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NATIONAL HEALTH INVESTORS INC (NHI)

CIK: 0000877860. SIC: 6798 Real Estate Investment Trusts. Latest 10-K as of: 2026-02-26.

SIC breadcrumb: Finance, Insurance, And Real Estate > Holding And Other Investment Offices > SIC 6798 Real Estate Investment Trusts

SEC company page: https://www.sec.gov/edgar/browse/?CIK=877860. Latest filing source: 0000877860-26-000053.

Selected Fundamentals

MetricValueUnitFYFiled
Revenue375,628,000USD20252026-02-26
Net income142,177,000USD20252026-02-26
Assets2,796,887,000USD20252026-02-26

Financials

Annual standardized facts from SEC companyfacts as of latest extracted filing date 2026-02-26. Source: https://data.sec.gov/api/xbrl/companyfacts/CIK0000877860.json. Derived margins, ratios, and free cash flow are computed from the extracted annual SEC facts.

Flow metrics use full-year FY periods from 10-K/10-K/A filings; balance-sheet metrics use FY-end instants. Free cash flow = operating cash flow - capital expenditures. Missing metrics are omitted rather than fabricated.

Metric20082009201020152016201720182019202020212022202320242025
Revenue248,460,000278,659,000294,612,000318,081,000332,811,000298,715,000278,194,000319,835,000335,181,000375,628,000
Net income151,540,000159,365,000154,333,000160,456,000185,126,000111,804,00066,403,000135,654,000137,985,000142,177,000
Diluted EPS3.873.873.673.674.142.441.483.133.133.02
Operating cash flow176,638,000198,095,000207,869,000240,955,000232,148,000210,859,000185,340,000184,450,000207,768,000236,563,000
Capital expenditures394,737,000175,793,000147,645,000237,186,000116,724,00050,346,00010,993,00049,556,000157,931,000294,034,000
Dividends paid138,303,000153,040,000165,391,000179,739,000194,584,000182,900,000161,771,000156,238,000156,510,000169,696,000
Share buybacks3,621,0000.000.000.000.00151,951,0000.000.00
Assets2,403,633,0002,545,821,0002,750,570,0003,042,235,0003,120,489,0002,838,876,0002,507,424,0002,488,480,0002,614,371,0002,796,887,000
Liabilities1,194,043,0001,223,704,0001,360,857,0001,543,983,0001,597,544,0001,321,893,0001,217,518,0001,214,433,0001,229,194,0001,256,983,000
Stockholders' equity1,133,292,0001,209,590,0001,389,713,0001,497,631,0001,512,234,0001,507,083,0001,270,225,0001,253,952,0001,366,475,0001,521,543,000
Cash and cash equivalents4,636,0003,063,0004,659,0005,215,00043,344,00037,412,00019,291,00022,347,00024,289,00019,624,000
Free cash flow-218,099,00022,302,00060,224,0003,769,000115,424,000160,513,000174,347,000134,894,00049,837,000-57,471,000

Ratios

ROE and ROA use period-end equity/assets. Liabilities / equity uses total liabilities divided by stockholders' equity. Current ratio uses current assets divided by current liabilities when both are reported.

Metric20082009201020152016201720182019202020212022202320242025
Net margin60.99%57.19%52.39%50.45%55.62%37.43%23.87%42.41%41.17%37.85%
Return on equity12.53%11.11%10.71%12.24%7.42%5.23%10.82%10.10%9.34%
Return on assets6.30%6.26%5.61%5.27%5.93%3.94%2.65%5.45%5.28%5.08%
Liabilities / equity0.990.981.031.060.880.960.970.900.83

Financial Charts

Quarterly

Quarterly standardized facts from SEC companyfacts as of latest extracted filing date 2026-05-04. Source: https://data.sec.gov/api/xbrl/companyfacts/CIK0000877860.json.

Flow metrics use discrete quarter-length periods from 10-Q/10-Q/A filings. Q4 revenue and net income are derived only when annual FY and nine-month YTD facts exist for the same fiscal year; derived Q4 values are labeled. EPS Q4 is not derived.

QuarterEnd DateRevenueNet IncomeDiluted EPSMethod
2022-Q22022-06-300.47reported discrete quarter
2022-Q32022-09-300.78reported discrete quarter
2023-Q12023-03-310.79reported discrete quarter
2023-Q22023-06-3077,876,00039,779,0000.92reported discrete quarter
2023-Q32023-09-3080,106,00029,346,0000.68reported discrete quarter
2023-Q42023-12-3179,465,00032,046,000derived Q4 = FY annual - nine-month YTD
2024-Q12024-03-3181,513,00030,947,0000.71reported discrete quarter
2024-Q22024-06-3084,970,00035,256,0000.81reported discrete quarter
2024-Q32024-09-3082,944,00028,540,0000.65reported discrete quarter
2024-Q42024-12-3185,755,00043,242,000derived Q4 = FY annual - nine-month YTD
2025-Q12025-03-3189,296,00034,165,0000.74reported discrete quarter
2025-Q22025-06-3090,662,00036,987,0000.79reported discrete quarter
2025-Q32025-09-3089,847,00032,862,0000.69reported discrete quarter
2025-Q42025-12-31105,823,00038,163,000derived Q4 = FY annual - nine-month YTD
2026-Q12026-03-31115,130,00040,102,0000.82reported discrete quarter

Quarterly Charts

Macro Cross-References

Latest quarter (10-Q)

Latest 10-Q source: 0000877860-26-000135.

Extracted structurally from real Item 2 body heading to real Item 3/4 boundary. Confidence: high. Filing date: 2026-05-04. Report date: 2026-03-31.

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

Unless the context otherwise requires, references throughout this document to “NHI” or the “Company” include National Health Investors, Inc., and its consolidated subsidiaries. In accordance with the “Plain English” guidelines of the Securities and Exchange Commission (“SEC”), this Quarterly Report on Form 10-Q for the quarterly period ended March 31, 2026 (“Quarterly Report”) has been written in the first person. In this document, the words “we”, “our”, “ours” and “us” refer only to National Health Investors, Inc. and its consolidated subsidiaries and not any other person.

Cautionary Statement Regarding Forward-Looking Statements

This Quarterly Report and other materials we have filed or may file with the SEC, as well as information included in oral statements made, or to be made, by our senior management, contain certain “forward-looking statements” as that term is defined by the Private Securities Litigation Reform Act of 1995. All statements regarding our expected future financial position, results of operations, cash flows, funds from operations, continued performance improvements, ability to service and refinance our debt obligations, ability to finance growth opportunities, and similar statements including, without limitation, those containing words such as “may”, “will”, “should”, “believes”, “anticipates”, “expects”, “intends”, “estimates”, “plans”, “projects”, “target”, “likely” and other similar expressions, are forward-looking statements.

Forward-looking statements involve known and unknown risks and uncertainties that may cause our actual results in future periods to differ materially from those projected or contemplated in forward-looking statements as a result of factors including, but not limited to, the following:

•We depend on the operating success of our tenants, managers and borrowers, and if their financial condition or business prospects deteriorate, our business, financial condition and results of operations could be adversely affected;

•Our tenants, managers and borrowers may become subject to bankruptcy or insolvency proceedings;

•A small number of tenants in our portfolio account for a significant percentage of the rental income we expect to generate from our portfolio, and the failure of any of these tenants to meet their obligations to us could materially and adversely affect our business, financial condition and results of operations;

•We may be unable to replace our managers if the management agreements are terminated or not renewed;

•Actual or perceived risks associated with pandemics, epidemics or outbreaks have had, and may in the future have, a material adverse effect on our operators’ businesses and results of operations;

•A member of our board of directors is also the chairperson of the board of directors of National HealthCare Corporation (“NHC”), and his interests may differ from those of our stockholders;

•We are exposed to risks related to government regulations and payors, principally Medicare and Medicaid, and the effect of changes to laws, regulations and reimbursement rates on the businesses of our tenants, managers and borrowers;

•The cash flows of our tenants, managers and borrowers may be adversely affected by increased liability claims and liability insurance costs;

•Significant legal or regulatory proceedings could adversely affect the liquidity, financial condition and results of operations of our tenants, managers and borrowers;

•We may not be fully indemnified by our tenants, managers and borrowers against future litigation;

•We depend on the success of property development and construction activities, which may fail to achieve the operating results we expect;

•The illiquidity of real estate investments could impede our ability to respond to adverse changes in the performance of our properties;

•Our investments are concentrated in healthcare properties;

•We are subject to risks related to our investment with Life Care Services for Timber Ridge, an entrance fee continuing care retirement community (“CCRC”), associated with Type A benefits offered to the residents of the CCRC and the related accounting requirements;

•Risks related to our joint venture investments could adversely affect our financial condition and results of operations;

•Inflation and increased interest rates may adversely affect our business, financial condition and results of operations;

•Adverse developments affecting the financial services industry, including events or concerns involving liquidity, defaults or non-performance by financial institutions, could adversely affect our business, financial condition, results of operations or prospects;

•Adverse geopolitical developments could have a material adverse impact on our business;

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•We are exposed to operational risks with respect to our senior housing operating portfolio (“SHOP”) structured communities;

•A cybersecurity incident or other form of data breach involving our business and its information could cause a loss of confidential consumer and other personal information, give rise to remediation and other expenses, expose us to liability under privacy and security and consumer protection laws, subject us to federal and state governmental inquiries, damage our reputation, and otherwise be disruptive to our business;

•We are exposed to risks related to environmental laws and the costs associated with liabilities related to hazardous substances;

•We are subject to risks of damage from catastrophic weather and other natural or man-made disasters and the physical effects of climate change;

•We depend on the success of our future acquisitions and investments;

•We depend on our ability to reinvest cash in real estate investments in a timely manner and on acceptable terms;

•Competition for acquisitions may result in increased market prices for properties;

•We depend on our ability to retain our management team and other personnel, and our ability to attract suitable replacements should any such personnel leave;

•We are exposed to the risk that our assets may be subject to impairment charges;

•Stockholder activism efforts could cause us to incur substantial costs, divert management’s attention and have an adverse effect on our business;

•Our ability to raise capital through equity sales is dependent, in part, on the market price of our common stock, and our failure to meet market expectations with respect to our business, or other factors we do not control, could negatively impact such market price and availability of equity capital;

•The United States (“U.S.”) federal income tax treatment of the cash that we might receive from cash settlement of our forward equity sales agreements is unclear and could jeopardize our ability to meet the real estate investment trust (“REIT”) qualification requirements;

•Our use of artificial intelligence could expose us to various risks;

•We may need to refinance existing debt or incur additional debt in the future, which may not be available on terms acceptable to us;

•We have covenants related to our indebtedness which impose certain operational limitations, and a breach of those covenants could materially adversely affect our financial condition and results of operations;

•Downgrades in our credit ratings could have a material adverse effect on our costs and availability of capital;

•We rely on external sources of capital to fund our future capital needs, and if we encounter difficulty in obtaining such capital, we may not be able to make future investments necessary to grow our business or meet maturing commitments;

•We depend on revenues derived mainly from fixed rate investments in real estate assets, while a portion of our debt used to finance those investments bears interest at variable rates, which subjects us to interest rate risk;

•We depend on the ability to continue to qualify for taxation as a REIT for U.S. federal income tax purposes;

•There are no assurances of our ability to pay dividends in the future;

•Complying with REIT requirements may cause us to forego otherwise attractive acquisition opportunities or liquidate otherwise attractive investments, which could materially hinder our performance;

•Our ownership of and relationship with any taxable REIT subsidiaries (“TRS”) that we have formed, or will form, will be limited, and a failure to comply with the limits would jeopardize our REIT status and may result in the application of a 100% excise tax;

•Legislative, regulatory or administrative tax changes could adversely affect us or our security holders;

•We have ownership limits in our charter with respect to our common stock and other classes of capital stock which may delay, defer or prevent a transaction or a change of control that might involve a premium price for our common stock or might otherwise be in the best interests of our stockholders;

37

•We are subject to certain provisions of Maryland law and in our charter and bylaws that could hinder, delay or prevent a change in control transaction, even if the transaction involves a premium price for our common stock or our stockholders believe such transaction to be otherwise in their best interests;

•Failure to complete the pending sale of the NHC properties could have an adverse effect on our business;

•The market price of our common stock may decline as a result of the sale of the NHC properties; and

•We may not be able to successfully redeploy the net proceeds from the sale of the NHC properties in a manner that generates comparable returns.

Reference “Part I, Item 1, Business”, “Part I, Item 1A, Risk Factors” and the notes to our audited consolidated financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2025 (“Annual Report”) and additionally “Part II, Item 1A, Risk Factors” in this Quarterly Report for a further discussion of these risks, various governmental regulations and other operating factors relating to the healthcare industry and the risk factors inherent therein. You should carefully consider these risks before making any investment decisions related to us. These risks and uncertainties are not the only ones facing us. There may be additional risks that we do not presently know of and/or that we currently deem immaterial. If any of the risks actually occur, our business, financial condition, results of operations and cash flows could be materially and adversely affected. In that case, the market price of our common stock could decline, and you may lose part or all of your investment. Given these risks and uncertainties, we can give no assurance that these forward-looking statements will, in fact, occur. We caution readers not to place undue reliance on such forward-looking statements, which speak only as of the dates made. We undertake no obligation to revise or update any of the forward-looking statements to reflect subsequent events or circumstances except to the extent required by applicable law.

Executive Overview

National Health Investors, Inc., established in 1991 as a Maryland corporation, is a self-managed REIT. We own, lease, operate and finance the development of high-quality real estate properties, focusing on senior housing communities and medical facilities. We operate through two reportable segments, Real Estate Investments and SHOP. Our investments in senior housing communities, also referred to as senior housing properties (“SHO”), include independent living facilities (“ILF”), assisted living facilities (“ALF”), entrance fee communities (“EFC”) and senior living campuses (“SLC”). Our investments in medical facilities include skilled nursing facilities (“SNF”) and hospitals (“HOSP”).

In our Real Estate Investments segment, our revenues primarily relate to triple-net leases with third-party operators at our properties. Additionally, we recognize interest income from financing arra

[Excerpt truncated for page length; source filing is linked above.]

Latest 10-K MD&A

Extracted structurally from real Item 7 body heading to real Item 7A/8 boundary. Confidence: high. Filing date: 2026-02-26. Report date: 2025-12-31.

ITEM 7. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS

The information set forth below is intended to provide readers with an understanding of our financial condition, changes in financial condition and results of operations. Our discussion and analysis are primarily based on our consolidated financial statements for the years presented and should be read together with the notes thereto contained in this Annual Report. This section generally discusses our results of operations for the year ended December 31, 2025 compared to the year ended December 31, 2024. For a discussion of our results of operations for the year ended December 31, 2024 compared to the year ended December 31, 2023, please refer to “Part II, Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our Annual Report for the fiscal year ended December 31, 2024, which we filed with the SEC on February 25, 2025.

The discussion below contains forward-looking statements that involve risks and uncertainties. Our actual results could differ materially from those anticipated in these forward-looking statements as a result of various factors, including those which are discussed in “Part I, Item 1A. Risk Factors” of this Annual Report. Also, reference “Cautionary Statement Regarding Forward-Looking Statements” preceding Part I of this Annual Report.

Executive Overview

National Health Investors, Inc., established in 1991 as a Maryland corporation, is a self-managed REIT. We own, lease, operate and finance the development of high-quality real estate properties, focusing on senior housing communities and medical facilities. We operate through two reportable segments, Real Estate Investments and SHOP. Our investments in senior housing communities, also referred to as SHOs, include ILFs, ALFs, EFCs and SLCs. Our investments in medical facilities include SNFs and HOSPs.

In our Real Estate Investments segment, our revenues primarily relate to triple-net leases with third-party operators at our properties. Additionally, we recognize interest income from financing arrangements we provide to our tenants, operators, or affiliates of our tenants and operators, and other third parties primarily for construction, renovation and expansion projects, funding of working capital or corporate needs and the acquisition of real estate properties. In our SHOP segment, we own and operate senior housing communities and generate revenues from resident fees and services. We utilize third-party managers to operate these properties on our behalf and pay a management fee for their services. Our investments across both segments are funded primarily through (i) operating cash flows, (ii) debt offerings, revolving lines of credit and term loans and (iii) sales of equity securities.

Real Estate Investments Portfolio

As of December 31, 2025, our investments comprising the Real Estate Investments segment included real estate properties and financing arrangements involving 189 properties located in 32 states, excluding one property classified as assets held for sale. The aggregate gross carrying value of these owned properties was $2.7 billion, which included 110 SHOs, 65 SNFs and one HOSP leased to 31 tenants. The aggregate gross carrying value of our mortgage and other notes receivable was $218.7 million, excluding $15.4 million of credit loss reserves.

Our tenant leases are typically structured as triple-net leases and relate to single-tenant properties having an initial lease term of 10 to 15 years with one or more five-year extension options. Most of our tenant leases contain annual rent escalators, which may be fixed or variable. Lease payments due to us that are subject to a variable rent escalator are typically determined annually and calculated using a variable index, such as the consumer price index (“CPI”) or an index that is dependent on a future date and indeterminable at the inception of the lease.

Senior Housing Operating Portfolio

As of December 31, 2025, our investments included in the SHOP segment consisted of 17 ILFs, six SLCs and three ALFs located in 13 states with a combined total of 3,009 units. The aggregate gross carrying value of these properties was $634.3 million. We have structured the operations at these senior housing communities to comply with the requirements of RIDEA and to utilize our TRS for activities that would otherwise be non-qualifying for REIT purposes.

The properties are operated by third-party managers in exchange for a management fee from us, and as such, we are not directly exposed to the credit risk of the managers in the same manner or to the same extent as we are related to our triple-net tenant leases. However, we rely on the managers’ personnel, expertise, technical resources and information systems, proprietary information, good faith and judgment to manage our communities efficiently and effectively. We also rely on the managers to set appropriate resident fees and to operate our communities in compliance with the terms of our management agreements and all applicable laws and regulations.

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Classifications of Real Estate Properties

We classify our investments in real estate properties as either SHOs or medical facilities and further classify our SHOs as either need-driven or discretionary properties based on the differing credit risk profiles represented by the underlying revenue sources.

A summary of each of these classifications follows:

Need-Driven Senior Housing

Need-driven senior housing properties include ALFs and SLCs which primarily attract private payment for services from residents who require assistance with activities of daily living. Need-driven properties are subject to regulatory oversight.

Discretionary Senior Housing

Discretionary senior housing properties include ILFs and EFCs which primarily attract private payment for services from residents who are making the lifestyle choice of living in an age-restricted, multi-family community that offers social programs, meals, housekeeping, and in some cases, access to healthcare services. Discretionary properties are subject to limited regulatory oversight. There is a correlation between demand for this type of community and the strength of the housing market.

Medical Facilities

Medical facilities within our Real Estate Investments segment receive payment for services primarily from Medicare, Medicaid and health insurance. These properties include SNFs and HOSPs that attract patients who have a need for acute or complex medical attention, preventative medicine or rehabilitation services. Medical facilities are subject to federal and state regulatory oversight and, in the case of hospitals, Joint Commission accreditation.

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Investment Portfolio Summary

The following tables summarize information related to the investment portfolios of our Real Estate Investments and SHOP segments as of and for the year ended December 31, 2025 ($ in thousands):

Gross

Number of

Number of

% of

Carrying

Properties1

Beds / Units

NOI

Total NOI

Amount2

Real Estate Investments segment:

Real estate properties:

Senior housing - need-driven:

Assisted living facilities

86 

4,704 

$

87,830 

28.9 

%

$

1,065,152 

Senior living campuses

9 

1,073 

14,858 

5.0 

%

179,351 

Total senior housing - need-driven

95 

5,777 

102,688 

33.9 

%

1,244,503 

Senior housing - discretionary:

Independent living facilities

3 

273 

1,544 

0.5 

%

9,233 

Entrance fee communities

12 

3,201 

64,663 

21.3 

%

804,823 

Total senior housing - discretionary

15 

3,474 

66,207 

21.8 

%

814,056 

Total senior housing

110 

9,251 

168,895 

55.7 

%

2,058,559 

Medical facilities:

Skilled nursing facilities

65 

8,534 

86,915 

28.6 

%

557,996 

Hospitals

1 

71 

4,308 

1.4 

%

42,298 

Total medical facilities

66 

8,605 

91,223 

30.0 

%

600,294 

Properties transitioned to SHOP segment

— 

— 

(2,004)

(0.7)

%

— 

Other

— 

— 

2,504 

0.8 

%

— 

Total real estate properties

176

17,856 

260,618 

85.8 

%

2,658,853 

Mortgage and other notes receivable:

Senior housing - need-driven

8 

591 

7,023 

2.3 

%

101,219 

Senior housing - discretionary

1 

141 

39 

— 

%

11,139 

Skilled nursing facilities

3 

367 

2,485 

0.8 

%

14,748 

Hospitals

1 

36 

1,858 

0.6 

%

27,220 

Mortgage and note payoffs

— 

— 

2,684 

0.9 

%

— 

Other notes

— 

— 

9,877 

3.3 

%

64,367 

Total mortgage and other

notes receivable

13 

1,135 

23,966 

7.9 

%

218,693 

Total Real Estate Investments

segment portfolio

189 

18,991 

284,584 

93.7 

%

2,877,546 

SHOP segment:

Real estate properties:

Independent living facilities

17 

1,994 

14,607 

4.8 

%

412,890 

Senior living campuses

6 

738

3,665 

1.2 

%

172,844 

Assisted living facilities

3 

277

862 

0.3 

%

48,521 

Total SHOP segment portfolio

26

3,009 

19,134 

6.3 

%

634,255 

Total investments portfolio

215 

22,000 

$

303,718 

100.0 

%

$

3,511,801 

1    The total number of properties, as presented in the table above, excludes our corporate office building and one property in the Real Estate Investments segment that was classified as assets held for sale as of December 31, 2025.

2    The total gross carrying amount, as presented in the table above, excludes $2.6 million related to our corporate office and equipment, $4.8 million related to one property in the Real Estate Investments segment that was classified as assets held for sale as of December 31, 2025 and $15.4 million of credit loss reserves related to our mortgage and other notes receivable investments.

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Gross

Number of

% of

Carrying

Properties1

NOI2

Total NOI

Amount2

Portfolio summary by operator type:

Real Estate Investments segment:

Public

60 

$

75,824 

25.0 

%

$

480,022 

National chain (privately owned)

10 

16,324 

5.4 

%

242,308 

Regional

111 

178,804 

58.9 

%

2,050,150 

Small

8 

10,298 

3.4 

%

105,066 

Properties transitioned to SHOP segment

— 

(2,004)

(0.7)

%

— 

Mortgage and note payoffs

— 

2,684 

0.9 

%

— 

Other

— 

2,654 

0.8 

%

— 

Total Real Estate Investments segment portfolio

189 

284,584 

93.7 

%

2,877,546 

SHOP segment portfolio

26 

19,134 

6.3 

%

634,255 

Total investments portfolio

215 

$

303,718 

100.0 

%

$

3,511,801 

1    The total number of properties, as presented in the table above, excludes our corporate office building and one property in the Real Estate Investments segment that was classified as assets held for sale as of December 31, 2025.

2    The total gross carrying amount, as presented in the table above, excludes $2.6 million related to our corporate office and equipment, $4.8 million related to one property in the Real Estate Investments segment that was classified as assets held for sale as of December 31, 2025 and $15.4 million of credit loss reserves related to our mortgage and other notes receivable investments.

The following table provides a summary of the impact of acquired and transitioned properties on our SHOP segment NOI for the year ended December 31, 2025 ($ in thousands):

Gross

Number of

Number of

Carrying

Properties

Units

NOI

Amount

Properties in SHOP segment as of December 31, 2024

15 

1,732 

$

13,089 

$

370,118 

Acquisitions

4 

339 

1,642 

74,495 

Transitioned properties

7 

938 

4,403 

189,642 

Total SHOP segment portfolio

26 

3,009 

$

19,134 

$

634,255 

As of December 31, 2025, our average effective annualized NOI for the leased properties in our Real Estate Investments segment was $13,988 per unit for SLCs, $20,519 per unit for ALFs, $5,536 per unit for ILFs, $21,476 per unit for EFCs, $10,105 per bed for SNFs and $60,574 per bed for the HOSP. As of December 31, 2025, the average effective annualized NOI for our SHOP segment was $9,709 per unit.

Recent Tax Legislation

In connection with the passing of the One Big Beautiful Bill Act (the “OBBBA”) on July 4, 2025, certain changes to U.S. tax laws were approved that impact us and our stockholders. Among other changes, the OBBBA (i) permanently extended the 20% deduction for “qualified REIT dividends” for individuals and other non-corporate taxpayers under Section 199A of the Internal Revenue Code, (ii) increased the percentage limit under the REIT asset test applicable to TRSs from 20% to 25% for taxable years beginning after December 31, 2025 and (iii) increased the base on which the 30% interest deduction limit under Section 163(j) of the Internal Revenue Code applies by excluding depreciation, amortization and depletion from the definition of “Adjusted Taxable Income” for taxable years beginning after December 31, 2024.

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Table of Contents

Fiscal 2025 Investment Activity

A summary of our significant investment activity that occurred during the year ended December 31, 2025 follows:

•We funded $325.6 million of acquisitions, which included the settlement of $50.8 million of mortgage and other notes receivable as part of the consideration paid by us.

•We funded $71.1 million of mortgage and other note investments.

•We transitioned seven properties from our Real Estate Investments segment into our SHOP segment and dissolved the Discovery partnership.

•We reclassified $3.6 million of assets as held for sale on our consolidated balance sheet as of December 31, 2025 which related to one real estate property in the Real Estate Investments segment.

Asset Acquisitions

During the year ended December 31, 2025, we completed the following asset acquisitions ($ in thousands):

Buildings,

Building

Improvements

Number of

Asset

and Intangible

Operator / Manager

Period

Properties

Class

Land

Assets

Total

Real Estate Investments segment:

Generations, LLC

Q1 2025

1

SLC

$

3,062 

$

18,138 

$

21,200 

Mainstay Healthcare

Q1 2025

1

ALF

2,864 

5,736 

8,600 

Juniper Communities, LLC

Q1 2025

1

ALF

4,154 

42,130 

46,284 

Agemark Senior Living

Q2 2025

6

ALF

7,461 

56,039 

63,500 

Priority Life Care

Q4 2025

1

ALF

3,539 

48,610 

52,149 

William James Group, LLC

Q4 2025

1

ALF

134 

6,903 

7,037 

Senior Living

Q4 2025

1

EFC

4,019 

48,514 

52,533 

SHOP segment:

Compass Senior Living

Q4 2025

4

SHO

5,173 

69,171 

74,344 

Total asset acquisitions

$

30,406 

$

295,241 

$

325,647 

In January 2025, we acquired a 108-unit SLC located in Colorado. The acquisition price was $21.2 million, including $0.2 million in closing costs. The property is leased pursuant to a 10-year triple-net lease with Generations, LLC, which includes two five-year extension options, an initial annual lease rate of 8.0% and fixed annual escalators of 2.0%.

In February 2025, we acquired an 88-unit ALF located in Florida upon the execution of a deed in lieu of foreclosure agreement initiated by Senior Living Management (“SLM”) to settle its $10.0 million non-performing mortgage note with us. We recognized the acquired property at its estimated fair value of $8.6 million, which equaled the net carrying value of the mortgage note. Concurrently, we executed a new lease on this acquired property with the existing operator, Mainstay Healthcare. This lease provides for approximately $0.7 million in annual contractual lease payments.

In March 2025, we acquired a 120-unit ALF located in New Jersey. The acquisition price was $46.3 million, including $0.3 million in closing costs. The property is leased pursuant to a 15-year triple-net lease with Juniper Communities, LLC, which includes two five-year extension options, an initial annual lease rate of 8.0% and fixed annual escalators of 2.0%. The lease includes a $0.8 million development commitment which will be added to the respective lease base, if funded.

In April 2025, we acquired a portfolio of six ALFs located in Nebraska for a total purchase price of $63.5 million, including $0.3 million in closing costs. The portfolio of properties is leased pursuant to a 15-year triple-net master lease with Agemark Senior Living, which includes two five-year extension options, an initial annual lease rate of 8.0% and fixed annual escalators of 2.0%.

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In October 2025, we acquired a portfolio of four SHOs located in Oklahoma and Oregon, consisting of two SLCs and two ALFs, with a combined total of 339 units. The total purchase price of $74.3 million, including $0.5 million in closing costs, was partially funded by the cancellation of a $9.5 million mortgage note with us which had an 8.5% annual interest rate. We recognized a $2.2 million in-place lease intangible asset in connection with this acquisition. This portfolio of properties has been included in our SHOP segment and is being managed by the existing operator, Compass Senior Living, pursuant to a management agreement.

In October 2025, we acquired a 251-unit CCRC located in South Carolina from an affiliate of Senior Living. The acquisition price of $52.5 million was partially funded by the cancellation of a $32.7 million mortgage note on the property. The property is being leased back to the affiliate of Senior Living pursuant to a 15-year triple-net lease with two five-year extension options, an initial annual lease rate of 8.25% and fixed annual escalators of 2.0%. Concurrently with the acquisition, we executed a $1.5 million revolving line of credit with the affiliate of Senior Living which has an initial annual interest rate of 8.25% and matures in October 2040.

In December 2025, we acquired a 107-unit ALF located in Pennsylvania. The acquisition price was $52.1 million, including $1.1 million in closing costs. The property is leased pursuant to a five-year triple-net lease with Priority Life Care, which has an initial annual lease rate of 8.0% plus a revenue participation clause and fixed annual escalators of 2.0%.

In December 2025, we acquired a 56-unit ALF located in Alabama. The acquisition price was $7.0 million, including $0.1 million in closing costs. The property was added to our existing triple-net master lease with William James Group, LLC. As of December 31, 2025, this master lease covers four properties, has an annual lease rate of 8.25%, contains fixed annual escalators of 2.0% and matures in November 2037.

First Quarter of 2026 Acquisitions and Divestitures

In January 2026, we sold a 42-unit SLC located in Michigan for $6.7 million in net cash consideration. As of December 31, 2025, the net carrying value of this property was $4.2 million. During each of the years ended December 31, 2025, 2024 and 2023, we recognized $0.5 million of rental income related to this property.

In February 2026, we acquired a portfolio of nine ALFs located in Kentucky, South Carolina and Tennessee with a combined total of 460 units. The total purchase price was $105.5 million, including $1.0 million in closing costs. This portfolio of properties has been included in our SHOP segment and is being managed by Allegro Living Management, an affiliate of Spring Arbor Management, LLC pursuant to a management agreement.

Discovery Transitions

Effective August 1, 2025, we terminated a triple-net master lease associated with a portfolio of six SHOs, consisting of four SLCs, one ILF and one ALF, which were held in a consolidated partnership with Discovery Senior Housing Investor XXIV, LLC (the “Discovery partner”). The tenant of the triple-net master lease was a related party of Discovery Senior Living (“Discovery”). In connection with the lease termination, we received net cash consideration of $3.1 million and other non-cash consideration of $0.6 million from the tenant and wrote off the related straight-line rents receivable of $8.9 million on this lease. Each of these amounts was recognized in rental income in our consolidated statement of income for the year ended December 31, 2025. Additionally, on August 1, 2025, we entered into a dissolution agreement with the Discovery partner, which provided for the write-off of the remaining partnership liabilities against the equity in the partnership and the Discovery partner contributing its 2.0% noncontrolling common equity interest to us for nominal consideration.

Concurrently with the activities above, we transitioned the portfolio of six SHOs from our Real Estate Investments segment into our SHOP segment and entered into agreements with an affiliate of Sinceri Senior Living (“Sinceri”) to serve as the manager of the properties. As of December 31, 2025, the aggregate net carrying value of this portfolio was $124.9 million. Prior to the transition, we recognized rental income of $3.2 million, $6.1 million and $8.6 million during the years ended December 31, 2025, 2024 and 2023, respectively, related to the triple-net master lease.

Also, effective August 1, 2025, we terminated a triple-net lease with an affiliate of Discovery for an ILF in Oklahoma. In connection with the lease termination, we received $0.8 million in cash consideration and $0.8 million in other non-cash consideration from the tenant and wrote off the related straight-line rent receivable of $3.2 million on this lease. Each of these amounts was recognized in rental income in our consolidated statement of income for the year ended December 31, 2025. Concurrently with the lease termination, we transitioned this property from our Real Estate Investments segment into our SHOP segment by contributing it to an existing consolidated partnership with DSHI NHI Holiday LLC (the “Discovery member”). As of December 31, 2025, the net carrying value of this property was $28.4 million. Prior to the transition, we recognized rental income of $1.6 million, $2.8 million and $2.9 million during the years ended December 31, 2025, 2024 and 2023, respectively. related to the triple-net lease.

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Mortgage and Other Notes Receivable

Vizion Health Loan Amendment - In March 2025, we amended a mezzanine loan agreement with affiliates of Vizion Health to provide additional funding of $5.4 million and to extend the maturity date to May 2028. The interest rate on the loan escalates on July 1st of each year. As of December 31, 2025, the principal amount outstanding on the loan was $16.5 million and the annual interest rate was 9.4%.

Construction Loan - In May 2025, we entered into a construction loan agreement to fund up to $28.0 million for the development of an 84-unit ALF located in Michigan which will be operated by Encore Senior Living upon completion. The loan agreement provides for an annual interest rate of 9.0% and a maturity date in April 2030. As of December 31, 2025, the principal amount outstanding on this construction loan was $8.5 million.

Fellowship Carolina Marsh Mortgage Note - In November 2025, we funded a new $18.8 million mortgage note secured by a 94-unit SLC located in South Carolina. The five-year loan agreement with Fellowship Senior Living has an annual interest rate of 8.5% with an option to purchase the property upon the satisfaction of certain conditions. The loan matures in November 2030.

Silver Wave Wichita Falls Mortgage Note - In December 2025, we funded a new $11.3 million mortgage note secured by a 141-unit ILF located in Texas. The five-year loan agreement with affiliates of Silver Wave Capital has an annual interest rate of 8.75% with an option to purchase the property upon the satisfaction of certain conditions. The loan matures in December 2030.

Assets Held for Sale

As of December 31, 2025, we had assets held for sale of $3.6 million related to one real estate property in our Real Estate Investments segment. During the years ended December 31, 2025, 2024 and 2023, we recognized rental income of $0.6 million, $0.6 million and $0.4 million, respectively, related to this property. We did not have any assets held for sale as of December 31, 2024.

Tenant Purchase and Sale Agreement

We lease a SLC that is subject to a purchase and sale agreement giving the tenant the option to acquire the property for $39.0 million. The purchase and sale agreement, as amended, is subject to monthly renewals through March 2026 by the tenant upon payment of a non-refundable fee. The property was included in real estate properties, net, on our consolidated balance sheets as of December 31, 2025 and 2024. During the years ended December 31, 2025, 2024 and 2023, we recognized rental income of $2.6 million, $2.8 million and $2.8 million, respectively, related to the existing triple-net lease at this property which expires in July 2027. The property will be reclassified to assets held for sale when the sale becomes probable, including when the tenant demonstrates its ability to obtain sufficient financing to close on the sale of the property within the terms of the purchase and sale agreement. As of December 31, 2025, the net carrying value of this property was $18.4 million.

Tenant Purchase Options

Certain of our tenant leases contain a purchase option clause allowing the tenant to acquire the leased property at a fixed base price, a fixed base price plus a specified share in any appreciation of the property or a price based on a specified fixed minimum internal rate of return on our investment. As of December 31, 2025, tenants had purchase options on four of our properties, with an aggregate net carrying value of $74.7 million, which have exercise dates ranging between 2028 and 2031. Rental income from these properties with tenant purchase options was $10.0 million, $8.8 million and $7.2 million for the years ended December 31, 2025, 2024 and 2023, respectively. As of December 31, 2025, we cannot reasonably estimate the probability that any of these tenant purchase options will be exercised in the future.

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Tenant Concentrations

The following table presents information related to concentrations of our tenants, or affiliates of tenants, that exceed 10% of our total revenues ($ in thousands):

December 31, 2025

Year Ended December 31,

Real

Mortgage

2025

2024

2023

Estate

and Other

% of

% of

% of

Properties1

Notes2

Revenues3

Total

Revenues3

Total

Revenues3

Total

Senior Living

$

632,253 

$

9,000 

$

55,091 

14.7 

%

$

53,570 

16.0 

%

$

51,274 

16.0 

%

Bickford

427,117 

15,959 

43,185 

11.5 

%

41,720 

12.4 

%

38,688 

12.1 

%

NHC

133,770 

— 

40,272 

10.7 

%

40,016 

11.9 

%

37,335 

11.7 

%

Escrow funds received from tenants

for property operating expenses

— 

— 

10,982 

2.9 

%

11,165 

3.3 

%

11,513 

3.6 

%

Other

1,465,713 

193,734 

146,036 

38.9 

%

134,289 

40.2 

%

132,216 

41.3 

%

Total tenant concentrations

$

2,658,853 

$

218,693 

295,566 

78.7 

%

280,760 

83.8 

%

271,026 

84.7 

%

Resident fees and services4

80,062 

21.3 

%

54,421 

16.2 

%

48,809 

15.3 

%

Total revenues

$

375,628 

100.0 

%

$

335,181 

100.0 

%

$

319,835 

100.0 

%

1    Real estate properties have been stated at their gross carrying amounts. Total real estate properties, as presented in the table above, excludes $2.6 million related to our corporate office and equipment, $4.8 million related to one property in the Real Estate Investments segment that was classified as assets held for sale as of December 31, 2025 and $634.3 million related to the properties in our SHOP segment.

2    Mortgage and other notes receivable have been stated at their gross carrying amounts. Total mortgage and other notes receivable, as presented in the table above, excludes our total credit loss reserves of $15.4 million as of December 31, 2025.

3    Revenues related to assets classified as held for sale are included in other revenues in the table above.

4    There are no concentrations in revenues from resident fees and services because the resident agreements at the senior housing communities are between us and the individual residents.

Senior Living Leases and Loans

As of December 31, 2025, we leased 11 SHOs with a combined total of 2,490 units to Senior Living. During the years ended December 31, 2025, 2024 and 2023, we recognized straight-line rent revenue of $(0.6) million, $(0.2) million and $(1.2) million, respectively, related to our leases with Senior Living.

As of December 31, 2025, we had a $15.0 million revolving line of credit with Senior Living which is available for working capital needs and to finance construction projects within Senior Living’s portfolio, including projects to build additional residential units at existing facilities. The $15.0 million revolving line of credit matures in December 2031. As of December 31, 2025, the principal amount outstanding on this revolving line of credit was $9.0 million and the annual interest rate was 8.0%. We also had a $1.5 million revolving line of credit with an affiliate of Senior Living which has not been drawn as of December 31, 2025.

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Table of Contents

Bickford Leases and Loans

As of December 31, 2025, we leased 38 SHOs to Bickford under four master leases. In 2022, we began recognizing rental income from Bickford’s leases using the cash basis of accounting for revenue recognition based upon information we obtained from Bickford regarding its financial condition that raised substantial doubt about its ability to continue as a going concern.

We have a fully funded construction loan with Bickford that is secured by a first mortgage lien on substantially all of the related real and personal property as well as a pledge of any and all leases or other agreements which may grant a right of use to the property. Pursuant to the loan agreement, Bickford is required to pay the related property taxes and insurance. The loan agreement contains a fair market value purchase option on the property that is available to us upon stabilization of the underlying operations. As of December 31, 2025, the principal amount outstanding on the construction loan was $14.7 million and the annual interest rate was 9.0%.

We have an unsecured mezzanine loan with Bickford that is classified as a non-performing note. The loan has an annual interest rate of 9.0% and matures in May 2033. As of December 31, 2025, the principal amount outstanding on the mezzanine loan was $1.3 million, which was fully covered by the related credit loss reserve.

NHC Leases

As of December 31, 2025, we leased 32 SNFs and three ILFs to NHC, a publicly owned company, under a triple-net master lease which expires in December 2026. The master lease includes two five-year extension options in which the annual lease rate resets at the current fair market value as negotiated between the parties. We have engaged Blueprint Healthcare Real Estate Advisors, a national advisory firm focused on skilled nursing and senior housing facilities, to assist with underwriting, due diligence and market analysis with respect to the master lease renewal.

On September 8, 2025, we provided formal written notice to NHC that it is in default of the triple-net master lease as a result of NHC’s failure to remedy its non-compliance with certain non-monetary provisions of the triple-net master lease previously identified by us. NHC had 30 days to cure such default and its failure to do so entitles us to declare an event of default and to pursue any and all remedies available to us under the triple-net master lease. We are currently evaluating potential courses of action.

On October 7, 2025, NHC informed us that it was exercising its option to renew the master lease for one five-year term commencing January 1, 2027. We are currently reviewing the effectiveness and legality of NHC’s notice.

Cash Basis Tenants

During the year ended December 31, 2025, two of our tenants were on the cash basis of accounting for revenue recognition for their leasing arrangements with us based on our assessment of each tenant’s ability to satisfy its contractual obligations under the terms of the respective leases. During the years ended December 31, 2024 and 2023, three of our tenants were on the cash basis of accounting for revenue recognition for their leasing arrangements with us.

A summary of lease payments received by us from cash basis tenants follows ($ in thousands):

Year Ended December 31,

2025

2024

2023

Bickford

$

40,497 

$

38,971 

$

33,352 

All others

6,633 

11,010 

12,444 

Total lease payments from cash basis tenants

$

47,130 

$

49,981 

$

45,796 

These lease payments from cash basis tenants included $5.9 million, $9.0 million and $2.8 million of rent deferrals granted during the COVID-19 pandemic for the years ended December 31, 2025, 2024 and 2023, respectively.

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SLM Leases

SLM was a cash basis tenant from 2022 until January 1, 2025 when the remaining two properties leased from us were transitioned to a new operator who had been serving as the interim manager at the properties. Concurrently with this transition, we executed a 15-year triple-net master lease with a new operator which includes two five-year extension options. The master lease with the new operator provides for approximately $1.1 million in initial annual contractual lease payments with fixed annual escalators of 2.0%. As of December 31, 2025, we had no properties leased to SLM.

Occupancy

The following table provides a summary of the average occupancy rates related to properties leased to Senior Living and Bickford for the periods indicated:

Number of

Properties

Q4 2025

Q3 2025

Q2 2025

Q1 2025

Q4 2024

Senior Living1

10

84.9%

83.9%

83.9%

84.3%

83.8%

Senior Living

11

84.9%

83.9%

83.8%

84.2%

83.8%

Bickford2

38

83.9%

86.1%

85.2%

85.0%

87.3%

1    The occupancy rates exclude a 251-unit CCRC acquired in October 2025.

2    The number of properties related to Bickford includes one property classified as assets held for sale as of December 31, 2025.

The following table provides a summary of the average occupancy rates related to properties in our SHOP segment for the periods indicated:

Q4 2025

Q3 2025

Q2 2025

Q1 2025

Q4 2024

Number of properties at the end of the period

15

15

15

15

15

SHOP segment1

86.4%

87.9%

89.1%

89.2%

89.4%

Number of properties at the end of the period

26

22

15

15

15

Total SHOP segment

86.9%

87.2%

89.1%

89.2%

89.4%

1     The occupancy rates relate to the 15 real estate properties in the SHOP portfolio as of December 31, 2024.

Tenant Monitoring

The operators of our properties in the Real Estate Investments segment report to us the results of their operations on a periodic basis, which we in turn subject to further analysis as a means of monitoring potential credit risks within our portfolio. We have identified EBITDARM, which is calculated as earnings before interest, taxes, depreciation, amortization, rent and management fees, as a primary performance measure for our tenants, based on results they have reported to us. We believe EBITDARM is useful in our most fundamental analyses, as it is a property-level measure of an operator’s success, by eliminating the effects of the operator’s method of acquiring the use of its assets (interest and rent), its non-cash expenses (depreciation and amortization), and expenses that are dependent on its level of success (income taxes), and also excluding the effect of the operator’s payment of its management fees, as typically those fees are contractually subordinate to our lease payments. For operators of our EFCs, our calculation of EBITDARM includes other cash flow adjustments typical of the industry which may include, but are not limited to, net cash flows from entrance fees, amortization of deferred entrance fees, adjustments for tenant rent obligations and management fee true-ups. The eliminations and adjustments reflect covenants in our leases and provide a comparable basis for assessing our various relationships.

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We believe that EBITDARM is a useful way to analyze the cash potential of a group of assets. From EBITDARM, we calculate a coverage ratio (EBITDARM / cash rent) measuring the ability of the operator to meet its monthly obligations. In addition to EBITDARM and the coverage ratio, we rely on a careful balance sheet analysis and other analytical procedures to help us identify potential areas of concern relative to our operators’ ability to generate sufficient liquidity to meet their obligations, including their obligations to continue to pay the amount due to us. Typical among our operators is a varying lag in reporting to us the results of their operations. Across our portfolio, however, our operators report their results, typically within either 30 or 45 days and at the latest, within 90 days of month end. For computational purposes, we exclude mortgage and other notes receivable, and development and lease-up properties that have been in operation less than 24 months. For stabilized acquisitions in the portfolio less than 24 months and renewing leases with changes in scheduled rent, we include pro forma cash rent. Same-store portfolio coverage, when presented herein, excludes properties that have transitioned operators in the past 24 months or assets subsequently sold except as noted.

The following table provides a summary of our portfolio and coverage ratios by property type on a trailing 12-month basis as of September 30, 2025 and 2024, the most recent periods available:

Real Estate Investments Portfolio1

Senior

Medical

Ratios by property type:

Housing

SNF

Non-SNF

Total

Number of properties

105

68

1

174

Q3 2025 coverage

1.61x

3.28x

2.54x

2.19x

Q3 2025 occupancy

86.5%

83.1%

76.7%

85.0%

Q3 2024 coverage

1.52x

3.06x

3.02x

2.08x

Q3 2024 occupancy

85.7%

82.8%

78.5%

84.2%

Discretionary

Need-Driven

(Excluding

Medical

Need-

(Excluding

Senior

(Excluding

Ratios by property class:

Driven

Bickford)

Discretionary

Living)

Medical

NHC)

Number of properties

91

53

14

4

69

34

Q3 2025 coverage

1.50x

1.37x

1.74x

2.37x

3.25x

2.42x

Q3 2025 occupancy

86.3%

86.6%

86.8%

91.6%

83.0%

78.7%

Q3 2024 coverage

1.40x

1.22x

1.67x

1.97x

3.06x

2.21x

Q3 2024 occupancy

86.0%

86.2%

85.4%

89.6%

82.7%

75.9%

Senior

Ratios by customer:

Living2

Bickford3

NHC4

Number of properties

11

38

35

Q3 2025 coverage

1.51x

1.72x

4.33x

Q3 2025 occupancy

83.9%

85.9%

89.3%

Q3 2024 coverage

1.54x

1.70x

4.13x

Q3 2024 occupancy

82.9%

85.6%

88.5%

1    The tables are based on trailing 12-month data, excluding (1) transitioned properties of cash basis tenants, (2) mortgage and other notes receivable, (3) development and lease-up properties operating less than 24 months and (4) the impact of security deposits maintained on any tenants. The tables include pro forma cash inflow from rent payments related to acquired properties that have stabilized operations and that have been in the portfolio less than 24 months.

2    Senior Living’s coverage ratios reported in the table above include the impact of our acquisition of a 251-unit CCRC in October 2025 for all periods presented. Senior Living’s coverage ratios for the other 10 properties were 1.50x and 1.56x for the trailing 12 months ended September 30, 2025 and 2024.

3    Bickford’s coverage ratios on a pro forma basis, which includes the impact of the April 2024 rent increase, were 1.72x and 1.63x for the trailing 12 months ended September 30, 2025 and 2024, respectively. Bickford’s coverage ratios on a pro forma basis, which includes the impact of the April 2024 rent increase and rent deferral repayments made by Bickford during the respective periods, were 1.49x and 1.42x for the trailing 12 months ended September 30, 2025 and 2024, respectively.

4    NHC’s coverage ratios have been reported in the table above at a consolidated level for NHC. The occupancy ratios for SNFs have been reported in the table above using data available in NHC’s public filings with the SEC.

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Fluctuations in our portfolio coverage and occupancy ratios primarily result from market and economic trends, local market competition, new or changing regulatory factors and the operational success of our tenants. In addition to the analysis above, we also evaluate and make decisions with respect to our tenants at an individual lease level. Generally, we have security deposits and/or corporate guarantees in place with many of our tenants if lease payment shortfalls materialize. In some instances, we may require a tenant to increase their security deposit with us in an amount equal to the lease payment shortfall until the required tenant lease coverage ratio is met. We monitor economic and financial conditions and also use credit enhancements, such as requiring our tenants to maintain security deposits and corporate guarantees with us, to mitigate the impact of an economic downturn on our business. The metrics presented in the tables above do not reflect the presence of these security deposits.

Critical Accounting Estimates

We prepare our consolidated financial statements in conformity with U.S. GAAP, which require us to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements, and the reported amounts of revenues and expenses during the reporting period. On an ongoing basis, we reconsider and evaluate our estimates and assumptions. Management has discussed the development and selection of its critical accounting policies and estimates with the Audit Committee of our Board of Directors.

We consider an accounting estimate or assumption critical if the nature of the estimate or assumption is material due to the levels of subjectivity and judgment necessary to account for highly uncertain matters or the susceptibility of such matters to change and if the impact of the estimate or assumption on financial condition or operating performance is material. We base our estimates on historical experience, current trends and various other assumptions that we believe to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. If actual experience differs from the assumptions and other considerations used in estimating amounts reflected in our consolidated financial statements, the resulting changes could have a material adverse effect on our consolidated results of operations, liquidity and/or financial condition.

Our significant accounting policies are discussed in Note 2 to our consolidated financial statements in this Annual Report. We believe the accounting estimates included below are the most critical for fully understanding and evaluating our financial results and require our most difficult, subjective or complex judgments.

Variable Interest Entities

Our consolidated financial statements include our wholly owned subsidiaries and partnerships that we control through voting rights or other means. We evaluate our contractual arrangements with other entities to identify those relationships in which control is achieved though means other than voting rights. A variable interest entity (“VIE”) is broadly defined as an entity with one or more of the following characteristics: (a) the total equity investment at risk is insufficient to finance the entity’s activities without additional subordinated financial support; (b) as a group, the holders of the equity investment at risk lack (i) the ability to make decisions about the entity’s activities through voting or similar rights, (ii) the obligation to absorb the expected losses of the entity, or (iii) the right to receive the expected residual returns of the entity; or (c) the equity investors have voting rights that are not proportional to their economic interests, and substantially all of the entity’s activities either involve, or are conducted on behalf of, an investor that has disproportionately few voting rights.

We make judgments about which entities are VIEs based on the criteria above and with respect to our level of influence or control of an entity and whether we are the primary beneficiary of a VIE. These considerations include, but are not limited to, our power to direct the activities that most significantly impact the entity's economic performance, the obligation to absorb losses or the right to receive benefits of the VIE that could be significant to the entity, and our ability and the rights of other investors to participate in policy making decisions, replace the manager and/or liquidate the entity. Our ability to correctly determine the primary beneficiary of a VIE at inception of our involvement impacts the presentation of these entities in our consolidated financial statements.

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Asset Acquisitions

Our investments in real estate properties are accounted for as asset acquisitions. We allocate the purchase price to the identified tangible and intangible assets at cost based on the relative fair values of the assets as of the acquisition date. The related transaction costs are included in the purchase price allocation. Contingent consideration deemed to be probable at the acquisition date, if any, is also included in the purchase price allocation to the extent that a significant reversal in amounts recognized is not likely to occur and the uncertainty associated with the contingent consideration has been resolved.

The most significant judgments applied in our purchase price allocations are typically related to the determination of the fair values of land, buildings, building improvements and intangible assets. Our estimates of the individual fair values of the assets acquired affect the amounts of depreciation and amortization we recognize over the respective estimated useful lives of the assets or the respective remaining lease term. While we believe our assumptions are reasonable, any changes in these assumptions could have a material impact on our financial results. We do not believe there is a reasonable likelihood that there will be a material change in the future estimates or assumptions we use for our purchase price allocations.

Impairment of Real Estate Properties

We evaluate the recoverability of the carrying values of our real estate properties on an individual property basis. We review each property for recoverability when events or circumstances, including any significant physical changes in a property, significant adverse changes in general economic conditions or significant deterioration of the underlying cash flows of a property indicate that the carrying amount of a property may not be recoverable. When indicators of potential impairment are present, we assess whether an impairment charge is needed by comparing the future estimated undiscounted cash flows and eventual disposition of the identified asset to its carrying amount. If recognition of an impairment charge is necessary, it is measured as the amount by which the carrying value of the identified asset exceeds its estimated fair value.

The most significant judgments applied in our analysis of the recoverability of the carrying values of our real estate properties relate to the determination of whether indicators of impairment exist and the determination of the future estimated undiscounted cash flows of the property. There were no material changes in the accounting methodology we used to evaluate the recoverability of our real estate properties during the year ended December 31, 2025.

Lease Classifications

Lease accounting standards require that, for purposes of lease classification, we assess whether the lease, by its terms, transfers substantially all of the fair value of the asset under lease to the tenant. This consideration will determine the accounting treatment for the alternative classifications among operating, sales-type, or direct financing types of leases. For classification purposes, we distinguish cash flows that follow under terms of the lease from those that will be derived, subsequent to the lease, from the ultimate disposition or re-deployment of the asset. From this segregation of the sources of cash flow, we are able to establish whether the lease is, in essence, a sale or financing based on it having transferred substantially all of the fair value of the leased asset. Accordingly, management’s projected residual values represent significant assumptions in our accounting for leases.

While we do not incorporate residual value guarantees in our lease provisions, the contractual structure of other provisions provides a basis for expectations of realizable value from our properties upon expiration of their lease terms. Additionally, we consider historical, demographic and market trends in developing our estimates. For each new lease, we discount our estimate of unguaranteed residual value and include this amount along with the stream of lease payments (also discounted) called for in the lease. We assess the stream of lease payments and the value deriving from eventual return of our property to establish whether the lease payments themselves comprise a return of substantially all of the fair value of the property under lease. We do not use a “bright line” in considering what constitutes “substantially all of the fair value”, but we undertake a more focused assessment when the lease payments approach 90% of the composition of all future cash flows expected from the asset. We do not believe there is a reasonable likelihood that there will be a material change in the future estimates or assumptions we use to assess lease classifications.

Credit Loss Reserves on Mortgage and Other Notes Receivable

We evaluate the collectability of our mortgage and other notes receivable and establish reserves for expected credit losses at the inception of these investments and subsequently on a quarterly basis at the end of the period. We take into consideration criteria, such as the borrower’s timeliness of required payments, the borrower’s current financial condition and the borrower’s compliance with other covenants and terms of the loan agreement. If we conclude that a loan has become non-performing, we place it on non-accrual status in the period in which it becomes known and probable that the borrower cannot pay the contractual amounts due to us. A non-performing loan is returned to accrual status if the borrower becomes contractually current on payments and management believes all future principal and interest will be received from the tenant in accordance with the terms of the loan agreement.

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Our models for estimating the future expected credit losses on mortgages and construction loans are calculated on a collective basis for these loan types. Our models for estimating the future expected credit losses on mezzanine loans and revolving credit lines are calculated on an individual loan basis or a borrower-specific basis for these loan types. We use a combination of credit quality indicators in our models including, among others, the current payment status of the loans, the overall financial strength of the borrowers and any guarantors, historical information on any loan write-offs related to our borrowers and the nature, extent and value of underlying collateral on the loans. In addition, we adjust our models using the probability of default method related to any current economic or other conditions occurring or becoming known during the reporting period and any changes in our most recent forecasts that exist as of the end of the reporting period which impact our previous estimates of necessary credit loss reserves. For construction loans, we perform an assessment each period end of the probability that we will acquire any properties in the event of default on any of these loans and, when necessary, reduce the basis of the applicable loans by the amounts that we expect to recover when construction of the applicable properties is complete.

Our most significant judgments in determining whether credit loss reserves are necessary relate to the assumptions we apply in assessing the probability of default or a loss as a result of a default by one or more of our borrowers. We assess all the evidence available to us, including the present value of the expected future discounted cash flows from a mortgage or note, general economic conditions and trends, the duration of a fair value deficiency and other relevant factors. When an economic downturn occurs that has a duration that is expected to span a year or more, we consider projections on the expected economic recovery before we conclude that evidence of impairment exists. While we believe our assumptions are reasonable, any changes in our assumptions may have a material impact on our financial results.

Other Investment Portfolio Activity

Real Estate and Mortgage Write-downs

In addition to inflation risk and increased interest rates, our tenants and borrowers may experience periods of significant financial pressures and difficulties similar to those encountered by other healthcare providers.

As of December 31, 2025, we had two loans designated as non-performing notes consisting of an unsecured mezzanine loan with a principal balance of $12.0 million due from affiliates of SLM and an unsecured loan due from Bickford with a principal balance of $1.3 million. These loans are fully covered by our credit loss reserves.

As of December 31, 2025, we reduced the carrying value of our mortgage and other notes receivable by a reserve for expected credit losses of $15.4 million and recognized a liability of $0.2 million for estimated credit losses on unfunded loan commitments. During the years ended December 31, 2025, 2024 and 2023, we recognized a provision for (reduction in) expected credit losses of $(3.4) million, $4.6 million and $(0.3) million, respectively.

We had no impairment charges related to long-lived assets during the year ended December 31, 2025. During the year ended December 31, 2024, we recognized an impairment charge of $0.7 million related to one property in our Real Estate Investments segment which was reclassified to assets held for sale in the second quarter of 2024 and sold in the fourth quarter of 2024. During the year ended December 31, 2023, we recognized impairment charges of $1.6 million related to four properties in our Real Estate Investments segment, which included $0.5 million of impairment charges on three of these properties which were either sold or reclassified to assets held for sale during the year ended December 31, 2023.

We believe that the carrying amounts of our real estate properties are recoverable and that mortgage and other notes receivables, net of credit loss reserves, are realizable and supported by the value of the underlying collateral. However, it is possible that future events could require us to make additional significant adjustments to these carrying amounts.

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Results of Operations

A summary of our operating results follows ($ in thousands):

Year Ended

December 31,

Variance

2025

2024

$

%

Revenues

Rental income:

Acquisitions

$

23,270 

$

3,741 

$

19,529 

NM

Discovery transitions

10,346 

7,668 

2,678 

34.9 

%

All other tenant leases

237,168 

234,337 

2,831 

1.2 

%

Total cash rental income

270,784 

245,746 

25,038 

10.2 

%

Straight-line rent revenue adjustments

(7,265)

3,031 

(10,296)

NM

Escrow funds received from tenants for

property operating expenses

10,982 

11,165 

(183)

(1.6)

%

Amortization of lease incentives

(2,901)

(2,893)

(8)

0.3 

%

Total rental income

271,600 

257,049 

14,551 

5.7 

%

Resident fees and services

80,062 

54,421 

25,641 

47.1 

%

Interest and other income

Senior Living Management

— 

1,143 

(1,143)

(100.0)

%

The Sanders Trust, LLC

1,858 

128 

1,730 

NM

Mortgage and other note payoffs

2,684 

1,242 

1,442 

NM

All other mortgage and notes receivable

19,274 

20,730 

(1,456)

(7.0)

%

Total interest income

23,816 

23,243 

573 

2.5 

%

Other income

150 

468 

(318)

(67.9)

%

Total revenues

375,628 

335,181 

40,447 

12.1 

%

Expenses:

Depreciation and amortization:

Acquisitions

9,733 

1,315 

8,418 

NM

All other assets

71,211 

70,128 

1,083 

1.5 

%

Total depreciation and amortization

80,944 

71,443 

9,501 

13.3 

%

Interest

57,368 

59,903 

(2,535)

(4.2)

%

Senior housing operating expenses

60,928 

42,251 

18,677 

44.2 

%

Legal

2,666 

1,052 

1,614 

NM

Franchise, excise and other taxes

1,080 

38 

1,042 

NM

Taxes and insurance on leased properties

10,982 

11,165 

(183)

(1.6)

%

Proxy contest and related expenses

1,572 

— 

1,572 

NM

Loan and realty (gains) losses, net

(3,447)

5,295 

(8,742)

NM

Other expenses

26,868 

— 

20,736 

6,132 

29.6 

%

Total expenses

238,961 

211,883 

27,078 

12.8 

%

Gains on sales of real estate properties, net

456 

6,678 

(6,222)

(93.2)

%

Gains from equity method investment

3,664 

402 

3,262 

NM

Gains on forward equity sales agreements, net

— 

6,261 

(6,261)

NM

Net income

140,787 

136,639 

4,148 

3.0 

%

Add: Net loss attributable to noncontrolling interests

1,390 

1,346 

44 

3.3 

%

Net income attributable to stockholders

142,177 

137,985 

4,192 

3.0 

%

Less: Net income attributable to unvested restricted

stock awards

(201)

(118)

(83)

70.3 

%

Net income attributable to common stockholders

$

141,976 

$

137,867 

$

4,109 

3.0 

%

NM - not meaningful

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Financial highlights for the year ended December 31, 2025, compared to the year ended December 31, 2024, were as follows:

•Rental income increased $14.6 million, or 5.7%, primarily due to $19.5 million of increased rental income from real estate properties in our Real Estate Investments segment that were acquired after January 1, 2024. We had a net decrease in rental income of $11.0 million related to the seven properties transitioned into the SHOP segment on August 1, 2025 from the Real Estate Investments segment.

•Resident fees and services, less senior housing operating expenses, increased $7.0 million, or 57.2%. We had an increase of $4.4 million resulting from the seven properties transitioned into the SHOP segment on August 1, 2025 and an increase of $1.6 million related to current year acquisitions.

•Interest income from mortgage and other notes receivable increased $0.6 million, or 2.5%. New investments since January 1, 2024 were mostly offset by mortgage and other notes payoffs since January 1, 2024.

•Depreciation and amortization expense increased $9.5 million, or 13.3%, which included an $8.4 million increase as a result of acquisitions since January 1, 2024.

•Interest expense decreased $2.5 million, or 4.2%, primarily due to a decrease in interest rates on our variable rate debt.

•Legal expense increased $1.6 million primarily from $1.2 million of costs incurred in the current year related to a large SHOP transaction that did not materialize and also the costs incurred in the current period related to the concurrent transactions on August 1, 2025 to terminate leases, transition properties to the SHOP segment and dissolve the Discovery partnership.

•Proxy contest and related expenses were $1.6 million for the year ended December 31, 2025 with no comparable costs in the prior year. These expenses consisted of proxy advisory costs related to our response to a proxy campaign associated with our 2025 annual meeting of stockholders.

•Loan and realty (gains) losses, net, was a net gain of $3.4 million for the year ended December 31, 2025 compared to a net loss of $5.3 million for the year ended December 31, 2024. The net gain in the current year primarily related to a reduction in our credit loss reserves related to loans that were paid off during the current year. The net loss in the prior year primarily related to an increase in the credit loss reserve on a mezzanine loan due from SLM.

•Other expenses increased $6.1 million, or 29.6%, primarily due to higher compensation costs and increases in professional fees and other purchased services.

•Gains on sales of real estate properties, net, was $0.5 million in the year ended December 31, 2025 compared to $6.7 million in the year ended December 31, 2024. In the prior year, we sold four real estate properties in our Real Estate Investments segment.

•Gains from equity method investment were $3.7 million in the year ended December 31, 2025 compared to $0.4 million in the year ended December 31, 2024. The current period included $1.7 million of gains due to a distribution received from our equity method investment.

•Gains from forward equity sales agreements were $6.3 million in the year ended December 31, 2024 with no comparable amount in the year ended December 31, 2025. During the year ended December 31, 2024, we recognized a gain on forward equity sales agreements under our ATM equity program for the period in which these agreements did not qualify for equity treatment under GAAP.

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Liquidity and Capital Resources

At December 31, 2025, we had $496.0 million available to draw on our $700.0 million unsecured revolving credit facility (“Credit Facility”), $19.6 million in unrestricted cash and cash equivalents, the ability to access $44.5 million of undrawn net proceeds through ATM forward sales agreements and the ability to access $315.8 million through the issuance of common stock under our ATM equity program. In addition, we maintain an effective automatic shelf registration statement through which capital could be raised through the issuance of additional debt or equity securities.

Sources and Uses of Funds

Our primary sources of cash include lease payments from tenants, receipts from residents, principal and interest payments on mortgage and other notes receivable, proceeds from the sales of real estate properties, net proceeds from offerings of debt and equity securities and borrowings from our Credit Facility. Our primary uses of cash include principal and interest payments on our debt, investments in new and existing real estate properties, mortgage and other notes, dividend distributions to our stockholders, operating expenses of our SHOP segment and general corporate overhead expenses.

A summary of our sources and uses of cash, cash equivalents and restricted cash follows ($ in thousands):

Year Ended December 31,

Variance

2025

2024

$

%

Cash, cash equivalents and restricted cash

at the beginning of the year

$

26,502 

$

24,617 

$

1,885 

7.7 

%

Net cash provided by operating activities

236,563 

207,768 

28,795 

13.9 

%

Net cash used in investing activities

(269,149)

(192,315)

(76,834)

40.0 

%

Net cash provided by (used in) financing activities

25,708 

(13,568)

39,276 

NM

Cash, cash equivalents and restricted cash

at the end of the year

$

19,624 

$

26,502 

$

(6,878)

(26.0)

%

NM Not meaningful

Operating Activities – Net cash provided by operating activities for the year ended December 31, 2025 included the impact of new tenant leases from acquisitions completed during the year, our SHOP segment operations, increased rental income due to rent escalators and interest payments on new loan investments completed during the year.

Investing Activities – Net cash used in investing activities for the year ended December 31, 2025 was primarily comprised of $365.1 million of investments in real estate properties, development projects at existing properties and mortgages and other notes, partially offset by the collection of principal amounts due on mortgage and other notes receivable during the year.

Financing Activities – Net cash provided by financing activities for the year ended December 31, 2025 included $346.2 million in proceeds received from the issuance of the 2033 Senior Notes and $181.5 million in proceeds received from the issuance of common shares, partially offset by $127.2 million of net paydown on our Credit Facility, $200.8 million of repayments on our term loan and private placement notes and $169.7 million of dividend payments to stockholders.

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Debt Obligations

As of December 31, 2025, we had $1.2 billion of outstanding indebtedness. Reference Note 8 to our consolidated financial statements included in this Annual Report for additional information on our debt. Reference “Part II, Item 7A. Quantitative and Qualitative Disclosures About Market Risk” in this Annual Report for more details on the impact of interest rate risk on our business.

Revolving Credit Facility and Bank Term Loan - We have a $700.0 million Credit Facility that matures in October 2028, which may be further extended by us pursuant to (i) one or both of the six-month extension options or (ii) one 12-month extension option. In October 2025, we amended the Credit Facility to remove the 0.10% credit spread adjustment applicable to the SOFR interest rates, which resulted in an effective decrease of 0.10% in the applicable interest rates with respect to the Credit Facility. Borrowings under the Credit Facility bear interest, at our election, at one of the following (a) Term SOFR plus a margin ranging from 0.725% to 1.400%, (b) Daily SOFR plus a margin ranging from 0.725% to 1.400% or (c) the base rate plus a margin ranging from 0.000% to 0.400%. In each election, the actual margin is determined according to our credit ratings. The base rate means, for any day, a fluctuating interest rate per annum equal to the highest of (x) the agent’s prime rate, (y) the federal funds rate on such day plus 0.50% or (z) the adjusted Term SOFR for a one-month tenor in effect on such day plus 1.0%. In addition, the Credit Facility requires a facility fee equal to 0.125% to 0.300%, based on our credit rating on the $700.0 million committed capacity, without regard to usage.

As of December 31, 2025, we had $496.0 million available to draw on the Credit Facility, subject to usual and customary covenants. Among other stipulations, our Credit Facility requires that we maintain certain financial ratios within limits set by our creditors. As of December 31, 2025, we were in compliance with these covenants.

We have a $200.0 million unsecured bank term loan (the “Bank Term Loan”), which was amended and restated in October 2024 to, among other things, align certain representations, covenants and events of default with the terms of the amended and restated Credit Facility. The Bank Term Loan bears interest at a variable rate which is SOFR-based with a margin determined according to our credit ratings. Concurrently with the most recent amendment of the Credit Facility in October 2025, we also amended the Bank Term Loan to remove the 0.10% credit spread adjustment applicable to the SOFR interest rates, which was also in alignment with the Credit Facility amendment.

During the year ended December 31, 2025, we repaid $75.0 million on the Bank Term Loan and exercised both six-month extension options, which extended the maturity of the Bank Term Loan to June 2026.

Pinnacle Bank is a participating member of our banking group. A member of our Board of Directors, who became the chairman of our Board of Directors effective in January 2025, is also the chairman of the board of directors of Pinnacle Financial Partners, Inc., the holding company for Pinnacle Bank. Our corporate banking transactions are conducted primarily through Pinnacle Bank.

We have provided summary information in the table below on the current SOFR credit spread adjustments and facility fee for our Credit Facility and Bank Term Loan reflecting our ratings compliance based on the applicable margin for SOFR loans with a debt rating of BBB-/Baa3:

SOFR Credit Spread Adjustments

Credit

Credit

Bank

Debt Ratings

Facility

Facility Fee

Term Loan

A-/A3

0.725%

0.125%

0.850%

BBB+/Baa1

0.775%

0.150%

0.900%

BBB/Baa2

0.850%

0.200%

1.000%

BBB-/Baa3

1.050%

0.250%

1.250%

Lower than BBB-/Baa3

1.400%

0.300%

1.650%

If our credit rating from at least two credit rating agencies is downgraded below “BBB-/Baa3”, the debt under our debt agreements will be subject to defined increases in interest rates and fees.

2031 Senior Notes - In January 2021, we issued $400.0 million in aggregate principal amount of 3.000% unsecured senior notes that mature in February 2031 (the “2031 Senior Notes”) and require semi-annual interest payments. The 2031 Senior Notes are subject to affirmative and negative covenants, including financial covenants. As of December 31, 2025 we were in compliance with these covenants.

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2033 Senior Notes - In September 2025, we issued $350.0 million in aggregate principal amount of 5.350% unsecured senior notes that mature in February 2033 (the ”2033 Senior Notes”). The 2033 Senior Notes were sold at an issue price of 98.903% of face value, before the underwriters’ discounts. Our net proceeds from the 2033 Senior Notes offering, after deducting underwriting discounts and expenses, were $342.5 million. We used the net proceeds to repay existing indebtedness. Interest on the 2033 Senior Notes is due semi-annually beginning in February 2026. The 2033 Senior Notes are subject to affirmative and negative covenants, including financial covenants. As of December 31, 2025 we were in compliance with these covenants.

Private Placement Notes - As of December 31, 2025, we had $100.0 million of principal amounts outstanding on our unsecured private placement notes. During the year ended December 31, 2025, we repaid $50.0 million of these notes upon maturity. The remainder of the private placement notes mature in January 2027 and have an annual interest rate of 4.51%.

Fannie Mae Term Loans - During the year ended December 31, 2025, we made the final repayment of $75.8 million, including accrued interest.

Debt Maturities - Reference Note 8 to the consolidated financial statements included in this Annual Report.

Credit Ratings - Moody’s Investors Services reaffirmed its credit rating and a senior unsecured debt rating of Baa3 and “Stable” outlook on NHI on September 21, 2025. Fitch Ratings reaffirmed its public issuer credit rating of BBB- and “Stable” outlook on NHI on April 16, 2025 and S&P Global reaffirmed its BBB- rating and “Stable” outlook on NHI on October 6, 2025. Our unsecured private placement notes agreements include a rate increase provision that is effective if any rating agency lowers our credit rating below investment grade and our compliance leverage increases to 50% or more. Any reduction in outlook or downgrade in our credit ratings from the rating agencies could negatively impact our costs of borrowings.

Debt Metrics - We believe that our fixed charge coverage ratio, which is the ratio of Adjusted EBITDA (earnings before interest, taxes, depreciation and amortization, excluding impairments of real estate properties and gains on dispositions) to fixed charges (interest expense at contractual rates, net of capitalized interest and principal payments on debt), and the ratio of consolidated net debt (debt less cash and cash equivalents) to Adjusted EBITDA are meaningful measures of our ability to service our debt. We use these two measures as a useful basis to compare the strength of our consolidated balance sheet with those of our peer group. We also believe our consolidated balance sheet gives us a competitive advantage when accessing debt markets.

Our fixed charge ratio was 5.3x for the year ended December 31, 2025. Reference the “Adjusted EBITDA” section below for a table showing the fixed charge ratio calculation. Giving effect to significant acquisitions, financing arrangements, dispositions and note payoffs on an annualized basis, our consolidated net debt to annualized Adjusted EBITDA ratio for the year ended December 31, 2025 was as follows ($ in thousands):

Consolidated Total Debt

$

1,163,814 

Less: Cash and cash equivalents

(19,624)

Consolidated Net Debt

$

1,144,190 

Adjusted EBITDA

$

287,650 

Annualized impact of recent investments, dispositions and payoffs

11,149 

Annualized Adjusted EBITDA

$

298,799 

Consolidated Net Debt to Annualized Adjusted EBITDA

3.8 

x

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Supplemental Guarantor Financial Information

The principal amounts due on each of our debt instruments outstanding as of December 31, 2025 are fully and unconditionally guaranteed on a senior unsecured basis by each of our subsidiaries, except for certain excluded subsidiaries (the “Guarantors”). The Guarantors are either owned or controlled by, or are affiliates of, us.

The following tables present summarized financial information NHI and the Guarantors, on a combined basis after eliminating (i) intercompany transactions and balances among the Guarantors and (ii) equity in earnings from, and any investments in, any subsidiary that is a non-guarantor ($ in thousands):

December 31,

2025

Real estate properties, net

$

2,232,633 

Other assets, net

310,682 

Note receivable due from non-guarantor subsidiary

81,490 

Total assets

$

2,624,805 

Debt, net

$

1,163,814 

Other liabilities

92,246 

Total liabilities

$

1,256,060 

Redeemable noncontrolling interest

$

10,195 

Noncontrolling interests

1,241 

Year Ended

December 31,

2025

Revenues

$

360,549 

Interest income on a note due from non-guarantor subsidiary

5,767 

Expenses

227,734 

Gains from equity method investment

3,664 

Gains on sales of real estate properties, net

456 

Other non-operating gains, net

3 

Net income

$

142,705 

Net income attributable to NHI and the subsidiary guarantors

$

144,095 

Equity and Dividends

As of December 31, 2025, we had 48,302,944 shares of our common stock outstanding with a market value of $3.7 billion. We had $1.5 billion of total equity on our consolidated balance sheet as of December 31, 2025.

Dividends - Our Board of Directors approves a regular quarterly dividend which is reflective of expected taxable income on a recurring basis. Taxable income is determined in accordance with the Internal Revenue Code and differs from net income for financial statement purposes that has been determined in accordance with GAAP. Our Board of Directors has historically directed us towards maintaining a strong consolidated balance sheet. Therefore, we consider the competing interests of short-term and long-term debt interest rates, maturities and other terms versus the higher cost of new equity, and we accept some level of risk associated with leveraging our investments. We intend to continue to make new investments that meet our underwriting criteria and where the credit spread over our costs of equity and debt capital on a leverage neutral basis will generate sufficient returns to our stockholders. We do not expect to utilize borrowings to satisfy the payment of dividends and project that cash flows from operations will be adequate to fund dividends at the current rate.

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We intend to comply with REIT dividend requirements that require us to distribute at least 90% of our annual taxable income for the year ended December 31, 2025 and thereafter. Historically, we have distributed at least 100% of our annual taxable income. Dividends declared for the fourth quarter of each fiscal year that are paid by the end of the following January are treated for federal income tax purposes, with some exceptions, as having been paid in the fiscal year just ended as provided in Section 857(b)(9) of the Internal Revenue Code. To the extent a portion, or all of such dividend, exceeds our current year earnings and profits, the excess is treated as having been received in the year paid for federal income tax purposes.

A summary of our cash distributions paid to common stockholders for federal income tax purposes on a per share basis follows:

Year Ended December 31,

2025

2024

2023

Ordinary income

$

3.16 

$

2.84 

$

2.41 

Capital gains

— 

— 

0.25 

Return of capital

0.32 

— 

0.94 

Total cash distributions on a per share basis

$

3.48 

$

2.84 

$

3.60 

Pursuant to Section 857(b)(9) of the Internal Revenue Code, the aggregate amount of cash distributions paid to common stockholders for federal income tax purposes is limited to our earnings and profits for the respective year. As a result, the $0.92 per share cash distribution paid by us on January 30, 2026 to stockholders of record as of December 31, 2025 was treated as received by our common stockholders on December 31, 2025 for federal income tax purposes up to the extent of our earnings and profits for the year ended December 31, 2025. The remainder of the $0.92 per share cash distribution received by our common stockholders was recognized in the year ending December 31, 2026 for federal income tax purposes.

During the years ended December 31, 2025, 2024 and 2023, we declared dividends of $3.64 per share, $3.60 per share and $3.60 per share, respectively. On February 17, 2026, the Board of Directors declared a $0.92 per share dividend payable on May 1, 2026 to common stockholders of record on March 31, 2026.

Shelf Registration Statement - We have an automatic shelf registration statement on file with the SEC that allows us to offer and sell to the public an unspecified amount of common stock, preferred stock, debt securities, warrants and/or units at prices and on terms to be announced when and if such securities are offered. The details of any future offerings, along with the use of proceeds from any securities offered, will be described in a prospectus supplement or other offering materials at the time of offering. Our shelf registration statement expires in March 2026.

Forward Equity Sales Agreements - During the year ended December 31, 2024, we entered into forward equity sales agreements with financial institutions to sell up to an aggregate of 2.8 million shares of common stock, at an initial forward sale price of $68.40 per share, pursuant to which the financial institutions borrowed and sold these shares of common stock in a public offering. We did not receive any proceeds from the sale of the shares of common stock by the forward purchasers at the time of the offering. The net forward sale price that we received upon physical settlement of the forward sales agreements is subject to adjustment for (i) a floating interest rate factor equal to a specified daily rate less a spread and (ii) scheduled dividends during the term of the forward equity sales agreements.

During the year ended December 31, 2024, we partially settled the above forward equity sales agreements by issuing 1.8 million shares of our common stock at a forward price of $68.00 per share for net proceeds of $122.4 million. During the year ended December 31, 2025, we settled the remainder of the above forward equity sales agreements by issuing 1.0 million shares of our common stock at a forward price of $68.21 per share for proceeds of $65.5 million.

ATM Equity Program - We maintain an ATM equity program which allows us to sell our common stock directly into the market. This program is governed by an ATM equity sales agreement which includes a forward sales provision that allows us to sell shares of our common stock to forward purchasers at a predetermined price at a future date. Pursuant to this agreement, we are authorized to sell up to $500.0 million of our common stock.

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During the year ended December 31, 2024, we entered into an ATM forward sales agreement with a financial institution to sell shares of our common stock over a forward selling period to be completed by the end of the year. Pursuant to this agreement, we sold 1.0 million shares of our common stock on a forward basis at a weighted average price of $74.99 per share, net of sales agent fees, which totaled $74.2 million. In accordance with Financial Accounting Standards Board’s (“FASB”) Accounting Standards Codification (“ASC”) 815-40, Derivatives and Hedges, Contracts in Entity’s Own Equity, we determined the ATM forward sales under this agreement did not qualify for equity classification on our consolidated balance sheet during the forward selling period. Accordingly, we recognized a $6.3 million gain on the forward sales agreement in our consolidated statement of income for the year ended December 31, 2024. We settled a portion of the ATM forward sales agreement during the year ended December 31, 2024 by issuing 0.3 million shares of our common stock for net proceeds of $20.0 million, or $75.22 per share.

During the year ended December 31, 2025, we entered into multiple ATM forward sales agreements with financial institutions to sell shares of our common stock. Pursuant to these agreements, we sold 1.5 million shares of our common stock on a forward basis at a weighted average price of $71.83 per share, net of sales agent fees, which totaled $107.2 million. These ATM forward sales agreements mature in the first and second quarters of 2026 and qualify for equity treatment in accordance with GAAP.

During the year ended December 31, 2025, we partially settled our outstanding ATM forward sales agreements by issuing 1.6 million shares of our common stock at a weighted average forward price of $73.75 for total consideration of $116.0 million, net of sales agent fees.

As of December 31, 2025, we had the ability to access 0.6 million shares of our common stock at a weighted average price of $69.23 per share, net of sales agent fees, under remaining active ATM forward sales agreements, which mature in the second quarter of 2026, and represent $44.5 million of undrawn net proceeds. As of December 31, 2025, we had the ability to access $315.8 million through the issuance of common stock under our ATM equity program.

We use ATM equity program proceeds to rebalance our leverage in response to our acquisitions activity which keeps our alternatives flexible for financing further growth of our business. We have historically used proceeds from the ATM equity program for general corporate purposes, which may include future acquisitions and repayment of indebtedness including borrowings under our Credit Facility. We view our ATM equity program as an effective way to match-fund our smaller acquisitions by exercising control over the timing and size of transactions and achieving a more favorable cost of capital as compared to larger follow-on offerings.

Material Cash Requirements

As of January 31, 2026, we had $29.7 million in cash and cash equivalents on hand and $356.0 million of availability under our Credit Facility. Our expected material cash requirements for the 12-months ending December 31, 2026 and thereafter consist of long-term debt maturities, interest payments on our debt and other contractually obligated expenditures. We expect to meet our short-term liquidity needs largely through cash generated from operations, borrowings under our Credit Facility, settlements of ATM forward sales agreements and proceeds from the sale of real estate properties, although we may choose to seek alternative sources of liquidity. Should we have additional liquidity needs, we believe that we could access long-term financing in the debt and equity capital markets.

We believe our current liquidity position, supplemented by our ability to generate positive cash flows from operations in the future, and our low net leverage will be sufficient to meet all of our short-term and long-term financial commitments.

Contractual Obligations and Contingent Liabilities

A summary of our contractual obligations as of December 31, 2025 follows ($ in thousands):

Less than

More than

Total

1 Year

1 - 3 Years

3 - 5 Years

5 Years

Debt, including interest1

$

1,406,965 

$

174,426 

$

386,287 

$

61,450 

$

784,802 

Loan commitments

35,858 

33,858 

2,000 

— 

— 

Development commitments

11,515 

— 

11,515 

— 

— 

Total contractual obligations

$

1,454,338 

$

208,284 

$

399,802 

$

61,450 

$

784,802 

1     Interest was calculated based on the weighted average interest rate on the principal amounts outstanding on our debt as of December 31, 2025. The calculation also includes a facility fee of 0.25%.

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A summary of our loan commitments as of December 31, 2025 follows ($ in thousands):

Asset

Type of

Total

Class

Commitment

Commitments

Funded

Remaining

Carriage Crossing Senior Living

Bloomington1

SHO

Mortgage

$

2,000 

$

— 

$

2,000 

Encore Senior Living

SHO

Construction Loan

56,525 

(37,010)

19,515 

Mainstay Healthcare

SHO

Revolving Credit

350 

(350)

— 

Montecito Medical Real Estate

MOB

Mezzanine Loan

20,389 

(20,389)

— 

Senior Living

SHO

Revolving Credit

16,500 

(9,000)

7,500 

Senior Living Hospitality Group2

SHO

Working Capital

5,000 

(3,476)

1,524 

The Sanders Trust, LLC

HOSP

Construction Loan

27,720 

(27,401)

319 

Timber Ridge OpCo

SHO

Working Capital

5,000 

— 

5,000 

Vizion Health

SHO

Mezzanine Loan

18,102 

(18,102)

— 

Total loan commitments

$

151,586 

$

(115,728)

$

35,858 

1     Funding is contingent upon the operating performance of the respective facility.

2    This operator was formerly referred to as Watermark Retirement.

As of December 31, 2025, the total credit loss liabilities established for our unfunded loan commitments were $0.2 million. We estimate the amounts we expect to fund using the same methodology as the one applied to provide for credit loss reserves on our mortgage and other notes receivable.

A summary of our outstanding development commitments as of December 31, 2025 follows ($ in thousands):

Asset

Type of

Total

Class

Commitment

Commitments

Funded

Remaining

Bickford

SHO

Renovation

$

8,000 

$

(5,172)

$

2,828 

Juniper Communities, LLC

SHO

Renovation

750 

— 

750 

Mainstay Healthcare

SHO

Renovation

250 

— 

250 

Navion Senior Solutions

SHO

Renovation

1,000 

(319)

681 

Senior Living

SHO

Renovation

10,000 

(6,089)

3,911 

Spring Arbor

SHO

Renovation

3,000 

— 

3,000 

William James Group, LLC

SHO

Renovation

600 

(505)

95 

Total development commitments

$

23,600 

$

(12,085)

$

11,515 

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A summary of our outstanding contingency commitments as of December 31, 2025 follows ($ in thousands):

Asset

Type of

Total

Class

Contingency

Commitments

Funded

Remaining

Acquisition

Compass Senior Living

SHO

consideration

$

2,750 

$

— 

$

2,750 

Lease

IntegraCare

SHO

inducement

750 

— 

750 

Lease

Navion Senior Solutions

SHO

inducement

4,850 

(2,700)

2,150 

Lease

Spring Arbor

SHO

inducement

10,000 

— 

10,000 

Total contingency commitments

$

18,350 

$

(2,700)

$

15,650 

Capital Funding Commitments

Capital expenditures in our Real Estate Investments segment primarily relate to new investments of real estate properties. Our tenant leases typically require the tenant to pay property taxes and insurance, repairs and maintenance costs and a minimum amount of capital expenditures each year. As a result, we do not expect to incur material capital expenditures on our existing properties in the Real Estate Investments segment during the year ending December 31, 2026.

Capital expenditures in our SHOP segment primarily relate to improvements made in our senior housing communities. During the year ending December 31, 2026, we expect to fund approximately $18.4 million of capital expenditures related to existing properties in our SHOP segment from our operating cash flows and other existing liquidity sources.

We expect the capital expenditures of our consolidated partnerships will be funded from the NOI of the respective consolidated partnership and additional capital contributions from the respective partners.

Litigation

From time to time, we are party to various lawsuits, investigations, claims and other legal and regulatory proceedings arising in connection with our business. Such claims may include, among other things, professional and general liability claims, as well as regulatory proceedings related to our SHOP segment. Further, from time to time, we are party to certain legal proceedings for which third parties, such as our tenants, managers and borrowers, are contractually obligated to indemnify us from and against various claims, litigation and liabilities arising in connection with their respective businesses. Management believes that the ultimate resolution of all such pending proceedings will have no material adverse effect on our financial condition, results of operations or cash flows.

Non-GAAP Financial Measures

The supplemental performance measures described below may not be comparable to similarly titled measures used by other REITs. Consequently, our funds from operations (“FFO”), Normalized FFO and Normalized Funds Available for Distribution (“FAD”) may not provide a meaningful measure of our performance as compared to that of other REITs. Since other REITs may not use our definition of these performance measures, caution should be exercised when comparing our FFO, Normalized FFO and Normalized FAD to that of other REITs. These performance measures do not represent cash generated from operating activities in accordance with GAAP as they exclude the changes in operating assets and liabilities, and therefore should not be considered an alternative to net income as an indication of our performance or as an alternative to net cash flows from operating activities as determined in accordance with GAAP as a measure of our liquidity, and are not necessarily indicative of cash available to fund cash needs.

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Funds From Operations - FFO

Our FFO per diluted share for the year ended December 31, 2025 increased $0.10 per share, or 2.2%, as compared to the year ended December 31, 2024 primarily due to new investments completed since January 1, 2024, partially offset by dispositions of real estate properties since January 1, 2024. FFO, as defined by the National Association of Real Estate Investment Trusts (“NAREIT”) and applied by us, is calculated using the two-class method with net income allocated to common stockholders and holders of unvested restricted stock awards by applying the respective weighted average shares outstanding during each period. The calculation of FFO begins with net income attributable to common stockholders (computed in accordance with GAAP) and excludes gains or losses on sales of real estate properties, impairments of real estate properties, and real estate depreciation and amortization after adjusting for unconsolidated partnerships and joint ventures, if any. FFO per diluted share attributable to common stockholders assumes the exercise of stock options and other potentially dilutive securities.

Our Normalized FFO per diluted share for the year ended December 31, 2025 increased $0.47 per share, or 10.7%, compared to the year ended December 31, 2024 primarily due to $12.4 million of non-cash write-offs of straight-line rents receivable related to the Discovery lease terminations in the year ended December 31, 2025 and $6.3 million of gains on forward equity sales agreements, net, in the year ended December 31, 2024. Normalized FFO excludes from FFO certain items which, due to their infrequent or unpredictable nature, may create some difficulty in comparing FFO for the current period to similar prior periods, and may include, but are not limited to including, impairments of non-real estate assets, gains or losses attributable to the acquisition and disposition of non-real estate assets and liabilities, and recoveries of previous write-downs.

FFO and Normalized FFO are important supplemental measures of operating performance for a REIT. Because the historical cost accounting convention used for real estate assets requires depreciation (except on land), such accounting presentation implies that the realizable value of real estate assets diminishes predictably over time. Since real estate asset values instead have historically risen and fallen with market conditions, presentation of operating results for a REIT that uses historical cost accounting for depreciation could be less informative and should be supplemented with a performance measure such as FFO. The term FFO was designed by the REIT industry to address this issue.

Funds Available for Distribution - FAD

Our Normalized FAD for the year ended December 31, 2025 increased $27.9 million, or 13.7%, compared to the year ended December 31, 2024. In addition to the adjustments made to net income attributable to common stockholders that are included in the calculation of Normalized FFO, Normalized FAD excludes the impact of straight-line rent revenue adjustments and the amortization of debt issuance costs and discounts. We also adjust Normalized FAD for the net change in our credit loss reserves, non-cash share-based compensation expense, SHOP capital expenditures, as well as certain non-cash items related to our equity method investment, such as straight-line lease expense and amortization of purchase accounting adjustments. Normalized FAD for the year ended December 31, 2025 includes an adjustment for transaction costs incurred related to a large SHOP transaction that did not materialize. Approximately $0.6 million of this adjustment related to amounts that were capitalized in other assets, net, on our consolidated balance sheet as of December 31, 2024.

Normalized FAD is an important supplemental performance measure for a REIT and a useful measure of liquidity as an indicator of our ability to distribute dividends to our stockholders. GAAP requires a lessor to recognize contractual lease payments as income on a straight-line basis over the expected term of the lease. This straight-line rent adjustment has the effect of reporting rental income that is significantly more or less than the contractual cash flows received pursuant to the terms of our lease agreements. GAAP also requires any discount or premium related to indebtedness and debt issuance costs to be amortized as non-cash adjustments to earnings.

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The following table reconciles our net income attributable to common stockholders, the most directly comparable GAAP financial measure, to NAREIT FFO, Normalized FFO and Normalized FAD and provides supplemental information on basic and diluted earnings per share using these metrics ($ in thousands, except per share amounts):

Year Ended December 31,

2025

2024

2023

Net income attributable to common stockholders

$

141,976 

$

137,867 

$

135,597 

Elimination of certain non-cash items in net income:

Real estate depreciation and amortization

78,772 

70,449 

69,436 

Real estate depreciation related to noncontrolling interests

(1,629)

(1,647)

(1,585)

Gains on sales of real estate properties, net

(456)

(6,678)

(14,721)

Impairments of real estate properties

— 

654 

1,642 

NAREIT FFO attributable to common stockholders

218,663 

200,645 

190,369 

Non-cash write-offs of straight-line rents receivable

12,350 

1,452 

— 

Non-cash rental income related to operations

transfers upon early lease terminations

(1,375)

— 

— 

Other non-cash rental income

— 

— 

(2,500)

Proxy contest and related expenses

1,572 

— 

— 

Gains on forward equity sales agreements, net

— 

(6,261)

— 

Loss on early retirement of debt

— 

— 

73 

Gains on operations transfers, net

— 

— 

(20)

Normalized FFO attributable to common stockholders

231,210 

195,836 

187,922 

Straight-line rent revenue adjustments

(5,085)

(4,483)

(6,961)

Straight-line rent revenue adjustments related to noncontrolling interests

(68)

(19)

58 

Amortization of lease incentives

2,901 

2,893 

2,521 

Amortization of lease incentives related to noncontrolling interests

(508)

(508)

(434)

Non-real estate depreciation

2,172 

994 

537 

Non-real estate depreciation related to noncontrolling interests

(257)

(140)

(49)

Amortization of debt discount

453 

322 

322 

Amortization of debt issuance costs

2,974 

3,461 

2,325 

Adjustments related to equity method investment, net

(1,219)

(1,863)

(1,647)

Gains from equity method investment

(3,664)

(402)

(555)

Equity method investment capital expenditures

(671)

(293)

(210)

SHOP recurring capital expenditures

(1,937)

(1,948)

(1,845)

SHOP recurring capital expenditures related to noncontrolling interests

216 

180 

191 

Equity method investment non-refundable fees received

2,339 

1,357 

1,327 

Notes receivable credit (benefit) loss expense

(3,447)

4,641 

(266)

Non-cash share-based compensation expense

5,576 

4,182 

4,605 

Transaction costs

1,164 

— 

— 

Normalized FAD attributable to common stockholders

$

232,149 

$

204,210 

$

187,841 

Basic:

Weighted average common shares outstanding

46,874,691 

43,844,771 

43,388,794 

NAREIT FFO attributable to common stockholders per share

$

4.66 

$

4.58 

$

4.39 

Normalized FFO attributable to common stockholders per share

$

4.93 

$

4.47 

$

4.33 

Diluted:

Weighted average common shares outstanding

47,051,763 

44,102,636 

43,389,466 

NAREIT FFO attributable to common stockholders per share

$

4.65 

$

4.55 

$

4.39 

Normalized FFO attributable to common stockholders per share

$

4.91 

$

4.44 

$

4.33 

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Adjusted EBITDA

We consider Adjusted EBITDA to be an important supplemental financial measure because it provides information which we use to evaluate our performance and serves as an indication of our ability to service debt. We define Adjusted EBITDA as consolidated earnings before interest, income taxes, depreciation and amortization, excluding impairments of real estate properties and gains on dispositions and certain items which, due to their infrequent or unpredictable nature, may create some difficulty in comparing Adjusted EBITDA for the current period to similar prior periods. These items include, but are not limited to, impairments of non-real estate assets, gains or losses on disposition of assets and liabilities, and recoveries of previous write-downs on mortgages and other notes. Adjusted EBITDA also includes our proportionate share of an unconsolidated equity method investment presented on a similar basis. Since others may not use our definition of Adjusted EBITDA, caution should be exercised when comparing our Adjusted EBITDA to that of other companies. Adjusted EBITDA reflect GAAP interest expense, which excludes amounts capitalized during the period.

The following table reconciles our net income, the most directly comparable GAAP financial measure, to Adjusted EBITDA ($ in thousands):

Year Ended December 31,

2025

2024

2023

Net income

$

140,787 

$

136,639 

$

134,381 

Depreciation and amortization

80,944 

71,443 

69,973 

Interest

57,368 

59,903 

58,160 

Franchise, excise and other taxes

1,080 

38 

449 

Write-offs of straight-line rents receivable

12,141 

1,452 

— 

Non-cash rental income related to operations

transfers upon early lease terminations

(1,375)

— 

— 

Notes receivable credit (benefit) loss expense

(3,447)

4,641 

(266)

Gains on sales of real estate properties, net

(456)

(6,678)

(14,721)

Loss on early retirement of debt

— 

— 

73 

Gains on forward equity sales agreements, net

— 

(6,261)

— 

Other non-cash rental income

— 

— 

(2,500)

Write-offs of transaction costs

608 

— 

— 

Gains on operations transfers, net

— 

— 

(20)

NHI’s share of EBITDA adjustments for

unconsolidated subsidiaries

— 

719 

2,432 

Impairments of real estate properties

— 

654 

1,642 

Adjusted EBITDA

$

287,650 

$

262,550 

$

249,603 

Interest expense at contractual rates1

$

53,941 

$

56,315 

$

55,603 

Principal payments on debt, excluding

balloon payments

222 

425 

408 

Fixed charges

$

54,163 

$

56,740 

$

56,011 

Fixed charge coverage

5.3x

4.6x

4.5x

1    Interest expense at contractual rates includes capitalized interest in the table above.

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Net Operating Income

NOI is a non-GAAP supplemental financial measure used to evaluate the operating performance of real estate. We define NOI as total revenues, less tenant reimbursements and property operating expenses. We believe NOI provides investors relevant and useful information as it measures the operating performance of real estate assets at the property level on an unleveraged basis. We use NOI to make decisions about resource allocations to our segments and to assess the property level performance of our investment portfolios.

The following table reconciles our net income, the most directly comparable GAAP financial measure, to NOI ($ in thousands):

Year Ended December 31,

2025

2024

2023

Net income

$

140,787 

$

136,639 

$

134,381 

Depreciation and amortization

80,944 

71,443 

69,973 

Interest expense

57,368 

59,903 

58,160 

Legal expense

2,666 

1,052 

507 

Franchise, excise and other taxes

1,080 

38 

449 

General and administrative expenses

26,868 

20,736 

19,314 

Proxy contest and related expenses

1,572 

— 

— 

Loan and realty (gains) losses, net

(3,447)

5,295 

1,376 

Gains on sales of real estate properties, net

(456)

(6,678)

(14,721)

Gains from equity method investment

(3,664)

(402)

(555)

Gains on forward equity sales agreements, net

— 

(6,261)

— 

Loss on early retirement of debt

— 

— 

73 

Gains on operations transfers, net

— 

— 

(20)

Other income

— 

— 

(202)

NOI

$

303,718 

$

281,765 

$

268,735 

The following table provides a summary of our NOI by segment ($ in thousands):

Year Ended December 31,

2025

2024

2023

Real Estate Investments segment

$

284,584 

$

269,127 

$

259,162 

SHOP segment

19,134 

12,170 

9,222 

Non-segment / corporate

— 

468 

351 

Total NOI

$

303,718 

$

281,765 

$

268,735 

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