed monthly payments that cover rent, property taxes, insurance and certain cost recoveries, primarily common area maintenance (“CAM”). The Company’s leases were determined to be operating leases and have a portfolio-average-lease-years remaining of approximately 10 years. Payments from the Company’s tenants for CAM are considered nonlease components that are separated from lease components and are generally accounted for in accordance with the revenue recognition standard. However, the Company qualified for and elected the practical expedient related to combining the components because the lease component is classified as an operating lease and the timing and pattern of transfer of CAM income, which is not the predominant component, is the same as the lease component, for all asset classes. As such, consideration for CAM is accounted for as part of the overall consideration in the lease. Payments from customers for property taxes and insurance are considered non-components of the lease and therefore no consideration is allocated to them because they do not transfer a good or service to the customer. Fixed contractual payments from the Company’s leases are recognized on a straight-line basis over the terms of the respective leases. This means that, with respect to a particular lease, actual amounts billed in accordance with the lease during any given period may be higher or lower than the amount of rental revenue recognized for the period. Straight-line rental revenue is commenced when the tenant assumes control of the leased premises. Accrued straight-line rents receivable represents the amount by which straight-line rental revenue exceeds rents currently billed in accordance with lease agreements.

Some of the Company’s leases are subject to annual changes in the Consumer Price Index (“CPI”). Although increases in CPI are not estimated as part of the Company’s measurement of straight-line rental revenue, for leases with base rent increases based on CPI, the amount of rent revenue recognized is adjusted in the period the changes in CPI are measured and effective. Additionally, some of the Company’s leases have extension options.

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Initial direct costs, primarily commissions, related to the leasing of our facilities are capitalized when material as incurred. Capitalized leasing costs are amortized on a straight-line basis over the remaining useful life of the respective leases. All other costs to negotiate or arrange a lease are expensed as incurred.

Lease-related receivables, which include accounts receivable and accrued straight-line rents receivable, are reduced for credit losses, if applicable. To date the Company’s receivables have not had any credit losses. Such amounts would be recognized as a reduction to rental and other revenues. The Company regularly evaluates the collectability of its lease-related receivables. The Company’s evaluation of collectability primarily consists of reviewing past due account balances and considering such factors as the credit quality of our tenant, historical trends of the tenant and changes in tenant payment terms. If the Company’s assumptions regarding the collectability of lease-related receivables prove incorrect, the Company could experience credit losses in excess of what was recognized in rental and other revenues.

The Company recognized $25,055 and $68,623 of rental revenue related to operating lease payments for the three and nine months ended September 30, 2017, is as follows:

  Three Months Ended September 30, 2017  Nine Months Ended September 30, 2017 
2016 Plan – Time Based Grants:        
    Service LTIPs – non-employee $258,033  $933,143 
    Service LTIPs – employee  56,567   123,967 
2017 Program – Performance Based Award Targets:        
    Annual Awards – non-employee  (22,107)  238,835 
    Long-Term Awards – non-employee  47,794   184,779 
           Total compensation expense $340,287  $1,480,724 

Total unamortized compensation expense2020, respectively. Of these amounts $1,136 and $3,739 were for variable lease payments related to these units of approximately $1.9 million is expected to be recognized subsequent toexpense recoveries for the three and nine months ended September 30, 2017 over a weighted average remaining period of 1.23 years.

Note 8 – Rental Revenue

2020, respectively. The aggregate annual minimum cash to be received by the Company on the noncancelable operating leases related to its portfolio of medical facilities in effect as of September 30, 2017, are2020 is as follows for the subsequent years ended December 3131:

2020 (three months remaining)

    

$

20,914

2021

    

 

81,984

2022

 

80,676

2023

 

77,908

2024

 

70,735

Thereafter

 

379,099

Total

$

711,316

Information as listed below.

2017 $8,035,103 
2018  32,516,357 
2019  33,166,395 
2020  33,811,627 
2021  32,003,983 
Thereafter  251,225,055 
    Total $390,758,520 

For the three months ended September 30, 2017, the HealthSouth facilities constituted approximately 18% of the Company’s rental revenue, the OCOM facilities constituted approximately 15% of the Company’ rental revenue, the Sherman facility constituted approximately 10% of the Company’s rental revenue, the Great Bend facility constituted approximately 8% of the Company’s rental revenue, the Omaha facility constituted approximately 6% of the Company’s rental revenue, and the Plano facility constituted approximately 5% of the Company’s rental revenue. All other facilities in the Company’s portfolio constituted the remaining 38% of the total rental revenue with no individual facility constituting greater than approximately 4% of total rental revenue.

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For the nine months ended September 30, 2017, the HealthSouth facilities constituted approximately 22% of the Company’s rental revenue, the OCOM facilities constituted approximately 12% of the Company’ rental revenue, the Omaha and Great Bend facilities each constituted approximately 7% of the Company’s rental revenue, the Plano and Tennessee facilities each constituted approximately 6% of the Company’s rental revenue, and the Marina Towers facility constituted approximately 5% of the Company’s rental revenue. All other facilities in the Company’s portfolio constituted the remaining 35% of the total rental revenue with no individual facility constituting greater than approximately 4% of total rental revenue.

For the three months ended September 30, 2016, the Omaha facility constituted approximately 22% of the Company’s rental revenue, the Tennessee facilities constituted approximately 18% of rental revenue, the Plano facility constituted approximately 17% of rental revenue, the West Mifflin facility constituted approximately 11% of rental revenue, the Melbourne facility constituted approximately 15% of rental revenue, and the Reading facility constituted approximately 8% of rental revenue. The Westland and Asheville facilities constituted approximately 6% and 3% of rental revenue, respectively.

For the nine months ended September 30, 2016, the Omaha facility constituted approximately 26% of the Company’s rental revenue, the Tennessee facilities constituted approximately 21% of rental revenue, the Plano facility constituted approximately 17% of rental revenue, the West Mifflin facility constituted approximately 13% of rental revenue, the Melbourne facility constituted approximately 12% of rental revenue, and the Reading facility constituted approximately 3% of rental revenue. The Asheville and Westland facilities each constituted approximately 4% of rental revenue.

Note 9 – Omaha and Clermont Land Leases

Lessee Under ASC Topic 842

The Omaha facilityCompany has seven buildings located on land lease expires in 2033,that is subject to future renewal options byoperating ground leases with a weighted average remaining term of approximately 41 years. Rental payments on these leases are adjusted periodically based on either the Company. UnderCPI or on a pre-determined schedule. The monthly payments on a pre-determined schedule are recognized on a straight-line basis over the terms of the Omaha land lease, annual rents increase 12.5% every fifth anniversaryrespective leases. Changes in the CPI are not estimated as part of our measurement of straight-line rental expense. The Company used a weighted average discount rate of approximately 7.5%, which was derived, using a portfolio approach, from our assessment of the lease.credit quality of the Company and adjusted to reflect secured borrowing, estimated yield curves and long-term spread adjustments over appropriate tenors. Some of the Company’s ground leases contain extension options and, where we determined it was reasonably certain that an extension would occur, they were included in our calculation of the right of use asset and liability. The initial Omaha landCompany recognized approximately $41 and $122 of ground lease increase occurredexpense, of which $26 and $64 was paid in April 2017. Duringcash, during the three and nine months ended September 30, 2017,2020, respectively.

The following table sets forth the Company expensed $18,153undiscounted cash flows of our scheduled obligations for future lease payments on operating ground leases at September 30, 2020, and $54,461, respectively, relateda reconciliation of those cash flows to the Omaha land lease. During the three and nine months endedoperating lease liability at September 30, 2016, the Company expensed $18,153 and $54,461, respectively, related to this lease.2020:

2020 (three months remaining)

    

$

97

2021

    

 

390

2022

 

409

2023

 

174

2024

 

129

Thereafter

 

4,626

Total

5,825

Discount

 

(2,735)

Lease liability

$

3,090

On March 1, 2017, the Company acquired an interest, as ground lessee, in the ground lease that covers and affects certain real property located in Clermont, Florida, along with the seller’s right, title and interest arising under the ground lease in and to the medical building located upon the land. The ground lease expense is a pass-through to the tenant so no expense related to this ground lease is recorded on the Company’s Consolidated Statements

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Note 9 – Rent Concentration

The aggregate minimum cash payments to be made by the Company on the Omaha land lease and the Clermont land lease in effectCompany’s facilities with a concentration of rental revenue of 5% or greater for any period presented is as of September 30, 2017, are as follows for the subsequent years ended December 31; as listed below.follows:

2017 $18,626 
2018  78,245 
2019  81,987 
2020  81,987 
2021  81,987 
Thereafter  1,883,702 
    Total $2,226,534 

Three Months Ended

 

Nine Months Ended

 

September 30, 

 

September 30, 

 

Facility

    

2020

    

2019

 

2020

    

2019

 

Encompass

 

7

%  

10

%  

8

%  

10

%

Belpre

 

6

 

8

6

 

8

OCOM

 

5

 

7

5

 

6

Sherman

 

3

 

5

4

 

5

Austin

 

3

 

5

4

 

5

Aggregate of all other facilities

 

76

 

65

73

 

66

Total

 

100

%  

100

%  

100

%  

100

%

Note 10 - Commitments and Contingencies

Litigation

The Company is not presently subject to any material litigation nor, to its knowledge, is any material litigation threatened against the Company, which if determined unfavorably to the Company, would have a material adverse effect on the Company’s financial position, results of operations, or cash flows.

Environmental Matters

The Company follows a policy of monitoring its properties for the presence of hazardous or toxic substances. While there can be no assurance that a material environmental liability does not exist at its properties, the Company is not currently aware of any environmental liability with respect to its properties that would have a material effect on its financial position, results of operations, or cash flows. Additionally, the Company is not aware of any material environmental liability or any unasserted claim or assessment with respect to an environmental liability that management believes would require additional disclosure or the recording of a loss contingency.

- 21 -

Note 11 – Subsequent Events

Subsequent events have been evaluated through November 6, 2020, the date the financial statements were issued.

Common Stock Dividend Paid

On October 9, 2017 the Company paid the third quarter 2017 dividend that was announced on September 18, 2017 in the amount

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Table of $4,416,164.

Preferred Stock Dividend Paid

The initial preferred stock dividend was paid on October 31, 2017 to holders of record as of October 15, 2017, for the pro rata dividend from, and including, the original issue date to, and including, October 30, 2017, in the pro rata amount of $0.2396 per share for a total dividend amount of $743,598.

LTIP Award

On October 11, 2017 the Board approved the grant of 32,787 LTIP units to the Company’s Chief Executive Officer. The LTIP units were granted under the 2016 Plan and vest over a period of two years, on October 11, 2018 and October 11, 2019.

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

The following discussion should be read in conjunction with our financial statements, including the notes to those financial statements, included elsewhere in this Report. 

Forward-Looking Statements

This Quarterly Report on Form 10-Q (this “Report”). Some of the comments we make in this section are forward-looking statements within the meaning of the federal securities laws. For a complete discussion of forward-looking statements, see the section below entitled “Special Note Regarding Forward-Looking Statements.” Certain risk factors may cause actual results, performance or achievements to differ materially from those expressed or implied by the following discussion. For a discussion of such risk factors, see Item 1A. Risk Factors of our Annual Report on Form 10-K for the year ended December 31, 2019, that was filed with the U.S. Securities and Exchange Commission (the “SEC” or the “Commission”) on March 9, 2020 and Item 1A. Risk Factors in this Quarterly Report on Form 10-Q. Unless otherwise indicated, all dollar and share amounts in the following discussion are presented in thousands.

Special Note Regarding Forward-Looking Statements

This Report contains “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995 (set forth in Section 27A of the Securities Act of 1933, as amended (the “Securities Act”), and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”)). In particular, statements pertaining to our trends, liquidity, capital resources, and the healthcare facility performanceindustry and results of operations,healthcare real estate opportunity, among others, contain forward-looking statements. You can identify forward-looking statements by the use of forward-looking terminology including, but not limited to, “believes,” “expects,” “may,” “will,” “should,” “seeks,” “approximately,” “intends,” “plans,” “estimates” or “anticipates” or the negative of these words and phrases or similar words or phrases which are predictions of or indicate future events or trends and which do not relate solely to historical matters. You can also identify forward-looking statements by discussions of strategy, plans or intentions.

Forward-looking statements involve numerous risks and uncertainties and you should not rely on them as predictions of future events. Forward-looking statements depend on assumptions, data or methods which may be incorrect or imprecise and we may not be able to realize them. We do not guarantee that the transactions and events described will happen as described (or that they will happen at all). The following factors, among others, could cause actual results and future events to differ materially from those set forth or contemplated in the forward-looking statements:

·the effects of the ongoing novel coronavirus (“COVID-19”) pandemic, which are highly uncertain, cannot be predicted and will depend upon future developments, including the severity of COVID-19, the duration of the outbreak and potential resurgences, the duration of existing or new social distancing and shelter-in-place orders, further mitigation strategies taken by applicable government authorities, the availability of a vaccine, adequate testing and treatments and the prevalence of widespread immunity to COVID-19;
defaults on or non-renewal of leases by tenants;
·our ability to collect rental revenue, expected rent deferral amounts and expected repayment periods;
our ability to satisfy the covenants in our existing and any future debt agreements, including the $600 million syndicated credit facility with BMO Harris Bank N.A. (“BMO”), as administrative agent (the “Credit Facility”);
decreased rental rates or increased vacancy rates;rates, including expected rent levels on acquired properties;
·difficulties in identifying healthcare facilities to acquire and completing such acquisitions;
·general economic conditions;
·adverse economic or real estate conditions or developments, either nationally or in the markets in which our facilities are located;
·our failure to generate sufficient cash flows to service our outstanding obligations;
·fluctuations in interest rates and increased operating costs;
·our failure to effectively hedge our interest rate risk;
our ability to satisfy our short and long-term liquidity requirements;
our ability to deploy the debt and equity capital we raise;
·our ability to raise additional equity and debt capital on terms that are attractive or at all;
·our ability to make distributions on shares of our capitalcommon and preferred stock;
·expectations regarding the timing and/or completion of any acquisition;
general volatility of the market price of our common and preferred stock;
·our lack of a significant operating history;
·changes in our business or our investment or financing strategy;
·our dependence upon key personnel whose continued service is not guaranteed;
·our ability to identify, hire and retain highly qualified personnel in the future;

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·the degree and nature of our competition;
·changes in healthcare laws, governmental regulations, tax rates and similar matters;
·competition for investment opportunities;changes in current healthcare and healthcare real estate trends;
·changes in expected trends in Medicare, Medicaid and commercial insurance reimbursement trends;
competition for investment opportunities;
our failure to successfully develop, integrate and operate acquired healthcare facilities and operations;facilities;
·our expected tenant improvement expenditures;
changes in accounting policies generally accepted in the United States of America (“GAAP”);
·lack of or insufficient amounts of insurance;
·other factors affecting the real estate industry generally;
·changes in the tax treatment of our distributions;
our failure to qualify and maintain our qualification as a real estate investment trust (“REIT”) for U.S. federal income tax purposes;
·our ability to qualify for the safe harbors from the “100% Prohibited Transactions Tax” under the REIT rules with respect to our property dispositions; and
limitations imposed on our business and our ability to satisfy complex rules relating to REIT qualification for U.S. federal income tax purposes; andpurposes.
·changes in governmental regulations or interpretations thereof, such as real estate and zoning laws and increases in real property tax rates and taxation of REITs.

See Item 1A. Risk Factors in Amendment No. 2 of our Annual Report on Form 10-K for the year ended December 31, 20162019 and Item 1A. Risk Factors in this Report for further discussion of these and other risks, as well as the risks, uncertainties and other factors discussed in this Report and identified in other documents we may file with the United States Securities and Exchange Commission (the “SEC”)SEC from time to time. You should carefully consider these risks before making any investment decisions in our company. New risks and uncertainties may also emerge from time to time that could materially and adversely affect us. While forward-looking statements reflect our good faith beliefs, they are not guarantees of future performance. We disclaim any obligation to update or revise any forward-looking statement to reflect changes in underlying assumptions or factors, of new information, data or methods, future events or other changes after the date of this Report, except as required by applicable law. You should not place undue reliance on any forward-looking statements that are based on information currently available to us or the third parties making the forward-looking statements.

- 23 -

Overview

Global Medical REIT Inc. (the “Company,” “us,” “we,” or “our”) is an externally-managed,a Maryland corporation engaged primarily in the acquisition of licensed, state-of-the-art, purpose-built healthcare facilities and the leasing of thesethose facilities to strong clinical operatorshealthcare systems and physician groups with leading market share.  WeAs described below, until July 9, 2020, the Company was externally managed and advised by Inter-American Management LLC (the “Former Advisor”).

On July 9, 2020, the Company acquired all of the outstanding shares of capital stock of Inter-American Group Holdings Inc. (“IAGH”), the parent company of the Former Advisor for a cash purchase price of $18.1 million, subject to a working capital adjustment (the “Internalization”).  The Internalization was completed our initial public offering (“IPO”) in July of 2016 and,pursuant to a stock purchase agreement, dated as of September 30, 2017, had 21,630,675 shares of common stock outstanding.

As of September 30, 2017, our portfolio consisted of 29 facilities with an aggregate of approximately 1,186,462 net leasable square feetJuly 9, 2020 (the "Stock Purchase Agreement"), by and an average remaining lease term of approximately 9.22 years. We seek to acquire or enter into (primarily through sale/leaseback transactions) triple-net leases, pursuant to which our tenants are responsible for all operating expenses relatingamong the Company, Zensun Enterprises Limited (“Zensun”) and Mr. Jeffrey Busch. Prior to the property,Internalization, IAGH was owned by Zensun (85%) and Mr. Busch (15%) (collectively, the “Sellers”).

 A special committee (the "Special Committee") comprised entirely of independent and disinterested members of the Company’s board of directors (the "Board"), after consultation with its independent legal and financial advisors, determined that also contain annual rent escalation provisions. This leasing structure provides us with more predictable cash flowthe Internalization was advisable to, and increasing returns from our properties. The table below summarizes our portfolio as of September 30, 2017:

Facility Location Date Acquired Facility Type Net Leasable Square Feet  Lease Years Remaining  Annualized $Rent1  Annualized $ Rent Per Square Foot1 
Omaha Omaha, NE 6/5/2014 LTAC  41,113   4.93  $1,762,512  $42.87 
Asheville Asheville, NC 9/19/2014 ASC  8,840   4.61   237,621   26.88 
West Mifflin West Mifflin, PA 9/25/2015 MOB/
ASC
  27,193   13.16   783,653   28.82 
Tennessee Memphis, TN 12/31/2015 MOB/
ASC
  52,266   10.43   1,300,000   24.87 
Plano Plano, TX 1/28/2016 Surgical Hospital  24,000   18.50   1,278,000   53.25 
Westland Detroit, MI 3/31/2016 ASC  15,018   8.68   389,500   25.94 
Melbourne Melbourne, FL 3/31/2016 MOB/
Imaging
  75,899   8.68   1,104,675   14.55 
Reading Wyomissing, PA 7/20/2016 MOB/
ASC
  23,500   8.98   690,045   29.36 
East Orange East Orange, NJ 9/29/2016 MOB  60,442   9.17   961,753   15.91 
Watertown Watertown, SD 9/30/2016 MOB  46,884   14.17   707,167   15.08 
Sandusky Sandusky, OH 10/7/16 – 8/15/17 MOB  55,760   10.26   842,481   15.11 
Carson City Carson City, NV 10/31/2016 MOB  20,632   6.26   344,000   16.67 
Ellijay Ellijay, GA 12/16/2016 MOB  44,162   8.92   364,224   8.25 
HealthSouth Mesa Mesa, AZ 12/20/2016 IRF  51,903   7.26   1,710,617   32.96 
HealthSouth Altoona Altoona, PA 12/20/2016 IRF  70,007   3.78   1,671,760   23.88 
HealthSouth Mechanicsburg Mechanicsburg. PA 12/20/2016 IRF  78,836   3.78   1,877,298   23.81 
Cape Coral Cape Coral, FL 1/10/2017 MOB  25,814   9.51   529,187   20.50 
Lewisburg Lewisburg, PA 1/12/2017 MOB/
Imaging
  28,480   5.76   542,501   19.05 
Las Cruces Las Cruces, NM 2/1/2017 MOB  15,761   11.51   354,623   22.50 
Prescott Prescott, AZ 2/9/2017 MOB  12,000   9.09   360,000   30.00 
Clermont Clermont. FL 3/1/2017 MOB  18,152   3.58   361,915   19.94 
OCOM Oklahoma City, OK 3/31/2017 Surgical Hospital  96,596   8.58   3,535,294   36.60 
Great Bend Great Bend, KS 3/31/2017 Hospital  63,978   14.68   2,143,750   33.51 
Brockport Brockport, NY 6/27/2017 MOB  29,497   13.23   620,653   21.04 
Flower Mound Flower Mound, TX 6/27/2017 ASC  10,062   9.17   288,362   28.66 
Sherman Sherman, TX 6/30/2017 IRF/LTAC  69,3522   19.92   2,346,140   33.83 
Lubbock Lubbock, TX 8/18/2017 MOB  27,280   12.00   600,160   22.00 
Germantown Germantown, TN 8/30/2017 MOB/
ASC
  33,777   6.67   1,459,024   43.20 
Austin Austin, TX 9/25/2017 Rehab.
Hospital
  59,258   9.58   2,884,650   48.68 
Total Portfolio/Average        1,186,462   9.22  $32,051,565  $27.01 

1Calculated by multiplying (a) monthly rent in place at September 30, 2017, by (b) 12. Accordingly, this methodology produces an annualized figure but does not take into account future contractual rental rate increases.
2Does not include 12,000 square feet of shell space.

- 24 -

Definitions for acronyms used in the “Facility Type” columnbest interests of, the Company and the Company’s stockholders and recommended that the Board authorize and approve the Internalization. Upon such recommendation from the Special Committee, the Board authorized and approved the Internalization. Approval by the Company’s stockholders was not required.

 Upon completion of the Internalization, the employees of the Former Advisor became employees of the Company and the functions previously performed by the Former Advisor were internalized by the Company.  As an internally managed company, the Company will no longer pay the Former Advisor any fees arising from the Management Agreement (as defined in the table above are as follows: “LTAC” refers to Long-Term Acute Care; “ASC” refers to Ambulatory Surgical Center; “MOB” refers to Medical Office Building; and “IRF” refers to Inpatient Rehabilitation Facility.

Note 6 – “Related Party Transactions”).

We elected to be taxed as a REIT for U.S. federal income tax purposes commencing with our taxable year ended December 31, 2016. We conduct our business through an umbrella partnership real estate investment trust, or UPREIT, structure in which our

-38-

properties are owned by wholly-ownedwholly owned subsidiaries of our operating partnership, Global Medical REIT L.P. (the “Operating Partnership”). Our wholly-ownedwholly owned subsidiary, Global Medical REIT GP, LLC, is the sole general partner of our Operating Partnership and, as of September 30, 2017,2020, we owned approximately 97.64%93.05% of the outstanding common operating partnership units (“OP Units”) of our Operating Partnership.

Recent Developments

Completed Series A Preferred Stock OfferingImpact of COVID-19 and Business Outlook

On September 15, 2017, we closedThe COVID-19 pandemic did not have a material impact on the public underwritten offeringour results of 3,105,000 sharesoperations, liquidity and capital resources as of our Series A Cumulative Redeemable Preferred Stock, $0.001 par value per share, with a liquidation preference of $25 per share (the “Series A Preferred Stock”), inclusive of 405,000 shares issued in connection with the underwriters’ exercise of their over-allotment option. The issuance raised aggregate net proceeds of approximately $75 million.

Completed Acquisitions

Duringand for the three and nine months ended September 30, 2017,2020. While we completed fourare still navigating the actual and potential impacts the pandemic will have on our tenants and our business, the sections below summarize management’s view of the potential impacts the COVID-19 pandemic may have on our future results of operations, liquidity and capital resources, and other various company-specific matters.

The COVID-19 outbreak and the measures taken by governmental authorities to contain its spread have resulted in substantial adverse effects on the U.S. economy, and specifically the healthcare industry. The full impact of COVID-19 on the U.S. economy and our tenants’ businesses and operations remains unknown, as the velocity of this economic slowdown and the subsequent job losses are unique and historical in many ways. While these events have already had a significant impact on the healthcare industry, we cannot reasonably estimate the duration and severity of such impact. However, at the onset of the outbreak, we began working with certain of our tenants that were experiencing significant disruptions in their businesses to help them navigate these uncertain times, including assisting our tenants in applying for government financial relief and, in certain limited circumstances, entering into rent deferral agreements. The aggregate amount of such rent deferrals equaled $1.1 million and, as of September 30, 2020, we have collected $0.6 million of this amount.  Because the extent of the impact of COVID-19 on our tenants will depend on future developments, including a resurgence of COVID-19, there can be no assurance that our tenants will continue to be able meet the requirements of these agreements, or that these tenants, or other tenants, may not seek additional relief in the future. The extent of the impact of COVID-19 on our liquidity and operational and financial performance will depend on, among other things, the ability of our tenants to return to normal patient volumes and whether a resurgence of COVID-19 causes further shutdowns or disruptions in our tenants’ businesses.

At the onset of the outbreak, many states banned elective and non-urgent medical procedures. Many states have since lifted these bans; however, the recent resurgence of COVID-19 cases in many states, including many states in which our facilities are located, may cause such states to reinstitute these bans. Certain localities, such as El Paso, Lubbock and Amarillo, Texas, have already reinstituted bans on elective surgeries due to a resurgence in COVID-19.  Given that many of our tenants depend on elective and non-urgent medical procedures as a major source of revenue, a reinstituted ban on these procedures may have a material adverse effect on our tenants’ businesses. In addition, in response to the recent resurgence of the COVID-19 pandemic, local, state and federal agencies have or may reinstitute stay-at-home or shelter-in-place orders, which may result in many of our tenants experiencing significantly reduced patient volumes and, when such bans and restrictions are lifted, patients may be reluctant to undertake certain medical procedures and our tenants may institute social distancing measures, each of which may cause our tenants to experience decreased patient volumes for an extended period of time. In addition, if additional government funding is not provided under the Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act") or new legislation, our tenants may not be able to rely on future government assistance programs to withstand the current or another downturn in their businesses.

Although we believe our acquisition pipeline has normalized since the onset of the COVID-19 pandemic, a resurgence of COVID-19 could cause another disruption in the medical real estate acquisition market that could have a material adverse effect on our acquisition growth.

To date, the COVID-19 pandemic has not had a material adverse effect on our liquidity, with our cash balances and available capacity under our Credit Facility equaling approximately $112 million as of October 31, 2020. However, a resurgence of COVID-19 that affects our tenants’ ability to pay rent to us, our lenders ability to lend to us, or our ability to raise equity capital could have a material adverse effect on our liquidity.

-39-

Our Business Objectives and Investment Strategy

Our principal business objective is to provide attractive, risk-adjusted returns to our stockholders through a combination of (i) reliable dividends and (ii) long-term capital appreciation. Our primary strategies to achieve our business objective are to:

construct a property portfolio that consists substantially of medical office buildings (MOBs), specialty hospitals, in-patient rehabilitation facilities (IRFs) and ambulatory surgery centers (ASCs), that are primarily located in secondary markets and are situated to take advantage of the aging of the U.S. population and the decentralization of healthcare;
focus on practice types that will be utilized by an aging population and are highly dependent on their purpose-built real estate to deliver core medical procedures, such as cardiovascular treatment, rehabilitation, eye surgery, gastroenterology, oncology treatment and orthopedics;
set aside a portion of our property portfolio for opportunistic acquisitions, including (i) certain acute-care hospitals and long-term acute care facilities (LTACs), that we believe provide premium, risk-adjusted returns and (ii) health system corporate office and administrative buildings, which we believe will help us develop relationships with larger health systems;
lease our facilities under long-term, triple-net leases with contractual annual rent escalations;
lease each facility to medical providers with a track record of successfully managing excellent clinical and profitable practices; and
receive credit protections from our tenants or their affiliates, including personal and corporate guarantees, rent reserves and rent coverage requirements.

Executive Summary

The following table summarizes the material changes in our business and operations during the periods presented, which includes a one-time charge related to the portion of consideration paid for the Internalization that was attributed to the settlement of a preexisting contractual relationship of $12.1 million, as well as related expenses incurred associated with the Internalization. Additionally, the remaining excess consideration paid for the Internalization over the fair value of underlying identifiable net liabilities of the business acquired of $5.9 million was recorded as “Goodwill” on the accompanying Condensed Consolidated Balance Sheets:

    

Three Months Ended September 30, 

    

Nine Months Ended September 30, 

    

2020

2019

    

2020

    

2019

(in thousands, except per share amounts)

Rental revenue

$

25,055

$

18,117

$

68,623

$

50,093

Depreciation and amortization expense

$

9,517

$

6,506

$

26,215

$

17,238

Interest expense

$

4,864

$

4,549

$

13,616

$

12,707

General and administrative expense

$

4,027

$

1,681

$

7,509

$

4,928

Management internalization expense

$

12,580

$

$

14,005

$

Net (loss) income attributable to common stockholders per share

$

(0.22)

$

0.02

$

(0.19)

$

0.07

FFO per share and unit(1)

$

(0.03)

$

0.19

$

0.34

$

0.54

AFFO per share and unit(1)

$

0.23

$

0.19

$

0.65

$

0.54

Dividends per share of common stock

$

0.20

$

0.20

$

0.60

$

0.60

Weighted average common stock outstanding

46,908

35,512

 

45,503

 

32,514

Weighted average OP Units outstanding

1,958

3,143

 

2,250

 

3,144

Weighted average LTIP Units outstanding

1,367

794

 

1,143

 

737

Total weighted average shares and units outstanding

50,233

39,449

 

48,896

 

36,395

(1)See “—Non-GAAP Financial Measures,” for a description of our non-GAAP financial measures and a reconciliation of our non-GAAP financial measures.

-40-

    

As of

 

    

September 30, 

December 31, 

 

    

2020

    

2019

 

    

(dollars in thousands)

 

Total investment in real estate, gross

$

1,061,380

$

905,529

Total debt, net

$

519,385

$

386,168

Weighted average interest rate

 

3.34

%  

 

3.90

%

Total equity (including noncontrolling interest)

$

449,207

$

460,353

Net rentable square feet

 

3,465,312

 

2,780,851

Our Properties

As of September 30, 2020, our portfolio consisted of gross investment in real estate of $1,061.4 million, which was comprised of 78 facilities with an aggregate purchase price of approximately $66 million. 3.5 million rentable square feet and approximately $81.9 million of annualized base rent.

Capital Raising Activity

During the nine months ended September 30, 2017,2020, we completed 16 acquisitions withgenerated gross proceeds of $39.2 million through at-the-market ("ATM") equity issuances of 3.2 million shares of our common stock at an aggregate purchaseaverage offering price of approximately $215 million. Our gross investment in real estate balance was $422.3$12.37 per share.

Debt Activity

On July 24, 2020, the Company received aggregate commitments of up to $100 million and $206.9 million asfrom certain of September 30, 2017 and December 31, 2016, respectively. A summary descriptionits lenders pursuant to the accordion feature (the “Accordion”) under its Credit Facility. With the closing of the facilities acquired inAccordion, the third quarterborrowing capacity under the Company’s Credit Facility was increased to $600 million, consisting of 2017 is contained in Note 3 – “Property Portfolio,” toa $250 million capacity revolver (the “Revolver”), a $350 million term loan (the “Term Loan”), and a remaining $50 million accordion. The remaining terms of the notes to the consolidated financial statements.

Trends Which May Influence Results of Operations

We believe the following trends in the healthcare real estate market positively impact our lease revenues and the ability to make distributions to our shareholders:

·growing healthcare expenditures;
·an aging population;
·a continuing shift towards outpatient care;
·physician practice group and hospital consolidation;
·healthcare industry employment growth;
·expected monetization and modernization of healthcare real estate; and
·a highly fragmented healthcare real estate market.

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We believe the following trends in the healthcare real estate market may negatively impact our lease revenues and the ability to make distributions to our shareholders:

·changes in demand for and methods of delivering healthcare services;
·changes in third party reimbursement methods and policies; and
·increased scrutiny of billing, referral and other practices by U.S. federal and state authorities.

Critical Accounting Policies

Refer to our audited consolidated financial statements and notes thereto for the year ended December 31, 2016 for a discussion of our significant accounting policies, including the critical accounting policies of: purchase of real estate, impairment of long lived assets, revenue recognition, fair value of financial instruments, and stock-based compensation, which are included in our 2016 Annual Report on Form 10-K, which was filedCredit Facility were unchanged. In connection with the SECclosing of the Accordion, on MarchJuly 27, 2017. 2020, the Company entered into an interest rate swap with Wells Fargo Bank, N.A. with a notional amount of $50 million (the term component of the Accordion), a fixed interest rate of 0.16% and a maturity date of August 8, 2023.

During the nine months ended September 30, 2017,2020, we borrowed $158.4 million under our Credit Facility and repaid $51.6 million, for a net amount borrowed of $106.8 million. As of September 30, 2020, the net outstanding Credit Facility balance was $454.3 million.

In connection with the acquisition of the Dumfries Facility in April 2020, we assumed a CMBS loan with an outstanding balance of approximately $12.1 million, an interest rate of 4.68% and a remaining term of four years. In connection with the acquisition of the Rosedale Facilities in July 2020, we entered into a third-party loan in the amount of $14.8 million with an annual interest rate of 3.85% and a term of five years.

Recent Developments

Completed Acquisitions

Since September 30, 2020, we have closed on the following properties:

    

    

Rentable

    

Purchase

    

Annualized

    

 

Square Feet

Price(1)

Base Rent(2)

Capitalization

 

Property

    

City

    

(RSF)

    

(in thousands)

    

(in thousands)

    

Rate(3)

 

DaVita Portfolio

Decatur, GA / Jackson, TN

36,092

$

10,775

$

755

7.0%

Prevea Portfolio

Sheboygan / Plymouth, WI

40,250

13,700

1,016

7.4%

Totals/Weighted Average

 

 

76,342

$

24,475

$

1,771

 

7.2%

(1)Represents contractual purchase price.
(2)October 2020 base rent multiplied by 12.

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(3)Capitalization rates are calculated based on current lease terms and do not give effect to future rent escalations.

Properties Under Contract

We have eight properties under contract for an aggregate purchase price of approximately $72 million. We are currently in the due diligence period for our properties under contract. If we identify problems with any of these properties or the operators of any properties during our due diligence review, we may not close the transactions on a timely basis or we may terminate the purchase agreements and not close the transactions.

Trends Which May Influence Our Results of Operations

We believe the following trends may negatively impact our results of operations:

Decreases in our tenants’ patient volumes and revenues due to the COVID-19 pandemic – In March 2020, the World Health Organization declared the outbreak of COVID-19, a novel strain of coronavirus, a pandemic. This outbreak, which has spread widely throughout the U.S. and nearly all other regions of the world, prompted federal, state and local governmental authorities in the U.S. to declare states of emergency and institute preventative measures to contain and/or mitigate the public health effects. Many states initially banned elective and non-urgent medical procedures and have since lifted such bans; however, the recent resurgence of COVID-19 cases in many states, including many states in which our facilities are located, may cause such states to reinstitute these bans. Certain localities, such as El Paso, Lubbock and Amarillo, Texas, have already reinstituted bans on elective surgeries due to a resurgence in COVID-19. Given that many of our tenants depend on elective and non-urgent medical procedures as a major source of revenue, a reinstituted ban on these procedures may have a material adverse effect on our tenants’ businesses. In addition, in response to the recent resurgence of the COVID-19 pandemic, local, state and federal agencies have reinstituted or may reinstitute stay-at-home or shelter-in-place orders, which may result in many of our tenants experiencing significantly reduced patient volumes and, even upon the lifting of such bans and restrictions, patients may be reluctant to undertake certain medical procedures and our tenants may institute social distancing measures, each of which may cause our tenants to experience decreased patient volumes for an extended period of time.

The COVID-19 pandemic has also caused historically high unemployment rates in the United States. Many unemployed workers have also lost their employer-based health insurance, which is a primary payor for our tenants. Even though our tenants have been able to operate during most of the pandemic, the extraordinarily high levels of U.S. unemployment and loss of health insurance may cause people to cancel or delay medical procedures, and it is unclear when, if ever, these workers will be able to regain employment or private health insurance. An extended period of high unemployment and loss of benefits could materially adversely affect our tenants’ businesses and thus our ability to collect rent from our tenants.

At the onset of the outbreak, we began working with certain of our tenants that were experiencing significant disruptions in their businesses to help them navigate these uncertain times, including assisting them in applying for government financial relief and, in certain limited circumstances, entering into rent deferral agreements. The aggregate amount of such rent deferrals equaled $1.1 million and, as of September 30, 2020, we have collected $0.6 million of this amount.  Because the extent of the impact of COVID-19 on the Company’s tenants will depend on future developments, including a resurgence of COVID-19, there werecan be no material changesassurance that the Company’s tenants will be able to continue to meet the requirements of these policies.agreements, or that these tenants, or other tenants, may not seek additional relief in the future.

Changes in third party reimbursement methods and policies. Even prior to the COVID-19 pandemic, the price of healthcare services was increasing, and we believed that third-party payors, such as Medicare and commercial insurance companies, would continue to scrutinize and reduce the types of healthcare services eligible for, and the amounts of, reimbursement under their health insurance plans. Additionally, many employer-based insurance plans were continuing to increase the percentage of insurance premiums for which covered individuals are responsible. We expect these trends will only be exacerbated by the COVID-19 pandemic, as federal and state budgets are likely to be under tremendous stress due to the pandemic and private insurers are likely to incur substantial losses due to COVID-19-related claims and the downturn in the financial and credit markets. If these trends continue, our tenants’ businesses will continue to be negatively affected, which may impact their ability to pay rent to us.

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Prior to the COVID-19 pandemic, we believed the following trends may positively impact our results of operations:

Growing healthcare expenditures. According to the U.S. Department of Health and Human Services, overall healthcare expenditures are expected to grow at an average rate of 5.5% per year through 2027. We believe the long-term growth in healthcare expenditures will help maintain or increase the value of our healthcare real estate portfolio.

An aging population. According to the 2010 U.S. Census, the segment of the population consisting of people 65 years or older comprise the fastest growing segment of the overall U.S. population. We believe this segment of the U.S. population will utilize many of the services provided at our healthcare facilities such as orthopedics, cardiac, gastroenterology and rehabilitation.

A continuing shift towards outpatient care. According to the American Hospital Association, patients are demanding more outpatient operations. We believe this shift in patient preference from inpatient to outpatient facilities will benefit our tenants as most of our properties consist of outpatient facilities.

Physician practice group and hospital consolidation. We believe the trend towards physician group consolidation will serve to strengthen the credit quality of our tenants if our tenants merge or are consolidated with larger health systems.

After the COVID-19 pandemic, it is unclear whether the above-listed positive trends will be reinstated or, if so, how such trends may be affected by the long-term effects of the COVID-19 pandemic.

Qualification as a REIT

We elected to be taxed as REIT commencing with our taxable year ended December 31, 2016. Subject to a number of significant exceptions, a corporation that qualifies as a REIT generally is not subject to U.S. federal corporate income taxes on income and gains that it distributes to its stockholders, thereby reducing its corporate-level taxes. In order to qualify as a REIT, a substantial percentage of our assets must be qualifying real estate assets and a substantial percentage of our income must be rental revenue from real property or interest on mortgage loans. We believe that we have organized and have operated in such a manner as to qualify for taxation as a REIT, and we intend to continue to operate in such a manner. However, we cannot provide assurances that we will continue to operate in a manner so as to qualify or remain qualified as a REIT.

Critical Accounting Policy

The preparation of financial statements in conformity with GAAP requires us to use judgment in the application of accounting policies, including making estimates and assumptions. We base estimates on the best information available to us at the time, our experience and on various other assumptions believed to be reasonable under the circumstances. These estimates affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting periods. If our judgment or interpretation of the facts and circumstances relating to various transactions or other matters had been different, it is possible that different accounting would have been applied, resulting in a different presentation of our financial statements. From time to time, we re-evaluate our estimates and assumptions. In the event estimates or assumptions prove to be different from actual results, adjustments are made in subsequent periods to reflect more current estimates and assumptions about matters that are inherently uncertain. Please refer to our Annual Report on Form 10-K for the year ended December 31, 2019, filed with the Commission on March 9, 2020, for further information regarding the critical accounting policies that affect our more significant estimates and judgments used in the preparation of our condensed consolidated financial statements included in Part I, Item 1 of this Report.

Consolidated Results of Operations

The major factorfactors that resulted in variances in our results of operations for each revenue and expense category for the three and nine months ended September 30, 2017,2020 compared to the three and nine months ended September 30, 2016 wassame periods in 2019 were (i) the increase in the size of our property portfolio.portfolio and (ii) expenses related to the Internalization. Our total investments in real estate, net of accumulated depreciation and amortization, was $412.1$977.5 million and $122.3$781.7 million as of September 30, 20172020 and 2016,2019, respectively.

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Three Months Ended September 30, 20172020 Compared to Three Months Ended September 30, 20162019

Three Months Ended September 30, 

    

2020

    

2019

    

$ Change

    

 For the Three Months Ended    
 September 30, 2017  September 30, 2016  $ Change 

(in thousands)

Revenue            

 

  

 

  

 

  

 

Rental revenue $7,921,913  $1,932,425  $5,989,488 

$

25,055

$

18,117

$

6,938

Expense recoveries  443,816   -   443,816 
Other income  23,134   70,225   (47,091)

 

42

 

78

 

(36)

Total revenue  8,388,863   2,002,650   6,386,213 

 

25,097

 

18,195

 

6,902

            

Expenses            

Acquisition fees  651,645   -   651,645 
General and administrative  989,526   1,720,651   (731,125)

 

4,027

 

1,681

 

2,346

Operating expenses  464,514   1,025   463,489 

 

3,619

 

1,362

 

2,257

Management fees – related party  803,804   627,147   176,657 

 

 

1,621

 

(1,621)

Depreciation expense  2,175,668   585,449   1,590,219 

 

6,954

 

5,006

 

1,948

Amortization expense  523,487   -   523,487 

 

2,563

 

1,500

 

1,063

Interest expense  2,174,683   1,051,204   1,123,479 

 

4,864

 

4,549

 

315

Management internalization expense

 

12,580

 

 

12,580

Preacquisition expense

 

70

 

168

 

(98)

Total expenses  7,783,327   3,985,476   3,797,851 

 

34,677

 

15,887

 

18,790

Net income (loss) $605,536  $(1,982,826) $2,588,362 

Net (loss) income

$

(9,580)

$

2,308

$

(11,888)

Revenue

Total Revenue

Total revenue for the three months ended September 30, 20172020 was $8,388,863,$25.1 million, compared to $2,002,650$18.2 million for the same period in 2016,2019, an increase of $6,386,213.$6.9 million. The increase iswas primarily the result of rental revenue earned from the facilities that we acquired subsequent to September 30, 2016,2019, as well as from the recognition of a full three months of rental revenue relating toin 2020 from acquisitions that occurredwere completed during the three months ended September 30, 2016.2019. Additionally, $443,816$3.9 million in revenue was recognized from expense recoveries during the three month period ended September 30, 2017, which related to tenant reimbursement of real estate taxes, insurance, and certain other operating expenses. We recognize these reimbursements and related expenses on a gross basis in our Consolidated Statements of Operations (i.e., we recognize an equivalent increase in revenue (expense recoveries) and expense (operating expenses)). We did not recognize any revenue from expense recoveries during the three month period ended September 30, 2016.

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Expenses

Acquisition Fees

Acquisition fees to unrelated parties for the three months ended September 30, 2017 were $651,645,2020, compared to zero$1.2 million for the same period in 2016. These acquisition fees during the 2017 three-month period were incurred on our acquisitions that were accounted for as business combinations. No acquisitions were accounted for as business combinations during the three-month period in 2016.2019.

Expenses

General and Administrative

General and administrative expenses for the three months ended September 30, 20172020 were $989,526,$4.0 million, compared with $1,720,651to $1.7 million for the same period in 2016, a decrease2019, an increase of $731,125. This decrease compared$2.3 million. The increase was primarily driven by the impact of the Internalization and our recognition of $1.7 million of compensation related costs and other administrative expenses that prior to the corresponding period inInternalization were the prior year primarily relates to a decrease in non-cash compensation expense incurred on the LTIP unitsobligation of our Former Advisor. In addition, reflecting the impact of LTIP forfeitures, a decreaselong-term incentive plan (“LTIP”) unit grants made in legal expenseconnection with the Internalization, this increase was also due to an increase in non-cash LTIP compensation expense which was $1.6 million for the internalization of many of our legal costs, as well as a decreasethree months ended September 30, 2020, compared to $0.9 million for the same period in insurance expense recognized reflecting actions taken to reduce property insurance costs.2019.

Operating expenses

Expenses

Operating expenses for the three months ended September 30, 20172020 were $464,514,$3.6 million, compared with $1,025to $1.4 million for the same period in 2016,2019, an increase of $463,489. Operating expenses primarily consist of $443,816$2.2 million. The increase resulted from $3.9 million of reimbursable property operating expenses incurred during the three months ended September 30, 2020, compared to $1.2 million for the same period in 2019, and $0.5 million of expense from properties that we paid on behalf of certain of ourinclude tenants but also for which we receive reimbursement from the tenant under the applicable lease.with gross leases.

Management FeesFee Expense – related party

Management feesAs a result of the Internalization, we incurred no management fee expense for the three months ended September 30, 2017 were $803,804, compared with $627,1472020.  Management fee expense was $1.6 million for the same period in 2016, an increase of $176,657. The increase in the management fee during the current quarter results from a largerthree months ended September 30, 2019, and was calculated based on our stockholders’ equity balance due to the common stock and preferred stock issuances that were completed during 2017.balance.

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Depreciation Expense

Depreciation expense for the three months ended September 30, 20172020 was $2,175,668,$7.0 million, compared with $585,449to $5.0 million for the same period in 2016,2019, an increase of $1,590,219.$2.0 million. The increase resultsresulted primarily from depreciation expense incurred on the facilities that we acquired subsequent to September 30, 2016 and2019, as well as from the recognition of a full three months of depreciation expense for a full three-month period related toin 2020 from acquisitions that were completed during the three months ended September 30, 2016. 2019.

Amortization Expense

Amortization expense for the three months ended September 30, 20172020 was $523,487,$2.6 million, compared to zero$1.5 million for the same period in 2016. Amortization2019, an increase of $1.1 million. The increase resulted primarily from amortization expense was incurred on the in-place lease and leasing cost intangible assets recognizedacquired subsequent September 30, 2019, as well as from our acquisitions that were accounted for as business combinations. No acquisitions were accounted for as business combinationsthe recognition of a full three months of amortization expense in 2020 from intangible assets recorded during the three-month period in 2016.three months ended September 30, 2019.

Interest Expense

Interest expense for the three months ended September 30, 20172020 was $2,174,683,$4.9 million, compared with $1,051,204to $4.5 million for the same period in 2016,2019, an increase of $1,123,479.$0.4 million. This increase iswas primarily due to higher average borrowings during the current quarter reflectingthree months ended September 30, 2020, compared to the same period last year, the proceeds of which were used to partially finance our property acquisitions during that time period.

The weighted average interest incurred onrate of our debt for the outstanding borrowings from our revolving credit facility as well as amortization ofthree months ended September 30, 2020 was 3.32%. Additionally, the deferred financing costs incurred to procure debt, which is recorded as interest expense.

The weighted average interest rate and term of our debt was 3.84%3.34% and 3.433.06 years respectively, at September 30, 2017,2020.

Management Internalization Expense

Management internalization expense for the three months ended September 30, 2020 was $12.6 million, compared to 4.88%zero for the same period in 2019. This expense represents a one-time expense of $12.1 million related to the settlement of a preexisting contractual relationship and 8.13 years, respectively, at$0.5 million of professional fees associated with the Internalization.

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Net (Loss) Income

Net loss for the nine months ended September 30, 2016.2020 was $(9.6) million, compared to net income of $2.3 million for the same period in 2019, a decrease of $11.9 million. The decrease resulted primarily from the recognition of $12.6 million of management internalization expense and the increase in expenses for the current three-month period, partially offset from an increase in rental revenue over the period.

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Nine Months Ended September 30, 20172020 Compared to Nine Months Ended September 30, 20162019

Nine Months Ended September 30, 

2020

2019

$ Change

(in thousands)

Revenue

    

  

    

  

    

  

Rental revenue

$

68,623

$

50,093

$

18,530

Other income

 

178

 

182

 

(4)

Total revenue

 

68,801

 

50,275

 

18,526

Expenses

 

  

 

  

 

  

General and administrative

 

7,509

 

4,928

 

2,581

Operating expenses

 

8,256

 

3,826

 

4,430

Management fees – related party

 

4,024

 

4,539

 

(515)

Depreciation expense

 

19,383

 

13,481

 

5,902

Amortization expense

 

6,832

 

3,757

 

3,075

Interest expense

 

13,616

 

12,707

 

909

Management internalization expense

 

14,005

 

 

14,005

Preacquisition expense

 

267

 

224

 

43

Total expenses

 

73,892

 

43,462

 

30,430

Net (loss) income

$

(5,091)

$

6,813

$

(11,904)

  For the Nine Months Ended    
  September 30, 2017  September 30, 2016  $ Change 
Revenue            
Rental revenue $19,217,710  $4,994,172  $14,223,538 
Expense recoveries  1,141,455   -   1,141,455 
Other income  111,502   93,196   18,306 
    Total revenue  20,470,667   5,087,368   15,383,299 
             
Expenses            
Acquisition fees  2,130,187   -   2,130,187 
Acquisition fees – related party  -   754,000   (754,000)
General and administrative  4,418,115   2,962,730   1,455,385 
Operating expenses  1,234,247   15,685   1,218,562 
Management fees – related party  2,059,325   807,147   1,252,178 
Depreciation expense  5,372,308   1,528,281   3,844,027 
Amortization expense  1,326,395   -   1,326,395 
Interest expense  5,265,262   3,443,113   1,822,149 
    Total expenses  21,805,839   9,510,956   12,294,883 
    Net loss $(1,335,172) $(4,423,588) $3,088,416 

Revenue

Revenue

Total Revenue

Total revenue for the nine months ended September 30, 20172020 was $20,470,667,$68.8 million, compared to $5,087,368$50.3 million for the same period in 2016,2019, an increase of $15,383,299.$18.5 million. The increase iswas primarily the result of rental revenue derivedearned from the facilities we acquired subsequent to September 30, 2016,2019, as well as from the recognition of a full nine months of rental revenue relating toin 2020 from acquisitions that occurredwere completed during the nine months ended September 30, 2016.2019. Additionally, $1,141,455$7.7 million in revenue was recognized from expense recoveries during the nine-month period ended September 30, 2017, which related to tenant reimbursement of real estate taxes, insurance, and certain other operating expenses that are recognized as expense recovery revenue. We recognize these reimbursements and related expenses on a gross basis in our Consolidated Statements of Operations (i.e., we recognize an equivalent increase in revenue (expense recoveries) and expense (operating expenses)). We did not recognize any revenue from expense recoveries during the nine month period ended September 30, 2016.

Expenses

Acquisition Fees

Acquisition fees to unrelated parties for the nine months ended September 30, 2017 were $2,130,187,2020, compared to zero$3.6 million for the same period in 2016. These acquisition fees during2019. The increase was partially offset by the nine-month period ended September 30, 2017 wererecognition of reserves for approximately $1.1 million of rent, including approximately $0.4 million of deferred rent, that was primarily related to acquisitions that were accounted for as business combinations. As discussed below in the “Acquisition Fees – related party” section, prior to July 1, 2016, the effective date of our amended management agreement (the “Amended Management Agreement”), our acquisition fees were payable to our Advisor.one tenant.

Expenses

Acquisition Fees – related party

Related party acquisition fees for the nine months ended September 30, 2017 were zero, compared with $754,000 for the same period in 2016. Related party acquisition fees for the nine months ended September 30, 2016 consisted of $350,000, $309,000 and $95,000 that were expensed in connection with the acquisitions of the Plano Facility, the Melbourne Facility, and the Westland Facility, respectively. Pursuant to our original management agreement, the acquisition fees payable to our Advisor were computed at a rate of 2% of the purchase price of the facility and, subsequent to July 1, 2016, our acquisitions were no longer subject to this fee.

General and Administrative

General and administrative expenses for the nine months ended September 30, 20172020 were $4,418,115,$7.5 million, compared with $2,962,730to $4.9 million for the same period in 2016,2019, an increase of $1,455,385.$2.6 million. The increase was primarily results from an increasedriven by the impact of $649,897 in non-cashthe Internalization and our recognition of compensation expense incurred related costs and other administrative expenses that prior to the Internalization were the obligation of our Former Advisor. In addition, reflecting the impact of LTIP units duringunit grants made in connection with the current nine-month period as well as fromInternalization, this increase was also due to an increase in costs incurred duringnon-cash LTIP compensation expense which was $3.4 million for the nine-monthnine months ended September 30, 2020, compared to $2.5 million for the same period related to Sarbanes-Oxley implementation and public company related costs such as capital market advisory and investor relations.in 2019.

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Operating expenses

Expenses

Operating expenses for the nine months ended September 30, 20172020 were $1,234,247,$8.3 million, compared with $15,685to $3.8 million for the same period in 2016,2019, an increase of $1,218,562. Operating expenses primarily consisted of $1,141,455,$4.5 million. The increase results from $7.7 million of reimbursable property operating expenses incurred

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during the nine months ended September 30, 2020, compared to $3.6 million for the same period in 2019, and $1.2 million of expense from properties that we paid on behalf of certain of ourinclude tenants but also for which we receive reimbursement from the tenant under the applicable lease.with gross leases.

Management Fees Expense - related party

Management feesfee expense for the nine months ended September 30, 2017 were $2,059,325,2020 was $4.0 million, compared with $807,147to $4.5 million for the same period in 2016, an increase2019, a decrease of $1,252,178. The increase in$0.5 million. As a result of the Internalization, management fee expense was incurred for the first six months of the current nine-month period compared to a full nine months during the nine months ended September 30, 2017 was due primarily to the larger stockholders’ equity balance due to common stock and preferred stock issuances during 2017 as well as changessame period in the fee calculation described below. The nine-month period ended September 30, 2017 management2019. This fee was calculated based on the terms of the Amended Management Agreement, which became effective on July 1, 2016 and requires an annual base management fee equal to 1.5% of our stockholders’ equity (as defined in the Amended Management Agreement). The management fee for the same period in 2016 was calculated based upon theterms ofthe Amended Management Agreement from July 1, 2016 through September 30, 2016 ($627,147 of expense) and based on the terms of the original management agreement from January 1, 2016 through June 30, 2016 with a fixed fee of $30,000 per month ($180,000 of expense).balance.

Depreciation Expense

Depreciation expense for the nine months ended September 30, 20172020 was $5,372,308,$19.4 million, compared with $1,528,281to $13.5 million for the same period in 2016,2019, an increase of $3,844,027.$5.9 million. The increase results primarily from depreciation expense incurred on the facilities we acquired subsequent to September 30, 2016 and2019, as well as from the recognition of a full nine months of depreciation expense for a full nine-month period related toin 2020 from acquisitions that were completed during the nine months ended September 30, 2016.2019.

Amortization Expense

Amortization expense for the nine months ended September 30, 20172020 was $1,326,395,$6.8 million, compared to zero$3.8 million for the same period in 2016. Amortization2019, an increase of $3.0 million. The increase results primarily from amortization expense was incurred on the in-place lease and leasing cost intangible assets recognizedrecorded subsequent to September 30, 2019, as well as from our acquisitions that were accounted for as business combinations. We had no acquisitions that were accounted for as business combinationsthe recognition of a full nine months of amortization expense in 2020 from intangible assets recorded during the nine-month periodnine months ended September 30, 2016.2019.

Interest Expense

Interest expense for the nine months ended September 30, 20172020 was $5,265,262,$13.6 million, compared with $3,443,113to $12.7 million for the same period in 2016,2019, an increase of $1,822,149.$0.9 million. This increase iswas primarily due to higher average borrowings during the current nine-monthnine months ended September 30, 2020, compared to the same period reflectinglast year, the proceeds of which were used to partially finance our property acquisitions during that time period.

The weighted average interest incurred onrate of our debt for the outstanding borrowings from our revolving credit facility as well as amortization ofnine months ended September 30, 2020 was 3.48%. Additionally, the deferred financing costs incurred to procure debt, which is recorded as interest expense.

The weighted average interest rate and term of our debt was 3.84%3.34% and 3.433.06 years respectively, at September 30, 2017,2020.

Management Internalization Expense

Management internalization expense for the nine months ended September 30, 2020 was $14.0 million, compared to 4.88%zero for the same period in 2019. This expense represents a one-time expense of $12.1 million related to the settlement of a preexisting contractual relationship and 8.13 years, respectively, at$1.9 million of professional fees associated with the Internalization.

Net (Loss) Income

Net loss for the nine months ended September 30, 2016.

2020 was $(5.1) million compared to net income of $6.8 million for the same period in 2019, a decrease of $11.9 million. The decrease resulted primarily from the recognition of $14.0 million of management internalization expense and the increase in expenses for the current nine-month period, partially offset from an increase in rental revenue over the period.

Assets and Liabilities

As of September 30, 20172020 and December 31, 2016,2019, our principal assets consisted of investments in real estate, net; cashnet, of $977.5 million and acquired lease intangible assets, net. As of September 30, 2017 and December 31, 2016, our$849.0 million, respectively. Our liquid assets consisted primarily of cash and cash equivalents and restricted cash of $6.8$7.3 million and $19.7$7.2 million, as of September 30, 2020 and December 31, 2019, respectively.

The increase in our investments in real estate, net, to $412.1$977.5 million as of September 30, 2017,2020 compared to $203.5$849.0 million as of December 31, 2016,2019, was primarily the result of the 1610 acquisitions that werewe completed during the nine months ended September 30, 2017.2020.

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The decreaseincrease in our cash balanceand cash equivalents and restricted cash balances to $6.8$7.3 million as of September 30, 2017,2020, compared to $19.7$7.2 million as of December 31, 2016,2019, was primarily due to $213.5 million of cash used for the 16 acquisitions during the nine-month period ended September 30, 2017, $10.8 million of dividends paid during the nine-month period ended September 30, 2017, $2.8 million ofinflows from net borrowings on our Credit Facility and additional borrowings, and net proceeds from common equity offerings. These cash paid for deferred financing costs during the nine-month period ended September 30, 2017 related to the revolving credit facility, and approximately $0.5 million used to repay related party debt. These decreases in cashinflows were partially offset by net borrowings fromfunds used to acquire real estate, pay the revolving credit facility in the amount of $98.4 million, net proceeds received fromInternalization consideration, and dividends paid to our common stock offering of $33.8 million, net proceeds received from ourand preferred stock offering of approximately $75 million, and an increase in cash provided by operating activities of $7.3 million.  stockholders.

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The increase in our total liabilities to $175.9$576.3 million as of September 30, 20172020 compared to $72.3$424.6 million as of December 31, 2016,2019, was primarily the result of higher net borrowings outstanding from our Credit Facility during the revolving credit facilitycurrent period, additional borrowings related to acquisitions, an increase in the amount of $98.4 million as well as from increases in the security depositour derivative liability balance, the accounts payable and accrued expenses balance, and thean increase in our acquired lease intangible liability balance.

Liquidity and Capital Resources

General

General

Our short-term liquidity requirements include:

Interest expense and scheduled principal payments on outstanding indebtedness;
General and administrative expenses;
Operating expenses; and
Property acquisitions and tenant improvements.
interest expense and scheduled principal payments on outstanding indebtedness,
general and administrative expenses, and
acquisition expenses.

In addition, we will require funds for future distributions expected to be paid to our common and preferred stockholders and OP Unit and LTIP unitUnit holders in our Operating Partnership.

As of September 30, 2017,October 31, 2020, we had $6.8 million of cash balances and also had borrowingavailable capacity under our revolving credit facility as described below.Credit Facility of approximately $112 million. Our primary sources of cash include rent and reimbursements we collect from our tenants, borrowings under our revolving credit facility,Credit Facility, secured term loans, and net proceeds received from equity issuances.issuances (including OP Unit transactions), and select property dispositions.

Assuming our current level of COVID-19-related rent deferrals, we believe we will be able to satisfy our short-term liquidity requirements through our existing cash and cash equivalents and cash flow from operations. In order to continue acquiring healthcare properties, we will need to continue to have access to debt and equity financing.

On June 30, 2017, we closed a public underwritten offering of our common stock and on July 20, 2017 we closed on the over-allotment option granted to the underwriters. These transactions resulted in an aggregate of 4,025,000 shares of its common stock being issued at a public offering price of $9 per share, resulting in aggregate net proceeds of approximately $33.8 million. We used the proceeds from this transaction primarily to repay borrowing on our revolving credit facility.

On September 15, 2017, we closed on a public underwritten offering of 3,105,000 shares of our Series A Preferred Stock, $0.001 par value per share, with a liquidation preference of $25 per share, inclusive of 405,000 shares issued in connection with the underwriters’ exercise of their over-allotment option. The issuance raised aggregate net proceeds of approximately $75 million. We used the proceeds from this transaction primarily to repay borrowing on our revolving credit facility.

On March 3, 2017, the Company, the Operating Partnership, as borrower, and the subsidiary guarantors of the Operating Partnership amended our revolving credit facility (the “Revolving Credit Facility”) with BMO Harris Bank N.A., as Administrative Agent, which increased the commitment amount to $200 million plus an accordion feature that allows for up to an additional $50 million of principal amountare subject to certain conditions. On September 28, 2017, certain of the Company’s lenders under the Revolving Credit Facility committed to fund all of the $50 million accordion feature. The subsidiary guarantors and the Company are guarantors of the obligations under the Revolving Credit Facility. The amount available to borrow from time to time under the Revolving Credit Facility is limited according to a quarterly borrowing base valuation of certain properties owned by the subsidiary guarantors. Our Operating Partnership is subject to ongoing compliance with a number of customary affirmative and negativefinancial covenants under the Revolvingour Credit Facility, including, limitations with respect to liens, indebtedness, distributions, mergers, consolidations, investments, restricted payments and asset sales. The Operating Partnership must also maintainamong other things, (i) a maximum consolidated leverage ratio commencing with the fiscal quarter ending December 31, 2016 and as of the end of each fiscal quarter thereafter, of less than (y) 0.65:1.00 for each fiscal quarter ending prior to October 1, 2019 and (z) thereafter, 0.60:1.00, (ii) a minimum fixed charge coverage ratio of 1.50:1.00, (iii) a minimum net worth of $119,781,219$203.8 million plus 75% of all net proceeds raised through subsequent equity offerings subsequent to March 31, 2018 and (iv) a ratio of total secured recourse debt to total asset value of not greater than 0.10:1.00. Additionally, beginning at the end of fourth quarter of 2020, our distributions to common stockholders will be limited to an amount equal to 95% of our AFFO (our AFFO payout ratio). As of September 30, 2020, we were in compliance with all of the financial covenants contained in the Credit Facility, and we do not believe our current level of COVID-19-related rent deferrals affect our ability to comply with such covenants. However, if the amounts of our rent deferrals exceed our expectations or our tenants default on their rent deferral agreements with us, our ability to satisfy our Credit Facility covenants may be adversely affected.

We have entered into six interest rate swaps with four counterparties to hedge the LIBOR component of our interest rate risk related to the Term Loan. Together, these swaps fix the LIBOR component of the entire $350 million term loan on a weighted average basis at 1.91%. An aggregate of $200 million of the swaps mature in August 2024 and an additional $150 million matures in August 2023.

In July 2017, the outstanding RevolvingFCA that regulates LIBOR announced its intention to stop compelling banks to submit rates for the calculation of LIBOR after 2021. As a result, the Federal Reserve Board and the Federal Reserve Bank of New York organized the ARRC which identified the SOFR as its preferred alternative to USD-LIBOR in derivatives and other financial contracts. The Credit Facility balance was $126.1 million.

On August 25, 2017,provides that, on or about the LIBOR cessation date (subject to an early opt-in election), LIBOR shall be replaced as a benchmark rate in the Credit Facility with a new benchmark rate to be agreed upon by the Company and BMO, with such adjustments to cause the Operating Partnership entered into separate Sales Agreements (the “Sales Agreements”) with each of Cantor Fitzgerald & Co. and FBR Capital Markets & Co. (the “Agents”), pursuant to which the Company may issue and sell, from time to time, its common shares having an aggregate offering price of up to $50.0 million, through the Agents (the “ATM Program”). In accordance with the Sales Agreements, the Company may offer and sell its common shares through any of the Agents, from time to time, by any method deemednew benchmark rate to be an “ateconomically equivalent to LIBOR. We are not able to predict when LIBOR will cease to be available or when there will be enough liquidity in the market offering” as defined in Rule 415 under the Securities Act of 1933, as amended, which includes sales made directly on the New York Stock Exchange or other existing trading market, sales made to or through a market maker, sales made through negotiated transactions or any other method permitted by law. As of September 30, 2017, we had not made any sales of our common shares through the ATM Program.

- 30 -SOFR markets.

-48-

Table of Contents

We believe we will be able to satisfy our short-term liquidity requirements through our existing cash and cash equivalents, cash flow from operating activities, and future equity offerings and borrowings under our Revolving Credit Facility and any other debt instruments we may enter into. However, although we are currently in compliance with our covenants under the Revolving Credit Facility, if we continue to borrow under the Revolving Credit Facility and are unable to raise additional equity capital in the future, we may be unable to utilize our Revolving Credit Facility to finance our short-term liquidity requirements unless we are able to obtain covenant waivers from our lenders.

Our long-term liquidity needs consist primarily of funds necessary to pay for acquisitions, recurringcapital and non-recurring capital expenditures,tenant improvements at our properties, scheduled debt maturities, general and administrative expenses, operating expenses, and dividends.distributions. We expect to satisfy our long-term liquidity needs through cash flow from operations, long-term secured and unsecured borrowings,debt financing, sales of additional equity securities, and,the issuance of OP Units in connection with acquisitions of additional properties, the issuance of OP Units, and proceeds from select property dispositions and joint venture transactions. We currently do not expect to sell any of our properties to meet our liquidity needs, although we may do so in the future.

We intend to invest in additional properties as suitable opportunities arise and adequate sources of financing are available. We currently are evaluating additional potential acquisitions consistent with the normal course of our business. There can be no assurance as to whether or when any portion of these acquisitions will be completed. Our ability to complete acquisitions is subject to a number of risks and variables, including our ability to negotiate mutually agreeable terms with sellers and our ability to finance the acquisitions. We may not be successful in identifying and consummating suitable acquisitions, which may impede our growth and negatively affect our results of operations and may result in the use of a significant amount of management resources.

To qualify as a REIT for federal income tax purposes, we are required to distribute annually at least 90% of our REIT taxable income, without regard to the deduction for dividends paid and excluding net capital gains, and to pay tax at regular corporate rates to the extent that we annually distribute less than 100% of our REIT taxable income. Subject to the requirements of the Maryland General Corporation Law, we intend to pay quarterly dividends to our stockholders, if and to the extent authorized by our Board.

Cash Flow Information

Net cash provided by operating activities for the nine months ended September 30, 20172020 was $7.3$18.4 million, compared with net cash used in operating activities of $2.1$26.7 million for the corresponding nine monthssame period in 2016. This increase in cash flows from operating activities2019. The decrease during the 2020 period was primarily derived fromdue to the increase innet loss for the sizenine-month period. The net loss was primarily the result of our property portfolio at September 30, 2017 compareda one-time expense of $12.1 million related to September 30, 2016.the settlement of a preexisting contractual relationship.

Net cash used in investing activities for the nine months ended September 30, 20172020 was $213.5$141.6 million, compared with $68.3$182.7 million for the corresponding nine monthssame period in 2016. This increase2019. The decrease during the 2020 period was primarily the result of increasedless real estate investment activity in 2017, specifically funds used for the 16 acquisitions that we completed2020 period compared to the same period in 2019, partially offset by cash paid during the current nine-month period ended September 30, 2017. Cash flows usedto acquire our Former Advisor in investing activities are heavily dependent uponconnection with the investment in properties and real estate assets. We anticipate cash flows used in investing activities to increase as we acquire additional properties in the future.Internalization.

Net cash provided by financing activities for the nine months ended September 30, 20172020 was $193.3$123.3 million, compared with $142.6$157.0 million for the corresponding nine monthssame period in 2016. Cash flows provided2019. The decrease during the 2020 period was primarily due to the fact that the current period had lower net proceeds from common equity offerings and higher dividends paid to our common stockholders, partially offset by financing activitieshigher net borrowings on the Credit Facility, and additional borrowings.

Common Stock Dividends

Common stock dividend activity for the nine months ended September 30, 2017 were derived primarily from net proceeds received from the Revolving Credit Facility, net proceeds received from our common stock offering, and net proceeds received from our preferred stock offering, partially offset by the payment of dividends and deferred financing costs.

Common Stock Dividends

Since July 2016, our Board had declared cash dividends on our common stock as2020 is summarized in the following table.table:

Date Announced Record Date Applicable
Quarter
 Payment Date Dividend Amount1  Dividends per Share 
             
September 14, 2016 September 27, 2016 Q3 2016 October 11, 2016 $3,592,786  $0.20 
December 14, 2016 December 27, 2016 Q4 2016 January 10, 2017 $3,604,037  $0.20 
March 20, 2017 March 27, 2017 Q1 2017 April 10, 2017 $3,603,485  $0.20 
June 16, 2017 June 27, 2017 Q2 2017 July 10, 2017 $3,607,726  $0.20 
September 8, 2017 September 26, 2017 Q3 2017 October 9, 2017 $4,416,1642 $0.20 

    

    

Applicable

    

    

Dividend

    

Dividends

Date Announced

Record Date

Quarter

Payment Date

Amount(1)

per Share

December 13, 2019

December 26, 2019

 

Q4 2019

January 9, 2020

$

9,541

$

0.20

March 4, 2020

March 25, 2020

Q1 2020

April 9, 2020

$

9,610

$

0.20

June 12, 2020

June 25, 2020

 

Q2 2020

July 9, 2020

$

9,861

$

0.20

September 3, 2020

 

September 24, 2020

 

Q3 2020

 

October 8, 2020

$

10,357

$

0.20

(1)

1

Includes dividendsdistributions on granted LTIP unitsUnits and OP Units issued to third parties.Units.

2This amount was accrued as of September 30, 2017 and paid on October 9, 2017. For additional details refer to Note 11 – “Subsequent Events.”

- 31 -

During the nine months ended September 30, 2017, we2020 and 2019, the Company paid total dividends on its common stock, LTIP Units and OP Units in the aggregate amount of $10,815,248, consisting of the dividends declared for the fourth quarter of 2016 through the second quarter of 2017. Additionally, during the nine months ended September 30, 2016, we paid total dividends in the amount of $285,703.

$29.6 million and $21.2 million, respectively.

The amount of the dividends paid to ourthe Company’s stockholders is determined by ourthe Board and is dependent on a number of factors, including funds available for payment of dividends, ourthe Company’s financial condition and capital expenditure requirements except that, in accordance with ourthe Company’s organizational documents and Maryland law, wethe Company may not make dividend distributions that would: (i) cause usit to be unable to pay ourits debts as they become due in the usual course of business; (ii) cause ourits total assets to be less than the sum of ourits total liabilities plus senior liquidation preferences; or (iii) jeopardize ourits ability to maintain ourits qualification as a REIT.

Preferred Stock Dividends

The holders of the Company’s Series A Preferred Stock will beare entitled to receive dividend payments only when, as and if declared by the Board (or a duly authorized committee of the Board. Any such dividendsBoard). Dividends will accrue or be payable in cash from the original issue date, on a cumulative basis, quarterly in arrears on each dividend payment date. Additionally, the terms specify that dividends will be payabledate at a fixed rate per annum equal to 7.50% of the liquidation preference of $25$25.00 per share (equivalent to $1.875 per share on an annual basis). Dividends on the Series A Preferred Stock will be cumulative and will accrue whether or not (i) funds are legally available for the payment of those dividends, whether or not(ii) the Company has earnings and whether or not(iii) those dividends are authorized.declared by the Board.

-49-

The quarterly dividend payment dates on the Series A Preferred Stock are January 31, April 30, July 31 and October 31 of each year, commencing on October 31, 2017. The initial dividend is scheduled to beyear. During each of the nine-month periods ended September 30, 2020 and 2019, the Company paid on October 31, 2017 to holderspreferred dividends of record as of October 15, 2017, and will be a pro rata dividend from, and including, the original issue date to, and including, October 30, 2017, in the pro rata amount of $0.2396 per share for a total dividend amount of $743,598. Refer to Note 11 – “Subsequent Events” for additional information regarding this dividend payment.$4.4 million.

Non-GAAP Financial Measures

Funds from operations (“FFO”), Adjusted and adjusted funds from operations (“AFFO”), and Normalized AFFO are non-GAAP financial measures within the meaning of the rules of the SEC. The Company considers FFO AFFO, and Normalized AFFO to be important supplemental measures of its operating performance and believes FFO is frequently used by securities analysts, investors, and other interested parties in the evaluation of REITs, many of which present FFO when reporting their results.

In accordance with the National Association of Real Estate Investment Trusts’ (“NAREIT”) definition, FFO means net income or loss computed in accordance with GAAP before non-controllingnoncontrolling interests of holders of operating partnership units,OP Units and LTIP Units, excluding gains (or losses) from sales of property and extraordinary items, less preferred stock dividends, plus real estate relatedestate-related depreciation and amortization (excluding amortization of deferred financing costs)debt issuance costs and the amortization of above and below market leases), and after adjustments for unconsolidated partnerships and joint ventures. The Company did not incur any gains or losses from the sales of property or record any adjustments for unconsolidated partnerships and joint ventures during the quartersthree or nine months ended September 30, 20172020 and September 30, 2016.2019. Because FFO excludes real estate relatedestate-related depreciation and amortization (other than amortization of deferred financing costs)debt issuance costs and above and below market lease amortization expense), the Company believes that FFO provides a performance measure that, when compared period-over-period, reflects the impact to operations from trends in occupancy rates, rental rates, operating costs, development activities and interest costs, providing perspective not immediately apparent from the closest GAAP measurement, net income or loss.

AFFO is a non-GAAP measure used by many investors and analysts to measure a real estate company’s operating performance by removing the effect of items that do not reflect ongoing property operations. Management calculates AFFO by modifying the NAREIT computation of FFO by adjusting it for certain cash and non-cash items and certain recurring and non-recurring items. For the Company these items include management internalization costs (including a one-time expense related to the settlement of a preexisting contractual relationship), recurring acquisition and disposition costs, loss on the extinguishment of debt, recurring straight line deferred rental revenue, recurring stock-based compensation expense, recurring amortization of deferred financingabove and below market leases, recurring amortization of debt issuance costs, recurring capital expenditures, recurring lease commissions, recurring tenant improvements, an advisory fee settled with the issuance of OP Units, and other items.

Management calculates Normalized AFFO, which is also a non-GAAP financial measure, by modifying AFFO by adjusting for non-recurring income and expenses. For the Company these items include the costs of establishing a system of Sarbanes-Oxley compliant internal controls and procedures and the portion of our General Counsel and Secretary’s salary for 2017 that is reimbursable by the Company to the Advisor (such reimbursement obligation expires on May 8, 2018).

Management believes that reporting AFFO in addition to FFO is a useful supplemental measure for the investment community to use when evaluating the operating performance of the Company on a comparative basis. Management also considers Normalized AFFO to be a useful measure to evaluate the Company’s operating results excluding non-recurring income and expenses. Normalized AFFO can help investors compare the operating performance of the Company between periods or as compared to other companies. The Company’s FFO AFFO, and Normalized AFFO computations may not be comparable to FFO AFFO, and Normalized AFFO reported by other REITs that do not compute FFO in accordance with the NAREIT definition, that interpret the NAREIT definition differently than the Company does, or that compute FFO AFFO, and Normalized AFFO in a different manner.

- 32 --50-

A reconciliation of FFO AFFO, and Normalized AFFO for the three and nine months ended September 30, 20172020 and 20162019 is as follows:

    

    

Three Months Ended September 30, 

    

Nine Months Ended September 30, 

    

2020

    

2019

    

2020

    

2019

    

(unaudited, in thousands except per share amounts)

Net (loss) income

$

(9,580)

$

2,308

$

(5,091)

$

6,813

Less: Preferred stock dividends

 

(1,455)

 

(1,455)

 

(4,366)

 

(4,366)

Depreciation and amortization expense

 

9,517

 

6,506

 

26,215

 

17,238

FFO

$

(1,518)

$

7,359

$

16,758

$

19,685

Internalization expense - settlement of a preexisting contractual relationship

12,094

12,094

Internalization expense - other transaction costs

486

1,911

Amortization of above market leases, net

 

69

 

229

 

472

 

634

Straight line deferred rental revenue

 

(1,520)

 

(1,476)

 

(4,336)

 

(4,314)

Stock-based compensation expense

 

1,572

 

868

 

3,391

 

2,493

Amortization of debt issuance costs and other

 

396

 

350

 

1,030

 

1,000

Preacquisition expense

 

70

 

168

 

267

 

223

AFFO

$

11,649

$

7,498

$

31,587

$

19,721

Net (loss) income attributable to common stockholders per share – basic and diluted

$

(0.22)

$

0.02

$

(0.19)

$

0.07

FFO per share and unit

$

(0.03)

$

0.19

$

0.34

$

0.54

AFFO per share and unit

$

0.23

$

0.19

$

0.65

$

0.54

Weighted Average Shares and Units Outstanding – basic and diluted

 

50,233

 

39,449

 

48,896

 

36,395

Weighted Average Shares and Units Outstanding:

Weighted Average Common Shares

 

46,908

 

35,512

 

45,503

 

32,514

Weighted Average OP Units

 

1,958

 

3,143

 

2,250

 

3,144

Weighted Average LTIP Units

 

1,367

 

794

 

1,143

 

737

Weighted Average Shares and Units Outstanding – basic and diluted

 

50,233

 

39,449

 

48,896

 

36,395

  

Three Months Ended

September 30,

  Nine Months Ended 
September 30,
 
  2017  2016  2017  2016 
  (unaudited)  (unaudited) 
          
Net income (loss) attributable to common stockholders $381,268  $(1,982,826) $(1,559,440) $(4,423,588)
Depreciation and amortization expense  2,699,155   585,449   6,698,703   1,528,281 
Amortization of above market leases  25,016   -   13,970   - 
    FFO $3,105,439  $(1,397,377) $5,153,233  $(2,895,307)
Acquisition costs  651,645   -   2,130,187   754,000 
Straight line deferred rental revenue  (942,877)  (90,905)  (2,072,198)  (222,324)
Stock-based compensation expense  340,287   830,827   1,480,724   830,827 
Amortization of deferred financing costs  340,638   62,604   840,214   215,449 
Non-cash advisory fee  119,163   -   119,163   - 
    AFFO $3,614,295  $(594,851) $7,651,323  $(1,317,355)
Professional fees and services related to Sarbanes-Oxley implementation  162,657   73,332   403,995   73,332 
Compensation expense reimbursement  31,250   -   49,395   - 
    Normalized AFFO $3,808,202  $(521,519) $8,104,713  $(1,244,023)
                 
Net income (loss) attributable to common stockholders per share – basic and diluted $0.02  $(0.11) $(0.08) $(0.68)
FFO per Share $0.14  $(0.08) $0.27  $(0.44)
AFFO per Share $0.17  $(0.03) $0.40  $(0.20)
Normalized AFFO per Share $0.18  $(0.03) $0.43  $(0.19)
                 
Weighted Average Shares Outstanding  21,522,251   17,371,743   18,938,367   6,514,230 

Off-Balance Sheet Arrangements

We have no off-balance sheet arrangements that have or are reasonably likely to have a current or future effect or change on our financial condition, revenues or expenses, results of operations, liquidity, capital expenditures or capital resources that are material to investors. The term “off-balance sheet arrangement” generally means any transaction, agreement or other contractual arrangement to which an entity unconsolidated with us is a party, under which we have (i) any obligation arising under a guarantee contract, derivative instrument or variable interest; or (ii) a retained or contingent interest in assets transferred to such entity or similar arrangement that serves as credit, liquidity or market risk support for such assets.

Inflation

Historically, inflation has had a minimal impact on the operating performance of our healthcare facilities. Many of our triple-net lease agreements contain provisions designed to mitigate the adverse impact of inflation. These provisions include clauses that enable us to receive payment of increased rent pursuant to escalation clauses which generally increase rental rates during the terms of the leases. These escalation clauses often provide for fixed rent increases or indexed escalations (based upon the consumer price indexCPI or other measures). However, some of these contractual rent increases may be less than the actual rate of inflation. Most of our triple-net lease agreements require the tenant-operator to pay an allocable share of operating expenses, including common area maintenance costs, real estate taxes and insurance. This requirement reduces our exposure to increases in these costs and operating expenses resulting from inflation.

- 33 --51-

Item 3. Quantitative and Qualitative Disclosures About Market Risk.

Market risk includes risks that arise from changes in interest rates, foreign currency exchange rates, commodity prices, equity prices and other market changes that affect market sensitive instruments. In pursuing our business and investment objectives, we expect that the primary market risk to which we will be exposed is interest rate risk.

We aremay be exposed to the effects of interest rate changes primarily as a smaller reporting company as defined by Rule 12b-2result of debt used to acquire healthcare facilities, including borrowings under the Credit Facility. The analysis below presents the sensitivity of the Exchange Actmarket value of our financial instruments to selected changes in market interest rates. The range of changes chosen reflects our view of changes which are reasonably possible over a one-year period.

As of September 30, 2020, we had $108.2 million of unhedged borrowings outstanding under the Revolver (before the netting of unamortized debt issuance costs) that bears interest at a variable rate. See the “Management’s Discussion and Analysis of Financial Condition and Results of Operation — Liquidity and Capital Resources” for a detailed discussion of our Credit Facility. At September 30, 2020, LIBOR on our outstanding floating-rate borrowings was 0.18%. Assuming no increase in the amount of our variable interest rate debt, if LIBOR increased 100 basis points, our cash flow would decrease by approximately $1.1 million annually. Assuming no increase in the amount of our variable rate debt, if LIBOR were reduced 100 basis points, our cash flow would increase by approximately $1.1 million annually.

Our interest rate risk management objectives are to limit the impact of interest rate changes on earnings and cash flows and to lower overall borrowing costs. To achieve our objectives, we may borrow at fixed rates or variable rates. As of September 30, 2020, in total we had entered into six interest rate swaps with four counterparties to hedge the LIBOR component of our interest rate risk related to the Term Loan. Together, these swaps fix the LIBOR component of the entire $350 million Term Loan on a weighted average basis at 1.91%. See Note 4 – “Credit Facility, Notes Payable and Derivative Instruments” for further details on our interest rate swaps. We may enter into additional derivative financial instruments, including interest rate swaps and caps, in order to mitigate our interest rate risk on our future borrowings. We will not requiredenter into derivative transactions for speculative purposes.

In addition to providechanges in interest rates, the information required under this Item 3.value of our investments is subject to fluctuations based on changes in local and regional economic conditions and changes in the creditworthiness of tenants/operators and borrowers, which may affect our ability to refinance our debt if necessary.

Item 4. Controls and Procedures.

Evaluation of Disclosure Controls and Procedures

We maintain disclosure controls and procedures as defined in Rules 13a-15(e) and 15d-15(e) of the Exchange Act that are designed to ensure that the information required to be disclosed in our reports filed or submitted to the SEC under the Exchange Act is recorded, processed, summarized and reported within the time periods specified by the SEC’s rules and forms, and that information is accumulated and communicated to management, including the principal executive officer (our Chief Executive Officer) and principal financial officer (our Chief Financial Officer) as appropriate, to allow timely decisions regarding required disclosures. Our Chief Executive Officer (our “CEO”)principal executive officer and Chief Financial Officer (our “CFO”)principal financial officer evaluated the effectiveness of our disclosure controls and procedures as of September 30, 2017.2020 pursuant to Rule 13a-15(b) under the Exchange Act. Based on that evaluation, our CEOprincipal executive officer and CFOprincipal financial officer concluded that, as of the end of the period covered by this Report, the Company’s disclosure controls and procedures were effective.effective to ensure that information required to be included in our periodic SEC filings is recorded, processed, summarized, and reported within the time periods specified in the SEC rules and forms.

Even with effectiveOur management, including our principal executive officer and principal financial officer, does not expect that our disclosure controls and procedures andor our internal controls over financial reporting, there is no assurance that errors or fraud will not occur in connection with a company’s disclosure or in its financial reporting.prevent all error and all fraud. A control system, no matter how well conceived and operated, can provide only reasonable, not absolute, assurance that the objectives of the control system are met. Further, the design of a control system must reflect the fact that there are resource constraints and the benefits of controls must be considered relative to their costs. Due to the inherent limitations in all control systems, no evaluation of controls can provide absolute assurance that all control issues and instances of fraud, if any, within our company have been detected.

-52-

Changes in Internal Control over Financial Reporting

As previously disclosed in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2016, the Company concluded that it had a material weakness in its internal controls over financial reporting dueNo changes were made to lack of segregation of duties in multiple areas within the Company. A material weakness is a deficiency, or a combination of deficiencies, inour internal control over financial reporting suchduring our most recently completed fiscal quarter that there is a reasonable possibility that a material misstatement ofhave materially affected, or are reasonably likely to materially affect, our annual or interim financial statements will not be prevented or detected in a timely basis.

Beginning in the first quarter of 2017, the Company began to undertake remedial measures to address the material weakness in its internal controls. To begin the remediation process, the Company engaged an independent consulting firm that specializes in compliance with the Sarbanes Oxley Act to undertake a full review and evaluation of our personnel levels, key processes, and procedures and to complete documentation that can be monitored and independently tested. During the first and second quarters of 2017, each department of the Company conducted a thorough review of its control processes and updated all of its internal controls. In the third quarter of 2017, the Company (i) hired a new Chief Financial Officer who has extensive experience with internal controls over financial reporting (ii) added a new staff member to its accounting team both increasing the capacity of the team and enhancing segregation of duties, and (iii) finalized each department’s control narratives and internal controls, necessary to begin testing internal controls over financial reporting.

PART II OTHER INFORMATION

Item 1. Legal Proceedings

We are not involved in any pending legal proceeding or litigation and, to the best of our knowledge, no governmental authority is contemplating any proceeding to which we are a party or to which any of our properties is subject, which would reasonably be likely to have a material adverse effect on our financial condition or results of operations. From time to time, we may become involved in litigation relating to claims arising out of our operations in the normal course of business. There can be no assurance that these matters that arise in the future, individually or in the aggregate, will not have a material adverse effect on our financial condition or results of operations in any future period.

Item 1A. Risk Factors

Risks Related to Our Business

DuringOur and our tenants’ businesses have been and may continue to be materially and adversely affected by the nine months ended September 30, 2017, there were no material changesongoing COVID-19 pandemic.

In March 2020, the World Health Organization declared the outbreak of COVID-19, a novel strain of coronavirus, a pandemic. This outbreak, which has spread widely throughout the U.S. and nearly all other regions of the world,  prompted federal, state and local governmental authorities in the U.S. to declare states of emergency and institute preventative measures to contain and/or mitigate the public health effects of COVID-19. These preventative measures, which include quarantines, shelter-in-place orders and similar mandates that substantially restricted daily activities for many individuals, as well as orders calling for the closure and/or curtailment of operations for many businesses, have caused and continue to cause significant disruption to businesses in affected areas, as well as the financial markets both globally and in the U.S.  Although many of these restrictions have been lifted, a resurgence of COVID-19 has caused and could cause governmental authorities to reimplement preventive measures.  For example, certain localities, such as El Paso, Lubbock and Amarillo, Texas, have already reinstituted bans on elective surgeries due to a resurgence in COVID-19. Reinstitution of COVID-19-related restrictions could cause additional significant disruptions to businesses and global and U.S. financial markets.

Effect of the COVID-19 Pandemic on Our Operations

In response to the COVID-19 pandemic and measures taken by applicable governmental authorities, we have been encouraging all of our employees at our corporate office to work remotely until further notice. While we believe these measures are advisable and in the best interests of our employees and communities, such measures, in combination with other factors, have caused disruptions to our normal operations and may continue to do so during the pendency of such measures. Additionally, certain of our service providers have instituted or may institute similar preventative measures, which could result in reductions in the availability, capacity and/or efficiency of the services upon which we depend for our operations. Further, in the event any of our employees, and/or employees of our service providers, contract COVID-19 or are otherwise compelled to self-quarantine, we may experience shortages in labor and services that we require for our operations. Also, remote work arrangements may increase the risk of cybersecurity incidents, data breaches or cyber-attacks, which could have a material adverse effect on our business and results of operations, due to, among other things, the loss of proprietary data, interruptions or delays in the operation of our business and damage to our reputation.

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Effect of COVID-19 Pandemic on Our and Our Tenants’ Businesses.

We and our tenants have been, and may continue to be, materially and adversely affected by the disruptions to U.S. and local economies that result from the COVID-19 pandemic, including due to reduced volumes at our healthcare facilities. Many states banned elective and non-urgent medical procedures during the first few months of the COVID-19 pandemic. Given that many of our tenants depend on elective and non-urgent medical procedures as a major source of revenue, the previous ban had a material adverse effect on our tenants’ businesses, and the previous ban, or a reinstitution of such ban, may continue to affect, many of our tenants’ ability to pay rent to us on a timely basis. For example, certain localities, such as El Paso, Lubbock and Amarillo, Texas, have already reinstituted bans on elective surgeries due to a resurgence in COVID-19. A reinstitution of the ban on elective medical procedures may have a material adverse effect on our and our tenants’ businesses and may lead to: (i) increased tenant rent deferrals, (ii) failure by tenants to comply with their current rent deferral agreements with us or (iii) tenant defaults. Also, even though most of these bans have currently been lifted, patients may be reluctant to undertake certain medical procedures and our tenants may institute social distancing measures, each of which may cause our tenants to experience decreased patient volumes for an extended period of time. Even with significant government financing programs available through the CARES Act, our tenants may not be eligible to participate in such programs or there may be insufficient funds available to withstand a prolonged downturn in their businesses.

The U.S. is currently experiencing historically high unemployment rates. Many of these unemployed workers have also lost their employer-based health insurance, which is a primary payor for our tenants. The extraordinarily high levels of U.S. unemployment and loss of health insurance may cause people to cancel or delay medical procedures even after the COVID-19 pandemic subsides, and it is unclear when, if ever, these workers will be able to regain employment or private health insurance. An extended period of high unemployment and loss of benefits could materially, adversely affect our tenants’ businesses and thus our ability to collect rent from our tenants.

Effect of the COVID-19 Pandemic on Our Access to Capital

The COVID-19 pandemic caused, and continues to cause, substantial volatility in U.S. and international debt and equity markets and caused, and continues to cause, significant decreases in the market prices of equity securities. Although equity security prices have generally stabilized, a resurgence of COVID-19 could cause U.S. and international debt and equity prices to fall and force liquidity constraints on our lenders, which could negatively affect our ability to access capital on commercially reasonable terms or at all.

Effect of the COVID-19 Pandemic on our Acquisition Pipeline

A resurgence of the COVID-19 pandemic could alter the market for healthcare real estate, which, in turn, could dramatically decrease our investment pipeline and cause us not to achieve our acquisition goals.

The declaration, amount and payment of future cash dividends are subject to uncertainty due to current market conditions.

All dividends will be declared at the discretion of our Board and will depend on our earnings, our financial condition, REIT distribution requirements, and other factors as our Board may deem relevant from time to time. A resurgence of the COVID-19 pandemic could adversely affect our ability to pay dividends. Our Board is under no obligation or requirement to declare a dividend distribution and will continue to assess our dividend rates on an ongoing basis, as market conditions and our financial position continue to evolve. We cannot assure you that were disclosedwe will achieve results that will allow us to pay dividends or that the level of dividends will be maintained to increased.

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Ultimately, the overall effects of the COVID-19 pandemic on our and our tenants’ businesses, which are highly uncertain and cannot be predicted, will depend upon future developments, including the severity of COVID-19 and the duration of the outbreak and potential resurgences; the duration of existing or future social distancing and shelter-in-place orders; further mitigation strategies taken by applicable government authorities; the availability of a vaccine, adequate testing and treatments and the prevalence of widespread immunity to COVID-19; the impacts on our tenants’ supply chain; the health of our and our tenants’ employees, service providers; and the reactions of U.S. and global markets and their effects on consumer confidence and spending. Such adverse effects, however, may include lower patient volumes or reduced revenues of our tenants, an increase in rent deferral requests, requests to extend the repayment periods for deferred rent, or a failure by our tenants to pay rent to us, which may materially impact our business, financial condition, results of operation, our ability to pay distributions on our common and preferred stock and the market prices of our common and preferred stock during the fourth quarter of 2020 and beyond, as well as our ability to satisfy the covenants in our existing and any future debt agreements, including the Credit Facility, and service our outstanding indebtedness. The impact of COVID-19 may also exacerbate other risks discussed in Part I, Item 1A. Risk Factors in Amendment No. 2 to our Annual Report on Form 10-K for the year ended December 31, 2016.2019, filed with the Commission on March 9, 2020, any of which could have a material effect on us.

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

None.

Item 3. Defaults Upon Senior Securities

None.

Item 4. Mine Safety Disclosures

Not applicable.

Item 5. Other Information

None.

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Item 6. Exhibits

(a)Exhibits

(a)
Exhibits

3.1

Exhibit No.

Description

2.1

Stock Purchase Agreement, dated July 9, 2020, by and among Global Medical REIT Inc., Zensun Enterprises Limited and Mr. Jeffrey Busch (incorporated herein by reference to Exhibit 2.1 to the Company’s Current Report on Form 8-K as filed with the SEC on July 9, 2020).

3.1

Articles of IncorporationRestatement of Global Medical REIT Inc. (incorporated herein by reference to Exhibit 3.1 to the Company’s Quarterly Report on Form 10-Q as filed with the CommissionSEC on April 22, 2014)August 8, 2018).

3.2

Articles of Amendment to Articles of Incorporation filed with the Secretary of State of Maryland (incorporated herein by reference to Annex A to the Company’s Definitive Information Statement on Schedule 14C as filed with the Commission on October 3, 2014).

3.3

Certificate of Correction of Articles of IncorporationThird Amended and Restated Bylaws of Global Medical REIT Inc., adopted as of August 13, 2019 (incorporated herein by reference to Exhibit 3.3 to the Company’s Registration Statement on Form S-11/A as filed with the Commission on June 15, 2016).
3.4Certificate of Correction of Articles of Incorporation of Global Medical REIT Inc. (incorporated herein by reference to Exhibit 3.4 to the Company’s Registration Statement on Form S-11/A as filed with the Commission on June 15, 2016).
3.5Articles Supplementary for the 7.50% Series A Cumulative Redeemable Preferred Stock (incorporated herein by reference to Exhibit 3.13.2 to the Company’s Current Report on Form 8-K as filed with the CommissionSEC on SeptemberAugust 14, 2017)2019).

4.1

Specimen of Common Stock Certificate (incorporated herein by reference to Exhibit 4.1 to the Company’s Registration Statement on Form S-11/A filed with the SEC on June 15, 2016).

4.2

Specimen of 7.50% Series A Cumulative Redeemable Preferred Stock Certificate (incorporated herein by reference to Exhibit 4.1 to the Company’s Current Report on Form 8-K as filed with the CommissionSEC on September 14, 2017).

10.1

Purchase Agreement, effective July 5, 2017, between Norvin Austin Rehab LLC and Global Medical REIT Inc. (incorporated herein by reference to Exhibit 10.1 to the Company’s Current Report on Form 8-K as filed with the Commission on July 6, 2017).

10.2

LeaseEmployment Agreement, dated June 30, 2017,as of July 9, 2020, by and between SDB Partners, LLCJeffrey Busch and GMR Sherman, LLC. (incorporated herein by reference to Exhibit 10.2 to the Company’s Current Report on Form 8-K as filed with the Commission on July 6, 2017).
10.3Separation Agreement and General Release, dated August 20, 2017, between Inter-American Management LLC and David A. Young (incorporated herein by reference to Exhibit 10.1 to the Company’s Current Report on Form 8-K as filed with the Commission on August 21, 2017).
10.4Form of Consulting Agreement, to be dated September 19, 2017, between Inter-American Management LLC and David A. Young (incorporated herein by reference to Exhibit 10.2 to the Company’s Current Report on Form 8-K as filed with the Commission on August 21, 2017).
10.5First Amendment to Agreement of Limited Partnership of Global Medical REIT L.P. (incorporated herein by reference to Exhibit 10.1 to the Company’s Current Report on Form 8-K as filed with the Commission on September 14, 2017).
10.6Lease Agreement, dated September 17, 2010, between Prevarian Hospital Partners, LP and CTRH, LLC (incorporated herein by reference to Exhibit 10.1 to the Company’s Current Report on Form 8-K as filed with the CommissionSEC on September 29, 2017)July 9, 2020).

31.1*

10.2

Employment Agreement, dated as of July 9, 2020, by and between Robert Kiernan and Inter-American Management LLC (incorporated herein by reference to Exhibit 10.2 to the Company’s Current Report on Form 8-K as filed with the SEC on July 9, 2020).

10.3

Employment Agreement, dated as of July 9, 2020, by and between Alfonzo Leon and Inter-American Management LLC (incorporated herein by reference to Exhibit 10.3 to the Company’s Current Report on Form 8-K as filed with the SEC on July 9, 2020).

10.4

Severance Plan (incorporated herein by reference to Exhibit 10.4 to the Company’s Current Report on Form 8-K as filed with the SEC on July 9, 2020).

10.5

Employment Agreement, dated December 1, 2016, by and between Allen Webb and Inter-American Management LLC (incorporated herein by reference to Exhibit 10.5 to the Company’s Current Report on Form 8-K as filed with the SEC on July 9, 2020).

10.6

Form of LTIP Award Agreement (incorporated herein by reference to Exhibit 10.6 to the Company’s Current Report on Form 8-K as filed with the SEC on July 9, 2020).

10.7*

Consent and Third Amendment to the Amended and Restated Credit Agreement, dated July 9, 2020, by and among Global Medical REIT L.P., Global Medical REIT Inc., the certain subsidiaries from time to time party thereto as guarantors, the lenders party thereto and BMO Harris Bank N.A., as administrative agent.

10.8*

Second Amended and Restated Management Agreement, dated July 9, 2020, by and between Global Medical REIT L.P., Global Medical REIT Inc. and Inter-American Management LLC.

31.1*

Certification of Principal Executive Officer pursuant to 18 U.S.C. Section 1350Rules 13a-14(a) and 15d-14(a) promulgated under the Securities Exchange Act of 1934, as amended, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.

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Table of Contents

31.2*

Certification of Principal Financial and Accounting Officer pursuant to 18 U.S.C. Section 1350Rules 13a-14(a) and 15d-14(a) promulgated under the Securities Exchange Act of 1934, as amended, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.

32.1**

Certification of Principal Executive Officer and Principal Financial Officer, pursuant to 18 U.S.C. Section 1350 as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.

99.1**First Amendment to Purchase and Sale Agreement, effective August 16, 2017, between Norvin Austin Rehab LLC and Global Medical REIT Inc.

101.INS *

Inline XBRL Instance Document

101.SCH *

XBRL Taxonomy Schema

101.CAL *

XBRL Taxonomy Calculation Linkbase

101.DEF *

XBRL Taxonomy Definition Linkbase

101.LAB *

XBRL Taxonomy Label Linkbase

101.PRE *

XBRL Taxonomy Presentation Linkbase

104

Cover Page Interactive Data File (embedded within the Inline XBRL document)

*

*

Filed herewith

** Furnished herewith

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Table of Contents

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.

GLOBAL MEDICAL REIT INC.

Dated:

Date: November 9, 20176, 2020

By:

/s/Jeffrey M. Busch

Jeffrey M. Busch

Chief Executive Officer (Principal Executive Officer)

Dated:

Date: November 9, 20176, 2020

By:

/s/Robert J. Kiernan

Robert J. Kiernan

Chief Financial Officer (Principal Financial and Accounting Officer)

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EXHIBIT INDEX

3.1Articles of Incorporation of Global Medical REIT Inc. (incorporated herein by reference to Exhibit 3.1 to the Company’s Quarterly Report on Form 10-Q as filed with the Commission on April 22, 2014).
3.2Articles of Amendment to Articles of Incorporation filed with the Secretary of State of Maryland (incorporated herein by reference to Annex A to the Company’s Definitive Information Statement on Schedule 14C as filed with the Commission on October 3, 2014).
3.3Certificate of Correction of Articles of Incorporation of Global Medical REIT Inc. (incorporated herein by reference to Exhibit 3.3 to the Company’s Registration Statement on Form S-11/A as filed with the Commission on June 15, 2016).
3.4Certificate of Correction of Articles of Incorporation of Global Medical REIT Inc. (incorporated herein by reference to Exhibit 3.4 to the Company’s Registration Statement on Form S-11/A as filed with the Commission on June 15, 2016).
3.5Articles Supplementary for the 7.50% Series A Cumulative Redeemable Preferred Stock (incorporated herein by reference to Exhibit 3.1 to the Company’s Current Report on Form 8-K as filed with the Commission on September 14, 2017).
4.1Specimen of 7.50% Series A Cumulative Redeemable Preferred Stock Certificate (incorporated herein by reference to Exhibit 4.1 to the Company’s Current Report on Form 8-K as filed with the Commission on September 14, 2017).
10.1Purchase Agreement, effective July 5, 2017, between Norvin Austin Rehab LLC and Global Medical REIT Inc. (incorporated herein by reference to Exhibit 10.1 to the Company’s Current Report on Form 8-K as filed with the Commission on July 6, 2017).
10.2Lease Agreement, dated June 30, 2017, between SDB Partners, LLC and GMR Sherman, LLC. (incorporated herein by reference to Exhibit 10.2 to the Company’s Current Report on Form 8-K as filed with the Commission on July 6, 2017).
10.3Separation Agreement and General Release, dated August 20, 2017, between Inter-American Management LLC and David A. Young (incorporated herein by reference to Exhibit 10.1 to the Company’s Current Report on Form 8-K as filed with the Commission on August 21, 2017).
10.4Form of Consulting Agreement, to be dated September 19, 2017, between Inter-American Management LLC and David A. Young (incorporated herein by reference to Exhibit 10.2 to the Company’s Current Report on Form 8-K as filed with the Commission on August 21, 2017).
10.5First Amendment to Agreement of Limited Partnership of Global Medical REIT L.P. (incorporated herein by reference to Exhibit 10.1 to the Company’s Current Report on Form 8-K as filed with the Commission on September 14, 2017).
10.6Lease Agreement, dated September 17, 2010, between Prevarian Hospital Partners, LP and CTRH, LLC (incorporated herein by reference to Exhibit 10.1 to the Company’s Current Report on Form 8-K as filed with the Commission on September 29, 2017).
31.1*Certification of Principal Executive Officer pursuant to 18 U.S.C. Section 1350 as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
31.2*Certification of Principal Financial and Accounting Officer pursuant to 18 U.S.C. Section 1350 as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
32.1**Certification of Principal Executive Officer and Principal Financial Officer, pursuant to 18 U.S.C. Section 1350 as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
99.1**First Amendment to Purchase and Sale Agreement, effective August 16, 2017, between Norvin Austin Rehab LLC and Global Medical REIT Inc.
101.INS *XBRL Instance Document
101.SCH *XBRL Taxonomy Schema
101.CAL *XBRL Taxonomy Calculation Linkbase
101.DEF *XBRL Taxonomy Definition Linkbase
101.LAB *XBRL Taxonomy Label Linkbase
101.PRE *XBRL Taxonomy Presentation Linkbase

* Filed herewith

** Furnished herewith

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