UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549 
FORM 10-Q
     QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
 
For the quarterly period ended JuneSeptember 30, 2022
or
     TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
 
Commission File Number 1-16817
ALERISLIFE INC.
(Exact Name of Registrant as Specified in Its Charter)
  
Maryland04-3516029
(State or Other Jurisdiction of Incorporation or Organization)(IRS Employer Identification No.)
400 CentreTwo Newton Place, 255 Washington Street, Suite 230, Newton, Massachusetts 02458
(Address of Principal Executive Offices) (Zip Code) 

617-796-8387
(Registrant’s Telephone Number, Including Area Code):
Securities registered pursuant to Section 12(b) of the Act:
Title of Each ClassTrading Symbol(s)Name of Each Exchange on Which Registered
Common StockALRThe Nasdaq Stock Market LLC
 
Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes   No  

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes   No  

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act. 
Large accelerated filerAccelerated filer
Non-accelerated filerSmaller reporting company
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act)
Yes   No   

Number of registrant’s shares of common stock, $0.01 par value, outstanding as of July 29,October 28, 2022: 32,638,395.32,609,007.



ALERISLIFE INC.
FORM 10-Q
JuneSeptember 30, 2022
Table of Contents
 
Page
 
 
 
 
 
 
 
 
References in this Quarterly Report on Form 10-Q to the Company, AlerisLife, we, us or our include AlerisLife Inc. and its consolidated subsidiaries, unless otherwise expressly stated or the context indicates otherwise.

This Quarterly Report on Form 10-Q includes our registered trademarks, such as “Five Star Senior Living”, “Bridge to Rediscovery”, "Ageility Physical Therapy Solutions” and "Ageility" which are our property and are protected under applicable intellectual property laws. Our trademark application for "AlerisLife" is currently pending. Solely for convenience, these trademarks referred to in this Quarterly Report on Form 10-Q may appear without the TM symbol, but such references are not intended to indicate, in any way, that we will not assert, to the fullest extent under applicable law, our rights to these trademarks.





PART I. Financial Information
Item 1. Financial Statements
AlerisLife Inc.
Condensed Consolidated Balance Sheets
(dollars in thousands, except per share amounts)

June 30, 2022December 31, 2021 September 30, 2022December 31, 2021
ASSETSASSETS(unaudited) ASSETS(unaudited) 
Current assets:Current assets:Current assets:
Cash and cash equivalentsCash and cash equivalents$83,460 $66,987 Cash and cash equivalents$79,126 $66,987 
Restricted cash and cash equivalentsRestricted cash and cash equivalents21,902 24,970 Restricted cash and cash equivalents21,317 24,970 
Accounts receivable, netAccounts receivable, net8,816 9,244 Accounts receivable, net9,676 9,244 
Due from related personDue from related person50,368 41,664 Due from related person56,497 41,664 
Debt and equity investments, of which $7,086 and $7,609 are restricted, respectively16,381 19,535 
Debt and equity investments, of which $7,100 and $7,609 are restricted, respectivelyDebt and equity investments, of which $7,100 and $7,609 are restricted, respectively10,890 19,535 
Prepaid expenses and other current assetsPrepaid expenses and other current assets24,175 24,433 Prepaid expenses and other current assets21,817 24,433 
Total current assetsTotal current assets205,102 186,833 Total current assets199,323 186,833 
Property and equipment, netProperty and equipment, net160,791 159,843 Property and equipment, net162,785 159,843 
Operating lease right-of-use assetsOperating lease right-of-use assets6,004 9,197 Operating lease right-of-use assets5,796 9,197 
Finance lease right-of-use assetsFinance lease right-of-use assets3,005 3,467 Finance lease right-of-use assets2,773 3,467 
Restricted cash and cash equivalentsRestricted cash and cash equivalents974 982 Restricted cash and cash equivalents991 982 
Restricted debt and equity investmentsRestricted debt and equity investments3,198 3,873 Restricted debt and equity investments2,715 3,873 
Other long-term assetsOther long-term assets10,932 12,082 Other long-term assets8,155 12,082 
Total assetsTotal assets$390,006 $376,277 Total assets$382,538 $376,277 
LIABILITIES AND SHAREHOLDERS’ EQUITYLIABILITIES AND SHAREHOLDERS’ EQUITY  LIABILITIES AND SHAREHOLDERS’ EQUITY  
Current liabilities:Current liabilities:Current liabilities:
Accounts payableAccounts payable$14,969 $37,516 Accounts payable$16,367 $37,516 
Accrued expenses and other current liabilitiesAccrued expenses and other current liabilities38,297 31,488 Accrued expenses and other current liabilities44,861 31,488 
Accrued compensation and benefitsAccrued compensation and benefits33,080 34,295 Accrued compensation and benefits33,413 34,295 
Accrued self-insurance obligationsAccrued self-insurance obligations29,772 31,739 Accrued self-insurance obligations26,701 31,739 
Operating lease liabilitiesOperating lease liabilities419 699 Operating lease liabilities501 699 
Finance lease liabilitiesFinance lease liabilities1,182 872 Finance lease liabilities1,351 872 
Due to related personsDue to related persons3,206 3,879 Due to related persons2,500 3,879 
Current portion of debtCurrent portion of debt429 419 Current portion of debt437 419 
Total current liabilitiesTotal current liabilities121,354 140,907 Total current liabilities126,131 140,907 
Long-term liabilities:Long-term liabilities:  Long-term liabilities:  
Accrued self-insurance obligationsAccrued self-insurance obligations29,662 34,744 Accrued self-insurance obligations27,007 34,744 
Operating lease liabilitiesOperating lease liabilities6,083 9,366 Operating lease liabilities5,331 9,366 
Finance lease liabilitiesFinance lease liabilities2,588 3,050 Finance lease liabilities2,351 3,050 
Long-term debtLong-term debt67,072 6,364 Long-term debt67,161 6,364 
Other long-term liabilitiesOther long-term liabilities236 256 Other long-term liabilities227 256 
Total long-term liabilitiesTotal long-term liabilities105,641 53,780 Total long-term liabilities102,077 53,780 
Commitments and contingenciesCommitments and contingencies00Commitments and contingencies
Shareholders’ equity:Shareholders’ equity:  Shareholders’ equity:  
Common stock, par value $0.01: 75,000,000 shares authorized, 32,638,395 and 32,662,649 shares issued and outstanding, respectively326 327 
Common stock, par value $0.01: 75,000,000 shares authorized, 32,609,009 and 32,662,649 shares issued and outstanding, respectivelyCommon stock, par value $0.01: 75,000,000 shares authorized, 32,609,009 and 32,662,649 shares issued and outstanding, respectively326 327 
Additional paid-in-capitalAdditional paid-in-capital462,038 461,298 Additional paid-in-capital462,144 461,298 
Accumulated deficitAccumulated deficit(299,599)(281,064)Accumulated deficit(308,107)(281,064)
Accumulated other comprehensive income246 1,029 
Accumulated other comprehensive (loss) incomeAccumulated other comprehensive (loss) income(33)1,029 
Total shareholders’ equityTotal shareholders’ equity163,011 181,590 Total shareholders’ equity154,330 181,590 
Total liabilities and shareholders' equityTotal liabilities and shareholders' equity$390,006 $376,277 Total liabilities and shareholders' equity$382,538 $376,277 

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.
1


AlerisLife Inc.
Condensed Consolidated Statements of Operations
(amountsdollars in thousands, except per share amounts)thousands)
(unaudited)


Three Months Ended June 30,Six Months Ended June 30,Three Months Ended September 30,Nine Months Ended September 30,
2022202120222021 2022202120222021
REVENUESREVENUESREVENUES
Lifestyle servicesLifestyle services$14,645 $17,453 $28,784 $37,006 Lifestyle services$14,546 $15,382 $43,330 $52,388 
ResidentialResidential16,094 16,378 31,480 33,435 Residential17,514 16,320 48,994 49,755 
Residential management feesResidential management fees8,971 12,927 17,903 26,777 Residential management fees9,477 11,220 27,380 37,997 
Total management and operating revenuesTotal management and operating revenues39,710 46,758 78,167 97,218 Total management and operating revenues41,537 42,922 119,704 140,140 
Reimbursed community-level costs incurred on behalf of managed communitiesReimbursed community-level costs incurred on behalf of managed communities127,648 195,271 258,584 408,431 Reimbursed community-level costs incurred on behalf of managed communities137,768 177,231 396,352 585,662 
Other reimbursed expensesOther reimbursed expenses3,765 16,592 7,515 22,072 Other reimbursed expenses3,354 5,678 10,869 27,750 
Total revenuesTotal revenues171,123 258,621 344,266 527,721 Total revenues182,659 225,831 526,925 753,552 
Other operating incomeOther operating income— 42 7,795 Other operating income— 44 7,795 
OPERATING EXPENSESOPERATING EXPENSESOPERATING EXPENSES
Lifestyle services expensesLifestyle services expenses14,329 15,668 27,550 31,878 Lifestyle services expenses14,562 13,536 42,112 45,414 
Residential wages and benefitsResidential wages and benefits9,159 9,896 17,786 21,909 Residential wages and benefits10,156 8,547 27,942 30,456 
Other residential operating expensesOther residential operating expenses4,973 8,968 12,322 15,234 Other residential operating expenses5,804 7,184 18,126 22,418 
Community-level costs incurred on behalf of managed communitiesCommunity-level costs incurred on behalf of managed communities127,648 195,271 258,584 408,431 Community-level costs incurred on behalf of managed communities137,768 177,231 396,352 585,662 
General and administrativeGeneral and administrative17,844 22,748 36,190 45,139 General and administrative17,015 21,817 53,205 66,956 
Restructuring expensesRestructuring expenses528 15,389 374 15,639 Restructuring expenses1,570 1,220 1,944 16,859 
Depreciation and amortizationDepreciation and amortization3,284 2,989 6,447 5,929 Depreciation and amortization3,088 2,983 9,535 8,912 
Total operating expensesTotal operating expenses177,765 270,929 359,253 544,159 Total operating expenses189,963 232,518 549,216 776,677 
Operating lossOperating loss(6,642)(12,306)(14,945)(8,643)Operating loss(7,302)(6,687)(22,247)(15,330)
Interest, dividend and other incomeInterest, dividend and other income129 76 209 160 Interest, dividend and other income225 84 434 244 
Interest and other expenseInterest and other expense(1,251)(409)(2,283)(872)Interest and other expense(1,474)(507)(3,757)(1,379)
Unrealized (loss) gain on equity investmentsUnrealized (loss) gain on equity investments(1,050)398 (1,682)533 Unrealized (loss) gain on equity investments(1,997)22 (3,679)555 
Realized gain (loss) on sale of debt and equity investments— 97 (45)193 
Gain on termination of lease— — 279 — 
Realized gain on sale of debt and equity investmentsRealized gain on sale of debt and equity investments1,573 — 1,528 193 
Gain (loss) on termination of leaseGain (loss) on termination of lease498 (3,277)777 (3,277)
Loss before income taxesLoss before income taxes(8,814)(12,144)(18,467)(8,629)Loss before income taxes(8,477)(10,365)(26,944)(18,994)
Benefit (provision) for income taxes(158)(68)(358)
(Provision) benefit for income taxes(Provision) benefit for income taxes(31)164 (99)(194)
Net lossNet loss$(8,805)$(12,302)$(18,535)$(8,987)Net loss$(8,508)$(10,201)$(27,043)$(19,188)
Weighted average shares outstanding—basic and dilutedWeighted average shares outstanding—basic and diluted31,810 31,552 31,799 31,541 Weighted average shares outstanding—basic and diluted31,875 31,618 31,825 31,567 
Net loss per share—basic and dilutedNet loss per share—basic and diluted$(0.28)$(0.39)$(0.58)$(0.28)Net loss per share—basic and diluted$(0.27)$(0.32)$(0.85)$(0.61)
 
The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.







2


AlerisLife Inc.
Condensed Consolidated Statements of Comprehensive Loss
(dollars in thousands)
(unaudited)


 Three Months Ended June 30,Six Months Ended June 30,
 2022202120222021
Net loss$(8,805)$(12,302)$(18,535)$(8,987)
Other comprehensive (loss) income:
Unrealized (loss) gain on debt investments, net of tax of $0(290)44 (784)(250)
Realized (gain) loss on debt investments reclassified and included in net loss, net of tax of $0(2)(18)(18)
Other comprehensive (loss) income(292)26 (783)(268)
Comprehensive loss$(9,097)$(12,276)$(19,318)$(9,255)

 Three Months Ended September 30,Nine Months Ended September 30,
 2022202120222021
Net loss$(8,508)$(10,201)$(27,043)$(19,188)
Other comprehensive loss:
Unrealized loss on debt investments, net of tax of $0(282)(67)(1,066)(317)
Realized loss (gain) on debt investments reclassified and included in net loss, net of tax of $0— (18)
Other comprehensive loss(279)(67)(1,062)(335)
Comprehensive loss$(8,787)$(10,268)$(28,105)$(19,523)

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.
3


AlerisLife Inc.
Condensed Consolidated Statements of Shareholders’ Equity
(dollars in thousands)
(unaudited)


Three and Six Months Ended June 30, 2022Three and Nine Months Ended September 30, 2022
Number of SharesCommon StockAdditional Paid-in CapitalAccumulated DeficitAccumulated Other Comprehensive IncomeTotal Shareholders' EquityNumber of SharesCommon StockAdditional Paid-in CapitalAccumulated DeficitAccumulated Other Comprehensive Income (Loss)Total Shareholders' Equity
Balance at January 1, 2022Balance at January 1, 202232,662,649 $327 $461,298 $(281,064)$1,029 $181,590 Balance at January 1, 202232,662,649 $327 $461,298 $(281,064)$1,029 $181,590 
Net lossNet loss— — — (9,730)— (9,730)Net loss— — — (9,730)— (9,730)
Unrealized loss on debt investments, net of taxUnrealized loss on debt investments, net of tax— — — — (494)(494)Unrealized loss on debt investments, net of tax— — — — (494)(494)
Realized loss on debt investments reclassified and included in net loss, net of taxRealized loss on debt investments reclassified and included in net loss, net of tax— — — — Realized loss on debt investments reclassified and included in net loss, net of tax— — — — 
Grants under share award plan and share-based compensationGrants under share award plan and share-based compensation— — 193 — — 193 Grants under share award plan and share-based compensation— — 193 — — 193 
Repurchases and forfeitures under share award planRepurchases and forfeitures under share award plan(111,754)(1)(23)— — (24)Repurchases and forfeitures under share award plan(111,754)(1)(23)— — (24)
Balance at March 31, 2022Balance at March 31, 202232,550,895 $326 $461,468 $(290,794)$538 $171,538 Balance at March 31, 202232,550,895 326 461,468 (290,794)538 171,538 
Net lossNet loss— — — (8,805)— (8,805)Net loss— — — (8,805)— (8,805)
Unrealized loss on debt investments, net of taxUnrealized loss on debt investments, net of tax— — — — (290)(290)Unrealized loss on debt investments, net of tax— — — — (290)(290)
Realized gain on debt investments reclassified and included in net loss, net of taxRealized gain on debt investments reclassified and included in net loss, net of tax— — — — (2)(2)Realized gain on debt investments reclassified and included in net loss, net of tax— — — — (2)(2)
Grants under share award plan and share-based compensationGrants under share award plan and share-based compensation87,500 — 570 — — 570 Grants under share award plan and share-based compensation87,500 — 570 — — 570 
Balance at June 30, 2022Balance at June 30, 202232,638,395 $326 $462,038 $(299,599)$246 $163,011 Balance at June 30, 202232,638,395 326 462,038 (299,599)246 163,011 
Net lossNet loss— — — (8,508)— (8,508)
Unrealized loss on debt investments, net of taxUnrealized loss on debt investments, net of tax— — — — (282)(282)
Realized loss on debt investments reclassified and included in net loss, net of taxRealized loss on debt investments reclassified and included in net loss, net of tax— — — — 
Grants under share award plan and share-based compensationGrants under share award plan and share-based compensation— — 123 — — 123 
Repurchases and forfeitures under share award planRepurchases and forfeitures under share award plan(29,386)— (17)— — (17)
Balance at September 30, 2022Balance at September 30, 202232,609,009 $326 $462,144 $(308,107)$(33)$154,330 









4


AlerisLife Inc.
Condensed Consolidated Statements of Shareholders’ Equity
(dollars in thousands)
(unaudited)

Three and Six Months Ended June 30, 2021Three and Nine Months Ended September 30, 2021
Number of SharesCommon StockAdditional Paid-in CapitalAccumulated DeficitAccumulated Other Comprehensive IncomeTotal Shareholders' EquityNumber of SharesCommon StockAdditional Paid-in CapitalAccumulated DeficitAccumulated Other Comprehensive IncomeTotal Shareholders' Equity
Balance at January 1, 2021Balance at January 1, 202131,679,207 $317 $460,038 $(251,139)$1,316 $210,532 Balance at January 1, 202131,679,207 $317 $460,038 $(251,139)$1,316 $210,532 
Net incomeNet income— — — 3,315 — 3,315 Net income— — — 3,315 — 3,315 
Unrealized loss on debt investments, net of taxUnrealized loss on debt investments, net of tax— — — — (294)(294)Unrealized loss on debt investments, net of tax— — — — (294)(294)
Grants under share award plan and share-based compensationGrants under share award plan and share-based compensation— — 76 — — 76 Grants under share award plan and share-based compensation— — 76 — — 76 
Repurchases and forfeitures under share award planRepurchases and forfeitures under share award plan(2,778)— (1)— — (1)Repurchases and forfeitures under share award plan(2,778)— (1)— — (1)
Balance at March 31, 2021Balance at March 31, 202131,676,429 317 460,113 (247,824)1,022 213,628 Balance at March 31, 202131,676,429 317 460,113 (247,824)1,022 213,628 
Net lossNet loss— — — (12,302)— (12,302)Net loss— — — (12,302)— (12,302)
Unrealized gain on debt investments, net of taxUnrealized gain on debt investments, net of tax— — — — 44 44 Unrealized gain on debt investments, net of tax— — — — 44 44 
Realized gain on debt investments reclassified and included in net loss, net of taxRealized gain on debt investments reclassified and included in net loss, net of tax— — — — (18)(18)Realized gain on debt investments reclassified and included in net loss, net of tax— — — — (18)(18)
Grants under share award plan and share-based compensationGrants under share award plan and share-based compensation87,500 637 — — 638 Grants under share award plan and share-based compensation87,500 637 — — 638 
Repurchases and forfeitures under share award planRepurchases and forfeitures under share award plan(2,801)— (13)(3)— (16)Repurchases and forfeitures under share award plan(2,801)— (13)(3)— (16)
Balance at June 30, 2021Balance at June 30, 202131,761,128 $318 $460,737 $(260,129)$1,048 $201,974 Balance at June 30, 202131,761,128 318 460,737 (260,129)1,048 201,974 
Net lossNet loss— — — (10,201)— (10,201)
Unrealized loss on debt investments, net of taxUnrealized loss on debt investments, net of tax— — — — (67)(67)
Grants under share award plan and share-based compensationGrants under share award plan and share-based compensation— — 76 — — 76 
Repurchases and forfeitures under share award planRepurchases and forfeitures under share award plan(7,644)— (15)— — (15)
Balance at September 30, 2021Balance at September 30, 202131,753,484 $318 $460,798 $(270,330)$981 $191,767 


The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.
5


AlerisLife Inc.
Condensed Consolidated Statements of Cash Flows
(dollars in thousands)
(unaudited)

Six Months Ended June 30, Nine Months Ended September 30,
20222021 20222021
CASH FLOW FROM OPERATING ACTIVITIES:CASH FLOW FROM OPERATING ACTIVITIES:  CASH FLOW FROM OPERATING ACTIVITIES:  
Net lossNet loss$(18,535)$(8,987)Net loss$(27,043)$(19,188)
Adjustments to reconcile net loss to net cash (used in) provided by operating activities:Adjustments to reconcile net loss to net cash (used in) provided by operating activities:  Adjustments to reconcile net loss to net cash (used in) provided by operating activities:  
Depreciation and amortizationDepreciation and amortization6,447 5,929 Depreciation and amortization9,535 8,912 
Unrealized loss (gain) on equity investmentsUnrealized loss (gain) on equity investments1,682 (533)Unrealized loss (gain) on equity investments3,679 (555)
Realized loss (gain) on sale of debt and equity investments45 (193)
Realized gain on sale of debt and equity investmentsRealized gain on sale of debt and equity investments(1,528)(193)
Gain on termination of leaseGain on termination of lease(777)(408)
Long-lived asset impairmentLong-lived asset impairment— 890 Long-lived asset impairment24 890 
Share-based compensationShare-based compensation739 700 Share-based compensation845 761 
Provision for losses on accounts receivablesProvision for losses on accounts receivables269 760 Provision for losses on accounts receivables438 1,432 
Other non-cash expense adjustments, net46 321 
Other non-cash (income) expense adjustments, netOther non-cash (income) expense adjustments, net571 652 
Changes in assets and liabilities:Changes in assets and liabilities:  Changes in assets and liabilities:  
Accounts receivableAccounts receivable159 (692)Accounts receivable(870)(975)
Due from related personDue from related person(8,704)15,988 Due from related person(14,833)63,142 
Prepaid expenses and other current assets934 5,505 
Prepaid expenses and other current and long term assetsPrepaid expenses and other current and long term assets6,076 2,175 
Accounts payableAccounts payable(19,863)(1,621)Accounts payable(18,142)(7,014)
Accrued expenses and other current liabilitiesAccrued expenses and other current liabilities6,891 (9,804)Accrued expenses and other current liabilities12,313 (10,387)
Accrued compensation and benefitsAccrued compensation and benefits(1,215)10,177 Accrued compensation and benefits(882)(32,471)
Due to related personsDue to related persons(673)(1,948)Due to related persons(1,379)(3,172)
Other current and long term liabilitiesOther current and long term liabilities(6,999)1,388 Other current and long term liabilities(12,670)(1,801)
Net cash (used in) provided by operating activitiesNet cash (used in) provided by operating activities(38,777)17,880 Net cash (used in) provided by operating activities(44,643)1,800 
CASH FLOW FROM INVESTING ACTIVITIES:CASH FLOW FROM INVESTING ACTIVITIES:  CASH FLOW FROM INVESTING ACTIVITIES:  
Acquisition of property and equipmentAcquisition of property and equipment(9,147)(4,466)Acquisition of property and equipment(13,201)(7,350)
Purchases of debt and equity investmentsPurchases of debt and equity investments— (231)Purchases of debt and equity investments(1,334)(231)
Proceeds from sale of debt and equity investmentsProceeds from sale of debt and equity investments1,226 2,035 Proceeds from sale of debt and equity investments7,824 2,035 
Net cash used in investing activitiesNet cash used in investing activities(7,921)(2,662)Net cash used in investing activities(6,711)(5,546)
CASH FLOW FROM FINANCING ACTIVITIES:CASH FLOW FROM FINANCING ACTIVITIES:  CASH FLOW FROM FINANCING ACTIVITIES:  
Net proceeds from borrowingsNet proceeds from borrowings60,563 — Net proceeds from borrowings60,563 — 
Repayments of borrowingsRepayments of borrowings(217)(204)Repayments of borrowings(327)(308)
Repayments of finance lease principalRepayments of finance lease principal(251)(397)Repayments of finance lease principal(387)(600)
Payment of employee tax obligations on withheld sharesPayment of employee tax obligations on withheld shares— (3)Payment of employee tax obligations on withheld shares— (3)
Net cash provided by (used in) financing activitiesNet cash provided by (used in) financing activities60,095 (604)Net cash provided by (used in) financing activities59,849 (911)
Increase in cash and cash equivalents and restricted cash and cash equivalents13,397 14,614 
Increase (decrease) in cash and cash equivalents and restricted cash and cash equivalentsIncrease (decrease) in cash and cash equivalents and restricted cash and cash equivalents8,495 (4,657)
Cash and cash equivalents and restricted cash and cash equivalents at beginning of periodCash and cash equivalents and restricted cash and cash equivalents at beginning of period92,939 109,597 Cash and cash equivalents and restricted cash and cash equivalents at beginning of period92,939 109,597 
Cash and cash equivalents and restricted cash and cash equivalents at end of periodCash and cash equivalents and restricted cash and cash equivalents at end of period$106,336 $124,211 Cash and cash equivalents and restricted cash and cash equivalents at end of period$101,434 $104,940 
Reconciliation of cash and cash equivalents and restricted cash and cash equivalents:Reconciliation of cash and cash equivalents and restricted cash and cash equivalents:Reconciliation of cash and cash equivalents and restricted cash and cash equivalents:
Cash and cash equivalentsCash and cash equivalents$83,460 $99,270 Cash and cash equivalents$79,126 $80,188 
Current restricted cash and cash equivalentsCurrent restricted cash and cash equivalents21,902 23,707 Current restricted cash and cash equivalents21,317 23,615 
Other restricted cash and cash equivalentsOther restricted cash and cash equivalents974 1,234 Other restricted cash and cash equivalents991 1,137 
Cash and cash equivalents and restricted cash and cash equivalents at end of periodCash and cash equivalents and restricted cash and cash equivalents at end of period$106,336 $124,211 Cash and cash equivalents and restricted cash and cash equivalents at end of period$101,434 $104,940 
Supplemental cash flow information:Supplemental cash flow information:  Supplemental cash flow information:  
Interest paidInterest paid$1,635 $403 Interest paid$2,863 $597 
Income taxes paid, netIncome taxes paid, net49 364 Income taxes paid, net49 436 
Operating lease paymentsOperating lease payments513 1,948 Operating lease payments724 6,388 
Financing lease interest paymentsFinancing lease interest payments142 570 Financing lease interest payments207 255 
Non-cash investing and financing activities:Non-cash investing and financing activities:Non-cash investing and financing activities:
Decrease (increase) in accrued capital$2,757 $(200)
Decrease in accrued capitalDecrease in accrued capital$1,935 $558 
Right-of-use assets obtained in exchange for operating lease liabilitiesRight-of-use assets obtained in exchange for operating lease liabilities(2,958)9,746 Right-of-use assets obtained in exchange for operating lease liabilities(2,991)9,746 

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.
6


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)

1. Basis of Presentation and Organization

General. AlerisLife Inc., collectively with its consolidated subsidiaries, the Company, we, us or our, is a holding company incorporated in Maryland. Substantially all of our business is conducted by our 2two segments: (i) our residential segment through our Five Star Senior Living, or Five Star, brand and (ii) our lifestyle services segment primarily through our Ageility Physical Therapy Solutions and Ageility Fitness, or collectively Ageility, brands, as well as Windsong Home Health. The accompanying condensed consolidated financial statements of the Company are unaudited. Certain information and disclosures required by the rules and regulations of the Securities and Exchange Commission, or SEC, and the U.S. Generally Accepted Accounting Principles, or GAAP, for complete financial statements have been condensed or omitted pursuant to SEC rules and regulations related to interim financial statements. We believe the disclosures made are adequate to make the information presented not misleading.

As of JuneSeptember 30, 2022, through our residential segment, we owned and operated or managed, 140 senior living communities located in 28 states with 19,973 living units, including 10,46010,422 independent living apartments and 9,5139,551 assisted living suites, which includes 1,817 Bridge to Rediscovery memory care units. We managed 120 of these senior living communities (17,886(17,889 living units) for Diversified Healthcare Trust, or DHC, and owned 20 of these senior living communities (2,087(2,084 living units). The foregoing numbers exclude living units categorized as out of service.

Our lifestyle services segment provides a comprehensive suite of lifestyle services including Ageility rehabilitation and fitness, Windsong Home Health and other home based, concierge services at senior living communities we own and operate or manage as well as at unaffiliated senior living communities. As of JuneSeptember 30, 2022, Ageility operated 10eight inpatient rehabilitation clinics in senior living communities owned by DHC that are not operated by Five Star. As of JuneSeptember 30, 2022, Ageility operated 202203 outpatient rehabilitation locations, of which 108109 were located at Five Star operated senior living communities and 94 were located within senior living communities not operated by Five Star.

The accompanying financial statements should be read in conjunction with the financial statements and notes contained in our Annual Report on Form 10-K for the year ended December 31, 2021, or Annual Report. In the opinion of our management, all adjustments, which include only normal recurring adjustments considered necessary for a fair presentation, have been included. All intercompany transactions and balances with or among our consolidated subsidiaries have been eliminated. Our operating results for interim periods are not necessarily indicative of the results that may be expected for the full year.

2. Summary of Significant Accounting Policies

Estimates and Assumptions. The preparation of these condensed consolidated financial statements in conformity with GAAP requires us to make estimates and assumptions that may affect the amounts reported in these condensed consolidated financial statements and related notes. Significant estimates in our condensed consolidated financial statements relate to revenue recognition, including contractual allowances and implicit price concessions, recoverability of long-lived assets, self-insurance reserves and estimates concerning our provision for income taxes or valuation allowance related to deferred tax assets.

Our actual results could differ from our estimates. We periodically review estimates and assumptions, and we reflect the effects of changes, if any, in the condensed consolidated financial statements in the period that they are determined.

There have been no changes to our significant accounting policies disclosed in our Annual Report. See Note 2 to our Consolidated Financial Statements included in Part IV, Item 15 of our Annual Report.

Recently Issued Accounting Pronouncements Not Yet Adopted. In June 2016, the Financial Accounting Standards Board, or FASB, issued Accounting Standards Update, or ASU, No. 2016-13, Financial Instruments-Credit Losses (Topic 326), which requires a financial asset or a group of financial assets measured at amortized cost basis to be presented at the net amount expected to be collected. This ASU eliminates the probable initial recognition threshold and instead requires reflection of an entity’s current estimate of all expected credit losses. In addition, this ASU amends the current other-than-temporary impairment model for available for sale debt securities. The length of time that the fair value of an available for sale debt security has been below the amortized cost will no longer impact the determination of whether a credit loss exists and credit losses will now be limited to the difference between a security’s amortized cost basis and its fair value. In November 2018, the
7

AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
FASB issued ASU No. 2018-19, Codification Improvements to Topic 326, Financial Instruments-Credit Losses, which amends the transition and effective date for nonpublic entities and smaller reporting companies, such as us, and clarifies that receivables arising from operating leases are not in the scope of this ASU. In November 2019, the FASB issued ASU No. 2019-11, Codification Improvements to Topic 326, Financial
7

AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
Instruments-Credit Losses, which clarifies guidance around how to report expected recoveries. Entities will apply the provisions of the ASU as a cumulative-effect adjustment to retained earnings as of the beginning of the first reporting period in which the guidance is effective. This ASU is effective for smaller reporting companies, like us, for reporting periods beginning after December 15, 2022. We are currently assessing the potential impact thatdo not expect the adoption of this ASU (and the related clarifying guidance issued by the FASB) willto have a material impact on our condensed consolidated financial statements.

In June 2022, the FASB issued ASU No. 2022-03, Fair Value Measurement (Topic 820) - Fair Value Measurement of Equity Securities Subject to Contractual Sale Restrictions, which clarifies that a contractual sale restriction prohibiting the sale of an equity security is a characteristic of the reporting entity holding the equity security and is not included in the equity security's unit of account. Accordingly, an entity should not consider the contractual sale restriction when measuring the equity security’s fair value. In addition, the ASU prohibits an entity from recognizing a contractual sale restriction as a separate unit of account. This ASU will be effective for fiscal years beginning after December 15, 2023, and interim periods within those fiscal years, with early adoption permitted. We are currently assessing the potential impact that the adoption of this ASU will have on our condensed consolidated financial statements.

3. Revenue and Other Operating Income

The following tables present revenue from contracts by segment with customers disaggregated by type of payer, as we believe that best depicts how the nature, amount, timing and uncertainty of our revenue and cash flows are affected by economic factors:

Three Months Ended June 30, 2022Three Months Ended September 30, 2022
ResidentialLifestyle ServicesTotalResidentialLifestyle ServicesTotal
Private payerPrivate payer$15,819 $141 $15,960 Private payer$17,263 $134 $17,397 
Medicare and Medicaid programsMedicare and Medicaid programs257 9,562 9,819 Medicare and Medicaid programs242 9,795 10,037 
Other third-party payer programsOther third-party payer programs18 4,942 4,960 Other third-party payer programs4,617 4,626 
Residential management feesResidential management fees8,971 (1)— 8,971 Residential management fees9,477 (1)— 9,477 
Reimbursed community-level costs incurred on behalf of managed communitiesReimbursed community-level costs incurred on behalf of managed communities127,648 (1)— 127,648 Reimbursed community-level costs incurred on behalf of managed communities137,768 (1)— 137,768 
Other reimbursed expensesOther reimbursed expenses3,765 (1) (2)— 3,765 Other reimbursed expenses3,354 (1)— 3,354 
Total revenuesTotal revenues$156,478 $14,645 $171,123 Total revenues$168,113 $14,546 $182,659 

(1)    Represents separate revenue sources earned from DHC; see Note 4 for discussion of Segment Information.

Three Months Ended September 30, 2021
ResidentialLifestyle ServicesTotal
Private payer$16,032 $293 $16,325 
Medicare and Medicaid programs288 10,073 10,361 
Other third-party payer programs— 5,016 5,016 
Residential management fees11,220 (1)— 11,220 
Reimbursed community-level costs incurred on behalf of managed communities177,231 (1)— 177,231 
Other reimbursed expenses5,678 (1) (2)— 5,678 
Total revenues$210,449 $15,382 $225,831 

(1)    Represents separate revenue sources earned from DHC; see Note 4 for discussion of Segment Information.
(2)    Includes $474 of restructuring expenses reimbursed by DHC, which are recognized as both income and expense, in the three months ended June 30, 2022.

Three Months Ended June 30, 2021
ResidentialLifestyle ServicesTotal
Private payer$16,116 $255 $16,371 
Medicare and Medicaid programs262 9,811 10,073 
Other third-party payer programs— 7,387 7,387 
Residential management fees12,927 (1)— 12,927 
Reimbursed community-level costs incurred on behalf of managed communities195,271 (1)— 195,271 
Other reimbursed expenses16,592 (1) (2)— 16,592 
Total revenues$241,168 $17,453 $258,621 

(1)    Represents separate revenue sources earned from DHC; see Note 4 for discussion of Segment Information.
(2)    Includes $11,531$813 of restructuring expenses reimbursed by DHC, which are recognized as both income and expense, in the three months ended JuneSeptember 30, 2021.


8


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
Six Months Ended June 30, 2022Nine Months Ended September 30, 2022
ResidentialLifestyle ServicesTotalResidentialLifestyle ServicesTotal
Private payerPrivate payer$30,929 $235 $31,164 Private payer$48,192 $369 $48,561 
Medicare and Medicaid programsMedicare and Medicaid programs510 18,803 19,313 Medicare and Medicaid programs752 28,598 29,350 
Other third-party payer programsOther third-party payer programs41 9,746 9,787 Other third-party payer programs50 14,363 14,413 
Residential management feesResidential management fees17,903 (1)— 17,903 Residential management fees27,380 (1)— 27,380 
Reimbursed community-level costs incurred on behalf of managed communitiesReimbursed community-level costs incurred on behalf of managed communities258,584 (1)— 258,584 Reimbursed community-level costs incurred on behalf of managed communities396,352 (1)— 396,352 
Other reimbursed expensesOther reimbursed expenses7,515 (1) (2)— 7,515 Other reimbursed expenses10,869 (1) (2)— 10,869 
Total revenuesTotal revenues$315,482 $28,784 $344,266 Total revenues$483,595 $43,330 $526,925 

(1)    Represents separate revenue sources earned from DHC; see Note 4 for discussion of Segment Information.
(2)    Includes $474$476 of restructuring expenses reimbursed by DHC, which are recognized as both income and expense, in the sixnine months ended JuneSeptember 30, 2022.

Six Months Ended June 30, 2021Nine Months Ended September 30, 2021
ResidentialLifestyle ServicesTotalResidentialLifestyle ServicesTotal
Private payerPrivate payer$32,903 $512 $33,415 Private payer$48,935 $805 $49,740 
Medicare and Medicaid programsMedicare and Medicaid programs532 21,360 21,892 Medicare and Medicaid programs820 31,433 32,253 
Other third-party payer programsOther third-party payer programs— 15,134 15,134 Other third-party payer programs— 20,150 20,150 
Residential management feesResidential management fees26,777 (1)— 26,777 Residential management fees37,997 (1)— 37,997 
Reimbursed community-level costs incurred on behalf of managed communitiesReimbursed community-level costs incurred on behalf of managed communities408,431 (1)— 408,431 Reimbursed community-level costs incurred on behalf of managed communities585,662 (1)— 585,662 
Other reimbursed expensesOther reimbursed expenses22,072 (1) (2)— 22,072 Other reimbursed expenses27,750 (1) (2)— 27,750 
Total revenuesTotal revenues$490,715 $37,006 $527,721 Total revenues$701,164 $52,388 $753,552 

(1)    Represents separate revenue sources earned from DHC; see Note 4 for discussion of Segment Information.
(2)    Includes $11,531$12,344 of restructuring expenses reimbursed by DHC, which are recognized as both income and expense, in the sixnine months ended JuneSeptember 30, 2021.

Other operating income. On March 27, 2020, the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, was signed into law. Under the CARES Act, the U.S. Department of Health and Human Services, or HHS, established the Provider Relief Fund. The Provider Relief Fund was further supplemented on December 27, 2020 by the Consolidated Appropriations Act, 2021. Retention and use of the funds received under the CARES Act are subject to certain terms and conditions, including certain reporting requirements. Other operating income includes income recognized for funds we have received pursuant to the Provider Relief Fund of the CARES Act for which we have determined that we were in compliance with the terms and conditions of the Provider Relief Fund of the CARES Act and other government grants. We recognize other operating income in our condensed consolidated statements of operations to the extent we estimate we have COVID-19 incurred losses or related costs for which provisions of the CARES Act is intended to compensate. The amount of income we recognize for these estimated losses and costs is limited to the amount of funds we received during the period in which the estimated losses and costs were recognized or incurred or, if funds were received subsequently, the period in which the funds were received. We received and recognized other operating income of $2 related to state programs for the three months ended JuneSeptember 30, 2021.2022. For the three months ended JuneSeptember 30, 2022,2021, no other operating income was received or recognized. We received and recognized other operating income of $42$44 and $7,795 for the sixnine months ended JuneSeptember 30, 2022 and 2021, respectively. For the sixnine months ended JuneSeptember 30, 2022, other operating income related to state programs. For the sixnine months ended JuneSeptember 30, 2021,$7,724 $7,724 related to Phase 3 distributions and $71 related to state programs.

4. Segment Information

We do not allocate assets to operating segments and, therefore, no asset information is provided for reportable segments. Certain of our general and administrative expenses incurred at our corporate office are deemed centralized services and allocated amongst operating segments. Centralized services are largely determined by job function and allocated by percentage of each community's and clinic's gross revenues. Results of operations and selected financial information by reportable segment and the reconciliation to the condensed consolidated financial statements are as follows:

9


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
Three Months Ended June 30, 2022Three Months Ended September 30, 2022
Residential(1)
Lifestyle Services
Corporate and Other(2)
TotalResidentialLifestyle Services
Corporate and Other(1)
Total
RevenuesRevenues$156,478 $14,645 $— $171,123 Revenues$168,113 $14,546 $— $182,659 
Other operating incomeOther operating income— — 
Operating expensesOperating expenses147,769 14,438 15,558 177,765 Operating expenses159,451 14,672 15,840 189,963 
Operating income (loss)Operating income (loss)8,709 207 (15,558)(6,642)Operating income (loss)8,664 (126)(15,840)(7,302)
Allocated corporate and other costsAllocated corporate and other costs(10,491)(805)11,296 — Allocated corporate and other costs(8,885)(654)9,539 — 
Other loss, netOther loss, net(1,066)— (1,106)(2,172)Other loss, net(400)— (775)(1,175)
Loss before income taxesLoss before income taxes(2,848)(598)(5,368)(8,814)Loss before income taxes(621)(780)(7,076)(8,477)
Benefit for income taxes— — 
Provision for income taxesProvision for income taxes— — (31)(31)
Net lossNet loss$(2,848)$(598)$(5,359)$(8,805)Net loss$(621)$(780)$(7,107)$(8,508)

(1)    As more fully described in Note 17, the corporate and other segment recognized $1,568 of restructuring expenses in the three months ended September 30, 2022.

Three Months Ended September 30, 2021
Residential(1)
Lifestyle Services(2)
Corporate and Other(3)
Total
Revenues$210,449 $15,382 $— $225,831 
Operating expenses200,570 13,349 18,599 232,518 
Operating income (loss)9,879 2,033 (18,599)(6,687)
Allocated corporate and other costs(10,388)(770)11,158 — 
Other loss, net(3,202)— (476)(3,678)
(Loss) income before income taxes(3,711)1,263 (7,917)(10,365)
Benefit for income taxes— — 164 164 
Net (loss) income$(3,711)$1,263 $(7,753)$(10,201)

(1)    As more fully described in Note 17, the residential segment recognized $474$813 of restructuring expenses that were reimbursed by DHC, which are recognized as both income and expense, in the three months ended JuneSeptember 30, 2021.
(2)    As more fully described in Note 17, the lifestyle services segment recognized $(310) of restructuring expenses in the three months ended September 30, 2021.
(3)    As more fully described in Note 17, the corporate and other segment recognized $717 of restructuring expenses in the three months ended September 30, 2021.

Nine Months Ended September 30, 2022
Residential(1)
Lifestyle Services
Corporate and Other(2)
Total
Revenues$483,595 $43,330 $— $526,925 
Other operating income44 — — 44 
Operating expenses460,111 42,444 46,661 549,216 
Operating income (loss)23,528 886 (46,661)(22,247)
Allocated corporate and other costs(25,566)(2,166)27,732 — 
Other loss, net(2,179)— (2,518)(4,697)
Loss before income taxes(4,217)(1,280)(21,447)(26,944)
Provision for income taxes— — (99)(99)
Net loss$(4,217)$(1,280)$(21,546)$(27,043)

(1)    As more fully described in Note 17, the residential segment recognized $476 of restructuring expenses that were reimbursed by DHC, which are recognized as both income and expense, in the nine months ended September 30, 2022.
(2)    As more fully described in Note 17, the corporate and other segment recognized $54 of restructuring expenses in the three months ended June 30, 2022.

Three Months Ended June 30, 2021
Residential(1)
Lifestyle Services(2)
Corporate and Other(3)
Total
Revenues$241,168 $17,453 $— $258,621 
Other operating income— — 
Operating expenses232,370 17,517 21,042 270,929 
Operating income (loss)8,800 (64)(21,042)(12,306)
Allocated corporate and other costs(11,766)(873)12,639 — 
Other (loss) income, net(119)— 281 162 
Loss before income taxes(3,085)(937)(8,122)(12,144)
Provision for income taxes— — (158)(158)
Net loss$(3,085)$(937)$(8,280)$(12,302)

(1)    As more fully described in Note 17, the residential segment recognized $11,531 of restructuring expenses that were reimbursed by DHC, which are recognized as both income and expense, in the three months ended June 30, 2021.
(2)    As more fully described in Note 17, the lifestyle services segment recognized $1,720 of restructuring expenses in the three months ended June 30, 2021.
(3)    As more fully described in Note 17, the corporate and other segment recognized $2,138 of restructuring expenses in the three months ended June 30, 2021.

Six Months Ended June 30, 2022
Residential(1)
Lifestyle Services
Corporate and Other(2)
Total
Revenues$315,482 $28,784 $— $344,266 
Other operating income42 — — 42 
Operating expenses300,660 27,772 30,821 359,253 
Operating income (loss)14,864 1,012 (30,821)(14,945)
Allocated corporate and other costs(16,681)(1,512)18,193 — 
Other loss, net(1,779)— (1,743)(3,522)
Loss before income taxes(3,596)(500)(14,371)(18,467)
Provision for income taxes— — (68)(68)
Net loss$(3,596)$(500)$(14,439)$(18,535)

(1)    As more fully described in Note 17, the residential segment recognized $474 of restructuring expenses that were reimbursed by DHC, which are recognized as both income and expense, in the six months ended June 30, 2022.
(2)    As more fully described in Note 17, the corporate and other segment recognized $(100)$1,468 of restructuring expenses in the sixnine months ended JuneSeptember 30, 2022.

10


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
Six Months Ended June 30, 2021Nine Months Ended September 30, 2021
Residential(1)
Lifestyle Services(2)
Corporate and Other(3)
Total
Residential(1)
Lifestyle Services(2)
Corporate and Other(3)
Total
RevenuesRevenues$490,715 $37,006 $— $527,721 Revenues$701,164 $52,388 $— $753,552 
Other operating incomeOther operating income7,776 19 — 7,795 Other operating income7,776 19 — 7,795 
Operating expensesOperating expenses470,327 33,855 39,977 544,159 Operating expenses671,991 47,204 57,482 776,677 
Operating income (loss)Operating income (loss)28,164 3,170 (39,977)(8,643)Operating income (loss)36,949 5,203 (57,482)(15,330)
Allocated corporate and other costsAllocated corporate and other costs(24,423)(1,851)26,274 — Allocated corporate and other costs(34,811)(2,621)37,432 — 
Other (loss) income, net(241)— 255 14 
Income (loss) before income taxes3,500 1,319 (13,448)(8,629)
Other loss, netOther loss, net(2,557)— (1,107)(3,664)
(Loss) income before income taxes(Loss) income before income taxes(419)2,582 (21,157)(18,994)
Provision for income taxesProvision for income taxes— — (358)(358)Provision for income taxes— — (194)(194)
Net income (loss)$3,500 $1,319 $(13,806)$(8,987)
Net (loss) incomeNet (loss) income$(419)$2,582 $(21,351)$(19,188)

(1)    As more fully described in Note 17, the residential segment recognized $11,531$12,344 of restructuring expenses that were reimbursed by DHC, which are recognized as both income and expense, in the sixnine months ended JuneSeptember 30, 2021.
(2)    As more fully described in Note 17, the lifestyle services segment recognized $1,720$1,410 of restructuring expenses in the sixnine months ended JuneSeptember 30, 2021.2021.
(3)    As more fully described in Note 17, the corporate and other segment recognized $2,388$3,105 of restructuring expenses in the sixnine months ended JuneSeptember 30, 2021.

5. Property and Equipment, net

Property and equipment, net consist of the following:
June 30, 2022December 31, 2021 September 30, 2022December 31, 2021
LandLand$12,155 $12,155 Land$12,155 $12,155 
Buildings, construction in process and improvementsBuildings, construction in process and improvements210,281 207,333 Buildings, construction in process and improvements212,155 207,333 
Furniture, fixtures and equipmentFurniture, fixtures and equipment66,048 62,606 Furniture, fixtures and equipment69,017 62,606 
Property and equipment, at costProperty and equipment, at cost288,484 282,094 Property and equipment, at cost293,327 282,094 
Less: accumulated depreciationLess: accumulated depreciation(127,693)(122,251)Less: accumulated depreciation(130,542)(122,251)
Property and equipment, netProperty and equipment, net$160,791 $159,843 Property and equipment, net$162,785 $159,843 
 
On September 30, 2021, we terminated our lease for the four communities that we leased from Healthpeak Properties, Inc., or PEAK. Under the terms of the termination agreements, we recorded a loss on lease termination of $3,277. Included in the calculation of the loss on lease termination was the derecognition of $1,173 of all property and equipment at the four previously leased communities. The loss was the aggregate of the lease termination fee of $3,100, other obligations of $548, legal transaction costs of $37, the net derecognition carrying amounts of our right of use asset of $16,055, and leasehold improvements and other fixed assets of $1,173, partially offset by the remaining lease obligations of $17,636.

On April 4, 2021, a fire at 1one of the 4four senior living communities that we previously leased from Healthpeak Properties, Inc., or PEAK caused extensive damage to the community. As a result, we recorded an impairment on certain furniture, fixtures and building improvements for the three and sixnine months ended JuneSeptember 30, 2021 of $890, which is recorded in other residential expenses in the condensed consolidated statement of operations. Insurance proceeds received for property damages to the previously leased community caused by the fire of $1,500 were subsequently transferred to PEAK. No impairment charges were recorded for the three and six months ended June 30, 2022.

We recorded depreciation expense relating to our property and equipment of $2,757$2,849 and $2,699$2,692 for the three months ended JuneSeptember 30, 2022 and 2021, respectively, and $5,442$8,291 and $5,390$8,082 for the sixnine months ended JuneSeptember 30, 2022 and 2021, respectively.

6. Accumulated Other Comprehensive (Loss) Income

Accumulated other comprehensive (loss) income of $246($33) and $1,029 as of JuneSeptember 30, 2022 and December 31, 2021, respectively, represents the unrealized gains and losses of our debt investments, net of tax. The cost of debt investments sold and for which realized gains and losses are reclassified and included in net loss are determined on a specific identification basis.

7. Income Taxes

We recognized a benefit for income taxes of $9 and a provision for income taxes of $68 for the three and six months ended June 30, 2022, respectively, and a provision for income taxes of $158 and $358 for the three and six months ended June 30, 2021, respectively. The benefit and provision for income taxes for the three and six months ended June 30, 2022 and 2021 is related to state income taxes.

11


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
7. Income Taxes

We recognized a provision for income taxes of $31 and $99 for the three and nine months ended September 30, 2022, respectively, and a benefit for income taxes of $164 and provision for income taxes of $194 for the three and nine months ended September 30, 2021, respectively. The provision and benefit for income taxes for the three and nine months ended September 30, 2022 and 2021 is related to state income taxes.

We previously determined it was more likely than not that as a result of our recurring net operating losses and forecasted net operating losses a majority of our net deferred tax assets would not be realized and concluded that a valuation allowance was required, which eliminated the majority of our net deferred tax assets recorded in our condensed consolidated balance sheets. In the future, if we believe that we will more likely than not realize the benefit of these deferred tax assets, we will adjust our valuation allowance and recognize an income tax benefit, which may affect our results of operations.

8. Net Income (Loss) Per Share

Basic net income (loss) per share is calculated by dividing net income (loss) by the weighted average number of outstanding common shares outstanding during the period. When applicable, net income (loss) per share—diluted reflects the more dilutive earnings per share using the weighted average number of our common shares calculated using the two-class method, or the treasury stock method.

The following table provides a reconciliation of the weighted average number of common shares used in the calculation of basic and diluted net loss per share (in thousands):

Three Months Ended June 30,Six Months Ended June 30,Three Months Ended September 30,Nine Months Ended September 30,
20222021202220212022202120222021
Weighted average shares outstanding—basicWeighted average shares outstanding—basic31,810 31,552 31,799 31,541 Weighted average shares outstanding—basic31,875 31,618 31,825 31,567 
Effect of dilutive securities: unvested share awardsEffect of dilutive securities: unvested share awards— — — — Effect of dilutive securities: unvested share awards— — — — 
Weighted average shares outstanding—diluted (1)
Weighted average shares outstanding—diluted (1)
31,810 31,552 31,799 31,541 
Weighted average shares outstanding—diluted (1)
31,875 31,618 31,825 31,567 

(1)    For the three months ended JuneSeptember 30, 2022 and 2021, 1,4151,433 and 150157 of our unvested common shares were not included in the calculation of net loss per share—diluted because to do so would have been anti-dilutive. For the sixnine months ended JuneSeptember 30, 2022 and 2021, 1,1731,218 and 141,146, respectively, of our unvested common shares were not included in the calculation of the net loss per share—diluted because to do so would have been antidilutive.

9. Fair Values of Assets and Liabilities

Recurring Fair Value Measures

The tables below present certain of our assets measured at fair value at JuneSeptember 30, 2022 and December 31, 2021, categorized by the level of input used in the valuation of each asset.

As of June 30, 2022 As of September 30, 2022
DescriptionDescriptionTotalQuoted Prices in
Active Markets
for Identical
 Assets
(Level 1)
Significant 
Other
Observable
 Inputs
(Level 2)
Significant
Unobservable 
Inputs
(Level 3)
DescriptionTotalQuoted Prices in
Active Markets
for Identical
 Assets
(Level 1)
Significant 
Other
Observable
 Inputs
(Level 2)
Significant
Unobservable 
Inputs
(Level 3)
Cash equivalents (1)
Cash equivalents (1)
$37,564 $37,564 $— $— 
Cash equivalents (1)
$36,548 $36,548 $— $— 
Investments:Investments:Investments:
Total equity investments (2)
Total equity investments (2)
10,846 5,399 5,447 — 
Total equity investments (2)
5,937 5,937 — — 
Total debt investments (3)
Total debt investments (3)
8,733 4,038 4,695 — 
Total debt investments (3)
7,668 3,192 4,476 — 
Total investmentsTotal investments19,579 9,437 10,142 — Total investments13,605 9,129 4,476 — 
TotalTotal$57,143 $47,001 $10,142 $— Total$50,153 $45,677 $4,476 $— 

12


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
 As of December 31, 2021
DescriptionTotalQuoted Prices in
Active Markets
for Identical
Assets
(Level 1)
Significant 
Other
Observable
Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
Cash equivalents (1)
$26,417 $26,417 $— $— 
Investments:
Total equity investments (2)
13,033 6,980 6,053 — 
Total debt investments (3)
10,375 4,612 5,763 — 
Total investments23,408 11,592 11,816 — 
Total$49,825 $38,009 $11,816 $— 
______________________________________
(1)    Cash equivalents consist of short-term, highly liquid investments and money market funds held primarily for obligations arising from our self-insurance programs. Cash equivalents are reported in our condensed consolidated balance sheets as cash and cash equivalents and current and long-term restricted cash and cash equivalents. Cash equivalents include $20,363$19,766 and $23,546 of balances that were restricted at JuneSeptember 30, 2022 and December 31, 2021, respectively. In addition to the cash equivalents of $37,564$36,548 and $26,417 at JuneSeptember 30, 2022 and December 31, 2021, respectively, reflected above, there were cash balances of $66,259$62,344 and $64,116 and restricted cash balances of $2,513$2,542 and $2,406 at JuneSeptember 30, 2022 and December 31, 2021, respectively.
(2)    The fair value of our equity investments is readily determinable. During the sixnine months ended JuneSeptember 30, 2022 and 2021, we received gross proceeds of $521$6,804 and $741, respectively, in connection with the sales of equity investments and recorded gross realized gains totaling $0$1,646 and $175, respectively, and gross realized losses totaling $45$114 and $0, respectively.
(3)    As of JuneSeptember 30, 2022, our debt investments, which are classified as available for sale, had a fair value of $8,733$7,668 with an amortized cost of $9,223;$8,438; the difference between the fair value and amortized cost amounts resulted from net unrealized losses of $490,$770, inclusive of unrealized gains of $6.$2. As of December 31, 2021, our debt investments had a fair value of $10,375 with an amortized cost of $10,079; the difference between the fair value and amortized cost amounts resulted from net unrealized gains of $296, inclusive of unrealized losses of $10. Debt investments include $7,081$6,055 and $6,907 of balances that were restricted as of JuneSeptember 30, 2022 and December 31, 2021, respectively. At JuneSeptember 30, 2022, 8687 debt investments we held, with a fair value of $7,383,$6,925, had been in a loss position for less than 12 months and 1one of the debt investments we held, with a fair value of $49,$45, had been in a loss position for greater than 12 months. We do not believe these investments are impaired primarily because they have not been in a loss position for an extended period of time, the financial conditions of the issuers of these investments remain strong with solid fundamentals as of JuneSeptember 30, 2022, we do not intend to sell the investments and it is not more likely than not that we will be required to sell the investments before recovery, and other factors that support our conclusion that the loss is temporary. During the sixnine months ended JuneSeptember 30, 2022 and 2021, we received gross proceeds of $705$1,020 and $1,294, respectively, in connection with the sales of debt investments and recorded gross realized losses of $(3)$5 and $0, respectively, and gross realized gains of $1 and $18, respectively, during the six months ended June 30, 2022 and 2021.respectively. We record gains and losses on the sales of these investments using the specific identification method.

The amortized cost basis and fair value of available for sale debt securities at JuneSeptember 30, 2022, by contractual maturity, are shown below:
Amortized CostFair ValueAmortized CostFair Value
Due in one year or lessDue in one year or less$997 $1,000 Due in one year or less$976 $973 
Due after one year through five yearsDue after one year through five years4,353 4,240 Due after one year through five years4,004 3,768 
Due after five years through ten yearsDue after five years through ten years2,835 2,592 Due after five years through ten years2,446 2,112 
Due after ten yearsDue after ten years1,038 901 Due after ten years1,012 815 
TotalTotal$9,223 $8,733 Total$8,438 $7,668 

Our financial assets (which include cash equivalents and investments) have been valued at the transaction price and subsequently valued, at the end of each reporting period, utilizing third-party pricing services or other market observable data. During the sixnine months ended JuneSeptember 30, 2022, we did not change the type of inputs used to determine the fair value of any of our assets and liabilities that we measure at fair value.

The carrying value of accounts receivable and accounts payable approximates fair value as of JuneSeptember 30, 2022 and December 31, 2021. The carrying value and fair value of our debt was $67,501$67,598 and $58,445,$57,463, respectively, as of JuneSeptember 30, 2022 and $6,783 and $7,689, respectively, as of December 31, 2021. These are categorized in Level 3 of the fair value hierarchy. We estimate the fair value of our debt by using discounted cash flow analyses and currently prevailing market terms as of the measurement date.

Non-Recurring Fair Value Measures
 
We review the carrying value of our long-lived assets, including our right-of-use assets and property and equipment, for impairment whenever events or changes in circumstances indicate that the carrying value of an asset or asset group may not
13


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
be recoverable. On April 4, 2021, a fire at 1one of the 4four senior living communities that we previously leased from PEAK caused extensive damage to the community. As a result, we deemed the recorded furniture, fixtures and equipment and building improvements at the community had no net recoverable value. We recorded an impairment equal to their carrying value for the sixnine months ended JuneSeptember 30, 2021 of $890, which is recorded in other residential expenses in the statement of operations. See Note 5 for more information regarding fair value measurements related to impairments of our long-lived assets.

For the sixnine months ended JuneSeptember 30, 2022, there were no non-recurring fair value adjustments related to long-lived assets.
 
10. Indebtedness

On January 27, 2022, certain of our subsidiaries entered into a credit and security agreement, or the Credit Agreement, with MidCap Funding VIII Trust as administrative agent and a lender, or MidCap. Under the terms of the Credit Agreement, we entered into a $95,000 senior secured term loan, or the Loan, $63,000 of which was funded upon effectiveness of the Credit Agreement, including approximately $3,200 in closing costs. The remaining proceeds include $12,000 for capital improvements at senior living communities we own and an opportunity for another $20,000 that is available to us upon achieving certain financial targets. Certain of our subsidiaries are borrowers under the Credit Agreement and we and one of our subsidiaries provided a payment guarantee of up to $40,000 of the obligations under the Credit Agreement as well as non-recourse carve-outs. The guaranty is evidenced by a Guaranty and Security Agreement, or the Guaranty Agreement, made by us and one of our subsidiaries in favor of MidCap. Pursuant to the Guaranty Agreement, our subsidiary granted MidCap a security interest on all of the assets of the subsidiary. The Guaranty Agreement requires us and our subsidiary to comply with various covenants, including restricting our ability to make distributions to shareholders. The Loan is secured by real estate mortgages on 14 senior living communities owned by us, our assets and certain related collateral. The maturity date of the Loan is January 27, 2025. Subject to the payment of an extension fee of 35 basis points and meeting certain other conditions, we may elect to extend the stated maturity date of the Loan for 2two one year periods. We are required to pay interest on outstanding amounts at an annual base rate of the Secured Overnight Financing Rate, or SOFR, plus a term SOFR adjustment of 11 basis points (subject to a minimum base rate of 50 basis points) plus 450 basis points. The Credit Agreement requires interest only payments for the first two years and requires mandatory prepayment of the Loan on account of certain events of default. Voluntary prepayments made within 18 months of the effective date of the Loan will be subject to a prepayment fee equal to the greater of the present value of remaining interest payments relating to the principal amount being repaid or 0.50% of the outstanding balance of the Loan as of the date of prepayment. The Loan may thereafter be voluntarily prepaid without premium or penalty. The CompanyWe will be required to pay an exit fee between 1.0% and 1.5%, subject to the conditions set forth in the Credit Agreement, upon any prepayment of the Loan, which would be in addition to any prepayment fees that may be payable. The Loan provides for acceleration of payment of all amounts outstanding upon the occurrence and continuation of certain events of default, including a change of control of us, as defined in the Credit Agreement. The default rate of interest is 5.0% per annum in excess of the rate otherwise payable under the Credit Agreement. The Credit Agreement also contains a number of financial and other covenants including covenants that restrict the borrowers'a borrower's ability to incur indebtedness or to pay or make distributions under certain circumstances and requires us to maintain certain financial ratios which become effectivea debt yield percentage ranging from 3.0% to 7.5% beginning March 31, 2023 and a debt service coverage ratio ranging from 1.15:1.00 to 1.25:1.00 beginning September 30, 2023. The Credit Agreement also contains certain representations and warranties and reporting obligations. The annual interest rate on the Loan as of JuneSeptember 30, 2022 was 6.3%7.7%. We incurred aggregate interest expense related to our Loan of $1,064$1,288 and $1,779$3,067 for the three and sixnine months ended JuneSeptember 30, 2022.2022, respectively.

The Loan replaced our $65,000 secured revolving credit facility, the Credit Facility, which was governed by a credit agreement with a syndicate of lenders, and was scheduled to expire on June 12, 2022, before it was terminated on January 27, 2022. No borrowings were outstanding under the Credit Facility at the time we entered into the Credit Agreement. We were required to pay a quarterly commitment fee of 0.35% per annum on the unused portion of the available capacity under our Credit Facility. We also had a letter of credit issued under the Credit Facility which was terminated when we replaced the Credit Facility with the Loan. We incurred aggregate interest expense related to our Credit Facility of $0 and $205$108 for the three months ended JuneSeptember 30, 2022 and 2021, respectively, and $28 and $458$566 for the sixnine months ended JuneSeptember 30, 2022 and 2021, respectively.

At JuneSeptember 30, 2022, 1one of our senior living communities was encumbered by a mortgage note. This mortgage note contains standard mortgage covenants. We recorded a discount in connection with the assumption of this mortgage note as part of our acquisition of the senior living community secured by this mortgage in order to record this mortgage note at its then estimated fair value. We amortize this discount as an increase in interest expense until the maturity of this mortgage note. This mortgage note requires payments of principal and interest monthly until maturity. The following table is a summary of this mortgage note as of June 30, 2022:
14


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
Balance as of
June 30, 2022
Contractual Stated
Interest Rate
Effective
Interest Rate
Maturity DateMonthly
Payment
Lender Type
$6,769 (1)6.20 %6.70 %September 2032$72 Federal Home Loan Mortgage Corporation
mortgage note requires payments of principal and interest monthly until maturity. The following table is a summary of this mortgage note as of September 30, 2022:
Balance as of
September 30, 2022
Contractual Stated
Interest Rate
Effective
Interest Rate
Maturity DateMonthly
Payment
Lender Type
$6,659 (1)6.20 %6.70 %September 2032$72 Federal Home Loan Mortgage Corporation

(1)    Contractual principal payments excluding unamortized discount of $190.$184.

We incurred interest expense, net of discount amortization, of $112$111 and $118$119 with respect to the mortgage note for the three months ended JuneSeptember 30, 2022 and 2021, respectively, and $227$339 and $240$359 for the sixnine months ended JuneSeptember 30, 2022 and 2021, respectively.
As of JuneSeptember 30, 2022, the required principal payments due during the next five years and thereafter under the terms of our mortgage note and Loan are as follows:

YearYearMortgage
Principal Payment
Loan Principal PaymentTotalYearMortgage
Principal Payment
Loan Principal PaymentTotal
20222022$223 $— $223 2022$113 $— $113 
20232023469 — 469 2023469 — 469 
20242024498 1,008 1,506 2024498 1,191 1,689 
20252025531 61,992 62,523 2025531 61,809 62,340 
20262026565 — 565 2026565 — 565 
ThereafterThereafter4,483 — 4,483 Thereafter4,483 — 4,483 
Total Total6,769 63,000 69,769  Total6,659 63,000 69,659 
Less: Unamortized net discount and issuance costsLess: Unamortized net discount and issuance costs(190)(2,078)(2,268)Less: Unamortized net discount and issuance costs(184)(1,877)(2,061)
Total debtTotal debt6,579 60,922 67,501 Total debt6,475 61,123 67,598 
Less: Current portion of debtLess: Current portion of debt(429)— (429)Less: Current portion of debt(437)— (437)
Long-term debtLong-term debt$6,150 $60,922 $67,072 Long-term debt$6,038 $61,123 $67,161 

At July 29,September 30, 2022, we had 1one irrevocable standby letter of credit outstanding, totaling $23,850. This letter of credit, which secures our workers' compensation insurance program, is collateralized by $19,521$19,159 of cash equivalents and $4,329$4,691 of debt and equity investments. This letter of credit expires in June 2023 and is automatically extended for one-year terms unless notice of nonrenewal is provided prior to the end of the applicable term. At JuneSeptember 30, 2022, the cash equivalents collateralizing this letter of credit are classified as current restricted cash and cash equivalents in our condensed consolidated balance sheets, and the debt and equity investments collateralizing this letter of credit are classified as current restricted debt and equity investments in our condensed consolidated balance sheets.

We believe we were in compliance with all applicable covenants under our Loan and mortgage note as of JuneSeptember 30, 2022.

11. Management Agreements with DHC
    
We manage for DHC most of the senior living communities that we operate.

2021 Amendments to our Management Arrangements with DHC. As part of the implementation of the repositioning of our residential management business, on June 9, 2021, we and DHC entered into an amended and restated master management agreement, or the Master Management Agreement, for the senior living communities that we manage for DHC and interim management agreements for the senior living communities that we and DHC agreed to transition to new operators. These agreements replaced our prior management and omnibus agreements with DHC. In addition, we delivered to DHC a related amended and restated guaranty agreement pursuant to which we will continue to guarantee the payment and performance of each of our applicable subsidiary's obligations under the applicable management agreements. The principal changes to the management arrangements include:

included:
15


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)

We agreed to cooperate with DHC to transition the operations for 107 senior living communities owned by DHC with approximately 7,400 living units that we then managed to other third party managers and to close 1one senior living community with approximately 100 living units, without payment of any termination fee to us;
DHC no longer has the right to sell up to an additional $682,000 of senior living communities managed by us and terminate our management of those senior living communities without payment of a termination fee to us upon sale;
DHC's ability to terminate the management agreement was revised: (i) to not commence until 2025; (ii) the maximum number of senior living communities that may be terminated was reduced to 10% (from 20%) of the total managed portfolio by revenue per year; and (iii) to provide that achieving less than 80% (rather than 90%) of budgeted earnings before interest, taxes, and depreciation and amortization, or EBITDA, will be required to qualify as a “Non-Performing Asset.” DHC will not be obligated to pay any termination fee to us if it exercises these termination rights;
We continue to manage for DHC 119 of the 120 senior living communities we managed for itthat were incorporated under the Master Management Agreement as of June 9, 2021;2021 (the management for one active adult community with 169 living units was terminated by mutual agreement effective October 31, 2022);
We closed the 27 skilled nursing units in continuing care retirement communities, or CCRCs, that we continue to manage for DHC as independent or assisted living communities, which had 1,532 living units;
The incentive fee that we may earn in any calendar year for the senior living communities that we continue to manage for DHC will no longer be subject to a cap, any senior living communities that are undergoing a major renovation or repositioning will be excluded from the calculation of the incentive fee and the incentive fee calculation will be reset pursuant to the terms of the management agreements as a result of expected capital projects DHC is planning in the next five years;through mid-2026;
The RMR Group LLC, or RMR, assumed oversight of major community renovation or repositioning activities at the senior living communities that we continue to manage for DHC; and
The term of our existing management agreements with DHC was extended by two years to December 31, 2036.

We have the right to extend the term for two consecutive five year terms if we achieve certain performance targets for the combined managed communities portfolio, unless earlier terminated.
Pursuant to the Master Management Agreement, we receive a management fee equal to 5% of the gross revenues realized at the applicable senior living communities plus reimbursement for our direct costs and expenses related to such communities. We also receive 3% of construction costs for construction projects we manage at the senior living communities we managed.manage. We may also receive an annual incentive fee equal to 15% of the amount by which the annual EBITDA of all senior living communities on a combined basis exceeds the target EBITDA for all senior living communities on a combined basis for such calendar year. The target EBITDA for those senior living communities on a combined basis is increased annually based on the greater of the annual increase of the Consumer Price Index, or CPI, or 2%, plus 6% of any capital investments funded at the managed senior living communities on a combined basis in excess of the target capital investment. Unless otherwise agreed, the target capital investment increases annually based on the greater of the annual increase of CPI or 2%. Any senior living communities that are undergoing a major renovation or repositioning are excluded from the calculation of the incentive fee.

The Master Management Agreement expires in 2036, subject to our right to extend for 2two consecutive five year terms if we achieve certain performance targets for the combined managed communities portfolio, unless earlier terminated. Pursuant to the Master Management Agreement, beginning in 2025, DHC will have the right to terminate up to 10% of the senior living communities, based on total revenues per year for failure to meet 80% of a target EBITDA for the applicable period.

As part of the repositioning of our residential management business, we transitioned the management of 107 senior living communities that we managed for DHC with approximately 7,400 living units to new operators during the third and fourth quarters of 2021, of which 69 senior living communities with approximately 4,800 living units were transitioned during the three months ended September 30, 2021. We closed 1one senior living community with approximately 100 living units that we managed for DHC in February 2022. During the year ended December 31, 2021, weWe also closed all 1,532 skilled nursing facility, or SNF, living units within the 27 CCRC communities, of which 1,473 living units were closed during the three months ended June 30, 2021. For the three and six months ended June 30, 2021, we recognized $4,378 and $9,619, respectively, of residential management fees related to the management of these senior living communities and living units.

16


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
CCRC communities, of which 1,473 and 59 living units were closed during the 2021 second and third quarters, respectively. For the three and nine months ended September 30, 2021, we recognized $2,710 and $12,329, respectively, of residential management fees related to the management of these senior living communities and living units.

As of JuneSeptember 30, 2022 and 2021, we managed 120 and 228159 senior living communities, respectively, for DHC. We earned residential management fees of $8,174$8,497 and $12,109$10,418 from the senior living communities we managed for DHC for the three months ended JuneSeptember 30, 2022 and 2021, respectively, and $16,216$24,713 and $25,019$35,437 for the sixnine months ended JuneSeptember 30, 2022 and 2021, respectively. In addition, we earned fees for our management of capital expenditure projects at the senior living communities we managed for DHC of $697$876 and $715$702 for the three months ended JuneSeptember 30, 2022 and 2021, respectively, and $1,487$2,363 and $1,549$2,251 for the sixnine months ended JuneSeptember 30, 2022 and 2021, respectively. These amounts are included in residential management fees in our condensed consolidated statements of operations. Effective October 31, 2022, the management for one active adult community that DHC owns in Plano, Texas was terminated by mutual agreement. We earned total management fees relating to that community of $61 and $54 for the three months ended September 30, 2022 and 2021, respectively, and $175 and $154 for the nine months ended September 30, 2022 and 2021, respectively. DHC paid us a termination fee of approximately $350 in connection with the termination of our management of this active adult community.

We also provide lifestyle services to residents at some of the senior living communities we manage for DHC, such as rehabilitation and wellness services. At senior living communities we manage for DHC where we provide rehabilitation and wellness services on an outpatient basis, the residents, third party payers or government programs pay us for those rehabilitation and wellness services. At senior living communities we previously managed for DHC where we currently provide or previously provided inpatient rehabilitation and wellness services, DHC generally pays us for these services and charges for such services are included in amounts charged to residents, third party payers or government programs. We earned revenues of $1,736$1,590 and $2,630$1,508 for the three months ended JuneSeptember 30, 2022 and 2021, respectively, and $3,652$5,242 and $8,071$9,579 for the sixnine months ended JuneSeptember 30, 2022 and 2021, respectively, for lifestyle services we provided at senior living communities we previously managed for DHC and that were payable by DHC. These amounts are included in lifestyle services revenues in our condensed consolidated statements of operations.

We earned residential management fees of $100$104 and $103$100 for the three months ended JuneSeptember 30, 2022 and 2021, respectively, and $200$304 and $209$309 for the sixnine months ended JuneSeptember 30, 2022 and 2021, respectively, for management services at a part of a senior living community DHC subleases to an affiliate, which amounts are included in residential management fees in our condensed consolidated statements of operations.

Included in accrued expenses and other current liabilities and accrued compensation and benefits on our condensed consolidated balance sheets are $28,747 and $21,352, respectively, at September 30, 2022, and $20,345 and $22,619, respectively, at December 31, 2021 that will be or were subsequently, as applicable, reimbursed by DHC and are included in due from related person.

See Note 1 to our Consolidated Financial Statements included in Part IV, Item 5 of our Annual Report for additional information about our management agreements with DHC.

12. Senior Living Communities Leased from Healthpeak Properties, Inc.

We previously leased 4four senior living communities from PEAK. On September 30, 2021, we and PEAK terminated our leases for all 4four communities that we leased from PEAK. These 4four communities had approximately 200 living units and had residential revenues of $1,554$1,457 and lease expense of $735$724 for the three months ended JuneSeptember 30, 2021, and $3,436residential revenues of $4,893 and $1,461lease expense of $2,185 for the sixnine months ended JuneSeptember 30, 2021, respectively.2021.

As of October 1, 2021, the PEAK senior living communities were no longer part of our residential operations. For further information about our PEAK lease termination, see Note 11 included in Part IV, Item 15 of our Annual Report.

17


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
13. Business Management Agreement with RMR

RMR provides us certain services that we require to operate our business, and which relate to various aspects of our business. RMR provides these services to us pursuant to our business management and shared services agreement. Pursuant to the business management and shared services agreement, we incurred aggregate fees and certain cost reimbursements payable to RMR of $1,239$1,299 and $1,795$1,550 for the three months ended JuneSeptember 30, 2022 and 2021, respectively, and $2,464$3,763 and $3,599$5,149 for the sixnine months ended JuneSeptember 30, 2022 and 2021, respectively. These amounts are included in general and administrative expenses in our condensed consolidated statements of operations.

For further information about our relationship with RMR, see Note 14 of this Quarterly Report on Form 10-Q and our Annual Report.

14. Related Person Transactions

We have relationships and historical and continuing transactions with DHC, RMR, ABP Trust and others related to them, including other companies to which RMR or its subsidiaries provide management services and some of which have trustees, directors and officers who are also our Directors or officers. The RMR Group Inc., or RMR Inc., is the managing member of RMR. The Chair of our Board and one of our Managing Directors, Adam D. Portnoy is the sole trustee, an officer and the controlling shareholder of ABP Trust, which is the controlling shareholder of RMR Inc., the chair of the board, a
17


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
managing director, the president and chief executive officer of RMR Inc. and an officer and employee of RMR. Jennifer B. Clark, our other Managing Director and our Secretary, also serves as a managing director and the executive vice president, general counsel and secretary of RMR Inc., an officer and employee of RMR and an officer of ABP Trust. Certain of our officers, and DHC’s officers, are also officers and employees of RMR. Some of our Independent Directors also serve as independent trustees or independent directors of other public companies to which RMR or its subsidiaries provide management services. Mr. Portnoy serves as the chair of the boards and as a managing director or managing trustee of those companies. Other officers of RMR, including Ms. Clark, serve as managing trustees or managing directors of certain of these companies. In addition, officers of RMR and RMR Inc. serve as our officers and officers of other companies to which RMR or its subsidiaries provide management services.

DHC. DHC is currently our largest shareholder, owning, as of JuneSeptember 30, 2022, 10,691,658 of our common shares, or 32.8% of our outstanding common shares. We manage for DHC most of the senior living communities we operate. RMR provides management services to both us and DHC and Mr. Portnoy is the chair of the board of trustees and a managing trustee of DHC. Ms. Clark is a former managing trustee and the secretary of DHC. Included in accrued expenses and other current liabilities and accrued compensation and benefits on our condensed consolidated balance sheets are $24,177 and $21,916, respectively, at June 30, 2022, and $20,345 and $22,619, respectively, at December 31, 2021 that will be or were subsequently, as applicable, reimbursed by DHC and are included in due from related person.

We lease space from DHC at certain of the senior living communities that we manage for DHC. We use this leased space for Ageility outpatient rehabilitation locations. We recognized rent expense of $325$328 and $398$370 for the three months ended JuneSeptember 30, 2022 and 2021, respectively, and $647$979 and $795$1,165 for the sixnine months ended JuneSeptember 30, 2022 and 2021, respectively, with respect to these leases.

See Note 11 for more information regarding our relationships, agreements and transactions with DHC and certain parties related to it and us.

RMR. We have an agreement with RMR for RMR to provide business management services to us. See Note 13 for more information regarding our management agreement with RMR.

Adam D. Portnoy and ABP Trust. Adam D. Portnoy and ABP Trust and its subsidiaries together owned approximately 2,030,115 of our common shares, representing 6.2% of our outstanding common shares, as of JuneSeptember 30, 2022.

We lease our current, and we previously leased our former, headquarters from a subsidiary of ABP Trust. On July 2, 2022, we entered into an agreement to terminate the lease for our former headquarters at 400 Centre Street in Newton, Massachusetts, with a termination date of September 30, 2022, and entered into a separate agreement to assume a lease for our current headquarters as of September 1, 2022 at 255 Washington Street, Newton, Massachusetts, from Sonesta International Hotels Corporation, or Sonesta. Mr. Portnoy is the controlling stockholder and a director of Sonesta, and Ms. Clark is a director and secretary of Sonesta. Another officer of RMR serves as a director and the president and chief executive officer of Sonesta and certain other officers of Sonesta are also officers of RMR. Commencing on September 1, 2022, our annual lease payments
18


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
range from $986 to $1,057 over the term of the lease, inclusive of certain operating costs, including a base amount for utilities and real estate taxes. The lease expires on May 31, 2030. The total aggregate estimated payments over the life of the lease will be approximately $7,861. As a result of the assumption of this lease, we established a right-of-use asset and lease liability of $5,843, using the incremental borrowing rate of 7.4%.

On February 24, 2021, we and the ABP Trust subsidiary renewed the lease for our former headquarters through December 31, 2031. As of the date of that renewal, the annual lease payments were scheduled to range from $1,026 to $1,395 over the term of the lease. On January 10, 2022, we and the ABP Trust subsidiary further amended the lease, which reduced the leased space from approximately 41,000 square feet to approximately 30,000 square feet. Commencing onAs of July 1, 2022, the annual base lease payments, exclusive of utilities and real estate taxes, willwere scheduled to range from $770 to $1,007 over the term of the lease.

Our rent expense for our current and former headquarters, including utilities and real estate taxes that we paypaid above the base amount, or as additional rent, was $498$342 and $559$518 for the three months ended JuneSeptember 30, 2022 and 2021, respectively, and $974$1,316 and $1,036$1,554 for the sixnine months ended JuneSeptember 30, 2022 and 2021, respectively, which amounts are included in general and administrative expenses.

As a result of the January 2022 amendment of the previous lease, we decreased our right-of-use asset and lease liability by $2,958 and $3,237, respectively, in the three months ended March 31,first quarter of 2022 to reflect the terms of the amendment using a currentthe incremental borrowing rate of 5.6%. at the time of the January 2022 amendment. As a result of entering into an agreement on July 2, 2022 to terminate this lease on September 30, 2022, we reduced the remaining right-of-use asset and lease liability by $5,876 and $6,374, respectively. The remaining right-of-use asset and lease liability related to this lease was amortized to zero as of September 30, 2022. We recognized $498 of gain on termination of this lease during the three months ended September 30, 2022.

As of September 30, 2022, we had a right-of-use asset and lease liability which amounts were $6,004of $5,796 and $9,197 for the$5,832, respectively, related to our lease at 255 Washington Street. As of December 31, 2021, we had a right-of-use asset and $6,502lease liability of $9,197 and $10,065, for therespectively, related to our lease liability as of June 30, 2022 and December 31, 2021, respectively.at 400 Centre Street. The right-of-use asset has been reduced by the amount of accrued lease payments, which amounts are not material to our condensed consolidated financial statements.

On July 2, 2022, we entered into an agreement to terminate the lease for our headquarters at 400 Centre Street in Newton, Massachusetts with a termination date of September 30, 2022 and entered into a separate agreement to assume a lease for our headquarters as of September 1, 2022 at 255 Washington Street, Newton, Massachusetts, from Sonesta International Hotels Corporation, or Sonesta. Mr. Portnoy is the controlling stockholder and a director of Sonesta, and Ms. Clark is a director and secretary of Sonesta. Other officers of RMR serve as a director and as officers of Sonesta. Commencing on September 1, 2022, our annual lease payment will range from $986 to $1,057 over the remaining period of the lease, inclusive of certain operating costs, including a base amount for utilities and real estate taxes, which expires on May 31, 2030. The total aggregate estimated payments over the life of the lease will be approximately $7,861.

18


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
Retirement and Separation Arrangements. Katherine E. Potter resigned as our President and Chief Executive Officer effective April 30, 2022. Ms. Potter will remain with the Company as an employee through December 31, 2022 in order to assist in transitioning her duties and responsibilities.

In connection with Ms. Potter’s resignation, the Companywe entered into a separation agreement with Ms. Potter on May 2, 2022. Under the separation agreement, the Companywe will pay Ms. Potter $12 per month from May 2022 until December 31, 2022 andwe also paid her a lump sum cash payment in the amount of $483 in May 2022. Provided that Ms. Potter signs and does not revoke a release of claims, and subject to the satisfaction of certain other conditions, on December 31, 2022, the Companywe will make an additional cash payment to Ms. Potter in the amount of $483 and will fully accelerate the vesting of any unvested common shares of the Company previously awarded to Ms. Potter as of December 31, 2022, unless that date is accelerated pursuant to the separation agreement. We recorded the full separation cost for Ms. Potter of $1,319 induring the three and sixnine months ended JuneSeptember 30, 2022.

In connection with her retirement, on November 22, 2021, we entered into a letter agreement with Margaret Wigglesworth, our former Executive Vice President and Chief Operating Officer. Pursuant to the letter agreement, Ms. Wigglesworth continued to serve as the Executive Vice President and Chief Operating Officer through November 22, 2021, and continued to serve as our employee through December 31, 2021. Pursuant to the letter agreement, we paid Ms. Wigglesworth her current cash salary and benefits through December 31, 2021 and recognized these costs in the fourth quarter of 2021. In addition, subject to the satisfaction of certain other conditions, we made a cash payment of $404 to Ms. Wigglesworth in January 2022 and recognized these costs in the first quarter of 2022.

For further information about these and other such relationships and certain other related person transactions, see Note 15 included in Part IV, Item 15 of our Annual Report.

15. Commitments and Contingencies

We have been, are currently, and expect in the future to be involved in claims, lawsuits, and regulatory and other government audits, investigations and proceedings arising in the ordinary course of our business, some of which may involve
19


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
material amounts. Also, the defense and resolution of these claims, lawsuits, and regulatory and other government audits, investigations and proceedings may require us to incur significant expense. Loss contingency provisions are recorded for probable and estimable losses at our best estimate of a loss or, when a best estimate cannot be made, at our estimate of the minimum loss. These estimates are often developed prior to knowing the amount of the ultimate loss, require the application of considerable judgment and are refined as additional information becomes known. Accordingly, we are often initially unable to develop a best estimate of loss and therefore the estimated minimum loss amount, which could be zero, is recorded; then, as information becomes known, the minimum loss amount is updated, as appropriate.

In July 2021, we became aware of a potential issue with respect to completion of a form at one of the SNFs we previously managed for DHC. As a result of this discovery, we have made a voluntary self-disclosure to the Office of the Inspector General of HHS, or OIG, pursuant to the OIG's Provider Self-Disclosure Protocol. We submitted our initial disclosure to the OIG in January 2022, and are in discussions with the OIG regarding possible damages. Based on the costs that we have incurred or expect to incur, including estimated OIG imposed penalties, and factoring in DHC's related obligations, we have recorded a total of $288 to general and administrative expenses in our consolidated statements of operations in the fourth quarter of 2021 and second quarter of 2022.

In connection with our arrangement with Compass Group, or the Compass Agreement, to manage resident dining at the senior living communities we own or manage, we are obligated to repay amounts totaling $1,433$2,405 and $1,232,$1,240, respectively, for incentives and transition costs incurred by the Compass Group in relation to the 20twenty communities that had been transitioned as of JuneSeptember 30, 2022, of which $1,2312022. Of those amounts, $2,065 and $969,$974, respectively, would be reimbursable by DHC, if we terminate the agreement prior to the end of 72 months, or January 1, 2028. The repaymentsrepayment amounts are also subject to interest. We expect the majority of the remaining senior living communities to transition dining services to Compass Group in the next twelve months.

16. Self-Insurance Reserves

We partially self-insure up to certain limits for workers’ compensation, professional and general liability and automobile insurance programs through an offshore captive insurance company subsidiary. Claims that exceed these limits are reinsured up to contractual limits and reserves for these programs are included in accrued self-insurance obligations in our
19


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
consolidated balance sheets. We fully self-insure all health-related claims for our covered employees and reserves are included in accrued compensation and benefits in our consolidated balance sheets.

As of JuneSeptember 30, 2022 and December 31, 2021, we had accrued reserves of $65,325$59,257 and $73,174, respectively, under these programs, of which $29,662$27,007 and $34,744, respectively, are classified as long-term liabilities. As of JuneSeptember 30, 2022 and December 31, 2021, we recorded $2,285$2,271 and $2,686, respectively, of estimated amounts receivable from the reinsurance companies under these programs.

At September 30, 2022, our workers' compensation insurance program was secured by an irrevocable standby letter of credit totaling $23,850 and collateralized by $19,159 of cash equivalents and $4,691 of debt and equity investments.

See Note 2 to our Consolidated Financial Statements included in Part IV, Item 15 of our Annual Report for further information on our critical accounting estimates and judgmentjudgments involved in determining our self-insurance obligations.

17. Restructuring Expense

On April 9, 2021, we announced the repositioning of our residential management business to focus on larger independent living, assisted living and memory care communities as well as stand-alone independent living and active adult communities. These repositioning activities were substantially completed prior to December 31, 2021.

A summary of the liabilities incurred as a result of this repositioning combined with a reconciliation of the related components of restructuring expense recognized in the three months ended JuneSeptember 30, 2022 and 2021, follows, first by cost component and then by segment. The expenses are aggregated and reported in the line item restructuring expenses in our condensed consolidated statements of operations.

Summary of Liabilities and Expenses as of and for the Three Months Ended June 30, 2022 (1)
Type of Expense:Beginning BalanceExpenses IncurredPaymentsEnding Balance
Retention bonuses$333 $(13)$320 $— 
Severance, benefits and transition expenses139 18 124 
Transaction expenses466 538 98 906 
Total$938 $528 $436 $1,030 
20


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
Summary of Liabilities and Expenses as of and for the Three Months Ended September 30, 2022 (1)
Type of Expense:Beginning BalanceExpenses IncurredPaymentsEnding Balance
Severance, benefits and transition expenses$124 $— $— $124 
Transaction expenses906 (66)112 728 
Total$1,030 $(66)$112 $852 

Summary of Liabilities and Expenses as of and for the Three Months Ended June 30, 2022 (1)
Summary of Liabilities and Expenses as of and for the Three Months Ended September 30, 2022 (1)
By Segment:By Segment:Beginning BalanceExpenses IncurredPaymentsEnding BalanceBy Segment:Beginning BalanceExpenses IncurredPaymentsEnding Balance
ResidentialResidential$833 $474 $415 $892 Residential$892 $$94 $800 
Corporate and OtherCorporate and Other105 54 21 138 Corporate and Other138 (68)18 52 
TotalTotal$938 $528 $436 $1,030 Total$1,030 $(66)$112 $852 
_______________________________________
(1)    The activity in 2022 relates to adjustments made to those obligations that were incurred in 2021 and recognized under ASC 420, Exit or Disposal Cost Obligations, and ASC 712, Compensation-Nonretirement Postemployment Benefits-special termination benefits. Accrued bonuses and other compensation are reported in the condensed consolidated balance sheetsheets as part of accrued compensation and benefits and accrued transaction expenses are reported in the condensed consolidated balance sheets as part of accrued expenses and other current liabilities in the condensed consolidated balance sheets.liabilities.

Summary of Liabilities and Expenses as of and for the Three Months Ended June 30, 2021Summary of Liabilities and Expenses as of and for the Three Months Ended September 30, 2021
Type of Expense:Type of Expense:Beginning BalanceExpenses IncurredPaymentsEnding BalanceType of Expense:Beginning BalanceExpenses IncurredPaymentsEnding Balance
Retention bonusesRetention bonuses$— $5,605 $3,110 $2,495 Retention bonuses$2,495 $875 $1,793 $1,577 
Severance, benefits and transition expensesSeverance, benefits and transition expenses— 8,939 5,445 3,494 Severance, benefits and transition expenses3,494 (810)1,475 1,209 
Transaction expensesTransaction expenses250 845 357 738 Transaction expenses738 1,155 1,441 452 
TotalTotal$250 $15,389 $8,912 $6,727 Total$6,727 $1,220 $4,709 $3,238 


20


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
Summary of Liabilities and Expenses as of and for the Three Months Ended June 30, 2021Summary of Liabilities and Expenses as of and for the Three Months Ended September 30, 2021
By Segment:By Segment:Beginning BalanceExpenses IncurredPaymentsEnding BalanceBy Segment:Beginning BalanceExpenses IncurredPaymentsEnding Balance
ResidentialResidential$— $11,531 $7,387 $4,144 Residential$4,144 $813 $2,752 $2,205 
Lifestyle ServicesLifestyle Services— 1,720 1,144 576 Lifestyle Services576 (310)266 — 
Corporate and OtherCorporate and Other250 2,138 381 2,007 Corporate and Other2,007 717 1,691 1,033 
TotalTotal$250 $15,389 $8,912 $6,727 Total$6,727 $1,220 $4,709 $3,238 

A summary of the liabilities incurred combined with a reconciliation of the related components of restructuring expense recognized in the sixnine months ended JuneSeptember 30, 2022 and 2021, follows, first by cost component and then by segment. The expenses are aggregated and reported in the line item restructuring expenses in our condensed consolidated statements of operations.

Summary of Liabilities and Expenses as of and for the Six Months Ended June 30, 2022 (1)
Summary of Liabilities and Expenses as of and for the Nine Months Ended September 30, 2022 (1)
Type of Expense:Type of Expense:Beginning BalanceExpenses IncurredPaymentsEnding BalanceType of Expense:Beginning BalanceExpenses IncurredPaymentsEnding Balance
Retention bonusesRetention bonuses$1,005 $(33)$972 $— Retention bonuses$1,005 $(33)$972 $— 
Severance, benefits and transition expensesSeverance, benefits and transition expenses1,437 (171)1,142 124 Severance, benefits and transition expenses1,437 (171)1,142 124 
Transaction expensesTransaction expenses488 578 160 906 Transaction expenses488 512 272 728 
TotalTotal$2,930 $374 $2,274 $1,030 Total$2,930 $308 $2,386 $852 

Summary of Liabilities and Expenses as of and for the Six Months Ended June 30, 2022 (1)
Summary of Liabilities and Expenses as of and for the Nine Months Ended September 30, 2022 (1)
By Segment:By Segment:Beginning BalanceExpenses IncurredPaymentsEnding BalanceBy Segment:Beginning BalanceExpenses IncurredPaymentsEnding Balance
ResidentialResidential$2,541 $474 $2,123 $892 Residential$2,541 $476 $2,217 $800 
Corporate and OtherCorporate and Other389 (100)151 138 Corporate and Other389 (168)169 52 
TotalTotal$2,930 $374 $2,274 $1,030 Total$2,930 $308 $2,386 $852 

(1)    The activity in 2022 relates to adjustments made to those obligations that were incurred in 2021 and recognized under ASC 420, Exit or Disposal Cost Obligations, and ASC 712, Compensation-Nonretirement Postemployment Benefits-special termination benefits. Accrued bonuses and other
21


AlerisLife Inc.
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share amounts)
(unaudited)
compensation are reported in the condensed consolidated balance sheetsheets as part of accrued compensation and benefits and accrued transaction expenses are reported in the condensed consolidated balance sheets as part of accrued expenses and other current liabilities in the condensed consolidated balance sheets.liabilities.

Summary of Liabilities and Expenses as of and for the Nine Months Ended September 30, 2021
Type of Expense:Beginning BalanceExpenses IncurredPaymentsEnding Balance
Retention bonuses$— $6,480 $4,903 $1,577 
Severance, benefits and transition expenses— 8,129 6,920 1,209 
Transaction expenses— 2,250 1,798 452 
Total$— $16,859 $13,621 $3,238 

Summary of Liabilities and Expenses as of and for the Nine Months Ended September 30, 2021
By Segment:Beginning BalanceExpenses IncurredPaymentsEnding Balance
Residential$— $12,344 $10,139 $2,205 
Lifestyle Services— 1,410 1,410 — 
Corporate and Other— 3,105 2,072 1,033 
Total$— $16,859 $13,621 $3,238 
In connection with the repositioning of our residential management services, we incurred restructuring obligations, recognized under ASC 420, Exit or Disposal Cost Obligations and ASC 712, Compensation-Nonretirement Postemployment Benefits-special termination benefits of $528$(66) and $374$308 in the three and sixnine months ended JuneSeptember 30, 2022, $474$2 and $476, respectively, of which were reimbursed by DHC. During the three and sixnine months ended JuneSeptember 30, 2021, $15,389$1,220 and $15,639$16,859 of restructuring expenses were incurred, $11,531respectively, of which were$813 and $12,344 was reimbursed by DHC.DHC, respectively. These expenses included $5,605$6,480 of retention bonus payments, $8,939$8,129 of severance, benefits and transition expenses, and $845$2,250 of transaction expenses.

In addition to the restructuring expenses recorded for the three months ended June 30, 2021, there were transaction expenses of $250 recorded in corporate and other in the first quarter of 2021.

18. Subsequent Event

On July 2, 2022, we entered into an agreement to terminate the lease for our headquarters with a termination date of September 30, 2022. We also entered into a separate agreement to assume a lease from Sonesta for our headquarters as of September 1, 2022 at 255 Washington Street, Newton, Massachusetts. See Note 14 for further information on these lease agreements.

On August 3, 2022, we announced a restructuring plan based on a comprehensive operational review that was completed by Alvarez & Marsal, or A&M. The recommendations made by A&M includeincluded general and administrative cost reductions, a corporate reorganization that is designed to enhance accountability and certain operational changes to support team members to ensure the delivery of high-quality experiences to residents and customers and to increase occupancy at the Company’sour senior living communities. Pursuant to thisThis restructuring plan we intend to eliminateincludes the elimination of certain positions in our corporate team. We expect to complete this restructuring by the middle of 2023.

In connection with implementing this restructuring plan, we expect to incur non-recurring cash expenses of up to $6,100. $3,000 in the corporate and other segment.

These expenses are expected to include up to $200$400 of retention payments, up to $2,600$2,000 of severance, benefits and transition expenses, and up to $3,300$600 of other restructuring expenses.

For the three and nine months ended September 30, 2022, $1,636 of these restructuring expenses were incurred related to the restructuring plan.

These expenses included $93 of retention expenses, $1,404 of severance, benefits and transition expenses, and $139 of other restructuring expenses, which were recorded in restructuring expenses in our condensed consolidated statements of operations.

As of September 30, 2022, $299 of these restructuring payments have been made.

These payments included $92 of retention payments, $198 of severance, benefits and transition payments, and $9 of other restructuring payments.

As of September 30, 2022, we have an ending liability balance of $1,337.

This ending liability balance is comprised of $1 of retention expenses, $1,206 of severance, benefits and transition expenses, and $130 of other restructuring expenses.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
The following discussion should be read in conjunction with the condensed consolidated financial statements and related notes included elsewhere in this Quarterly Report on Form 10-Q, or Quarterly Report, and with our Annual Report on Form 10-K for the year ended December 31, 2021, or Annual Report.

Summary of Senior Living Communities and Outpatient Rehabilitation Locations

Presented below is a summary of the units owned and managed by us as of JuneSeptember 30, 2022:

Total
  Units (1)
Independent living10,46010,422
Assisted living7,6967,734
Memory care1,817
Total19,973

(1)    The units operated as of JuneSeptember 30, 2022 include 2,0872,084 in Five Star senior living communities that we own and 17,88617,889 in Five Star senior living communities that we manage for Diversified Health Care Trust, or DHC.

Presented below is a summary of the communities, units, average occupancy, quarter end occupancy, revenues and residential management fees for the Five Star senior living communities we manage for DHC, as of and for the three and sixnine months ended JuneSeptember 30, 2022 (dollars in thousands):

As of and for the three months ended June 30, 2022
CommunitiesUnitsAverage OccupancyQuarter End Occupancy
Community Revenues (1)
Management Fees
Independent and assisted living communities12017,88674.1%75.4%$165,179 $8,971 
As of and for the Three Months Ended September 30, 2022
CommunitiesUnitsAverage OccupancyQuarter End Occupancy
Community Revenues (1)
Management Fees
Independent and assisted living communities12017,88975.3%77.0%$171,684 $9,477 

As of and for the six months ended June 30, 2022
CommunitiesUnitsAverage OccupancyQuarter End Occupancy
Community Revenues (1)
Management Fees
Independent and assisted living communities12017,88674.1%75.4%$327,731 $17,903 
As of and for the Nine Months Ended September 30, 2022
CommunitiesUnitsAverage OccupancyQuarter End Occupancy
Community Revenues (1)
Management Fees
Independent and assisted living communities12017,88974.5%77.0%$499,415 $27,380 

(1)    Managed senior living communities' revenues do not represent our revenues and are included to provide supplemental information regarding the operating results of the Five Star senior living communities from which we earn residential management fees.

Presented below is a summary of our Ageility outpatient rehabilitation locations we operated as of and for the three and sixnine months ended JuneSeptember 30, 2022 (dollars in thousands):

As of and for the
Three Months Ended June 30, 2022
As of and for the
Three Months Ended September 30, 2022
Number of Locations
Total Revenue (1)(2)
Caseload as a % of occupancy (3)
EBITDA MarginNumber of Locations
Total Revenue (1)(2)
Caseload as a % of occupancy (3)
EBITDA Margin
Outpatient Locations in DHC Owned Communities Managed by Five StarOutpatient Locations in DHC Owned Communities Managed by Five Star93$7,572 25.6 %—%Outpatient Locations in DHC Owned Communities Managed by Five Star94$7,789 25.9 %(0.2)%
Outpatient Locations at AlerisLife Inc. Owned CommunitiesOutpatient Locations at AlerisLife Inc. Owned Communities15783 27.3 %(2.0)%Outpatient Locations at AlerisLife Inc. Owned Communities15868 29.9 %4.6%
Outpatient Locations at Other Communities (4)
Outpatient Locations at Other Communities (4)
944,339 23.0 %(2.2)%
Outpatient Locations at Other Communities (4)
944,124 21.7 %(8.3)%
Total Outpatient LocationsTotal Outpatient Locations202$12,694 24.5 %(0.9)%Total Outpatient Locations203$12,781 24.3 %(2.5)%

(1)    Excludes revenue of $1,736$1,590 earned during the three months ended JuneSeptember 30, 2022 for ten Ageility inpatient rehabilitation clinics.clinics (inclusive of two inpatient rehabilitation clinics that were closed during the three months ended September 30, 2022).
(2)    Total Ageility revenue includes fitness revenue. Total Ageility revenue excludes home health care services, which is part of the lifestyle services segment.
(3)    Represents the average number of Ageility customers divided by average total occupancy at each of the senior living communities where we operate Ageility outpatient rehabilitation locations. Occupancy is defined as the average total number of residents residing at the senior living communities.
(4)    Other communities include outpatient rehabilitation locations at senior living communities not owned or managed by us.
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Table of Contents
As of and for the
Six Months Ended June 30, 2022
As of and for the
Nine Months Ended September 30, 2022
Number of Locations
Total Revenue (1)(2)
Caseload as a % of occupancy (3)
EBITDA MarginNumber of Locations
Total Revenue (1)(2)
Caseload as a % of occupancy (3)
EBITDA Margin
Outpatient Locations in DHC Owned Communities Managed by Five StarOutpatient Locations in DHC Owned Communities Managed by Five Star93$14,870 25.5 %1.5%Outpatient Locations in DHC Owned Communities Managed by Five Star94$22,927 25.6 %0.9%
Outpatient Locations at AlerisLife Inc. Owned CommunitiesOutpatient Locations at AlerisLife Inc. Owned Communities151,545 27.6 %0.2%Outpatient Locations at AlerisLife Inc. Owned Communities152,412 28.3 %1.8%
Outpatient Locations at Other Communities (4)
Outpatient Locations at Other Communities (4)
948,324 22.3 %(0.9)%
Outpatient Locations at Other Communities (4)
9412,180 22.1 %(3.4)%
Total Outpatient LocationsTotal Outpatient Locations202$24,739 24.2 %0.6%Total Outpatient Locations203$37,519 24.2 %(0.4)%

(1)    Excludes revenue of $3,652$5,242 earned during the sixnine months ended JuneSeptember 30, 2022 for ten Ageility inpatient rehabilitation clinics.clinics (inclusive of two inpatient rehabilitation clinics that were closed during the nine months ended September 30, 2022).
(2)    Total Ageility revenue includes fitness revenue. Total Ageility revenue excludes home health care services, which is part of the lifestyle services segment.
(3)    Represents the average number of Ageility customers divided by average total occupancy at each of the senior living communities where we operate Ageility outpatient rehabilitation locations. Occupancy is defined as the average total number of residents residing at the senior living communities.
(4)    Other communities include outpatient rehabilitation locations at senior living communities not owned or managed by us.

We currently expect to continue to diversify revenue through growth of our lifestyle service offerings, including opening new outpatient rehabilitation locations and expanding our fitness and other home-based service offerings within and outside of Five Star senior living communities. With respect to outpatient rehabilitation locations, since January 1, 2021 we have opened 1213 net new Ageility outpatient rehabilitation locations, 15 of which were opened in 2021 (exclusive of the closure of 17 Ageility outpatient rehabilitation locations in December 2021 in Five Star senior living communities that were transitioned to new operators or closed).

Operational Review

During the quarter ended June 30, 2022, we engaged the healthcare consulting arm of Alvarez & Marsal, or A&M, to provide a comprehensive operational review of our business and make recommendations to our Board of Directors. The recommendations made by A&M includeincluded general and administrative cost reductions, a corporate reorganization that is designed to enhance accountability and certain operational changes to support team members to ensure the delivery of high-quality experiences to residents and customers and to increase occupancy at the Company'sour senior living communities, as further described below:

Reduce costs annually by a target of approximately $14.0$2.0 million, net of investments to be made of approximately $4.0$3.3 million as described below, by:

Streamlining redundant business processes and reducing investments in non-core functions,
rationalizing information technology systems to those that directly support core business functions, and ensuring their optimal utilization, and
continually assessing general and administrative expenses to identify cost savings opportunities.
Invest approximately $4.0$3.3 million to refocus on our core business and invest strategically in projects, processes and systems that will enhance our ability to successfully operate our residential and lifestyle services businesses, including:

Re-definingEnhancing the executive leadership team inclusive of hiringwith a Chief Operating Officer to oversee field and national operations and a Chief Financial Officer,
investing in a scalable and agile national operations infrastructure to drive operational excellence and results, and
establishing a centralized sales function with reinstituted regional sales support to focus on both sales and marketing efforts.
Based on A&M's operational review, on August 3, 2022, we announced a restructuring plan in which we intend to eliminateincludes the elimination of certain positions in our corporate team. We expect to complete this restructuring by the middle of 2023. As of the date of this Form 10-Q, we made the following progress with respect to the restructuring plan:
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Aligned several functions, including sales, marketing, clinical and resident programming, under the national operations support function;
Deployed sales support functions to directly support community level sales directors to focus on improved tour to move-in conversion rate;
Appointed a Chief Financial Officer, effective September 19, 2022, and a Chief Operating Officer, effective October 17, 2022. In addition, we continue to invest in the sales and marketing function, including hiring a Vice President of Marketing, effective October 3, 2022, and five sales directors; and
Implemented approximately $2.6 million of labor and non-labor annual cost savings, net of approximately $1.8 million in labor investments.
In addition to the restructuring plan, management achieved further cost savings of $4.9 million from the elimination of certain unfilled positions.
In connection with implementing thisour restructuring plan, we expect to incur non-recurring cash expenses of up to $6.1$3.0 million. These expenses are expected to include up to $0.2$0.4 million of retention payments, up to $2.6$2.0 million of severance, benefits and transition expenses and up to $3.3$0.6 million of other restructuring expenses. WeFor the three and nine months ended September 30, 2022, we recognized $1.6 million of expenses related to the restructuring plan, including $0.1 million of retention payments, $1.4 million of severance, benefits and transition expenses, and $0.1 million of other restructuring expenses, which was recorded in restructuring expenses in our condensed consolidated statements of operations. Additionally, we recognized costs of $0.7$0.6 million and $1.3 million, respectively, related to the implementation of the A&M
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operational review for the three and nine months ended JuneSeptember 30, 2022, which are recorded in general and administrative expenses in our condensed consolidated statements of operations.
General Industry Trends

We believe that, in the United States, the current primary market for services to older adults is focused on individuals age 75 and older. As a result of medical advances, adults are living longer and expanding their options as to where they choose to reside as they age. The aging of the Baby Boomers and their increasing life expectancy are leading to a fundamental demographic shift. The U.S. age profile reflects a 27.2% rise in the 75+ demographic in the last ten years. This is expected to rise even more significantly by 2030 (as evidenced by the aging boomers in the 65-74 age category)(1).

Due to these demographic trends, service providers are evolving to serve the growing number of older adults and we expect the demand for these services to increase in future years regardless of where the older adults may reside. As we continuously evaluate market opportunities related to older adults, we are cognizant of the demographic trends and projections that indicate that the age 65 and older demographic will represent the largest growth population in the United States over the next decade and beyond. We believe that increased longevity, coupled with evolving consumer preferences, will heighten demand for physical and recreational activities, as well as lifestyle-enhancing services, as older adults seek quality of life, ongoing engagement and sustained independence.

The senior living industry has been materially adversely impacted by the novel coronavirus SARS-CoV-2, or COVID-19, and the resulting pandemic, or the Pandemic, and its economic impact.impact, including the changes in market and older adults' practices during and in response to the Pandemic. While the U.S. economy has grownsenior living industry conditions have improved from itsa low point during the peak of the Pandemic, they remain below pre-Pandemic levels. In addition, U.S. economic conditions are currently experiencing significant challenges, including inflation, increasing interest rates, geopolitical risks, labor availability and commercial activities have been increasingly returning to pre-Pandemic levels, in part as asupply chain issues, that many economic forecasters expect will result of recent government spending on relief from the Pandemic, there continues to be adverse impacts from increasing levels of inflation, high labor and other costs, and decreased labor availability. There remains uncertainty as to the ultimate duration and severity of the Pandemic on the U.S. economy and commercial activities, including risks that may arise from (i) mutations or related strains of the virus, which continue to develop, and have previously and recently resulted in an increasing number of cases, (ii) the ability to successfully administer vaccinations to a sufficient number of persons or attain immunity to the virus by natural or other means to achieve herd immunity, and (iii) the impact on the U.S. economy that may result from the inability of other countries to administer vaccinations to their citizens or their citizens' ability to otherwise achieve immunity to the virus. For further information and risks relating to the Pandemic on us and our business, see Part I, Item 1, "Business—COVID Pandemic" and Part I, Item 1A, "Risk Factors", of our Annual Report.economic recession.

Occupancy. As a result of the Pandemic and changed market practices in response to, arising from or accelerated during, the Pandemic, we have experienced overall declines in average occupancy at our owned and leased senior living communities. However, with the widespread administration of vaccinations, particularly in the typical age group of our residents, we have experienced recent increases in our owned community average occupancy from 68.1%69.9% for the three months ended JuneSeptember 30, 2021 to 72.5%76.0% for the three months ended JuneSeptember 30, 2022. Consistent with our owned and leased portfolio, the senior living communities we manage for DHC also have experienced increases in average occupancy from 69.5%72.2% for the three months ended JuneSeptember 30, 2021 to 74.1%75.3% for the three months ended JuneSeptember 30, 2022.

With1) Source: Bureau of labor statistics, 2021.
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In order to drive occupancy growth, we recently have launched several initiatives, including i) adding regional staffing positions focused on revenue growth through sales, marketing and rate management, ii) launching a sales training and sales best practices program that we successfully piloted earlier in 2022, and iii) launching a sales incentive program that provides the widespread administration of vaccinationsleadership teams at our senior living communities andan opportunity to share in the requirement for team members to be vaccinated, we have been able to significantly reduce or eliminate restrictionsrevenue growth at ourtheir communities, with the intent of increasing occupancy at each senior living communities, which has enabled us to shift our efforts to new admissions and resident programs. community.

Despite the distribution of the COVID-19 vaccine, as a result of the ongoing effects of the Pandemic,these initiatives, there is a possibility of further occupancy declines in the near term, due to possible surges of COVID variant viruses, or other public health issues that may emerge, current residents leaving our senior living communities, restrictions on new residents moving into and/or touring our senior living communities, older adults continuing the trend of aging at home and the possibility that older adults will forego or delay moving into senior living communities because of perceived safety issues associated with the Pandemic.Pandemic or other public health safety concerns. Our revenues are largely dependent on occupancy at our senior living communities and any decline in occupancy adversely impacts these revenues, unless we are able to offset those lost revenues with increased rates we charge our residents and clients or other sources of increased revenues.

Expenses. Our labor costs have been negatively impacted as a result of increased labor costs for community based team members due to competitive market conditions and high levels of inflation. While health insurance costs have decreased as a result of the reduction in the number of team members, there is a possibility that these costs will rise again in the future as a result of claims made related to possible surges of COVID variant viruses and by team members pursuing elective proceduresor other public health issues that had been deferred or they were not able to obtain earlier in the Pandemic.may emerge. The Pandemic alsoand other current economic and market challenges have disrupted the global supply chain, including many of our medical and technological suppliers, due to factory closures and reduced manufacturing output. We believe that our current supplies and supplies we currently have on order should be sufficient to support our needs for the reasonably foreseeable future.

1) Source: Bureau of labor statistics, 2021.
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We have undertaken efforts to mitigate potential future impacts on the supply chain by increasing our stock of critical materials to meet our expected increased needs for the reasonably foreseeable future and by identifying and engaging alternative suppliers.

We continue to be alert to the potential for disruptions that could arise from the Pandemic and remain in close contact with our suppliers. Both labor costs and the costs of supplies and materials, in particular food and gasoline costs, have risen over the past year due to either the Russia-Ukraine war or from inflation. While inflation with inflationrates have eased slightly from their highest levels in the United States reaching a 40 year high in June 2022.2022, they are still running significantly higher than historical averages. We expect these increased costs to continue to impact our results of operations for the foreseeable future.

We incur these costs for our owned senior living communities, rehabilitation services locations and corporate and regional operations. Although DHC is responsible for these costs at the senior living communities we manage for DHC, increases in these costs would reduce earnings before interest, taxes, depreciation and amortization, or EBITDA, realized at these communities and, hence, negatively impact our ability to earn, and the amount of, any incentive fees, as well as possibly impact other aspects of our management arrangements.

Results of Operations. We have experienced negative impacts on our operating results and on the operating results for those senior living communities we manage for DHC as a result of the Pandemic as well as economic, market and industry conditions since the onset of the Pandemic. Although, as noted above, conditions have improved from the lows experienced during the Pandemic, the senior living industry continues to be negatively impacted by the Pandemic, and business at our owned and managed senior living communities and rehabilitation locations continues to be below pre-Pandemic levels. Although we believe that our business and operating results will improve if and as the Pandemic further wanes, we expect that it may take an extended period for our business to return to pre-Pandemic levels, if at all, and our business remains subject to decline if Pandemic conditions worsen or for other reasons.reasons including the challenging current and forecasted economic and market conditions which may result in an economic recession. Going forward, the amounts and type of revenue, expense and cash flow impacts resulting from the Pandemic will be dependent on a number of factors, including: the speed, depth, geographic reach and duration of the spread of new variants or surges of the disease;disease or other public safety developments; the effectiveness of therapeutic treatments for COVID-19 to our residents, clientstreatments; the impact of the current and team members;forecasted economic and market conditions, including the depth and length of any economic recession; consumer confidence and the demand for our senior living communities and services.

An increase in labor costs due to worker shortages as well as a general increase in costs due to rising inflation have resulted in negative impacts on our operating results and on the operating results for those senior living communities we manage for DHC. We also expect that other direct and indirect impacts of the Pandemic or other public health issues that may arise, potential economic recession, lower levels of consumer confidence, stock market volatility, inflation, rising interest rates and/or changes in demographics could adversely affect the ability of older adults and their families to afford our services.
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Senior Living Development. In the years prior to the Pandemic, increased access to capital and low-interest rates encouraged increased senior living development, particularly in areas where existing senior living communities have historically experienced high occupancy. This has resulted in a significant increase in new senior living community inventory entering the market in recent years, increasing competitive pressures on us, particularly in certain of our geographic markets. Although new development had been slowing prior to the onset of the Pandemic, and the impact of the Pandemic and current and forecasted economic and market conditions have further impacted new development, we expect that the new inventory that entered the market will continue to have a competitive effect on our business for at least the next few years; these challenges may continue to be intensified as a result of the Pandemic andif older adults' demand for senior living communities declines or fails to sufficiently grow its impact on the senior living community industry.

Labor Market. We have increased the rates paid to community based team members in order to be competitive with the increasing rates in the market for these front line team members. We also have increased staffing needs at the senior living communities we operate, for which we continue to use temporary staffing through our arrangements with staffing agencies to accommodate staffing shortages due to a tight labor market. The market for skilled front line workers within and outside of the senior living industry continues to be very competitive, and the current demand for those workers remains strong. As of JuneSeptember 30, 2022, there are approximately 10.710.1 million(1) jobs available in the United States, with only approximately 5.95.8 million(1) available workers. Our current rate of open positions is approximately 16.8%15.0%, a rate which will continue to result in increased expenses from temporary staffing, and increased rates and overtime paid to our community based team members, and may restrict our ability to fully operate our senior living communities.






1) Source: Bureau of labor statistics, 2021.
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Management Arrangements with DHC

As part of the repositioning of our residential management business in 2021, we and DHC amended our management arrangements. For more information on the amendments to our management arrangements with DHC, see Note 11 to our condensed consolidated financial statements included in Part I, Item 1 of this Quarterly Report or "Properties--Our Leases and Management Agreements with DHC" in Part I, Item 2 and Notes 1 and 10 included in Part IV, Item 15 of our Annual Report.

Debt Financing

On January 27, 2022, we entered into a $95.0 million senior secured term loan, or the Loan, $63.0 million of which was funded upon effectiveness of a credit and security agreement, or the Credit Agreement, that we entered into with MidCap Funding VIII Trust, or MidCap, including approximately $3.2 million in closing costs. Upon entering into the Loan, we terminated our $65.0 million secured revolving facility, or our Credit Facility, that we had with a syndicate of lenders and was available for us to use for general business purposes. At JuneSeptember 30, 2022, we had one mortgage note outstanding totaling $6.8$6.7 million. For more information about the Loan, our previous Credit Facility and our mortgage note, see Note 10 to our condensed consolidated financial statements included in Part I, Item 1 of this Quarterly Report.

Our Revenues

Our revenues are derived from the services we provide to residents at our senior living communities and to older adults through our lifestyle services, and these revenues are our primary source of cash to fund our operating expenses, including capital expenditures at the senior living communities we own and principal and interest payments on our debt.

Medicare and Medicaid programs provide operating revenues for lifestyle services and certain of our former skilled nursing facility, or SNF, units. We derived approximately 5.6% and 4.1%4.3% of our consolidated revenues from these government-funded programs during the sixnine months ended JuneSeptember 30, 2022 and 2021, respectively. Revenues from Medicare programs totaled $18.8$28.6 million and $21.3$31.4 million during the sixnine months ended JuneSeptember 30, 2022 and 2021, respectively. Revenues from Medicaid programs totaled $0.5$0.8 million and $0.6$0.9 million during the sixnine months ended JuneSeptember 30, 2022 and 2021, respectively. The concentration of revenues derived from Medicare and Medicaid is principally earned in connection with our lifestyle services.

In connection with the repositioning of our residential management business, we transitioned 107 senior living communities that we managed for DHC with approximately 7,400 living units to new operators, of which 69 senior living communities with approximately 4,800 living units were transitioned during the three months ended September 30, 2021, and closed one senior living community with approximately 100 living units. In addition, we and DHC closed all 1,532 SNF living units in 27 managed continuing care retirement communities, or CCRCs that we continue to manage for DHC as independent or assisted living communities. communities, of which 1,473 and 59 living units were closed during the second and third quarters of 2021, respectively.
1) Source: Bureau of labor statistics, 2021.
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For the three and sixnine months ended JuneSeptember 30, 2021, we recognized $4.4$2.7 million and $9.6$12.3 million of residential management fees related to these senior living communities and living units, respectively. Through JuneSeptember 30, 2022, we also closed 2729 of the 37 Ageility inpatient rehabilitation clinics. For the three and sixnine months ended JuneSeptember 30, 2021, we recognized $2.6$1.5 million and $8.1$9.6 million of revenue related to all 37 inpatient rehabilitation clinics, respectively. For the three and sixnine months ended JuneSeptember 30, 2022, we recognized $1.7$1.6 million and $3.7$5.2 million of revenue related to the ten inpatient rehabilitation clinics we continue to operate.operate (inclusive of revenue earned from twoinpatient rehabilitation clinics that were closed during the three months ended September 30, 2022).

Effective September 30, 2021, we terminated our lease for four communities with approximately 200 living units, which had residential revenues of $1.6$1.5 million and $3.4$4.9 million for the three and sixnine months ended JuneSeptember 30, 2021.2021, respectively. For more information regarding the termination of these leases, see Note 12 to our condensed consolidated financial statements in Part I, Item I of this Quarterly Report.

Federal and state governments have taken a number of actions to respond to the Pandemic. Certain of these actions may increase our operational costs or reduce our revenue, while others are designed to alleviate the adverse operational and financial consequences related to the Pandemic on operators of long-term care and senior living communities like us.

For further information regarding federal actions in response to the Pandemic, government healthcare funding and regulation and their possible impact on us and our business, revenues and operations, see the sections captioned “Business—Government Regulation and Reimbursement” in Part I, Item I of our Annual Report.

Results of Operations

We operate in two reportable segments: (1) residential and (2) lifestyle services. In the residential segment, we manage for others and operate, respectively, primarily independent living communities and assisted living communities and an active adult community that are subject to centralized oversight and provide housing and services to older adults. Included in the
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results of the assisted living communities are memory care living units. In the lifestyle services segment, we provide a comprehensive suite of rehabilitation and wellness services, including physical, occupational, speech and other specialized therapy services, in inpatient clinics and outpatient locations as well as home health and fitness services.

For the three and sixnine months ended JuneSeptember 30, 2021, we recognized $4.4$2.7 million and $9.6$12.3 million, respectively, of residential management fees related to the senior living communities and living units that we previously managed for DHC, that have been transitioned to other operators or were closed pursuant to the repositioning of our residential management business. We recognized lifestyle services revenue of $1.7$1.6 million and $2.6$1.5 million for the three months ended JuneSeptember 30, 2022 and 2021, respectively, and $3.7$5.2 million and $8.1$9.6 million for the sixnine months ended JuneSeptember 30, 2022 and 2021, respectively, related to the inpatient rehabilitation clinics. The decrease from the nine months ended September 30, 2022 as compared to the nine months ended September 30, 2021 was due to the closure of 27 inpatient clinics in the prior year. The information in the Key Statistical Data table below includes those senior living communities, living units and rehabilitation clinics in the results reported.

All of our operations and assets are located in the United States, except for the operations of our Cayman Islands organized captive insurance company subsidiary, which participates in our workers’ compensation, professional and general liability and certain automobile insurance programs.

Key Statistical Data For the Three Months Ended JuneSeptember 30, 2022 and 2021:

The following tables present a summary of our operations for the three months ended JuneSeptember 30, 2022 and 2021 (dollars and visits in thousands, except RevPAR and RevPOR):
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Three Months Ended June 30,Increase/(Decrease) Three Months Ended September 30,Increase/(Decrease)
2022
2021(1)
AmountPercent2022
2021(1)
AmountPercent
REVENUESREVENUESREVENUES
Lifestyle servicesLifestyle services$14,645 $17,453 $(2,808)(16.1)%Lifestyle services$14,546 $15,382 $(836)(5.4)%
ResidentialResidential16,094 16,378 (284)(1.7)%Residential17,514 16,320 1,194 7.3 %
Residential management feesResidential management fees8,971 12,927 (3,956)(30.6)%Residential management fees9,477 11,220 (1,743)(15.5)%
Total management and operating revenuesTotal management and operating revenues39,710 46,758 (7,048)(15.1)%Total management and operating revenues41,537 42,922 (1,385)(3.2)%
Reimbursed community-level costs incurred on behalf of managed communitiesReimbursed community-level costs incurred on behalf of managed communities127,648 195,271 (67,623)(34.6)%Reimbursed community-level costs incurred on behalf of managed communities137,768 177,231 (39,463)(22.3)%
Other reimbursed expensesOther reimbursed expenses3,765 16,592 (12,827)(77.3)%Other reimbursed expenses3,354 5,678 (2,324)(40.9)%
Total revenuesTotal revenues171,123 258,621 (87,498)(33.8)%Total revenues182,659 225,831 (43,172)(19.1)%
Other operating incomeOther operating income— (2)(100.0)%Other operating income— n/m
OPERATING EXPENSESOPERATING EXPENSESOPERATING EXPENSES
Lifestyle services expensesLifestyle services expenses14,329 15,668 (1,339)(8.5)%Lifestyle services expenses14,562 13,536 1,026 7.6 %
Residential wages and benefitsResidential wages and benefits9,159 9,896 (737)(7.4)%Residential wages and benefits10,156 8,547 1,609 18.8 %
Other residential operating expensesOther residential operating expenses4,973 8,968 (3,995)(44.5)%Other residential operating expenses5,804 7,184 (1,380)(19.2)%
Community-level costs incurred on behalf of managed communitiesCommunity-level costs incurred on behalf of managed communities127,648 195,271 (67,623)(34.6)%Community-level costs incurred on behalf of managed communities137,768 177,231 (39,463)(22.3)%
General and administrativeGeneral and administrative17,844 22,748 (4,904)(21.6)%General and administrative17,015 21,817 (4,802)(22.0)%
Restructuring expensesRestructuring expenses528 15,389 (14,861)(96.6)%Restructuring expenses1,570 1,220 350 28.7 %
Depreciation and amortizationDepreciation and amortization3,284 2,989 295 9.9 %Depreciation and amortization3,088 2,983 105 3.5 %
Total operating expensesTotal operating expenses177,765 270,929 (93,164)(34.4)%Total operating expenses189,963 232,518 (42,555)(18.3)%
Operating lossOperating loss(6,642)(12,306)5,664 (46.0)%Operating loss(7,302)(6,687)(615)9.2 %
Interest, dividend and other incomeInterest, dividend and other income129 76 53 69.7 %Interest, dividend and other income225 84 141 n/m
Interest and other expenseInterest and other expense(1,251)(409)(842)n/mInterest and other expense(1,474)(507)(967)n/m
Unrealized (loss) gain on equity investmentsUnrealized (loss) gain on equity investments(1,050)398 (1,448)n/mUnrealized (loss) gain on equity investments(1,997)22 (2,019)n/m
Realized gain on sale of debt and equity investmentsRealized gain on sale of debt and equity investments— 97 (97)(100.0)%Realized gain on sale of debt and equity investments1,573 — 1,573 n/m
Gain (loss) on termination of leasesGain (loss) on termination of leases498 (3,277)3,775 n/m
Loss before income taxesLoss before income taxes(8,814)(12,144)3,330 (27.4)%Loss before income taxes(8,477)(10,365)1,888 (18.2)%
Benefit (provision) for income taxes(158)167 n/m
(Provision) benefit for income taxes(Provision) benefit for income taxes(31)164 (195)n/m
Net lossNet loss$(8,805)$(12,302)$3,497 (28.4)%Net loss$(8,508)$(10,201)$1,693 (16.6)%
Owned and leased communities:Owned and leased communities:    Owned and leased communities:    
Number of communities (end of period)Number of communities (end of period)20 24 (4)(16.7)%Number of communities (end of period)20 20 — — %
Number of living units (end of period) (2)
Number of living units (end of period) (2)
2,087 2,251 (164)(7.3)%
Number of living units (end of period) (2)
2,084 2,099 (15)(0.7)%
Quarter end occupancy at June 30,75.5 %69.7 %580 bps8.3 %
Quarter end occupancy at September 30,Quarter end occupancy at September 30,78.4 %72.9 %550 bps7.5 %
Average occupancyAverage occupancy72.5 %68.1 %440 bps6.5 %Average occupancy76.0 %69.9 %610 bps8.7 %
RevPAR (3)
RevPAR (3)
$2,560 $2,425 $135 5.6 %
RevPAR (3)
$2,801 $2,411 $390 16.2 %
RevPOR (4)
RevPOR (4)
$3,492 $3,524 $(32)(0.9)%
RevPOR (4)
$3,604 $3,375 $229 6.8 %
Managed communities:Managed communities:    Managed communities:    
Number of communities (end of period)Number of communities (end of period)120 228 (108)(47.4)%Number of communities (end of period)120 159 (39)(24.5)%
Number of living units (end of period) (2)
Number of living units (end of period) (2)
17,886 25,482 (7,596)(29.8)%
Number of living units (end of period) (2)
17,889 20,669 (2,780)(13.5)%
Quarter end occupancy at June 30,75.4 %71.3 %410 bps5.8 %
Quarter end occupancy at September 30,Quarter end occupancy at September 30,77.0 %73.8 %320 bps4.3 %
Average occupancyAverage occupancy74.1 %69.5 %460 bps6.6 %Average occupancy75.3 %72.2 %310 bps4.3 %
RevPAR (3)
RevPAR (3)
$3,077 $3,086 $(9)(0.3)%
RevPAR (3)
$3,200 $3,046 $154 5.1 %
RevPOR (4)
RevPOR (4)
$4,109 $4,389 $(280)(6.4)%
RevPOR (4)
$4,158 $4,129 $29 0.7 %
Lifestyle services:Lifestyle services:    Lifestyle services:    
Caseload as a % of Occupancy (5)
Caseload as a % of Occupancy (5)
24.5 %27.5 %(360) bps(13.1)%
Caseload as a % of Occupancy (5)
24.3 %24.7 %(40) bps1.6 %
Number of visits at outpatient locationsNumber of visits at outpatient locations153 156 (3)(1.9)%Number of visits at outpatient locations156 147 6.1 %
Number of inpatient clinics (end of period)Number of inpatient clinics (end of period)10 10 — — %Number of inpatient clinics (end of period)10 (2)(20.0)%
Number of outpatient locations (end of period)Number of outpatient locations (end of period)202 218 (16)(7.3)%Number of outpatient locations (end of period)203 223 (20)(9.0)%
Total clinics and locationsTotal clinics and locations212 228 (16)(7.0)%Total clinics and locations211 233 (22)(9.4)%
_______________________________________
n/m - not meaningful
(1)    The following were included in the summary of operations for the three months ended JuneSeptember 30, 2021 that were not included for the three months ended JuneSeptember 30, 2022: (i) 107 senior living communities we managed for DHC with approximately 7,400 living units that were transitioned to new operators during the third and fourth quarters of 2021 (of which 69 senior living communities with approximately 4,800 living units were transitioned to new operators during the three months ended September 30, 2021), and one senior living community with approximately 100 living units that we managed for DHC that was closed in February 2022, (ii) 1,532 SNF living units that were closed in 27 CCRCs during 2021 (of which 1,473 living units were closed during the three months ended June 30, 2021), (iii) 27 Ageility inpatient rehabilitation clinics that were closed during the three months ended June 30, 2021, (iv) 17
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managed for DHC that was closed in February 2022, (ii) 59 SNF living units that were closed in one CCRC during the three months ended September 30, 2021, (iii) 17 Ageility outpatient rehabilitation locations that were closed during the fourth quarter of 2021 in senior living communities that were transitioned to a new operator or closed and (v)(iv) four leased communities with approximately 200 living units where the leases were terminated on September 30, 2021.
(2)    Includes only living units categorized as in service. As a result, the number of living units may change from period to period for reasons other than the acquisition or disposition of senior living communities.
(3)    RevPAR is defined by us as resident fee revenues for the corresponding portfolio for the period divided by the average number of available units for the corresponding portfolio for the period, divided by the number of months in the period. Data for the three months ended JuneSeptember 30, 2022 and 2021 exclude income received by senior living communities under the Provider Relief Fund of the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, and other governmental grants.
(4)    RevPOR is defined by us as resident fee revenues for the corresponding portfolio for the period divided by the average number of occupied units for the corresponding portfolio for the period, divided by the number of months in the period. Data for the three months ended JuneSeptember 30, 2022 and 2021 exclude income received by senior living communities under the Provider Relief Fund of the CARES Act and other governmental grants.
(5)    Represents the average number of Ageility customers divided by average total occupancy at each of the senior living communities where we operate Ageility outpatient rehabilitation locations. Occupancy is defined as the average total number of residents residing at the senior living communities.

Comparable Communities and Outpatient Locations

Comparable senior living communities and outpatient rehabilitation locations (senior living communities and outpatient rehabilitation locations that we have continually operated or managed since AprilJuly 1, 2021, excluding inpatient rehabilitation clinics) results for the three months ended JuneSeptember 30, 2022, compared to the three months ended JuneSeptember 30, 2021, are listed below (dollars in thousands, except RevPOR and RevPAR):

Three Months Ended June 30,Increase/(Decrease) Three Months Ended September 30,Increase/(Decrease)
2022(1)
2021(1)
AmountPercent
2022(1)
2021(1)
AmountPercent
REVENUESREVENUESREVENUES
Lifestyle servicesLifestyle services$12,332 $13,983 $(1,651)(11.8)%Lifestyle services$12,183 $12,823 $(640)(5.0)%
ResidentialResidential16,066 14,846 1,220 8.2 %Residential17,519 14,829 2,690 18.1 %
Residential management feesResidential management fees8,970 8,552 418 4.9 %Residential management fees9,478 8,510 968 11.4 %
Other operating incomeOther operating income— (2)(100.0)%Other operating income— n/m
OPERATING EXPENSESOPERATING EXPENSESOPERATING EXPENSES
Lifestyle services expensesLifestyle services expenses12,268 12,312 (44)(0.4)%Lifestyle services expenses12,211 11,479 732 6.4 %
Residential wages and benefitsResidential wages and benefits9,158 9,020 138 1.5 %Residential wages and benefits10,149 7,760 2,389 30.8 %
Other residential operating expensesOther residential operating expenses5,416 6,422 (1,006)(15.7)%Other residential operating expenses5,939 5,763 176 3.1 %
Owned communities:Owned communities:Owned communities:
Number of communities (end of period)Number of communities (end of period)20 20 — — %Number of communities (end of period)20 20 — — %
Number of living units (end of period) (2)
Number of living units (end of period) (2)
2,087 2,099 (12)(0.6)%
Number of living units (end of period) (2)
2,084 2,099 (15)(0.7)%
Quarter end occupancy at June 30,75.5 %70.1 %540 bps7.7 %
Quarter end occupancy at September 30,Quarter end occupancy at September 30,78.4 %72.9 %550 bps7.5 %
Average occupancyAverage occupancy72.5 %68.3 %420 bps6.1 %Average occupancy76.0 %70.4 %560 bps8.0 %
RevPAR (3)
RevPAR (3)
$2,560 $2,357 $203 8.6 %
RevPAR (3)
$2,801 $2,354 $447 19.0 %
RevPOR (4)
RevPOR (4)
$3,492 $3,413 $79 2.3 %
RevPOR (4)
$3,604 $3,270 $334 10.2 %
Managed communities:Managed communities:Managed communities:
Number of communities (end of period)Number of communities (end of period)120 120 — — %Number of communities (end of period)120 120 — — %
Number of living units (end of period) (2)
Number of living units (end of period) (2)
17,886 17,898 (12)(0.1)%
Number of living units (end of period) (2)
17,889 17,899 (10)(0.1)%
Quarter end occupancy at June 30,75.4 %73.3 %210 bps2.9 %
Quarter end occupancy at September 30,Quarter end occupancy at September 30,77.0 %74.6 %240 bps3.2 %
Average occupancyAverage occupancy74.1 %72.9 %120 bps1.6 %Average occupancy75.3 %73.4 %190 bps2.6 %
RevPAR (3)
RevPAR (3)
$3,077 $2,961 $116 3.9 %
RevPAR (3)
$3,200 $2,941 $259 8.8 %
RevPOR (4)
RevPOR (4)
$4,109 $4,018 $91 2.3 %
RevPOR (4)
$4,158 $3,922 $236 6.0 %
Lifestyle services:Lifestyle services:Lifestyle services:
Caseload as a % of occupancy (5)
Caseload as a % of occupancy (5)
24.8 %28.2 %(340) bps(12.1)%
Caseload as a % of occupancy (5)
24.6 %24.6 %— — %
Number of visits at outpatient locationsNumber of visits at outpatient locations146 147 (1)(0.7)%Number of visits at outpatient locations146 135 11 8.1 %
Number of outpatient locations (end of period)Number of outpatient locations (end of period)187 187 — — %Number of outpatient locations (end of period)185 185 — — %

n/m - not meaningful
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(1)    The three months ended JuneSeptember 30, 2022 and 2021 include data for 20 owned senior living communities, 120 managed senior living communities and 187185 outpatient rehabilitation locations that we have continuously owned or managed since AprilJuly 1, 2021. The summary of operations for comparable communities and locations excludes (i) 1,53259 SNF living units that were closed in 27 CCRCsone CCRC and (ii) teneight Ageility inpatient rehabilitation clinics.
(2)    Includes only living units categorized as in service. As a result, the number of living units may change from period to period for reasons other than the acquisition or disposition of senior living communities.
(3)    RevPAR is defined by us as resident fee revenues for the corresponding portfolio for the period divided by the average number of available units for the corresponding portfolio for the period, divided by the number of months in the period. Data for the three months ended JuneSeptember 30, 2022 and 2021 exclude income received by senior living communities under the Provider Relief Fund of the CARES Act and other governmental grants.
(4)    RevPOR is defined by us as resident fee revenues for the corresponding portfolio for the period divided by the average number of occupied units for the corresponding portfolio for the period, divided by the number of months in the period. Data for the three months ended JuneSeptember 30, 2022 and 2021 exclude income received by senior living communities under the Provider Relief Fund of the CARES Act and other governmental grants.
(5)    Represents the average number of Ageility customers divided by average total occupancy at each of the senior living communities where we operate Ageility outpatient rehabilitation locations. Occupancy is defined as the average total number of residents residing at the senior living communities.

The following is a discussion of our operating results for the three months ended JuneSeptember 30, 2022 compared to the three months ended JuneSeptember 30, 2021.

Lifestyle services revenues. The decrease in lifestyle services revenues is primarily due to a decrease in inpatient rehabilitation clinic revenues of $0.9 million and outpatient rehabilitation location revenues of $1.8 million. The reduction of our inpatient rehabilitation clinic revenues is$0.8 million, primarily associated withresulting from the closure of 27 inpatient rehabilitation clinics in the second quarter of 2021 as part of the repositioning of the residential management business. The reduction of our outpatient rehabilitation location revenues primarily resulted from a decrease in outpatient visits, the $0.5$0.4 million impact of the closure of 17 outpatient rehabilitation locations in December 2021 in senior living communities that were transitioned to new operators or closed, as well as the $0.6$0.5 million impact of a Medicare fee schedule rate cut in 2022.2022, partially offset by an increase in outpatient clinic visits. The decrease in lifestyle services revenues at our comparable locations is primarily due to the $0.7$0.5 million impact of a Medicare fee schedule rate cut in 2022 as well as a slight decrease in outpatient visits for the three months ended JuneSeptember 30, 2022.

Residential revenues. The decreaseincrease in residential revenues is primarily due to an increase in average occupancy from 69.9% for the three months ended September 30, 2021 to 76.0% for the three months ended September 30, 2022 at our owned and leased senior living communities, as well as a slight increase in average rates. This increase was partially offset by the termination of a lease for four communities on September 30, 2021. The discontinuation of these four communities resulted in a decrease in revenues of $1.6$1.5 million. This decrease was mostly offset by an increase in average occupancy from 68.1% for the three months ended June 30, 2021 to 72.5% for the three months ended June 30, 2022 at our owned senior living communities. The increase in residential revenues at our comparable communities is primarily due to the increase in average occupancy from 68.3%70.4% for the three months ended JuneSeptember 30, 2021 to 72.5%76.0% for the three months ended JuneSeptember 30, 2022 as well as a slight increase in average rates.

Residential management fees. The decrease in residential management fees is due to declines in gross revenues at the senior living communities we manage, primarily caused by the transitioning of approximately 7,400 living units to new operators in 2021, of which approximately 4,800 living units transitioned during the three months ended September 30, 2021, and the closure of approximately 100 living units subsequent to JuneSeptember 30, 2021, resulting in a decrease in residential management fees of $3.9 million, and the closure of 1,532 SNF living units subsequent to June 30, 2021, resulting in a decrease in residential management fees of $0.5$2.7 million. These declines in gross revenues as a result of the repositioning of the residential management business have been partially offset with the improvement in average occupancy from 69.5%72.2% for the three months ended JuneSeptember 30, 2021 to 74.1%75.3% for the three months ended JuneSeptember 30, 2022.2022, as well as a slight increase in residential construction management fees we earn on construction projects we manage. The increase in residential management fees at our comparable senior living communities was primarily due to the improvement in gross revenues at the senior living communities we manage related to the increase in average occupancy from 72.9%73.4% for the three months ended JuneSeptember 30, 2021 to 74.1%75.3% for the three months ended JuneSeptember 30, 2022, as well as due to an increase in residential construction management fees we earn on construction projects we manage.

Reimbursed community-level costs incurred on behalf of managed communities. The decrease in reimbursed community-level costs incurred on behalf of managed communities was primarily due to the transitioning of the management of approximately 7,400 living units to new operators subsequent to Junein 2021, of which approximately 4,800 living units transitioned during the three months ended September 30, 2021, and the closure of approximately 100 living units in February 2022, and the closure of 1,532 SNF living units, of which 1,473 units were closed during the three months ended June 30, 2021.2022.

Other reimbursed expenses. Other reimbursed expenses represent reimbursements that arise from certain centralized services we provide pursuant to our management agreements with DHC. The decrease in other reimbursed expenses was primarily due to reimbursements of $11.5 million related to restructuring expenses in the three months ended June 30, 2021, as well as a decrease in the expenses that are reimbursable as a result of the reduced corporate headcount of approximately 27.0%20% in connection with the repositioning of our residential management business.business, as well as a decrease in reimbursements of $0.8 million related to restructuring expenses in the three months ended September 30, 2021.

Other operating income. Other operating income represents funds received and recognized under the Provider Relief Fund of the CARES Act General Fund Distribution and other government grants.

Lifestyle services expenses. The decreaseincrease in lifestyle services expenses is primarily due to $1.4 millionthe full quarter impact of lifestyle services expenses that had been incurredthe new outpatient rehabilitation locations opened during or subsequent to the third quarter of 2021, an increase in outpatient rehabilitation location visits during the three months ended JuneSeptember 30, 2021 with respect2022 when compared to the 27 inpatientsame quarter in the prior year and higher labor costs due to rising wages and market conditions. Those increases were partially offset by $0.4 million of
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rehabilitation clinics that were closed during that period as part of the repositioning of our residential management business, $0.4 million of expenses that had been incurred during the three months ended JuneSeptember 30, 2021 related to 17 outpatient rehabilitation locations that were subsequently closed in December 2021 in senior living communities that were transitioned to new operators or closed, and a decreaseclosed. The increase in lifestyle services expenses at our comparable locations was due primarily to the increase in outpatient rehabilitation location visits during the three months ended JuneSeptember 30, 2022 when compared to the same quarter in the prior year. Those decreases were partially offset by the full quarter impact of the new outpatient rehabilitation locations opened during or subsequent to the second quarter of 2021. The decrease in lifestyle services expenses at our comparable locations was due to the decrease in outpatient rehabilitation location visits during the three months ended June 30, 2022 when compared to the same quarter in the prior year.year as well as higher labor costs.

Residential wages and benefits. The decreaseincrease in residential wages and benefits is primarily due to decreasedincreased medical insurance and workers compensation costs of $0.9 million as a result of a reductionan increase in the number of claims received compared to the secondthird quarter of 2021 as well as an increase in labor costs due to rising wages and market conditions. These increases were partially offset by the termination of a lease for four communities on September 30, 2021, which resulted in a decrease in residential wages and benefits of $0.8 million. These decreases were partially offset by an increase in labor costs due to rising wages, temporary staffing needs and market conditions. The increase in residential wages and benefits at our comparable communities is primarily due to higher labor costs, mostly offset by decreasedincreased costs for medical insurance and workers compensation of $1.0 million as well as higher labor costs.
 
Other residential operating expenses. Other residential operating expenses are comprised of utilities, housekeeping, dietary, repairs and maintenance, insurance and other community-level costs. The decrease in other residential operating expenses is primarily due to the termination of a lease for four communities on September 30, 2021, which resulted in a decrease in other residential operating expenses of $2.6$1.3 million, including a $0.9 million asset impairment recorded for the three months ended June 30, 2021 related to a senior living community that was damaged by a fire, as well as slightly decreased costs associated with our self-insurance obligations and a $0.5 million business interruption insurance recovery received in the three months ended June 30, 2022. These decreases were partially offset by increased costs related to marketing, utilities, disposable food supplies and other costs that have been impacted by rising inflation and supply chain issues.obligations. The decreaseincrease in other residential operating expenses at our comparable communities is primarily due to decreased costs associated with our self-insurance obligations, partially offset by increases in costs related to marketing, utilities, disposable food supplies and other costs that have been impacted by rising inflation and supply chain issues.issues, partially offset by reductions in building maintenance and medical supplies.

General and administrative. The decrease in general and administrative expenses was primarily attributable to lower corporate wages and benefits due to reduced corporate headcount of approximately 27.0%20% primarily in connection with the repositioning of the residential management business and lower fees for services performed by RMR due to a decrease in revenues for which those fees are determined, partially offset by costs associated with the separation agreement with our former President and Chief Executive Officer, Katherine Potter, of approximately $1.3 million, and $0.7$0.6 million of costs related to the operational review performed by A&M.&M for the three months ended September 30, 2022.

Restructuring expenses. The decreaseincrease in restructuring expenses was primarily due to severance, benefits, transition and retention costs related to the repositioning of our residential management business incurred during the three months ended JuneSeptember 30, 2021,2022, related to the restructuring plan implemented as a result of which $11.5 million was reimbursed by DHC and is also included in other reimbursed expenses.A&M's operational review.

Depreciation and amortization. The increase in depreciation and amortization is primarily due to an increase in depreciation as a result of the investment of capital in our owned senior living communities, partially offset by the termination of a lease for four communities on September 30, 2021, which resulted in a decrease in depreciation and amortization of $0.1 million.

Interest, dividend and other income. Interest, dividend and other income consists of interest earned primarily on our debt and equity investments.

Interest and other expense. Interest and other expense consists primarily of interest expense on the Loan, amortization of deferred financing fees on the Loan, and interest on our finance leases and mortgage note for the three months ended September 30, 2022. Interest and other expense consists primarily of amortization of deferred financing fees and commitment fees related to our Credit Facility, and interest on our finance leases and mortgage note for the three months ended JuneSeptember 30, 2021. Interest and other expense consists primarily of interest expense on the Loan, amortization of deferred financing fees on the Loan, and interest on our finance leases and mortgage note for three months ended June 30, 2022. The increase in interest and other expense for the three months ended JuneSeptember 30, 2022 was due to interest related to the Loan.
    
Unrealized (loss) gain on equity investments. Unrealized (loss) gain on equity investments represents adjustments made to our investments in equity securities to record amounts at fair value. The increase in unrealized loss in the three months ended JuneSeptember 30, 2022 is due to market conditions.

Realized gain (loss) on sale of debt and equity investments. Realized gain (loss) on sale of debt and equity investments represents our realized gains and losses on investments.

Gain (loss) on termination of leases Gain on termination of lease for the three months ended September 30, 2022 is due to the termination of our previous headquarters lease. Loss on termination of leases for the three months ended September 30, 2021 represents a $3.3 million loss on the lease termination of four communities. These costs include a $3.1 million lease termination fee, the write off of the remaining net assets at the communities including property and equipment and the remaining right of use assets, less the remaining recorded lease liability and the remaining obligation under the insurance deductible for a fire that occurred at one of the four leased communities. For more information about the lease terminations, see
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Note 14 to our condensed consolidated financial statements included in Part I, Item 1 of this Quarterly Report on Form 10-Q and Note 11 included in Part IV, Item 15 of our Annual Report.

Benefit (provision)(Provision) benefit for income taxes. For the three months ended JuneSeptember 30, 2022 and 2021, we recognized a benefitprovision for income taxes of $0.0 million and a provisionbenefit for income taxes of $0.2 million, respectively, both of which arerespectively. The benefit for income taxes for the three months ended September 30, 2021 is related to a decrease in the annual projection for state income taxes.

Key Statistical Data For the SixNine Months Ended JuneSeptember 30, 2022 and 2021:

The following tables present a summary of our operations for the sixnine months ended JuneSeptember 30, 2022 and 2021 (dollars and visits in thousands, except RevPAR and RevPOR):
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Six Months Ended
June 30,
Increase/(Decrease) Nine Months Ended
September 30,
Increase/(Decrease)
2022
2021 (1)
AmountPercent2022
2021 (1)
AmountPercent
REVENUESREVENUESREVENUES
Lifestyle servicesLifestyle services$28,784 $37,006 $(8,222)(22.2)%Lifestyle services$43,330 $52,388 $(9,058)(17.3)%
ResidentialResidential31,480 33,435 (1,955)(5.8)%Residential48,994 49,755 (761)(1.5)%
Residential management feesResidential management fees17,903 26,777 (8,874)(33.1)%Residential management fees27,380 37,997 (10,617)(27.9)%
Total management and operating revenuesTotal management and operating revenues78,167 97,218 (19,051)(19.6)%Total management and operating revenues119,704 140,140 (20,436)(14.6)%
Reimbursed community-level costs incurred on behalf of managed communitiesReimbursed community-level costs incurred on behalf of managed communities258,584 408,431 (149,847)(36.7)%Reimbursed community-level costs incurred on behalf of managed communities396,352 585,662 (189,310)(32.3)%
Other reimbursed expensesOther reimbursed expenses7,515 22,072 (14,557)(66.0)%Other reimbursed expenses10,869 27,750 (16,881)(60.8)%
Total revenuesTotal revenues344,266 527,721 (183,455)(34.8)%Total revenues526,925 753,552 (226,627)(30.1)%
Other operating incomeOther operating income42 7,795 (7,753)(99.5)%Other operating income44 7,795 (7,751)(99.4)%
OPERATING EXPENSESOPERATING EXPENSESOPERATING EXPENSES
Lifestyle services expensesLifestyle services expenses27,550 31,878 (4,328)(13.6)%Lifestyle services expenses42,112 45,414 (3,302)(7.3)%
Residential wages and benefitsResidential wages and benefits17,786 21,909 (4,123)(18.8)%Residential wages and benefits27,942 30,456 (2,514)(8.3)%
Other residential operating expensesOther residential operating expenses12,322 15,234 (2,912)(19.1)%Other residential operating expenses18,126 22,418 (4,292)(19.1)%
Community-level costs incurred on behalf of managed communitiesCommunity-level costs incurred on behalf of managed communities258,584 408,431 (149,847)(36.7)%Community-level costs incurred on behalf of managed communities396,352 585,662 (189,310)(32.3)%
General and administrativeGeneral and administrative36,190 45,139 (8,949)(19.8)%General and administrative53,205 66,956 (13,751)(20.5)%
Restructuring expensesRestructuring expenses374 15,639 (15,265)(97.6)%Restructuring expenses1,944 16,859 (14,915)(88.5)%
Depreciation and amortizationDepreciation and amortization6,447 5,929 518 8.7 %Depreciation and amortization9,535 8,912 623 7.0 %
Total operating expensesTotal operating expenses359,253 544,159 (184,906)(34.0)%Total operating expenses549,216 776,677 (227,461)(29.3)%
Operating lossOperating loss(14,945)(8,643)(6,302)72.9 %Operating loss(22,247)(15,330)(6,917)45.1 %
Interest, dividend and other incomeInterest, dividend and other income209 160 49 30.6 %Interest, dividend and other income434 244 190 77.9 %
Interest and other expenseInterest and other expense(2,283)(872)(1,411)n/mInterest and other expense(3,757)(1,379)(2,378)n/m
Unrealized (loss) gain on equity investmentsUnrealized (loss) gain on equity investments(1,682)533 (2,215)n/mUnrealized (loss) gain on equity investments(3,679)555 (4,234)n/m
Realized (loss) gain on sale of debt and equity investments(45)193 (238)n/m
Gain on termination of lease279 — 279 n/m
Realized gain on sale of debt and equity investmentsRealized gain on sale of debt and equity investments1,528 193 1,335 n/m
Gain (loss) on termination of leaseGain (loss) on termination of lease777 (3,277)4,054 n/m
Loss before income taxesLoss before income taxes(18,467)(8,629)(9,838)n/mLoss before income taxes(26,944)(18,994)(7,950)n/m
Provision for income taxesProvision for income taxes(68)(358)290 (81.0)%Provision for income taxes(99)(194)95 (49.0)%
Net lossNet loss$(18,535)$(8,987)$(9,548)n/mNet loss$(27,043)$(19,188)$(7,855)40.9 %
Owned and leased communities:Owned and leased communities:    Owned and leased communities:    
Number of communities (end of period)Number of communities (end of period)20 24 (4)(16.7)%Number of communities (end of period)20 20 — — %
Number of living units (end of period) (2)
Number of living units (end of period) (2)
2,087 2,251 (164)(7.3)%
Number of living units (end of period) (2)
2,084 2,099 (15)(0.7)%
Quarter end occupancy at June 30,75.5 %69.7 %580 bps8.3 %
Quarter end occupancy at September 30,Quarter end occupancy at September 30,78.4 %72.9 %550 bps7.5 %
Average occupancyAverage occupancy71.7 %68.2 %350 bps5.1 %Average occupancy73.2 %68.8 %440 bps6.4 %
RevPAR (3)
RevPAR (3)
$2,502 $2,453 $49 2.0 %
RevPAR (3)
$2,601 $2,439 $162 6.6 %
RevPOR (4)
RevPOR (4)
$3,468 $3,577 $(109)(3.0)%
RevPOR (4)
$3,516 $3,509 $0.2 %
Managed communities:Managed communities:  Managed communities:  
Number of communities (end of period)Number of communities (end of period)120 228 (108)(47.4)%Number of communities (end of period)120 159 (39)(24.5)%
Number of living units (end of period) (2)
Number of living units (end of period) (2)
17,886 25,482 (7,596)(29.8)%
Number of living units (end of period) (2)
17,889 20,669 (2,780)(13.5)%
Quarter end occupancy at June 30,75.4 %71.3 %410 bps5.8 %
Quarter end occupancy at September 30,Quarter end occupancy at September 30,77.0 %73.8 %320 bps4.3 %
Average occupancyAverage occupancy74.1 %69.5 %460 bps6.6 %Average occupancy74.5 %70.3 %420 bps6.0 %
RevPAR (3)
RevPAR (3)
$3,052 $3,150 $(98)(3.1)%
RevPAR (3)
$3,101 $3,120 $(19)(0.6)%
RevPOR (4)
RevPOR (4)
$4,096 $4,507 $(411)(9.1)%
RevPOR (4)
$4,117 $4,388 $(271)(6.2)%
Lifestyle services:Lifestyle services:Lifestyle services:
Caseload as a % of occupancy (5)
Caseload as a % of occupancy (5)
24.2 %26.8 %(320) bps(11.9)%
Caseload as a % of occupancy (5)
24.2 %26.5 %(230) bps(8.7)%
Number of visits at outpatient locationsNumber of visits at outpatient locations297 305 (8)(2.6)%Number of visits at outpatient locations453 452 0.2 %
Number of inpatient clinics (end of period)Number of inpatient clinics (end of period)10 10 — — %Number of inpatient clinics (end of period)10 (2)(20.0)%
Number of outpatient locations (end of period)Number of outpatient locations (end of period)202 218 (16)(7.3)%Number of outpatient locations (end of period)203 223 (20)(9.0)%
Total clinics and locationsTotal clinics and locations212 228 (16)(7.0)%Total clinics and locations211 233 (22)(9.4)%

n/m - not meaningful
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(1)    The following were included in the summary of operations for the sixnine months ended JuneSeptember 30, 2021 that were not included for the sixnine months ended JuneSeptember 30, 20222022: (i) 107 senior living communities we managed for DHC with approximately 7,400 living units that were transitioned to new operators during the third and fourth quarters of 2021 (of which 69 senior living communities with approximately 4,800 living units were transitioned to new operators during the nine months ended September 30, 2021), and one senior living community with approximately 100 living units that we managed for DHC that was closed in February 2022, (ii) 1,532 SNF living units that were closed in 27 CCRCs during 2021 (of which 1,473 and 59 living units, respectively, were closed during the six months ended June 30, 2021)second and third quarters), (iii) 27 Ageility inpatient rehabilitation clinics that were closed during the six months ended June 30,second quarter of 2021, (iv) 17 Ageility outpatient rehabilitation locations that were closed during the fourth quarter of 2021 in senior living communities that were transitioned to a new operator or closed and (v) four leased communities with approximately 200 living units where the leases were terminated on September 30, 2021.
(2)    Includes only living units categorized as in service. As a result, the number of living units may change from period to period for reasons other than the acquisition or disposition of senior living communities.
(3)    RevPAR is defined by us as resident fee revenues for the corresponding portfolio for the period divided by the average number of available units for the corresponding portfolio for the period, divided by the number of months in the period. Data for the sixnine months ended JuneSeptember 30, 2022 and 2021 exclude income received by senior living communities under the Provider Relief Fund of the CARES Act and other governmental grants.
(4)    RevPOR is defined by us as resident fee revenues for the corresponding portfolio for the period divided by the average number of occupied units for the corresponding portfolio for the period, divided by the number of months in the period. Data for the sixnine months ended JuneSeptember 30, 2022 and 2021 exclude income received by senior living communities under the Provider Relief Fund of the CARES Act and other governmental grants.
(5)    Represents the average number of Ageility customers divided by average total occupancy at each of the senior living communities where we operate Ageility outpatient rehabilitation locations. Occupancy is defined as the average total number of residents residing at the senior living communities.

Comparable Communities and Outpatient Locations

Comparable senior living communities and outpatient rehabilitation locations (senior living communities and outpatient rehabilitation locations that we have continually operated or managed since January 1, 2021, excluding inpatient rehabilitation clinics) results for the sixnine months ended JuneSeptember 30, 2022, compared to the sixnine months ended JuneSeptember 30, 2021, are listed below (dollars in thousands, except RevPOR and RevPAR):
Six Months Ended June 30,Increase/(Decrease) Nine Months Ended September 30,Increase/(Decrease)
2022(1)
2021(1)
AmountPercent
2022(1)
2021(1)
AmountPercent
REVENUESREVENUESREVENUES
Lifestyle servicesLifestyle services$23,678 $26,935 $(3,257)(12.1)%Lifestyle services$35,056 $38,959 $(3,903)(10.0)%
ResidentialResidential31,459 30,094 1,365 4.5 %Residential48,978 44,923 4,055 9.0 %
Residential management feesResidential management fees17,900 17,146 754 4.4 %Residential management fees27,378 25,657 1,721 6.7 %
Other operating incomeOther operating income42 6,980 (6,938)(99.4)%Other operating income45 6,980 (6,935)(99.4)%
OPERATING EXPENSESOPERATING EXPENSESOPERATING EXPENSES
Lifestyle services expensesLifestyle services expenses23,242 23,388 (146)(0.6)%Lifestyle services expenses34,704 34,171 533 1.6 %
Residential wages and benefitsResidential wages and benefits17,798 19,974 (2,176)(10.9)%Residential wages and benefits27,947 27,734 213 0.8 %
Other residential operating expensesOther residential operating expenses12,504 11,473 1,031 9.0 %Other residential operating expenses18,443 17,237 1,206 7.0 %
Owned communities:Owned communities:Owned communities:
Number of communities (end of period)Number of communities (end of period)20 20 — — %Number of communities (end of period)20 20 — — %
Number of living units (end of period) (2)
Number of living units (end of period) (2)
2,087 2,099 (12)(0.6)%
Number of living units (end of period) (2)
2,084 2,099 (15)(0.7)%
Quarter end occupancy at June 30,75.5 %70.1 %540 bps7.7 %
Quarter end occupancy at September 30,Quarter end occupancy at September 30,78.4 %72.9 %550 bps7.5 %
Average occupancyAverage occupancy71.7 %68.6 %310 bps4.5 %Average occupancy73.2 %69.2 %400 bps5.8 %
RevPAR (3)
RevPAR (3)
$2,502 $2,389 $113 4.7 %
RevPAR (3)
$2,601 $2,377 $224 9.4 %
RevPOR (4)
RevPOR (4)
$3,468 $3,464 $0.1 %
RevPOR (4)
$3,516 $3,397 $119 3.5 %
Managed communities:Managed communities:Managed communities:
Number of communities (end of period)Number of communities (end of period)120 120 — — %Number of communities (end of period)120 120 — — %
Number of living units (end of period) (2)
Number of living units (end of period) (2)
17,886 17,898 (12)(0.1)%
Number of living units (end of period) (2)
17,889 17,899 (10)(0.1)%
Quarter end occupancy at June 30,75.4 %73.3 %210 bps2.9 %
Quarter end occupancy at September 30,Quarter end occupancy at September 30,77.0 %74.6 %240 bps3.2 %
Average occupancyAverage occupancy74.1 %72.8 %130 bps1.8 %Average occupancy74.5 %73.0 %150 bps2.1 %
RevPAR (3)
RevPAR (3)
$3,052 $2,954 $98 3.3 %
RevPAR (3)
$3,101 $2,949 $152 5.2 %
RevPOR (4)
RevPOR (4)
$4,096 $4,035 $61 1.5 %
RevPOR (4)
$4,117 $3,996 $121 3.0 %
Lifestyle services:Lifestyle services:Lifestyle services:
Caseload as a % of occupancy (5)
Caseload as a % of occupancy (5)
24.3 %27.6 %(330) bps(12.0)%
Caseload as a % of occupancy (5)
24.4 %26.6 %(220) bps(8.3)%
Number of visits at outpatient locationsNumber of visits at outpatient locations279 283 (4)(1.4)%Number of visits at outpatient locations415 410 1.2 %
Number of outpatient locations (end of period)Number of outpatient locations (end of period)182 182 — — %Number of outpatient locations (end of period)178 178 — — %

n/m - not meaningful
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(1)    The sixnine months ended JuneSeptember 30, 2022 and 2021 include data for 20 owned senior living communities, 120 managed senior living communities and 182178 outpatient rehabilitation locations that we have continuously owned or managed since January 1, 2021. The summary of operations for comparable communities and locations excludes (i) 1,532 SNF living units that were closed in 27 CCRCs and (ii) teneight Ageility inpatient rehabilitation clinics.
(2)    Includes only living units categorized as in service. As a result, the number of living units may change from period to period for reasons other than the acquisition or disposition of senior living communities.
(3)    RevPAR is defined by us as resident fee revenues for the corresponding portfolio for the period divided by the average number of available units for the corresponding portfolio for the period, divided by the number of months in the period. Data for the sixnine months ended JuneSeptember 30, 2022 and 2021 exclude income received by senior living communities under the Provider Relief Fund of the CARES Act and other governmental grants.
(4)    RevPOR is defined by us as resident fee revenues for the corresponding portfolio for the period divided by the average number of occupied units for the corresponding portfolio for the period, divided by the number of months in the period. Data for the sixnine months ended JuneSeptember 30, 2022 and 2021 exclude income received by senior living communities under the Provider Relief Fund of the CARES Act and other governmental grants.
(5)    Represents the average number of Ageility customers divided by average total occupancy at each of the senior living communities where we operate Ageility outpatient rehabilitation locations. Occupancy is defined as the average total number of residents residing at the senior living communities.

The following is a discussion of our operating results for the sixnine months ended JuneSeptember 30, 2022 compared to the sixnine months ended JuneSeptember 30, 2021.

Lifestyle services revenues. The decrease in lifestyle services revenues is primarily due to a decrease in inpatient rehabilitation clinic revenues of $4.4$4.3 million and outpatient rehabilitation location revenues of $3.6$4.4 million. The reduction of our inpatient rehabilitation clinic revenues is primarily associated with the closure of 27 inpatient rehabilitation clinics during the sixnine months ended JuneSeptember 30, 2021 as part of the repositioning of the residential management business. The reduction of our outpatient rehabilitation location revenues primarily resulted from a decrease in outpatient visits, the $1.0$1.4 million impact of the closure of the 17 outpatient rehabilitation locations in December 2021 in senior living communities that were transitioned to new operators or closed, as well as the $1.3$1.8 million impact of a Medicare fee schedule rate cut in 2022. The decrease in lifestyle services revenues at our comparable locations is due to the $1.3$1.8 million impact of a Medicare fee schedule rate cut in 2022 as well as a slight decrease in outpatient visits for the sixnine months ended JuneSeptember 30, 2022.

Residential revenues. The decrease in residential revenues is primarily due to the termination of a lease for four communities on September 30, 2021. The discontinuation of these four communities resulted in a decrease in revenues of $3.4$4.9 million. This decrease was partially offset by an increase in average occupancy from 68.2%68.8% for the sixnine months ended JuneSeptember 30, 2021 to 71.7%73.2% for the sixnine months ended JuneSeptember 30, 2022 at our owned senior living communities. The increase in residential revenues at our comparable communities is primarily due to the increase in average occupancy from 68.6%69.2% for the sixnine months ended JuneSeptember 30, 2021 to 71.7%73.2% for the sixnine months ended JuneSeptember 30, 2022, partially offset by an increase of $0.7 million in residential fee discounts and concessions we provided to increase occupancy.2022.

Residential management fees. The decrease in residential management fees is due to declines in gross revenues at the senior living communities we manage, primarily caused by the transitioning of approximately 7,400 living units to new operators in 2021 and the closure of approximately 100 living units subsequent to June 30, 2021,in February 2022, resulting in a decrease in residential management fees of $7.8$10.5 million, and the closure of 1,532 SNF living units subsequent to Juneduring the nine months ended September 30, 2021, resulting in a decrease in residential management fees of $1.8$1.9 million. These declines in gross revenues as a result of the repositioning of the residential management business have been partially offset with the improvement in average occupancy from 69.5%70.3% for the sixnine months ended JuneSeptember 30, 2021 to 74.1%74.5% for the sixnine months ended JuneSeptember 30, 2022. The increase in residential management fees at our comparable senior living communities was primarily due to the improvement in gross revenues at the senior living communities we manage related to the increase in average occupancy from 72.8%73.0% for the sixnine months ended JuneSeptember 30, 2021 to 74.1%74.5% for the sixnine months ended JuneSeptember 30, 2022, as well as due to an increase in residential construction management fees we earn on construction projects we manage.2022.

Reimbursed community-level costs incurred on behalf of managed communities. The decrease in reimbursed community-level costs incurred on behalf of managed communities was primarily due to the transitioning of the management of approximately 7,400 living units to new operators subsequent to June 30,in 2021, the closure of approximately 100 living units in February 2022, and the closure of 1,532 SNF living units of which 1,473 living units were closed during the sixnine months ended JuneSeptember 30, 2021.

Other reimbursed expenses. Other reimbursed expenses represent reimbursements that arise from certain centralized services we provide pursuant to our management agreements with DHC. The decrease in other reimbursed expenses was primarily due to reimbursements of $11.5$12.3 million related to restructuring expenses in the sixnine months ended JuneSeptember 30, 2021, as well as a decrease in the expenses that are reimbursable as a result of the reduced corporate headcount of approximately 27.0%20% primarily in connection with the repositioning of our residential management business.

Other operating income. Other operating income represents funds received and recognized under the Provider Relief Fund of the CARES Act General Fund Distribution and other government grants. The decrease in other operating income was due to the decrease in Cares Act funds received during the 2022 period.nine months ended September 30, 2022.
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Lifestyle services expenses. The decrease in lifestyle services expenses is primarily due to $4.2 million of lifestyle services expenses that had been incurred during the sixnine months ended JuneSeptember 30, 2021 with respect to the 27 inpatient rehabilitation clinics that were closed during that period as part of the repositioning of our residential management business $0.9and
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$1.3 million of expenses that had been incurred during the sixnine months ended JuneSeptember 30, 2021 related to 17 outpatient rehabilitation locations that were subsequently closed in December 2021 in senior living communities that were transitioned to new operators or closed, and a decrease in outpatient rehabilitation location visits during the six months ended June 30, 2022 when compared to the same period in the prior year.closed. Those decreases were partially offset by the full period impact of the new outpatient rehabilitation locations opened during or subsequent to the sixnine months ended JuneSeptember 30, 2021. The decreaseincrease in lifestyle services expenses at our comparable communities was due to the decreaseslight increase in outpatient rehabilitation location visits during the sixnine months ended JuneSeptember 30, 2022 when compared to the sixnine months ended JuneSeptember 30, 2021.

Residential wages and benefits. The decrease in residential wages and benefits is primarily due to decreased medical insurance and workers compensation costs as a result of a reduction in claims received compared to the six months ended June 30, 2021, as well as the termination of a lease for four communities on September 30, 2021, which resulted in a decrease in residential wages and benefits of $1.8$2.6 million. These decreases were partially offset by anThe increase in labor costs due to rising wages, temporary staffing needs and market conditions. The decrease in residential wages and benefits at our comparable communities is primarily due to higher labor costs, mostly offset by decreased costs for medical insurance and workers compensation costs, partially offset by higher labor costs.
 
Other residential operating expenses. Other residential operating expenses are comprised of utilities, housekeeping, dietary, repairs and maintenance, insurance and other community-level costs. The decrease in other residential operating expenses is primarily due to the termination of a lease for four communities on September 30, 2021, which resulted in a decrease in other residential operating expenses of $4.0$5.2 million, including a $0.9 million asset impairment recorded for the sixnine months ended JuneSeptember 30, 2021 related to a senior living community that was damaged by a fire, as well as decreased costs associated with our self-insurance obligations and a $0.5 million business interruption insurance recovery recorded for the sixnine months ended JuneSeptember 30, 2022. These decreases were partially offset by increased costs related to marketing, utilities, disposable food supplies and other costs that have been impacted by rising inflation and supply chain issues. The increase in other residential operating expenses at our comparable communities is primarily due to increased costs related to marketing, utilities, disposable food supplies and other costs that have been impacted by rising inflation and supply chain issues.issues, partially offset by lower building maintenance and medical supplies costs and decreased costs associated with our self-insurance obligations.

General and administrative. The decrease in general and administrative expenses was primarily attributable to lower corporate wages and benefits due to reduced corporate headcount of approximately 27.0%20% primarily in connection with the repositioning of the residential management business and lower fees for services performed by RMR due to a decrease in revenues for which those fees are determined, partially offset by costs associated with the separation agreement with our former President and Chief Executive Officer Katherine Potter, of approximately $1.3 million, and $0.7$1.3 million of costs related to the operational review performed by A&M.&M during the nine months ended September 30, 2022.

Restructuring expenses. The decrease in restructuring expenses was primarily due to severance and retention costs related to the repositioning of our residential management business incurred during the sixnine months ended JuneSeptember 30, 2021, of which $11.5$12.3 million was reimbursed by DHC and is also included in other reimbursed expenses.expenses, partially offset by the restructuring plan implemented as a result of A&M's operational review.

Depreciation and amortization. The increase in depreciation and amortization is primarily due to an increase in depreciation as a result of the investment of capital in our owned senior living communities, partially offset by the termination of a lease for four communities on September 30, 2021, which resulted in a decrease in depreciation and amortization of $0.3$0.4 million.

Interest, dividend and other income. Interest, dividend and other income consists of interest earned primarily on our debt and equity investments.

Interest and other expense. Interest and other expense consists primarily of interest expense on the Loan, amortization of deferred financing fees on the Loan, and interest on our finance leases and mortgage note for the nine months ended September 30, 2022. Interest and other expense consists primarily of amortization of deferred financing fees and commitment fees related to our Credit Facility, and interest on our finance leases and mortgage note for the sixnine months ended JuneSeptember 30, 2021. Interest and other expense consists primarily of interest expense on the Loan, amortization of deferred financing fees on the Loan, and interest on our finance leases and mortgage note for the six months ended June 30, 2022. The increase in interest and other expense for the sixnine months ended JuneSeptember 30, 2022 was due to interest related to the Loan.

Unrealized (loss) gain on equity investments. Unrealized (loss) gain on equity investments represents adjustments made to our investments in equity securities to record amounts at fair value. The increase in unrealized loss in the sixnine months ended JuneSeptember 30, 2022 is due to market conditions.

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Realized gain (loss) on sale of debt and equity investments. Realized gain (loss) on sale of debt and equity investments represents our realized gains and losses on investments.

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Gain (loss) on termination of leases. Gain on termination of lease for the sixnine months ended JuneSeptember 30, 2022 represents a gain on the partialis due to termination of our previous headquarters lease. Loss on termination of leases for the nine months ended September 30, 2021 represents a $3.3 million loss on the lease termination for four communities. These costs include a $3.1 million lease termination fee, the write off of the remaining net assets at the communities including property and equipment and the remaining right of use assets, less the remaining recorded lease liability and the remaining lease obligations under the insurance deductible for a fire that occurred at one of the four leased communities.

Provision for income taxes. For the sixnine months ended JuneSeptember 30, 2022 and 2021, we recognized a provision for income taxes of $0.1 million and $0.4$0.2 million, respectively. The provision for income taxes for the sixnine months ended JuneSeptember 30, 2022 and 2021 is related to state income taxes.

Liquidity and Capital Resources

We require cash to fund our operating expenses, to make capital expenditures and to service our debt obligations. As of JuneSeptember 30, 2022, we had $83.5$79.1 million of unrestricted cash and cash equivalents. As of JuneSeptember 30, 2022, our restricted cash and cash equivalents included $22.8$19.2 million of bank term deposits in our captive insurance company. On January 27, 2022, we entered into the $95.0 million Loan, $63.0 million of which was funded upon effectiveness of the Credit Agreement, including approximately $3.2 million in closing costs. For more information about the Loan, see Note 10 to our condensed consolidated financial statements included in Part I, Item 1 of this Quarterly Report.

As of JuneSeptember 30, 2022 and December 31, 2021, we had current assets of $205.1$199.3 million and $186.8 million, respectively, and current liabilities of $121.4$126.1 million and $140.9 million, respectively.

The following table presents selected data on our operations from our condensed consolidated statements of cash flows for the periods presented (dollars in thousands):

Six Months Ended June 30,Nine Months Ended September 30,
Net cash (used in) provided byNet cash (used in) provided by20222021$ Change% ChangeNet cash (used in) provided by20222021$ Change% Change
Operating ActivitiesOperating Activities$(38,777)$17,880 $(56,657)n/mOperating Activities$(44,643)$1,800 $(46,443)n/m
Investing ActivitiesInvesting Activities(7,921)(2,662)(5,259)n/mInvesting Activities(6,711)(5,546)(1,165)21.0 %
Financing ActivitiesFinancing Activities60,095 (604)60,699 n/mFinancing Activities59,849 (911)60,760 n/m
Increase in cash and cash equivalents and restricted cash and cash equivalents13,397 14,614 (1,217)(8.3)%
Increase (decrease) in cash and cash equivalents and restricted cash and cash equivalentsIncrease (decrease) in cash and cash equivalents and restricted cash and cash equivalents8,495 (4,657)13,152 n/m
Cash and cash equivalents and restricted cash and cash equivalents at beginning of periodCash and cash equivalents and restricted cash and cash equivalents at beginning of period92,939 109,597 (16,658)(15.2)%Cash and cash equivalents and restricted cash and cash equivalents at beginning of period92,939 109,597 (16,658)(15.2)%
Cash and cash equivalents and restricted cash and cash equivalents at end of periodCash and cash equivalents and restricted cash and cash equivalents at end of period$106,336 $124,211 $(17,875)(14.4)%Cash and cash equivalents and restricted cash and cash equivalents at end of period$101,434 $104,940 $(3,506)(3.3)%

Operating Activities

The increase in cash flows used in operating activities for the sixnine months ended JuneSeptember 30, 2022 compared to the same period in 2021 is primarily due to the increase in net loss ($9.57.9 million), as well as an increase in cash used related to accounts payable ($18.2 million) and due from related person ($24.778.0 million) as a result of the repositioning of our residential management business in 2021, and an increase in cash used related to accounts payable ($11.1 million) partially offset by a decrease in cash used related to accrued expenses and other current liabilities ($22.7 million).

Investing Activities

Cash flows used in investing activities for the sixnine months ended JuneSeptember 30, 2022, increased as compared to the same period in 2021 primarily due to increased investments of property and equipment for owned senior living communities, rehabilitation locations and shared services infrastructure.infrastructure, partially offset by an increase in proceeds received from the sale of debt and equity investments.

Financing Activities

The increase in net cash provided by financing activities for the sixnine months ended JuneSeptember 30, 2022, compared to the same period in 2021 is primarily due to the $60.6 million of proceeds received from the Loan, net of deferred financing fees.




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Capital Expenditures

During the sixnine months ended JuneSeptember 30, 2022, we invested $6.5$10.2 million primarily in our owned senior living communities and rehabilitation locations as well as shared services infrastructure.locations. During the sixnine months ended JuneSeptember 30, 2021, we invested $4.2$7.1 million primarily in our owned and leased senior living communities and rehabilitation locations. DHC funds the capital expenditures at the senior living communities we manage for the account of DHC pursuant to our management agreements with DHC.
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Liquidity

Our liquidity and capital funding requirements depend on numerous factors, including our operating results, our working capital requirements and capital expenditures to the extent not funded by DHC pursuant to our management agreements with DHC, general economic conditions and the cost of capital. Shortfalls in cash flows from operating results or other principal sources of liquidity may have an adverse impact on our ability to execute our strategy or to maintain appropriate capital spending levels. We believe we have adequate financial resources from our existing cash flows from operations, together with unrestricted cash on hand and amounts available under our Loan, to support our business for at least the next twelve months.

We are closely monitoring the effect of the Pandemiccurrent and forecasted economic and market conditions, including the current inflationary conditions, on our liquidity. We currently expect to use cash on hand and cash flows from operations to fund our future operations and capital expenditures, to the extent not funded or reimbursed by DHC pursuant to our management agreements with DHC. We also have up to $12.0 million of additional proceeds available from the Loan to fund capital improvements at senior living communities we own. DHC funds the operating and capital expenses for the senior living communities we manage for DHC. We intend to conduct our business in a manner that will afford us reasonable access to capital for investment and financing activities, but we cannot be certain that we will be able to successfully carry out this intention, particularly because of the uncertainty surrounding the durationcurrent and severity offorecasted economic conditions and whether the current economic impact resulting from the Pandemic.senior living industry will return to pre-pandemic levels. A long, protracted and extensive decline in economic conditions, adverse market conditions in the senior living industry or disruption on the capital markets may cause a decline in financing availability and increased costs for financings.

Insurance

Increases over time in the cost of insurance, especially professional and general liability insurance, workers’ compensation and employee health insurance, have had an adverse impact upon our results of operations. We self-insure our professional and general liability and auto insurance. Recently, the costs that we incur for health insurance, to settle claims and to purchase insurance for claims in excess of the self-insured amounts have decreased as a result of the reduction in team members, some of which related to the senior living communities we manage on behalf of DHC and are reimbursed to us by DHC pursuant to our management agreements with DHC. However, these costs may not continue to decrease in the future, as team members could pursue elective procedures that had been deferred or they were not able to obtain during the Pandemic.future. We also have purchased property insurance coverage under DHC's policy with unrelated third party insurance providers.

For more information about our existing insurance see “Business—Insurance” in Part I, Item I of our Annual Report.

Debt Financings and Covenants

On January 27, 2022, certain of our subsidiaries entered into the Credit Agreement with MidCap. Under the terms of the Credit Agreement, we entered into a $95.0 million Loan, $63.0 million of which was funded upon effectiveness of the Credit Agreement, including approximately $3.2 million in closing costs. The remaining proceeds include $12.0 million for capital improvements at senior living communities we own and an opportunity for another $20.0 million that is available to us upon achieving certain financial targets. Certain of our subsidiaries are borrowers under the Credit Agreement and we and one of our subsidiaries provided a payment guarantee of up to $40.0 million of the obligations under the Credit Agreement as well as non-recourse carve-outs. The guaranty is evidenced by a Guaranty and Security Agreement, or the Guaranty Agreement, made by us and one of our subsidiaries in favor of MidCap. Pursuant to the Guaranty Agreement, our subsidiary granted MidCap a security interest on all of the assets of the subsidiary. The Guaranty Agreement requires us and our subsidiary to comply with various covenants, including restricting our ability to make distributions to shareholders. The Loan is secured by real estate mortgages on 14 senior living communities owned by us, our assets and certain related collateral. The maturity date of the Loan is January 27, 2025. Subject to the payment of an extension fee of 35 basis points and meeting certain other conditions, we may elect to extend the stated maturity date of the Loan for two one-year periods. We are required to pay interest on outstanding amounts at an annual base rate of the Secured Overnight Financing Rate, or SOFR, plus a term SOFR adjustment of 11 basis points (subject to a minimum base rate of 50 basis points) plus 450 basis points. The Credit Agreement requires interest only payments for the first two years and requires mandatory prepayment of the Loan on account of certain events of default. Voluntary prepayments made within 18 months of the effective date of the Loan will be subject to a
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prepayment fee, equal to the greater of the present value of remaining interest payments relating to the principal amount being repaid or 0.50% of the outstanding balance of the Loan as of the date of prepayment. The Loan may thereafter be voluntarily prepaid without premium or penalty. The Company will be required to pay an exit fee between 1.0% and 1.5%, subject to the conditions set forth in the Credit Agreement, upon any prepayment of the Loan, which would be in addition to any prepayment fees that may be payable. The Loan provides for acceleration of payment of all amounts outstanding upon the occurrence and continuation of certain events of default, including a change of control of us, as defined in the Credit Agreement. The default
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rate of interest is 5.0% per annum in excess of the rate otherwise payable under the Credit Agreement. The Credit Agreement also contains a number of financial and other covenants including covenants that restrict thea borrowers' ability to incur indebtedness or to pay or make distributions under certain circumstances and requires us to maintain certain financial ratios which become effectivea debt yield percentage ranging from 3.0% to 7.5% beginning March 31, 2023, and a debt service coverage ratio ranging from 1.15:1.00 to 1.25:1.00 beginning September 30, 2023. The Credit Agreement also contains certain representations and warranties and reporting obligations. The annual interest rate on the Loan as of September 30, 2022 was 7.7%. For more information about the Loan, see Note 10 to our condensed consolidated financial statements included in Part I, Item 1 of this Quarterly Report on Form 10-Q.

The Loan replaced our $65.0 million Credit Facility, which was available for general business purposes and was scheduled to expire on June 12, 2022 before it was terminated on January 27, 2022. No borrowings were outstanding under the Credit Facility at the time we entered into the Credit Agreement. We were required to pay interest on borrowings under our Credit Facility at an annual rate of LIBOR plus a premium of 250 basis points per annum; or at a base rate, as defined in the credit agreement, plus 150 basis points per annum. We were also required to pay a quarterly commitment fee of 0.35% per annum on the unused portion of the available capacity under our Credit Facility. No principal repayment was due until maturity.

We also have a mortgage note as of JuneSeptember 30, 2022, that we assumed in connection with a previous acquisition of a senior living community. Payments of principal and interest are due monthly under this mortgage debt until maturity in September 2032. The annual interest rate on this mortgage debt was 6.20% as of JuneSeptember 30, 2022.

At July 29,September 30, 2022, we had one irrevocable standby letter of credit outstanding, totaling $23.9 million. This letter of credit, which secures our workers' compensation insurance program, is collateralized by approximately $19.5$19.2 million of cash equivalents and $4.3$4.7 million of debt and equity investments. This letter of credit expires in June 2023 and is automatically extended for one-year terms unless notice of nonrenewal is provided prior to the end of the applicable term. At JuneSeptember 30, 2022, the cash equivalents collateralizing this letter of credit are classified as current restricted cash and cash equivalents in our consolidated balance sheets, and the debt and equity investments collateralizing this letter of credit are classified as current restricted debt and equity investments in our consolidated balance sheets.

As of JuneSeptember 30, 2022, we had $63.0 million outstanding on our Loan, and $6.8$6.7 million outstanding on the mortgage note. As of JuneSeptember 30, 2022, we believe we were in compliance with all applicable covenants under our debt agreements.

For more information regarding our debt financings and covenants, see Note 10 to our condensed consolidated financial statements in Part I, Item 1 of this Quarterly Report on Form 10-Q.

Related Person Transactions

We have relationships and historical and continuing transactions with DHC, RMR, ABP Trust and others related to them. For further information about these and other such relationships and related person transactions, see Notes 11, 13 and 14 to our condensed consolidated financial statements included in Part I, Item 1 of this Quarterly Report on Form 10-Q, our Annual Report, our definitive Proxy Statement for our 2022 Annual Meeting of Stockholders and our other filings with the SEC. In addition, see the sectionssection captioned "Warning Concerning Forward-Looking Statements, Part I, Item 1, "Business" and Part I, Item 1A, "Risk Factors" in our Annual Report for a description of risks that may arise as a result of these and other related person transactions and relationships. We may engage in additional transactions with related persons, including businesses to which RMR or its subsidiaries provide management services.

Seasonality

Revenues derived from our senior living and managed communities are subject to modest effects of seasonality, which we experience in certain regions more than others, due to weather patterns, geography and higher incidence and severity of flu and other illnesses during winter months. We do not expect these seasonal differences to cause material fluctuations in our revenues or operating cash flows. It is uncertain what the long-term survival, recurrence and resurgence of COVID-19 will be, including whether it will weaken, transform or otherwise become a common seasonal virus, which may change or amplify seasonal aspects and effects on our business.
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Item 3. Quantitative and Qualitative Disclosures About Market Risk
Not applicable.

Item 4. Controls and Procedures

As of the end of the period covered by this Quarterly Report on Form 10-Q, our management carried out an evaluation, under the supervision and with the participation of our President and Chief Executive Officer and our Senior Vice President, Chief Financial Officer and Treasurer, of the effectiveness of our disclosure controls and procedures pursuant to Rules 13a-15 and 15d-15 under the Securities Exchange Act of 1934, as amended. Based upon that evaluation, our management, including our President and Chief Executive Officer and our Senior Vice President, Chief Financial Officer and Treasurer, concluded that our disclosure controls and procedures are effective.
 
There have been no changes in our internal control over financial reporting during the quarter ended JuneSeptember 30, 2022, that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

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Warning Concerning Forward-Looking Statements
 
This Quarterly Report on Form 10-Q contains statements that constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 and other securities laws. Also, whenever we use words such as “believe”, “expect”, “anticipate”, “intend”, “plan”, “estimate”, “will”, “may” and negatives or derivatives of these or similar expressions, we are making forward-looking statements. Forward-looking statements in this Quarterly Report on Form 10-Q relate to various aspects of our business, including, but are not limited to the following:

The duration and severity of the novel coronavirus SARS-CoV-2, or COVID-19, pandemic, or the Pandemic and its impact on public health and safety, particularly older adults, and on our and Diversified Healthcare Trust's, or DHC's, business, results, operations and liquidity,

The availability, effectiveness, impact and extent of administration of COVID-19 vaccines and therapeutic treatments on public health and safety, economic conditions, the older adult customer we service and our business,

Our expectations for the operation and performance of the business following implementation of our repositioning of the residential management business,

The implementation of the restructuring plan recommended by Alvarez & Marsal, or A&M, and our expectations regarding the timing, costs, savings and benefits of the restructuring,

Our ability to attract and retain qualified and skilled employees,

Our ability to operate our senior living communities and deliver lifestyle services profitably,

Our ability to grow and diversify revenues,

Our expectation to focus our expansion activities on internal growth from our existing senior living communities we operate and other lifestyle services we may provide,

Our ability to increase the number of senior living communities we operate and residents we serve, and to grow through other sources of revenues, including lifestyle services,

Whether the aging U.S. population and increasing life spans of older adults will increase the demand for senior living communities and lifestyle services,

Our expectations of the types of services older adults will demand and our ability to satisfy those demands,

Our expectation that we will continue to diversify revenue through growth of our lifestyle service offerings, including opening new outpatient rehabilitation locations and expanding our fitness and other home-based service offerings within and outside our senior living communities,

Our ability to comply and to remain in compliance with applicable Medicare, Medicaid and other federal and state regulatory, rulemaking and rate setting requirements,

Our belief regarding the adequacy of our financial resources to support our business, and

Our ability to access or raise debt or equity capital.

Our actual results may differ materially from those contained in or implied by our forward-looking statements. Forward-looking statements involve known and unknown risks, uncertainties and other factors, some of which are beyond our control. A summary of the risks, uncertainties and other factors that could have a material adverse effect on our forward-looking statements and upon our business, results of operations, financial condition, cash flows, liquidity and prospects identified in Part I, Item 1A. "Risk Factors" of our Annual Report on Form 10-K include, but are not limited to: 

The impact of conditions in the economy and the capital markets on us and our customers,

Competition for older adult customers within the residential and lifestyle services businesses,

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Older adults delaying or forgoing moving into senior living communities or purchasing lifestyle services from us,
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Increases in our labor costs or in costs we pay for goods and services, delays in supply chain and price inflation,

Increases in tort and insurance liability costs,

Our operating and debt leverage,

Actual and potential conflicts of interest with our related parties, including our Managing Directors, DHC, RMR, ABP Trust and others affiliated with them,

Changes in Medicare or Medicaid policies and regulations or the possible future repeal, replacement or modification of these or other existing or proposed legislation or regulations, which could result in reduced Medicare or Medicaid rates, a failure of such rates to cover our costs or limit the scope or funding of either or both programs, or reductions in private insurance utilization and coverage,

Delays or nonpayment of government payments to us,
Compliance with, and changes to, federal, state and local laws and regulations that could affect our services or impose requirements, costs and administrative burdens that may reduce our ability to profitably operate our business,

Our exposure to litigation and regulatory and government proceedings due to the nature of our business, including adverse determinations resulting from government reviews, audits and investigations and unanticipated costs to comply with legislative or regulatory developments,

Ongoing healthcare reform efforts, including continued efforts by third-party payers to reduce costs,

Acts of terrorism, outbreaks of so-called pandemics or other human-made or natural disasters beyond our control, and

The effects of the implementation of the repositioning of our residential management business and restructuring of our business based on the recommendations of A&M on our business and operations.

For example:

Challenging conditions continue to exist, including inflation, high interest rates and geopolitical risks, and some forecasts expect worsening economic and market conditions, including a possible economic recession, and our business and operations remainis subject to substantial risks, many of which are beyond our control. As a result, our operations may not be profitable in the future and we may realize losses,

Our ability to deliver residential management or lifestyle services profitably and increase the revenues we generate depends upon many factors, including our ability to integrate new senior living communities and rehabilitation locations into our existing operations, as well as some factors that are beyond our control, such as the demand for our services arising from economic conditions generally and competition from other providers of services to older adults. We may not be able to successfully integrate, operate, compete and profitably manage our senior living communities and deliver lifestyle services,

We expect to enter into management arrangements with DHC or other owners for additional senior living communities. However, we cannot be sure that we will enter into any additional management arrangements,

Our belief that the aging of the U.S. population and increasing life spans of older adults will increase demand for senior living communities and lifestyle services may not be realized or may not result in increased demand for our services,

Our investments in our workforce and continued focus on reducing team member turnover by enhancing our competitiveness in the marketplace with respect to cash compensation and other benefits, as well as our efforts to attract talent, may not be successful and may not result in the benefits we expect to achieve through such investments,

The costs of executing the repositioning of our residential management business may be more than we expect,

We may not realize the benefits we anticipate from the repositioning of our residential management business,

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We may not be able to achieve our objectives following implementation of the repositioning of our residential management business, including partially offsetting the revenue loss from the senior living communities we transitioned with expense reductions to right-size operations, on the anticipated timeline, or at all,

We may not be able to achieve the objectives of the restructuring plan recommended by A&M, including reducing our costs and improving occupancy, and it may take longer and cost more to complete the restructuring than we expect,

We cannot be sure that the terms of our new management arrangements with DHC will achieve the anticipated benefit on our operating results,

Our expectation that our lifestyle services segment will grow may not be realized or any growth it does achieve may not be profitable or produce the benefits we expect,

Current inflationary pressures may continue or increase, which may significantly harm our business and results of operations,

Our strategic arrangements or collaborations with third party service providers may not be successful and we may not realize the benefits we expect from these arrangements,

Our sales and marketing initiatives may not succeed in increasing our revenues, and they may cost more than any increased revenues they may generate,

Our strategic investments to enhance efficiencies and enhance our service offerings or grow our business may not be successful or generate the returns we expect,

Circumstances that adversely affect the ability of older adults or their families to pay for our services, such as economic downturns, inflation, weakening housing market conditions, higher levels of unemployment among our customers or their family members, lower levels of consumer confidence, stock market volatility and/or changes in demographics generally could affect the revenues and profitability of our business,

Customers who pay for our services with their private resources may become unable to afford our services, resulting in decreased revenues,

The various federal and state government agencies that pay us for the services we provide to some of our customers are still experiencing budgetary constraints and may lower the Medicare, Medicaid and other rates they pay us,

Our efforts to mitigate the continued effects of the Pandemic may not be sufficient,
We expect that the Pandemic may continue to adversely affect our business, operating results and financial condition, due to potential deterioration or reduced improvements of occupancy at our senior living communities, staffing pressures and potential medical and food supply shortages that may have an adverse effect on the operating costs of our senior living communities,

We believe that our insurance costs may rise as a result of claims or litigation associated with the Pandemic, employees pursuing elective health procedures they deferred during the Pandemic and general market conditions,

We may be unable to repay or refinance our debt obligations when they become due,
We believe that we have adequate financial resources to fund our business for at least the next 12 months. However, we have incurred in the most recent period, and in prior periods, and we may continue to incur in future periods, operating losses and we have a large accumulated deficit. Moreover, certain aspects of our operations and future growth opportunities that we may pursue in our business may require significant amounts of cash and require us to make significant capital expenditures. As a result, we may not have sufficient cash liquidity,
The amount of available borrowings under our Loan is subject to our having qualified collateral, which is primarily based on the value of the assets securing our obligations under our Loan. Accordingly, the available borrowings under the Loan at any time may be less than $95.0 million as it was as of JuneSeptember 30, 2022. Also, the availability of borrowings under our Loan is subject to our satisfying certain financial covenants and other conditions that we may be unable to satisfy,
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We intend to conduct our business in a manner that will afford us reasonable access to capital for investment and financing activities. However, we may not be able to successfully carry out this intention. Further, market disruptions, caused and continued by the Pandemic as well as general economic conditions, may significantly limit our access to capital,

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Our actions and approach to managing our insurance costs, including our operating an offshore captive insurance company and self-insuring with respect to certain liability matters, may not be successful and could result in our incurring significant costs and liabilities that we will be responsible for funding,

Contingencies in any applicable acquisition or sale agreements we have entered into, or may enter into, may not be satisfied and our applicable acquisitions or sales, and any related management arrangements we may expect to enter into or exit, may not occur, may be delayed or the terms of such transactions or arrangements may change,

We may be unable to meet collateral requirements related to our workers’ compensation insurance program for future policy years, which may result in increased costs for such insurance program,

We may not be able to sell senior living communities that we own or manage, that we, or DHC may seek to sell, on acceptable terms or we may incur losses in connection with any such sales,

We believe that our relationships with our related parties, including DHC, RMR, ABP Trust and others affiliated with them may benefit us and provide us with competitive advantages in operating and growing our business. However, the advantages we believe we may realize from these relationships may not materialize, and

Components of our residential management and lifestyle services are subject to extensive government regulation, licensure and oversight. We sometimes have regulatory issues in the operation of our senior living communities and delivery of lifestyle services and, as a result, we may periodically be prohibited from or limited in admitting new residents or providing services, or our license to continue operations may be suspended or revoked. Also, operating deficiencies or a license revocation may have an adverse impact on our ability to operate, obtain licenses for, or attract customers.

Currently, unexpected results could occur due to many different circumstances, some of which are beyond our control, such as acts of terrorism, natural disasters, war or other hostilities, global climate change, pandemics, epidemics and other widespread illnesses, including the Pandemic, changed Medicare or Medicaid rates, new legislation, regulations or rulemaking affecting our business, or changes in capital markets or the economy generally.

We have based our forward-looking statements on our current expectations about future events that we believe may affect our business, financial condition and results of operations. Because forward-looking statements are inherently subject to risk and uncertainties, some of which cannot be predicted or qualified, our forward-looking statements should not be relied on as predictions of future events. The events and circumstances reflected in our forward-looking statements may not be achieved or occur and actual results could differ materially from those projected or implied in our forward-looking statements. The matters discussed in this warning should not be construed as exhaustive and should be read in conjunction with the other cautionary statements that are included in this Quarterly Report on Form 10-Q.

The information contained elsewhere in this Quarterly Report on Form 10-Q or in our other filings with the Securities and Exchange Commission, or SEC, including under the caption “Risk Factors”, or incorporated herein or therein, identifies other important factors that could cause differences from our forward-looking statements. Our filings with the SEC are available on the SEC’s website at www.sec.gov.

You should not place undue reliance upon our forward-looking statements.

Except as required by law, we do not intend to update or change any forward-looking statements as a result of new information, future events or otherwise.
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PART II. Other Information

Item 1. Legal Proceedings
Information on material developments in our legal proceedings is included in Note 15 to our condensed consolidated financial statements included in Part I, Item 1 of this Quarterly Report on Form 10-Q.

Item 1A. Risk Factors

Our business faces many risks, a number of which are described under the caption “Risk Factors” in our Annual Report on Form 10-K. The risks described in our Annual Report may not be the only risks we face. Other risks of which we are not yet aware, or that we currently believe are not material, may also materially and adversely impact our business operations or financial results. If any of the events or circumstances described in the risk factors contained in our Annual Report occurs, our business, financial condition or results of operations could be adversely impacted and the value of an investment in our securities could decline. Investors and prospective investors should consider the risks described in our Annual Report and this Quarterly Report on Form 10-Q, and the information contained under the caption “Warning Concerning Forward-Looking Statements” and elsewhere in this Quarterly Report on Form 10-Q before deciding whether to invest in our securities.

Item 5. Other Information

On August 3,November 2, 2022, we announcedDr. Michael E. Wagner notified our Board of Directors, or the Board, that he will resign as an Independent Director of the Board, effective November 30, 2022. Dr. Wagner advised the Board that the reason for his resignation is that he has accepted an executive position at a restructuring plan basedcompany whose policies do not permit him to continue to serve as a member of the Board and was not the result of any disagreement with us, our management or the Board on a comprehensive operational review that was completed by Alvarez & Marsal,any matter relating to our operations, policies or A&M. The recommendations made by A&M include general and administrative cost reductions, a corporate reorganization that is designed to enhance accountability and certain operational changes to support team members to ensure the delivery of high-quality experiences to residents and customers and to increase occupancy at the Company’s senior living communities. Pursuant to this restructuring plan, we intend to eliminate certain positions in our corporate team. We expect to complete this restructuring by the middle of 2023. In connection with implementing this restructuring plan, we expect to incur non-recurring cash expenses of up to $6.1 million. These expenses are expected to include up to $0.2 million of retention payments, up to $2.6 million of severance, benefits and transition expenses, and up to $3.3 million of restructuring expenses.

practices.

Item 6. Exhibits

Incorporated by Reference
Exhibit
Number
DescriptionFormExhibit NumberFile NumberFiling DateFiled
Herewith
3.110-Q3.1001-1681711/6/2019
3.210-K3.6001-168173/3/2017
4.110-Q4.1001-1681711/6/2019
4.28-K10.1001-1681710/6/2016
10.110-Q10.1001-168175/3/2022
10.28-K10.1001-168176/8/2022
10.38-K10.2001-168176/8/2022
31.110-Q31.1X
Incorporated by Reference
Exhibit
Number
DescriptionFormExhibit NumberFile NumberFiling DateFiled
Herewith
3.110-Q3.1001-1681711/6/2019
3.210-K3.6001-168173/3/2017
4.110-Q4.1001-1681711/6/2019
4.28-K10.1001-1681710/6/2016
31.110-Q31.1X
31.210-Q31.2X
32.110-Q32.1X
101.INSXBRL Instance Document- the instance document does not appear in the Interactive Date File because its XBRL tags are embedded within the Inline XBRL document.X
101.SCHXBRL Taxonomy Extension Schema Document. (Filed herewith.)X
101.CALXBRL Taxonomy Extension Calculation Linkbase Document. (Filed herewith.)X
101.DEFXBRL Taxonomy Extension Definition Linkbase Document. (Filed herewith.)X
101.LABXBRL Taxonomy Extension Label Linkbase Document. (Filed herewith.)X
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32.110-Q32.1X
99.110-Q99.1X
99.210-Q99.2X
99.310-Q99.3X
99.410-Q99.4X
99.510-Q99.5X
99.610-Q99.6X
101.INSXBRL Instance Document- the instance document does not appear in the Interactive Date File because its XBRL tags are embedded within the Inline XBRL document.X
101.SCHXBRL Taxonomy Extension Schema Document. (Filed herewith.)X
101.CALXBRL Taxonomy Extension Calculation Linkbase Document. (Filed herewith.)X
101.DEFXBRL Taxonomy Extension Definition Linkbase Document. (Filed herewith.)X
101.LABXBRL Taxonomy Extension Label Linkbase Document. (Filed herewith.)X
101.PREXBRL Taxonomy Extension Presentation Linkbase Document. (Filed herewith.)X
104Cover Page Interactive Data File (formatted in Inline XBRL and contained in Exhibit 101).X
101.PREXBRL Taxonomy Extension Presentation Linkbase Document. (Filed herewith.)X
104Cover Page Interactive Data File (formatted in Inline XBRL and contained in Exhibit 101).X

(+) Management contract or compensatory plan or arrangement.
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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.
  
 ALERISLIFE INC.
 /s/ Jeffrey C. Leer
 Jeffrey C. Leer
 President and Chief Executive Officer
(Principal Executive Officer)
Dated: November 2, 2022
/s/ Heather C. Pereira
Heather C. Pereira
Senior Vice President, Chief Financial Officer and Treasurer
(Principal Executive Officer and Principal Financial Officer)
Dated: August 3,November 2, 2022
 
/s/ Stephen R. Geiger
Stephen R. Geiger
Vice President and Chief Accounting Officer
(Principal Accounting Officer)
Dated: August 3,November 2, 2022

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